HF 1362

CCR--HF1362A - 86th Legislature (2009 - 2010)

Posted on 01/15/2013 08:25 p.m.

1.1CONFERENCE COMMITTEE REPORT ON H. F. No. 1362 1.2A bill for an act 1.3relating to state government; establishing the health and human services budget; 1.4making changes to licensing; Minnesota family investment program, children, 1.5and adult supports; child support; the Department of Health; health care 1.6programs; making technical changes; chemical and mental health; continuing 1.7care programs; establishing the State-County Results, Accountability, and 1.8Service Delivery Redesign; public health; health-related fees; making forecast 1.9adjustments; creating work groups and pilot projects; requiring reports; 1.10decreasing provider reimbursements; increasing fees; appropriating money to 1.11various state agencies for health and human services provisions;amending 1.12Minnesota Statutes 2008, sections 62J.495; 62J.496; 62J.497, subdivisions 1.131, 2, by adding subdivisions; 62J.692, subdivision 7; 103I.208, subdivision 2; 1.14125A.744, subdivision 3; 144.0724, subdivisions 2, 4, 8, by adding subdivisions; 1.15144.121, subdivisions 1a, 1b; 144.122; 144.1222, subdivision 1a; 144.125, 1.16subdivision 1; 144.226, subdivision 4; 144.72, subdivisions 1, 3; 144.9501, 1.17subdivisions 22b, 26a, by adding subdivisions; 144.9505, subdivisions 1g, 4; 1.18144.9508, subdivisions 2, 3, 4; 144.9512, subdivision 2; 144.966, by adding 1.19a subdivision; 144.97, subdivisions 2, 4, 6, by adding subdivisions; 144.98, 1.20subdivisions 1, 2, 3, by adding subdivisions; 144.99, subdivision 1; 144A.073, by 1.21adding a subdivision; 144A.44, subdivision 2; 144A.46, subdivision 1; 148.108; 1.22148.6445, by adding a subdivision; 148D.180, subdivisions 1, 2, 3, 5; 148E.180, 1.23subdivisions 1, 2, 3, 5; 153A.17; 156.015; 157.15, by adding a subdivision; 1.24157.16; 157.22; 176.011, subdivision 9; 245.462, subdivision 18; 245.470, 1.25subdivision 1; 245.4871, subdivision 27; 245.488, subdivision 1; 245.4885, 1.26subdivision 1; 245A.03, by adding a subdivision; 245A.10, subdivisions 2, 3, 1.274, 5, by adding subdivisions; 245A.11, subdivision 2a, by adding a subdivision; 1.28245A.16, subdivisions 1, 3; 245C.03, subdivision 2; 245C.04, subdivisions 1, 1.293; 245C.05, subdivision 4; 245C.08, subdivision 2; 245C.10, subdivision 3, 1.30by adding subdivisions; 245C.17, by adding a subdivision; 245C.20; 245C.21, 1.31subdivision 1a; 245C.23, subdivision 2; 246.50, subdivision 5, by adding 1.32subdivisions; 246.51, by adding subdivisions; 246.511; 246.52; 246B.01, by 1.33adding subdivisions; 252.46, by adding a subdivision; 252.50, subdivision 1.341; 254A.02, by adding a subdivision; 254A.16, by adding a subdivision; 1.35254B.03, subdivisions 1, 3, by adding a subdivision; 254B.05, subdivision 1.361; 254B.09, subdivision 2; 256.01, subdivision 2b, by adding subdivisions; 1.37256.045, subdivision 3; 256.476, subdivisions 5, 11; 256.962, subdivisions 1.382, 6; 256.963, by adding a subdivision; 256.969, subdivision 3a; 256.975, 1.39subdivision 7; 256.983, subdivision 1; 256B.04, subdivision 16; 256B.055, 1.40subdivisions 7, 12; 256B.056, subdivisions 3, 3b, 3c, by adding a subdivision; 1.41256B.057, subdivisions 3, 9, by adding a subdivision; 256B.0575; 256B.0595, 1.42subdivisions 1, 2; 256B.06, subdivisions 4, 5; 256B.0621, subdivision 2; 2.1256B.0622, subdivision 2; 256B.0623, subdivision 5; 256B.0624, subdivisions 2.25, 8; 256B.0625, subdivisions 3c, 7, 8, 8a, 9, 13e, 17, 19a, 19c, 26, 41, 42, 47; 2.3256B.0631, subdivision 1; 256B.0641, subdivision 3; 256B.0651; 256B.0652; 2.4256B.0653; 256B.0654; 256B.0655, subdivisions 1b, 4; 256B.0657, subdivisions 2.52, 6, 8, by adding a subdivision; 256B.08, by adding a subdivision; 256B.0911, 2.6subdivisions 1, 1a, 3, 3a, 4a, 5, 6, 7, by adding subdivisions; 256B.0913, 2.7subdivision 4; 256B.0915, subdivisions 3e, 3h, 5, by adding a subdivision; 2.8256B.0916, subdivision 2; 256B.0917, by adding a subdivision; 256B.092, 2.9subdivision 8a, by adding subdivisions; 256B.0943, subdivision 1; 256B.0944, 2.10by adding a subdivision; 256B.0945, subdivision 4; 256B.0947, subdivision 2.111; 256B.15, subdivisions 1, 1a, 1h, 2, by adding subdivisions; 256B.37, 2.12subdivisions 1, 5; 256B.434, by adding a subdivision; 256B.437, subdivision 6; 2.13256B.441, subdivisions 48, 55, by adding subdivisions; 256B.49, subdivisions 2.1412, 13, 14, 17, by adding subdivisions; 256B.501, subdivision 4a; 256B.5011, 2.15subdivision 2; 256B.5012, by adding a subdivision; 256B.5013, subdivision 2.161; 256B.69, subdivisions 5a, 5c, 5f; 256B.76, subdivisions 1, 4, by adding 2.17a subdivision; 256B.761; 256D.024, by adding a subdivision; 256D.03, 2.18subdivision 4; 256D.051, subdivision 2a; 256D.0515; 256D.06, subdivision 2.192; 256D.09, subdivision 6; 256D.44, subdivision 5; 256D.49, subdivision 3; 2.20256G.02, subdivision 6; 256I.03, subdivision 7; 256I.05, subdivisions 1a, 7c; 2.21256J.08, subdivision 73a; 256J.20, subdivision 3; 256J.24, subdivisions 5a, 2.2210; 256J.26, by adding a subdivision; 256J.37, subdivision 3a, by adding a 2.23subdivision; 256J.38, subdivision 1; 256J.45, subdivision 3; 256J.49, subdivision 2.2413; 256J.575, subdivisions 3, 6, 7; 256J.621; 256J.626, subdivision 6; 256J.751, 2.25by adding a subdivision; 256J.95, subdivision 12; 256L.04, subdivision 10a, 2.26by adding a subdivision; 256L.05, subdivision 1, by adding subdivisions; 2.27256L.11, subdivisions 1, 7; 256L.12, subdivision 9; 256L.17, subdivision 3; 2.28259.67, by adding a subdivision; 270A.09, by adding a subdivision; 295.52, 2.29by adding a subdivision; 327.14, by adding a subdivision; 327.15; 327.16; 2.30327.20, subdivision 1, by adding a subdivision; 393.07, subdivision 10; 501B.89, 2.31by adding a subdivision; 518A.53, subdivisions 1, 4, 10; 519.05; 604A.33, 2.32subdivision 1; 609.232, subdivision 11; 626.556, subdivision 3c; 626.5572, 2.33subdivisions 6, 13, 21; Laws 2003, First Special Session chapter 14, article 2.3413C, section 2, subdivision 1, as amended; Laws 2007, chapter 147, article 2.3519, section 3, subdivision 4, as amended; proposing coding for new law in 2.36Minnesota Statutes, chapters 62A; 62Q; 156; 246B; 254B; 256; 256B; proposing 2.37coding for new law as Minnesota Statutes, chapter 402A; repealing Minnesota 2.38Statutes 2008, sections 62U.08; 103I.112; 144.9501, subdivision 17b; 148D.180, 2.39subdivision 8; 246.51, subdivision 1; 246.53, subdivision 3; 256.962, subdivision 2.407; 256B.0655, subdivisions 1, 1a, 1c, 1d, 1e, 1f, 1g, 1h, 1i, 2, 3, 5, 6, 7, 8, 9, 10, 2.4111, 12, 13; 256B.071, subdivisions 1, 2, 3, 4; 256B.092, subdivision 5a; 256B.19, 2.42subdivision 1d; 256B.431, subdivision 23; 256D.46; 256I.06, subdivision 9; 2.43256J.626, subdivision 7; 327.14, subdivisions 5, 6; Laws 1988, chapter 689, 2.44section 251; Minnesota Rules, parts 4626.2015, subpart 9; 9100.0400, subparts 2.451, 3; 9100.0500; 9100.0600; 9500.1243, subpart 3; 9500.1261, subparts 3, 4, 5, 2.466; 9555.6125, subpart 4, item B. 2.47May 10, 2009 2.48The Honorable Margaret Anderson Kelliher 2.49Speaker of the House of Representatives 2.50The Honorable James P. Metzen 2.51President of the Senate 2.52We, the undersigned conferees for H. F. No. 1362 report that we have agreed upon 2.53the items in dispute and recommend as follows: 3.1That the Senate recede from its amendment and that H. F. No. 1362 be further 3.2amended as follows: 3.3Delete everything after the enacting clause and insert: 3.4"ARTICLE 1 3.5LICENSING 3.6    Section 1. Minnesota Statutes 2008, section 245A.10, subdivision 2, is amended to 3.7read: 3.8    Subd. 2. County fees for background studies and licensing inspections. (a) For 3.9purposes of family and group family child care licensing under this chapter, a county 3.10agency may charge a fee to an applicant or license holder to recover the actual cost of 3.11background studies, but in any case not to exceed $100 annually. A county agency may 3.12also charge a license fee to an applicant or license holder not to exceed $50 for a one-year 3.13license or $100 for a two-year license. 3.14    (b) A county agency may charge a fee to a legal nonlicensed child care provider or 3.15applicant for authorization to recover the actual cost of background studies completed 3.16under section 119B.125, but in any case not to exceed $100 annually. 3.17    (c) Counties may elect to reduce or waive the fees in paragraph (a) or (b): 3.18    (1) in cases of financial hardship; 3.19    (2) if the county has a shortage of providers in the county's area; 3.20    (3) for new providers; or 3.21    (4) for providers who have attained at least 16 hours of training before seeking 3.22initial licensure. 3.23    (d) Counties may allow providers to pay the applicant fees in paragraph (a) or (b) on 3.24an installment basis for up to one year. If the provider is receiving child care assistance 3.25payments from the state, the provider may have the fees under paragraph (a) or (b) 3.26deducted from the child care assistance payments for up to one year and the state shall 3.27reimburse the county for the county fees collected in this manner. 3.28    (e) For purposes of adult foster care and child foster care licensing under this 3.29chapter, a county agency may charge a fee to a corporate applicant or corporate license 3.30holder to recover the actual cost of background studies. A county agency may also charge 3.31a fee to a corporate applicant or corporate license holder to recover the actual cost of 3.32licensing inspections, not to exceed $500 annually. 3.33    (f) Counties may elect to reduce or waive the fees in paragraph (e) under the 3.34following circumstances: 3.35(1) in cases of financial hardship; 4.1(2) if the county has a shortage of providers in the county's area; or 4.2(3) for new providers. 4.3    Sec. 2. Minnesota Statutes 2008, section 245A.10, subdivision 3, is amended to read: 4.4    Subd. 3. Application fee for initial license or certification. (a) For fees required 4.5under subdivision 1, an applicant for an initial license or certification issued by the 4.6commissioner shall submit a $500 application fee with each new application required 4.7under this subdivision. The application fee shall not be prorated, is nonrefundable, and 4.8is in lieu of the annual license or certification fee that expires on December 31. The 4.9commissioner shall not process an application until the application fee is paid. 4.10(b) Except as provided in clauses (1) to (3), an applicant shall apply for a license 4.11to provide services at a specific location. 4.12(1) For a license to provide waivered new text begin residential-based habilitation new text end services to 4.13persons with developmental disabilities or related conditions new text begin under chapter 245B new text end , an 4.14applicant shall submit an application for each county in which the waivered services will 4.15be provided. new text begin Upon licensure, the license holder may provide services to persons in that new text end 4.16 new text begin county plus no more than three persons at any one time in each of up to ten additional new text end 4.17 new text begin counties. A license holder in one county may not provide services under the home and new text end 4.18 new text begin community-based waiver for persons with developmental disabilities to more than three new text end 4.19 new text begin people in a second county without holding a separate license for that second county. new text end 4.20 new text begin Applicants or licensees providing services under this clause to not more than three persons new text end 4.21 new text begin remain subject to the inspection fees established in section 245A.10, subdivision 2, for new text end 4.22 new text begin each location. The license issued by the commissioner must state the name of each new text end 4.23 new text begin additional county where services are being provided to persons with developmental new text end 4.24 new text begin disabilities. A license holder must notify the commissioner before making any changes new text end 4.25 new text begin that would alter the license information listed under section 245A.04, subdivision 7, new text end 4.26 new text begin paragraph (a), including any additional counties where persons with developmental new text end 4.27 new text begin disabilities are being served. new text end 4.28(2) For a license to provide new text begin supported employment, crisis respite, or new text end 4.29semi-independent living services to persons with developmental disabilities or related 4.30conditions new text begin under chapter 245B new text end , an applicant shall submit a single application to provide 4.31services statewide. 4.32(3) For a license to provide independent living assistance for youth under section 4.33245A.22 , an applicant shall submit a single application to provide services statewide. 4.34    Sec. 3. Minnesota Statutes 2008, section 245A.11, subdivision 2a, is amended to read: 5.1    Subd. 2a. Adult foster care license capacity. new text begin The commissioner shall issue adult new text end 5.2 new text begin foster care licenses with a maximum licensed capacity of four beds, including nonstaff new text end 5.3 new text begin roomers and boarders, except that the commissioner may issue a license with a capacity of new text end 5.4 new text begin five beds, including roomers and boarders, according to paragraphs (a) to (e). new text end 5.5(a) An adult foster care license holder may have a maximum license capacity of five 5.6if all persons in care are age 55 or over and do not have a serious and persistent mental 5.7illness or a developmental disability. 5.8(b) The commissioner may grant variances to paragraph (a) to allow a foster care 5.9provider with a licensed capacity of five persons to admit an individual under the age of 55 5.10if the variance complies with section 245A.04, subdivision 9, and approval of the variance 5.11is recommended by the county in which the licensed foster care provider is located. 5.12(c) The commissioner may grant variances to paragraph (a) to allow the use of a fifth 5.13bed for emergency crisis services for a person with serious and persistent mental illness 5.14or a developmental disability, regardless of age, if the variance complies with section 5.15245A.04, subdivision 9 , and approval of the variance is recommended by the county in 5.16which the licensed foster care provider is located. 5.17(d) Notwithstanding paragraph (a), new text begin If the 2009 legislature adopts a rate reduction new text end 5.18 new text begin that impacts providers of adult foster care services, new text end the commissioner may issue an adult 5.19foster care license with a capacity of five adults new text begin if the fifth bed does not increase the new text end 5.20 new text begin overall statewide capacity of licensed adult foster care beds in homes that are not the new text end 5.21 new text begin primary residence of the license holder, over the licensed capacity in such homes on July new text end 5.22 new text begin 1, 2009, as identified in a plan submitted to the commissioner by the county, new text end when the 5.23capacity is recommended by the county licensing agency of the county in which the 5.24facility is located and if the recommendation verifies that: 5.25(1) the facility meets the physical environment requirements in the adult foster 5.26care licensing rule; 5.27(2) the five-bed living arrangement is specified for each resident in the resident's: 5.28(i) individualized plan of care; 5.29(ii) individual service plan under section 256B.092, subdivision 1b, if required; or 5.30(iii) individual resident placement agreement under Minnesota Rules, part 5.319555.5105, subpart 19, if required; 5.32(3) the license holder obtains written and signed informed consent from each 5.33resident or resident's legal representative documenting the resident's informed choice to 5.34living in the home and that the resident's refusal to consent would not have resulted in 5.35service termination; and 5.36(4) the facility was licensed for adult foster care before March 1, 2003 new text begin 2009 new text end . 6.1(e) The commissioner shall not issue a new adult foster care license under paragraph 6.2(d) after June 30, 2005 new text begin 2011 new text end . The commissioner shall allow a facility with an adult foster 6.3care license issued under paragraph (d) before June 30, 2005 new text begin 2011 new text end , to continue with a 6.4capacity of five adults if the license holder continues to comply with the requirements in 6.5paragraph (d). 6.6 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2009. new text end 6.7    Sec. 4. Minnesota Statutes 2008, section 245A.11, is amended by adding a subdivision 6.8to read: 6.9     new text begin Subd. 7a. new text end new text begin Alternate overnight supervision technology; adult foster care license. new text end 6.10     new text begin (a) The commissioner may grant an applicant or license holder an adult foster care license new text end 6.11 new text begin for a residence that does not have a caregiver in the residence during normal sleeping new text end 6.12 new text begin hours as required under Minnesota Rules, part 9555.5105, subpart 37, item B, but uses new text end 6.13 new text begin monitoring technology to alert the license holder when an incident occurs that may new text end 6.14 new text begin jeopardize the health, safety, or rights of a foster care recipient. The applicant or license new text end 6.15 new text begin holder must comply with all other requirements under Minnesota Rules, parts 9555.5105 new text end 6.16 new text begin to 9555.6265, and the requirements under this subdivision. The license printed by the new text end 6.17 new text begin commissioner must state in bold and large font: new text end 6.18     new text begin (1) that the facility is under electronic monitoring; and new text end 6.19     new text begin (2) the telephone number of the county's common entry point for making reports of new text end 6.20 new text begin suspected maltreatment of vulnerable adults under section 626.557, subdivision 9. new text end 6.21 new text begin (b) Applications for a license under this section must be submitted directly to new text end 6.22 new text begin the Department of Human Services licensing division. The licensing division must new text end 6.23 new text begin immediately notify the host county and lead county contract agency and the host county new text end 6.24 new text begin licensing agency. The licensing division must collaborate with the county licensing new text end 6.25 new text begin agency in the review of the application and the licensing of the program. new text end 6.26     new text begin (c) Before a license is issued by the commissioner, and for the duration of the new text end 6.27 new text begin license, the applicant or license holder must establish, maintain, and document the new text end 6.28 new text begin implementation of written policies and procedures addressing the requirements in new text end 6.29 new text begin paragraphs (d) through (f). new text end 6.30     new text begin (d) The applicant or license holder must have policies and procedures that: new text end 6.31     new text begin (1) establish characteristics of target populations that will be admitted into the home, new text end 6.32 new text begin and characteristics of populations that will not be accepted into the home; new text end 6.33     new text begin (2) explain the discharge process when a foster care recipient requires overnight new text end 6.34 new text begin supervision or other services that cannot be provided by the license holder due to the new text end 6.35 new text begin limited hours that the license holder is on-site; new text end 7.1     new text begin (3) describe the types of events to which the program will respond with a physical new text end 7.2 new text begin presence when those events occur in the home during time when staff are not on-site, and new text end 7.3 new text begin how the license holder's response plan meets the requirements in paragraph (e), clause new text end 7.4 new text begin (1) or (2); new text end 7.5     new text begin (4) establish a process for documenting a review of the implementation and new text end 7.6 new text begin effectiveness of the response protocol for the response required under paragraph (e), new text end 7.7 new text begin clause (1) or (2). The documentation must include: new text end 7.8     new text begin (i) a description of the triggering incident; new text end 7.9     new text begin (ii) the date and time of the triggering incident; new text end 7.10     new text begin (iii) the time of the response or responses under paragraph (e), clause (1) or (2); new text end 7.11     new text begin (iv) whether the response met the resident's needs; new text end 7.12     new text begin (v) whether the existing policies and response protocols were followed; and new text end 7.13     new text begin (vi) whether the existing policies and protocols are adequate or need modification. new text end 7.14     new text begin When no physical presence response is completed for a three-month period, the new text end 7.15 new text begin license holder's written policies and procedures must require a physical presence response new text end 7.16 new text begin drill be to conducted for which the effectiveness of the response protocol under paragraph new text end 7.17 new text begin (e), clause (1) or (2), will be reviewed and documented as required under this clause; and new text end 7.18     new text begin (5) establish that emergency and nonemergency phone numbers are posted in a new text end 7.19 new text begin prominent location in a common area of the home where they can be easily observed by a new text end 7.20 new text begin person responding to an incident who is not otherwise affiliated with the home. new text end 7.21     new text begin (e) The license holder must document and include in the license application which new text end 7.22 new text begin response alternative under clause (1) or (2) is in place for responding to situations that new text end 7.23 new text begin present a serious risk to the health, safety, or rights of people receiving foster care services new text end 7.24 new text begin in the home: new text end 7.25     new text begin (1) response alternative (1) requires only the technology to provide an electronic new text end 7.26 new text begin notification or alert to the license holder that an event is underway that requires a response. new text end 7.27 new text begin Under this alternative, no more than ten minutes will pass before the license holder will be new text end 7.28 new text begin physically present on-site to respond to the situation; or new text end 7.29     new text begin (2) response alternative (2) requires the electronic notification and alert system new text end 7.30 new text begin under alternative (1), but more than ten minutes may pass before the license holder is new text end 7.31 new text begin present on-site to respond to the situation. Under alternative (2), all of the following new text end 7.32 new text begin conditions are met: new text end 7.33     new text begin (i) the license holder has a written description of the interactive technological new text end 7.34 new text begin applications that will assist the licenser holder in communicating with and assessing the new text end 7.35 new text begin needs related to care, health, and safety of the foster care recipients. This interactive new text end 7.36 new text begin technology must permit the license holder to remotely assess the well being of the foster new text end 8.1 new text begin care recipient without requiring the initiation of the foster care recipient. Requiring the new text end 8.2 new text begin foster care recipient to initiate a telephone call does not meet this requirement; new text end 8.3 new text begin (ii) the license holder documents how the remote license holder is qualified and new text end 8.4 new text begin capable of meeting the needs of the foster care recipients and assessing foster care new text end 8.5 new text begin recipients' needs under item (i) during the absence of the license holder on-site; new text end 8.6 new text begin (iii) the license holder maintains written procedures to dispatch emergency response new text end 8.7 new text begin personnel to the site in the event of an identified emergency; and new text end 8.8     new text begin (iv) each foster care recipient's individualized plan of care, individual service plan new text end 8.9 new text begin under section 256B.092, subdivision 1b, if required, or individual resident placement new text end 8.10 new text begin agreement under Minnesota Rules, part 9555.5105, subpart 19, if required, identifies the new text end 8.11 new text begin maximum response time, which may be greater than ten minutes, for the license holder new text end 8.12 new text begin to be on-site for that foster care recipient. new text end 8.13     new text begin (f) All placement agreements, individual service agreements, and plans applicable new text end 8.14 new text begin to the foster care recipient must clearly state that the adult foster care license category is new text end 8.15 new text begin a program without the presence of a caregiver in the residence during normal sleeping new text end 8.16 new text begin hours; the protocols in place for responding to situations that present a serious risk to new text end 8.17 new text begin health, safety, or rights of foster care recipients under paragraph (e), clause (1) or (2); and a new text end 8.18 new text begin signed informed consent from each foster care recipient or the person's legal representative new text end 8.19 new text begin documenting the person's or legal representative's agreement with placement in the new text end 8.20 new text begin program. If electronic monitoring technology is used in the home, the informed consent new text end 8.21 new text begin form must also explain the following: new text end 8.22     new text begin (1) how any electronic monitoring is incorporated into the alternative supervision new text end 8.23 new text begin system; new text end 8.24     new text begin (2) the backup system for any electronic monitoring in times of electrical outages or new text end 8.25 new text begin other equipment malfunctions; new text end 8.26     new text begin (3) how the license holder is trained on the use of the technology; new text end 8.27     new text begin (4) the event types and license holder response times established under paragraph (e); new text end 8.28     new text begin (5) how the license holder protects the foster care recipient's privacy related to new text end 8.29 new text begin electronic monitoring and related to any electronically recorded data generated by the new text end 8.30 new text begin monitoring system. A foster care recipient may not be removed from a program under new text end 8.31 new text begin this subdivision for failure to consent to electronic monitoring. The consent form must new text end 8.32 new text begin explain where and how the electronically recorded data is stored, with whom it will be new text end 8.33 new text begin shared, and how long it is retained; and new text end 8.34     new text begin (6) the risks and benefits of the alternative overnight supervision system. new text end 9.1     new text begin The written explanations under clauses (1) to (6) may be accomplished through new text end 9.2 new text begin cross-references to other policies and procedures as long as they are explained to the new text end 9.3 new text begin person giving consent, and the person giving consent is offered a copy. new text end 9.4 new text begin (g) Nothing in this section requires the applicant or license holder to develop or new text end 9.5 new text begin maintain separate or duplicative polices, procedures, documentation, consent forms, or new text end 9.6 new text begin individual plans that may be required for other licensing standards, if the requirements of new text end 9.7 new text begin this section are incorporated into those documents. new text end 9.8 new text begin (h) The commissioner may grant variances to the requirements of this section new text end 9.9 new text begin according to section 245A.04, subdivision 9. new text end 9.10 new text begin (i) For the purposes of paragraphs (d) through (h), license holder has the meaning new text end 9.11 new text begin under section 245A.2, subdivision 9, and additionally includes all staff, volunteers, and new text end 9.12 new text begin contractors affiliated with the license holder. new text end 9.13 new text begin (j) For the purposes of paragraph (e), the terms "assess" and "assessing" mean to new text end 9.14 new text begin remotely determine what action the license holder needs to take to protect the well-being new text end 9.15 new text begin of the foster care recipient. new text end 9.16    Sec. 5. Minnesota Statutes 2008, section 245A.11, is amended by adding a subdivision 9.17to read: 9.18     new text begin Subd. 8b. new text end new text begin Adult foster care data privacy and security. new text end new text begin (a) An adult foster new text end 9.19 new text begin care license holder who creates, collects, records, maintains, stores, or discloses any new text end 9.20 new text begin individually identifiable recipient data, whether in an electronic or any other format, new text end 9.21 new text begin must comply with the privacy and security provisions of applicable privacy laws and new text end 9.22 new text begin regulations, including: new text end 9.23 new text begin (1) the federal Health Insurance Portability and Accountability Act of 1996 new text end 9.24 new text begin (HIPAA), Public Law 104-1; and the HIPAA Privacy Rule, Code of Federal Regulations, new text end 9.25 new text begin title 45, part 160, and subparts A and E of part 164; and new text end 9.26 new text begin (2) the Minnesota Government Data Practices Act as codified in chapter 13. new text end 9.27 new text begin (b) For purposes of licensure, the license holder shall be monitored for compliance new text end 9.28 new text begin with the following data privacy and security provisions: new text end 9.29 new text begin (1) the license holder must control access to data on foster care recipients according new text end 9.30 new text begin to the definitions of public and private data on individuals under section 13.02; new text end 9.31 new text begin classification of the data on individuals as private under section 13.46, subdivision 2; new text end 9.32 new text begin and control over the collection, storage, use, access, protection, and contracting related new text end 9.33 new text begin to data according to section 13.05, in which the license holder is assigned the duties new text end 9.34 new text begin of a government entity; new text end 10.1 new text begin (2) the license holder must provide each foster care recipient with a notice that new text end 10.2 new text begin meets the requirements under section 13.04, in which the license holder is assigned the new text end 10.3 new text begin duties of the government entity, and that meets the requirements of Code of Federal new text end 10.4 new text begin Regulations, title 45, part 164.52. The notice shall describe the purpose for collection of new text end 10.5 new text begin the data, and to whom and why it may be disclosed pursuant to law. The notice must new text end 10.6 new text begin inform the recipient that the license holder uses electronic monitoring and, if applicable, new text end 10.7 new text begin that recording technology is used; new text end 10.8 new text begin (3) the license holder must not install monitoring cameras in bathrooms; new text end 10.9 new text begin (4) electronic monitoring cameras must not be concealed from the foster care new text end 10.10 new text begin recipients; and new text end 10.11 new text begin (5) electronic video and audio recordings of foster care recipients shall not be stored new text end 10.12 new text begin by the license holder for more than five days. new text end 10.13 new text begin (c) The commissioner shall develop, and make available to license holders and new text end 10.14 new text begin county licensing workers, a checklist of the data privacy provisions to be monitored new text end 10.15 new text begin for purposes of licensure. new text end 10.16    Sec. 6. Minnesota Statutes 2008, section 245A.16, subdivision 1, is amended to read: 10.17    Subdivision 1. Delegation of authority to agencies. (a) County agencies and 10.18private agencies that have been designated or licensed by the commissioner to perform 10.19licensing functions and activities under section 245A.04 new text begin and new text end background studies for 10.20adult foster care, family adult day services, and family child care, under chapter 245C; to 10.21recommend denial of applicants under section 245A.05; to issue correction orders, to issue 10.22variances, and recommend a conditional license under section 245A.06, or to recommend 10.23suspending or revoking a license or issuing a fine under section 245A.07, shall comply 10.24with rules and directives of the commissioner governing those functions and with this 10.25section. The following variances are excluded from the delegation of variance authority 10.26and may be issued only by the commissioner: 10.27    (1) dual licensure of family child care and child foster care, dual licensure of child 10.28and adult foster care, and adult foster care and family child care; 10.29    (2) adult foster care maximum capacity; 10.30    (3) adult foster care minimum age requirement; 10.31    (4) child foster care maximum age requirement; 10.32    (5) variances regarding disqualified individuals except that county agencies may 10.33issue variances under section 245C.30 regarding disqualified individuals when the county 10.34is responsible for conducting a consolidated reconsideration according to sections 245C.25 11.1and 245C.27, subdivision 2, clauses (a) and (b), of a county maltreatment determination 11.2and a disqualification based on serious or recurring maltreatment; and 11.3    (6) the required presence of a caregiver in the adult foster care residence during 11.4normal sleeping hours. 11.5    (b) County agencies must report information about disqualification reconsiderations 11.6under sections 245C.25 and 245C.27, subdivision 2, paragraphs (a) and (b), and variances 11.7granted under paragraph (a), clause (5), to the commissioner at least monthly in a format 11.8prescribed by the commissioner. 11.9    (c) For family day care programs, the commissioner may authorize licensing reviews 11.10every two years after a licensee has had at least one annual review. 11.11    (d) For family adult day services programs, the commissioner may authorize 11.12licensing reviews every two years after a licensee has had at least one annual review. 11.13    (e) A license issued under this section may be issued for up to two years. 11.14    Sec. 7. Minnesota Statutes 2008, section 245A.16, subdivision 3, is amended to read: 11.15    Subd. 3. Recommendations to commissioner. The county or private agency 11.16shall not make recommendations to the commissioner regarding licensure without first 11.17conducting an inspection, and for adult foster care, family adult day services, and family 11.18child care, a background study of the applicant under chapter 245C. The county or private 11.19agency must forward its recommendation to the commissioner regarding the appropriate 11.20licensing action within 20 working days of receipt of a completed application. 11.21    Sec. 8. Minnesota Statutes 2008, section 245C.04, subdivision 1, is amended to read: 11.22    Subdivision 1. Licensed programs. (a) The commissioner shall conduct a 11.23background study of an individual required to be studied under section 245C.03, 11.24subdivision 1 , at least upon application for initial license for all license types. 11.25    (b) The commissioner shall conduct a background study of an individual required to 11.26be studied under section 245C.03, subdivision 1, at reapplication for a license for adult 11.27foster care, family adult day services, and family child care. 11.28    (c) The commissioner is not required to conduct a study of an individual at the time 11.29of reapplication for a license if the individual's background study was completed by the 11.30commissioner of human services for an adult foster care license holder that is also: 11.31    (1) registered under chapter 144D; or 11.32    (2) licensed to provide home and community-based services to people with 11.33disabilities at the foster care location and the license holder does not reside in the foster 11.34care residence; and 12.1    (3) the following conditions are met: 12.2    (i) a study of the individual was conducted either at the time of initial licensure or 12.3when the individual became affiliated with the license holder; 12.4    (ii) the individual has been continuously affiliated with the license holder since 12.5the last study was conducted; and 12.6    (iii) the last study of the individual was conducted on or after October 1, 1995. 12.7    (d) From July 1, 2007, to June 30, 2009, the commissioner of human services shall 12.8conduct a study of an individual required to be studied under section 245C.03, at the 12.9time of reapplication for a child foster care license. The county or private agency shall 12.10collect and forward to the commissioner the information required under section 245C.05, 12.11subdivisions 1, paragraphs (a) and (b), and 5, paragraphs (a) and (b). The background 12.12study conducted by the commissioner of human services under this paragraph must 12.13include a review of the information required under section 245C.08, subdivisions 1, 12.14paragraph (a), clauses (1) to (5), 3, and 4. 12.15    (e) The commissioner of human services shall conduct a background study of an 12.16individual specified under section 245C.03, subdivision 1, paragraph (a), clauses (2) 12.17to (6), who is newly affiliated with a child foster care license holder. The county or 12.18private agency shall collect and forward to the commissioner the information required 12.19under section 245C.05, subdivisions 1 and 5. The background study conducted by the 12.20commissioner of human services under this paragraph must include a review of the 12.21information required under section 245C.08, subdivisions 1, 3, and 4. 12.22    (f) new text begin From January 1, 2010, to December 31, 2012, unless otherwise specified in new text end 12.23 new text begin paragraph (c), the commissioner shall conduct a study of an individual required to be new text end 12.24 new text begin studied under section 245C.03 at the time of reapplication for an adult foster care or family new text end 12.25 new text begin adult day services license: (1) the county shall collect and forward to the commissioner new text end 12.26 new text begin the information required under section 245C.05, subdivision 1, paragraphs (a) and (b), new text end 12.27 new text begin and subdivision 5, paragraphs (a) and (b), for background studies conducted by the new text end 12.28 new text begin commissioner for adult foster care and family adult day services when the license holder new text end 12.29 new text begin resides in the adult foster care or family adult day services residence; (2) the license new text end 12.30 new text begin holder shall collect and forward to the commissioner the information required under new text end 12.31 new text begin section 245C.05, subdivisions 1, paragraphs (a) and (b); and 5, paragraphs (a) and (b), new text end 12.32 new text begin for background studies conducted by the commissioner for adult foster care when the new text end 12.33 new text begin license holder does not reside in the adult foster care residence; and (3) the background new text end 12.34 new text begin study conducted by the commissioner under this paragraph must include a review of the new text end 12.35 new text begin information required under section 245C.08, subdivision 1, paragraph (a), clauses (1) new text end 12.36 new text begin to (5), and subdivisions 3 and 4. new text end 13.1 new text begin (g) The commissioner shall conduct a background study of an individual specified new text end 13.2 new text begin under section 245C.03, subdivision 1, paragraph (a), clauses (2) to (6), who is newly new text end 13.3 new text begin affiliated with an adult foster care or family adult day services license holder: (1) the new text end 13.4 new text begin county shall collect and forward to the commissioner the information required under new text end 13.5 new text begin section 245C.05, subdivision 1, paragraphs (a) and (b), and subdivision 5, paragraphs (a) new text end 13.6 new text begin and (b), for background studies conducted by the commissioner for adult foster care new text end 13.7 new text begin and family adult day services when the license holder resides in the adult foster care or new text end 13.8 new text begin family adult day services residence; (2) the license holder shall collect and forward to the new text end 13.9 new text begin commissioner the information required under section 245C.05, subdivisions 1, paragraphs new text end 13.10 new text begin (a) and (b); and 5, paragraphs (a) and (b), for background studies conducted by the new text end 13.11 new text begin commissioner for adult foster care when the license holder does not reside in the adult new text end 13.12 new text begin foster care residence; and (3) the background study conducted by the commissioner under new text end 13.13 new text begin this paragraph must include a review of the information required under section 245C.08, new text end 13.14 new text begin subdivision 1, paragraph (a), and subdivisions 3 and 4. new text end 13.15 new text begin (h) new text end Applicants for licensure, license holders, and other entities as provided in this 13.16chapter must submit completed background study forms to the commissioner before 13.17individuals specified in section 245C.03, subdivision 1, begin positions allowing direct 13.18contact in any licensed program. 13.19    (g) new text begin (i) new text end For purposes of this section, a physician licensed under chapter 147 is 13.20considered to be continuously affiliated upon the license holder's receipt from the 13.21commissioner of health or human services of the physician's background study results. 13.22    Sec. 9. Minnesota Statutes 2008, section 245C.05, is amended by adding a subdivision 13.23to read: 13.24     new text begin Subd. 2b. new text end new text begin County agency to collect and forward information to the new text end 13.25 new text begin commissioner. new text end new text begin For background studies related to adult foster care and family adult new text end 13.26 new text begin day services when the license holder resides in the adult foster care or family adult new text end 13.27 new text begin day services residence, the county agency must collect the information required under new text end 13.28 new text begin subdivision 1 and forward it to the commissioner. new text end 13.29    Sec. 10. Minnesota Statutes 2008, section 245C.05, subdivision 4, is amended to read: 13.30    Subd. 4. Electronic transmission. For background studies conducted by the 13.31Department of Human Services, the commissioner shall implement a system for the 13.32electronic transmission of: 13.33    (1) background study information to the commissioner; 13.34    (2) background study results to the license holder; and 14.1    (3) background study results to county and private agencies for background studies 14.2conducted by the commissioner for child foster care new text begin ; and new text end 14.3 new text begin (4) background study results to county agencies for background studies conducted new text end 14.4 new text begin by the commissioner for adult foster care and family adult day services new text end . 14.5    Sec. 11. Minnesota Statutes 2008, section 245C.08, subdivision 2, is amended to read: 14.6    Subd. 2. Background studies conducted by a county agency. (a) For a background 14.7study conducted by a county agency for adult foster care, family adult day services, and 14.8family child care services, the commissioner shall review: 14.9    (1) information from the county agency's record of substantiated maltreatment 14.10of adults and the maltreatment of minors; 14.11    (2) information from juvenile courts as required in subdivision 4 for individuals 14.12listed in section 245C.03, subdivision 1, clauses (2), (5), and (6); and 14.13    (3) information from the Bureau of Criminal Apprehension. 14.14    (b) If the individual has resided in the county for less than five years, the study shall 14.15include the records specified under paragraph (a) for the previous county or counties of 14.16residence for the past five years. 14.17    (c) Notwithstanding expungement by a court, the county agency may consider 14.18information obtained under paragraph (a), clause (3), unless the commissioner received 14.19notice of the petition for expungement and the court order for expungement is directed 14.20specifically to the commissioner. 14.21    Sec. 12. Minnesota Statutes 2008, section 245C.10, is amended by adding a 14.22subdivision to read: 14.23     new text begin Subd. 5. new text end new text begin Adult foster care services. new text end new text begin The commissioner shall recover the cost of new text end 14.24 new text begin background studies required under section 245C.03, subdivision 1, for the purposes of new text end 14.25 new text begin adult foster care and family adult day services licensing, through a fee of no more than new text end 14.26 new text begin $20 per study charged to the license holder. The fees collected under this subdivision are new text end 14.27 new text begin appropriated to the commissioner for the purpose of conducting background studies. new text end 14.28    Sec. 13. Minnesota Statutes 2008, section 245C.10, is amended by adding a 14.29subdivision to read: 14.30     new text begin Subd. 8. new text end new text begin Private agencies. new text end new text begin The commissioner shall recover the cost of conducting new text end 14.31 new text begin background studies under section 245C.33 for studies initiated by private agencies for the new text end 14.32 new text begin purpose of adoption through a fee of no more than $70 per study charged to the private new text end 15.1 new text begin agency. The fees collected under this subdivision are appropriated to the commissioner for new text end 15.2 new text begin the purpose of conducting background studies. new text end 15.3    Sec. 14. Minnesota Statutes 2008, section 245C.17, is amended by adding a 15.4subdivision to read: 15.5     new text begin Subd. 6. new text end new text begin Notice to county agency. new text end new text begin For studies on individuals related to a license new text end 15.6 new text begin to provide adult foster care and family adult day services, the commissioner shall also new text end 15.7 new text begin provide a notice of the background study results to the county agency that initiated the new text end 15.8 new text begin background study. new text end 15.9    Sec. 15. Minnesota Statutes 2008, section 245C.20, is amended to read: 15.10245C.20 LICENSE HOLDER RECORD KEEPING. 15.11A licensed program shall document the date the program initiates a background 15.12study under this chapter in the program's personnel files. When a background study is 15.13completed under this chapter, a licensed program shall maintain a notice that the study 15.14was undertaken and completed in the program's personnel files. new text begin Except when background new text end 15.15 new text begin studies are initiated through the commissioner's online system, new text end if a licensed program 15.16has not received a response from the commissioner under section 245C.17 within 45 15.17days of initiation of the background study request, the licensed program must contact the 15.18commissioner new text begin human services licensing division new text end to inquire about the status of the study. new text begin If new text end 15.19 new text begin a license holder initiates a background study under the commissioner's online system, but new text end 15.20 new text begin the background study subject's name does not appear in the list of active or recent studies new text end 15.21 new text begin initiated by that license holder, the license holder must either contact the human services new text end 15.22 new text begin licensing division or resubmit the background study information online for that individual. new text end 15.23    Sec. 16. Minnesota Statutes 2008, section 245C.21, subdivision 1a, is amended to read: 15.24    Subd. 1a. Submission of reconsideration request to county or private agency. (a) 15.25For disqualifications related to studies conducted by county agencies new text begin for family child care new text end , 15.26and for disqualifications related to studies conducted by the commissioner for child foster 15.27care new text begin , adult foster care, and family adult day services new text end , the individual shall submit the request 15.28for reconsideration to the county or private agency that initiated the background study. 15.29    (b) new text begin For disqualifications related to studies conducted by the commissioner for child new text end 15.30 new text begin foster care, the individual shall submit the request for reconsideration to the private agency new text end 15.31 new text begin that initiated the background study. new text end 16.1 new text begin (c) new text end A reconsideration request shall be submitted within 30 days of the individual's 16.2receipt of the disqualification notice or the time frames specified in subdivision 2, 16.3whichever time frame is shorter. 16.4    (c) new text begin (d) new text end The county or private agency shall forward the individual's request for 16.5reconsideration and provide the commissioner with a recommendation whether to set aside 16.6the individual's disqualification. 16.7    Sec. 17. Minnesota Statutes 2008, section 245C.23, subdivision 2, is amended to read: 16.8    Subd. 2. Commissioner's notice of disqualification that is not set aside. (a) The 16.9commissioner shall notify the license holder of the disqualification and order the license 16.10holder to immediately remove the individual from any position allowing direct contact 16.11with persons receiving services from the license holder if: 16.12    (1) the individual studied does not submit a timely request for reconsideration 16.13under section 245C.21; 16.14    (2) the individual submits a timely request for reconsideration, but the commissioner 16.15does not set aside the disqualification for that license holder under section 245C.22; 16.16    (3) an individual who has a right to request a hearing under sections 245C.27 and 16.17256.045 , or 245C.28 and chapter 14 for a disqualification that has not been set aside, does 16.18not request a hearing within the specified time; or 16.19    (4) an individual submitted a timely request for a hearing under sections 245C.27 16.20and 256.045, or 245C.28 and chapter 14, but the commissioner does not set aside the 16.21disqualification under section 245A.08, subdivision 5, or 256.045. 16.22    (b) If the commissioner does not set aside the disqualification under section 245C.22, 16.23and the license holder was previously ordered under section 245C.17 to immediately 16.24remove the disqualified individual from direct contact with persons receiving services or 16.25to ensure that the individual is under continuous, direct supervision when providing direct 16.26contact services, the order remains in effect pending the outcome of a hearing under 16.27sections 245C.27 and 256.045, or 245C.28 and chapter 14. 16.28    (c) For background studies related to child foster care, the commissioner shall 16.29also notify the county or private agency that initiated the study of the results of the 16.30reconsideration. 16.31 new text begin (d) For background studies related to adult foster care and family adult day services, new text end 16.32 new text begin the commissioner shall also notify the county that initiated the study of the results of new text end 16.33 new text begin the reconsideration. new text end 17.1    Sec. 18. Minnesota Statutes 2008, section 256B.092, is amended by adding a 17.2subdivision to read: 17.3     new text begin Subd. 5b. new text end new text begin Revised per diem based on legislated rate reduction. new text end new text begin Notwithstanding new text end 17.4 new text begin section 252.28, subdivision 3, paragraph (d), if the 2009 legislature adopts a rate reduction new text end 17.5 new text begin that impacts payment to providers of adult foster care services, the commissioner may new text end 17.6 new text begin issue adult foster care licenses that permit a capacity of five adults. The application for a new text end 17.7 new text begin five-bed license must meet the requirements of section 245A.11, subdivision 2a. Prior to new text end 17.8 new text begin admission of the fifth recipient of adult foster care services, the county must negotiate a new text end 17.9 new text begin revised per diem rate for room and board and waiver services that reflects the legislated new text end 17.10 new text begin rate reduction and results in an overall average per diem reduction for all foster care new text end 17.11 new text begin recipients in that home. The revised per diem must allow the provider to maintain, as new text end 17.12 new text begin much as possible, the level of services or enhanced services provided in the residence, new text end 17.13 new text begin while mitigating the losses of the legislated rate reduction. new text end 17.14 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2009. new text end 17.15    Sec. 19. Minnesota Statutes 2008, section 256B.49, subdivision 17, is amended to read: 17.16    Subd. 17. Cost of services and supports. (a) The commissioner shall ensure 17.17that the average per capita expenditures estimated in any fiscal year for home and 17.18community-based waiver recipients does not exceed the average per capita expenditures 17.19that would have been made to provide institutional services for recipients in the absence 17.20of the waiver. 17.21(b) The commissioner shall implement on January 1, 2002, one or more aggregate, 17.22need-based methods for allocating to local agencies the home and community-based 17.23waivered service resources available to support recipients with disabilities in need of 17.24the level of care provided in a nursing facility or a hospital. The commissioner shall 17.25allocate resources to single counties and county partnerships in a manner that reflects 17.26consideration of: 17.27(1) an incentive-based payment process for achieving outcomes; 17.28(2) the need for a state-level risk pool; 17.29(3) the need for retention of management responsibility at the state agency level; and 17.30(4) a phase-in strategy as appropriate. 17.31(c) Until the allocation methods described in paragraph (b) are implemented, the 17.32annual allowable reimbursement level of home and community-based waiver services 17.33shall be the greater of: 18.1(1) the statewide average payment amount which the recipient is assigned under the 18.2waiver reimbursement system in place on June 30, 2001, modified by the percentage of 18.3any provider rate increase appropriated for home and community-based services; or 18.4(2) an amount approved by the commissioner based on the recipient's extraordinary 18.5needs that cannot be met within the current allowable reimbursement level. The 18.6increased reimbursement level must be necessary to allow the recipient to be discharged 18.7from an institution or to prevent imminent placement in an institution. The additional 18.8reimbursement may be used to secure environmental modifications; assistive technology 18.9and equipment; and increased costs for supervision, training, and support services 18.10necessary to address the recipient's extraordinary needs. The commissioner may approve 18.11an increased reimbursement level for up to one year of the recipient's relocation from an 18.12institution or up to six months of a determination that a current waiver recipient is at 18.13imminent risk of being placed in an institution. 18.14(d) Beginning July 1, 2001, medically necessary private duty nursing services will be 18.15authorized under this section as complex and regular care according to sections 256B.0651 18.16and 256B.0653 to 256B.0656. The rate established by the commissioner for registered 18.17nurse or licensed practical nurse services under any home and community-based waiver as 18.18of January 1, 2001, shall not be reduced. 18.19 new text begin (e) Notwithstanding section 252.28, subdivision 3, paragraph (d), if the 2009 new text end 18.20 new text begin legislature adopts a rate reduction that impacts payment to providers of adult foster care new text end 18.21 new text begin services, the commissioner may issue adult foster care licenses that permit a capacity of new text end 18.22 new text begin five adults. The application for a five-bed license must meet the requirements of section new text end 18.23 new text begin 245A.11, subdivision 2a. Prior to admission of the fifth recipient of adult foster care new text end 18.24 new text begin services, the county must negotiate a revised per diem rate for room and board and waiver new text end 18.25 new text begin services that reflects the legislated rate reduction and results in an overall average per new text end 18.26 new text begin diem reduction for all foster care recipients in that home. The revised per diem must allow new text end 18.27 new text begin the provider to maintain, as much as possible, the level of services or enhanced services new text end 18.28 new text begin provided in the residence, while mitigating the losses of the legislated rate reduction. new text end 18.29 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2009. new text end 18.30    Sec. 20. new text begin WAIVER. new text end 18.31 new text begin By December 1, 2009, the commissioner shall request all federal approvals and new text end 18.32 new text begin waiver amendments to the disability home and community-based waivers to allow properly new text end 18.33 new text begin licensed adult foster care homes to provide residential services for up to five individuals. new text end 18.34 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2009. new text end 19.1    Sec. 21. new text begin REPEALER. new text end 19.2 new text begin (a) new text end new text begin Minnesota Statutes 2008, section 245C.11, subdivisions 1 and 2, new text end new text begin are repealed. new text end 19.3 new text begin (b) new text end new text begin Minnesota Statutes 2008, section 256B.092, subdivision 5a, new text end new text begin is repealed effective new text end 19.4 new text begin July 1, 2009. new text end 19.5 new text begin (c) new text end new text begin Minnesota Rules, part 9555.6125, subpart 4, item B, new text end new text begin is repealed. new text end 19.6ARTICLE 2 19.7MFIP/CHILD CARE/ADULT SUPPORTS/FRAUD PREVENTION 19.8    Section 1. Minnesota Statutes 2008, section 119B.09, subdivision 7, is amended to read: 19.9    Subd. 7. Date of eligibility for assistance. (a) The date of eligibility for child 19.10care assistance under this chapter is the later of the date the application was signed; the 19.11beginning date of employment, education, or training; the date the infant is born for 19.12applicants to the at-home infant care program; or the date a determination has been made 19.13that the applicant is a participant in employment and training services under Minnesota 19.14Rules, part 3400.0080, or chapter 256J. 19.15    (b) Payment ceases for a family under the at-home infant child care program when a 19.16family has used a total of 12 months of assistance as specified under section 119B.035. 19.17Payment of child care assistance for employed persons on MFIP is effective the date of 19.18employment or the date of MFIP eligibility, whichever is later. Payment of child care 19.19assistance for MFIP or DWP participants in employment and training services is effective 19.20the date of commencement of the services or the date of MFIP or DWP eligibility, 19.21whichever is later. Payment of child care assistance for transition year child care must be 19.22made retroactive to the date of eligibility for transition year child care. 19.23 new text begin (c) Notwithstanding paragraph (b), payment of child care assistance for participants new text end 19.24 new text begin eligible under section 119B.05 may only be made retroactive for a maximum of six new text end 19.25 new text begin months from the date of application for child care assistance. new text end 19.26 new text begin EFFECTIVE DATE. new text end new text begin This section is effective October 1, 2009. new text end 19.27    Sec. 2. Minnesota Statutes 2008, section 119B.13, subdivision 6, is amended to read: 19.28    Subd. 6. Provider payments. (a) Counties or the state shall make vendor payments 19.29to the child care provider or pay the parent directly for eligible child care expenses. 19.30(b) If payments for child care assistance are made to providers, the provider shall 19.31bill the county for services provided within ten days of the end of the service period. If 19.32bills are submitted within ten days of the end of the service period, a county or the state 19.33shall issue payment to the provider of child care under the child care fund within 30 days 20.1of receiving a bill from the provider. Counties or the state may establish policies that 20.2make payments on a more frequent basis. 20.3(c) All bills new text begin If a provider has received an authorization of care and been issued a new text end 20.4 new text begin billing form for an eligible family, the bill new text end must be submitted within 60 days of the last 20.5date of service on the bill. A county may pay a bill submitted more than 60 days after 20.6the last date of service if the provider shows good cause why the bill was not submitted 20.7within 60 days. Good cause must be defined in the county's child care fund plan under 20.8section 119B.08, subdivision 3, and the definition of good cause must include county 20.9error. A county may not pay any bill submitted more than a year after the last date of 20.10service on the bill. 20.11(d) new text begin If a provider provided care for a time period without receiving an authorization new text end 20.12 new text begin of care and a billing form for an eligible family, payment of child care assistance may only new text end 20.13 new text begin be made retroactively for a maximum of six months from the date the provider is issued new text end 20.14 new text begin an authorization of care and billing form. new text end 20.15 new text begin (e) new text end A county may stop payment issued to a provider or may refuse to pay a bill 20.16submitted by a provider if: 20.17(1) the provider admits to intentionally giving the county materially false information 20.18on the provider's billing forms; or 20.19(2) a county finds by a preponderance of the evidence that the provider intentionally 20.20gave the county materially false information on the provider's billing forms. 20.21(e) new text begin (f) new text end A county's payment policies must be included in the county's child care plan 20.22under section 119B.08, subdivision 3. If payments are made by the state, in addition to 20.23being in compliance with this subdivision, the payments must be made in compliance 20.24with section 16A.124. 20.25 new text begin EFFECTIVE DATE. new text end new text begin This section is effective October 1, 2009. new text end 20.26    Sec. 3. Minnesota Statutes 2008, section 119B.21, subdivision 5, is amended to read: 20.27    Subd. 5. Child care services grants. (a) A child care resource and referral program 20.28designated under section 119B.19, subdivision 1a, may award child care services grants 20.29for: 20.30    (1) creating new licensed child care facilities and expanding existing facilities, 20.31including, but not limited to, supplies, equipment, facility renovation, and remodeling; 20.32    (2) improving licensed child care facility programs; 20.33    (3) staff training and development services including, but not limited to, in-service 20.34training, curriculum development, accreditation, certification, consulting, resource 21.1centers, program and resource materials, supporting effective teacher-child interactions, 21.2child-focused teaching, and content-driven classroom instruction; 21.3    (4) interim financing; 21.4    (5) capacity building through the purchase of appropriate technology to create, 21.5enhance, and maintain business management systems; 21.6    (6) emergency assistance for child care programs; 21.7    (7) new programs or projects for the creation, expansion, or improvement of 21.8programs that serve ethnic immigrant and refugee communities; and 21.9    (8) targeted recruitment initiatives to expand and build the capacity of the child 21.10care system and to improve the quality of care provided by legal nonlicensed child care 21.11providers. 21.12    (b) A child care resource and referral program designated under section 119B.19, 21.13subdivision 1a , may award child care services grants to: 21.14    (1) licensed providers; 21.15    (2) providers in the process of being licensed; 21.16    (3) corporations or public agencies that develop or provide child care services; 21.17    (4) school-age care programs; 21.18    (5) legal nonlicensed or family, friend, and neighbor care providers; or 21.19    (6) any combination of clauses (1) to (5). 21.20    (c) A recipient of a child care services grant for facility improvements, interim 21.21financing, or staff training and development must provide a 25 percent local match. 21.22 new text begin (d) Beginning July 1, 2009, grants under this subdivision shall be increasingly new text end 21.23 new text begin awarded for activities that improve provider quality, including activities under paragraph new text end 21.24 new text begin (a), clauses (1) to (3) and (7). new text end 21.25    Sec. 4. Minnesota Statutes 2008, section 119B.21, subdivision 10, is amended to read: 21.26    Subd. 10. Family child care technical assistance grants. (a) A child care resource 21.27and referral organization designated under section 119B.19, subdivision 1a, may award 21.28technical assistance grants of up to $1,000. These grants may be used for: 21.29    (1) facility improvements, including, but not limited to, improvements to meet 21.30licensing requirements; 21.31    (2) improvements to expand a child care facility or program; 21.32    (3) toys new text begin , materials, new text end and equipment new text begin to improve the learning environment new text end ; 21.33    (4) technology and software to create, enhance, and maintain business management 21.34systems; 21.35    (5) start-up costs; 22.1    (6) staff training and development; and 22.2    (7) other uses approved by the commissioner. 22.3    (b) A child care resource and referral program may award family child care technical 22.4assistance grants to: 22.5    (1) licensed family child care providers; 22.6    (2) child care providers in the process of becoming licensed; or 22.7    (3) legal nonlicensed or family, friend, and neighbor care providers. 22.8    (c) A local match is not required for a family child care technical assistance grant. 22.9 new text begin (d) Beginning July 1, 2009, grants under this subdivision shall be increasingly new text end 22.10 new text begin awarded for activities that improve provider quality, including activities under paragraph new text end 22.11 new text begin (a), clauses (1), (3), and (6). new text end 22.12    Sec. 5. Minnesota Statutes 2008, section 119B.231, subdivision 2, is amended to read: 22.13    Subd. 2. Provider eligibility. (a) To be considered for an SRSA, a provider shall 22.14apply to the commissioner new text begin or have been chosen as an SRSA provider prior to June 30, new text end 22.15 new text begin 2009, and have complied with all requirements of the SRSA agreement. Priority for funds new text end 22.16 new text begin is given to providers who had agreements prior to June 30, 2009. If sufficient funds are new text end 22.17 new text begin available, the commissioner shall make applications available to additional providers new text end . To 22.18be eligible to apply for an SRSA, a provider shall: 22.19    (1) be eligible for child care assistance payments under chapter 119B; 22.20    (2) have at least 25 percent of the children enrolled with the provider subsidized 22.21through the child care assistance program; 22.22    (3) provide full-time, full-year child care services; and 22.23    (4) serve at least one child who is subsidized through the child care assistance 22.24program and who is expected to enter kindergarten within the following 30 months new text begin have new text end 22.25 new text begin obtained a level 3 or 4 star rating under the voluntary Parent Aware quality rating system new text end . 22.26    (b) The commissioner may waive the 25 percent requirement in paragraph (a), 22.27clause (2), if necessary to achieve geographic distribution of SRSA providers and diversity 22.28of types of care provided by SRSA providers. 22.29    (c) An eligible provider who would like to enter into an SRSA with the commissioner 22.30shall submit an SRSA application. To determine whether to enter into an SRSA with a 22.31provider, the commissioner shall evaluate the following factors: 22.32    (1) the qualifications of the provider and the provider's staff new text begin provider's Parent new text end 22.33 new text begin Aware rating score new text end ; 22.34    (2) the provider's staff-child ratios; 22.35    (3) the provider's curriculum; 23.1    (4) the provider's current or planned parent education activities; 23.2    (5) new text begin (2) new text end the provider's current or planned social service and employment linkages; 23.3    (6) the provider's child development assessment plan; 23.4    (7) new text begin (3) new text end the geographic distribution needed for SRSA providers; 23.5    (8) new text begin (4) new text end the inclusion of a variety of child care delivery models; and 23.6    (9) new text begin (5) new text end other related factors determined by the commissioner. 23.7    Sec. 6. Minnesota Statutes 2008, section 119B.231, subdivision 3, is amended to read: 23.8    Subd. 3. Family and child eligibility. (a) A family eligible to choose an SRSA 23.9provider for their children shall: 23.10    (1) be eligible to receive child care assistance under any provision in chapter 119B 23.11except section 119B.035; 23.12    (2) be in an authorized activity for an average of at least 35 hours per week when 23.13initial eligibility is determined; and 23.14    (3) include a child who has not yet entered kindergarten. 23.15    (b) A family who is determined to be eligible to choose an SRSA provider remains 23.16eligible to be paid at a higher rate through the SRSA provider when the following 23.17conditions exist: 23.18    (1) the child attends child care with the SRSA provider a minimum of 25 hours per 23.19week, on average; 23.20    (2) the family has a child who has not yet entered kindergarten; and 23.21    (3) the family maintains eligibility under chapter 119B except section 119B.035. 23.22    (c) For the 12 months After initial eligibility has been determined, a decrease in the 23.23family's authorized activities to an average of less than 35 hours per week does not result 23.24in ineligibility for the SRSA rate. new text begin A family must continue to maintain eligibility under this new text end 23.25 new text begin chapter and be in an authorized activity. new text end 23.26    (d) A family that moves between counties but continues to use the same SRSA 23.27provider shall continue to receive SRSA funding for the increased payments. 23.28    Sec. 7. Minnesota Statutes 2008, section 119B.231, subdivision 4, is amended to read: 23.29    Subd. 4. Requirements of providers. An SRSA must include assessment, 23.30evaluation, and reporting requirements that promote the goals of improved school 23.31readiness and movement toward appropriate child development milestones. A provider 23.32who enters into an SRSA shall comply with new text begin all SRSA requirements, including new text end the 23.33assessment, evaluation, and reporting requirements in the SRSA. new text begin Providers who have been new text end 23.34 new text begin selected previously for SRSAs must begin the process to obtain a rating using Parent new text end 24.1 new text begin Aware according to timelines established by the commissioner. If the initial Parent Aware new text end 24.2 new text begin rating is less than three stars, the provider must submit a plan to improve the rating. If new text end 24.3 new text begin a 3 or 4 star rating is not obtained within established timelines, the commissioner may new text end 24.4 new text begin consider continuation of the agreement, depending upon the progress made and other new text end 24.5 new text begin factors. Providers who apply and are selected for a new SRSA agreement on or after July new text end 24.6 new text begin 1, 2009, must have a level 3 or 4 star rating under the voluntary Parent Aware quality new text end 24.7 new text begin rating system at the time the SRSA agreement is signed. new text end 24.8    Sec. 8. Minnesota Statutes 2008, section 145A.17, is amended by adding a subdivision 24.9to read: 24.10     new text begin Subd. 4a. new text end new text begin Home visitors as MFIP employment and training service providers. new text end 24.11 new text begin The county social service agency and the local public health department may mutually new text end 24.12 new text begin agree to utilize home visitors under this section as MFIP employment and training service new text end 24.13 new text begin providers under section 256J.49, subdivision 4, for MFIP participants who are: (1) ill or new text end 24.14 new text begin incapacitated under section 256J.425, subdivision 2; or (2) minor caregivers under section new text end 24.15 new text begin 256J.54. The county social service agency and the local public health department may new text end 24.16 new text begin also mutually agree to utilize home visitors to provide outreach to MFIP families who are new text end 24.17 new text begin being sanctioned or who have been terminated from MFIP due to the 60-month time limit. new text end 24.18    Sec. 9. Minnesota Statutes 2008, section 256.045, subdivision 3, is amended to read: 24.19    Subd. 3. State agency hearings. (a) State agency hearings are available for the 24.20following: 24.21    (1) any person applying for, receiving or having received public assistance, medical 24.22care, or a program of social services granted by the state agency or a county agency or 24.23the federal Food Stamp Act whose application for assistance is denied, not acted upon 24.24with reasonable promptness, or whose assistance is suspended, reduced, terminated, or 24.25claimed to have been incorrectly paid; 24.26    (2) any patient or relative aggrieved by an order of the commissioner under section 24.27252.27 ; 24.28    (3) a party aggrieved by a ruling of a prepaid health plan; 24.29    (4) except as provided under chapter 245C, any individual or facility determined by 24.30a lead agency to have maltreated a vulnerable adult under section 626.557 after they have 24.31exercised their right to administrative reconsideration under section 626.557; 24.32    (5) any person whose claim for foster care payment according to a placement of the 24.33child resulting from a child protection assessment under section 626.556 is denied or not 24.34acted upon with reasonable promptness, regardless of funding source; 25.1    (6) any person to whom a right of appeal according to this section is given by other 25.2provision of law; 25.3    (7) an applicant aggrieved by an adverse decision to an application for a hardship 25.4waiver under section 256B.15; 25.5    (8) an applicant aggrieved by an adverse decision to an application or redetermination 25.6for a Medicare Part D prescription drug subsidy under section 256B.04, subdivision 4a; 25.7    (9) except as provided under chapter 245A, an individual or facility determined 25.8to have maltreated a minor under section 626.556, after the individual or facility has 25.9exercised the right to administrative reconsideration under section 626.556; or 25.10    (10) except as provided under chapter 245C, an individual disqualified under sections 25.11245C.14 and 245C.15, on the basis of serious or recurring maltreatment; a preponderance 25.12of the evidence that the individual has committed an act or acts that meet the definition 25.13of any of the crimes listed in section 245C.15, subdivisions 1 to 4; or for failing to make 25.14reports required under section 626.556, subdivision 3, or 626.557, subdivision 3. Hearings 25.15regarding a maltreatment determination under clause (4) or (9) and a disqualification under 25.16this clause in which the basis for a disqualification is serious or recurring maltreatment, 25.17which has not been set aside under sections 245C.22 and 245C.23, shall be consolidated 25.18into a single fair hearing. In such cases, the scope of review by the human services referee 25.19shall include both the maltreatment determination and the disqualification. The failure to 25.20exercise the right to an administrative reconsideration shall not be a bar to a hearing under 25.21this section if federal law provides an individual the right to a hearing to dispute a finding 25.22of maltreatment. Individuals and organizations specified in this section may contest the 25.23specified action, decision, or final disposition before the state agency by submitting a 25.24written request for a hearing to the state agency within 30 days after receiving written 25.25notice of the action, decision, or final disposition, or within 90 days of such written notice 25.26if the applicant, recipient, patient, or relative shows good cause why the request was not 25.27submitted within the 30-day time limit. new text begin ; or new text end 25.28     new text begin (11) any person with an outstanding debt resulting from receipt of public assistance, new text end 25.29 new text begin medical care, or the federal Food Stamp Act who is contesting a setoff claim by the new text end 25.30 new text begin Department of Human Services or a county agency. The scope of the appeal is the validity new text end 25.31 new text begin of the claimant agency's intention to request a setoff of a refund under chapter 270A new text end 25.32 new text begin against the debt. new text end 25.33    (b) The hearing for an individual or facility under paragraph (a), clause (4), (9), or 25.34(10), is the only administrative appeal to the final agency determination specifically, 25.35including a challenge to the accuracy and completeness of data under section 13.04. 25.36Hearings requested under paragraph (a), clause (4), apply only to incidents of maltreatment 26.1that occur on or after October 1, 1995. Hearings requested by nursing assistants in nursing 26.2homes alleged to have maltreated a resident prior to October 1, 1995, shall be held as a 26.3contested case proceeding under the provisions of chapter 14. Hearings requested under 26.4paragraph (a), clause (9), apply only to incidents of maltreatment that occur on or after 26.5July 1, 1997. A hearing for an individual or facility under paragraph (a), clause (9), is 26.6only available when there is no juvenile court or adult criminal action pending. If such 26.7action is filed in either court while an administrative review is pending, the administrative 26.8review must be suspended until the judicial actions are completed. If the juvenile court 26.9action or criminal charge is dismissed or the criminal action overturned, the matter may be 26.10considered in an administrative hearing. 26.11    (c) For purposes of this section, bargaining unit grievance procedures are not an 26.12administrative appeal. 26.13    (d) The scope of hearings involving claims to foster care payments under paragraph 26.14(a), clause (5), shall be limited to the issue of whether the county is legally responsible 26.15for a child's placement under court order or voluntary placement agreement and, if so, 26.16the correct amount of foster care payment to be made on the child's behalf and shall not 26.17include review of the propriety of the county's child protection determination or child 26.18placement decision. 26.19    (e) A vendor of medical care as defined in section 256B.02, subdivision 7, or a 26.20vendor under contract with a county agency to provide social services is not a party and 26.21may not request a hearing under this section, except if assisting a recipient as provided in 26.22subdivision 4. 26.23    (f) An applicant or recipient is not entitled to receive social services beyond the 26.24services prescribed under chapter 256M or other social services the person is eligible 26.25for under state law. 26.26    (g) The commissioner may summarily affirm the county or state agency's proposed 26.27action without a hearing when the sole issue is an automatic change due to a change in 26.28state or federal law. 26.29    Sec. 10. Minnesota Statutes 2008, section 256.983, subdivision 1, is amended to read: 26.30    Subdivision 1. Programs established. Within the limits of available appropriations, 26.31the commissioner of human services shall require the maintenance of budget neutral 26.32fraud prevention investigation programs in the counties participating in the fraud 26.33prevention investigation project established under this section. If funds are sufficient, 26.34the commissioner may also extend fraud prevention investigation programs to other 26.35counties provided the expansion is budget neutral to the state. new text begin Under any expansion, the new text end 27.1 new text begin commissioner has the final authority in decisions regarding the creation and realignment new text end 27.2 new text begin of individual county or regional operations. new text end 27.3    Sec. 11. Minnesota Statutes 2008, section 256I.03, subdivision 7, is amended to read: 27.4    Subd. 7. Countable income. "Countable income" means all income received by an 27.5applicant or recipient less any applicable exclusions or disregards. For a recipient of any 27.6cash benefit from the SSI program, countable income means the SSI benefit limit in effect 27.7at the time the person is in a GRH setting less $20, less the medical assistance personal 27.8needs allowance. If the SSI limit has been reduced for a person due to events occurring 27.9prior to the persons entering the GRH setting, countable income means actual income less 27.10any applicable exclusions and disregards. 27.11 new text begin EFFECTIVE DATE. new text end new text begin This section is effective April 1, 2010. new text end 27.12    Sec. 12. Minnesota Statutes 2008, section 256I.05, subdivision 7c, is amended to read: 27.13    Subd. 7c. Demonstration project. The commissioner is authorized to pursue new text begin the new text end 27.14 new text begin expansion of new text end a demonstration project under federal food stamp regulation for the purpose 27.15of gaining new text begin additional new text end federal reimbursement of food and nutritional costs currently paid by 27.16the state group residential housing program. The commissioner shall seek approval no 27.17later than January 1, 2004 new text begin October 1, 2009 new text end . Any reimbursement received is nondedicated 27.18revenue to the general fund. 27.19    Sec. 13. Minnesota Statutes 2008, section 256J.24, subdivision 5, is amended to read: 27.20    Subd. 5. MFIP transitional standard. The MFIP transitional standard is based 27.21on the number of persons in the assistance unit eligible for both food and cash assistance 27.22unless the restrictions in subdivision 6 on the birth of a child apply. The following table 27.23represents the transitional standards effective October 1, 2007 new text begin April 1, 2009 new text end . 27.24 Number of Eligible People Transitional Standard Cash Portion Food Portion 27.25 1 $391 new text begin $428 new text end : $250 $141 new text begin $178 new text end 27.26 2 $698 new text begin $764 new text end : $437 $261 new text begin $327 new text end 27.27 3 $910 new text begin $1,005 new text end : $532 $378 new text begin $473 new text end 27.28 4 $1,091 new text begin $1,217 new text end : $621 $470 new text begin $596 new text end 27.29 5 $1,245 new text begin $1,393 new text end : $697 $548 new text begin $696 new text end 27.30 6 $1,425 new text begin $1,602 new text end : $773 $652 new text begin $829 new text end 28.1 7 $1,553 new text begin $1,748 new text end : $850 $703 new text begin $898 new text end 28.2 8 $1,713 new text begin $1,934 new text end : $916 $797 new text begin $1,018 new text end 28.3 9 $1,871 new text begin $2,119 new text end : $980 $891 new text begin $1,139 new text end 28.4 10 $2,024 new text begin $2,298 new text end : $1,035 $989 new text begin $1,263 new text end 28.5 over 10 add $151 new text begin $178 new text end : $53 $98 new text begin $125 new text end 28.6 per additional member. 28.7    The commissioner shall annually publish in the State Register the transitional 28.8standard for an assistance unit sizes 1 to 10 including a breakdown of the cash and food 28.9portions. 28.10 new text begin EFFECTIVE DATE. new text end new text begin This section is effective retroactively from April 1, 2009. new text end 28.11    Sec. 14. Minnesota Statutes 2008, section 256J.425, subdivision 2, is amended to read: 28.12    Subd. 2. Ill or incapacitated. (a) An assistance unit subject to the time limit in 28.13section 256J.42, subdivision 1, is eligible to receive months of assistance under a hardship 28.14extension if the participant who reached the time limit belongs to any of the following 28.15groups: 28.16(1) participants who are suffering from an illness, injury, or incapacity which 28.17has been certified by a qualified professional when the illness, injury, or incapacity is 28.18expected to continue for more than 30 days and prevents the person from obtaining or 28.19retaining employment new text begin severely limits the person's ability to obtain or maintain suitable new text end 28.20 new text begin employment new text end . These participants must follow the treatment recommendations of the 28.21qualified professional certifying the illness, injury, or incapacity; 28.22(2) participants whose presence in the home is required as a caregiver because of 28.23the illness, injury, or incapacity of another member in the assistance unit, a relative in the 28.24household, or a foster child in the household when the illness or incapacity and the need 28.25for a person to provide assistance in the home has been certified by a qualified professional 28.26and is expected to continue for more than 30 days; or 28.27(3) caregivers with a child or an adult in the household who meets the disability or 28.28medical criteria for home care services under section 256B.0651, subdivision 1, paragraph 28.29(c), or a home and community-based waiver services program under chapter 256B, or 28.30meets the criteria for severe emotional disturbance under section 245.4871, subdivision 28.316 , or for serious and persistent mental illness under section 245.462, subdivision 20, 28.32paragraph (c). Caregivers in this category are presumed to be prevented from obtaining 28.33or retaining employment. 29.1(b) An assistance unit receiving assistance under a hardship extension under this 29.2subdivision may continue to receive assistance as long as the participant meets the criteria 29.3in paragraph (a), clause (1), (2), or (3). 29.4    Sec. 15. Minnesota Statutes 2008, section 256J.425, subdivision 3, is amended to read: 29.5    Subd. 3. Hard-to-employ participants. new text begin (a) new text end An assistance unit subject to the time 29.6limit in section 256J.42, subdivision 1, is eligible to receive months of assistance under 29.7a hardship extension if the participant who reached the time limit belongs to any of the 29.8following groups: 29.9(1) a person who is diagnosed by a licensed physician, psychological practitioner, 29.10or other qualified professional, as developmentally disabled or mentally ill, and that 29.11condition prevents the person from obtaining or retaining unsubsidized employment new text begin the new text end 29.12 new text begin condition severely limits the person's ability to obtain or maintain suitable employment new text end ; 29.13(2) a person who: 29.14(i) has been assessed by a vocational specialist or the county agency to be 29.15unemployable for purposes of this subdivision; or 29.16(ii) has an IQ below 80 who has been assessed by a vocational specialist or a county 29.17agency to be employable, but not at a level that makes the participant eligible for an 29.18extension under subdivision 4 new text begin the condition severely limits the person's ability to obtain or new text end 29.19 new text begin maintain suitable employment new text end . The determination of IQ level must be made by a qualified 29.20professional. In the case of a non-English-speaking person: (A) the determination must 29.21be made by a qualified professional with experience conducting culturally appropriate 29.22assessments, whenever possible; (B) the county may accept reports that identify an 29.23IQ range as opposed to a specific score; (C) these reports must include a statement of 29.24confidence in the results; 29.25(3) a person who is determined by a qualified professional to be learning disabled, 29.26and the disability new text begin condition new text end severely limits the person's ability to obtain, perform, or 29.27maintain suitable employment. For purposes of the initial approval of a learning disability 29.28extension, the determination must have been made or confirmed within the previous 12 29.29months. In the case of a non-English-speaking person: (i) the determination must be made 29.30by a qualified professional with experience conducting culturally appropriate assessments, 29.31whenever possible; and (ii) these reports must include a statement of confidence in the 29.32results. If a rehabilitation plan for a participant extended as learning disabled is developed 29.33or approved by the county agency, the plan must be incorporated into the employment 29.34plan. However, a rehabilitation plan does not replace the requirement to develop and 29.35comply with an employment plan under section 256J.521; or 30.1(4) a person who has been granted a family violence waiver, and who is complying 30.2with an employment plan under section 256J.521, subdivision 3. 30.3 new text begin (b) For purposes of this section, "severely limits the person's ability to obtain or new text end 30.4 new text begin maintain suitable employment" means that a qualified professional has determined that the new text end 30.5 new text begin person's condition prevents the person from working 20 or more hours per week. new text end 30.6    Sec. 16. Minnesota Statutes 2008, section 256J.49, subdivision 1, is amended to read: 30.7    Subdivision 1. Scope. The terms used in sections new text begin 256J.425 new text end to 256J.72 have 30.8the meanings given them in this section. 30.9    Sec. 17. Minnesota Statutes 2008, section 256J.49, subdivision 4, is amended to read: 30.10    Subd. 4. Employment and training service provider. "Employment and training 30.11service provider" means: 30.12(1) a public, private, or nonprofit agency with which a county has contracted to 30.13provide employment and training services and which is included in the county's service 30.14agreement submitted under section 256J.626, subdivision 4; or 30.15(2) a county agency, if the county has opted to provide employment and training 30.16services and the county has indicated that fact in the service agreement submitted under 30.17section 256J.626, subdivision 4 new text begin ; or new text end 30.18 new text begin (3) a local public health department under section 145A.17, subdivision 3a, that a new text end 30.19 new text begin county has designated to provide employment and training services and is included in the new text end 30.20 new text begin county's service agreement submitted under section 256J.626, subdivision 4 new text end . 30.21Notwithstanding section 116L.871, an employment and training services provider 30.22meeting this definition may deliver employment and training services under this chapter. 30.23    Sec. 18. Minnesota Statutes 2008, section 256J.521, subdivision 2, is amended to read: 30.24    Subd. 2. Employment plan; contents. (a) Based on the assessment under 30.25subdivision 1, the job counselor and the participant must develop an employment plan 30.26that includes participation in activities and hours that meet the requirements of section 30.27256J.55, subdivision 1 . The purpose of the employment plan is to identify for each 30.28participant the most direct path to unsubsidized employment and any subsequent steps that 30.29support long-term economic stability. The employment plan should be developed using 30.30the highest level of activity appropriate for the participant. Activities must be chosen from 30.31clauses (1) to (6), which are listed in order of preference. Notwithstanding this order of 30.32preference for activities, priority must be given for activities related to a family violence 30.33waiver when developing the employment plan. The employment plan must also list the 31.1specific steps the participant will take to obtain employment, including steps necessary 31.2for the participant to progress from one level of activity to another, and a timetable for 31.3completion of each step. Levels of activity include: 31.4    (1) unsubsidized employment; 31.5    (2) job search; 31.6    (3) subsidized employment or unpaid work experience; 31.7    (4) unsubsidized employment and job readiness education or job skills training; 31.8    (5) unsubsidized employment or unpaid work experience and activities related to 31.9a family violence waiver or preemployment needs; and 31.10    (6) activities related to a family violence waiver or preemployment needs. 31.11    (b) Participants who are determined to possess sufficient skills such that the 31.12participant is likely to succeed in obtaining unsubsidized employment must job search at 31.13least 30 hours per week for up to six weeks and accept any offer of suitable employment. 31.14The remaining hours necessary to meet the requirements of section 256J.55, subdivision 31.151 , may be met through participation in other work activities under section 256J.49, 31.16subdivision 13 . The participant's employment plan must specify, at a minimum: (1) 31.17whether the job search is supervised or unsupervised; (2) support services that will 31.18be provided; and (3) how frequently the participant must report to the job counselor. 31.19Participants who are unable to find suitable employment after six weeks must meet 31.20with the job counselor to determine whether other activities in paragraph (a) should be 31.21incorporated into the employment plan. Job search activities which are continued after six 31.22weeks must be structured and supervised. 31.23    (c) Beginning July 1, 2004, activities and hourly requirements in the employment 31.24plan may be adjusted as necessary to accommodate the personal and family circumstances 31.25of participants identified under section 256J.561, subdivision 2, paragraph (d). Participants 31.26who no longer meet the provisions of section 256J.561, subdivision 2, paragraph (d), 31.27must meet with the job counselor within ten days of the determination to revise the 31.28employment plan. 31.29    (d) Participants who are determined to have barriers to obtaining or retaining 31.30employment that will not be overcome during six weeks of job search under paragraph (b) 31.31must work with the job counselor to develop an employment plan that addresses those 31.32barriers by incorporating appropriate activities from paragraph (a), clauses (1) to (6). 31.33The employment plan must include enough hours to meet the participation requirements 31.34in section 256J.55, subdivision 1, unless a compelling reason to require fewer hours 31.35is noted in the participant's file. 32.1    (e) new text begin (d) new text end The job counselor and the participant must sign the employment plan to 32.2indicate agreement on the contents. 32.3    (f) new text begin (e) new text end Except as provided under paragraph (g) new text begin (f) new text end , failure to develop or comply with 32.4activities in the plan, or voluntarily quitting suitable employment without good cause, will 32.5result in the imposition of a sanction under section 256J.46. 32.6    (g) new text begin (f) new text end When a participant fails to meet the agreed upon hours of participation in paid 32.7employment because the participant is not eligible for holiday pay and the participant's 32.8place of employment is closed for a holiday, the job counselor shall not impose a sanction 32.9or increase the hours of participation in any other activity, including paid employment, to 32.10offset the hours that were missed due to the holiday. 32.11    (h) new text begin (g) new text end Employment plans must be reviewed at least every three months to determine 32.12whether activities and hourly requirements should be revised. The job counselor is 32.13encouraged to allow participants who are participating in at least 20 hours of work 32.14activities to also participate in education and training activities in order to meet the federal 32.15hourly participation rates. 32.16    Sec. 19. Minnesota Statutes 2008, section 256J.545, is amended to read: 32.17256J.545 FAMILY VIOLENCE WAIVER CRITERIA. 32.18    (a) In order to qualify for a family violence waiver, an individual must provide 32.19documentation of past or current family violence which may prevent the individual from 32.20participating in certain employment activities. 32.21    (b) The following items may be considered acceptable documentation or verification 32.22of family violence: 32.23    (1) police, government agency, or court records; 32.24    (2) a statement from a battered women's shelter staff with knowledge of the 32.25circumstances or credible evidence that supports the sworn statement; 32.26    (3) a statement from a sexual assault or domestic violence advocate with knowledge 32.27of the circumstances or credible evidence that supports the sworn statement; or 32.28    (4) a statement from professionals from whom the applicant or recipient has sought 32.29assistance for the abuse. 32.30    (c) A claim of family violence may also be documented by a sworn statement from 32.31the applicant or participant and a sworn statement from any other person with knowledge 32.32of the circumstances or credible evidence that supports the client's statement. 32.33    Sec. 20. Minnesota Statutes 2008, section 256J.561, subdivision 2, is amended to read: 33.1    Subd. 2. Participation requirements. (a) All MFIP caregivers, except caregivers 33.2who meet the criteria in subdivision 3, must participate in employment services new text begin develop an new text end 33.3 new text begin individualized employment plan that identifies the activities the participant is required to new text end 33.4 new text begin participate in and the required hours of participation new text end . Except as specified in paragraphs (b) 33.5to (d), the employment plan must meet the requirements of section 256J.521, subdivision 33.62 , contain allowable work activities, as defined in section 256J.49, subdivision 13, and, 33.7include at a minimum, the number of participation hours required under section 256J.55, 33.8subdivision 1 . 33.9(b) Minor caregivers and caregivers who are less than age 20 who have not 33.10completed high school or obtained a GED are required to comply with section . 33.11(c) A participant who has a family violence waiver shall develop and comply with 33.12an employment plan under section 256J.521, subdivision 3. 33.13(d) As specified in section 256J.521, subdivision 2, paragraph (c), a participant who 33.14meets any one of the following criteria may work with the job counselor to develop an 33.15employment plan that contains less than the number of participation hours under section 33.16256J.55, subdivision 1. Employment plans for participants covered under this paragraph 33.17must be tailored to recognize the special circumstances of caregivers and families 33.18including limitations due to illness or disability and caregiving needs: 33.19(1) a participant who is age 60 or older; 33.20(2) a participant who has been diagnosed by a qualified professional as suffering 33.21from an illness or incapacity that is expected to last for 30 days or more, including a 33.22pregnant participant who is determined to be unable to obtain or retain employment due 33.23to the pregnancy; or 33.24(3) a participant who is determined by a qualified professional as being needed in 33.25the home to care for an ill or incapacitated family member, including caregivers with a 33.26child or an adult in the household who meets the disability or medical criteria for home 33.27care services under section 256B.0651, subdivision 1, paragraph (c), or a home and 33.28community-based waiver services program under chapter 256B, or meets the criteria for 33.29severe emotional disturbance under section 245.4871, subdivision 6, or for serious and 33.30persistent mental illness under section 245.462, subdivision 20, paragraph (c). 33.31(e) For participants covered under paragraphs (c) and (d), the county shall review 33.32the participant's employment services status every three months to determine whether 33.33conditions have changed. When it is determined that the participant's status is no longer 33.34covered under paragraph (c) or (d), the county shall notify the participant that a new or 33.35revised employment plan is needed. The participant and job counselor shall meet within 33.36ten days of the determination to revise the employment plan. 34.1 new text begin (b) Participants who meet the eligibility requirements in section 256J.575, new text end 34.2 new text begin subdivision 3, must develop a family stabilization services plan that meets the new text end 34.3 new text begin requirements in section 256J.575, subdivision 5. new text end 34.4 new text begin (c) Minor caregivers and caregivers who are less than age 20 who have not new text end 34.5 new text begin completed high school or obtained a GED must develop an education plan that meets the new text end 34.6 new text begin requirements in section 256J.54. new text end 34.7 new text begin (d) Participants with a family violence waiver must develop an employment plan new text end 34.8 new text begin that meets the requirements in section 256J.521, which cover the provisions in section new text end 34.9 new text begin 256J.575, subdivision 5. new text end 34.10 new text begin (e) All other participants must develop an employment plan that meets the new text end 34.11 new text begin requirements of section new text end new text begin 256J.521, subdivision 2 new text end new text begin , and contains allowable work activities, new text end 34.12 new text begin as defined in section new text end new text begin 256J.49, subdivision 13 new text end new text begin . The employment plan must include, at a new text end 34.13 new text begin minimum, the number of participation hours required under section new text end new text begin 256J.55, subdivision 1 new text end new text begin . new text end 34.14    Sec. 21. Minnesota Statutes 2008, section 256J.561, subdivision 3, is amended to read: 34.15    Subd. 3. Child under 12 weeks new text begin months new text end of age. (a) A participant who has a 34.16natural born child who is less than 12 weeks new text begin months new text end of age who meets the criteria in this 34.17subdivision is not required to participate in employment services until the child reaches 34.1812 weeks new text begin months new text end of age. To be eligible for this provision, the assistance unit must not 34.19have already used this provision or the previously allowed child under age one exemption. 34.20However, an assistance unit that has an approved child under age one exemption at the 34.21time this provision becomes effective may continue to use that exemption until the child 34.22reaches one year of age. 34.23(b) The provision in paragraph (a) ends the first full month after the child reaches 34.2412 weeks new text begin months new text end of age. This provision is available only once in a caregiver's lifetime. 34.25In a two-parent household, only one parent shall be allowed to use this provision. The 34.26participant and job counselor must meet within ten days after the child reaches 12 weeks new text begin new text end 34.27 new text begin months new text end of age to revise the participant's employment plan. 34.28 new text begin EFFECTIVE DATE. new text end new text begin This section is effective March 1, 2010. new text end 34.29    Sec. 22. Minnesota Statutes 2008, section 256J.57, subdivision 1, is amended to read: 34.30    Subdivision 1. Good cause for failure to comply. The county agency shall not 34.31impose the sanction under section 256J.46 if it determines that the participant has good 34.32cause for failing to comply with the requirements of sections 256J.515 to 256J.57. Good 34.33cause exists when: 34.34(1) appropriate child care is not available; 35.1(2) the job does not meet the definition of suitable employment; 35.2(3) the participant is ill or injured; 35.3(4) a member of the assistance unit, a relative in the household, or a foster child in 35.4the household is ill and needs care by the participant that prevents the participant from 35.5complying with the employment plan; 35.6(5) the participant is unable to secure necessary transportation; 35.7(6) the participant is in an emergency situation that prevents compliance with the 35.8employment plan; 35.9(7) the schedule of compliance with the employment plan conflicts with judicial 35.10proceedings; 35.11(8) a mandatory MFIP meeting is scheduled during a time that conflicts with a 35.12judicial proceeding or a meeting related to a juvenile court matter, or a participant's work 35.13schedule; 35.14(9) the participant is already participating in acceptable work activities; 35.15(10) the employment plan requires an educational program for a caregiver under age 35.1620, but the educational program is not available; 35.17(11) activities identified in the employment plan are not available; 35.18(12) the participant is willing to accept suitable employment, but suitable 35.19employment is not available; or 35.20(13) the participant documents other verifiable impediments to compliance with the 35.21employment plan beyond the participant's control new text begin ; or new text end 35.22 new text begin (14) the documentation needed to determine if a participant is eligible for family new text end 35.23 new text begin stabilization services is not available, but there is information that the participant may new text end 35.24 new text begin qualify and the participant is cooperating with the county or employment service provider's new text end 35.25 new text begin efforts to obtain the documentation necessary to determine eligibility new text end . 35.26The job counselor shall work with the participant to reschedule mandatory meetings 35.27for individuals who fall under clauses (1), (3), (4), (5), (6), (7), and (8). 35.28    Sec. 23. Minnesota Statutes 2008, section 256J.575, subdivision 3, is amended to read: 35.29    Subd. 3. Eligibility. (a) The following MFIP or diversionary work program (DWP) 35.30participants are eligible for the services under this section: 35.31    (1) a participant who meets the requirements for or has been granted a hardship 35.32extension under section 256J.425, subdivision 2 or 3, except that it is not necessary for 35.33the participant to have reached or be approaching 60 months of eligibility for this section 35.34to apply; 36.1    (2) a participant who is applying for Supplemental Security Income or Social 36.2Security disability insurance; and 36.3    (3) a participant who is a noncitizen who has been in the United States for 12 or 36.4fewer months new text begin ; and new text end 36.5 new text begin (4) a participant who is age 60 or older new text end . 36.6    (b) Families must meet all other eligibility requirements for MFIP established in 36.7this chapter. Families are eligible for financial assistance to the same extent as if they 36.8were participating in MFIP. 36.9    (c) A participant under paragraph (a), clause (3), must be provided with English as a 36.10second language opportunities and skills training for up to 12 months. After 12 months, 36.11the case manager and participant must determine whether the participant should continue 36.12with English as a second language classes or skills training, or both, and continue to 36.13receive family stabilization services. 36.14 new text begin (d) If a county agency or employment services provider has information that new text end 36.15 new text begin an MFIP participant may meet the eligibility criteria set forth in this subdivision, the new text end 36.16 new text begin county agency or employment services provider must assist the participant in obtaining new text end 36.17 new text begin the documentation necessary to determine eligibility. Until necessary documentation is new text end 36.18 new text begin obtained, the participant must be treated as an eligible participant under subdivisions 5 to 7. new text end 36.19 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2009, except the amendment new text end 36.20 new text begin to paragraph (a) striking "or diversionary work program (DWP)" is effective March 1, new text end 36.21 new text begin 2010. new text end 36.22    Sec. 24. Minnesota Statutes 2008, section 256J.575, subdivision 4, is amended to read: 36.23    Subd. 4. Universal participation. All caregivers must participate in family 36.24stabilization services as defined in subdivision 2 new text begin , except for caregivers exempt under new text end 36.25 new text begin section 256J.561, subdivision 3 new text end . 36.26 new text begin EFFECTIVE DATE. new text end new text begin This section is effective March 1, 2010. new text end 36.27    Sec. 25. Minnesota Statutes 2008, section 256J.575, subdivision 6, is amended to read: 36.28    Subd. 6. Cooperation with services requirements. (a) To be eligible, A participant 36.29 new text begin who is eligible for family stabilization services under this section new text end shall comply with 36.30paragraphs (b) to (d). 36.31    (b) Participants shall engage in family stabilization plan services for the appropriate 36.32number of hours per week that the activities are scheduled and available, unless good 36.33cause exists for not doing so, as defined in section 256J.57, subdivision 1. The appropriate 36.34number of hours must be based on the participant's plan. 37.1    (c) The case manager shall review the participant's progress toward the goals in the 37.2family stabilization plan every six months to determine whether conditions have changed, 37.3including whether revisions to the plan are needed. 37.4    (d) A participant's requirement to comply with any or all family stabilization plan 37.5requirements under this subdivision is excused when the case management services, 37.6training and educational services, or family support services identified in the participant's 37.7family stabilization plan are unavailable for reasons beyond the control of the participant, 37.8including when money appropriated is not sufficient to provide the services. 37.9    Sec. 26. Minnesota Statutes 2008, section 256J.575, subdivision 7, is amended to read: 37.10    Subd. 7. Sanctions. (a) new text begin The county agency or employment services provider must new text end 37.11 new text begin follow the requirements of this subdivision at the time the county agency or employment new text end 37.12 new text begin services provider has information that an MFIP recipient may meet the eligibility criteria new text end 37.13 new text begin in subdivision 3. new text end 37.14 new text begin (b) new text end The financial assistance grant of a participating family is reduced according to 37.15section 256J.46, if a participating adult fails without good cause to comply or continue 37.16to comply with the family stabilization plan requirements in this subdivision, unless 37.17compliance has been excused under subdivision 6, paragraph (d). 37.18    (b) new text begin (c) new text end Given the purpose of the family stabilization services in this section and the 37.19nature of the underlying family circumstances that act as barriers to both employment and 37.20full compliance with program requirements, there must be a review by the county agency 37.21prior to imposing a sanction to determine whether the plan was appropriated to the needs 37.22of the participant and family, and new text begin . There must be a current assessment by a behavioral new text end 37.23 new text begin health or medical professional confirming new text end that the participant in all ways had the ability to 37.24comply with the plan, as confirmed by a behavioral health or medical professional. 37.25    (c) new text begin (d) new text end Prior to the imposition of a sanction, the county agency or employment 37.26services provider shall review the participant's case to determine if the family stabilization 37.27plan is still appropriate and meet with the participant face-to-face. The participant may 37.28bring an advocate new text begin The county agency or employment services provider must inform the new text end 37.29 new text begin participant of the right to bring an advocate new text end to the face-to-face meeting. 37.30    During the face-to-face meeting, the county agency shall: 37.31    (1) determine whether the continued noncompliance can be explained and mitigated 37.32by providing a needed family stabilization service, as defined in subdivision 2, paragraph 37.33(d); 37.34    (2) determine whether the participant qualifies for a good cause exception under 37.35section 256J.57, or if the sanction is for noncooperation with child support requirements, 38.1determine if the participant qualifies for a good cause exemption under section 256.741, 38.2subdivision 10; 38.3    (3) determine whether activities in the family stabilization plan are appropriate 38.4based on the family's circumstances; 38.5    (4) explain the consequences of continuing noncompliance; 38.6    (5) identify other resources that may be available to the participant to meet the 38.7needs of the family; and 38.8    (6) inform the participant of the right to appeal under section 256J.40. 38.9    If the lack of an identified activity or service can explain the noncompliance, the 38.10county shall work with the participant to provide the identified activity. 38.11    (d) If the participant fails to come to the face-to-face meeting, the case manager or a 38.12designee shall attempt at least one home visit. If a face-to-face meeting is not conducted, 38.13the county agency shall send the participant a written notice that includes the information 38.14under paragraph (c). 38.15    (e) After the requirements of paragraphs (c) and (d) are met and prior to imposition 38.16of a sanction, the county agency shall provide a notice of intent to sanction under section 38.17256J.57, subdivision 2 , and, when applicable, a notice of adverse action under section 38.18256J.31 . 38.19    (f) Section 256J.57 applies to this section except to the extent that it is modified 38.20by this subdivision. 38.21    Sec. 27. Minnesota Statutes 2008, section 256J.621, is amended to read: 38.22256J.621 WORK PARTICIPATION CASH BENEFITS. 38.23    (a) Effective October 1, 2009, upon exiting the diversionary work program (DWP) 38.24or upon terminating the Minnesota family investment program with earnings, a participant 38.25who is employed may be eligible for work participation cash benefits of $75 new text begin $50 new text end per 38.26month to assist in meeting the family's basic needs as the participant continues to move 38.27toward self-sufficiency. 38.28    (b) To be eligible for work participation cash benefits, the participant shall not 38.29receive MFIP or diversionary work program assistance during the month and the 38.30participant or participants must meet the following work requirements: 38.31    (1) if the participant is a single caregiver and has a child under six years of age, the 38.32participant must be employed at least 87 hours per month; 38.33    (2) if the participant is a single caregiver and does not have a child under six years of 38.34age, the participant must be employed at least 130 hours per month; or 39.1    (3) if the household is a two-parent family, at least one of the parents must be 39.2employed an average of at least 130 hours per month. 39.3    Whenever a participant exits the diversionary work program or is terminated from 39.4MFIP and meets the other criteria in this section, work participation cash benefits are 39.5available for up to 24 consecutive months. 39.6    (c) Expenditures on the program are maintenance of effort state funds new text begin under new text end 39.7 new text begin a separate state program new text end for participants under paragraph (b), clauses (1) and (2). 39.8Expenditures for participants under paragraph (b), clause (3), are nonmaintenance of effort 39.9funds. Months in which a participant receives work participation cash benefits under this 39.10section do not count toward the participant's MFIP 60-month time limit. 39.11    Sec. 28. Minnesota Statutes 2008, section 256J.626, subdivision 7, is amended to read: 39.12    Subd. 7. Performance base funds. (a) new text begin For the purpose of this section, the following new text end 39.13 new text begin terms have the meanings given. new text end 39.14 new text begin (1) "Caseload Reduction Credit" (CRC) means the measure of how much Minnesota new text end 39.15 new text begin TANF and separate state program caseload has fallen relative to federal fiscal year 2005 new text end 39.16 new text begin based on caseload data from October 1 to September 30. new text end 39.17 new text begin (2) "TANF participation rate target" means a 50 percent participation rate reduced by new text end 39.18 new text begin the CRC for the previous year. new text end 39.19 new text begin (b) new text end For calendar year 2009 new text begin 2010 new text end and yearly thereafter, each county and tribe will be 39.20allocated 95 percent of their initial calendar year allocation. Counties and tribes will be 39.21allocated additional funds based on performance as follows: 39.22    (1) a county or tribe that achieves a 50 percent new text begin the new text end TANF participation rate new text begin target new text end 39.23or a five percentage point improvement over the previous year's TANF participation rate 39.24under section 256J.751, subdivision 2, clause (7), as averaged across 12 consecutive 39.25months for the most recent year for which the measurements are available, will receive an 39.26additional allocation equal to 2.5 percent of its initial allocation; and 39.27    (2) a county or tribe that performs within or above its range of expected performance 39.28on the annualized three-year self-support index under section 256J.751, subdivision 2, 39.29clause (6), will receive an additional allocation equal to 2.5 percent of its initial allocation; 39.30and 39.31    (3) a county or tribe that does not achieve a 50 percent new text begin the new text end TANF participation rate new text begin new text end 39.32 new text begin target new text end or a five percentage point improvement over the previous year's TANF participation 39.33rate under section 256J.751, subdivision 2, clause (7), as averaged across 12 consecutive 39.34months for the most recent year for which the measurements are available, will not 40.1receive an additional 2.5 percent of its initial allocation until after negotiating a multiyear 40.2improvement plan with the commissioner; or 40.3    (4) a county or tribe that does not perform within or above its range of expected 40.4performance on the annualized three-year self-support index under section 256J.751, 40.5subdivision 2 , clause (6), will not receive an additional allocation equal to 2.5 percent 40.6of its initial allocation until after negotiating a multiyear improvement plan with the 40.7commissioner. 40.8    (b) new text begin (c) new text end For calendar year 2009 and yearly thereafter, performance-based funds for 40.9a federally approved tribal TANF program in which the state and tribe have in place 40.10a contract under section 256.01, addressing consolidated funding, will be allocated as 40.11follows: 40.12    (1) a tribe that achieves the participation rate approved in its federal TANF plan 40.13using the average of 12 consecutive months for the most recent year for which the 40.14measurements are available, will receive an additional allocation equal to 2.5 percent of 40.15its initial allocation; and 40.16    (2) a tribe that performs within or above its range of expected performance on the 40.17annualized three-year self-support index under section 256J.751, subdivision 2, clause (6), 40.18will receive an additional allocation equal to 2.5 percent of its initial allocation; or 40.19    (3) a tribe that does not achieve the participation rate approved in its federal TANF 40.20plan using the average of 12 consecutive months for the most recent year for which the 40.21measurements are available, will not receive an additional allocation equal to 2.5 percent 40.22of its initial allocation until after negotiating a multiyear improvement plan with the 40.23commissioner; or 40.24    (4) a tribe that does not perform within or above its range of expected performance 40.25on the annualized three-year self-support index under section 256J.751, subdivision 40.262 , clause (6), will not receive an additional allocation equal to 2.5 percent until after 40.27negotiating a multiyear improvement plan with the commissioner. 40.28    (c) new text begin (d) new text end Funds remaining unallocated after the performance-based allocations 40.29in paragraph (a) new text begin (b) new text end are available to the commissioner for innovation projects under 40.30subdivision 5. 40.31    (d) (1) If available funds are insufficient to meet county and tribal allocations under 40.32paragraph (a) new text begin (b) new text end , the commissioner may make available for allocation funds that are 40.33unobligated and available from the innovation projects through the end of the current 40.34biennium. 40.35    (2) If after the application of clause (1) funds remain insufficient to meet county 40.36and tribal allocations under paragraph (a) new text begin (b) new text end , the commissioner must proportionally 41.1reduce the allocation of each county and tribe with respect to their maximum allocation 41.2available under paragraph (a) new text begin (b) new text end . 41.3    Sec. 29. Minnesota Statutes 2008, section 256J.95, subdivision 3, is amended to read: 41.4    Subd. 3. Eligibility for diversionary work program. (a) Except for the categories 41.5of family units listed below, all family units who apply for cash benefits and who 41.6meet MFIP eligibility as required in sections 256J.11 to 256J.15 are eligible and must 41.7participate in the diversionary work program. Family units that are not eligible for the 41.8diversionary work program include: 41.9    (1) child only cases; 41.10    (2) a single-parent family unit that includes a child under 12 weeks new text begin months new text end of age. 41.11A parent is eligible for this exception once in a parent's lifetime and is not eligible if 41.12the parent has already used the previously allowed child under age one exemption from 41.13MFIP employment services; 41.14    (3) a minor parent without a high school diploma or its equivalent; 41.15    (4) an 18- or 19-year-old caregiver without a high school diploma or its equivalent 41.16who chooses to have an employment plan with an education option; 41.17    (5) a caregiver age 60 or over; 41.18    (6) family units with a caregiver who received DWP benefits in the 12 months prior 41.19to the month the family applied for DWP, except as provided in paragraph (c); 41.20    (7) family units with a caregiver who received MFIP within the 12 months prior to 41.21the month the family unit applied for DWP; 41.22    (8) a family unit with a caregiver who received 60 or more months of TANF 41.23assistance; 41.24    (9) a family unit with a caregiver who is disqualified from DWP or MFIP due to 41.25fraud; and 41.26    (10) refugees and asylees as defined in Code of Federal Regulations, title 45, part 41.27400, subpart d, section 400.43, who arrived in the United States in the 12 months prior to 41.28the date of application for family cash assistance. 41.29    (b) A two-parent family must participate in DWP unless both caregivers meet the 41.30criteria for an exception under paragraph (a), clauses (1) through (5), or the family unit 41.31includes a parent who meets the criteria in paragraph (a), clause (6), (7), (8), (9), or (10). 41.32    (c) Once DWP eligibility is determined, the four months run consecutively. If a 41.33participant leaves the program for any reason and reapplies during the four-month period, 41.34the county must redetermine eligibility for DWP. 41.35 new text begin EFFECTIVE DATE. new text end new text begin This section is effective March 1, 2010. new text end 42.1    Sec. 30. Minnesota Statutes 2008, section 256J.95, subdivision 11, is amended to read: 42.2    Subd. 11. Universal participation required. (a) All DWP caregivers, except 42.3caregivers who meet the criteria in paragraph (d), are required to participate in DWP 42.4employment services. Except as specified in paragraphs (b) and (c), employment plans 42.5under DWP must, at a minimum, meet the requirements in section 256J.55, subdivision 1. 42.6(b) A caregiver who is a member of a two-parent family that is required to participate 42.7in DWP who would otherwise be ineligible for DWP under subdivision 3 may be allowed 42.8to develop an employment plan under section 256J.521, subdivision 2, paragraph (c), that 42.9may contain alternate activities and reduced hours. 42.10(c) A participant who is a victim of family violence shall be allowed to develop an 42.11employment plan under section 256J.521, subdivision 3. A claim of family violence must 42.12be documented by the applicant or participant by providing a sworn statement which is 42.13supported by collateral documentation in section 256J.545, paragraph (b). 42.14(d) One parent in a two-parent family unit that has a natural born child under 12 42.15weeks new text begin months new text end of age is not required to have an employment plan until the child reaches 12 42.16weeks new text begin months new text end of age unless the family unit has already used the exclusion under section 42.17256J.561, subdivision 3 , or the previously allowed child under age one exemption under 42.18section 256J.56, paragraph (a), clause (5). 42.19(e) The provision in paragraph (d) ends the first full month after the child reaches 12 42.20weeks new text begin months new text end of age. This provision is allowable only once in a caregiver's lifetime. In a 42.21two-parent household, only one parent shall be allowed to use this category. 42.22(f) The participant and job counselor must meet within ten working days after the 42.23child reaches 12 weeks new text begin months new text end of age to revise the participant's employment plan. The 42.24employment plan for a family unit that has a child under 12 weeks new text begin months new text end of age that has 42.25already used the exclusion in section 256J.561 or the previously allowed child under 42.26age one exemption under section 256J.56, paragraph (a), clause (5), must be tailored to 42.27recognize the caregiving needs of the parent. 42.28 new text begin EFFECTIVE DATE. new text end new text begin This section is effective March 1, 2010. new text end 42.29    Sec. 31. Minnesota Statutes 2008, section 256J.95, subdivision 12, is amended to read: 42.30    Subd. 12. Conversion or referral to MFIP. (a) If at any time during the DWP 42.31application process or during the four-month DWP eligibility period, it is determined that 42.32a participant is unlikely to benefit from the diversionary work program, the county shall 42.33convert or refer the participant to MFIP as specified in paragraph (d). Participants who are 42.34determined to be unlikely to benefit from the diversionary work program must develop 42.35and sign an employment plan. Participants who meet any one of the criteria in paragraph 43.1(b) shall be considered to be unlikely to benefit from DWP, provided the necessary 43.2documentation is available to support the determination. 43.3(b) A participant who: new text begin meets the eligibility requirements under section 256J.575, new text end 43.4 new text begin subdivision 3, must be considered to be unlikely to benefit from DWP, provided the new text end 43.5 new text begin necessary documentation is available to support the determination. new text end 43.6(1) has been determined by a qualified professional as being unable to obtain or retain 43.7employment due to an illness, injury, or incapacity that is expected to last at least 60 days; 43.8(2) is required in the home as a caregiver because of the illness, injury, or incapacity, 43.9of a family member, or a relative in the household, or a foster child, and the illness, injury, 43.10or incapacity and the need for a person to provide assistance in the home has been certified 43.11by a qualified professional and is expected to continue more than 60 days; 43.12(3) is determined by a qualified professional as being needed in the home to care for 43.13a child or adult meeting the special medical criteria in section 256J.561, subdivision 2, 43.14paragraph (d), clause (3); 43.15(4) is pregnant and is determined by a qualified professional as being unable to 43.16obtain or retain employment due to the pregnancy; or 43.17(5) has applied for SSI or SSDI. 43.18(c) In a two-parent family unit, both parents must be new text begin if one parent is new text end determined 43.19to be unlikely to benefit from the diversionary work program before new text begin , new text end the family unit 43.20can new text begin must new text end be converted or referred to MFIP. 43.21(d) A participant who is determined to be unlikely to benefit from the diversionary 43.22work program shall be converted to MFIP and, if the determination was made within 30 43.23days of the initial application for benefits, no additional application form is required. 43.24A participant who is determined to be unlikely to benefit from the diversionary work 43.25program shall be referred to MFIP and, if the determination is made more than 30 43.26days after the initial application, the participant must submit a program change request 43.27form. The county agency shall process the program change request form by the first of 43.28the following month to ensure that no gap in benefits is due to delayed action by the 43.29county agency. In processing the program change request form, the county must follow 43.30section 256J.32, subdivision 1, except that the county agency shall not require additional 43.31verification of the information in the case file from the DWP application unless the 43.32information in the case file is inaccurate, questionable, or no longer current. 43.33(e) The county shall not request a combined application form for a participant who 43.34has exhausted the four months of the diversionary work program, has continued need for 43.35cash and food assistance, and has completed, signed, and submitted a program change 43.36request form within 30 days of the fourth month of the diversionary work program. The 44.1county must process the program change request according to section 256J.32, subdivision 44.21 , except that the county agency shall not require additional verification of information 44.3in the case file unless the information is inaccurate, questionable, or no longer current. 44.4When a participant does not request MFIP within 30 days of the diversionary work 44.5program benefits being exhausted, a new combined application form must be completed 44.6for any subsequent request for MFIP. 44.7 new text begin EFFECTIVE DATE. new text end new text begin This section is effective March 1, 2010. new text end 44.8    Sec. 32. Minnesota Statutes 2008, section 256J.95, subdivision 13, is amended to read: 44.9    Subd. 13. Immediate referral to employment services. Within one working day of 44.10determination that the applicant is eligible for the diversionary work program, but before 44.11benefits are issued to or on behalf of the family unit, the county shall refer all caregivers to 44.12employment services. The referral to the DWP employment services must be in writing 44.13and must contain the following information: 44.14(1) notification that, as part of the application process, applicants are required to 44.15develop an employment plan or the DWP application will be denied; 44.16(2) the employment services provider name and phone number; 44.17(3) the date, time, and location of the scheduled employment services interview; 44.18(4) the immediate availability of supportive services, including, but not limited to, 44.19child care, transportation, and other work-related aid; and 44.20(5) new text begin (4) new text end the rights, responsibilities, and obligations of participants in the program, 44.21including, but not limited to, the grounds for good cause, the consequences of refusing or 44.22failing to participate fully with program requirements, and the appeal process. 44.23    Sec. 33. Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision 44.24to read: 44.25     new text begin Subd. 3b. new text end new text begin Extension; adoption finalized after age 16. new text end new text begin A child who has attained the new text end 44.26 new text begin age of 16 prior to finalization of their adoption is eligible for extension of the adoption new text end 44.27 new text begin assistance agreement to the date the child attains age 21 if the child is: new text end 44.28     new text begin (1) completing a secondary education program or a program leading to an equivalent new text end 44.29 new text begin credential; new text end 44.30     new text begin (2) enrolled in an institution which provides postsecondary or vocational education; new text end 44.31     new text begin (3) participating in a program or activity designed to promote or remove barriers to new text end 44.32 new text begin employment; new text end 44.33     new text begin (4) employed for at least 80 hours per month; or new text end 45.1     new text begin (5) incapable of doing any of the activities described in clauses (1) to (4) due to a new text end 45.2 new text begin medical condition which incapability is supported by regularly updated information in new text end 45.3 new text begin the case plan of the child. new text end 45.4 new text begin EFFECTIVE DATE. new text end new text begin This section is effective October 1, 2010. new text end 45.5    Sec. 34. Minnesota Statutes 2008, section 270A.09, is amended by adding a 45.6subdivision to read: 45.7     new text begin Subd. 1b. new text end new text begin Department of Human Services claims. new text end new text begin Notwithstanding subdivision 1, new text end 45.8 new text begin any debtor contesting a setoff claim by the Department of Human Services or a county new text end 45.9 new text begin agency whose claim relates to a debt resulting from receipt of public assistance, medical new text end 45.10 new text begin care, or the federal Food Stamp Act shall have a hearing conducted in the same manner as new text end 45.11 new text begin an appeal under sections 256.045 and 256.0451. new text end 45.12    Sec. 35. new text begin AMERICAN INDIAN CHILD WELFARE PROJECTS. new text end 45.13 new text begin Notwithstanding Minnesota Statutes, section 16A.28, the commissioner of human new text end 45.14 new text begin services shall extend payment of state fiscal year 2009 funds in state fiscal year 2010 new text end 45.15 new text begin to tribes participating in the American Indian child welfare projects under Minnesota new text end 45.16 new text begin Statutes, section 256.01, subdivision 14b. Future extensions of payment for a tribe new text end 45.17 new text begin participating in the Indian child welfare projects under Minnesota Statutes, section 256.01, new text end 45.18 new text begin subdivision 14b, must be granted according to the commissioner's authority under new text end 45.19 new text begin Minnesota Statutes, section 16A.28. new text end 45.20    Sec. 36. new text begin REPEALER. new text end 45.21 new text begin Minnesota Statutes 2008, section 256I.06, subdivision 9, new text end new text begin is repealed. new text end 45.22ARTICLE 3 45.23STATE-OPERATED SERVICES/MINNESOTA SEX OFFENDER PROGRAM 45.24    Section 1. Minnesota Statutes 2008, section 246.50, subdivision 5, is amended to read: 45.25    Subd. 5. Cost of care. "Cost of care" means the commissioner's charge for services 45.26provided to any person admitted to a state facility. 45.27For purposes of this subdivision, "charge for services" means the cost of services, 45.28treatment, maintenance, bonds issued for capital improvements, depreciation of buildings 45.29and equipment, and indirect costs related to the operation of state facilities. The 45.30commissioner may determine the charge for services on an anticipated average per diem 45.31basis as an all inclusive charge per facility, per disability group, or per treatment program. 45.32The commissioner may determine a charge per service, using a method that includes direct 46.1and indirect costs new text begin usual and customary fee charged for services provided to clients. The new text end 46.2 new text begin usual and customary fee shall be established in a manner required to appropriately bill new text end 46.3 new text begin services to all payers and shall include the costs related to the operations of any program new text end 46.4 new text begin offered by the state new text end . 46.5    Sec. 2. Minnesota Statutes 2008, section 246.50, is amended by adding a subdivision 46.6to read: 46.7     new text begin Subd. 10. new text end new text begin State-operated community-based program. new text end new text begin "State-operated new text end 46.8 new text begin community-based program" means any program operated in the community including new text end 46.9 new text begin community behavioral health hospitals, crisis centers, residential facilities, outpatient new text end 46.10 new text begin services, and other community-based services developed and operated by the state and new text end 46.11 new text begin under the commissioner's control. new text end 46.12    Sec. 3. Minnesota Statutes 2008, section 246.50, is amended by adding a subdivision 46.13to read: 46.14     new text begin Subd. 11. new text end new text begin Health plan company. new text end new text begin "Health plan company" has the meaning given it new text end 46.15 new text begin in section 62Q.01, subdivision 4, and also includes a demonstration provider as defined in new text end 46.16 new text begin section 256B.69, subdivision 2, paragraph (b), a county or group of counties participating new text end 46.17 new text begin in county-based purchasing according to section 256B.692, and a children's mental health new text end 46.18 new text begin collaborative under contract to provide medical assistance for individuals enrolled in new text end 46.19 new text begin the prepaid medical assistance and MinnesotaCare programs under sections 245.493 to new text end 46.20 new text begin 245.495. new text end 46.21    Sec. 4. Minnesota Statutes 2008, section 246.51, is amended by adding a subdivision 46.22to read: 46.23     new text begin Subd. 1a. new text end new text begin Clients in state-operated community-based programs; determination. new text end 46.24 new text begin The commissioner shall determine available health plan coverage from a health plan new text end 46.25 new text begin company for services provided to clients admitted to a state-operated community-based new text end 46.26 new text begin program. If the health plan coverage requires a co-pay or deductible, or if there is no new text end 46.27 new text begin available health plan coverage, the commissioner shall determine or redetermine, what new text end 46.28 new text begin part of the noncovered cost of care, if any, the client is able to pay. If the client is unable to new text end 46.29 new text begin pay the uncovered cost of care, the commissioner shall determine the client's relatives' new text end 46.30 new text begin ability to pay. The client and relatives shall provide to the commissioner documents and new text end 46.31 new text begin proof necessary to determine the client and relatives' ability to pay. Failure to provide the new text end 46.32 new text begin commissioner with sufficient information to determine ability to pay may make the client new text end 46.33 new text begin or relatives liable for the full cost of care until the time when sufficient information is new text end 47.1 new text begin provided. If it is determined that the responsible party does not have the ability to pay, new text end 47.2 new text begin the commissioner shall waive payment of the portion that exceeds ability to pay under new text end 47.3 new text begin the determination. new text end 47.4    Sec. 5. Minnesota Statutes 2008, section 246.51, is amended by adding a subdivision 47.5to read: 47.6     new text begin Subd. 1b. new text end new text begin Clients served by regional treatment centers or nursing homes; new text end 47.7 new text begin determination. new text end new text begin The commissioner shall determine or redetermine, if necessary, what part new text end 47.8 new text begin of the cost of care, if any, a client served in regional treatment centers or nursing homes new text end 47.9 new text begin operated by state-operated services, is able to pay. If the client is unable to pay the full cost new text end 47.10 new text begin of care, the commissioner shall determine if the client's relatives have the ability to pay. new text end 47.11 new text begin The client and relatives shall provide to the commissioner documents and proof necessary new text end 47.12 new text begin to determine the client and relatives' ability to pay. Failure to provide the commissioner new text end 47.13 new text begin with sufficient information to determine ability to pay may make the client or relatives new text end 47.14 new text begin liable for the full cost of care until the time when sufficient information is provided. No new text end 47.15 new text begin parent shall be liable for the cost of care given a client at a regional treatment center after new text end 47.16 new text begin the client has reached the age of 18 years. new text end 47.17    Sec. 6. Minnesota Statutes 2008, section 246.511, is amended to read: 47.18246.511 RELATIVE RESPONSIBILITY. 47.19Except for chemical dependency services paid for with funds provided under chapter 47.20254B, a client's relatives shall not, pursuant to the commissioner's authority under section 47.21246.51 , be ordered to pay more than ten percent of the cost of new text begin the following: (1) for new text end 47.22 new text begin services provided in a community-based service, the noncovered cost of care as determined new text end 47.23 new text begin under the ability to pay determination; and (2) for services provided at a regional treatment new text end 47.24 new text begin center operated by state-operated services, 20 percent of the cost of new text end care, unless they 47.25reside outside the state. Parents of children in state facilities shall have their responsibility 47.26to pay determined according to section 252.27, subdivision 2, or in rules adopted under 47.27chapter 254B if the cost of care is paid under chapter 254B. The commissioner may 47.28accept voluntary payments in excess of ten new text begin 20 new text end percent. The commissioner may require 47.29full payment of the full per capita cost of care in state facilities for clients whose parent, 47.30parents, spouse, guardian, or conservator do not reside in Minnesota. 47.31    Sec. 7. Minnesota Statutes 2008, section 246.52, is amended to read: 47.32246.52 PAYMENT FOR CARE; ORDER; ACTION. 48.1The commissioner shall issue an order to the client or the guardian of the estate, if 48.2there be one, and relatives determined able to pay requiring them to pay monthly to the 48.3state of Minnesota the amounts so determined the total of which shall not exceed the full 48.4cost of care. Such order shall specifically state the commissioner's determination and shall 48.5be conclusive unless appealed from as herein provided. When a client or relative fails to 48.6pay the amount due hereunder the attorney general, upon request of the commissioner, 48.7may institute, or direct the appropriate county attorney to institute, civil action to recover 48.8such amount. 48.9    Sec. 8. Minnesota Statutes 2008, section 246.54, subdivision 2, is amended to read: 48.10    Subd. 2. Exceptions. (a) Subdivision 1 does not apply to services provided at the 48.11Minnesota Security Hospital, the Minnesota sex offender program, or the Minnesota 48.12extended treatment options program. For services at these facilities, a county's payment 48.13shall be made from the county's own sources of revenue and payments shall be paid as 48.14follows: payments to the state from the county shall equal ten percent of the cost of care, 48.15as determined by the commissioner, for each day, or the portion thereof, that the client 48.16spends at the facility. If payments received by the state under sections 246.50 to 246.53 48.17exceed 90 percent of the cost of care, the county shall be responsible for paying the state 48.18only the remaining amount. The county shall not be entitled to reimbursement from the 48.19client, the client's estate, or from the client's relatives, except as provided in section 246.53. 48.20    (b) Regardless of the facility to which the client is committed, subdivision 1 does 48.21not apply to the following individuals: 48.22    (1) clients who are committed as mentally ill and dangerous under section 253B.02, 48.23subdivision 17; 48.24    (2) clients who are committed as sexual psychopathic personalities under section 48.25253B.02, subdivision 18b ; and 48.26    (3) clients who are committed as sexually dangerous persons under section 253B.02, 48.27subdivision 18c. 48.28    For each of the individuals in clauses (1) to (3), the payment by the county to the state 48.29shall equal ten percent of the cost of care for each day as determined by the commissioner. 48.30    Sec. 9. Minnesota Statutes 2008, section 246B.01, is amended by adding a subdivision 48.31to read: 48.32     new text begin Subd. 1a. new text end new text begin Client. new text end new text begin "Client" means a person who is admitted to the Minnesota sex new text end 48.33 new text begin offender program or subject to a court hold order under section 253B.185 for the purpose new text end 49.1 new text begin of assessment, diagnosis, care, treatment, supervision, or other services provided by the new text end 49.2 new text begin Minnesota sex offender program. new text end 49.3    Sec. 10. Minnesota Statutes 2008, section 246B.01, is amended by adding a 49.4subdivision to read: 49.5     new text begin Subd. 1b. new text end new text begin Client's county. new text end new text begin "Client's county" means the county of the client's new text end 49.6 new text begin legal settlement for poor relief purposes at the time of commitment. If the client has no new text end 49.7 new text begin legal settlement for poor relief in this state, it means the county of commitment, except new text end 49.8 new text begin that when a client with no legal settlement for poor relief is committed while serving a new text end 49.9 new text begin sentence at a penal institution, it means the county from which the client was sentenced. new text end 49.10    Sec. 11. Minnesota Statutes 2008, section 246B.01, is amended by adding a subdivision 49.11to read: 49.12     new text begin Subd. 2a. new text end new text begin Cost of care. new text end new text begin "Cost of care" means the commissioner's charge for housing new text end 49.13 new text begin and treatment services provided to any person admitted to the Minnesota sex offender new text end 49.14 new text begin program. new text end 49.15 new text begin For purposes of this subdivision, "charge for housing and treatment services" means new text end 49.16 new text begin the cost of services, treatment, maintenance, bonds issued for capital improvements, new text end 49.17 new text begin depreciation of buildings and equipment, and indirect costs related to the operation of new text end 49.18 new text begin state facilities. The commissioner may determine the charge for services on an anticipated new text end 49.19 new text begin average per diem basis as an all-inclusive charge per facility. new text end 49.20    Sec. 12. Minnesota Statutes 2008, section 246B.01, is amended by adding a 49.21subdivision to read: 49.22     new text begin Subd. 2b. new text end new text begin Local social services agency. new text end new text begin "Local social services agency" means the new text end 49.23 new text begin local social services agency of the client's county as defined in subdivision 1b and of the new text end 49.24 new text begin county of commitment, and any other local social services agency possessing information new text end 49.25 new text begin regarding, or requested by the commissioner to investigate, the financial circumstances new text end 49.26 new text begin of a client. new text end 49.27    Sec. 13. new text begin [246B.07] PAYMENT FOR CARE AND TREATMENT: new text end 49.28 new text begin DETERMINATION. new text end 49.29     new text begin Subdivision 1. new text end new text begin Procedures. new text end new text begin The commissioner shall determine or redetermine, if new text end 49.30 new text begin necessary, what amount of the cost of care, if any, the client is able to pay. The client shall new text end 49.31 new text begin provide to the commissioner documents and proof necessary to determine the ability to new text end 49.32 new text begin pay. Failure to provide the commissioner with sufficient information to determine ability new text end 50.1 new text begin to pay may make the client liable for the full cost of care until the time when sufficient new text end 50.2 new text begin information is provided. new text end 50.3     new text begin Subd. 2. new text end new text begin Rules. new text end new text begin The commissioner shall use the standards in section 246.51, new text end 50.4 new text begin subdivision 2, to determine the client's liability for the care provided by the Minnesota sex new text end 50.5 new text begin offender program. new text end 50.6     new text begin Subd. 3. new text end new text begin Applicability. new text end new text begin The commissioner may recover, under sections 246B.07 to new text end 50.7 new text begin 246B.10, the cost of any care provided by the Minnesota sex offender program. new text end 50.8    Sec. 14. new text begin [246B.08] PAYMENT FOR CARE; ORDER; ACTION. new text end 50.9 new text begin The commissioner shall issue an order to the client or the guardian of the estate, if new text end 50.10 new text begin there is one, requiring the client or guardian to pay to the state the amounts determined, the new text end 50.11 new text begin total of which must not exceed the full cost of care. The order must specifically state the new text end 50.12 new text begin commissioner's determination and must be conclusive, unless appealed. If a client fails to new text end 50.13 new text begin pay the amount due, the attorney general, upon request of the commissioner, may institute, new text end 50.14 new text begin or direct the appropriate county attorney to institute a civil action to recover the amount. new text end 50.15    Sec. 15. new text begin [246B.09] CLAIM AGAINST ESTATE OF DECEASED CLIENT. new text end 50.16     new text begin Subdivision 1. new text end new text begin Client's estate. new text end new text begin Upon the death of a client, or a former client, the new text end 50.17 new text begin total cost of care provided to the client, less the amount actually paid toward the cost of new text end 50.18 new text begin care by the client, must be filed by the commissioner as a claim against the estate of the new text end 50.19 new text begin client with the court having jurisdiction to probate the estate, and all proceeds collected new text end 50.20 new text begin by the state in the case must be divided between the state and county in proportion to new text end 50.21 new text begin the cost of care each has borne. new text end 50.22     new text begin Subd. 2. new text end new text begin Preferred status. new text end new text begin An estate claim in subdivision 1 must be considered an new text end 50.23 new text begin expense of the last illness for purposes of section 524.3-805. new text end 50.24 new text begin If the commissioner determines that the property or estate of a client is not more new text end 50.25 new text begin than needed to care for and maintain the spouse and minor or dependent children of a new text end 50.26 new text begin deceased client, the commissioner has the power to compromise the claim of the state in a new text end 50.27 new text begin manner deemed just and proper. new text end 50.28     new text begin Subd. 3. new text end new text begin Exception from statute of limitations. new text end new text begin Any statute of limitations that new text end 50.29 new text begin limits the commissioner in recovering the cost of care obligation incurred by a client or new text end 50.30 new text begin former client must not apply to any claim against an estate made under this section to new text end 50.31 new text begin recover cost of care. new text end 50.32    Sec. 16. new text begin [246B.10] LIABILITY OF COUNTY; REIMBURSEMENT. new text end 51.1 new text begin The client's county shall pay to the state a portion of the cost of care provided in new text end 51.2 new text begin the Minnesota sex offender program to a client who has legally settled in that county. A new text end 51.3 new text begin county's payment must be made from the county's own sources of revenue and payments new text end 51.4 new text begin must equal ten percent of the cost of care, as determined by the commissioner, for each new text end 51.5 new text begin day or portion of a day, that the client spends at the facility. If payments received by the new text end 51.6 new text begin state under this chapter exceed 90 percent of the cost of care, the county is responsible new text end 51.7 new text begin for paying the state the remaining amount. The county is not entitled to reimbursement new text end 51.8 new text begin from the client, the client's estate, or from the client's relatives, except as provided in new text end 51.9 new text begin section 246B.07. new text end 51.10    Sec. 17. Minnesota Statutes 2008, section 252.025, subdivision 7, is amended to read: 51.11    Subd. 7. Minnesota extended treatment options. The commissioner shall develop 51.12by July 1, 1997, the Minnesota extended treatment options to serve Minnesotans who have 51.13developmental disabilities and exhibit severe behaviors which present a risk to public 51.14safety. This program new text begin is statewide and new text end must provide specialized residential services in 51.15Cambridge and an array of community support new text begin community-based new text end services statewide new text begin with new text end 51.16 new text begin sufficient levels of care and a sufficient number of specialists to ensure that individuals new text end 51.17 new text begin referred to the program receive the appropriate care. The individuals working in the new text end 51.18 new text begin community-based services under this section are state employees supervised by the new text end 51.19 new text begin commissioner of human services. No layoffs shall occur as a result of restructuring new text end 51.20 new text begin under this section new text end . 