<a id="pl.1.4"></a><var>1.4</var>making changes to licensing; Minnesota family investment program, children, <br/>
<a id="pl.1.5"></a><var>1.5</var>and adult supports; child support; the Department of Health; health care <br/>
<a id="pl.1.6"></a><var>1.6</var>programs; making technical changes; chemical and mental health; continuing <br/>
<a id="pl.1.7"></a><var>1.7</var>care programs; establishing the State-County Results, Accountability, and <br/>
<a id="pl.1.8"></a><var>1.8</var>Service Delivery Redesign; public health; health-related fees; making forecast <br/>
<a id="pl.1.9"></a><var>1.9</var>adjustments; creating work groups and pilot projects; requiring reports; <br/>
<a id="pl.1.10"></a><var>1.10</var>decreasing provider reimbursements; increasing fees; appropriating money to <br/>
<a id="pl.1.11"></a><var>1.11</var>various state agencies for health and human services provisions;amending <br/>
<a id="pl.1.12"></a><var>1.12</var>Minnesota Statutes 2008, sections 62J.495; 62J.496; 62J.497, subdivisions <br/>
<a id="pl.1.13"></a><var>1.13</var>1, 2, by adding subdivisions; 62J.692, subdivision 7; 103I.208, subdivision 2; <br/>
<a id="pl.1.14"></a><var>1.14</var>125A.744, subdivision 3; 144.0724, subdivisions 2, 4, 8, by adding subdivisions; <br/>
<a id="pl.1.15"></a><var>1.15</var>144.121, subdivisions 1a, 1b; 144.122; 144.1222, subdivision 1a; 144.125, <br/>
<a id="pl.1.16"></a><var>1.16</var>subdivision 1; 144.226, subdivision 4; 144.72, subdivisions 1, 3; 144.9501, <br/>
<a id="pl.1.17"></a><var>1.17</var>subdivisions 22b, 26a, by adding subdivisions; 144.9505, subdivisions 1g, 4; <br/>
<a id="pl.1.18"></a><var>1.18</var>144.9508, subdivisions 2, 3, 4; 144.9512, subdivision 2; 144.966, by adding <br/>
<a id="pl.1.19"></a><var>1.19</var>a subdivision; 144.97, subdivisions 2, 4, 6, by adding subdivisions; 144.98, <br/>
<a id="pl.1.20"></a><var>1.20</var>subdivisions 1, 2, 3, by adding subdivisions; 144.99, subdivision 1; 144A.073, by <br/>
<a id="pl.1.21"></a><var>1.21</var>adding a subdivision; 144A.44, subdivision 2; 144A.46, subdivision 1; 148.108; <br/>
<a id="pl.1.22"></a><var>1.22</var>148.6445, by adding a subdivision; 148D.180, subdivisions 1, 2, 3, 5; 148E.180, <br/>
<a id="pl.1.23"></a><var>1.23</var>subdivisions 1, 2, 3, 5; 153A.17; 156.015; 157.15, by adding a subdivision; <br/>
<a id="pl.1.24"></a><var>1.24</var>157.16; 157.22; 176.011, subdivision 9; 245.462, subdivision 18; 245.470, <br/>
<a id="pl.1.25"></a><var>1.25</var>subdivision 1; 245.4871, subdivision 27; 245.488, subdivision 1; 245.4885, <br/>
<a id="pl.1.26"></a><var>1.26</var>subdivision 1; 245A.03, by adding a subdivision; 245A.10, subdivisions 2, 3, <br/>
<a id="pl.1.27"></a><var>1.27</var>4, 5, by adding subdivisions; 245A.11, subdivision 2a, by adding a subdivision; <br/>
<a id="pl.1.28"></a><var>1.28</var>245A.16, subdivisions 1, 3; 245C.03, subdivision 2; 245C.04, subdivisions 1, <br/>
<a id="pl.1.29"></a><var>1.29</var>3; 245C.05, subdivision 4; 245C.08, subdivision 2; 245C.10, subdivision 3, <br/>
<a id="pl.1.30"></a><var>1.30</var>by adding subdivisions; 245C.17, by adding a subdivision; 245C.20; 245C.21, <br/>
<a id="pl.1.31"></a><var>1.31</var>subdivision 1a; 245C.23, subdivision 2; 246.50, subdivision 5, by adding <br/>
<a id="pl.1.32"></a><var>1.32</var>subdivisions; 246.51, by adding subdivisions; 246.511; 246.52; 246B.01, by <br/>