51.21    Sec. 18. new text begin REQUIRING THE DEVELOPMENT OF COMMUNITY-BASED new text end 51.22 new text begin MENTAL HEALTH SERVICES FOR PATIENTS COMMITTED TO THE new text end 51.23 new text begin ANOKA-METRO REGIONAL TREATMENT CENTER. new text end 51.24 new text begin In consultation with community partners, the commissioner of human services new text end 51.25 new text begin shall develop an array of community-based services to transform the current services new text end 51.26 new text begin now provided to patients at the Anoka-Metro Regional Treatment Center. The new text end 51.27 new text begin community-based services may be provided in facilities with 16 or fewer beds, and must new text end 51.28 new text begin provide the appropriate level of care for the patients being admitted to the facilities. The new text end 51.29 new text begin planning for this transition must be completed by October 1, 2009, with an initial report new text end 51.30 new text begin to the committee chairs of health and human services by November 30, 2009, and a new text end 51.31 new text begin semiannual report on progress until the transition is completed. The commissioner of new text end 51.32 new text begin human services shall solicit interest from stakeholders and potential community partners. new text end 51.33 new text begin The individuals working in the community-based services facilities under this section are new text end 52.1 new text begin state employees supervised by the commissioner of human services. No layoffs shall new text end 52.2 new text begin occur as a result of restructuring under this section. new text end 52.3    Sec. 19. new text begin REPEALER. new text end 52.4 new text begin Minnesota Statutes 2008, sections 246.51, subdivision 1; and 246.53, subdivision new text end 52.5 new text begin 3, new text end new text begin are repealed. new text end 52.6ARTICLE 4 52.7DEPARTMENT OF HEALTH 52.8    Section 1. Minnesota Statutes 2008, section 62J.495, is amended to read: 52.962J.495 HEALTH INFORMATION TECHNOLOGY AND 52.10INFRASTRUCTURE. 52.11    Subdivision 1. Implementation. By January 1, 2015, all hospitals and health care 52.12providers must have in place an interoperable electronic health records system within their 52.13hospital system or clinical practice setting. The commissioner of health, in consultation 52.14with the new text begin e- new text end Health Information Technology and Infrastructure Advisory Committee, 52.15shall develop a statewide plan to meet this goal, including uniform standards to be used 52.16for the interoperable system for sharing and synchronizing patient data across systems. 52.17The standards must be compatible with federal efforts. The uniform standards must be 52.18developed by January 1, 2009, with a status report on the development of these standards 52.19submitted to the legislature by January 15, 2008 new text begin and updated on an ongoing basis. The new text end 52.20 new text begin commissioner shall include an update on standards development as part of an annual new text end 52.21 new text begin report to the legislature new text end . 52.22     new text begin Subd. 1a. new text end new text begin Definitions. new text end new text begin (a) "Certified electronic health record technology" means an new text end 52.23 new text begin electronic health record that is certified pursuant to section 3001(c)(5) of the HITECH new text end 52.24 new text begin Act to meet the standards and implementation specifications adopted under section 3004 new text end 52.25 new text begin as applicable. new text end 52.26 new text begin (b) "Commissioner" means the commissioner of health. new text end 52.27 new text begin (c) "Pharmaceutical electronic data intermediary" means any entity that provides new text end 52.28 new text begin the infrastructure to connect computer systems or other electronic devices utilized new text end 52.29 new text begin by prescribing practitioners with those used by pharmacies, health plans, third party new text end 52.30 new text begin administrators, and pharmacy benefit manager in order to facilitate the secure transmission new text end 52.31 new text begin of electronic prescriptions, refill authorization requests, communications, and other new text end 52.32 new text begin prescription-related information between such entities. new text end 52.33 new text begin (d) "HITECH Act" means the Health Information Technology for Economic and new text end 52.34 new text begin Clinical Health Act in division A, title XIII and division B, title IV of the American new text end 53.1 new text begin Recovery and Reinvestment Act of 2009, including federal regulations adopted under new text end 53.2 new text begin that act. new text end 53.3 new text begin (e) "Interoperable electronic health record" means an electronic health record that new text end 53.4 new text begin securely exchanges health information with another electronic health record system that new text end 53.5 new text begin meets national requirements for certification under the HITECH Act. new text end 53.6 new text begin (f) "Qualified electronic health record" means an electronic record of health-related new text end 53.7 new text begin information on an individual that includes patient demographic and clinical health new text end 53.8 new text begin information and has the capacity to: new text end 53.9 new text begin (1) provide clinical decision support; new text end 53.10 new text begin (2) support physician order entry; new text end 53.11 new text begin (3) capture and query information relevant to health care quality; and new text end 53.12 new text begin (4) exchange electronic health information with, and integrate such information new text end 53.13 new text begin from, other sources. new text end 53.14    Subd. 2. new text begin E- new text end Health Information Technology and Infrastructure Advisory 53.15Committee. (a) The commissioner shall establish a new text begin an e- new text end Health Information Technology 53.16and Infrastructure Advisory Committee governed by section 15.059 to advise the 53.17commissioner on the following matters: 53.18    (1) assessment of the new text begin adoption and effective new text end use of health information technology by 53.19the state, licensed health care providers and facilities, and local public health agencies; 53.20    (2) recommendations for implementing a statewide interoperable health information 53.21infrastructure, to include estimates of necessary resources, and for determining standards 53.22for administrative new text begin clinical new text end data exchange, clinical support programs, patient privacy 53.23requirements, and maintenance of the security and confidentiality of individual patient 53.24data; 53.25    (3) recommendations for encouraging use of innovative health care applications 53.26using information technology and systems to improve patient care and reduce the cost 53.27of care, including applications relating to disease management and personal health 53.28management that enable remote monitoring of patients' conditions, especially those with 53.29chronic conditions; and 53.30    (4) other related issues as requested by the commissioner. 53.31    (b) The members of the new text begin e- new text end Health Information Technology and Infrastructure 53.32Advisory Committee shall include the commissioners, or commissioners' designees, of 53.33health, human services, administration, and commerce and additional members to be 53.34appointed by the commissioner to include persons representing Minnesota's local public 53.35health agencies, licensed hospitals and other licensed facilities and providers, private 53.36purchasers, the medical and nursing professions, health insurers and health plans, the 54.1state quality improvement organization, academic and research institutions, consumer 54.2advisory organizations with an interest and expertise in health information technology, and 54.3other stakeholders as identified by the Health Information Technology and Infrastructure 54.4Advisory Committee new text begin commissioner to fulfill the requirements of section 3013, paragraph new text end 54.5 new text begin (g) of the HITECH Act new text end . 54.6    (c) The commissioner shall prepare and issue an annual report not later than January 54.730 of each year outlining progress to date in implementing a statewide health information 54.8infrastructure and recommending future projects new text begin action on policy and necessary resources new text end 54.9 new text begin to continue the promotion of adoption and effective use of health information technology new text end . 54.10(d) Notwithstanding section 15.059, this subdivision expires June 30, 2015. 54.11    Subd. 3. Interoperable electronic health record requirements. (a) To meet the 54.12requirements of subdivision 1, hospitals and health care providers must meet the following 54.13criteria when implementing an interoperable electronic health records system within their 54.14hospital system or clinical practice setting. 54.15 new text begin (a) The electronic health record must be a qualified electronic health record. new text end 54.16    (b) The electronic health record must be certified by the Certification Commission 54.17for Healthcare Information Technology, or its successor new text begin Office of the National Coordinator new text end 54.18 new text begin pursuant to the HITECH Act new text end . This criterion only applies to hospitals and health care 54.19providers whose practice setting is a practice setting covered by the Certification 54.20Commission for Healthcare Information Technology certifications new text begin only if a certified new text end 54.21 new text begin electronic health record product for the provider's particular practice setting is available new text end . 54.22This criterion shall be considered met if a hospital or health care provider is using an 54.23electronic health records system that has been certified within the last three years, even if a 54.24more current version of the system has been certified within the three-year period. 54.25 new text begin (c) The electronic health record must meet the standards established according to new text end 54.26 new text begin section 3004 of the HITECH Act as applicable. new text end 54.27 new text begin (d) The electronic health record must have the ability to generate information on new text end 54.28 new text begin clinical quality measures and other measures reported under sections 4101, 4102, and new text end 54.29 new text begin 4201 of the HITECH Act. new text end 54.30    (c) new text begin (e) new text end A health care provider who is a prescriber or dispenser of controlled 54.31substances new text begin legend drugs new text end must have an electronic health record system that meets the 54.32requirements of section 62J.497. 54.33     new text begin Subd. 4. new text end new text begin Coordination with national HIT activities. new text end new text begin (a) The commissioner, new text end 54.34 new text begin in consultation with the e-Health Advisory Committee, shall update the statewide new text end 54.35 new text begin implementation plan required under subdivision 2 and released June 2008, to be consistent new text end 54.36 new text begin with the updated Federal HIT Strategic Plan released by the Office of the National new text end 55.1 new text begin Coordinator in accordance with section 3001 of the HITECH Act. The statewide plan new text end 55.2 new text begin shall meet the requirements for a plan required under section 3013 of the HITECH Act. new text end 55.3 new text begin (b) The commissioner, in consultation with the e-Health Advisory Committee, shall new text end 55.4 new text begin work to ensure coordination between state, regional, and national efforts to support and new text end 55.5 new text begin accelerate efforts to effectively use health information technology to improve the quality new text end 55.6 new text begin and coordination of health care and continuity of patient care among health care providers, new text end 55.7 new text begin to reduce medical errors, to improve population health, to reduce health disparities, and new text end 55.8 new text begin to reduce chronic disease. The commissioner's coordination efforts shall include but not new text end 55.9 new text begin be limited to: new text end 55.10 new text begin (1) assisting in the development and support of health information technology new text end 55.11 new text begin regional extension centers established under section 3012(c) of the HITECH Act to new text end 55.12 new text begin provide technical assistance and disseminate best practices; and new text end 55.13 new text begin (2) providing supplemental information to the best practices gathered by regional new text end 55.14 new text begin centers to ensure that the information is relayed in a meaningful way to the Minnesota new text end 55.15 new text begin health care community. new text end 55.16 new text begin (c) The commissioner, in consultation with the e-Health Advisory Committee, shall new text end 55.17 new text begin monitor national activity related to health information technology and shall coordinate new text end 55.18 new text begin statewide input on policy development. The commissioner shall coordinate statewide new text end 55.19 new text begin responses to proposed federal health information technology regulations in order to ensure new text end 55.20 new text begin that the needs of the Minnesota health care community are adequately and efficiently new text end 55.21 new text begin addressed in the proposed regulations. The commissioner's responses may include, but new text end 55.22 new text begin are not limited to: new text end 55.23 new text begin (1) reviewing and evaluating any standard, implementation specification, or new text end 55.24 new text begin certification criteria proposed by the national HIT standards committee; new text end 55.25 new text begin (2) reviewing and evaluating policy proposed by the national HIT policy new text end 55.26 new text begin committee relating to the implementation of a nationwide health information technology new text end 55.27 new text begin infrastructure; new text end 55.28 new text begin (3) monitoring and responding to activity related to the development of quality new text end 55.29 new text begin measures and other measures as required by section 4101 of the HITECH Act. Any new text end 55.30 new text begin response related to quality measures shall consider and address the quality efforts required new text end 55.31 new text begin under chapter 62U; and new text end 55.32 new text begin (4) monitoring and responding to national activity related to privacy, security, and new text end 55.33 new text begin data stewardship of electronic health information and individually identifiable health new text end 55.34 new text begin information. new text end 55.35 new text begin (d) To the extent that the state is either required or allowed to apply, or designate an new text end 55.36 new text begin entity to apply for or carry out activities and programs under section 3013 of the HITECH new text end 56.1 new text begin Act, the commissioner of health, in consultation with the e-Health Advisory Committee new text end 56.2 new text begin and the commissioner of human services, shall be the lead applicant or sole designating new text end 56.3 new text begin authority. The commissioner shall make such designations consistent with the goals and new text end 56.4 new text begin objectives of sections 62J.495 to 62J.497, and sections 62J.50 to 62J.61. new text end 56.5 new text begin (e) The commissioner of human services shall apply for funding necessary to new text end 56.6 new text begin administer the incentive payments to providers authorized under title IV of the American new text end 56.7 new text begin Recovery and Reinvestment Act. new text end 56.8 new text begin (f) The commissioner shall include in the report to the legislature information on the new text end 56.9 new text begin activities of this subdivision and provide recommendations on any relevant policy changes new text end 56.10 new text begin that should be considered in Minnesota. new text end 56.11     new text begin Subd. 5. new text end new text begin Collection of data for assessment and eligibility determination. new text end new text begin (a) new text end 56.12 new text begin The commissioner of health, in consultation with the commissioner of human services, new text end 56.13 new text begin may require providers, dispensers, group purchasers, and pharmaceutical electronic data new text end 56.14 new text begin intermediaries to submit data in a form and manner specified by the commissioner to new text end 56.15 new text begin assess the status of adoption, effective use, and interoperability of electronic health new text end 56.16 new text begin records for the purpose of: new text end 56.17 new text begin (1) demonstrating Minnesota's progress on goals established by the Office of the new text end 56.18 new text begin National Coordinator to accelerate the adoption and effective use of health information new text end 56.19 new text begin technology established under the HITECH Act; new text end 56.20 new text begin (2) assisting the Center for Medicare and Medicaid Services and Department of new text end 56.21 new text begin Human Services in determining eligibility of health care professionals and hospitals new text end 56.22 new text begin to receive federal incentives for the adoption and effective use of health information new text end 56.23 new text begin technology under the HITECH Act or other federal incentive programs; new text end 56.24 new text begin (3) assisting the Office of the National Coordinator in completing required new text end 56.25 new text begin assessments of the impact of the implementation and effective use of health information new text end 56.26 new text begin technology in achieving goals identified in the national strategic plan, and completing new text end 56.27 new text begin studies required by the HITECH Act; new text end 56.28 new text begin (4) providing the data necessary to assist the Office of the National Coordinator in new text end 56.29 new text begin conducting evaluations of regional extension centers as required by the HITECH Act; and new text end 56.30 new text begin (5) other purposes as necessary to support the implementation of the HITECH Act. new text end 56.31 new text begin (b) The commissioner shall coordinate with the commissioner of human services new text end 56.32 new text begin and other state agencies in the collection of data required under this section to: new text end 56.33 new text begin (1) avoid duplicative reporting requirements; new text end 56.34 new text begin (2) maximize efficiencies in the development of reports on state activities as new text end 56.35 new text begin required by HITECH; and new text end 57.1 new text begin (3) determine health professional and hospital eligibility for incentives available new text end 57.2 new text begin under the HITECH Act. new text end 57.3 new text begin (c) The commissioner must not collect data or publish analyses that identify, or could new text end 57.4 new text begin potentially identify, individual patients. The commissioner must not collect individual new text end 57.5 new text begin data in identified or de-identified form. new text end 57.6    Sec. 2. Minnesota Statutes 2008, section 62J.496, is amended to read: 57.762J.496 ELECTRONIC HEALTH RECORD SYSTEM REVOLVING 57.8ACCOUNT AND LOAN PROGRAM. 57.9    Subdivision 1. Account establishment. new text begin (a) new text end An account is established to new text begin : new text end provide 57.10loans to eligible borrowers to assist in financing the installation or support of an 57.11interoperable health record system. The system must provide for the interoperable 57.12exchange of health care information between the applicant and, at a minimum, a hospital 57.13system, pharmacy, and a health care clinic or other physician group. 57.14 new text begin (1) finance the purchase of certified electronic health records or qualified electronic new text end 57.15 new text begin health records as defined in section 62J.495, subdivision 1a; new text end 57.16 new text begin (2) enhance the utilization of electronic health record technology, which may include new text end 57.17 new text begin costs associated with upgrading the technology to meet the criteria necessary to be a new text end 57.18 new text begin certified electronic health record or a qualified electronic health record; new text end 57.19 new text begin (3) train personnel in the use of electronic health record technology; and new text end 57.20 new text begin (4) improve the secure electronic exchange of health information. new text end 57.21 new text begin (b) Amounts deposited in the account, including any grant funds obtained through new text end 57.22 new text begin federal or other sources, loan repayments, and interest earned on the amounts shall be new text end 57.23 new text begin used only for awarding loans or loan guarantees, as a source of reserve and security for new text end 57.24 new text begin leveraged loans, or for the administration of the account. new text end 57.25 new text begin (c) The commissioner may accept contributions to the account from private sector new text end 57.26 new text begin entities subject to the following provisions: new text end 57.27 new text begin (1) the contributing entity may not specify the recipient or recipients of any loan new text end 57.28 new text begin issued under this subdivision; new text end 57.29 new text begin (2) the commissioner shall make public the identity of any private contributor to the new text end 57.30 new text begin loan fund, as well as the amount of the contribution provided; and new text end 57.31 new text begin (3) the commissioner may issue letters of commendation or make other awards that new text end 57.32 new text begin have no financial value to any such entity. new text end 57.33 new text begin A contributing entity may not specify that the recipient or recipients of any loan use new text end 57.34 new text begin specific products or services, nor may the contributing entity imply that a contribution is new text end 57.35 new text begin an endorsement of any specific product or service. new text end 58.1 new text begin (d) The commissioner may use the loan funds to reimburse private sector entities new text end 58.2 new text begin for any contribution made to the loan fund. Reimbursement to private entities may not new text end 58.3 new text begin exceed the principle amount contributed to the loan fund. new text end 58.4 new text begin (e) The commissioner may use funds deposited in the account to guarantee, or new text end 58.5 new text begin purchase insurance for, a local obligation if the guarantee or purchase would improve new text end 58.6 new text begin credit market access or reduce the interest rate applicable to the obligation involved. new text end 58.7 new text begin (f) The commissioner may use funds deposited in the account as a source of revenue new text end 58.8 new text begin or security for the payment of principal and interest on revenue or bonds issued by the new text end 58.9 new text begin state if the proceeds of the sale of the bonds will be deposited into the loan fund. new text end 58.10    Subd. 2. Eligibility. (a) "Eligible borrower" means one of the following: 58.11 new text begin (1) federally qualified health centers; new text end 58.12    (1) new text begin (2) new text end community clinics, as defined under section 145.9268; 58.13    (2) new text begin (3) nonprofit or local unit of government new text end hospitals eligible for rural hospital 58.14capital improvement grants, as defined in section new text begin licensed under sections 144.50 new text end 58.15 new text begin to 144.56 new text end ; 58.16    (3) physician clinics located in a community with a population of less than 50,000 58.17according to United States Census Bureau statistics and outside the seven-county 58.18metropolitan area; 58.19 new text begin (4) individual or small group physician practices that are focused primarily on new text end 58.20 new text begin primary care; new text end 58.21    (4) new text begin (5) new text end nursing facilities licensed under sections 144A.01 to 144A.27; and 58.22 new text begin (6) local public health departments as defined in chapter 145A; and new text end 58.23    (5) new text begin (7) new text end other providers of health or health care services approved by the 58.24commissioner for which interoperable electronic health record capability would improve 58.25quality of care, patient safety, or community health. 58.26 new text begin (b) The commissioner shall administer the loan fund to prioritize support and new text end 58.27 new text begin assistance to: new text end 58.28 new text begin (1) critical access hospitals; new text end 58.29 new text begin (2) federally qualified health centers; new text end 58.30 new text begin (3) entities that serve uninsured, underinsured, and medically underserved new text end 58.31 new text begin individuals, regardless of whether such area is urban or rural; and new text end 58.32 new text begin (4) individual or small group practices that are primarily focused on primary care. new text end 58.33    (b) To be eligible for a loan under this section, the new text begin (c) An eligible new text end applicant must 58.34submit a loan application to the commissioner of health on forms prescribed by the 58.35commissioner. The application must include, at a minimum: 59.1    (1) the amount of the loan requested and a description of the purpose or project 59.2for which the loan proceeds will be used; 59.3    (2) a quote from a vendor; 59.4    (3) a description of the health care entities and other groups participating in the 59.5project; 59.6    (4) evidence of financial stability and a demonstrated ability to repay the loan; and 59.7    (5) a description of how the system to be financed interconnects new text begin interoperates new text end or 59.8plans in the future to interconnect new text begin interoperate new text end with other health care entities and provider 59.9groups located in the same geographical area new text begin ; new text end 59.10 new text begin (6) a plan on how the certified electronic health record technology will be maintained new text end 59.11 new text begin and supported over time; and new text end 59.12 new text begin (7) any other requirements for applications included or developed pursuant to new text end 59.13 new text begin section 3014 of the HITECH Act new text end . 59.14    Subd. 3. Loans. (a) The commissioner of health may make a no interest new text begin loan or new text end 59.15 new text begin low interest new text end loan to a provider or provider group who is eligible under subdivision 2 59.16on a first-come, first-served basis provided that the applicant is able to comply with this 59.17section new text begin consistent with the priorities established in subdivision 2 new text end . The total accumulative 59.18loan principal must not exceed $1,500,000 new text begin $3,000,000 new text end per loan. new text begin The interest rate for each new text end 59.19 new text begin loan, if imposed, shall not exceed the current market interest rate. new text end The commissioner of 59.20health has discretion over the size new text begin , interest rate, new text end and number of loans made. new text begin Nothing in new text end 59.21 new text begin this section shall require the commissioner to make a loan to an eligible borrower under new text end 59.22 new text begin subdivision 2. new text end 59.23    (b) The commissioner of health may prescribe forms and establish an application 59.24process and, notwithstanding section 16A.1283, may impose a reasonable nonrefundable 59.25application fee to cover the cost of administering the loan program. Any application 59.26fees imposed and collected under the electronic health records system revolving account 59.27and loan program in this section are appropriated to the commissioner of health for the 59.28duration of the loan program. new text begin The commissioner may apply for and use all federal funds new text end 59.29 new text begin available through the HITECH Act to administer the loan program. new text end 59.30    (c) new text begin For loans approved prior to July 1, 2009, new text end the borrower must begin repaying the 59.31principal no later than two years from the date of the loan. Loans must be amortized no 59.32later than six years from the date of the loan. 59.33 new text begin (d) For loans granted on January 1, 2010, or thereafter, the borrower must begin new text end 59.34 new text begin repaying the principle no later than one year from the date of the loan. Loans must be new text end 59.35 new text begin amortized no later than six years after the date of the loan. new text end 60.1    (d) Repayments new text begin (e) All repayments and interest paid on each loan new text end must be credited 60.2to the account. 60.3 new text begin (f) The loan agreement shall include the assurances that borrower meets requirements new text end 60.4 new text begin included or developed pursuant to section 3014 of the HITECH Act. The requirements new text end 60.5 new text begin shall include, but are not limited to: new text end 60.6 new text begin (1) submitting reports on quality measures in compliance with regulations adopted new text end 60.7 new text begin by the federal government; new text end 60.8 new text begin (2) demonstrating that any certified electronic health record technology purchased, new text end 60.9 new text begin improved, or otherwise financially supported by this loan program is used to exchange new text end 60.10 new text begin health information in a manner that, in accordance with law and standards applicable to new text end 60.11 new text begin the exchange of information, improves the quality of health care; new text end 60.12 new text begin (3) including a plan on how the borrower intends to maintain and support the new text end 60.13 new text begin certified electronic health record technology over time and the resources expected to be new text end 60.14 new text begin used to maintain and support the technology purchased with the loan; and new text end 60.15 new text begin (4) complying with other requirements the secretary may require to use loans funds new text end 60.16 new text begin under the HITECH Act. new text end 60.17    Subd. 4. Data classification. Data collected by the commissioner of health on the 60.18application to determine eligibility under subdivision 2 and to monitor borrowers' default 60.19risk or collect payments owed under subdivision 3 are (1) private data on individuals as 60.20defined in section 13.02, subdivision 12; and (2) nonpublic data as defined in section 60.2113.02, subdivision 9 . The names of borrowers and the amounts of the loans granted 60.22are public data. 60.23    Sec. 3. Minnesota Statutes 2008, section 62J.497, subdivision 1, is amended to read: 60.24    Subdivision 1. Definitions. For the purposes of this section, the following terms 60.25have the meanings given. 60.26 new text begin (a) "Backward compatible" means that the newer version of a data transmission new text end 60.27 new text begin standard would retain, at a minimum, the full functionality of the versions previously new text end 60.28 new text begin adopted, and would permit the successful completion of the applicable transactions with new text end 60.29 new text begin entities that continue to use the older versions. new text end 60.30    (a) new text begin (b) new text end "Dispense" or "dispensing" has the meaning given in section 151.01, 60.31subdivision 30. Dispensing does not include the direct administering of a controlled 60.32substance to a patient by a licensed health care professional. 60.33    (b) new text begin (c) new text end "Dispenser" means a person authorized by law to dispense a controlled 60.34substance, pursuant to a valid prescription. 61.1    (c) new text begin (d) new text end "Electronic media" has the meaning given under Code of Federal Regulations, 61.2title 45, part 160.103. 61.3    (d) new text begin (e) new text end "E-prescribing" means the transmission using electronic media of prescription 61.4or prescription-related information between a prescriber, dispenser, pharmacy benefit 61.5manager, or group purchaser, either directly or through an intermediary, including 61.6an e-prescribing network. E-prescribing includes, but is not limited to, two-way 61.7transmissions between the point of care and the dispenser new text begin and two-way transmissions new text end 61.8 new text begin related to eligibility, formulary, and medication history information new text end . 61.9    (e) new text begin (f) new text end "Electronic prescription drug program" means a program that provides for 61.10e-prescribing. 61.11    (f) new text begin (g) new text end "Group purchaser" has the meaning given in section 62J.03, subdivision 6. 61.12    (g) new text begin (h) new text end "HL7 messages" means a standard approved by the standards development 61.13organization known as Health Level Seven. 61.14    (h) new text begin (i) new text end "National Provider Identifier" or "NPI" means the identifier described under 61.15Code of Federal Regulations, title 45, part 162.406. 61.16    (i) new text begin (j) new text end "NCPDP" means the National Council for Prescription Drug Programs, Inc. 61.17    (j) new text begin (k) new text end "NCPDP Formulary and Benefits Standard" means the National Council for 61.18Prescription Drug Programs Formulary and Benefits Standard, Implementation Guide, 61.19Version 1, Release 0, October 2005. 61.20    (k) new text begin (l) new text end "NCPDP SCRIPT Standard" means the National Council for Prescription 61.21Drug Programs Prescriber/Pharmacist Interface SCRIPT Standard, Implementation 61.22Guide Version 8, Release 1 (Version 8.1), October 2005 new text begin , or the most recent standard new text end 61.23 new text begin adopted by the Centers for Medicare and Medicaid Services for e-prescribing under new text end 61.24 new text begin Medicare Part D as required by section 1860D-4(e)(4)(D) of the Social Security Act, and new text end 61.25 new text begin regulations adopted under it. The standards shall be implemented according to the Centers new text end 61.26 new text begin for Medicare and Medicaid Services schedule for compliance. Subsequently released new text end 61.27 new text begin versions of the NCPDP SCRIPT Standard may be used, provided that the new version new text end 61.28 new text begin of the standard is backward compatible to the current version adopted by the Centers for new text end 61.29 new text begin Medicare and Medicaid Services new text end . 61.30    (l) new text begin (m) new text end "Pharmacy" has the meaning given in section 151.01, subdivision 2. 61.31    (m) new text begin (n) new text end "Prescriber" means a licensed health care professional who is authorized to 61.32prescribe a controlled substance under section 152.12, subdivision 1. new text begin practitioner, other new text end 61.33 new text begin than a veterinarian, as defined in section 151.01, subdivision 23. new text end 61.34    (n) new text begin (o) new text end "Prescription-related information" means information regarding eligibility for 61.35drug benefits, medication history, or related health or drug information. 62.1    (o) new text begin (p) new text end "Provider" or "health care provider" has the meaning given in section 62J.03, 62.2subdivision 8. 62.3    Sec. 4. Minnesota Statutes 2008, section 62J.497, subdivision 2, is amended to read: 62.4    Subd. 2. Requirements for electronic prescribing. (a) Effective January 1, 2011, 62.5all providers, group purchasers, prescribers, and dispensers must establish and new text begin , new text end maintain new text begin , new text end 62.6 new text begin and use new text end an electronic prescription drug program that complies new text begin . This program must comply new text end 62.7with the applicable standards in this section for transmitting, directly or through an 62.8intermediary, prescriptions and prescription-related information using electronic media. 62.9    (b) Nothing in this section requires providers, group purchasers, prescribers, or 62.10dispensers to conduct the transactions described in this section. If transactions described in 62.11this section are conducted, they must be done electronically using the standards described 62.12in this section. Nothing in this section requires providers, group purchasers, prescribers, 62.13or dispensers to electronically conduct transactions that are expressly prohibited by other 62.14sections or federal law. 62.15    (c) Providers, group purchasers, prescribers, and dispensers must use either HL7 62.16messages or the NCPDP SCRIPT Standard to transmit prescriptions or prescription-related 62.17information internally when the sender and the recipient are part of the same legal entity. If 62.18an entity sends prescriptions outside the entity, it must use the NCPDP SCRIPT Standard 62.19or other applicable standards required by this section. Any pharmacy within an entity 62.20must be able to receive electronic prescription transmittals from outside the entity using 62.21the adopted NCPDP SCRIPT Standard. This exemption does not supersede any Health 62.22Insurance Portability and Accountability Act (HIPAA) requirement that may require the 62.23use of a HIPAA transaction standard within an organization. 62.24    (d) Entities transmitting prescriptions or prescription-related information where the 62.25prescriber is required by law to issue a prescription for a patient to a nonprescribing 62.26provider that in turn forwards the prescription to a dispenser are exempt from the 62.27requirement to use the NCPDP SCRIPT Standard when transmitting prescriptions or 62.28prescription-related information. 62.29    Sec. 5. Minnesota Statutes 2008, section 62J.497, is amended by adding a subdivision 62.30to read: 62.31     new text begin Subd. 4. new text end new text begin Development and use of uniform formulary exception form. new text end new text begin (a) The new text end 62.32 new text begin commissioner of health, in consultation with the Minnesota Administrative Uniformity new text end 62.33 new text begin Committee, shall develop by July 1, 2009, or six weeks after enactment of this subdivision, new text end 62.34 new text begin whichever is later, a uniform formulary exception form that allows health care providers new text end 63.1 new text begin to request exceptions from group purchaser formularies using a uniform form. Upon new text end 63.2 new text begin development of the form, all health care providers must submit requests for formulary new text end 63.3 new text begin exceptions using the uniform form, and all group purchasers must accept this form from new text end 63.4 new text begin health care providers. new text end 63.5     new text begin (b) No later than January 1, 2011, the uniform formulary exception form must be new text end 63.6 new text begin accessible and submitted by health care providers, and accepted and processed by group new text end 63.7 new text begin purchasers, through secure electronic transmissions. Facsimile shall not be considered new text end 63.8 new text begin secure electronic transmissions. new text end 63.9    Sec. 6. Minnesota Statutes 2008, section 62J.497, is amended by adding a subdivision 63.10to read: 63.11     new text begin Subd. 5. new text end new text begin Electronic drug prior authorization standardization and transmission. new text end 63.12     new text begin (a) The commissioner of health, in consultation with the Minnesota e-Health Advisory new text end 63.13 new text begin Committee and the Minnesota Administrative Uniformity Committee, shall, by February new text end 63.14 new text begin 15, 2010, identify an outline on how best to standardize drug prior authorization request new text end 63.15 new text begin transactions between providers and group purchasers with the goal of maximizing new text end 63.16 new text begin administrative simplification and efficiency in preparation for electronic transmissions. new text end 63.17     new text begin (b) No later than January 1, 2011, drug prior authorization requests must be new text end 63.18 new text begin accessible and submitted by health care providers, and accepted and processed by group new text end 63.19 new text begin purchasers, electronically through secure electronic transmissions. Facsimile shall not be new text end 63.20 new text begin considered electronic transmission. new text end 63.21    Sec. 7. new text begin [62Q.676] MEDICATION THERAPY MANAGEMENT. new text end 63.22     new text begin A pharmacy benefit manager that provides prescription drug services must make new text end 63.23 new text begin available medication therapy management services for enrollees taking four or more new text end 63.24 new text begin prescriptions to treat or prevent two or more chronic medical conditions. For purposes new text end 63.25 new text begin of this section, "medication therapy management" means the provision of the following new text end 63.26 new text begin pharmaceutical care services by, or under the supervision of, a licensed pharmacist to new text end 63.27 new text begin optimize the therapeutic outcomes of the patient's medications: new text end 63.28     new text begin (1) performing a comprehensive medication review to identify, resolve, and prevent new text end 63.29 new text begin medication-related problems, including adverse drug events; new text end 63.30     new text begin (2) communicating essential information to the patient's other primary care new text end 63.31 new text begin providers; and new text end 63.32     new text begin (3) providing verbal education and training designed to enhance patient new text end 63.33 new text begin understanding and appropriate use of the patient's medications. new text end 64.1     new text begin Nothing in this section shall be construed to expand or modify the scope of practice new text end 64.2 new text begin of the pharmacist as defined in section 151.01, subdivision 27. new text end 64.3    Sec. 8. Minnesota Statutes 2008, section 144.122, is amended to read: 64.4144.122 LICENSE, PERMIT, AND SURVEY FEES. 64.5    (a) The state commissioner of health, by rule, may prescribe procedures and fees 64.6for filing with the commissioner as prescribed by statute and for the issuance of original 64.7and renewal permits, licenses, registrations, and certifications issued under authority of 64.8the commissioner. The expiration dates of the various licenses, permits, registrations, 64.9and certifications as prescribed by the rules shall be plainly marked thereon. Fees may 64.10include application and examination fees and a penalty fee for renewal applications 64.11submitted after the expiration date of the previously issued permit, license, registration, 64.12and certification. The commissioner may also prescribe, by rule, reduced fees for permits, 64.13licenses, registrations, and certifications when the application therefor is submitted 64.14during the last three months of the permit, license, registration, or certification period. 64.15Fees proposed to be prescribed in the rules shall be first approved by the Department of 64.16Finance. All fees proposed to be prescribed in rules shall be reasonable. The fees shall be 64.17in an amount so that the total fees collected by the commissioner will, where practical, 64.18approximate the cost to the commissioner in administering the program. All fees collected 64.19shall be deposited in the state treasury and credited to the state government special revenue 64.20fund unless otherwise specifically appropriated by law for specific purposes. 64.21    (b) The commissioner may charge a fee for voluntary certification of medical 64.22laboratories and environmental laboratories, and for environmental and medical laboratory 64.23services provided by the department, without complying with paragraph (a) or chapter 14. 64.24Fees charged for environment and medical laboratory services provided by the department 64.25must be approximately equal to the costs of providing the services. 64.26    (c) The commissioner may develop a schedule of fees for diagnostic evaluations 64.27conducted at clinics held by the services for children with disabilities program. All 64.28receipts generated by the program are annually appropriated to the commissioner for use 64.29in the maternal and child health program. 64.30    (d) The commissioner shall set license fees for hospitals and nursing homes that are 64.31not boarding care homes at the following levels: 65.1 65.2 65.3 65.4 Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and American Osteopathic Association (AOA) hospitals $7,555 new text begin $7,655 new text end plus $13 new text begin $16 new text end per bed 65.5 Non-JCAHO and non-AOA hospitals $5,180 new text begin $5,280 new text end plus $247 new text begin $250 new text end per bed 65.6 Nursing home $183 plus $91 per bed 65.7    The commissioner shall set license fees for outpatient surgical centers, boarding care 65.8homes, and supervised living facilities at the following levels: 65.9 Outpatient surgical centers $3,349 new text begin $3,712 new text end 65.10 Boarding care homes $183 plus $91 per bed 65.11 Supervised living facilities $183 plus $91 per bed. 65.12    (e) Unless prohibited by federal law, the commissioner of health shall charge 65.13applicants the following fees to cover the cost of any initial certification surveys required 65.14to determine a provider's eligibility to participate in the Medicare or Medicaid program: 65.15 Prospective payment surveys for hospitals $ 900 65.16 Swing bed surveys for nursing homes $ 1,200 65.17 Psychiatric hospitals $ 1,400 65.18 Rural health facilities $ 1,100 65.19 Portable x-ray providers $ 500 65.20 Home health agencies $ 1,800 65.21 Outpatient therapy agencies $ 800 65.22 End stage renal dialysis providers $ 2,100 65.23 Independent therapists $ 800 65.24 Comprehensive rehabilitation outpatient facilities $ 1,200 65.25 Hospice providers $ 1,700 65.26 Ambulatory surgical providers $ 1,800 65.27 Hospitals $ 4,200 65.28 65.29 65.30 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. 66.1    These fees shall be submitted at the time of the application for federal certification 66.2and shall not be refunded. All fees collected after the date that the imposition of fees is not 66.3prohibited by federal law shall be deposited in the state treasury and credited to the state 66.4government special revenue fund. 66.5    Sec. 9. Minnesota Statutes 2008, section 144.226, subdivision 4, is amended to read: 66.6    Subd. 4. Vital records surcharge. (a) In addition to any fee prescribed under 66.7subdivision 1, there is a nonrefundable surcharge of $2 for each certified and noncertified 66.8birth, stillbirth, or death record, and for a certification that the record cannot be found. 66.9The local or state registrar shall forward this amount to the commissioner of finance to 66.10be deposited into the state government special revenue fund. This surcharge shall not be 66.11charged under those circumstances in which no fee for a birth, stillbirth, or death record is 66.12permitted under subdivision 1, paragraph (a). 66.13(b) Effective August 1, 2005, to June 30, 2009, the surcharge in paragraph (a) shall 66.14be new text begin is new text end $4. 66.15    Sec. 10. Minnesota Statutes 2008, section 148.6445, is amended by adding a 66.16subdivision to read: 66.17     new text begin Subd. 2a. new text end new text begin Duplicate license fee. new text end new text begin The fee for a duplicate license is $25. new text end 66.18ARTICLE 5 66.19HEALTH CARE 66.20    Section 1. Minnesota Statutes 2008, section 60A.092, subdivision 2, is amended to 66.21read: 66.22    Subd. 2. Licensed assuming insurer. Reinsurance is ceded to an assuming insurer 66.23if the assuming insurer is licensed to transact insurance or reinsurance in this state. new text begin For new text end 66.24 new text begin purposes of reinsuring any health risk, an insurer is defined under section 62A.63. new text end 66.25    Sec. 2. Minnesota Statutes 2008, section 62D.03, subdivision 4, is amended to read: 66.26    Subd. 4. Application requirements. Each application for a certificate of authority 66.27shall be verified by an officer or authorized representative of the applicant, and shall be 66.28in a form prescribed by the commissioner of health. Each application shall include the 66.29following: 66.30(a) a copy of the basic organizational document, if any, of the applicant and of 66.31each major participating entity; such as the articles of incorporation, or other applicable 66.32documents, and all amendments thereto; 67.1(b) a copy of the bylaws, rules and regulations, or similar document, if any, and all 67.2amendments thereto which regulate the conduct of the affairs of the applicant and of 67.3each major participating entity; 67.4(c) a list of the names, addresses, and official positions of the following: 67.5(1) all members of the board of directors, or governing body of the local government 67.6unit, and the principal officers and shareholders of the applicant organization; and 67.7(2) all members of the board of directors, or governing body of the local government 67.8unit, and the principal officers of the major participating entity and each shareholder 67.9beneficially owning more than ten percent of any voting stock of the major participating 67.10entity; 67.11The commissioner may by rule identify persons included in the term "principal 67.12officers"; 67.13(d) a full disclosure of the extent and nature of any contract or financial arrangements 67.14between the following: 67.15(1) the health maintenance organization and the persons listed in clause (c)(1); 67.16(2) the health maintenance organization and the persons listed in clause (c)(2); 67.17(3) each major participating entity and the persons listed in clause (c)(1) concerning 67.18any financial relationship with the health maintenance organization; and 67.19(4) each major participating entity and the persons listed in clause (c)(2) concerning 67.20any financial relationship with the health maintenance organization; 67.21(e) the name and address of each participating entity and the agreed upon duration of 67.22each contract or agreement; 67.23(f) a copy of the form of each contract binding the participating entities and the 67.24health maintenance organization. Contractual provisions shall be consistent with the 67.25purposes of sections 62D.01 to 62D.30, in regard to the services to be performed under the 67.26contract, the manner in which payment for services is determined, the nature and extent 67.27of responsibilities to be retained by the health maintenance organization, the nature and 67.28extent of risk sharing permissible, and contractual termination provisions; 67.29(g) a copy of each contract binding major participating entities and the health 67.30maintenance organization. Contract information filed with the commissioner shall be 67.31confidential and subject to the provisions of section 13.37, subdivision 1, clause (b), upon 67.32the request of the health maintenance organization. 67.33Upon initial filing of each contract, the health maintenance organization shall file 67.34a separate document detailing the projected annual expenses to the major participating 67.35entity in performing the contract and the projected annual revenues received by the entity 67.36from the health maintenance organization for such performance. The commissioner 68.1shall disapprove any contract with a major participating entity if the contract will result 68.2in an unreasonable expense under section 62D.19. The commissioner shall approve or 68.3disapprove a contract within 30 days of filing. 68.4Within 120 days of the anniversary of the implementation of each contract, the 68.5health maintenance organization shall file a document detailing the actual expenses 68.6incurred and reported by the major participating entity in performing the contract in the 68.7preceding year and the actual revenues received from the health maintenance organization 68.8by the entity in payment for the performance; 68.9(h) a statement generally describing the health maintenance organization, its health 68.10maintenance contracts and separate health service contracts, facilities, and personnel, 68.11including a statement describing the manner in which the applicant proposes to provide 68.12enrollees with comprehensive health maintenance services and separate health services; 68.13(i) a copy of the form of each evidence of coverage to be issued to the enrollees; 68.14(j) a copy of the form of each individual or group health maintenance contract 68.15and each separate health service contract which is to be issued to enrollees or their 68.16representatives; 68.17(k) financial statements showing the applicant's assets, liabilities, and sources of 68.18financial support. If the applicant's financial affairs are audited by independent certified 68.19public accountants, a copy of the applicant's most recent certified financial statement 68.20may be deemed to satisfy this requirement; 68.21(l) a description of the proposed method of marketing the plan, a schedule of 68.22proposed charges, and a financial plan which includes a three-year projection of the 68.23expenses and income and other sources of future capital; 68.24(m) a statement reasonably describing the geographic area or areas to be served and 68.25the type or types of enrollees to be served; 68.26(n) a description of the complaint procedures to be utilized as required under section 68.2762D.11 ; 68.28(o) a description of the procedures and programs to be implemented to meet the 68.29requirements of section 62D.04, subdivision 1, clauses (b) and (c) and to monitor the 68.30quality of health care provided to enrollees; 68.31(p) a description of the mechanism by which enrollees will be afforded an 68.32opportunity to participate in matters of policy and operation under section 62D.06; 68.33(q) a copy of any agreement between the health maintenance organization and 68.34an insurer or new text begin , including any new text end nonprofit health service corporation new text begin or another health new text end 68.35 new text begin maintenance organization, new text end regarding reinsurance, stop-loss coverage, insolvency 69.1coverage, or any other type of coverage for potential costs of health services, as authorized 69.2in sections 62D.04, subdivision 1, clause (f), 62D.05, subdivision 3, and 62D.13; 69.3(r) a copy of the conflict of interest policy which applies to all members of the board 69.4of directors and the principal officers of the health maintenance organization, as described 69.5in section 62D.04, subdivision 1, paragraph (g). All currently licensed health maintenance 69.6organizations shall also file a conflict of interest policy with the commissioner within 60 69.7days after August 1, 1990, or at a later date if approved by the commissioner; 69.8(s) a copy of the statement that describes the health maintenance organization's prior 69.9authorization administrative procedures; and 69.10(t) other information as the commissioner of health may reasonably require to be 69.11provided. 69.12    Sec. 3. Minnesota Statutes 2008, section 62D.05, subdivision 3, is amended to read: 69.13    Subd. 3. Contracts; health services. A health maintenance organization may 69.14contract with providers of health care services to render the services the health maintenance 69.15organization has promised to provide under the terms of its health maintenance contracts, 69.16may, subject to section 62D.12, subdivision 11, enter into separate prepaid dental contracts, 69.17or other separate health service contracts, may, subject to the limitations of section 69.1862D.04, subdivision 1 , clause (f), contract with insurance companies and new text begin , including new text end 69.19 nonprofit health service plan corporations new text begin or other health maintenance organizations, new text end 69.20for insurance, indemnity or reimbursement of its cost of providing health care services 69.21for enrollees or against the risks incurred by the health maintenance organization, may 69.22contract with insurance companies and nonprofit health service plan corporations for 69.23insolvency insurance coverage, and may contract with insurance companies and nonprofit 69.24health service plan corporations to insure or cover the enrollees' costs and expenses in the 69.25health maintenance organization, including the customary prepayment amount and any 69.26co-payment obligations new text begin , and may contract to provide reinsurance or insolvency insurance new text end 69.27 new text begin coverage to health insurers or nonprofit health service plan corporations new text end . 69.28    Sec. 4. Minnesota Statutes 2008, section 62J.692, subdivision 7, is amended to read: 69.29    Subd. 7. Transfers from the commissioner of human services. (a) The amount 69.30transferred according to section 256B.69, subdivision 5c, paragraph (a), clause (1), shall 69.31be distributed by the commissioner annually to clinical medical education programs that 69.32meet the qualifications of subdivision 3 based on the formula in subdivision 4, paragraph 69.33(a) new text begin Of the amount transferred according to section 256B.69, subdivision 5c, paragraph (a), new text end 69.34 new text begin clauses (1) to (4), $21,714,000 shall be distributed as follows: new text end 70.1 new text begin (1) $2,157,000 shall be distributed by the commissioner to the University of new text end 70.2 new text begin Minnesota Board of Regents for the purposes described in sections 137.38 to 137.40; new text end 70.3 new text begin (2) $1,035,360 shall be distributed by the commissioner to the Hennepin County new text end 70.4 new text begin Medical Center for clinical medical education; new text end 70.5 new text begin (3) $17,400,000 shall be distributed by the commissioner to the University of new text end 70.6 new text begin Minnesota Board of Regents for purposes of medial education; new text end 70.7 new text begin (4) $1,121,640 shall be distributed by the commissioner to clinical medical education new text end 70.8 new text begin dental innovation grants in accordance with subdivision 7a; and new text end 70.9 new text begin (5) the remainder of the amount transferred according to section 256B.69, new text end 70.10 new text begin subdivision 5c, clauses (1) to (4), shall be distributed by the commissioner annually to new text end 70.11 new text begin clinical medical education programs that meet the qualifications of subdivision 3 based on new text end 70.12 new text begin the formula in subdivision 4, paragraph (a) new text end . 70.13(b) Fifty percent of the amount transferred according to section 256B.69, subdivision 70.145c , paragraph (a), clause (2), shall be distributed by the commissioner to the University of 70.15Minnesota Board of Regents for the purposes described in sections to . Of 70.16the remaining amount transferred according to section 256B.69, subdivision 5c, paragraph 70.17(a), clause (2), 24 percent of the amount shall be distributed by the commissioner to 70.18the Hennepin County Medical Center for clinical medical education. The remaining 26 70.19percent of the amount transferred shall be distributed by the commissioner in accordance 70.20with subdivision 7a. If the federal approval is not obtained for the matching funds under 70.21section 256B.69, subdivision 5c, paragraph (a), clause (2), 100 percent of the amount 70.22transferred under this paragraph shall be distributed by the commissioner to the University 70.23of Minnesota Board of Regents for the purposes described in sections to . 70.24(c) The amount transferred according to section 256B.69, subdivision 5c, paragraph 70.25(a), clauses (3) and (4), shall be distributed by the commissioner upon receipt to the 70.26University of Minnesota Board of Regents for the purposes of clinical graduate medical 70.27education. 70.28    Sec. 5. Minnesota Statutes 2008, section 256.01, subdivision 2b, is amended to read: 70.29    Subd. 2b. Performance payments. (a) The commissioner shall develop and 70.30implement a pay-for-performance system to provide performance payments to eligible 70.31medical groups and clinics that demonstrate optimum care in serving individuals 70.32with chronic diseases who are enrolled in health care programs administered by the 70.33commissioner under chapters 256B, 256D, and 256L. The commissioner may receive any 70.34federal matching money that is made available through the medical assistance program 70.35for managed care oversight contracted through vendors, including consumer surveys, 71.1studies, and external quality reviews as required by the federal Balanced Budget Act of 71.21997, Code of Federal Regulations, title 42, part 438-managed care, subpart E-external 71.3quality review. Any federal money received for managed care oversight is appropriated 71.4to the commissioner for this purpose. The commissioner may expend the federal money 71.5received in either year of the biennium. 71.6    (b) Effective July 1, 2008, or upon federal approval, whichever is later, the 71.7commissioner shall develop and implement a patient incentive health program to provide 71.8incentives and rewards to patients who are enrolled in health care programs administered 71.9by the commissioner under chapters 256B, 256D, and 256L, and who have agreed to and 71.10have met personal health goals established with the patients' primary care providers to 71.11manage a chronic disease or condition, including but not limited to diabetes, high blood 71.12pressure, and coronary artery disease. 71.13    Sec. 6. Minnesota Statutes 2008, section 256.01, is amended by adding a subdivision 71.14to read: 71.15     new text begin Subd. 18a. new text end new text begin Public Assistance Reporting Information System. new text end new text begin (a) Effective new text end 71.16 new text begin October 1, 2009, the commissioner shall comply with the federal requirements in Public new text end 71.17 new text begin Law 110-379 in implementing the Public Assistance Reporting Information System new text end 71.18 new text begin (PARIS) to determine eligibility for all individuals applying for: new text end 71.19 new text begin (1) health care benefits under chapters 256B, 256D, and 256L; and new text end 71.20 new text begin (2) public benefits under chapters 119B, 256D, 256I, and the supplemental nutrition new text end 71.21 new text begin assistance program. new text end 71.22 new text begin (b) The commissioner shall determine eligibility under paragraph (a) by performing new text end 71.23 new text begin data matches, including matching with medical assistance, cash, child care, and new text end 71.24 new text begin supplemental assistance programs operated by other states. new text end 71.25 new text begin EFFECTIVE DATE. new text end new text begin This section is effective October 1, 2009. new text end 71.26    Sec. 7. Minnesota Statutes 2008, section 256.01, is amended by adding a subdivision 71.27to read: 71.28     new text begin Subd. 18b. new text end new text begin Protections for American Indians. new text end new text begin Effective February 18, 2009, the new text end 71.29 new text begin commissioner shall comply with the federal requirements in the American Recovery and new text end 71.30 new text begin Reinvestment Act of 2009, Public Law 111-5, section 5006, regarding American Indians. new text end 71.31    Sec. 8. Minnesota Statutes 2008, section 256.962, subdivision 2, is amended to read: 72.1    Subd. 2. Outreach grants. (a) The commissioner shall award grants to public and 72.2private organizations, regional collaboratives, and regional health care outreach centers 72.3for outreach activities, including, but not limited to: 72.4    (1) providing information, applications, and assistance in obtaining coverage 72.5through Minnesota public health care programs; 72.6    (2) collaborating with public and private entities such as hospitals, providers, health 72.7plans, legal aid offices, pharmacies, insurance agencies, and faith-based organizations to 72.8develop outreach activities and partnerships to ensure the distribution of information 72.9and applications and provide assistance in obtaining coverage through Minnesota health 72.10care programs; and 72.11    (3) providing or collaborating with public and private entities to provide multilingual 72.12and culturally specific information and assistance to applicants in areas of high 72.13uninsurance in the state or populations with high rates of uninsurance new text begin ; and new text end 72.14 new text begin (4) targeting geographic areas with high rates of (i) eligible but unenrolled children, new text end 72.15 new text begin including children who reside in rural areas, or (ii) racial and ethnic minorities and health new text end 72.16 new text begin disparity populations new text end . 72.17    (b) The commissioner shall ensure that all outreach materials are available in 72.18languages other than English. 72.19    (c) The commissioner shall establish an outreach trainer program to provide 72.20training to designated individuals from the community and public and private entities on 72.21application assistance in order for these individuals to provide training to others in the 72.22community on an as-needed basis. 72.23    Sec. 9. Minnesota Statutes 2008, section 256.962, subdivision 6, is amended to read: 72.24    Subd. 6. School districts new text begin and charter schools new text end . (a) At the beginning of each school 72.25year, a school district new text begin or charter school new text end shall provide information to each student on the 72.26availability of health care coverage through the Minnesota health care programs new text begin and how new text end 72.27 new text begin to obtain an application for the Minnesota health care programs new text end . 72.28    (b) For each child who is determined to be eligible for the free and reduced-price 72.29school lunch program, the district shall provide the child's family with information on how 72.30to obtain an application for the Minnesota health care programs and application assistance. 72.31    (c) A new text begin school new text end district new text begin or charter school new text end shall also ensure that applications and 72.32information on application assistance are available at early childhood education sites and 72.33public schools located within the district's jurisdiction. 72.34    (d) new text begin (c) new text end Each district shall designate an enrollment specialist to provide application 72.35assistance and follow-up services with families who have indicated an interest in receiving 73.1information or an application for the Minnesota health care program. A district is eligible 73.2for the application assistance bonus described in subdivision 5. 73.3    (e) Each new text begin (d) If a school district or charter school maintains a district Web site, the new text end 73.4school district new text begin or charter school new text end shall provide on their new text begin its new text end Web site a link to information on 73.5how to obtain an application and application assistance. 73.6    Sec. 10. new text begin [256.964] DENTAL CARE PILOT PROJECTS. new text end 73.7 new text begin The commissioner shall authorize pilot projects to reduce the total cost to the state new text end 73.8 new text begin for dental services provided to enrollees of the state public health care programs by new text end 73.9 new text begin reducing hospital emergency room costs for preventable or nonemergency dental services. new text end 73.10 new text begin As part of the project, a community dental clinic or dental provider, in collaboration with a new text end 73.11 new text begin hospital emergency room, shall provide urgent care dental services as an alternative to the new text end 73.12 new text begin hospital emergency room for nonemergency dental care. The project participants shall new text end 73.13 new text begin establish a process to divert a patient presenting at the emergency room for nonemergency new text end 73.14 new text begin dental care to the dental community clinic or to an appropriate dental provider. The new text end 73.15 new text begin commissioner may establish special payment rates for urgent care services provided and new text end 73.16 new text begin may change or waive existing payment policies in order to adequately reimburse providers new text end 73.17 new text begin for providing cost-effective alternative services in an outpatient or urgent care setting. new text end 73.18 new text begin The commissioner may establish a project in conjunction with the initiative authorized new text end 73.19 new text begin under section 256.963. new text end 73.20    Sec. 11. Minnesota Statutes 2008, section 256.969, subdivision 2b, is amended to read: 73.21    Subd. 2b. Operating payment rates. In determining operating payment rates for 73.22admissions occurring on or after the rate year beginning January 1, 1991, and every two 73.23years after, or more frequently as determined by the commissioner, the commissioner 73.24shall obtain operating data from an updated base year and establish operating payment 73.25rates per admission for each hospital based on the cost-finding methods and allowable 73.26costs of the Medicare program in effect during the base year. Rates under the general 73.27assistance medical care, medical assistance, and MinnesotaCare programs shall not be 73.28rebased to more current data on January 1, 1997, January 1, 2005, and for the first 24 73.29months of the rebased period beginning January 1, 2009 new text begin , and for the first three months of new text end 73.30 new text begin the rebased period beginning January 1, 2011. From April 1, 2011, to March 31, 2012, new text end 73.31 new text begin rates shall be rebased at 39.2 percent of the full value of the rebasing percentage change. new text end 73.32 new text begin Effective April 1, 2012, rates shall be rebased at full value new text end . The base year operating 73.33payment rate per admission is standardized by the case mix index and adjusted by the 73.34hospital cost index, relative values, and disproportionate population adjustment. The 74.1cost and charge data used to establish operating rates shall only reflect inpatient services 74.2covered by medical assistance and shall not include property cost information and costs 74.3recognized in outlier payments. 74.4    Sec. 12. Minnesota Statutes 2008, section 256.969, subdivision 3a, is amended to read: 74.5    Subd. 3a. Payments. (a) Acute care hospital billings under the medical 74.6assistance program must not be submitted until the recipient is discharged. However, 74.7the commissioner shall establish monthly interim payments for inpatient hospitals that 74.8have individual patient lengths of stay over 30 days regardless of diagnostic category. 74.9Except as provided in section 256.9693, medical assistance reimbursement for treatment 74.10of mental illness shall be reimbursed based on diagnostic classifications. Individual 74.11hospital payments established under this section and sections 256.9685, 256.9686, and 74.12256.9695 , in addition to third party and recipient liability, for discharges occurring during 74.13the rate year shall not exceed, in aggregate, the charges for the medical assistance covered 74.14inpatient services paid for the same period of time to the hospital. This payment limitation 74.15shall be calculated separately for medical assistance and general assistance medical 74.16care services. The limitation on general assistance medical care shall be effective for 74.17admissions occurring on or after July 1, 1991. Services that have rates established under 74.18subdivision 11 or 12, must be limited separately from other services. After consulting with 74.19the affected hospitals, the commissioner may consider related hospitals one entity and 74.20may merge the payment rates while maintaining separate provider numbers. The operating 74.21and property base rates per admission or per day shall be derived from the best Medicare 74.22and claims data available when rates are established. The commissioner shall determine 74.23the best Medicare and claims data, taking into consideration variables of recency of the 74.24data, audit disposition, settlement status, and the ability to set rates in a timely manner. 74.25The commissioner shall notify hospitals of payment rates by December 1 of the year 74.26preceding the rate year. The rate setting data must reflect the admissions data used to 74.27establish relative values. Base year changes from 1981 to the base year established for the 74.28rate year beginning January 1, 1991, and for subsequent rate years, shall not be limited 74.29to the limits ending June 30, 1987, on the maximum rate of increase under subdivision 74.301. The commissioner may adjust base year cost, relative value, and case mix index data 74.31to exclude the costs of services that have been discontinued by the October 1 of the year 74.32preceding the rate year or that are paid separately from inpatient services. Inpatient stays 74.33that encompass portions of two or more rate years shall have payments established based 74.34on payment rates in effect at the time of admission unless the date of admission preceded 74.35the rate year in effect by six months or more. In this case, operating payment rates for 75.1services rendered during the rate year in effect and established based on the date of 75.2admission shall be adjusted to the rate year in effect by the hospital cost index. 75.3    (b) For fee-for-service admissions occurring on or after July 1, 2002, the total 75.4payment, before third-party liability and spenddown, made to hospitals for inpatient 75.5services is reduced by .5 percent from the current statutory rates. 75.6    (c) In addition to the reduction in paragraph (b), the total payment for fee-for-service 75.7admissions occurring on or after July 1, 2003, made to hospitals for inpatient services 75.8before third-party liability and spenddown, is reduced five percent from the current 75.9statutory rates. Mental health services within diagnosis related groups 424 to 432, and 75.10facilities defined under subdivision 16 are excluded from this paragraph. 75.11    (d) In addition to the reduction in paragraphs (b) and (c), the total payment for 75.12fee-for-service admissions occurring on or after July 1, 2005, made to hospitals for 75.13inpatient services before third-party liability and spenddown, is reduced 6.0 percent 75.14from the current statutory rates. Mental health services within diagnosis related groups 75.15424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph. 75.16Notwithstanding section 256.9686, subdivision 7, for purposes of this paragraph, medical 75.17assistance does not include general assistance medical care. Payments made to managed 75.18care plans shall be reduced for services provided on or after January 1, 2006, to reflect 75.19this reduction. 75.20    (e) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for 75.21fee-for-service admissions occurring on or after July 1, 2008, through June 30, 2009, made 75.22to hospitals for inpatient services before third-party liability and spenddown, is reduced 75.233.46 percent from the current statutory rates. Mental health services with diagnosis related 75.24groups 424 to 432 and facilities defined under subdivision 16 are excluded from this 75.25paragraph. Payments made to managed care plans shall be reduced for services provided 75.26on or after January 1, 2009, through June 30, 2009, to reflect this reduction. 75.27    (f) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for 75.28fee-for-service admissions occurring on or after July 1, 2009, through June 30, 2010, made 75.29to hospitals for inpatient services before third-party liability and spenddown, is reduced 75.301.9 percent from the current statutory rates. Mental health services with diagnosis related 75.31groups 424 to 432 and facilities defined under subdivision 16 are excluded from this 75.32paragraph. Payments made to managed care plans shall be reduced for services provided 75.33on or after July 1, 2009, through June 30, 2010, to reflect this reduction. 75.34    (g) In addition to the reductions in paragraphs (b), (c), and (d), the total payment 75.35for fee-for-service admissions occurring on or after July 1, 2010, made to hospitals for 75.36inpatient services before third-party liability and spenddown, is reduced 1.79 percent 76.1from the current statutory rates. Mental health services with diagnosis related groups 76.2424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph. 76.3Payments made to managed care plans shall be reduced for services provided on or after 76.4July 1, 2010, to reflect this reduction. 76.5 new text begin (h) In addition to the reductions in paragraphs (b), (c), (d), (f), and (g), the total new text end 76.6 new text begin payment for fee-for-service admissions occurring on or after July 1, 2009, made to new text end 76.7 new text begin hospitals for inpatient services before third-party liability and spenddown, is reduced new text end 76.8 new text begin one percent from the current statutory rates. Facilities defined under subdivision 16 are new text end 76.9 new text begin excluded from this paragraph. Payments made to managed care plans shall be reduced for new text end 76.10 new text begin services provided on or after October 1, 2009, to reflect this reduction. new text end 76.11    Sec. 13. Minnesota Statutes 2008, section 256.969, is amended by adding a subdivision 76.12to read: 76.13     new text begin Subd. 3b. new text end new text begin Nonpayment for hospital-acquired conditions and for certain new text end 76.14 new text begin treatments. new text end new text begin (a) The commissioner must not make medical assistance payments to a new text end 76.15 new text begin hospital for any costs of care that result from a condition listed in paragraph (c), if the new text end 76.16 new text begin condition was hospital acquired. new text end 76.17     new text begin (b) For purposes of this subdivision, a condition is hospital acquired if it is not new text end 76.18 new text begin identified by the hospital as present on admission. For purposes of this subdivision, new text end 76.19 new text begin medical assistance includes general assistance medical care and MinnesotaCare. new text end 76.20 new text begin (c) The prohibition in paragraph (a) applies to payment for each hospital-acquired new text end 76.21 new text begin condition listed in this paragraph that is represented by an ICD-9-CM diagnosis code and new text end 76.22 new text begin is designated as a complicating condition or a major complicating condition: new text end 76.23 new text begin (1) foreign object retained after surgery (ICD-9-CM codes 998.4 or 998.7); new text end 76.24 new text begin (2) air embolism (ICD-9-CM code 999.1); new text end 76.25 new text begin (3) blood incompatibility (ICD-9-CM code 999.6); new text end 76.26 new text begin (4) pressure ulcers stage III or IV (ICD-9-CM codes 707.23 or 707.24); new text end 76.27 new text begin (5) falls and trauma, including fracture, dislocation, intracranial injury, crushing new text end 76.28 new text begin injury, burn, and electric shock (ICD-9-CM codes with these ranges on the complicating new text end 76.29 new text begin condition and major complicating condition list: 800-829; 830-839; 850-854; 925-929; new text end 76.30 new text begin 940-949; and 991-994); new text end 76.31 new text begin (6) catheter-associated urinary tract infection (ICD-9-CM code 996.64); new text end 76.32 new text begin (7) vascular catheter-associated infection (ICD-9-CM code 999.31); new text end 76.33 new text begin (8) manifestations of poor glycemic control (ICD-9-CM codes 249.10; 249.11; new text end 76.34 new text begin 249.20; 249.21; 250.10; 250.11; 250.12; 250.13; 250.20; 250.21; 250.22; 250.23; and new text end 76.35 new text begin 251.0); new text end 77.1 new text begin (9) surgical site infection (ICD-9-CM codes 996.67 or 998.59) following certain new text end 77.2 new text begin orthopedic procedures (procedure codes 81.01; 81.02; 81.03; 81.04; 81.05; 81.06; 81.07; new text end 77.3 new text begin 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 new text end 77.4 new text begin 81.85); new text end 77.5 new text begin (10) surgical site infection (ICD-9-CM code 998.59) following bariatric surgery new text end 77.6 new text begin (procedure codes 44.38; 44.39; or 44.95) for a principal diagnosis of morbid obesity new text end 77.7 new text begin (ICD-9-CM code 278.01); new text end 77.8 new text begin (11) surgical site infection, mediastinitis (ICD-9-CM code 519.2) following coronary new text end 77.9 new text begin artery bypass graft (procedure codes 36.10 to 36.19); and new text end 77.10 new text begin (12) deep vein thrombosis (ICD-9-CM codes 453.40 to 453.42) or pulmonary new text end 77.11 new text begin embolism (ICD-9-CM codes 415.11 or 415.91) following total knee replacement new text end 77.12 new text begin (procedure code 81.54) or hip replacement (procedure codes 00.85 to 00.87 or 81.51 new text end 77.13 new text begin to 81.52). new text end 77.14 new text begin (d) The prohibition in paragraph (a) applies to any additional payments that result new text end 77.15 new text begin from a hospital-acquired condition listed in paragraph (c), including, but not limited to, new text end 77.16 new text begin additional treatment or procedures, readmission to the facility after discharge, increased new text end 77.17 new text begin length of stay, change to a higher diagnostic category, or transfer to another hospital. In new text end 77.18 new text begin the event of a transfer to another hospital, the hospital where the condition listed under new text end 77.19 new text begin paragraph (c) was acquired is responsible for any costs incurred at the hospital to which new text end 77.20 new text begin the patient is transferred. new text end 77.21 new text begin (e) A hospital shall not bill a recipient of services for any payment disallowed under new text end 77.22 new text begin this subdivision. new text end 77.23    Sec. 14. Minnesota Statutes 2008, section 256.969, is amended by adding a subdivision 77.24to read: 77.25     new text begin Subd. 28. new text end new text begin Temporary rate increase for qualifying hospitals. new text end new text begin For the period new text end 77.26 new text begin from April 1, 2009, to September 30, 2010, for each hospital with a medical assistance new text end 77.27 new text begin utilization rate equal to or greater than 25 percent during the base year, the commissioner new text end 77.28 new text begin shall provide an equal percentage rate increase for each medical assistance admission. The new text end 77.29 new text begin commissioner shall estimate the percentage rate increase using as the state share of the new text end 77.30 new text begin increase the amount available under section 256B.199, paragraph (d). The commissioner new text end 77.31 new text begin shall settle up payments to qualifying hospitals based on actual payments under that new text end 77.32 new text begin section and actual hospital admissions. new text end 77.33 new text begin EFFECTIVE DATE. new text end new text begin This section is effective the day following final enactment. new text end 78.1    Sec. 15. Minnesota Statutes 2008, section 256.969, is amended by adding a subdivision 78.2to read: 78.3     new text begin Subd. 29. new text end new text begin Reimbursement for the fee increase for the early hearing detection new text end 78.4 new text begin and intervention program. new text end new text begin For services provided on or after July 1, 2010, in addition to new text end 78.5 new text begin any other payment under this section, the commissioner shall reimburse hospitals for the new text end 78.6 new text begin increase in the fee for the early hearing detection and intervention program described in new text end 78.7 new text begin section 144.125, subdivision 1, paid by the hospital for public program recipients. new text end 78.8    Sec. 16. new text begin [256B.032] ELIGIBLE VENDORS OF MEDICAL CARE. new text end 78.9 new text begin (a) Effective January 1, 2011, the commissioner shall establish performance new text end 78.10 new text begin thresholds for health care providers included in the provider peer grouping system new text end 78.11 new text begin developed by the commissioner of health under section 62U.04. The thresholds shall be new text end 78.12 new text begin set at the 10th percentile of the combined cost and quality measure used for provider peer new text end 78.13 new text begin grouping, and separate thresholds shall be set for hospital and physician services. new text end 78.14 new text begin (b) Beginning January 1, 2012, any health care provider with a combined cost and new text end 78.15 new text begin quality score below the threshold set in paragraph (a) shall be prohibited from enrolling new text end 78.16 new text begin as a vendor of medical care in the medical assistance, general assistance medical care, new text end 78.17 new text begin or MinnesotaCare programs, and shall not be eligible for direct payments under those new text end 78.18 new text begin programs or for payments made by managed care plans under their contracts with the new text end 78.19 new text begin commissioner under section 256B.69 or 256L.12. A health care provider that is prohibited new text end 78.20 new text begin from enrolling as a vendor or receiving payments under this paragraph may reenroll new text end 78.21 new text begin effective January 1 of any subsequent year if the provider's most recent combined cost and new text end 78.22 new text begin quality score exceeds the threshold established in paragraph (a). new text end 78.23 new text begin (c) Notwithstanding paragraph (b), a provider may continue to participate as a vendor new text end 78.24 new text begin or as part of a managed care plan provider network if the commissioner determines that a new text end 78.25 new text begin contract with the provider is necessary to ensure adequate access to health care services. new text end 78.26 new text begin (d) By January 15, 2013, the commissioner shall report to the legislature on the new text end 78.27 new text begin impact of this section. The commissioner's report shall include information on: new text end 78.28 new text begin (1) the providers falling below the thresholds as of January 1, 2012; new text end 78.29 new text begin (2) the volume of services and cost of care provided to enrollees in the medical new text end 78.30 new text begin assistance, general assistance medical care, or MinnesotaCare programs in the 12 months new text end 78.31 new text begin prior to January 1, 2012, by providers falling below the thresholds; new text end 78.32 new text begin (3) providers who fell below the thresholds but continued to be eligible vendors new text end 78.33 new text begin under paragraph (c); new text end 78.34 new text begin (4) the estimated cost savings achieved by not contracting with providers who do new text end 78.35 new text begin not meet the performance thresholds; and new text end 79.1 new text begin (5) recommendations for increasing the threshold levels of performance over time. new text end 79.2    Sec. 17. Minnesota Statutes 2008, section 256B.056, subdivision 3c, is amended to 79.3read: 79.4    Subd. 3c. Asset limitations for families and children. A household of two or more 79.5persons must not own more than $20,000 in total net assets, and a household of one 79.6person must not own more than $10,000 in total net assets. In addition to these maximum 79.7amounts, an eligible individual or family may accrue interest on these amounts, but they 79.8must be reduced to the maximum at the time of an eligibility redetermination. The value of 79.9assets that are not considered in determining eligibility for medical assistance for families 79.10and children is the value of those assets excluded under the AFDC state plan as of July 16, 79.111996, as required by the Personal Responsibility and Work Opportunity Reconciliation 79.12Act of 1996 (PRWORA), Public Law 104-193, with the following exceptions: 79.13(1) household goods and personal effects are not considered; 79.14(2) capital and operating assets of a trade or business up to $200,000 are not 79.15considered new text begin , except that a bank account that contains personal income or assets, or is used to new text end 79.16 new text begin pay personal expenses, is not considered a capital or operating asset of a trade or business new text end ; 79.17(3) one motor vehicle is excluded for each person of legal driving age who is 79.18employed or seeking employment; 79.19(4) one burial plot and all other burial expenses equal to the supplemental security 79.20income program asset limit are not considered for each individual; 79.21(5) court-ordered settlements up to $10,000 are not considered; 79.22(6) individual retirement accounts and funds are not considered; and 79.23(7) assets owned by children are not considered. 79.24 new text begin The assets specified in clause (2) must be disclosed to the local agency at the time of new text end 79.25 new text begin application and at the time of an eligibility redetermination, and must be verified upon new text end 79.26 new text begin request of the local agency. new text end 79.27 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2011, or upon federal new text end 79.28 new text begin approval, whichever is later. new text end 79.29    Sec. 18. Minnesota Statutes 2008, section 256B.056, subdivision 3d, is amended to 79.30read: 79.31    Subd. 3d. Reduction of excess assets. Assets in excess of the limits in subdivisions 79.323 to 3c may be reduced to allowable limits as follows: 79.33(a) Assets may be reduced in any of the three calendar months before the month 79.34of application in which the applicant seeks coverage by: 80.1(1) designating burial funds up to $1,500 for each applicant, spouse, and MA-eligible 80.2dependent child; and 80.3(2) paying health service bills new text begin for health services that are new text end incurred in the retroactive 80.4period for which the applicant seeks eligibility, starting with the oldest bill. After assets 80.5are reduced to allowable limits, eligibility begins with the next dollar of MA-covered 80.6health services incurred in the retroactive period. Applicants reducing assets under this 80.7subdivision who also have excess income shall first spend excess assets to pay health 80.8service bills and may meet the income spenddown on remaining bills. 80.9(b) Assets may be reduced beginning the month of application by: 80.10(1) paying bills for health services new text begin that are incurred during the period specified in new text end 80.11 new text begin Minnesota Rules, part 9505.0090, subpart 2, new text end that would otherwise be paid by medical 80.12assistance; and new text begin . After assets are reduced to allowable limits, eligibility begins with the new text end 80.13 new text begin next dollar of medical assistance covered health services incurred in the period. Applicants new text end 80.14 new text begin reducing assets under this subdivision who also have excess income shall first spend excess new text end 80.15 new text begin assets to pay health service bills and may meet the income spenddown on remaining bills. new text end 80.16(2) using any means other than a transfer of assets for less than fair market value as 80.17defined in section 256B.0595, subdivision 1, paragraph (b). 80.18 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2011. new text end 80.19    Sec. 19. Minnesota Statutes 2008, section 256B.057, is amended by adding a 80.20subdivision to read: 80.21     new text begin Subd. 11. new text end new text begin Treatment for colorectal cancer. new text end new text begin (a) Medical assistance shall be paid for new text end 80.22 new text begin an individual who: new text end 80.23 new text begin (1) has been screened for colorectal cancer by the colorectal cancer prevention new text end 80.24 new text begin demonstration project; new text end 80.25 new text begin (2) according to the individual's treating health professional, needs treatment for new text end 80.26 new text begin colorectal cancer; new text end 80.27 new text begin (3) meets income eligibility guidelines for the colorectal cancer prevention new text end 80.28 new text begin demonstration project; new text end 80.29 new text begin (4) is under the age of 65; and new text end 80.30 new text begin (5) is not otherwise eligible for medical assistance or covered under creditable new text end 80.31 new text begin coverage as defined under United States Code, title 42, section 300gg(a). new text end 80.32 new text begin (b) Medical assistance provided under this subdivision shall be limited to services new text end 80.33 new text begin provided during the period that the individual receives treatment for colorectal cancer. new text end 81.1 new text begin (c) An individual meeting the criteria in paragraph (a) is eligible for medical new text end 81.2 new text begin assistance without meeting the eligibility criteria relating to income and assets in section new text end 81.3 new text begin 256B.056, subdivisions 1a to 5b. new text end 81.4 new text begin (d) This subdivision expires December 31, 2010. new text end 81.5    Sec. 20. Minnesota Statutes 2008, section 256B.0575, is amended to read: 81.6256B.0575 AVAILABILITY OF INCOME FOR INSTITUTIONALIZED 81.7PERSONS. 81.8     new text begin Subdivision 1. new text end new text begin Income deductions. new text end When an institutionalized person is determined 81.9eligible for medical assistance, the income that exceeds the deductions in paragraphs (a) 81.10and (b) must be applied to the cost of institutional care. 81.11(a) The following amounts must be deducted from the institutionalized person's 81.12income in the following order: 81.13(1) the personal needs allowance under section 256B.35 or, for a veteran who 81.14does not have a spouse or child, or a surviving spouse of a veteran having no child, the 81.15amount of an improved pension received from the veteran's administration not exceeding 81.16$90 per month; 81.17(2) the personal allowance for disabled individuals under section 256B.36; 81.18(3) if the institutionalized person has a legally appointed guardian or conservator, 81.19five percent of the recipient's gross monthly income up to $100 as reimbursement for 81.20guardianship or conservatorship services; 81.21(4) a monthly income allowance determined under section 256B.058, subdivision 81.222 , but only to the extent income of the institutionalized spouse is made available to the 81.23community spouse; 81.24(5) a monthly allowance for children under age 18 which, together with the net 81.25income of the children, would provide income equal to the medical assistance standard 81.26for families and children according to section 256B.056, subdivision 4, for a family size 81.27that includes only the minor children. This deduction applies only if the children do not 81.28live with the community spouse and only to the extent that the deduction is not included 81.29in the personal needs allowance under section 256B.35, subdivision 1, as child support 81.30garnished under a court order; 81.31(6) a monthly family allowance for other family members, equal to one-third of the 81.32difference between 122 percent of the federal poverty guidelines and the monthly income 81.33for that family member; 82.1(7) reparations payments made by the Federal Republic of Germany and reparations 82.2payments made by the Netherlands for victims of Nazi persecution between 1940 and 82.31945; 82.4(8) all other exclusions from income for institutionalized persons as mandated by 82.5federal law; and 82.6(9) amounts for reasonable expenses new text begin , as specified in subdivision 2, new text end incurred for 82.7necessary medical or remedial care for the institutionalized person that are new text begin recognized new text end 82.8 new text begin under state law, new text end not medical assistance covered expenses new text begin , new text end and that are not subject to 82.9payment by a third party. 82.10Reasonable expenses are limited to expenses that have not been previously used as a 82.11deduction from income and are incurred during the enrollee's current period of eligibility, 82.12including retroactive months associated with the current period of eligibility, for medical 82.13assistance payment of long-term care services. 82.14For purposes of clause (6), "other family member" means a person who resides 82.15with the community spouse and who is a minor or dependent child, dependent parent, or 82.16dependent sibling of either spouse. "Dependent" means a person who could be claimed as 82.17a dependent for federal income tax purposes under the Internal Revenue Code. 82.18(b) Income shall be allocated to an institutionalized person for a period of up to three 82.19calendar months, in an amount equal to the medical assistance standard for a family 82.20size of one if: 82.21(1) a physician certifies that the person is expected to reside in the long-term care 82.22facility for three calendar months or less; 82.23(2) if the person has expenses of maintaining a residence in the community; and 82.24(3) if one of the following circumstances apply: 82.25(i) the person was not living together with a spouse or a family member as defined in 82.26paragraph (a) when the person entered a long-term care facility; or 82.27(ii) the person and the person's spouse become institutionalized on the same date, in 82.28which case the allocation shall be applied to the income of one of the spouses. 82.29For purposes of this paragraph, a person is determined to be residing in a licensed nursing 82.30home, regional treatment center, or medical institution if the person is expected to remain 82.31for a period of one full calendar month or more. 82.32     new text begin Subd. 2. new text end new text begin Reasonable expenses. new text end new text begin For the purposes of subdivision 1, paragraph (a), new text end 82.33 new text begin clause (9), reasonable expenses are limited to expenses that have not been previously used new text end 82.34 new text begin as a deduction from income and were not: new text end 82.35     new text begin (1) for long-term care expenses incurred during a period of ineligibility as defined in new text end 82.36 new text begin section 256B.0595, subdivision 2; new text end 83.1     new text begin (2) incurred more than three months before the month of application associated with new text end 83.2 new text begin the current period of eligibility; new text end 83.3     new text begin (3) for expenses incurred by a recipient that are duplicative of services that are new text end 83.4 new text begin covered under chapter 256B; or new text end 83.5     new text begin (4) nursing facility expenses incurred without a timely assessment as required under new text end 83.6 new text begin section 256B.0911. new text end 83.7    Sec. 21. Minnesota Statutes 2008, section 256B.0595, subdivision 1, is amended to 83.8read: 83.9    Subdivision 1. Prohibited transfers. (a) For transfers of assets made on or before 83.10August 10, 1993, if an institutionalized person or the institutionalized person's spouse has 83.11given away, sold, or disposed of, for less than fair market value, any asset or interest 83.12therein, except assets other than the homestead that are excluded under the supplemental 83.13security program, within 30 months before or any time after the date of institutionalization 83.14if the person has been determined eligible for medical assistance, or within 30 months 83.15before or any time after the date of the first approved application for medical assistance 83.16if the person has not yet been determined eligible for medical assistance, the person is 83.17ineligible for long-term care services for the period of time determined under subdivision 83.182. 83.19    (b) Effective for transfers made after August 10, 1993, an institutionalized person, an 83.20institutionalized person's spouse, or any person, court, or administrative body with legal 83.21authority to act in place of, on behalf of, at the direction of, or upon the request of the 83.22institutionalized person or institutionalized person's spouse, may not give away, sell, or 83.23dispose of, for less than fair market value, any asset or interest therein, except assets other 83.24than the homestead that are excluded under the Supplemental Security Income program, 83.25for the purpose of establishing or maintaining medical assistance eligibility. This applies 83.26to all transfers, including those made by a community spouse after the month in which 83.27the institutionalized spouse is determined eligible for medical assistance. For purposes of 83.28determining eligibility for long-term care services, any transfer of such assets within 36 83.29months before or any time after an institutionalized person requests medical assistance 83.30payment of long-term care services, or 36 months before or any time after a medical 83.31assistance recipient becomes an institutionalized person, for less than fair market value 83.32may be considered. Any such transfer is presumed to have been made for the purpose 83.33of establishing or maintaining medical assistance eligibility and the institutionalized 83.34person is ineligible for long-term care services for the period of time determined under 83.35subdivision 2, unless the institutionalized person furnishes convincing evidence to 84.1establish that the transaction was exclusively for another purpose, or unless the transfer is 84.2permitted under subdivision 3 or 4. In the case of payments from a trust or portions of a 84.3trust that are considered transfers of assets under federal law, or in the case of any other 84.4disposal of assets made on or after February 8, 2006, any transfers made within 60 months 84.5before or any time after an institutionalized person requests medical assistance payment of 84.6long-term care services and within 60 months before or any time after a medical assistance 84.7recipient becomes an institutionalized person, may be considered. 84.8    (c) This section applies to transfers, for less than fair market value, of income 84.9or assets, including assets that are considered income in the month received, such as 84.10inheritances, court settlements, and retroactive benefit payments or income to which the 84.11institutionalized person or the institutionalized person's spouse is entitled but does not 84.12receive due to action by the institutionalized person, the institutionalized person's spouse, 84.13or any person, court, or administrative body with legal authority to act in place of, on 84.14behalf of, at the direction of, or upon the request of the institutionalized person or the 84.15institutionalized person's spouse. 84.16    (d) This section applies to payments for care or personal services provided by a 84.17relative, unless the compensation was stipulated in a notarized, written agreement which 84.18was in existence when the service was performed, the care or services directly benefited 84.19the person, and the payments made represented reasonable compensation for the care 84.20or services provided. A notarized written agreement is not required if payment for the 84.21services was made within 60 days after the service was provided. 84.22    (e) This section applies to the portion of any asset or interest that an institutionalized 84.23person, an institutionalized person's spouse, or any person, court, or administrative body 84.24with legal authority to act in place of, on behalf of, at the direction of, or upon the request 84.25of the institutionalized person or the institutionalized person's spouse, transfers to any 84.26annuity that exceeds the value of the benefit likely to be returned to the institutionalized 84.27person or institutionalized person's spouse while alive, based on estimated life expectancy 84.28as determined according to the current actuarial tables published by the Office of the 84.29Chief Actuary of the Social Security Administration. The commissioner may adopt rules 84.30reducing life expectancies based on the need for long-term care. This section applies to an 84.31annuity purchased on or after March 1, 2002, that: 84.32    (1) is not purchased from an insurance company or financial institution that is 84.33subject to licensing or regulation by the Minnesota Department of Commerce or a similar 84.34regulatory agency of another state; 84.35    (2) does not pay out principal and interest in equal monthly installments; or 84.36    (3) does not begin payment at the earliest possible date after annuitization. 85.1    (f) Effective for transactions, including the purchase of an annuity, occurring on or 85.2after February 8, 2006, by or on behalf of an institutionalized person who has applied for 85.3or is receiving long-term care services or the institutionalized person's spouse shall be 85.4treated as the disposal of an asset for less than fair market value unless the department is 85.5named a preferred remainder beneficiary as described in section 256B.056, subdivision 85.611 . Any subsequent change to the designation of the department as a preferred remainder 85.7beneficiary shall result in the annuity being treated as a disposal of assets for less than 85.8fair market value. The amount of such transfer shall be the maximum amount the 85.9institutionalized person or the institutionalized person's spouse could receive from the 85.10annuity or similar financial instrument. Any change in the amount of the income or 85.11principal being withdrawn from the annuity or other similar financial instrument at the 85.12time of the most recent disclosure shall be deemed to be a transfer of assets for less than 85.13fair market value unless the institutionalized person or the institutionalized person's spouse 85.14demonstrates that the transaction was for fair market value. In the event a distribution 85.15of income or principal has been improperly distributed or disbursed from an annuity or 85.16other retirement planning instrument of an institutionalized person or the institutionalized 85.17person's spouse, a cause of action exists against the individual receiving the improper 85.18distribution for the cost of medical assistance services provided or the amount of the 85.19improper distribution, whichever is less. 85.20    (g) Effective for transactions, including the purchase of an annuity, occurring on 85.21or after February 8, 2006, by or on behalf of an institutionalized person applying for or 85.22receiving long-term care services shall be treated as a disposal of assets for less than fair 85.23market value unless it is: 85.24    (i) an annuity described in subsection (b) or (q) of section 408 of the Internal 85.25Revenue Code of 1986; or 85.26    (ii) purchased with proceeds from: 85.27    (A) an account or trust described in subsection (a), (c), or (p) of section 408 of the 85.28Internal Revenue Code; 85.29    (B) a simplified employee pension within the meaning of section 408(k) of the 85.30Internal Revenue Code; or 85.31    (C) a Roth IRA described in section 408A of the Internal Revenue Code; or 85.32    (iii) an annuity that is irrevocable and nonassignable; is actuarially sound as 85.33determined in accordance with actuarial publications of the Office of the Chief Actuary of 85.34the Social Security Administration; and provides for payments in equal amounts during 85.35the term of the annuity, with no deferral and no balloon payments made. 86.1     (h) For purposes of this section, long-term care services include services in a nursing 86.2facility, services that are eligible for payment according to section 256B.0625, subdivision 86.32 , because they are provided in a swing bed, intermediate care facility for persons with 86.4developmental disabilities, and home and community-based services provided pursuant 86.5to sections 256B.0915, 256B.092, and 256B.49. For purposes of this subdivision and 86.6subdivisions 2, 3, and 4, "institutionalized person" includes a person who is an inpatient 86.7in a nursing facility or in a swing bed, or intermediate care facility for persons with 86.8developmental disabilities or who is receiving home and community-based services under 86.9sections 256B.0915, 256B.092, and 256B.49. 86.10    (i) This section applies to funds used to purchase a promissory note, loan, or 86.11mortgage unless the note, loan, or mortgage: 86.12    (1) has a repayment term that is actuarially sound; 86.13    (2) provides for payments to be made in equal amounts during the term of the loan, 86.14with no deferral and no balloon payments made; and 86.15    (3) prohibits the cancellation of the balance upon the death of the lender. 86.16    In the case of a promissory note, loan, or mortgage that does not meet an exception 86.17in clauses (1) to (3), the value of such note, loan, or mortgage shall be the outstanding 86.18balance due as of the date of the institutionalized person's request for medical assistance 86.19payment of long-term care services. 86.20    (j) This section applies to the purchase of a life estate interest in another person's 86.21home unless the purchaser resides in the home for a period of at least one year after the 86.22date of purchase. 86.23 new text begin (k) This section applies to transfers into a pooled trust that qualifies under United new text end 86.24 new text begin States Code, title 42, section 1396p(d)(4)(C), by: new text end 86.25 new text begin (1) a person age 65 or older or the person's spouse; or new text end 86.26 new text begin (2) any person, court, or administrative body with legal authority to act in place new text end 86.27 new text begin of, on behalf of, at the direction of, or upon the request of a person age 65 or older or new text end 86.28 new text begin the person's spouse. new text end 86.29    Sec. 22. Minnesota Statutes 2008, section 256B.0595, subdivision 2, is amended to 86.30read: 86.31    Subd. 2. Period of ineligibility new text begin for long-term care services new text end . (a) For any 86.32uncompensated transfer occurring on or before August 10, 1993, the number of months 86.33of ineligibility for long-term care services shall be the lesser of 30 months, or the 86.34uncompensated transfer amount divided by the average medical assistance rate for nursing 86.35facility services in the state in effect on the date of application. The amount used to 87.1calculate the average medical assistance payment rate shall be adjusted each July 1 to 87.2reflect payment rates for the previous calendar year. The period of ineligibility begins 87.3with the month in which the assets were transferred. If the transfer was not reported to 87.4the local agency at the time of application, and the applicant received long-term care 87.5services during what would have been the period of ineligibility if the transfer had been 87.6reported, a cause of action exists against the transferee for the cost of long-term care 87.7services provided during the period of ineligibility, or for the uncompensated amount of 87.8the transfer, whichever is less. The uncompensated transfer amount is the fair market 87.9value of the asset at the time it was given away, sold, or disposed of, less the amount of 87.10compensation received. 87.11    (b) For uncompensated transfers made after August 10, 1993, the number of months 87.12of ineligibility for long-term care services shall be the total uncompensated value of the 87.13resources transferred divided by the average medical assistance rate for nursing facility 87.14services in the state in effect on the date of application. The amount used to calculate 87.15the average medical assistance payment rate shall be adjusted each July 1 to reflect 87.16payment rates for the previous calendar year. The period of ineligibility begins with the 87.17first day of the month after the month in which the assets were transferred except that 87.18if one or more uncompensated transfers are made during a period of ineligibility, the 87.19total assets transferred during the ineligibility period shall be combined and a penalty 87.20period calculated to begin on the first day of the month after the month in which the first 87.21uncompensated transfer was made. If the transfer was reported to the local agency after 87.22the date that advance notice of a period of ineligibility that affects the next month could 87.23be provided to the recipient and the recipient received medical assistance services or the 87.24transfer was not reported to the local agency, and the applicant or recipient received 87.25medical assistance services during what would have been the period of ineligibility if 87.26the transfer had been reported, a cause of action exists against the transferee for that 87.27portion of long-term care services provided during the period of ineligibility, or for the 87.28uncompensated amount of the transfer, whichever is less. The uncompensated transfer 87.29amount is the fair market value of the asset at the time it was given away, sold, or disposed 87.30of, less the amount of compensation received. Effective for transfers made on or after 87.31March 1, 1996, involving persons who apply for medical assistance on or after April 13, 87.321996, no cause of action exists for a transfer unless: 87.33    (1) the transferee knew or should have known that the transfer was being made by a 87.34person who was a resident of a long-term care facility or was receiving that level of care in 87.35the community at the time of the transfer; 88.1    (2) the transferee knew or should have known that the transfer was being made to 88.2assist the person to qualify for or retain medical assistance eligibility; or 88.3    (3) the transferee actively solicited the transfer with intent to assist the person to 88.4qualify for or retain eligibility for medical assistance. 88.5    (c) For uncompensated transfers made on or after February 8, 2006, the period 88.6of ineligibility: 88.7    (1) for uncompensated transfers by or on behalf of individuals receiving medical 88.8assistance payment of long-term care services, begins the first day of the month following 88.9advance notice of the penalty period new text begin of ineligibility new text end , but no later than the first day of the 88.10month that follows three full calendar months from the date of the report or discovery 88.11of the transfer; or 88.12    (2) for uncompensated transfers by individuals requesting medical assistance 88.13payment of long-term care services, begins the date on which the individual is eligible 88.14for medical assistance under the Medicaid state plan and would otherwise be receiving 88.15long-term care services based on an approved application for such care but for the 88.16application of the penalty period new text begin of ineligibility resulting from the uncompensated new text end 88.17 new text begin transfer new text end ; and 88.18    (3) cannot begin during any other period of ineligibility. 88.19    (d) If a calculation of a penalty period new text begin of ineligibility new text end results in a partial month, 88.20payments for long-term care services shall be reduced in an amount equal to the fraction. 88.21    (e) In the case of multiple fractional transfers of assets in more than one month for 88.22less than fair market value on or after February 8, 2006, the period of ineligibility is 88.23calculated by treating the total, cumulative, uncompensated value of all assets transferred 88.24during all months on or after February 8, 2006, as one transfer. 88.25     new text begin (f) A period of ineligibility established under paragraph (c) may be eliminated if new text end 88.26 new text begin all of the assets transferred for less than fair market value used to calculate the period of new text end 88.27 new text begin ineligibility, or cash equal to the value of the assets at the time of the transfer, are returned new text end 88.28 new text begin within 12 months after the date the period of ineligibility began. A period of ineligibility new text end 88.29 new text begin must not be adjusted if less than the full amount of the transferred assets or the full cash new text end 88.30 new text begin value of the transferred assets are returned. new text end 88.31 new text begin EFFECTIVE DATE. new text end new text begin This section is effective for periods of ineligibility established new text end 88.32 new text begin on or after January 1, 2011. new text end 88.33    Sec. 23. Minnesota Statutes 2008, section 256B.06, subdivision 4, is amended to read: 88.34    Subd. 4. Citizenship requirements. (a) Eligibility for medical assistance is limited 88.35to citizens of the United States, qualified noncitizens as defined in this subdivision, and 89.1other persons residing lawfully in the United States. Citizens or nationals of the United 89.2States must cooperate in obtaining satisfactory documentary evidence of citizenship or 89.3nationality according to the requirements of the federal Deficit Reduction Act of 2005, 89.4Public Law 109-171. 89.5(b) "Qualified noncitizen" means a person who meets one of the following 89.6immigration criteria: 89.7(1) admitted for lawful permanent residence according to United States Code, title 8; 89.8(2) admitted to the United States as a refugee according to United States Code, 89.9title 8, section 1157; 89.10(3) granted asylum according to United States Code, title 8, section 1158; 89.11(4) granted withholding of deportation according to United States Code, title 8, 89.12section 1253(h); 89.13(5) paroled for a period of at least one year according to United States Code, title 8, 89.14section 1182(d)(5); 89.15(6) granted conditional entrant status according to United States Code, title 8, 89.16section 1153(a)(7); 89.17(7) determined to be a battered noncitizen by the United States Attorney General 89.18according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, 89.19title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200; 89.20(8) is a child of a noncitizen determined to be a battered noncitizen by the United 89.21States Attorney General according to the Illegal Immigration Reform and Immigrant 89.22Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill, 89.23Public Law 104-200; or 89.24(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public 89.25Law 96-422, the Refugee Education Assistance Act of 1980. 89.26(c) All qualified noncitizens who were residing in the United States before August 89.2722, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for 89.28medical assistance with federal financial participation. 89.29(d) All qualified noncitizens who entered the United States on or after August 22, 89.301996, and who otherwise meet the eligibility requirements of this chapter, are eligible for 89.31medical assistance with federal financial participation through November 30, 1996. 89.32Beginning December 1, 1996, qualified noncitizens who entered the United States 89.33on or after August 22, 1996, and who otherwise meet the eligibility requirements of this 89.34chapter are eligible for medical assistance with federal participation for five years if they 89.35meet one of the following criteria: 90.1(i) refugees admitted to the United States according to United States Code, title 8, 90.2section 1157; 90.3(ii) persons granted asylum according to United States Code, title 8, section 1158; 90.4(iii) persons granted withholding of deportation according to United States Code, 90.5title 8, section 1253(h); 90.6(iv) veterans of the United States armed forces with an honorable discharge for 90.7a reason other than noncitizen status, their spouses and unmarried minor dependent 90.8children; or 90.9(v) persons on active duty in the United States armed forces, other than for training, 90.10their spouses and unmarried minor dependent children. 90.11Beginning December 1, 1996, qualified noncitizens who do not meet one of the 90.12criteria in items (i) to (v) are eligible for medical assistance without federal financial 90.13participation as described in paragraph (j). 90.14 new text begin Notwithstanding paragraph (j), beginning July 1, 2010, children and pregnant new text end 90.15 new text begin women who are qualified noncitizens, as described in paragraph (b), are eligible for new text end 90.16 new text begin medical assistance with federal financial participation as provided by the federal Children's new text end 90.17 new text begin Health Insurance Program Reauthorization Act of 2009, Public Law 111-3. new text end 90.18(e) Noncitizens who are not qualified noncitizens as defined in paragraph (b), who 90.19are lawfully present in the United States, as defined in Code of Federal Regulations, title 90.208, section 103.12, and who otherwise meet the eligibility requirements of this chapter, are 90.21eligible for medical assistance under clauses (1) to (3). These individuals must cooperate 90.22with the United States Citizenship and Immigration Services to pursue any applicable 90.23immigration status, including citizenship, that would qualify them for medical assistance 90.24with federal financial participation. 90.25(1) Persons who were medical assistance recipients on August 22, 1996, are eligible 90.26for medical assistance with federal financial participation through December 31, 1996. 90.27(2) Beginning January 1, 1997, persons described in clause (1) are eligible for 90.28medical assistance without federal financial participation as described in paragraph (j). 90.29(3) Beginning December 1, 1996, persons residing in the United States prior to 90.30August 22, 1996, who were not receiving medical assistance and persons who arrived on 90.31or after August 22, 1996, are eligible for medical assistance without federal financial 90.32participation as described in paragraph (j). 90.33(f) Nonimmigrants who otherwise meet the eligibility requirements of this chapter 90.34are eligible for the benefits as provided in paragraphs (g) to (i). For purposes of this 90.35subdivision, a "nonimmigrant" is a person in one of the classes listed in United States 90.36Code, title 8, section 1101(a)(15). 91.1(g) Payment shall also be made for care and services that are furnished to noncitizens, 91.2regardless of immigration status, who otherwise meet the eligibility requirements of 91.3this chapter, if such care and services are necessary for the treatment of an emergency 91.4medical condition, except for organ transplants and related care and services and routine 91.5prenatal care. 91.6(h) For purposes of this subdivision, the term "emergency medical condition" means 91.7a medical condition that meets the requirements of United States Code, title 42, section 91.81396b(v). 91.9(i) new text begin Beginning July 1, 2009, new text end pregnant noncitizens who are undocumented, 91.10nonimmigrants, or eligible for medical assistance as described in paragraph (j), new text begin lawfully new text end 91.11 new text begin present as designated in paragraph (e) new text end and who are not covered by a group health plan 91.12or health insurance coverage according to Code of Federal Regulations, title 42, section 91.13457.310, and who otherwise meet the eligibility requirements of this chapter, are eligible 91.14for medical assistance through the period of pregnancy, including labor and delivery, new text begin new text end 91.15 new text begin and 60 days postpartum, new text end to the extent federal funds are available under title XXI of the 91.16Social Security Act, and the state children's health insurance program, followed by 60 91.17days postpartum without federal financial participation. 91.18(j) Qualified noncitizens as described in paragraph (d), and all other noncitizens 91.19lawfully residing in the United States as described in paragraph (e), who are ineligible 91.20for medical assistance with federal financial participation and who otherwise meet the 91.21eligibility requirements of chapter 256B and of this paragraph, are eligible for medical 91.22assistance without federal financial participation. Qualified noncitizens as described 91.23in paragraph (d) are only eligible for medical assistance without federal financial 91.24participation for five years from their date of entry into the United States. 91.25(k) Beginning October 1, 2003, persons who are receiving care and rehabilitation 91.26services from a nonprofit center established to serve victims of torture and are otherwise 91.27ineligible for medical assistance under this chapter are eligible for medical assistance 91.28without federal financial participation. These individuals are eligible only for the period 91.29during which they are receiving services from the center. Individuals eligible under this 91.30paragraph shall not be required to participate in prepaid medical assistance. 91.31 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2009. new text end 91.32    Sec. 24. Minnesota Statutes 2008, section 256B.06, subdivision 5, is amended to read: 91.33    Subd. 5. Deeming of sponsor income and resources. When determining eligibility 91.34for any federal or state funded medical assistance under this section, the income 91.35and resources of all noncitizens shall be deemed to include their sponsors' income 92.1and resources as required under the Personal Responsibility and Work Opportunity 92.2Reconciliation Act of 1996, title IV, Public Law 104-193, sections 421 and 422, and 92.3subsequently set out in federal rules. This section is effective May 1, 1997. new text begin Beginning new text end 92.4 new text begin July 1, 2010, sponsor deeming does not apply to pregnant women and children who are new text end 92.5 new text begin qualified noncitizens, as described in section 256B.06, subdivision 4, paragraph (b). new text end 92.6 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2010. new text end 92.7    Sec. 25. Minnesota Statutes 2008, section 256B.0625, subdivision 3, is amended to 92.8read: 92.9    Subd. 3. Physicians' services. new text begin (a) new text end Medical assistance covers physicians' services. 92.10 new text begin (b) new text end Rates paid for anesthesiology services provided by physicians shall be according 92.11to the formula utilized in the Medicare program and shall use a conversion factor "at 92.12percentile of calendar year set by legislature. new text begin , new text end " new text begin except that rates paid to physicians for the new text end 92.13 new text begin medical direction of a certified registered nurse anesthetist shall be the same as the rate new text end 92.14 new text begin paid to the certified registered nurse anesthetist under medical direction. new text end 92.15    Sec. 26. Minnesota Statutes 2008, section 256B.0625, subdivision 3c, is amended to 92.16read: 92.17    Subd. 3c. Health Services Policy Committee. new text begin (a) new text end The commissioner, after 92.18receiving recommendations from professional physician associations, professional 92.19associations representing licensed nonphysician health care professionals, and consumer 92.20groups, shall establish a 13-member Health Services Policy Committee, which consists of 92.2112 voting members and one nonvoting member. The Health Services Policy Committee 92.22shall advise the commissioner regarding health services pertaining to the administration 92.23of health care benefits covered under the medical assistance, general assistance medical 92.24care, and MinnesotaCare programs. The Health Services Policy Committee shall meet at 92.25least quarterly. The Health Services Policy Committee shall annually elect a physician 92.26chair from among its members, who shall work directly with the commissioner's medical 92.27director, to establish the agenda for each meeting. The Health Services Policy Committee 92.28shall also recommend criteria for verifying centers of excellence for specific aspects of 92.29medical care where a specific set of combined services, a volume of patients necessary to 92.30maintain a high level of competency, or a specific level of technical capacity is associated 92.31with improved health outcomes. 92.32 new text begin (b) The commissioner shall establish a dental subcommittee to operate under the new text end 92.33 new text begin Health Services Policy Committee. The dental subcommittee consists of general dentists, new text end 92.34 new text begin dental specialists, safety net providers, dental hygienists, health plan company and new text end 93.1 new text begin county and public health representatives, health researchers, consumers, and a designee new text end 93.2 new text begin of the commissioner of health. The dental subcommittee shall advise the commissioner new text end 93.3 new text begin regarding: new text end 93.4 new text begin (1) the critical access dental program under section 256B.76, subdivision 4, including new text end 93.5 new text begin but not limited to criteria for designating and terminating critical access dental providers; new text end 93.6 new text begin (2) any changes to the critical access dental provider program necessary to comply new text end 93.7 new text begin with program expenditure limits; new text end 93.8 new text begin (3) dental coverage policy based on evidence, quality, continuity of care, and best new text end 93.9 new text begin practices; new text end 93.10 new text begin (4) the development of dental delivery models; and new text end 93.11 new text begin (5) dental services to be added or eliminated from subdivision 9, paragraph (b). new text end 93.12 new text begin (c) The Health Services Policy Committee shall study approaches to making new text end 93.13 new text begin provider reimbursement under the medical assistance, MinnesotaCare, and general new text end 93.14 new text begin assistance medical care programs contingent on patient participation in a patient-centered new text end 93.15 new text begin decision-making process, and shall evaluate the impact of these approaches on health new text end 93.16 new text begin care quality, patient satisfaction, and health care costs. The committee shall present new text end 93.17 new text begin findings and recommendations to the commissioner and the legislative committees with new text end 93.18 new text begin jurisdiction over health care by January 15, 2010. new text end 93.19 new text begin (d) The Health Services Policy Committee shall monitor and track the practice new text end 93.20 new text begin patterns of physicians providing services to medical assistance, MinnesotaCare, and new text end 93.21 new text begin general assistance medical care enrollees under fee-for-service, managed care, and new text end 93.22 new text begin county-based purchasing. The committee shall focus on services or specialties for which new text end 93.23 new text begin there is a high variation in utilization across physicians, or which are associated with new text end 93.24 new text begin high medical costs. The commissioner, based upon the findings of the committee, shall new text end 93.25 new text begin regularly notify physicians whose practice patterns indicate higher than average utilization new text end 93.26 new text begin or costs. Managed care and county-based purchasing plans shall provide the committee new text end 93.27 new text begin with utilization and cost data necessary to implement this paragraph. new text end 93.28     new text begin (e) The Health Services Policy Committee shall review caesarean section rates new text end 93.29 new text begin for the fee-for-service medical assistance population. The committee may develop best new text end 93.30 new text begin practices policies related to the minimization of caesarean sections, including but not new text end 93.31 new text begin limited to standards and guidelines for health care providers and health care facilities. new text end 93.32    Sec. 27. Minnesota Statutes 2008, section 256B.0625, subdivision 9, is amended to 93.33read: 94.1    Subd. 9. Dental services. new text begin (a) new text end Medical assistance covers dental services. Dental 94.2services include, with prior authorization, fixed bridges that are cost-effective for persons 94.3who cannot use removable dentures because of their medical condition. 94.4 new text begin (b) Medical assistance dental coverage for nonpregnant adults is limited to the new text end 94.5 new text begin following services: new text end 94.6 new text begin (1) comprehensive exams, limited to once every five years; new text end 94.7 new text begin (2) periodic exams, limited to one per year; new text end 94.8 new text begin (3) limited exams; new text end 94.9 new text begin (4) bitewing x-rays, limited to one per year; new text end 94.10 new text begin (5) periapical x-rays; new text end 94.11 new text begin (6) panoramic x-rays, limited to one every five years, and only if provided in new text end 94.12 new text begin conjunction with a posterior extraction or scheduled outpatient facility procedure, or as new text end 94.13 new text begin medically necessary for the diagnosis and follow-up of oral and maxillofacial pathology new text end 94.14 new text begin and trauma. Panoramic x-rays may be taken once every two years for patients who cannot new text end 94.15 new text begin cooperate for intraoral film due to a developmental disability or medical condition that new text end 94.16 new text begin does not allow for intraoral film placement; new text end 94.17 new text begin (7) prophylaxis, limited to one per year; new text end 94.18 new text begin (8) application of fluoride varnish, limited to one per year; new text end 94.19 new text begin (9) posterior fillings, all at the amalgam rate; new text end 94.20 new text begin (10) anterior fillings; new text end 94.21 new text begin (11) endodontics, limited to root canals on the anterior and premolars only; new text end 94.22 new text begin (12) removable prostheses, each dental arch limited to one every six years; new text end 94.23 new text begin (13) oral surgery, limited to extractions, biopsies, and incision and drainage of new text end 94.24 new text begin abscesses; new text end 94.25 new text begin (14) palliative treatment and sedative fillings for relief of pain; and new text end 94.26 new text begin (15) full-mouth debridement, limited to one every five years. new text end 94.27 new text begin (c) In addition to the services specified in paragraph (b), medical assistance new text end 94.28 new text begin covers the following services for adults, if provided in an outpatient hospital setting or new text end 94.29 new text begin freestanding ambulatory surgical center as part of outpatient dental surgery: new text end 94.30 new text begin (1) periodontics, limited to periodontal scaling and root planing once every two new text end 94.31 new text begin years; new text end 94.32 new text begin (2) general anesthesia; and new text end 94.33 new text begin (3) full-mouth survey once every five years. new text end 94.34 new text begin (d) Medical assistance covers dental services for children that are medically new text end 94.35 new text begin necessary. The following guidelines apply: new text end 94.36 new text begin (1) posterior fillings are paid at the amalgam rate; new text end 95.1 new text begin (2) application of sealants once every five years per permanent molar; and new text end 95.2 new text begin (3) application of fluoride varnish once every six months. new text end 95.3 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2010. new text end 95.4    Sec. 28. Minnesota Statutes 2008, section 256B.0625, subdivision 11, is amended to 95.5read: 95.6    Subd. 11. Nurse anesthetist services. Medical assistance covers nurse anesthetist 95.7services. Rates paid for anesthesiology services provided by new text begin a new text end certified registered nurse 95.8anesthetists new text begin anesthetist under the direction of a physician new text end shall be according to the formula 95.9utilized in the Medicare program and shall use the conversion factor that is used by 95.10the Medicare program. new text begin Rates paid for anesthesiology services provided by a certified new text end 95.11 new text begin registered nurse anesthetist who is not directed by a physician shall be the same rate as new text end 95.12 new text begin paid under subdivision 3, paragraph (b). new text end 95.13    Sec. 29. Minnesota Statutes 2008, section 256B.0625, subdivision 13, is amended to 95.14read: 95.15    Subd. 13. Drugs. (a) Medical assistance covers drugs, except for fertility drugs 95.16when specifically used to enhance fertility, if prescribed by a licensed practitioner and 95.17dispensed by a licensed pharmacist, by a physician enrolled in the medical assistance 95.18program as a dispensing physician, or by a physician new text begin , physician assistant, new text end or a nurse 95.19practitioner employed by or under contract with a community health board as defined in 95.20section 145A.02, subdivision 5, for the purposes of communicable disease control. 95.21(b) The dispensed quantity of a prescription drug must not exceed a 34-day supply, 95.22unless authorized by the commissioner. 95.23(c) Medical assistance covers the following over-the-counter drugs when prescribed 95.24by a licensed practitioner or by a licensed pharmacist who meets standards established by 95.25the commissioner, in consultation with the board of pharmacy: antacids, acetaminophen, 95.26family planning products, aspirin, insulin, products for the treatment of lice, vitamins for 95.27adults with documented vitamin deficiencies, vitamins for children under the age of seven 95.28and pregnant or nursing women, and any other over-the-counter drug identified by the 95.29commissioner, in consultation with the formulary committee, as necessary, appropriate, 95.30and cost-effective for the treatment of certain specified chronic diseases, conditions, 95.31or disorders, and this determination shall not be subject to the requirements of chapter 95.3214. A pharmacist may prescribe over-the-counter medications as provided under this 95.33paragraph for purposes of receiving reimbursement under Medicaid. When prescribing 95.34over-the-counter drugs under this paragraph, licensed pharmacists must consult with the 96.1recipient to determine necessity, provide drug counseling, review drug therapy for potential 96.2adverse interactions, and make referrals as needed to other health care professionals. 96.3(d) Effective January 1, 2006, medical assistance shall not cover drugs that 96.4are coverable under Medicare Part D as defined in the Medicare Prescription Drug, 96.5Improvement, and Modernization Act of 2003, Public Law 108-173, section 1860D-2(e), 96.6for individuals eligible for drug coverage as defined in the Medicare Prescription 96.7Drug, Improvement, and Modernization Act of 2003, Public Law 108-173, section 96.81860D-1(a)(3)(A). For these individuals, medical assistance may cover drugs from the 96.9drug classes listed in United States Code, title 42, section 1396r-8(d)(2), subject to this 96.10subdivision and subdivisions 13a to 13g, except that drugs listed in United States Code, 96.11title 42, section 1396r-8(d)(2)(E), shall not be covered. 96.12    Sec. 30. Minnesota Statutes 2008, section 256B.0625, subdivision 13e, is amended to 96.13read: 96.14    Subd. 13e. Payment rates. (a) The basis for determining the amount of payment 96.15shall be the lower of the actual acquisition costs of the drugs plus a fixed dispensing fee; 96.16the maximum allowable cost set by the federal government or by the commissioner plus 96.17the fixed dispensing fee; or the usual and customary price charged to the public. The 96.18amount of payment basis must be reduced to reflect all discount amounts applied to the 96.19charge by any provider/insurer agreement or contract for submitted charges to medical 96.20assistance programs. The net submitted charge may not be greater than the patient liability 96.21for the service. The pharmacy dispensing fee shall be $3.65, except that the dispensing fee 96.22for intravenous solutions which must be compounded by the pharmacist shall be $8 per 96.23bag, $14 per bag for cancer chemotherapy products, and $30 per bag for total parenteral 96.24nutritional products dispensed in one liter quantities, or $44 per bag for total parenteral 96.25nutritional products dispensed in quantities greater than one liter. Actual acquisition 96.26cost includes quantity and other special discounts except time and cash discounts. 96.27Effective July 1, 2008 new text begin 2009 new text end , the actual acquisition cost of a drug shall be estimated by the 96.28commissioner, at average wholesale price minus 14 new text begin 15 new text end percent. The actual acquisition 96.29cost of antihemophilic factor drugs shall be estimated at the average wholesale price 96.30minus 30 percent. The maximum allowable cost of a multisource drug may be set by the 96.31commissioner and it shall be comparable to, but no higher than, the maximum amount 96.32paid by other third-party payors in this state who have maximum allowable cost programs. 96.33Establishment of the amount of payment for drugs shall not be subject to the requirements 96.34of the Administrative Procedure Act. 97.1    (b) An additional dispensing fee of $.30 may be added to the dispensing fee paid 97.2to pharmacists for legend drug prescriptions dispensed to residents of long-term care 97.3facilities when a unit dose blister card system, approved by the department, is used. Under 97.4this type of dispensing system, the pharmacist must dispense a 30-day supply of drug. 97.5The National Drug Code (NDC) from the drug container used to fill the blister card must 97.6be identified on the claim to the department. The unit dose blister card containing the 97.7drug must meet the packaging standards set forth in Minnesota Rules, part 6800.2700, 97.8that govern the return of unused drugs to the pharmacy for reuse. The pharmacy provider 97.9will be required to credit the department for the actual acquisition cost of all unused 97.10drugs that are eligible for reuse. Over-the-counter medications must be dispensed in the 97.11manufacturer's unopened package. The commissioner may permit the drug clozapine to be 97.12dispensed in a quantity that is less than a 30-day supply. 97.13    (c) Whenever a generically equivalent product is available, payment shall be on the 97.14basis of the actual acquisition cost of the generic drug, or on the maximum allowable cost 97.15established by the commissioner. 97.16    (d) The basis for determining the amount of payment for drugs administered in an 97.17outpatient setting shall be the lower of the usual and customary cost submitted by the 97.18provider or the amount established for Medicare by the United States Department of 97.19Health and Human Services pursuant to title XVIII, section 1847a of the federal Social 97.20Security Act. 97.21    (e) The commissioner may negotiate lower reimbursement rates for specialty 97.22pharmacy products than the rates specified in paragraph (a). The commissioner may 97.23require individuals enrolled in the health care programs administered by the department 97.24to obtain specialty pharmacy products from providers with whom the commissioner has 97.25negotiated lower reimbursement rates. Specialty pharmacy products are defined as those 97.26used by a small number of recipients or recipients with complex and chronic diseases 97.27that require expensive and challenging drug regimens. Examples of these conditions 97.28include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis 97.29C, growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms 97.30of cancer. Specialty pharmaceutical products include injectable and infusion therapies, 97.31biotechnology drugs, high-cost therapies, and therapies that require complex care. The 97.32commissioner shall consult with the formulary committee to develop a list of specialty 97.33pharmacy products subject to this paragraph. In consulting with the formulary committee 97.34in developing this list, the commissioner shall take into consideration the population 97.35served by specialty pharmacy products, the current delivery system and standard of care in 98.1the state, and access to care issues. The commissioner shall have the discretion to adjust 98.2the reimbursement rate to prevent access to care issues. 98.3    Sec. 31. Minnesota Statutes 2008, section 256B.0625, subdivision 13h, is amended to 98.4read: 98.5    Subd. 13h. Medication therapy management services. (a) Medical assistance 98.6and general assistance medical care cover medication therapy management services for 98.7a recipient taking four or more prescriptions to treat or prevent two or more chronic 98.8medical conditions, or a recipient with a drug therapy problem that is identified or prior 98.9authorized by the commissioner that has resulted or is likely to result in significant 98.10nondrug program costs. The commissioner may cover medical therapy management 98.11services under MinnesotaCare if the commissioner determines this is cost-effective. For 98.12purposes of this subdivision, "medication therapy management" means the provision 98.13of the following pharmaceutical care services by a licensed pharmacist to optimize the 98.14therapeutic outcomes of the patient's medications: 98.15    (1) performing or obtaining necessary assessments of the patient's health status; 98.16    (2) formulating a medication treatment plan; 98.17    (3) monitoring and evaluating the patient's response to therapy, including safety 98.18and effectiveness; 98.19    (4) performing a comprehensive medication review to identify, resolve, and prevent 98.20medication-related problems, including adverse drug events; 98.21    (5) documenting the care delivered and communicating essential information to 98.22the patient's other primary care providers; 98.23    (6) providing verbal education and training designed to enhance patient 98.24understanding and appropriate use of the patient's medications; 98.25    (7) providing information, support services, and resources designed to enhance 98.26patient adherence with the patient's therapeutic regimens; and 98.27    (8) coordinating and integrating medication therapy management services within the 98.28broader health care management services being provided to the patient. 98.29Nothing in this subdivision shall be construed to expand or modify the scope of practice of 98.30the pharmacist as defined in section 151.01, subdivision 27. 98.31    (b) To be eligible for reimbursement for services under this subdivision, a pharmacist 98.32must meet the following requirements: 98.33    (1) have a valid license issued under chapter 151; 98.34    (2) have graduated from an accredited college of pharmacy on or after May 1996, or 98.35completed a structured and comprehensive education program approved by the Board of 99.1Pharmacy and the American Council of Pharmaceutical Education for the provision and 99.2documentation of pharmaceutical care management services that has both clinical and 99.3didactic elements; 99.4    (3) be practicing in an ambulatory care setting as part of a multidisciplinary team or 99.5have developed a structured patient care process that is offered in a private or semiprivate 99.6patient care area that is separate from the commercial business that also occurs in the 99.7setting, or in home settings, excluding long-term care and group homes, if the service is 99.8ordered by the provider-directed care coordination team; and 99.9    (4) make use of an electronic patient record system that meets state standards. 99.10    (c) For purposes of reimbursement for medication therapy management services, 99.11the commissioner may enroll individual pharmacists as medical assistance and general 99.12assistance medical care providers. The commissioner may also establish contact 99.13requirements between the pharmacist and recipient, including limiting the number of 99.14reimbursable consultations per recipient. 99.15    (d) The commissioner, after receiving recommendations from professional medical 99.16associations, professional pharmacy associations, and consumer groups, shall convene 99.17an 11-member Medication Therapy Management Advisory Committee to advise 99.18the commissioner on the implementation and administration of medication therapy 99.19management services. The committee shall be comprised of: two licensed physicians; 99.20two licensed pharmacists; two consumer representatives; two health plan company 99.21representatives; and three members with expertise in the area of medication therapy 99.22management, who may be licensed physicians or licensed pharmacists. The committee is 99.23governed by section , except that committee members do not receive compensation 99.24or reimbursement for expenses. The advisory committee expires on June 30, 2007. 99.25    (e) The commissioner shall evaluate the effect of medication therapy management 99.26on quality of care, patient outcomes, and program costs, and shall include a description 99.27of any savings generated in the medical assistance and general assistance medical care 99.28programs that can be attributable to this coverage. The evaluation shall be submitted to 99.29the legislature by December 15, 2007. The commissioner may contract with a vendor 99.30or an academic institution that has expertise in evaluating health care outcomes for the 99.31purpose of completing the evaluation. 99.32 new text begin (d) The commissioner shall establish a pilot project for an intensive medication new text end 99.33 new text begin therapy management program for patients identified by the commissioner with multiple new text end 99.34 new text begin chronic conditions and a high number of medications who are at high risk of preventable new text end 99.35 new text begin hospitalizations, emergency room use, medication complications, and suboptimal new text end 99.36 new text begin treatment outcomes due to medication-related problems. For purposes of the pilot new text end 100.1 new text begin project, medication therapy management services may be provided in a patient's home new text end 100.2 new text begin or community setting, in addition to other authorized settings. The commissioner may new text end 100.3 new text begin waive existing payment policies and establish special payment rates for the pilot project. new text end 100.4 new text begin The pilot project must be designed to produce a net savings to the state compared to the new text end 100.5 new text begin estimated costs that would otherwise be incurred for similar patients without the program. new text end 100.6    Sec. 32. Minnesota Statutes 2008, section 256B.0625, subdivision 17, is amended to 100.7read: 100.8    Subd. 17. Transportation costs. (a) Medical assistance covers new text begin medical new text end 100.9transportation costs incurred solely for obtaining emergency medical care or transportation 100.10costs incurred by eligible persons in obtaining emergency or nonemergency medical 100.11care when paid directly to an ambulance company, common carrier, or other recognized 100.12providers of transportation services. new text begin Medical transportation must be provided by: new text end 100.13 new text begin (1) an ambulance, as defined in section 144E.001, subdivision 2; new text end 100.14 new text begin (2) special transportation; or new text end 100.15 new text begin (3) common carrier including, but not limited to, bus, taxicab, other commercial new text end 100.16 new text begin carrier, or private automobile. new text end 100.17(b) Medical assistance covers special transportation, as defined in Minnesota Rules, 100.18part 9505.0315, subpart 1, item F, if the recipient has a physical or mental impairment that 100.19would prohibit the recipient from safely accessing and using a bus, taxi, other commercial 100.20transportation, or private automobile. 100.21The commissioner may use an order by the recipient's attending physician to certify that 100.22the recipient requires special transportation services. Special transportation includes new text begin new text end 100.23 new text begin providers shall perform new text end driver-assisted service to new text begin services for new text end eligible individuals. 100.24Driver-assisted service includes passenger pickup at and return to the individual's 100.25residence or place of business, assistance with admittance of the individual to the medical 100.26facility, and assistance in passenger securement or in securing of wheelchairs or stretchers 100.27in the vehicle. Special transportation providers must obtain written documentation 100.28from the health care service provider who is serving the recipient being transported, 100.29identifying the time that the recipient arrived. Special transportation providers may not 100.30bill for separate base rates for the continuation of a trip beyond the original destination. 100.31Special transportation providers must take recipients to the nearest appropriate health 100.32care provider, using the most direct route available. The maximum new text begin minimum new text end medical 100.33assistance reimbursement rates for special transportation services are: 100.34(1) new text begin (i) new text end $17 for the base rate and $1.35 per mile for new text begin special transportation new text end services to 100.35eligible persons who need a wheelchair-accessible van; 101.1(2) new text begin (ii) new text end $11.50 for the base rate and $1.30 per mile for new text begin special transportation new text end services 101.2to eligible persons who do not need a wheelchair-accessible van; and 101.3(3) new text begin (iii) new text end $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, 101.4for new text begin special transportation new text end services to eligible persons who need a stretcher-accessible 101.5vehicle new text begin ; new text end 101.6 new text begin (2) the base rates for special transportation services in areas defined under RUCA new text end 101.7 new text begin to be super rural shall be equal to the reimbursement rate established in clause (1) plus new text end 101.8 new text begin 11.3 percent; and new text end 101.9 new text begin (3) for special transportation services in areas defined under RUCA to be rural new text end 101.10 new text begin or super rural areas: new text end 101.11 new text begin (i) for a trip equal to 17 miles or less, mileage reimbursement shall be equal to 125 new text end 101.12 new text begin percent of the respective mileage rate in clause (1); and new text end 101.13 new text begin (ii) for a trip between 18 and 50 miles, mileage reimbursement shall be equal to new text end 101.14 new text begin 112.5 percent of the respective mileage rate in clause (1). new text end 101.15 new text begin (c) For purposes of reimbursement rates for special transportation services under new text end 101.16 new text begin paragraph (b), the zip code of the recipient's place of residence shall determine whether new text end 101.17 new text begin the urban, rural, or super rural reimbursement rate applies new text end . 101.18 new text begin (d) For purposes of this subdivision, "rural urban commuting area" or "RUCA" new text end 101.19 new text begin means a census-tract based classification system under which a geographical area is new text end 101.20 new text begin determined to be urban, rural, or super rural. new text end 101.21    Sec. 33. Minnesota Statutes 2008, section 256B.0625, subdivision 17a, is amended to 101.22read: 101.23    Subd. 17a. Payment for ambulance services. new text begin Medical assistance covers new text end 101.24 new text begin ambulance services. Providers shall bill ambulance services according to Medicare new text end 101.25 new text begin criteria. Nonemergency ambulance services shall not be paid as emergencies. new text end Effective 101.26for services rendered on or after July 1, 2001, medical assistance payments for ambulance 101.27services shall be paid at the Medicare reimbursement rate or at the medical assistance 101.28payment rate in effect on July 1, 2000, whichever is greater. 101.29    Sec. 34. Minnesota Statutes 2008, section 256B.0625, is amended by adding a 101.30subdivision to read: 101.31     new text begin Subd. 18b. new text end new text begin Broker dispatching prohibition. new text end new text begin The commissioner shall not use a new text end 101.32 new text begin broker or coordinator for any purpose related to transportation services under subdivision new text end 101.33 new text begin 18. new text end 102.1    Sec. 35. Minnesota Statutes 2008, section 256B.0625, is amended by adding a 102.2subdivision to read: 102.3     new text begin Subd. 25a. new text end new text begin Prior authorization of diagnostic imaging services. new text end new text begin (a) Effective new text end 102.4 new text begin January 1, 2010, the commissioner shall require prior authorization or decision support new text end 102.5 new text begin for the ordering providers at the time the service is ordered for the following outpatient new text end 102.6 new text begin diagnostic imaging services: computerized tomography (CT), magnetic resonance new text end 102.7 new text begin imaging (MRI), magnetic resonance angiography (MRA), positive emission tomography new text end 102.8 new text begin (PET), cardiac imaging and ultrasound diagnostic imaging. new text end 102.9 new text begin (b) Prior authorization under this subdivision is not required for diagnostic imaging new text end 102.10 new text begin services performed as part of a hospital emergency room visit, inpatient hospitalization, or new text end 102.11 new text begin if concurrent with or on the same day as an urgent care facility visit. new text end 102.12 new text begin (c) This subdivision does not apply to services provided to recipients who are new text end 102.13 new text begin enrolled in Medicare, the prepaid medical assistance program, the prepaid general new text end 102.14 new text begin assistance medical care program, or the MinnesotaCare program. new text end 102.15 new text begin (d) The commissioner may contract with a private entity to provide the prior new text end 102.16 new text begin authorization or decision support required under this subdivision. The contracting entity new text end 102.17 new text begin must incorporate clinical guidelines that are based on evidence-based medical literature, if new text end 102.18 new text begin available. By January 1, 2012, the contracting entity shall report to the commissioner the new text end 102.19 new text begin results of prior authorization or decision support. new text end 102.20    Sec. 36. Minnesota Statutes 2008, section 256B.0625, subdivision 26, is amended to 102.21read: 102.22    Subd. 26. Special education services. (a) Medical assistance covers medical 102.23services identified in a recipient's individualized education plan and covered under the 102.24medical assistance state plan. Covered services include occupational therapy, physical 102.25therapy, speech-language therapy, clinical psychological services, nursing services, 102.26school psychological services, school social work services, personal care assistants 102.27serving as management aides, assistive technology devices, transportation services, 102.28health assessments, and other services covered under the medical assistance state plan. 102.29Mental health services eligible for medical assistance reimbursement must be provided or 102.30coordinated through a children's mental health collaborative where a collaborative exists if 102.31the child is included in the collaborative operational target population. The provision or 102.32coordination of services does not require that the individual education plan be developed 102.33by the collaborative. 102.34The services may be provided by a Minnesota school district that is enrolled as a 102.35medical assistance provider or its subcontractor, and only if the services meet all the 103.1requirements otherwise applicable if the service had been provided by a provider other 103.2than a school district, in the following areas: medical necessity, physician's orders, 103.3documentation, personnel qualifications, and prior authorization requirements. The 103.4nonfederal share of costs for services provided under this subdivision is the responsibility 103.5of the local school district as provided in section 125A.74. Services listed in a child's 103.6individual education plan are eligible for medical assistance reimbursement only if those 103.7services meet criteria for federal financial participation under the Medicaid program. 103.8(b) Approval of health-related services for inclusion in the individual education plan 103.9does not require prior authorization for purposes of reimbursement under this chapter. 103.10The commissioner may require physician review and approval of the plan not more than 103.11once annually or upon any modification of the individual education plan that reflects a 103.12change in health-related services. 103.13(c) Services of a speech-language pathologist provided under this section are covered 103.14notwithstanding Minnesota Rules, part 9505.0390, subpart 1, item L, if the person: 103.15(1) holds a masters degree in speech-language pathology; 103.16(2) is licensed by the Minnesota Board of Teaching as an educational 103.17speech-language pathologist; and 103.18(3) either has a certificate of clinical competence from the American Speech and 103.19Hearing Association, has completed the equivalent educational requirements and work 103.20experience necessary for the certificate or has completed the academic program and is 103.21acquiring supervised work experience to qualify for the certificate. 103.22(d) Medical assistance coverage for medically necessary services provided under 103.23other subdivisions in this section may not be denied solely on the basis that the same or 103.24similar services are covered under this subdivision. 103.25(e) The commissioner shall develop and implement package rates, bundled rates, or 103.26per diem rates for special education services under which separately covered services are 103.27grouped together and billed as a unit in order to reduce administrative complexity. 103.28(f) The commissioner shall develop a cost-based payment structure for payment 103.29of these services. new text begin The commissioner shall reimburse claims submitted based on an new text end 103.30 new text begin interim rate, and shall settle at a final rate once the department has determined it. The new text end 103.31 new text begin commissioner shall notify the school district of the final rate. The school district has 60 new text end 103.32 new text begin days to appeal the final rate. To appeal the final rate, the school district shall file a written new text end 103.33 new text begin appeal request to the commissioner within 60 days of the date the final rate determination new text end 103.34 new text begin was mailed. The appeal request shall specify (1) the disputed items and (2) the name and new text end 103.35 new text begin address of the person to contact regarding the appeal. new text end 104.1(g) Effective July 1, 2000, medical assistance services provided under an individual 104.2education plan or an individual family service plan by local school districts shall not count 104.3against medical assistance authorization thresholds for that child. 104.4(h) Nursing services as defined in section 148.171, subdivision 15, and provided 104.5as an individual education plan health-related service, are eligible for medical assistance 104.6payment if they are otherwise a covered service under the medical assistance program. 104.7Medical assistance covers the administration of prescription medications by a licensed 104.8nurse who is employed by or under contract with a school district when the administration 104.9of medications is identified in the child's individualized education plan. The simple 104.10administration of medications alone is not covered under medical assistance when 104.11administered by a provider other than a school district or when it is not identified in the 104.12child's individualized education plan. 104.13    Sec. 37. Minnesota Statutes 2008, section 256B.08, is amended by adding a 104.14subdivision to read: 104.15     new text begin Subd. 4. new text end new text begin Data from Social Security. new text end new text begin The commissioner shall accept data from the new text end 104.16 new text begin Social Security Administration in accordance with United States Code, title 42, section new text end 104.17 new text begin 1396U-5(a). new text end 104.18 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2010. new text end 104.19    Sec. 38. Minnesota Statutes 2008, section 256B.15, subdivision 1, is amended to read: 104.20    Subdivision 1. Policy and applicability. (a) It is the policy of this state that 104.21individuals or couples, either or both of whom participate in the medical assistance 104.22program, use their own assets to pay their share of the total cost of their care during or 104.23after their enrollment in the program according to applicable federal law and the laws of 104.24this state. The following provisions apply: 104.25    (1) subdivisions 1c to 1k shall not apply to claims arising under this section which 104.26are presented under section 525.313; 104.27    (2) the provisions of subdivisions 1c to 1k expanding the interests included in an 104.28estate for purposes of recovery under this section give effect to the provisions of United 104.29States Code, title 42, section 1396p, governing recoveries, but do not give rise to any 104.30express or implied liens in favor of any other parties not named in these provisions; 104.31    (3) the continuation of a recipient's life estate or joint tenancy interest in real 104.32property after the recipient's death for the purpose of recovering medical assistance under 104.33this section modifies common law principles holding that these interests terminate on 104.34the death of the holder; 105.1    (4) all laws, rules, and regulations governing or involved with a recovery of medical 105.2assistance shall be liberally construed to accomplish their intended purposes; 105.3    (5) a deceased recipient's life estate and joint tenancy interests continued under this 105.4section shall be owned by the remaindermen or surviving joint tenants as their interests 105.5may appear on the date of the recipient's death. They shall not be merged into the 105.6remainder interest or the interests of the surviving joint tenants by reason of ownership. 105.7They shall be subject to the provisions of this section. Any conveyance, transfer, sale, 105.8assignment, or encumbrance by a remainderman, a surviving joint tenant, or their heirs, 105.9successors, and assigns shall be deemed to include all of their interest in the deceased 105.10recipient's life estate or joint tenancy interest continued under this section; and 105.11    (6) the provisions of subdivisions 1c to 1k continuing a recipient's joint tenancy 105.12interests in real property after the recipient's death do not apply to a homestead owned 105.13of record, on the date the recipient dies, by the recipient and the recipient's spouse as 105.14joint tenants with a right of survivorship. Homestead means the real property occupied 105.15by the surviving joint tenant spouse as their sole residence on the date the recipient dies 105.16and classified and taxed to the recipient and surviving joint tenant spouse as homestead 105.17property for property tax purposes in the calendar year in which the recipient dies. For 105.18purposes of this exemption, real property the recipient and their surviving joint tenant 105.19spouse purchase solely with the proceeds from the sale of their prior homestead, own 105.20of record as joint tenants, and qualify as homestead property under section 273.124 in 105.21the calendar year in which the recipient dies and prior to the recipient's death shall be 105.22deemed to be real property classified and taxed to the recipient and their surviving joint 105.23tenant spouse as homestead property in the calendar year in which the recipient dies. 105.24The surviving spouse, or any person with personal knowledge of the facts, may provide 105.25an affidavit describing the homestead property affected by this clause and stating facts 105.26showing compliance with this clause. The affidavit shall be prima facie evidence of the 105.27facts it states. 105.28    (b) For purposes of this section, "medical assistance" includes the medical assistance 105.29program under this chapter and the general assistance medical care program under chapter 105.30256D and alternative care for nonmedical assistance recipients under section 256B.0913. 105.31    (c) new text begin For purposes of this section, beginning January 1, 2010, "medical assistance" new text end 105.32 new text begin does not include Medicare cost-sharing benefits in accordance with United States Code, new text end 105.33 new text begin title 42, section 1396p. new text end 105.34     new text begin (d) new text end All provisions in this subdivision, and subdivisions 1d, 1f, 1g, 1h, 1i, and 1j, 105.35related to the continuation of a recipient's life estate or joint tenancy interests in real 105.36property after the recipient's death for the purpose of recovering medical assistance, are 106.1effective only for life estates and joint tenancy interests established on or after August 1, 106.22003. For purposes of this paragraph, medical assistance does not include alternative care. 106.3    Sec. 39. Minnesota Statutes 2008, section 256B.15, subdivision 1a, is amended to read: 106.4    Subd. 1a. Estates subject to claims. new text begin (a) new text end If a person receives any medical assistance 106.5hereunder, on the person's death, if single, or on the death of the survivor of a married 106.6couple, either or both of whom received medical assistance, or as otherwise provided 106.7for in this section, the total amount paid for medical assistance rendered for the person 106.8and spouse shall be filed as a claim against the estate of the person or the estate of the 106.9surviving spouse in the court having jurisdiction to probate the estate or to issue a decree 106.10of descent according to sections 525.31 to 525.313. 106.11 new text begin (b) For the purposes of this section, the person's estate must consist of: new text end 106.12 new text begin (1) the person's probate estate; new text end 106.13 new text begin (2) all of the person's interests or proceeds of those interests in real property the new text end 106.14 new text begin person owned as a life tenant or as a joint tenant with a right of survivorship at the time of new text end 106.15 new text begin the person's death; new text end 106.16 new text begin (3) all of the person's interests or proceeds of those interests in securities the person new text end 106.17 new text begin owned in beneficiary form as provided under sections 524.6-301 to 524.6-311 at the time new text end 106.18 new text begin of the person's death, to the extent the interests or proceeds of those interests become part new text end 106.19 new text begin of the probate estate under section 524.6-307; new text end 106.20 new text begin (4) all of the person's interests in joint accounts, multiple-party accounts, and new text end 106.21 new text begin pay-on-death accounts, brokerage accounts, investment accounts, or the proceeds of new text end 106.22 new text begin those accounts, as provided under sections 524.6-201 to 524.6-214 at the time of the new text end 106.23 new text begin person's death to the extent the interests become part of the probate estate under section new text end 106.24 new text begin 524.6-207; and new text end 106.25 new text begin (5) assets conveyed to a survivor, heir, or assign of the person through survivorship, new text end 106.26 new text begin living trust, or other arrangements. new text end 106.27 new text begin (c) For the purpose of this section and recovery in a surviving spouse's estate for new text end 106.28 new text begin medical assistance paid for a predeceased spouse, the estate must consist of all of the legal new text end 106.29 new text begin title and interests the deceased individual's predeceased spouse had in jointly owned or new text end 106.30 new text begin marital property at the time of the spouse's death, as defined in subdivision 2b, and the new text end 106.31 new text begin proceeds of those interests, that passed to the deceased individual or another individual, a new text end 106.32 new text begin survivor, an heir, or an assign of the predeceased spouse through a joint tenancy, tenancy new text end 106.33 new text begin in common, survivorship, life estate, living trust, or other arrangement. A deceased new text end 106.34 new text begin recipient who, at death, owned the property jointly with the surviving spouse shall have new text end 106.35 new text begin an interest in the entire property. new text end 107.1 new text begin (d) For the purpose of recovery in a single person's estate or the estate of a survivor new text end 107.2 new text begin of a married couple, "other arrangement" includes any other means by which title to all or new text end 107.3 new text begin any part of the jointly owned or marital property or interest passed from the predeceased new text end 107.4 new text begin spouse to another including, but not limited to, transfers between spouses which are new text end 107.5 new text begin permitted, prohibited, or penalized for purposes of medical assistance. new text end 107.6 new text begin (e) new text end A claim shall be filed if medical assistance was rendered for either or both 107.7persons under one of the following circumstances: 107.8(a) new text begin (1) new text end the person was over 55 years of age, and received services under this chapter; 107.9(b) new text begin (2) new text end the person resided in a medical institution for six months or longer, received 107.10services under this chapter, and, at the time of institutionalization or application for 107.11medical assistance, whichever is later, the person could not have reasonably been expected 107.12to be discharged and returned home, as certified in writing by the person's treating 107.13physician. For purposes of this section only, a "medical institution" means a skilled 107.14nursing facility, intermediate care facility, intermediate care facility for persons with 107.15developmental disabilities, nursing facility, or inpatient hospital; or 107.16(c) new text begin (3) new text end the person received general assistance medical care services under chapter 107.17256D. 107.18 new text begin (f) new text end The claim shall be considered an expense of the last illness of the decedent for the 107.19purpose of section 524.3-805. new text begin Notwithstanding any law or rule to the contrary, a state or new text end 107.20 new text begin county agency with a claim under this section must be a creditor under section 524.6-307. new text end 107.21Any statute of limitations that purports to limit any county agency or the state agency, 107.22or both, to recover for medical assistance granted hereunder shall not apply to any claim 107.23made hereunder for reimbursement for any medical assistance granted hereunder. Notice 107.24of the claim shall be given to all heirs and devisees of the decedent whose identity can be 107.25ascertained with reasonable diligence. The notice must include procedures and instructions 107.26for making an application for a hardship waiver under subdivision 5; time frames for 107.27submitting an application and determination; and information regarding appeal rights and 107.28procedures. Counties are entitled to one-half of the nonfederal share of medical assistance 107.29collections from estates that are directly attributable to county effort. Counties are entitled 107.30to ten percent of the collections for alternative care directly attributable to county effort. 107.31    Sec. 40. Minnesota Statutes 2008, section 256B.15, subdivision 1h, is amended to read: 107.32    Subd. 1h. Estates of specific persons receiving medical assistance. (a) For 107.33purposes of this section, paragraphs (b) to (k) new text begin (j) new text end apply if a person received medical 107.34assistance for which a claim may be filed under this section and died single, or the 108.1surviving spouse of the couple and was not survived by any of the persons described 108.2in subdivisions 3 and 4. 108.3    (b) For purposes of this section, the person's estate consists of: (1) the person's 108.4probate estate; (2) all of the person's interests or proceeds of those interests in real property 108.5the person owned as a life tenant or as a joint tenant with a right of survivorship at the 108.6time of the person's death; (3) all of the person's interests or proceeds of those interests in 108.7securities the person owned in beneficiary form as provided under sections to 108.8 at the time of the person's death, to the extent they become part of the probate 108.9estate under section ; (4) all of the person's interests in joint accounts, multiple 108.10party accounts, and pay on death accounts, or the proceeds of those accounts, as provided 108.11under sections to at the time of the person's death to the extent 108.12they become part of the probate estate under section ; and (5) the person's 108.13legal title or interest at the time of the person's death in real property transferred under 108.14a transfer on death deed under section , or in the proceeds from the subsequent 108.15sale of the person's interest in the real property. Notwithstanding any law or rule to the 108.16contrary, a state or county agency with a claim under this section shall be a creditor under 108.17section . 108.18    (c) new text begin (b) new text end Notwithstanding any law or rule to the contrary, the person's life estate or joint 108.19tenancy interest in real property not subject to a medical assistance lien under sections 108.20514.980 to 514.985 on the date of the person's death shall not end upon the person's death 108.21and shall continue as provided in this subdivision. The life estate in the person's estate 108.22shall be that portion of the interest in the real property subject to the life estate that is equal 108.23to the life estate percentage factor for the life estate as listed in the Life Estate Mortality 108.24Table of the health care program's manual for a person who was the age of the medical 108.25assistance recipient on the date of the person's death. The joint tenancy interest in real 108.26property in the estate shall be equal to the fractional interest the person would have owned 108.27in the jointly held interest in the property had they and the other owners held title to the 108.28property as tenants in common on the date the person died. 108.29    (d) new text begin (c) new text end The court upon its own motion, or upon motion by the personal representative 108.30or any interested party, may enter an order directing the remaindermen or surviving joint 108.31tenants and their spouses, if any, to sign all documents, take all actions, and otherwise 108.32fully cooperate with the personal representative and the court to liquidate the decedent's 108.33life estate or joint tenancy interests in the estate and deliver the cash or the proceeds of 108.34those interests to the personal representative and provide for any legal and equitable 108.35sanctions as the court deems appropriate to enforce and carry out the order, including an 108.36award of reasonable attorney fees. 109.1    (e) new text begin (d) new text end The personal representative may make, execute, and deliver any conveyances 109.2or other documents necessary to convey the decedent's life estate or joint tenancy interest 109.3in the estate that are necessary to liquidate and reduce to cash the decedent's interest or 109.4for any other purposes. 109.5    (f) new text begin (e) new text end Subject to administration, all costs, including reasonable attorney fees, 109.6directly and immediately related to liquidating the decedent's life estate or joint tenancy 109.7interest in the decedent's estate, shall be paid from the gross proceeds of the liquidation 109.8allocable to the decedent's interest and the net proceeds shall be turned over to the personal 109.9representative and applied to payment of the claim presented under this section. 109.10    (g) new text begin (f) new text end The personal representative shall bring a motion in the district court in which 109.11the estate is being probated to compel the remaindermen or surviving joint tenants to 109.12account for and deliver to the personal representative all or any part of the proceeds of any 109.13sale, mortgage, transfer, conveyance, or any disposition of real property allocable to the 109.14decedent's life estate or joint tenancy interest in the decedent's estate, and do everything 109.15necessary to liquidate and reduce to cash the decedent's interest and turn the proceeds of 109.16the sale or other disposition over to the personal representative. The court may grant any 109.17legal or equitable relief including, but not limited to, ordering a partition of real estate 109.18under chapter 558 necessary to make the value of the decedent's life estate or joint tenancy 109.19interest available to the estate for payment of a claim under this section. 109.20    (h) new text begin (g) new text end Subject to administration, the personal representative shall use all of the cash 109.21or proceeds of interests to pay an allowable claim under this section. The remaindermen 109.22or surviving joint tenants and their spouses, if any, may enter into a written agreement 109.23with the personal representative or the claimant to settle and satisfy obligations imposed at 109.24any time before or after a claim is filed. 109.25    (i) new text begin (h) new text end The personal representative may, at their discretion, provide any or all of the 109.26other owners, remaindermen, or surviving joint tenants with an affidavit terminating the 109.27decedent's estate's interest in real property the decedent owned as a life tenant or as a joint 109.28tenant with others, if the personal representative determines in good faith that neither the 109.29decedent nor any of the decedent's predeceased spouses received any medical assistance 109.30for which a claim could be filed under this section, or if the personal representative has 109.31filed an affidavit with the court that the estate has other assets sufficient to pay a claim, as 109.32presented, or if there is a written agreement under paragraph (h) new text begin (g) new text end , or if the claim, as 109.33allowed, has been paid in full or to the full extent of the assets the estate has available 109.34to pay it. The affidavit may be recorded in the office of the county recorder or filed in 109.35the Office of the Registrar of Titles for the county in which the real property is located. 109.36Except as provided in section 514.981, subdivision 6, when recorded or filed, the affidavit 110.1shall terminate the decedent's interest in real estate the decedent owned as a life tenant or a 110.2joint tenant with others. The affidavit shall: 110.3(1) be signed by the personal representative; 110.4(2) identify the decedent and the interest being terminated; 110.5(3) give recording information sufficient to identify the instrument that created the 110.6interest in real property being terminated; 110.7(4) legally describe the affected real property; 110.8(5) state that the personal representative has determined that neither the decedent 110.9nor any of the decedent's predeceased spouses received any medical assistance for which 110.10a claim could be filed under this section; 110.11(6) state that the decedent's estate has other assets sufficient to pay the claim, as 110.12presented, or that there is a written agreement between the personal representative and 110.13the claimant and the other owners or remaindermen or other joint tenants to satisfy the 110.14obligations imposed under this subdivision; and 110.15(7) state that the affidavit is being given to terminate the estate's interest under this 110.16subdivision, and any other contents as may be appropriate. 110.17The recorder or registrar of titles shall accept the affidavit for recording or filing. The 110.18affidavit shall be effective as provided in this section and shall constitute notice even if it 110.19does not include recording information sufficient to identify the instrument creating the 110.20interest it terminates. The affidavit shall be conclusive evidence of the stated facts. 110.21    (j) new text begin (i) new text end The holder of a lien arising under subdivision 1c shall release the lien at 110.22the holder's expense against an interest terminated under paragraph (h) new text begin (g) new text end to the extent 110.23of the termination. 110.24    (k) new text begin (j) new text end If a lien arising under subdivision 1c is not released under paragraph (j) new text begin (i) new text end , 110.25prior to closing the estate, the personal representative shall deed the interest subject to the 110.26lien to the remaindermen or surviving joint tenants as their interests may appear. Upon 110.27recording or filing, the deed shall work a merger of the recipient's life estate or joint 110.28tenancy interest, subject to the lien, into the remainder interest or interest the decedent and 110.29others owned jointly. The lien shall attach to and run with the property to the extent of 110.30the decedent's interest at the time of the decedent's death. 110.31    Sec. 41. Minnesota Statutes 2008, section 256B.15, subdivision 2, is amended to read: 110.32    Subd. 2. Limitations on claims. The claim shall include only the total amount 110.33of medical assistance rendered after age 55 or during a period of institutionalization 110.34described in subdivision 1a, clause (b) new text begin paragraph (e) new text end , and the total amount of general 110.35assistance medical care rendered, and shall not include interest. Claims that have been 111.1allowed but not paid shall bear interest according to section 524.3-806, paragraph (d). A 111.2claim against the estate of a surviving spouse who did not receive medical assistance, for 111.3medical assistance rendered for the predeceased spouse, new text begin shall be payable from the full new text end 111.4 new text begin value of all of the predeceased spouse's assets and interests which are part of the surviving new text end 111.5 new text begin spouse's estate under subdivisions 1a and 2b. Recovery of medical assistance expenses in new text end 111.6 new text begin the nonrecipient surviving spouse's estate new text end is limited to the value of the assets of the estate 111.7that were marital property or jointly owned property at any time during the marriage. new text begin The new text end 111.8 new text begin claim is not payable from the value of assets or proceeds of assets in the estate attributable new text end 111.9 new text begin to a predeceased spouse whom the individual married after the death of the predeceased new text end 111.10 new text begin recipient spouse for whom the claim is filed or from assets and the proceeds of assets in the new text end 111.11 new text begin estate which the nonrecipient decedent spouse acquired with assets which were not marital new text end 111.12 new text begin property or jointly owned property after the death of the predeceased recipient spouse. new text end 111.13Claims for alternative care shall be net of all premiums paid under section 256B.0913, 111.14subdivision 12 , on or after July 1, 2003, and shall be limited to services provided on or 111.15after July 1, 2003. new text begin Claims against marital property shall be limited to claims against new text end 111.16 new text begin recipients who died on or after July 1, 2009. new text end 111.17    Sec. 42. Minnesota Statutes 2008, section 256B.15, is amended by adding a 111.18subdivision to read: 111.19     new text begin Subd. 2b. new text end new text begin Controlling provisions. new text end new text begin (a) For purposes of this subdivision and new text end 111.20 new text begin subdivisions 1a and 2, paragraphs (b) to (d) apply. new text end 111.21 new text begin (b) At the time of death of a recipient spouse and solely for purpose of recovery of new text end 111.22 new text begin medical assistance benefits received, a predeceased recipient spouse shall have a legal new text end 111.23 new text begin title or interest in the undivided whole of all of the property which the recipient and the new text end 111.24 new text begin recipient's surviving spouse owned jointly or which was marital property at any time new text end 111.25 new text begin during their marriage regardless of the form of ownership and regardless of whether new text end 111.26 new text begin it was owned or titled in the names of one or both the recipient and the recipient's new text end 111.27 new text begin spouse. Title and interest in the property of a predeceased recipient spouse shall not end new text end 111.28 new text begin or extinguish upon the person's death and shall continue for the purpose of allowing new text end 111.29 new text begin recovery of medical assistance in the estate of the surviving spouse. Upon the death of new text end 111.30 new text begin the predeceased recipient spouse, title and interest in the predeceased spouse's property new text end 111.31 new text begin shall vest in the surviving spouse by operation of law and without the necessity for any new text end 111.32 new text begin probate or decree of descent proceedings and shall continue to exist after the death of the new text end 111.33 new text begin predeceased spouse and the surviving spouse to permit recovery of medical assistance. new text end 111.34 new text begin The recipient spouse and the surviving spouse of a deceased recipient spouse shall not new text end 112.1 new text begin encumber, disclaim, transfer, alienate, hypothecate, or otherwise divest themselves of new text end 112.2 new text begin these interests before or upon death. new text end 112.3 new text begin (c) For purposes of this section, "marital property" includes any and all real or new text end 112.4 new text begin personal property of any kind or interests in such property the predeceased recipient new text end 112.5 new text begin spouse and their spouse, or either of them, owned at the time of their marriage to each new text end 112.6 new text begin other or acquired during their marriage regardless of whether it was owned or titled in new text end 112.7 new text begin the names of one or both of them. If either or both spouses of a married couple received new text end 112.8 new text begin medical assistance, all property owned during the marriage or which either or both spouses new text end 112.9 new text begin acquired during their marriage shall be presumed to be marital property for purposes of new text end 112.10 new text begin recovering medical assistance unless there is clear and convincing evidence to the contrary. new text end 112.11 new text begin (d) The agency responsible for the claim for medical assistance for a recipient spouse new text end 112.12 new text begin may, at its discretion, release specific real and personal property from the provisions of new text end 112.13 new text begin this section. The release shall extinguish the interest created under paragraph (b) in the new text end 112.14 new text begin land it describes upon filing or recording. The release need not be attested, certified, or new text end 112.15 new text begin acknowledged as a condition of filing or recording and shall be filed or recorded in the new text end 112.16 new text begin office of the county recorder or registrar of titles, as appropriate, in the county where the new text end 112.17 new text begin real property is located. The party to whom the release is given shall be responsible for new text end 112.18 new text begin paying all fees and costs necessary to record and file the release. If the property described new text end 112.19 new text begin in the release is registered property, the registrar of titles shall accept it for recording and new text end 112.20 new text begin shall record it on the certificate of title for each parcel of property described in the release. new text end 112.21 new text begin If the property described in the release is abstract property, the recorder shall accept it new text end 112.22 new text begin for filing and file it in the county's grantor-grantee indexes and any tract index the county new text end 112.23 new text begin maintains for each parcel of property described in the release. new text end 112.24    Sec. 43. Minnesota Statutes 2008, section 256B.15, is amended by adding a 112.25subdivision to read: 112.26     new text begin Subd. 9. new text end new text begin Commissioner's intervention. new text end new text begin The commissioner shall be permitted to new text end 112.27 new text begin intervene as a party in any proceeding involving recovery of medical assistance upon new text end 112.28 new text begin filing a notice of intervention and serving such notice on the other parties. new text end 112.29    Sec. 44. new text begin [256B.196] INTERGOVERNMENTAL TRANSFERS; HOSPITAL new text end 112.30 new text begin PAYMENTS. new text end 112.31     new text begin Subdivision 1. new text end new text begin Federal approval required. new text end new text begin This section is contingent on federal new text end 112.32 new text begin approval of the intergovernmental transfers and payments authorized under this section. new text end 112.33 new text begin This section is also contingent on current payment by the government entities of the new text end 112.34 new text begin intergovernmental transfers under this section. new text end 113.1     new text begin Subd. 2. new text end new text begin Commissioner's duties. new text end new text begin (a) For the purposes of this subdivision and new text end 113.2 new text begin subdivision 3, the commissioner shall determine the fee-for-service outpatient hospital new text end 113.3 new text begin services upper payment limit for nonstate government hospitals. The commissioner shall new text end 113.4 new text begin then determine the amount of a supplemental payment to Hennepin County Medical new text end 113.5 new text begin Center and Regions Hospital for these services that would increase medical assistance new text end 113.6 new text begin spending in this category to the aggregate upper payment limit for all nonstate government new text end 113.7 new text begin hospitals in Minnesota. In making this determination, the commissioner shall allot the new text end 113.8 new text begin available increases between Hennepin County Medical Center and Regions Hospital new text end 113.9 new text begin based on the ratio of medical assistance fee-for-service outpatient hospital payments to new text end 113.10 new text begin the two facilities. The commissioner shall adjust this allotment as necessary based on new text end 113.11 new text begin federal approvals, the amount of intergovernmental transfers received from Hennepin and new text end 113.12 new text begin Ramsey Counties, and other factors, in order to maximize the additional total payments. new text end 113.13 new text begin The commissioner shall inform Hennepin County and Ramsey County of the periodic new text end 113.14 new text begin intergovernmental transfers necessary to match federal Medicaid payments available new text end 113.15 new text begin under this subdivision in order to make supplementary medical assistance payments to new text end 113.16 new text begin Hennepin County Medical Center and Regions Hospital equal to an amount that when new text end 113.17 new text begin combined with existing medical assistance payments to nonstate governmental hospitals new text end 113.18 new text begin would increase total payments to hospitals in this category for outpatient services to new text end 113.19 new text begin the aggregate upper payment limit for all hospitals in this category in Minnesota. Upon new text end 113.20 new text begin receipt of these periodic transfers, the commissioner shall make supplementary payments new text end 113.21 new text begin to Hennepin County Medical Center and Regions Hospital. new text end 113.22 new text begin (b) For the purposes of this subdivision and subdivision 3, the commissioner shall new text end 113.23 new text begin determine an upper payment limit for physicians affiliated with Hennepin County Medical new text end 113.24 new text begin Center and with Regions Hospital. The upper payment limit shall be based on the average new text end 113.25 new text begin commercial rate or be determined using another method acceptable to the Centers for new text end 113.26 new text begin Medicare and Medicaid Services. The commissioner shall inform Hennepin County and new text end 113.27 new text begin Ramsey County of the periodic intergovernmental transfers necessary to match the federal new text end 113.28 new text begin Medicaid payments available under this subdivision in order to make supplementary new text end 113.29 new text begin payments to physicians affiliated with Hennepin County Medical Center and Regions new text end 113.30 new text begin Hospital equal to the difference between the established medical assistance payment for new text end 113.31 new text begin physician services and the upper payment limit. Upon receipt of these periodic transfers, new text end 113.32 new text begin the commissioner shall make supplementary payments to physicians of Hennepin Faculty new text end 113.33 new text begin Associates and HealthPartners. new text end 113.34 new text begin (c) Beginning January 1, 2010, Hennepin County and Ramsey County shall make new text end 113.35 new text begin monthly intergovernmental transfers to the commissioner in the following amounts: new text end 113.36 new text begin $133,333 by Hennepin County and $100,000 by Ramsey County. The commissioner shall new text end 114.1 new text begin increase the medical assistance capitation payments to Metropolitan Health Plan and new text end 114.2 new text begin HealthPartners by an amount equal to the annual value of the monthly transfers plus new text end 114.3 new text begin federal financial participation. new text end 114.4 new text begin (d) The commissioner shall inform Hennepin County and Ramsey County on an new text end 114.5 new text begin ongoing basis of the need for any changes needed in the intergovernmental transfers new text end 114.6 new text begin in order to continue the payments under paragraphs (a) to (c), at their maximum level, new text end 114.7 new text begin including increases in upper payment limits, changes in the federal Medicaid match, and new text end 114.8 new text begin other factors. new text end 114.9 new text begin (e) The payments in paragraphs (a) to (c) shall be implemented independently of new text end 114.10 new text begin each other, subject to federal approval and to the receipt of transfers under subdivision 3. new text end 114.11     new text begin Subd. 3. new text end new text begin Intergovernmental transfers. new text end new text begin Based on the determination by the new text end 114.12 new text begin commissioner under subdivision 2, Hennepin County and Ramsey County shall make new text end 114.13 new text begin periodic intergovernmental transfers to the commissioner for the purposes of subdivision new text end 114.14 new text begin 2, paragraphs (a) to (c). All of the intergovernmental transfers made by Hennepin County new text end 114.15 new text begin shall be used to match federal payments to Hennepin County Medical Center under new text end 114.16 new text begin subdivision 2, paragraph (a); to physicians affiliated with Hennepin Faculty Associates new text end 114.17 new text begin under subdivision 2, paragraph (b); and to Metropolitan Health Plan under subdivision new text end 114.18 new text begin 2, paragraph (c). All of the intergovernmental transfers made by Ramsey County shall new text end 114.19 new text begin be used to match federal payments to Regions Hospital under subdivision 2, paragraph new text end 114.20 new text begin (a); to physicians affiliated with HealthPartners under subdivision 2, paragraph (b); and to new text end 114.21 new text begin HealthPartners under subdivision 2, paragraph (c). new text end 114.22     new text begin Subd. 4. new text end new text begin Adjustments permitted. new text end new text begin (a) The commissioner may adjust the new text end 114.23 new text begin intergovernmental transfers under subdivision 3 and the payments under subdivision new text end 114.24 new text begin 2, based on the commissioner's determination of Medicare upper payment limits, new text end 114.25 new text begin hospital-specific charge limits, hospital-specific limitations on disproportionate share new text end 114.26 new text begin payments, medical inflation, actuarial certification, and cost-effectiveness for purposes new text end 114.27 new text begin of federal waivers. Any adjustments must be made on a proportional basis. The new text end 114.28 new text begin commissioner may make adjustments under this subdivision only after consultation new text end 114.29 new text begin with the affected counties and hospitals. All payments under subdivision 2 and all new text end 114.30 new text begin intergovernmental transfers under subdivision 3 are limited to amounts available after all new text end 114.31 new text begin other base rates, adjustments, and supplemental payments in chapter 256B are calculated. new text end 114.32 new text begin (b) The ratio of medical assistance payments specified in subdivision 2 to the new text end 114.33 new text begin voluntary intergovernmental transfers specified in subdivision 3 shall not be reduced new text end 114.34 new text begin except as provided under paragraph (a). new text end 115.1     new text begin Subd. 5. new text end new text begin Recession period. new text end new text begin Each type of intergovernmental transfer in subdivision new text end 115.2 new text begin 2, paragraphs (a) to (d), for payment periods from October 1, 2008, through December new text end 115.3 new text begin 31, 2010, is voluntary on the part of Hennepin and Ramsey Counties, meaning that the new text end 115.4 new text begin transfer must be agreed to, in writing, by the counties prior to any payments being issued. new text end 115.5 new text begin One agreement on each type of transfer shall cover the entire recession period. new text end 115.6    Sec. 45. Minnesota Statutes 2008, section 256B.199, is amended to read: 115.7256B.199 PAYMENTS REPORTED BY GOVERNMENTAL ENTITIES. 115.8    (a) Effective July 1, 2007, the commissioner shall apply for federal matching funds 115.9for the expenditures in paragraphs (b) and (c). 115.10    (b) The commissioner shall apply for federal matching funds for certified public 115.11expenditures as follows: 115.12    (1) Hennepin County, Hennepin County Medical Center, Ramsey County, Regions 115.13Hospital, the University of Minnesota, and Fairview-University Medical Center shall 115.14report quarterly to the commissioner beginning June 1, 2007, payments made during the 115.15second previous quarter that may qualify for reimbursement under federal law; 115.16     (2) based on these reports, the commissioner shall apply for federal matching 115.17funds. These funds are appropriated to the commissioner for the payments under section 115.18256.969, subdivision 27 ; and 115.19     (3) by May 1 of each year, beginning May 1, 2007, the commissioner shall inform 115.20the nonstate entities listed in paragraph (a) of the amount of federal disproportionate share 115.21hospital payment money expected to be available in the current federal fiscal year. 115.22    (c) The commissioner shall apply for federal matching funds for general assistance 115.23medical care expenditures as follows: 115.24    (1) for hospital services occurring on or after July 1, 2007, general assistance medical 115.25care expenditures for fee-for-service inpatient and outpatient hospital payments made by 115.26the department shall be used to apply for federal matching funds, except as limited below: 115.27    (i) only those general assistance medical care expenditures made to an individual 115.28hospital that would not cause the hospital to exceed its individual hospital limits under 115.29section 1923 of the Social Security Act may be considered; and 115.30    (ii) general assistance medical care expenditures may be considered only to the extent 115.31of Minnesota's aggregate allotment under section 1923 of the Social Security Act; and 115.32    (2) all hospitals must provide any necessary expenditure, cost, and revenue 115.33information required by the commissioner as necessary for purposes of obtaining federal 115.34Medicaid matching funds for general assistance medical care expenditures. 116.1 new text begin (d) For the period from April 1, 2009, to September 30, 2010, the commissioner shall new text end 116.2 new text begin apply for additional federal matching funds available as disproportionate share hospital new text end 116.3 new text begin payments under the American Recovery and Reinvestment Act of 2009. These funds shall new text end 116.4 new text begin be made available as the state share of payments under section 256.969, subdivision 28. new text end 116.5 new text begin The entities required to report certified public expenditures under paragraph (b), clause new text end 116.6 new text begin (1), shall report additional certified public expenditures as necessary under this paragraph. new text end 116.7 new text begin EFFECTIVE DATE. new text end new text begin This section is effective the day following final enactment. new text end 116.8    Sec. 46. Minnesota Statutes 2008, section 256B.69, subdivision 5a, is amended to read: 116.9    Subd. 5a. Managed care contracts. (a) Managed care contracts under this section 116.10and sections 256L.12 and 256D.03, shall be entered into or renewed on a calendar year 116.11basis beginning January 1, 1996. Managed care contracts which were in effect on June 116.1230, 1995, and set to renew on July 1, 1995, shall be renewed for the period July 1, 1995 116.13through December 31, 1995 at the same terms that were in effect on June 30, 1995. The 116.14commissioner may issue separate contracts with requirements specific to services to 116.15medical assistance recipients age 65 and older. 116.16    (b) A prepaid health plan providing covered health services for eligible persons 116.17pursuant to chapters 256B, 256D, and 256L, is responsible for complying with the terms 116.18of its contract with the commissioner. Requirements applicable to managed care programs 116.19under chapters 256B, 256D, and 256L, established after the effective date of a contract 116.20with the commissioner take effect when the contract is next issued or renewed. 116.21    (c) Effective for services rendered on or after January 1, 2003, the commissioner shall 116.22withhold five percent of managed care plan payments under this section new text begin and county-based new text end 116.23 new text begin purchasing plan's payment rate under section 256B.692 new text end for the prepaid medical assistance 116.24and general assistance medical care programs pending completion of performance targets. 116.25Each performance target must be quantifiable, objective, measurable, and reasonably 116.26attainable, except in the case of a performance target based on a federal or state law or rule. 116.27Criteria for assessment of each performance target must be outlined in writing prior to the 116.28contract effective date. The managed care plan must demonstrate, to the commissioner's 116.29satisfaction, that the data submitted regarding attainment of the performance target is 116.30accurate. The commissioner shall periodically change the administrative measures used 116.31as performance targets in order to improve plan performance across a broader range of 116.32administrative services. The performance targets must include measurement of plan 116.33efforts to contain spending on health care services and administrative activities. The 116.34commissioner may adopt plan-specific performance targets that take into account factors 116.35affecting only one plan, including characteristics of the plan's enrollee population. The 117.1withheld funds must be returned no sooner than July of the following year if performance 117.2targets in the contract are achieved. The commissioner may exclude special demonstration 117.3projects under subdivision 23. A managed care plan or a county-based purchasing plan 117.4under section may include as admitted assets under section any amount 117.5withheld under this paragraph that is reasonably expected to be returned. 117.6    (d)(1) Effective for services rendered on or after January 1, 2009, new text begin through December new text end 117.7 new text begin 31, 2009, new text end the commissioner shall withhold three percent of managed care plan payments 117.8under this section new text begin and county-based purchasing plan payments under section 256B.692 new text end for 117.9the prepaid medical assistance and general assistance medical care programs. The withheld 117.10funds must be returned no sooner than July 1 and no later than July 31 of the following 117.11year. The commissioner may exclude special demonstration projects under subdivision 23. 117.12    (2) A managed care plan or a county-based purchasing plan under section 256B.692 117.13may include as admitted assets under section any amount withheld under 117.14this paragraph. The return of the withhold under this paragraph is not subject to the 117.15requirements of paragraph (c). 117.16 new text begin (e) Effective for services rendered on or after January 1, 2010, through December new text end 117.17 new text begin 31, 2010, the commissioner shall withhold 3.5 percent of managed care plan payments new text end 117.18 new text begin under this section and county-based purchasing plan payments under section 256B.692 new text end 117.19 new text begin for the prepaid medical assistance program. The withheld funds must be returned no new text end 117.20 new text begin sooner than July 1 and no later than July 31 of the following year. The commissioner may new text end 117.21 new text begin exclude special demonstration projects under subdivision 23. new text end 117.22 new text begin (f) Effective for services rendered on or after January 1, 2011, through December 31, new text end 117.23 new text begin 2011, the commissioner shall withhold four percent of managed care plan payments under new text end 117.24 new text begin this section and county-based purchasing plan payments under section 256B.692 for the new text end 117.25 new text begin prepaid medical assistance program. The withheld funds must be returned no sooner than new text end 117.26 new text begin July 1 and no later than July 31 of the following year. The commissioner may exclude new text end 117.27 new text begin special demonstration projects under subdivision 23. new text end 117.28 new text begin (g) Effective for services rendered on or after January 1, 2012, through December new text end 117.29 new text begin 31, 2012, the commissioner shall withhold 4.5 percent of managed care plan payments new text end 117.30 new text begin under this section and county-based purchasing plan payments under section 256B.692 new text end 117.31 new text begin for the prepaid medical assistance program. The withheld funds must be returned no new text end 117.32 new text begin sooner than July 1 and no later than July 31 of the following year. The commissioner may new text end 117.33 new text begin exclude special demonstration projects under subdivision 23. new text end 117.34 new text begin (h) Effective for services rendered on or after January 1, 2013, through December new text end 117.35 new text begin 31, 2013, the commissioner shall withhold 4.5 percent of managed care plan payments new text end 117.36 new text begin under this section and county-based purchasing plan payments under section 256B.692 new text end 118.1 new text begin for the prepaid medical assistance program. The withheld funds must be returned no new text end 118.2 new text begin sooner than July 1 and no later than July 31 of the following year. The commissioner may new text end 118.3 new text begin exclude special demonstration projects under subdivision 23. new text end 118.4 new text begin (i) Effective for services rendered on or after January 1, 2014, the commissioner new text end 118.5 new text begin shall withhold three percent of managed care plan payments under this section and new text end 118.6 new text begin county-based purchasing plan payments under section 256B.692 for the prepaid medical new text end 118.7 new text begin assistance and prepaid general assistance medical care programs. The withheld funds must new text end 118.8 new text begin be returned no sooner than July 1 and no later than July 31 of the following year. The new text end 118.9 new text begin commissioner may exclude special demonstration projects under subdivision 23. new text end 118.10 new text begin (j) A managed care plan or a county-based purchasing plan under section 256B.692 new text end 118.11 new text begin may include as admitted assets under section 62D.044 any amount withheld under this new text end 118.12 new text begin section that is reasonably expected to be returned. new text end 118.13    Sec. 47. Minnesota Statutes 2008, section 256B.69, subdivision 5c, is amended to read: 118.14    Subd. 5c. Medical education and research fund. (a) Except as provided in 118.15paragraph (c), the commissioner of human services shall transfer each year to the medical 118.16education and research fund established under section 62J.692, the following: 118.17(1) an amount equal to the reduction in the prepaid medical assistance and prepaid 118.18general assistance medical care payments as specified in this clause. Until January 1, 118.192002, the county medical assistance and general assistance medical care capitation base 118.20rate prior to plan specific adjustments and after the regional rate adjustments under section 118.21256B.69, subdivision 5b , is reduced 6.3 percent for Hennepin County, two percent for 118.22the remaining metropolitan counties, and no reduction for nonmetropolitan Minnesota 118.23counties; and after January 1, 2002, the county medical assistance and general assistance 118.24medical care capitation base rate prior to plan specific adjustments is reduced 6.3 percent 118.25for Hennepin County, two percent for the remaining metropolitan counties, and 1.6 percent 118.26for nonmetropolitan Minnesota counties. Nursing facility and elderly waiver payments 118.27and demonstration project payments operating under subdivision 23 are excluded from 118.28this reduction. The amount calculated under this clause shall not be adjusted for periods 118.29already paid due to subsequent changes to the capitation payments; 118.30(2) beginning July 1, 2003, $2,157,000 new text begin $4,314,000 new text end from the capitation rates paid 118.31under this section plus any federal matching funds on this amount; 118.32(3) beginning July 1, 2002, an additional $12,700,000 from the capitation rates 118.33paid under this section; and 118.34(4) beginning July 1, 2003, an additional $4,700,000 from the capitation rates paid 118.35under this section. 119.1(b) This subdivision shall be effective upon approval of a federal waiver which 119.2allows federal financial participation in the medical education and research fund. new text begin Effective new text end 119.3 new text begin July 1, 2009, and thereafter, the transfers required by paragraph (a), clauses (1) to (4), new text end 119.4 new text begin shall not exceed the total amount transferred for fiscal year 2009. Any excess shall first new text end 119.5 new text begin reduce the amounts otherwise required to be transferred under paragraph (a), clauses new text end 119.6 new text begin (2) to (4). Any excess following this reduction shall proportionally reduce the transfers new text end 119.7 new text begin under paragraph (a), clause (1). new text end 119.8(c) Effective July 1, 2003, the amount reduced from the prepaid general assistance 119.9medical care payments under paragraph (a), clause (1), shall be transferred to the general 119.10fund. 119.11 new text begin (d) Beginning July 1, 2009, of the amounts in paragraph (a), the commissioner shall new text end 119.12 new text begin transfer $21,714,000 each fiscal year to the medical education and research fund. The new text end 119.13 new text begin balance of the transfers under paragraph (a) shall be transferred to the medical education new text end 119.14 new text begin and research fund no earlier than July 1 of the following fiscal year. new text end 119.15    Sec. 48. Minnesota Statutes 2008, section 256B.69, subdivision 5f, is amended to read: 119.16    Subd. 5f. Capitation rates. new text begin (a) new text end Beginning July 1, 2002, the capitation rates paid 119.17under this section are increased by $12,700,000 per year. Beginning July 1, 2003, the 119.18capitation rates paid under this section are increased by $4,700,000 per year. 119.19 new text begin (b) Beginning July 1, 2009, the capitation rates paid under this section are increased new text end 119.20 new text begin each year by the lesser of $21,714,000 or an amount equal to the difference between the new text end 119.21 new text begin estimated value of the reductions described in subdivision 5c, paragraph (a), clause (1), new text end 119.22 new text begin and the amount of the limit described in subdivision 5c, paragraph (b). new text end 119.23    Sec. 49. Minnesota Statutes 2008, section 256B.69, subdivision 23, is amended to read: 119.24    Subd. 23. Alternative services; elderly and disabled persons. (a) The 119.25commissioner may implement demonstration projects to create alternative integrated 119.26delivery systems for acute and long-term care services to elderly persons and persons 119.27with disabilities as defined in section 256B.77, subdivision 7a, that provide increased 119.28coordination, improve access to quality services, and mitigate future cost increases. 119.29The commissioner may seek federal authority to combine Medicare and Medicaid 119.30capitation payments for the purpose of such demonstrations and may contract with 119.31Medicare-approved special needs plans to provide Medicaid services. Medicare funds and 119.32services shall be administered according to the terms and conditions of the federal contract 119.33and demonstration provisions. For the purpose of administering medical assistance funds, 119.34demonstrations under this subdivision are subject to subdivisions 1 to 22. The provisions 120.1of Minnesota Rules, parts 9500.1450 to 9500.1464, apply to these demonstrations, 120.2with the exceptions of parts 9500.1452, subpart 2, item B; and 9500.1457, subpart 1, 120.3items B and C, which do not apply to persons enrolling in demonstrations under this 120.4section. An initial open enrollment period may be provided. Persons who disenroll from 120.5demonstrations under this subdivision remain subject to Minnesota Rules, parts 9500.1450 120.6to 9500.1464. When a person is enrolled in a health plan under these demonstrations and 120.7the health plan's participation is subsequently terminated for any reason, the person shall 120.8be provided an opportunity to select a new health plan and shall have the right to change 120.9health plans within the first 60 days of enrollment in the second health plan. Persons 120.10required to participate in health plans under this section who fail to make a choice of 120.11health plan shall not be randomly assigned to health plans under these demonstrations. 120.12Notwithstanding section 256L.12, subdivision 5, and Minnesota Rules, part 9505.5220, 120.13subpart 1, item A, if adopted, for the purpose of demonstrations under this subdivision, 120.14the commissioner may contract with managed care organizations, including counties, to 120.15serve only elderly persons eligible for medical assistance, elderly and disabled persons, or 120.16disabled persons only. For persons with a primary diagnosis of developmental disability, 120.17serious and persistent mental illness, or serious emotional disturbance, the commissioner 120.18must ensure that the county authority has approved the demonstration and contracting 120.19design. Enrollment in these projects for persons with disabilities shall be voluntary. The 120.20commissioner shall not implement any demonstration project under this subdivision for 120.21persons with a primary diagnosis of developmental disabilities, serious and persistent 120.22mental illness, or serious emotional disturbance, without approval of the county board of 120.23the county in which the demonstration is being implemented. 120.24    (b) Notwithstanding chapter 245B, sections 252.40 to 252.46, 256B.092, 256B.501 120.25to 256B.5015, and Minnesota Rules, parts 9525.0004 to 9525.0036, 9525.1200 to 120.269525.1330, 9525.1580, and 9525.1800 to 9525.1930, the commissioner may implement 120.27under this section projects for persons with developmental disabilities. The commissioner 120.28may capitate payments for ICF/MR services, waivered services for developmental 120.29disabilities, including case management services, day training and habilitation and 120.30alternative active treatment services, and other services as approved by the state and by the 120.31federal government. Case management and active treatment must be individualized and 120.32developed in accordance with a person-centered plan. Costs under these projects may not 120.33exceed costs that would have been incurred under fee-for-service. Beginning July 1, 2003, 120.34and until four years after the pilot project implementation date, subcontractor participation 120.35in the long-term care developmental disability pilot is limited to a nonprofit long-term 120.36care system providing ICF/MR services, home and community-based waiver services, 121.1and in-home services to no more than 120 consumers with developmental disabilities in 121.2Carver, Hennepin, and Scott Counties. The commissioner shall report to the legislature 121.3prior to expansion of the developmental disability pilot project. This paragraph expires 121.4four years after the implementation date of the pilot project. 121.5    (c) Before implementation of a demonstration project for disabled persons, the 121.6commissioner must provide information to appropriate committees of the house of 121.7representatives and senate and must involve representatives of affected disability groups 121.8in the design of the demonstration projects. 121.9    (d) A nursing facility reimbursed under the alternative reimbursement methodology 121.10in section 256B.434 may, in collaboration with a hospital, clinic, or other health care entity 121.11provide services under paragraph (a). The commissioner shall amend the state plan and 121.12seek any federal waivers necessary to implement this paragraph. 121.13    (e) The commissioner, in consultation with the commissioners of commerce and 121.14health, may approve and implement programs for all-inclusive care for the elderly (PACE) 121.15according to federal laws and regulations governing that program and state laws or rules 121.16applicable to participating providers. The process for approval of these programs shall 121.17begin only after the commissioner receives grant money in an amount sufficient to cover 121.18the state share of the administrative and actuarial costs to implement the programs during 121.19state fiscal years 2006 and 2007. Grant amounts for this purpose shall be deposited in an 121.20account in the special revenue fund and are appropriated to the commissioner to be used 121.21solely for the purpose of PACE administrative and actuarial costs. A PACE provider is 121.22not required to be licensed or certified as a health plan company as defined in section 121.2362Q.01, subdivision 4 . Persons age 55 and older who have been screened by the county 121.24and found to be eligible for services under the elderly waiver or community alternatives 121.25for disabled individuals or who are already eligible for Medicaid but meet level of 121.26care criteria for receipt of waiver services may choose to enroll in the PACE program. 121.27Medicare and Medicaid services will be provided according to this subdivision and 121.28federal Medicare and Medicaid requirements governing PACE providers and programs. 121.29PACE enrollees will receive Medicaid home and community-based services through the 121.30PACE provider as an alternative to services for which they would otherwise be eligible 121.31through home and community-based waiver programs and Medicaid State Plan Services. 121.32The commissioner shall establish Medicaid rates for PACE providers that do not exceed 121.33costs that would have been incurred under fee-for-service or other relevant managed care 121.34programs operated by the state. 121.35    (f) The commissioner shall seek federal approval to expand the Minnesota disability 121.36health options (MnDHO) program established under this subdivision in stages, first to 122.1regional population centers outside the seven-county metro area and then to all areas of 122.2the state. Until July 1, 2009, expansion for MnDHO projects that include home and 122.3community-based services is limited to the two projects and service areas in effect on 122.4March 1, 2006. Enrollment in integrated MnDHO programs that include home and 122.5community-based services shall remain voluntary. Costs for home and community-based 122.6services included under MnDHO must not exceed costs that would have been incurred 122.7under the fee-for-service program. new text begin Notwithstanding whether expansion occurs under new text end 122.8 new text begin this paragraph, in determining MnDHO payment rates and risk adjustment methods for new text end 122.9 new text begin contract years starting in 2012, the commissioner must consider the methods used to new text end 122.10 new text begin determine county allocations for home and community-based program participants. If new text end 122.11 new text begin necessary to reduce MnDHO rates to comply with the provision regarding MnDHO costs new text end 122.12 new text begin for home and community-based services, the commissioner shall achieve the reduction by new text end 122.13 new text begin maintaining the base rate for contract years 2010 and 2011 for services provided under the new text end 122.14 new text begin community alternatives for disabled individuals waiver at the same level as for contract new text end 122.15 new text begin year 2009. The commissioner may apply other reductions to MnDHO rates to implement new text end 122.16 new text begin decreases in provider payment rates required by state law. new text end In developing program 122.17specifications for expansion of integrated programs, the commissioner shall involve and 122.18consult the state-level stakeholder group established in subdivision 28, paragraph (d), 122.19including consultation on whether and how to include home and community-based waiver 122.20programs. Plans for further expansion of MnDHO projects shall be presented to the chairs 122.21of the house of representatives and senate committees with jurisdiction over health and 122.22human services policy and finance by February 1, 2007. 122.23    (g) Notwithstanding section 256B.0261, health plans providing services under this 122.24section are responsible for home care targeted case management and relocation targeted 122.25case management. Services must be provided according to the terms of the waivers and 122.26contracts approved by the federal government. 122.27    Sec. 50. new text begin [256B.756] REIMBURSEMENT RATES FOR BIRTHS. new text end 122.28     new text begin Subdivision 1. new text end new text begin Facility rate. new text end new text begin (a) Notwithstanding section 256.969, effective for new text end 122.29 new text begin services provided on or after October 1, 2009, the facility payment rate for the following new text end 122.30 new text begin diagnosis-related groups, as they fall within the diagnostic categories: (1) 371 cesarean new text end 122.31 new text begin section without complicating diagnosis; (2) 372 vaginal delivery with complicating new text end 122.32 new text begin diagnosis; and (3) 373 vaginal delivery without complicating diagnosis, shall be calculated new text end 122.33 new text begin as provided in paragraph (b). new text end 122.34 new text begin (b) The commissioner shall calculate a single rate for all of the diagnostic related new text end 122.35 new text begin groups specified in paragraph (a) consistent with an increase in the proportion of births new text end 123.1 new text begin by vaginal delivery and a reduction in the percentage of births by cesarean section. The new text end 123.2 new text begin calculated single rate must be based on an expected increase in the number of vaginal new text end 123.3 new text begin births and expected reduction in the number of cesarean section such that the reduction new text end 123.4 new text begin in cesarean sections is less than or equal to one standard deviation below the average in new text end 123.5 new text begin the frequency of cesarean births for Minnesota health care program clients at hospitals new text end 123.6 new text begin performing greater than 50 deliveries per year. new text end 123.7 new text begin (c) The rates described in this subdivision do not include newborn care. new text end 123.8     new text begin Subd. 2. new text end new text begin Provider rate. new text end new text begin Notwithstanding section 256B.76, effective for services new text end 123.9 new text begin provided on or after October 1, 2009, the payment rate for professional services related new text end 123.10 new text begin to labor, delivery, and antepartum and postpartum care when provided for any of the new text end 123.11 new text begin diagnostic categories identified in subdivision 1, paragraph (a), shall be calculated using new text end 123.12 new text begin the methodology specified in subdivision 1, paragraph (b). new text end 123.13     new text begin Subd. 3. new text end new text begin Health plans. new text end new text begin Payments to managed care and county-based purchasing new text end 123.14 new text begin plans under sections 256B.69, 256B.692, or 256L.12 shall be reduced for services new text end 123.15 new text begin provided on or after October 1, 2009, to reflect the adjustments in subdivisions 1 and 2. new text end 123.16     new text begin Subd. 4. new text end new text begin Prior authorization. new text end new text begin Prior authorization shall not be required before new text end 123.17 new text begin reimbursement is paid for a cesarean section delivery. new text end 123.18    Sec. 51. Minnesota Statutes 2008, section 256B.76, subdivision 1, is amended to read: 123.19    Subdivision 1. Physician reimbursement. (a) Effective for services rendered on 123.20or after October 1, 1992, the commissioner shall make payments for physician services 123.21as follows: 123.22    (1) payment for level one Centers for Medicare and Medicaid Services' common 123.23procedural coding system codes titled "office and other outpatient services," "preventive 123.24medicine new and established patient," "delivery, antepartum, and postpartum care," 123.25"critical care," cesarean delivery and pharmacologic management provided to psychiatric 123.26patients, and level three codes for enhanced services for prenatal high risk, shall be paid 123.27at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June 123.2830, 1992. If the rate on any procedure code within these categories is different than the 123.29rate that would have been paid under the methodology in section 256B.74, subdivision 2, 123.30then the larger rate shall be paid; 123.31    (2) payments for all other services shall be paid at the lower of (i) submitted charges, 123.32or (ii) 15.4 percent above the rate in effect on June 30, 1992; and 123.33    (3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th 123.34percentile of 1989, less the percent in aggregate necessary to equal the above increases 124.1except that payment rates for home health agency services shall be the rates in effect 124.2on September 30, 1992. 124.3    (b) Effective for services rendered on or after January 1, 2000, payment rates for 124.4physician and professional services shall be increased by three percent over the rates 124.5in effect on December 31, 1999, except for home health agency and family planning 124.6agency services. The increases in this paragraph shall be implemented January 1, 2000, 124.7for managed care. 124.8 new text begin (c) Effective for services rendered on or after July 1, 2009, payment rates for new text end 124.9 new text begin physician and professional services shall be reduced by five percent over the rates in effect new text end 124.10 new text begin on June 30, 2009. This reduction does not apply to office or other outpatient services new text end 124.11 new text begin (procedure codes 99201 to 99215), preventive medicine services (procedure codes 99381 new text end 124.12 new text begin to 99412) and family planning services billed by the following primary care specialties: new text end 124.13 new text begin general practice, internal medicine, pediatrics, geriatrics, family practice, or by an new text end 124.14 new text begin advanced practice registered nurse or physician assistant practicing in pediatrics, geriatrics, new text end 124.15 new text begin or family practice. This reduction does not apply to federally qualified health centers, new text end 124.16 new text begin rural health centers, and Indian health services. Effective October 1, 2009, payments new text end 124.17 new text begin made to managed care plans and county-based purchasing plans under sections 256B.69, new text end 124.18 new text begin 256B.692, and 256L.12 shall reflect the payment reduction described in this paragraph. new text end 124.19    Sec. 52. new text begin [256B.766] REIMBURSEMENT FOR BASIC CARE SERVICES. new text end 124.20 new text begin (a) Effective for services provided on or after July 1, 2009, total payments for basic new text end 124.21 new text begin care services, shall be reduced by three percent, prior to third-party liability and spenddown new text end 124.22 new text begin calculation. Payments made to managed care plans and county-based purchasing plans new text end 124.23 new text begin shall be reduced for services provided on or after October 1, 2009, to reflect this reduction. new text end 124.24 new text begin (b) This section does not apply to physician and professional services, inpatient new text end 124.25 new text begin hospital services, family planning services, mental health services, dental services, new text end 124.26 new text begin prescription drugs, and medical transportation. new text end 124.27    Sec. 53. Minnesota Statutes 2008, section 256D.03, subdivision 4, is amended to read: 124.28    Subd. 4. General assistance medical care; services. (a)(i) For a person who is 124.29eligible under subdivision 3, paragraph (a), clause (2), item (i), general assistance medical 124.30care covers, except as provided in paragraph (c): 124.31    (1) inpatient hospital services; 124.32    (2) outpatient hospital services; 124.33    (3) services provided by Medicare certified rehabilitation agencies; 125.1    (4) prescription drugs and other products recommended through the process 125.2established in section 256B.0625, subdivision 13; 125.3    (5) equipment necessary to administer insulin and diagnostic supplies and equipment 125.4for diabetics to monitor blood sugar level; 125.5    (6) eyeglasses and eye examinations provided by a physician or optometrist; 125.6    (7) hearing aids; 125.7    (8) prosthetic devices; 125.8    (9) laboratory and X-ray services; 125.9    (10) physician's services; 125.10    (11) medical transportation except special transportation; 125.11    (12) chiropractic services as covered under the medical assistance program; 125.12    (13) podiatric services; 125.13    (14) dental services as covered under the medical assistance program; 125.14    (15) mental health services covered under chapter 256B; 125.15    (16) prescribed medications for persons who have been diagnosed as mentally ill as 125.16necessary to prevent more restrictive institutionalization; 125.17    (17) medical supplies and equipment, and Medicare premiums, coinsurance and 125.18deductible payments; 125.19    (18) medical equipment not specifically listed in this paragraph when the use of 125.20the equipment will prevent the need for costlier services that are reimbursable under 125.21this subdivision; 125.22    (19) services performed by a certified pediatric nurse practitioner, a certified family 125.23nurse practitioner, a certified adult nurse practitioner, a certified obstetric/gynecological 125.24nurse practitioner, a certified neonatal nurse practitioner, or a certified geriatric nurse 125.25practitioner in independent practice, if (1) the service is otherwise covered under this 125.26chapter as a physician service, (2) the service provided on an inpatient basis is not included 125.27as part of the cost for inpatient services included in the operating payment rate, and (3) the 125.28service is within the scope of practice of the nurse practitioner's license as a registered 125.29nurse, as defined in section 148.171; 125.30    (20) services of a certified public health nurse or a registered nurse practicing in 125.31a public health nursing clinic that is a department of, or that operates under the direct 125.32authority of, a unit of government, if the service is within the scope of practice of the 125.33public health nurse's license as a registered nurse, as defined in section 148.171; 125.34    (21) telemedicine consultations, to the extent they are covered under section 125.35256B.0625, subdivision 3b ; 126.1    (22) care coordination and patient education services provided by a community 126.2health worker according to section 256B.0625, subdivision 49; and 126.3    (23) regardless of the number of employees that an enrolled health care provider 126.4may have, sign language interpreter services when provided by an enrolled health care 126.5provider during the course of providing a direct, person-to-person covered health care 126.6service to an enrolled recipient who has a hearing loss and uses interpreting services. 126.7    (ii) Effective October 1, 2003, for a person who is eligible under subdivision 3, 126.8paragraph (a), clause (2), item (ii), general assistance medical care coverage is limited 126.9to inpatient hospital services, including physician services provided during the inpatient 126.10hospital stay. A $1,000 deductible is required for each inpatient hospitalization. 126.11    (b) Effective August 1, 2005, sex reassignment surgery is not covered under this 126.12subdivision. 126.13    (c) In order to contain costs, the commissioner of human services shall select 126.14vendors of medical care who can provide the most economical care consistent with high 126.15medical standards and shall where possible contract with organizations on a prepaid 126.16capitation basis to provide these services. The commissioner shall consider proposals by 126.17counties and vendors for prepaid health plans, competitive bidding programs, block grants, 126.18or other vendor payment mechanisms designed to provide services in an economical 126.19manner or to control utilization, with safeguards to ensure that necessary services are 126.20provided. Before implementing prepaid programs in counties with a county operated or 126.21affiliated public teaching hospital or a hospital or clinic operated by the University of 126.22Minnesota, the commissioner shall consider the risks the prepaid program creates for the 126.23hospital and allow the county or hospital the opportunity to participate in the program in a 126.24manner that reflects the risk of adverse selection and the nature of the patients served by 126.25the hospital, provided the terms of participation in the program are competitive with the 126.26terms of other participants considering the nature of the population served. Payment for 126.27services provided pursuant to this subdivision shall be as provided to medical assistance 126.28vendors of these services under sections 256B.02, subdivision 8, and 256B.0625. For 126.29payments made during fiscal year 1990 and later years, the commissioner shall consult 126.30with an independent actuary in establishing prepayment rates, but shall retain final control 126.31over the rate methodology. 126.32    (d) Effective January 1, 2008, drug coverage under general assistance medical 126.33care is limited to prescription drugs that: 126.34    (i) are covered under the medical assistance program as described in section 126.35256B.0625, subdivisions 13 and 13d; and 127.1    (ii) are provided by manufacturers that have fully executed general assistance 127.2medical care rebate agreements with the commissioner and comply with the agreements. 127.3Prescription drug coverage under general assistance medical care must conform to 127.4coverage under the medical assistance program according to section 256B.0625, 127.5subdivisions 13 to 13g. 127.6     (e) Recipients eligible under subdivision 3, paragraph (a), shall pay the following 127.7co-payments for services provided on or after October 1, 2003, and before January 1, 2009: 127.8    (1) $25 for eyeglasses; 127.9    (2) $25 for nonemergency visits to a hospital-based emergency room; 127.10    (3) $3 per brand-name drug prescription and $1 per generic drug prescription, 127.11subject to a $12 per month maximum for prescription drug co-payments. No co-payments 127.12shall apply to antipsychotic drugs when used for the treatment of mental illness; and 127.13    (4) 50 percent coinsurance on restorative dental services. 127.14    (f) Recipients eligible under subdivision 3, paragraph (a), shall include the following 127.15co-payments for services provided on or after January 1, 2009: 127.16    (1) $25 for nonemergency visits to a hospital-based emergency room; and 127.17    (2) $3 per brand-name drug prescription and $1 per generic drug prescription, 127.18subject to a $7 per month maximum for prescription drug co-payments. No co-payments 127.19shall apply to antipsychotic drugs when used for the treatment of mental illness. 127.20    (g) MS 2007 Supp [Expired] 127.21    (h) Effective January 1, 2009, co-payments shall be limited to one per day per 127.22provider for nonemergency visits to a hospital-based emergency room. Recipients of 127.23general assistance medical care are responsible for all co-payments in this subdivision. 127.24The general assistance medical care reimbursement to the provider shall be reduced by the 127.25amount of the co-payment, except that reimbursement for prescription drugs shall not be 127.26reduced once a recipient has reached the $7 per month maximum for prescription drug 127.27co-payments. The provider collects the co-payment from the recipient. Providers may not 127.28deny services to recipients who are unable to pay the co-payment. 127.29    (i) General assistance medical care reimbursement to fee-for-service providers 127.30and payments to managed care plans shall not be increased as a result of the removal of 127.31the co-payments effective January 1, 2009. 127.32    (j) Any county may, from its own resources, provide medical payments for which 127.33state payments are not made. 127.34    (k) Chemical dependency services that are reimbursed under chapter 254B must not 127.35be reimbursed under general assistance medical care. 128.1    (l) The maximum payment for new vendors enrolled in the general assistance 128.2medical care program after the base year shall be determined from the average usual and 128.3customary charge of the same vendor type enrolled in the base year. 128.4    (m) The conditions of payment for services under this subdivision are the same 128.5as the conditions specified in rules adopted under chapter 256B governing the medical 128.6assistance program, unless otherwise provided by statute or rule. 128.7     (n) Inpatient and outpatient payments shall be reduced by five percent, effective July 128.81, 2003. This reduction is in addition to the five percent reduction effective July 1, 2003, 128.9and incorporated by reference in paragraph (l). 128.10    (o) Payments for all other health services except inpatient, outpatient, and pharmacy 128.11services shall be reduced by five percent, effective July 1, 2003. 128.12    (p) Payments to managed care plans shall be reduced by five percent for services 128.13provided on or after October 1, 2003. 128.14    (q) A hospital receiving a reduced payment as a result of this section may apply the 128.15unpaid balance toward satisfaction of the hospital's bad debts. 128.16    (r) Fee-for-service payments for nonpreventive visits shall be reduced by $3 for 128.17services provided on or after January 1, 2006. For purposes of this subdivision, a visit 128.18means an episode of service which is required because of a recipient's symptoms, 128.19diagnosis, or established illness, and which is delivered in an ambulatory setting by 128.20a physician or physician ancillary, chiropractor, podiatrist, advance practice nurse, 128.21audiologist, optician, or optometrist. 128.22    (s) Payments to managed care plans shall not be increased as a result of the removal 128.23of the $3 nonpreventive visit co-payment effective January 1, 2006. 128.24    (t) Payments for mental health services added as covered benefits after December 128.2531, 2007, are not subject to the reductions in paragraphs (l), (n), (o), and (p). 128.26 new text begin (u) Effective for services provided on or after July 1, 2009, total payment rates for new text end 128.27 new text begin basic care services shall be reduced by three percent, in accordance with section 256B.766. new text end 128.28 new text begin Payments made to managed care plans shall be reduced for services provided on or after new text end 128.29 new text begin October 1, 2009, to reflect this reduction. new text end 128.30 new text begin (v) Effective for services provided on or after July 1, 2009, payment rates for new text end 128.31 new text begin physician and professional services shall be reduced as described under section 256B.76, new text end 128.32 new text begin subdivision 1, paragraph (c). Payments made to managed care plans shall be reduced for new text end 128.33 new text begin services provided on or after October 1, 2009, to reflect this reduction. new text end 128.34    Sec. 54. Minnesota Statutes 2008, section 256L.03, is amended by adding a subdivision 128.35to read: 129.1     new text begin Subd. 3b. new text end new text begin Chiropractic services. new text end new text begin MinnesotaCare covers the following chiropractic new text end 129.2 new text begin services: medically necessary exams, manual manipulation of the spine, and x-rays. new text end 129.3 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2010. new text end 129.4    Sec. 55. Minnesota Statutes 2008, section 256L.04, subdivision 1, is amended to read: 129.5    Subdivision 1. Families with children. (a) Families with children with family 129.6income equal to or less than 275 percent of the federal poverty guidelines for the 129.7applicable family size shall be eligible for MinnesotaCare according to this section. All 129.8other provisions of sections 256L.01 to 256L.18, including the insurance-related barriers 129.9to enrollment under section 256L.07, shall apply unless otherwise specified. 129.10    (b) Parents who enroll in the MinnesotaCare program must also enroll their children, 129.11if the children are eligible. Children may be enrolled separately without enrollment by 129.12parents. However, if one parent in the household enrolls, both parents must enroll, unless 129.13other insurance is available. If one child from a family is enrolled, all children must 129.14be enrolled, unless other insurance is available. If one spouse in a household enrolls, 129.15the other spouse in the household must also enroll, unless other insurance is available. 129.16Families cannot choose to enroll only certain uninsured members. 129.17    (c) Beginning October 1, 2003, the dependent sibling definition no longer applies 129.18to the MinnesotaCare program. These persons are no longer counted in the parental 129.19household and may apply as a separate household. 129.20    (d) Beginning July 1, 2003, or upon federal approval, whichever is later, parents are 129.21not eligible for MinnesotaCare if their gross income exceeds $57,500. 129.22    (e) Children formerly enrolled in medical assistance and automatically deemed 129.23eligible for MinnesotaCare according to section 256B.057, subdivision 2c, are exempt 129.24from the requirements of this section until renewal. 129.25 new text begin (f) Children deemed eligible for MinnesotaCare under section 256L.07, subdivision new text end 129.26 new text begin 8, are exempt from the eligibility requirements of this subdivision. new text end 129.27    Sec. 56. Minnesota Statutes 2008, section 256L.04, is amended by adding a subdivision 129.28to read: 129.29     new text begin Subd. 1b. new text end new text begin Children with family income greater than 275 percent of federal new text end 129.30 new text begin poverty guidelines. new text end new text begin Children with family income greater than 275 percent of federal new text end 129.31 new text begin poverty guidelines for the applicable family size shall be eligible for MinnesotaCare. All new text end 129.32 new text begin other provisions of sections 256L.01 to 256L.18, including the insurance-related barriers new text end 129.33 new text begin to enrollment under section 256L.07, shall apply unless otherwise specified. new text end 130.1 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2009, or upon federal new text end 130.2 new text begin approval, whichever is later. new text end 130.3    Sec. 57. Minnesota Statutes 2008, section 256L.04, subdivision 7a, is amended to read: 130.4    Subd. 7a. Ineligibility. Applicants new text begin Adults new text end whose income is greater than the limits 130.5established under this section may not enroll in the MinnesotaCare program. 130.6 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2009, or upon federal new text end 130.7 new text begin approval, whichever is later. new text end 130.8    Sec. 58. Minnesota Statutes 2008, section 256L.04, subdivision 10a, is amended to 130.9read: 130.10    Subd. 10a. Sponsor's income and resources deemed available; documentation. 130.11When determining eligibility for any federal or state benefits under sections 256L.01 to 130.12256L.18 , the income and resources of all noncitizens whose sponsor signed an affidavit of 130.13support as defined under United States Code, title 8, section 1183a, shall be deemed to 130.14include their sponsors' income and resources as defined in the Personal Responsibility 130.15and Work Opportunity Reconciliation Act of 1996, title IV, Public Law 104-193, sections 130.16421 and 422, and subsequently set out in federal rules. To be eligible for the program, 130.17noncitizens must provide documentation of their immigration status. new text begin Beginning July new text end 130.18 new text begin 1, 2010, or upon federal approval, whichever is later, sponsor deeming does not apply new text end 130.19 new text begin to pregnant women and children who are qualified noncitizens, as described in section new text end 130.20 new text begin 256B.06, subdivision 4, paragraph (b). new text end 130.21 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2010, or upon federal new text end 130.22 new text begin approval, whichever is later. The commissioner shall notify the revisor of statutes when new text end 130.23 new text begin federal approval has been obtained. new text end 130.24    Sec. 59. Minnesota Statutes 2008, section 256L.05, subdivision 1, is amended to read: 130.25    Subdivision 1. Application new text begin assistance new text end and information availability. new text begin (a) new text end 130.26Applications and application assistance must be made available at provider offices, local 130.27human services agencies, school districts, public and private elementary schools in which 130.2825 percent or more of the students receive free or reduced price lunches, community health 130.29offices, Women, Infants and Children (WIC) program sites, Head Start program sites, 130.30public housing councils, crisis nurseries, child care centers, early childhood education 130.31and preschool program sites, legal aid offices, and libraries. These sites may accept 130.32applications and forward the forms to the commissioner or local county human services 131.1agencies that choose to participate as an enrollment site. Otherwise, applicants may apply 131.2directly to the commissioner or to participating local county human services agencies. 131.3 new text begin (b) Application assistance must be available for applicants choosing to file an new text end 131.4 new text begin online application. new text end 131.5    Sec. 60. Minnesota Statutes 2008, section 256L.05, is amended by adding a subdivision 131.6to read: 131.7     new text begin Subd. 1c. new text end new text begin Open enrollment and streamlined application and enrollment new text end 131.8 new text begin process. new text end new text begin (a) The commissioner and local agencies working in partnership must develop a new text end 131.9 new text begin streamlined and efficient application and enrollment process for medical assistance and new text end 131.10 new text begin MinnesotaCare enrollees that meets the criteria specified in this subdivision. new text end 131.11 new text begin (b) The commissioners of human services and education shall provide new text end 131.12 new text begin recommendations to the legislature by January 15, 2010, on the creation of an open new text end 131.13 new text begin enrollment process for medical assistance and MinnesotaCare that is coordinated with new text end 131.14 new text begin the public education system. The recommendations must: new text end 131.15 new text begin (1) be developed in consultation with medical assistance and MinnesotaCare new text end 131.16 new text begin enrollees and representatives from organizations that advocate on behalf of children and new text end 131.17 new text begin families, low-income persons and minority populations, counties, school administrators new text end 131.18 new text begin and nurses, health plans, and health care providers; new text end 131.19 new text begin (2) be based on enrollment and renewal procedures best practices, including express new text end 131.20 new text begin lane eligibility as required under subdivision 1d; new text end 131.21 new text begin (3) simplify the enrollment and renewal processes wherever possible; and new text end 131.22 new text begin (4) establish a process: new text end 131.23 new text begin (i) to disseminate information on medical assistance and MinnesotaCare to all new text end 131.24 new text begin children in the public education system, including prekindergarten programs; and new text end 131.25 new text begin (ii) for the commissioner of human services to enroll children and other household new text end 131.26 new text begin members who are eligible. new text end 131.27 new text begin The commissioner of human services in coordination with the commissioner of new text end 131.28 new text begin education shall implement an open enrollment process by August 1, 2010, to be effective new text end 131.29 new text begin beginning with the 2010-2011 school year. new text end 131.30 new text begin (c) The commissioner and local agencies shall develop an online application process new text end 131.31 new text begin for medical assistance and MinnesotaCare. new text end 131.32 new text begin (d) The commissioner shall develop an application that is easily understandable new text end 131.33 new text begin and does not exceed four pages in length. new text end 132.1 new text begin (e) The commissioner of human services shall present to the legislature, by January new text end 132.2 new text begin 15, 2010, an implementation plan for the open enrollment period and online application new text end 132.3 new text begin process. new text end 132.4 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2010, or upon federal new text end 132.5 new text begin approval, which must be requested by the commissioner, whichever is later. new text end 132.6    Sec. 61. Minnesota Statutes 2008, section 256L.05, subdivision 3, is amended to read: 132.7    Subd. 3. Effective date of coverage. (a) The effective date of coverage is the 132.8first day of the month following the month in which eligibility is approved and the first 132.9premium payment has been received. As provided in section 256B.057, coverage for 132.10newborns is automatic from the date of birth and must be coordinated with other health 132.11coverage. The effective date of coverage for eligible newly adoptive children added to a 132.12family receiving covered health services is the month of placement. The effective date 132.13of coverage for other new members added to the family is the first day of the month 132.14following the month in which the change is reported. All eligibility criteria must be met 132.15by the family at the time the new family member is added. The income of the new family 132.16member is included with the family's gross income and the adjusted premium begins in 132.17the month the new family member is added. 132.18(b) The initial premium must be received by the last working day of the month for 132.19coverage to begin the first day of the following month. 132.20(c) Benefits are not available until the day following discharge if an enrollee is 132.21hospitalized on the first day of coverage. 132.22(d) Notwithstanding any other law to the contrary, benefits under sections 256L.01 to 132.23256L.18 are secondary to a plan of insurance or benefit program under which an eligible 132.24person may have coverage and the commissioner shall use cost avoidance techniques to 132.25ensure coordination of any other health coverage for eligible persons. The commissioner 132.26shall identify eligible persons who may have coverage or benefits under other plans of 132.27insurance or who become eligible for medical assistance. 132.28(e) The effective date of coverage for single adults and households with no children 132.29formerly enrolled in general assistance medical care and enrolled in MinnesotaCare 132.30according to section 256D.03, subdivision 3, is the first day of the month following the 132.31last day of general assistance medical care coverage. 132.32 new text begin (f) The effective date of coverage for children eligible under section 256L.07, new text end 132.33 new text begin subdivision 8, is the first day of the month following the date of termination from foster new text end 132.34 new text begin care or release from a juvenile residential correctional facility. new text end 133.1 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2009, or upon federal new text end 133.2 new text begin approval, whichever is later. new text end 133.3    Sec. 62. Minnesota Statutes 2008, section 256L.05, subdivision 3a, is amended to read: 133.4    Subd. 3a. Renewal of eligibility. (a) Beginning July 1, 2007, an enrollee's eligibility 133.5must be renewed every 12 months. The 12-month period begins in the month after the 133.6month the application is approved. 133.7    (b) Each new period of eligibility must take into account any changes in 133.8circumstances that impact eligibility and premium amount. An enrollee must provide all 133.9the information needed to redetermine eligibility by the first day of the month that ends 133.10the eligibility period. If there is no change in circumstances, the enrollee may renew 133.11eligibility at designated locations that include community clinics and health care providers' 133.12offices. The designated sites shall forward the renewal forms to the commissioner. The 133.13commissioner may establish criteria and timelines for sites to forward applications to the 133.14commissioner or county agencies. The premium for the new period of eligibility must be 133.15received as provided in section 256L.06 in order for eligibility to continue. 133.16    (c) For single adults and households with no children formerly enrolled in general 133.17assistance medical care and enrolled in MinnesotaCare according to section 256D.03, 133.18subdivision 3 , the first period of eligibility begins the month the enrollee submitted the 133.19application or renewal for general assistance medical care. 133.20    (d) An enrollee new text begin Notwithstanding paragraph (e), an enrollee new text end who fails to submit 133.21renewal forms and related documentation necessary for verification of continued eligibility 133.22in a timely manner shall remain eligible for one additional month beyond the end of the 133.23current eligibility period before being disenrolled. The enrollee remains responsible for 133.24MinnesotaCare premiums for the additional month. 133.25 new text begin (e) Children in families with family income equal to or below 275 percent of federal new text end 133.26 new text begin poverty guidelines who fail to submit renewal forms and related documentation necessary new text end 133.27 new text begin for verification of continued eligibility in a timely manner shall remain eligible for the new text end 133.28 new text begin program. The commissioner shall use the means described in subdivision 2 or any other new text end 133.29 new text begin means available to verify family income. If the commissioner determines that there has new text end 133.30 new text begin been a change in income in which premium payment is required to remain enrolled, the new text end 133.31 new text begin commissioner shall notify the family of the premium payment, and that the children new text end 133.32 new text begin will be disenrolled if the premium payment is not received effective the first day of the new text end 133.33 new text begin calendar month following the calendar month for which the premium is due. new text end 133.34 new text begin (f) For children enrolled in MinnesotaCare under section 256L.07, subdivision 8, the new text end 133.35 new text begin first period of renewal begins the month the enrollee turns 21 years of age. new text end 134.1 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2009, or upon federal new text end 134.2 new text begin approval, whichever is later. new text end 134.3    Sec. 63. Minnesota Statutes 2008, section 256L.07, subdivision 1, is amended to read: 134.4    Subdivision 1. General requirements. (a) Children enrolled in the original 134.5children's health plan as of September 30, 1992, children who enrolled in the 134.6MinnesotaCare program after September 30, 1992, pursuant to Laws 1992, chapter 549, 134.7article 4, section 17, and children who have family gross incomes that are equal to or 134.8less than 150 new text begin 200 new text end percent of the federal poverty guidelines are eligible without meeting 134.9the requirements of subdivision 2 and the four-month requirement in subdivision 3, as 134.10long as they maintain continuous coverage in the MinnesotaCare program or medical 134.11assistance. Children who apply for MinnesotaCare on or after the implementation date 134.12of the employer-subsidized health coverage program as described in Laws 1998, chapter 134.13407, article 5, section 45, who have family gross incomes that are equal to or less than 150 134.14percent of the federal poverty guidelines, must meet the requirements of subdivision 2 to 134.15be eligible for MinnesotaCare. 134.16    Families new text begin Parents new text end enrolled in MinnesotaCare under section 256L.04, subdivision 1, 134.17whose income increases above 275 percent of the federal poverty guidelines, are no longer 134.18eligible for the program and shall be disenrolled by the commissioner. Beginning January 134.191, 2008, individuals enrolled in MinnesotaCare under section 256L.04, subdivision 134.207 , whose income increases above 200 percent of the federal poverty guidelines or 250 134.21percent of the federal poverty guidelines on or after July 1, 2009, are no longer eligible for 134.22the program and shall be disenrolled by the commissioner. For persons disenrolled under 134.23this subdivision, MinnesotaCare coverage terminates the last day of the calendar month 134.24following the month in which the commissioner determines that the income of a family or 134.25individual exceeds program income limits. 134.26    (b) Notwithstanding paragraph (a), Children may remain enrolled in MinnesotaCare 134.27if ten percent of their gross individual or gross family income as defined in section 134.28256L.01, subdivision 4 , is less than the annual premium for a policy with a $500 134.29deductible available through the Minnesota Comprehensive Health Association. Children 134.30who are no longer eligible for MinnesotaCare under this clause shall be given a 12-month 134.31notice period from the date that ineligibility is determined before disenrollment new text begin greater new text end 134.32 new text begin than 275 percent of federal poverty guidelines new text end . The premium for children remaining 134.33eligible under this clause new text begin paragraph new text end shall be the maximum premium determined under 134.34section 256L.15, subdivision 2, paragraph (b). 135.1    (c) Notwithstanding paragraphs new text begin paragraph new text end (a) and (b), parents are not eligible for 135.2MinnesotaCare if gross household income exceeds $57,500 for the 12-month period 135.3of eligibility. 135.4 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2009, or upon federal new text end 135.5 new text begin approval, whichever is later. new text end 135.6    Sec. 64. Minnesota Statutes 2008, section 256L.07, subdivision 2, is amended to read: 135.7    Subd. 2. Must not have access to employer-subsidized coverage. (a) To be 135.8eligible, a family or individual must not have access to subsidized health coverage through 135.9an employer and must not have had access to employer-subsidized coverage through 135.10a current employer for 18 months prior to application or reapplication. A family or 135.11individual whose employer-subsidized coverage is lost due to an employer terminating 135.12health care coverage as an employee benefit during the previous 18 months is not eligible. 135.13(b) This subdivision does not apply to a family or individual who was enrolled 135.14in MinnesotaCare within six months or less of reapplication and who no longer has 135.15employer-subsidized coverage due to the employer terminating health care coverage as an 135.16employee benefit. new text begin This subdivision does not apply to children with family gross incomes new text end 135.17 new text begin that are equal to or less than 200 percent of federal poverty guidelines. new text end 135.18(c) For purposes of this requirement, subsidized health coverage means health 135.19coverage for which the employer pays at least 50 percent of the cost of coverage for 135.20the employee or dependent, or a higher percentage as specified by the commissioner. 135.21Children are eligible for employer-subsidized coverage through either parent, including 135.22the noncustodial parent. The commissioner must treat employer contributions to Internal 135.23Revenue Code Section 125 plans and any other employer benefits intended to pay 135.24health care costs as qualified employer subsidies toward the cost of health coverage for 135.25employees for purposes of this subdivision. 135.26 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2009, or upon federal new text end 135.27 new text begin approval, whichever is later. new text end 135.28    Sec. 65. Minnesota Statutes 2008, section 256L.07, subdivision 3, is amended to read: 135.29    Subd. 3. Other health coverage. (a) Families and individuals enrolled in the 135.30MinnesotaCare program must have no health coverage while enrolled or for at least four 135.31months prior to application and renewal. new text begin Children with family gross incomes equal to or new text end 135.32 new text begin greater than 200 percent of federal poverty guidelines, and adults, must have had no health new text end 135.33 new text begin coverage for at least four months prior to application and renewal. new text end Children enrolled in the 135.34original children's health plan and children in families with income equal to or less than 136.1150 new text begin 200 new text end percent of the federal poverty guidelines, who have other health insurance, are 136.2eligible if the coverage: 136.3(1) lacks two or more of the following: 136.4(i) basic hospital insurance; 136.5(ii) medical-surgical insurance; 136.6(iii) prescription drug coverage; 136.7(iv) dental coverage; or 136.8(v) vision coverage; 136.9(2) requires a deductible of $100 or more per person per year; or 136.10(3) lacks coverage because the child has exceeded the maximum coverage for a 136.11particular diagnosis or the policy excludes a particular diagnosis. 136.12The commissioner may change this eligibility criterion for sliding scale premiums 136.13in order to remain within the limits of available appropriations. The requirement of no 136.14health coverage does not apply to newborns. 136.15(b) Medical assistance, general assistance medical care, and the Civilian Health and 136.16Medical Program of the Uniformed Service, CHAMPUS, or other coverage provided under 136.17United States Code, title 10, subtitle A, part II, chapter 55, are not considered insurance or 136.18health coverage for purposes of the four-month requirement described in this subdivision. 136.19(c) For purposes of this subdivision, an applicant or enrollee who is entitled to 136.20Medicare Part A or enrolled in Medicare Part B coverage under title XVIII of the Social 136.21Security Act, United States Code, title 42, sections 1395c to 1395w-152, is considered to 136.22have health coverage. An applicant or enrollee who is entitled to premium-free Medicare 136.23Part A may not refuse to apply for or enroll in Medicare coverage to establish eligibility 136.24for MinnesotaCare. 136.25(d) Applicants who were recipients of medical assistance or general assistance 136.26medical care within one month of application must meet the provisions of this subdivision 136.27and subdivision 2. 136.28(e) Cost-effective health insurance that was paid for by medical assistance is not 136.29considered health coverage for purposes of the four-month requirement under this 136.30section, except if the insurance continued after medical assistance no longer considered it 136.31cost-effective or after medical assistance closed. 136.32 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2009, or upon federal new text end 136.33 new text begin approval, whichever is later. new text end 136.34    Sec. 66. Minnesota Statutes 2008, section 256L.07, is amended by adding a subdivision 136.35to read: 137.1     new text begin Subd. 8. new text end new text begin Automatic eligibility for certain children. new text end new text begin Any child who was residing new text end 137.2 new text begin in foster care or a juvenile residential correctional facility on the child's 18th birthday is new text end 137.3 new text begin automatically deemed eligible for MinnesotaCare upon termination or release until the new text end 137.4 new text begin child reaches the age of 21, and is exempt from the requirements of this section and new text end 137.5 new text begin section 256L.15. To be enrolled under this section, a child must complete an initial new text end 137.6 new text begin application for MinnesotaCare. The commissioner shall contact individuals enrolled new text end 137.7 new text begin under this section annually to ensure the individual continues to reside in the state and is new text end 137.8 new text begin interested in continuing MinnesotaCare coverage. new text end 137.9 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2009, or upon federal new text end 137.10 new text begin approval, whichever is later. new text end 137.11    Sec. 67. Minnesota Statutes 2008, section 256L.11, subdivision 1, is amended to read: 137.12    Subdivision 1. Medical assistance rate to be used. new text begin (a) new text end Payment to providers under 137.13sections 256L.01 to 256L.11 shall be at the same rates and conditions established for 137.14medical assistance, except as provided in subdivisions 2 to 6. 137.15 new text begin (b) Effective for services provided on or after July 1, 2009, total payments for basic new text end 137.16 new text begin care services shall be reduced by three percent, in accordance with section 256B.766. new text end 137.17 new text begin Payments made to managed care plans shall be reduced for services provided on or after new text end 137.18 new text begin October 1, 2009, to reflect this reduction. new text end 137.19    Sec. 68. Minnesota Statutes 2008, section 256L.15, subdivision 2, is amended to read: 137.20    Subd. 2. Sliding fee scale; monthly gross individual or family income. (a) The 137.21commissioner shall establish a sliding fee scale to determine the percentage of monthly 137.22gross individual or family income that households at different income levels must pay to 137.23obtain coverage through the MinnesotaCare program. The sliding fee scale must be based 137.24on the enrollee's monthly gross individual or family income. The sliding fee scale must 137.25contain separate tables based on enrollment of one, two, or three or more persons. Until 137.26June 30, 2009, the sliding fee scale begins with a premium of 1.5 percent of monthly gross 137.27individual or family income for individuals or families with incomes below the limits for 137.28the medical assistance program for families and children in effect on January 1, 1999, and 137.29proceeds through the following evenly spaced steps: 1.8, 2.3, 3.1, 3.8, 4.8, 5.9, 7.4, and 137.308.8 percent. These percentages are matched to evenly spaced income steps ranging from 137.31the medical assistance income limit for families and children in effect on January 1, 1999, 137.32to 275 percent of the federal poverty guidelines for the applicable family size, up to a 137.33family size of five. The sliding fee scale for a family of five must be used for families of 137.34more than five. The sliding fee scale and percentages are not subject to the provisions of 138.1chapter 14. If a family or individual reports increased income after enrollment, premiums 138.2shall be adjusted at the time the change in income is reported. 138.3    (b) Children in families whose gross income is above 275 percent of the federal 138.4poverty guidelines shall pay the maximum premium. The maximum premium is defined 138.5as a base charge for one, two, or three or more enrollees so that if all MinnesotaCare 138.6cases paid the maximum premium, the total revenue would equal the total cost of 138.7MinnesotaCare medical coverage and administration. In this calculation, administrative 138.8costs shall be assumed to equal ten percent of the total. The costs of medical coverage 138.9for pregnant women and children under age two and the enrollees in these groups shall 138.10be excluded from the total. The maximum premium for two enrollees shall be twice the 138.11maximum premium for one, and the maximum premium for three or more enrollees shall 138.12be three times the maximum premium for one. 138.13    (c) Beginning July 1, 2009, MinnesotaCare enrollees shall pay premiums according 138.14to the premium scale specified in paragraph (d) with the exception that children in families 138.15with income at or below 150 new text begin 200 new text end percent of the federal poverty guidelines shall pay 138.16a monthly premium of $4 new text begin no premiums new text end . For purposes of paragraph (d), "minimum" 138.17means a monthly premium of $4. 138.18    (d) The following premium scale is established for individuals and families with 138.19gross family incomes of 300 percent of the federal poverty guidelines or less: 138.20 138.21 Federal Poverty Guideline RangePercent of Average Gross Monthly Income 138.22 0-45% minimum 138.23 46-54% 1.1% 138.24 55-81% 1.6% 138.25 82-109% 2.2% 138.26 110-136% 2.9% 138.27 137-164% 3.6% 138.28 165-191% 4.6% 138.29 192-219% 5.6% 138.30 220-248% 6.5% 138.31 249-274% 7.2% 138.32 275-300% 8.0% 139.1 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2009, or upon federal new text end 139.2 new text begin approval, whichever is later. new text end 139.3    Sec. 69. Minnesota Statutes 2008, section 256L.15, subdivision 3, is amended to read: 139.4    Subd. 3. Exceptions to sliding scale. Children in families with income at or below 139.5150 new text begin 200 new text end percent of the federal poverty guidelines new text begin shall new text end pay a new text begin no new text end monthly premium of 139.6$4 new text begin premiums new text end . 139.7 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2009, or upon federal new text end 139.8 new text begin approval, whichever is later. new text end 139.9    Sec. 70. Minnesota Statutes 2008, section 256L.17, subdivision 3, is amended to read: 139.10    Subd. 3. Documentation. (a) The commissioner of human services shall require 139.11individuals and families, at the time of application or renewal, to indicate on a checkoff 139.12form developed by the commissioner whether they satisfy the MinnesotaCare asset 139.13requirement. 139.14    (b) The commissioner may require individuals and families to provide any 139.15information the commissioner determines necessary to verify compliance with the asset 139.16requirement, if the commissioner determines that there is reason to believe that an 139.17individual or family has assets that exceed the program limit. 139.18    Sec. 71. Minnesota Statutes 2008, section 256L.17, subdivision 5, is amended to read: 139.19    Subd. 5. Exemption. This section does not apply to pregnant women new text begin or children new text end . 139.20For purposes of this subdivision, a woman is considered pregnant for 60 days postpartum. 139.21    Sec. 72. Minnesota Statutes 2008, section 501B.89, is amended by adding a 139.22subdivision to read: 139.23     new text begin Subd. 4. new text end new text begin Annual filing requirement for supplemental needs trusts. new text end new text begin (a) A trustee new text end 139.24 new text begin of a trust under subdivision 3 and United States Code, title 42, section 1396p(d)(4)(A) or new text end 139.25 new text begin (C), shall submit to the commissioner of human services, at the time of a beneficiary's new text end 139.26 new text begin request for medical assistance, the following information about the trust: new text end 139.27 new text begin (1) a copy of the trust instrument; and new text end 139.28 new text begin (2) an inventory of the beneficiary's trust account assets and the value of those assets. new text end 139.29 new text begin (b) A trustee of a trust under subdivision 3 and United States Code, title 42, section new text end 139.30 new text begin 1396p(d)(4)(A) or (C), shall submit an accounting of the beneficiary's trust account to the new text end 139.31 new text begin commissioner of human services at least annually until the trust, or the beneficiary's new text end 139.32 new text begin interest in the trust, terminates. Accountings are due on the anniversary of the execution new text end 140.1 new text begin date of the trust unless another annual date is established by the terms of the trust. The new text end 140.2 new text begin accounting must include the following information for the accounting period: new text end 140.3 new text begin (1) an inventory of trust assets and the value of those assets at the beginning of the new text end 140.4 new text begin accounting period; new text end 140.5 new text begin (2) additions to the trust during the accounting period and the source of those new text end 140.6 new text begin additions; new text end 140.7 new text begin (3) itemized distributions from the trust during the accounting period, including the new text end 140.8 new text begin purpose of the distributions and to whom the distributions were made; new text end 140.9 new text begin (4) an inventory of trust assets and the value of those assets at the end of the new text end 140.10 new text begin accounting period; and new text end 140.11 new text begin (5) changes to the trust instrument during the accounting period. new text end 140.12 new text begin (c) For the purpose of paragraph (b), an accounting period is 12 months unless an new text end 140.13 new text begin accounting period of a different length is permitted by the commissioner. new text end 140.14 new text begin EFFECTIVE DATE. new text end new text begin This section is effective for applications for medical new text end 140.15 new text begin assistance and renewals of medical assistance submitted on or after July 1, 2009. new text end 140.16    Sec. 73. Minnesota Statutes 2008, section 519.05, is amended to read: 140.17519.05 LIABILITY OF HUSBAND AND WIFE. 140.18(a) A spouse is not liable to a creditor for any debts of the other spouse. Where 140.19husband and wife are living together, they shall be jointly and severally liable for 140.20necessary medical services that have been furnished to either spouse, new text begin including any claims new text end 140.21 new text begin arising under section 246.53, 256B.15, 256D.16, or 261.04, new text end and necessary household 140.22articles and supplies furnished to and used by the family. Notwithstanding this paragraph, 140.23in a proceeding under chapter 518 the court may apportion such debt between the spouses. 140.24(b) Either spouse may close a credit card account or other unsecured consumer line 140.25of credit on which both spouses are contractually liable, by giving written notice to the 140.26creditor. 140.27    Sec. 74. Laws 2003, First Special Session chapter 14, article 13C, section 2, subdivision 140.281, as amended by Laws 2004, chapter 272, article 2, section 2, is amended to read: 140.29 Subdivision 1.Total Appropriation$3,848,049,000$4,135,780,000 140.30 Summary by Fund 140.31 General 3,301,811,000 3,561,055,000 141.1 141.2 State Government Special Revenue 534,000 534,000 141.3 Health Care Access 273,723,000 302,272,000 141.4 Federal TANF 270,425,000 270,363,000 141.5 Lottery Cash Flow 1,556,000 1,556,000 141.6Federal Contingency Appropriation. (a) 141.7Federal Medicaid funds made available 141.8under title IV of the federal Jobs and Growth 141.9Tax Relief Reconciliation Act of 2003 141.10are appropriated to the commissioner of 141.11human services for use in the state's medical 141.12assistance and MinnesotaCare programs. 141.13The commissioners of human services and 141.14finance shall report to the legislative advisory 141.15committee on the additional federal Medicaid 141.16matching funds that will be available to the 141.17state. 141.18(b) Because of the availability of these funds, 141.19the following policies shall become effective: 141.20(1) medical assistance and MinnesotaCare 141.21eligibility and local financial participation 141.22changes provided for in this act may be 141.23implemented prior to September 2, 2003, or 141.24may be delayed as necessary to maximize 141.25the use of federal funds received under 141.26title IV of the Jobs and Growth Tax Relief 141.27Reconciliation Act of 2003; 141.28(2) the aggregate cap on the services 141.29identified in Minnesota Statutes, section 141.30256L.035 , paragraph (a), clause (3), shall 141.31be increased from $2,000 to $5,000. This 141.32increase shall expire at the end of fiscal year 141.332007. Funds may be transferred from the 142.1general fund to the health care access fund as 142.2necessary to implement this provision; and 142.3(3) the following payment shifts shall not be 142.4implemented: 142.5(i) MFIP payment shift found in subdivision 142.611; 142.7(ii) the county payment shift found in 142.8subdivision 1; and 142.9(iii) the delay in medical assistance 142.10and general assistance medical care 142.11fee-for-service payments found in 142.12subdivision 6. 142.13(c) Notwithstanding section 14, paragraphs 142.14(a) and (b) shall expire June 30, 2007. 142.15Receipts for Systems Projects. 142.16Appropriations and federal receipts for 142.17information system projects for MAXIS, 142.18PRISM, MMIS, and SSIS must be deposited 142.19in the state system account authorized in 142.20Minnesota Statutes, section 256.014. Money 142.21appropriated for computer projects approved 142.22by the Minnesota office of technology, 142.23funded by the legislature, and approved 142.24by the commissioner of finance may be 142.25transferred from one project to another 142.26and from development to operations as the 142.27commissioner of human services considers 142.28necessary. Any unexpended balance in 142.29the appropriation for these projects does 142.30not cancel but is available for ongoing 142.31development and operations. 142.32Gifts. Notwithstanding Minnesota Statutes, 142.33chapter 7, the commissioner may accept 142.34on behalf of the state additional funding 143.1from sources other than state funds for the 143.2purpose of financing the cost of assistance 143.3program grants or nongrant administration. 143.4All additional funding is appropriated to the 143.5commissioner for use as designated by the 143.6grantor of funding. 143.7Systems Continuity. In the event of 143.8disruption of technical systems or computer 143.9operations, the commissioner may use 143.10available grant appropriations to ensure 143.11continuity of payments for maintaining the 143.12health, safety, and well-being of clients 143.13served by programs administered by the 143.14department of human services. Grant funds 143.15must be used in a manner consistent with the 143.16original intent of the appropriation. 143.17Nonfederal Share Transfers. The 143.18nonfederal share of activities for which 143.19federal administrative reimbursement is 143.20appropriated to the commissioner may be 143.21transferred to the special revenue fund. 143.22TANF Funds Appropriated to Other 143.23Entities. Any expenditures from the TANF 143.24block grant shall be expended in accordance 143.25with the requirements and limitations of part 143.26A of title IV of the Social Security Act, as 143.27amended, and any other applicable federal 143.28requirement or limitation. Prior to any 143.29expenditure of these funds, the commissioner 143.30shall assure that funds are expended in 143.31compliance with the requirements and 143.32limitations of federal law and that any 143.33reporting requirements of federal law are 143.34met. It shall be the responsibility of any entity 143.35to which these funds are appropriated to 144.1implement a memorandum of understanding 144.2with the commissioner that provides the 144.3necessary assurance of compliance prior to 144.4any expenditure of funds. The commissioner 144.5shall receipt TANF funds appropriated 144.6to other state agencies and coordinate all 144.7related interagency accounting transactions 144.8necessary to implement these appropriations. 144.9Unexpended TANF funds appropriated to 144.10any state, local, or nonprofit entity cancel 144.11at the end of the state fiscal year unless 144.12appropriating language permits otherwise. 144.13TANF Funds Transferred to Other Federal 144.14Grants. The commissioner must authorize 144.15transfers from TANF to other federal block 144.16grants so that funds are available to meet the 144.17annual expenditure needs as appropriated. 144.18Transfers may be authorized prior to the 144.19expenditure year with the agreement of the 144.20receiving entity. Transferred funds must be 144.21expended in the year for which the funds 144.22were appropriated unless appropriation 144.23language permits otherwise. In accelerating 144.24transfer authorizations, the commissioner 144.25must aim to preserve the future potential 144.26transfer capacity from TANF to other block 144.27grants. 144.28TANF Maintenance of Effort. (a) In 144.29order to meet the basic maintenance of 144.30effort (MOE) requirements of the TANF 144.31block grant specified under Code of Federal 144.32Regulations, title 45, section 263.1, the 144.33commissioner may only report nonfederal 144.34money expended for allowable activities 144.35listed in the following clauses as TANF/MOE 144.36expenditures: 145.1(1) MFIP cash, diversionary work program, 145.2and food assistance benefits under Minnesota 145.3Statutes, chapter 256J; 145.4(2) the child care assistance programs 145.5under Minnesota Statutes, sections 119B.03 145.6and 119B.05, and county child care 145.7administrative costs under Minnesota 145.8Statutes, section 119B.15; 145.9(3) state and county MFIP administrative 145.10costs under Minnesota Statutes, chapters 145.11256J and 256K; 145.12(4) state, county, and tribal MFIP 145.13employment services under Minnesota 145.14Statutes, chapters 256J and 256K; 145.15(5) expenditures made on behalf of 145.16noncitizen MFIP recipients who qualify 145.17for the medical assistance without federal 145.18financial participation program under 145.19Minnesota Statutes, section 256B.06, 145.20subdivision 4 , paragraphs (d), (e), and (j); 145.21and 145.22(6) qualifying working family credit 145.23expenditures under Minnesota Statutes, 145.24section 290.0671. 145.25(b) The commissioner shall ensure that 145.26sufficient qualified nonfederal expenditures 145.27are made each year to meet the state's 145.28TANF/MOE requirements. For the activities 145.29listed in paragraph (a), clauses (2) to 145.30(6), the commissioner may only report 145.31expenditures that are excluded from the 145.32definition of assistance under Code of 145.33Federal Regulations, title 45, section 260.31. 146.1(c) By August 31 of each year, the 146.2commissioner shall make a preliminary 146.3calculation to determine the likelihood 146.4that the state will meet its annual federal 146.5work participation requirement under Code 146.6of Federal Regulations, title 45, sections 146.7261.21 and 261.23, after adjustment for any 146.8caseload reduction credit under Code of 146.9Federal Regulations, title 45, section 261.41. 146.10If the commissioner determines that the 146.11state will meet its federal work participation 146.12rate for the federal fiscal year ending that 146.13September, the commissioner may reduce the 146.14expenditure under paragraph (a), clause (1), 146.15to the extent allowed under Code of Federal 146.16Regulations, title 45, section 263.1(a)(2). 146.17(d) For fiscal years beginning with state 146.18fiscal year 2003, the commissioner shall 146.19assure that the maintenance of effort used 146.20by the commissioner of finance for the 146.21February and November forecasts required 146.22under Minnesota Statutes, section 16A.103, 146.23contains expenditures under paragraph (a), 146.24clause (1), equal to at least 25 percent of 146.25the total required under Code of Federal 146.26Regulations, title 45, section 263.1. 146.27(e) If nonfederal expenditures for the 146.28programs and purposes listed in paragraph 146.29(a) are insufficient to meet the state's 146.30TANF/MOE requirements, the commissioner 146.31shall recommend additional allowable 146.32sources of nonfederal expenditures to the 146.33legislature, if the legislature is or will be in 146.34session to take action to specify additional 146.35sources of nonfederal expenditures for 146.36TANF/MOE before a federal penalty is 147.1imposed. The commissioner shall otherwise 147.2provide notice to the legislative commission 147.3on planning and fiscal policy under paragraph 147.4(g). 147.5(f) If the commissioner uses authority 147.6granted under section 11, or similar authority 147.7granted by a subsequent legislature, to 147.8meet the state's TANF/MOE requirement 147.9in a reporting period, the commissioner 147.10shall inform the chairs of the appropriate 147.11legislative committees about all transfers 147.12made under that authority for this purpose. 147.13(g) If the commissioner determines that 147.14nonfederal expenditures under paragraph 147.15(a) are insufficient to meet TANF/MOE 147.16expenditure requirements, and if the 147.17legislature is not or will not be in 147.18session to take timely action to avoid a 147.19federal penalty, the commissioner may 147.20report nonfederal expenditures from 147.21other allowable sources as TANF/MOE 147.22expenditures after the requirements of this 147.23paragraph are met. The commissioner 147.24may report nonfederal expenditures 147.25in addition to those specified under 147.26paragraph (a) as nonfederal TANF/MOE 147.27expenditures, but only ten days after the 147.28commissioner of finance has first submitted 147.29the commissioner's recommendations for 147.30additional allowable sources of nonfederal 147.31TANF/MOE expenditures to the members of 147.32the legislative commission on planning and 147.33fiscal policy for their review. 147.34(h) The commissioner of finance shall not 147.35incorporate any changes in federal TANF 148.1expenditures or nonfederal expenditures for 148.2TANF/MOE that may result from reporting 148.3additional allowable sources of nonfederal 148.4TANF/MOE expenditures under the interim 148.5procedures in paragraph (g) into the February 148.6or November forecasts required under 148.7Minnesota Statutes, section 16A.103, unless 148.8the commissioner of finance has approved 148.9the additional sources of expenditures under 148.10paragraph (g). 148.11(i) Minnesota Statutes, section 256.011, 148.12subdivision 3 , which requires that federal 148.13grants or aids secured or obtained under that 148.14subdivision be used to reduce any direct 148.15appropriations provided by law, do not apply 148.16if the grants or aids are federal TANF funds. 148.17(j) Notwithstanding section 14, paragraph 148.18(a), clauses (1) to (6), and paragraphs (b) to 148.19(j) expire June 30, 2007. 148.20Working Family Credit Expenditures as 148.21TANF MOE. The commissioner may claim 148.22as TANF maintenance of effort up to the 148.23following amounts of working family credit 148.24expenditures for the following fiscal years: 148.25(1) fiscal year 2004, $7,013,000; 148.26(2) fiscal year 2005, $25,133,000; 148.27(3) fiscal year 2006, $6,942,000; and 148.28(4) fiscal year 2007, $6,707,000. 148.29Fiscal Year 2003 Appropriations 148.30Carryforward. Effective the day following 148.31final enactment, notwithstanding Minnesota 148.32Statutes, section 16A.28, or any other law to 148.33the contrary, state agencies and constitutional 148.34offices may carry forward unexpended 149.1and unencumbered nongrant operating 149.2balances from fiscal year 2003 general fund 149.3appropriations into fiscal year 2004 to offset 149.4general budget reductions. 149.5Transfer of Grant Balances. Effective 149.6the day following final enactment, the 149.7commissioner of human services, with 149.8the approval of the commissioner of 149.9finance and after notification of the chair 149.10of the senate health, human services and 149.11corrections budget division and the chair 149.12of the house of representatives health 149.13and human services finance committee, 149.14may transfer unencumbered appropriation 149.15balances for the biennium ending June 30, 149.162003, in fiscal year 2003 among the MFIP, 149.17MFIP child care assistance under Minnesota 149.18Statutes, section 119B.05, general assistance, 149.19general assistance medical care, medical 149.20assistance, Minnesota supplemental aid, 149.21and group residential housing programs, 149.22and the entitlement portion of the chemical 149.23dependency consolidated treatment fund, and 149.24between fiscal years of the biennium. 149.25TANF Appropriation Cancellation. 149.26Notwithstanding the provisions of Laws 149.272000, chapter 488, article 1, section 16, 149.28any prior appropriations of TANF funds 149.29to the department of trade and economic 149.30development or to the job skills partnership 149.31board or any transfers of TANF funds from 149.32another agency to the department of trade 149.33and economic development or to the job 149.34skills partnership board are not available 149.35until expended, and if unobligated as of June 150.130, 2003, these appropriations or transfers 150.2shall cancel to the TANF fund. 150.3Shift County Payment. The commissioner 150.4shall make up to 100 percent of the 150.5calendar year 2005 payments to counties for 150.6developmental disabilities semi-independent 150.7living services grants, developmental 150.8disabilities family support grants, and 150.9adult mental health grants from fiscal year 150.102006 appropriations. This is a onetime 150.11payment shift. Calendar year 2006 and future 150.12payments for these grants are not affected by 150.13this shift. This provision expires June 30, 150.142006. 150.15Capitation Rate Increase. Of the health care 150.16access fund appropriations to the University 150.17of Minnesota in the higher education 150.18omnibus appropriation bill, $2,157,000 in 150.19fiscal year 2004 and $2,157,000 in fiscal year 150.202005 are to be used to increase the capitation 150.21payments under new text begin for fiscal years beginning new text end 150.22 new text begin July 1, 2003, and thereafter, $2,157,000 each new text end 150.23 new text begin year shall be transferred to the commissioner new text end 150.24 new text begin for purposes of new text end Minnesota Statutes, section 150.25256B.69 . Notwithstanding the provisions of 150.26section 14, this provision shall not expire. 150.27    Sec. 75. new text begin ASTHMA COVERAGE DEMONSTRATION PROJECT. new text end 150.28     new text begin Subdivision 1. new text end new text begin Medical assistance coverage. new text end new text begin The commissioner of human services new text end 150.29 new text begin shall establish a demonstration project to provide additional medical assistance coverage new text end 150.30 new text begin for a maximum of 200 American Indian children in Minneapolis, St. Paul, and Duluth new text end 150.31 new text begin who are burdened by health disparities associated with the cumulative health impact of new text end 150.32 new text begin toxic environmental exposures. Under this demonstration project, the additional medical new text end 150.33 new text begin assistance coverage for this population must include, but is not limited to, the following new text end 150.34 new text begin durable medical equipment: high efficiency particulate air (HEPA) cleaners, HEPA new text end 150.35 new text begin vacuum cleaners, allergy bed and pillow encasements, high filtration filters for forced air new text end 151.1 new text begin gas furnaces, and dehumidifiers with medical tubing to connect the appliance to a floor new text end 151.2 new text begin drain, if the listed item is medically necessary to reduce asthma symptoms. Provision new text end 151.3 new text begin of these items must be preceded by a home environmental assessment for triggers of new text end 151.4 new text begin asthma and in-home asthma education on the proper medical management of asthma by a new text end 151.5 new text begin Certified Asthma Educator or public health nurse with asthma management training. new text end 151.6     new text begin Subd. 2. new text end new text begin Report. new text end new text begin (a) Two years following implementation of the medical assistance new text end 151.7 new text begin coverage demonstration project established under this section, the commissioner of health, new text end 151.8 new text begin in collaboration with the Department of Human Services, must report to the legislature new text end 151.9 new text begin on the number of asthma-related hospital admittances that occurred in the population of new text end 151.10 new text begin children described in subdivision 1, before and after implementation of the demonstration new text end 151.11 new text begin project, and whether the demonstration project had an impact on asthma-related school new text end 151.12 new text begin absenteeism for this population of children. new text end 151.13 new text begin (b) The commissioner of health must seek nonstate funding to conduct this report. new text end 151.14 new text begin The reporting requirement is contingent upon the availability of nonstate funds. new text end 151.15    Sec. 76. new text begin CLAIMS AND UTILIZATION DATA. new text end 151.16 new text begin The commissioner of human services, in consultation with the Health Services new text end 151.17 new text begin Policy Committee, shall develop and provide to the legislature by December 15, 2009, a new text end 151.18 new text begin methodology and any draft legislation necessary to allow for the release, upon request, of new text end 151.19 new text begin summary data as defined in Minnesota Statutes, section 13.02, subdivision 19, on claims new text end 151.20 new text begin and utilization for medical assistance, general assistance medical care, and MinnesotaCare new text end 151.21 new text begin enrollees at no charge to the University of Minnesota Medical School, the Mayo Medical new text end 151.22 new text begin School, Northwestern Health Sciences University, the Institute for Clinical Systems new text end 151.23 new text begin Improvement, and other research institutions, to conduct analyses of health care outcomes new text end 151.24 new text begin and treatment effectiveness, provided the research institutions do not release private or new text end 151.25 new text begin nonpublic data, or data for which dissemination is prohibited by law. new text end 151.26    Sec. 77. new text begin ADMINISTRATION OF PUBLICLY FUNDED HEALTH CARE new text end 151.27 new text begin PROGRAMS. new text end 151.28 new text begin (a) The commissioner of human services, in cooperation with the representatives new text end 151.29 new text begin of county human services agencies and with input from organizations that advocate on new text end 151.30 new text begin behalf of families and children, shall develop a plan that, to the extent feasible, seeks to new text end 151.31 new text begin align standards, income and asset methodologies, and procedures for families and children new text end 151.32 new text begin under medical assistance and MinnesotaCare. The commissioner shall evaluate the impact new text end 151.33 new text begin of different approaches toward alignment on the number of potential medical assistance new text end 151.34 new text begin and MinnesotaCare enrollees who are families and children, and on administrative, health new text end 152.1 new text begin care, and other costs to the state. The commissioner shall present recommendations to the new text end 152.2 new text begin legislative committees with jurisdiction over health care by September 15, 2010. new text end 152.3 new text begin (b) The commissioner shall report in detail to the chair of the Health Care and new text end 152.4 new text begin Human Services Finance Committee of the house of representatives and to the chair of new text end 152.5 new text begin the Health and Human Services Division of the Finance Committee of the senate, prior new text end 152.6 new text begin to entering into any contracts involving counties for streamlined electronic enrollment new text end 152.7 new text begin and eligibility determinations for publicly funded health care programs, if such contracts new text end 152.8 new text begin would require payment from either the general fund, or the health care access fund, as new text end 152.9 new text begin described in Minnesota Statutes, sections 295.58 and 297I.05. new text end 152.10    Sec. 78. new text begin COBRA PREMIUM STATE SUBSIDY. new text end 152.11     new text begin Subdivision 1. new text end new text begin Eligibility. new text end new text begin (a) An individual and the individual's qualified new text end 152.12 new text begin beneficiaries shall be eligible for a state premium subsidy equal to 35 percent of the new text end 152.13 new text begin premiums the individual is required to pay for the continuation of health care coverage new text end 152.14 new text begin under COBRA, if the individual and the individual's qualified beneficiaries: new text end 152.15 new text begin (1) are eligible for the 65 percent COBRA continuation premium subsidy for health new text end 152.16 new text begin care coverage under the American Recovery and Reinvestment Act of 2009; new text end 152.17 new text begin (2) elect COBRA continuation health care coverage; and new text end 152.18 new text begin (3) are eligible for medical assistance under Minnesota Statutes, chapter 256B; new text end 152.19 new text begin general assistance medical care under Minnesota Statutes, section 256D.03; or new text end 152.20 new text begin MinnesotaCare under Minnesota Statutes, chapter 256L, except for the four-month barrier new text end 152.21 new text begin requirement under Minnesota Statutes, section 256L.07, subdivision 3. new text end 152.22 new text begin (b) Eligibility for the state subsidy shall continue for as long as the individual new text end 152.23 new text begin remains eligible for the COBRA premium subsidies provided under the American new text end 152.24 new text begin Recovery and Reinvestment Act of 2009. new text end 152.25     new text begin Subd. 2. new text end new text begin Subsidy. new text end new text begin (a) The commissioner of human services shall pay 35 percent of new text end 152.26 new text begin the COBRA premiums that the individual must pay for continuation health care coverage new text end 152.27 new text begin for the individual and the individual's qualified beneficiaries, if the individual and the new text end 152.28 new text begin individual's qualified beneficiaries meet the requirements in subdivision 1. new text end 152.29 new text begin (b) The state subsidy payment required under this section shall be made directly to new text end 152.30 new text begin the entity to which the individual is required to make COBRA premium payments. new text end 152.31 new text begin (c) If any eligible individual has paid either the full amount of the COBRA premiums new text end 152.32 new text begin or 35 percent of the COBRA premiums before the date of enactment of this section, the new text end 152.33 new text begin individual is not entitled to a reimbursement of any premium paid. new text end 152.34     new text begin Subd. 3. new text end new text begin Notification. new text end new text begin (a) All employers and plan administrators who are required to new text end 152.35 new text begin provide notice to all qualified individuals under the American Recovery and Reinvestment new text end 153.1 new text begin Act of 2009 must include information to qualified individuals residing in Minnesota of new text end 153.2 new text begin the availability of the state subsidy available under this section. The notice shall include new text end 153.3 new text begin the eligibility requirements for the state subsidy and that the individual must apply to the new text end 153.4 new text begin commissioner of human services to receive the state subsidy. new text end 153.5 new text begin (b) The commissioner of employment and economic development must inform an new text end 153.6 new text begin applicant for unemployment benefits of the availability of a state subsidy if the applicant new text end 153.7 new text begin elects COBRA continuation coverage and the applicant meets the eligibility requirements new text end 153.8 new text begin of this section. new text end 153.9     new text begin Subd. 4. new text end new text begin Exemption. new text end new text begin Any individual who receives a state subsidy under this new text end 153.10 new text begin section is exempt from the four-month requirement under Minnesota Statutes, section new text end 153.11 new text begin 256L.07, subdivision 3, if the individual or the individual's qualified beneficiaries apply new text end 153.12 new text begin for MinnesotaCare after the individual no longer receives COBRA continuation coverage. new text end 153.13     new text begin Subd. 5. new text end new text begin Expiration. new text end new text begin This section expires December 31, 2010. new text end 153.14    Sec. 79. new text begin FEDERAL APPROVAL. new text end 153.15 new text begin The commissioner of human services shall resubmit for federal approval the new text end 153.16 new text begin elimination of depreciation for self-employed farmers in determining income eligibility new text end 153.17 new text begin for MinnesotaCare passed in Laws 2007, chapter 147, article 5, section 19. new text end 153.18    Sec. 80. new text begin REPEALER. new text end 153.19 new text begin Minnesota Statutes 2008, sections 256.962, subdivision 7; and 256L.17, subdivision new text end 153.20 new text begin 6, new text end new text begin are repealed. new text end 153.21ARTICLE 6 153.22TECHNICAL 153.23    Section 1. Minnesota Statutes 2008, section 144A.46, subdivision 1, is amended to 153.24read: 153.25    Subdivision 1. License required. (a) A home care provider may not operate in the 153.26state without a current license issued by the commissioner of health. A home care provider 153.27may hold a separate license for each class of home care licensure. 153.28    (b) Within ten days after receiving an application for a license, the commissioner 153.29shall acknowledge receipt of the application in writing. The acknowledgment must 153.30indicate whether the application appears to be complete or whether additional information 153.31is required before the application will be considered complete. Within 90 days after 153.32receiving a complete application, the commissioner shall either grant or deny the license. 153.33If an applicant is not granted or denied a license within 90 days after submitting a 154.1complete application, the license must be deemed granted. An applicant whose license has 154.2been deemed granted must provide written notice to the commissioner before providing a 154.3home care service. 154.4    (c) Each application for a home care provider license, or for a renewal of a license, 154.5shall be accompanied by a fee to be set by the commissioner under section 144.122. 154.6    (d) The commissioner of health, in consultation with the commissioner of human 154.7services, shall provide recommendations to the legislature by February 15, 2009, for 154.8provider standards for personal care assistant services as described in section new text begin new text end 154.9 new text begin 256B.0659 new text end . 154.10    Sec. 2. Minnesota Statutes 2008, section 176.011, subdivision 9, is amended to read: 154.11    Subd. 9. Employee. "Employee" means any person who performs services for 154.12another for hire including the following: 154.13(1) an alien; 154.14(2) a minor; 154.15(3) a sheriff, deputy sheriff, police officer, firefighter, county highway engineer, and 154.16peace officer while engaged in the enforcement of peace or in the pursuit or capture of a 154.17person charged with or suspected of crime; 154.18(4) a person requested or commanded to aid an officer in arresting or retaking a 154.19person who has escaped from lawful custody, or in executing legal process, in which 154.20cases, for purposes of calculating compensation under this chapter, the daily wage of the 154.21person shall be the prevailing wage for similar services performed by paid employees; 154.22(5) a county assessor; 154.23(6) an elected or appointed official of the state, or of a county, city, town, school 154.24district, or governmental subdivision in the state. An officer of a political subdivision 154.25elected or appointed for a regular term of office, or to complete the unexpired portion of a 154.26regular term, shall be included only after the governing body of the political subdivision 154.27has adopted an ordinance or resolution to that effect; 154.28(7) an executive officer of a corporation, except those executive officers excluded 154.29by section 176.041; 154.30(8) a voluntary uncompensated worker, other than an inmate, rendering services in 154.31state institutions under the commissioners of human services and corrections similar to 154.32those of officers and employees of the institutions, and whose services have been accepted 154.33or contracted for by the commissioner of human services or corrections as authorized by 154.34law. In the event of injury or death of the worker, the daily wage of the worker, for the 154.35purpose of calculating compensation under this chapter, shall be the usual wage paid at 155.1the time of the injury or death for similar services in institutions where the services are 155.2performed by paid employees; 155.3(9) a voluntary uncompensated worker engaged in emergency management as 155.4defined in section 12.03, subdivision 4, who is: 155.5(i) registered with the state or any political subdivision of it, according to the 155.6procedures set forth in the state or political subdivision emergency operations plan; and 155.7(ii) acting under the direction and control of, and within the scope of duties approved 155.8by, the state or political subdivision. 155.9The daily wage of the worker, for the purpose of calculating compensation under this 155.10chapter, shall be the usual wage paid at the time of the injury or death for similar services 155.11performed by paid employees; 155.12(10) a voluntary uncompensated worker participating in a program established by a 155.13local social services agency. For purposes of this clause, "local social services agency" 155.14means any agency established under section 393.01. In the event of injury or death of the 155.15worker, the wage of the worker, for the purpose of calculating compensation under this 155.16chapter, shall be the usual wage paid in the county at the time of the injury or death for 155.17similar services performed by paid employees working a normal day and week; 155.18(11) a voluntary uncompensated worker accepted by the commissioner of natural 155.19resources who is rendering services as a volunteer pursuant to section 84.089. The daily 155.20wage of the worker for the purpose of calculating compensation under this chapter, shall 155.21be the usual wage paid at the time of injury or death for similar services performed by 155.22paid employees; 155.23(12) a voluntary uncompensated worker in the building and construction industry 155.24who renders services for joint labor-management nonprofit community service projects. 155.25The daily wage of the worker for the purpose of calculating compensation under this 155.26chapter shall be the usual wage paid at the time of injury or death for similar services 155.27performed by paid employees; 155.28(13) a member of the military forces, as defined in section 190.05, while in state 155.29active service, as defined in section 190.05, subdivision 5a. The daily wage of the member 155.30for the purpose of calculating compensation under this chapter shall be based on the 155.31member's usual earnings in civil life. If there is no evidence of previous occupation or 155.32earning, the trier of fact shall consider the member's earnings as a member of the military 155.33forces; 155.34(14) a voluntary uncompensated worker, accepted by the director of the Minnesota 155.35Historical Society, rendering services as a volunteer, pursuant to chapter 138. The daily 155.36wage of the worker, for the purposes of calculating compensation under this chapter, 156.1shall be the usual wage paid at the time of injury or death for similar services performed 156.2by paid employees; 156.3(15) a voluntary uncompensated worker, other than a student, who renders services 156.4at the Minnesota State Academy for the Deaf or the Minnesota State Academy for the 156.5Blind, and whose services have been accepted or contracted for by the commissioner of 156.6education, as authorized by law. In the event of injury or death of the worker, the daily 156.7wage of the worker, for the purpose of calculating compensation under this chapter, shall 156.8be the usual wage paid at the time of the injury or death for similar services performed in 156.9institutions by paid employees; 156.10(16) a voluntary uncompensated worker, other than a resident of the veterans home, 156.11who renders services at a Minnesota veterans home, and whose services have been 156.12accepted or contracted for by the commissioner of veterans affairs, as authorized by law. 156.13In the event of injury or death of the worker, the daily wage of the worker, for the purpose 156.14of calculating compensation under this chapter, shall be the usual wage paid at the time of 156.15the injury or death for similar services performed in institutions by paid employees; 156.16(17) a worker performing services under section new text begin 256B.0659 new text end for a 156.17recipient in the home of the recipient or in the community under section 256B.0625, 156.18subdivision 19a , who is paid from government funds through a fiscal intermediary under 156.19section 256B.0655, subdivision 7 new text begin 256B.0659, subdivision 33 new text end . For purposes of maintaining 156.20workers' compensation insurance, the employer of the worker is as designated in law 156.21by the commissioner of the Department of Human Services, notwithstanding any other 156.22law to the contrary; 156.23(18) students enrolled in and regularly attending the Medical School of the 156.24University of Minnesota in the graduate school program or the postgraduate program. The 156.25students shall not be considered employees for any other purpose. In the event of the 156.26student's injury or death, the weekly wage of the student for the purpose of calculating 156.27compensation under this chapter, shall be the annualized educational stipend awarded to 156.28the student, divided by 52 weeks. The institution in which the student is enrolled shall 156.29be considered the "employer" for the limited purpose of determining responsibility for 156.30paying benefits under this chapter; 156.31(19) a faculty member of the University of Minnesota employed for an academic 156.32year is also an employee for the period between that academic year and the succeeding 156.33academic year if: 156.34(a) the member has a contract or reasonable assurance of a contract from the 156.35University of Minnesota for the succeeding academic year; and 157.1(b) the personal injury for which compensation is sought arises out of and in the 157.2course of activities related to the faculty member's employment by the University of 157.3Minnesota; 157.4(20) a worker who performs volunteer ambulance driver or attendant services is an 157.5employee of the political subdivision, nonprofit hospital, nonprofit corporation, or other 157.6entity for which the worker performs the services. The daily wage of the worker for the 157.7purpose of calculating compensation under this chapter shall be the usual wage paid at the 157.8time of injury or death for similar services performed by paid employees; 157.9(21) a voluntary uncompensated worker, accepted by the commissioner of 157.10administration, rendering services as a volunteer at the Department of Administration. In 157.11the event of injury or death of the worker, the daily wage of the worker, for the purpose of 157.12calculating compensation under this chapter, shall be the usual wage paid at the time of the 157.13injury or death for similar services performed in institutions by paid employees; 157.14(22) a voluntary uncompensated worker rendering service directly to the Pollution 157.15Control Agency. The daily wage of the worker for the purpose of calculating compensation 157.16payable under this chapter is the usual going wage paid at the time of injury or death for 157.17similar services if the services are performed by paid employees; 157.18(23) a voluntary uncompensated worker while volunteering services as a first 157.19responder or as a member of a law enforcement assistance organization while acting 157.20under the supervision and authority of a political subdivision. The daily wage of the 157.21worker for the purpose of calculating compensation payable under this chapter is the 157.22usual going wage paid at the time of injury or death for similar services if the services 157.23are performed by paid employees; 157.24(24) a voluntary uncompensated member of the civil air patrol rendering service on 157.25the request and under the authority of the state or any of its political subdivisions. The 157.26daily wage of the member for the purposes of calculating compensation payable under this 157.27chapter is the usual going wage paid at the time of injury or death for similar services if 157.28the services are performed by paid employees; and 157.29(25) a Minnesota Responds Medical Reserve Corps volunteer, as provided in 157.30sections 145A.04 and 145A.06, responding at the request of or engaged in training 157.31conducted by the commissioner of health. The daily wage of the volunteer for the purposes 157.32of calculating compensation payable under this chapter is established in section 145A.06. 157.33A person who qualifies under this clause and who may also qualify under another clause 157.34of this subdivision shall receive benefits in accordance with this clause. 157.35If it is difficult to determine the daily wage as provided in this subdivision, the trier 157.36of fact may determine the wage upon which the compensation is payable. 158.1    Sec. 3. Minnesota Statutes 2008, section 245C.03, subdivision 2, is amended to read: 158.2    Subd. 2. Personal care provider organizations. The commissioner shall conduct 158.3background studies on any individual required under sections 256B.0651 and 158.4to 256B.0656 new text begin and 256B.0659 new text end to have a background study completed under this chapter. 158.5    Sec. 4. Minnesota Statutes 2008, section 245C.04, subdivision 3, is amended to read: 158.6    Subd. 3. Personal care provider organizations. (a) The commissioner shall 158.7conduct a background study of an individual required to be studied under section 245C.03, 158.8subdivision 2 , at least upon application for initial enrollment under sections 256B.0651 158.9and to 256B.0656 new text begin and 256B.0659 new text end . 158.10(b) Organizations required to initiate background studies under sections 256B.0651 158.11and to 256B.0656 new text begin and 256B.0659 new text end for individuals described in section 245C.03, 158.12subdivision 2 , must submit a completed background study form to the commissioner 158.13before those individuals begin a position allowing direct contact with persons served 158.14by the organization. 158.15    Sec. 5. Minnesota Statutes 2008, section 245C.10, subdivision 3, is amended to read: 158.16    Subd. 3. Personal care provider organizations. The commissioner shall recover 158.17the cost of background studies initiated by a personal care provider organization under 158.18sections 256B.0651 and to 256B.0656 new text begin and 256B.0659 new text end through a fee of no 158.19more than $20 per study charged to the organization responsible for submitting the 158.20background study form. The fees collected under this subdivision are appropriated to the 158.21commissioner for the purpose of conducting background studies. 158.22    Sec. 6. Minnesota Statutes 2008, section 256B.04, subdivision 16, is amended to read: 158.23    Subd. 16. Personal care services. (a) Notwithstanding any contrary language in 158.24this paragraph, the commissioner of human services and the commissioner of health shall 158.25jointly promulgate rules to be applied to the licensure of personal care services provided 158.26under the medical assistance program. The rules shall consider standards for personal care 158.27services that are based on the World Institute on Disability's recommendations regarding 158.28personal care services. These rules shall at a minimum consider the standards and 158.29requirements adopted by the commissioner of health under section 144A.45, which the 158.30commissioner of human services determines are applicable to the provision of personal 158.31care services, in addition to other standards or modifications which the commissioner of 158.32human services determines are appropriate. 159.1The commissioner of human services shall establish an advisory group including 159.2personal care consumers and providers to provide advice regarding which standards or 159.3modifications should be adopted. The advisory group membership must include not less 159.4than 15 members, of which at least 60 percent must be consumers of personal care services 159.5and representatives of recipients with various disabilities and diagnoses and ages. At least 159.651 percent of the members of the advisory group must be recipients of personal care. 159.7The commissioner of human services may contract with the commissioner of health 159.8to enforce the jointly promulgated licensure rules for personal care service providers. 159.9Prior to final promulgation of the joint rule the commissioner of human services 159.10shall report preliminary findings along with any comments of the advisory group and a 159.11plan for monitoring and enforcement by the Department of Health to the legislature by 159.12February 15, 1992. 159.13Limits on the extent of personal care services that may be provided to an individual 159.14must be based on the cost-effectiveness of the services in relation to the costs of inpatient 159.15hospital care, nursing home care, and other available types of care. The rules must 159.16provide, at a minimum: 159.17(1) that agencies be selected to contract with or employ and train staff to provide and 159.18supervise the provision of personal care services; 159.19(2) that agencies employ or contract with a qualified applicant that a qualified 159.20recipient proposes to the agency as the recipient's choice of assistant; 159.21(3) that agencies bill the medical assistance program for a personal care service 159.22by a personal care assistant and supervision by a qualified professional supervising the 159.23personal care assistant unless the recipient selects the fiscal agent option under section 159.24256B.0655, subdivision 7 new text begin 256B.0659, subdivision 33 new text end ; 159.25(4) that agencies establish a grievance mechanism; and 159.26(5) that agencies have a quality assurance program. 159.27(b) The commissioner may waive the requirement for the provision of personal care 159.28services through an agency in a particular county, when there are less than two agencies 159.29providing services in that county and shall waive the requirement for personal care 159.30assistants required to join an agency for the first time during 1993 when personal care 159.31services are provided under a relative hardship waiver under Minnesota Statutes 1992, 159.32section 256B.0627, subdivision 4, paragraph (b), clause (7), and at least two agencies 159.33providing personal care services have refused to employ or contract with the independent 159.34personal care assistant. 159.35    Sec. 7. Minnesota Statutes 2008, section 256B.055, subdivision 12, is amended to read: 160.1    Subd. 12. Disabled children. (a) A person is eligible for medical assistance if the 160.2person is under age 19 and qualifies as a disabled individual under United States Code, 160.3title 42, section 1382c(a), and would be eligible for medical assistance under the state 160.4plan if residing in a medical institution, and the child requires a level of care provided in 160.5a hospital, nursing facility, or intermediate care facility for persons with developmental 160.6disabilities, for whom home care is appropriate, provided that the cost to medical 160.7assistance under this section is not more than the amount that medical assistance would pay 160.8for if the child resides in an institution. After the child is determined to be eligible under 160.9this section, the commissioner shall review the child's disability under United States Code, 160.10title 42, section 1382c(a) and level of care defined under this section no more often than 160.11annually and may elect, based on the recommendation of health care professionals under 160.12contract with the state medical review team, to extend the review of disability and level of 160.13care up to a maximum of four years. The commissioner's decision on the frequency of 160.14continuing review of disability and level of care is not subject to administrative appeal 160.15under section 256.045. The county agency shall send a notice of disability review to the 160.16enrollee six months prior to the date the recertification of disability is due. Nothing in this 160.17subdivision shall be construed as affecting other redeterminations of medical assistance 160.18eligibility under this chapter and annual cost-effective reviews under this section. 160.19    (b) For purposes of this subdivision, "hospital" means an institution as defined 160.20in section 144.696, subdivision 3, 144.55, subdivision 3, or Minnesota Rules, part 160.214640.3600, and licensed pursuant to sections 144.50 to 144.58. For purposes of this 160.22subdivision, a child requires a level of care provided in a hospital if the child is determined 160.23by the commissioner to need an extensive array of health services, including mental health 160.24services, for an undetermined period of time, whose health condition requires frequent 160.25monitoring and treatment by a health care professional or by a person supervised by a 160.26health care professional, who would reside in a hospital or require frequent hospitalization 160.27if these services were not provided, and the daily care needs are more complex than 160.28a nursing facility level of care. 160.29    A child with serious emotional disturbance requires a level of care provided in a 160.30hospital if the commissioner determines that the individual requires 24-hour supervision 160.31because the person exhibits recurrent or frequent suicidal or homicidal ideation or 160.32behavior, recurrent or frequent psychosomatic disorders or somatopsychic disorders that 160.33may become life threatening, recurrent or frequent severe socially unacceptable behavior 160.34associated with psychiatric disorder, ongoing and chronic psychosis or severe, ongoing 160.35and chronic developmental problems requiring continuous skilled observation, or severe 161.1disabling symptoms for which office-centered outpatient treatment is not adequate, and 161.2which overall severely impact the individual's ability to function. 161.3    (c) For purposes of this subdivision, "nursing facility" means a facility which 161.4provides nursing care as defined in section 144A.01, subdivision 5, licensed pursuant to 161.5sections 144A.02 to 144A.10, which is appropriate if a person is in active restorative 161.6treatment; is in need of special treatments provided or supervised by a licensed nurse; or 161.7has unpredictable episodes of active disease processes requiring immediate judgment 161.8by a licensed nurse. For purposes of this subdivision, a child requires the level of care 161.9provided in a nursing facility if the child is determined by the commissioner to meet 161.10the requirements of the preadmission screening assessment document under section 161.11256B.0911 and the home care independent rating document under section 256B.0655, 161.12subdivision 4 , clause (3), adjusted to address age-appropriate standards for children age 18 161.13and under, pursuant to section 256B.0655, subdivision 3. 161.14    (d) For purposes of this subdivision, "intermediate care facility for persons with 161.15developmental disabilities" or "ICF/MR" means a program licensed to provide services to 161.16persons with developmental disabilities under section 252.28, and chapter 245A, and a 161.17physical plant licensed as a supervised living facility under chapter 144, which together 161.18are certified by the Minnesota Department of Health as meeting the standards in Code of 161.19Federal Regulations, title 42, part 483, for an intermediate care facility which provides 161.20services for persons with developmental disabilities who require 24-hour supervision 161.21and active treatment for medical, behavioral, or habilitation needs. For purposes of this 161.22subdivision, a child requires a level of care provided in an ICF/MR if the commissioner 161.23finds that the child has a developmental disability in accordance with section 256B.092, 161.24is in need of a 24-hour plan of care and active treatment similar to persons with 161.25developmental disabilities, and there is a reasonable indication that the child will need 161.26ICF/MR services. 161.27    (e) For purposes of this subdivision, a person requires the level of care provided 161.28in a nursing facility if the person requires 24-hour monitoring or supervision and a plan 161.29of mental health treatment because of specific symptoms or functional impairments 161.30associated with a serious mental illness or disorder diagnosis, which meet severity criteria 161.31for mental health established by the commissioner and published in March 1997 as 161.32the Minnesota Mental Health Level of Care for Children and Adolescents with Severe 161.33Emotional Disorders. 161.34    (f) The determination of the level of care needed by the child shall be made by 161.35the commissioner based on information supplied to the commissioner by the parent or 161.36guardian, the child's physician or physicians, and other professionals as requested by the 162.1commissioner. The commissioner shall establish a screening team to conduct the level of 162.2care determinations according to this subdivision. 162.3    (g) If a child meets the conditions in paragraph (b), (c), (d), or (e), the commissioner 162.4must assess the case to determine whether: 162.5    (1) the child qualifies as a disabled individual under United States Code, title 42, 162.6section 1382c(a), and would be eligible for medical assistance if residing in a medical 162.7institution; and 162.8    (2) the cost of medical assistance services for the child, if eligible under this 162.9subdivision, would not be more than the cost to medical assistance if the child resides in a 162.10medical institution to be determined as follows: 162.11    (i) for a child who requires a level of care provided in an ICF/MR, the cost of 162.12care for the child in an institution shall be determined using the average payment rate 162.13established for the regional treatment centers that are certified as ICF's/MR; 162.14    (ii) for a child who requires a level of care provided in an inpatient hospital setting 162.15according to paragraph (b), cost-effectiveness shall be determined according to Minnesota 162.16Rules, part 9505.3520, items F and G; and 162.17    (iii) for a child who requires a level of care provided in a nursing facility according 162.18to paragraph (c) or (e), cost-effectiveness shall be determined according to Minnesota 162.19Rules, part 9505.3040, except that the nursing facility average rate shall be adjusted to 162.20reflect rates which would be paid for children under age 16. The commissioner may 162.21authorize an amount up to the amount medical assistance would pay for a child referred to 162.22the commissioner by the preadmission screening team under section 256B.0911. 162.23    (h) Children eligible for medical assistance services under section 256B.055, 162.24subdivision 12 , as of June 30, 1995, must be screened according to the criteria in this 162.25subdivision prior to January 1, 1996. Children found to be ineligible may not be removed 162.26from the program until January 1, 1996. 162.27    Sec. 8. Minnesota Statutes 2008, section 256B.0621, subdivision 2, is amended to read: 162.28    Subd. 2. Targeted case management; definitions. For purposes of subdivisions 3 162.29to 10, the following terms have the meanings given them: 162.30    (1) "home care service recipients" means those individuals receiving the following 162.31services under sections 256B.0651 to 256B.0656 new text begin and 256B.0659 new text end : skilled nursing visits, 162.32home health aide visits, private duty nursing, personal care assistants, or therapies 162.33provided through a home health agency; 163.1    (2) "home care targeted case management" means the provision of targeted case 163.2management services for the purpose of assisting home care service recipients to gain 163.3access to needed services and supports so that they may remain in the community; 163.4    (3) "institutions" means hospitals, consistent with Code of Federal Regulations, title 163.542, section 440.10; regional treatment center inpatient services, consistent with section 163.6245.474 ; nursing facilities; and intermediate care facilities for persons with developmental 163.7disabilities; 163.8    (4) "relocation targeted case management" includes the provision of both county 163.9targeted case management and public or private vendor service coordination services 163.10for the purpose of assisting recipients to gain access to needed services and supports if 163.11they choose to move from an institution to the community. Relocation targeted case 163.12management may be provided during the lesser of: 163.13    (i) the last 180 consecutive days of an eligible recipient's institutional stay; or 163.14    (ii) the limits and conditions which apply to federal Medicaid funding for this 163.15service; and 163.16    (5) "targeted case management" means case management services provided to help 163.17recipients gain access to needed medical, social, educational, and other services and 163.18supports. 163.19    Sec. 9. Minnesota Statutes 2008, section 256B.0652, subdivision 3, is amended to read: 163.20    Subd. 3. Assessment and prior authorization process. Effective January 1, 1996, 163.21for purposes of providing informed choice, coordinating of local planning decisions, and 163.22streamlining administrative requirements, the assessment and prior authorization process 163.23for persons receiving both home care and home and community-based waivered services 163.24for persons with developmental disabilities shall meet the requirements of sections 163.25256B.0651 and to 256B.0656 new text begin and 256B.0659 new text end with the following exceptions: 163.26(a) Upon request for home care services and subsequent assessment by the public 163.27health nurse under sections 256B.0651 and to 256B.0656 new text begin and 256B.0659 new text end , 163.28the public health nurse shall participate in the screening process, as appropriate, and, 163.29if home care services are determined to be necessary, participate in the development 163.30of a service plan coordinating the need for home care and home and community-based 163.31waivered services with the assigned county case manager, the recipient of services, and 163.32the recipient's legal representative, if any. 163.33(b) The public health nurse shall give prior authorization for home care services 163.34to the extent that home care services are: 163.35(1) medically necessary; 164.1(2) chosen by the recipient and their legal representative, if any, from the array of 164.2home care and home and community-based waivered services available; 164.3(3) coordinated with other services to be received by the recipient as described 164.4in the service plan; and 164.5(4) provided within the county's reimbursement limits for home care and home and 164.6community-based waivered services for persons with developmental disabilities. 164.7(c) If the public health agency is or may be the provider of home care services to the 164.8recipient, the public health agency shall provide the commissioner of human services with 164.9a written plan that specifies how the assessment and prior authorization process will be 164.10held separate and distinct from the provision of services. 164.11    Sec. 10. Minnesota Statutes 2008, section 256B.0657, subdivision 2, is amended to 164.12read: 164.13    Subd. 2. Eligibility. (a) The self-directed supports option is available to a person 164.14who: 164.15    (1) is a recipient of medical assistance as determined under sections 256B.055, 164.16256B.056 , and 256B.057, subdivision 9; 164.17    (2) is eligible for personal care assistant services under section new text begin new text end 164.18 new text begin 256B.0659 new text end ; 164.19    (3) lives in the person's own apartment or home, which is not owned, operated, or 164.20controlled by a provider of services not related by blood or marriage; 164.21    (4) has the ability to hire, fire, supervise, establish staff compensation for, and 164.22manage the individuals providing services, and to choose and obtain items, related 164.23services, and supports as described in the participant's plan. If the recipient is not able to 164.24carry out these functions but has a legal guardian or parent to carry them out, the guardian 164.25or parent may fulfill these functions on behalf of the recipient; and 164.26    (5) has not been excluded or disenrolled by the commissioner. 164.27    (b) The commissioner may disenroll or exclude recipients, including guardians and 164.28parents, under the following circumstances: 164.29    (1) recipients who have been restricted by the Primary Care Utilization Review 164.30Committee may be excluded for a specified time period; 164.31    (2) recipients who exit the self-directed supports option during the recipient's 164.32service plan year shall not access the self-directed supports option for the remainder of 164.33that service plan year; and 164.34    (3) when the department determines that the recipient cannot manage recipient 164.35responsibilities under the program. 165.1    Sec. 11. Minnesota Statutes 2008, section 256B.0657, subdivision 6, is amended to 165.2read: 165.3    Subd. 6. Services covered. (a) Services covered under the self-directed supports 165.4option include: 165.5    (1) personal care assistant services under section new text begin 256B.0659 new text end ; and 165.6    (2) items, related services, and supports, including assistive technology, that increase 165.7independence or substitute for human assistance to the extent expenditures would 165.8otherwise be used for human assistance. 165.9    (b) Items, supports, and related services purchased under this option shall not be 165.10considered home care services for the purposes of section 144A.43. 165.11    Sec. 12. Minnesota Statutes 2008, section 256B.0657, subdivision 8, is amended to 165.12read: 165.13    Subd. 8. Self-directed budget requirements. The budget for the provision of the 165.14self-directed service option shall be equal to the greater of either: 165.15    (1) the annual amount of personal care assistant services under section 165.16 new text begin 256B.0659 new text end that the recipient has used in the most recent 12-month period; or 165.17    (2) the amount determined using the consumer support grant methodology under 165.18section 256.476, subdivision 11, except that the budget amount shall include the federal 165.19and nonfederal share of the average service costs. 165.20    Sec. 13. Minnesota Statutes 2008, section 256B.49, subdivision 17, is amended to read: 165.21    Subd. 17. Cost of services and supports. (a) The commissioner shall ensure 165.22that the average per capita expenditures estimated in any fiscal year for home and 165.23community-based waiver recipients does not exceed the average per capita expenditures 165.24that would have been made to provide institutional services for recipients in the absence 165.25of the waiver. 165.26(b) The commissioner shall implement on January 1, 2002, one or more aggregate, 165.27need-based methods for allocating to local agencies the home and community-based 165.28waivered service resources available to support recipients with disabilities in need of 165.29the level of care provided in a nursing facility or a hospital. The commissioner shall 165.30allocate resources to single counties and county partnerships in a manner that reflects 165.31consideration of: 165.32(1) an incentive-based payment process for achieving outcomes; 165.33(2) the need for a state-level risk pool; 165.34(3) the need for retention of management responsibility at the state agency level; and 166.1(4) a phase-in strategy as appropriate. 166.2(c) Until the allocation methods described in paragraph (b) are implemented, the 166.3annual allowable reimbursement level of home and community-based waiver services 166.4shall be the greater of: 166.5(1) the statewide average payment amount which the recipient is assigned under the 166.6waiver reimbursement system in place on June 30, 2001, modified by the percentage of 166.7any provider rate increase appropriated for home and community-based services; or 166.8(2) an amount approved by the commissioner based on the recipient's extraordinary 166.9needs that cannot be met within the current allowable reimbursement level. The 166.10increased reimbursement level must be necessary to allow the recipient to be discharged 166.11from an institution or to prevent imminent placement in an institution. The additional 166.12reimbursement may be used to secure environmental modifications; assistive technology 166.13and equipment; and increased costs for supervision, training, and support services 166.14necessary to address the recipient's extraordinary needs. The commissioner may approve 166.15an increased reimbursement level for up to one year of the recipient's relocation from an 166.16institution or up to six months of a determination that a current waiver recipient is at 166.17imminent risk of being placed in an institution. 166.18(d) Beginning July 1, 2001, medically necessary private duty nursing services 166.19will be authorized under this section as complex and regular care according to sections 166.20256B.0651 and to 256B.0656 new text begin and 256B.0659 new text end . The rate established by the 166.21commissioner for registered nurse or licensed practical nurse services under any home and 166.22community-based waiver as of January 1, 2001, shall not be reduced. 166.23    Sec. 14. Minnesota Statutes 2008, section 256B.501, subdivision 4a, is amended to 166.24read: 166.25    Subd. 4a. Inclusion of home care costs in waiver rates. The commissioner 166.26shall adjust the limits of the established average daily reimbursement rates for waivered 166.27services to include the cost of home care services that may be provided to waivered 166.28services recipients. This adjustment must be used to maintain or increase services and 166.29shall not be used by county agencies for inflation increases for waivered services vendors. 166.30Home care services referenced in this section are those listed in section 256B.0651, 166.31subdivision 2 . The average daily reimbursement rates established in accordance with 166.32the provisions of this subdivision apply only to the combined average, daily costs of 166.33waivered and home care services and do not change home care limitations under sections 166.34256B.0651 and to 256B.0656 new text begin and 256B.0659 new text end . Waivered services recipients 167.1receiving home care as of June 30, 1992, shall not have the amount of their services 167.2reduced as a result of this section. 167.3    Sec. 15. Minnesota Statutes 2008, section 256G.02, subdivision 6, is amended to read: 167.4    Subd. 6. Excluded time. "Excluded time" means: 167.5(a) any period an applicant spends in a hospital, sanitarium, nursing home, shelter 167.6other than an emergency shelter, halfway house, foster home, semi-independent living 167.7domicile or services program, residential facility offering care, board and lodging facility 167.8or other institution for the hospitalization or care of human beings, as defined in section 167.9144.50 , 144A.01, or 245A.02, subdivision 14; maternity home, battered women's shelter, 167.10or correctional facility; or any facility based on an emergency hold under sections 167.11253B.05, subdivisions 1 and 2 , and 253B.07, subdivision 6; 167.12(b) any period an applicant spends on a placement basis in a training and habilitation 167.13program, including a rehabilitation facility or work or employment program as defined 167.14in section 268A.01; or receiving personal care assistant services pursuant to section 167.15256B.0655, subdivision 2 new text begin 256B.0659 new text end ; semi-independent living services provided under 167.16section 252.275, and Minnesota Rules, parts 9525.0500 to 9525.0660; day training and 167.17habilitation programs and assisted living services; and 167.18(c) any placement for a person with an indeterminate commitment, including 167.19independent living. 167.20    Sec. 16. Minnesota Statutes 2008, section 256I.05, subdivision 1a, is amended to read: 167.21    Subd. 1a. Supplementary service rates. (a) Subject to the provisions of section 167.22256I.04, subdivision 3 , the county agency may negotiate a payment not to exceed $426.37 167.23for other services necessary to provide room and board provided by the group residence 167.24if the residence is licensed by or registered by the Department of Health, or licensed by 167.25the Department of Human Services to provide services in addition to room and board, 167.26and if the provider of services is not also concurrently receiving funding for services for 167.27a recipient under a home and community-based waiver under title XIX of the Social 167.28Security Act; or funding from the medical assistance program under section 256B.0655, 167.29subdivision 2 new text begin 256B.0659 new text end , for personal care services for residents in the setting; or residing 167.30in a setting which receives funding under Minnesota Rules, parts 9535.2000 to 9535.3000. 167.31If funding is available for other necessary services through a home and community-based 167.32waiver, or personal care services under section 256B.0655, subdivision 2 new text begin 256B.0659 new text end , 167.33then the GRH rate is limited to the rate set in subdivision 1. Unless otherwise provided 167.34in law, in no case may the supplementary service rate exceed $426.37. The registration 168.1and licensure requirement does not apply to establishments which are exempt from state 168.2licensure because they are located on Indian reservations and for which the tribe has 168.3prescribed health and safety requirements. Service payments under this section may be 168.4prohibited under rules to prevent the supplanting of federal funds with state funds. The 168.5commissioner shall pursue the feasibility of obtaining the approval of the Secretary of 168.6Health and Human Services to provide home and community-based waiver services under 168.7title XIX of the Social Security Act for residents who are not eligible for an existing home 168.8and community-based waiver due to a primary diagnosis of mental illness or chemical 168.9dependency and shall apply for a waiver if it is determined to be cost-effective. 168.10(b) The commissioner is authorized to make cost-neutral transfers from the GRH 168.11fund for beds under this section to other funding programs administered by the department 168.12after consultation with the county or counties in which the affected beds are located. 168.13The commissioner may also make cost-neutral transfers from the GRH fund to county 168.14human service agencies for beds permanently removed from the GRH census under a plan 168.15submitted by the county agency and approved by the commissioner. The commissioner 168.16shall report the amount of any transfers under this provision annually to the legislature. 168.17(c) The provisions of paragraph (b) do not apply to a facility that has its 168.18reimbursement rate established under section 256B.431, subdivision 4, paragraph (c). 168.19    Sec. 17. Minnesota Statutes 2008, section 256J.45, subdivision 3, is amended to read: 168.20    Subd. 3. Good cause exemptions for not attending orientation. (a) The county 168.21agency shall not impose the sanction under section 256J.46 if it determines that the 168.22participant has good cause for failing to attend orientation. Good cause exists when: 168.23(1) appropriate child care is not available; 168.24(2) the participant is ill or injured; 168.25(3) a family member is ill and needs care by the participant that prevents the 168.26participant from attending orientation. For a caregiver with a child or adult in the 168.27household who meets the disability or medical criteria for home care services under 168.28section 256B.0655, subdivision 1c new text begin 256B.0659 new text end , or a home and community-based waiver 168.29services program under chapter 256B, or meets the criteria for severe emotional 168.30disturbance under section 245.4871, subdivision 6, or for serious and persistent mental 168.31illness under section 245.462, subdivision 20, paragraph (c), good cause also exists when 168.32an interruption in the provision of those services occurs which prevents the participant 168.33from attending orientation; 168.34(4) the caregiver is unable to secure necessary transportation; 168.35(5) the caregiver is in an emergency situation that prevents orientation attendance; 169.1(6) the orientation conflicts with the caregiver's work, training, or school schedule; or 169.2(7) the caregiver documents other verifiable impediments to orientation attendance 169.3beyond the caregiver's control. 169.4(b) Counties must work with clients to provide child care and transportation 169.5necessary to ensure a caregiver has every opportunity to attend orientation. 169.6    Sec. 18. Minnesota Statutes 2008, section 604A.33, subdivision 1, is amended to read: 169.7    Subdivision 1. Application. This section applies to residential treatment programs 169.8for children or group homes for children licensed under chapter 245A, residential 169.9services and programs for juveniles licensed under section 241.021, providers licensed 169.10pursuant to sections 144A.01 to 144A.33 or sections 144A.43 to 144A.47, personal care 169.11provider organizations under section 256B.0655, subdivision 1g new text begin 256B.0659 new text end , providers 169.12of day training and habilitation services under sections 252.40 to 252.46, board and 169.13lodging facilities licensed under chapter 157, intermediate care facilities for persons with 169.14developmental disabilities, and other facilities licensed to provide residential services to 169.15persons with developmental disabilities. 169.16    Sec. 19. Minnesota Statutes 2008, section 609.232, subdivision 11, is amended to read: 169.17    Subd. 11. Vulnerable adult. "Vulnerable adult" means any person 18 years of 169.18age or older who: 169.19(1) is a resident inpatient of a facility; 169.20(2) receives services at or from a facility required to be licensed to serve adults 169.21under sections 245A.01 to 245A.15, except that a person receiving outpatient services for 169.22treatment of chemical dependency or mental illness, or one who is committed as a sexual 169.23psychopathic personality or as a sexually dangerous person under chapter 253B, is not 169.24considered a vulnerable adult unless the person meets the requirements of clause (4); 169.25(3) receives services from a home care provider required to be licensed under section 169.26144A.46 ; or from a person or organization that exclusively offers, provides, or arranges 169.27for personal care assistant services under the medical assistance program as authorized 169.28under sections 256B.04, subdivision 16, 256B.0625, subdivision 19a, 256B.0651, and 169.29 to 256B.0656 new text begin and 256B.0659 new text end ; or 169.30(4) regardless of residence or whether any type of service is received, possesses a 169.31physical or mental infirmity or other physical, mental, or emotional dysfunction: 169.32(i) that impairs the individual's ability to provide adequately for the individual's 169.33own care without assistance, including the provision of food, shelter, clothing, health 169.34care, or supervision; and 170.1(ii) because of the dysfunction or infirmity and the need for assistance, the individual 170.2has an impaired ability to protect the individual from maltreatment. 170.3    Sec. 20. Minnesota Statutes 2008, section 626.5572, subdivision 6, is amended to read: 170.4    Subd. 6. Facility. (a) "Facility" means a hospital or other entity required to be 170.5licensed under sections 144.50 to 144.58; a nursing home required to be licensed to 170.6serve adults under section 144A.02; a residential or nonresidential facility required to 170.7be licensed to serve adults under sections 245A.01 to 245A.16; a home care provider 170.8licensed or required to be licensed under section 144A.46; a hospice provider licensed 170.9under sections 144A.75 to 144A.755; or a person or organization that exclusively offers, 170.10provides, or arranges for personal care assistant services under the medical assistance 170.11program as authorized under sections 256B.04, subdivision 16, 256B.0625, subdivision 170.1219a , 256B.0651, and to 256B.0656 new text begin , and 256B.0659 new text end . 170.13(b) For home care providers and personal care attendants, the term "facility" refers 170.14to the provider or person or organization that exclusively offers, provides, or arranges for 170.15personal care services, and does not refer to the client's home or other location at which 170.16services are rendered. 170.17    Sec. 21. Minnesota Statutes 2008, section 626.5572, subdivision 21, is amended to 170.18read: 170.19    Subd. 21. Vulnerable adult. "Vulnerable adult" means any person 18 years of 170.20age or older who: 170.21    (1) is a resident or inpatient of a facility; 170.22    (2) receives services at or from a facility required to be licensed to serve adults 170.23under sections 245A.01 to 245A.15, except that a person receiving outpatient services for 170.24treatment of chemical dependency or mental illness, or one who is served in the Minnesota 170.25sex offender program on a court-hold order for commitment, or is committed as a sexual 170.26psychopathic personality or as a sexually dangerous person under chapter 253B, is not 170.27considered a vulnerable adult unless the person meets the requirements of clause (4); 170.28    (3) receives services from a home care provider required to be licensed under section 170.29144A.46 ; or from a person or organization that exclusively offers, provides, or arranges 170.30for personal care assistant services under the medical assistance program as authorized 170.31under sections 256B.04, subdivision 16, 256B.0625, subdivision 19a, 256B.0651, and 170.32256B.0653 to 256B.0656 new text begin , and 256B.0659 new text end ; or 170.33    (4) regardless of residence or whether any type of service is received, possesses a 170.34physical or mental infirmity or other physical, mental, or emotional dysfunction: 171.1    (i) that impairs the individual's ability to provide adequately for the individual's 171.2own care without assistance, including the provision of food, shelter, clothing, health 171.3care, or supervision; and 171.4    (ii) because of the dysfunction or infirmity and the need for assistance, the individual 171.5has an impaired ability to protect the individual from maltreatment. 171.6ARTICLE 7 171.7CHEMICAL AND MENTAL HEALTH 171.8    Section 1. Minnesota Statutes 2008, section 245.462, subdivision 18, is amended to 171.9read: 171.10    Subd. 18. Mental health professional. "Mental health professional" means a 171.11person providing clinical services in the treatment of mental illness who is qualified in at 171.12least one of the following ways: 171.13    (1) in psychiatric nursing: a registered nurse who is licensed under sections 148.171 171.14to 148.285; and: 171.15    (i) who is certified as a clinical specialist or as a nurse practitioner in adult or family 171.16psychiatric and mental health nursing by a national nurse certification organization; or 171.17    (ii) who has a master's degree in nursing or one of the behavioral sciences or related 171.18fields from an accredited college or university or its equivalent, with at least 4,000 hours 171.19of post-master's supervised experience in the delivery of clinical services in the treatment 171.20of mental illness; 171.21    (2) in clinical social work: a person licensed as an independent clinical social worker 171.22under chapter 148D, or a person with a master's degree in social work from an accredited 171.23college or university, with at least 4,000 hours of post-master's supervised experience in 171.24the delivery of clinical services in the treatment of mental illness; 171.25    (3) in psychology: an individual licensed by the Board of Psychology under sections 171.26148.88 to 148.98 who has stated to the Board of Psychology competencies in the diagnosis 171.27and treatment of mental illness; 171.28    (4) in psychiatry: a physician licensed under chapter 147 and certified by the 171.29American Board of Psychiatry and Neurology or eligible for board certification in 171.30psychiatry; 171.31    (5) in marriage and family therapy: the mental health professional must be a 171.32marriage and family therapist licensed under sections 148B.29 to 148B.39 with at least 171.33two years of post-master's supervised experience in the delivery of clinical services in 171.34the treatment of mental illness; or 172.1    (6) new text begin in licensed professional clinical counseling, the mental health professional new text end 172.2 new text begin shall be a licensed professional clinical counselor under section 148B.5301 with at least new text end 172.3 new text begin 4,000 hours of postmaster's supervised experience in the delivery of clinical services in new text end 172.4 new text begin the treatment of mental illness; or new text end 172.5     new text begin (7) new text end in allied fields: a person with a master's degree from an accredited college or 172.6university in one of the behavioral sciences or related fields, with at least 4,000 hours of 172.7post-master's supervised experience in the delivery of clinical services in the treatment of 172.8mental illness. 172.9    Sec. 2. Minnesota Statutes 2008, section 245.470, subdivision 1, is amended to read: 172.10    Subdivision 1. Availability of outpatient services. (a) County boards must provide 172.11or contract for enough outpatient services within the county to meet the needs of adults 172.12with mental illness residing in the county. Services may be provided directly by the 172.13county through county-operated mental health centers or mental health clinics approved 172.14by the commissioner under section 245.69, subdivision 2; by contract with privately 172.15operated mental health centers or mental health clinics approved by the commissioner 172.16under section 245.69, subdivision 2; by contract with hospital mental health outpatient 172.17programs certified by the Joint Commission on Accreditation of Hospital Organizations; 172.18or by contract with a licensed mental health professional as defined in section 245.462, 172.19subdivision 18 , clauses (1) to (4) new text begin (6) new text end . Clients may be required to pay a fee according to 172.20section 245.481. Outpatient services include: 172.21    (1) conducting diagnostic assessments; 172.22    (2) conducting psychological testing; 172.23    (3) developing or modifying individual treatment plans; 172.24    (4) making referrals and recommending placements as appropriate; 172.25    (5) treating an adult's mental health needs through therapy; 172.26    (6) prescribing and managing medication and evaluating the effectiveness of 172.27prescribed medication; and 172.28    (7) preventing placement in settings that are more intensive, costly, or restrictive 172.29than necessary and appropriate to meet client needs. 172.30    (b) County boards may request a waiver allowing outpatient services to be provided 172.31in a nearby trade area if it is determined that the client can best be served outside the 172.32county. 172.33    Sec. 3. Minnesota Statutes 2008, section 245.4871, subdivision 27, is amended to read: 173.1    Subd. 27. Mental health professional. "Mental health professional" means a 173.2person providing clinical services in the diagnosis and treatment of children's emotional 173.3disorders. A mental health professional must have training and experience in working with 173.4children consistent with the age group to which the mental health professional is assigned. 173.5A mental health professional must be qualified in at least one of the following ways: 173.6    (1) in psychiatric nursing, the mental health professional must be a registered nurse 173.7who is licensed under sections 148.171 to 148.285 and who is certified as a clinical 173.8specialist in child and adolescent psychiatric or mental health nursing by a national nurse 173.9certification organization or who has a master's degree in nursing or one of the behavioral 173.10sciences or related fields from an accredited college or university or its equivalent, with 173.11at least 4,000 hours of post-master's supervised experience in the delivery of clinical 173.12services in the treatment of mental illness; 173.13    (2) in clinical social work, the mental health professional must be a person licensed 173.14as an independent clinical social worker under chapter 148D, or a person with a master's 173.15degree in social work from an accredited college or university, with at least 4,000 hours of 173.16post-master's supervised experience in the delivery of clinical services in the treatment 173.17of mental disorders; 173.18    (3) in psychology, the mental health professional must be an individual licensed by 173.19the board of psychology under sections 148.88 to 148.98 who has stated to the board of 173.20psychology competencies in the diagnosis and treatment of mental disorders; 173.21    (4) in psychiatry, the mental health professional must be a physician licensed under 173.22chapter 147 and certified by the American board of psychiatry and neurology or eligible 173.23for board certification in psychiatry; 173.24    (5) in marriage and family therapy, the mental health professional must be a 173.25marriage and family therapist licensed under sections 148B.29 to 148B.39 with at least 173.26two years of post-master's supervised experience in the delivery of clinical services in the 173.27treatment of mental disorders or emotional disturbances; or 173.28    (6) new text begin in licensed professional clinical counseling, the mental health professional shall new text end 173.29 new text begin be a licensed professional clinical counselor under section 148B.5301 with at least 4,000 new text end 173.30 new text begin hours of postmaster's supervised experience in the delivery of clinical services in the new text end 173.31 new text begin treatment of mental disorders or emotional disturbances; or new text end 173.32     new text begin (7) new text end in allied fields, the mental health professional must be a person with a master's 173.33degree from an accredited college or university in one of the behavioral sciences or related 173.34fields, with at least 4,000 hours of post-master's supervised experience in the delivery of 173.35clinical services in the treatment of emotional disturbances. 174.1    Sec. 4. Minnesota Statutes 2008, section 245.488, subdivision 1, is amended to read: 174.2    Subdivision 1. Availability of outpatient services. (a) County boards must provide 174.3or contract for enough outpatient services within the county to meet the needs of each 174.4child with emotional disturbance residing in the county and the child's family. Services 174.5may be provided directly by the county through county-operated mental health centers or 174.6mental health clinics approved by the commissioner under section 245.69, subdivision 2; 174.7by contract with privately operated mental health centers or mental health clinics approved 174.8by the commissioner under section 245.69, subdivision 2; by contract with hospital 174.9mental health outpatient programs certified by the Joint Commission on Accreditation 174.10of Hospital Organizations; or by contract with a licensed mental health professional as 174.11defined in section 245.4871, subdivision 27, clauses (1) to (4) new text begin (6) new text end . A child or a child's 174.12parent may be required to pay a fee based in accordance with section 245.481. Outpatient 174.13services include: 174.14    (1) conducting diagnostic assessments; 174.15    (2) conducting psychological testing; 174.16    (3) developing or modifying individual treatment plans; 174.17    (4) making referrals and recommending placements as appropriate; 174.18    (5) treating the child's mental health needs through therapy; and 174.19    (6) prescribing and managing medication and evaluating the effectiveness of 174.20prescribed medication. 174.21    (b) County boards may request a waiver allowing outpatient services to be provided 174.22in a nearby trade area if it is determined that the child requires necessary and appropriate 174.23services that are only available outside the county. 174.24    (c) Outpatient services offered by the county board to prevent placement must be at 174.25the level of treatment appropriate to the child's diagnostic assessment. 174.26    Sec. 5. Minnesota Statutes 2008, section 254A.02, is amended by adding a subdivision 174.27to read: 174.28     new text begin Subd. 8a. new text end new text begin Placing authority. new text end new text begin "Placing authority" means a county, prepaid health new text end 174.29 new text begin plan, or tribal governing board governed by Minnesota Rules, parts 9530.6600 to new text end 174.30 new text begin 9530.6655. new text end 174.31    Sec. 6. Minnesota Statutes 2008, section 254A.16, is amended by adding a subdivision 174.32to read: 174.33     new text begin Subd. 6. new text end new text begin Monitoring. new text end new text begin The commissioner shall gather and placing authorities shall new text end 174.34 new text begin provide information to measure compliance with Minnesota Rules, parts 9530.6600 to new text end 175.1 new text begin 9530.6655. The commissioner shall specify the format for data collection to facilitate new text end 175.2 new text begin tracking, aggregating, and using the information. new text end 175.3    Sec. 7. Minnesota Statutes 2008, section 254B.03, subdivision 1, is amended to read: 175.4    Subdivision 1. Local agency duties. (a) Every local agency shall provide chemical 175.5dependency services to persons residing within its jurisdiction who meet criteria 175.6established by the commissioner for placement in a chemical dependency residential or 175.7nonresidential treatment service. Chemical dependency money must be administered 175.8by the local agencies according to law and rules adopted by the commissioner under 175.9sections 14.001 to 14.69. 175.10    (b) In order to contain costs, the county board shall, with the approval of the 175.11commissioner of human services, new text begin shall new text end select eligible vendors of chemical dependency 175.12services who can provide economical and appropriate treatment. Unless the local agency 175.13is a social services department directly administered by a county or human services board, 175.14the local agency shall not be an eligible vendor under section 254B.05. The commissioner 175.15may approve proposals from county boards to provide services in an economical manner 175.16or to control utilization, with safeguards to ensure that necessary services are provided. 175.17If a county implements a demonstration or experimental medical services funding plan, 175.18the commissioner shall transfer the money as appropriate. If a county selects a vendor 175.19located in another state, the county shall ensure that the vendor is in compliance with the 175.20rules governing licensure of programs located in the state. 175.21    (c) A culturally specific vendor that provides assessments under a variance under 175.22Minnesota Rules, part 9530.6610, shall be allowed to provide assessment services to 175.23persons not covered by the variance. 175.24 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2011. new text end 175.25    Sec. 8. Minnesota Statutes 2008, section 254B.03, subdivision 3, is amended to read: 175.26    Subd. 3. Local agencies to pay state for county share. Local agencies shall pay 175.27the state for the county share of the services authorized by the local agency new text begin , except when new text end 175.28 new text begin the payment is made according to section 254B.09, subdivision 8 new text end . 175.29    Sec. 9. Minnesota Statutes 2008, section 254B.03, is amended by adding a subdivision 175.30to read: 175.31     new text begin Subd. 9. new text end new text begin Commissioner to select vendors and set rates. new text end new text begin (a) Effective July 1, 2011, new text end 175.32 new text begin the commissioner shall: new text end 175.33 new text begin (1) enter into agreements with eligible vendors that: new text end 176.1 new text begin (i) meet the standards in section 254B.05, subdivision 1; new text end 176.2 new text begin (ii) have good standing in all applicable licensure; and new text end 176.3 new text begin (iii) have a current approved provider agreement as a Minnesota health care program new text end 176.4 new text begin provider; and new text end 176.5 new text begin (2) set rates for services reimbursed under this chapter. new text end 176.6 new text begin (b) When setting rates, the commissioner shall consider the complexity and the new text end 176.7 new text begin acuity of the problems presented by the client. new text end 176.8 new text begin (c) When rates set under this section and rates set under section 254B.09, subdivision new text end 176.9 new text begin 8, apply to the same treatment placement, section 254B.09, subdivision 8, supersedes. new text end 176.10    Sec. 10. Minnesota Statutes 2008, section 254B.05, subdivision 1, is amended to read: 176.11    Subdivision 1. Licensure required. Programs licensed by the commissioner are 176.12eligible vendors. Hospitals may apply for and receive licenses to be eligible vendors, 176.13notwithstanding the provisions of section 245A.03. American Indian programs located on 176.14federally recognized tribal lands that provide chemical dependency primary treatment, 176.15extended care, transitional residence, or outpatient treatment services, and are licensed by 176.16tribal government are eligible vendors. Detoxification programs are not eligible vendors. 176.17Programs that are not licensed as a chemical dependency residential or nonresidential 176.18treatment program by the commissioner or by tribal government are not eligible vendors. 176.19To be eligible for payment under the Consolidated Chemical Dependency Treatment Fund, 176.20a vendor of a chemical dependency service must participate in the Drug and Alcohol 176.21Abuse Normative Evaluation System and the treatment accountability plan. 176.22Effective January 1, 2000, vendors of room and board are eligible for chemical 176.23dependency fund payment if the vendor: 176.24(1) is certified by the county or tribal governing body as having new text begin has new text end rules prohibiting 176.25residents bringing chemicals into the facility or using chemicals while residing in the 176.26facility and provide consequences for infractions of those rules; 176.27(2) has a current contract with a county or tribal governing body; 176.28(3) is determined to meet applicable health and safety requirements; 176.29(4) is not a jail or prison; and 176.30(5) is not concurrently receiving funds under chapter 256I for the recipient. 176.31 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2011. new text end 176.32    Sec. 11. Minnesota Statutes 2008, section 254B.09, subdivision 2, is amended to read: 176.33    Subd. 2. American Indian agreements. The commissioner may enter into 176.34agreements with federally recognized tribal units to pay for chemical dependency 177.1treatment services provided under Laws 1986, chapter 394, sections 8 to 20. The 177.2agreements must clarify how the governing body of the tribal unit fulfills local agency 177.3responsibilities regarding: 177.4(1) selection of eligible vendors under section 254B.03, subdivision 1; 177.5(2) negotiation of agreements that establish vendor services and rates for programs 177.6located on the tribal governing body's reservation; 177.7(3) new text begin (1) new text end the form and manner of invoicing; and 177.8(4) new text begin (2) new text end provide that only invoices for eligible vendors according to section 254B.05 177.9will be included in invoices sent to the commissioner for payment, to the extent that 177.10money allocated under subdivisions 4 and 5 is used. 177.11 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2011. new text end 177.12    Sec. 12. new text begin [254B.11] MAXIMUM RATES. new text end 177.13 new text begin The commissioner shall publish maximum rates for vendors of the consolidated new text end 177.14 new text begin chemical dependency treatment fund by July 1 of each year for implementation the new text end 177.15 new text begin following January 1. Rates for calendar year 2010 must not exceed 185 percent of the new text end 177.16 new text begin average rate on January 1, 2009, for each group of vendors with similar attributes. Unless new text end 177.17 new text begin a new rate methodology is developed under section 254B.12, rates for services provided on new text end 177.18 new text begin and after July 1, 2011, must not exceed 160 percent of the average rate on January 1, 2009, new text end 177.19 new text begin for each group of vendors with similar attributes. Payment for services provided by Indian new text end 177.20 new text begin Health Services or by agencies operated by Indian tribes for medical assistance-eligible new text end 177.21 new text begin individuals must be governed by the applicable federal rate methodology. new text end 177.22    Sec. 13. new text begin [254B.12] RATE METHODOLOGY. new text end 177.23 new text begin The commissioner shall, with broad-based stakeholder input, develop a new text end 177.24 new text begin recommendation and present a report to the 2011 legislature, including proposed new text end 177.25 new text begin legislation for a new rate methodology for the consolidated chemical dependency new text end 177.26 new text begin treatment fund. The new methodology must replace county-negotiated rates with a new text end 177.27 new text begin uniform statewide methodology that must include a graduated reimbursement scale based new text end 177.28 new text begin on the patients' level of acuity and complexity. new text end 177.29    Sec. 14. Minnesota Statutes 2008, section 256B.0622, subdivision 2, is amended to 177.30read: 177.31    Subd. 2. Definitions. For purposes of this section, the following terms have the 177.32meanings given them. 178.1    (a) "Intensive nonresidential rehabilitative mental health services" means adult 178.2rehabilitative mental health services as defined in section 256B.0623, subdivision 2, 178.3paragraph (a), except that these services are provided by a multidisciplinary staff using 178.4a total team approach consistent with assertive community treatment, the Fairweather 178.5Lodge treatment model, as defined by the standards established by the National Coalition 178.6for Community Living, and other evidence-based practices, and directed to recipients with 178.7a serious mental illness who require intensive services. 178.8    (b) "Intensive residential rehabilitative mental health services" means short-term, 178.9time-limited services provided in a residential setting to recipients who are in need of 178.10more restrictive settings and are at risk of significant functional deterioration if they do 178.11not receive these services. Services are designed to develop and enhance psychiatric 178.12stability, personal and emotional adjustment, self-sufficiency, and skills to live in a more 178.13independent setting. Services must be directed toward a targeted discharge date with 178.14specified client outcomes and must be consistent with the Fairweather Lodge treatment 178.15model as defined in paragraph (a), and other evidence-based practices. 178.16    (c) "Evidence-based practices" are nationally recognized mental health services that 178.17are proven by substantial research to be effective in helping individuals with serious 178.18mental illness obtain specific treatment goals. 178.19    (d) "Overnight staff" means a member of the intensive residential rehabilitative 178.20mental health treatment team who is responsible during hours when recipients are 178.21typically asleep. 178.22    (e) "Treatment team" means all staff who provide services under this section to 178.23recipients. At a minimum, this includes the clinical supervisor, mental health professionals 178.24as defined in section 245.462, subdivision 18, clauses (1) to (5) new text begin (6) new text end ; mental health 178.25practitioners as defined in section 245.462, subdivision 17; mental health rehabilitation 178.26workers under section 256B.0623, subdivision 5, clause (3); and certified peer specialists 178.27under section 256B.0615. 178.28    Sec. 15. Minnesota Statutes 2008, section 256B.0623, subdivision 5, is amended to 178.29read: 178.30    Subd. 5. Qualifications of provider staff. Adult rehabilitative mental health 178.31services must be provided by qualified individual provider staff of a certified provider 178.32entity. Individual provider staff must be qualified under one of the following criteria: 178.33    (1) a mental health professional as defined in section 245.462, subdivision 18, 178.34clauses (1) to (5) new text begin (6) new text end . If the recipient has a current diagnostic assessment by a licensed 178.35mental health professional as defined in section 245.462, subdivision 18, clauses (1) to (5) new text begin new text end 179.1 new text begin (6) new text end , recommending receipt of adult mental health rehabilitative services, the definition of 179.2mental health professional for purposes of this section includes a person who is qualified 179.3under section 245.462, subdivision 18, clause (6) new text begin (7) new text end , and who holds a current and valid 179.4national certification as a certified rehabilitation counselor or certified psychosocial 179.5rehabilitation practitioner; 179.6    (2) a mental health practitioner as defined in section 245.462, subdivision 17. The 179.7mental health practitioner must work under the clinical supervision of a mental health 179.8professional; 179.9    (3) a certified peer specialist under section 256B.0615. The certified peer specialist 179.10must work under the clinical supervision of a mental health professional; or 179.11    (4) a mental health rehabilitation worker. A mental health rehabilitation worker 179.12means a staff person working under the direction of a mental health practitioner or mental 179.13health professional and under the clinical supervision of a mental health professional in 179.14the implementation of rehabilitative mental health services as identified in the recipient's 179.15individual treatment plan who: 179.16    (i) is at least 21 years of age; 179.17    (ii) has a high school diploma or equivalent; 179.18    (iii) has successfully completed 30 hours of training during the past two years in all 179.19of the following areas: recipient rights, recipient-centered individual treatment planning, 179.20behavioral terminology, mental illness, co-occurring mental illness and substance abuse, 179.21psychotropic medications and side effects, functional assessment, local community 179.22resources, adult vulnerability, recipient confidentiality; and 179.23    (iv) meets the qualifications in subitem (A) or (B): 179.24    (A) has an associate of arts degree in one of the behavioral sciences or human 179.25services, or is a registered nurse without a bachelor's degree, or who within the previous 179.26ten years has: 179.27    (1) three years of personal life experience with serious and persistent mental illness; 179.28    (2) three years of life experience as a primary caregiver to an adult with a serious 179.29mental illness or traumatic brain injury; or 179.30    (3) 4,000 hours of supervised paid work experience in the delivery of mental health 179.31services to adults with a serious mental illness or traumatic brain injury; or 179.32    (B)(1) is fluent in the non-English language or competent in the culture of the 179.33ethnic group to which at least 20 percent of the mental health rehabilitation worker's 179.34clients belong; 179.35    (2) receives during the first 2,000 hours of work, monthly documented individual 179.36clinical supervision by a mental health professional; 180.1    (3) has 18 hours of documented field supervision by a mental health professional 180.2or practitioner during the first 160 hours of contact work with recipients, and at least six 180.3hours of field supervision quarterly during the following year; 180.4    (4) has review and cosignature of charting of recipient contacts during field 180.5supervision by a mental health professional or practitioner; and 180.6    (5) has 40 hours of additional continuing education on mental health topics during 180.7the first year of employment. 180.8    Sec. 16. Minnesota Statutes 2008, section 256B.0624, subdivision 5, is amended to 180.9read: 180.10    Subd. 5. Mobile crisis intervention staff qualifications. For provision of adult 180.11mental health mobile crisis intervention services, a mobile crisis intervention team is 180.12comprised of at least two mental health professionals as defined in section 245.462, 180.13subdivision 18 , clauses (1) to (5) new text begin (6) new text end , or a combination of at least one mental health 180.14professional and one mental health practitioner as defined in section 245.462, subdivision 180.1517 , with the required mental health crisis training and under the clinical supervision of 180.16a mental health professional on the team. The team must have at least two people with 180.17at least one member providing on-site crisis intervention services when needed. Team 180.18members must be experienced in mental health assessment, crisis intervention techniques, 180.19and clinical decision-making under emergency conditions and have knowledge of local 180.20services and resources. The team must recommend and coordinate the team's services 180.21with appropriate local resources such as the county social services agency, mental health 180.22services, and local law enforcement when necessary. 180.23    Sec. 17. Minnesota Statutes 2008, section 256B.0624, subdivision 8, is amended to 180.24read: 180.25    Subd. 8. Adult crisis stabilization staff qualifications. (a) Adult mental health 180.26crisis stabilization services must be provided by qualified individual staff of a qualified 180.27provider entity. Individual provider staff must have the following qualifications: 180.28    (1) be a mental health professional as defined in section 245.462, subdivision 18, 180.29clauses (1) to (5) new text begin (6) new text end ; 180.30    (2) be a mental health practitioner as defined in section 245.462, subdivision 17. 180.31The mental health practitioner must work under the clinical supervision of a mental health 180.32professional; or 180.33    (3) be a mental health rehabilitation worker who meets the criteria in section 180.34256B.0623, subdivision 5 , clause (3); works under the direction of a mental health 181.1practitioner as defined in section 245.462, subdivision 17, or under direction of a 181.2mental health professional; and works under the clinical supervision of a mental health 181.3professional. 181.4    (b) Mental health practitioners and mental health rehabilitation workers must have 181.5completed at least 30 hours of training in crisis intervention and stabilization during 181.6the past two years. 181.7    Sec. 18. Minnesota Statutes 2008, section 256B.0625, subdivision 42, is amended to 181.8read: 181.9    Subd. 42. Mental health professional. Notwithstanding Minnesota Rules, part 181.109505.0175, subpart 28, the definition of a mental health professional shall include a person 181.11who is qualified as specified in section 245.462, subdivision 18, clause new text begin clauses new text end (5) new text begin and (6) new text end ; 181.12or 245.4871, subdivision 27, clause new text begin clauses new text end (5) new text begin and (6) new text end , for the purpose of this section and 181.13Minnesota Rules, parts 9505.0170 to 9505.0475. 181.14    Sec. 19. Minnesota Statutes 2008, section 256B.0943, subdivision 1, is amended to 181.15read: 181.16    Subdivision 1. Definitions. For purposes of this section, the following terms have 181.17the meanings given them. 181.18    (a) "Children's therapeutic services and supports" means the flexible package of 181.19mental health services for children who require varying therapeutic and rehabilitative 181.20levels of intervention. The services are time-limited interventions that are delivered using 181.21various treatment modalities and combinations of services designed to reach treatment 181.22outcomes identified in the individual treatment plan. 181.23    (b) "Clinical supervision" means the overall responsibility of the mental health 181.24professional for the control and direction of individualized treatment planning, service 181.25delivery, and treatment review for each client. A mental health professional who is an 181.26enrolled Minnesota health care program provider accepts full professional responsibility 181.27for a supervisee's actions and decisions, instructs the supervisee in the supervisee's work, 181.28and oversees or directs the supervisee's work. 181.29    (c) "County board" means the county board of commissioners or board established 181.30under sections 402.01 to 402.10 or 471.59. 181.31    (d) "Crisis assistance" has the meaning given in section 245.4871, subdivision 9a. 181.32    (e) "Culturally competent provider" means a provider who understands and can 181.33utilize to a client's benefit the client's culture when providing services to the client. A 181.34provider may be culturally competent because the provider is of the same cultural or 182.1ethnic group as the client or the provider has developed the knowledge and skills through 182.2training and experience to provide services to culturally diverse clients. 182.3    (f) "Day treatment program" for children means a site-based structured program 182.4consisting of group psychotherapy for more than three individuals and other intensive 182.5therapeutic services provided by a multidisciplinary team, under the clinical supervision 182.6of a mental health professional. 182.7    (g) "Diagnostic assessment" has the meaning given in section 245.4871, subdivision 182.811 . 182.9    (h) "Direct service time" means the time that a mental health professional, mental 182.10health practitioner, or mental health behavioral aide spends face-to-face with a client 182.11and the client's family. Direct service time includes time in which the provider obtains 182.12a client's history or provides service components of children's therapeutic services and 182.13supports. Direct service time does not include time doing work before and after providing 182.14direct services, including scheduling, maintaining clinical records, consulting with others 182.15about the client's mental health status, preparing reports, receiving clinical supervision 182.16directly related to the client's psychotherapy session, and revising the client's individual 182.17treatment plan. 182.18    (i) "Direction of mental health behavioral aide" means the activities of a mental 182.19health professional or mental health practitioner in guiding the mental health behavioral 182.20aide in providing services to a client. The direction of a mental health behavioral aide 182.21must be based on the client's individualized treatment plan and meet the requirements in 182.22subdivision 6, paragraph (b), clause (5). 182.23    (j) "Emotional disturbance" has the meaning given in section 245.4871, subdivision 182.2415 . For persons at least age 18 but under age 21, mental illness has the meaning given in 182.25section 245.462, subdivision 20, paragraph (a). 182.26    (k) "Individual behavioral plan" means a plan of intervention, treatment, and 182.27services for a child written by a mental health professional or mental health practitioner, 182.28under the clinical supervision of a mental health professional, to guide the work of the 182.29mental health behavioral aide. 182.30    (l) "Individual treatment plan" has the meaning given in section 245.4871, 182.31subdivision 21 . 182.32    (m) "Mental health professional" means an individual as defined in section 245.4871, 182.33subdivision 27 , clauses (1) to (5) new text begin (6) new text end , or tribal vendor as defined in section 256B.02, 182.34subdivision 7 , paragraph (b). 182.35    (n) "Preschool program" means a day program licensed under Minnesota Rules, 182.36parts 9503.0005 to 9503.0175, and enrolled as a children's therapeutic services and 183.1supports provider to provide a structured treatment program to a child who is at least 33 183.2months old but who has not yet attended the first day of kindergarten. 183.3    (o) "Skills training" means individual, family, or group training designed to improve 183.4the basic functioning of the child with emotional disturbance and the child's family in the 183.5activities of daily living and community living, and to improve the social functioning of the 183.6child and the child's family in areas important to the child's maintaining or reestablishing 183.7residency in the community. Individual, family, and group skills training must: 183.8    (1) consist of activities designed to promote skill development of the child and the 183.9child's family in the use of age-appropriate daily living skills, interpersonal and family 183.10relationships, and leisure and recreational services; 183.11    (2) consist of activities that will assist the family's understanding of normal child 183.12development and to use parenting skills that will help the child with emotional disturbance 183.13achieve the goals outlined in the child's individual treatment plan; and 183.14    (3) promote family preservation and unification, promote the family's integration 183.15with the community, and reduce the use of unnecessary out-of-home placement or 183.16institutionalization of children with emotional disturbance. 183.17    Sec. 20. Minnesota Statutes 2008, section 256B.0625, subdivision 47, is amended to 183.18read: 183.19    Subd. 47. Treatment foster care services. Effective July 1, 2007 new text begin 2011 new text end , and subject 183.20to federal approval, medical assistance covers treatment foster care services according to 183.21section 256B.0946. 183.22    Sec. 21. Minnesota Statutes 2008, section 256B.0943, subdivision 12, is amended to 183.23read: 183.24    Subd. 12. Excluded services. The following services are not eligible for medical 183.25assistance payment as children's therapeutic services and supports: 183.26    (1) service components of children's therapeutic services and supports 183.27simultaneously provided by more than one provider entity unless prior authorization is 183.28obtained; 183.29    (2) new text begin treatment by multiple providers within the same agency at the same clock time; new text end 183.30 new text begin (3) new text end children's therapeutic services and supports provided in violation of medical 183.31assistance policy in Minnesota Rules, part 9505.0220; 183.32    (3) new text begin (4) new text end mental health behavioral aide services provided by a personal care assistant 183.33who is not qualified as a mental health behavioral aide and employed by a certified 183.34children's therapeutic services and supports provider entity; 184.1    (4) new text begin (5) new text end service components of CTSS that are the responsibility of a residential or 184.2program license holder, including foster care providers under the terms of a service 184.3agreement or administrative rules governing licensure; 184.4    (5) new text begin (6) new text end adjunctive activities that may be offered by a provider entity but are not 184.5otherwise covered by medical assistance, including: 184.6    (i) a service that is primarily recreation oriented or that is provided in a setting that 184.7is not medically supervised. This includes sports activities, exercise groups, activities 184.8such as craft hours, leisure time, social hours, meal or snack time, trips to community 184.9activities, and tours; 184.10    (ii) a social or educational service that does not have or cannot reasonably be 184.11expected to have a therapeutic outcome related to the client's emotional disturbance; 184.12    (iii) consultation with other providers or service agency staff about the care or 184.13progress of a client; 184.14    (iv) prevention or education programs provided to the community; and 184.15    (v) treatment for clients with primary diagnoses of alcohol or other drug abuse; and 184.16    (6) new text begin (7) new text end activities that are not direct service time. 184.17    Sec. 22. Minnesota Statutes 2008, section 256B.0944, is amended by adding a 184.18subdivision to read: 184.19     new text begin Subd. 4a. new text end new text begin Alternative provider standards. new text end new text begin If a provider entity demonstrates that, new text end 184.20 new text begin due to geographic or other barriers, it is not feasible to provide mobile crisis intervention new text end 184.21 new text begin services 24 hours a day, seven days a week, according to the standards in subdivision 4, new text end 184.22 new text begin paragraph (b), clause (1), the commissioner may approve a crisis response provider based new text end 184.23 new text begin on an alternative plan proposed by a provider entity. The alternative plan must: new text end 184.24 new text begin (1) result in increased access and a reduction in disparities in the availability of new text end 184.25 new text begin crisis services; and new text end 184.26 new text begin (2) provide mobile services outside of the usual nine-to-five office hours and on new text end 184.27 new text begin weekends and holidays. new text end 184.28    Sec. 23. Minnesota Statutes 2008, section 256B.0947, subdivision 1, is amended to 184.29read: 184.30    Subdivision 1. Scope. Subject to federal approval new text begin Effective November 1, 2010, and new text end 184.31 new text begin subject to federal approval new text end , medical assistance covers medically necessary, intensive 184.32nonresidential rehabilitative mental health services as defined in subdivision 2, for 184.33recipients as defined in subdivision 3, when the services are provided by an entity meeting 184.34the standards in this section. 185.1    Sec. 24. Minnesota Statutes 2008, section 256J.08, subdivision 73a, is amended to read: 185.2    Subd. 73a. Qualified professional. (a) For physical illness, injury, or incapacity, 185.3a "qualified professional" means a licensed physician, a physician's assistant, a nurse 185.4practitioner, or a licensed chiropractor. 185.5    (b) For developmental disability and intelligence testing, a "qualified professional" 185.6means an individual qualified by training and experience to administer the tests necessary 185.7to make determinations, such as tests of intellectual functioning, assessments of adaptive 185.8behavior, adaptive skills, and developmental functioning. These professionals include 185.9licensed psychologists, certified school psychologists, or certified psychometrists working 185.10under the supervision of a licensed psychologist. 185.11    (c) For learning disabilities, a "qualified professional" means a licensed psychologist 185.12or school psychologist with experience determining learning disabilities. 185.13    (d) For mental health, a "qualified professional" means a licensed physician or a 185.14qualified mental health professional. A "qualified mental health professional" means: 185.15    (1) for children, in psychiatric nursing, a registered nurse who is licensed under 185.16sections 148.171 to 148.285, and who is certified as a clinical specialist in child 185.17and adolescent psychiatric or mental health nursing by a national nurse certification 185.18organization or who has a master's degree in nursing or one of the behavioral sciences 185.19or related fields from an accredited college or university or its equivalent, with at least 185.204,000 hours of post-master's supervised experience in the delivery of clinical services in 185.21the treatment of mental illness; 185.22    (2) for adults, in psychiatric nursing, a registered nurse who is licensed under 185.23sections 148.171 to 148.285, and who is certified as a clinical specialist in adult psychiatric 185.24and mental health nursing by a national nurse certification organization or who has a 185.25master's degree in nursing or one of the behavioral sciences or related fields from an 185.26accredited college or university or its equivalent, with at least 4,000 hours of post-master's 185.27supervised experience in the delivery of clinical services in the treatment of mental illness; 185.28    (3) in clinical social work, a person licensed as an independent clinical social worker 185.29under chapter 148D, or a person with a master's degree in social work from an accredited 185.30college or university, with at least 4,000 hours of post-master's supervised experience in 185.31the delivery of clinical services in the treatment of mental illness; 185.32    (4) in psychology, an individual licensed by the Board of Psychology under sections 185.33148.88 to 148.98, who has stated to the Board of Psychology competencies in the 185.34diagnosis and treatment of mental illness; 186.1    (5) in psychiatry, a physician licensed under chapter 147 and certified by the 186.2American Board of Psychiatry and Neurology or eligible for board certification in 186.3psychiatry; and 186.4    (6) in marriage and family therapy, the mental health professional must be a 186.5marriage and family therapist licensed under sections 148B.29 to 148B.39, with at least 186.6two years of post-master's supervised experience in the delivery of clinical services in the 186.7treatment of mental illness new text begin ; and new text end 186.8     new text begin (7) in licensed professional clinical counseling, the mental health professional new text end 186.9 new text begin shall be a licensed professional clinical counselor under section 148B.5301 with at least new text end 186.10 new text begin 4,000 hours of postmaster's supervised experience in the delivery of clinical services in new text end 186.11 new text begin the treatment of mental illness new text end . 186.12    Sec. 25. new text begin AUTISM SPECTRUM DISORDER TASK FORCE. new text end 186.13 new text begin (a) The Autism Spectrum Disorder Task Force is composed of 15 members, new text end 186.14 new text begin appointed as follows: new text end 186.15 new text begin (1) two members of the senate appointed by the Subcommittee on Committees of the new text end 186.16 new text begin Committee on Rules and Administration, one of whom must be a member of the minority; new text end 186.17 new text begin (2) two members of the house of representatives, one from the majority party, new text end 186.18 new text begin appointed by the speaker of the house, and one from the minority party, appointed by new text end 186.19 new text begin the minority leader; new text end 186.20     new text begin (3) two members appointed by the legislature, with regard to geographic diversity in new text end 186.21 new text begin the state, who are parents of children with autism spectrum disorder (ASD); one member new text end 186.22 new text begin shall be appointed by the senate Subcommittee on Committees of the Committee on new text end 186.23 new text begin Rules and Administration making appointments for the senate; and one member shall be new text end 186.24 new text begin appointed by the speaker of the house making the appointments for the house; new text end 186.25 new text begin (4) one member appointed by the Minnesota chapter of the American Academy of new text end 186.26 new text begin Pediatrics who is a general primary care pediatrician; new text end 186.27 new text begin (5) one member appointed by the Minnesota Academy of Family Physicians who is new text end 186.28 new text begin a family practice physician; new text end 186.29 new text begin (6) one member appointed by the Minnesota Psychological Association who is a new text end 186.30 new text begin neuropsychologist; new text end 186.31 new text begin (7) one member appointed by the directors of public school student support services; new text end 186.32 new text begin (8) one member appointed by the Somali American Autism Foundation; new text end 186.33 new text begin (9) one member appointed by the ARC of Minnesota; new text end 186.34 new text begin (10) one member appointed by the Autism Society of Minnesota; new text end 187.1 new text begin (11) one member appointed by the Parent Advocacy Coalition for Educational new text end 187.2 new text begin Rights; and new text end 187.3 new text begin (12) one member appointed by the Minnesota Council of Health Plans. new text end 187.4 new text begin Appointments must be made by September 1, 2009. The Legislative Coordinating new text end 187.5 new text begin Commission shall provide meeting space for the task force. The senate member appointed new text end 187.6 new text begin by the minority leader of the senate shall convene the first meeting of the task force no new text end 187.7 new text begin later than October 1, 2009. The task force shall elect a chair at the first meeting. new text end 187.8 new text begin (b) If federal or state funding is available, the commissioners of education, new text end 187.9 new text begin employment and economic development, health, and human services shall provide new text end 187.10 new text begin assistance to the task force. new text end 187.11 new text begin (c) The task force shall develop recommendations and report on the following topics: new text end 187.12 new text begin (1) ways to improve services provided by all state and political subdivisions; new text end 187.13 new text begin (2) sources of public and private funding available for treatment and ways to new text end 187.14 new text begin improve efficiency in the use of these funds; new text end 187.15 new text begin (3) methods to improve coordination in the delivery of service between public new text end 187.16 new text begin and private agencies, health providers, and schools, and to address any geographic new text end 187.17 new text begin discrepancies in the delivery of services; new text end 187.18 new text begin (4) increasing the availability of and the training for medical providers and educators new text end 187.19 new text begin who identify and provide services to individuals with ASD; and new text end 187.20 new text begin (5) treatment options supported by peer-reviewed, established scientific research new text end 187.21 new text begin for individuals with ASD. new text end 187.22 new text begin (d) The task force shall coordinate with existing efforts at the Departments of new text end 187.23 new text begin Education, Health, Human Services, and Employment and Economic Development new text end 187.24 new text begin related to ASD. new text end 187.25 new text begin (e) By January 15 of each year, the task force shall provide a report regarding its new text end 187.26 new text begin findings and consideration of the topics listed under paragraph (c), and the action taken new text end 187.27 new text begin under paragraph (d), including draft legislation if necessary, to the chairs and ranking new text end 187.28 new text begin minority members of the legislative committees with jurisdiction over health and human new text end 187.29 new text begin services. new text end 187.30 new text begin (f) This section expires June 30, 2011. new text end 187.31    Sec. 26. new text begin STATE-COUNTY CHEMICAL HEALTH CARE HOME PILOT new text end 187.32 new text begin PROJECT. new text end 187.33     new text begin Subdivision 1. new text end new text begin Establishment; purpose. new text end new text begin There is established a state-county new text end 187.34 new text begin chemical health care home pilot project. The purpose of the pilot project is for the new text end 187.35 new text begin Department of Human Services and counties to authentically and creatively work in new text end 188.1 new text begin partnership to redesign the current chemical health service delivery system in a way new text end 188.2 new text begin that promotes greater accountability, productivity, and results in the delivery of state new text end 188.3 new text begin chemical dependency services. The pilot project or projects must look to provide new text end 188.4 new text begin appropriate flexibility in a way that ensures timely access to needed services as well new text end 188.5 new text begin as better aligning systems and services to offer the most appropriate level of chemical new text end 188.6 new text begin health care services to the client. This may include, but is not limited to, looking into new new text end 188.7 new text begin governance agreements, performance agreements, or service level agreements. Pilot new text end 188.8 new text begin projects must maintain eligibility requirements for the consolidated chemical dependency new text end 188.9 new text begin treatment fund, continue to meet the requirements of Minnesota Rules, parts 9530.6600 to new text end 188.10 new text begin 9530.6655 (also known as Rule 25) and Minnesota Rules, parts 9530.6405 to 9530.6505 new text end 188.11 new text begin (also known as Rule 31), and must not put at risk current and future federal funding toward new text end 188.12 new text begin chemical health-related services in the state of Minnesota. new text end 188.13     new text begin Subd. 2. new text end new text begin Workgroup; report. new text end new text begin A workgroup must be convened on or before July new text end 188.14 new text begin 15, 2009, consisting of representatives from the Department of Human Services and new text end 188.15 new text begin potential participating counties to develop draft proposals for pilot projects meeting the new text end 188.16 new text begin requirements of this section. The workgroup shall report back to the legislative committees new text end 188.17 new text begin with jurisdiction over chemical health by January 15, 2010, for potential approval of one new text end 188.18 new text begin metro and one nonmetro county pilot project to be implemented beginning July 10, 2010. new text end 188.19     new text begin Subd. 3. new text end new text begin Report. new text end new text begin The Department of Human Services shall evaluate the efficacy and new text end 188.20 new text begin feasibility of the pilot projects and report the results of that evaluation to the legislative new text end 188.21 new text begin committees having jurisdiction over chemical health by June 30, 2011. Expansion of pilot new text end 188.22 new text begin projects may occur only if the department's report finds the pilot projects effective. new text end 188.23     new text begin Subd. 4. new text end new text begin Expiration. new text end new text begin This section expires June 30, 2012. new text end 188.24 new text begin EFFECTIVE DATE. new text end new text begin This section is effective the day following final enactment. new text end 188.25ARTICLE 8 188.26CONTINUING CARE 188.27    Section 1. Minnesota Statutes 2008, section 144.0724, subdivision 2, is amended to 188.28read: 188.29    Subd. 2. Definitions. For purposes of this section, the following terms have the 188.30meanings given. 188.31(a) "Assessment reference date" means the last day of the minimum data set 188.32observation period. The date sets the designated endpoint of the common observation 188.33period, and all minimum data set items refer back in time from that point. 189.1(b) "Case mix index" means the weighting factors assigned to the RUG-III 189.2classifications. 189.3(c) "Index maximization" means classifying a resident who could be assigned to 189.4more than one category, to the category with the highest case mix index. 189.5(d) "Minimum data set" means the assessment instrument specified by the Centers for 189.6Medicare and Medicaid Services and designated by the Minnesota Department of Health. 189.7(e) "Representative" means a person who is the resident's guardian or conservator, 189.8the person authorized to pay the nursing home expenses of the resident, a representative 189.9of the nursing home ombudsman's office whose assistance has been requested, or any 189.10other individual designated by the resident. 189.11(f) "Resource utilization groups" or "RUG" means the system for grouping a nursing 189.12facility's residents according to their clinical and functional status identified in data 189.13supplied by the facility's minimum data set. 189.14 new text begin (g) "Activities of daily living" means grooming, dressing, bathing, transferring, new text end 189.15 new text begin mobility, positioning, eating, and toileting. new text end 189.16 new text begin (h) "Nursing facility level of care determination" means the assessment process new text end 189.17 new text begin that results in a determination of a resident's or prospective resident's need for nursing new text end 189.18 new text begin facility level of care as established in subdivision 11 for purposes of medical assistance new text end 189.19 new text begin payment of long-term care services for: new text end 189.20 new text begin (1) nursing facility services under section 256B.434 or 256B.441; new text end 189.21 new text begin (2) elderly waiver services under section 256B.0915; new text end 189.22 new text begin (3) CADI and TBI waiver services under section 256B.49; and new text end 189.23 new text begin (4) state payment of alternative care services under section 256B.0913. new text end 189.24 new text begin EFFECTIVE DATE. new text end new text begin The section is effective January 1, 2011. new text end 189.25    Sec. 2. Minnesota Statutes 2008, section 144.0724, subdivision 4, is amended to read: 189.26    Subd. 4. Resident assessment schedule. (a) A facility must conduct and 189.27electronically submit to the commissioner of health case mix assessments that conform 189.28with the assessment schedule defined by Code of Federal Regulations, title 42, section 189.29483.20 , and published by the United States Department of Health and Human Services, 189.30Centers for Medicare and Medicaid Services, in the Long Term Care Assessment 189.31Instrument User's Manual, version 2.0, October 1995, and subsequent clarifications made 189.32in the Long-Term Care Assessment Instrument Questions and Answers, version 2.0, 189.33August 1996. The commissioner of health may substitute successor manuals or question 189.34and answer documents published by the United States Department of Health and Human 190.1Services, Centers for Medicare and Medicaid Services, to replace or supplement the 190.2current version of the manual or document. 190.3(b) The assessments used to determine a case mix classification for reimbursement 190.4include the following: 190.5(1) a new admission assessment must be completed by day 14 following admission; 190.6(2) an annual assessment must be completed within 366 days of the last 190.7comprehensive assessment; 190.8(3) a significant change assessment must be completed within 14 days of the 190.9identification of a significant change; and 190.10(4) the second quarterly assessment following either a new admission assessment, 190.11an annual assessment, or a significant change assessment, and all quarterly assessments 190.12beginning October 1, 2006. Each quarterly assessment must be completed within 92 190.13days of the previous assessment. 190.14 new text begin (c) In addition to the assessments listed in paragraph (b), the assessments used to new text end 190.15 new text begin determine nursing facility level of care include the following: new text end 190.16 new text begin (1) preadmission screening completed under section 256B.0911, subdivision 4a, new text end 190.17 new text begin by a county, tribe, or managed care organization under contract with the Department new text end 190.18 new text begin of Human Services; and new text end 190.19 new text begin (2) a face-to-face long-term care consultation assessment completed under section new text end 190.20 new text begin 256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or managed care organization new text end 190.21 new text begin under contract with the Department of Human Services. new text end 190.22 new text begin EFFECTIVE DATE. new text end new text begin The section is effective January 1, 2011. new text end 190.23    Sec. 3. Minnesota Statutes 2008, section 144.0724, subdivision 8, is amended to read: 190.24    Subd. 8. Request for reconsideration of resident classifications. (a) The resident, 190.25or resident's representative, or the nursing facility or boarding care home may request that 190.26the commissioner of health reconsider the assigned reimbursement classification. The 190.27request for reconsideration must be submitted in writing to the commissioner within 190.2830 days of the day the resident or the resident's representative receives the resident 190.29classification notice. The request for reconsideration must include the name of the 190.30resident, the name and address of the facility in which the resident resides, the reasons for 190.31the reconsideration, the requested classification changes, and documentation supporting 190.32the requested classification. The documentation accompanying the reconsideration request 190.33is limited to documentation which establishes that the needs of the resident at the time of 190.34the assessment justify a classification which is different than the classification established 190.35by the commissioner of health. 191.1(b) Upon request, the nursing facility must give the resident or the resident's 191.2representative a copy of the assessment form and the other documentation that was given 191.3to the commissioner of health to support the assessment findings. The nursing facility 191.4shall also provide access to and a copy of other information from the resident's record that 191.5has been requested by or on behalf of the resident to support a resident's reconsideration 191.6request. A copy of any requested material must be provided within three working days of 191.7receipt of a written request for the information. If a facility fails to provide the material 191.8within this time, it is subject to the issuance of a correction order and penalty assessment 191.9under sections 144.653 and 144A.10. Notwithstanding those sections, any correction order 191.10issued under this subdivision must require that the nursing facility immediately comply 191.11with the request for information and that as of the date of the issuance of the correction 191.12order, the facility shall forfeit to the state a $100 fine for the first day of noncompliance, and 191.13an increase in the $100 fine by $50 increments for each day the noncompliance continues. 191.14(c) In addition to the information required under paragraphs (a) and (b), a 191.15reconsideration request from a nursing facility must contain the following information: (i) 191.16the date the reimbursement classification notices were received by the facility; (ii) the date 191.17the classification notices were distributed to the resident or the resident's representative; 191.18and (iii) a copy of a notice sent to the resident or to the resident's representative. This 191.19notice must inform the resident or the resident's representative that a reconsideration of the 191.20resident's classification is being requested, the reason for the request, that the resident's 191.21rate will change if the request is approved by the commissioner, the extent of the change, 191.22that copies of the facility's request and supporting documentation are available for review, 191.23and that the resident also has the right to request a reconsideration. If the facility fails to 191.24provide the required information with the reconsideration request, the request must be 191.25denied, and the facility may not make further reconsideration requests on that specific 191.26reimbursement classification. 191.27(d) Reconsideration by the commissioner must be made by individuals not involved 191.28in reviewing the assessment, audit, or reconsideration that established the disputed 191.29classification. The reconsideration must be based upon the initial assessment and upon the 191.30information provided to the commissioner under paragraphs (a) and (b). If necessary for 191.31evaluating the reconsideration request, the commissioner may conduct on-site reviews. 191.32Within 15 working days of receiving the request for reconsideration, the commissioner 191.33shall affirm or modify the original resident classification. The original classification 191.34must be modified if the commissioner determines that the assessment resulting in the 191.35classification did not accurately reflect the needs or assessment characteristics of the 191.36resident at the time of the assessment. The resident and the nursing facility or boarding 192.1care home shall be notified within five working days after the decision is made. A decision 192.2by the commissioner under this subdivision is the final administrative decision of the 192.3agency for the party requesting reconsideration. 192.4(e) The resident classification established by the commissioner shall be the 192.5classification that applies to the resident while the request for reconsideration is pending. new text begin new text end 192.6 new text begin If a request for reconsideration applies to an assessment used to determine nursing facility new text end 192.7 new text begin level of care under subdivision 4, paragraph (c), the resident shall continue to be eligible new text end 192.8 new text begin for nursing facility level of care while the request for reconsideration is pending. new text end 192.9(f) The commissioner may request additional documentation regarding a 192.10reconsideration necessary to make an accurate reconsideration determination. 192.11 new text begin EFFECTIVE DATE. new text end new text begin The section is effective January 1, 2011. new text end 192.12    Sec. 4. Minnesota Statutes 2008, section 144.0724, is amended by adding a subdivision 192.13to read: 192.14     new text begin Subd. 11. new text end new text begin Nursing facility level of care. new text end new text begin (a) For purposes of medical assistance new text end 192.15 new text begin payment of long-term care services, a recipient must be determined, using assessments new text end 192.16 new text begin defined in subdivision 4, to meet one of the following nursing facility level of care criteria: new text end 192.17 new text begin (1) the person needs the assistance of another person or constant supervision to begin new text end 192.18 new text begin and complete at least four of the following activities of living: bathing, bed mobility, new text end 192.19 new text begin dressing, eating, grooming, toileting, transferring, and walking; new text end 192.20 new text begin (2) the person needs the assistance of another person or constant supervision to begin new text end 192.21 new text begin and complete toileting, transferring, or positioning and the assistance cannot be scheduled; new text end 192.22 new text begin (3) the person has significant difficulty with memory, using information, daily new text end 192.23 new text begin decision making, or behavioral needs that require intervention; new text end 192.24 new text begin (4) the person has had a qualifying nursing facility stay of at least 90 days; or new text end 192.25 new text begin (5) the person is determined to be at risk for nursing facility admission or new text end 192.26 new text begin readmission through a face-to-face long-term care consultation assessment as specified new text end 192.27 new text begin in section 256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or managed care new text end 192.28 new text begin organization under contract with the Department of Human Services. The person is new text end 192.29 new text begin considered at risk under this clause if the person currently lives alone or will live alone new text end 192.30 new text begin upon discharge and also meets one of the following criteria: new text end 192.31 new text begin (i) the person has experienced a fall resulting in a fracture; new text end 192.32 new text begin (ii) the person has been determined to be at risk of maltreatment or neglect, new text end 192.33 new text begin including self-neglect; or new text end 192.34 new text begin (iii) the person has a sensory impairment that substantially impacts functional ability new text end 192.35 new text begin and maintenance of a community residence. new text end 193.1 new text begin (b) The assessment used to establish medical assistance payment for nursing facility new text end 193.2 new text begin services must be the most recent assessment performed under subdivision 4, paragraph new text end 193.3 new text begin (b), that occurred no more than 90 calendar days before the effective date of medical new text end 193.4 new text begin assistance eligibility for payment of long-term care services. In no case shall medical new text end 193.5 new text begin assistance payment for long-term care services occur prior to the date of the determination new text end 193.6 new text begin of nursing facility level of care. new text end 193.7 new text begin (c) The assessment used to establish medical assistance payment for long-term care new text end 193.8 new text begin services provided under sections 256B.0915 and 256B.49 and alternative care payment new text end 193.9 new text begin for services provided under section 256B.0913 must be the most recent face-to-face new text end 193.10 new text begin assessment performed under section 256B.0911, subdivision 3a, that occurred no more new text end 193.11 new text begin than 60 calendar days before the effective date of medical assistance eligibility for new text end 193.12 new text begin payment of long-term care services. new text end 193.13 new text begin EFFECTIVE DATE. new text end new text begin The section is effective January 1, 2011. new text end 193.14    Sec. 5. Minnesota Statutes 2008, section 144.0724, is amended by adding a subdivision 193.15to read: 193.16     new text begin Subd. 12. new text end new text begin Appeal of nursing facility level of care determination. new text end new text begin A resident or new text end 193.17 new text begin prospective resident whose level of care determination results in a denial of long-term care new text end 193.18 new text begin services can appeal the determination as outlined in section 256B.0911, subdivision 3a, new text end 193.19 new text begin paragraph (h), clause (7). new text end 193.20 new text begin EFFECTIVE DATE. new text end new text begin The section is effective January 1, 2011. new text end 193.21    Sec. 6. Minnesota Statutes 2008, section 144A.073, is amended by adding a 193.22subdivision to read: 193.23     new text begin Subd. 12. new text end new text begin Extension of approval of moratorium exception projects. new text end 193.24 new text begin Notwithstanding subdivision 3, the commissioner of health shall extend project approval new text end 193.25 new text begin by an additional 18 months for an approved proposal for an exception to the nursing home new text end 193.26 new text begin licensure and certification moratorium if the proposal was approved under this section new text end 193.27 new text begin between July 1, 2007, and June 30, 2009. new text end 193.28    Sec. 7. Minnesota Statutes 2008, section 144A.44, subdivision 2, is amended to read: 193.29    Subd. 2. Interpretation and enforcement of rights. These rights are established 193.30for the benefit of persons who receive home care services. "Home care services" means 193.31home care services as defined in section 144A.43, subdivision 3 new text begin , and unlicensed personal new text end 193.32 new text begin care assistance services, including services covered by medical assistance under section new text end 193.33 new text begin 256B.0625, subdivision 19a new text end . A home care provider may not require a person to surrender 194.1these rights as a condition of receiving services. A guardian or conservator or, when there 194.2is no guardian or conservator, a designated person, may seek to enforce these rights. This 194.3statement of rights does not replace or diminish other rights and liberties that may exist 194.4relative to persons receiving home care services, persons providing home care services, or 194.5providers licensed under Laws 1987, chapter 378. A copy of these rights must be provided 194.6to an individual at the time home care services new text begin , including personal care assistance new text end 194.7 new text begin services, new text end are initiated. The copy shall also contain the address and phone number of the 194.8Office of Health Facility Complaints and the Office of Ombudsman for Long-Term Care 194.9and a brief statement describing how to file a complaint with these offices. Information 194.10about how to contact the Office of Ombudsman for Long-Term Care shall be included in 194.11notices of change in client fees and in notices where home care providers initiate transfer 194.12or discontinuation of services. 194.13    Sec. 8. Minnesota Statutes 2008, section 245A.03, is amended by adding a subdivision 194.14to read: 194.15     new text begin Subd. 7. new text end new text begin Licensing moratorium. new text end new text begin (a) The commissioner shall not issue an new text end 194.16 new text begin initial license for child foster care licensed under Minnesota Rules, parts 2960.3000 to new text end 194.17 new text begin 2960.3340, or adult foster care licensed under Minnesota Rules, parts 9555.5105 to new text end 194.18 new text begin 9555.6265, under this chapter for a physical location that will not be the primary residence new text end 194.19 new text begin of the license holder for the entire period of licensure. If a license is issued during this new text end 194.20 new text begin moratorium, and the license holder changes the license holder's primary residence away new text end 194.21 new text begin from the physical location of the foster care license, the commissioner shall revoke the new text end 194.22 new text begin license according to section 245A.07. Exceptions to the moratorium include: new text end 194.23 new text begin (1) foster care settings that are required to be registered under chapter 144D; new text end 194.24 new text begin (2) foster care licenses replacing foster care licenses in existence on the effective new text end 194.25 new text begin date of this section and determined to be needed by the commissioner under paragraph (b); new text end 194.26 new text begin (3) new foster care licenses determined to be needed by the commissioner under new text end 194.27 new text begin paragraph (b) for the closure of a nursing facility, ICF/MR, or regional treatment center; new text end 194.28 new text begin (4) new foster care licenses determined to be needed by the commissioner under new text end 194.29 new text begin paragraph (b) for persons requiring hospital level care; or new text end 194.30 new text begin (5) new foster care licenses determined to be needed by the commissioner for the new text end 194.31 new text begin transition of people from personal care assistance to the home and community-based new text end 194.32 new text begin services. new text end 194.33 new text begin (b) The commissioner shall determine the need for newly licensed foster care homes new text end 194.34 new text begin as defined under this subdivision. As part of the determination, the commissioner shall new text end 194.35 new text begin consider the availability of foster care capacity in the area which the licensee seeks to new text end 195.1 new text begin operate, and the recommendation of the local county board. The determination by the new text end 195.2 new text begin commissioner must be final. A determination of need is not required for a change in new text end 195.3 new text begin ownership at the same address. new text end 195.4     new text begin (c) Residential settings that would otherwise be subject to the moratorium established new text end 195.5 new text begin in paragraph (a), that are in the process of receiving an adult or child foster care license as new text end 195.6 new text begin of July 1, 2009, shall be allowed to continue to complete the process of receiving an adult new text end 195.7 new text begin or child foster care license. For this paragraph, all of the following conditions must be met new text end 195.8 new text begin to be considered in process of receiving an adult or child foster care license: new text end 195.9     new text begin (1) participants have made decisions to move into the residential setting, including new text end 195.10 new text begin documentation in each participant's care plan; new text end 195.11     new text begin (2) the provider has purchased housing or has made a financial investment in the new text end 195.12 new text begin property; new text end 195.13     new text begin (3) the lead agency has approved the plans, including costs for the residential setting new text end 195.14 new text begin for each individual; new text end 195.15     new text begin (4) the completion of the licensing process, including all necessary inspections, is new text end 195.16 new text begin the only remaining component prior to being able to provide services; and new text end 195.17     new text begin (5) the needs of the individuals cannot be met within the existing capacity in that new text end 195.18 new text begin county. new text end 195.19 new text begin To qualify for the process under this paragraph, the lead agency must submit new text end 195.20 new text begin documentation to the commissioner by August 1, 2009, that all of the above criteria are new text end 195.21 new text begin met. new text end 195.22 new text begin (d) The commissioner shall study the effects of the license moratorium under this new text end 195.23 new text begin subdivision and shall report back to the legislature by January 15, 2011. new text end 195.24 new text begin EFFECTIVE DATE. new text end new text begin This section is effective the day following final enactment. new text end 195.25    Sec. 9. Minnesota Statutes 2008, section 245A.11, is amended by adding a subdivision 195.26to read: 195.27     new text begin Subd. 8. new text end new text begin Community residential setting license. new text end new text begin (a) The commissioner shall new text end 195.28 new text begin establish provider standards for residential support services that integrate service standards new text end 195.29 new text begin and the residential setting under one license. The commissioner shall propose statutory new text end 195.30 new text begin language and an implementation plan for licensing requirements for residential support new text end 195.31 new text begin services to the legislature by January 15, 2011. new text end 195.32 new text begin (b) Providers licensed under chapter 245B, and providing, contracting, or arranging new text end 195.33 new text begin for services in settings licensed as adult foster care under Minnesota Rules, parts new text end 195.34 new text begin 9555.5105 to 9555.6265, or child foster care under Minnesota Rules, parts 2960.3000 to new text end 196.1 new text begin 2960.3340; and meeting the provisions of section 256B.092, subdivision 11, paragraph new text end 196.2 new text begin (b), must be required to obtain a community residential setting license. new text end 196.3    Sec. 10. Minnesota Statutes 2008, section 252.46, is amended by adding a subdivision 196.4to read: 196.5     new text begin Subd. 1a. new text end new text begin Day training and habilitation rates. new text end new text begin The commissioner shall establish new text end 196.6 new text begin a statewide rate-setting methodology for all day training and habilitation services. The new text end 196.7 new text begin rate-setting methodology must abide by the principles of transparency and equitability new text end 196.8 new text begin across the state. The methodology must involve a uniform process of structuring rates for new text end 196.9 new text begin each service and must promote quality and participant choice. new text end 196.10    Sec. 11. Minnesota Statutes 2008, section 252.50, subdivision 1, is amended to read: 196.11    Subdivision 1. Community-based programs established. The commissioner 196.12shall establish a system of state-operated, community-based programs for persons with 196.13developmental disabilities. For purposes of this section, "state-operated, community-based 196.14program" means a program administered by the state to provide treatment and habilitation 196.15in noninstitutional community settings to persons with developmental disabilities. 196.16Employees of the programs, except clients who work within and benefit from these 196.17treatment and habilitation programs, must be state employees under chapters 43A and 196.18179A. new text begin Although any clients who work within and benefit from these treatment and new text end 196.19 new text begin habilitation programs are not employees under chapters 43A and 179A, the Department new text end 196.20 new text begin of Human Services may consider clients who work within and benefit from these new text end 196.21 new text begin programs employees for federal tax purposes. new text end The establishment of state-operated, 196.22community-based programs must be within the context of a comprehensive definition of 196.23the role of state-operated services in the state. The role of state-operated services must 196.24be defined within the context of a comprehensive system of services for persons with 196.25developmental disabilities. State-operated, community-based programs may include, but 196.26are not limited to, community group homes, foster care, supportive living services, day 196.27training and habilitation programs, and respite care arrangements. The commissioner 196.28may operate the pilot projects established under Laws 1985, First Special Session 196.29chapter 9, article 1, section 2, subdivision 6, and shall, within the limits of available 196.30appropriations, establish additional state-operated, community-based programs for 196.31persons with developmental disabilities. State-operated, community-based programs may 196.32accept admissions from regional treatment centers, from the person's own home, or from 196.33community programs. State-operated, community-based programs offering day program 196.34services may be provided for persons with developmental disabilities who are living in 197.1state-operated, community-based residential programs until July 1, 2000. No later than 197.21994, the commissioner, together with family members, counties, advocates, employee 197.3representatives, and other interested parties, shall begin planning so that by July 1, 2000, 197.4state-operated, community-based residential facilities will be in compliance with section 197.5252.41, subdivision 9 . 197.6    Sec. 12. Minnesota Statutes 2008, section 256.01, is amended by adding a subdivision 197.7to read: 197.8     new text begin Subd. 29. new text end new text begin State medical review team. new text end new text begin (a) To ensure the timely processing of new text end 197.9 new text begin determinations of disability by the commissioner's state medical review team under new text end 197.10 new text begin sections 256B.055, subdivision 7, paragraph (b), 256B.057, subdivision 9, paragraph new text end 197.11 new text begin (j), and 256B.055, subdivision 12, the commissioner shall review all medical evidence new text end 197.12 new text begin submitted by county agencies with a referral and seek additional information from new text end 197.13 new text begin providers, applicants, and enrollees to support the determination of disability where new text end 197.14 new text begin necessary. Disability shall be determined according to the rules of title XVI and title new text end 197.15 new text begin XIX of the Social Security Act and pertinent rules and policies of the Social Security new text end 197.16 new text begin Administration. new text end 197.17     new text begin (b) Prior to a denial or withdrawal of a requested determination of disability due new text end 197.18 new text begin to insufficient evidence, the commissioner shall (1) ensure that the missing evidence is new text end 197.19 new text begin necessary and appropriate to a determination of disability, and (2) assist applicants and new text end 197.20 new text begin enrollees to obtain the evidence, including, but not limited to, medical examinations new text end 197.21 new text begin and electronic medical records. new text end 197.22 new text begin (c) The commissioner shall provide the chairs of the legislative committees with new text end 197.23 new text begin jurisdiction over health and human services finance and budget the following information new text end 197.24 new text begin on the activities of the state medical review team by February 1, 2010, and annually new text end 197.25 new text begin thereafter: new text end 197.26 new text begin (1) the number of applications to the state medical review team that were denied, new text end 197.27 new text begin approved, or withdrawn; new text end 197.28 new text begin (2) the average length of time from receipt of the application to a decision; new text end 197.29 new text begin (3) the number of appeals and appeal results; new text end 197.30 new text begin (4) for applicants, their age, health coverage at the time of application, hospitalization new text end 197.31 new text begin history within three months of application, and whether an application for Social Security new text end 197.32 new text begin or Supplemental Security Income benefits is pending; and new text end 197.33 new text begin (5) specific information on the medical certification, licensure, or other credentials new text end 197.34 new text begin of the person or persons performing the medical review determinations and length of new text end 197.35 new text begin time in that position. new text end 198.1    Sec. 13. new text begin [256.0281] INTERAGENCY DATA EXCHANGE. new text end 198.2 new text begin The Department of Human Services, the Department of Health, and the Office of the new text end 198.3 new text begin Ombudsman for Mental Health and Developmental Disabilities may establish interagency new text end 198.4 new text begin agreements governing the electronic exchange of data on providers and individuals new text end 198.5 new text begin collected, maintained, or used by each agency when such exchange is outlined by each new text end 198.6 new text begin agency in an interagency agreement to accomplish the purposes in clauses (1) to (4): new text end 198.7 new text begin (1) to improve provider enrollment processes for home and community-based new text end 198.8 new text begin services and state plan home care services; new text end 198.9 new text begin (2) to improve quality management of providers between state agencies; new text end 198.10 new text begin (3) to establish and maintain provider eligibility to participate as providers under new text end 198.11 new text begin Minnesota health care programs; or new text end 198.12 new text begin (4) to meet the quality assurance reporting requirements under federal law under new text end 198.13 new text begin section 1915(c) of the Social Security Act related to home and community-based waiver new text end 198.14 new text begin programs. new text end 198.15 new text begin Each interagency agreement must include provisions to ensure anonymity of individuals, new text end 198.16 new text begin including mandated reporters, and must outline the specific uses of and access to shared new text end 198.17 new text begin data within each agency. Electronic interfaces between source data systems developed new text end 198.18 new text begin under these interagency agreements must incorporate these provisions as well as other new text end 198.19 new text begin HIPPA provisions related to individual data. new text end 198.20    Sec. 14. Minnesota Statutes 2008, section 256.476, subdivision 5, is amended to read: 198.21    Subd. 5. Reimbursement, allocations, and reporting. (a) For the purpose of 198.22transferring persons to the consumer support grant program from the family support 198.23program and personal care assistant services, home health aide services, or private duty 198.24nursing services, the amount of funds transferred by the commissioner between the 198.25family support program account, the medical assistance account, or the consumer support 198.26grant account shall be based on each county's participation in transferring persons to the 198.27consumer support grant program from those programs and services. 198.28    (b) At the beginning of each fiscal year, county allocations for consumer support 198.29grants shall be based on: 198.30    (1) the number of persons to whom the county board expects to provide consumer 198.31supports grants; 198.32    (2) their eligibility for current program and services; 198.33    (3) the amount of nonfederal dollars new text begin monthly grant levels new text end allowed under subdivision 198.3411; and 199.1    (4) projected dates when persons will start receiving grants. County allocations shall 199.2be adjusted periodically by the commissioner based on the actual transfer of persons or 199.3service openings, and the nonfederal dollars new text begin monthly grant levels new text end associated with those 199.4persons or service openings, to the consumer support grant program. 199.5    (c) The amount of funds transferred by the commissioner from the medical 199.6assistance account for an individual may be changed if it is determined by the county or its 199.7agent that the individual's need for support has changed. 199.8    (d) The authority to utilize funds transferred to the consumer support grant account 199.9for the purposes of implementing and administering the consumer support grant program 199.10will not be limited or constrained by the spending authority provided to the program 199.11of origination. 199.12    (e) The commissioner may use up to five percent of each county's allocation, as 199.13adjusted, for payments for administrative expenses, to be paid as a proportionate addition 199.14to reported direct service expenditures. 199.15    (f) The county allocation for each person or the person's legal representative or other 199.16authorized representative cannot exceed the amount allowed under subdivision 11. 199.17    (g) The commissioner may recover, suspend, or withhold payments if the county 199.18board, local agency, or grantee does not comply with the requirements of this section. 199.19    (h) Grant funds unexpended by consumers shall return to the state once a year. The 199.20annual return of unexpended grant funds shall occur in the quarter following the end of 199.21the state fiscal year. 199.22    Sec. 15. Minnesota Statutes 2008, section 256.476, subdivision 11, is amended to read: 199.23    Subd. 11. Consumer support grant program after July 1, 2001. (a) Effective 199.24July 1, 2001, the commissioner shall allocate consumer support grant resources to 199.25serve additional individuals based on a review of Medicaid authorization and payment 199.26information of persons eligible for a consumer support grant from the most recent fiscal 199.27year. The commissioner shall use the following methodology to calculate maximum 199.28allowable monthly consumer support grant levels: 199.29    (1) For individuals whose program of origination is medical assistance home care 199.30under sections 256B.0651 and 256B.0653 to 256B.0656, the maximum allowable monthly 199.31grant levels are calculated by: 199.32    (i) determining the nonfederal share new text begin 50 percent new text end of the average service authorization 199.33for each home care rating; 199.34    (ii) calculating the overall ratio of actual payments to service authorizations by 199.35program; 200.1    (iii) applying the overall ratio to the average service authorization level of each 200.2home care rating; 200.3    (iv) adjusting the result for any authorized rate increases provided by the legislature; 200.4and 200.5    (v) adjusting the result for the average monthly utilization per recipient. 200.6    (2) The commissioner may review and evaluate the methodology to reflect changes 200.7in the home care program's overall ratio of actual payments to service authorizations new text begin new text end 200.8 new text begin programs new text end . 200.9    (b) Effective January 1, 2004, persons previously receiving exception grants will 200.10have their grants calculated using the methodology in paragraph (a), clause (1). If a person 200.11currently receiving an exception grant wishes to have their home care rating reevaluated, 200.12they may request an assessment as defined in section 256B.0651, subdivision 1, paragraph 200.13(b). 200.14    Sec. 16. Minnesota Statutes 2008, section 256.975, subdivision 7, is amended to read: 200.15    Subd. 7. Consumer information and assistance new text begin and long-term care options new text end 200.16 new text begin counseling new text end ; senior linkage new text begin Senior LinkAge Line new text end . (a) The Minnesota Board on Aging 200.17shall operate a statewide information and assistance service to aid older Minnesotans and 200.18their families in making informed choices about long-term care options and health care 200.19benefits. Language services to persons with limited English language skills may be made 200.20available. The service, known as Senior LinkAge Line, must be available during business 200.21hours through a statewide toll-free number and must also be available through the Internet. 200.22    (b) The service must assist new text begin provide long-term care options counseling by assisting new text end 200.23older adults, caregivers, and providers in accessing information new text begin and options counseling new text end 200.24about choices in long-term care services that are purchased through private providers or 200.25available through public options. The service must: 200.26    (1) develop a comprehensive database that includes detailed listings in both 200.27consumer- and provider-oriented formats; 200.28    (2) make the database accessible on the Internet and through other telecommunication 200.29and media-related tools; 200.30    (3) link callers to interactive long-term care screening tools and make these tools 200.31available through the Internet by integrating the tools with the database; 200.32    (4) develop community education materials with a focus on planning for long-term 200.33care and evaluating independent living, housing, and service options; 200.34    (5) conduct an outreach campaign to assist older adults and their caregivers in 200.35finding information on the Internet and through other means of communication; 201.1    (6) implement a messaging system for overflow callers and respond to these callers 201.2by the next business day; 201.3    (7) link callers with county human services and other providers to receive more 201.4in-depth assistance and consultation related to long-term care options; 201.5    (8) link callers with quality profiles for nursing facilities and other providers 201.6developed by the commissioner of health; and 201.7    (9) incorporate information about housing with services and consumer rights 201.8within the MinnesotaHelp.info network long-term care database to facilitate consumer 201.9comparison of services and costs among housing with services establishments and with 201.10other in-home services and to support financial self-sufficiency as long as possible. 201.11Housing with services establishments and their arranged home care providers shall provide 201.12information to the commissioner of human services that is consistent with information 201.13required by the commissioner of health under section 144G.06, the Uniform Consumer 201.14Information Guide. The commissioner of human services shall provide the data to the 201.15Minnesota Board on Aging for inclusion in the MinnesotaHelp.info network long-term 201.16care database. new text begin ; new text end 201.17 new text begin (10) provide long-term care options counseling. Long-term care options counselors new text end 201.18 new text begin shall: new text end 201.19 new text begin (i) for individuals not eligible for case management under a public program or public new text end 201.20 new text begin funding source, provide interactive decision support under which consumers, family new text end 201.21 new text begin members, or other helpers are supported in their deliberations to determine appropriate new text end 201.22 new text begin long-term care choices in the context of the consumer's needs, preferences, values, and new text end 201.23 new text begin individual circumstances, including implementing a community support plan; new text end 201.24 new text begin (ii) provide Web-based educational information and collateral written materials to new text end 201.25 new text begin familiarize consumers, family members, or other helpers with the long-term care basics, new text end 201.26 new text begin issues to be considered, and the range of options available in the community; new text end 201.27 new text begin (iii) provide long-term care futures planning, which means providing assistance to new text end 201.28 new text begin individuals who anticipate having long-term care needs to develop a plan for the more new text end 201.29 new text begin distant future; and new text end 201.30 new text begin (iv) provide expertise in benefits and financing options for long-term care, including new text end 201.31 new text begin Medicare, long-term care insurance, tax or employer-based incentives, reverse mortgages, new text end 201.32 new text begin private pay options, and ways to access low or no-cost services or benefits through new text end 201.33 new text begin volunteer-based or charitable programs; and new text end 201.34 new text begin (11) using risk management and support planning protocols, provide long-term care new text end 201.35 new text begin options counseling to current residents of nursing homes deemed appropriate for discharge new text end 201.36 new text begin by the commissioner. In order to meet this requirement, the commissioner shall provide new text end 202.1 new text begin designated Senior LinkAge Line contact centers with a list of nursing home residents new text end 202.2 new text begin appropriate for discharge planning via a secure Web portal. Senior LinkAge Line shall new text end 202.3 new text begin provide these residents, if they indicate a preference to receive long-term care options new text end 202.4 new text begin counseling, with initial assessment, review of risk factors, independent living support new text end 202.5 new text begin consultation, or referral to: new text end 202.6 new text begin (i) services under section 256B.0911, subdivision 3; new text end 202.7 new text begin (ii) designated care coordinators of contracted entities under section 256B.035 for new text end 202.8 new text begin persons who are enrolled in a managed care plan; or new text end 202.9 new text begin (iii) the long-term care consultation team for those who are appropriate for relocation new text end 202.10 new text begin service coordination due to high-risk factors or psychological or physical disability. new text end 202.11    (c) The Minnesota Board on Aging shall conduct an evaluation of the effectiveness 202.12of the statewide information and assistance, and submit this evaluation to the legislature 202.13by December 1, 2002. The evaluation must include an analysis of funding adequacy, gaps 202.14in service delivery, continuity in information between the service and identified linkages, 202.15and potential use of private funding to enhance the service. 202.16    Sec. 17. Minnesota Statutes 2008, section 256B.055, subdivision 7, is amended to read: 202.17    Subd. 7. Aged, blind, or disabled persons. new text begin (a) new text end Medical assistance may be paid for 202.18a person who meets the categorical eligibility requirements of the supplemental security 202.19income program or, who would meet those requirements except for excess income or 202.20assets, and who meets the other eligibility requirements of this section. 202.21 new text begin (b) Following a determination that the applicant is not aged or blind and does not new text end 202.22 new text begin meet any other category of eligibility for medical assistance and has not been determined new text end 202.23 new text begin disabled by the Social Security Administration, applicants under this subdivision shall be new text end 202.24 new text begin referred to the commissioner's state medical review team for a determination of disability. new text end 202.25    Sec. 18. Minnesota Statutes 2008, section 256B.0625, subdivision 6a, is amended to 202.26read: 202.27    Subd. 6a. Home health services. Home health services are those services specified 202.28in Minnesota Rules, part 9505.0295 new text begin and sections 256B.0651 and 256B.0653 new text end . Medical 202.29assistance covers home health services at a recipient's home residence. Medical assistance 202.30does not cover home health services for residents of a hospital, nursing facility, or 202.31intermediate care facility, unless the commissioner of human services has prior authorized 202.32skilled nurse visits for less than 90 days for a resident at an intermediate care facility for 202.33persons with developmental disabilities, to prevent an admission to a hospital or nursing 202.34facility or unless a resident who is otherwise eligible is on leave from the facility and the 203.1facility either pays for the home health services or forgoes the facility per diem for the 203.2leave days that home health services are used. Home health services must be provided by 203.3a Medicare certified home health agency. All nursing and home health aide services must 203.4be provided according to sections 256B.0651 to new text begin new text end . 203.5    Sec. 19. Minnesota Statutes 2008, section 256B.0625, subdivision 7, is amended to 203.6read: 203.7    Subd. 7. Private duty nursing. Medical assistance covers private duty nursing 203.8services in a recipient's home. Recipients who are authorized to receive private duty 203.9nursing services in their home may use approved hours outside of the home during hours 203.10when normal life activities take them outside of their home. To use private duty nursing 203.11services at school, the recipient or responsible party must provide written authorization in 203.12the care plan identifying the chosen provider and the daily amount of services to be used at 203.13school. Medical assistance does not cover private duty nursing services for residents of a 203.14hospital, nursing facility, intermediate care facility, or a health care facility licensed by the 203.15commissioner of health, except as authorized in section 256B.64 for ventilator-dependent 203.16recipients in hospitals or unless a resident who is otherwise eligible is on leave from the 203.17facility and the facility either pays for the private duty nursing services or forgoes the 203.18facility per diem for the leave days that private duty nursing services are used. Total hours 203.19of service and payment allowed for services outside the home cannot exceed that which is 203.20otherwise allowed in an in-home setting according to sections 256B.0651 and 203.21 new text begin 256B.0654 new text end to 256B.0656. All private duty nursing services must be provided according to 203.22the limits established under sections 256B.0651 and 256B.0653 to 256B.0656. Private 203.23duty nursing services may not be reimbursed if the nurse is the new text begin family new text end foster care provider 203.24of a recipient who is under age 18 new text begin , unless allowed under section 256B.0654, subdivision 4 new text end . 203.25    Sec. 20. Minnesota Statutes 2008, section 256B.0625, subdivision 19a, is amended to 203.26read: 203.27    Subd. 19a. Personal care assistant new text begin assistance new text end services. Medical assistance covers 203.28personal care assistant new text begin assistance new text end services in a recipient's home. new text begin Effective January 1, new text end 203.29 new text begin 2010, new text end to qualify for personal care assistant new text begin assistance new text end services, new text begin a recipient must require new text end 203.30 new text begin assistance and be determined dependent in one activity of daily living as defined in section new text end 203.31 new text begin 256B.0659, subdivision 1, paragraph (b), or in a Level I behavior as defined in section new text end 203.32 new text begin 256B.0659, subdivision 1, paragraph (c). Beginning July 1, 2011, to qualify for personal new text end 203.33 new text begin care assistance services, a recipient must require assistance and be determined dependent new text end 203.34 new text begin in at least two activities of daily living as defined in section 256B.0659. new text end Recipients or 204.1responsible parties must be able to identify the recipient's needs, direct and evaluate task 204.2accomplishment, and provide for health and safety. Approved hours may be used outside 204.3the home when normal life activities take them outside the home. To use personal care 204.4assistant new text begin assistance new text end services at school, the recipient or responsible party must provide 204.5written authorization in the care plan identifying the chosen provider and the daily amount 204.6of services to be used at school. Total hours for services, whether actually performed 204.7inside or outside the recipient's home, cannot exceed that which is otherwise allowed for 204.8personal care assistant new text begin assistance new text end services in an in-home setting according to sections 204.9256B.0651 and to 256B.0656. Medical assistance does not cover personal care 204.10assistant new text begin assistance new text end services for residents of a hospital, nursing facility, intermediate care 204.11facility, health care facility licensed by the commissioner of health, or unless a resident 204.12who is otherwise eligible is on leave from the facility and the facility either pays for the 204.13personal care assistant new text begin assistance new text end services or forgoes the facility per diem for the leave 204.14days that personal care assistant new text begin assistance new text end services are used. All personal care assistant new text begin new text end 204.15 new text begin assistance new text end services must be provided according to sections 256B.0651 and 204.16to 256B.0656. Personal care assistant new text begin assistance new text end services may not be reimbursed if the 204.17personal care assistant is the spouse or legal new text begin paid new text end guardian of the recipient or the parent of 204.18a recipient under age 18, or the responsible party or the new text begin family new text end foster care provider of a 204.19recipient who cannot direct the recipient's own care unless, in the case of a foster care 204.20provider, a county or state case manager visits the recipient as needed, but not less than 204.21every six months, to monitor the health and safety of the recipient and to ensure the goals 204.22of the care plan are met. Parents of adult recipients, adult children of the recipient or 204.23adult siblings of the recipient may be reimbursed for personal care assistant services, 204.24if they are granted a waiver under sections and to . 204.25Notwithstanding the provisions of section 256B.0655, subdivision 2, paragraph (b), clause 204.26(4) new text begin 256B.0659 new text end , the noncorporate legal new text begin unpaid new text end guardian or conservator of an adult, who is 204.27not the responsible party and not the personal care provider organization, may be granted a 204.28hardship waiver under sections and to , to be reimbursed 204.29to provide personal care assistant new text begin assistance new text end services to the recipient new text begin if the guardian or new text end 204.30 new text begin conservator meets all criteria for a personal care assistant according to section new text end , 204.31and shall not be considered to have a service provider interest for purposes of participation 204.32on the screening team under section 256B.092, subdivision 7. 204.33    Sec. 21. Minnesota Statutes 2008, section 256B.0625, subdivision 19c, is amended to 204.34read: 205.1    Subd. 19c. Personal care. Medical assistance covers personal care assistant new text begin new text end 205.2 new text begin assistance new text end services provided by an individual who is qualified to provide the services 205.3according to subdivision 19a and sections 256B.0651 and to 256B.0656, 205.4where the services have a statement of need by a physician, provided in accordance with 205.5a plan, and are supervised by the recipient or a qualified professional. The physician's 205.6statement of need for personal care assistant services shall be documented on a form 205.7approved by the commissioner and include the diagnosis or condition of the person that 205.8results in a need for personal care assistant services and be updated when the person's 205.9medical condition requires a change, but at least annually if the need for personal care 205.10assistant services is ongoing. 205.11"Qualified professional" means a mental health professional as defined in section 245.462, 205.12subdivision 18 , or 245.4871, subdivision 27; or a registered nurse as defined in sections 205.13148.171 to 148.285, or a licensed social worker as defined in section 148B.21 new text begin , or a new text end 205.14 new text begin qualified developmental disabilities specialist undersection 245B.07, subdivision 4 new text end . 205.15As part of the assessment, the county public health nurse will assist the recipient or 205.16responsible party to identify the most appropriate person to provide supervision of the 205.17personal care assistant. The qualified professional shall perform the duties described 205.18 new text begin required new text end in Minnesota Rules, part 9505.0335, subpart 4 new text begin section 256B.0659 new text end . 205.19    Sec. 22. Minnesota Statutes 2008, section 256B.0641, subdivision 3, is amended to 205.20read: 205.21    Subd. 3. Facility in receivership. Subdivision 2 does not apply to the change of 205.22ownership of a facility to a nonrelated organization while the facility to be sold, transferred 205.23or reorganized is in receivership under section new text begin 144A.14, 144A.15, new text end 245A.12 new text begin , new text end or 245A.13, 205.24and the commissioner during the receivership has not determined the need to place 205.25residents of the facility into a newly constructed or newly established facility. Nothing 205.26in this subdivision limits the liability of a former owner. 205.27    Sec. 23. Minnesota Statutes 2008, section 256B.0651, is amended to read: 205.28256B.0651 HOME CARE SERVICES. 205.29    Subdivision 1. Definitions. (a) "Activities of daily living" includes eating, toileting, 205.30grooming, dressing, bathing, transferring, mobility, and positioning new text begin For the purposes of new text end 205.31 new text begin sections 256B.0651 to 256B.0656 and 256B.0659, the terms in paragraphs (b) to (g) new text end 205.32 new text begin have the meanings given new text end . 205.33(b) new text begin "Activities of daily living" has the meaning given in section 256B.0659, new text end 205.34 new text begin subdivision 1, paragraph (b). new text end 206.1 new text begin (c) new text end "Assessment" means a review and evaluation of a recipient's need for home care 206.2services conducted in person. Assessments for home health agency services shall be 206.3conducted by a home health agency nurse. Assessments for medical assistance home care 206.4services for developmental disability and alternative care services for developmentally 206.5disabled home and community-based waivered recipients may be conducted by the county 206.6public health nurse to ensure coordination and avoid duplication. Assessments must be 206.7completed on forms provided by the commissioner within 30 days of a request for home 206.8care services by a recipient or responsible party. 206.9(c) new text begin (d) new text end "Home care services" means a health service, determined by the commissioner 206.10as medically necessary, that is ordered by a physician and documented in a service plan 206.11that is reviewed by the physician at least once every 60 days for the provision of home 206.12health services, or private duty nursing, or at least once every 365 days for personal care. 206.13Home care services are provided to the recipient at the recipient's residence that is a 206.14place other than a hospital or long-term care facility or as specified in section new text begin new text end 206.15 new text begin means medical assistance covered services that are home health agency services, including new text end 206.16 new text begin skilled nurse visits; home health aide visits; physical therapy, occupational therapy, new text end 206.17 new text begin respiratory therapy, and language-speech pathology therapy; private duty nursing; and new text end 206.18 new text begin personal care assistance new text end . 206.19 new text begin (e) "Home residence," effective January 1, 2010, means a residence owned or rented new text end 206.20 new text begin by the recipient either alone, with roommates of the recipient's choosing, or with an unpaid new text end 206.21 new text begin responsible party or legal representative; or a family foster home where the license holder new text end 206.22 new text begin lives with the recipient and is not paid to provide home care services for the recipient new text end 206.23 new text begin except as allowed under sections 256B.0651, subdivision 9, and 256B.0654, subdivision 4. new text end 206.24(d) new text begin (f) new text end "Medically necessary" has the meaning given in Minnesota Rules, parts 206.259505.0170 to 9505.0475. 206.26(e) "Telehomecare" means the use of telecommunications technology by a home 206.27health care professional to deliver home health care services, within the professional's 206.28scope of practice, to a patient located at a site other than the site where the practitioner 206.29is located. 206.30 new text begin (g) "Ventilator-dependent" means an individual who receives mechanical ventilation new text end 206.31 new text begin for life support at least six hours per day and is expected to be or has been dependent on a new text end 206.32 new text begin ventilator for at least 30 consecutive days. new text end 206.33    Subd. 2. Services covered. Home care services covered under this section and 206.34sections new text begin 256B.0652 new text end to 256B.0656 new text begin and 256B.0659 new text end include: 206.35(1) nursing services under section new text begin sections new text end 256B.0625, subdivision 6a new text begin , and new text end 206.36 new text begin 256B.0653 new text end ; 207.1(2) private duty nursing services under section new text begin sections new text end 256B.0625, subdivision 207.27 new text begin , and 256B.0654 new text end ; 207.3(3) home health services under section new text begin sections new text end 256B.0625, subdivision 6a new text begin , and new text end 207.4 new text begin 256B.0653 new text end ; 207.5(4) personal care assistant new text begin assistance new text end services under section new text begin sections new text end 256B.0625, 207.6subdivision 19a new text begin , and 256B.0659 new text end ; 207.7(5) supervision of personal care assistant new text begin assistance new text end services provided by a qualified 207.8professional under section new text begin sections new text end 256B.0625, subdivision 19a new text begin , and 256B.0659 new text end ; 207.9(6) qualified professional of personal care assistant services under the fiscal 207.10intermediary option as specified in section 256B.0655, subdivision 7; 207.11(7) face-to-face assessments by county public health nurses for services under 207.12section new text begin sections new text end 256B.0625, subdivision 19a new text begin , 256B.0655, and 256B.0659 new text end ; and 207.13(8) new text begin (7) new text end service updates and review of temporary increases for personal care assistant new text begin new text end 207.14 new text begin assistance new text end services by the county public health nurse for services under section new text begin sections new text end 207.15256B.0625, subdivision 19a new text begin , and 256B.0659 new text end . 207.16    Subd. 3. Noncovered home care services. The following home care services are 207.17not eligible for payment under medical assistance: 207.18(1) skilled nurse visits for the sole purpose of supervision of the home health aide; 207.19(2) a skilled nursing visit: 207.20(i) only for the purpose of monitoring medication compliance with an established 207.21medication program for a recipient; or 207.22(ii) to administer or assist with medication administration, including injections, 207.23prefilling syringes for injections, or oral medication set-up of an adult recipient, when as 207.24determined and documented by the registered nurse, the need can be met by an available 207.25pharmacy or the recipient is physically and mentally able to self-administer or prefill 207.26a medication; 207.27(3) home care services to a recipient who is eligible for covered services under the 207.28Medicare program or any other insurance held by the recipient; 207.29(4) services to other members of the recipient's household; 207.30(5) a visit made by a skilled nurse solely to train other home health agency workers; 207.31(6) any home care service included in the daily rate of the community-based 207.32residential facility where the recipient is residing; 207.33(7) nursing and rehabilitation therapy services that are reasonably accessible to a 207.34recipient outside the recipient's place of residence, excluding the assessment, counseling 207.35and education, and personal assistant care; 208.1(8) any home health agency service, excluding personal care assistant services and 208.2private duty nursing services, which are performed in a place other than the recipient's 208.3residence; and 208.4(9) Medicare evaluation or administrative nursing visits on dual-eligible recipients 208.5that do not qualify for Medicare visit billing. 208.6 new text begin (1) services provided in a nursing facility, hospital, or intermediate care facility with new text end 208.7 new text begin exceptions in section 256B.0653; new text end 208.8 new text begin (2) services for the sole purpose of monitoring medication compliance with an new text end 208.9 new text begin established medication program for a recipient; new text end 208.10 new text begin (3) home care services for covered services under the Medicare program or any other new text end 208.11 new text begin insurance held by the recipient; new text end 208.12 new text begin (4) services to other members of the recipient's household; new text end 208.13 new text begin (5) any home care service included in the daily rate of the community-based new text end 208.14 new text begin residential facility where the recipient is residing; new text end 208.15 new text begin (6) nursing and rehabilitation therapy services that are reasonably accessible to a new text end 208.16 new text begin recipient outside the recipient's place of residence, excluding the assessment, counseling new text end 208.17 new text begin and education, and personal assistance care; or new text end 208.18 new text begin (7) Medicare evaluation or administrative nursing visits on dual-eligible recipients new text end 208.19 new text begin that do not qualify for Medicare visit billing. new text end 208.20    Subd. 4. Prior Authorization; exceptions. All home care services above the limits 208.21in subdivision 11 must receive the commissioner's prior authorization new text begin before services new text end 208.22 new text begin begin new text end , except when: 208.23(1) the home care services were required to treat an emergency medical condition 208.24that if not immediately treated could cause a recipient serious physical or mental disability, 208.25continuation of severe pain, or death. The provider must request retroactive authorization 208.26no later than five working days after giving the initial service. The provider must be able 208.27to substantiate the emergency by documentation such as reports, notes, and admission or 208.28discharge histories; 208.29(2) the home care services were provided on or after the date on which the recipient's 208.30eligibility began, but before the date on which the recipient was notified that the case was 208.31opened. Authorization will be considered if the request is submitted by the provider 208.32within 20 working days of the date the recipient was notified that the case was opened; new text begin new text end 208.33 new text begin a recipient's medical assistance eligibility has lapsed, is then retroactively reinstated, new text end 208.34 new text begin and an authorization for home care services is completed based on the date of a current new text end 208.35 new text begin assessment, eligibility, and request for authorization; new text end 209.1(3) a third-party payor for home care services has denied or adjusted a payment. 209.2Authorization requests must be submitted by the provider within 20 working days of the 209.3notice of denial or adjustment. A copy of the notice must be included with the request; 209.4(4) the commissioner has determined that a county or state human services agency 209.5has made an error; or 209.6(5) the professional nurse determines an immediate need for up to 40 skilled nursing 209.7or home health aide visits per calendar year and submits a request for authorization within 209.820 working days of the initial service date, and medical assistance is determined to be 209.9the appropriate payer. new text begin if a recipient enrolled in managed care experiences a temporary new text end 209.10 new text begin disenrollment from a health plan, the commissioner shall accept the current health plan new text end 209.11 new text begin authorization for personal care assistance services for up to 60 days. The request must new text end 209.12 new text begin be received within the first 30 days of the disenrollment. If the recipient's reenrollment new text end 209.13 new text begin in managed care is after the 60 days and before 90 days, the provider shall request an new text end 209.14 new text begin additional 30-day extension of the current health plan authorization, for a total limit of new text end 209.15 new text begin 90 days from the time of disenrollment. new text end 209.16    Subd. 5. Retroactive authorization. A request for retroactive authorization will be 209.17evaluated according to the same criteria applied to prior authorization requests. 209.18    Subd. 6. Prior Authorization. new text begin (a) new text end The commissioner, or the commissioner's 209.19designee, shall review the assessment, service update, request for temporary services, 209.20request for flexible use option, service plan, and any additional information that is 209.21submitted. The commissioner shall, within 30 days after receiving a complete request, 209.22assessment, and service plan, authorize home care services as follows: new text begin provided in this new text end 209.23 new text begin section. new text end 209.24(a) Home health services. new text begin (b) new text end All Home health services provided by a home health 209.25aide new text begin including skilled nurse visits and home health aide visits new text end must be prior authorized 209.26by the commissioner or the commissioner's designee. Prior Authorization must be based 209.27on medical necessity and cost-effectiveness when compared with other care options. 209.28 new text begin The commissioner must receive the request for authorization of skilled nurse visits and new text end 209.29 new text begin home health aide visits within 20 working days of the start of service. new text end When home health 209.30services are used in combination with personal care and private duty nursing, the cost of 209.31all home care services shall be considered for cost-effectiveness. The commissioner shall 209.32limit home health aide visits to no more than one visit each per day. The commissioner, or 209.33the commissioner's designee, may authorize up to two skilled nurse visits per day. 209.34(b) Ventilator-dependent recipients. new text begin (c) new text end If the recipient is ventilator-dependent, the 209.35monthly medical assistance authorization for home care services shall not exceed what the 209.36commissioner would pay for care at the highest cost hospital designated as a long-term 210.1hospital under the Medicare program. For purposes of this paragraph, home care services 210.2means all new text begin direct care new text end services provided in the home that would be included in the payment 210.3for care at the long-term hospital. "Ventilator-dependent" means an individual who 210.4receives mechanical ventilation for life support at least six hours per day and is expected 210.5to be or has been dependent for at least 30 consecutive days. new text begin Recipients who meet the new text end 210.6 new text begin definition of ventilator dependent and the EN home care rating and utilize a combination new text end 210.7 new text begin of home care services are limited up to a total of 24 hours of home care services per day. new text end 210.8 new text begin Additional hours may be authorized when a recipient's assessment indicates a need for two new text end 210.9 new text begin staff to perform activities. Additional time is limited to four hours per day. new text end 210.10    Subd. 7. Prior Authorization; time limits. new text begin (a) new text end The commissioner or the 210.11commissioner's designee shall determine the time period for which a prior new text begin an new text end authorization 210.12shall be effective and, if flexible use has been requested, whether to allow the flexible use 210.13option. If the recipient continues to require home care services beyond the duration of 210.14the prior authorization, the home care provider must request a new prior authorization. 210.15A personal care provider agency must request a new personal care assistant new text begin assistance new text end 210.16 services assessment, or service update if allowed, at least 60 days prior to the end of 210.17the current prior authorization time period. The request for the assessment must be 210.18made on a form approved by the commissioner. Under no circumstances, other than the 210.19exceptions in subdivision 4, shall a prior new text begin An new text end authorization new text begin must new text end be valid prior to the date 210.20the commissioner receives the request or for new text begin no new text end more than 12 months. 210.21 new text begin (b) The amount and type of personal care assistance services authorized based new text end 210.22 new text begin upon the assessment and service plan must remain in effect for the recipient whether new text end 210.23 new text begin the recipient chooses a different provider or enrolls or disenrolls from a managed care new text end 210.24 new text begin plan under section 256B.0659, unless the service needs of the recipient change and new new text end 210.25 new text begin assessment is warranted under section 256B.0655, subdivision 1b. new text end 210.26 new text begin (c) new text end A recipient who appeals a reduction in previously authorized home care 210.27services may continue previously authorized services, other than temporary services 210.28under subdivision 8, pending an appeal under section 256.045. The commissioner must 210.29provide new text begin ensure that the recipient has a copy of the most recent service plan that contains new text end 210.30 a detailed explanation of why the authorized services new text begin which areas of covered personal new text end 210.31 new text begin care assistance tasks new text end are reduced in amount from those requested by the home care 210.32provider new text begin , and provide notice of the amount of time per day reduced, and the reasons for new text end 210.33 new text begin the reduction in the recipient's notice of denial, termination, or reduction new text end . 210.34    Subd. 8. Prior Authorization requests; temporary services. The agency nurse, 210.35the independently enrolled private duty nurse, or county public health nurse may request 210.36a temporary authorization for home care services by telephone. The commissioner may 211.1approve a temporary level of home care services based on the assessment, and service 211.2or care plan information, and primary payer coverage determination information as 211.3required. Authorization for a temporary level of home care services including nurse 211.4supervision is limited to the time specified by the commissioner, but shall not exceed 211.545 days, unless extended because the county public health nurse has not completed the 211.6required assessment and service plan, or the commissioner's determination has not been 211.7made. The level of services authorized under this provision shall have no bearing on a 211.8future prior authorization. 211.9    Subd. 9. Prior Authorization for foster care setting. new text begin (a) new text end Home care services 211.10provided in an adult or child foster care setting must receive prior authorization by the 211.11department new text begin commissioner new text end according to the limits established in subdivision 11. 211.12 new text begin (b) new text end The commissioner may not authorize: 211.13(1) home care services that are the responsibility of the foster care provider under 211.14the terms of the foster care placement agreement new text begin , difficulty of care rate as of January 1, new text end 211.15 new text begin 2010, new text end and administrative rules; 211.16(2) personal care assistant new text begin assistance new text end services when the foster care license holder is 211.17also the personal care provider or personal care assistant unless the recipient can direct the 211.18recipient's own care, or case management is provided as required in section 256B.0625, 211.19subdivision 19a new text begin , unless the foster home is the licensed provider's primary residence as new text end 211.20 new text begin defined in section 256B.0625, subdivision 19a new text end ; new text begin or new text end 211.21(3) personal care assistant services when the responsible party is an employee of, or 211.22under contract with, or has any direct or indirect financial relationship with the personal 211.23care provider or personal care assistant, unless case management is provided as required 211.24in section 256B.0625, subdivision 19a; or 211.25(4) new text begin (3) new text end personal care assistant and private duty nursing services when the number 211.26of foster care residents new text begin licensed capacity new text end is greater than four unless the county responsible 211.27for the recipient's foster placement made the placement prior to April 1, 1992, requests 211.28that personal care assistant and private duty nursing services be provided, and case 211.29management is provided as required in section 256B.0625, subdivision 19a. 211.30    Subd. 10. Limitation on payments. Medical assistance payments for home care 211.31services shall be limited according to subdivisions 4 to 12 and sections 256B.0654, 211.32subdivision 2 , and 256B.0655, subdivisions 3 and 4. 211.33    Subd. 11. Limits on services without prior authorization. A recipient may receive 211.34the following home care services during a calendar year: 212.1(1) up to two face-to-face assessments to determine a recipient's need for personal 212.2care assistant new text begin assistance new text end services; 212.3(2) one service update done to determine a recipient's need for personal care assistant new text begin new text end 212.4 new text begin assistance new text end services; and 212.5(3) up to nine new text begin face-to-face new text end skilled nurse visits. 212.6    Subd. 12. Approval of home care services. The commissioner or the 212.7commissioner's designee shall determine the medical necessity of home care services, 212.8the level of caregiver according to subdivision 2, and the institutional comparison 212.9according to subdivisions 4 to 12 and sections 256B.0654, subdivision 2, and 256B.0655, 212.10subdivisions 3 and 4 new text begin , and 256B.0659 new text end , the cost-effectiveness of services, and the amount, 212.11scope, and duration of home care services reimbursable by medical assistance, based 212.12on the assessment, primary payer coverage determination information as required, the 212.13service plan, the recipient's age, the cost of services, the recipient's medical condition, and 212.14diagnosis or disability. The commissioner may publish additional criteria for determining 212.15medical necessity according to section 256B.04. 212.16    Subd. 13. Recovery of excessive payments. The commissioner shall seek 212.17monetary recovery from providers of payments made for services which exceed the limits 212.18established in this section and sections 256B.0653 to 256B.0656 new text begin , and 256B.0659 new text end . This 212.19subdivision does not apply to services provided to a recipient at the previously authorized 212.20level pending an appeal under section 256.045, subdivision 10. 212.21     new text begin Subd. 14. new text end new text begin Referrals to Medicare providers required. new text end new text begin Home care providers that new text end 212.22 new text begin do not participate in or accept Medicare assignment must refer and document the referral new text end 212.23 new text begin of dual-eligible recipients to Medicare providers when Medicare is determined to be the new text end 212.24 new text begin appropriate payer for services and supplies and equipment. Providers must be terminated new text end 212.25 new text begin from participation in the medical assistance program for failure to make these referrals. new text end 212.26     new text begin Subd. 15. new text end new text begin Quality assurance for program integrity. new text end new text begin The commissioner shall new text end 212.27 new text begin establish an ongoing quality assurance process for home care services to monitor program new text end 212.28 new text begin integrity, including provider standards and training, consumer surveys, and random new text end 212.29 new text begin reviews of documentation. new text end 212.30     new text begin Subd. 16. new text end new text begin Oversight of enrolled providers. new text end new text begin The commissioner has the authority to new text end 212.31 new text begin request proof of documentation of meeting provider standards, quality standards of care, new text end 212.32 new text begin correct billing practices, and other information. Failure to comply with or to provide access new text end 212.33 new text begin and information to demonstrate compliance with laws, rules, or policies may result in new text end 212.34 new text begin suspension, denial, or termination of the provider agency's enrollment with the department. new text end 213.1    Sec. 24. Minnesota Statutes 2008, section 256B.0652, is amended to read: 213.2256B.0652 PRIOR AUTHORIZATION AND REVIEW OF HOME CARE 213.3SERVICES. 213.4    Subdivision 1. State coordination. The commissioner shall supervise the 213.5coordination of the prior authorization and review of home care services that are 213.6reimbursed by medical assistance. 213.7    Subd. 2. Duties. (a) The commissioner may contract with or employ qualified 213.8registered nurses and necessary support staff, or contract with qualified agencies, to 213.9provide home care prior authorization and review services for medical assistance 213.10recipients who are receiving home care services. 213.11(b) Reimbursement for the prior authorization function shall be made through the 213.12medical assistance administrative authority. The state shall pay the nonfederal share. 213.13The functions will be to: 213.14(1) assess the recipient's individual need for services required to be cared for safely 213.15in the community; 213.16(2) ensure that a service new text begin care new text end plan that meets the recipient's needs is developed 213.17by the appropriate agency or individual; 213.18(3) ensure cost-effectiveness new text begin and nonduplication new text end of medical assistance home care 213.19services; 213.20(4) recommend the approval or denial of the use of medical assistance funds to pay 213.21for home care services; 213.22(5) reassess the recipient's need for and level of home care services at a frequency 213.23determined by the commissioner; and 213.24(6) conduct on-site assessments when determined necessary by the commissioner 213.25and recommend changes to care plans that will provide more efficient and appropriate 213.26home care new text begin ; and new text end 213.27 new text begin (7) on the department's Web site: new text end 213.28 new text begin (i) provide a link to MinnesotaHelp.info for a list of enrolled home care agencies new text end 213.29 new text begin with the following information: main office address, contact information for the agency, new text end 213.30 new text begin counties in which services are provided, type of home care services provided, whether new text end 213.31 new text begin the personal care assistance choice option is offered, types of qualified professionals new text end 213.32 new text begin employed, number of personal care assistants employed, and data on staff turnover; and new text end 213.33 new text begin (ii) post data on home care services including information from both fee-for-service new text end 213.34 new text begin and managed care plans on recipients as available new text end . 213.35(c) In addition, the commissioner or the commissioner's designee may: 214.1(1) review new text begin care plans, new text end service plans new text begin , new text end and reimbursement data for utilization of 214.2services that exceed community-based standards for home care, inappropriate home care 214.3services, medical necessity, home care services that do not meet quality of care standards, 214.4or unauthorized services and make appropriate referrals within the department or to other 214.5appropriate entities based on the findings; 214.6(2) assist the recipient in obtaining services necessary to allow the recipient to 214.7remain safely in or return to the community; 214.8(3) coordinate home care services with other medical assistance services under 214.9section 256B.0625; 214.10(4) assist the recipient with problems related to the provision of home care services; 214.11(5) assure the quality of home care services; and 214.12(6) assure that all liable third-party payers including new text begin , but not limited to, new text end Medicare 214.13have been used prior to medical assistance for home care services, including but not 214.14limited to, home health agency, elected hospice benefit, waivered services, alternative care 214.15program services, and personal care services. 214.16(d) For the purposes of this section, "home care services" means medical assistance 214.17services defined under section 256B.0625, subdivisions 6a, 7, and 19a. 214.18    Subd. 3. Assessment and prior authorization process new text begin for persons receiving new text end 214.19 new text begin personal care assistance and developmental disabilities services new text end . Effective January 1, 214.201996, For purposes of providing informed choice, coordinating of local planning decisions, 214.21and streamlining administrative requirements, the assessment and prior authorization 214.22process for persons receiving both home care and home and community-based waivered 214.23services for persons with developmental disabilities shall meet the requirements of 214.24sections 256B.0651 and 256B.0653 to 256B.0656 with the following exceptions: 214.25(a) Upon request for home care services and subsequent assessment by the public 214.26health nurse under sections 256B.0651 and 256B.0653 to 256B.0656, the public health 214.27nurse shall participate in the screening process, as appropriate, and, if home care 214.28services are determined to be necessary, participate in the development of a service plan 214.29coordinating the need for home care and home and community-based waivered services 214.30with the assigned county case manager, the recipient of services, and the recipient's legal 214.31representative, if any. 214.32(b) The public health nurse shall give prior authorization for home care services 214.33to the extent that home care services are: 214.34(1) medically necessary; 214.35(2) chosen by the recipient and their legal representative, if any, from the array of 214.36home care and home and community-based waivered services available; 215.1(3) coordinated with other services to be received by the recipient as described 215.2in the service plan; and 215.3(4) provided within the county's reimbursement limits for home care and home and 215.4community-based waivered services for persons with developmental disabilities. 215.5(c) If the public health agency is or may be the provider of home care services to the 215.6recipient, the public health agency shall provide the commissioner of human services with 215.7a written plan that specifies how the assessment and prior authorization process will be 215.8held separate and distinct from the provision of services. 215.9    Sec. 25. Minnesota Statutes 2008, section 256B.0653, is amended to read: 215.10256B.0653 HOME HEALTH AGENCY COVERED SERVICES. 215.11    Subdivision 1. Homecare; skilled nurse visits new text begin Scope new text end . "Skilled nurse visits" are 215.12provided in a recipient's residence under a plan of care or service plan that specifies a level 215.13of care which the nurse is qualified to provide. These services are: 215.14(1) nursing services according to the written plan of care or service plan and accepted 215.15standards of medical and nursing practice in accordance with chapter 148; 215.16(2) services which due to the recipient's medical condition may only be safely and 215.17effectively provided by a registered nurse or a licensed practical nurse; 215.18(3) assessments performed only by a registered nurse; and 215.19(4) teaching and training the recipient, the recipient's family, or other caregivers 215.20requiring the skills of a registered nurse or licensed practical nurse. new text begin This section applies to new text end 215.21 new text begin home health agency services including, home health aide, skilled nursing visits, physical new text end 215.22 new text begin therapy, occupational therapy, respiratory therapy, and speech language pathology therapy. new text end 215.23    Subd. 2. Telehomecare; skilled nurse visits new text begin Definitions new text end . Medical assistance 215.24covers skilled nurse visits according to section 256B.0625, subdivision 6a, provided via 215.25telehomecare, for services which do not require hands-on care between the home care 215.26nurse and recipient. The provision of telehomecare must be made via live, two-way 215.27interactive audiovisual technology and may be augmented by utilizing store-and-forward 215.28technologies. Store-and-forward technology includes telehomecare services that do not 215.29occur in real time via synchronous transmissions, and that do not require a face-to-face 215.30encounter with the recipient for all or any part of any such telehomecare visit. Individually 215.31identifiable patient data obtained through real-time or store-and-forward technology must 215.32be maintained as health records according to sections 144.291 to 144.298. If the video 215.33is used for research, training, or other purposes unrelated to the care of the patient, the 215.34identity of the patient must be concealed. A communication between the home care nurse 215.35and recipient that consists solely of a telephone conversation, facsimile, electronic mail, or 216.1a consultation between two health care practitioners, is not to be considered a telehomecare 216.2visit. Multiple daily skilled nurse visits provided via telehomecare are allowed. Coverage 216.3of telehomecare is limited to two visits per day. All skilled nurse visits provided via 216.4telehomecare must be prior authorized by the commissioner or the commissioner's 216.5designee and will be covered at the same allowable rate as skilled nurse visits provided 216.6in-person. new text begin For the purposes of this section, the following terms have the meanings given. new text end 216.7 new text begin (a) "Assessment" means an evaluation of the recipient's medical need for home new text end 216.8 new text begin health agency services by a registered nurse or appropriate therapist that is conducted new text end 216.9 new text begin within 30 days of a request. new text end 216.10 new text begin (b) "Home care therapies" means occupational, physical, and respiratory therapy new text end 216.11 new text begin and speech-language pathology services provided in the home by a Medicare certified new text end 216.12 new text begin home health agency. new text end 216.13 new text begin (c) "Home health agency services" means services delivered in the recipient's home new text end 216.14 new text begin residence, except as specified in section 256B.0625, by a home health agency to a recipient new text end 216.15 new text begin with medical needs due to illness, disability, or physical conditions. new text end 216.16 new text begin (d) "Home health aide" means an employee of a home health agency who completes new text end 216.17 new text begin medically oriented tasks written in the plan of care for a recipient. new text end 216.18 new text begin (e) "Home health agency" means a home care provider agency that is new text end 216.19 new text begin Medicare-certified. new text end 216.20 new text begin (f) "Occupational therapy services" mean the services defined in Minnesota Rules, new text end 216.21 new text begin part 9505.0390. new text end 216.22 new text begin (g) "Physical therapy services" mean the services defined in Minnesota Rules, part new text end 216.23 new text begin 9505.0390. new text end 216.24 new text begin (h) "Respiratory therapy services" mean the services defined in chapter 147C and new text end 216.25 new text begin Minnesota Rules, part 4668.0003, subpart 37. new text end 216.26 new text begin (i) "Speech-language pathology services" mean the services defined in Minnesota new text end 216.27 new text begin Rules, part 9505.0390. new text end 216.28 new text begin (j) "Skilled nurse visit" means a professional nursing visit to complete nursing tasks new text end 216.29 new text begin required due to a recipient's medical condition that can only be safely provided by a new text end 216.30 new text begin professional nurse to restore and maintain optimal health. new text end 216.31 new text begin (k) "Store-and-forward technology" means telehomecare services that do not occur new text end 216.32 new text begin in real time via synchronous transmissions such as diabetic and vital sign monitoring. new text end 216.33 new text begin (l) "Telehomecare" means the use of telecommunications technology via new text end 216.34 new text begin live, two-way interactive audiovisual technology which may be augmented by new text end 216.35 new text begin store-and-forward technology. new text end 217.1 new text begin (m) "Telehomecare skilled nurse visit" means a visit by a professional nurse to new text end 217.2 new text begin deliver a skilled nurse visit to a recipient located at a site other than the site where the new text end 217.3 new text begin nurse is located and is used in combination with face-to-face skilled nurse visits to new text end 217.4 new text begin adequately meet the recipient's needs. new text end 217.5    Subd. 3. Therapies through home health agencies new text begin Home health aide visits new text end . 217.6(a) Medical assistance covers physical therapy and related services, including specialized 217.7maintenance therapy. Services provided by a physical therapy assistant shall be 217.8reimbursed at the same rate as services performed by a physical therapist when the 217.9services of the physical therapy assistant are provided under the direction of a physical 217.10therapist who is on the premises. Services provided by a physical therapy assistant that are 217.11provided under the direction of a physical therapist who is not on the premises shall be 217.12reimbursed at 65 percent of the physical therapist rate. Direction of the physical therapy 217.13assistant must be provided by the physical therapist as described in Minnesota Rules, part 217.149505.0390, subpart 1, item B. The physical therapist and physical therapist assistant may 217.15not both bill for services provided to a recipient on the same day. 217.16(b) Medical assistance covers occupational therapy and related services, including 217.17specialized maintenance therapy. Services provided by an occupational therapy assistant 217.18shall be reimbursed at the same rate as services performed by an occupational therapist 217.19when the services of the occupational therapy assistant are provided under the direction of 217.20the occupational therapist who is on the premises. Services provided by an occupational 217.21therapy assistant under the direction of an occupational therapist who is not on the 217.22premises shall be reimbursed at 65 percent of the occupational therapist rate. Direction 217.23of the occupational therapy assistant must be provided by the occupational therapist as 217.24described in Minnesota Rules, part 9505.0390, subpart 1, item B. The occupational 217.25therapist and occupational therapist assistant may not both bill for services provided 217.26to a recipient on the same day. 217.27 new text begin (a) Home health aide visits must be provided by a certified home health aide new text end 217.28 new text begin using a written plan of care that is updated in compliance with Medicare regulations. new text end 217.29 new text begin A home health aide shall provide hands-on personal care, perform simple procedures new text end 217.30 new text begin as an extension of therapy or nursing services, and assist in instrumental activities of new text end 217.31 new text begin daily living as defined in section 256B.0659. Home health aide visits must be provided new text end 217.32 new text begin in the recipient's home. new text end 217.33 new text begin (b) All home health aide visits must have authorization under section 256B.0652. new text end 217.34 new text begin The commissioner shall limit home health aide visits to no more than one visit per day new text end 217.35 new text begin per recipient. new text end 218.1 new text begin (c) Home health aides must be supervised by a registered nurse or an appropriate new text end 218.2 new text begin therapist when providing services that are an extension of therapy. new text end 218.3     new text begin Subd. 4. new text end new text begin Skilled nurse visit services. new text end new text begin (a) Skilled nurse visit services must be new text end 218.4 new text begin provided by a registered nurse or a licensed practical nurse under the supervision of a new text end 218.5 new text begin registered nurse, according to the written plan of care and accepted standards of medical new text end 218.6 new text begin and nursing practice according to chapter 148. Skilled nurse visit services must be ordered new text end 218.7 new text begin by a physician and documented in a plan of care that is reviewed and approved by the new text end 218.8 new text begin ordering physician at least once every 60 days. All skilled nurse visits must be medically new text end 218.9 new text begin necessary and provided in the recipient's home residence except as allowed under section new text end 218.10 new text begin 256B.0625, subdivision 6a. new text end 218.11 new text begin (b) Skilled nurse visits include face-to-face and telehomecare visits with a limit of new text end 218.12 new text begin up to two visits per day per recipient. All visits must be based on assessed needs. new text end 218.13 new text begin (c) Telehomecare skilled nurse visits are allowed when the recipient's health status new text end 218.14 new text begin can be accurately measured and assessed without a need for a face-to-face, hands-on new text end 218.15 new text begin encounter. All telehomecare skilled nurse visits must have authorization and are paid at new text end 218.16 new text begin the same allowable rates as face-to-face skilled nurse visits. new text end 218.17 new text begin (d) The provision of telehomecare must be made via live, two-way interactive new text end 218.18 new text begin audiovisual technology and may be augmented by utilizing store-and-forward new text end 218.19 new text begin technologies. Individually identifiable patient data obtained through real-time or new text end 218.20 new text begin store-and-forward technology must be maintained as health records according to sections new text end 218.21 new text begin 144.291 to 144.298. If the video is used for research, training, or other purposes unrelated new text end 218.22 new text begin to the care of the patient, the identity of the patient must be concealed. new text end 218.23 new text begin (e) Authorization for skilled nurse visits must be completed under section new text end 218.24 new text begin 256B.0652. A total of nine face-to-face skilled nurses visits per calendar year do not new text end 218.25 new text begin require authorization. All telehomecare skilled nurse visits require authorization. new text end 218.26     new text begin Subd. 5. new text end new text begin Home care therapies. new text end new text begin (a) Home care therapies include the following: new text end 218.27 new text begin physical therapy, occupational therapy, respiratory therapy, and speech and language new text end 218.28 new text begin pathology therapy services. new text end 218.29 new text begin (b) Home care therapies must be: new text end 218.30 new text begin (1) provided in the recipient's residence after it has been determined the recipient is new text end 218.31 new text begin unable to access outpatient therapy; new text end 218.32 new text begin (2) prescribed, ordered, or referred by a physician and documented in a plan of care new text end 218.33 new text begin and reviewed, according to Minnesota Rules, part 9505.0390; new text end 218.34 new text begin (3) assessed by an appropriate therapist; and new text end 218.35 new text begin (4) provided by a Medicare-certified home health agency enrolled as a Medicaid new text end 218.36 new text begin provider agency. new text end 219.1 new text begin (c) Restorative and specialized maintenance therapies must be provided according to new text end 219.2 new text begin Minnesota Rules, part 9505.0390. Physical and occupational therapy assistants may be new text end 219.3 new text begin used as allowed under Minnesota Rules, part 9505.0390, subpart 1, item B. new text end 219.4 new text begin (d) For both physical and occupational therapies, the therapist and the therapist's new text end 219.5 new text begin assistant may not both bill for services provided to a recipient on the same day. new text end 219.6     new text begin Subd. 6. new text end new text begin Noncovered home health agency services. new text end new text begin The following are not eligible new text end 219.7 new text begin for payment under medical assistance as a home health agency service: new text end 219.8 new text begin (1) telehomecare skilled nurses services that is communication between the home new text end 219.9 new text begin care nurse and recipient that consists solely of a telephone conversation, facsimile, new text end 219.10 new text begin electronic mail, or a consultation between two health care practitioners; new text end 219.11 new text begin (2) the following skilled nurse visits: new text end 219.12 new text begin (i) for the purpose of monitoring medication compliance with an established new text end 219.13 new text begin medication program for a recipient; new text end 219.14 new text begin (ii) administering or assisting with medication administration, including injections, new text end 219.15 new text begin prefilling syringes for injections, or oral medication setup of an adult recipient, when, new text end 219.16 new text begin as determined and documented by the registered nurse, the need can be met by an new text end 219.17 new text begin available pharmacy or the recipient or a family member is physically and mentally able new text end 219.18 new text begin to self-administer or prefill a medication; new text end 219.19 new text begin (iii) services done for the sole purpose of supervision of the home health aide or new text end 219.20 new text begin personal care assistant; new text end 219.21 new text begin (iv) services done for the sole purpose to train other home health agency workers; new text end 219.22 new text begin (v) services done for the sole purpose of blood samples or lab draw when the new text end 219.23 new text begin recipient is able to access these services outside the home; and new text end 219.24 new text begin (vi) Medicare evaluation or administrative nursing visits required by Medicare; new text end 219.25 new text begin (3) home health aide visits when the following activities are the sole purpose for the new text end 219.26 new text begin visit: companionship, socialization, household tasks, transportation, and education; and new text end 219.27 new text begin (4) home care therapies provided in other settings such as a clinic, day program, or as new text end 219.28 new text begin an inpatient or when the recipient can access therapy outside of the recipient's residence. new text end 219.29    Sec. 26. Minnesota Statutes 2008, section 256B.0654, is amended to read: 219.30256B.0654 PRIVATE DUTY NURSING. 219.31    Subdivision 1. Definitions. (a) "Assessment" means a review and evaluation of a 219.32recipient's need for home care services conducted in person. Assessments for private duty 219.33nursing shall be conducted by a registered private duty nurse. Assessments for medical 219.34assistance home care services for developmental disabilities and alternative care services 220.1for developmentally disabled home and community-based waivered recipients may be 220.2conducted by the county public health nurse to ensure coordination and avoid duplication. 220.3(b) new text begin (a) new text end "Complex and regular private duty nursing care" means: 220.4(1) complex care is private duty nursing new text begin services new text end provided to recipients who are 220.5ventilator dependent or for whom a physician has certified that were it not for private duty 220.6nursing the recipient would meet the criteria for inpatient hospital intensive care unit 220.7(ICU) level of care; and 220.8(2) regular care is private duty nursing provided to all other recipients. 220.9 new text begin (b) "Private duty nursing" means ongoing professional nursing services by a new text end 220.10 new text begin registered or licensed practical nurse including assessment, professional nursing tasks, and new text end 220.11 new text begin education, based on an assessment and physician orders to maintain or restore optimal new text end 220.12 new text begin health of the recipient. new text end 220.13 new text begin (c) "Private duty nursing agency" means a medical assistance enrolled provider new text end 220.14 new text begin licensed under chapter 144A to provide private duty nursing services. new text end 220.15 new text begin (d) "Regular private duty nursing" means nursing services provided to a recipient new text end 220.16 new text begin who is considered stable and not at an inpatient hospital intensive care unit level of care, new text end 220.17 new text begin but may have episodes of instability that are not life threatening. new text end 220.18 new text begin (e) "Shared private duty nursing" means the provision of nursing services by a new text end 220.19 new text begin private duty nurse to two recipients at the same time and in the same setting. new text end 220.20    Subd. 2. new text begin Authorization; new text end private duty nursing services. (a) All private duty 220.21nursing services shall be prior authorized by the commissioner or the commissioner's 220.22designee. Prior Authorization for private duty nursing services shall be based on 220.23medical necessity and cost-effectiveness when compared with alternative care options. 220.24The commissioner may authorize medically necessary private duty nursing services in 220.25quarter-hour units when: 220.26(1) the recipient requires more individual and continuous care than can be provided 220.27during a new text begin skilled new text end nurse visit; or 220.28(2) the cares are outside of the scope of services that can be provided by a home 220.29health aide or personal care assistant. 220.30(b) The commissioner may authorize: 220.31(1) up to two times the average amount of direct care hours provided in nursing 220.32facilities statewide for case mix classification "K" as established by the annual cost report 220.33submitted to the department by nursing facilities in May 1992; 220.34(2) private duty nursing in combination with other home care services up to the total 220.35cost allowed under section 256B.0655, subdivision 4; 221.1(3) up to 16 hours per day if the recipient requires more nursing than the maximum 221.2number of direct care hours as established in clause (1) and the recipient meets the hospital 221.3admission criteria established under Minnesota Rules, parts 9505.0501 to 9505.0540. 221.4(c) The commissioner may authorize up to 16 hours per day of medically necessary 221.5private duty nursing services or up to 24 hours per day of medically necessary private duty 221.6nursing services until such time as the commissioner is able to make a determination of 221.7eligibility for recipients who are cooperatively applying for home care services under 221.8the community alternative care program developed under section 256B.49, or until it is 221.9determined by the appropriate regulatory agency that a health benefit plan is or is not 221.10required to pay for appropriate medically necessary health care services. Recipients 221.11or their representatives must cooperatively assist the commissioner in obtaining this 221.12determination. Recipients who are eligible for the community alternative care program 221.13may not receive more hours of nursing under this section and sections 256B.0651, 221.14256B.0653 , , and 256B.0656 new text begin , and 256B.0659 new text end than would otherwise be 221.15authorized under section 256B.49. 221.16     new text begin Subd. 2a. new text end new text begin Private duty nursing services. new text end new text begin (a) Private duty nursing services must new text end 221.17 new text begin be used: new text end 221.18 new text begin (1) in the recipient's home or outside the home when normal life activities require; new text end 221.19 new text begin (2) when the recipient requires more individual and continuous care than can be new text end 221.20 new text begin provided during a skilled nurse visit; and new text end 221.21 new text begin (3) when the care required is outside of the scope of services that can be provided by new text end 221.22 new text begin a home health aide or personal care assistant. new text end 221.23 new text begin (b) Private duty nursing services must be: new text end 221.24 new text begin (1) assessed by a registered nurse on a form approved by the commissioner; new text end 221.25 new text begin (2) ordered by a physician and documented in a plan of care that is reviewed by the new text end 221.26 new text begin physician at least once every 60 days; and new text end 221.27 new text begin (3) authorized by the commissioner under section 256B.0652. new text end 221.28     new text begin Subd. 2b. new text end new text begin Noncovered private duty nursing services. new text end new text begin Private duty nursing new text end 221.29 new text begin services do not cover the following: new text end 221.30 new text begin (1) nursing services by a nurse who is the family foster care provider of a person new text end 221.31 new text begin who has not reached 18 years of age unless allowed under subdivision 4; new text end 221.32 new text begin (2) nursing services to more than two persons receiving shared private duty nursing new text end 221.33 new text begin services from a private duty nurse in a single setting; and new text end 221.34 new text begin (3) nursing services provided by a registered nurse or licensed practical nurse who is new text end 221.35 new text begin the recipient's legal guardian or related to the recipient as spouse, parent, or family foster new text end 222.1 new text begin parent whether by blood, marriage, or adoption except as specified in section 256B.0652, new text end 222.2 new text begin subdivision 4. new text end 222.3    Subd. 3. Shared private duty nursing care option. (a) Medical assistance 222.4payments for shared private duty nursing services by a private duty nurse shall be limited 222.5according to this subdivision. For the purposes of this section and sections , 222.6, , and , "private duty nursing agency" means an agency 222.7licensed under chapter 144A to provide private duty nursing services. new text begin Unless otherwise new text end 222.8 new text begin provided in this subdivision, all other statutory and regulatory provisions relating to new text end 222.9 new text begin private duty nursing services apply to shared private duty nursing services. Nothing in new text end 222.10 new text begin this subdivision shall be construed to reduce the total number of private duty nursing new text end 222.11 new text begin hours authorized for an individual recipient. new text end 222.12(b) Recipients of private duty nursing services may share nursing staff and the 222.13commissioner shall provide a rate methodology for shared private duty nursing. For two 222.14persons sharing nursing care, the rate paid to a provider shall not exceed 1.5 times the 222.15regular private duty nursing rates paid for serving a single individual by a registered nurse 222.16or licensed practical nurse. These rates apply only to situations in which both recipients 222.17are present and receive shared private duty nursing care on the date for which the service 222.18is billed. No more than two persons may receive shared private duty nursing services 222.19from a private duty nurse in a single setting. 222.20(c) new text begin (b) new text end Shared private duty nursing care is the provision of nursing services by a 222.21private duty nurse to two new text begin medical assistance eligible new text end recipients at the same time and in 222.22the same setting. new text begin This subdivision does not apply when a private duty nurse is caring for new text end 222.23 new text begin multiple recipients in more than one setting. new text end 222.24 new text begin (c) new text end For the purposes of this subdivision, "setting" means: 222.25(1) the home new text begin residence new text end or foster care home of one of the individual recipients new text begin as new text end 222.26 new text begin defined in section 256B.0651 new text end ; or 222.27(2) a child care program licensed under chapter 245A or operated by a local school 222.28district or private school; or 222.29(3) an adult day care service licensed under chapter 245A; or 222.30(4) outside the home new text begin residence new text end or foster care home of one of the recipients when 222.31normal life activities take the recipients outside the home. 222.32This subdivision does not apply when a private duty nurse is caring for multiple 222.33recipients in more than one setting. 222.34 new text begin (d) The private duty nursing agency must offer the recipient the option of shared or new text end 222.35 new text begin one-on-one private duty nursing services. The recipient may withdraw from participating new text end 222.36 new text begin in a shared service arrangement at any time. new text end 223.1(d) new text begin (e) new text end The recipient or the recipient's legal representative, and the recipient's 223.2physician, in conjunction with the home health care new text begin private duty nursing new text end agency, shall 223.3determine: 223.4(1) whether shared private duty nursing care is an appropriate option based on the 223.5individual needs and preferences of the recipient; and 223.6(2) the amount of shared private duty nursing services authorized as part of the 223.7overall authorization of nursing services. 223.8(e) new text begin (f) new text end The recipient or the recipient's legal representative, in conjunction with the 223.9private duty nursing agency, shall approve the setting, grouping, and arrangement of 223.10shared private duty nursing care based on the individual needs and preferences of the 223.11recipients. Decisions on the selection of recipients to share services must be based on the 223.12ages of the recipients, compatibility, and coordination of their care needs. 223.13(f) new text begin (g) new text end The following items must be considered by the recipient or the recipient's 223.14legal representative and the private duty nursing agency, and documented in the recipient's 223.15health service record: 223.16(1) the additional training needed by the private duty nurse to provide care to 223.17two recipients in the same setting and to ensure that the needs of the recipients are met 223.18appropriately and safely; 223.19(2) the setting in which the shared private duty nursing care will be provided; 223.20(3) the ongoing monitoring and evaluation of the effectiveness and appropriateness 223.21of the service and process used to make changes in service or setting; 223.22(4) a contingency plan which accounts for absence of the recipient in a shared private 223.23duty nursing setting due to illness or other circumstances; 223.24(5) staffing backup contingencies in the event of employee illness or absence; and 223.25(6) arrangements for additional assistance to respond to urgent or emergency care 223.26needs of the recipients. 223.27(g) The provider must offer the recipient or responsible party the option of shared or 223.28one-on-one private duty nursing services. The recipient or responsible party can withdraw 223.29from participating in a shared service arrangement at any time. 223.30(h) The private duty nursing agency must document the following in the 223.31health service record for each individual recipient sharing private duty nursing care new text begin new text end 223.32 new text begin The documentation for shared private duty nursing must be on a form approved by new text end 223.33 new text begin the commissioner for each individual recipient sharing private duty nursing. The new text end 223.34 new text begin documentation must be part of the recipient's health service record and include new text end : 223.35(1) permission by the recipient or the recipient's legal representative for the 223.36maximum number of shared nursing care hours per week chosen by the recipient new text begin and new text end 224.1 new text begin permission for shared private duty nursing services provided in and outside the recipient's new text end 224.2 new text begin home residence new text end ; 224.3(2) permission by the recipient or the recipient's legal representative for shared 224.4private duty nursing services provided outside the recipient's residence; 224.5(3) permission by the recipient or the recipient's legal representative for others to 224.6receive shared private duty nursing services in the recipient's residence; 224.7(4) revocation by the recipient or the recipient's legal representative of new text begin for new text end the shared 224.8private duty nursing care authorization, or the shared care to be provided to others in the 224.9recipient's residence, or the shared private duty nursing services to be provided outside new text begin new text end 224.10 new text begin permission, or services provided to others in and outside new text end the recipient's residence; and 224.11(5) new text begin (3) new text end daily documentation of the shared private duty nursing services provided by 224.12each identified private duty nurse, including: 224.13(i) the names of each recipient receiving shared private duty nursing services 224.14together; 224.15(ii) the setting for the shared services, including the starting and ending times that 224.16the recipient received shared private duty nursing care; and 224.17(iii) notes by the private duty nurse regarding changes in the recipient's condition, 224.18problems that may arise from the sharing of private duty nursing services, and scheduling 224.19and care issues. 224.20(i) Unless otherwise provided in this subdivision, all other statutory and regulatory 224.21provisions relating to private duty nursing services apply to shared private duty nursing 224.22services. 224.23Nothing in this subdivision shall be construed to reduce the total number of private 224.24duty nursing hours authorized for an individual recipient under subdivision 2. 224.25 new text begin (i) The commissioner shall provide a rate methodology for shared private duty new text end 224.26 new text begin nursing. For two persons sharing nursing care, the rate paid to a provider must not exceed new text end 224.27 new text begin 1.5 times the regular private duty nursing rates paid for serving a single individual by a new text end 224.28 new text begin registered nurse or licensed practical nurse. These rates apply only to situations in which new text end 224.29 new text begin both recipients are present and receive shared private duty nursing care on the date for new text end 224.30 new text begin which the service is billed. new text end 224.31    Subd. 4. Hardship criteria; private duty nursing. (a) Payment is allowed for 224.32extraordinary services that require specialized nursing skills and are provided by parents 224.33of minor children, new text begin family foster parents, new text end spouses, and legal guardians who are providing 224.34private duty nursing care under the following conditions: 224.35(1) the provision of these services is not legally required of the parents, spouses, 224.36or legal guardians; 225.1(2) the services are necessary to prevent hospitalization of the recipient; and 225.2(3) the recipient is eligible for state plan home care or a home and community-based 225.3waiver and one of the following hardship criteria are met: 225.4(i) the parent, spouse, or legal guardian resigns from a part-time or full-time job to 225.5provide nursing care for the recipient; or 225.6(ii) the parent, spouse, or legal guardian goes from a full-time to a part-time job with 225.7less compensation to provide nursing care for the recipient; or 225.8(iii) the parent, spouse, or legal guardian takes a leave of absence without pay to 225.9provide nursing care for the recipient; or 225.10(iv) because of labor conditions, special language needs, or intermittent hours of 225.11care needed, the parent, spouse, or legal guardian is needed in order to provide adequate 225.12private duty nursing services to meet the medical needs of the recipient. 225.13(b) Private duty nursing may be provided by a parent, spouse, new text begin family foster parent, new text end 225.14or legal guardian who is a nurse licensed in Minnesota. Private duty nursing services 225.15provided by a parent, spouse, new text begin family foster parent, new text end or legal guardian cannot be used in 225.16lieu of nursing services covered and available under liable third-party payors, including 225.17Medicare. The private duty nursing provided by a parent, spouse, new text begin family foster parent, new text end or 225.18legal guardian must be included in the service plan new text begin agreement new text end . Authorized skilled nursing 225.19services new text begin for a single recipient or recipients with the same residence and new text end provided by the 225.20parent, spouse, new text begin family foster parent, new text end or legal guardian may not exceed 50 percent of the 225.21total approved nursing hours, or eight hours per day, whichever is less, up to a maximum 225.22of 40 hours per week. new text begin A parent or parents, spouse, family foster parent, or legal guardian new text end 225.23 new text begin shall not provide more than 40 hours of services in a seven-day period. For parents, family new text end 225.24 new text begin foster parents, and legal guardians, 40 hours is the total amount allowed regardless of the new text end 225.25 new text begin number of children or adults who receive services. new text end Nothing in this subdivision precludes 225.26the parent's, spouse's, or legal guardian's obligation of assuming the nonreimbursed family 225.27responsibilities of emergency backup caregiver and primary caregiver. 225.28(c) A parent new text begin , family foster parent, new text end or a spouse may not be paid to provide private 225.29duty nursing care if new text begin : new text end 225.30 new text begin (1) new text end the parent or spouse fails to pass a criminal background check according to 225.31chapter 245C, or if new text begin ; new text end 225.32 new text begin (2) new text end it has been determined by the home health new text begin private duty nursing new text end agency, the 225.33case manager, or the physician that the private duty nursing care provided by the parent, 225.34 new text begin family foster parent, new text end spouse, or legal guardian is unsafe new text begin ; or new text end 225.35 new text begin (3) the parent, family foster parent, spouse, or legal guardian do not follow physician new text end 225.36 new text begin orders new text end . 226.1 new text begin (d) For purposes of this section, "assessment" means a review and evaluation of a new text end 226.2 new text begin recipient's need for home care services conducted in person. Assessments for private duty new text end 226.3 new text begin nursing must be conducted by a registered nurse. new text end 226.4    Sec. 27. Minnesota Statutes 2008, section 256B.0655, subdivision 1b, is amended to 226.5read: 226.6    Subd. 1b. Assessment. "Assessment" means a review and evaluation of a recipient's 226.7need for home care services conducted in person. Assessments for personal care assistant 226.8services shall be conducted by the county public health nurse or a certified public 226.9health nurse under contract with the county. A face-to-face new text begin An in-person new text end assessment 226.10must include: documentation of health status, determination of need, evaluation of 226.11service effectiveness, identification of appropriate services, service plan development 226.12or modification, coordination of services, referrals and follow-up to appropriate payers 226.13and community resources, completion of required reports, recommendation of service 226.14authorization, and consumer education. Once the need for personal care assistant 226.15services is determined under this section or sections 256B.0651, 256B.0653, 256B.0654, 226.16and 256B.0656, the county public health nurse or certified public health nurse under 226.17contract with the county is responsible for communicating this recommendation to the 226.18commissioner and the recipient. A face-to-face assessment for personal care assistant 226.19services is conducted on those recipients who have never had a county public health 226.20nurse assessment. A face-to-face new text begin An in-person new text end assessment must occur at least annually or 226.21when there is a significant change in the recipient's condition or when there is a change 226.22in the need for personal care assistant services. A service update may substitute for 226.23the annual face-to-face assessment when there is not a significant change in recipient 226.24condition or a change in the need for personal care assistant service. A service update 226.25may be completed by telephone, used when there is no need for an increase in personal 226.26care assistant services, and used for two consecutive assessments if followed by a 226.27face-to-face assessment. A service update must be completed on a form approved by the 226.28commissioner. A service update or review for temporary increase includes a review of 226.29initial baseline data, evaluation of service effectiveness, redetermination of service need, 226.30modification of service plan and appropriate referrals, update of initial forms, obtaining 226.31service authorization, and on going consumer education. Assessments must be completed 226.32on forms provided by the commissioner within 30 days of a request for home care services 226.33by a recipient or responsible party or personal care provider agency. 227.1    Sec. 28. Minnesota Statutes 2008, section 256B.0655, subdivision 4, is amended to 227.2read: 227.3    Subd. 4. Prior Authorization new text begin ; personal care assistance and qualified new text end 227.4 new text begin professional new text end . The commissioner, or the commissioner's designee, shall review the 227.5assessment, service update, request for temporary services, request for flexible use option, 227.6service plan, and any additional information that is submitted. The commissioner shall, 227.7within 30 days after receiving a complete request, assessment, and service plan, authorize 227.8home care services as follows: 227.9(1) new text begin (a) new text end All personal care assistant new text begin assistance new text end services and new text begin , new text end supervision by a 227.10qualified professional, if requested by the recipient, new text begin and additional services beyond the new text end 227.11 new text begin limits established in section 256B.0651, subdivision 11, new text end must be prior authorized by 227.12the commissioner or the commissioner's designee new text begin before services begin new text end except for the 227.13assessments established in section new text begin sections new text end 256B.0651, subdivision 11 new text begin , and 256B.0911 new text end . new text begin new text end 227.14 new text begin The authorization for personal care assistance and qualified professional services under new text end 227.15 new text begin section 256B.0659 must be completed within 30 days after receiving a complete request. new text end 227.16 new text begin (b) new text end The amount of personal care assistant new text begin assistance new text end services authorized must be 227.17based on the recipient's home care rating. new text begin The home care rating shall be determined by new text end 227.18 new text begin the commissioner or the commissioner's designee based on information submitted to the new text end 227.19 new text begin commissioner identifying the following: new text end 227.20 new text begin (1) total number of dependencies of activities of daily living as defined in section new text end 227.21 new text begin 256B.0659; new text end 227.22 new text begin (2) number of complex health-related functions as defined in section 256B.0659; and new text end 227.23 new text begin (3) number of behavior descriptions as defined in section 256B.0659. new text end 227.24 new text begin (c) The methodology to determine total time for personal care assistance services for new text end 227.25 new text begin each home care rating is based on the median paid units per day for each home care rating new text end 227.26 new text begin from fiscal year 2007 data for the personal care assistance program. Each home care rating new text end 227.27 new text begin has a base level of hours assigned. Additional time is added through the assessment and new text end 227.28 new text begin identification of the following: new text end 227.29 new text begin (1) 30 additional minutes per day for a dependency in each critical activity of daily new text end 227.30 new text begin living as defined in section 256B.0659; new text end 227.31 new text begin (2) 30 additional minutes per day for each complex health-related function as new text end 227.32 new text begin defined in section 256B.0659; and new text end 227.33 new text begin (3) 30 additional minutes per day for each behavior issue as defined in section new text end 227.34 new text begin 256B.0659. new text end 227.35 new text begin (d) A limit of 96 units of qualified professional supervision may be authorized for new text end 227.36 new text begin each recipient receiving personal care assistance services. A request to the commissioner new text end 228.1 new text begin to exceed this total in a calendar year must be requested by the personal care provider new text end 228.2 new text begin agency on a form approved by the commissioner. new text end 228.3A child may not be found to be dependent in an activity of daily living if because 228.4of the child's age an adult would either perform the activity for the child or assist the 228.5child with the activity and the amount of assistance needed is similar to the assistance 228.6appropriate for a typical child of the same age. Based on medical necessity, the 228.7commissioner may authorize: 228.8(A) up to two times the average number of direct care hours provided in nursing 228.9facilities for the recipient's comparable case mix level; or 228.10(B) up to three times the average number of direct care hours provided in nursing 228.11facilities for recipients who have complex medical needs or are dependent in at least seven 228.12activities of daily living and need physical assistance with eating or have a neurological 228.13diagnosis; or 228.14(C) up to 60 percent of the average reimbursement rate, as of July 1, 1991, for care 228.15provided in a regional treatment center for recipients who have Level I behavior, plus any 228.16inflation adjustment as provided by the legislature for personal care service; or 228.17(D) up to the amount the commissioner would pay, as of July 1, 1991, plus any 228.18inflation adjustment provided for home care services, for care provided in a regional 228.19treatment center for recipients referred to the commissioner by a regional treatment center 228.20preadmission evaluation team. For purposes of this clause, home care services means 228.21all services provided in the home or community that would be included in the payment 228.22to a regional treatment center; or 228.23(E) up to the amount medical assistance would reimburse for facility care for 228.24recipients referred to the commissioner by a preadmission screening team established 228.25under section or ; and 228.26(F) a reasonable amount of time for the provision of supervision by a qualified 228.27professional of personal care assistant services, if a qualified professional is requested by 228.28the recipient or responsible party. 228.29(2) The number of direct care hours shall be determined according to the annual cost 228.30report submitted to the department by nursing facilities. The average number of direct care 228.31hours, as established by May 1, 1992, shall be calculated and incorporated into the home 228.32care limits on July 1, 1992. These limits shall be calculated to the nearest quarter hour. 228.33(3) The home care rating shall be determined by the commissioner or the 228.34commissioner's designee based on information submitted to the commissioner by the 228.35county public health nurse on forms specified by the commissioner. The home care rating 228.36shall be a combination of current assessment tools developed under sections 229.1and with an addition for seizure activity that will assess the frequency and 229.2severity of seizure activity and with adjustments, additions, and clarifications that are 229.3necessary to reflect the needs and conditions of recipients who need home care including 229.4children and adults under 65 years of age. The commissioner shall establish these forms 229.5and protocols under this section and sections , , , and 229.6 and shall use an advisory group, including representatives of recipients, 229.7providers, and counties, for consultation in establishing and revising the forms and 229.8protocols. 229.9(4) A recipient shall qualify as having complex medical needs if the care required is 229.10difficult to perform and because of recipient's medical condition requires more time than 229.11community-based standards allow or requires more skill than would ordinarily be required 229.12and the recipient needs or has one or more of the following: 229.13(A) daily tube feedings; 229.14(B) daily parenteral therapy; 229.15(C) wound or decubiti care; 229.16(D) postural drainage, percussion, nebulizer treatments, suctioning, tracheotomy 229.17care, oxygen, mechanical ventilation; 229.18(E) catheterization; 229.19(F) ostomy care; 229.20(G) quadriplegia; or 229.21(H) other comparable medical conditions or treatments the commissioner determines 229.22would otherwise require institutional care. 229.23(5) A recipient shall qualify as having Level I behavior if there is reasonable 229.24supporting evidence that the recipient exhibits, or that without supervision, observation, or 229.25redirection would exhibit, one or more of the following behaviors that cause, or have the 229.26potential to cause: 229.27(A) injury to the recipient's own body; 229.28(B) physical injury to other people; or 229.29(C) destruction of property. 229.30(6) Time authorized for personal care relating to Level I behavior in paragraph 229.31(5), clauses (A) to (C), shall be based on the predictability, frequency, and amount of 229.32intervention required. 229.33(7) A recipient shall qualify as having Level II behavior if the recipient exhibits on a 229.34daily basis one or more of the following behaviors that interfere with the completion of 229.35personal care assistant services under subdivision 2, paragraph (a): 229.36(A) unusual or repetitive habits; 230.1(B) withdrawn behavior; or 230.2(C) offensive behavior. 230.3(8) A recipient with a home care rating of Level II behavior in paragraph (7), clauses 230.4(A) to (C), shall be rated as comparable to a recipient with complex medical needs under 230.5paragraph (4). If a recipient has both complex medical needs and Level II behavior, the 230.6home care rating shall be the next complex category up to the maximum rating under 230.7paragraph (1), clause (B). 230.8 new text begin EFFECTIVE DATE. new text end new text begin The amendments to paragraphs (a) and (b) are effective new text end 230.9 new text begin January 1, 2010. new text end 230.10    Sec. 29. Minnesota Statutes 2008, section 256B.0657, subdivision 8, is amended to 230.11read: 230.12    Subd. 8. Self-directed budget requirements. The budget for the provision of the 230.13self-directed service option shall be equal to the greater of either new text begin established based on new text end : 230.14    (1) the annual amount of personal care assistant services under section 230.15that the recipient has used in the most recent 12-month period new text begin assessed personal care new text end 230.16 new text begin assistance units, not to exceed the maximum number of personal care assistance units new text end 230.17 new text begin available, as determined by section 256B.0655 new text end ; or new text begin and new text end 230.18    (2) the amount determined using the consumer support grant methodology under 230.19section 256.476, subdivision 11, except that the budget amount shall include the federal 230.20and nonfederal share of the average service costs. new text begin the personal care assistance unit rate: new text end 230.21     new text begin (i) with a reduction to the unit rate to pay for a program administrator as defined in new text end 230.22 new text begin subdivision 10; and new text end 230.23     new text begin (ii) an additional adjustment to the unit rate as needed to ensure cost neutrality for new text end 230.24 new text begin the state. new text end 230.25    Sec. 30. Minnesota Statutes 2008, section 256B.0657, is amended by adding a 230.26subdivision to read: 230.27     new text begin Subd. 12. new text end new text begin Enrollment and evaluation. new text end new text begin Enrollment in the self-directed supports new text end 230.28 new text begin option is available to current personal care assistance recipients upon annual personal care new text end 230.29 new text begin assistance reassessment, with a maximum enrollment of 1,000 people in the first fiscal new text end 230.30 new text begin year of implementation and an additional 1,000 people in the second fiscal year. The new text end 230.31 new text begin commissioner shall evaluate the self-directed supports option during the first two years of new text end 230.32 new text begin implementation and make any necessary changes prior to the option becoming available new text end 230.33 new text begin statewide. new text end 231.1    Sec. 31. new text begin [256B.0659] PERSONAL CARE ASSISTANCE PROGRAM. new text end 231.2     new text begin Subdivision 1. new text end new text begin Definitions. new text end new text begin (a) For the purposes of this section, the terms defined in new text end 231.3 new text begin paragraphs (b) to (p) have the meanings given unless otherwise provided in text. new text end 231.4 new text begin (b) "Activities of daily living" means grooming, dressing, bathing, transferring, new text end 231.5 new text begin mobility, positioning, eating, and toileting. new text end 231.6 new text begin (c) "Behavior," effective January 1, 2010, means a category to determine the home new text end 231.7 new text begin care rating and is based on the criteria found in this section. "Level I behavior" means new text end 231.8 new text begin physical aggression towards self, others, or destruction of property that requires the new text end 231.9 new text begin immediate response of another person. new text end 231.10 new text begin (d) "Complex health-related needs," effective January 1, 2010, means a category to new text end 231.11 new text begin determine the home care rating and is based on the criteria found in this section. new text end 231.12 new text begin (e) "Critical activities of daily living," effective January 1, 2010, means transferring, new text end 231.13 new text begin mobility, eating, and toileting. new text end 231.14 new text begin (f) "Dependency in activities of daily living" means a person requires assistance to new text end 231.15 new text begin begin and complete one or more of the activities of daily living. new text end 231.16 new text begin (g) "Health-related procedures and tasks" means procedures and tasks that can new text end 231.17 new text begin be delegated or assigned by a licensed health care professional under state law to be new text end 231.18 new text begin performed by a personal care assistant. new text end 231.19 new text begin (h) "Instrumental activities of daily living" means activities to include meal planning new text end 231.20 new text begin and preparation; basic assistance with paying bills; shopping for food, clothing, and new text end 231.21 new text begin other essential items; performing household tasks integral to the personal care assistance new text end 231.22 new text begin services; communication by telephone and other media; and traveling, including to new text end 231.23 new text begin medical appointments and to participate in the community. new text end 231.24 new text begin (i) "Managing employee" has the same definition as Code of Federal Regulations, new text end 231.25 new text begin title 42, section 455. new text end 231.26 new text begin (j) "Qualified professional" means a professional providing supervision of personal new text end 231.27 new text begin care assistance services and staff as defined in section 256B.0625, subdivision 19c. new text end 231.28 new text begin (k) "Personal care assistance provider agency" means a medical assistance enrolled new text end 231.29 new text begin provider that provides or assists with providing personal care assistance services and new text end 231.30 new text begin includes personal care assistance provider organizations, personal care assistance choice new text end 231.31 new text begin agency, class A licensed nursing agency, and Medicare-certified home health agency. new text end 231.32 new text begin (l) "Personal care assistant" or "PCA" means an individual employed by a personal new text end 231.33 new text begin care assistance agency who provides personal care assistance services. new text end 231.34 new text begin (m) "Personal care assistance care plan" means a written description of personal new text end 231.35 new text begin care assistance services developed by the personal care assistance provider according new text end 231.36 new text begin to the service plan. new text end 232.1 new text begin (n) "Responsible party" means an individual who is capable of providing the support new text end 232.2 new text begin necessary to assist the recipient to live in the community. new text end 232.3 new text begin (o) "Self-administered medication" means medication taken orally, by injection or new text end 232.4 new text begin insertion, or applied topically without the need for assistance. new text end 232.5 new text begin (p) "Service plan" means a written summary of the assessment and description of the new text end 232.6 new text begin services needed by the recipient. new text end 232.7     new text begin Subd. 2. new text end new text begin Personal care assistance services; covered services. new text end new text begin (a) The personal new text end 232.8 new text begin care assistance services eligible for payment include services and supports furnished new text end 232.9 new text begin to an individual, as needed, to assist in: new text end 232.10 new text begin (1) activities of daily living; new text end 232.11 new text begin (2) health-related procedures and tasks; new text end 232.12 new text begin (3) observation and redirection of behaviors; and new text end 232.13 new text begin (4) instrumental activities of daily living. new text end 232.14 new text begin (b) Activities of daily living include the following covered services: new text end 232.15 new text begin (1) dressing, including assistance with choosing, application, and changing of new text end 232.16 new text begin clothing and application of special appliances, wraps, or clothing; new text end 232.17 new text begin (2) grooming, including assistance with basic hair care, oral care, shaving, applying new text end 232.18 new text begin cosmetics and deodorant, and care of eyeglasses and hearing aids. Nail care is included, new text end 232.19 new text begin except for recipients who are diabetic or have poor circulation; new text end 232.20 new text begin (3) bathing, including assistance with basic personal hygiene and skin care; new text end 232.21 new text begin (4) eating, including assistance with hand washing and application of orthotics new text end 232.22 new text begin required for eating, transfers, and feeding; new text end 232.23 new text begin (5) transfers, including assistance with transferring the recipient from one seating or new text end 232.24 new text begin reclining area to another; new text end 232.25 new text begin (6) mobility, including assistance with ambulation, including use of a wheelchair. new text end 232.26 new text begin Mobility does not include providing transportation for a recipient; new text end 232.27 new text begin (7) positioning, including assistance with positioning or turning a recipient for new text end 232.28 new text begin necessary care and comfort; and new text end 232.29 new text begin (8) toileting, including assistance with helping recipient with bowel or bladder new text end 232.30 new text begin elimination and care including transfers, mobility, positioning, feminine hygiene, use of new text end 232.31 new text begin toileting equipment or supplies, cleansing the perineal area, inspection of the skin, and new text end 232.32 new text begin adjusting clothing. new text end 232.33 new text begin (c) Health-related procedures and tasks include the following covered services: new text end 232.34 new text begin (1) range of motion and passive exercise to maintain a recipient's strength and new text end 232.35 new text begin muscle functioning; new text end 233.1 new text begin (2) assistance with self-administered medication as defined by this section, including new text end 233.2 new text begin reminders to take medication, bringing medication to the recipient, and assistance with new text end 233.3 new text begin opening medication under the direction of the recipient or responsible party; new text end 233.4 new text begin (3) interventions for seizure disorders, including monitoring and observation; and new text end 233.5 new text begin (4) other activities considered within the scope of the personal care service and new text end 233.6 new text begin meeting the definition of health-related procedures and tasks under this section. new text end 233.7 new text begin (d) A personal care assistant may provide health-related procedures and tasks new text end 233.8 new text begin associated with the complex health-related needs of a recipient if the procedures and new text end 233.9 new text begin tasks meet the definition of health-related procedures and tasks under this section and the new text end 233.10 new text begin personal care assistant is trained by a qualified professional and demonstrates competency new text end 233.11 new text begin to safely complete the procedures and tasks. Delegation of health-related procedures and new text end 233.12 new text begin tasks and all training must be documented in the personal care assistance care plan and the new text end 233.13 new text begin recipient's and personal care assistant's files. new text end 233.14 new text begin (e) Effective January 1, 2010, for a personal care assistant to provide the new text end 233.15 new text begin health-related procedures and tasks of tracheostomy suctioning and services to recipients new text end 233.16 new text begin on ventilator support there must be: new text end 233.17 new text begin (1) delegation and training by a registered nurse, certified or licensed respiratory new text end 233.18 new text begin therapist, or a physician; new text end 233.19 new text begin (2) utilization of clean rather than sterile procedure; new text end 233.20 new text begin (3) specialized training about the health-related procedures and tasks and equipment, new text end 233.21 new text begin including ventilator operation and maintenance; new text end 233.22 new text begin (4) individualized training regarding the needs of the recipient; and new text end 233.23 new text begin (5) supervision by a qualified professional who is a registered nurse. new text end 233.24 new text begin (f) Effective January 1, 2010, a personal care assistant may observe and redirect the new text end 233.25 new text begin recipient for episodes where there is a need for redirection due to behaviors. Training of new text end 233.26 new text begin the personal care assistant must occur based on the needs of the recipient, the personal new text end 233.27 new text begin care assistance care plan, and any other support services provided. new text end 233.28 new text begin (g) Instrumental activities of daily living under subdivision 1, paragraph (h). new text end 233.29     new text begin Subd. 3. new text end new text begin Noncovered personal care assistance services. new text end new text begin (a) Personal care new text end 233.30 new text begin assistance services are not eligible for medical assistance payment under this section new text end 233.31 new text begin when provided: new text end 233.32 new text begin (1) by the recipient's spouse, parent of a recipient under the age of 18, paid legal new text end 233.33 new text begin guardian, licensed foster provider, except as allowed under section 256B.0651, subdivision new text end 233.34 new text begin 9a, or responsible party; new text end 233.35 new text begin (2) in lieu of other staffing options in a residential or child care setting; new text end 233.36 new text begin (3) solely as a child care or babysitting service; or new text end 234.1 new text begin (4) without authorization by the commissioner or the commissioner's designee. new text end 234.2 new text begin (b) The following personal care services are not eligible for medical assistance new text end 234.3 new text begin payment under this section when provided in residential settings: new text end 234.4 new text begin (1) effective January 1, 2010, when the provider of home care services who is not new text end 234.5 new text begin related by blood, marriage, or adoption owns or otherwise controls the living arrangement, new text end 234.6 new text begin including licensed or unlicensed services; or new text end 234.7 new text begin (2) when personal care assistance services are the responsibility of a residential or new text end 234.8 new text begin program license holder under the terms of a service agreement and administrative rules. new text end 234.9 new text begin (c) Other specific tasks not covered under paragraph (a) or (b) that are not eligible new text end 234.10 new text begin for medical assistance reimbursement for personal care assistance services under this new text end 234.11 new text begin section include: new text end 234.12 new text begin (1) sterile procedures; new text end 234.13 new text begin (2) injections of fluids and medications into veins, muscles, or skin; new text end 234.14 new text begin (3) home maintenance or chore services; new text end 234.15 new text begin (4) homemaker services not an integral part of assessed personal care assistance new text end 234.16 new text begin services needed by a recipient; new text end 234.17 new text begin (5) application of restraints or implementation of procedures under section 245.825; new text end 234.18 new text begin (6) instrumental activities of daily living for children under the age of 18; and new text end 234.19 new text begin (7) assessments for personal care assistance services by personal care assistance new text end 234.20 new text begin provider agencies or by independently enrolled registered nurses. new text end 234.21     new text begin Subd. 4. new text end new text begin Assessment for personal care assistance services. new text end new text begin (a) An assessment new text end 234.22 new text begin as defined in section 256B.0655, subdivision 1b, must be completed for personal care new text end 234.23 new text begin assistance services. new text end 234.24 new text begin (b) The following limitations apply to the assessment: new text end 234.25 new text begin (1) a person must be assessed as dependent in an activity of daily living based new text end 234.26 new text begin on the person's need, on a daily basis, for: new text end 234.27 new text begin (i) cueing and constant supervision to complete the task; or new text end 234.28 new text begin (ii) hands-on assistance to complete the task; and new text end 234.29 new text begin (2) a child may not be found to be dependent in an activity of daily living if because new text end 234.30 new text begin of the child's age an adult would either perform the activity for the child or assist the child new text end 234.31 new text begin with the activity. Assistance needed is the assistance appropriate for a typical child of new text end 234.32 new text begin the same age. new text end 234.33 new text begin (c) Assessment for complex health-related needs must meet the criteria in this new text end 234.34 new text begin paragraph. During the assessment process, a recipient qualifies as having complex new text end 234.35 new text begin health-related needs if the recipient has one or more of the interventions that are ordered by new text end 234.36 new text begin a physician, specified in a personal care assistance care plan, and found in the following: new text end 235.1 new text begin (1) tube feedings requiring: new text end 235.2 new text begin (i) a gastro/jejunostomy tube; or new text end 235.3 new text begin (ii) continuous tube feeding lasting longer than 12 hours per day; new text end 235.4 new text begin (2) wounds described as: new text end 235.5     new text begin (i) stage III or stage IV; new text end 235.6     new text begin (ii) multiple wounds; new text end 235.7     new text begin (iii) requiring sterile or clean dressing changes or a wound vac; or new text end 235.8     new text begin (iv) open lesions such as burns, fistulas, tube sites, or ostomy sites that require new text end 235.9 new text begin specialized care; new text end 235.10     new text begin (3) parenteral therapy described as: new text end 235.11     new text begin (i) IV therapy more than two times per week lasting longer than four hours for new text end 235.12 new text begin each treatment; or new text end 235.13     new text begin (ii) total parenteral nutrition (TPN) daily; new text end 235.14     new text begin (4) respiratory interventions including: new text end 235.15     new text begin (i) oxygen required more than eight hours per day; new text end 235.16     new text begin (ii) respiratory vest more than one time per day; new text end 235.17     new text begin (iii) bronchial drainage treatments more than two times per day; new text end 235.18     new text begin (iv) sterile or clean suctioning more than six times per day; new text end 235.19     new text begin (v) dependence on another to apply respiratory ventilation augmentation devises new text end 235.20 new text begin such as BiPAP and CPAP; and new text end 235.21     new text begin (vi) ventilator dependence under section 256B.0652; new text end 235.22     new text begin (5) insertion and maintenance of catheter including: new text end 235.23 new text begin (i) sterile catheter changes more than one time per month; new text end 235.24 new text begin (ii) clean self-catheterization more than six times per day; or new text end 235.25 new text begin (iii) bladder irrigations; new text end 235.26 new text begin (6) bowel program more than two times per week requiring more than 30 minutes to new text end 235.27 new text begin perform each time; new text end 235.28 new text begin (7) neurological intervention including: new text end 235.29 new text begin (i) seizures more than two times per week and requiring significant physical new text end 235.30 new text begin assistance to maintain safety; or new text end 235.31 new text begin (ii) swallowing disorders diagnosed by a physician and requiring specialized new text end 235.32 new text begin assistance from another on a daily basis; and new text end 235.33 new text begin (8) other congenital or acquired diseases creating a need for significantly increased new text end 235.34 new text begin direct hands-on assistance and interventions in six to eight activities of daily living. new text end 236.1 new text begin (d) An assessment of behaviors must meet the criteria in this paragraph. A recipient new text end 236.2 new text begin qualifies as having a need for assistance due to behaviors if the recipient's behavior requires new text end 236.3 new text begin assistance at least four times per week and shows one or more of the following behaviors: new text end 236.4 new text begin (1) physical aggression towards self or others, or destruction of property that requires new text end 236.5 new text begin the immediate response of another person; new text end 236.6 new text begin (2) increased vulnerability due to cognitive deficits or socially inappropriate new text end 236.7 new text begin behavior; or new text end 236.8 new text begin (3) verbally aggressive and resistive to care. new text end 236.9     new text begin Subd. 5. new text end new text begin Service, support planning, and referral. new text end new text begin (a) The assessor, with the new text end 236.10 new text begin recipient or responsible party, shall review the assessment information and determine new text end 236.11 new text begin referrals for other payers, services, and community supports as appropriate. new text end 236.12 new text begin (b) The recipient must be referred for evaluation, services, or supports that are new text end 236.13 new text begin appropriate to help meet the recipient's needs including, but not limited to, the following new text end 236.14 new text begin circumstances: new text end 236.15 new text begin (1) when there is another payer who is responsible to provide the service to meet new text end 236.16 new text begin the recipient's needs; new text end 236.17 new text begin (2) when the recipient qualifies for assistance due to mental illness or behaviors new text end 236.18 new text begin under this section, a referral for a mental health diagnostic and functional assessment new text end 236.19 new text begin must be completed, or referral must be made for other specific mental health services or new text end 236.20 new text begin other community services; new text end 236.21 new text begin (3) when the recipient is eligible for medical assistance and meets medical assistance new text end 236.22 new text begin eligibility for a home health aide or skilled nurse visit; new text end 236.23 new text begin (4) when the recipient would benefit from an evaluation for another service; and new text end 236.24 new text begin (5) when there is a more appropriate service to meet the assessed needs. new text end 236.25     new text begin (c) The reimbursement rates for public health nurse visits that relate to the provision new text end 236.26 new text begin of personal care assistance services under this section and section new text end new text begin 256B.0625, subdivision new text end 236.27 new text begin 19a new text end new text begin , are: new text end 236.28     new text begin (1) $210.50 for a face-to-face assessment visit; new text end 236.29     new text begin (2) $105.25 for each service update; and new text end 236.30     new text begin (3) $105.25 for each request for a temporary service increase. new text end 236.31     new text begin (d) The rates specified in paragraph (c) must be adjusted to reflect provider rate new text end 236.32 new text begin increases for personal care assistance services that are approved by the legislature for the new text end 236.33 new text begin fiscal year ending June 30, 2000, and subsequent fiscal years. Any requirements applied new text end 236.34 new text begin by the legislature to provider rate increases for personal care assistance services also new text end 236.35 new text begin apply to adjustments under this paragraph. new text end 237.1     new text begin (e) Effective July 1, 2008, the payment rate for an assessment under this section and new text end 237.2 new text begin section new text end new text begin shall be reduced by 25 percent when the assessment is not completed new text end 237.3 new text begin on time and the service agreement documentation is not submitted in time to continue new text end 237.4 new text begin services. The commissioner shall reduce the amount of the claim for those assessments new text end 237.5 new text begin that are not submitted on time. new text end 237.6     new text begin Subd. 6. new text end new text begin Service plan. new text end new text begin The service plan must be completed by the assessor with the new text end 237.7 new text begin recipient and responsible party on a form determined by the commissioner and include new text end 237.8 new text begin a summary of the assessment with a description of the need, authorized amount, and new text end 237.9 new text begin expected outcomes and goals of personal care assistance services. The recipient and new text end 237.10 new text begin the provider chosen by the recipient or responsible party must be given a copy of the new text end 237.11 new text begin completed service plan within ten working days of the assessment. The recipient or new text end 237.12 new text begin responsible party must be given information by the assessor about the options in the new text end 237.13 new text begin personal care assistance program to allow for review and decision making. new text end 237.14     new text begin Subd. 7. new text end new text begin Personal care assistance care plan. new text end new text begin (a) Each recipient must have a new text end 237.15 new text begin current personal care assistance care plan based on the service plan in subdivision 6 that is new text end 237.16 new text begin developed by the qualified professional with the recipient and responsible party. A copy of new text end 237.17 new text begin the most current personal care assistance care plan is required to be in the recipient's home new text end 237.18 new text begin and in the recipient's file at the provider agency. new text end 237.19 new text begin (b) The personal care assistance care plan must have the following components: new text end 237.20 new text begin (1) start and end date of the care plan; new text end 237.21 new text begin (2) recipient demographic information, including name and telephone number; new text end 237.22 new text begin (3) emergency numbers, procedures, and a description of measures to address new text end 237.23 new text begin identified safety and vulnerability issues, including a backup staffing plan; new text end 237.24 new text begin (4) name of responsible party and instructions for contact; new text end 237.25 new text begin (5) description of the recipient's individualized needs for assistance with activities of new text end 237.26 new text begin daily living, instrumental activities of daily living, health-related tasks, and behaviors; and new text end 237.27 new text begin (6) dated signatures of recipient or responsible party and qualified professional. new text end 237.28 new text begin (c) The personal care assistance care plan must have instructions and comments new text end 237.29 new text begin about the recipient's needs for assistance and any special instructions or procedures new text end 237.30 new text begin required. The month-to-month plan for the use of personal care assistance services is part new text end 237.31 new text begin of the personal care assistance care plan. The personal care assistance care plan must new text end 237.32 new text begin be completed within the first week after start of services with a personal care provider new text end 237.33 new text begin agency and must be updated as needed when there is a change in need for personal care new text end 237.34 new text begin assistance services. A new personal care assistance care plan is required annually at the new text end 237.35 new text begin time of the reassessment. new text end 238.1     new text begin Subd. 8. new text end new text begin Communication with recipient's physician. new text end new text begin The personal care assistance new text end 238.2 new text begin program requires communication with the recipient's physician about a recipient's assessed new text end 238.3 new text begin needs for personal care assistance services. The commissioner shall work with the state new text end 238.4 new text begin medical director to develop options for communication with the recipient's physician. new text end 238.5     new text begin Subd. 9. new text end new text begin Responsible party; generally. new text end new text begin (a) "Responsible party," effective January new text end 238.6 new text begin 1, 2010, means an individual who is capable of providing the support necessary to assist new text end 238.7 new text begin the recipient to live in the community. new text end 238.8 new text begin (b) A responsible party must be 18 years of age, actively participate in planning and new text end 238.9 new text begin directing of personal care assistance services, and attend all assessments for the recipient. new text end 238.10 new text begin (c) A responsible party must not be the: new text end 238.11 new text begin (1) personal care assistant; new text end 238.12 new text begin (2) home care provider agency owner or staff; or new text end 238.13 new text begin (3) county staff acting as part of employment. new text end 238.14 new text begin (d) A licensed family foster parent who lives with the recipient may be the new text end 238.15 new text begin responsible party as long as the family foster parent meets the other responsible party new text end 238.16 new text begin requirements. new text end 238.17 new text begin (e) A responsible party is required when: new text end 238.18 new text begin (1) the person is a minor according to section 524.5-102, subdivision 10; new text end 238.19 new text begin (2) the person is an incapacitated adult according to section 524.5-102, subdivision new text end 238.20 new text begin 6, resulting in a court-appointed guardian; or new text end 238.21 new text begin (3) the assessment according to section 256B.0655, subdivision 1b, determines that new text end 238.22 new text begin the recipient is in need of a responsible party to direct the recipient's care. new text end 238.23 new text begin (f) There may be two persons designated as the responsible party for reasons such new text end 238.24 new text begin as divided households and court-ordered custodies. Each person named as responsible new text end 238.25 new text begin party must meet the program criteria and responsibilities. new text end 238.26 new text begin (g) The recipient or the recipient's legal representative shall appoint a responsible new text end 238.27 new text begin party if necessary to direct and supervise the care provided to the recipient. The new text end 238.28 new text begin responsible party must be identified at the time of assessment and listed on the recipient's new text end 238.29 new text begin service agreement and personal care assistance care plan. new text end 238.30     new text begin Subd. 10. new text end new text begin Responsible party; duties; delegation. new text end new text begin (a) A responsible party shall new text end 238.31 new text begin enter into a written agreement with a personal care assistance provider agency, on a form new text end 238.32 new text begin determined by the commissioner, to perform the following duties: new text end 238.33 new text begin (1) be available while care is provided in a method agreed upon by the individual new text end 238.34 new text begin or the individual's legal representative and documented in the recipient's personal care new text end 238.35 new text begin assistance care plan; new text end 239.1 new text begin (2) monitor personal care assistance services to ensure the recipient's personal care new text end 239.2 new text begin assistance care plan is being followed; and new text end 239.3 new text begin (3) review and sign personal care assistance time sheets after services are provided new text end 239.4 new text begin to provide verification of the personal care assistance services. new text end 239.5 new text begin Failure to provide the support required by the recipient must result in a referral to the new text end 239.6 new text begin county common entry point. new text end 239.7 new text begin (b) Responsible parties who are parents of minors or guardians of minors or new text end 239.8 new text begin incapacitated persons may delegate the responsibility to another adult who is not the new text end 239.9 new text begin personal care assistant during a temporary absence of at least 24 hours but not more new text end 239.10 new text begin than six months. The person delegated as a responsible party must be able to meet the new text end 239.11 new text begin definition of the responsible party, except that the delegated responsible party is required new text end 239.12 new text begin to reside with the recipient only while serving as the responsible party. The responsible new text end 239.13 new text begin party must ensure that the delegate performs the functions of the responsible party, is new text end 239.14 new text begin identified at the time of the assessment, and is listed on the personal care assistance new text end 239.15 new text begin care plan. The responsible party must communicate to the personal care assistance new text end 239.16 new text begin provider agency about the need for a delegate responsible party, including the name of the new text end 239.17 new text begin delegated responsible party, dates the delegated responsible party will be living with the new text end 239.18 new text begin recipient, and contact numbers. new text end 239.19     new text begin Subd. 11. new text end new text begin Personal care assistant; requirements. new text end new text begin (a) A personal care assistant new text end 239.20 new text begin must meet the following requirements: new text end 239.21 new text begin (1) be at least 18 years of age with the exception of persons who are 16 or 17 years new text end 239.22 new text begin of age with these additional requirements: new text end 239.23 new text begin (i) supervision by a qualified professional every 60 days; and new text end 239.24 new text begin (ii) employment by only one personal care assistance provider agency responsible new text end 239.25 new text begin for compliance with current labor laws; new text end 239.26 new text begin (2) be employed by a personal care assistance provider agency; new text end 239.27 new text begin (3) enroll with the department as a personal care assistant after clearing a background new text end 239.28 new text begin study. Before a personal care assistant provides services, the personal care assistance new text end 239.29 new text begin provider agency must initiate a background study on the personal care assistant under new text end 239.30 new text begin chapter 245C, and the personal care assistance provider agency must have received a new text end 239.31 new text begin notice from the commissioner that the personal care assistant is: new text end 239.32 new text begin (i) not disqualified under section 245C.14; or new text end 239.33 new text begin (ii) is disqualified, but the personal care assistant has received a set aside of the new text end 239.34 new text begin disqualification under section 245C.22; new text end 239.35 new text begin (4) be able to effectively communicate with the recipient and personal care new text end 239.36 new text begin assistance provider agency; new text end 240.1 new text begin (5) be able to provide covered personal care assistance services according to the new text end 240.2 new text begin recipient's personal care assistance care plan, respond appropriately to recipient needs, new text end 240.3 new text begin and report changes in the recipient's condition to the supervising qualified professional new text end 240.4 new text begin or physician; new text end 240.5 new text begin (6) not be a consumer of personal care assistance services; new text end 240.6 new text begin (7) maintain daily written records including, but not limited to, time sheets under new text end 240.7 new text begin subdivision 12; new text end 240.8 new text begin (8) effective January 1, 2010, complete standardized training as determined by the new text end 240.9 new text begin commissioner before completing enrollment. Personal care assistant training must include new text end 240.10 new text begin successful completion of the following training components: basic first aid, vulnerable new text end 240.11 new text begin adult, child maltreatment, OSHA universal precautions, basic roles and responsibilities of new text end 240.12 new text begin personal care assistants including information about assistance with lifting and transfers new text end 240.13 new text begin for recipients, emergency preparedness, orientation to positive behavioral practices, fraud new text end 240.14 new text begin issues, and completion of time sheets. Upon completion of the training components, new text end 240.15 new text begin the personal care assistant must demonstrate the competency to provide assistance to new text end 240.16 new text begin recipients; new text end 240.17 new text begin (9) complete training and orientation on the needs of the recipient within the first new text end 240.18 new text begin seven days after the services begin; and new text end 240.19 new text begin (10) be limited to providing and being paid for up to 310 hours per month of personal new text end 240.20 new text begin care assistance services regardless of the number of recipients being served or the number new text end 240.21 new text begin of personal care assistance provider agencies enrolled with. new text end 240.22 new text begin (b) A legal guardian may be a personal care assistant if the guardian is not being paid new text end 240.23 new text begin for the guardian services and meets the criteria for personal care assistants in paragraph (a). new text end 240.24 new text begin (c) Effective January 1, 2010, persons who do not qualify as a personal care assistant new text end 240.25 new text begin include parents and stepparents of minors, spouses, paid legal guardians, family foster new text end 240.26 new text begin care providers, except as otherwise allowed in section 256B.0625, subdivision 19a, or new text end 240.27 new text begin staff of a residential setting. new text end 240.28     new text begin Subd. 12. new text end new text begin Documentation of personal care assistance services provided. new text end new text begin (a) new text end 240.29 new text begin Personal care assistance services for a recipient must be documented daily by each personal new text end 240.30 new text begin care assistant, on a time sheet form approved by the commissioner. All documentation new text end 240.31 new text begin may be Web-based, electronic, or paper documentation. The completed form must be new text end 240.32 new text begin submitted on a monthly basis to the provider and kept in the recipient's health record. new text end 240.33 new text begin (b) The activity documentation must correspond to the personal care assistance care new text end 240.34 new text begin plan and be reviewed by the qualified professional. new text end 241.1 new text begin (c) The personal care assistant time sheet must be on a form approved by the new text end 241.2 new text begin commissioner documenting time the personal care assistant provides services in the home. new text end 241.3 new text begin The following criteria must be included in the time sheet: new text end 241.4 new text begin (1) full name of personal care assistant and individual provider number; new text end 241.5 new text begin (2) provider name and telephone numbers; new text end 241.6 new text begin (3) full name of recipient; new text end 241.7 new text begin (4) consecutive dates, including month, day, and year, and arrival and departure new text end 241.8 new text begin time with a.m. or p.m. notations; new text end 241.9 new text begin (5) signatures of recipient or the responsible party; new text end 241.10 new text begin (6) personal signature of the personal care assistant; new text end 241.11 new text begin (7) any shared care provided, if applicable; new text end 241.12 new text begin (8) a statement that it is a federal crime to provide false information on personal new text end 241.13 new text begin care service billings for medical assistance payments; and new text end 241.14 new text begin (9) dates and location of recipient stays in a hospital, care facility, or incarceration. new text end 241.15     new text begin Subd. 13. new text end new text begin Qualified professional; qualifications. new text end new text begin (a) The qualified professional new text end 241.16 new text begin must be employed by a personal care assistance provider agency and meet the definition new text end 241.17 new text begin under section 256B.0625, subdivision 19c. Before a qualified professional provides new text end 241.18 new text begin services, the personal care assistance provider agency must initiate a background study on new text end 241.19 new text begin the qualified professional under chapter 245C, and the personal care assistance provider new text end 241.20 new text begin agency must have received a notice from the commissioner that the qualified professional: new text end 241.21 new text begin (1) is not disqualified under section 245C.14; or new text end 241.22 new text begin (2) is disqualified, but the qualified professional has received a set aside of the new text end 241.23 new text begin disqualification under section 245C.22. new text end 241.24 new text begin (b) The qualified professional shall perform the duties of training, supervision, and new text end 241.25 new text begin evaluation of the personal care assistance staff and evaluation of the effectiveness of new text end 241.26 new text begin personal care assistance services. The qualified professional shall: new text end 241.27 new text begin (1) develop and monitor with the recipient a personal care assistance care plan based new text end 241.28 new text begin on the service plan and individualized needs of the recipient; new text end 241.29 new text begin (2) develop and monitor with the recipient a monthly plan for the use of personal new text end 241.30 new text begin care assistance services; new text end 241.31 new text begin (3) review documentation of personal care assistance services provided; new text end 241.32 new text begin (4) provide training and ensure competency for the personal care assistant in the new text end 241.33 new text begin individual needs of the recipient; and new text end 241.34 new text begin (5) document all training, communication, evaluations, and needed actions to new text end 241.35 new text begin improve performance of the personal care assistants. new text end 242.1 new text begin (c) The qualified professional shall complete the provider training with basic new text end 242.2 new text begin information about the personal care assistance program approved by the commissioner new text end 242.3 new text begin within six months of the date hired by a personal care assistance provider agency. new text end 242.4 new text begin Qualified professionals who have completed the required trainings as an employee with a new text end 242.5 new text begin personal care assistance provider agency do not need to repeat the required trainings if they new text end 242.6 new text begin are hired by another agency, if they have completed the training within the last three years. new text end 242.7     new text begin Subd. 14. new text end new text begin Qualified professional; duties. new text end new text begin (a) Effective January 1, 2010, all personal new text end 242.8 new text begin care assistants must be supervised by a qualified professional. new text end 242.9 new text begin (b) Through direct training, observation, return demonstrations, and consultation new text end 242.10 new text begin with the staff and the recipient, the qualified professional must ensure and document new text end 242.11 new text begin that the personal care assistant is: new text end 242.12 new text begin (1) capable of providing the required personal care assistance services; new text end 242.13 new text begin (2) knowledgeable about the plan of personal care assistance services before services new text end 242.14 new text begin are performed; and new text end 242.15 new text begin (3) able to identify conditions that should be immediately brought to the attention of new text end 242.16 new text begin the qualified professional. new text end 242.17 new text begin (c) The qualified professional shall evaluate the personal care assistant within the new text end 242.18 new text begin first 14 days of starting to provide services for a recipient except for the personal care new text end 242.19 new text begin assistance choice option under subdivision 19, paragraph (a), clause (4). The qualified new text end 242.20 new text begin professional shall evaluate the personal care assistance services for a recipient through new text end 242.21 new text begin direct observation of a personal care assistant's work: new text end 242.22 new text begin (1) at least every 90 days thereafter for the first year of a recipient's services; and new text end 242.23 new text begin (2) every 120 days after the first year of a recipient's service or whenever needed for new text end 242.24 new text begin response to a recipient's request for increased supervision of the personal care assistance new text end 242.25 new text begin staff. new text end 242.26 new text begin (d) Communication with the recipient is a part of the evaluation process of the new text end 242.27 new text begin personal care assistance staff. new text end 242.28 new text begin (e) At each supervisory visit, the qualified professional shall evaluate personal care new text end 242.29 new text begin assistance services including the following information: new text end 242.30 new text begin (1) satisfaction level of the recipient with personal care assistance services; new text end 242.31 new text begin (2) review of the month-to-month plan for use of personal care assistance services; new text end 242.32 new text begin (3) review of documentation of personal care assistance services provided; new text end 242.33 new text begin (4) whether the personal care assistance services are meeting the goals of the service new text end 242.34 new text begin as stated in the personal care assistance care plan and service plan; new text end 242.35 new text begin (5) a written record of the results of the evaluation and actions taken to correct any new text end 242.36 new text begin deficiencies in the work of a personal care assistant; and new text end 243.1 new text begin (6) revision of the personal care assistance care plan as necessary in consultation new text end 243.2 new text begin with the recipient or responsible party, to meet the needs of the recipient. new text end 243.3 new text begin (f) The qualified professional shall complete the required documentation in the new text end 243.4 new text begin agency recipient and employee files and the recipient's home, including the following new text end 243.5 new text begin documentation: new text end 243.6 new text begin (1) the personal care assistance care plan based on the service plan and individualized new text end 243.7 new text begin needs of the recipient; new text end 243.8 new text begin (2) a month-to-month plan for use of personal care assistance services; new text end 243.9 new text begin (3) changes in need of the recipient requiring a change to the level of service and the new text end 243.10 new text begin personal care assistance care plan; new text end 243.11 new text begin (4) evaluation results of supervision visits and identified issues with personal care new text end 243.12 new text begin assistance staff with actions taken; new text end 243.13 new text begin (5) all communication with the recipient and personal care assistance staff; and new text end 243.14 new text begin (6) hands-on training or individualized training for the care of the recipient. new text end 243.15 new text begin (g) The documentation in paragraph (f) must be done on agency forms. new text end 243.16 new text begin (h) The services that are not eligible for payment as qualified professional services new text end 243.17 new text begin include: new text end 243.18 new text begin (1) direct professional nursing tasks that could be assessed and authorized as skilled new text end 243.19 new text begin nursing tasks; new text end 243.20 new text begin (2) supervision of personal care assistance completed by telephone; new text end 243.21 new text begin (3) agency administrative activities; new text end 243.22 new text begin (4) training other than the individualized training required to provide care for a new text end 243.23 new text begin recipient; and new text end 243.24 new text begin (5) any other activity that is not described in this section. new text end 243.25     new text begin Subd. 15. new text end new text begin Flexible use. new text end new text begin (a) "Flexible use" means the scheduled use of authorized new text end 243.26 new text begin hours of personal care assistance services, which vary within a service authorization new text end 243.27 new text begin period covering no more than six months, in order to more effectively meet the needs and new text end 243.28 new text begin schedule of the recipient. Each 12-month service agreement is divided into two six-month new text end 243.29 new text begin authorization date spans. No more than 75 percent of the total authorized units for a new text end 243.30 new text begin 12-month service agreement may be used in a six-month date span. new text end 243.31 new text begin (b) Authorization of flexible use occurs during the authorization process under new text end 243.32 new text begin section 256B.0652. The flexible use of authorized hours does not increase the total new text end 243.33 new text begin amount of authorized hours available to a recipient. The commissioner shall not authorize new text end 243.34 new text begin additional personal care assistance services to supplement a service authorization that new text end 243.35 new text begin is exhausted before the end date under a flexible service use plan, unless the assessor new text end 243.36 new text begin determines a change in condition and a need for increased services is established. new text end 244.1 new text begin Authorized hours not used within the six-month period must not be carried over to another new text end 244.2 new text begin time period. new text end 244.3 new text begin (c) A recipient who has terminated personal care assistance services before the end new text end 244.4 new text begin of the 12-month authorization period must not receive additional hours upon reapplying new text end 244.5 new text begin during the same 12-month authorization period, except if a change in condition is new text end 244.6 new text begin documented. Services must be prorated for the remainder of the 12-month authorization new text end 244.7 new text begin period based on the first six-month assessment. new text end 244.8 new text begin (d) The recipient, responsible party, and qualified professional must develop a new text end 244.9 new text begin written month-to-month plan of the projected use of personal care assistance services that new text end 244.10 new text begin is part of the personal care assistance care plan and ensures: new text end 244.11 new text begin (1) that the health and safety needs of the recipient are met throughout both date new text end 244.12 new text begin spans of the authorization period; and new text end 244.13 new text begin (2) that the total authorized amount of personal care assistance services for each date new text end 244.14 new text begin span must not be used before the end of each date span in the authorization period. new text end 244.15 new text begin (e) The personal care assistance provider agency shall monitor the use of personal new text end 244.16 new text begin care assistance services to ensure health and safety needs of the recipient are met new text end 244.17 new text begin throughout both date spans of the authorization period. The commissioner or the new text end 244.18 new text begin commissioner's designee shall provide written notice to the provider and the recipient or new text end 244.19 new text begin responsible party when a recipient is at risk of exceeding the personal care assistance new text end 244.20 new text begin services prior to the end of the six-month period. new text end 244.21 new text begin (f) Misuse and abuse of the flexible use of personal care assistance services resulting new text end 244.22 new text begin in the overuse of units in a manner where the recipient will not have enough units to meet new text end 244.23 new text begin their needs for assistance and ensure health and safety for the entire six-month date span new text end 244.24 new text begin may lead to an action by the commissioner. The commissioner may take action including, new text end 244.25 new text begin but not limited to: (1) restricting recipients to service authorizations of no more than one new text end 244.26 new text begin month in duration; (2) requiring the recipient to have a responsible party; and (3) requiring new text end 244.27 new text begin a qualified professional to monitor and report services on a monthly basis. new text end 244.28     new text begin Subd. 16. new text end new text begin Shared services. new text end new text begin (a) Medical assistance payments for shared personal new text end 244.29 new text begin care assistance services are limited according to this subdivision. new text end 244.30 new text begin (b) Shared service is the provision of personal care assistance services by a personal new text end 244.31 new text begin care assistant to two or three recipients, eligible for medical assistance, who voluntarily new text end 244.32 new text begin enter into an agreement to receive services at the same time and in the same setting. new text end 244.33 new text begin (c) For the purposes of this subdivision, "setting" means: new text end 244.34 new text begin (1) the home residence or family foster care home of one or more of the individual new text end 244.35 new text begin recipients; or new text end 245.1 new text begin (2) a child care program licensed under chapter 245A or operated by a local school new text end 245.2 new text begin district or private school. new text end 245.3 new text begin (d) Shared personal care assistance services follow the same criteria for covered new text end 245.4 new text begin services as subdivision 2. new text end 245.5 new text begin (e) Noncovered shared personal care assistance services include the following: new text end 245.6 new text begin (1) services for more than three recipients by one personal care assistant at one time; new text end 245.7 new text begin (2) staff requirements for child care programs under chapter 245C; new text end 245.8 new text begin (3) caring for multiple recipients in more than one setting; new text end 245.9 new text begin (4) additional units of personal care assistance based on the selection of the option; new text end 245.10 new text begin and new text end 245.11 new text begin (5) use of more than one personal care assistance provider agency for the shared new text end 245.12 new text begin care services. new text end 245.13 new text begin (f) The option of shared personal care assistance is elected by the recipient or the new text end 245.14 new text begin responsible party with the assistance of the assessor. The option must be determined new text end 245.15 new text begin appropriate based on the ages of the recipients, compatibility, and coordination of their new text end 245.16 new text begin assessed care needs. The recipient or the responsible party, in conjunction with the new text end 245.17 new text begin qualified professional, shall arrange the setting and grouping of shared services based new text end 245.18 new text begin on the individual needs and preferences of the recipients. The personal care assistance new text end 245.19 new text begin provider agency shall offer the recipient or the responsible party the option of shared or new text end 245.20 new text begin one-on-one personal care assistance services or a combination of both. The recipient or new text end 245.21 new text begin the responsible party may withdraw from participating in a shared services arrangement at new text end 245.22 new text begin any time. new text end 245.23 new text begin (g) Authorization for the shared service option must be determined by the new text end 245.24 new text begin commissioner based on the criteria that the shared service is appropriate to meet all of the new text end 245.25 new text begin recipients' needs and their health and safety is maintained. The authorization of shared new text end 245.26 new text begin services is part of the overall authorization of personal care assistance services. Nothing new text end 245.27 new text begin in this subdivision must be construed to reduce the total number of hours authorized for new text end 245.28 new text begin an individual recipient. new text end 245.29 new text begin (h) A personal care assistant providing shared personal care assistance services must: new text end 245.30 new text begin (1) receive training specific for each recipient served; and new text end 245.31 new text begin (2) follow all required documentation requirements for time and services provided. new text end 245.32 new text begin (i) A qualified professional shall: new text end 245.33 new text begin (1) evaluate the ability of the personal care assistant to provide services for all of new text end 245.34 new text begin the recipients in a shared setting; new text end 246.1 new text begin (2) visit the shared setting as services are being provided at least once every six new text end 246.2 new text begin months or whenever needed for response to a recipient's request for increased supervision new text end 246.3 new text begin of the personal care assistance staff; new text end 246.4 new text begin (3) provide ongoing monitoring and evaluation of the effectiveness and new text end 246.5 new text begin appropriateness of the shared services; new text end 246.6 new text begin (4) develop a contingency plan with each of the recipients which accounts for new text end 246.7 new text begin absence of the recipient in a share services setting due to illness or other circumstances; new text end 246.8 new text begin (5) obtain permission from each of the recipients who are sharing a personal care new text end 246.9 new text begin assistant for number of shared hours for services provided inside and outside the home new text end 246.10 new text begin residence; and new text end 246.11 new text begin (6) document the training completed by the personal care assistants specific to the new text end 246.12 new text begin shared setting and recipients sharing services. new text end 246.13     new text begin Subd. 17. new text end new text begin Shared services; rates. new text end new text begin The commissioner shall provide a rate system for new text end 246.14 new text begin shared personal care assistance services. For two persons sharing services, the rate paid new text end 246.15 new text begin to a provider must not exceed one and one-half times the rate paid for serving a single new text end 246.16 new text begin individual, and for three persons sharing services, the rate paid to a provider must not new text end 246.17 new text begin exceed twice the rate paid for serving a single individual. These rates apply only when all new text end 246.18 new text begin of the criteria for the shared care personal care assistance service have been met. new text end 246.19     new text begin Subd. 18. new text end new text begin Personal care assistance choice option; generally. new text end new text begin (a) The new text end 246.20 new text begin commissioner may allow a recipient of personal care assistance services to use a fiscal new text end 246.21 new text begin intermediary to assist the recipient in paying and accounting for medically necessary new text end 246.22 new text begin covered personal care assistance services. Unless otherwise provided in this section, all new text end 246.23 new text begin other statutory and regulatory provisions relating to personal care assistance services apply new text end 246.24 new text begin to a recipient using the personal care assistance choice option. new text end 246.25 new text begin (b) Personal care assistance choice is an option of the personal care assistance new text end 246.26 new text begin program that allows the recipient who receives personal care assistance services to be new text end 246.27 new text begin responsible for the hiring, training, scheduling, and firing of personal care assistants. This new text end 246.28 new text begin program offers greater control and choice for the recipient in who provides the personal new text end 246.29 new text begin care assistance service and when the service is scheduled. The recipient or the recipient's new text end 246.30 new text begin responsible party must choose a personal care assistance choice provider agency as new text end 246.31 new text begin a fiscal intermediary. This personal care assistance choice provider agency manages new text end 246.32 new text begin payroll, invoices the state, is responsible for all payroll related taxes and insurance, and is new text end 246.33 new text begin responsible for providing the consumer training and support in managing the recipient's new text end 246.34 new text begin personal care assistance services. new text end 247.1     new text begin Subd. 19. new text end new text begin Personal care assistance choice option; qualifications; duties. new text end new text begin (a) new text end 247.2 new text begin Under personal care assistance choice, the recipient or responsible party shall: new text end 247.3 new text begin (1) recruit, hire, schedule, and terminate personal care assistants and a qualified new text end 247.4 new text begin professional; new text end 247.5 new text begin (2) develop a personal care assistance care plan based on the assessed needs new text end 247.6 new text begin and addressing the health and safety of the recipient with the assistance of a qualified new text end 247.7 new text begin professional as needed; new text end 247.8 new text begin (3) orient and train the personal care assistant with assistance as needed from the new text end 247.9 new text begin qualified professional; new text end 247.10 new text begin (4) effective January 1, 2010, supervise and evaluate the personal care assistant with new text end 247.11 new text begin the qualified professional, who is required to visit the recipient at least every 180 days; new text end 247.12 new text begin (5) monitor and verify in writing and report to the personal care assistance choice new text end 247.13 new text begin agency the number of hours worked by the personal care assistant and the qualified new text end 247.14 new text begin professional; new text end 247.15 new text begin (6) engage in an annual face-to-face reassessment to determine continuing eligibility new text end 247.16 new text begin and service authorization; and new text end 247.17 new text begin (7) use the same personal care assistance choice provider agency if shared personal new text end 247.18 new text begin assistance care is being used. new text end 247.19 new text begin (b) The personal care assistance choice provider agency shall: new text end 247.20 new text begin (1) meet all personal care assistance provider agency standards; new text end 247.21 new text begin (2) enter into a written agreement with the recipient, responsible party, and personal new text end 247.22 new text begin care assistants; new text end 247.23 new text begin (3) not be related as a parent, child, sibling, or spouse to the recipient, qualified new text end 247.24 new text begin professional, or the personal care assistant; and new text end 247.25 new text begin (4) ensure arm's-length transactions without undue influence or coercion with the new text end 247.26 new text begin recipient and personal care assistant. new text end 247.27 new text begin (c) The duties of the personal care assistance choice provider agency are to: new text end 247.28 new text begin (1) be the employer of the personal care assistant and the qualified professional for new text end 247.29 new text begin employment law and related regulations including, but not limited to, purchasing and new text end 247.30 new text begin maintaining workers' compensation, unemployment insurance, surety and fidelity bonds, new text end 247.31 new text begin and liability insurance, and submit any or all necessary documentation including, but not new text end 247.32 new text begin limited to, workers' compensation and unemployment insurance; new text end 247.33 new text begin (2) bill the medical assistance program for personal care assistance services and new text end 247.34 new text begin qualified professional services; new text end 247.35 new text begin (3) request and complete background studies that comply with the requirements for new text end 247.36 new text begin personal care assistants and qualified professionals; new text end 248.1 new text begin (4) pay the personal care assistant and qualified professional based on actual hours new text end 248.2 new text begin of services provided; new text end 248.3 new text begin (5) withhold and pay all applicable federal and state taxes; new text end 248.4 new text begin (6) verify and keep records of hours worked by the personal care assistant and new text end 248.5 new text begin qualified professional; new text end 248.6 new text begin (7) make the arrangements and pay taxes and other benefits, if any; and comply with new text end 248.7 new text begin any legal requirements for a Minnesota employer; new text end 248.8 new text begin (8) enroll in the medical assistance program as a personal care assistance choice new text end 248.9 new text begin agency; and new text end 248.10 new text begin (9) enter into a written agreement as specified in subdivision 20 before services new text end 248.11 new text begin are provided. new text end 248.12     new text begin Subd. 20. new text end new text begin Personal care assistance choice option; administration. new text end new text begin (a) Before new text end 248.13 new text begin services commence under the personal care assistance choice option, and annually new text end 248.14 new text begin thereafter, the personal care assistance choice provider agency, recipient, or responsible new text end 248.15 new text begin party, each personal care assistant, and the qualified professional shall enter into a written new text end 248.16 new text begin agreement. The agreement must include at a minimum: new text end 248.17 new text begin (1) duties of the recipient, qualified professional, personal care assistant, and new text end 248.18 new text begin personal care assistance choice provider agency; new text end 248.19 new text begin (2) salary and benefits for the personal care assistant and the qualified professional; new text end 248.20 new text begin (3) administrative fee of the personal care assistance choice provider agency and new text end 248.21 new text begin services paid for with that fee, including background study fees; new text end 248.22 new text begin (4) grievance procedures to respond to complaints; new text end 248.23 new text begin (5) procedures for hiring and terminating the personal care assistant; and new text end 248.24 new text begin (6) documentation requirements including, but not limited to, time sheets, activity new text end 248.25 new text begin records, and the personal care assistance care plan. new text end 248.26 new text begin (b) Effective January 1, 2010, except for the administrative fee of the personal care new text end 248.27 new text begin assistance choice provider agency as reported on the written agreement, the remainder new text end 248.28 new text begin of the rates paid to the personal care assistance choice provider agency must be used to new text end 248.29 new text begin pay for the salary and benefits for the personal care assistant or the qualified professional. new text end 248.30 new text begin The provider agency must use a minimum of 72.5 percent of the revenue generated by new text end 248.31 new text begin the medical assistance rate for personal care assistance services for employee personal new text end 248.32 new text begin care assistant wages and benefits. new text end 248.33 new text begin (c) The commissioner shall deny, revoke, or suspend the authorization to use the new text end 248.34 new text begin personal care assistance choice option if: new text end 248.35 new text begin (1) it has been determined by the qualified professional or public health nurse that new text end 248.36 new text begin the use of this option jeopardizes the recipient's health and safety; new text end 249.1 new text begin (2) the parties have failed to comply with the written agreement specified in this new text end 249.2 new text begin subdivision; new text end 249.3 new text begin (3) the use of the option has led to abusive or fraudulent billing for personal care new text end 249.4 new text begin assistance services; or new text end 249.5 new text begin (4) the department terminates the personal care assistance choice option. new text end 249.6 new text begin (d) The recipient or responsible party may appeal the commissioner's decision in new text end 249.7 new text begin paragraph (c) according to section 256.045. The denial, revocation, or suspension to new text end 249.8 new text begin use the personal care assistance choice option must not affect the recipient's authorized new text end 249.9 new text begin level of personal care assistance services. new text end 249.10     new text begin Subd. 21. new text end new text begin Requirements for initial enrollment of personal care assistance new text end 249.11 new text begin provider agencies. new text end new text begin (a) All personal care assistance provider agencies must provide, at the new text end 249.12 new text begin time of enrollment as a personal care assistance provider agency in a format determined new text end 249.13 new text begin by the commissioner, information and documentation that includes, but is not limited to, new text end 249.14 new text begin the following: new text end 249.15 new text begin (1) the personal care assistance provider agency's current contact information new text end 249.16 new text begin including address, telephone number, and e-mail address; new text end 249.17 new text begin (2) proof of surety bond coverage in the amount of $50,000 or ten percent of the new text end 249.18 new text begin provider's payments from Medicaid in the previous year, whichever is less; new text end 249.19 new text begin (3) proof of fidelity bond coverage in the amount of $20,000; new text end 249.20 new text begin (4) proof of workers' compensation insurance coverage; new text end 249.21 new text begin (5) a description of the personal care assistance provider agency's organization new text end 249.22 new text begin identifying the names of all owners, managing employees, staff, board of directors, and new text end 249.23 new text begin the affiliations of the directors, owners, or staff to other service providers; new text end 249.24 new text begin (6) a copy of the personal care assistance provider agency's written policies and new text end 249.25 new text begin procedures including: hiring of employees; training requirements; service delivery; new text end 249.26 new text begin and employee and consumer safety including process for notification and resolution new text end 249.27 new text begin of consumer grievances, identification and prevention of communicable diseases, and new text end 249.28 new text begin employee misconduct; new text end 249.29 new text begin (7) copies of all other forms the personal care assistance provider agency uses in new text end 249.30 new text begin the course of daily business including, but not limited to: new text end 249.31 new text begin (i) a copy of the personal care assistance provider agency's time sheet if the time new text end 249.32 new text begin sheet varies from the standard time sheet for personal care assistance services approved new text end 249.33 new text begin by the commissioner, and a letter requesting approval of the personal care assistance new text end 249.34 new text begin provider agency's nonstandard time sheet; new text end 249.35 new text begin (ii) the personal care assistance provider agency's template for the personal care new text end 249.36 new text begin assistance care plan; and new text end 250.1 new text begin (iii) the personal care assistance provider agency's template and the written new text end 250.2 new text begin agreement in subdivision 20 for recipients using the personal care assistance choice new text end 250.3 new text begin option, if applicable; new text end 250.4 new text begin (8) a list of all trainings and classes that the personal care assistance provider agency new text end 250.5 new text begin requires of its staff providing personal care assistance services; new text end 250.6 new text begin (9) documentation that the personal care assistance provider agency and staff have new text end 250.7 new text begin successfully completed all the training required by this section; new text end 250.8 new text begin (10) documentation of the agency's marketing practices; new text end 250.9 new text begin (11) disclosure of ownership, leasing, or management of all residential properties new text end 250.10 new text begin that is used or could be used for providing home care services; and new text end 250.11 new text begin (12) documentation that the agency will use the following percentages of revenue new text end 250.12 new text begin generated from the medical assistance rate paid for personal care assistance services new text end 250.13 new text begin for employee personal care assistant wages and benefits: 72.5 percent of revenue in the new text end 250.14 new text begin personal care assistance choice option and 72.5 percent of revenue from other personal new text end 250.15 new text begin care assistance providers. new text end 250.16 new text begin (b) Personal care assistance provider agencies shall provide the information specified new text end 250.17 new text begin in paragraph (a) to the commissioner at the time the personal care assistance provider new text end 250.18 new text begin agency enrolls as a vendor or upon request from the commissioner. The commissioner new text end 250.19 new text begin shall collect the information specified in paragraph (a) from all personal care assistance new text end 250.20 new text begin providers beginning upon enactment of this section. new text end 250.21 new text begin (c) All personal care assistance provider agencies shall complete mandatory training new text end 250.22 new text begin as determined by the commissioner before enrollment as a provider. Personal care new text end 250.23 new text begin assistance provider agencies are required to send all owners, qualified professionals new text end 250.24 new text begin employed by the agency, and all other managing employees to the initial and subsequent new text end 250.25 new text begin trainings. Personal care assistance provider agency billing staff shall complete training new text end 250.26 new text begin about personal care assistance program financial management. This training is effective new text end 250.27 new text begin upon enactment of this section. Any personal care assistance provider agency enrolled new text end 250.28 new text begin before that date shall, if it has not already, complete the provider training within 18 months new text end 250.29 new text begin of the effective date of this section. Any new owners, new qualified professionals, and new new text end 250.30 new text begin managing employees are required to complete mandatory training as a requisite of hiring. new text end 250.31     new text begin Subd. 22. new text end new text begin Annual review for personal care providers. new text end new text begin (a) All personal care new text end 250.32 new text begin assistance provider agencies shall resubmit, on an annual basis, the information specified new text end 250.33 new text begin in subdivision 21, in a format determined by the commissioner, and provide a copy of the new text end 250.34 new text begin personal care assistance provider agency's most current version of its grievance policies new text end 250.35 new text begin and procedures along with a written record of grievances and resolutions of the grievances new text end 251.1 new text begin that the personal care assistance provider agency has received in the previous year and any new text end 251.2 new text begin other information requested by the commissioner. new text end 251.3 new text begin (b) The commissioner shall send annual review notification to personal care new text end 251.4 new text begin assistance provider agencies 30 days prior to renewal. The notification must: new text end 251.5 new text begin (1) list the materials and information the personal care assistance provider agency is new text end 251.6 new text begin required to submit; new text end 251.7 new text begin (2) provide instructions on submitting information to the commissioner; and new text end 251.8 new text begin (3) provide a due date by which the commissioner must receive the requested new text end 251.9 new text begin information. new text end 251.10 new text begin Personal care assistance provider agencies shall submit required documentation for new text end 251.11 new text begin annual review within 30 days of notification from the commissioner. If no documentation new text end 251.12 new text begin is submitted, the personal care assistance provider agency enrollment number must be new text end 251.13 new text begin terminated or suspended. new text end 251.14 new text begin (c) Personal care assistance provider agencies also currently licensed under new text end 251.15 new text begin Minnesota Rules, part 4668.0012, as a class A provider or currently certified for new text end 251.16 new text begin participation in Medicare as a home health agency are deemed in compliance with new text end 251.17 new text begin the personal care assistance requirements for enrollment, annual review process, and new text end 251.18 new text begin documentation. new text end 251.19     new text begin Subd. 23. new text end new text begin Enrollment requirements following termination. new text end new text begin (a) A terminated new text end 251.20 new text begin personal care assistance provider agency, including all named individuals on the current new text end 251.21 new text begin enrollment disclosure form and known or discovered affiliates of the personal care new text end 251.22 new text begin assistance provider agency, is not eligible to enroll as a personal care assistance provider new text end 251.23 new text begin agency for two years following the termination. new text end 251.24 new text begin (b) After the two-year period in paragraph (a), if the provider seeks to reenroll new text end 251.25 new text begin as a personal care assistance provider agency, the personal care assistance provider new text end 251.26 new text begin agency must be placed on a one-year probation period, beginning after completion of new text end 251.27 new text begin the following: new text end 251.28 new text begin (1) the department's provider trainings under this section; and new text end 251.29 new text begin (2) initial enrollment requirements under subdivision 21. new text end 251.30 new text begin (c) During the probationary period the commissioner shall complete site visits and new text end 251.31 new text begin request submission of documentation to review compliance with program policy. new text end 251.32     new text begin Subd. 24. new text end new text begin Personal care assistance provider agency; general duties. new text end new text begin A personal new text end 251.33 new text begin care assistance provider agency shall: new text end 251.34 new text begin (1) enroll as a Medicaid provider meeting all provider standards, including new text end 251.35 new text begin completion of the required provider training; new text end 251.36 new text begin (2) comply with general medical assistance coverage requirements; new text end 252.1 new text begin (3) demonstrate compliance with law and policies of the personal care assistance new text end 252.2 new text begin program to be determined by the commissioner; new text end 252.3 new text begin (4) comply with background study requirements; new text end 252.4 new text begin (5) verify and keep records of hours worked by the personal care assistant and new text end 252.5 new text begin qualified professional; new text end 252.6 new text begin (6) market agency services only through printed information in brochures and on new text end 252.7 new text begin Web sites and not engage in any agency-initiated direct contact or marketing in person, by new text end 252.8 new text begin phone, or other electronic means to potential recipients, guardians, or family members; new text end 252.9 new text begin (7) pay the personal care assistant and qualified professional based on actual hours new text end 252.10 new text begin of services provided; new text end 252.11 new text begin (8) withhold and pay all applicable federal and state taxes; new text end 252.12 new text begin (9) effective January 1, 2010, document that the agency uses a minimum of 72.5 new text end 252.13 new text begin percent of the revenue generated by the medical assistance rate for personal care assistance new text end 252.14 new text begin services for employee personal care assistant wages and benefits; new text end 252.15 new text begin (10) make the arrangements and pay unemployment insurance, taxes, workers' new text end 252.16 new text begin compensation, liability insurance, and other benefits, if any; new text end 252.17 new text begin (11) enter into a written agreement under subdivision 20 before services are provided; new text end 252.18 new text begin (12) report suspected neglect and abuse to the common entry point according to new text end 252.19 new text begin section 256B.0651; new text end 252.20 new text begin (13) provide the recipient with a copy of the home care bill of rights at start of new text end 252.21 new text begin service; and new text end 252.22     new text begin (14) request reassessments at least 60 days prior to the end of the current new text end 252.23 new text begin authorization for personal care assistance services, on forms provided by the commissioner. new text end 252.24     new text begin Subd. 25. new text end new text begin Personal care assistance provider agency; background studies. new text end 252.25 new text begin Personal care assistance provider agencies enrolled to provide personal care assistance new text end 252.26 new text begin services under the medical assistance program shall comply with the following: new text end 252.27 new text begin (1) owners who have a five percent interest or more and all managing employees new text end 252.28 new text begin are subject to a background study as provided in chapter 245C. This applies to currently new text end 252.29 new text begin enrolled personal care assistance provider agencies and those agencies seeking enrollment new text end 252.30 new text begin as a personal care assistance provider agency. Managing employee has the same meaning new text end 252.31 new text begin as Code of Federal Regulations, title 42, section 455. An organization is barred from new text end 252.32 new text begin enrollment if: new text end 252.33 new text begin (i) the organization has not initiated background studies on owners and managing new text end 252.34 new text begin employees; or new text end 252.35 new text begin (ii) the organization has initiated background studies on owners and managing new text end 252.36 new text begin employees, but the commissioner has sent the organization a notice that an owner or new text end 253.1 new text begin managing employee of the organization has been disqualified under section 245C.14, new text end 253.2 new text begin and the owner or managing employee has not received a set aside of the disqualification new text end 253.3 new text begin under section 245C.22; new text end 253.4 new text begin (2) a background study must be initiated and completed for all qualified new text end 253.5 new text begin professionals; and new text end 253.6 new text begin (3) a background study must be initiated and completed for all personal care new text end 253.7 new text begin assistants. new text end 253.8     new text begin Subd. 26. new text end new text begin Personal care assistance provider agency; communicable disease new text end 253.9 new text begin prevention. new text end new text begin A personal care assistance provider agency shall establish and implement new text end 253.10 new text begin policies and procedures for prevention, control, and investigation of infections and new text end 253.11 new text begin communicable diseases according to current nationally recognized infection control new text end 253.12 new text begin practices or guidelines established by the United States Centers for Disease Control and new text end 253.13 new text begin Prevention, as well as applicable regulations of other federal or state agencies. new text end 253.14     new text begin Subd. 27. new text end new text begin Personal care assistance provider agency; ventilator training. new text end new text begin The new text end 253.15 new text begin personal care assistance provider agency is required to provide training for the personal new text end 253.16 new text begin care assistant responsible for working with a recipient who is ventilator dependent. All new text end 253.17 new text begin training must be administered by a respiratory therapist, nurse, or physician. Qualified new text end 253.18 new text begin professional supervision by a nurse must be completed and documented on file in the new text end 253.19 new text begin personal care assistant's employment record and the recipient's health record. If offering new text end 253.20 new text begin personal care services to a ventilator-dependent recipient, the personal care assistance new text end 253.21 new text begin provider agency shall demonstrate the ability to: new text end 253.22 new text begin (1) train the personal care assistant; new text end 253.23 new text begin (2) supervise the personal care assistant in ventilator operation and maintenance; and new text end 253.24 new text begin (3) supervise the recipient and responsible party in ventilator operation and new text end 253.25 new text begin maintenance. new text end 253.26     new text begin Subd. 28. new text end new text begin Personal care assistance provider agency; required documentation. new text end 253.27 new text begin Required documentation must be completed and kept in the personal care assistance new text end 253.28 new text begin provider agency file or the recipient's home residence. The required documentation new text end 253.29 new text begin consists of: new text end 253.30 new text begin (1) employee files, including: new text end 253.31 new text begin (i) applications for employment; new text end 253.32 new text begin (ii) background study requests and results; new text end 253.33 new text begin (iii) orientation records about the agency policies; new text end 253.34 new text begin (iv) trainings completed with demonstration of competence; new text end 253.35 new text begin (v) supervisory visits; new text end 254.1 new text begin (vi) evaluations of employment; and new text end 254.2 new text begin (vii) signature on fraud statement; new text end 254.3 new text begin (2) recipient files, including: new text end 254.4 new text begin (i) demographics; new text end 254.5 new text begin (ii) emergency contact information and emergency backup plan; new text end 254.6 new text begin (iii) personal care assistance service plan; new text end 254.7 new text begin (iv) personal care assistance care plan; new text end 254.8 new text begin (v) month-to-month service use plan; new text end 254.9 new text begin (vi) all communication records; new text end 254.10 new text begin (vii) start of service information, including the written agreement with recipient; and new text end 254.11 new text begin (viii) date the home care bill of rights was given to the recipient; new text end 254.12 new text begin (3) agency policy manual, including: new text end 254.13 new text begin (i) policies for employment and termination; new text end 254.14 new text begin (ii) grievance policies with resolution of consumer grievances; new text end 254.15 new text begin (iii) staff and consumer safety; new text end 254.16 new text begin (iv) staff misconduct; and new text end 254.17 new text begin (v) staff hiring, service delivery, staff and consumer safety, staff misconduct, and new text end 254.18 new text begin resolution of consumer grievances; new text end 254.19 new text begin (4) time sheets for each personal care assistant along with completed activity sheets new text end 254.20 new text begin for each recipient served; and new text end 254.21 new text begin (5) agency marketing and advertising materials and documentation of marketing new text end 254.22 new text begin activities and costs. new text end 254.23     new text begin Subd. 29. new text end new text begin Transitional assistance. new text end new text begin The commissioner, counties, health plans, new text end 254.24 new text begin tribes, and personal care assistance providers shall work together to provide transitional new text end 254.25 new text begin assistance for recipients and families to come into compliance with the new requirements new text end 254.26 new text begin of this section and ensure the personal care assistance services are not provided by the new text end 254.27 new text begin housing provider. new text end 254.28     new text begin Subd. 30. new text end new text begin Notice of service changes to recipients. new text end new text begin The commissioner must provide: new text end 254.29 new text begin (1) by October 31, 2009, information to recipients likely to be affected that (i) new text end 254.30 new text begin describes the changes to the personal care assistance program that may result in the new text end 254.31 new text begin loss of access to personal care assistance services, and (ii) includes resources to obtain new text end 254.32 new text begin further information; and new text end 254.33 new text begin (2) notice of changes in medical assistance home care services to each affected new text end 254.34 new text begin recipient at least 30 days before the effective date of the change. new text end 254.35 new text begin The notice shall include how to get further information on the changes, how to get help to new text end 254.36 new text begin obtain other services, a list of community resources, and appeal rights. Notwithstanding new text end 255.1 new text begin section 256.045, a recipient may request continued services pending appeal within the new text end 255.2 new text begin time period allowed to request an appeal. new text end 255.3 new text begin EFFECTIVE DATE. new text end new text begin Subdivisions 4, 22, and 27 are effective January 1, 2010. new text end 255.4    Sec. 32. Minnesota Statutes 2008, section 256B.0911, subdivision 1, is amended to 255.5read: 255.6    Subdivision 1. Purpose and goal. (a) The purpose of long-term care consultation 255.7services is to assist persons with long-term or chronic care needs in making long-term 255.8care decisions and selecting options that meet their needs and reflect their preferences. 255.9The availability of, and access to, information and other types of assistance new text begin , including new text end 255.10 new text begin assessment and support planning, new text end is also intended to prevent or delay certified nursing 255.11facility placements and to provide transition assistance after admission. Further, the goal 255.12of these services is to contain costs associated with unnecessary certified nursing facility 255.13admissions. new text begin Long-term consultation services must be available to any person regardless new text end 255.14 new text begin of public program eligibility. new text end The commissioners new text begin commissioner new text end of human services and 255.15health shall seek to maximize use of available federal and state funds and establish the 255.16broadest program possible within the funding available. 255.17(b) These services must be coordinated with services new text begin long-term care options new text end 255.18 new text begin counseling new text end provided under section 256.975, subdivision 7, and with services provided by 255.19other public and private agencies in the community new text begin section 256.01, subdivision 24, for new text end 255.20 new text begin telephone assistance and follow up and new text end to offer a variety of cost-effective alternatives to 255.21persons with disabilities and elderly persons. The county new text begin or tribal new text end agency new text begin or managed new text end 255.22 new text begin care plan new text end providing long-term care consultation services shall encourage the use of 255.23volunteers from families, religious organizations, social clubs, and similar civic and 255.24service organizations to provide community-based services. 255.25    Sec. 33. Minnesota Statutes 2008, section 256B.0911, subdivision 1a, is amended to 255.26read: 255.27    Subd. 1a. Definitions. For purposes of this section, the following definitions apply: 255.28(a) "Long-term care consultation services" means: 255.29(1) providing information and education to the general public regarding availability 255.30of the services authorized under this section; 255.31(2) an intake process that provides access to the services described in this section; 255.32(3) assessment of the health, psychological, and social needs of referred individuals; 255.33(4) assistance in identifying services needed to maintain an individual in the least 255.34restrictive new text begin most inclusive new text end environment; 256.1(5) new text begin (2) new text end providing recommendations on cost-effective community services that are 256.2available to the individual; 256.3(6) new text begin (3) new text end development of an individual's new text begin person-centered new text end community support plan; 256.4(7) new text begin (4) new text end providing information regarding eligibility for Minnesota health care 256.5programs; 256.6 new text begin (5) face-to-face long-term care consultation assessments, which may be completed new text end 256.7 new text begin in a hospital, nursing facility, intermediate care facility for persons with developmental new text end 256.8 new text begin disabilities (ICF/DDs), regional treatment centers, or the person's current or planned new text end 256.9 new text begin residence; new text end 256.10(8) preadmission new text begin (6) federally mandated new text end screening to determine the need for 256.11a nursing facility new text begin institutional new text end level of care new text begin under section 256B.0911, subdivision 4, new text end 256.12 new text begin paragraph (a) new text end ; 256.13(9) preliminary new text begin (7) new text end determination of Minnesota health care programs new text begin home and new text end 256.14 new text begin community-based waiver service new text end eligibility new text begin including level of care determination new text end for 256.15individuals who need a nursing facility new text begin an institutional new text end level of care new text begin as defined under new text end 256.16 new text begin section 144.0724, subdivision 11, or 256B.092 new text end , new text begin service eligibility including state plan new text end 256.17 new text begin home care services identified in section 256B.0625, subdivisions 6, 7, and 19, paragraphs new text end 256.18 new text begin (a) and (c), based on assessment and support plan development new text end with appropriate referrals 256.19for final determination; 256.20(10) new text begin (8) new text end providing recommendations for nursing facility placement when there are 256.21no cost-effective community services available; and 256.22(11) new text begin (9) new text end assistance to transition people back to community settings after facility 256.23admission. 256.24 new text begin (b) "Long-term options counseling" means the services provided by the linkage new text end 256.25 new text begin lines as mandated by sections 256.01 and 256.975, subdivision 7, and also includes new text end 256.26 new text begin telephone assistance and follow up once a long-term care consultation assessment has new text end 256.27 new text begin been completed. new text end 256.28(b) new text begin (c) new text end "Minnesota health care programs" means the medical assistance program 256.29under chapter 256B and the alternative care program under section 256B.0913. 256.30 new text begin (d) "Lead agencies" means counties or a collaboration of counties, tribes, and health new text end 256.31 new text begin plans administering long-term care consultation assessment and support planning services. new text end 256.32 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2011. new text end 256.33    Sec. 34. Minnesota Statutes 2008, section 256B.0911, is amended by adding a 256.34subdivision to read: 257.1     new text begin Subd. 2b. new text end new text begin Certified assessors. new text end new text begin (a) Beginning January 1, 2011, each lead agency new text end 257.2 new text begin shall use certified assessors who have completed training and certification process new text end 257.3 new text begin determined by the commissioner in subdivision 2c. Certified assessors shall demonstrate new text end 257.4 new text begin best practices in assessment and support planning including person-centered planning new text end 257.5 new text begin principals and have a common set of skills that must ensure consistency and equitable new text end 257.6 new text begin access to services statewide. Assessors must be part of a multidisciplinary team of new text end 257.7 new text begin professionals that includes public health nurses, social workers, and other professionals new text end 257.8 new text begin as defined in paragraph (b). For persons with complex health care needs, a public health new text end 257.9 new text begin nurse or registered nurse from a multidisciplinary team must be consulted. new text end 257.10 new text begin (b) Certified assessors are persons with a minimum of a bachelor's degree in social new text end 257.11 new text begin work, nursing with a public health nursing certificate, or other closely related field with at new text end 257.12 new text begin least one year of home and community-based experience or a two-year registered nursing new text end 257.13 new text begin degree with at least three years of home and community-based experience that have new text end 257.14 new text begin received training and certification specific to assessment and consultation for long-term new text end 257.15 new text begin care services in the state. new text end 257.16    Sec. 35. Minnesota Statutes 2008, section 256B.0911, is amended by adding a 257.17subdivision to read: 257.18     new text begin Subd. 2c. new text end new text begin Assessor training and certification. new text end new text begin The commissioner shall develop a new text end 257.19 new text begin curriculum and an assessor certification process to begin no later than January 1, 2010. new text end 257.20 new text begin All existing lead agency staff designated to provide the services defined in subdivision new text end 257.21 new text begin 1a must be certified by December 30, 2010. Each lead agency is required to ensure that new text end 257.22 new text begin they have sufficient numbers of certified assessors to provide long-term consultation new text end 257.23 new text begin assessment and support planning within the timelines and parameters of the service by new text end 257.24 new text begin January 1, 2011. Certified assessors are required to be recertified every three years. new text end 257.25    Sec. 36. Minnesota Statutes 2008, section 256B.0911, subdivision 3, is amended to 257.26read: 257.27    Subd. 3. Long-term care consultation team. (a) new text begin Until January 1, 2011, new text end a long-term 257.28care consultation team shall be established by the county board of commissioners. Each 257.29local consultation team shall consist of at least one social worker and at least one public 257.30health nurse from their respective county agencies. The board may designate public 257.31health or social services as the lead agency for long-term care consultation services. If a 257.32county does not have a public health nurse available, it may request approval from the 257.33commissioner to assign a county registered nurse with at least one year experience in 258.1home care to participate on the team. Two or more counties may collaborate to establish 258.2a joint local consultation team or teams. 258.3(b) The team is responsible for providing long-term care consultation services to 258.4all persons located in the county who request the services, regardless of eligibility for 258.5Minnesota health care programs. 258.6 new text begin (c) The commissioner shall allow arrangements and make recommendations that new text end 258.7 new text begin encourage counties to collaborate to establish joint local long-term care consultation teams new text end 258.8 new text begin to ensure that long-term care consultations are done within the timelines and parameters new text end 258.9 new text begin of the service. This includes integrated service models as required in subdivision 1, new text end 258.10 new text begin paragraph (b). new text end 258.11    Sec. 37. Minnesota Statutes 2008, section 256B.0911, subdivision 3a, is amended to 258.12read: 258.13    Subd. 3a. Assessment and support planning. (a) Persons requesting assessment, 258.14services planning, or other assistance intended to support community-based living, 258.15including persons who need assessment in order to determine waiver or alternative 258.16care program eligibility, must be visited by a long-term care consultation team within 258.17ten working new text begin 15 calendar new text end days after the date on which an assessment was requested or 258.18recommended. new text begin After January 1, 2011, these requirements also apply to personal care new text end 258.19 new text begin assistance services, private duty nursing, and home health agency services, on timelines new text end 258.20 new text begin established in subdivision 5. Face-to-face new text end assessments must be conducted according 258.21to paragraphs (b) to (i). 258.22    (b) The county may utilize a team of either the social worker or public health nurse, 258.23or both, new text begin . After January 1, 2011, lead agencies shall use certified assessors new text end to conduct the 258.24assessment in a face-to-face interview. The consultation team members must confer 258.25regarding the most appropriate care for each individual screened or assessed. 258.26    (c) The long-term care consultation team must assess the health and social needs of 258.27the person new text begin assessment must be comprehensive and include a person-centered assessment new text end 258.28 new text begin of the health, psychological, functional, environmental, and social needs of referred new text end 258.29 new text begin individuals and provide information necessary to develop a support plan that meets the new text end 258.30 new text begin consumers needs new text end , using an assessment form provided by the commissioner. 258.31    (d) The team must conduct the assessment new text begin must be conducted new text end in a face-to-face 258.32interview with the person being assessed and the person's legal representative, if applicable new text begin new text end 258.33 new text begin as required by legally executed documents, and other individuals as requested by the new text end 258.34 new text begin person, who can provide information on the needs, strengths, and preferences of the new text end 259.1 new text begin person necessary to develop a support plan that ensures the person's health and safety, but new text end 259.2 new text begin who is not a provider of service or has any financial interest in the provision of services new text end . 259.3    (e) The team must provide the person, or the person's legal representative, new text begin must new text end 259.4 new text begin be provided new text end with written recommendations for facility- or community-based services. 259.5The team must document new text begin or institutional care that include documentation new text end that the most 259.6cost-effective alternatives available were offered to the individual. For purposes of 259.7this requirement, "cost-effective alternatives" means community services and living 259.8arrangements that cost the same as or less than nursing facility new text begin institutional new text end care. 259.9    (f) If the person chooses to use community-based services, the team must provide 259.10the person or the person's legal representative new text begin must be provided new text end with a written community 259.11support plan, regardless of whether the individual is eligible for Minnesota health care 259.12programs. The new text begin A new text end person may request assistance in developing a community support plan 259.13 new text begin identifying community supports new text end without participating in a complete assessment. new text begin Upon new text end 259.14 new text begin a request for assistance identifying community support, the person must be transferred new text end 259.15 new text begin or referred to the services available under sections 256.975, subdivision 7, and 256.01, new text end 259.16 new text begin subdivision 24, for telephone assistance and follow up. new text end 259.17    (g) The person has the right to make the final decision between nursing 259.18facility new text begin institutional new text end placement and community placement after the screening team's 259.19recommendation new text begin recommendations have been provided new text end , except as provided in subdivision 259.204a, paragraph (c). 259.21    (h) The team must give the person receiving assessment or support planning, or 259.22the person's legal representative, materials, and forms supplied by the commissioner 259.23containing the following information: 259.24    (1) the need for and purpose of preadmission screening if the person selects nursing 259.25facility placement; 259.26    (2) the role of the long-term care consultation assessment and support planning in 259.27waiver and alternative care program eligibility determination; 259.28    (3) information about Minnesota health care programs; 259.29    (4) the person's freedom to accept or reject the recommendations of the team; 259.30    (5) the person's right to confidentiality under the Minnesota Government Data 259.31Practices Act, chapter 13; 259.32    (6) the long-term care consultant's decision regarding the person's need for nursing 259.33facility new text begin institutional new text end level of care new text begin as determined under criteria established in section new text end 259.34 new text begin 144.0724, subdivision 11, or 256B.092 new text end ; and 260.1    (7) the person's right to appeal the decision regarding the need for nursing facility 260.2level of care or the county's final decisions regarding public programs eligibility according 260.3to section 256.045, subdivision 3. 260.4    (i) Face-to-face assessment completed as part of eligibility determination for 260.5the alternative care, elderly waiver, community alternatives for disabled individuals, 260.6community alternative care, and traumatic brain injury waiver programs under sections 260.7256B.0915 , 256B.0917, and 256B.49 is valid to establish service eligibility for no more 260.8than 60 calendar days after the date of assessment. The effective eligibility start date 260.9for these programs can never be prior to the date of assessment. If an assessment was 260.10completed more than 60 days before the effective waiver or alternative care program 260.11eligibility start date, assessment and support plan information must be updated in a 260.12face-to-face visit and documented in the department's Medicaid Management Information 260.13System (MMIS). The effective date of program eligibility in this case cannot be prior to 260.14the date the updated assessment is completed. 260.15    Sec. 38. Minnesota Statutes 2008, section 256B.0911, subdivision 3b, is amended to 260.16read: 260.17    Subd. 3b. Transition assistance. (a) A long-term care consultation team shall 260.18provide assistance to persons residing in a nursing facility, hospital, regional treatment 260.19center, or intermediate care facility for persons with developmental disabilities who 260.20request or are referred for assistance. Transition assistance must include assessment, 260.21community support plan development, referrals new text begin to long-term care options counseling new text end 260.22 new text begin under section 256B.975, subdivision 10, for community support plan implementation and new text end 260.23to Minnesota health care programs, and referrals to programs that provide assistance 260.24with housing. Transition assistance must also include information about the Centers for 260.25Independent Living new text begin and the Senior LinkAge Line, new text end and about other organizations that 260.26can provide assistance with relocation efforts, and information about contacting these 260.27organizations to obtain their assistance and support. 260.28    (b) The county shall develop transition processes with institutional social workers 260.29and discharge planners to ensure that: 260.30    (1) persons admitted to facilities receive information about transition assistance 260.31that is available; 260.32    (2) the assessment is completed for persons within ten working days of the date of 260.33request or recommendation for assessment; and 260.34    (3) there is a plan for transition and follow-up for the individual's return to the 260.35community. The plan must require notification of other local agencies when a person 261.1who may require assistance is screened by one county for admission to a facility located 261.2in another county. 261.3    (c) If a person who is eligible for a Minnesota health care program is admitted to a 261.4nursing facility, the nursing facility must include a consultation team member or the case 261.5manager in the discharge planning process. 261.6    Sec. 39. Minnesota Statutes 2008, section 256B.0911, subdivision 3c, is amended to 261.7read: 261.8    Subd. 3c. Transition to housing with services. (a) Housing with services 261.9establishments offering or providing assisted living under chapter 144G shall inform 261.10all prospective residents of the availability of and contact information for transitional 261.11consultation services under this subdivision prior to executing a lease or contract with the 261.12prospective resident. The purpose of transitional long-term care consultation is to support 261.13persons with current or anticipated long-term care needs in making informed choices 261.14among options that include the most cost-effective and least restrictive settings, and to 261.15delay spenddown to eligibility for publicly funded programs by connecting people to 261.16alternative services in their homes before transition to housing with services. Regardless 261.17of the consultation, prospective residents maintain the right to choose housing with 261.18services or assisted living if that option is their preference. 261.19    (b) Transitional consultation services are provided as determined by the 261.20commissioner of human services in partnership with county long-term care consultation 261.21units, and the Area Agencies on Aging, and are a combination of telephone-based 261.22and in-person assistance provided under models developed by the commissioner. The 261.23consultation shall be performed in a manner that provides objective and complete 261.24information. Transitional consultation must be provided within five working days of the 261.25request of the prospective resident as follows: 261.26    (1) the consultation must be provided by a qualified professional as determined by 261.27the commissioner; 261.28    (2) the consultation must include a review of the prospective resident's reasons for 261.29considering assisted living, the prospective resident's personal goals, a discussion of the 261.30prospective resident's immediate and projected long-term care needs, and alternative 261.31community services or assisted living settings that may meet the prospective resident's 261.32needs; and 261.33    (3) the prospective resident shall be informed of the availability of long-term care 261.34consultation services described in subdivision 3a that are available at no charge to the 261.35prospective resident to assist the prospective resident in assessment and planning to meet 262.1the prospective resident's long-term care needs. new text begin The Senior LinkAge Line and long-term new text end 262.2 new text begin care consultation team shall give the highest priority to referrals who are at highest risk of new text end 262.3 new text begin nursing facility placement or as needed for determining eligibility. new text end 262.4    Sec. 40. Minnesota Statutes 2008, section 256B.0911, subdivision 4a, is amended to 262.5read: 262.6    Subd. 4a. Preadmission screening activities related to nursing facility 262.7admissions. (a) All applicants to Medicaid certified nursing facilities, including certified 262.8boarding care facilities, must be screened prior to admission regardless of income, assets, 262.9or funding sources for nursing facility care, except as described in subdivision 4b. The 262.10purpose of the screening is to determine the need for nursing facility level of care as 262.11described in paragraph (d) and to complete activities required under federal law related to 262.12mental illness and developmental disability as outlined in paragraph (b). 262.13(b) A person who has a diagnosis or possible diagnosis of mental illness or 262.14developmental disability must receive a preadmission screening before admission 262.15regardless of the exemptions outlined in subdivision 4b, paragraph (b), to identify the need 262.16for further evaluation and specialized services, unless the admission prior to screening is 262.17authorized by the local mental health authority or the local developmental disabilities case 262.18manager, or unless authorized by the county agency according to Public Law 101-508. 262.19The following criteria apply to the preadmission screening: 262.20(1) the county must use forms and criteria developed by the commissioner to identify 262.21persons who require referral for further evaluation and determination of the need for 262.22specialized services; and 262.23(2) the evaluation and determination of the need for specialized services must be 262.24done by: 262.25(i) a qualified independent mental health professional, for persons with a primary or 262.26secondary diagnosis of a serious mental illness; or 262.27(ii) a qualified developmental disability professional, for persons with a primary or 262.28secondary diagnosis of developmental disability. For purposes of this requirement, a 262.29qualified developmental disability professional must meet the standards for a qualified 262.30developmental disability professional under Code of Federal Regulations, title 42, section 262.31483.430 . 262.32(c) The local county mental health authority or the state developmental disability 262.33authority under Public Law Numbers 100-203 and 101-508 may prohibit admission to a 262.34nursing facility if the individual does not meet the nursing facility level of care criteria or 262.35needs specialized services as defined in Public Law Numbers 100-203 and 101-508. For 263.1purposes of this section, "specialized services" for a person with developmental disability 263.2means active treatment as that term is defined under Code of Federal Regulations, title 263.342, section 483.440 (a)(1). 263.4(d) The determination of the need for nursing facility level of care must be made 263.5according to criteria new text begin established in section 144.0724, subdivision 11, and 256B.092, new text end 263.6 new text begin using forms new text end developed by the commissioner. In assessing a person's needs, consultation 263.7team members shall have a physician available for consultation and shall consider the 263.8assessment of the individual's attending physician, if any. The individual's physician must 263.9be included if the physician chooses to participate. Other personnel may be included on 263.10the team as deemed appropriate by the county. 263.11 new text begin EFFECTIVE DATE. new text end new text begin The section is effective January 1, 2011. new text end 263.12    Sec. 41. Minnesota Statutes 2008, section 256B.0911, subdivision 5, is amended to 263.13read: 263.14    Subd. 5. Administrative activity. The commissioner shall minimize the number 263.15of forms required in the provision of long-term care consultation services and shall 263.16limit the screening document to items necessary for community support plan approval, 263.17reimbursement, program planning, evaluation, and policy development new text begin streamline the new text end 263.18 new text begin processes, including timelines for when assessments need to be completed, required to new text end 263.19 new text begin provide the services in this section and shall implement integrated solutions to automate new text end 263.20 new text begin the business processes to the extent necessary for community support plan approval, new text end 263.21 new text begin reimbursement, program planning, evaluation, and policy development new text end . 263.22    Sec. 42. Minnesota Statutes 2008, section 256B.0911, subdivision 6, is amended to 263.23read: 263.24    Subd. 6. Payment for long-term care consultation services. (a) The total payment 263.25for each county must be paid monthly by certified nursing facilities in the county. The 263.26monthly amount to be paid by each nursing facility for each fiscal year must be determined 263.27by dividing the county's annual allocation for long-term care consultation services by 12 263.28to determine the monthly payment and allocating the monthly payment to each nursing 263.29facility based on the number of licensed beds in the nursing facility. Payments to counties 263.30in which there is no certified nursing facility must be made by increasing the payment 263.31rate of the two facilities located nearest to the county seat. 263.32    (b) The commissioner shall include the total annual payment determined under 263.33paragraph (a) for each nursing facility reimbursed under section 256B.431 or 256B.434 263.34according to section 256B.431, subdivision 2b, paragraph (g). 264.1    (c) In the event of the layaway, delicensure and decertification, or removal from 264.2layaway of 25 percent or more of the beds in a facility, the commissioner may adjust 264.3the per diem payment amount in paragraph (b) and may adjust the monthly payment 264.4amount in paragraph (a). The effective date of an adjustment made under this paragraph 264.5shall be on or after the first day of the month following the effective date of the layaway, 264.6delicensure and decertification, or removal from layaway. 264.7    (d) Payments for long-term care consultation services are available to the county 264.8or counties to cover staff salaries and expenses to provide the services described in 264.9subdivision 1a. The county shall employ, or contract with other agencies to employ, within 264.10the limits of available funding, sufficient personnel to provide long-term care consultation 264.11services while meeting the state's long-term care outcomes and objectives as defined in 264.12section 256B.0917, subdivision 1. The county shall be accountable for meeting local 264.13objectives as approved by the commissioner in the biennial home and community-based 264.14services quality assurance plan on a form provided by the commissioner. 264.15    (e) Notwithstanding section 256B.0641, overpayments attributable to payment of the 264.16screening costs under the medical assistance program may not be recovered from a facility. 264.17    (f) The commissioner of human services shall amend the Minnesota medical 264.18assistance plan to include reimbursement for the local consultation teams. 264.19    (g) The county may bill, as case management services, assessments, support 264.20planning, and follow-along provided to persons determined to be eligible for case 264.21management under Minnesota health care programs. No individual or family member 264.22shall be charged for an initial assessment or initial support plan development provided 264.23under subdivision 3a or 3b. 264.24 new text begin (h) The commissioner shall develop an alternative payment methodology for new text end 264.25 new text begin long-term care consultation services that includes the funding available under this new text end 264.26 new text begin subdivision, and sections 256B.092 and 256B.0659. In developing the new payment new text end 264.27 new text begin methodology, the commissioner shall consider the maximization of federal funding for new text end 264.28 new text begin this activity. new text end 264.29    Sec. 43. Minnesota Statutes 2008, section 256B.0911, subdivision 7, is amended to 264.30read: 264.31    Subd. 7. Reimbursement for certified nursing facilities. (a) Medical assistance 264.32reimbursement for nursing facilities shall be authorized for a medical assistance recipient 264.33only if a preadmission screening has been conducted prior to admission or the county has 264.34authorized an exemption. Medical assistance reimbursement for nursing facilities shall 264.35not be provided for any recipient who the local screener has determined does not meet the 265.1level of care criteria for nursing facility placement new text begin in section 144.0724, subdivision 11, new text end or, 265.2if indicated, has not had a level II OBRA evaluation as required under the federal Omnibus 265.3Budget Reconciliation Act of 1987 completed unless an admission for a recipient with 265.4mental illness is approved by the local mental health authority or an admission for a 265.5recipient with developmental disability is approved by the state developmental disability 265.6authority. 265.7    (b) The nursing facility must not bill a person who is not a medical assistance 265.8recipient for resident days that preceded the date of completion of screening activities as 265.9required under subdivisions 4a, 4b, and 4c. The nursing facility must include unreimbursed 265.10resident days in the nursing facility resident day totals reported to the commissioner. 265.11 new text begin EFFECTIVE DATE. new text end new text begin The section is effective January 1, 2011. new text end 265.12    Sec. 44. Minnesota Statutes 2008, section 256B.0913, subdivision 4, is amended to 265.13read: 265.14    Subd. 4. Eligibility for funding for services for nonmedical assistance recipients. 265.15    (a) Funding for services under the alternative care program is available to persons who 265.16meet the following criteria: 265.17    (1) the person has been determined by a community assessment under section 265.18256B.0911 to be a person who would require the level of care provided in a nursing 265.19facility, but for the provision of services under the alternative care program new text begin . Effective new text end 265.20 new text begin January 1, 2011, this determination must be made according to the criteria established in new text end 265.21 new text begin section 144.0724, subdivision 11 new text end ; 265.22    (2) the person is age 65 or older; 265.23    (3) the person would be eligible for medical assistance within 135 days of admission 265.24to a nursing facility; 265.25    (4) the person is not ineligible for the payment of long-term care services by the 265.26medical assistance program due to an asset transfer penalty under section 256B.0595 or 265.27equity interest in the home exceeding $500,000 as stated in section 256B.056; 265.28    (5) the person needs long-term care services that are not funded through other state 265.29or federal funding; 265.30    (6) new text begin except for individuals described in clause (7), new text end the monthly cost of the alternative 265.31care services funded by the program for this person does not exceed 75 percent of the 265.32monthly limit described under section 256B.0915, subdivision 3a. This monthly limit 265.33does not prohibit the alternative care client from payment for additional services, but in no 265.34case may the cost of additional services purchased under this section exceed the difference 265.35between the client's monthly service limit defined under section 256B.0915, subdivision 266.13 , and the alternative care program monthly service limit defined in this paragraph. If 266.2care-related supplies and equipment or environmental modifications and adaptations are or 266.3will be purchased for an alternative care services recipient, the costs may be prorated on a 266.4monthly basis for up to 12 consecutive months beginning with the month of purchase. 266.5If the monthly cost of a recipient's other alternative care services exceeds the monthly 266.6limit established in this paragraph, the annual cost of the alternative care services shall be 266.7determined. In this event, the annual cost of alternative care services shall not exceed 12 266.8times the monthly limit described in this paragraph; and 266.9    (7) new text begin for individuals assigned a case mix classification A as described under section new text end 266.10 new text begin 256B.0915, subdivision 3a, paragraph (a), with (i) no dependencies in activities of daily new text end 266.11 new text begin living, (ii) only one dependency in bathing, dressing, grooming, or walking, or (iii) a new text end 266.12 new text begin dependency score of less than three if eating is the only dependency as determined by an new text end 266.13 new text begin assessment performed under section 256B.0911, the monthly cost of alternative care new text end 266.14 new text begin services funded by the program cannot exceed $600 per month for all new participants new text end 266.15 new text begin enrolled in the program on or after July 1, 2009. This monthly limit shall be applied to new text end 266.16 new text begin all other participants who meet this criteria at reassessment. This monthly limit shall be new text end 266.17 new text begin increased annually as described in section 256B.0915, subdivision 3a, paragraph (a). This new text end 266.18 new text begin monthly limit does not prohibit the alternative care client from payment for additional new text end 266.19 new text begin services, but in no case may the cost of additional services purchased exceed the difference new text end 266.20 new text begin between the client's monthly service limit defined in this clause and the limit described in new text end 266.21 new text begin clause (6) for case mix classification A; and new text end 266.22 new text begin (8) new text end the person is making timely payments of the assessed monthly fee. 266.23A person is ineligible if payment of the fee is over 60 days past due, unless the person 266.24agrees to: 266.25    (i) the appointment of a representative payee; 266.26    (ii) automatic payment from a financial account; 266.27    (iii) the establishment of greater family involvement in the financial management of 266.28payments; or 266.29    (iv) another method acceptable to the lead agency to ensure prompt fee payments. 266.30    The lead agency may extend the client's eligibility as necessary while making 266.31arrangements to facilitate payment of past-due amounts and future premium payments. 266.32Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be 266.33reinstated for a period of 30 days. 266.34    (b) Alternative care funding under this subdivision is not available for a person 266.35who is a medical assistance recipient or who would be eligible for medical assistance 266.36without a spenddown or waiver obligation. A person whose initial application for medical 267.1assistance and the elderly waiver program is being processed may be served under the 267.2alternative care program for a period up to 60 days. If the individual is found to be eligible 267.3for medical assistance, medical assistance must be billed for services payable under the 267.4federally approved elderly waiver plan and delivered from the date the individual was 267.5found eligible for the federally approved elderly waiver plan. Notwithstanding this 267.6provision, alternative care funds may not be used to pay for any service the cost of which: 267.7(i) is payable by medical assistance; (ii) is used by a recipient to meet a waiver obligation; 267.8or (iii) is used to pay a medical assistance income spenddown for a person who is eligible 267.9to participate in the federally approved elderly waiver program under the special income 267.10standard provision. 267.11    (c) Alternative care funding is not available for a person who resides in a licensed 267.12nursing home, certified boarding care home, hospital, or intermediate care facility, except 267.13for case management services which are provided in support of the discharge planning 267.14process for a nursing home resident or certified boarding care home resident to assist with 267.15a relocation process to a community-based setting. 267.16    (d) Alternative care funding is not available for a person whose income is greater 267.17than the maintenance needs allowance under section 256B.0915, subdivision 1d, but equal 267.18to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal 267.19year for which alternative care eligibility is determined, who would be eligible for the 267.20elderly waiver with a waiver obligation. 267.21    Sec. 45. Minnesota Statutes 2008, section 256B.0915, subdivision 3a, is amended to 267.22read: 267.23    Subd. 3a. Elderly waiver cost limits. (a) The monthly limit for the cost of 267.24waivered services to an individual elderly waiver client new text begin except for individuals described new text end 267.25 new text begin in paragraph (b) new text end shall be the weighted average monthly nursing facility rate of the case 267.26mix resident class to which the elderly waiver client would be assigned under Minnesota 267.27Rules, parts 9549.0050 to 9549.0059, less the recipient's maintenance needs allowance 267.28as described in subdivision 1d, paragraph (a), until the first day of the state fiscal year in 267.29which the resident assessment system as described in section 256B.438 for nursing home 267.30rate determination is implemented. Effective on the first day of the state fiscal year in 267.31which the resident assessment system as described in section 256B.438 for nursing home 267.32rate determination is implemented and the first day of each subsequent state fiscal year, the 267.33monthly limit for the cost of waivered services to an individual elderly waiver client shall 267.34be the rate of the case mix resident class to which the waiver client would be assigned 267.35under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect on the last day of the 268.1previous state fiscal year, adjusted by the greater of any legislatively adopted home and 268.2community-based services percentage rate increase or the average statewide percentage 268.3increase in nursing facility payment rates. 268.4    (b) new text begin The monthly limit for the cost of waivered services to an individual elderly new text end 268.5 new text begin waiver client assigned to a case mix classification A under paragraph (a) with (1) no new text end 268.6 new text begin dependencies in activities of daily living, (2) only one dependency in bathing, dressing, new text end 268.7 new text begin grooming, or walking, or (3) a dependency score of less than three if eating is the only new text end 268.8 new text begin dependency, shall be the lower of the case mix classification amount for case mix A as new text end 268.9 new text begin determined under paragraph (a) or the case mix classification amount for case mix A new text end 268.10 new text begin effective on October 1, 2008, per month for all new participants enrolled in the program new text end 268.11 new text begin on or after July 1, 2009. This monthly limit shall be applied to all other participants who new text end 268.12 new text begin meet this criteria at reassessment. new text end 268.13 new text begin (c) new text end If extended medical supplies and equipment or environmental modifications are 268.14or will be purchased for an elderly waiver client, the costs may be prorated for up to 268.1512 consecutive months beginning with the month of purchase. If the monthly cost of a 268.16recipient's waivered services exceeds the monthly limit established in paragraph (a) new text begin or (b) new text end , 268.17the annual cost of all waivered services shall be determined. In this event, the annual cost 268.18of all waivered services shall not exceed 12 times the monthly limit of waivered services 268.19as described in paragraph (a) new text begin or (b) new text end . 268.20    Sec. 46. Minnesota Statutes 2008, section 256B.0915, subdivision 3e, is amended to 268.21read: 268.22    Subd. 3e. Customized living service rate. (a) Payment for customized living 268.23services shall be a monthly rate negotiated and authorized by the lead agency within the 268.24parameters established by the commissioner. The payment agreement must delineate the 268.25services that have been customized for each recipient and specify the amount of each 268.26 new text begin component service included in the recipient's customized living new text end service to be provided new text begin new text end 268.27 new text begin plan new text end . The lead agency shall ensure that there is a documented need for all new text begin within the new text end 268.28 new text begin parameters established by the commissioner for all component customized living new text end services 268.29authorized. Customized living services must not include rent or raw food costs. 268.30 new text begin (b) new text end The negotiated payment rate must be based on new text begin the amount of component new text end services 268.31to be provided new text begin utilizing component rates established by the commissioner. Counties and new text end 268.32 new text begin tribes shall use tools issued by the commissioner to develop and document customized new text end 268.33 new text begin living service plans and rates new text end . 269.1Negotiated new text begin (c) Component service new text end rates must not exceed payment rates for 269.2comparable elderly waiver or medical assistance services and must reflect economies of 269.3scale. new text begin Customized living services must not include rent or raw food costs. new text end 269.4    (b) new text begin (d) new text end The individualized monthly negotiated new text begin authorized new text end payment for new text begin the new text end 269.5customized living services new text begin service plan new text end shall not exceed the nonfederal share, in effect 269.6on July 1 of the state fiscal year for which the rate limit is being calculated, new text begin 50 percent new text end 269.7of the greater of either the statewide or any of the geographic groups' weighted average 269.8monthly nursing facility rate of the case mix resident class to which the elderly waiver 269.9eligible client would be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, 269.10less the maintenance needs allowance as described in subdivision 1d, paragraph (a), until 269.11the July 1 of the state fiscal year in which the resident assessment system as described 269.12in section 256B.438 for nursing home rate determination is implemented. Effective on 269.13July 1 of the state fiscal year in which the resident assessment system as described in 269.14section 256B.438 for nursing home rate determination is implemented and July 1 of each 269.15subsequent state fiscal year, the individualized monthly negotiated new text begin authorized new text end payment 269.16for the services described in this clause shall not exceed the limit described in this clause 269.17which was in effect on June 30 of the previous state fiscal year and which has been 269.18adjusted by the greater of any legislatively adopted home and community-based services 269.19cost-of-living percentage increase or any legislatively adopted statewide percent rate 269.20increase for nursing facilities new text begin updated annually based on legislatively adopted changes to new text end 269.21 new text begin all service rate maximums for home and community-based service providers new text end . 269.22    (c) new text begin (e) new text end Customized living services are delivered by a provider licensed by the 269.23Department of Health as a class A or class F home care provider and provided in a 269.24building that is registered as a housing with services establishment under chapter 144D. 269.25    Sec. 47. Minnesota Statutes 2008, section 256B.0915, subdivision 3h, is amended to 269.26read: 269.27    Subd. 3h. Service rate limits; 24-hour customized living services. new text begin (a) new text end The 269.28payment rates new text begin rate new text end for 24-hour customized living services is a monthly rate negotiated 269.29and authorized by the lead agency within the parameters established by the commissioner 269.30of human services. The payment agreement must delineate the services that have been 269.31customized for each recipient and specify the amount of each new text begin component service included new text end 269.32 new text begin in each recipient's customized living new text end service to be provided new text begin plan new text end . The lead agency 269.33shall ensure that there is a documented need new text begin within the parameters established by the new text end 269.34 new text begin commissioner new text end for all new text begin component customized living new text end services authorized. The lead agency 270.1shall not authorize 24-hour customized living services unless there is a documented need 270.2for 24-hour supervision. 270.3 new text begin (b) new text end For purposes of this section, "24-hour supervision" means that the recipient 270.4requires assistance due to needs related to one or more of the following: 270.5    (1) intermittent assistance with toileting new text begin , positioning, new text end or transferring; 270.6    (2) cognitive or behavioral issues; 270.7    (3) a medical condition that requires clinical monitoring; or 270.8    (4) other conditions or needs as defined by the commissioner of human services new text begin for new text end 270.9 new text begin all new participants enrolled in the program on or after January 1, 2011, and all other new text end 270.10 new text begin participants at their first reassessment after January 1, 2011, dependency in at least two new text end 270.11 new text begin of the following activities of daily living as determined by assessment under section new text end 270.12 new text begin 256B.0911: bathing; dressing; grooming; walking; or eating; and needs medication new text end 270.13 new text begin management and at least 50 hours of service per month new text end . The lead agency shall ensure that 270.14the frequency and mode of supervision of the recipient and the qualifications of staff 270.15providing supervision are described and meet the needs of the recipient. Customized 270.16living services must not include rent or raw food costs. 270.17 new text begin (c) new text end The negotiated payment rate for 24-hour customized living services must be 270.18based on new text begin the amount of component new text end services to be provided new text begin utilizing component rates new text end 270.19 new text begin established by the commissioner. Counties and tribes will use tools issued by the new text end 270.20 new text begin commissioner to develop and document customized living plans and authorize rates new text end . 270.21Negotiated new text begin (d) Component service new text end rates must not exceed payment rates for 270.22comparable elderly waiver or medical assistance services and must reflect economies 270.23of scale. 270.24 new text begin (e) new text end The individually negotiated new text begin authorized new text end 24-hour customized living payments, 270.25in combination with the payment for other elderly waiver services, including case 270.26management, must not exceed the recipient's community budget cap specified in 270.27subdivision 3a. new text begin Customized living services must not include rent or raw food costs. new text end 270.28 new text begin (f) The individually authorized 24-hour customized living payment rates shall not new text end 270.29 new text begin exceed the 95 percentile of statewide monthly authorizations for 24-hour customized new text end 270.30 new text begin living services in effect and in the Medicaid management information systems on March new text end 270.31 new text begin 31, 2009, for each case mix resident class under Minnesota Rules, parts 9549.0050 new text end 270.32 new text begin to 9549.0059, to which elderly waiver service clients are assigned. When there are new text end 270.33 new text begin fewer than 50 authorizations in effect in the case mix resident class, the commissioner new text end 270.34 new text begin shall multiply the calculated service payment rate maximum for the A classification by new text end 270.35 new text begin the standard weight for that classification under Minnesota Rules, parts 9549.0050 to new text end 270.36 new text begin 9549.0059, to determine the applicable payment rate maximum. Service payment rate new text end 271.1 new text begin maximums shall be updated annually based on legislatively adopted changes to all service new text end 271.2 new text begin rates for home and community-based service providers. new text end 271.3     new text begin (g) Notwithstanding the requirements of paragraphs (d) and (f), the commissioner new text end 271.4 new text begin may establish alternative payment rate systems for 24-hour customized living services in new text end 271.5 new text begin housing with services establishments which are freestanding buildings with a capacity of new text end 271.6 new text begin 16 or fewer, by applying a single hourly rate for covered component services provided new text end 271.7 new text begin in either: new text end 271.8     new text begin (1) licensed corporate adult foster homes; or new text end 271.9     new text begin (2) specialized dementia care units which meet the requirements of section 144D.065 new text end 271.10 new text begin and in which: new text end 271.11     new text begin (i) each resident is offered the option of having their own apartment; or new text end 271.12     new text begin (ii) the units are licensed as board and lodge establishments with maximum capacity new text end 271.13 new text begin of eight residents, and which meet the requirements of Minnesota Rules, part 9555.6205, new text end 271.14 new text begin subparts 1, 2, 3, and 4, item A. new text end 271.15    Sec. 48. Minnesota Statutes 2008, section 256B.0915, subdivision 5, is amended to 271.16read: 271.17    Subd. 5. Assessments and reassessments for waiver clients. new text begin (a) new text end Each client 271.18shall receive an initial assessment of strengths, informal supports, and need for services 271.19in accordance with section 256B.0911, subdivisions 3, 3a, and 3b. A reassessment of a 271.20client served under the elderly waiver must be conducted at least every 12 months and at 271.21other times when the case manager determines that there has been significant change in 271.22the client's functioning. This may include instances where the client is discharged from 271.23the hospital. new text begin There must be a determination that the client requires nursing facility level of new text end 271.24 new text begin care as defined in section 144.0724, subdivision 11, at initial and subsequent assessments new text end 271.25 new text begin to initiate and maintain participation in the waiver program. new text end 271.26 new text begin (b) Regardless of other assessments identified in section 144.0724, subdivision new text end 271.27 new text begin 4, as appropriate to determine nursing facility level of care for purposes of medical new text end 271.28 new text begin assistance payment for nursing facility services, only face-to-face assessments conducted new text end 271.29 new text begin according to section 256B.0911, subdivisions 3a and 3b, that result in a nursing facility new text end 271.30 new text begin level of care determination will be accepted for purposes of initial and ongoing access to new text end 271.31 new text begin waiver service payment. new text end 271.32 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2011. new text end 271.33    Sec. 49. Minnesota Statutes 2008, section 256B.0915, is amended by adding a 271.34subdivision to read: 272.1     new text begin Subd. 10. new text end new text begin Waiver payment rates; managed care organizations. new text end new text begin The new text end 272.2 new text begin commissioner shall adjust the elderly waiver capitation payment rates for managed care new text end 272.3 new text begin organizations paid under section 256B.69, subdivisions 6a and 23, to reflect the maximum new text end 272.4 new text begin service rate limits for customized living services and 24-hour customized living services new text end 272.5 new text begin under subdivisions 3e and 3h for the contract period beginning October 1, 2009. Medical new text end 272.6 new text begin assistance rates paid to customized living providers by managed care organizations new text end 272.7 new text begin under this section shall not exceed the maximum service rate limits determined by the new text end 272.8 new text begin commissioner under subdivisions 3e and 3h. new text end 272.9    Sec. 50. Minnesota Statutes 2008, section 256B.0916, subdivision 2, is amended to 272.10read: 272.11    Subd. 2. Distribution of funds; partnerships. (a) Beginning with fiscal year 2000, 272.12the commissioner shall distribute all funding available for home and community-based 272.13waiver services for persons with developmental disabilities to individual counties or to 272.14groups of counties that form partnerships to jointly plan, administer, and authorize funding 272.15for eligible individuals. The commissioner shall encourage counties to form partnerships 272.16that have a sufficient number of recipients and funding to adequately manage the risk 272.17and maximize use of available resources. 272.18    (b) Counties must submit a request for funds and a plan for administering the 272.19program as required by the commissioner. The plan must identify the number of clients to 272.20be served, their ages, and their priority listing based on: 272.21    (1) requirements in Minnesota Rules, part 9525.1880; new text begin and new text end 272.22    (2) unstable living situations due to the age or incapacity of the primary caregiver; new text begin new text end 272.23 new text begin statewide priorities identified in section 256B.092, subdivision 12. new text end 272.24    (3) the need for services to avoid out-of-home placement of children; 272.25    (4) the need to serve persons affected by private sector ICF/MR closures; and 272.26    (5) the need to serve persons whose consumer support grant exception amount 272.27was eliminated in 2004. 272.28The plan must also identify changes made to improve services to eligible persons and to 272.29improve program management. 272.30    (c) In allocating resources to counties, priority must be given to groups of counties 272.31that form partnerships to jointly plan, administer, and authorize funding for eligible 272.32individuals and to counties determined by the commissioner to have sufficient waiver 272.33capacity to maximize resource use. 273.1    (d) Within 30 days after receiving the county request for funds and plans, the 273.2commissioner shall provide a written response to the plan that includes the level of 273.3resources available to serve additional persons. 273.4    (e) Counties are eligible to receive medical assistance administrative reimbursement 273.5for administrative costs under criteria established by the commissioner. 273.6    Sec. 51. Minnesota Statutes 2008, section 256B.0917, is amended by adding a 273.7subdivision to read: 273.8     new text begin Subd. 14. new text end new text begin Essential community supports grants. new text end new text begin (a) The purpose of the essential new text end 273.9 new text begin community supports grant program is to provide targeted services to persons 65 years and new text end 273.10 new text begin older who need essential community support, but whose needs do not meet the level of new text end 273.11 new text begin care required for nursing facility placement under section 144.0724, subdivision 11. new text end 273.12 new text begin (b) Within the limits of the appropriation and not to exceed $400 per person per new text end 273.13 new text begin month, funding must be available to a person who: new text end 273.14 new text begin (1) is age 65 or older; new text end 273.15 new text begin (2) is not eligible for medical assistance; new text end 273.16 new text begin (3) would otherwise be financially eligible for the alternative care program under new text end 273.17 new text begin section 256B.0913, subdivision 4; new text end 273.18 new text begin (4) has received a community assessment under section 256B.0911, subdivision 3a new text end 273.19 new text begin or 3b, and does not require the level of care provided in a nursing facility; new text end 273.20 new text begin (5) has a community support plan; and new text end 273.21 new text begin (6) has been determined by a community assessment under section 256B.0911, new text end 273.22 new text begin subdivision 3a or 3b, to be a person who would require provision of at least one of the new text end 273.23 new text begin following services, as defined in the approved elderly waiver plan, in order to maintain new text end 273.24 new text begin their community residence: new text end 273.25 new text begin (i) caregiver support; new text end 273.26 new text begin (ii) homemaker; new text end 273.27 new text begin (iii) chore; or new text end 273.28 new text begin (iv) a personal emergency response device or system. new text end 273.29 new text begin (c) The person receiving any of the essential community supports in this subdivision new text end 273.30 new text begin must also receive service coordination as part of their community support plan. new text end 273.31 new text begin (d) A person who has been determined to be eligible for an essential community new text end 273.32 new text begin support grant must be reassessed at least annually and continue to meet the criteria in new text end 273.33 new text begin paragraph (b) to remain eligible for an essential community support grant. new text end 274.1 new text begin (e) The commissioner shall allocate grants to counties and tribes under contract with new text end 274.2 new text begin the department based upon the historic use of the medical assistance elderly waiver and new text end 274.3 new text begin alternative care grant programs and other criteria as determined by the commissioner. new text end 274.4 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2011. new text end 274.5    Sec. 52. Minnesota Statutes 2008, section 256B.092, subdivision 8a, is amended to 274.6read: 274.7    Subd. 8a. County concurrence. (a) If the county of financial responsibility wishes 274.8to place a person in another county for services, the county of financial responsibility shall 274.9seek concurrence from the proposed county of service and the placement shall be made 274.10cooperatively between the two counties. Arrangements shall be made between the two 274.11counties for ongoing social service, including annual reviews of the person's individual 274.12service plan. The county where services are provided may not make changes in the 274.13person's service plan without approval by the county of financial responsibility. 274.14(b) When a person has been screened and authorized for services in an intermediate 274.15care facility for persons with developmental disabilities or for home and community-based 274.16services for persons with developmental disabilities, the case manager shall assist that 274.17person in identifying a service provider who is able to meet the needs of the person 274.18according to the person's individual service plan. If the identified service is to be provided 274.19in a county other than the county of financial responsibility, the county of financial 274.20responsibility shall request concurrence of the county where the person is requesting to 274.21receive the identified services. The county of service may refuse to concur if: 274.22(1) it can demonstrate that the provider is unable to provide the services identified in 274.23the person's individual service plan as services that are needed and are to be provided; new text begin or new text end 274.24(2) in the case of an intermediate care facility for persons with developmental 274.25disabilities, there has been no authorization for admission by the admission review team 274.26as required in section 256B.0926; or new text begin . new text end 274.27(3) in the case of home and community-based services for persons with 274.28developmental disabilities, the county of service can demonstrate that the prospective 274.29provider has failed to substantially comply with the terms of a past contract or has had a 274.30prior contract terminated within the last 12 months for failure to provide adequate services, 274.31or has received a notice of intent to terminate the contract. 274.32(c) The county of service shall notify the county of financial responsibility of 274.33concurrence or refusal to concur no later than 20 working days following receipt of the 274.34written request. Unless other mutually acceptable arrangements are made by the involved 274.35county agencies, the county of financial responsibility is responsible for costs of social 275.1services and the costs associated with the development and maintenance of the placement. 275.2The county of service may request that the county of financial responsibility purchase 275.3case management services from the county of service or from a contracted provider 275.4of case management when the county of financial responsibility is not providing case 275.5management as defined in this section and rules adopted under this section, unless other 275.6mutually acceptable arrangements are made by the involved county agencies. Standards 275.7for payment limits under this section may be established by the commissioner. Financial 275.8disputes between counties shall be resolved as provided in section 256G.09. 275.9    Sec. 53. Minnesota Statutes 2008, section 256B.092, is amended by adding a 275.10subdivision to read: 275.11     new text begin Subd. 11. new text end new text begin Residential support services. new text end new text begin (a) Upon federal approval, there is new text end 275.12 new text begin established a new service called residential support that is available on the CAC, CADI, new text end 275.13 new text begin DD, and TBI waivers. Existing waiver service descriptions must be modified to the extent new text end 275.14 new text begin necessary to ensure there is no duplication between other services. Residential support new text end 275.15 new text begin services must be provided by vendors licensed as a community residential setting as new text end 275.16 new text begin defined in section 245A.11, subdivision 8. new text end 275.17 new text begin (b) Residential support services must meet the following criteria: new text end 275.18 new text begin (1) providers of residential support services must own or control the residential site; new text end 275.19 new text begin (2) the residential site must not be the primary residence of the license holder; new text end 275.20 new text begin (3) the residential site must have a designated program supervisor responsible for new text end 275.21 new text begin program oversight, development, and implementation of policies and procedures; new text end 275.22 new text begin (4) the provider of residential support services must provide supervision, training, new text end 275.23 new text begin and assistance as described in the person's community support plan; and new text end 275.24 new text begin (5) the provider of residential support services must meet the requirements of new text end 275.25 new text begin licensure and additional requirements of the person's community support plan. new text end 275.26 new text begin (c) Providers of residential support services that meet the definition in paragraph (a) new text end 275.27 new text begin must be registered using a process determined by the commissioner beginning July 1, 2009. new text end 275.28    Sec. 54. Minnesota Statutes 2008, section 256B.092, is amended by adding a 275.29subdivision to read: 275.30     new text begin Subd. 12. new text end new text begin Waivered services statewide priorities. new text end new text begin (a) The commissioner shall new text end 275.31 new text begin establish statewide priorities for individuals on the waiting list for developmental new text end 275.32 new text begin disabilities (DD) waiver services, as of January 1, 2010. The statewide priorities must new text end 275.33 new text begin include, but are not limited to, individuals who continue to have a need for waiver services new text end 275.34 new text begin after they have maximized the use of state plan services and other funding resources, new text end 276.1 new text begin including natural supports, prior to accessing waiver services, and who meet at least one new text end 276.2 new text begin of the following criteria: new text end 276.3 new text begin (1) have unstable living situations due to the age, incapacity, or sudden loss of new text end 276.4 new text begin the primary caregivers; new text end 276.5 new text begin (2) are moving from an institution due to bed closures; new text end 276.6 new text begin (3) experience a sudden closure of their current living arrangement; new text end 276.7 new text begin (4) require protection from confirmed abuse, neglect, or exploitation; new text end 276.8 new text begin (5) experience a sudden change in need that can no longer be met through state plan new text end 276.9 new text begin services or other funding resources alone; or new text end 276.10 new text begin (6) meet other priorities established by the department. new text end 276.11 new text begin (b) When allocating resources to lead agencies, the commissioner must take into new text end 276.12 new text begin consideration the number of individuals waiting who meet statewide priorities and the new text end 276.13 new text begin lead agencies' current use of waiver funds and existing service options. new text end 276.14 new text begin (c) The commissioner shall evaluate the impact of the use of statewide priorities and new text end 276.15 new text begin provide recommendations to the legislature on whether to continue the use of statewide new text end 276.16 new text begin priorities in the November 1, 2011, annual report required by the commissioner in sections new text end 276.17 new text begin 256B.0916, subdivision 7, and 256B.49, subdivision 21. new text end 276.18    Sec. 55. new text begin [256B.0948] FOSTER CARE RATE LIMITS. new text end 276.19 new text begin The commissioner shall decrease by five percent rates for adult foster care and new text end 276.20 new text begin supportive living services that are reimbursed under section 256B.092 or 256B.49, and new text end 276.21 new text begin are above the 95th percentile of the statewide rates for the service. The reduction in rates new text end 276.22 new text begin shall take into account the acuity of individuals served based on the methodology used to new text end 276.23 new text begin allocate dollars to local lead agency budgets, and assure that affected service rates are not new text end 276.24 new text begin reduced below the rate level represented by the above percentile due to this rate change. new text end 276.25 new text begin Lead agency contracts for services specified in this section shall be amended to implement new text end 276.26 new text begin these rate changes for services rendered on or after July 1, 2009. The commissioner shall new text end 276.27 new text begin make corresponding reductions to waiver allocations and capitated rates. new text end 276.28    Sec. 56. Minnesota Statutes 2008, section 256B.37, subdivision 1, is amended to read: 276.29    Subdivision 1. Subrogation. Upon furnishing medical assistance new text begin or alternative new text end 276.30 new text begin care services under section 256B.0913 new text end to any person who has private accident or health 276.31care coverage, or receives or has a right to receive health or medical care from any 276.32type of organization or entity, or has a cause of action arising out of an occurrence that 276.33necessitated the payment of medical assistance, the state agency or the state agency's agent 276.34shall be subrogated, to the extent of the cost of medical care furnished, to any rights the 277.1person may have under the terms of the coverage, or against the organization or entity 277.2providing or liable to provide health or medical care, or under the cause of action. 277.3    The right of subrogation created in this section includes all portions of the cause 277.4of action, notwithstanding any settlement allocation or apportionment that purports to 277.5dispose of portions of the cause of action not subject to subrogation. 277.6    Sec. 57. Minnesota Statutes 2008, section 256B.37, subdivision 5, is amended to read: 277.7    Subd. 5. Private benefits to be used first. Private accident and health care coverage 277.8including Medicare for medical services is primary coverage and must be exhausted before 277.9medical assistance is new text begin or alternative care services are new text end paid for medical services including 277.10home health care, personal care assistant services, hospice, new text begin supplies and equipment, new text end or 277.11services covered under a Centers for Medicare and Medicaid Services waiver. When a 277.12person who is otherwise eligible for medical assistance has private accident or health care 277.13coverage, including Medicare or a prepaid health plan, the private health care benefits 277.14available to the person must be used first and to the fullest extent. 277.15    Sec. 58. Minnesota Statutes 2008, section 256B.434, subdivision 4, is amended to read: 277.16    Subd. 4. Alternate rates for nursing facilities. (a) For nursing facilities which 277.17have their payment rates determined under this section rather than section 256B.431, the 277.18commissioner shall establish a rate under this subdivision. The nursing facility must enter 277.19into a written contract with the commissioner. 277.20    (b) A nursing facility's case mix payment rate for the first rate year of a facility's 277.21contract under this section is the payment rate the facility would have received under 277.22section 256B.431. 277.23    (c) A nursing facility's case mix payment rates for the second and subsequent years 277.24of a facility's contract under this section are the previous rate year's contract payment 277.25rates plus an inflation adjustment and, for facilities reimbursed under this section or 277.26section 256B.431, an adjustment to include the cost of any increase in Health Department 277.27licensing fees for the facility taking effect on or after July 1, 2001. The index for the 277.28inflation adjustment must be based on the change in the Consumer Price Index-All Items 277.29(United States City average) (CPI-U) forecasted by the commissioner of finance's national 277.30economic consultant, as forecasted in the fourth quarter of the calendar year preceding 277.31the rate year. The inflation adjustment must be based on the 12-month period from the 277.32midpoint of the previous rate year to the midpoint of the rate year for which the rate is 277.33being determined. For the rate years beginning on July 1, 1999, July 1, 2000, July 1, 2001, 277.34July 1, 2002, July 1, 2003, July 1, 2004, July 1, 2005, July 1, 2006, July 1, 2007, July 1, 278.12008, October 1, 2009, and October 1, 2010, new text begin October 1, 2011, and October 1, 2012. new text end This 278.2paragraph shall apply only to the property-related payment rate, except that adjustments 278.3to include the cost of any increase in Health Department licensing fees taking effect on 278.4or after July 1, 2001, shall be provided. Beginning in 2005, adjustment to the property 278.5payment rate under this section and section 256B.431 shall be effective on October 1. 278.6In determining the amount of the property-related payment rate adjustment under this 278.7paragraph, the commissioner shall determine the proportion of the facility's rates that are 278.8property-related based on the facility's most recent cost report. 278.9    (d) The commissioner shall develop additional incentive-based payments of up to 278.10five percent above a facility's operating payment rate for achieving outcomes specified 278.11in a contract. The commissioner may solicit contract amendments and implement those 278.12which, on a competitive basis, best meet the state's policy objectives. The commissioner 278.13shall limit the amount of any incentive payment and the number of contract amendments 278.14under this paragraph to operate the incentive payments within funds appropriated for this 278.15purpose. The contract amendments may specify various levels of payment for various 278.16levels of performance. Incentive payments to facilities under this paragraph may be in the 278.17form of time-limited rate adjustments or onetime supplemental payments. In establishing 278.18the specified outcomes and related criteria, the commissioner shall consider the following 278.19state policy objectives: 278.20    (1) successful diversion or discharge of residents to the residents' prior home or other 278.21community-based alternatives; 278.22    (2) adoption of new technology to improve quality or efficiency; 278.23    (3) improved quality as measured in the Nursing Home Report Card; 278.24    (4) reduced acute care costs; and 278.25    (5) any additional outcomes proposed by a nursing facility that the commissioner 278.26finds desirable. 278.27    (e) Notwithstanding the threshold in section 256B.431, subdivision 16, facilities that 278.28take action to come into compliance with existing or pending requirements of the life 278.29safety code provisions or federal regulations governing sprinkler systems must receive 278.30reimbursement for the costs associated with compliance if all of the following conditions 278.31are met: 278.32    (1) the expenses associated with compliance occurred on or after January 1, 2005, 278.33and before December 31, 2008; 278.34    (2) the costs were not otherwise reimbursed under subdivision 4f or section 278.35144A.071 or 144A.073; and 279.1    (3) the total allowable costs reported under this paragraph are less than the minimum 279.2threshold established under section 256B.431, subdivision 15, paragraph (e), and 279.3subdivision 16. 279.4The commissioner shall use money appropriated for this purpose to provide to qualifying 279.5nursing facilities a rate adjustment beginning October 1, 2007, and ending September 30, 279.62008. Nursing facilities that have spent money or anticipate the need to spend money 279.7to satisfy the most recent life safety code requirements by (1) installing a sprinkler 279.8system or (2) replacing all or portions of an existing sprinkler system may submit to the 279.9commissioner by June 30, 2007, on a form provided by the commissioner the actual 279.10costs of a completed project or the estimated costs, based on a project bid, of a planned 279.11project. The commissioner shall calculate a rate adjustment equal to the allowable 279.12costs of the project divided by the resident days reported for the report year ending 279.13September 30, 2006. If the costs from all projects exceed the appropriation for this 279.14purpose, the commissioner shall allocate the money appropriated on a pro rata basis 279.15to the qualifying facilities by reducing the rate adjustment determined for each facility 279.16by an equal percentage. Facilities that used estimated costs when requesting the rate 279.17adjustment shall report to the commissioner by January 31, 2009, on the use of this 279.18money on a form provided by the commissioner. If the nursing facility fails to provide 279.19the report, the commissioner shall recoup the money paid to the facility for this purpose. 279.20If the facility reports expenditures allowable under this subdivision that are less than 279.21the amount received in the facility's annualized rate adjustment, the commissioner shall 279.22recoup the difference. 279.23    Sec. 59. Minnesota Statutes 2008, section 256B.434, is amended by adding a 279.24subdivision to read: 279.25     new text begin Subd. 21. new text end new text begin Payment of post-PERA pension benefit costs. new text end new text begin Nursing facilities that new text end 279.26 new text begin convert or converted after September 30, 2006, from public to private ownership shall new text end 279.27 new text begin have a portion of their post-PERA pension costs treated as a component of the historic new text end 279.28 new text begin operating rate. Effective for the rate years beginning on or after October 1, 2009, and prior new text end 279.29 new text begin to October 1, 2016, the commissioner shall determine the pension costs to be included new text end 279.30 new text begin in the facility's base for determining rates under this section by using the following new text end 279.31 new text begin formula: post-privatization pension benefit costs as a percent of salary shall be determined new text end 279.32 new text begin from either the cost report for the first full reporting year after privatization or the most new text end 279.33 new text begin recent report year available, whichever is later. This percentage shall be applied to the new text end 279.34 new text begin salary costs of the alternative payment system base rate year to determine the allowable new text end 279.35 new text begin amount of pension costs. The adjustments provided for in sections 256B.431, 256B.434, new text end 280.1 new text begin 256B.441, and any other law enacted after the base rate year and prior to the year for new text end 280.2 new text begin which rates are being determined shall be applied to the allowable amount. The adjusted new text end 280.3 new text begin allowable amount shall be added to the operating rate effective the first rate year PERA new text end 280.4 new text begin ceases to remain as a pass-through component of the rate. new text end 280.5    Sec. 60. Minnesota Statutes 2008, section 256B.437, subdivision 6, is amended to read: 280.6    Subd. 6. Planned closure rate adjustment. (a) The commissioner of human 280.7services shall calculate the amount of the planned closure rate adjustment available under 280.8subdivision 3, paragraph (b), for up to 5,140 beds according to clauses (1) to (4): 280.9(1) the amount available is the net reduction of nursing facility beds multiplied 280.10by $2,080; 280.11(2) the total number of beds in the nursing facility or facilities receiving the planned 280.12closure rate adjustment must be identified; 280.13(3) capacity days are determined by multiplying the number determined under 280.14clause (2) by 365; and 280.15(4) the planned closure rate adjustment is the amount available in clause (1), divided 280.16by capacity days determined under clause (3). 280.17(b) A planned closure rate adjustment under this section is effective on the first day 280.18of the month following completion of closure of the facility designated for closure in the 280.19application and becomes part of the nursing facility's total operating payment rate. 280.20(c) Applicants may use the planned closure rate adjustment to allow for a property 280.21payment for a new nursing facility or an addition to an existing nursing facility or as an 280.22operating payment rate adjustment. Applications approved under this subdivision are 280.23exempt from other requirements for moratorium exceptions under section 144A.073, 280.24subdivisions 2 and 3 . 280.25(d) Upon the request of a closing facility, the commissioner must allow the facility a 280.26closure rate adjustment as provided under section 144A.161, subdivision 10. 280.27(e) A facility that has received a planned closure rate adjustment may reassign it 280.28to another facility that is under the same ownership at any time within three years of its 280.29effective date. The amount of the adjustment shall be computed according to paragraph (a). 280.30(f) If the per bed dollar amount specified in paragraph (a), clause (1), is increased, 280.31the commissioner shall recalculate planned closure rate adjustments for facilities that 280.32delicense beds under this section on or after July 1, 2001, to reflect the increase in the per 280.33bed dollar amount. The recalculated planned closure rate adjustment shall be effective 280.34from the date the per bed dollar amount is increased. 281.1 new text begin (g) For planned closures approved after June 30, 2009, the commissioner of human new text end 281.2 new text begin services shall calculate the amount of the planned closure rate adjustment available under new text end 281.3 new text begin subdivision 3, paragraph (b), according to paragraph (a), clauses (1) to (4). new text end 281.4    Sec. 61. Minnesota Statutes 2008, section 256B.441, subdivision 55, is amended to 281.5read: 281.6    Subd. 55. Phase-in of rebased operating payment rates. (a) For the rate years 281.7beginning October 1, 2008, to October 1, 2015, the operating payment rate calculated 281.8under this section shall be phased in by blending the operating rate with the operating 281.9payment rate determined under section 256B.434. For purposes of this subdivision, the 281.10rate to be used that is determined under section 256B.434 shall not include the portion of 281.11the operating payment rate related to performance-based incentive payments under section 281.12256B.434, subdivision 4 , paragraph (d). For the rate year beginning October 1, 2008, the 281.13operating payment rate for each facility shall be 13 percent of the operating payment rate 281.14from this section, and 87 percent of the operating payment rate from section 256B.434. 281.15For the rate year new text begin period new text end beginning October 1, 2009 new text begin , through September 30, 2013 new text end , the 281.16operating payment rate for each facility shall be 14 percent of the operating payment rate 281.17from this section, and 86 percent of the operating payment rate from section 256B.434. 281.18For the rate year beginning October 1, 2010, the operating payment rate for each facility 281.19shall be 14 percent of the operating payment rate from this section, and 86 percent of the 281.20operating payment rate from section . For the rate year beginning October 1, 281.212011, the operating payment rate for each facility shall be 31 percent of the operating 281.22payment rate from this section, and 69 percent of the operating payment rate from section 281.23. For the rate year beginning October 1, 2012, the operating payment rate for 281.24each facility shall be 48 percent of the operating payment rate from this section, and 52 281.25percent of the operating payment rate from section . For the rate year beginning 281.26October 1, 2013, the operating payment rate for each facility shall be 65 percent of the 281.27operating payment rate from this section, and 35 percent of the operating payment rate 281.28from section 256B.434. For the rate year beginning October 1, 2014, the operating 281.29payment rate for each facility shall be 82 percent of the operating payment rate from this 281.30section, and 18 percent of the operating payment rate from section 256B.434. For the rate 281.31year beginning October 1, 2015, the operating payment rate for each facility shall be the 281.32operating payment rate determined under this section. The blending of operating payment 281.33rates under this section shall be performed separately for each RUG's class. 282.1    (b) For the rate year beginning October 1, 2008, the commissioner shall apply limits 282.2to the operating payment rate increases under paragraph (a) by creating a minimum 282.3percentage increase and a maximum percentage increase. 282.4    (1) Each nursing facility that receives a blended October 1, 2008, operating payment 282.5rate increase under paragraph (a) of less than one percent, when compared to its operating 282.6payment rate on September 30, 2008, computed using rates with RUG's weight of 1.00, 282.7shall receive a rate adjustment of one percent. 282.8    (2) The commissioner shall determine a maximum percentage increase that will 282.9result in savings equal to the cost of allowing the minimum increase in clause (1). Nursing 282.10facilities with a blended October 1, 2008, operating payment rate increase under paragraph 282.11(a) greater than the maximum percentage increase determined by the commissioner, when 282.12compared to its operating payment rate on September 30, 2008, computed using rates with 282.13a RUG's weight of 1.00, shall receive the maximum percentage increase. 282.14    (3) Nursing facilities with a blended October 1, 2008, operating payment rate 282.15increase under paragraph (a) greater than one percent and less than the maximum 282.16percentage increase determined by the commissioner, when compared to its operating 282.17payment rate on September 30, 2008, computed using rates with a RUG's weight of 1.00, 282.18shall receive the blended October 1, 2008, operating payment rate increase determined 282.19under paragraph (a). 282.20    (4) The October 1, 2009, through October 1, 2015, operating payment rate for 282.21facilities receiving the maximum percentage increase determined in clause (2) shall be 282.22the amount determined under paragraph (a) less the difference between the amount 282.23determined under paragraph (a) for October 1, 2008, and the amount allowed under clause 282.24(2). This rate restriction does not apply to rate increases provided in any other section. 282.25    (c) A portion of the funds received under this subdivision that are in excess of 282.26operating payment rates that a facility would have received under section 256B.434, as 282.27determined in accordance with clauses (1) to (3), shall be subject to the requirements in 282.28section 256B.434, subdivision 19, paragraphs (b) to (h). 282.29    (1) Determine the amount of additional funding available to a facility, which shall be 282.30equal to total medical assistance resident days from the most recent reporting year times 282.31the difference between the blended rate determined in paragraph (a) for the rate year being 282.32computed and the blended rate for the prior year. 282.33    (2) Determine the portion of all operating costs, for the most recent reporting year, 282.34that are compensation related. If this value exceeds 75 percent, use 75 percent. 282.35    (3) Subtract the amount determined in clause (2) from 75 percent. 283.1    (4) The portion of the fund received under this subdivision that shall be subject to 283.2the requirements in section 256B.434, subdivision 19, paragraphs (b) to (h), shall equal 283.3the amount determined in clause (1) times the amount determined in clause (3). 283.4    Sec. 62. Minnesota Statutes 2008, section 256B.441, subdivision 58, is amended to 283.5read: 283.6    Subd. 58. Implementation delay. Within six months prior to the effective date of 283.7(1) rebasing of property payment rates under subdivision 1; (2) quality-based rate limits 283.8under subdivision 50; and (3) the removal of planned closure rate adjustments and single 283.9bed room incentives from external fixed costs under subdivision 53, the commissioner 283.10shall compare the average operating cost for all facilities combined from the most recent 283.11cost reports to the average medical assistance operating payment rates for all facilities 283.12combined from the same time period. Each provision shall not go into effect until the 283.13average medical assistance operating payment rate is at least 92 percent of the average 283.14operating cost. new text begin The rebasing of property payment rates under subdivision 1, and the new text end 283.15 new text begin removal of planned closure rate adjustments and single-bed room incentives from external new text end 283.16 new text begin fixed costs under subdivision 53 shall not go into effect until 82 percent of the operating new text end 283.17 new text begin payment rate from this section is phased in as described in subdivision 55. new text end 283.18    Sec. 63. Minnesota Statutes 2008, section 256B.441, is amended by adding a 283.19subdivision to read: 283.20     new text begin Subd. 59. new text end new text begin Single-bed payments for medical assistance recipients. new text end new text begin Effective new text end 283.21 new text begin October 1, 2009, the amount paid for a private room under Minnesota Rules, part new text end 283.22 new text begin 9549.0070, subpart 3, is reduced from 115 percent to 111.5 percent. new text end 283.23    Sec. 64. Minnesota Statutes 2008, section 256B.49, is amended by adding a 283.24subdivision to read: 283.25     new text begin Subd. 11a. new text end new text begin Waivered services waiting list. new text end new text begin (a) The commissioner shall establish new text end 283.26 new text begin statewide priorities for individuals on the waiting list for CAC, CADI, and TBI waiver new text end 283.27 new text begin services, as of January 1, 2010. The statewide priorities must include, but are not limited new text end 283.28 new text begin to, individuals who continue to have a need for waiver services after they have maximized new text end 283.29 new text begin the use of state plan services and other funding resources, including natural supports, prior new text end 283.30 new text begin to accessing waiver services, and who meet at least one of the following criteria: new text end 283.31 new text begin (1) have unstable living situations due to the age, incapacity, or sudden loss of new text end 283.32 new text begin the primary caregivers; new text end 283.33 new text begin (2) are moving from an institution due to bed closures; new text end 284.1 new text begin (3) experience a sudden closure of their current living arrangement; new text end 284.2 new text begin (4) require protection from confirmed abuse, neglect, or exploitation; new text end 284.3 new text begin (5) experience a sudden change in need that can no longer be met through state plan new text end 284.4 new text begin services or other funding resources alone; or new text end 284.5 new text begin (6) meet other priorities established by the department. new text end 284.6 new text begin (b) When allocating resources to lead agencies, the commissioner must take into new text end 284.7 new text begin consideration the number of individuals waiting who meet statewide priorities and the new text end 284.8 new text begin lead agencies' current use of waiver funds and existing service options. new text end 284.9 new text begin (c) The commissioner shall evaluate the impact of the use of statewide priorities and new text end 284.10 new text begin provide recommendations to the legislature on whether to continue the use of statewide new text end 284.11 new text begin priorities in the November 1, 2011, annual report required by the commissioner in sections new text end 284.12 new text begin 256B.0916, subdivision 7, and 256B.49, subdivision 21. new text end 284.13    Sec. 65. Minnesota Statutes 2008, section 256B.49, subdivision 12, is amended to read: 284.14    Subd. 12. Informed choice. Persons who are determined likely to require the level 284.15of care provided in a nursing facility new text begin as determined under sections 144.0724, subdivision new text end 284.16 new text begin 11, and 256B.0911, new text end or hospital shall be informed of the home and community-based 284.17support alternatives to the provision of inpatient hospital services or nursing facility 284.18services. Each person must be given the choice of either institutional or home and 284.19community-based services using the provisions described in section 256B.77, subdivision 284.202 , paragraph (p). 284.21 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2011. new text end 284.22    Sec. 66. Minnesota Statutes 2008, section 256B.49, subdivision 13, is amended to read: 284.23    Subd. 13. Case management. (a) Each recipient of a home and community-based 284.24waiver shall be provided case management services by qualified vendors as described 284.25in the federally approved waiver application. The case management service activities 284.26provided will include: 284.27    (1) assessing the needs of the individual within 20 working days of a recipient's 284.28request; 284.29    (2) developing the written individual service plan within ten working days after the 284.30assessment is completed; 284.31    (3) informing the recipient or the recipient's legal guardian or conservator of service 284.32options; 284.33    (4) assisting the recipient in the identification of potential service providers; 284.34    (5) assisting the recipient to access services; 285.1    (6) coordinating, evaluating, and monitoring of the services identified in the service 285.2plan; 285.3    (7) completing the annual reviews of the service plan; and 285.4    (8) informing the recipient or legal representative of the right to have assessments 285.5completed and service plans developed within specified time periods, and to appeal county 285.6action or inaction under section 256.045, subdivision 3 new text begin , including the determination of new text end 285.7 new text begin nursing facility level of care new text end . 285.8    (b) The case manager may delegate certain aspects of the case management service 285.9activities to another individual provided there is oversight by the case manager. The case 285.10manager may not delegate those aspects which require professional judgment including 285.11assessments, reassessments, and care plan development. 285.12 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2011. new text end 285.13    Sec. 67. Minnesota Statutes 2008, section 256B.49, subdivision 14, is amended to read: 285.14    Subd. 14. Assessment and reassessment. (a) Assessments of each recipient's 285.15strengths, informal support systems, and need for services shall be completed within 285.1620 working days of the recipient's request. Reassessment of each recipient's strengths, 285.17support systems, and need for services shall be conducted at least every 12 months and at 285.18other times when there has been a significant change in the recipient's functioning. 285.19(b) new text begin There must be a determination that the client requires a hospital level of care or a new text end 285.20 new text begin nursing facility level of care as defined in section 144.0724, subdivision 11, at initial and new text end 285.21 new text begin subsequent assessments to initiate and maintain participation in the waiver program. new text end 285.22 new text begin (c) Regardless of other assessments identified in section 144.0724, subdivision 4, as new text end 285.23 new text begin appropriate to determine nursing facility level of care for purposes of medical assistance new text end 285.24 new text begin payment for nursing facility services, only face-to-face assessments conducted according new text end 285.25 new text begin to section 256B.0911, subdivisions 3a, 3b, and 4d, that result in a hospital level of care new text end 285.26 new text begin determination or a nursing facility level of care determination must be accepted for new text end 285.27 new text begin purposes of initial and ongoing access to waiver services payment. new text end 285.28 new text begin (d) new text end Persons with developmental disabilities who apply for services under the nursing 285.29facility level waiver programs shall be screened for the appropriate level of care according 285.30to section 256B.092. 285.31(c) new text begin (e) new text end Recipients who are found eligible for home and community-based services 285.32under this section before their 65th birthday may remain eligible for these services after 285.33their 65th birthday if they continue to meet all other eligibility factors. 285.34 new text begin EFFECTIVE DATE. new text end new text begin The section is effective January 1, 2011. new text end 286.1    Sec. 68. Minnesota Statutes 2008, section 256B.49, is amended by adding a 286.2subdivision to read: 286.3     new text begin Subd. 22. new text end new text begin Residential support services. new text end new text begin For the purposes of this section, the new text end 286.4 new text begin provisions of section 256B.092, subdivision 11, are controlling. new text end 286.5    Sec. 69. new text begin [256B.4912] HOME AND COMMUNITY-BASED WAIVERS; new text end 286.6 new text begin PROVIDERS AND PAYMENT. new text end 286.7     new text begin Subdivision 1. new text end new text begin Provider qualifications. new text end new text begin For the home and community-based new text end 286.8 new text begin waivers providing services to seniors and individuals with disabilities, the commissioner new text end 286.9 new text begin shall establish: new text end 286.10 new text begin (1) agreements with enrolled waiver service providers to ensure providers meet new text end 286.11 new text begin qualifications defined in the waiver plans; new text end 286.12 new text begin (2) regular reviews of provider qualifications; and new text end 286.13 new text begin (3) processes to gather the necessary information to determine provider new text end 286.14 new text begin qualifications. new text end 286.15 new text begin By July 2010, staff that provide direct contact, as defined in section 245C.02, subdivision new text end 286.16 new text begin 11, that are employees of waiver service providers must meet the requirements of chapter new text end 286.17 new text begin 245C prior to providing waiver services and as part of ongoing enrollment. Upon federal new text end 286.18 new text begin approval, this requirement must also apply to consumer-directed community supports. new text end 286.19     new text begin Subd. 2. new text end new text begin Rate-setting methodologies. new text end new text begin The commissioner shall establish new text end 286.20 new text begin statewide rate-setting methodologies that meet federal waiver requirements for home new text end 286.21 new text begin and community-based waiver services for individuals with disabilities. The rate-setting new text end 286.22 new text begin methodologies must abide by the principles of transparency and equitability across the new text end 286.23 new text begin state. The methodologies must involve a uniform process of structuring rates for each new text end 286.24 new text begin service and must promote quality and participant choice. new text end 286.25    Sec. 70. Minnesota Statutes 2008, section 256B.5011, subdivision 2, is amended to 286.26read: 286.27    Subd. 2. Contract provisions. (a) The service contract with each intermediate 286.28care facility must include provisions for: 286.29(1) modifying payments when significant changes occur in the needs of the 286.30consumers; 286.31(2) the establishment and use of a quality improvement plan. Using criteria and 286.32options for performance measures developed by the commissioner, each intermediate care 286.33facility must identify a minimum of one performance measure on which to focus its efforts 286.34for quality improvement during the contract period; 287.1(3) appropriate and necessary statistical information required by the commissioner; 287.2(4) new text begin (3) new text end annual aggregate facility financial information; and 287.3(5) new text begin (4) new text end additional requirements for intermediate care facilities not meeting the 287.4standards set forth in the service contract. 287.5(b) The commissioner of human services and the commissioner of health, in 287.6consultation with representatives from counties, advocacy organizations, and the provider 287.7community, shall review the consolidated standards under chapter 245B and the supervised 287.8living facility rule under Minnesota Rules, chapter 4665, to determine what provisions 287.9in Minnesota Rules, chapter 4665, may be waived by the commissioner of health for 287.10intermediate care facilities in order to enable facilities to implement the performance 287.11measures in their contract and provide quality services to residents without a duplication 287.12of or increase in regulatory requirements. 287.13    Sec. 71. Minnesota Statutes 2008, section 256B.5012, is amended by adding a 287.14subdivision to read: 287.15     new text begin Subd. 8. new text end new text begin ICF/MR rate decreases effective July 1, 2009. new text end new text begin Effective July 1, 2009, new text end 287.16 new text begin the commissioner shall decrease each facility reimbursed under this section operating new text end 287.17 new text begin payment adjustments equal to 2.58 percent of the operating payment rates in effect on new text end 287.18 new text begin June 30, 2009. For each facility, the commissioner shall implement the rate reduction, new text end 287.19 new text begin based on occupied beds, using the percentage specified in this subdivision multiplied by new text end 287.20 new text begin the total payment rate, including the variable rate but excluding the property-related new text end 287.21 new text begin payment rate, in effect on the preceding date. The total rate reduction shall include the new text end 287.22 new text begin adjustment provided in section 256B.502, subdivision 7. new text end 287.23    Sec. 72. Minnesota Statutes 2008, section 256B.69, subdivision 5a, is amended to read: 287.24    Subd. 5a. Managed care contracts. (a) Managed care contracts under this section 287.25and sections 256L.12 and 256D.03, shall be entered into or renewed on a calendar year 287.26basis beginning January 1, 1996. Managed care contracts which were in effect on June 287.2730, 1995, and set to renew on July 1, 1995, shall be renewed for the period July 1, 1995 287.28through December 31, 1995 at the same terms that were in effect on June 30, 1995. The 287.29commissioner may issue separate contracts with requirements specific to services to 287.30medical assistance recipients age 65 and older. 287.31    (b) A prepaid health plan providing covered health services for eligible persons 287.32pursuant to chapters 256B, 256D, and 256L, is responsible for complying with the terms 287.33of its contract with the commissioner. Requirements applicable to managed care programs 288.1under chapters 256B, 256D, and 256L, established after the effective date of a contract 288.2with the commissioner take effect when the contract is next issued or renewed. 288.3    (c) Effective for services rendered on or after January 1, 2003, the commissioner 288.4shall withhold five percent of managed care plan payments under this section for the 288.5prepaid medical assistance and general assistance medical care programs pending 288.6completion of performance targets. Each performance target must be quantifiable, 288.7objective, measurable, and reasonably attainable, except in the case of a performance 288.8target based on a federal or state law or rule. Criteria for assessment of each performance 288.9target must be outlined in writing prior to the contract effective date. The managed 288.10care plan must demonstrate, to the commissioner's satisfaction, that the data submitted 288.11regarding attainment of the performance target is accurate. The commissioner shall 288.12periodically change the administrative measures used as performance targets in order 288.13to improve plan performance across a broader range of administrative services. The 288.14performance targets must include measurement of plan efforts to contain spending 288.15on health care services and administrative activities. The commissioner may adopt 288.16plan-specific performance targets that take into account factors affecting only one plan, 288.17including characteristics of the plan's enrollee population. The withheld funds must be 288.18returned no sooner than July of the following year if performance targets in the contract 288.19are achieved. The commissioner may exclude special demonstration projects under 288.20subdivision 23. A managed care plan or a county-based purchasing plan under section 288.21256B.692 may include as admitted assets under section 62D.044 any amount withheld 288.22under this paragraph that is reasonably expected to be returned. 288.23    (d)(1) Effective for services rendered on or after January 1, 2009, the commissioner 288.24shall withhold three percent of managed care plan payments under this section for the 288.25prepaid medical assistance and general assistance medical care programs. The withheld 288.26funds must be returned no sooner than July 1 and no later than July 31 of the following 288.27year. The commissioner may exclude special demonstration projects under subdivision 23. 288.28    (2) A managed care plan or a county-based purchasing plan under section 256B.692 288.29may include as admitted assets under section 62D.044 any amount withheld under 288.30this paragraph. The return of the withhold under this paragraph is not subject to the 288.31requirements of paragraph (c). 288.32 new text begin (e) Effective for services provided on or after January 1, 2010, the commissioner new text end 288.33 new text begin shall require that managed care plans use the assessment and authorization processes, new text end 288.34 new text begin forms, timelines, standards, documentation, and data reporting requirements, protocols, new text end 288.35 new text begin billing processes, and policies consistent with medical assistance fee-for-service or the new text end 288.36 new text begin Department of Human Services contract requirements consistent with medical assistance new text end 289.1 new text begin fee-for-service or the Department of Human Services contract requirements for all new text end 289.2 new text begin personal care assistance services under section 256B.0659. new text end 289.3    Sec. 73. Minnesota Statutes 2008, section 256D.44, subdivision 5, is amended to read: 289.4    Subd. 5. Special needs. In addition to the state standards of assistance established in 289.5subdivisions 1 to 4, payments are allowed for the following special needs of recipients of 289.6Minnesota supplemental aid who are not residents of a nursing home, a regional treatment 289.7center, or a group residential housing facility. 289.8    (a) The county agency shall pay a monthly allowance for medically prescribed 289.9diets if the cost of those additional dietary needs cannot be met through some other 289.10maintenance benefit. The need for special diets or dietary items must be prescribed by 289.11a licensed physician. Costs for special diets shall be determined as percentages of the 289.12allotment for a one-person household under the thrifty food plan as defined by the United 289.13States Department of Agriculture. The types of diets and the percentages of the thrifty 289.14food plan that are covered are as follows: 289.15    (1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan; 289.16    (2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent 289.17of thrifty food plan; 289.18    (3) controlled protein diet, less than 40 grams and requires special products, 125 289.19percent of thrifty food plan; 289.20    (4) low cholesterol diet, 25 percent of thrifty food plan; 289.21    (5) high residue diet, 20 percent of thrifty food plan; 289.22    (6) pregnancy and lactation diet, 35 percent of thrifty food plan; 289.23    (7) gluten-free diet, 25 percent of thrifty food plan; 289.24    (8) lactose-free diet, 25 percent of thrifty food plan; 289.25    (9) antidumping diet, 15 percent of thrifty food plan; 289.26    (10) hypoglycemic diet, 15 percent of thrifty food plan; or 289.27    (11) ketogenic diet, 25 percent of thrifty food plan. 289.28    (b) Payment for nonrecurring special needs must be allowed for necessary home 289.29repairs or necessary repairs or replacement of household furniture and appliances using 289.30the payment standard of the AFDC program in effect on July 16, 1996, for these expenses, 289.31as long as other funding sources are not available. 289.32    (c) A fee for guardian or conservator service is allowed at a reasonable rate 289.33negotiated by the county or approved by the court. This rate shall not exceed five percent 289.34of the assistance unit's gross monthly income up to a maximum of $100 per month. If the 289.35guardian or conservator is a member of the county agency staff, no fee is allowed. 290.1    (d) The county agency shall continue to pay a monthly allowance of $68 for 290.2restaurant meals for a person who was receiving a restaurant meal allowance on June 1, 290.31990, and who eats two or more meals in a restaurant daily. The allowance must continue 290.4until the person has not received Minnesota supplemental aid for one full calendar month 290.5or until the person's living arrangement changes and the person no longer meets the criteria 290.6for the restaurant meal allowance, whichever occurs first. 290.7    (e) A fee of ten percent of the recipient's gross income or $25, whichever is less, 290.8is allowed for representative payee services provided by an agency that meets the 290.9requirements under SSI regulations to charge a fee for representative payee services. This 290.10special need is available to all recipients of Minnesota supplemental aid regardless of 290.11their living arrangement. 290.12    (f)(1) Notwithstanding the language in this subdivision, an amount equal to the 290.13maximum allotment authorized by the federal Food Stamp Program for a single individual 290.14which is in effect on the first day of July of each year will be added to the standards of 290.15assistance established in subdivisions 1 to 4 for adults under the age of 65 who qualify 290.16as shelter needy and are: (i) relocating from an institution, or an adult mental health 290.17residential treatment program under section 256B.0622; (ii) eligible for the self-directed 290.18supports option as defined under section 256B.0657, subdivision 2; or (iii) home and 290.19community-based waiver recipients living in their own home or rented or leased apartment 290.20which is not owned, operated, or controlled by a provider of service not related by blood 290.21or marriage. 290.22    (2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the 290.23shelter needy benefit under this paragraph is considered a household of one. An eligible 290.24individual who receives this benefit prior to age 65 may continue to receive the benefit 290.25after the age of 65. 290.26    (3) "Shelter needy" means that the assistance unit incurs monthly shelter costs that 290.27exceed 40 percent of the assistance unit's gross income before the application of this 290.28special needs standard. "Gross income" for the purposes of this section is the applicant's or 290.29recipient's income as defined in section 256D.35, subdivision 10, or the standard specified 290.30in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient of a federal or 290.31state housing subsidy, that limits shelter costs to a percentage of gross income, shall not be 290.32considered shelter needy for purposes of this paragraph. 290.33 new text begin (g) Notwithstanding this subdivision, recipients of home and community-based new text end 290.34 new text begin services may relocate to services without 24-hour supervision and receive the equivalent new text end 290.35 new text begin of the recipient's group residential housing allocation in Minnesota supplemental new text end 290.36 new text begin assistance shelter needy funding if the cost of the services and housing is equal to or less new text end 291.1 new text begin than provided to the recipient in home and community-based services and the relocation is new text end 291.2 new text begin the recipient's choice and is approved by the recipient or guardian. new text end 291.3 new text begin (h) To access housing and services as provided in paragraph (g), the recipient may new text end 291.4 new text begin choose housing that may or may not be owned, operated, or controlled by the recipient's new text end 291.5 new text begin service provider. new text end 291.6 new text begin (i) The provisions in paragraphs (g) and (h) are effective to June 30, 2011. The new text end 291.7 new text begin commissioner shall assess the development of publicly owned housing, other housing new text end 291.8 new text begin alternatives, and whether a public equity housing fund may be established that would new text end 291.9 new text begin maintain the state's interest, to the extent paid from group residential housing and new text end 291.10 new text begin Minnesota supplemental aid shelter needy funds in provider-owned housing so that when new text end 291.11 new text begin sold, the state would recover its share for a public equity fund to be used for future public new text end 291.12 new text begin needs under this chapter. The commissioner shall report findings and recommendations to new text end 291.13 new text begin the legislative committees and budget divisions with jurisdiction over health and human new text end 291.14 new text begin services policy and financing by January 15, 2012. new text end 291.15 new text begin (j) In selecting prospective services needed by recipients for whom home and new text end 291.16 new text begin community-based services have been authorized, the recipient and the recipient's guardian new text end 291.17 new text begin shall first consider alternatives to home and community-based services. Minnesota new text end 291.18 new text begin supplemental aid shelter needy funding for recipients who utilize Minnesota supplemental new text end 291.19 new text begin aid shelter needy funding as provided in this section shall remain permanent unless the new text end 291.20 new text begin recipient with the recipient's guardian later chooses to access home and community-based new text end 291.21 new text begin services. new text end 291.22    Sec. 74. Minnesota Statutes 2008, section 626.556, subdivision 3c, is amended to read: 291.23    Subd. 3c. Local welfare agency, Department of Human Services or Department 291.24of Health responsible for assessing or investigating reports of maltreatment. (a) 291.25The county local welfare agency is the agency responsible for assessing or investigating 291.26allegations of maltreatment in child foster care, family child care, and legally unlicensed 291.27child care and in new text begin , new text end juvenile correctional facilities licensed under section 241.021 located 291.28in the local welfare agency's county new text begin , and unlicensed personal care assistance provider new text end 291.29 new text begin organizations providing services and receiving reimbursements under chapter 256B new text end . 291.30(b) The Department of Human Services is the agency responsible for assessing or 291.31investigating allegations of maltreatment in facilities licensed under chapters 245A and 291.32245B, except for child foster care and family child care. 291.33(c) The Department of Health is the agency responsible for assessing or investigating 291.34allegations of child maltreatment in facilities licensed under sections 144.50 to 144.58, 291.35and in unlicensed home health care new text begin and 144A.46 new text end . 292.1(d) The commissioners of human services, public safety, and education must 292.2jointly submit a written report by January 15, 2007, to the education policy and finance 292.3committees of the legislature recommending the most efficient and effective allocation 292.4of agency responsibility for assessing or investigating reports of maltreatment and must 292.5specifically address allegations of maltreatment that currently are not the responsibility 292.6of a designated agency. 292.7    Sec. 75. Minnesota Statutes 2008, section 626.5572, subdivision 13, is amended to 292.8read: 292.9    Subd. 13. Lead agency. "Lead agency" is the primary administrative agency 292.10responsible for investigating reports made under section 626.557. 292.11(a) The Department of Health is the lead agency for the facilities which are licensed 292.12or are required to be licensed as hospitals, home care providers, nursing homes, residential 292.13care homes, or boarding care homes. 292.14(b) The Department of Human Services is the lead agency for the programs licensed 292.15or required to be licensed as adult day care, adult foster care, programs for people with 292.16developmental disabilities, mental health programs, new text begin or new text end chemical health programs, or 292.17personal care provider organizations. 292.18(c) The county social service agency or its designee is the lead agency for all 292.19other reports new text begin , including reports involving vulnerable adults receiving services from an new text end 292.20 new text begin unlicensed personal care provider organization under section 256B.0659 new text end . 292.21    Sec. 76. new text begin DEVELOPMENT OF ALTERNATIVE SERVICES. new text end 292.22 new text begin The commissioner of human services, in consultation with advocates, consumers, new text end 292.23 new text begin and legislators, shall develop alternative services to personal care assistance services for new text end 292.24 new text begin persons with mental health and other behavioral challenges who can benefit from other new text end 292.25 new text begin services that more appropriately meet their needs and assist them in living independently new text end 292.26 new text begin in the community. In the development of these services, the commissioner shall: new text end 292.27 new text begin (1) take into consideration ways in which these alternative services will qualify for new text end 292.28 new text begin federal financial participation; and new text end 292.29 new text begin (2) analyze a variety of alternatives, including but not limited to a 1915(i) state new text end 292.30 new text begin plan option. new text end 292.31 new text begin The commissioner shall report to the legislature by January 15, 2011, with plans for new text end 292.32 new text begin implementation of these services by July 1, 2011. new text end 292.33    Sec. 77. new text begin 30-DAY NOTICE REQUIRED. new text end 293.1 new text begin Notwithstanding any contrary provision in law, persons impacted by amendments new text end 293.2 new text begin in this article to Minnesota Statutes, sections 256B.0625, subdivision 19c; 256B.0655, new text end 293.3 new text begin subdivision 4; 256B.0659; and 256B.0911, subdivision 1, must be given a 30-day notice new text end 293.4 new text begin of action by the commissioner. This section expires July 1, 2011. new text end 293.5    Sec. 78. new text begin COLA COMPENSATION REQUIREMENTS. new text end 293.6 new text begin Effective July 1, 2009, providers who received rate increases under Laws 2007, new text end 293.7 new text begin chapter 147, article 7, section 71, as amended by Laws 2008, chapter 363, article 15, new text end 293.8 new text begin section 17, and Minnesota Statutes, section 256B.5012, subdivision 7, for state fiscal years new text end 293.9 new text begin 2008 and 2009 are no longer required to continue or retain employee compensation or new text end 293.10 new text begin wage-related increases required by those sections. This paragraph shall not apply to new text end 293.11 new text begin employees covered by a collective bargaining agreement. new text end 293.12    Sec. 79. new text begin PROVIDER RATE AND GRANT REDUCTIONS. new text end 293.13 new text begin (a) The commissioner of human services shall decrease grants, allocations, new text end 293.14 new text begin reimbursement rates, or rate limits, as applicable, by 2.58 percent effective July 1, 2009, new text end 293.15 new text begin for services rendered on or after that date. County or tribal contracts for services specified new text end 293.16 new text begin in this section must be amended to pass through these rate reductions within 60 days of new text end 293.17 new text begin the effective date of the decrease and must be retroactive from the effective date of the new text end 293.18 new text begin rate decrease. new text end 293.19 new text begin (b) The annual rate decreases described in this section must be provided to: new text end 293.20 new text begin (1) home and community-based waivered services for persons with developmental new text end 293.21 new text begin disabilities or related conditions, including consumer-directed community supports, under new text end 293.22 new text begin Minnesota Statutes, section 256B.501; new text end 293.23 new text begin (2) home and community-based waivered services for the elderly, including new text end 293.24 new text begin consumer-directed community supports, under Minnesota Statutes, section 256B.0915; new text end 293.25 new text begin (3) waivered services under community alternatives for disabled individuals, new text end 293.26 new text begin including consumer-directed community supports, under Minnesota Statutes, section new text end 293.27 new text begin 256B.49; new text end 293.28 new text begin (4) community alternative care waivered services, including consumer-directed new text end 293.29 new text begin community supports, under Minnesota Statutes, section 256B.49; new text end 293.30 new text begin (5) traumatic brain injury waivered services, including consumer-directed new text end 293.31 new text begin community supports, under Minnesota Statutes, section 256B.49; new text end 293.32 new text begin (6) nursing services and home health services under Minnesota Statutes, section new text end 293.33 new text begin 256B.0625, subdivision 6a; new text end 293.34 new text begin (7) personal care services and qualified professional supervision of personal care new text end 293.35 new text begin services under Minnesota Statutes, section 256B.0625, subdivisions 6a and 19a; new text end 294.1 new text begin (8) private duty nursing services under Minnesota Statutes, section 256B.0625, new text end 294.2 new text begin subdivision 7; new text end 294.3 new text begin (9) day training and habilitation services for adults with developmental disabilities new text end 294.4 new text begin or related conditions under Minnesota Statutes, sections 252.40 to 252.46, including the new text end 294.5 new text begin additional cost of rate adjustments on day training and habilitation services, provided as a new text end 294.6 new text begin social service under Minnesota Statutes, section 256M.60; new text end 294.7 new text begin (10) alternative care services under Minnesota Statutes, section 256B.0913; new text end 294.8 new text begin (11) the group residential housing supplementary service rate under Minnesota new text end 294.9 new text begin Statutes, section 256I.05, subdivision 1a; new text end 294.10 new text begin (12) semi-independent living services (SILS) under Minnesota Statutes, section new text end 294.11 new text begin 252.275, including SILS funding under county social services grants formerly funded new text end 294.12 new text begin under Minnesota Statutes, chapter 256I; new text end 294.13 new text begin (13) community support services for deaf and hard-of-hearing adults with mental new text end 294.14 new text begin illness who use or wish to use sign language as their primary means of communication new text end 294.15 new text begin under Minnesota Statutes, section 256.01, subdivision 2; and deaf and hard-of-hearing new text end 294.16 new text begin grants under Minnesota Statutes, sections 256C.233 and 256C.25; Laws 1985, chapter 9; new text end 294.17 new text begin and Laws 1997, First Special Session chapter 5, section 20; new text end 294.18 new text begin (14) physical therapy services under Minnesota Statutes, sections 256B.0625, new text end 294.19 new text begin subdivision 8, and 256D.03, subdivision 4; new text end 294.20 new text begin (15) occupational therapy services under Minnesota Statutes, sections 256B.0625, new text end 294.21 new text begin subdivision 8a, and 256D.03, subdivision 4; new text end 294.22 new text begin (16) speech-language therapy services under Minnesota Statutes, section 256D.03, new text end 294.23 new text begin subdivision 4, and Minnesota Rules, part 9505.0390; new text end 294.24 new text begin (17) respiratory therapy services under Minnesota Statutes, section 256D.03, new text end 294.25 new text begin subdivision 4, and Minnesota Rules, part 9505.0295; new text end 294.26 new text begin (18) consumer support grants under Minnesota Statutes, section 256.476; new text end 294.27 new text begin (19) family support grants under Minnesota Statutes, section 252.32; new text end 294.28 new text begin (20) aging grants under Minnesota Statutes, sections 256.975 to 256.977, 256B.0917, new text end 294.29 new text begin and 256B.0928; new text end 294.30 new text begin (21) disability linkage line grants under Minnesota Statutes, section 256.01, new text end 294.31 new text begin subdivision 24; and new text end 294.32 new text begin (22) housing access grants under Minnesota Statutes, section 256B.0658. new text end 294.33 new text begin (c) A managed care plan receiving state payments for the services in this section new text end 294.34 new text begin must include these decreases in their payments to providers effective on October 1 new text end 294.35 new text begin following the effective date of the rate decrease. new text end 295.1    Sec. 80. new text begin RECOMMENDATIONS FOR PERSONAL CARE ASSISTANCE new text end 295.2 new text begin SERVICES CHANGES, CONSULTATION WITH STAKEHOLDERS, AND DATA new text end 295.3 new text begin REPORTING. new text end 295.4 new text begin The commissioner shall: new text end 295.5 new text begin (1) consult with existing stakeholder groups convened under the commissioner's new text end 295.6 new text begin authority, including the home and community-based expert services panel beginning in new text end 295.7 new text begin August 2009 on implementation of the changes in the personal care assistance program, new text end 295.8 new text begin assistance for recipients whose services and housing must change, alternative services new text end 295.9 new text begin for those whose personal care assistance services are terminated or reduced, costs for new text end 295.10 new text begin those whose services will change, data on the effects of the changes in the personal care new text end 295.11 new text begin assistance program for recipients, and ongoing data on personal care assistance services new text end 295.12 new text begin for public reporting; and new text end 295.13 new text begin (2) report data on the training developed and delivered for all types of participants in new text end 295.14 new text begin the personal care assistance program, audit and financial integrity measures and results, new text end 295.15 new text begin information developed for consumers and responsible parties, available demographic, new text end 295.16 new text begin health care service use, and housing information about individuals who no longer qualify new text end 295.17 new text begin for personal care assistance, and quality assurance measures and results to the legislative new text end 295.18 new text begin committees with jurisdiction over health and human services policy and finance by new text end 295.19 new text begin January 15, 2010, and January 15, 2011. new text end 295.20    Sec. 81. new text begin ESTABLISHING A SINGLE SET OF STANDARDS. new text end 295.21 new text begin (a) The commissioner of human services shall consult with disability service new text end 295.22 new text begin providers, advocates, counties, and consumer families to develop a single set of standards new text end 295.23 new text begin governing services for people with disabilities receiving services under the home and new text end 295.24 new text begin community-based waiver services program to replace all or portions of existing laws and new text end 295.25 new text begin rules including, but not limited to, data practices, licensure of facilities and providers, new text end 295.26 new text begin background studies, reporting of maltreatment of minors, reporting of maltreatment of new text end 295.27 new text begin vulnerable adults, and the psychotropic medication checklist. The standards must: new text end 295.28 new text begin (1) enable optimum consumer choice; new text end 295.29 new text begin (2) be consumer driven; new text end 295.30 new text begin (3) link services to individual needs and life goals; new text end 295.31 new text begin (4) be based on quality assurance and individual outcomes; new text end 295.32 new text begin (5) utilize the people closest to the recipient, who may include family, friends, and new text end 295.33 new text begin health and service providers, in conjunction with the recipient's risk management plan to new text end 295.34 new text begin assist the recipient or the recipient's guardian in making decisions that meet the recipient's new text end 295.35 new text begin needs in a cost-effective manner and assure the recipient's health and safety; new text end 296.1 new text begin (6) utilize person-centered planning; and new text end 296.2 new text begin (7) maximize federal financial participation. new text end 296.3 new text begin (b) The commissioner may consult with existing stakeholder groups convened under new text end 296.4 new text begin the commissioner's authority, including the home and community-based expert services new text end 296.5 new text begin panel established by the commissioner in 2008, to meet all or some of the requirements new text end 296.6 new text begin of this section. new text end 296.7 new text begin (c) The commissioner shall provide the reports and plans required by this section to new text end 296.8 new text begin the legislative committees and budget divisions with jurisdiction over health and human new text end 296.9 new text begin services policy and finance by January 15, 2012. new text end 296.10    Sec. 82. new text begin COMMON SERVICE MENU FOR HOME AND COMMUNITY-BASED new text end 296.11 new text begin WAIVER PROGRAMS. new text end 296.12 new text begin The commissioner of human services shall confer with representatives of recipients, new text end 296.13 new text begin advocacy groups, counties, providers, and health plans to develop and update a common new text end 296.14 new text begin service menu for home and community-based waiver programs. The commissioner may new text end 296.15 new text begin consult with existing stakeholder groups convened under the commissioner's authority to new text end 296.16 new text begin meet all or some of the requirements of this section. new text end 296.17    Sec. 83. new text begin INTERMEDIATE CARE FACILITIES FOR PERSONS WITH new text end 296.18 new text begin DEVELOPMENTAL DISABILITIES REPORT. new text end 296.19 new text begin The commissioner of human services shall consult with providers and advocates of new text end 296.20 new text begin intermediate care facilities for persons with developmental disabilities to monitor progress new text end 296.21 new text begin made in response to the commissioner's December 15, 2008, report to the legislature new text end 296.22 new text begin regarding intermediate care facilities for persons with developmental disabilities. new text end 296.23    Sec. 84. new text begin HOUSING OPTIONS. new text end 296.24 new text begin The commissioner of human services, in consultation with the commissioner of new text end 296.25 new text begin administration and the Minnesota Housing Finance Agency, and representatives of new text end 296.26 new text begin counties, residents' advocacy groups, consumers of housing services, and provider new text end 296.27 new text begin agencies shall explore ways to maximize the availability and affordability of housing new text end 296.28 new text begin choices available to persons with disabilities or who need care assistance due to other new text end 296.29 new text begin health challenges. A goal shall also be to minimize state physical plant costs in order to new text end 296.30 new text begin serve more persons with appropriate program and care support. Consideration shall be new text end 296.31 new text begin given to: new text end 296.32 new text begin (1) improved access to rent subsidies; new text end 296.33 new text begin (2) use of cooperatives, land trusts, and other limited equity ownership models; new text end 297.1 new text begin (3) whether a public equity housing fund should be established that would maintain new text end 297.2 new text begin the state's interest, to the extent paid from state funds, including group residential housing new text end 297.3 new text begin and Minnesota supplemental aid shelter-needy funds in provider-owned housing, so that new text end 297.4 new text begin when sold, the state would recover its share for a public equity fund to be used for future new text end 297.5 new text begin public needs under this chapter; new text end 297.6 new text begin (4) the desirability of the state acquiring an ownership interest or promoting the new text end 297.7 new text begin use of publicly owned housing; new text end 297.8 new text begin (5) promoting more choices in the market for accessible housing that meets the new text end 297.9 new text begin needs of persons with physical challenges; and new text end 297.10 new text begin (6) what consumer ownership models, if any, are appropriate. new text end 297.11 new text begin The commissioner shall provide a written report on the findings of the evaluation of new text end 297.12 new text begin housing options to the chairs and ranking minority members of the house of representatives new text end 297.13 new text begin and senate standing committees with jurisdiction over health and human services policy new text end 297.14 new text begin and funding by December 15, 2010. This report shall replace the November 1, 2010, new text end 297.15 new text begin annual report by the commissioner required in Minnesota Statutes, sections 256B.0916, new text end 297.16 new text begin subdivision 7, and 256B.49, subdivision 21. new text end 297.17    Sec. 85. new text begin REVISOR'S INSTRUCTION. new text end 297.18     new text begin Subdivision 1. new text end new text begin Renumbering of Minnesota Statutes, section 256B.0652, new text end 297.19 new text begin authorization and review of home care services. new text end new text begin (a) The revisor of statutes shall new text end 297.20 new text begin renumber each section of Minnesota Statutes listed in column A with the number in new text end 297.21 new text begin column B. new text end 297.22 new text begin Column A new text end new text begin Column B new text end 297.23 new text begin 256B.0652, subdivision 3 new text end new text begin 256B.0652, subdivision 14 new text end 297.24 new text begin 256B.0651, subdivision 6, paragraph (a) new text end new text begin 256B.0652, subdivision 3 new text end 297.25 new text begin 256B.0651, subdivision 6, paragraph (b) new text end new text begin 256B.0652, subdivision 4 new text end 297.26 new text begin 256B.0651, subdivision 6, paragraph (c) new text end new text begin 256B.0652, subdivision 7 new text end 297.27 new text begin 256B.0651, subdivision 7, paragraph (a) new text end new text begin 256B.0652, subdivision 8 new text end 297.28 new text begin 256B.0651, subdivision 7, paragraph (b) new text end new text begin 256B.0652, subdivision 14 new text end 297.29 new text begin 256B.0651, subdivision 8 new text end new text begin 256B.0652, subdivision 9 new text end 297.30 new text begin 256B.0651, subdivision 9 new text end new text begin 256B.0652, subdivision 10 new text end 297.31 new text begin 256B.0651, subdivision 11 new text end new text begin 256B.0652, subdivision 11 new text end 298.1 new text begin 256B.0654, subdivision 2 new text end new text begin 256B.0652, subdivision 5 new text end 298.2 new text begin 256B.0655, subdivision 4 new text end new text begin 256B.0652, subdivision 6 new text end 298.3 new text begin (b) The revisor of statutes shall make necessary cross-reference changes in statutes new text end 298.4 new text begin and rules consistent with the renumbering in paragraph (a). The Department of Human new text end 298.5 new text begin Services shall assist the revisor with any cross-reference changes. The revisor may make new text end 298.6 new text begin changes necessary to correct the punctuation, grammar, or structure of the remaining text new text end 298.7 new text begin to conform with the intent of the renumbering in paragraph (a). new text end 298.8     new text begin Subd. 2. new text end new text begin Renumbering personal care assistance services. new text end new text begin The revisor of statutes new text end 298.9 new text begin shall replace any reference to Minnesota Statutes, section 256B.0655 with section new text end 298.10 new text begin 256B.0659, wherever it appears in statutes or rules. The revisor shall correct any cross new text end 298.11 new text begin reference changes that are necessary as a result of this section. The Department of Human new text end 298.12 new text begin Services shall assist the revisor in making these changes, and if necessary, shall draft a new text end 298.13 new text begin corrections bill with changes for introduction in the 2010 legislative session. The revisor new text end 298.14 new text begin may make changes to punctuation, grammar, or sentence structure to preserve the integrity new text end 298.15 new text begin of statutes and effectuate the intention of this section. new text end 298.16    Sec. 86. new text begin REPEALER. new text end 298.17 new text begin (a) new text end new text begin Minnesota Statutes 2008, sections 256B.0655, subdivisions 1, 1a, 1c, 1d, 1e, new text end 298.18 new text begin 1h, 1i, 3, 5, 6, 7, 8, 9, 10, 11, 12, and 13; and 256B.071, subdivisions 1, 2, 3, and 4, new text end new text begin are new text end 298.19 new text begin repealed. new text end 298.20 new text begin (b) new text end new text begin Minnesota Statutes 2008, sections 256B.19, subdivision 1d; and 256B.431, new text end 298.21 new text begin subdivision 23, new text end new text begin are repealed effective May 1, 2009. new text end 298.22 new text begin (c) new text end new text begin Minnesota Statutes 2008, section 256B.0655, subdivisions 1f, 1g, and 2, new text end new text begin are new text end 298.23 new text begin repealed effective January 1, 2010. new text end 298.24ARTICLE 9 298.25STATE-COUNTY RESULTS, ACCOUNTABILITY, AND SERVICE 298.26DELIVERY REFORM ACT 298.27    Section 1. new text begin [402A.01] CITATION. new text end 298.28 new text begin Sections 402A.01 to 402A.50 may be cited as the "State-County Results, new text end 298.29 new text begin Accountability, and Service Delivery Reform Act." new text end 298.30    Sec. 2. new text begin [402A.10] DEFINITIONS. new text end 298.31     new text begin Subdivision 1. new text end new text begin Terms defined. new text end new text begin For the purposes of this chapter, the terms defined new text end 298.32 new text begin in this section have the meanings given. new text end 299.1     new text begin Subd. 2. new text end new text begin Commissioner. new text end new text begin "Commissioner" means the commissioner of human new text end 299.2 new text begin services. new text end 299.3     new text begin Subd. 3. new text end new text begin Council. new text end new text begin "Council" means the State-County Results, Accountability, and new text end 299.4 new text begin Service Delivery Redesign Council established in section 402A.20. new text end 299.5     new text begin Subd. 4. new text end new text begin Essential human services or essential services. new text end new text begin "Essential human new text end 299.6 new text begin services" or "essential services" means assistance and services to recipients or potential new text end 299.7 new text begin recipients of public welfare and other services delivered by counties that are mandated in new text end 299.8 new text begin federal and state law that are to be available in all counties of the state. new text end 299.9     new text begin Subd. 5. new text end new text begin Service delivery authority. new text end new text begin "Service delivery authority" means a single new text end 299.10 new text begin county, or group of counties operating by execution of a joint powers agreement under new text end 299.11 new text begin section 471.59 or other contractual agreement, that has voluntarily chosen by resolution of new text end 299.12 new text begin the county board of commissioners to participate in the redesign under this chapter. new text end 299.13     new text begin Subd. 6. new text end new text begin Steering committee. new text end new text begin "Steering committee" means the Steering Committee new text end 299.14 new text begin on Performance and Outcome Reforms. new text end 299.15 new text begin EFFECTIVE DATE. new text end new text begin This section is effective the day following final enactment. new text end 299.16    Sec. 3. new text begin [402A.15] STEERING COMMITTEE ON PERFORMANCE AND new text end 299.17 new text begin OUTCOME REFORMS. new text end 299.18     new text begin Subdivision 1. new text end new text begin Duties. new text end new text begin (a) The Steering Committee on Performance and Outcome new text end 299.19 new text begin Reforms shall develop a uniform process to establish and review performance and new text end 299.20 new text begin outcome standards for all essential human services based on the current level of resources new text end 299.21 new text begin available, and to develop appropriate reporting measures and a uniform accountability new text end 299.22 new text begin process for responding to a county's or human service authority's failure to make adequate new text end 299.23 new text begin progress on achieving performance measures. The accountability process shall focus on new text end 299.24 new text begin the performance measures rather than inflexible implementation requirements. new text end 299.25 new text begin (b) The steering committee shall: new text end 299.26 new text begin (1) by November 1, 2009, establish an agreed upon list of essential services; new text end 299.27 new text begin (2) by February 15, 2010, develop and recommend to the legislature a uniform, new text end 299.28 new text begin graduated process, in addition to the remedies identified in section 402A.18, for responding new text end 299.29 new text begin to a county's failure to make adequate progress on achieving performance measures; and new text end 299.30 new text begin (3) by December 15, 2012, for each essential service make recommendations to the new text end 299.31 new text begin legislature regarding (1) performance measures and goals based on those measures for new text end 299.32 new text begin each essential service, (2) a system for reporting on the performance measures and goals, new text end 299.33 new text begin and (3) appropriate resources, including funding, needed to achieve those performance new text end 299.34 new text begin measures and goals. The resource recommendations shall take into consideration program new text end 300.1 new text begin demand and the unique differences of local areas in geography and the populations new text end 300.2 new text begin served. Priority shall be given to services with the greatest variation in availability and new text end 300.3 new text begin greatest administrative demands. By January 15 of each year starting January 15, 2011, new text end 300.4 new text begin the steering committee shall report its recommendations to the governor and legislative new text end 300.5 new text begin committees with jurisdiction over health and human services. As part of its report, the new text end 300.6 new text begin steering committee shall, as appropriate, recommend statutory provisions, rules and new text end 300.7 new text begin requirements, and reports that should be repealed or eliminated. new text end 300.8 new text begin (c) As far as possible, the performance measures, reporting system, and funding new text end 300.9 new text begin shall be consistent across program areas. The development of performance measures shall new text end 300.10 new text begin consider the manner in which data will be collected and performance will be reported. new text end 300.11 new text begin The steering committee shall consider state and local administrative costs related to new text end 300.12 new text begin collecting data and reporting outcomes when developing performance measures. The new text end 300.13 new text begin steering committee shall correlate the performance measures and goals to available new text end 300.14 new text begin levels of resources, including state and local funding. The steering committee shall new text end 300.15 new text begin take into consideration that the goal of implementing changes to program monitoring new text end 300.16 new text begin and reporting the progress toward achieving outcomes is to significantly minimize the new text end 300.17 new text begin cost of administrative requirements and to allow funds freed by reduced administrative new text end 300.18 new text begin expenditures to be used to provide additional services, allow flexibility in service design new text end 300.19 new text begin and management, and focus energies on achieving program and client outcomes. new text end 300.20 new text begin (d) In making its recommendations, the steering committee shall consider input from new text end 300.21 new text begin the council established in section 402A.20. The steering committee shall review the new text end 300.22 new text begin measurable goals established in a memorandum of understanding entered into under new text end 300.23 new text begin section 402A.30, subdivision 2, paragraph (b), and consider whether they may be applied new text end 300.24 new text begin as statewide performance outcomes. new text end 300.25 new text begin (e) The steering committee shall form work groups that include persons who provide new text end 300.26 new text begin or receive essential services and representatives of organizations who advocate on behalf new text end 300.27 new text begin of those persons. new text end 300.28 new text begin (f) By December 15, 2009, the steering committee shall establish a three-year new text end 300.29 new text begin schedule for completion of its work. The schedule shall be published on the Department of new text end 300.30 new text begin Human Services Web site and reported to the legislative committees with jurisdiction over new text end 300.31 new text begin health and human services. In addition, the commissioner shall post quarterly updates on new text end 300.32 new text begin the progress of the steering committee on the Department of Human Services Web site. new text end 300.33     new text begin Subd. 2. new text end new text begin Composition. new text end new text begin (a) The steering committee shall include: new text end 300.34 new text begin (1) the commissioner of human services, or designee, and two additional new text end 300.35 new text begin representatives of the department; new text end 301.1 new text begin (2) two county commissioners, representative of rural and urban counties, selected new text end 301.2 new text begin by the Association of Minnesota Counties; new text end 301.3 new text begin (3) two county directors of human services, representative of rural and urban new text end 301.4 new text begin counties, selected by the Minnesota Association of County Social Service Administrators; new text end 301.5 new text begin and new text end 301.6 new text begin (4) three clients or client advocates representing different populations receiving new text end 301.7 new text begin services from the Department of Human Services, who are appointed by the commissioner. new text end 301.8 new text begin (b) The commissioner, or designee, and a county commissioner shall serve as new text end 301.9 new text begin cochairs of the committee. The committee shall be convened within 60 days of final new text end 301.10 new text begin enactment of this legislation. new text end 301.11 new text begin (c) State agency staff shall serve as informational resources and staff to the steering new text end 301.12 new text begin committee. Statewide county associations may assemble county program data as required. new text end 301.13 new text begin (d) To promote information sharing and coordination between the steering committee new text end 301.14 new text begin and council, one of the county representatives from paragraph (a), clause (2), and one of the new text end 301.15 new text begin county representatives from paragraph (a), clause (3), must also serve as a representative new text end 301.16 new text begin on the council under section 402A.20, subdivision 1, paragraph (b), clause (5) or (6). new text end 301.17 new text begin EFFECTIVE DATE. new text end new text begin This section is effective the day following final enactment. new text end 301.18    Sec. 4. new text begin [402A.18] COMMISSIONER POWER TO REMEDY FAILURE TO new text end 301.19 new text begin MEET PERFORMANCE OUTCOMES. new text end 301.20     new text begin Subdivision 1. new text end new text begin Underperforming county; specific service. new text end new text begin If the commissioner new text end 301.21 new text begin determines that a county or service delivery authority is deficient in achieving minimum new text end 301.22 new text begin performance outcomes for a specific essential service, the commissioner may impose new text end 301.23 new text begin the following remedies: new text end 301.24 new text begin (1) voluntary incorporation of the administration and operation of the specific new text end 301.25 new text begin essential service with an existing service delivery authority or another county. A new text end 301.26 new text begin service delivery authority or county incorporating an underperforming county shall new text end 301.27 new text begin not be financially liable for the costs associated with remedying performance outcome new text end 301.28 new text begin deficiencies; new text end 301.29 new text begin (2) mandatory incorporation of the administration and operation of the specific new text end 301.30 new text begin essential service with an existing service delivery authority or another county. A new text end 301.31 new text begin service delivery authority or county incorporating an underperforming county shall new text end 301.32 new text begin not be financially liable for the costs associated with remedying performance outcome new text end 301.33 new text begin deficiencies; or new text end 301.34 new text begin (3) transfer of authority for program administration and operation of the specific new text end 301.35 new text begin essential service to the commissioner. new text end 302.1     new text begin Subd. 2. new text end new text begin Underperforming county; more than one-half of service. new text end new text begin If the new text end 302.2 new text begin commissioner determines that a county or service delivery authority is deficient in new text end 302.3 new text begin achieving minimum performance outcomes for more than one-half of the defined essential new text end 302.4 new text begin service, the commissioner may impose the following remedies: new text end 302.5 new text begin (1) voluntary incorporation of the administration and operation of the specific new text end 302.6 new text begin essential service with an existing service delivery authority or another county. A new text end 302.7 new text begin service delivery authority or county incorporating an underperforming county shall new text end 302.8 new text begin not be financially liable for the costs associated with remedying performance outcome new text end 302.9 new text begin deficiencies; new text end 302.10 new text begin (2) mandatory incorporation of the administration and operation of the specific new text end 302.11 new text begin essential service with an existing service delivery authority or another county. A new text end 302.12 new text begin service delivery authority or county incorporating an underperforming county shall new text end 302.13 new text begin not be financially liable for the costs associated with remedying performance outcome new text end 302.14 new text begin deficiencies; or new text end 302.15 new text begin (3) transfer of authority for program administration and operation of the specific new text end 302.16 new text begin essential service to the commissioner. new text end 302.17     new text begin Subd. 3. new text end new text begin Conditions prior to imposing remedies. new text end new text begin Before the commissioner may new text end 302.18 new text begin impose the remedies authorized under this section, the following conditions must be met: new text end 302.19 new text begin (1) the county or service delivery authority determined by the commissioner new text end 302.20 new text begin to be deficient in achieving minimum performance outcomes has the opportunity, in new text end 302.21 new text begin coordination with the council, to develop a program outcome improvement plan. The new text end 302.22 new text begin program outcome improvement plan must be developed no later than six months from the new text end 302.23 new text begin date of the deficiency determination; and new text end 302.24 new text begin (2) the council has conducted an assessment of the program outcome improvement new text end 302.25 new text begin plan to determine if the county or service delivery authority has made satisfactory progress new text end 302.26 new text begin toward performance outcomes and has made a recommendation about remedies to the new text end 302.27 new text begin commissioner. The review and recommendation must be made to the commissioner within new text end 302.28 new text begin 12 months from the date of the deficiency determination. new text end 302.29    Sec. 5. new text begin [402A.20] COUNCIL. new text end 302.30     new text begin Subdivision 1. new text end new text begin Council. new text end new text begin (a) The State-County Results, Accountability, and Service new text end 302.31 new text begin Delivery Redesign Council is established. Appointed council members must be appointed new text end 302.32 new text begin by their respective agencies, associations, or governmental units by November 1, 2009. new text end 302.33 new text begin The council shall be cochaired by the commissioner of human services, or designee, and a new text end 302.34 new text begin county representative from paragraph (b), clause (4) or (5), appointed by the Association new text end 302.35 new text begin of Minnesota Counties. Recommendations of the council must be approved by a majority new text end 303.1 new text begin of the council members. The provisions of section 15.059 do not apply to this council, new text end 303.2 new text begin and this council does not expire. new text end 303.3 new text begin (b) The council must consist of the following members: new text end 303.4 new text begin (1) two legislators appointed by the speaker of the house, one from the minority new text end 303.5 new text begin and one from the majority; new text end 303.6 new text begin (2) two legislators appointed by the Senate Rules Committee, one from the majority new text end 303.7 new text begin and one from the minority; new text end 303.8 new text begin (3) the commissioner of human services, or designee, and three employees from new text end 303.9 new text begin the department; new text end 303.10 new text begin (4) two county commissioners appointed by the Association of Minnesota Counties; new text end 303.11 new text begin (5) two county representatives appointed by the Minnesota Association of County new text end 303.12 new text begin Social Service Administrators; new text end 303.13 new text begin (6) one representative appointed by AFSCME as a nonvoting member; and new text end 303.14 new text begin (7) one representative appointed by the Teamsters as a nonvoting member. new text end 303.15 new text begin (c) Administrative support to the council may be provided by the Association of new text end 303.16 new text begin Minnesota Counties and affiliates. new text end 303.17 new text begin (d) Member agencies and associations are responsible for initial and subsequent new text end 303.18 new text begin appointments to the council. new text end 303.19     new text begin Subd. 2. new text end new text begin Council duties. new text end new text begin The council shall: new text end 303.20 new text begin (1) provide review of the redesign process; new text end 303.21 new text begin (2) certify, in accordance with section 402A.30, subdivision 4, the formation of new text end 303.22 new text begin a service delivery authority, including the memorandum of understanding in section new text end 303.23 new text begin 402A.30, subdivision 2, paragraph (b); new text end 303.24 new text begin (3) ensure the consistency of the memoranda of understanding entered into new text end 303.25 new text begin under section 402A.30, subdivision 2, paragraph (b), with the performance standards new text end 303.26 new text begin recommended by the steering committee and enacted by the legislature; new text end 303.27 new text begin (4) ensure the consistency of the memoranda of understanding, to the extent new text end 303.28 new text begin appropriate, or other memoranda of understanding entered into by other service delivery new text end 303.29 new text begin authorities; new text end 303.30 new text begin (5) establish a process to take public input on the service delivery framework new text end 303.31 new text begin specified in the memorandum of understanding in section 402A.30, subdivision 2, new text end 303.32 new text begin paragraph (b); new text end 303.33 new text begin (6) form work groups as necessary to carry out the duties of the council under the new text end 303.34 new text begin redesign; new text end 304.1 new text begin (7) serve as a forum for resolving conflicts among participating counties or between new text end 304.2 new text begin participating counties and the commissioner of human services, provided nothing in this new text end 304.3 new text begin section is intended to create a formal binding legal process; new text end 304.4 new text begin (8) engage in the program improvement process established in section 402A.18, new text end 304.5 new text begin subdivision 3; and new text end 304.6 new text begin (9) identify and recommend incentives for counties to participate in human services new text end 304.7 new text begin authorities. new text end 304.8 new text begin EFFECTIVE DATE. new text end new text begin This section is effective the day following final enactment. new text end 304.9    Sec. 6. new text begin [402A.30] DESIGNATION OF SERVICE DELIVERY AUTHORITY. new text end 304.10     new text begin Subdivision 1. new text end new text begin Establishment. new text end new text begin After certification by the council and approval by new text end 304.11 new text begin the commissioner, in accordance with subdivision 4, a county or consortium of counties new text end 304.12 new text begin may establish a service delivery authority to redesign the delivery of some or all essential new text end 304.13 new text begin services. Once a county or consortium of counties establishes a service delivery authority, new text end 304.14 new text begin no county that is a participant in the service delivery authority may participate in or be new text end 304.15 new text begin a member of any other service delivery authority. The service delivery authority may new text end 304.16 new text begin allow an additional county or counties to join the service delivery authority subject to the new text end 304.17 new text begin approval of the council and the commissioner. new text end 304.18     new text begin Subd. 2. new text end new text begin New state-county governance framework. new text end new text begin (a) To establish a service new text end 304.19 new text begin delivery authority, each participating county and the state must enter into a binding new text end 304.20 new text begin memorandum of understanding to establish a joint state-county service delivery new text end 304.21 new text begin framework: new text end 304.22 new text begin (b) The memorandum of understanding must: new text end 304.23 new text begin (1) comply with current state and federal law except where waivers are approved new text end 304.24 new text begin under clause (7); new text end 304.25 new text begin (2) define the scope of essential services over which the service delivery authority new text end 304.26 new text begin has jurisdiction; new text end 304.27 new text begin (3) designate a single administrative structure to oversee the delivery of services over new text end 304.28 new text begin which the service delivery authority has jurisdiction and identify a single administrative new text end 304.29 new text begin agent for purposes of contact and communication with the department; new text end 304.30 new text begin (4) define measurable performance and outcome goals in key operational areas new text end 304.31 new text begin that the service delivery authority is expected to achieve, provided that the performance new text end 304.32 new text begin goals must, at a minimum, satisfy performance outcomes recommended by the steering new text end 304.33 new text begin committee and enacted into law; new text end 305.1 new text begin (5) identify the state and local resources, including funding and administrative and new text end 305.2 new text begin information technology support, and other requirements necessary for the service delivery new text end 305.3 new text begin authority to achieve the performance and outcome goals; new text end 305.4 new text begin (6) state the relief available to the service delivery authority if the resource new text end 305.5 new text begin commitments identified in clause (5) are not met; new text end 305.6 new text begin (7) identify in the agreement the waivers from statutory requirements that are needed new text end 305.7 new text begin to ensure greater local control and flexibility to determine the most cost-effective means new text end 305.8 new text begin of achieving specified measurable goals and the date by which the commissioner shall new text end 305.9 new text begin grant the identified waivers; new text end 305.10 new text begin (8) set forth a graduated accountability process and penalties for responding to a new text end 305.11 new text begin county's failure to make adequate progress on achieving performance and outcome goals; new text end 305.12 new text begin (9) set forth a reasonable level of targeted reductions in overhead and administrative new text end 305.13 new text begin costs for each county participating in the service delivery authority; and new text end 305.14 new text begin (10) set forth the terms under which a county may withdraw from participation. new text end 305.15 new text begin The memorandum of understanding may be later amended to add additional services over new text end 305.16 new text begin which the service delivery authority has jurisdiction. new text end 305.17 new text begin (c) Nothing in this chapter precludes local governments from utilizing sections new text end 305.18 new text begin 465.81 and 465.82 to establish procedures for local governments to merge, with the new text end 305.19 new text begin consent of the voters. Any agreement under paragraph (b) must be governed by this new text end 305.20 new text begin chapter. Nothing in this chapter limits the authority of a county board to enter into new text end 305.21 new text begin contractual agreements for services not covered by the provisions of a memorandum of new text end 305.22 new text begin understanding establishing a service delivery authority with other agencies or with other new text end 305.23 new text begin units of government. new text end 305.24     new text begin Subd. 3. new text end new text begin Duties. new text end new text begin The service delivery authority shall: new text end 305.25 new text begin (1) within the scope of essential services set forth in the memorandum of new text end 305.26 new text begin understanding establishing the authority, carry out the responsibilities required of local new text end 305.27 new text begin agencies under chapter 393 and human services boards under chapter 402; new text end 305.28 new text begin (2) manage the public resources devoted to human services and other public services new text end 305.29 new text begin delivered or purchased by the counties that are subsidized or regulated by the Department new text end 305.30 new text begin of Human Services under chapters 245 and 267; new text end 305.31 new text begin (3) employ staff to assist in carrying out its duties; new text end 305.32 new text begin (4) develop and maintain a continuity of operations plan to ensure the continued new text end 305.33 new text begin operation or resumption of essential human services functions in the event of any business new text end 305.34 new text begin interruption according to local, state, and federal emergency planning requirements; new text end 305.35 new text begin (5) receive and expend funds received for the redesign process under the new text end 305.36 new text begin memorandum of understanding; new text end 306.1 new text begin (6) plan and deliver services directly or through contract with other governmental new text end 306.2 new text begin or nongovernmental providers; new text end 306.3 new text begin (7) rent, purchase, sell, and otherwise dispose of real and personal property as new text end 306.4 new text begin necessary to carry out the redesign; and new text end 306.5 new text begin (8) carry out any other service designated as a responsibility of a county. new text end 306.6     new text begin Subd. 4. new text end new text begin Process for establishing a service delivery authority. new text end new text begin (a) The county or new text end 306.7 new text begin consortium of counties proposing to form a service delivery authority shall, in conjunction new text end 306.8 new text begin with the commissioner, prevent a proposed memorandum of understanding to the council new text end 306.9 new text begin accompanied by a resolution from the board of commissioners of each participating new text end 306.10 new text begin county stating the county's intent to participate in a service delivery authority. new text end 306.11 new text begin (b) The council shall certify a county or consortium of counties as a service delivery new text end 306.12 new text begin authority if: new text end 306.13 new text begin (1) the conditions in subdivision 2, paragraphs (a) and (b), are met; and new text end 306.14 new text begin (2) the county or consortium of counties are: new text end 306.15 new text begin (i) a single county with a population of 55,000 or more; new text end 306.16 new text begin (ii) a consortium of counties with a total combined population of 55,000 or more and new text end 306.17 new text begin the counties comprising the consortium are in reasonable geographic proximity; or new text end 306.18 new text begin (iii) four or more counties in reasonable geographic proximity without regard new text end 306.19 new text begin to population. new text end 306.20 new text begin The council may recommend that the commissioner of human services exempt a new text end 306.21 new text begin single county or multicounty service delivery authority from the minimum population new text end 306.22 new text begin standard if that service delivery authority can demonstrate that it can otherwise meet new text end 306.23 new text begin the requirements of this chapter. new text end 306.24 new text begin (c) After the council has certified a county or consortium of counties as a service new text end 306.25 new text begin delivery authority, the commissioner may enter into the memoranda of understanding with new text end 306.26 new text begin the participating counties to form the service delivery authority. new text end 306.27     new text begin Subd. 5. new text end new text begin Single county service delivery authority. new text end new text begin For counties with populations new text end 306.28 new text begin over 55,000, the board of county commissioners may be the service delivery authority and new text end 306.29 new text begin retain existing authority under law. new text end 306.30    Sec. 7. new text begin [402A.45] ESSENTIAL SERVICES OUTSIDE THE JURISDICTION OF new text end 306.31 new text begin A SERVICE DELIVERY AUTHORITY. new text end 306.32 new text begin (a) With the approval of the council, a county that is a participant in a service new text end 306.33 new text begin delivery authority may enter into cooperative arrangements with other service delivery new text end 306.34 new text begin authorities or other counties to provide essential services that are not within the jurisdiction new text end 306.35 new text begin and duties of the service delivery authority. new text end 307.1 new text begin (b) With the approval of the council, a service delivery authority may enter into a new text end 307.2 new text begin cooperative arrangement with a nonparticipating county to provide an essential service new text end 307.3 new text begin within the jurisdiction and duties of the service delivery authority. new text end 307.4    Sec. 8. new text begin [402A.50] PRIVATE SECTOR FUNDING. new text end 307.5 new text begin The council may support stakeholder agencies, if not otherwise prohibited by law, to new text end 307.6 new text begin separately or jointly seek and receive funds to provide expert technical assistance to the new text end 307.7 new text begin council, the council's work group, and any subwork groups for executing the provisions new text end 307.8 new text begin of the redesign. new text end 307.9    Sec. 9. new text begin APPROPRIATION. new text end 307.10 new text begin $350,000 is appropriated for the biennium beginning July 1, 2009, from the general new text end 307.11 new text begin fund to the State-County Results, Accountability, and Service Delivery Redesign Council, new text end 307.12 new text begin for the purposes of the State-County Results, Accountability, and Service Delivery Reform new text end 307.13 new text begin Act under Minnesota Statutes, sections 402A.01 to 402A.50. The council shall establish a new text end 307.14 new text begin methodology for distributing funds to certified service delivery authorities for the purposes new text end 307.15 new text begin of carrying out the requirements of the redesign. new text end 307.16ARTICLE 10 307.17PUBLIC HEALTH 307.18    Section 1. Minnesota Statutes 2008, section 103I.208, subdivision 2, is amended to 307.19read: 307.20    Subd. 2. Permit fee. The permit fee to be paid by a property owner is: 307.21    (1) for a water supply well that is not in use under a maintenance permit, $175 307.22annually; 307.23    (2) for construction of a monitoring well, $215, which includes the state core 307.24function fee; 307.25    (3) for a monitoring well that is unsealed under a maintenance permit, $175 annually; 307.26    (4) new text begin for a monitoring well owned by a federal agency, state agency, or local unit of new text end 307.27 new text begin government that is unsealed under a maintenance permit, $50 annually. "Local unit of new text end 307.28 new text begin government" means a statutory or home rule charter city, town, county, or soil and water new text end 307.29 new text begin conservation district, watershed district, an organization formed for the joint exercise of new text end 307.30 new text begin powers under section 471.59, a board of health or community health board, or other new text end 307.31 new text begin special purpose district or authority with local jurisdiction in water and related land new text end 307.32 new text begin resources management; new text end 307.33 new text begin (5) new text end for monitoring wells used as a leak detection device at a single motor fuel retail 307.34outlet, a single petroleum bulk storage site excluding tank farms, or a single agricultural 308.1chemical facility site, the construction permit fee is $215, which includes the state core 308.2function fee, per site regardless of the number of wells constructed on the site, and 308.3the annual fee for a maintenance permit for unsealed monitoring wells is $175 per site 308.4regardless of the number of monitoring wells located on site; 308.5    (5) new text begin (6) new text end for a groundwater thermal exchange device, in addition to the notification fee 308.6for water supply wells, $215, which includes the state core function fee; 308.7    (6) new text begin (7) new text end for a vertical heat exchanger new text begin with less than ten tons of heating/cooling new text end 308.8 new text begin capacity new text end , $215; 308.9 new text begin (8) for a vertical heat exchanger with ten to 50 tons of heating/cooling capacity, $425; new text end 308.10 new text begin (9) for a vertical heat exchanger with greater than 50 tons of heating/cooling new text end 308.11 new text begin capacity, $650; new text end 308.12    (7) new text begin (10) new text end for a dewatering well that is unsealed under a maintenance permit, $175 308.13annually for each dewatering well, except a dewatering project comprising more than five 308.14dewatering wells shall be issued a single permit for $875 annually for dewatering wells 308.15recorded on the permit; and 308.16    (8) new text begin (11) new text end for an elevator boring, $215 for each boring. 308.17    Sec. 2. Minnesota Statutes 2008, section 144.121, subdivision 1a, is amended to read: 308.18    Subd. 1a. Fees for ionizing radiation-producing equipment. new text begin (a) new text end A facility with 308.19ionizing radiation-producing equipment must pay an annual initial or annual renewal 308.20registration fee consisting of a base facility fee of $66 new text begin $100 new text end and an additional fee for 308.21each radiation source, as follows: 308.22 (1) medical or veterinary equipment $ 53 new text begin 100 new text end 308.23 (2) dental x-ray equipment $ 33 new text begin 40 new text end 308.24 (3) accelerator $ 66 308.25 (4) radiation therapy equipment $ 66 308.26 308.27 (5) new text begin (3) new text end x-ray equipment not used on humans or animals $ 53 new text begin 100 new text end 308.28 308.29 308.30 (6) new text begin (4) new text end devices with sources of ionizing radiation not used on humans or animals $ 53 new text begin 100 new text end 308.31 new text begin (b) A facility with radiation therapy and accelerator equipment must pay an annual new text end 308.32 new text begin registration fee of $500. A facility with an industrial accelerator must pay an annual new text end 308.33 new text begin registration fee of $150. new text end 309.1 new text begin (c) Electron microscopy equipment is exempt from the registration fee requirements new text end 309.2 new text begin of this section. new text end 309.3    Sec. 3. Minnesota Statutes 2008, section 144.121, subdivision 1b, is amended to read: 309.4    Subd. 1b. Penalty fee for late registration. Applications for initial or renewal 309.5registrations submitted to the commissioner after the time specified by the commissioner 309.6shall be accompanied by a penalty fee of $20 new text begin an amount equal to 25 percent of the fee new text end 309.7 new text begin due new text end in addition to the fees prescribed in subdivision 1a. 309.8    Sec. 4. Minnesota Statutes 2008, section 144.1222, subdivision 1a, is amended to read: 309.9    Subd. 1a. Fees. All plans and specifications for public pool and spa construction, 309.10installation, or alteration or requests for a variance that are submitted to the commissioner 309.11according to Minnesota Rules, part 4717.3975, shall be accompanied by the appropriate 309.12fees. All public pool construction plans submitted for review after January 1, 2009, 309.13must be certified by a professional engineer registered in the state of Minnesota. If the 309.14commissioner determines, upon review of the plans, that inadequate fees were paid, the 309.15necessary additional fees shall be paid before plan approval. For purposes of determining 309.16fees, a project is defined as a proposal to construct or install a public pool, spa, special 309.17purpose pool, or wading pool and all associated water treatment equipment and drains, 309.18gutters, decks, water recreation features, spray pads, and those design and safety features 309.19that are within five feet of any pool or spa. The commissioner shall charge the following 309.20fees for plan review and inspection of public pools and spas and for requests for variance 309.21from the public pool and spa rules: 309.22    (1) each pool, $800 new text begin $1,500 new text end ; 309.23    (2) each spa pool, $500 new text begin $800 new text end ; 309.24    (3) each slide, $400 new text begin $600 new text end ; 309.25    (4) projects valued at $250,000 or more, the greater of the sum of the fees in clauses 309.26(1), (2), and (3) or 0.5 percent of the documented estimated project cost to a maximum 309.27fee of $10,000 new text begin $15,000 new text end ; 309.28    (5) alterations to an existing pool without changing the size or configuration of 309.29the pool, $400 new text begin $600 new text end ; 309.30    (6) removal or replacement of pool disinfection equipment only, $75 new text begin $100 new text end ; and 309.31    (7) request for variance from the public pool and spa rules, $500. 309.32    Sec. 5. Minnesota Statutes 2008, section 144.125, subdivision 1, is amended to read: 310.1    Subdivision 1. Duty to perform testing. It is the duty of (1) the administrative 310.2officer or other person in charge of each institution caring for infants 28 days or less 310.3of age, (2) the person required in pursuance of the provisions of section 144.215, to 310.4register the birth of a child, or (3) the nurse midwife or midwife in attendance at the 310.5birth, to arrange to have administered to every infant or child in its care tests for heritable 310.6and congenital disorders according to subdivision 2 and rules prescribed by the state 310.7commissioner of health. Testing and the recording and reporting of test results shall be 310.8performed at the times and in the manner prescribed by the commissioner of health. The 310.9commissioner shall charge a fee so that the total of fees collected will approximate the 310.10costs of conducting the tests and implementing and maintaining a system to follow-up 310.11infants with heritable or congenital disorders, including hearing loss detected through the 310.12early hearing detection and intervention program under section 144.966. The fee is $101 310.13per specimen. new text begin Effective July 1, 2010, the fee shall be increased to $106 per specimen. The new text end 310.14 new text begin increased fee amount shall be deposited in the general fund. new text end Costs associated with capital 310.15expenditures and the development of new procedures may be prorated over a three-year 310.16period when calculating the amount of the fees. 310.17 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2010. new text end 310.18    Sec. 6. Minnesota Statutes 2008, section 144.72, subdivision 1, is amended to read: 310.19    Subdivision 1. Permits new text begin License required new text end . The state commissioner of health is 310.20authorized to issue permits for the operation of youth camps which are required to obtain 310.21the permits new text begin a license according to chapter 157 new text end . 310.22    Sec. 7. Minnesota Statutes 2008, section 144.72, subdivision 3, is amended to read: 310.23    Subd. 3. Issuance of permits new text begin license new text end . If the commissioner should determine from 310.24the application that the health and safety of the persons using the camp will be properly 310.25safeguarded, the commissioner may, prior to actual inspection of the camp, issue the 310.26permit new text begin license new text end in writing. No fee shall be charged for the permit. The permit new text begin license new text end shall 310.27be posted in a conspicuous place on the premises occupied by the camp. 310.28    Sec. 8. Minnesota Statutes 2008, section 144.9501, is amended by adding a subdivision 310.29to read: 310.30     new text begin Subd. 8a. new text end new text begin Disclosure pamphlet. new text end new text begin "Disclosure pamphlet" means the EPA pamphlet new text end 310.31 new text begin titled "Renovate Right: Important Lead Hazard Information for Families, Child Care new text end 310.32 new text begin Providers and Schools" developed under section 406(a) of the Toxic Substance Control new text end 310.33 new text begin Act. new text end 311.1    Sec. 9. Minnesota Statutes 2008, section 144.9501, subdivision 22b, is amended to 311.2read: 311.3    Subd. 22b. Lead sampling technician. "Lead sampling technician" means an 311.4individual who performs clearance inspections for nonabatement or nonorder lead hazard 311.5reduction new text begin renovation new text end sites, new text begin and new text end lead dust sampling in other settings, or visual assessment 311.6for deteriorated paint new text begin for nonabatement sites new text end , and who is registered with the commissioner 311.7under section 144.9505. 311.8    Sec. 10. Minnesota Statutes 2008, section 144.9501, subdivision 26a, is amended to 311.9read: 311.10    Subd. 26a. Regulated lead work. (a) "Regulated lead work" means: 311.11(1) abatement; 311.12(2) interim controls; 311.13(3) a clearance inspection; 311.14(4) a lead hazard screen; 311.15(5) a lead inspection; 311.16(6) a lead risk assessment; 311.17(7) lead project designer services; 311.18(8) lead sampling technician services; or 311.19(9) swab team services. new text begin ; new text end 311.20 new text begin (10) renovation activities; or new text end 311.21 new text begin (11) activities performed to comply with lead orders issued by a board of health. new text end 311.22(b) Regulated lead work does not include new text begin abatement, interim controls, swab team new text end 311.23 new text begin services, or renovation activities that disturb painted surfaces that total no more than new text end : 311.24(1) activities such as remodeling, renovation, installation, rehabilitation, or 311.25landscaping activities, the primary intent of which is to remodel, repair, or restore a 311.26structure or dwelling, rather than to permanently eliminate lead hazards, even though these 311.27activities may incidentally result in a reduction in lead hazards; or 311.28(2) interim control activities that are not performed as a result of a lead order and 311.29that do not disturb painted surfaces that total more than: 311.30(i) new text begin (1) new text end 20 square feet (two square meters) on exterior surfaces; new text begin or new text end 311.31(ii) two new text begin (2) six new text end square feet (0.2 new text begin 0.6 new text end square meters) in an interior room; or new text begin . new text end 311.32(iii) ten percent of the total surface area on an interior or exterior type of component 311.33with a small surface area. 312.1    Sec. 11. Minnesota Statutes 2008, section 144.9501, is amended by adding a 312.2subdivision to read: 312.3     new text begin Subd. 26b. new text end new text begin Renovation. new text end new text begin "Renovation" means the modification of any affected new text end 312.4 new text begin property that results in the disturbance of painted surfaces, unless that activity is performed new text end 312.5 new text begin as an abatement. A renovation performed for the purpose of converting a building or part new text end 312.6 new text begin of a building into an affected property is a renovation under this subdivision. new text end 312.7    Sec. 12. Minnesota Statutes 2008, section 144.9505, subdivision 1g, is amended to 312.8read: 312.9    Subd. 1g. Certified lead firm. A person within the state intending to directly 312.10perform or cause to be performed through subcontracting or similar delegation any 312.11regulated lead work shall first obtain certification from the commissioner new text begin A person who new text end 312.12 new text begin employs individuals to perform regulated lead work outside of the person's property must new text end 312.13 new text begin obtain certification as a lead firm new text end . The certificate must be in writing, contain an expiration 312.14date, be signed by the commissioner, and give the name and address of the person to 312.15whom it is issued. The certification fee is $100, is nonrefundable, and must be submitted 312.16with each application. The certificate or a copy of the certificate must be readily available 312.17at the worksite for review by the contracting entity, the commissioner, and other public 312.18health officials charged with the health, safety, and welfare of the state's citizens. 312.19    Sec. 13. Minnesota Statutes 2008, section 144.9505, subdivision 4, is amended to read: 312.20    Subd. 4. Notice of regulated lead work. (a) At least five working days before 312.21starting work at each regulated lead worksite, the person performing the regulated lead 312.22work shall give written notice to the commissioner and the appropriate board of health. 312.23(b) This provision does not apply to lead hazard screen, lead inspection, lead risk 312.24assessment, lead sampling technician, new text begin renovation, new text end or lead project design activities. 312.25    Sec. 14. Minnesota Statutes 2008, section 144.9508, subdivision 2, is amended to read: 312.26    Subd. 2. Regulated lead work standards and methods. (a) The commissioner 312.27shall adopt rules establishing regulated lead work standards and methods in accordance 312.28with the provisions of this section, for lead in paint, dust, drinking water, and soil in 312.29a manner that protects public health and the environment for all residences, including 312.30residences also used for a commercial purpose, child care facilities, playgrounds, and 312.31schools. 312.32(b) In the rules required by this section, the commissioner shall require lead hazard 312.33reduction of intact paint only if the commissioner finds that the intact paint is on a 313.1chewable or lead-dust producing surface that is a known source of actual lead exposure to 313.2a specific individual. The commissioner shall prohibit methods that disperse lead dust into 313.3the air that could accumulate to a level that would exceed the lead dust standard specified 313.4under this section. The commissioner shall work cooperatively with the commissioner 313.5of administration to determine which lead hazard reduction methods adopted under this 313.6section may be used for lead-safe practices including prohibited practices, preparation, 313.7disposal, and cleanup. The commissioner shall work cooperatively with the commissioner 313.8of the Pollution Control Agency to develop disposal procedures. In adopting rules under 313.9this section, the commissioner shall require the best available technology for regulated 313.10lead work methods, paint stabilization, and repainting. 313.11(c) The commissioner of health shall adopt regulated lead work standards and 313.12methods for lead in bare soil in a manner to protect public health and the environment. 313.13The commissioner shall adopt a maximum standard of 100 parts of lead per million in 313.14bare soil. The commissioner shall set a soil replacement standard not to exceed 25 parts 313.15of lead per million. Soil lead hazard reduction methods shall focus on erosion control 313.16and covering of bare soil. 313.17(d) The commissioner shall adopt regulated lead work standards and methods for 313.18lead in dust in a manner to protect the public health and environment. Dust standards 313.19shall use a weight of lead per area measure and include dust on the floor, on the window 313.20sills, and on window wells. Lead hazard reduction methods for dust shall focus on dust 313.21removal and other practices which minimize the formation of lead dust from paint, soil, or 313.22other sources. 313.23(e) The commissioner shall adopt lead hazard reduction standards and methods for 313.24lead in drinking water both at the tap and public water supply system or private well 313.25in a manner to protect the public health and the environment. The commissioner may 313.26adopt the rules for controlling lead in drinking water as contained in Code of Federal 313.27Regulations, title 40, part 141. Drinking water lead hazard reduction methods may include 313.28an educational approach of minimizing lead exposure from lead in drinking water. 313.29(f) The commissioner of the Pollution Control Agency shall adopt rules to ensure that 313.30removal of exterior lead-based coatings from residences and steel structures by abrasive 313.31blasting methods is conducted in a manner that protects health and the environment. 313.32(g) All regulated lead work standards shall provide reasonable margins of safety that 313.33are consistent with more than a summary review of scientific evidence and an emphasis on 313.34overprotection rather than underprotection when the scientific evidence is ambiguous. 313.35(h) No unit of local government shall have an ordinance or regulation governing 313.36regulated lead work standards or methods for lead in paint, dust, drinking water, or soil 314.1that require a different regulated lead work standard or method than the standards or 314.2methods established under this section. 314.3(i) Notwithstanding paragraph (h), the commissioner may approve the use by a unit 314.4of local government of an innovative lead hazard reduction method which is consistent 314.5in approach with methods established under this section. 314.6(j) The commissioner shall adopt rules for issuing lead orders required under section 314.7144.9504 , rules for notification of abatement or interim control activities requirements, 314.8and other rules necessary to implement sections 144.9501 to 144.9512. 314.9 new text begin (k) The commissioner shall adopt rules consistent with section 402(c)(3) of the new text end 314.10 new text begin Toxic Substances Control Act to ensure that renovation in a pre-1978 affected property new text end 314.11 new text begin where a child or pregnant female resides is conducted in a manner that protects health new text end 314.12 new text begin and the environment. new text end 314.13 new text begin (l) The commissioner shall adopt rules consistent with sections 406(a) and 406(b) of new text end 314.14 new text begin the Toxic Substances Control Act. new text end 314.15    Sec. 15. Minnesota Statutes 2008, section 144.9508, subdivision 3, is amended to read: 314.16    Subd. 3. Licensure and certification. The commissioner shall adopt rules to 314.17license lead supervisors, lead workers, lead project designers, lead inspectors, and lead 314.18risk assessors new text begin , and lead sampling technicians new text end . The commissioner shall also adopt rules 314.19requiring certification of firms that perform regulated lead work and rules requiring 314.20registration of lead sampling technicians. The commissioner shall require periodic renewal 314.21of licenses, new text begin and new text end certificates, and registrations and shall establish the renewal periods. 314.22    Sec. 16. Minnesota Statutes 2008, section 144.9508, subdivision 4, is amended to read: 314.23    Subd. 4. Lead training course. The commissioner shall establish by rule 314.24requirements for training course providers and the renewal period for each lead-related 314.25training course required for certification or licensure. The commissioner shall establish 314.26criteria in rules for the content and presentation of training courses intended to qualify 314.27trainees for licensure under subdivision 3. The commissioner shall establish criteria 314.28in rules for the content and presentation of training courses for lead interim control 314.29workers new text begin renovation and lead sampling technicians new text end . Training course permit fees shall be 314.30nonrefundable and must be submitted with each application in the amount of $500 for an 314.31initial training course, $250 for renewal of a permit for an initial training course, $250 for 314.32a refresher training course, and $125 for renewal of a permit of a refresher training course. 314.33    Sec. 17. Minnesota Statutes 2008, section 144.9512, subdivision 2, is amended to read: 315.1    Subd. 2. Grants; administration. Within the limits of the available appropriation, 315.2the commissioner shall make grants to a nonprofit organization currently operating the 315.3CLEARCorps lead hazard reduction project new text begin organizations new text end to train workers to provide new text begin lead new text end 315.4 new text begin screening, education, outreach, and new text end swab team services for residential property. new text begin Projects new text end 315.5 new text begin that provide Americorps funding or positions, or leverage matching funds, as part of the new text end 315.6 new text begin delivery of the services must be given priority for the grant funds. new text end 315.7    Sec. 18. Minnesota Statutes 2008, section 144.966, is amended by adding a subdivision 315.8to read: 315.9     new text begin Subd. 3a. new text end new text begin Support services to families. new text end new text begin The commissioner shall contract with new text end 315.10 new text begin a nonprofit organization to provide support and assistance to families with children new text end 315.11 new text begin who are deaf or have a hearing loss. The family support provided must include direct new text end 315.12 new text begin parent-to-parent assistance and information on communication, educational, and medical new text end 315.13 new text begin options. The commissioner shall give preference to a nonprofit organization that has the new text end 315.14 new text begin ability to provide these services throughout the state. new text end 315.15    Sec. 19. Minnesota Statutes 2008, section 144.97, subdivision 2, is amended to read: 315.16    Subd. 2. Certification new text begin Accreditation new text end . "Certification" means written 315.17acknowledgment of a laboratory's demonstrated capability to perform tests for a specific 315.18purpose new text begin "Accreditation" means written acknowledgment that a laboratory has the new text end 315.19 new text begin policies, procedures, equipment, and practices to produce reliable data in the analysis of new text end 315.20 new text begin environmental samples new text end . 315.21 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2009. new text end 315.22    Sec. 20. Minnesota Statutes 2008, section 144.97, subdivision 4, is amended to read: 315.23    Subd. 4. Contract new text begin Commercial new text end laboratory. "Contract new text begin Commercial new text end laboratory" 315.24means a laboratory that performs tests on samples on a contract or fee-for-service basis. 315.25 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2009. new text end 315.26    Sec. 21. Minnesota Statutes 2008, section 144.97, is amended by adding a subdivision 315.27to read: 315.28     new text begin Subd. 5a. new text end new text begin Field of testing. new text end new text begin "Field of testing" means the combination of analyte, new text end 315.29 new text begin method, matrix, and test category for which a laboratory may hold accreditation. new text end 315.30 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2009. new text end 316.1    Sec. 22. Minnesota Statutes 2008, section 144.97, subdivision 6, is amended to read: 316.2    Subd. 6. Laboratory. "Laboratory" means the state, a person, corporation, or other 316.3entity, including governmental, that examines, analyzes, or tests samples new text begin in a specified new text end 316.4 new text begin physical location new text end . 316.5 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2009. new text end 316.6    Sec. 23. Minnesota Statutes 2008, section 144.97, is amended by adding a subdivision 316.7to read: 316.8     new text begin Subd. 8. new text end new text begin Test category. new text end new text begin "Test category" means the combination of program and new text end 316.9 new text begin category as provided by section 144.98, subdivisions 3, paragraph (b), clauses (1) to (10), new text end 316.10 new text begin and 3a, paragraph (a), clauses (1) to (5). new text end 316.11 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2009. new text end 316.12    Sec. 24. Minnesota Statutes 2008, section 144.98, subdivision 1, is amended to read: 316.13    Subdivision 1. Authorization. The commissioner of health may certify new text begin shall new text end 316.14 new text begin accredit environmental new text end laboratories that test environmental samples new text begin according to national new text end 316.15 new text begin standards developed using a consensus process as established by Circular A-119, new text end 316.16 new text begin published by the United States Office of Management and Budget new text end . 316.17 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2009. new text end 316.18    Sec. 25. Minnesota Statutes 2008, section 144.98, subdivision 2, is amended to read: 316.19    Subd. 2. Rules new text begin and standards new text end . The commissioner may adopt rules to implement 316.20this section, including: new text begin carry out the commissioner's responsibilities under the national new text end 316.21 new text begin standards specified in subdivisions 1 and 2a. new text end 316.22(1) procedures, requirements, and fee adjustments for laboratory certification, 316.23including provisional status and recertification; 316.24(2) standards and fees for certificate approval, suspension, and revocation; 316.25(3) standards for environmental samples; 316.26(4) analysis methods that assure reliable test results; 316.27(5) laboratory quality assurance, including internal quality control, proficiency 316.28testing, and personnel training; and 316.29(6) criteria for recognition of certification programs of other states and the federal 316.30government. 316.31 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2009. new text end 317.1    Sec. 26. Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision 317.2to read: 317.3     new text begin Subd. 2a. new text end new text begin Standards. new text end new text begin The commissioner shall accredit laboratories according to new text end 317.4 new text begin the most current environmental laboratory accreditation standards under subdivision 1 new text end 317.5 new text begin and as accepted by the accreditation bodies recognized by the National Environmental new text end 317.6 new text begin Laboratory Accreditation Program (NELAP) of the NELAC Institute. new text end 317.7 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2009. new text end 317.8    Sec. 27. Minnesota Statutes 2008, section 144.98, subdivision 3, is amended to read: 317.9    Subd. 3. new text begin Annual new text end fees. (a) An application for certification new text begin accreditation new text end under 317.10subdivision 1 new text begin 6 new text end must be accompanied by the biennial fee new text begin annual fees new text end specified in this 317.11subdivision. The fees are for new text begin annual fees include new text end : 317.12(1) base certification new text begin accreditation new text end fee, $1,600 new text begin $1,500 new text end ; 317.13(2) sample preparation techniques fees new text begin fee new text end , $100 new text begin $200 new text end per technique; and 317.14(3) new text begin an administrative fee for laboratories located outside this state, $3,750; and new text end 317.15 new text begin (4) new text end test category certification fees: new text begin . new text end 317.16 Test Category Certification Fee 317.17 Clean water program bacteriology $800 317.18 Safe drinking water program bacteriology $800 317.19 Clean water program inorganic chemistry $800 317.20 Safe drinking water program inorganic chemistry $800 317.21 Clean water program chemistry metals $1,200 317.22 Safe drinking water program chemistry metals $1,200 317.23 Resource conservation and recovery program chemistry metals $1,200 317.24 Clean water program volatile organic compounds $1,500 317.25 Safe drinking water program volatile organic compounds $1,500 317.26 317.27 Resource conservation and recovery program volatile organic compounds $1,500 317.28 Underground storage tank program volatile organic compounds $1,500 317.29 Clean water program other organic compounds $1,500 317.30 Safe drinking water program other organic compounds $1,500 317.31 Resource conservation and recovery program other organic compounds $1,500 318.1 Clean water program radiochemistry $2,500 318.2 Safe drinking water program radiochemistry $2,500 318.3 Resource conservation and recovery program agricultural contaminants $2,500 318.4 Resource conservation and recovery program emerging contaminants $2,500 318.5(b) Laboratories located outside of this state that require an on-site inspection shall be 318.6assessed an additional $3,750 fee. new text begin For the programs in subdivision 3a, the commissioner new text end 318.7 new text begin may accredit laboratories for fields of testing under the categories listed in clauses (1) to new text end 318.8 new text begin (10) upon completion of the application requirements provided by subdivision 6 and new text end 318.9 new text begin receipt of the fees for each category under each program that accreditation is requested. new text end 318.10 new text begin The categories offered and related fees include: new text end 318.11 new text begin (1) microbiology, $450; new text end 318.12 new text begin (2) inorganics, $450; new text end 318.13 new text begin (3) metals, $1,000; new text end 318.14 new text begin (4) volatile organics, $1,300; new text end 318.15 new text begin (5) other organics, $1,300; new text end 318.16 new text begin (6) radiochemistry, $1,500; new text end 318.17 new text begin (7) emerging contaminants, $1,500; new text end 318.18 new text begin (8) agricultural contaminants, $1,250; new text end 318.19 new text begin (9) toxicity (bioassay), $1,000; and new text end 318.20 new text begin (10) physical characterization, $250. new text end 318.21(c) The total biennial certification new text begin annual new text end fee includes the base fee, the sample 318.22preparation techniques fees, the test category fees new text begin per program new text end , and, when applicable, the 318.23on-site inspection fee new text begin an administrative fee for out-of-state laboratories new text end . 318.24(d) Fees must be set so that the total fees support the laboratory certification program. 318.25Direct costs of the certification service include program administration, inspections, the 318.26agency's general support costs, and attorney general costs attributable to the fee function. 318.27(e) A change fee shall be assessed if a laboratory requests additional analytes 318.28or methods at any time other than when applying for or renewing its certification. The 318.29change fee is equal to the test category certification fee for the analyte. 318.30(f) A variance fee shall be assessed if a laboratory requests and is granted a variance 318.31from a rule adopted under this section. The variance fee is $500 per variance. 318.32(g) Refunds or credits shall not be made for analytes or methods requested but 318.33not approved. 318.34(h) Certification of a laboratory shall not be awarded until all fees are paid. 319.1    Sec. 28. Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision 319.2to read: 319.3     new text begin Subd. 3a. new text end new text begin Available programs, categories, and analytes. new text end new text begin (a) The commissioner new text end 319.4 new text begin shall accredit laboratories that test samples under the following programs: new text end 319.5 new text begin (1) the clean water program, such as compliance monitoring under the federal Clean new text end 319.6 new text begin Water Act, and ambient monitoring of surface and groundwater, or analysis of biological new text end 319.7 new text begin tissue; new text end 319.8 new text begin (2) the safe drinking water program, including compliance monitoring under the new text end 319.9 new text begin federal Safe Drinking Water Act, and the state requirements for monitoring private wells; new text end 319.10 new text begin (3) the resource conservation and recovery program, including federal and state new text end 319.11 new text begin requirements for monitoring solid and hazardous wastes, biological tissue, leachates, and new text end 319.12 new text begin groundwater monitoring wells not intended as drinking water sources; new text end 319.13 new text begin (4) the underground storage tank program; and new text end 319.14 new text begin (5) the clean air program, including air and emissions testing under the federal Clean new text end 319.15 new text begin Air Act, and state and federal requirements for vapor intrusion monitoring. new text end 319.16 new text begin (b) The commissioner shall maintain and publish a list of analytes available for new text end 319.17 new text begin accreditation. The list must be reviewed at least once every six months and the changes new text end 319.18 new text begin published in the State Register and posted on the program's Web site. The commissioner new text end 319.19 new text begin shall publish the notification of changes and review comments on the changes no less than new text end 319.20 new text begin 30 days from the date the list is published. new text end 319.21    Sec. 29. Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision 319.22to read: 319.23     new text begin Subd. 3b. new text end new text begin Additional fees. new text end new text begin (a) Laboratories located outside of this state that require new text end 319.24 new text begin an on-site assessment more frequent than once every two years must pay an additional new text end 319.25 new text begin assessed fee of $3,000 per assessment for each additional on-site assessment conducted. new text end 319.26 new text begin The laboratory must pay the fee within 15 business days of receiving the commissioner's new text end 319.27 new text begin notification that an on-site assessment is required. The commissioner may conduct new text end 319.28 new text begin additional on-site assessments to determine a laboratory's continued compliance with new text end 319.29 new text begin the standards provided in subdivision 2a. new text end 319.30 new text begin (b) A late fee of $200 shall be added to the annual fee for accredited laboratories new text end 319.31 new text begin submitting renewal applications to the commissioner after November 1. new text end 319.32 new text begin (c) A change fee shall be assessed if a laboratory requests additional fields of testing new text end 319.33 new text begin at any time other than when initially applying for or renewing its accreditation. A change new text end 319.34 new text begin fee does not apply for applications to add fields of testing for new analytes in response new text end 319.35 new text begin to the published notice under subdivision 3a, paragraph (b), if the laboratory holds valid new text end 320.1 new text begin accreditation for the changed test category and applies for additional analytes within the new text end 320.2 new text begin same test category. The change fee is equal to the applicable test category fee for the new text end 320.3 new text begin field of testing requested. An application that requests accreditation of multiple fields of new text end 320.4 new text begin testing within a test category requires a single payment of the applicable test category fee new text end 320.5 new text begin per application submitted. new text end 320.6 new text begin (d) A variance fee shall be assessed if a laboratory requests a variance from a new text end 320.7 new text begin standard provided in subdivision 2a. The variance fee is $500 per variance. new text end 320.8 new text begin (e) The commissioner shall assess a fee for changes to laboratory information new text end 320.9 new text begin regarding ownership, name, address, or personnel. Laboratories must submit changes new text end 320.10 new text begin through the application process under subdivision 6. The information update fee is $250 new text end 320.11 new text begin per application. new text end 320.12 new text begin (f) Fees must be set so that the total fees support the laboratory accreditation new text end 320.13 new text begin program. Direct costs of the accreditation service include program administration, new text end 320.14 new text begin assessments, the agency's general support costs, and attorney general costs attributable new text end 320.15 new text begin to the fee function. new text end 320.16    Sec. 30. Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision 320.17to read: 320.18     new text begin Subd. 3c. new text end new text begin Refunds and nonpayment. new text end new text begin Refunds or credits shall not be made for new text end 320.19 new text begin applications received but not approved. Accreditation of a laboratory shall not be awarded new text end 320.20 new text begin until all fees are paid. new text end 320.21    Sec. 31. Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision 320.22to read: 320.23     new text begin Subd. 6. new text end new text begin Application. new text end new text begin (a) Laboratories seeking accreditation must apply on a form new text end 320.24 new text begin provided by the commissioner, include the laboratory's procedures and quality manual, new text end 320.25 new text begin and pay the applicable fees. new text end 320.26 new text begin (b) Laboratories may be fixed-base or mobile. The commissioner shall accredit new text end 320.27 new text begin mobile laboratories individually and require a vehicle identification number, license new text end 320.28 new text begin plate number, or other uniquely identifying information in addition to the application new text end 320.29 new text begin requirements of paragraph (a). new text end 320.30 new text begin (c) Laboratories maintained on separate properties, even though operated under the new text end 320.31 new text begin same management or ownership, must apply separately. Laboratories with more than one new text end 320.32 new text begin building on the same or adjoining properties do not need to submit a separate application. new text end 320.33 new text begin (d) The commissioner may accredit laboratories located out-of-state. Accreditation new text end 320.34 new text begin for out-of-state laboratories may be obtained directly from the commissioner following new text end 321.1 new text begin the requirements in paragraph (a), or out-of-state laboratories may be accredited through new text end 321.2 new text begin a reciprocal agreement if the laboratory: new text end 321.3 new text begin (1) is accredited by a NELAP-recognized accreditation body for those fields of new text end 321.4 new text begin testing in which the laboratory requests accreditation from the commissioner; new text end 321.5 new text begin (2) submits an application and documentation according to this subdivision; and new text end 321.6 new text begin (3) submits a current copy of the laboratory's unexpired accreditation from a new text end 321.7 new text begin NELAP-recognized accreditation body showing the fields of accreditation for which the new text end 321.8 new text begin laboratory is currently accredited. new text end 321.9 new text begin (e) Under the conflict of interest determinations provided in section 43A.38, new text end 321.10 new text begin subdivision 6, clause (a), the commissioner shall not accredit governmental laboratories new text end 321.11 new text begin operated by agencies of the executive branch of the state. If accreditation is required, new text end 321.12 new text begin laboratories operated by agencies of the executive branch of the state must apply for new text end 321.13 new text begin accreditation through any other NELAP-recognized accreditation body. new text end 321.14 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2009. new text end 321.15    Sec. 32. Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision 321.16to read: 321.17     new text begin Subd. 6a. new text end new text begin Implementation and effective date. new text end new text begin All laboratories must comply with new text end 321.18 new text begin standards under this section by July 1, 2009. Fees under subdivisions 3 and 3b apply to new text end 321.19 new text begin applications received and accreditations issued after June 30, 2009. Accreditations issued new text end 321.20 new text begin on or before June 30, 2009, shall expire upon their current expiration date. new text end 321.21    Sec. 33. Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision 321.22to read: 321.23     new text begin Subd. 7. new text end new text begin Initial accreditation and annual accreditation renewal. new text end new text begin (a) The new text end 321.24 new text begin commissioner shall issue or renew accreditation after receipt of the completed application new text end 321.25 new text begin and documentation required in this section, provided the laboratory maintains compliance new text end 321.26 new text begin with the standards specified in subdivision 2a, and attests to the compliance on the new text end 321.27 new text begin application form. new text end 321.28 new text begin (b) The commissioner shall prorate the fees in subdivision 3 for laboratories new text end 321.29 new text begin applying for accreditation after December 31. The fees are prorated on a quarterly basis new text end 321.30 new text begin beginning with the quarter in which the commissioner receives the completed application new text end 321.31 new text begin from the laboratory. new text end 321.32 new text begin (c) Applications for renewal of accreditation must be received by November 1 and new text end 321.33 new text begin no earlier than October 1 of each year. The commissioner shall send annual renewal new text end 322.1 new text begin notices to laboratories 90 days before expiration. Failure to receive a renewal notice does new text end 322.2 new text begin not exempt laboratories from meeting the annual November 1 renewal date. new text end 322.3 new text begin (d) The commissioner shall issue all accreditations for the calendar year for which new text end 322.4 new text begin the application is made, and the accreditation shall expire on December 31 of that year. new text end 322.5 new text begin (e) The accreditation of any laboratory that fails to submit a renewal application new text end 322.6 new text begin and fees to the commissioner expires automatically on December 31 without notice or new text end 322.7 new text begin further proceeding. Any person who operates a laboratory as accredited after expiration of new text end 322.8 new text begin accreditation or without having submitted an application and paid the fees is in violation new text end 322.9 new text begin of the provisions of this section and is subject to enforcement action under sections new text end 322.10 new text begin 144.989 to 144.993, the Health Enforcement Consolidation Act. A laboratory with expired new text end 322.11 new text begin accreditation may reapply under subdivision 6. new text end 322.12 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2009. new text end 322.13    Sec. 34. Minnesota Statutes 2008, section 144.99, subdivision 1, is amended to read: 322.14    Subdivision 1. Remedies available. The provisions of chapters 103I and 157 and 322.15sections 115.71 to 115.77; 144.12, subdivision 1, paragraphs (1), (2), (5), (6), (10), (12), 322.16(13), (14), and (15) ; 144.1201 to 144.1204; 144.121; 144.1222; 144.35; 144.381 to 322.17144.385 ; 144.411 to 144.417; 144.495; 144.71 to 144.74; 144.9501 to 144.9512; new text begin 144.97 new text end 322.18 new text begin to 144.98; new text end 144.992; 326.70 to 326.785; 327.10 to 327.131; and 327.14 to 327.28 and 322.19all rules, orders, stipulation agreements, settlements, compliance agreements, licenses, 322.20registrations, certificates, and permits adopted or issued by the department or under any 322.21other law now in force or later enacted for the preservation of public health may, in 322.22addition to provisions in other statutes, be enforced under this section. 322.23 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2009. new text end 322.24    Sec. 35. Minnesota Statutes 2008, section 153A.17, is amended to read: 322.25153A.17 EXPENSES; FEES. 322.26The expenses for administering the certification requirements including the 322.27complaint handling system for hearing aid dispensers in sections and 322.28and the Consumer Information Center under section must be paid from 322.29initial application and examination fees, renewal fees, penalties, and fines. All fees 322.30are nonrefundable. The certificate application fee is $350, the examination fee is $250 322.31for the written portion and $250 for the practical portion each time one or the other is 322.32taken, and the trainee application fee is $200. The penalty fee for late submission of a 322.33renewal application is $200. The fee for verification of certification to other jurisdictions 322.34or entities is $25. All fees, penalties, and fines received must be deposited in the state 323.1government special revenue fund. The commissioner may prorate the certification fee for 323.2new applicants based on the number of quarters remaining in the annual certification 323.3period. new text begin (a) The expenses for administering the certification requirements, including the new text end 323.4 new text begin complaint handling system for hearing aid dispensers in sections 153A.14 and 153A.15, new text end 323.5 new text begin and the Consumer Information Center under section 153A.18, must be paid from initial new text end 323.6 new text begin application and examination fees, renewal fees, penalties, and fines. new text end 323.7 new text begin (b) The fees are as follows: new text end 323.8 new text begin (1) the initial and annual renewal certification application fee is $600; new text end 323.9 new text begin (2) the initial examination fee for the written portion is $500, and for each time it new text end 323.10 new text begin is taken, thereafter; new text end 323.11 new text begin (3) the initial examination fee for the practical portion is $1,200, and $600 for each new text end 323.12 new text begin time it is taken, thereafter; for individuals meeting the requirements of section 148.515, new text end 323.13 new text begin subdivision 2, the fee for the practical portion of the hearing instrument dispensing new text end 323.14 new text begin examination is $250 each time it is taken; new text end 323.15 new text begin (4) the trainee application fee is $200; new text end 323.16 new text begin (5) the penalty fee for late submission of a renewal application is $200; and new text end 323.17 new text begin (6) the fee for verification of certification to other jurisdictions or entities is $25. new text end 323.18 new text begin (c) The commissioner may prorate the certification fee for new applicants based on new text end 323.19 new text begin the number of quarters remaining in the annual certification period. new text end 323.20 new text begin (d) All fees are nonrefundable. All fees, penalties, and fines received must be new text end 323.21 new text begin deposited in the state government special revenue fund. new text end 323.22 new text begin (e) Beginning July 1, 2009, until June 30, 2016, a surcharge of $100 shall be paid new text end 323.23 new text begin at the time of initial certification application or renewal to recover the commissioner's new text end 323.24 new text begin accumulated direct expenditures for administering the requirements of this chapter. new text end 323.25    Sec. 36. Minnesota Statutes 2008, section 157.15, is amended by adding a subdivision 323.26to read: 323.27     new text begin Subd. 20. new text end new text begin Youth camp. new text end new text begin "Youth camp" has the meaning given in section 144.71, new text end 323.28 new text begin subdivision 2. new text end 323.29    Sec. 37. Minnesota Statutes 2008, section 157.16, is amended to read: 323.30157.16 LICENSES REQUIRED; FEES. 323.31    Subdivision 1. License required annually. A license is required annually for every 323.32person, firm, or corporation engaged in the business of conducting a food and beverage 323.33service establishment, new text begin youth camp, new text end hotel, motel, lodging establishment, public pool, or 323.34resort. Any person wishing to operate a place of business licensed in this section shall 324.1first make application, pay the required fee specified in this section, and receive approval 324.2for operation, including plan review approval. Seasonal and temporary food stands and 324.3Special event food stands are not required to submit plans. Nonprofit organizations 324.4operating a special event food stand with multiple locations at an annual one-day event 324.5shall be issued only one license. Application shall be made on forms provided by the 324.6commissioner and shall require the applicant to state the full name and address of the 324.7owner of the building, structure, or enclosure, the lessee and manager of the food and 324.8beverage service establishment, hotel, motel, lodging establishment, public pool, or resort; 324.9the name under which the business is to be conducted; and any other information as may 324.10be required by the commissioner to complete the application for license. 324.11    Subd. 2. License renewal. Initial and renewal licenses for all food and beverage 324.12service establishments, new text begin youth camps, new text end hotels, motels, lodging establishments, public pools, 324.13and resorts shall be issued for the calendar year for which application is made and shall 324.14expire on December 31 of such year new text begin on an annual basis new text end . Any person who operates a place 324.15of business after the expiration date of a license or without having submitted an application 324.16and paid the fee shall be deemed to have violated the provisions of this chapter and shall 324.17be subject to enforcement action, as provided in the Health Enforcement Consolidation 324.18Act, sections 144.989 to 144.993. In addition, a penalty of $50 new text begin $60 new text end shall be added to the 324.19total of the license fee for any food and beverage service establishment operating without 324.20a license as a mobile food unit, a seasonal temporary or seasonal permanent food stand, or 324.21a special event food stand, and a penalty of $100 new text begin $120 new text end shall be added to the total of the 324.22license fee for all restaurants, food carts, hotels, motels, lodging establishments, new text begin youth new text end 324.23 new text begin camps, new text end public pools, and resorts operating without a license for a period of up to 30 days. 324.24A late fee of $300 new text begin $360 new text end shall be added to the license fee for establishments operating more 324.25than 30 days without a license. 324.26    Subd. 2a. Food manager certification. An applicant for certification or certification 324.27renewal as a food manager must submit to the commissioner a $28 new text begin $35 new text end nonrefundable 324.28certification fee payable to the Department of Health. new text begin The commissioner shall issue a new text end 324.29 new text begin duplicate certificate to replace a lost, destroyed, or mutilated certificate if the applicant new text end 324.30 new text begin submits a completed application on a form provided by the commissioner for a duplicate new text end 324.31 new text begin certificate and pays $20 to the department for the cost of duplication. new text end 324.32    Subd. 3. Establishment fees; definitions. (a) The following fees are required 324.33for food and beverage service establishments, new text begin youth camps, new text end hotels, motels, lodging 324.34establishments, public pools, and resorts licensed under this chapter. Food and beverage 324.35service establishments must pay the highest applicable fee under paragraph (d), clause 325.1(1), (2), (3), or (4), and establishments serving alcohol must pay the highest applicable 325.2fee under paragraph (d), clause (6) or (7). The license fee for new operators previously 325.3licensed under this chapter for the same calendar year is one-half of the appropriate annual 325.4license fee, plus any penalty that may be required. The license fee for operators opening 325.5on or after October 1 is one-half of the appropriate annual license fee, plus any penalty 325.6that may be required. 325.7    (b) All food and beverage service establishments, except special event food stands, 325.8and all hotels, motels, lodging establishments, public pools, and resorts shall pay an 325.9annual base fee of $150. 325.10    (c) A special event food stand shall pay a flat fee of $40 new text begin $50 new text end annually. "Special event 325.11food stand" means a fee category where food is prepared or served in conjunction with 325.12celebrations, county fairs, or special events from a special event food stand as defined 325.13in section 157.15. 325.14    (d) In addition to the base fee in paragraph (b), each food and beverage service 325.15establishment, other than a special event food stand, and each hotel, motel, lodging 325.16establishment, public pool, and resort shall pay an additional annual fee for each fee 325.17category, additional food service, or required additional inspection specified in this 325.18paragraph: 325.19    (1) Limited food menu selection, $50 new text begin $60 new text end . "Limited food menu selection" means a 325.20fee category that provides one or more of the following: 325.21    (i) prepackaged food that receives heat treatment and is served in the package; 325.22    (ii) frozen pizza that is heated and served; 325.23    (iii) a continental breakfast such as rolls, coffee, juice, milk, and cold cereal; 325.24    (iv) soft drinks, coffee, or nonalcoholic beverages; or 325.25    (v) cleaning for eating, drinking, or cooking utensils, when the only food served 325.26is prepared off site. 325.27    (2) Small establishment, including boarding establishments, $100 new text begin $120 new text end . "Small 325.28establishment" means a fee category that has no salad bar and meets one or more of 325.29the following: 325.30    (i) possesses food service equipment that consists of no more than a deep fat fryer, a 325.31grill, two hot holding containers, and one or more microwave ovens; 325.32    (ii) serves dipped ice cream or soft serve frozen desserts; 325.33    (iii) serves breakfast in an owner-occupied bed and breakfast establishment; 325.34    (iv) is a boarding establishment; or 325.35    (v) meets the equipment criteria in clause (3), item (i) or (ii), and has a maximum 325.36patron seating capacity of not more than 50. 326.1    (3) Medium establishment, $260 new text begin $310 new text end . "Medium establishment" means a fee 326.2category that meets one or more of the following: 326.3    (i) possesses food service equipment that includes a range, oven, steam table, salad 326.4bar, or salad preparation area; 326.5    (ii) possesses food service equipment that includes more than one deep fat fryer, 326.6one grill, or two hot holding containers; or 326.7    (iii) is an establishment where food is prepared at one location and served at one or 326.8more separate locations. 326.9    Establishments meeting criteria in clause (2), item (v), are not included in this fee 326.10category. 326.11    (4) Large establishment, $460 new text begin $540 new text end . "Large establishment" means either: 326.12    (i) a fee category that (A) meets the criteria in clause (3), items (i) or (ii), for a 326.13medium establishment, (B) seats more than 175 people, and (C) offers the full menu 326.14selection an average of five or more days a week during the weeks of operation; or 326.15    (ii) a fee category that (A) meets the criteria in clause (3), item (iii), for a medium 326.16establishment, and (B) prepares and serves 500 or more meals per day. 326.17    (5) Other food and beverage service, including food carts, mobile food units, 326.18seasonal temporary food stands, and seasonal permanent food stands, $50 new text begin $60 new text end . 326.19    (6) Beer or wine table service, $50 new text begin $60 new text end . "Beer or wine table service" means a fee 326.20category where the only alcoholic beverage service is beer or wine, served to customers 326.21seated at tables. 326.22    (7) Alcoholic beverage service, other than beer or wine table service, $135 new text begin $165 new text end . 326.23    "Alcohol beverage service, other than beer or wine table service" means a fee 326.24category where alcoholic mixed drinks are served or where beer or wine are served from 326.25a bar. 326.26    (8) Lodging per sleeping accommodation unit, $8 new text begin $10 new text end , including hotels, motels, 326.27lodging establishments, and resorts, up to a maximum of $800 new text begin $1,000 new text end . "Lodging per 326.28sleeping accommodation unit" means a fee category including the number of guest rooms, 326.29cottages, or other rental units of a hotel, motel, lodging establishment, or resort; or the 326.30number of beds in a dormitory. 326.31    (9) First public pool, $180 new text begin $325 new text end ; each additional public pool, $100 new text begin $175 new text end . "Public 326.32pool" means a fee category that has the meaning given in section 144.1222, subdivision 4. 326.33    (10) First spa, $110 new text begin $175 new text end ; each additional spa, $50 new text begin $100 new text end . "Spa pool" means a fee 326.34category that has the meaning given in Minnesota Rules, part 4717.0250, subpart 9. 326.35    (11) Private sewer or water, $50 new text begin $60 new text end . "Individual private water" means a fee 326.36category with a water supply other than a community public water supply as defined in 327.1Minnesota Rules, chapter 4720. "Individual private sewer" means a fee category with an 327.2individual sewage treatment system which uses subsurface treatment and disposal. 327.3    (12) Additional food service, $130 new text begin $150 new text end . "Additional food service" means a location 327.4at a food service establishment, other than the primary food preparation and service area, 327.5used to prepare or serve food to the public. 327.6    (13) Additional inspection fee, $300 new text begin $360 new text end . "Additional inspection fee" means a 327.7fee to conduct the second inspection each year for elementary and secondary education 327.8facility school lunch programs when required by the Richard B. Russell National School 327.9Lunch Act. 327.10    (e) A fee of $350 for review of the construction plans must accompany the initial 327.11license application for restaurants, hotels, motels, lodging establishments, or resorts with 327.12five or more sleeping units. new text begin , seasonal food stands, and mobile food units. The fee for new text end 327.13 new text begin this construction plan review is as follows: new text end 327.14 new text begin Service Area new text end new text begin Type new text end new text begin Fee new text end 327.15 new text begin Food new text end new text begin limited food menu new text end new text begin $275 new text end 327.16 new text begin small establishment new text end new text begin $400 new text end 327.17 new text begin medium establishment new text end new text begin $450 new text end 327.18 new text begin large food establishment new text end new text begin $500 new text end 327.19 new text begin additional food service new text end new text begin $150 new text end 327.20 new text begin Transient food service new text end new text begin food cart new text end new text begin $250 new text end 327.21 new text begin seasonal permanent food stand new text end new text begin $250 new text end 327.22 new text begin seasonal temporary food stand new text end new text begin $250 new text end 327.23 new text begin mobile food unit new text end new text begin $350 new text end 327.24 new text begin Alcohol new text end new text begin beer or wine table service new text end new text begin $150 new text end 327.25 new text begin alcohol service from bar new text end new text begin $250 new text end 327.26 new text begin Lodging new text end new text begin less than 25 rooms new text end new text begin $375 new text end 327.27 new text begin 25 to less than 100 rooms new text end new text begin $400 new text end 327.28 new text begin 100 rooms or more new text end new text begin $500 new text end 327.29 new text begin less than five cabins new text end new text begin $350 new text end 327.30 new text begin five to less than ten cabins new text end new text begin $400 new text end 327.31 new text begin ten cabins or more new text end new text begin $450 new text end 328.1    (f) When existing food and beverage service establishments, hotels, motels, lodging 328.2establishments, or resorts new text begin , seasonal food stands, and mobile food units new text end are extensively 328.3remodeled, a fee of $250 must be submitted with the remodeling plans. A fee of $250 328.4must be submitted for new construction or remodeling for a restaurant with a limited food 328.5menu selection, a seasonal permanent food stand, a mobile food unit, or a food cart, or for 328.6a hotel, motel, resort, or lodging establishment addition of less than five sleeping units. new text begin new text end 328.7 new text begin The fee for this construction plan review is as follows: new text end 328.8 new text begin Service Area new text end new text begin Type new text end new text begin Fee new text end 328.9 new text begin Food new text end new text begin limited food menu new text end new text begin $250 new text end 328.10 new text begin small establishment new text end new text begin $300 new text end 328.11 new text begin medium establishment new text end new text begin $350 new text end 328.12 new text begin large food establishment new text end new text begin $400 new text end 328.13 new text begin additional food service new text end new text begin $150 new text end 328.14 new text begin Transient food service new text end new text begin food cart new text end new text begin $250 new text end 328.15 new text begin seasonal permanent food stand new text end new text begin $250 new text end 328.16 new text begin seasonal temporary food stand new text end new text begin $250 new text end 328.17 new text begin mobile food unit new text end new text begin $250 new text end 328.18 new text begin Alcohol new text end new text begin beer or wine table service new text end new text begin $150 new text end 328.19 new text begin alcohol service from bar new text end new text begin $250 new text end 328.20 new text begin Lodging new text end new text begin less than 25 rooms new text end new text begin $250 new text end 328.21 new text begin 25 to less than 100 rooms new text end new text begin $300 new text end 328.22 new text begin 100 rooms new text end new text begin or more new text end new text begin $450 new text end 328.23 new text begin less than five cabins new text end new text begin $250 new text end 328.24 new text begin five to less than ten cabins new text end new text begin $350 new text end 328.25 new text begin ten cabins or more new text end new text begin $400 new text end 328.26    (g) Seasonal temporary food stands and Special event food stands are not required to 328.27submit construction or remodeling plans for review. 328.28 new text begin (h) Youth camps shall pay an annual single fee for food and lodging as follows: new text end 328.29 new text begin (1) camps with up to 99 campers, $325; new text end 328.30 new text begin (2) camps with 100 to 199 campers, $550; and new text end 328.31 new text begin (3) camps with 200 or more campers; $750. new text end 329.1    Subd. 3a. Statewide hospitality fee. Every person, firm, or corporation that 329.2operates a licensed boarding establishment, food and beverage service establishment, 329.3seasonal temporary or permanent food stand, special event food stand, mobile food unit, 329.4food cart, resort, hotel, motel, or lodging establishment in Minnesota must submit to the 329.5commissioner a $35 annual statewide hospitality fee for each licensed activity. The fee 329.6for establishments licensed by the Department of Health is required at the same time the 329.7licensure fee is due. For establishments licensed by local governments, the fee is due by 329.8July 1 of each year. 329.9    Subd. 4. Posting requirements. Every food and beverage service establishment, new text begin new text end 329.10 new text begin for-profit youth camp, new text end hotel, motel, lodging establishment, public pool, or resort must have 329.11the license posted in a conspicuous place at the establishment. new text begin Mobile food units, food new text end 329.12 new text begin carts, and seasonal temporary food stands shall be issued decals with the initial license and new text end 329.13 new text begin each calendar year with license renewals. The current license year decal must be placed on new text end 329.14 new text begin the unit or stand in a location determined by the commissioner. Decals are not transferable. new text end 329.15    Sec. 38. Minnesota Statutes 2008, section 157.22, is amended to read: 329.16157.22 EXEMPTIONS. 329.17This chapter shall not be construed to new text begin does not new text end apply to: 329.18(1) interstate carriers under the supervision of the United States Department of 329.19Health and Human Services; 329.20(2) any building constructed and primarily used for religious worship; 329.21(3) any building owned, operated, and used by a college or university in accordance 329.22with health regulations promulgated by the college or university under chapter 14; 329.23(4) any person, firm, or corporation whose principal mode of business is licensed 329.24under sections 28A.04 and 28A.05, is exempt at that premises from licensure as a food 329.25or beverage establishment; provided that the holding of any license pursuant to sections 329.2628A.04 and 28A.05 shall not exempt any person, firm, or corporation from the applicable 329.27provisions of this chapter or the rules of the state commissioner of health relating to 329.28food and beverage service establishments; 329.29(5) family day care homes and group family day care homes governed by sections 329.30245A.01 to 245A.16; 329.31(6) nonprofit senior citizen centers for the sale of home-baked goods; 329.32(7) fraternal or patriotic organizations that are tax exempt under section 501(c)(3), 329.33501(c)(4), 501(c)(6), 501(c)(7), 501(c)(10), or 501(c)(19) of the Internal Revenue Code of 329.341986, or organizations related to or affiliated with such fraternal or patriotic organizations. 330.1Such organizations may organize events at which home-prepared food is donated by 330.2organization members for sale at the events, provided: 330.3(i) the event is not a circus, carnival, or fair; 330.4(ii) the organization controls the admission of persons to the event, the event agenda, 330.5or both; and 330.6(iii) the organization's licensed kitchen is not used in any manner for the event; 330.7(8) food not prepared at an establishment and brought in by individuals attending a 330.8potluck event for consumption at the potluck event. An organization sponsoring a potluck 330.9event under this clause may advertise the potluck event to the public through any means. 330.10Individuals who are not members of an organization sponsoring a potluck event under this 330.11clause may attend the potluck event and consume the food at the event. Licensed food 330.12establishments other than schools cannot be sponsors of potluck events. A school may 330.13sponsor and hold potluck events in areas of the school other than the school's kitchen, 330.14provided that the school's kitchen is not used in any manner for the potluck event. For 330.15purposes of this clause, "school" means a public school as defined in section 120A.05, 330.16subdivisions 9, 11, 13, and 17 , or a nonpublic school, church, or religious organization 330.17at which a child is provided with instruction in compliance with sections 120A.22 and 330.18120A.24 . Potluck event food shall not be brought into a licensed food establishment 330.19kitchen; and 330.20(9) a home school in which a child is provided instruction at home new text begin ; and new text end 330.21 new text begin (10) concession stands operated in conjunction with school-sponsored events on new text end 330.22 new text begin school property are exempt from the 21-day restriction new text end . 330.23    Sec. 39. Minnesota Statutes 2008, section 327.14, is amended by adding a subdivision 330.24to read: 330.25     new text begin Subd. 9. new text end new text begin Special event recreational camping area. new text end new text begin "Special event recreational new text end 330.26 new text begin camping area" means a recreational camping area which operates no more than two times new text end 330.27 new text begin annually and for no more than 14 consecutive days. new text end 330.28    Sec. 40. Minnesota Statutes 2008, section 327.15, is amended to read: 330.29327.15 LICENSE REQUIRED; RENEWAL; PLANS FOR EXPANSION new text begin FEES new text end . 330.30     new text begin Subdivision 1. new text end new text begin License required; plan review. new text end No person, firm or corporation shall 330.31establish, maintain, conduct or operate a manufactured home park or recreational camping 330.32area within this state without first obtaining a new text begin an annual new text end license therefor from the state 330.33Department of Health. new text begin Any person wishing to obtain a license shall submit an application, new text end 330.34 new text begin pay the required fee specified in this section, and receive approval for operation, including new text end 331.1 new text begin plan review approval. Application shall be made on forms provided by the commissioner new text end 331.2 new text begin and shall require the applicant to state the full name and address of the owner of the new text end 331.3 new text begin manufactured home park or recreational camping area, the name under which the business new text end 331.4 new text begin is to be conducted, and any other information as may be required by the commissioner new text end 331.5 new text begin to complete the application for license. new text end Any person, firm, or corporation desiring to 331.6operate either a manufactured home park or a recreational camping area on the same site 331.7in connection with the other, need only obtain one license. A license shall expire and be 331.8renewed as prescribed by the commissioner pursuant to section . The license shall 331.9state the number of manufactured home sites and recreational camping sites allowed 331.10according to state commissioner of health approval. No renewal license shall be issued if 331.11the number of sites specified in the application exceeds those of the original application new text begin new text end 331.12 new text begin The number of licensed sites shall not be increased new text end unless the plans for expansion or 331.13the construction for expansion are first new text begin submitted and the expansion is new text end approved by 331.14the Department of Health. Any manufactured home park or recreational camping area 331.15located in more than one municipality shall be dealt with as two separate manufactured 331.16home parks or camping areas. The license shall be conspicuously displayed in the office 331.17of the manufactured home park or camping area. The license is not transferable as to new text begin to new text end 331.18 new text begin another person or new text end place. 331.19     new text begin Subd. 2. new text end new text begin License renewal. new text end new text begin Initial and renewal licenses for all manufactured home new text end 331.20 new text begin parks and recreational camping areas shall be issued annually and shall have an expiration new text end 331.21 new text begin date included on the license. Any person who operates a manufactured home park or new text end 331.22 new text begin recreational camping area after the expiration date of a license or without having submitted new text end 331.23 new text begin an application and paid the fee shall be deemed to have violated the provisions of this new text end 331.24 new text begin chapter and shall be subject to enforcement action, as provided in the Health Enforcement new text end 331.25 new text begin Consolidation Act, sections 144.989 to 144.993. In addition, a penalty of $120 shall new text end 331.26 new text begin be added to the total of the license fee for any manufactured home park or recreational new text end 331.27 new text begin camping area operating without a license for a period of up to 30 days. A late fee of $360 new text end 331.28 new text begin shall be added to the license fee for any manufactured home park or recreational camping new text end 331.29 new text begin area operating more than 30 days without a license. new text end 331.30     new text begin Subd. 3. new text end new text begin Fees, manufactured home parks and recreational camping areas. new text end new text begin (a) new text end 331.31 new text begin The following fees are required for manufactured home parks and recreational camping new text end 331.32 new text begin areas licensed under this chapter. Recreational camping areas and manufactured home new text end 331.33 new text begin parks shall pay the highest applicable fee under paragraph (c). The license fee for new new text end 331.34 new text begin operators of a manufactured home park or recreational camping area previously licensed new text end 331.35 new text begin under this chapter for the same calendar year is one-half of the appropriate annual license new text end 331.36 new text begin fee, plus any penalty that may be required. The license fee for operators opening on new text end 332.1 new text begin or after October 1 is one-half of the appropriate annual license fee, plus any penalty new text end 332.2 new text begin that may be required. new text end 332.3 new text begin (b) All manufactured home parks and recreational camping areas shall pay the new text end 332.4 new text begin following annual base fee: new text end 332.5 new text begin (1) a manufactured home park, $150; and new text end 332.6 new text begin (2) a recreational camping area with: new text end 332.7 new text begin (i) 24 or less sites, $50; new text end 332.8 new text begin (ii) 25-99 sites, $212; and new text end 332.9 new text begin (iii) 100 or more sites, $300. new text end 332.10 new text begin In addition to the base fee, manufactured home parks and recreational camping areas shall new text end 332.11 new text begin pay $4 for each licensed site. This paragraph does not apply to special event recreational new text end 332.12 new text begin camping areas or to operators of a manufactured home park or a recreational camping area new text end 332.13 new text begin licensed under section 157.16 for the same location. new text end 332.14 new text begin (c) In addition to the fee in paragraph (b), each manufactured home park or new text end 332.15 new text begin recreational camping area shall pay an additional annual fee for each fee category new text end 332.16 new text begin specified in this paragraph: new text end 332.17 new text begin (1) Manufactured home parks and recreational camping areas with public swimming new text end 332.18 new text begin pools and spas shall pay the appropriate fees specified in section 157.16. new text end 332.19 new text begin (2) Individual private sewer or water, $60. "Individual private water" means a fee new text end 332.20 new text begin category with a water supply other than a community public water supply as defined in new text end 332.21 new text begin Minnesota Rules, chapter 4720. "Individual private sewer" means a fee category with an new text end 332.22 new text begin individual sewage treatment system which uses subsurface treatment and disposal. new text end 332.23 new text begin (d) The following fees must accompany a plan review application for initial new text end 332.24 new text begin construction of a manufactured home park or recreational camping area: new text end 332.25 new text begin (1) for initial construction of less than 25 sites, $375; new text end 332.26 new text begin (2) for initial construction of 25 to less than 100 sites, $400; and new text end 332.27 new text begin (3) for initial construction of 100 or more sites, $500. new text end 332.28 new text begin (e) The following fees must accompany a plan review application when an existing new text end 332.29 new text begin manufactured home park or recreational camping area is expanded: new text end 332.30 new text begin (1) for expansion of less than 25 sites, $250; new text end 332.31 new text begin (2) for expansion of 25 and less than 100 sites, $300; and new text end 332.32 new text begin (3) for expansion of 100 or more sites, $450. new text end 332.33     new text begin Subd. 4. new text end new text begin Fees, special event recreational camping areas. new text end new text begin (a) The following fees new text end 332.34 new text begin are required for special event recreational camping areas licensed under this chapter. new text end 332.35 new text begin (b) All special event recreational camping areas shall pay an annual fee of $150 plus new text end 332.36 new text begin $1 for each licensed site. new text end 333.1 new text begin (c) A special event recreational camping area shall pay a late fee of $360 for failing new text end 333.2 new text begin to obtain a license prior to operating. new text end 333.3 new text begin (d) The following fees must accompany a plan review application for initial new text end 333.4 new text begin construction of a special event recreational camping area: new text end 333.5 new text begin (1) for initial construction of less than 25 special event recreational camping sites, new text end 333.6 new text begin $375; new text end 333.7 new text begin (2) for initial construction of 25 to less than 100 sites, $400; and new text end 333.8 new text begin (3) for initial construction of 100 or more sites, $500. new text end 333.9 new text begin (e) The following fees must accompany a plan review application for expansion of a new text end 333.10 new text begin special event recreational camping area: new text end 333.11 new text begin (1) for expansion of less than 25 sites, $250; new text end 333.12 new text begin (2) for expansion of 25 and less than 100 sites, $300; and new text end 333.13 new text begin (3) for expansion of 100 or more sites, $450. new text end 333.14    Sec. 41. Minnesota Statutes 2008, section 327.16, is amended to read: 333.15327.16 LICENSE new text begin PLAN REVIEW new text end APPLICATION. 333.16    Subdivision 1. Made to state Department of Health. The new text begin plan review new text end application 333.17for license to operate and maintain a manufactured home park or recreational camping 333.18area shall be made to the state Department of Health, at such office and in such manner 333.19as may be prescribed by that department. 333.20    Subd. 2. Contents. The applicant for a primary license or annual license shall make 333.21application in writing new text begin plan review application shall be made new text end upon a form provided by the 333.22state Department of Health setting forth: 333.23(1) The full name and address of the applicant or applicants, or names and addresses 333.24of the partners if the applicant is a partnership, or the names and addresses of the officers 333.25if the applicant is a corporation. 333.26(2) A legal description of the site, lot, field, or tract of land upon which the applicant 333.27proposes to operate and maintain a manufactured home park or recreational camping area. 333.28(3) The proposed and existing facilities on and about the site, lot, field, or tract of 333.29land for the proposed construction or alteration and maintaining of a sanitary community 333.30building for toilets, urinals, sinks, wash basins, slop-sinks, showers, drains, laundry 333.31facilities, source of water supply, sewage, garbage and waste disposal; except that no 333.32toilet facilities shall be required in any manufactured home park which permits only 333.33manufactured homes equipped with toilet facilities discharging to water carried sewage 333.34disposal systems; and method of fire and storm protection. 334.1(4) The proposed method of lighting the structures and site, lot, field, or tract of land 334.2upon which the manufactured home park or recreational camping area is to be located. 334.3(5) The calendar months of the year which the applicant will operate the 334.4manufactured home park or recreational camping area. 334.5(6) Plans and drawings for new construction or alteration, including buildings, wells, 334.6plumbing and sewage disposal systems. 334.7    Subd. 3. Fees; Approval. The application for the primary license new text begin plan review new text end shall 334.8be submitted with all plans and specifications enumerated in subdivision 2, and payment 334.9of a fee in an amount prescribed by the state commissioner of health pursuant to section 334.10 and shall be accompanied by an approved zoning permit from the municipality or 334.11county wherein the park is to be located, or a statement from the municipality or county 334.12that it does not require an approved zoning permit. The fee for the annual license shall be 334.13in an amount prescribed by the state commissioner of health pursuant to section . 334.14All license fees paid to the commissioner of health shall be turned over to the state 334.15treasury. The fee submitted for the primary license new text begin plan review new text end shall be retained by the 334.16state even though the proposed project is not approved and a license is denied. 334.17When construction has been completed in accordance with approved plans and 334.18specifications the state commissioner of health shall promptly cause the manufactured 334.19home park or recreational camping area and appurtenances thereto to be inspected. When 334.20the inspection and report has been made and the state commissioner of health finds that 334.21all requirements of sections 327.10, 327.11, 327.14 to 327.28, and such conditions of 334.22health and safety as the state commissioner of health may require, have been met by 334.23the applicant, the state commissioner of health shall forthwith issue the primary license 334.24in the name of the state. 334.25    Subd. 4. Sanitary facilities new text begin Compliance with current state law new text end . During the 334.26pendency of the application for such primary license any change in the sanitary or safety 334.27facilities of the intended manufactured home park or recreational camping area shall be 334.28immediately reported in writing to the state Department of Health through the office 334.29through which the application was made. If no objection is made by the state Department 334.30of Health to such change in such sanitary or safety facilities within 60 days of the date 334.31such change is reported, it shall be deemed to have the approval of the state Department of 334.32Health. new text begin Any manufactured home park or recreational camping area must be constructed new text end 334.33 new text begin and operated according to all applicable state electrical, fire, plumbing, and building codes. new text end 334.34    Subd. 5. Permit. When the plans and specifications have been approved, the state 334.35Department of Health shall issue an approval report permitting the applicant to construct 335.1or make alterations upon a manufactured home park or recreational camping area and the 335.2appurtenances thereto according to the plans and specifications presented. 335.3Such approval does not relieve the applicant from securing building permits in 335.4municipalities that require permits or from complying with any other municipal ordinance 335.5or ordinances, applicable thereto, not in conflict with this statute. 335.6    Subd. 6. Denial of construction. If the application to construct or make alterations 335.7upon a manufactured home park or recreational camping area and the appurtenances 335.8thereto or a primary license to operate and maintain the same is denied by the state 335.9commissioner of health, the commissioner shall so state in writing giving the reason 335.10or reasons for denying the application. If the objections can be corrected the applicant 335.11may amend the application and resubmit it for approval, and if denied the applicant may 335.12appeal from the decision of the state commissioner of health as provided in section 335.13144.99, subdivision 10 . 335.14    Sec. 42. Minnesota Statutes 2008, section 327.20, subdivision 1, is amended to read: 335.15    Subdivision 1. Rules. No domestic animals or house pets of occupants of 335.16manufactured home parks or recreational camping areas shall be allowed to run at large, 335.17or commit any nuisances within the limits of a manufactured home park or recreational 335.18camping area. Each manufactured home park or recreational camping area licensed under 335.19the provisions of sections 327.10, 327.11, new text begin and new text end 327.14 to 327.28 shall, among other things, 335.20provide for the following, in the manner hereinafter specified: 335.21    (1) A responsible attendant or caretaker shall be in charge of every manufactured 335.22home park or recreational camping area at all times, who shall maintain the park or 335.23area, and its facilities and equipment in a clean, orderly and sanitary condition. In any 335.24manufactured home park containing more than 50 lots, the attendant, caretaker, or other 335.25responsible park employee, shall be readily available at all times in case of emergency. 335.26    (2) All manufactured home parks shall be well drained and be located so that the 335.27drainage of the park area will not endanger any water supply. No wastewater from 335.28manufactured homes or recreational camping vehicles shall be deposited on the surface of 335.29the ground. All sewage and other water carried wastes shall be discharged into a municipal 335.30sewage system whenever available. When a municipal sewage system is not available, a 335.31sewage disposal system acceptable to the state commissioner of health shall be provided. 335.32    (3) No manufactured home shall be located closer than three feet to the side lot lines 335.33of a manufactured home park, if the abutting property is improved property, or closer than 335.34ten feet to a public street or alley. Each individual site shall abut or face on a driveway 335.35or clear unoccupied space of not less than 16 feet in width, which space shall have 336.1unobstructed access to a public highway or alley. There shall be an open space of at least 336.2ten feet between the sides of adjacent manufactured homes including their attachments 336.3and at least three feet between manufactured homes when parked end to end. The space 336.4between manufactured homes may be used for the parking of motor vehicles and other 336.5property, if the vehicle or other property is parked at least ten feet from the nearest 336.6adjacent manufactured home position. The requirements of this paragraph shall not apply 336.7to recreational camping areas and variances may be granted by the state commissioner 336.8of health in manufactured home parks when the variance is applied for in writing and in 336.9the opinion of the commissioner the variance will not endanger the health, safety, and 336.10welfare of manufactured home park occupants. 336.11    (4) An adequate supply of water of safe, sanitary quality shall be furnished at each 336.12manufactured home park or recreational camping area. The source of the water supply 336.13shall first be approved by the state Department of Health. 336.14    (5) All plumbing shall be installed in accordance with the rules of the state 336.15commissioner of labor and industry and the provisions of the Minnesota Plumbing Code. 336.16    (6) In the case of a manufactured home park with less than ten manufactured homes, 336.17a plan for the sheltering or the safe evacuation to a safe place of shelter of the residents of 336.18the park in times of severe weather conditions, such as tornadoes, high winds, and floods. 336.19The shelter or evacuation plan shall be developed with the assistance and approval of 336.20the municipality where the park is located and shall be posted at conspicuous locations 336.21throughout the park. The park owner shall provide each resident with a copy of the 336.22approved shelter or evacuation plan, as provided by section 327C.01, subdivision 1c. 336.23Nothing in this paragraph requires the Department of Health to review or approve any 336.24shelter or evacuation plan developed by a park. Failure of a municipality to approve a plan 336.25submitted by a park shall not be grounds for action against the park by the Department of 336.26Health if the park has made a good faith effort to develop the plan and obtain municipal 336.27approval. 336.28    (7) A manufactured home park with ten or more manufactured homes, licensed prior 336.29to March 1, 1988, shall provide a safe place of shelter for park residents or a plan for the 336.30evacuation of park residents to a safe place of shelter within a reasonable distance of the 336.31park for use by park residents in times of severe weather, including tornadoes and high 336.32winds. The shelter or evacuation plan must be approved by the municipality by March 1, 336.331989. The municipality may require the park owner to construct a shelter if it determines 336.34that a safe place of shelter is not available within a reasonable distance from the park. A 336.35copy of the municipal approval and the plan shall be submitted by the park owner to the 337.1Department of Health. The park owner shall provide each resident with a copy of the 337.2approved shelter or evacuation plan, as provided by section 327C.01, subdivision 1c. 337.3    (8) A manufactured home park with ten or more manufactured homes, receiving 337.4a primary new text begin an initial new text end license after March 1, 1988, must provide the type of shelter required 337.5by section 327.205, except that for manufactured home parks established as temporary, 337.6emergency housing in a disaster area declared by the President of the United States or 337.7the governor, an approved evacuation plan may be provided in lieu of a shelter for a 337.8period not exceeding 18 months. 337.9    (9) For the purposes of this subdivision, "park owner" and "resident" have the 337.10meaning new text begin meanings new text end given them in section 327C.01. 337.11    Sec. 43. Minnesota Statutes 2008, section 327.20, is amended by adding a subdivision 337.12to read: 337.13     new text begin Subd. 4. new text end new text begin Special event recreational camping areas. new text end new text begin Each special event camping new text end 337.14 new text begin area licensed under sections 327.10, 327.11, and 327.14 to 327.28 is subject to this section. new text end 337.15 new text begin (1) Recreational camping vehicles and tents, including attachments, must be new text end 337.16 new text begin separated from each other and other structures by at least seven feet. new text end 337.17 new text begin (2) A minimum area of 300 square feet per site must be provided and the total new text end 337.18 new text begin number of sites must not exceed one site for every 300 square feet of usable land area. new text end 337.19 new text begin (3) Each site must abut or face a driveway or clear unoccupied space of at least 16 new text end 337.20 new text begin feet in width, which space must have unobstructed access to a public roadway. new text end 337.21 new text begin (4) If no approved on-site water supply system is available, hauled water may be new text end 337.22 new text begin used, provided that persons using hauled water comply with Minnesota Rules, parts new text end 337.23 new text begin 4720.4000 to 4720.4600. new text end 337.24 new text begin (5) Nonburied sewer lines may be permitted provided they are of approved materials, new text end 337.25 new text begin watertight, and properly maintained. new text end 337.26 new text begin (6) If a sanitary dumping station is not provided on-site, arrangements must be new text end 337.27 new text begin made with a licensed sewage pumper to service recreational camping vehicle holding new text end 337.28 new text begin tanks as needed. new text end 337.29 new text begin (7) Toilet facilities must be provided consisting of toilets connected to an approved new text end 337.30 new text begin sewage disposal system, portable toilets, or approved, properly constructed privies. new text end 337.31 new text begin (8) Toilets must be provided in the ratio of one toilet for each sex for each 150 sites. new text end 337.32 new text begin (9) Toilets must be not more than 400 feet from any site. new text end 337.33 new text begin (10) If a central building or buildings are provided with running water, then toilets new text end 337.34 new text begin and handwashing lavatories must be provided in the building or buildings that meet the new text end 337.35 new text begin requirements of this subdivision. new text end 338.1 new text begin (11) Showers, if provided, must be provided in the ratio of one shower for each sex new text end 338.2 new text begin for each 250 sites. Showerheads must be provided, where running water is available, for new text end 338.3 new text begin each camping event exceeding two nights. new text end 338.4 new text begin (12) Central toilet and shower buildings, if provided, must be constructed with new text end 338.5 new text begin adequate heating, ventilation, and lighting, and floors of impervious material sloped new text end 338.6 new text begin to drain. Walls must be of a washable material. Permanent facilities must meet the new text end 338.7 new text begin requirements of the Americans with Disabilities Act. new text end 338.8 new text begin (13) An adequate number of durable, covered, watertight containers must be new text end 338.9 new text begin provided for all garbage and refuse. Garbage and refuse must be collected as often as new text end 338.10 new text begin necessary to prevent nuisance conditions. new text end 338.11 new text begin (14) Campgrounds must be located in areas free of poison ivy or other noxious new text end 338.12 new text begin weeds considered detrimental to health. Sites must not be located in areas of tall grass or new text end 338.13 new text begin weeds and sites must be adequately drained. new text end 338.14 new text begin (15) Campsites for recreational vehicles may not be located on inclines of greater new text end 338.15 new text begin than eight percent grade or one inch drop per lineal foot. new text end 338.16 new text begin (16) A responsible attendant or caretaker must be available on-site at all times during new text end 338.17 new text begin the operation of any special event recreational camping area that has 50 or more sites. new text end 338.18    Sec. 44. new text begin MINNESOTA COLORECTAL CANCER PREVENTION new text end 338.19 new text begin DEMONSTRATION PROJECT. new text end 338.20     new text begin Subdivision 1. new text end new text begin Establishment. new text end new text begin The commissioner of health shall award grants new text end 338.21 new text begin to Hennepin County Medical Center and MeritCare Bemidji for a colorectal screening new text end 338.22 new text begin demonstration project to provide screening to uninsured and underinsured women and new text end 338.23 new text begin men. The project shall expire December 31, 2010. new text end 338.24     new text begin Subd. 2. new text end new text begin Eligibility. new text end new text begin To be eligible for colorectal screening under this demonstration new text end 338.25 new text begin project, an applicant must: new text end 338.26 new text begin (1) be at least 50 years of age, or under the age of 50 and at high risk for colon cancer; new text end 338.27 new text begin (2) be uninsured, or if insured, have coverage that does not cover the full cost of new text end 338.28 new text begin colorectal cancer screenings; new text end 338.29 new text begin (3) not be eligible for medical assistance, general assistance medical care, or new text end 338.30 new text begin MinnesotaCare programs; and new text end 338.31 new text begin (4) have a gross family income at or below 250 percent of the federal poverty level. new text end 338.32     new text begin Subd. 3. new text end new text begin Services. new text end new text begin Services provided under this project shall include: new text end 338.33 new text begin (1) colorectal cancer screening, according to standard practices of medicine, or new text end 338.34 new text begin guidelines provided by the Institute for Clinical Systems Improvement or the American new text end 338.35 new text begin Cancer Society; new text end 339.1 new text begin (2) follow-up services for abnormal tests; and new text end 339.2 new text begin (3) diagnostic services to determine the extent and proper course of treatment. new text end 339.3     new text begin Subd. 4. new text end new text begin Project evaluation. new text end new text begin The commissioner of health shall evaluate the new text end 339.4 new text begin demonstration project and make recommendations for increasing the number of persons in new text end 339.5 new text begin Minnesota who receive recommended colon cancer screening. The commissioner of health new text end 339.6 new text begin shall submit the evaluation and recommendations to the legislature by January 15, 2011. new text end 339.7    Sec. 45. new text begin RESEARCH OF EXPOSURE PATHWAYS FOR new text end 339.8 new text begin PERFLUOROCHEMICALS. new text end 339.9 new text begin The commissioner of health shall study and report to the legislature by January new text end 339.10 new text begin 15, 2011, on the exposure pathways for perfluorochemicals, focusing on food sources new text end 339.11 new text begin that might be affected by contact with contaminated water or air. This research will be new text end 339.12 new text begin performed to the extent that nonstate funds and environmental health tracking funds are new text end 339.13 new text begin available and include garden vegetables produced or consumed by a representative sample new text end 339.14 new text begin of the population from the east metropolitan area including indigenous people and people new text end 339.15 new text begin of color. In developing and performing the research, the commissioner must convene and new text end 339.16 new text begin consult with a citizen advisory group consisting of residents from the east metropolitan new text end 339.17 new text begin area, including indigenous people and people of color. new text end 339.18    Sec. 46. new text begin FEASIBILITY PILOT PROJECT FOR CANCER SURVEILLANCE. new text end 339.19 new text begin The commissioner of health must provide a grant to the Hennepin County Medical new text end 339.20 new text begin Center for a one-year feasibility pilot project to collect occupational, residential, and new text end 339.21 new text begin military service history data from newly diagnosed cancer patients at the Hennepin new text end 339.22 new text begin County Medical Center's Cancer Center. Funding for this grant shall come from the new text end 339.23 new text begin Department of Health's current resources for the Chronic Disease and Environmental new text end 339.24 new text begin Epidemiology Section. new text end 339.25 new text begin Under this pilot project, Hennepin County Medical Center will design an expansion new text end 339.26 new text begin of its existing cancer registry to include the collection of additional data, including the new text end 339.27 new text begin cancer patient's occupational, residential, and military service history. Patient consent is new text end 339.28 new text begin required for collection of these additional data. The consent must be in writing and must new text end 339.29 new text begin contain notice informing the patient about private and confidential data concerning the new text end 339.30 new text begin patient pursuant to Minnesota Statutes, section 13.04, subdivision 2. The patient is entitled new text end 339.31 new text begin to opt out of the project at any time. The data collection expansion may also include the new text end 339.32 new text begin cancer patient's possible toxic environmental exposure history, if known. The purpose of new text end 339.33 new text begin this pilot project is to determine the following: new text end 339.34 new text begin (1) the feasibility of collecting these data on a statewide scale; new text end 340.1 new text begin (2) the potential design of a self-administered patient questionnaire template; and new text end 340.2 new text begin (3) necessary qualifications for staff who will collect these data. new text end 340.3 new text begin Hennepin County Medical Center must report the results of this pilot project to the new text end 340.4 new text begin legislature by October 1, 2010. new text end 340.5    Sec. 47. new text begin SMOKING CESSATION. new text end 340.6 new text begin The commissioner of health must prioritize smoking prevention and smoking new text end 340.7 new text begin cessation activities in low-income, indigenous, and minority communities in their new text end 340.8 new text begin collaborations with the organization specifically described in Minnesota Statutes, section new text end 340.9 new text begin 144.396, subdivision 8. new text end 340.10    Sec. 48. new text begin MEDICAL RESPONSE UNIT REIMBURSEMENT PILOT PROGRAM. new text end 340.11 new text begin (a) The Department of Public Safety or its contract designee shall collaborate new text end 340.12 new text begin with the Minnesota Ambulance Association to create the parameters of the medical new text end 340.13 new text begin response unit reimbursement pilot program, including determining criteria for baseline new text end 340.14 new text begin data reporting. new text end 340.15 new text begin (b) In conducting the pilot program, the Department of Public Safety must consult new text end 340.16 new text begin with the Minnesota Ambulance Association, Minnesota Fire Chiefs Association, new text end 340.17 new text begin Emergency Services Regulatory Board, and the Minnesota Council of Health Plans to: new text end 340.18 new text begin (1) identify no more than five medical response units registered as medical response new text end 340.19 new text begin units with the Minnesota Emergency Medical Services Regulatory Board according to new text end 340.20 new text begin Minnesota Statutes, chapter 144E, to participate in the program; new text end 340.21 new text begin (2) outline and develop criteria for reimbursement; new text end 340.22 new text begin (3) determine the amount of reimbursement for each unit response; and new text end 340.23 new text begin (4) collect program data to be analyzed for a final report. new text end 340.24 new text begin (c) Further criteria for the medical response unit reimbursement pilot program new text end 340.25 new text begin shall include: new text end 340.26 new text begin (1) the pilot program will expire on December 31, 2010, or when the appropriation new text end 340.27 new text begin is extended, whichever occurs first; new text end 340.28 new text begin (2) a report shall be made to the legislature by March 1, 2011, by the Department new text end 340.29 new text begin of Public Safety or its contractor as to the effectiveness and value of this reimbursement new text end 340.30 new text begin pilot program to the emergency medical services delivery system, any actual or potential new text end 340.31 new text begin savings to the health care system, and impact on patient outcomes; new text end 340.32 new text begin (3) participating medical response units must adhere to the requirements of this new text end 340.33 new text begin pilot program outlined in an agreement between the Department of Public Safety and new text end 340.34 new text begin the medical response unit, including but not limited to, requirements relating to data new text end 340.35 new text begin collection, response criteria, and patient outcomes and disposition; new text end 341.1 new text begin (4) individual entities licensed to provide ambulance care under Minnesota Statutes, new text end 341.2 new text begin chapter 144E, are not eligible for participation in this pilot program; new text end 341.3 new text begin (5) if a participating medical response unit withdraws from the pilot program, the new text end 341.4 new text begin Department of Public Safety in consultation with the Minnesota Ambulance Association new text end 341.5 new text begin may choose another pilot site if funding is available; new text end 341.6 new text begin (6) medical response units must coordinate their operations under this pilot project new text end 341.7 new text begin with the ambulance service or services licensed to provide care in their first response new text end 341.8 new text begin geographic areas; new text end 341.9 new text begin (7) licensed ambulance services that participate with the medical response unit in new text end 341.10 new text begin the pilot program assume no financial or legal liability for the actions of the participating new text end 341.11 new text begin medical response unit; and new text end 341.12 new text begin (8) the Department of Public Safety and its pilot program partners have no ongoing new text end 341.13 new text begin responsibility to reimburse medical response units beyond the parameters of the pilot new text end 341.14 new text begin program. new text end 341.15    Sec. 49. new text begin REVIEW OF PROPOSED REGULATIONS FOR BODY ART new text end 341.16 new text begin TECHNICIANS AND BODY ART ESTABLISHMENTS. new text end 341.17 new text begin The commissioner of health shall review proposed regulatory legislation for new text end 341.18 new text begin body art technicians and body art establishments and develop recommendations on the new text end 341.19 new text begin proper level of regulation needed for body art technicians and establishments in order new text end 341.20 new text begin to protect public health. The recommendations must include a review of how other new text end 341.21 new text begin states comply with the American Association of Blood Banks standards, how regulatory new text end 341.22 new text begin requirements affect currently operating body art establishments, and the appropriate level new text end 341.23 new text begin of coordination between the state and local jurisdictions that currently regulate body art new text end 341.24 new text begin establishments. The commissioner shall submit the results of the review and possible new text end 341.25 new text begin regulatory recommendations for body art technicians and establishments to the chairs and new text end 341.26 new text begin ranking minority members of the legislative committees with jurisdiction over health new text end 341.27 new text begin care by January 15, 2010. new text end 341.28    Sec. 50. new text begin HEARING AIDS; ENFORCEMENT. new text end 341.29 new text begin Costs incurred by the Minnesota Department of Health for conducting investigations new text end 341.30 new text begin of unlicensed hearing aid dispensers shall be apportioned between all licensed or new text end 341.31 new text begin credentialed professions that dispense hearing aids. new text end 341.32 new text begin EFFECTIVE DATE. new text end new text begin This section is effect July 1, 2011. new text end 341.33    Sec. 51. new text begin REPEALER. new text end 342.1 new text begin (a) new text end new text begin Minnesota Statutes 2008, sections 103I.112; 144.9501, subdivision 17b; and new text end 342.2 new text begin 327.14, subdivisions 5 and 6, new text end new text begin are repealed. new text end 342.3 new text begin (b) new text end new text begin Minnesota Rules, part 4626.2015, subpart 9, new text end new text begin is repealed. new text end 342.4ARTICLE 11 342.5HEALTH-RELATED FEES 342.6    Section 1. Minnesota Statutes 2008, section 148D.180, subdivision 1, is amended to 342.7read: 342.8    Subdivision 1. Application fees. Application fees for licensure are as follows: 342.9(1) for a licensed social worker, $45; 342.10(2) for a licensed graduate social worker, $45; 342.11(3) for a licensed independent social worker, $90 new text begin $45 new text end ; 342.12(4) for a licensed independent clinical social worker, $90 new text begin $45 new text end ; 342.13(5) for a temporary license, $50; and 342.14(6) for a licensure by endorsement, $150 new text begin $85 new text end . 342.15The fee for criminal background checks is the fee charged by the Bureau of Criminal 342.16Apprehension. The criminal background check fee must be included with the application 342.17fee as required pursuant to section 148D.055. 342.18    Sec. 2. Minnesota Statutes 2008, section 148D.180, subdivision 2, is amended to read: 342.19    Subd. 2. License fees. License fees are as follows: 342.20(1) for a licensed social worker, $115.20 new text begin $81 new text end ; 342.21(2) for a licensed graduate social worker, $201.60 new text begin $144 new text end ; 342.22(3) for a licensed independent social worker, $302.40 new text begin $216 new text end ; 342.23(4) for a licensed independent clinical social worker, $331.20 new text begin $238.50 new text end ; 342.24(5) for an emeritus license, $43.20; and 342.25(6) for a temporary leave fee, the same as the renewal fee specified in subdivision 3. 342.26If the licensee's initial license term is less or more than 24 months, the required 342.27license fees must be prorated proportionately. 342.28    Sec. 3. Minnesota Statutes 2008, section 148D.180, subdivision 3, is amended to read: 342.29    Subd. 3. Renewal fees. Renewal fees for licensure are as follows: 342.30(1) for a licensed social worker, $115.20 new text begin $81 new text end ; 342.31(2) for a licensed graduate social worker, $201.60 new text begin $144 new text end ; 342.32(3) for a licensed independent social worker, $302.40 new text begin $216 new text end ; and 342.33(4) for a licensed independent clinical social worker, $331.20 new text begin $238.50 new text end . 343.1    Sec. 4. Minnesota Statutes 2008, section 148D.180, subdivision 5, is amended to read: 343.2    Subd. 5. Late fees. Late fees are as follows: 343.3(1) renewal late fee, one-half new text begin one-fourth new text end of the renewal fee specified in subdivision 343.43; and 343.5(2) supervision plan late fee, $40. 343.6    Sec. 5. Minnesota Statutes 2008, section 148E.180, subdivision 1, is amended to read: 343.7    Subdivision 1. Application fees. Application fees for licensure are as follows: 343.8    (1) for a licensed social worker, $45; 343.9    (2) for a licensed graduate social worker, $45; 343.10    (3) for a licensed independent social worker, $90 new text begin $45 new text end ; 343.11    (4) for a licensed independent clinical social worker, $90 new text begin $45 new text end ; 343.12    (5) for a temporary license, $50; and 343.13    (6) for a licensure by endorsement, $150 new text begin $85 new text end . 343.14    The fee for criminal background checks is the fee charged by the Bureau of Criminal 343.15Apprehension. The criminal background check fee must be included with the application 343.16fee as required according to section 148E.055. 343.17    Sec. 6. Minnesota Statutes 2008, section 148E.180, subdivision 2, is amended to read: 343.18    Subd. 2. License fees. License fees are as follows: 343.19    (1) for a licensed social worker, $115.20 new text begin $81 new text end ; 343.20    (2) for a licensed graduate social worker, $201.60 new text begin $144 new text end ; 343.21    (3) for a licensed independent social worker, $302.40 new text begin $216 new text end ; 343.22    (4) for a licensed independent clinical social worker, $331.20 new text begin $238.50 new text end ; 343.23    (5) for an emeritus license, $43.20; and 343.24    (6) for a temporary leave fee, the same as the renewal fee specified in subdivision 3. 343.25    If the licensee's initial license term is less or more than 24 months, the required 343.26license fees must be prorated proportionately. 343.27    Sec. 7. Minnesota Statutes 2008, section 148E.180, subdivision 3, is amended to read: 343.28    Subd. 3. Renewal fees. Renewal fees for licensure are as follows: 343.29    (1) for a licensed social worker, $115.20 new text begin $81 new text end ; 343.30    (2) for a licensed graduate social worker, $201.60 new text begin $144 new text end ; 343.31    (3) for a licensed independent social worker, $302.40 new text begin $216 new text end ; and 343.32    (4) for a licensed independent clinical social worker, $331.20 new text begin $238.50 new text end . 344.1    Sec. 8. Minnesota Statutes 2008, section 148E.180, subdivision 5, is amended to read: 344.2    Subd. 5. Late fees. Late fees are as follows: 344.3    (1) renewal late fee, one-half new text begin one-fourth new text end of the renewal fee specified in subdivision 344.43; and 344.5    (2) supervision plan late fee, $40. 344.6    Sec. 9. Minnesota Statutes 2008, section 152.126, subdivision 1, is amended to read: 344.7    Subdivision 1. Definitions. For purposes of this section, the terms defined in this 344.8subdivision have the meanings given. 344.9    (a) "Board" means the Minnesota State Board of Pharmacy established under 344.10chapter 151. 344.11    (b) "Controlled substances" means those substances listed in section 152.02, 344.12subdivisions 3 and 4 new text begin to 5 new text end , and those substances defined by the board pursuant to section 344.13152.02, subdivisions 7 , 8, and 12. 344.14    (c) "Dispense" or "dispensing" has the meaning given in section 151.01, subdivision 344.1530. Dispensing does not include the direct administering of a controlled substance to a 344.16patient by a licensed health care professional. 344.17    (d) "Dispenser" means a person authorized by law to dispense a controlled substance, 344.18pursuant to a valid prescription. For the purposes of this section, a dispenser does not 344.19include a licensed hospital pharmacy that distributes controlled substances for inpatient 344.20hospital care or a veterinarian who is dispensing prescriptions under section 156.18. 344.21    (e) "Prescriber" means a licensed health care professional who is authorized to 344.22prescribe a controlled substance under section 152.12, subdivision 1. 344.23    (f) "Prescription" has the meaning given in section 151.01, subdivision 16. 344.24    Sec. 10. Minnesota Statutes 2008, section 152.126, subdivision 2, is amended to read: 344.25    Subd. 2. Prescription electronic reporting system. (a) The board shall establish 344.26by January 1, 2010, an electronic system for reporting the information required under 344.27subdivision 4 for all controlled substances dispensed within the state. 344.28    (b) The board may contract with a vendor for the purpose of obtaining technical 344.29assistance in the design, implementation, new text begin operation, new text end and maintenance of the electronic 344.30reporting system. The vendor's role shall be limited to providing technical support to the 344.31board concerning the software, databases, and computer systems required to interface with 344.32the existing systems currently used by pharmacies to dispense prescriptions and transmit 344.33prescription data to other third parties. 345.1    Sec. 11. Minnesota Statutes 2008, section 152.126, subdivision 6, is amended to read: 345.2    Subd. 6. Access to reporting system data. (a) Except as indicated in this 345.3subdivision, the data submitted to the board under subdivision 4 is private data on 345.4individuals as defined in section 13.02, subdivision 12, and not subject to public disclosure. 345.5    (b) Except as specified in subdivision 5, the following persons shall be considered 345.6permissible users and may access the data submitted under subdivision 4 in the same or 345.7similar manner, and for the same or similar purposes, as those persons who are authorized 345.8to access similar private data on individuals under federal and state law: 345.9    (1) a prescriber, to the extent the information relates specifically to a current patient, 345.10to whom the prescriber is prescribing or considering prescribing any controlled substance; 345.11    (2) a dispenser, to the extent the information relates specifically to a current patient 345.12to whom that dispenser is dispensing or considering dispensing any controlled substance; 345.13    (3) an individual who is the recipient of a controlled substance prescription for 345.14which data was submitted under subdivision 4, or a guardian of the individual, parent or 345.15guardian of a minor, or health care agent of the individual acting under a health care 345.16directive under chapter 145C; 345.17    (4) personnel of the board specifically assigned to conduct a bona fide investigation 345.18of a specific licensee; 345.19    (5) personnel of the board engaged in the collection of controlled substance 345.20prescription information as part of the assigned duties and responsibilities under this 345.21section; 345.22    (6) authorized personnel of a vendor under contract with the board who are engaged 345.23in the design, implementation, new text begin operation, new text end and maintenance of the electronic reporting 345.24system as part of the assigned duties and responsibilities of their employment, provided 345.25that access to data is limited to the minimum amount necessary to test and maintain the 345.26system databases new text begin carry out such duties and responsibilities new text end ; 345.27    (7) federal, state, and local law enforcement authorities acting pursuant to a valid 345.28search warrant; and 345.29    (8) personnel of the medical assistance program assigned to use the data collected 345.30under this section to identify recipients whose usage of controlled substances may warrant 345.31restriction to a single primary care physician, a single outpatient pharmacy, or a single 345.32hospital. 345.33    For purposes of clause (3), access by an individual includes persons in the definition 345.34of an individual under section 13.02. 345.35    (c) Any permissible user identified in paragraph (b), who directly accesses 345.36the data electronically, shall implement and maintain a comprehensive information 346.1security program that contains administrative, technical, and physical safeguards that 346.2are appropriate to the user's size and complexity, and the sensitivity of the personal 346.3information obtained. The permissible user shall identify reasonably foreseeable internal 346.4and external risks to the security, confidentiality, and integrity of personal information 346.5that could result in the unauthorized disclosure, misuse, or other compromise of the 346.6information and assess the sufficiency of any safeguards in place to control the risks. 346.7    (d) The board shall not release data submitted under this section unless it is provided 346.8with evidence, satisfactory to the board, that the person requesting the information is 346.9entitled to receive the data. 346.10    (e) The board shall not release the name of a prescriber without the written consent 346.11of the prescriber or a valid search warrant or court order. The board shall provide a 346.12mechanism for a prescriber to submit to the board a signed consent authorizing the release 346.13of the prescriber's name when data containing the prescriber's name is requested. 346.14    (f) The board shall maintain a log of all persons who access the data and shall ensure 346.15that any permissible user complies with paragraph (c) prior to attaining direct access to 346.16the data. 346.17 new text begin (g) Section 13.05, subdivision 6, shall apply to any contract the board enters into new text end 346.18 new text begin pursuant to subdivision 2. A vendor shall not use data collected under this section for new text end 346.19 new text begin any purpose not specified in this section. new text end 346.20    Sec. 12. new text begin REPEALER. new text end 346.21 new text begin Minnesota Statutes 2008, section 148D.180, subdivision 8, new text end new text begin is repealed. new text end 346.22ARTICLE 12 346.23HUMAN SERVICES FORECAST ADJUSTMENTS 346.24 346.25 Section 1. new text begin SUMMARY OF APPROPRIATIONS; DEPARTMENT OF HUMAN new text end new text begin SERVICES FORECAST ADJUSTMENT. new text end 346.26     new text begin The dollar amounts shown are added to or, if shown in parentheses, are subtracted new text end 346.27 new text begin from the appropriations in Laws 2008, chapter 363, from the general fund, or any other new text end 346.28 new text begin fund named, to the Department of Human Services for the purposes specified in this new text end 346.29 new text begin article, to be available for the fiscal year indicated for each purpose. The figure "2009" new text end 346.30 new text begin used in this article means that the appropriation or appropriations listed are available new text end 346.31 new text begin for the fiscal year ending June 30, 2009. new text end 346.32 346.33 Sec. 2. new text begin COMMISSIONER OF HUMAN new text end new text begin SERVICES new text end 347.1 new text begin Subdivision 1. new text end new text begin Total Appropriation new text end new text begin $ new text end new text begin (478,994,000) new text end 347.2 new text begin Appropriations by Fund new text end 347.3 new text begin 2009 new text end 347.4 new text begin General new text end new text begin (445,130,000) new text end 347.5 new text begin Health Care Access new text end new text begin (19,460,000) new text end 347.6 new text begin Federal TANF new text end new text begin (14,404,000) new text end 347.7 new text begin Subd. 2. new text end new text begin Revenue and Pass-Through new text end 347.8 new text begin Federal TANF new text end new text begin 1,107,000 new text end 347.9 347.10 new text begin Subd. 3. new text end new text begin Children and Economic Assistance new text end new text begin Grants new text end 347.11 new text begin General new text end new text begin 27,002,000 new text end 347.12 new text begin Federal TANF new text end new text begin (16,211,000) new text end 347.13 new text begin The amounts that may be spent from this new text end 347.14 new text begin appropriation for each purpose are as follows: new text end 347.15 new text begin (a) new text end new text begin MFIP/DWP Grants new text end 347.16 new text begin General new text end new text begin 17,530,000 new text end 347.17 new text begin Federal TANF new text end new text begin (16,211,000) new text end 347.18 new text begin (b) new text end new text begin MFIP Child Care Assistance Grants new text end new text begin 4,933,000 new text end 347.19 new text begin (c) new text end new text begin General Assistance Grants new text end new text begin 1,458,000 new text end 347.20 new text begin (d) new text end new text begin Minnesota Supplemental Aid Grants new text end new text begin 513,000 new text end 347.21 new text begin (e) new text end new text begin Group Residential Housing Grants new text end new text begin 2,568,000 new text end 347.22 new text begin Subd. 4. new text end new text begin Basic Health Care Grants new text end 347.23 new text begin General new text end new text begin (224,341,000) new text end 347.24 new text begin Health Care Access new text end new text begin (19,460,000) new text end 348.1 new text begin The amounts that may be spent from this new text end 348.2 new text begin appropriation for each purpose are as follows: new text end 348.3 new text begin (a) new text end new text begin MinnesotaCare new text end 348.4 new text begin Health Care Access new text end new text begin (19,460,000) new text end 348.5 348.6 new text begin (b) new text end new text begin MA Basic Health Care - Families and new text end new text begin Children new text end new text begin (100,055,000) new text end 348.7 348.8 new text begin (c) new text end new text begin MA Basic Health Care - Elderly and new text end new text begin Disabled new text end new text begin (136,795,000) new text end 348.9 new text begin (d) new text end new text begin General Assistance Medical Care new text end new text begin 12,539,000 new text end 348.10 new text begin Subd. 5. new text end new text begin Continuing Care Grants new text end new text begin (247,791,000) new text end 348.11 new text begin The amounts that may be spent from this new text end 348.12 new text begin appropriation for each purpose are as follows: new text end 348.13 new text begin (a) new text end new text begin MA Long-Term Care Facilities new text end new text begin (59,204,000) new text end 348.14 new text begin (b) new text end new text begin MA Long-Term Care Waivers new text end new text begin (168,927,000) new text end 348.15 new text begin (c) new text end new text begin Chemical Dependency Entitlement Grants new text end new text begin (19,660,000) new text end 348.16    Sec. 3. new text begin EFFECTIVE DATE. new text end 348.17 new text begin Sections 1 and 2 are effective the day following final enactment. new text end 348.18ARTICLE 13 348.19APPROPRIATIONS 348.20 Section 1. new text begin SUMMARY OF APPROPRIATIONS. new text end 348.21     new text begin The amounts shown in this section summarize direct appropriations by fund made new text end 348.22 new text begin in this article. new text end 348.23 new text begin 2010 new text end new text begin 2011 new text end new text begin Total new text end 348.24 new text begin General new text end new text begin $ new text end new text begin 4,452,323,000 new text end new text begin $ new text end new text begin 5,280,470,000 new text end new text begin $ new text end new text begin 9,732,793,000 new text end 348.25 348.26 new text begin State Government Special new text end new text begin Revenue new text end new text begin 62,451,000 new text end new text begin 61,515,000 new text end new text begin 123,966,000 new text end 349.1 new text begin Health Care Access new text end new text begin 489,995,000 new text end new text begin 568,298,000 new text end new text begin 1,058,293,000 new text end 349.2 new text begin Federal TANF new text end new text begin 301,220,000 new text end new text begin 268,711,000 new text end new text begin 569,931,000 new text end 349.3 new text begin Lottery Prize new text end new text begin 1,665,000 new text end new text begin 1,665,000 new text end new text begin 3,330,000 new text end 349.4 new text begin Federal Fund new text end new text begin 110,000,000 new text end new text begin 0 new text end new text begin 110,000,000 new text end 349.5 new text begin Total new text end new text begin $ new text end new text begin 5,417,704,000 new text end new text begin $ new text end new text begin 6,180,659,000 new text end new text begin $ new text end new text begin 11,598,363,000 new text end 349.6 Sec. 2. new text begin HEALTH AND HUMAN SERVICES APPROPRIATION. new text end 349.7     new text begin The sums shown in the columns marked "Appropriations" are appropriated to the new text end 349.8 new text begin agencies and for the purposes specified in this article. The appropriations are from the new text end 349.9 new text begin general fund, or another named fund, and are available for the fiscal years indicated new text end 349.10 new text begin for each purpose. The figures "2010" and "2011" used in this article mean that the new text end 349.11 new text begin appropriations listed under them are available for the fiscal year ending June 30, 2010, or new text end 349.12 new text begin June 30, 2011, respectively. "The first year" is fiscal year 2010. "The second year" is fiscal new text end 349.13 new text begin year 2011. "The biennium" is fiscal years 2010 and 2011. Appropriations for the fiscal new text end 349.14 new text begin year ending June 30, 2009, are effective the day following final enactment. new text end 349.15 new text begin APPROPRIATIONS new text end 349.16 new text begin Available for the Year new text end 349.17 new text begin Ending June 30 new text end 349.18 new text begin 2010 new text end new text begin 2011 new text end 349.19 Sec. 3. new text begin HUMAN SERVICES new text end 349.20 new text begin Subdivision 1. new text end new text begin Total Appropriation new text end new text begin $ new text end new text begin 5,230,100,000 new text end new text begin $ new text end new text begin 5,997,715,000 new text end 349.21 new text begin Appropriations by Fund new text end 349.22 new text begin 2010 new text end new text begin 2011 new text end 349.23 new text begin General new text end new text begin 4,376,839,000 new text end new text begin 5,211,018,000 new text end 349.24 349.25 new text begin State Government new text end new text begin Special Revenue new text end new text begin 1,315,000 new text end new text begin 565,000 new text end 349.26 new text begin Health Care Access new text end new text begin 450,792,000 new text end new text begin 527,489,000 new text end 349.27 new text begin Federal TANF new text end new text begin 289,487,000 new text end new text begin 256,978,000 new text end 349.28 new text begin Lottery Prize new text end new text begin 1,665,000 new text end new text begin 1,665,000 new text end 349.29 new text begin Federal Fund new text end new text begin 110,000,000 new text end new text begin 0 new text end 350.1 new text begin Receipts for Systems Projects. new text end new text begin new text end 350.2 new text begin Appropriations and federal receipts for new text end 350.3 new text begin information systems projects for MAXIS, new text end 350.4 new text begin PRISM, MMIS, and SSIS must be deposited new text end 350.5 new text begin in the state system account authorized in new text end 350.6 new text begin Minnesota Statutes, section 256.014. Money new text end 350.7 new text begin appropriated for computer projects approved new text end 350.8 new text begin by the Minnesota Office of Enterprise new text end 350.9 new text begin Technology, funded by the legislature, and new text end 350.10 new text begin approved by the commissioner of finance, new text end 350.11 new text begin may be transferred from one project to new text end 350.12 new text begin another and from development to operations new text end 350.13 new text begin as the commissioner of human services new text end 350.14 new text begin considers necessary, except that any transfers new text end 350.15 new text begin to one project that exceed $1,000,000 or new text end 350.16 new text begin multiple transfers to one project that exceed new text end 350.17 new text begin $1,000,000 in total require the express new text end 350.18 new text begin approval of the legislature. The preceding new text end 350.19 new text begin requirement for legislative approval does not new text end 350.20 new text begin apply to transfers made to establish a project's new text end 350.21 new text begin initial operating budget each year; instead, new text end 350.22 new text begin the requirements of section 11, subdivision 2, new text end 350.23 new text begin of this article apply to those transfers. Any new text end 350.24 new text begin unexpended balance in the appropriation new text end 350.25 new text begin for these projects does not cancel but is new text end 350.26 new text begin available for ongoing development and new text end 350.27 new text begin operations. Any computer project with a new text end 350.28 new text begin total cost exceeding $1,000,000, including, new text end 350.29 new text begin but not limited to, a replacement for the new text end 350.30 new text begin proposed HealthMatch system, shall not be new text end 350.31 new text begin commenced without the express approval of new text end 350.32 new text begin the legislature. new text end 350.33 new text begin HealthMatch Systems Project. new text end new text begin In fiscal new text end 350.34 new text begin year 2010, $3,054,000 shall be transferred new text end 350.35 new text begin from the HealthMatch account in the state new text end 351.1 new text begin systems account in the special revenue fund new text end 351.2 new text begin to the general fund. new text end 351.3 new text begin Nonfederal Share Transfers. new text end new text begin The new text end 351.4 new text begin nonfederal share of activities for which new text end 351.5 new text begin federal administrative reimbursement is new text end 351.6 new text begin appropriated to the commissioner may be new text end 351.7 new text begin transferred to the special revenue fund. new text end 351.8 new text begin TANF Maintenance of Effort. new text end 351.9 new text begin (a) In order to meet the basic maintenance new text end 351.10 new text begin of effort (MOE) requirements of the TANF new text end 351.11 new text begin block grant specified under Code of Federal new text end 351.12 new text begin Regulations, title 45, section 263.1, the new text end 351.13 new text begin commissioner may only report nonfederal new text end 351.14 new text begin money expended for allowable activities new text end 351.15 new text begin listed in the following clauses as TANF/MOE new text end 351.16 new text begin expenditures: new text end 351.17 new text begin (1) MFIP cash, diversionary work program, new text end 351.18 new text begin and food assistance benefits under Minnesota new text end 351.19 new text begin Statutes, chapter 256J; new text end 351.20 new text begin (2) the child care assistance programs new text end 351.21 new text begin under Minnesota Statutes, sections 119B.03 new text end 351.22 new text begin and 119B.05, and county child care new text end 351.23 new text begin administrative costs under Minnesota new text end 351.24 new text begin Statutes, section 119B.15; new text end 351.25 new text begin (3) state and county MFIP administrative new text end 351.26 new text begin costs under Minnesota Statutes, chapters new text end 351.27 new text begin 256J and 256K; new text end 351.28 new text begin (4) state, county, and tribal MFIP new text end 351.29 new text begin employment services under Minnesota new text end 351.30 new text begin Statutes, chapters 256J and 256K; new text end 351.31 new text begin (5) expenditures made on behalf of new text end 351.32 new text begin noncitizen MFIP recipients who qualify new text end 351.33 new text begin for the medical assistance without federal new text end 351.34 new text begin financial participation program under new text end 352.1 new text begin Minnesota Statutes, section 256B.06, new text end 352.2 new text begin subdivision 4, paragraphs (d), (e), and (j); new text end 352.3 new text begin and new text end 352.4 new text begin (6) qualifying working family credit new text end 352.5 new text begin expenditures under Minnesota Statutes, new text end 352.6 new text begin section 290.0671. new text end 352.7 new text begin (b) The commissioner shall ensure that new text end 352.8 new text begin sufficient qualified nonfederal expenditures new text end 352.9 new text begin are made each year to meet the state's new text end 352.10 new text begin TANF/MOE requirements. For the activities new text end 352.11 new text begin listed in paragraph (a), clauses (2) to new text end 352.12 new text begin (6), the commissioner may only report new text end 352.13 new text begin expenditures that are excluded from the new text end 352.14 new text begin definition of assistance under Code of new text end 352.15 new text begin Federal Regulations, title 45, section 260.31. new text end 352.16 new text begin (c) For fiscal years beginning with state new text end 352.17 new text begin fiscal year 2003, the commissioner shall new text end 352.18 new text begin ensure that the maintenance of effort used new text end 352.19 new text begin by the commissioner of finance for the new text end 352.20 new text begin February and November forecasts required new text end 352.21 new text begin under Minnesota Statutes, section 16A.103, new text end 352.22 new text begin contains expenditures under paragraph (a), new text end 352.23 new text begin clause (1), equal to at least 16 percent of new text end 352.24 new text begin the total required under Code of Federal new text end 352.25 new text begin Regulations, title 45, section 263.1. new text end 352.26 new text begin (d) For the federal fiscal years beginning on new text end 352.27 new text begin or after October 1, 2007, the commissioner new text end 352.28 new text begin may not claim an amount of TANF/MOE in new text end 352.29 new text begin excess of the 75 percent standard in Code new text end 352.30 new text begin of Federal Regulations, title 45, section new text end 352.31 new text begin 263.1(a)(2), except: new text end 352.32 new text begin (1) to the extent necessary to meet the 80 new text end 352.33 new text begin percent standard under Code of Federal new text end 352.34 new text begin Regulations, title 45, section 263.1(a)(1), new text end 352.35 new text begin if it is determined by the commissioner new text end 353.1 new text begin that the state will not meet the TANF work new text end 353.2 new text begin participation target rate for the current year; new text end 353.3 new text begin (2) to provide any additional amounts new text end 353.4 new text begin under Code of Federal Regulations, title 45, new text end 353.5 new text begin section 264.5, that relate to replacement of new text end 353.6 new text begin TANF funds due to the operation of TANF new text end 353.7 new text begin penalties; and new text end 353.8 new text begin (3) to provide any additional amounts that new text end 353.9 new text begin may contribute to avoiding or reducing new text end 353.10 new text begin TANF work participation penalties through new text end 353.11 new text begin the operation of the excess MOE provisions new text end 353.12 new text begin of Code of Federal Regulations, title 45, new text end 353.13 new text begin section 261.43(a)(2). new text end 353.14 new text begin For the purposes of clauses (1) to (3), new text end 353.15 new text begin the commissioner may supplement the new text end 353.16 new text begin MOE claim with working family credit new text end 353.17 new text begin expenditures to the extent such expenditures new text end 353.18 new text begin or other qualified expenditures are otherwise new text end 353.19 new text begin available after considering the expenditures new text end 353.20 new text begin allowed in this section. new text end 353.21 new text begin (e) Minnesota Statutes, section 256.011, new text end 353.22 new text begin subdivision 3, which requires that federal new text end 353.23 new text begin grants or aids secured or obtained under that new text end 353.24 new text begin subdivision be used to reduce any direct new text end 353.25 new text begin appropriations provided by law, do not apply new text end 353.26 new text begin if the grants or aids are federal TANF funds. new text end 353.27 new text begin (f) Notwithstanding any contrary provision new text end 353.28 new text begin in this article, this provision expires June 30, new text end 353.29 new text begin 2013. new text end 353.30 new text begin Working Family Credit Expenditures as new text end 353.31 new text begin TANF/MOE. new text end new text begin The commissioner may claim new text end 353.32 new text begin as TANF/MOE up to $6,707,000 per year of new text end 353.33 new text begin working family credit expenditures for fiscal new text end 353.34 new text begin year 2010 through fiscal year 2011. new text end 354.1 new text begin Working Family Credit Expenditures new text end 354.2 new text begin to be Claimed for TANF/MOE. new text end new text begin The new text end 354.3 new text begin commissioner may count the following new text end 354.4 new text begin amounts of working family credit expenditure new text end 354.5 new text begin as TANF/MOE: new text end 354.6 new text begin (1) fiscal year 2010, $30,217,000; new text end 354.7 new text begin (2) fiscal year 2011, $55,596,000; new text end 354.8 new text begin (3) fiscal year 2012, $28,519,000; and new text end 354.9 new text begin (4) fiscal year 2013, $22,138,000. new text end 354.10 new text begin Notwithstanding any contrary provision in new text end 354.11 new text begin this article, this rider expires June 30, 2013. new text end 354.12 new text begin TANF Transfer to Federal Child Care new text end 354.13 new text begin and Development Fund. new text end new text begin The following new text end 354.14 new text begin TANF fund amounts are appropriated to the new text end 354.15 new text begin commissioner for the purposes of MFIP and new text end 354.16 new text begin transition year child care under Minnesota new text end 354.17 new text begin Statutes, section 119B.05: new text end 354.18 new text begin (1) fiscal year 2010, $5,909,000; new text end 354.19 new text begin (2) fiscal year 2011, $9,808,000; new text end 354.20 new text begin (3) fiscal year 2012, $10,826,000; and new text end 354.21 new text begin (4) fiscal year 2013, $4,026,000. new text end 354.22 new text begin The commissioner shall authorize the new text end 354.23 new text begin transfer of sufficient TANF funds to the new text end 354.24 new text begin federal child care and development fund to new text end 354.25 new text begin meet this appropriation and shall ensure that new text end 354.26 new text begin all transferred funds are expended according new text end 354.27 new text begin to federal child care and development fund new text end 354.28 new text begin regulations. new text end 354.29 new text begin Food Stamps Employment and Training. new text end new text begin new text end 354.30 new text begin (a) The commissioner shall apply for and new text end 354.31 new text begin claim the maximum allowable federal new text end 354.32 new text begin matching funds under United States Code, new text end 355.1 new text begin title 7, section 2025, paragraph (h), for new text end 355.2 new text begin state expenditures made on behalf of family new text end 355.3 new text begin stabilization services participants voluntarily new text end 355.4 new text begin engaged in food stamp employment and new text end 355.5 new text begin training activities, where appropriate. new text end 355.6 new text begin (b) Notwithstanding Minnesota Statutes, new text end 355.7 new text begin sections 256D.051, subdivisions 1a, 6b, new text end 355.8 new text begin and 6c, and 256J.626, federal food stamps new text end 355.9 new text begin employment and training funds received new text end 355.10 new text begin as reimbursement of MFIP consolidated new text end 355.11 new text begin fund grant expenditures for diversionary new text end 355.12 new text begin work program participants and child new text end 355.13 new text begin care assistance program expenditures for new text end 355.14 new text begin two-parent families must be deposited in the new text end 355.15 new text begin general fund. The amount of funds must be new text end 355.16 new text begin limited to $3,350,000 in fiscal year 2010 new text end 355.17 new text begin and $4,440,000 in fiscal years 2011 through new text end 355.18 new text begin 2013, contingent on approval by the federal new text end 355.19 new text begin Food and Nutrition Service. new text end 355.20 new text begin (c) Consistent with the receipt of these federal new text end 355.21 new text begin funds, the commissioner may adjust the new text end 355.22 new text begin level of working family credit expenditures new text end 355.23 new text begin claimed as TANF maintenance of effort. new text end 355.24 new text begin Notwithstanding any contrary provision in new text end 355.25 new text begin this article, this rider expires June 30, 2013. new text end 355.26 new text begin ARRA Food Support Administration. new text end new text begin new text end 355.27 new text begin The funds available for food support new text end 355.28 new text begin administration under the American Recovery new text end 355.29 new text begin and Reinvestment Act (ARRA) of 2009 new text end 355.30 new text begin are appropriated to the commissioner new text end 355.31 new text begin to pay actual costs of implementing the new text end 355.32 new text begin food support benefit increases, increased new text end 355.33 new text begin eligibility determinations, and outreach. Of new text end 355.34 new text begin these funds, 20 percent shall be allocated new text end 355.35 new text begin to the commissioner and 80 percent shall new text end 356.1 new text begin be allocated to counties. The commissioner new text end 356.2 new text begin shall allocate the county portion based on new text end 356.3 new text begin caseload. Reimbursement shall be based on new text end 356.4 new text begin actual costs reported by counties through new text end 356.5 new text begin existing processes. Tribal reimbursement new text end 356.6 new text begin must be made from the state portion based new text end 356.7 new text begin on a caseload factor equivalent to that of a new text end 356.8 new text begin county. new text end 356.9 new text begin ARRA Food Support Benefit Increases. new text end new text begin new text end 356.10 new text begin The funds provided for food support benefit new text end 356.11 new text begin increases under the Supplemental Nutrition new text end 356.12 new text begin Assistance Program provisions of the new text end 356.13 new text begin American Recovery and Reinvestment Act new text end 356.14 new text begin (ARRA) of 2009 must be used for benefit new text end 356.15 new text begin increases beginning July 1, 2009. new text end 356.16 new text begin Emergency Fund for the TANF Program. new text end new text begin new text end 356.17 new text begin TANF Emergency Contingency funds new text end 356.18 new text begin available under the American Recovery new text end 356.19 new text begin and Reinvestment Act of 2009 (Public Law new text end 356.20 new text begin 111-5) are appropriated to the commissioner. new text end 356.21 new text begin The commissioner must request TANF new text end 356.22 new text begin Emergency Contingency funds from the new text end 356.23 new text begin Secretary of the Department of Health new text end 356.24 new text begin and Human Services to the extent the new text end 356.25 new text begin commissioner meets or expects to meet the new text end 356.26 new text begin requirements of section 403(c) of the Social new text end 356.27 new text begin Security Act. The commissioner must seek new text end 356.28 new text begin to maximize such grants. The funds received new text end 356.29 new text begin must be used as appropriated. Each county new text end 356.30 new text begin must maintain the county's current level of new text end 356.31 new text begin emergency assistance funding under the new text end 356.32 new text begin MFIP consolidated fund and use the funds new text end 356.33 new text begin under this paragraph to supplement existing new text end 356.34 new text begin emergency assistance funding levels. new text end 356.35 new text begin Subd. 2. new text end new text begin Agency Management new text end 357.1 new text begin The amounts that may be spent from the new text end 357.2 new text begin appropriation for each purpose are as follows: new text end 357.3 new text begin (a) Financial Operations new text end 357.4 new text begin Appropriations by Fund new text end 357.5 new text begin General new text end new text begin 3,380,000 new text end new text begin 3,908,000 new text end 357.6 new text begin Health Care Access new text end new text begin 1,281,000 new text end new text begin 1,016,000 new text end 357.7 new text begin Federal TANF new text end new text begin 122,000 new text end new text begin 122,000 new text end 357.8 new text begin (b) Legal and Regulatory Operations new text end 357.9 new text begin Appropriations by Fund new text end 357.10 new text begin General new text end new text begin 13,749,000 new text end new text begin 13,534,000 new text end 357.11 357.12 new text begin State Government new text end new text begin Special Revenue new text end new text begin 440,000 new text end new text begin 440,000 new text end 357.13 new text begin Health Care Access new text end new text begin 943,000 new text end new text begin 943,000 new text end 357.14 new text begin Federal TANF new text end new text begin 100,000 new text end new text begin 100,000 new text end 357.15 new text begin (c) Management Operations new text end 357.16 new text begin Appropriations by Fund new text end 357.17 new text begin General new text end new text begin 4,334,000 new text end new text begin 4,562,000 new text end 357.18 new text begin Health Care Access new text end new text begin 242,000 new text end new text begin 242,000 new text end 357.19 new text begin Lease Cost Reduction. new text end new text begin Base level funding new text end 357.20 new text begin to the commissioner shall be reduced by new text end 357.21 new text begin $381,000 in fiscal year 2010, and $153,000 new text end 357.22 new text begin in fiscal year 2011, to reflect a reduction in new text end 357.23 new text begin lease costs related to the Minnehaha Avenue new text end 357.24 new text begin building. new text end 357.25 new text begin Base Adjustment. new text end new text begin The general fund base is new text end 357.26 new text begin increased by $153,000 in each of fiscal years new text end 357.27 new text begin 2012 and 2013. new text end 357.28 new text begin (d) Information Technology Operations new text end 358.1 new text begin Appropriations by Fund new text end 358.2 new text begin General new text end new text begin 28,077,000 new text end new text begin 28,077,000 new text end 358.3 new text begin Health Care Access new text end new text begin 4,856,000 new text end new text begin 4,868,000 new text end 358.4 358.5 new text begin Subd. 3. new text end new text begin Revenue and Pass-Through Revenue new text end new text begin Expenditures new text end new text begin 65,746,000 new text end new text begin 67,068,000 new text end 358.6 new text begin This appropriation is from the federal TANF new text end 358.7 new text begin fund. new text end 358.8 358.9 new text begin Subd. 4. new text end new text begin Children and Economic Assistance new text end new text begin Grants new text end 358.10 new text begin The amounts that may be spent from this new text end 358.11 new text begin appropriation for each purpose are as follows: new text end 358.12 new text begin (a) MFIP/DWP Grants new text end 358.13 new text begin Appropriations by Fund new text end 358.14 new text begin General new text end new text begin 63,205,000 new text end new text begin 89,033,000 new text end 358.15 new text begin Federal TANF new text end new text begin 100,404,000 new text end new text begin 85,789,000 new text end 358.16 new text begin (b) Support Services Grants new text end 358.17 new text begin Appropriations by Fund new text end 358.18 new text begin General new text end new text begin 8,715,000 new text end new text begin 12,498,000 new text end 358.19 new text begin Federal TANF new text end new text begin 121,257,000 new text end new text begin 102,757,000 new text end 358.20 new text begin MFIP Consolidated Fund. new text end new text begin The MFIP new text end 358.21 new text begin consolidated fund TANF appropriation is new text end 358.22 new text begin reduced by $1,854,000 in fiscal year 2011 new text end 358.23 new text begin and fiscal year 2012. new text end 358.24 new text begin Notwithstanding Minnesota Statutes, section new text end 358.25 new text begin 256J.626, subdivision 8, paragraph (b), the new text end 358.26 new text begin commissioner shall reduce proportionately new text end 358.27 new text begin the reimbursement to counties for new text end 358.28 new text begin administrative expenses. new text end 359.1 new text begin Subsidized Employment Funding Through new text end 359.2 new text begin ARRA. new text end new text begin The commissioner is authorized to new text end 359.3 new text begin apply for TANF emergency fund grants for new text end 359.4 new text begin subsidized employment activities. Growth new text end 359.5 new text begin in expenditures for subsidized employment new text end 359.6 new text begin within the supported work program and the new text end 359.7 new text begin MFIP consolidated fund over the amount new text end 359.8 new text begin expended in the calendar quarters in the new text end 359.9 new text begin TANF emergency fund base year shall be new text end 359.10 new text begin used to leverage the TANF emergency fund new text end 359.11 new text begin grants for subsidized employment and to new text end 359.12 new text begin fund supported work. The commissioner new text end 359.13 new text begin shall develop procedures to maximize new text end 359.14 new text begin reimbursement of these expenditures over the new text end 359.15 new text begin TANF emergency fund base year quarters, new text end 359.16 new text begin and may contract directly with employers new text end 359.17 new text begin and providers to maximize these TANF new text end 359.18 new text begin emergency fund grants. new text end 359.19 new text begin Supported Work. new text end new text begin Of the TANF new text end 359.20 new text begin appropriation, $6,400,000 in fiscal year new text end 359.21 new text begin 2011 is to the commissioner for supported new text end 359.22 new text begin work for MFIP recipients and is available new text end 359.23 new text begin until expended. Supported work includes new text end 359.24 new text begin paid transitional work experience and new text end 359.25 new text begin a continuum of employment assistance, new text end 359.26 new text begin including outreach and recruitment, new text end 359.27 new text begin program orientation and intake, testing and new text end 359.28 new text begin assessment, job development and marketing, new text end 359.29 new text begin preworksite training, supported worksite new text end 359.30 new text begin experience, job coaching, and postplacement new text end 359.31 new text begin follow-up, in addition to extensive case new text end 359.32 new text begin management and referral services. new text end 359.33 new text begin Base Adjustment. new text end new text begin The general fund base new text end 359.34 new text begin is reduced by $3,783,000 in each of fiscal new text end 359.35 new text begin years 2012 and 2013. The TANF fund base new text end 360.1 new text begin is increased by $9,704,000 in each of fiscal new text end 360.2 new text begin years 2012 and 2013. new text end 360.3 new text begin Integrated Services Program Funding. new text end new text begin new text end 360.4 new text begin The TANF appropriation for integrated new text end 360.5 new text begin services program funding is $1,250,000 in new text end 360.6 new text begin fiscal year 2010 and $2,500,000 in fiscal year new text end 360.7 new text begin 2011. new text end 360.8 new text begin TANF Emergency Fund; Nonrecurrent new text end 360.9 new text begin Short-Term Benefits. new text end new text begin TANF emergency new text end 360.10 new text begin contingency fund grants received due to new text end 360.11 new text begin increases in expenditures for nonrecurrent new text end 360.12 new text begin short-term benefits must be used to offset the new text end 360.13 new text begin increase in these expenditures for counties new text end 360.14 new text begin under the MFIP consolidated fund, under new text end 360.15 new text begin Minnesota Statutes, section 256J.626, new text end 360.16 new text begin and the diversionary work program. The new text end 360.17 new text begin commissioner shall develop procedures new text end 360.18 new text begin to maximize reimbursement of these new text end 360.19 new text begin expenditures over the TANF emergency fund new text end 360.20 new text begin base year quarters. Growth in expenditures new text end 360.21 new text begin for the diversionary work program over the new text end 360.22 new text begin amount expended in the calendar quarters in new text end 360.23 new text begin the TANF emergency fund base year shall be new text end 360.24 new text begin used to leverage these funds. new text end 360.25 new text begin (c) MFIP Child Care Assistance Grants new text end 360.26 new text begin Appropriations by Fund new text end 360.27 new text begin General new text end new text begin 61,171,000 new text end new text begin 65,214,000 new text end 360.28 new text begin Federal TANF new text end new text begin 1,022,000 new text end new text begin 406,000 new text end 360.29 new text begin ARRA Child Care Development Block new text end 360.30 new text begin Grant Funds. new text end new text begin The funds available from the new text end 360.31 new text begin child care development block grant under new text end 360.32 new text begin ARRA must be used for MFIP child care to new text end 360.33 new text begin the extent that those funds are not earmarked new text end 361.1 new text begin for quality expansion or to improve the new text end 361.2 new text begin quality of infant and toddler care. new text end 361.3 new text begin Acceleration of ARRA Child Care and new text end 361.4 new text begin Development Fund Expenditure. new text end new text begin The new text end 361.5 new text begin commissioner must liquidate all child care new text end 361.6 new text begin and development money available under new text end 361.7 new text begin the American Recovery and Reinvestment new text end 361.8 new text begin Act (ARRA) of 2009, Public Law 111-5, new text end 361.9 new text begin by September 30, 2010. In order to expend new text end 361.10 new text begin those funds by September 30, 2010, the new text end 361.11 new text begin commissioner may redesignate and expend new text end 361.12 new text begin the ARRA child care and development funds new text end 361.13 new text begin appropriated in fiscal year 2011 for purposes new text end 361.14 new text begin under this section for related purposes that new text end 361.15 new text begin will allow liquidation by September 30, new text end 361.16 new text begin 2010. Child care and development funds new text end 361.17 new text begin otherwise available to the commissioner new text end 361.18 new text begin for those related purposes shall be used to new text end 361.19 new text begin fund the purposes from which the ARRA new text end 361.20 new text begin child care and development funds had been new text end 361.21 new text begin redesignated. new text end 361.22 361.23 new text begin (d) Basic Sliding Fee Child Care Assistance new text end new text begin Grants new text end new text begin 40,104,000 new text end new text begin 45,096,000 new text end 361.24 new text begin Base Adjustment. new text end new text begin The general fund base is new text end 361.25 new text begin decreased by $260,000 in each of fiscal years new text end 361.26 new text begin 2012 and 2013. new text end 361.27 new text begin School Readiness Service Agreements. new text end new text begin new text end 361.28 new text begin $261,000 in fiscal year 2010 and $261,000 new text end 361.29 new text begin in fiscal year 2011 are from the federal new text end 361.30 new text begin child care development funds received from new text end 361.31 new text begin the American Recovery and Reinvestment new text end 361.32 new text begin Act of 2009, Public Law 111-5, to the new text end 361.33 new text begin commissioner of human services consistent new text end 361.34 new text begin with federal regulations for the purpose of new text end 362.1 new text begin school readiness service agreements under new text end 362.2 new text begin Minnesota Statutes, section 119B.231. This new text end 362.3 new text begin is a onetime appropriation. Any unexpended new text end 362.4 new text begin balance the first year is available in the new text end 362.5 new text begin second year. new text end 362.6 new text begin Child Care Development Fund new text end 362.7 new text begin Unexpended Balance. new text end new text begin In addition to new text end 362.8 new text begin the amount provided in this section, the new text end 362.9 new text begin commissioner shall expend $5,244,000 in new text end 362.10 new text begin fiscal year 2010 from the federal child care new text end 362.11 new text begin development fund unexpended balance new text end 362.12 new text begin for basic sliding fee child care under new text end 362.13 new text begin Minnesota Statutes, section 119B.03. The new text end 362.14 new text begin commissioner shall ensure that all child new text end 362.15 new text begin care and development funds are expended new text end 362.16 new text begin according to the federal child care and new text end 362.17 new text begin development fund regulations. new text end 362.18 new text begin Basic Sliding Fee. new text end new text begin $7,045,000 in fiscal year new text end 362.19 new text begin 2010 and $6,974,000 in fiscal year 2011 are new text end 362.20 new text begin from the federal child care development new text end 362.21 new text begin funds received from the American Recovery new text end 362.22 new text begin and Reinvestment Act of 2009, Public new text end 362.23 new text begin Law 111-5, to the commissioner of human new text end 362.24 new text begin services consistent with federal regulations new text end 362.25 new text begin for the purpose of basic sliding fee child care new text end 362.26 new text begin assistance under Minnesota Statutes, section new text end 362.27 new text begin 119B.03. This is a onetime appropriation. new text end 362.28 new text begin Any unexpended balance the first year is new text end 362.29 new text begin available in the second year. new text end 362.30 new text begin Basic Sliding Fee Allocation for Calendar new text end 362.31 new text begin Year 2010. new text end new text begin Notwithstanding Minnesota new text end 362.32 new text begin Statutes, section 119B.03, subdivision 6, new text end 362.33 new text begin in calendar year 2010, basic sliding fee new text end 362.34 new text begin funds shall be distributed according to new text end 362.35 new text begin this provision. Funds shall be allocated new text end 363.1 new text begin first in amounts equal to each county's new text end 363.2 new text begin guaranteed floor, according to Minnesota new text end 363.3 new text begin Statutes, section 119B.03, subdivision 8, new text end 363.4 new text begin with any remaining available funds allocated new text end 363.5 new text begin according to the following formula: new text end 363.6 new text begin (a) Up to one-fourth of the funds shall be new text end 363.7 new text begin allocated in proportion to the number of new text end 363.8 new text begin families participating in the transition year new text end 363.9 new text begin child care program as reported during and new text end 363.10 new text begin averaged over the most recent six months new text end 363.11 new text begin completed at the time of the notice of new text end 363.12 new text begin allocation. Funds in excess of the amount new text end 363.13 new text begin necessary to serve all families in this category new text end 363.14 new text begin shall be allocated according to paragraph (d). new text end 363.15 new text begin (b) Up to three-fourths of the funds shall new text end 363.16 new text begin be allocated in proportion to the average new text end 363.17 new text begin of each county's most recent six months of new text end 363.18 new text begin reported waiting list as defined in Minnesota new text end 363.19 new text begin Statutes, section 119B.03, subdivision 2, and new text end 363.20 new text begin the reinstatement list of those families whose new text end 363.21 new text begin assistance was terminated with the approval new text end 363.22 new text begin of the commissioner under Minnesota Rules, new text end 363.23 new text begin part 3400.0183, subpart 1. Funds in excess new text end 363.24 new text begin of the amount necessary to serve all families new text end 363.25 new text begin in this category shall be allocated according new text end 363.26 new text begin to paragraph (d). new text end 363.27 new text begin (c) The amount necessary to serve all families new text end 363.28 new text begin in paragraphs (a) and (b) shall be calculated new text end 363.29 new text begin based on the basic sliding fee average cost of new text end 363.30 new text begin care per family in the county with the highest new text end 363.31 new text begin cost in the most recently completed calendar new text end 363.32 new text begin year. new text end 363.33 new text begin (d) Funds in excess of the amount necessary new text end 363.34 new text begin to serve all families in paragraphs (a) and new text end 363.35 new text begin (b) shall be allocated in proportion to each new text end 364.1 new text begin county's total expenditures for the basic new text end 364.2 new text begin sliding fee child care program reported new text end 364.3 new text begin during the most recent fiscal year completed new text end 364.4 new text begin at the time of the notice of allocation. To new text end 364.5 new text begin the extent that funds are available, and new text end 364.6 new text begin notwithstanding Minnesota Statutes, section new text end 364.7 new text begin 119B.03, subdivision 8, for the period new text end 364.8 new text begin January 1, 2011, to December 31, 2011, each new text end 364.9 new text begin county's guaranteed floor must be equal to its new text end 364.10 new text begin original calendar year 2010 allocation. new text end 364.11 new text begin (e) Child Care Development Grants new text end new text begin 1,487,000 new text end new text begin 1,487,000 new text end 364.12 new text begin Family, friends, and neighbor grants. new text end new text begin new text end 364.13 new text begin $375,000 in fiscal year 2010 and $375,000 new text end 364.14 new text begin in fiscal year 2011 are from the child new text end 364.15 new text begin care development fund required targeted new text end 364.16 new text begin quality funds for quality expansion and new text end 364.17 new text begin infant/toddler from the American Recovery new text end 364.18 new text begin and Reinvestment Act of 2009, Public new text end 364.19 new text begin Law 111-5, to the commissioner of human new text end 364.20 new text begin services for family, friends, and neighbor new text end 364.21 new text begin grants under Minnesota Statutes, section new text end 364.22 new text begin 119B.232. This appropriation may be used new text end 364.23 new text begin on programs receiving family, friends, and new text end 364.24 new text begin neighbor grant funds as of June 30, 2009, new text end 364.25 new text begin or on new programs or projects. This is a new text end 364.26 new text begin onetime appropriation. Any unexpended new text end 364.27 new text begin balance the first year is available in the new text end 364.28 new text begin second year. new text end 364.29 new text begin Voluntary quality rating system training, new text end 364.30 new text begin coaching, consultation, and supports. new text end new text begin new text end 364.31 new text begin $633,000 in fiscal year 2010 and $633,000 new text end 364.32 new text begin in fiscal year 2011 are from the federal child new text end 364.33 new text begin care development fund required targeted new text end 364.34 new text begin quality funds for quality expansion and new text end 364.35 new text begin infant/toddler from the American Recovery new text end 365.1 new text begin and Reinvestment Act of 2009, Public new text end 365.2 new text begin Law 111-5, to the commissioner of human new text end 365.3 new text begin services consistent with federal regulations new text end 365.4 new text begin for the purpose of providing grants to provide new text end 365.5 new text begin statewide child-care provider training, new text end 365.6 new text begin coaching, consultation, and supports to new text end 365.7 new text begin prepare for the voluntary Minnesota quality new text end 365.8 new text begin rating system rating tool. This is a onetime new text end 365.9 new text begin appropriation. Any unexpended balance the new text end 365.10 new text begin first year is available in the second year. new text end 365.11 new text begin Voluntary quality rating system. new text end new text begin $184,000 new text end 365.12 new text begin in fiscal year 2010 and $1,200,000 in fiscal new text end 365.13 new text begin year 2011 are from the federal child care new text end 365.14 new text begin development fund required targeted funds for new text end 365.15 new text begin quality expansion and infant/toddler from the new text end 365.16 new text begin American Recovery and Reinvestment Act of new text end 365.17 new text begin 2009, Public Law 111-5, to the commissioner new text end 365.18 new text begin of human services consistent with federal new text end 365.19 new text begin regulations for the purpose of implementing new text end 365.20 new text begin the voluntary Parent Aware quality star new text end 365.21 new text begin rating system pilot in coordination with the new text end 365.22 new text begin Minnesota Early Learning Foundation. The new text end 365.23 new text begin appropriation for the first year is to complete new text end 365.24 new text begin and promote the voluntary Parent Aware new text end 365.25 new text begin quality rating system pilot program through new text end 365.26 new text begin June 30, 2010, and the appropriation for the new text end 365.27 new text begin second year is to continue the voluntary new text end 365.28 new text begin Minnesota quality rating system pilot new text end 365.29 new text begin through June 30, 2011. This is a onetime new text end 365.30 new text begin appropriation. Any unexpended balance the new text end 365.31 new text begin first year is available in the second year. new text end 365.32 new text begin (f) Child Support Enforcement Grants new text end new text begin 3,705,000 new text end new text begin 3,705,000 new text end 365.33 new text begin (g) Children's Services Grants new text end 366.1 new text begin Appropriations by Fund new text end 366.2 new text begin General new text end new text begin 48,333,000 new text end new text begin 50,498,000 new text end 366.3 new text begin Federal TANF new text end new text begin 340,000 new text end new text begin 240,000 new text end 366.4 new text begin Base Adjustment. new text end new text begin The general fund base is new text end 366.5 new text begin decreased by $5,371,000 in fiscal year 2012 new text end 366.6 new text begin and increased $8,737,000 in fiscal year 2013. new text end 366.7 new text begin Privatized Adoption Grants. new text end new text begin Federal new text end 366.8 new text begin reimbursement for privatized adoption grant new text end 366.9 new text begin and foster care recruitment grant expenditures new text end 366.10 new text begin is appropriated to the commissioner for new text end 366.11 new text begin adoption grants and foster care and adoption new text end 366.12 new text begin administrative purposes. new text end 366.13 new text begin Adoption Assistance Incentive Grants. new text end new text begin new text end 366.14 new text begin Federal funds available during fiscal year new text end 366.15 new text begin 2010 and fiscal year 2011 for the adoption new text end 366.16 new text begin incentive grants are appropriated to the new text end 366.17 new text begin commissioner for these purposes. new text end 366.18 new text begin Adoption Assistance and Relative Custody new text end 366.19 new text begin Assistance. new text end new text begin The commissioner may transfer new text end 366.20 new text begin unencumbered appropriation balances for new text end 366.21 new text begin adoption assistance and relative custody new text end 366.22 new text begin assistance between fiscal years and between new text end 366.23 new text begin programs. new text end 366.24 new text begin (h) Children and Community Services Grants new text end new text begin 67,663,000 new text end new text begin 67,542,000 new text end 366.25 new text begin Targeted Case Management Temporary new text end 366.26 new text begin Funding Adjustment. new text end new text begin The commissioner new text end 366.27 new text begin shall recover from each county and tribe new text end 366.28 new text begin receiving a targeted case management new text end 366.29 new text begin temporary funding payment in fiscal year new text end 366.30 new text begin 2008 an amount equal to that payment. The new text end 366.31 new text begin commissioner shall recover one-half of the new text end 366.32 new text begin funds by February 1, 2010, and the remainder new text end 366.33 new text begin by February 1, 2011. At the commissioner's new text end 367.1 new text begin discretion and at the request of a county new text end 367.2 new text begin or tribe, the commissioner may revise new text end 367.3 new text begin the payment schedule, but full payment new text end 367.4 new text begin must not be delayed beyond May 1, 2011. new text end 367.5 new text begin The commissioner may use the recovery new text end 367.6 new text begin procedure under Minnesota Statutes, section new text end 367.7 new text begin 256.017, to recover the funds. Recovered new text end 367.8 new text begin funds must be deposited into the general new text end 367.9 new text begin fund. new text end 367.10 new text begin (i) General Assistance Grants new text end new text begin 48,215,000 new text end new text begin 48,608,000 new text end 367.11 new text begin General Assistance Standard. new text end new text begin The new text end 367.12 new text begin commissioner shall set the monthly standard new text end 367.13 new text begin of assistance for general assistance units new text end 367.14 new text begin consisting of an adult recipient who is new text end 367.15 new text begin childless and unmarried or living apart new text end 367.16 new text begin from parents or a legal guardian at $203. new text end 367.17 new text begin The commissioner may reduce this amount new text end 367.18 new text begin according to Laws 1997, chapter 85, article new text end 367.19 new text begin 3, section 54. new text end 367.20 new text begin Emergency General Assistance. new text end new text begin The new text end 367.21 new text begin amount appropriated for emergency general new text end 367.22 new text begin assistance funds is limited to no more new text end 367.23 new text begin than $7,889,812 in fiscal year 2010 and new text end 367.24 new text begin $7,889,812 in fiscal year 2011. Funds new text end 367.25 new text begin to counties must be allocated by the new text end 367.26 new text begin commissioner using the allocation method new text end 367.27 new text begin specified in Minnesota Statutes, section new text end 367.28 new text begin 256D.06. new text end 367.29 new text begin (j) Minnesota Supplemental Aid Grants new text end new text begin 33,930,000 new text end new text begin 35,191,000 new text end 367.30 new text begin Emergency Minnesota Supplemental new text end 367.31 new text begin Aid Funds. new text end new text begin The amount appropriated for new text end 367.32 new text begin emergency Minnesota supplemental aid new text end 367.33 new text begin funds is limited to no more than $1,100,000 new text end 367.34 new text begin in fiscal year 2010 and $1,100,000 in fiscal new text end 368.1 new text begin year 2011. Funds to counties must be new text end 368.2 new text begin allocated by the commissioner using the new text end 368.3 new text begin allocation method specified in Minnesota new text end 368.4 new text begin Statutes, section 256D.46. new text end 368.5 new text begin (k) Group Residential Housing Grants new text end new text begin 111,778,000 new text end new text begin 114,034,000 new text end 368.6 new text begin Group Residential Housing Costs new text end 368.7 new text begin Refinanced. new text end new text begin (a) Effective July 1, 2011, the new text end 368.8 new text begin commissioner shall increase the home and new text end 368.9 new text begin community-based service rates and county new text end 368.10 new text begin allocations provided to programs for persons new text end 368.11 new text begin with disabilities established under section new text end 368.12 new text begin 1915(c) of the Social Security Act to the new text end 368.13 new text begin extent that these programs will be paying new text end 368.14 new text begin for the costs above the rate established new text end 368.15 new text begin in Minnesota Statutes, section 256I.05, new text end 368.16 new text begin subdivision 1. new text end 368.17 new text begin (b) For persons receiving services under new text end 368.18 new text begin Minnesota Statutes, section 245A.02, who new text end 368.19 new text begin reside in licensed adult foster care beds new text end 368.20 new text begin for which a difficulty of care payment new text end 368.21 new text begin was being made under Minnesota Statutes, new text end 368.22 new text begin section 256I.05, subdivision 1c, paragraph new text end 368.23 new text begin (b), counties may request an exception to new text end 368.24 new text begin the individual's service authorization not to new text end 368.25 new text begin exceed the difference between the client's new text end 368.26 new text begin monthly service expenditures plus the new text end 368.27 new text begin amount of the difficulty of care payment. new text end 368.28 new text begin (l) Children's Mental Health Grants new text end new text begin 16,885,000 new text end new text begin 16,882,000 new text end 368.29 new text begin Funding Usage. new text end new text begin Up to 75 percent of a fiscal new text end 368.30 new text begin year's appropriation for children's mental new text end 368.31 new text begin health grants may be used to fund allocations new text end 368.32 new text begin in that portion of the fiscal year ending new text end 368.33 new text begin December 31. new text end 369.1 369.2 new text begin (m) Other Children and Economic Assistance new text end new text begin Grants new text end new text begin 16,047,000 new text end new text begin 15,339,000 new text end 369.3 new text begin Fraud Prevention Grants. new text end new text begin Of this new text end 369.4 new text begin appropriation, $379,000 in fiscal year 2010 new text end 369.5 new text begin and $379,000 in fiscal year 2011 is to the new text end 369.6 new text begin commissioner for fraud prevention grants to new text end 369.7 new text begin counties. new text end 369.8 new text begin Homeless and Runaway Youth. new text end new text begin $218,000 new text end 369.9 new text begin in fiscal year 2010 is for the Runaway new text end 369.10 new text begin and Homeless Youth Act under Minnesota new text end 369.11 new text begin Statutes, section 256K.45. Funds shall be new text end 369.12 new text begin spent in each area of the continuum of care new text end 369.13 new text begin to ensure that programs are meeting the new text end 369.14 new text begin greatest need. Any unexpended balance in new text end 369.15 new text begin the first year is available in the second year. new text end 369.16 new text begin Beginning July 1, 2011, the base is increased new text end 369.17 new text begin by $119,000 each year. new text end 369.18 new text begin ARRA Homeless Youth Funds. new text end new text begin To the new text end 369.19 new text begin extent permitted under federal law, the new text end 369.20 new text begin commissioner shall designate $2,500,000 new text end 369.21 new text begin of the Homeless Prevention and Rapid new text end 369.22 new text begin Re-Housing Program funds provided under new text end 369.23 new text begin the American Recovery and Reinvestment new text end 369.24 new text begin Act of 2009, Public Law 111-5, for agencies new text end 369.25 new text begin providing homelessness prevention and rapid new text end 369.26 new text begin rehousing services to youth. new text end 369.27 new text begin Supportive Housing Services. new text end new text begin $1,500,000 new text end 369.28 new text begin each year is for supportive services under new text end 369.29 new text begin Minnesota Statutes, section 256K.26. This is new text end 369.30 new text begin a onetime appropriation. Beginning in fiscal new text end 369.31 new text begin year 2012, the base is increased by $68,000 new text end 369.32 new text begin per year. new text end 369.33 new text begin Community Action Grants. new text end new text begin Community new text end 369.34 new text begin action grants are reduced one time by new text end 370.1 new text begin $1,764,000 each year. This reduction is due new text end 370.2 new text begin to the availability of federal funds under the new text end 370.3 new text begin American Recovery and Reinvestment Act. new text end 370.4 new text begin Base Adjustment. new text end new text begin The general fund base new text end 370.5 new text begin is increased by $773,000 in fiscal year 2012 new text end 370.6 new text begin and $773,000 in fiscal year 2013. new text end 370.7 new text begin Federal ARRA Funds for Existing new text end 370.8 new text begin Programs. new text end new text begin (a) Federal funds received by the new text end 370.9 new text begin commissioner for the emergency food and new text end 370.10 new text begin shelter program from the American Recovery new text end 370.11 new text begin and Reinvestment Act of 2009, Public new text end 370.12 new text begin Law 111-5, but not previously approved new text end 370.13 new text begin by the legislature are appropriated to the new text end 370.14 new text begin commissioner for the purposes of the grant new text end 370.15 new text begin program. new text end 370.16 new text begin (b) Federal funds received by the new text end 370.17 new text begin commissioner for the emergency shelter new text end 370.18 new text begin grant program including the Homelessness new text end 370.19 new text begin Prevention and Rapid Re-Housing new text end 370.20 new text begin Program from the American Recovery and new text end 370.21 new text begin Reinvestment Act of 2009, Public Law new text end 370.22 new text begin 111-5, are appropriated to the commissioner new text end 370.23 new text begin for the purposes of the grant programs. new text end 370.24 new text begin (c) Federal funds received by the new text end 370.25 new text begin commissioner for the emergency food new text end 370.26 new text begin assistance program from the American new text end 370.27 new text begin Recovery and Reinvestment Act of 2009, new text end 370.28 new text begin Public Law 111-5, are appropriated to the new text end 370.29 new text begin commissioner for the purposes of the grant new text end 370.30 new text begin program. new text end 370.31 new text begin (d) Federal funds received by the new text end 370.32 new text begin commissioner for senior congregate meals new text end 370.33 new text begin and senior home-delivered meals from the new text end 370.34 new text begin American Recovery and Reinvestment Act new text end 370.35 new text begin of 2009, Public Law 111-5, are appropriated new text end 371.1 new text begin to the commissioner for the Minnesota Board new text end 371.2 new text begin on Aging, for purposes of the grant programs. new text end 371.3 new text begin (e) Federal funds received by the new text end 371.4 new text begin commissioner for the community services new text end 371.5 new text begin block grant program from the American new text end 371.6 new text begin Recovery and Reinvestment Act of 2009, new text end 371.7 new text begin Public Law 111-5, are appropriated to the new text end 371.8 new text begin commissioner for the purposes of the grant new text end 371.9 new text begin program. new text end 371.10 new text begin Long-Term Homeless Supportive new text end 371.11 new text begin Service Fund Appropriation. new text end new text begin To the new text end 371.12 new text begin extent permitted under federal law, the new text end 371.13 new text begin commissioner shall designate $3,000,000 new text end 371.14 new text begin of the Homelessness Prevention and Rapid new text end 371.15 new text begin Re-Housing Program funds provided under new text end 371.16 new text begin the American Recovery and Reinvestment new text end 371.17 new text begin Act of 2009, Public Law, 111-5, to the new text end 371.18 new text begin long-term homeless service fund under new text end 371.19 new text begin Minnesota Statutes, section 256K.26. This new text end 371.20 new text begin appropriation shall become available by July new text end 371.21 new text begin 1, 2009. This paragraph is effective the day new text end 371.22 new text begin following final enactment. new text end 371.23 371.24 new text begin Subd. 5. new text end new text begin Children and Economic Assistance new text end new text begin Management new text end 371.25 new text begin The amounts that may be spent from the new text end 371.26 new text begin appropriation for each purpose are as follows: new text end 371.27 371.28 new text begin (a) Children and Economic Assistance new text end new text begin Administration new text end 371.29 new text begin Appropriations by Fund new text end 371.30 new text begin General new text end new text begin 10,318,000 new text end new text begin 10,308,000 new text end 371.31 new text begin Federal TANF new text end new text begin 496,000 new text end new text begin 496,000 new text end 372.1 new text begin Base Adjustment. new text end new text begin The federal TANF base new text end 372.2 new text begin is increased by $700,000 in each of fiscal new text end 372.3 new text begin years 2012 and 2013. new text end 372.4 new text begin School Readiness Service Agreements. new text end new text begin new text end 372.5 new text begin $406,000 in fiscal year 2010 and $406,000 new text end 372.6 new text begin in fiscal year 2011 are from the federal new text end 372.7 new text begin child care development funds received from new text end 372.8 new text begin the American Recovery and Reinvestment new text end 372.9 new text begin Act of 2009, Public Law 111-5, to the new text end 372.10 new text begin commissioner of human services consistent new text end 372.11 new text begin with federal regulations for the purpose of new text end 372.12 new text begin school readiness service agreements under new text end 372.13 new text begin Minnesota Statutes, section 119B.231. This new text end 372.14 new text begin is a onetime appropriation. Any unexpended new text end 372.15 new text begin balance the first year is available in the new text end 372.16 new text begin second year. new text end 372.17 372.18 new text begin (b) Children and Economic Assistance new text end new text begin Operations new text end 372.19 new text begin Appropriations by Fund new text end 372.20 new text begin General new text end new text begin 33,590,000 new text end new text begin 33,423,000 new text end 372.21 new text begin Health Care Access new text end new text begin 361,000 new text end new text begin 361,000 new text end 372.22 new text begin Financial Institution Data Match and new text end 372.23 new text begin Payment of Fees. new text end new text begin The commissioner is new text end 372.24 new text begin authorized to allocate up to $310,000 each new text end 372.25 new text begin year in fiscal years 2010 and 2011 from the new text end 372.26 new text begin PRISM special revenue account to make new text end 372.27 new text begin payments to financial institutions in exchange new text end 372.28 new text begin for performing data matches between account new text end 372.29 new text begin information held by financial institutions new text end 372.30 new text begin and the public authority's database of child new text end 372.31 new text begin support obligors as authorized by Minnesota new text end 372.32 new text begin Statutes, section 13B.06, subdivision 7. new text end 373.1 new text begin School Readiness Service Agreements. new text end new text begin new text end 373.2 new text begin $106,000 in fiscal year 2010 and $241,000 new text end 373.3 new text begin in fiscal year 2011 are from the federal new text end 373.4 new text begin child care development funds received from new text end 373.5 new text begin the American Recovery and Reinvestment new text end 373.6 new text begin Act of 2009, Public Law 111-5, to the new text end 373.7 new text begin commissioner of human services consistent new text end 373.8 new text begin with federal regulations for the purpose of new text end 373.9 new text begin school readiness service agreements under new text end 373.10 new text begin Minnesota Statutes, section 119B.231. This new text end 373.11 new text begin is a onetime appropriation. new text end 373.12 new text begin Use of Federal Stabilization Funds. new text end new text begin new text end 373.13 new text begin $33,000,000 in fiscal year 2010 is new text end 373.14 new text begin appropriated from the fiscal stabilization new text end 373.15 new text begin account in the federal fund to the new text end 373.16 new text begin commissioner. This appropriation must not new text end 373.17 new text begin be used for any activity or service for which new text end 373.18 new text begin federal reimbursement is claimed. This is a new text end 373.19 new text begin onetime appropriation. new text end 373.20 new text begin Subd. 6. new text end new text begin Basic Health Care Grants new text end 373.21 new text begin The amounts that may be spent from this new text end 373.22 new text begin appropriation for each purpose are as follows: new text end 373.23 new text begin (a) MinnesotaCare Grants new text end new text begin 391,915,000 new text end new text begin 485,448,000 new text end 373.24 new text begin This appropriation is from the health care new text end 373.25 new text begin access fund. new text end 373.26 373.27 new text begin (b) MA Basic Health Care Grants - Families new text end new text begin and Children new text end new text begin 751,988,000 new text end new text begin 973,088,000 new text end 373.28 new text begin Medical Education Research Costs new text end 373.29 new text begin (MERC). new text end new text begin Of these funds, the commissioner new text end 373.30 new text begin of human services shall transfer $38,000,000 new text end 373.31 new text begin in fiscal year 2010 to the medical education new text end 373.32 new text begin research fund. These funds must restore the new text end 373.33 new text begin fiscal year 2009 unallotment of the transfers new text end 374.1 new text begin under Minnesota Statutes, section 256B.69, new text end 374.2 new text begin subdivision 5c, paragraph (a), for the July 1, new text end 374.3 new text begin 2008, through June 30, 2009, period. new text end 374.4 new text begin Newborn Screening Fee. new text end new text begin Of the general new text end 374.5 new text begin fund appropriation, $34,000 in fiscal new text end 374.6 new text begin year 2011 is to the commissioner for the new text end 374.7 new text begin hospital reimbursement increase described new text end 374.8 new text begin under Minnesota Statutes, section 256.969, new text end 374.9 new text begin subdivision 28. new text end 374.10 new text begin Local Share Payment Modification new text end 374.11 new text begin Required for ARRA Compliance. new text end new text begin new text end 374.12 new text begin Effective from July 1, 2009, to December new text end 374.13 new text begin 31, 2010, Hennepin County's monthly new text end 374.14 new text begin contribution to the nonfederal share of new text end 374.15 new text begin medical assistance costs must be reduced new text end 374.16 new text begin to the percentage required on September new text end 374.17 new text begin 1, 2008, to meet federal requirements for new text end 374.18 new text begin enhanced federal match under the American new text end 374.19 new text begin Reinvestment and Recovery Act (ARRA) new text end 374.20 new text begin of 2009. Notwithstanding the requirements new text end 374.21 new text begin of Minnesota Statutes, section 256B.19, new text end 374.22 new text begin subdivision 1c, paragraph (d), for the period new text end 374.23 new text begin beginning July 1, 2009, to December 31, new text end 374.24 new text begin 2010, Hennepin County's monthly payment new text end 374.25 new text begin under that provision is reduced to $434,688. new text end 374.26 new text begin Capitation Payments. new text end new text begin Effective from new text end 374.27 new text begin July 1, 2009, to December 31, 2010, new text end 374.28 new text begin notwithstanding the provisions of Minnesota new text end 374.29 new text begin Statutes 2008, section 256B.19, subdivision new text end 374.30 new text begin 1c, paragraph (c), the commissioner shall new text end 374.31 new text begin increase capitation payments made to the new text end 374.32 new text begin Metropolitan Health Plan under Minnesota new text end 374.33 new text begin Statutes 2008, section 256B.69, by new text end 374.34 new text begin $6,800,000 to recognize higher than average new text end 375.1 new text begin medical education costs. The increased new text end 375.2 new text begin amount includes federal matching funds. new text end 375.3 new text begin Use of Savings. new text end new text begin Any savings derived new text end 375.4 new text begin from implementation of the prohibition in new text end 375.5 new text begin Minnesota Statutes, section 256B.032, on the new text end 375.6 new text begin enrollment of low-quality, high-cost health new text end 375.7 new text begin care providers as vendors of state health care new text end 375.8 new text begin program services shall be used to offset on a new text end 375.9 new text begin pro rata basis the reimbursement reductions new text end 375.10 new text begin for basic care services in Minnesota Statutes, new text end 375.11 new text begin section 256B.766. new text end 375.12 375.13 new text begin (c) MA Basic Health Care Grants - Elderly and new text end new text begin Disabled new text end new text begin 970,183,000 new text end new text begin 1,142,310,000 new text end 375.14 new text begin Minnesota Disability Health Options. new text end 375.15 new text begin Notwithstanding Minnesota Statutes, section new text end 375.16 new text begin 256B.69, subdivision 5a, paragraph (b), for new text end 375.17 new text begin the period beginning July 1, 2009, to June new text end 375.18 new text begin 30, 2011, the monthly enrollment of persons new text end 375.19 new text begin receiving home and community-based new text end 375.20 new text begin waivered services under Minnesota new text end 375.21 new text begin Disability Health Options shall not exceed new text end 375.22 new text begin 1,000. If the budget neutrality provision new text end 375.23 new text begin in Minnesota Statutes, section 256B.69, new text end 375.24 new text begin subdivision 23, paragraph (f), is reached new text end 375.25 new text begin prior to June 30, 2013, the commissioner may new text end 375.26 new text begin waive this monthly enrollment requirement. new text end 375.27 new text begin Hospital Fee-for-Service Payment Delay. new text end new text begin new text end 375.28 new text begin Payments from the Medicaid Management new text end 375.29 new text begin Information System that would otherwise new text end 375.30 new text begin have been made for inpatient hospital new text end 375.31 new text begin services for Minnesota health care program new text end 375.32 new text begin enrollees must be delayed as follows: for new text end 375.33 new text begin fiscal year 2011, payments in the month of new text end 375.34 new text begin June equal to $15,937,000 must be included new text end 376.1 new text begin in the first payment of fiscal year 2012 and new text end 376.2 new text begin for fiscal year 2013, payments in the month new text end 376.3 new text begin of June equal to $6,666,000 must be included new text end 376.4 new text begin in the first payment of fiscal year 2014. The new text end 376.5 new text begin provisions of Minnesota Statutes, section new text end 376.6 new text begin 16A.124, do not apply to these delayed new text end 376.7 new text begin payments. Notwithstanding any contrary new text end 376.8 new text begin provision in this article, this paragraph new text end 376.9 new text begin expires December 31, 2014. new text end 376.10 new text begin Nonhospital Fee-for-Service Payment new text end 376.11 new text begin Delay. new text end new text begin Payments from the Medicaid new text end 376.12 new text begin Management Information System that would new text end 376.13 new text begin otherwise have been made for nonhospital new text end 376.14 new text begin acute care services for Minnesota health new text end 376.15 new text begin care program enrollees must be delayed as new text end 376.16 new text begin follows: payments in the month of June equal new text end 376.17 new text begin to $23,438,000 for fiscal year 2011 must be new text end 376.18 new text begin included in the first payment for fiscal year new text end 376.19 new text begin 2012, and payments in the month of June new text end 376.20 new text begin equal to $27,156,000 for fiscal year 2013 new text end 376.21 new text begin must be included in the first payment for new text end 376.22 new text begin fiscal year 2014. This payment delay must new text end 376.23 new text begin not include nursing facilities, intermediate new text end 376.24 new text begin care facilities for persons with developmental new text end 376.25 new text begin disabilities, home and community-based new text end 376.26 new text begin services, prepaid health plans, personal care new text end 376.27 new text begin provider organizations, and home health new text end 376.28 new text begin agencies. The provisions of Minnesota new text end 376.29 new text begin Statutes, section 16A.124, do not apply to new text end 376.30 new text begin these delayed payments. Notwithstanding new text end 376.31 new text begin any contrary provision in this article, this new text end 376.32 new text begin paragraph expires December 31, 2014. new text end 376.33 new text begin (d) General Assistance Medical Care Grants new text end new text begin 345,223,000 new text end new text begin 381,081,000 new text end 376.34 new text begin (e) Other Health Care Grants new text end 377.1 new text begin Appropriations by Fund new text end 377.2 new text begin General new text end new text begin 295,000 new text end new text begin 295,000 new text end 377.3 new text begin Health Care Access new text end new text begin 23,533,000 new text end new text begin 7,080,000 new text end 377.4 new text begin Base Adjustment. new text end new text begin The health care access new text end 377.5 new text begin fund base is reduced to $190,000 in each of new text end 377.6 new text begin fiscal years 2012 and 2013. new text end 377.7 new text begin Subd. 7. new text end new text begin Health Care Management new text end 377.8 new text begin The amounts that may be spent from the new text end 377.9 new text begin appropriation for each purpose are as follows: new text end 377.10 new text begin (a) Health Care Administration new text end 377.11 new text begin Appropriations by Fund new text end 377.12 new text begin General new text end new text begin 7,831,000 new text end new text begin 7,742,000 new text end 377.13 new text begin Health Care Access new text end new text begin 1,812,000 new text end new text begin 906,000 new text end 377.14 new text begin (b) Health Care Operations new text end 377.15 new text begin Appropriations by Fund new text end 377.16 new text begin General new text end new text begin 19,914,000 new text end new text begin 18,949,000 new text end 377.17 new text begin Health Care Access new text end new text begin 25,099,000 new text end new text begin 25,875,000 new text end 377.18 new text begin Base Adjustment. new text end new text begin The health care access new text end 377.19 new text begin fund base is increased by $1,006,000 in new text end 377.20 new text begin fiscal year 2012 and $1,781,000 in fiscal year new text end 377.21 new text begin 2013. The general fund base is decreased by new text end 377.22 new text begin $237,000 in fiscal year 2012 and $237,000 in new text end 377.23 new text begin fiscal year 2013. new text end 377.24 new text begin Subd. 8. new text end new text begin Continuing Care Grants new text end 377.25 new text begin The amounts that may be spent from the new text end 377.26 new text begin appropriation for each purpose are as follows: new text end 377.27 new text begin (a) Aging and Adult Services Grants new text end 378.1 new text begin Appropriations by Fund new text end 378.2 new text begin General new text end new text begin 13,488,000 new text end new text begin 15,779,000 new text end 378.3 new text begin Federal new text end new text begin 500,000 new text end new text begin 0 new text end 378.4 new text begin Base Adjustment. new text end new text begin The general fund base is new text end 378.5 new text begin increased by $5,751,000 in fiscal year 2012 new text end 378.6 new text begin and $6,705,000 in fiscal year 2013. new text end 378.7 new text begin Information and Assistance new text end 378.8 new text begin Reimbursement. new text end new text begin Federal administrative new text end 378.9 new text begin reimbursement obtained from information new text end 378.10 new text begin and assistance services provided by the new text end 378.11 new text begin Senior LinkAge or Disability Linkage lines new text end 378.12 new text begin to people who are identified as eligible for new text end 378.13 new text begin medical assistance shall be appropriated to new text end 378.14 new text begin the commissioner for this activity. new text end 378.15 new text begin Community Service Development Grant new text end 378.16 new text begin Reduction. new text end new text begin Funding for community service new text end 378.17 new text begin development grants must be reduced by new text end 378.18 new text begin $251,000 for fiscal year 2010; $266,000 in new text end 378.19 new text begin fiscal year 2011; $25,000 in fiscal year 2012; new text end 378.20 new text begin and $25,000 in fiscal year 2013. Base level new text end 378.21 new text begin funding shall be restored in fiscal year 2014. new text end 378.22 new text begin Senior Nutrition Use of Federal Funds. new text end new text begin new text end 378.23 new text begin For fiscal year 2010, general fund grants new text end 378.24 new text begin for home-delivered meals and congregate new text end 378.25 new text begin dining shall be reduced by $500,000. The new text end 378.26 new text begin commissioner must replace these general new text end 378.27 new text begin fund reductions with equal amounts from new text end 378.28 new text begin federal funding for senior nutrition from the new text end 378.29 new text begin American Recovery and Reinvestment Act new text end 378.30 new text begin of 2009. new text end 378.31 new text begin (b) Alternative Care Grants new text end new text begin 50,234,000 new text end new text begin 48,576,000 new text end 379.1 new text begin Base Adjustment. new text end new text begin The general fund base is new text end 379.2 new text begin decreased by $3,598,000 in fiscal year 2012 new text end 379.3 new text begin and $3,470,000 in fiscal year 2013. new text end 379.4 new text begin Alternative Care Transfer. new text end new text begin Any money new text end 379.5 new text begin allocated to the alternative care program that new text end 379.6 new text begin is not spent for the purposes indicated does new text end 379.7 new text begin not cancel but must be transferred to the new text end 379.8 new text begin medical assistance account. new text end 379.9 379.10 new text begin (c) Medical Assistance Grants; Long-Term new text end new text begin Care Facilities. new text end new text begin 367,444,000 new text end new text begin 419,749,000 new text end 379.11 379.12 new text begin (d) Medical Assistance Long-Term Care new text end new text begin Waivers and Home Care Grants new text end new text begin 854,373,000 new text end new text begin 1,043,411,000 new text end 379.13 new text begin Manage Growth in TBI and CADI new text end 379.14 new text begin Waivers. new text end new text begin During the fiscal years beginning new text end 379.15 new text begin on July 1, 2009, and July 1, 2010, the new text end 379.16 new text begin commissioner shall allocate money for home new text end 379.17 new text begin and community-based waiver programs new text end 379.18 new text begin under Minnesota Statutes, section 256B.49, new text end 379.19 new text begin to ensure a reduction in state spending that is new text end 379.20 new text begin equivalent to limiting the caseload growth of new text end 379.21 new text begin the TBI waiver to 12.5 allocations per month new text end 379.22 new text begin each year of the biennium and the CADI new text end 379.23 new text begin waiver to 95 allocations per month each year new text end 379.24 new text begin of the biennium. Limits do not apply: (1) new text end 379.25 new text begin when there is an approved plan for nursing new text end 379.26 new text begin facility bed closures for individuals under new text end 379.27 new text begin age 65 who require relocation due to the new text end 379.28 new text begin bed closure; (2) to fiscal year 2009 waiver new text end 379.29 new text begin allocations delayed due to unallotment; or (3) new text end 379.30 new text begin to transfers authorized by the commissioner new text end 379.31 new text begin from the personal care assistance program new text end 379.32 new text begin of individuals having a home care rating new text end 379.33 new text begin of "CS," "MT," or "HL." Priorities for the new text end 379.34 new text begin allocation of funds must be for individuals new text end 380.1 new text begin anticipated to be discharged from institutional new text end 380.2 new text begin settings or who are at imminent risk of a new text end 380.3 new text begin placement in an institutional setting. new text end 380.4 new text begin Manage Growth in DD Waiver. new text end new text begin The new text end 380.5 new text begin commissioner shall manage the growth in new text end 380.6 new text begin the DD waiver by limiting the allocations new text end 380.7 new text begin included in the February 2009 forecast to 15 new text end 380.8 new text begin additional diversion allocations each month new text end 380.9 new text begin for the calendar years that begin on January new text end 380.10 new text begin 1, 2010, and January 1, 2011. Additional new text end 380.11 new text begin allocations must be made available for new text end 380.12 new text begin transfers authorized by the commissioner new text end 380.13 new text begin from the personal care program of individuals new text end 380.14 new text begin having a home care rating of "CS," "MT," new text end 380.15 new text begin or "HL." new text end 380.16 new text begin Adjustment to Lead Agency Waiver new text end 380.17 new text begin Allocations. new text end new text begin Prior to the availability of the new text end 380.18 new text begin alternative license defined in Minnesota new text end 380.19 new text begin Statutes, section 245A.11, subdivision 8, new text end 380.20 new text begin the commissioner shall reduce lead agency new text end 380.21 new text begin waiver allocations for the purposes of new text end 380.22 new text begin implementing a moratorium on corporate new text end 380.23 new text begin foster care. new text end 380.24 new text begin Alternatives to Personal Care Assistance new text end 380.25 new text begin Services. new text end new text begin Base level funding of $3,237,000 new text end 380.26 new text begin in fiscal year 2012 and $4,856,000 in new text end 380.27 new text begin fiscal year 2013 is to implement alternative new text end 380.28 new text begin services to personal care assistance services new text end 380.29 new text begin for persons with mental health and other new text end 380.30 new text begin behavioral challenges who can benefit new text end 380.31 new text begin from other services that more appropriately new text end 380.32 new text begin meet their needs and assist them in living new text end 380.33 new text begin independently in the community. These new text end 380.34 new text begin services may include, but not be limited to, a new text end 380.35 new text begin 1915(i) state plan option. new text end 381.1 new text begin (e) Mental Health Grants new text end 381.2 new text begin Appropriations by Fund new text end 381.3 new text begin General new text end new text begin 77,739,000 new text end new text begin 77,739,000 new text end 381.4 new text begin Health Care Access new text end new text begin 750,000 new text end new text begin 750,000 new text end 381.5 new text begin Lottery Prize new text end new text begin 1,508,000 new text end new text begin 1,508,000 new text end 381.6 new text begin Funding Usage. new text end new text begin Up to 75 percent of a fiscal new text end 381.7 new text begin year's appropriation for adult mental health new text end 381.8 new text begin grants may be used to fund allocations in that new text end 381.9 new text begin portion of the fiscal year ending December new text end 381.10 new text begin 31. new text end 381.11 new text begin (f) Deaf and Hard-of-Hearing Grants new text end new text begin 1,930,000 new text end new text begin 1,917,000 new text end 381.12 new text begin (g) Chemical Dependency Entitlement Grants new text end new text begin 111,303,000 new text end new text begin 122,822,000 new text end 381.13 new text begin Payments for Substance Abuse Treatment. new text end new text begin new text end 381.14 new text begin For services provided during fiscal years new text end 381.15 new text begin 2010 and 2011, county-negotiated rates and new text end 381.16 new text begin provider claims to the consolidated chemical new text end 381.17 new text begin dependency fund must not exceed rates new text end 381.18 new text begin charged for these services on January 1, 2009. new text end 381.19 new text begin For services provided in fiscal years 2012 new text end 381.20 new text begin and 2013, statewide average rates under the new text end 381.21 new text begin new rate methodology to be developed under new text end 381.22 new text begin Minnesota Statutes, section 254B.12, must new text end 381.23 new text begin not exceed the average rates charged for these new text end 381.24 new text begin services on January 1, 2009, plus $3,787,000 new text end 381.25 new text begin for fiscal year 2012 and $5,023,000 for fiscal new text end 381.26 new text begin year 2013. Notwithstanding any provision new text end 381.27 new text begin to the contrary in this article, this provision new text end 381.28 new text begin expires on June 30, 2013. new text end 381.29 new text begin Chemical Dependency Special Revenue new text end 381.30 new text begin Account. new text end new text begin For fiscal year 2010, $750,000 new text end 381.31 new text begin must be transferred from the consolidated new text end 382.1 new text begin chemical dependency treatment fund new text end 382.2 new text begin administrative account and deposited into the new text end 382.3 new text begin general fund. new text end 382.4 new text begin County CD Share of MA Costs for new text end 382.5 new text begin ARRA Compliance. new text end new text begin Notwithstanding the new text end 382.6 new text begin provisions of Minnesota Statutes, chapter new text end 382.7 new text begin 254B, for chemical dependency services new text end 382.8 new text begin provided during the period July 1, 2009, new text end 382.9 new text begin to December 31, 2010, and reimbursed by new text end 382.10 new text begin medical assistance at the enhanced federal new text end 382.11 new text begin matching rate provided under the American new text end 382.12 new text begin Recovery and Reinvestment Act of 2009, the new text end 382.13 new text begin county share is 30 percent of the nonfederal new text end 382.14 new text begin share. new text end 382.15 382.16 new text begin (h) Chemical Dependency Nonentitlement new text end new text begin Grants new text end new text begin 1,729,000 new text end new text begin 1,729,000 new text end 382.17 new text begin Base Adjustment. new text end new text begin The general fund base is new text end 382.18 new text begin decreased by $3,000 in each of fiscal years new text end 382.19 new text begin 2012 and 2013. new text end 382.20 new text begin (i) Other Continuing Care Grants new text end new text begin 18,272,000 new text end new text begin 13,139,000 new text end 382.21 new text begin Base Adjustment. new text end new text begin The general fund base is new text end 382.22 new text begin increased by $7,028,000 in fiscal year 2012 new text end 382.23 new text begin and increased by $8,243,000 in fiscal year new text end 382.24 new text begin 2013. new text end 382.25 new text begin Technology Grants. new text end new text begin $650,000 in fiscal new text end 382.26 new text begin year 2010 and $1,000,000 in fiscal year new text end 382.27 new text begin 2011 are for technology grants, case new text end 382.28 new text begin consultation, evaluation, and consumer new text end 382.29 new text begin information grants related to developing and new text end 382.30 new text begin supporting alternatives to shift-staff foster new text end 382.31 new text begin care residential service models. new text end 382.32 new text begin Other Continuing Care Grants; HIV new text end 382.33 new text begin Grants. new text end new text begin Money appropriated for the HIV new text end 383.1 new text begin drug and insurance grant program in fiscal new text end 383.2 new text begin year 2010 may be used in either year of the new text end 383.3 new text begin biennium. new text end 383.4 new text begin Subd. 9. new text end new text begin Continuing Care Management new text end 383.5 new text begin Appropriations by Fund new text end 383.6 new text begin General new text end new text begin 24,927,000 new text end new text begin 25,314,000 new text end 383.7 383.8 new text begin State Government new text end new text begin Special Revenue new text end new text begin 875,000 new text end new text begin 125,000 new text end 383.9 new text begin Lottery Prize new text end new text begin 157,000 new text end new text begin 157,000 new text end 383.10 new text begin Quality Assurance Commission. new text end new text begin Effective new text end 383.11 new text begin July 1, 2009, state funding for the quality new text end 383.12 new text begin assurance commission under Minnesota new text end 383.13 new text begin Statutes, section 256B.0951, is canceled. new text end 383.14 new text begin County Maintenance of Effort. new text end new text begin $350,000 in new text end 383.15 new text begin fiscal year 2010 is from the general fund for new text end 383.16 new text begin the State-County Results Accountability and new text end 383.17 new text begin Service Delivery Reform under Minnesota new text end 383.18 new text begin Statutes, chapter 402A. new text end 383.19 new text begin Base Adjustment. new text end new text begin The general fund base is new text end 383.20 new text begin decreased $2,697,000 in fiscal year 2012 and new text end 383.21 new text begin $2,791,000 in fiscal year 2013. new text end 383.22 new text begin Subd. 10. new text end new text begin State-Operated Services new text end new text begin 258,794,000 new text end new text begin 266,191,000 new text end 383.23 new text begin The amounts that may be spent from the new text end 383.24 new text begin appropriation for each purpose are as follows: new text end 383.25 new text begin Transfer Authority Related to new text end 383.26 new text begin State-Operated Services. new text end new text begin Money new text end 383.27 new text begin appropriated to finance state-operated new text end 383.28 new text begin services may be transferred between the new text end 383.29 new text begin fiscal years of the biennium with the approval new text end 383.30 new text begin of the commissioner of finance. new text end 383.31 new text begin County Past Due Receivables. new text end new text begin The new text end 383.32 new text begin commissioner is authorized to withhold new text end 384.1 new text begin county federal administrative reimbursement new text end 384.2 new text begin when the county of financial responsibility new text end 384.3 new text begin for cost-of-care payments due the state new text end 384.4 new text begin under Minnesota Statutes, section 246.54 new text end 384.5 new text begin or 253B.045, is 90 days past due. The new text end 384.6 new text begin commissioner shall deposit the withheld new text end 384.7 new text begin federal administrative earnings for the county new text end 384.8 new text begin into the general fund to settle the claims with new text end 384.9 new text begin the county of financial responsibility. The new text end 384.10 new text begin process for withholding funds is governed by new text end 384.11 new text begin Minnesota Statutes, section 256.017. new text end 384.12 new text begin Forecast and Census Data. new text end new text begin The new text end 384.13 new text begin commissioner shall include census data and new text end 384.14 new text begin fiscal projections for state-operated services new text end 384.15 new text begin and Minnesota sex offender services with the new text end 384.16 new text begin November and February budget forecasts. new text end 384.17 new text begin Notwithstanding any contrary provision in new text end 384.18 new text begin this article, this paragraph shall not expire. new text end 384.19 new text begin (a) Adult Mental Health Services new text end new text begin 107,702,000 new text end new text begin 107,201,000 new text end 384.20 new text begin Appropriation Limitation. new text end new text begin No part of new text end 384.21 new text begin the appropriation in this article to the new text end 384.22 new text begin commissioner for mental health treatment new text end 384.23 new text begin services provided by state-operated services new text end 384.24 new text begin shall be used for the Minnesota sex offender new text end 384.25 new text begin program. new text end 384.26 new text begin Community Behavioral Health Hospitals. new text end new text begin new text end 384.27 new text begin Under Minnesota Statutes, section 246.51, new text end 384.28 new text begin subdivision 1, a determination order for the new text end 384.29 new text begin clients served in a community behavioral new text end 384.30 new text begin health hospital operated by the commissioner new text end 384.31 new text begin of human services is only required when new text end 384.32 new text begin a client's third-party coverage has been new text end 384.33 new text begin exhausted. new text end 385.1 new text begin Base Adjustment. new text end new text begin The general fund base is new text end 385.2 new text begin decreased by $500,000 for fiscal year 2012 new text end 385.3 new text begin and by $500,000 for fiscal year 2013. new text end 385.4 new text begin (b) Minnesota Sex Offender Services new text end 385.5 new text begin Appropriations by Fund new text end 385.6 new text begin General new text end new text begin 38,348,000 new text end new text begin 67,503,000 new text end 385.7 new text begin Federal Fund new text end new text begin 26,495,000 new text end new text begin 0 new text end 385.8 new text begin Use of Federal Stabilization Funds. new text end new text begin Of new text end 385.9 new text begin this appropriation, $26,495,000 in fiscal year new text end 385.10 new text begin 2010 is from the fiscal stabilization account new text end 385.11 new text begin in the federal fund to the commissioner. new text end 385.12 new text begin This appropriation must not be used for new text end 385.13 new text begin any activity or service for which federal new text end 385.14 new text begin reimbursement is claimed. This is a onetime new text end 385.15 new text begin appropriation. new text end 385.16 385.17 new text begin (c) Minnesota Security Hospital and METO new text end new text begin Services new text end 385.18 new text begin Appropriations by Fund new text end 385.19 new text begin General new text end new text begin 230,000,000 new text end new text begin 83,735,000 new text end 385.20 new text begin Federal Fund new text end new text begin 83,504,000 new text end new text begin 0 new text end 385.21 new text begin Minnesota Security Hospital. new text end new text begin For the new text end 385.22 new text begin purposes of enhancing the safety of new text end 385.23 new text begin the public, improving supervision, and new text end 385.24 new text begin enhancing community-based mental health new text end 385.25 new text begin treatment, state-operated services may new text end 385.26 new text begin establish additional community capacity new text end 385.27 new text begin for providing treatment and supervision new text end 385.28 new text begin of clients who have been ordered into a new text end 385.29 new text begin less restrictive alternative of care from the new text end 385.30 new text begin state-operated services transitional services new text end 386.1 new text begin program consistent with Minnesota Statutes, new text end 386.2 new text begin section 246.014. new text end 386.3 new text begin Use of Federal Stabilization Funds. new text end new text begin new text end 386.4 new text begin $83,505,000 in fiscal year 2010 is new text end 386.5 new text begin appropriated from the fiscal stabilization new text end 386.6 new text begin account in the federal fund to the new text end 386.7 new text begin commissioner. This appropriation must not new text end 386.8 new text begin be used for any activity or service for which new text end 386.9 new text begin federal reimbursement is claimed. This is a new text end 386.10 new text begin onetime appropriation. new text end 386.11 Sec. 4. new text begin COMMISSIONER OF HEALTH new text end 386.12 new text begin Subdivision 1. new text end new text begin Total Appropriation new text end new text begin $ new text end new text begin 165,717,000 new text end new text begin $ new text end new text begin 161,841,000 new text end 386.13 new text begin Appropriations by Fund new text end 386.14 new text begin 2010 new text end new text begin 2011 new text end 386.15 new text begin General new text end new text begin 69,366,000 new text end new text begin 63,884,000 new text end 386.16 386.17 new text begin State Government new text end new text begin Special Revenue new text end new text begin 45,415,000 new text end new text begin 45,415,000 new text end 386.18 new text begin Health Care Access new text end new text begin 39,203,000 new text end new text begin 40,809,000 new text end 386.19 new text begin Federal TANF new text end new text begin 11,733,000 new text end new text begin 11,733,000 new text end 386.20 386.21 new text begin Subd. 2. new text end new text begin Community and Family Health new text end new text begin Promotion new text end 386.22 new text begin Appropriations by Fund new text end 386.23 new text begin General new text end new text begin 44,814,000 new text end new text begin 39,671,000 new text end 386.24 386.25 new text begin State Government new text end new text begin Special Revenue new text end new text begin 1,033,000 new text end new text begin 1,304,000 new text end 386.26 new text begin Federal TANF new text end new text begin 11,733,000 new text end new text begin 11,733,000 new text end 386.27 new text begin Health Care Access new text end new text begin 21,642,000 new text end new text begin 28,719,000 new text end 386.28 new text begin Newborn Screening Fee. new text end new text begin Of the general new text end 386.29 new text begin fund appropriation, $300,000 in fiscal year new text end 386.30 new text begin 2011 is to the commissioner for the purpose new text end 387.1 new text begin of providing support services to families as new text end 387.2 new text begin required under Minnesota Statutes, section new text end 387.3 new text begin 144.966, subdivision 3a. $74,000 of this new text end 387.4 new text begin appropriation in fiscal year 2011 and $51,000 new text end 387.5 new text begin of this appropriation in subsequent fiscal new text end 387.6 new text begin years may be used by the commissioner new text end 387.7 new text begin for administrative costs associated with new text end 387.8 new text begin increasing the fee, contract administration, new text end 387.9 new text begin program oversight, and provide follow-up to new text end 387.10 new text begin families who need assistance beyond those new text end 387.11 new text begin available through the contractor. new text end 387.12 new text begin Support Services for Families With new text end 387.13 new text begin Children Who are Deaf or Have Hearing new text end 387.14 new text begin Loss. new text end new text begin Of the general fund amount, $16,000 new text end 387.15 new text begin in fiscal year 2010 and $284,000 in fiscal new text end 387.16 new text begin year 2011 is for support services to families new text end 387.17 new text begin with children who are deaf or have hearing new text end 387.18 new text begin loss. Of this amount, in fiscal year 2011, new text end 387.19 new text begin $223,000 is for grants and the balance is for new text end 387.20 new text begin administrative costs. Base funding in fiscal new text end 387.21 new text begin years 2012 and 2013 is $300,000 each year. new text end 387.22 new text begin Of this amount, $241,000 each year is for new text end 387.23 new text begin grants and the balance is for administrative new text end 387.24 new text begin costs. new text end 387.25 new text begin Funding Usage. new text end new text begin Up to 75 percent of the new text end 387.26 new text begin fiscal year 2012 appropriation for local public new text end 387.27 new text begin health grants may be used to fund calendar new text end 387.28 new text begin year 2011 allocations for this program. The new text end 387.29 new text begin general fund reduction of $5,193,000 in new text end 387.30 new text begin fiscal year 2011 for local public health grants new text end 387.31 new text begin is onetime and the base funding for local new text end 387.32 new text begin public health grants for fiscal year 2012 is new text end 387.33 new text begin increased by $5,193,000. new text end 387.34 new text begin Colorectal Screening. new text end new text begin $88,000 in fiscal year new text end 387.35 new text begin 2010 and $62,000 in fiscal year 2011 are new text end 388.1 new text begin for grants to the Hennepin County Medical new text end 388.2 new text begin Center and MeritCare Bemidji for colorectal new text end 388.3 new text begin screening demonstration projects. new text end 388.4 new text begin Feasibility Pilot Project for Cancer new text end 388.5 new text begin Surveillance. new text end new text begin Of the general fund new text end 388.6 new text begin appropriation for fiscal year 2010, $100,000 new text end 388.7 new text begin is to the commissioner to provide grant new text end 388.8 new text begin funding to cover the cost of one full-time new text end 388.9 new text begin equivalent position at the Hennepin County new text end 388.10 new text begin Medical Center to carry out the feasibility new text end 388.11 new text begin pilot project. new text end 388.12 new text begin American Recovery and Reinvestment new text end 388.13 new text begin Act Funds. new text end new text begin Federal funds received by the new text end 388.14 new text begin commissioner for WIC program management new text end 388.15 new text begin information systems from the American new text end 388.16 new text begin Recovery and Reinvestment Act of 2009, new text end 388.17 new text begin Public Law 111-5, are appropriated to the new text end 388.18 new text begin commissioner for the purpose of the grant. new text end 388.19 new text begin TANF Appropriations. new text end new text begin (1) $1,156,000 of new text end 388.20 new text begin the TANF funds are appropriated each year to new text end 388.21 new text begin the commissioner for family planning grants new text end 388.22 new text begin under Minnesota Statutes, section 145.925. new text end 388.23 new text begin (2) $3,579,000 of the TANF funds are new text end 388.24 new text begin appropriated each year to the commissioner new text end 388.25 new text begin for home visiting and nutritional services new text end 388.26 new text begin listed under Minnesota Statutes, section new text end 388.27 new text begin 145.882, subdivision 7, clauses (6) and (7). new text end 388.28 new text begin Funds must be distributed to community new text end 388.29 new text begin health boards according to Minnesota new text end 388.30 new text begin Statutes, section 145A.131, subdivision 1. new text end 388.31 new text begin (3) $2,000,000 of the TANF funds are new text end 388.32 new text begin appropriated each year to the commissioner new text end 388.33 new text begin for decreasing racial and ethnic disparities new text end 388.34 new text begin in infant mortality rates under Minnesota new text end 388.35 new text begin Statutes, section 145.928, subdivision 7. new text end 389.1 new text begin (4) $4,998,000 of the TANF funds are new text end 389.2 new text begin appropriated each year to the commissioner new text end 389.3 new text begin for the family home visiting grant program new text end 389.4 new text begin according to Minnesota Statutes, section new text end 389.5 new text begin 145A.17. $4,000,000 of the funding must new text end 389.6 new text begin be distributed to community health boards new text end 389.7 new text begin according to Minnesota Statutes, section new text end 389.8 new text begin 145A.131, subdivision 1. $998,000 of new text end 389.9 new text begin the funding must be distributed to tribal new text end 389.10 new text begin governments based on Minnesota Statutes, new text end 389.11 new text begin section 145A.14, subdivision 2a. The new text end 389.12 new text begin commissioner may use five percent of new text end 389.13 new text begin the funds appropriated each fiscal year to new text end 389.14 new text begin conduct the ongoing evaluations required new text end 389.15 new text begin under Minnesota Statutes, section 145A.17, new text end 389.16 new text begin subdivision 7, and may use ten percent of new text end 389.17 new text begin the funds appropriated each fiscal year to new text end 389.18 new text begin provide training and technical assistance as new text end 389.19 new text begin required under Minnesota Statutes, section new text end 389.20 new text begin 145A.17, subdivisions 4 and 5. new text end 389.21 new text begin Base Adjustment. new text end new text begin The general fund base new text end 389.22 new text begin is increased by $10,302,000 for fiscal year new text end 389.23 new text begin 2012 and increased by $5,109,000 for fiscal new text end 389.24 new text begin year 2013. The health care access fund base new text end 389.25 new text begin is reduced to $1,719,000 for both fiscal years new text end 389.26 new text begin 2012 and 2013. new text end 389.27 new text begin TANF Carryforward. new text end new text begin Any unexpended new text end 389.28 new text begin balance of the TANF appropriation in the new text end 389.29 new text begin first year of the biennium does not cancel but new text end 389.30 new text begin is available for the second year. new text end 389.31 new text begin Subd. 3. new text end new text begin Policy Quality and Compliance new text end 389.32 new text begin Appropriations by Fund new text end 389.33 new text begin General new text end new text begin 7,491,000 new text end new text begin 7,242,000 new text end 390.1 390.2 new text begin State Government new text end new text begin Special Revenue new text end new text begin 14,173,000 new text end new text begin 14,173,000 new text end 390.3 new text begin Health Care Access new text end new text begin 17,561,000 new text end new text begin 12,090,000 new text end 390.4 new text begin Community-Based Health Care new text end 390.5 new text begin Demonstration Project. new text end new text begin Notwithstanding new text end 390.6 new text begin the provisions of Laws 2007, chapter 147, new text end 390.7 new text begin article 19, section 3, subdivision 6, paragraph new text end 390.8 new text begin (e), base level funding to the commissioner new text end 390.9 new text begin for the demonstration project grant described new text end 390.10 new text begin in Minnesota Statutes, section 62Q.80, new text end 390.11 new text begin subdivision 1a, shall be zero for fiscal years new text end 390.12 new text begin 2011 and 2012. new text end 390.13 new text begin Medical Education and Research Cost new text end 390.14 new text begin Federal Compliance. new text end new text begin Notwithstanding new text end 390.15 new text begin Laws 2008, chapter 363, article 18, section new text end 390.16 new text begin 4, subdivision 3, the base level funding new text end 390.17 new text begin for the commissioner to distribute to the new text end 390.18 new text begin Mayo Clinic for transitional funding while new text end 390.19 new text begin federal compliance changes are made to the new text end 390.20 new text begin medical education and research cost funding new text end 390.21 new text begin distribution formula shall be $0 for fiscal new text end 390.22 new text begin years 2010 and 2011. new text end 390.23 new text begin Autism Clinical Research. new text end new text begin The new text end 390.24 new text begin commissioner, in partnership with a new text end 390.25 new text begin Minnesota research institution, shall apply new text end 390.26 new text begin for funds available for research grants under new text end 390.27 new text begin the American Recovery and Reinvestment new text end 390.28 new text begin Act (ARRA) of 2009 in order to expand new text end 390.29 new text begin research and treatment of autism spectrum new text end 390.30 new text begin disorders. new text end 390.31 new text begin Health Information Technology. new text end new text begin (a) Of new text end 390.32 new text begin the health care access fund appropriation, new text end 390.33 new text begin $4,000,000 is to fund the revolving loan new text end 390.34 new text begin account under Minnesota Statutes, section new text end 391.1 new text begin 62J.496. This appropriation must not be new text end 391.2 new text begin expended unless it is matched with federal new text end 391.3 new text begin funding under the federal Health Information new text end 391.4 new text begin Technology for Economic and Clinical new text end 391.5 new text begin Health (HITECH) Act. This appropriation new text end 391.6 new text begin must not be included in the agency's base new text end 391.7 new text begin budget for the fiscal year beginning July 1, new text end 391.8 new text begin 2012. new text end 391.9 new text begin (b) On or before June 30, 2013, $1,200,000 new text end 391.10 new text begin shall be transferred from the revolving loan new text end 391.11 new text begin account under Minnesota Statutes, section new text end 391.12 new text begin 62J.496, to the health care access fund. new text end 391.13 new text begin This is a onetime transfer and must not be new text end 391.14 new text begin included in the agency's base budget for the new text end 391.15 new text begin fiscal year beginning July 1, 2014. new text end 391.16 new text begin Base Adjustment. new text end new text begin The general fund new text end 391.17 new text begin base is $8,243,000 in fiscal year 2012 and new text end 391.18 new text begin $8,243,000 in fiscal year 2013. The health new text end 391.19 new text begin care access fund base is $10,950,000 in fiscal new text end 391.20 new text begin year 2012 and $6,816,000 in fiscal year 2013. new text end 391.21 new text begin Subd. 4. new text end new text begin Health Protection new text end 391.22 new text begin Appropriations by Fund new text end 391.23 new text begin General new text end new text begin 9,871,000 new text end new text begin 9,780,000 new text end 391.24 391.25 new text begin State Government new text end new text begin Special Revenue new text end new text begin 30,209,000 new text end new text begin 30,209,000 new text end 391.26 new text begin Base Adjustment. new text end new text begin The general fund base is new text end 391.27 new text begin reduced by $50,000 in each of fiscal years new text end 391.28 new text begin 2012 and 2013. new text end 391.29 new text begin Health Protection Appropriations. new text end new text begin (a) new text end 391.30 new text begin $163,000 each year is for the lead abatement new text end 391.31 new text begin grant program. new text end 391.32 new text begin (b) $100,000 each year is for emergency new text end 391.33 new text begin preparedness and response activities. new text end 392.1 new text begin (c) $50,000 each year is for tuberculosis new text end 392.2 new text begin prevention and control. This is a onetime new text end 392.3 new text begin appropriation. new text end 392.4 new text begin American Recovery and Reinvestment new text end 392.5 new text begin Act Funds. new text end new text begin Federal funds received new text end 392.6 new text begin by the commissioner for immunization new text end 392.7 new text begin operations from the American Recovery new text end 392.8 new text begin and Reinvestment Act of 2009, Public Law new text end 392.9 new text begin 111-5, are appropriated to the commissioner new text end 392.10 new text begin for the purposes of the grant. new text end 392.11 new text begin Subd. 5. new text end new text begin Administrative Support Services new text end new text begin 7,190,000 new text end new text begin 7,190,000 new text end 392.12 Sec. 5. new text begin HEALTH-RELATED BOARDS new text end 392.13 new text begin Subdivision 1. new text end new text begin Total Appropriation new text end new text begin $ new text end new text begin 15,017,000 new text end new text begin $ new text end new text begin 14,831,000 new text end 392.14 new text begin This appropriation is from the state new text end 392.15 new text begin government special revenue fund. new text end 392.16 new text begin Transfer. new text end new text begin In fiscal year 2010, $6,000,000 new text end 392.17 new text begin shall be transferred from the state government new text end 392.18 new text begin special revenue fund to the general fund. new text end 392.19 new text begin The amounts that may be spent for each new text end 392.20 new text begin purpose are specified in the following new text end 392.21 new text begin subdivisions. new text end 392.22 new text begin Subd. 2. new text end new text begin Board of Chiropractic Examiners new text end new text begin 447,000 new text end new text begin 447,000 new text end 392.23 new text begin Subd. 3. new text end new text begin Board of Dentistry new text end new text begin 1,009,000 new text end new text begin 1,009,000 new text end 392.24 392.25 new text begin Subd. 4. new text end new text begin Board of Dietetic and Nutrition new text end new text begin Practice new text end new text begin 105,000 new text end new text begin 105,000 new text end 392.26 392.27 new text begin Subd. 5. new text end new text begin Board of Marriage and Family new text end new text begin Therapy new text end new text begin 137,000 new text end new text begin 137,000 new text end 392.28 new text begin Subd. 6. new text end new text begin Board of Medical Practice new text end new text begin 3,674,000 new text end new text begin 3,674,000 new text end 392.29 new text begin Subd. 7. new text end new text begin Board of Nursing new text end new text begin 4,217,000 new text end new text begin 4,219,000 new text end 393.1 393.2 new text begin Subd. 8. new text end new text begin Board of Nursing Home new text end new text begin Administrators new text end new text begin 1,146,000 new text end new text begin 958,000 new text end 393.3 new text begin Administrative Services Unit - Operating new text end 393.4 new text begin Costs. new text end new text begin Of this appropriation, $524,000 new text end 393.5 new text begin in fiscal year 2010 and $526,000 in new text end 393.6 new text begin fiscal year 2011 are for operating costs new text end 393.7 new text begin of the administrative services unit. The new text end 393.8 new text begin administrative services unit may receive new text end 393.9 new text begin and expend reimbursements for services new text end 393.10 new text begin performed by other agencies. new text end 393.11 new text begin Administrative Services Unit - Retirement new text end 393.12 new text begin Costs. new text end new text begin Of this appropriation in fiscal year new text end 393.13 new text begin 2010, $201,000 is for onetime retirement new text end 393.14 new text begin costs in the health-related boards. This new text end 393.15 new text begin funding may be transferred to the health new text end 393.16 new text begin boards incurring those costs for their new text end 393.17 new text begin payment. These funds are available either new text end 393.18 new text begin year of the biennium. new text end 393.19 new text begin Administrative Services Unit - Volunteer new text end 393.20 new text begin Health Care Provider Program. new text end new text begin Of this new text end 393.21 new text begin appropriation, $79,000 in fiscal year 2010 new text end 393.22 new text begin and $89,000 in fiscal year 2011 are to pay new text end 393.23 new text begin for medical professional liability coverage new text end 393.24 new text begin required under Minnesota Statutes, section new text end 393.25 new text begin 214.40. new text end 393.26 new text begin Administrative Services Unit - Contested new text end 393.27 new text begin Cases and Other Legal Proceedings. new text end new text begin Of new text end 393.28 new text begin this appropriation, $200,000 in fiscal year new text end 393.29 new text begin 2010 and $200,000 in fiscal year 2011 new text end 393.30 new text begin are for costs of contested case hearings new text end 393.31 new text begin and other unanticipated costs of legal new text end 393.32 new text begin proceedings involving health-related new text end 393.33 new text begin boards funded under this section. Upon new text end 393.34 new text begin certification of a health-related board to the new text end 394.1 new text begin administrative services unit that the costs new text end 394.2 new text begin will be incurred and that there is insufficient new text end 394.3 new text begin money available to pay for the costs out of new text end 394.4 new text begin money currently available to that board, the new text end 394.5 new text begin administrative services unit is authorized new text end 394.6 new text begin to transfer money from this appropriation new text end 394.7 new text begin to the board for payment of those costs new text end 394.8 new text begin with the approval of the commissioner of new text end 394.9 new text begin finance. This appropriation does not cancel. new text end 394.10 new text begin Any unencumbered and unspent balances new text end 394.11 new text begin remain available for these expenditures in new text end 394.12 new text begin subsequent fiscal years. new text end 394.13 new text begin Subd. 9. new text end new text begin Board of Optometry new text end new text begin 101,000 new text end new text begin 101,000 new text end 394.14 new text begin Subd. 10. new text end new text begin Board of Pharmacy new text end new text begin 1,413,000 new text end new text begin 1,413,000 new text end 394.15 new text begin Subd. 11. new text end new text begin Board of Physical Therapy new text end new text begin 295,000 new text end new text begin 295,000 new text end 394.16 new text begin Subd. 12. new text end new text begin Board of Podiatry new text end new text begin 56,000 new text end new text begin 56,000 new text end 394.17 new text begin Subd. 13. new text end new text begin Board of Psychology new text end new text begin 806,000 new text end new text begin 806,000 new text end 394.18 new text begin Subd. 14. new text end new text begin Board of Social Work new text end new text begin 1,022,000 new text end new text begin 1,022,000 new text end 394.19 new text begin Subd. 15. new text end new text begin Board of Veterinary Medicine new text end new text begin 195,000 new text end new text begin 195,000 new text end 394.20 394.21 new text begin Subd. 16. new text end new text begin Board of Behavioral Health and new text end new text begin Therapy new text end new text begin 394,000 new text end new text begin 394,000 new text end 394.22 394.23 Sec. 6. new text begin EMERGENCY MEDICAL SERVICES new text end new text begin BOARD new text end new text begin $ new text end new text begin 4,378,000 new text end new text begin $ new text end new text begin 3,828,000 new text end 394.24 new text begin Appropriations by Fund new text end 394.25 new text begin 2010 new text end new text begin 2011 new text end 394.26 new text begin General new text end new text begin 3,674,000 new text end new text begin 3,124,000 new text end 394.27 394.28 new text begin State Government new text end new text begin Special Revenue new text end new text begin 704,000 new text end new text begin 704 ,000 new text end 394.29 new text begin Longevity Award and Incentive Program. new text end new text begin new text end 394.30 new text begin Of the general fund appropriation, $700,000 new text end 395.1 new text begin in fiscal year 2010 and $700,000 in fiscal year new text end 395.2 new text begin 2011 are to the board for the Cooper/Sams new text end 395.3 new text begin volunteer ambulance program, under new text end 395.4 new text begin Minnesota Statutes, section 144E.40. new text end 395.5 new text begin Transfer. new text end new text begin In fiscal year 2010, $6,182,000 new text end 395.6 new text begin is transferred from the Cooper/Sams new text end 395.7 new text begin volunteer ambulance trust, established under new text end 395.8 new text begin Minnesota Statutes, section 144E.42, to the new text end 395.9 new text begin general fund. new text end 395.10 new text begin Health Professional Services Program. new text end new text begin new text end 395.11 new text begin $704,000 in fiscal year 2010 and $704,000 in new text end 395.12 new text begin fiscal year 2011 from the state government new text end 395.13 new text begin special revenue fund are for the health new text end 395.14 new text begin professional services program. new text end 395.15 new text begin Comprehensive Advanced Life-Support new text end 395.16 new text begin Educational (CALS) Program. new text end new text begin $100,000 in new text end 395.17 new text begin the first year from the Cooper/Sams volunteer new text end 395.18 new text begin ambulance trust is for the comprehensive new text end 395.19 new text begin advanced life-support educational (CALS) new text end 395.20 new text begin program established under Minnesota new text end 395.21 new text begin Statutes, section 144E.37. This appropriation new text end 395.22 new text begin is to extend availability and affordability new text end 395.23 new text begin of the CALS program for rural emergency new text end 395.24 new text begin medical personnel and to assist hospital staff new text end 395.25 new text begin in attaining the credentialing levels necessary new text end 395.26 new text begin for implementation of the statewide trauma new text end 395.27 new text begin system. new text end 395.28 395.29 Sec. 7. new text begin DEPARTMENT OF VETERANS new text end new text begin AFFAIRS new text end new text begin $ new text end new text begin 200,000 new text end new text begin $ new text end new text begin 0 new text end 395.30 new text begin Veterans Paramedic Apprenticeship new text end 395.31 new text begin Program. new text end new text begin Of this appropriation, $200,000 new text end 395.32 new text begin in the first year is from the Cooper/Sams new text end 395.33 new text begin volunteer ambulance trust for transfer new text end 395.34 new text begin to the commissioner of veterans affairs new text end 396.1 new text begin for a grant to the Minnesota Ambulance new text end 396.2 new text begin Association to implement a veterans new text end 396.3 new text begin paramedic apprenticeship program to new text end 396.4 new text begin reintegrate returning military medics into new text end 396.5 new text begin Minnesota's workforce in the field of new text end 396.6 new text begin paramedic and emergency services, thereby new text end 396.7 new text begin guaranteeing returning military medics new text end 396.8 new text begin gainful employment with livable wages and new text end 396.9 new text begin benefits. This appropriation is available until new text end 396.10 new text begin expended. new text end 396.11 Sec. 8. new text begin DEPARTMENT OF PUBLIC SAFETY new text end new text begin $ new text end new text begin 250,000 new text end new text begin $ new text end new text begin 0 new text end 396.12 new text begin Medical Response Unit Reimbursement new text end 396.13 new text begin Pilot Program. new text end new text begin (a) $250,000 in the first new text end 396.14 new text begin year is from the Cooper/Sams volunteer new text end 396.15 new text begin ambulance trust for a transfer to the new text end 396.16 new text begin Department of Public Safety for a medical new text end 396.17 new text begin response unit reimbursement pilot program. new text end 396.18 new text begin Of this appropriation, $75,000 is for new text end 396.19 new text begin administrative costs to the Department of new text end 396.20 new text begin Public Safety, including providing contract new text end 396.21 new text begin staff support and technical assistance to the new text end 396.22 new text begin pilot program partners if necessary. new text end 396.23 new text begin (b) Of the amount in paragraph (a), $175,000 new text end 396.24 new text begin is to be used to provide a predetermined new text end 396.25 new text begin reimbursement amount to the participating new text end 396.26 new text begin medical response units. The Department new text end 396.27 new text begin of Public Safety or its contract designee new text end 396.28 new text begin will develop an agreement with the medical new text end 396.29 new text begin response units outlining reimbursement and new text end 396.30 new text begin program requirements to include HIPAA new text end 396.31 new text begin compliance while participating in the pilot new text end 396.32 new text begin program. new text end 396.33 Sec. 9. new text begin COUNCIL ON DISABILITY new text end new text begin $ new text end new text begin 524,000 new text end new text begin $ new text end new text begin 524,000 new text end 397.1 397.2 397.3 Sec. 10. new text begin OMBUDSMAN FOR MENTAL new text end new text begin HEALTH AND DEVELOPMENTAL new text end new text begin DISABILITIES new text end new text begin $ new text end new text begin 1,655,000 new text end new text begin $ new text end new text begin 1,655,000 new text end 397.4 Sec. 11. new text begin OMBUDSPERSON FOR FAMILIES new text end new text begin $ new text end new text begin 265,000 new text end new text begin $ new text end new text begin 265,000 new text end 397.5    Sec. 12. Laws 2007, chapter 147, article 19, section 3, subdivision 4, as amended 397.6by Laws 2008, chapter 277, article 5, section 1; and Laws 2008, chapter 363, article 397.718, section 7, is amended to read: 397.8 397.9 Subd. 4. Children and Economic Assistance Grants397.10The amounts that may be spent from this 397.11appropriation for each purpose are as follows: 397.12 (a) MFIP/DWP Grants 397.13 Appropriations by Fund 397.14 General 62,069,000 62,405,000 397.15 Federal TANF 75,904,000 80,841,000 397.16 (b) Support Services Grants 397.17 Appropriations by Fund 397.18 General 8,715,000 8,715,000 397.19 Federal TANF 113,429,000 115,902,000 397.20TANF Prior Appropriation Cancellation. 397.21Notwithstanding Laws 2001, First Special 397.22Session chapter 9, article 17, section 397.232, subdivision 11, paragraph (b), any 397.24unexpended TANF funds appropriated to the 397.25commissioner to contract with the Board of 397.26Trustees of Minnesota State Colleges and 397.27Universities, to provide tuition waivers to 397.28employees of health care and human service 398.1providers that are members of qualifying 398.2consortia operating under Minnesota 398.3Statutes, sections 116L.10 to 116L.15, must 398.4cancel at the end of fiscal year 2007. 398.5MFIP Pilot Program. Of the TANF 398.6appropriation, $100,000 in fiscal year 2008 398.7and $750,000 in fiscal year 2009 are for a 398.8grant to the Stearns-Benton Employment and 398.9Training Council for the Workforce U pilot 398.10program. Base level funding for this program 398.11shall be $750,000 in 2010 and $0 in 2011. 398.12Supported Work. (1) Of the TANF 398.13appropriation, $5,468,000 in fiscal year 2008 398.14is for supported work for MFIP participants, 398.15to be allocated to counties and tribes based 398.16on the criteria under clauses (2) and (3), and 398.17is available until expended. Paid transitional 398.18work experience and other supported 398.19employment under this rider provides 398.20a continuum of employment assistance, 398.21including outreach and recruitment, 398.22program orientation and intake, testing and 398.23assessment, job development and marketing, 398.24preworksite training, supported worksite 398.25experience, job coaching, and postplacement 398.26follow-up, in addition to extensive case 398.27management and referral services. * (The 398.28preceding text "and $7,291,000 in fiscal 398.29year 2009" was indicated as vetoed by the 398.30governor.) 398.31(2) A county or tribe is eligible to receive an 398.32allocation under this rider if: 398.33(i) the county or tribe is not meeting the 398.34federal work participation rate; 399.1(ii) the county or tribe has participants who 399.2are required to perform work activities under 399.3Minnesota Statutes, chapter 256J, but are not 399.4meeting hourly work requirements; and 399.5(iii) the county or tribe has assessed 399.6participants who have completed six weeks 399.7of job search or are required to perform 399.8work activities and are not meeting the 399.9hourly requirements, and the county or tribe 399.10has determined that the participant would 399.11benefit from working in a supported work 399.12environment. 399.13(3) A county or tribe may also be eligible for 399.14funds in order to contract for supplemental 399.15hours of paid work at the participant's child's 399.16place of education, child care location, or the 399.17child's physical or mental health treatment 399.18facility or office. This grant to counties and 399.19tribes is specifically for MFIP participants 399.20who need to work up to five hours more 399.21per week in order to meet the hourly work 399.22requirement, and the participant's employer 399.23cannot or will not offer more hours to the 399.24participant. 399.25Work Study. Of the TANF appropriation, 399.26$750,000 each year are to the commissioner 399.27to contract with the Minnesota Office of 399.28Higher Education for the biennium beginning 399.29July 1, 2007, for work study grants under 399.30Minnesota Statutes, section 136A.233, 399.31specifically for low-income individuals who 399.32receive assistance under Minnesota Statutes, 399.33chapter 256J, and for grants to opportunities 399.34industrialization centers. * (The preceding 399.35text beginning "Work Study. Of the TANF 400.1appropriation," was indicated as vetoed 400.2by the governor.) 400.3Integrated Service Projects. $2,500,000 400.4in fiscal year 2008 and $2,500,000 in fiscal 400.5year 2009 are appropriated from the TANF 400.6fund to the commissioner to continue to 400.7fund the existing integrated services projects 400.8for MFIP families, and if funding allows, 400.9additional similar projects. 400.10Base Adjustment. The TANF base for fiscal 400.11year 2010 is $115,902,000 and for fiscal year 400.122011 is $115,152,000. 400.13 (c) MFIP Child Care Assistance Grants 400.14 General 74,654,000 71,951,000 400.15 400.16 (d) Basic Sliding Fee Child Care Assistance Grants 400.17 General 42,995,000 45,008,000 400.18Base Adjustment. The general fund base 400.19is $44,881,000 for fiscal year 2010 and 400.20$44,852,000 for fiscal year 2011. 400.21At-Home Infant Care Program. No 400.22funding shall be allocated to or spent on 400.23the at-home infant care program under 400.24Minnesota Statutes, section 119B.035. 400.25 (e) Child Care Development Grants 400.26 General 4,390,000 6,390,000 400.27Prekindergarten Exploratory Projects. Of 400.28the general fund appropriation, $2,000,000 400.29the first year and $4,000,000 the second 401.1year are for grants to the city of St. Paul, 401.2Hennepin County, and Blue Earth County to 401.3establish scholarship demonstration projects 401.4to be conducted in partnership with the 401.5Minnesota Early Learning Foundation to 401.6promote children's school readiness. This 401.7appropriation is available until June 30, 2009. 401.8Child Care Services Grants. Of this 401.9appropriation, $250,000 each year are for 401.10the purpose of providing child care services 401.11grants under Minnesota Statutes, section 401.12119B.21, subdivision 5 . This appropriation 401.13is for the 2008-2009 biennium only, and does 401.14not increase the base funding. 401.15Early Childhood Professional 401.16Development System. Of this appropriation, 401.17$250,000 each year are for purposes of the 401.18early childhood professional development 401.19system, which increases the quality and 401.20continuum of professional development 401.21opportunities for child care practitioners. 401.22This appropriation is for the 2008-2009 401.23biennium only, and does not increase the 401.24base funding. 401.25Base Adjustment. The general fund base 401.26is $1,515,000 for each of fiscal years 2010 401.27and 2011. 401.28 (f) Child Support Enforcement Grants 401.29 General 11,038,000 3,705,000 401.30Child Support Enforcement. $7,333,000 401.31for fiscal year 2008 is to make grants to 401.32counties for child support enforcement 401.33programs to make up for the loss under the 402.12005 federal Deficit Reduction Act of federal 402.2matching funds for federal incentive funds 402.3passed on to the counties by the state. 402.4This appropriation is available until June 30, 402.52009. 402.6 (g) Children's Services Grants 402.7 Appropriations by Fund 402.8 General 63,647,000 71,147,000 402.9 Health Care Access 250,000 -0- 402.10 TANF 240,000 340,000 402.11Grants for Programs Serving Young 402.12Parents. Of the TANF fund appropriation, 402.13$140,000 each year is for a grant to a program 402.14or programs that provide comprehensive 402.15services through a private, nonprofit agency 402.16to young parents in Hennepin County who 402.17have dropped out of school and are receiving 402.18public assistance. The program administrator 402.19shall report annually to the commissioner on 402.20skills development, education, job training, 402.21and job placement outcomes for program 402.22participants. 402.23County Allocations for Rate Increases. 402.24County Children and Community Services 402.25Act allocations shall be increased by 402.26$197,000 effective October 1, 2007, and 402.27$696,000 effective October 1, 2008, to help 402.28counties pay for the rate adjustments to 402.29day training and habilitation providers for 402.30participants paid by county social service 402.31funds. Notwithstanding the provisions of 402.32Minnesota Statutes, section 256M.40, the 402.33allocation to a county shall be based on 403.1the county's proportion of social services 403.2spending for day training and habilitation 403.3services as determined in the most recent 403.4social services expenditure and grant 403.5reconciliation report. 403.6Privatized Adoption Grants. Federal 403.7reimbursement for privatized adoption grant 403.8and foster care recruitment grant expenditures 403.9is appropriated to the commissioner for 403.10adoption grants and foster care and adoption 403.11administrative purposes. 403.12Adoption Assistance Incentive Grants. 403.13Federal funds available during fiscal year 403.142008 and fiscal year 2009 for the adoption 403.15incentive grants are appropriated to the 403.16commissioner for these purposes. 403.17Adoption Assistance and Relative Custody 403.18Assistance. The commissioner may transfer 403.19unencumbered appropriation balances for 403.20adoption assistance and relative custody 403.21assistance between fiscal years and between 403.22programs. 403.23Children's Mental Health Grants. Of the 403.24general fund appropriation, $5,913,000 in 403.25fiscal year 2008 and $6,825,000 in fiscal year 403.262009 are for children's mental health grants. 403.27The purpose of these grants is to increase and 403.28maintain the state's children's mental health 403.29service capacity, especially for school-based 403.30mental health services. The commissioner 403.31shall require grantees to utilize all available 403.32third party reimbursement sources as a 403.33condition of using state grant funds. At 403.34least 15 percent of these funds shall be 403.35used to encourage efficiencies through early 404.1intervention services. At least another 15 404.2percent shall be used to provide respite care 404.3services for children with severe emotional 404.4disturbance at risk of out-of-home placement. 404.5Mental Health Crisis Services. Of the 404.6general fund appropriation, $2,528,000 in 404.7fiscal year 2008 and $2,850,000 in fiscal year 404.82009 are for statewide funding of children's 404.9mental health crisis services. Providers must 404.10utilize all available funding streams. 404.11Children's Mental Health Evidence-Based 404.12and Best Practices. Of the general fund 404.13appropriation, $375,000 in fiscal year 2008 404.14and $750,000 in fiscal year 2009 are for 404.15children's mental health evidence-based and 404.16best practices including, but not limited 404.17to: Adolescent Integrated Dual Diagnosis 404.18Treatment services; school-based mental 404.19health services; co-location of mental 404.20health and physical health care, and; the 404.21use of technological resources to better 404.22inform diagnosis and development of 404.23treatment plan development by mental 404.24health professionals. The commissioner 404.25shall require grantees to utilize all available 404.26third-party reimbursement sources as a 404.27condition of using state grant funds. 404.28Culturally Specific Mental Health 404.29Treatment Grants. Of the general fund 404.30appropriation, $75,000 in fiscal year 2008 404.31and $300,000 in fiscal year 2009 are for 404.32children's mental health grants to support 404.33increased availability of mental health 404.34services for persons from cultural and 404.35ethnic minorities within the state. The 405.1commissioner shall use at least 20 percent 405.2of these funds to help members of cultural 405.3and ethnic minority communities to become 405.4qualified mental health professionals and 405.5practitioners. The commissioner shall assist 405.6grantees to meet third-party credentialing 405.7requirements and require them to utilize all 405.8available third-party reimbursement sources 405.9as a condition of using state grant funds. 405.10Mental Health Services for Children with 405.11Special Treatment Needs. Of the general 405.12fund appropriation, $50,000 in fiscal year 405.132008 and $200,000 in fiscal year 2009 are 405.14for children's mental health grants to support 405.15increased availability of mental health 405.16services for children with special treatment 405.17needs. These shall include, but not be limited 405.18to: victims of trauma, including children 405.19subjected to abuse or neglect, veterans and 405.20their families, and refugee populations; 405.21persons with complex treatment needs, such 405.22as eating disorders; and those with low 405.23incidence disorders. 405.24MFIP and Children's Mental Health 405.25Pilot Project. Of the TANF appropriation, 405.26$100,000 in fiscal year 2008 and $200,000 405.27in fiscal year 2009 are to fund the MFIP 405.28and children's mental health pilot project. 405.29Of these amounts, up to $100,000 may be 405.30expended on evaluation of this pilot. 405.31Prenatal Alcohol or Drug Use. Of the 405.32general fund appropriation, $75,000 each 405.33year is to award grants beginning July 1, 405.342007, to programs that provide services 405.35under Minnesota Statutes, section , 406.1in Pine, Kanabec, and Carlton Counties. 406.2 new text begin the second year is for a grant to A Circle new text end 406.3 new text begin of Women for program services. new text end This 406.4appropriation shall become part of the base 406.5appropriation. 406.6Base Adjustment. The general fund base 406.7is $62,572,000 in fiscal year 2010 and 406.8$62,575,000 in fiscal year 2011. 406.9 (h) Children and Community Services Grants 406.10 General 101,369,000 69,208,000 406.11Base Adjustment. The general fund base 406.12is $69,274,000 in each of fiscal years 2010 406.13and 2011. 406.14Targeted Case Management Temporary 406.15Funding. (a) Of the general fund 406.16appropriation, $32,667,000 in fiscal year 406.172008 is transferred to the targeted case 406.18management contingency reserve account in 406.19the general fund to be allocated to counties 406.20and tribes affected by reductions in targeted 406.21case management federal Medicaid revenue 406.22as a result of the provisions in the federal 406.23Deficit Reduction Act of 2005, Public Law 406.24109-171. 406.25(b) Contingent upon (1) publication by the 406.26federal Centers for Medicare and Medicaid 406.27Services of final regulations implementing 406.28the targeted case management provisions 406.29of the federal Deficit Reduction Act of 406.302005, Public Law 109-171, or (2) the 406.31issuance of a finding by the Centers for 406.32Medicare and Medicaid Services of federal 406.33Medicaid overpayments for targeted case 407.1management expenditures, up to $32,667,000 407.2is appropriated to the commissioner of human 407.3services. Prior to distribution of funds, the 407.4commissioner shall estimate and certify the 407.5amount by which the federal regulations or 407.6federal disallowance will reduce targeted 407.7case management Medicaid revenue over the 407.82008-2009 biennium. 407.9(c) Within 60 days of a contingency described 407.10in paragraph (b), the commissioner shall 407.11distribute the grants proportionate to each 407.12affected county or tribe's targeted case 407.13management federal earnings for calendar 407.14year 2005, not to exceed the lower of (1) the 407.15amount of the estimated reduction in federal 407.16revenue or (2) $32,667,000. 407.17(d) These funds are available in either year of 407.18the biennium. Counties and tribes shall use 407.19these funds to pay for social service-related 407.20costs, but the funds are not subject to 407.21provisions of the Children and Community 407.22Services Act grant under Minnesota Statutes, 407.23chapter 256M. 407.24(e) This appropriation shall be available to 407.25pay counties and tribes for expenses incurred 407.26on or after July 1, 2007. The appropriation 407.27shall be available until expended. 407.28 (i) General Assistance Grants 407.29 General 37,876,000 38,253,000 407.30General Assistance Standard. The 407.31commissioner shall set the monthly standard 407.32of assistance for general assistance units 407.33consisting of an adult recipient who is 408.1childless and unmarried or living apart 408.2from parents or a legal guardian at $203. 408.3The commissioner may reduce this amount 408.4according to Laws 1997, chapter 85, article 408.53, section 54. 408.6Emergency General Assistance. The 408.7amount appropriated for emergency general 408.8assistance funds is limited to no more 408.9than $7,889,812 in fiscal year 2008 and 408.10$7,889,812 in fiscal year 2009. Funds 408.11to counties must be allocated by the 408.12commissioner using the allocation method 408.13specified in Minnesota Statutes, section 408.14256D.06 . 408.15 (j) Minnesota Supplemental Aid Grants 408.16 General 30,505,000 30,812,000 408.17Emergency Minnesota Supplemental 408.18Aid Funds. The amount appropriated for 408.19emergency Minnesota supplemental aid 408.20funds is limited to no more than $1,100,000 408.21in fiscal year 2008 and $1,100,000 in fiscal 408.22year 2009. Funds to counties must be 408.23allocated by the commissioner using the 408.24allocation method specified in Minnesota 408.25Statutes, section 256D.46. 408.26 (k) Group Residential Housing Grants 408.27 General 91,069,000 98,671,000 408.28People Incorporated. Of the general fund 408.29appropriation, $460,000 each year is to 408.30augment community support and mental 408.31health services provided to individuals 409.1residing in facilities under Minnesota 409.2Statutes, section 256I.05, subdivision 1m. 409.3 409.4 (l) Other Children and Economic Assistance Grants 409.5 General 20,183,000 16,333,000 409.6 Federal TANF 1,500,000 1,500,000 409.7Base Adjustment. The general fund base 409.8shall be $16,033,000 in fiscal year 2010 and 409.9$15,533,000 in fiscal year 2011. The TANF 409.10base shall be $1,500,000 in fiscal year 2010 409.11and $1,181,000 in fiscal year 2011. 409.12Homeless and Runaway Youth. Of the 409.13general fund appropriation, $500,000 each 409.14year are for the Runaway and Homeless 409.15Youth Act under Minnesota Statutes, section 409.16256K.45 . Funds shall be spent in each area 409.17of the continuum of care to ensure that 409.18programs are meeting the greatest need. This 409.19is a onetime appropriation. 409.20Long-Term Homelessness. Of the general 409.21fund appropriation, $2,000,000 in fiscal year 409.222008 is for implementation of programs 409.23to address long-term homelessness and is 409.24available in either year of the biennium. This 409.25is a onetime appropriation. 409.26Minnesota Community Action Grants. (a) 409.27Of the general fund appropriation, $250,000 409.28each year is for the purposes of Minnesota 409.29community action grants under Minnesota 409.30Statutes, sections 256E.30 to 256E.32. This 409.31is a onetime appropriation. 409.32(b) Of the TANF appropriation, $1,500,000 409.33each year is for community action agencies 410.1for auto repairs, auto loans, and auto 410.2purchase grants to individuals who are 410.3eligible to receive benefits under Minnesota 410.4Statutes, chapter 256J, or who have lost 410.5eligibility for benefits under Minnesota 410.6Statutes, chapter 256J, due to earnings in the 410.7prior 12 months. Base level funding for this 410.8activity shall be $1,500,000 in fiscal year 410.92010 and $1,181,000 in fiscal year 2011. * 410.10(The preceding text beginning "(b) Of the 410.11TANF appropriation," was indicated as 410.12vetoed by the governor.) 410.13(c) Money appropriated under paragraphs (a) 410.14and (b) that is not spent in the first year does 410.15not cancel but is available for the second 410.16year. 410.17 new text begin EFFECTIVE DATE. new text end new text begin This section is effective the day following final enactment. new text end 410.18    Sec. 13. new text begin EMERGENCY SERVICES SHELTER GRANTS FROM AMERICAN new text end 410.19 new text begin RECOVERY AND REINVESTMENT ACT. new text end 410.20     new text begin (a) To the extent permitted under federal law, the commissioner of human services, new text end 410.21 new text begin when determining the uses of the emergency services shelter grants provided under the new text end 410.22 new text begin American Recovery and Reinvestment Act, shall give priority to programs that serve new text end 410.23 new text begin the following: new text end 410.24     new text begin (1) homeless youth; new text end 410.25     new text begin (2) American Indian women who are victims of trafficking; new text end 410.26     new text begin (3) high-risk adult males considered to be very likely to enter or reenter state or new text end 410.27 new text begin county correctional programs, or chemical and mental health programs; new text end 410.28     new text begin (4) battered women; and new text end 410.29     new text begin (5) families affected by foreclosure. new text end 410.30 new text begin (b) Paragraph (a) does not supersede use of ARRA funds as otherwise provided new text end 410.31 new text begin in this act. new text end 410.32    Sec. 14. new text begin TRANSFERS. new text end 410.33     new text begin Subdivision 1. new text end new text begin Grants. new text end new text begin The commissioner of human services, with the approval new text end 410.34 new text begin of the commissioner of finance, and after notification of the chairs of the relevant senate new text end 411.1 new text begin budget division and house of representatives finance division committee, may transfer new text end 411.2 new text begin unencumbered appropriation balances for the biennium ending June 30, 2011, within new text end 411.3 new text begin fiscal years among the MFIP, general assistance, general assistance medical care, medical new text end 411.4 new text begin assistance, MinnesotaCare, MFIP child care assistance under Minnesota Statutes, section new text end 411.5 new text begin 119B.05, Minnesota supplemental aid, and group residential housing programs, and the new text end 411.6 new text begin entitlement portion of the chemical dependency consolidated treatment fund, and between new text end 411.7 new text begin fiscal years of the biennium. new text end 411.8     new text begin Subd. 2. new text end new text begin Administration. new text end new text begin Positions, salary money, and nonsalary administrative new text end 411.9 new text begin money may be transferred within the Departments of Human Services and Health as the new text end 411.10 new text begin commissioners consider necessary, with the advance approval of the commissioner of new text end 411.11 new text begin finance. The commissioner shall inform the chairs of the relevant house and senate health new text end 411.12 new text begin committees quarterly about transfers made under this provision. new text end 411.13    Sec. 15. new text begin 2007 AND 2008 APPROPRIATION AMENDMENTS. new text end 411.14 new text begin (a) Notwithstanding Laws 2007, chapter 147, article 19, section 3, subdivision 4, new text end 411.15 new text begin paragraph (g), as amended by Laws 2008, chapter 363, article 18, section 7, the TANF new text end 411.16 new text begin fund base for the Children's Mental Health Pilots is $0 in fiscal year 2011. This paragraph new text end 411.17 new text begin is effective retroactively from July 1, 2008. new text end 411.18 new text begin (b) The appropriation for patient incentive programs under Laws 2007, chapter 147, new text end 411.19 new text begin article 19, section 3, subdivision 6, paragraph (e), is canceled. This paragraph is effective new text end 411.20 new text begin retroactively from July 1, 2007. new text end 411.21 new text begin (c) The onetime general fund base reduction for Child Care Development Grants new text end 411.22 new text begin under Laws 2008, chapter 363, article 18, section 3, subdivision 4, paragraph (d), is new text end 411.23 new text begin increased by $4,000. This paragraph is effective retroactively from July 1, 2008. new text end 411.24 new text begin (d) The base for Children Services Grants under Laws 2008, chapter 363, article 18, new text end 411.25 new text begin section 3, subdivision 4, paragraph (e), is decreased $1,000 in each year of the fiscal year new text end 411.26 new text begin 2010 and 2011 biennium. This paragraph is effective retroactively from July 1, 2008. new text end 411.27 new text begin (e) Notwithstanding Laws 2008, chapter 363, article 18, section 3, subdivision 4, the new text end 411.28 new text begin general fund base adjustment for Children and Community Services Grants under Laws new text end 411.29 new text begin 2008, chapter 363, article 18, section 3, subdivision 4, paragraph (f), is increased by new text end 411.30 new text begin $98,000 each year of fiscal years 2010 and 2011. This paragraph is effective retroactively new text end 411.31 new text begin from July 1, 2008. new text end 411.32 new text begin (f) The base for Other Continuing Care Grants under Laws 2008, chapter 363, article new text end 411.33 new text begin 18, section 3, subdivision 6, paragraph (h), is decreased by $10,000 in fiscal year 2010. new text end 411.34 new text begin This paragraph is effective retroactively from July 1, 2008. new text end 412.1    Sec. 16. new text begin INDIRECT COSTS NOT TO FUND PROGRAMS. new text end 412.2 new text begin The commissioners of health and human services shall not use indirect cost new text end 412.3 new text begin allocations to pay for the operational costs of any program for which they are responsible. new text end 412.4    Sec. 17. new text begin EXPIRATION OF UNCODIFIED LANGUAGE. new text end 412.5     new text begin All uncodified language contained in this article expires on June 30, 2011, unless a new text end 412.6 new text begin different expiration date is explicit. new text end 412.7    Sec. 18. new text begin EFFECTIVE DATE. new text end 412.8     new text begin The provisions in this article are effective July 1, 2009, unless a different effective new text end 412.9 new text begin date is specified. new text end " 412.10Delete the title and insert: 412.11"A bill for an act 412.12relating to state government; making changes to health and human services; 412.13amending provisions related to licensing, the Minnesota family investment 412.14program, child care, adult supports; fraud prevention, state-operated services, 412.15the Minnesota sex offender program, the Department of Health, health care 412.16programs, chemical and mental health; continuing care programs, and public 412.17health; establishing the State-County Results, Accountability, and Service 412.18Delivery Redesign; making technical changes; making forecast adjustments; 412.19requiring reports; establishing and increasing fees; appropriating money; 412.20amending Minnesota Statutes 2008, sections 60A.092, subdivision 2; 62D.03, 412.21subdivision 4; 62D.05, subdivision 3; 62J.495; 62J.496; 62J.497, subdivisions 412.221, 2, by adding subdivisions; 62J.692, subdivision 7; 103I.208, subdivision 412.232; 119B.09, subdivision 7; 119B.13, subdivision 6; 119B.21, subdivisions 5, 412.2410; 119B.231, subdivisions 2, 3, 4; 144.0724, subdivisions 2, 4, 8, by adding 412.25subdivisions; 144.121, subdivisions 1a, 1b; 144.122; 144.1222, subdivision 412.261a; 144.125, subdivision 1; 144.226, subdivision 4; 144.72, subdivisions 1, 3; 412.27144.9501, subdivisions 22b, 26a, by adding subdivisions; 144.9505, subdivisions 412.281g, 4; 144.9508, subdivisions 2, 3, 4; 144.9512, subdivision 2; 144.966, by 412.29adding a subdivision; 144.97, subdivisions 2, 4, 6, by adding subdivisions; 412.30144.98, subdivisions 1, 2, 3, by adding subdivisions; 144.99, subdivision 412.311; 144A.073, by adding a subdivision; 144A.44, subdivision 2; 144A.46, 412.32subdivision 1; 145A.17, by adding a subdivision; 148.6445, by adding a 412.33subdivision; 148D.180, subdivisions 1, 2, 3, 5; 148E.180, subdivisions 1, 2, 3, 5; 412.34152.126, subdivisions 1, 2, 6; 153A.17; 157.15, by adding a subdivision; 157.16; 412.35157.22; 176.011, subdivision 9; 245.462, subdivision 18; 245.470, subdivision 412.361; 245.4871, subdivision 27; 245.488, subdivision 1; 245A.03, by adding a 412.37subdivision; 245A.10, subdivisions 2, 3; 245A.11, subdivision 2a, by adding 412.38subdivisions; 245A.16, subdivisions 1, 3; 245C.03, subdivision 2; 245C.04, 412.39subdivisions 1, 3; 245C.05, subdivision 4, by adding a subdivision; 245C.08, 412.40subdivision 2; 245C.10, subdivision 3, by adding subdivisions; 245C.17, by 412.41adding a subdivision; 245C.20; 245C.21, subdivision 1a; 245C.23, subdivision 2; 412.42246.50, subdivision 5, by adding subdivisions; 246.51, by adding subdivisions; 412.43246.511; 246.52; 246.54, subdivision 2; 246B.01, by adding subdivisions; 412.44252.025, subdivision 7; 252.46, by adding a subdivision; 252.50, subdivision 1; 412.45254A.02, by adding a subdivision; 254A.16, by adding a subdivision; 254B.03, 412.46subdivisions 1, 3, by adding a subdivision; 254B.05, subdivision 1; 254B.09, 412.47subdivision 2; 256.01, subdivision 2b, by adding subdivisions; 256.045, 412.48subdivision 3; 256.476, subdivisions 5, 11; 256.962, subdivisions 2, 6; 256.969, 412.49subdivisions 2b, 3a, by adding subdivisions; 256.975, subdivision 7; 256.983, 413.1subdivision 1; 256B.04, subdivision 16; 256B.055, subdivisions 7, 12; 256B.056, 413.2subdivisions 3c, 3d; 256B.057, by adding a subdivision; 256B.0575; 256B.0595, 413.3subdivisions 1, 2; 256B.06, subdivisions 4, 5; 256B.0621, subdivision 2; 413.4256B.0622, subdivision 2; 256B.0623, subdivision 5; 256B.0624, subdivisions 413.55, 8; 256B.0625, subdivisions 3, 3c, 6a, 7, 9, 11, 13, 13e, 13h, 17, 17a, 19a, 413.619c, 26, 42, 47, by adding subdivisions; 256B.0641, subdivision 3; 256B.0651; 413.7256B.0652; 256B.0653; 256B.0654; 256B.0655, subdivisions 1b, 4; 256B.0657, 413.8subdivisions 2, 6, 8, by adding a subdivision; 256B.08, by adding a subdivision; 413.9256B.0911, subdivisions 1, 1a, 3, 3a, 3b, 3c, 4a, 5, 6, 7, by adding subdivisions; 413.10256B.0913, subdivision 4; 256B.0915, subdivisions 3a, 3e, 3h, 5, by adding a 413.11subdivision; 256B.0916, subdivision 2; 256B.0917, by adding a subdivision; 413.12256B.092, subdivision 8a, by adding subdivisions; 256B.0943, subdivisions 1, 413.1312; 256B.0944, by adding a subdivision; 256B.0947, subdivision 1; 256B.15, 413.14subdivisions 1, 1a, 1h, 2, by adding subdivisions; 256B.199; 256B.37, 413.15subdivisions 1, 5; 256B.434, subdivision 4, by adding a subdivision; 256B.437, 413.16subdivision 6; 256B.441, subdivisions 55, 58, by adding a subdivision; 256B.49, 413.17subdivisions 12, 13, 14, 17, by adding subdivisions; 256B.501, subdivision 413.184a; 256B.5011, subdivision 2; 256B.5012, by adding a subdivision; 256B.69, 413.19subdivisions 5a, 5c, 5f, 23; 256B.76, subdivision 1; 256D.03, subdivision 4; 413.20256D.44, subdivision 5; 256G.02, subdivision 6; 256I.03, subdivision 7; 256I.05, 413.21subdivisions 1a, 7c; 256J.08, subdivision 73a; 256J.24, subdivision 5; 256J.425, 413.22subdivisions 2, 3; 256J.45, subdivision 3; 256J.49, subdivisions 1, 4; 256J.521, 413.23subdivision 2; 256J.545; 256J.561, subdivisions 2, 3; 256J.57, subdivision 413.241; 256J.575, subdivisions 3, 4, 6, 7; 256J.621; 256J.626, subdivision 7; 413.25256J.95, subdivisions 3, 11, 12, 13; 256L.03, by adding a subdivision; 256L.04, 413.26subdivisions 1, 7a, 10a, by adding a subdivision; 256L.05, subdivisions 1, 3, 3a, 413.27by adding a subdivision; 256L.07, subdivisions 1, 2, 3, by adding a subdivision; 413.28256L.11, subdivision 1; 256L.15, subdivisions 2, 3; 256L.17, subdivisions 3, 5; 413.29259.67, by adding a subdivision; 270A.09, by adding a subdivision; 327.14, 413.30by adding a subdivision; 327.15; 327.16; 327.20, subdivision 1, by adding a 413.31subdivision; 501B.89, by adding a subdivision; 519.05; 604A.33, subdivision 413.321; 609.232, subdivision 11; 626.556, subdivision 3c; 626.5572, subdivisions 413.336, 13, 21; Laws 2003, First Special Session chapter 14, article 13C, section 413.342, subdivision 1, as amended; Laws 2007, chapter 147, article 19, section 3, 413.35subdivision 4, as amended; proposing coding for new law in Minnesota Statutes, 413.36chapters 62Q; 246B; 254B; 256; 256B; proposing coding for new law as 413.37Minnesota Statutes, chapter 402A; repealing Minnesota Statutes 2008, sections 413.38103I.112; 144.9501, subdivision 17b; 148D.180, subdivision 8; 245C.11, 413.39subdivisions 1, 2; 246.51, subdivision 1; 246.53, subdivision 3; 256.962, 413.40subdivision 7; 256B.0655, subdivisions 1, 1a, 1c, 1d, 1e, 1f, 1g, 1h, 1i, 2, 3, 5, 6, 413.417, 8, 9, 10, 11, 12, 13; 256B.071, subdivisions 1, 2, 3, 4; 256B.092, subdivision 413.425a; 256B.19, subdivision 1d; 256B.431, subdivision 23; 256I.06, subdivision 413.439; 256L.17, subdivision 6; 327.14, subdivisions 5, 6; Minnesota Rules, parts 413.444626.2015, subpart 9; 9555.6125, subpart 4, item B." We request the adoption of this report and repassage of the bill.House Conferees: (Signed) Thomas Huntley, Paul Thissen, Larry Hosch, Karen Clark, Jim AbelerSenate Conferees: (Signed) Linda Berglin, Tony Lourey, Kathy Sheran, Julie Rosen, Yvonne Prettner Solon 414.1 We request the adoption of this report and repassage of the bill. 414.2 House Conferees:(Signed) 414.3 ..... ..... 414.4 Thomas Huntley Paul Thissen 414.5 ..... ..... 414.6 Larry Hosch Karen Clark 414.7 ..... 414.8 Jim Abeler 414.9 Senate Conferees:(Signed) 414.10 ..... ..... 414.11 Linda Berglin Tony Lourey 414.12 ..... ..... 414.13 Kathy Sheran Julie Rosen 414.14 ..... 414.15 Yvonne Prettner Solon