<a id="pl.1.33"></a><var>1.33</var>adding subdivisions; 252.46, by adding a subdivision; 252.50, subdivision <br/>
<a id="pl.1.34"></a><var>1.34</var>1; 254A.02, by adding a subdivision; 254A.16, by adding a subdivision; <br/>
<a id="pl.1.35"></a><var>1.35</var>254B.03, subdivisions 1, 3, by adding a subdivision; 254B.05, subdivision <br/>
<a id="pl.1.36"></a><var>1.36</var>1; 254B.09, subdivision 2; 256.01, subdivision 2b, by adding subdivisions; <br/>
<a id="pl.1.37"></a><var>1.37</var>256.045, subdivision 3; 256.476, subdivisions 5, 11; 256.962, subdivisions <br/>
<a id="pl.1.38"></a><var>1.38</var>2, 6; 256.963, by adding a subdivision; 256.969, subdivision 3a; 256.975, <br/>
<a id="pl.1.39"></a><var>1.39</var>subdivision 7; 256.983, subdivision 1; 256B.04, subdivision 16; 256B.055, <br/>
<a id="pl.1.40"></a><var>1.40</var>subdivisions 7, 12; 256B.056, subdivisions 3, 3b, 3c, by adding a subdivision; <br/>
<a id="pl.1.41"></a><var>1.41</var>256B.057, subdivisions 3, 9, by adding a subdivision; 256B.0575; 256B.0595, <br/>
<a id="pl.1.42"></a><var>1.42</var>subdivisions 1, 2; 256B.06, subdivisions 4, 5; 256B.0621, subdivision 2; <br/>
<a id="pl.2.1"></a><var>2.1</var>256B.0622, subdivision 2; 256B.0623, subdivision 5; 256B.0624, subdivisions <br/>
<a id="pl.2.2"></a><var>2.2</var>5, 8; 256B.0625, subdivisions 3c, 7, 8, 8a, 9, 13e, 17, 19a, 19c, 26, 41, 42, 47; <br/>
<a id="pl.2.3"></a><var>2.3</var>256B.0631, subdivision 1; 256B.0641, subdivision 3; 256B.0651; 256B.0652; <br/>
<a id="pl.2.4"></a><var>2.4</var>256B.0653; 256B.0654; 256B.0655, subdivisions 1b, 4; 256B.0657, subdivisions <br/>
<a id="pl.2.5"></a><var>2.5</var>2, 6, 8, by adding a subdivision; 256B.08, by adding a subdivision; 256B.0911, <br/>
<a id="pl.2.6"></a><var>2.6</var>subdivisions 1, 1a, 3, 3a, 4a, 5, 6, 7, by adding subdivisions; 256B.0913, <br/>
<a id="pl.2.7"></a><var>2.7</var>subdivision 4; 256B.0915, subdivisions 3e, 3h, 5, by adding a subdivision; <br/>
<a id="pl.2.8"></a><var>2.8</var>256B.0916, subdivision 2; 256B.0917, by adding a subdivision; 256B.092, <br/>
<a id="pl.2.9"></a><var>2.9</var>subdivision 8a, by adding subdivisions; 256B.0943, subdivision 1; 256B.0944, <br/>
<a id="pl.2.10"></a><var>2.10</var>by adding a subdivision; 256B.0945, subdivision 4; 256B.0947, subdivision <br/>
<a id="pl.2.11"></a><var>2.11</var>1; 256B.15, subdivisions 1, 1a, 1h, 2, by adding subdivisions; 256B.37, <br/>
<a id="pl.2.12"></a><var>2.12</var>subdivisions 1, 5; 256B.434, by adding a subdivision; 256B.437, subdivision 6; <br/>
<a id="pl.2.13"></a><var>2.13</var>256B.441, subdivisions 48, 55, by adding subdivisions; 256B.49, subdivisions <br/>
<a id="pl.2.14"></a><var>2.14</var>12, 13, 14, 17, by adding subdivisions; 256B.501, subdivision 4a; 256B.5011, <br/>
<a id="pl.2.15"></a><var>2.15</var>subdivision 2; 256B.5012, by adding a subdivision; 256B.5013, subdivision <br/>
<a id="pl.2.16"></a><var>2.16</var>1; 256B.69, subdivisions 5a, 5c, 5f; 256B.76, subdivisions 1, 4, by adding <br/>
<a id="pl.2.17"></a><var>2.17</var>a subdivision; 256B.761; 256D.024, by adding a subdivision; 256D.03, <br/>
<a id="pl.2.18"></a><var>2.18</var>subdivision 4; 256D.051, subdivision 2a; 256D.0515; 256D.06, subdivision <br/>
<a id="pl.2.19"></a><var>2.19</var>2; 256D.09, subdivision 6; 256D.44, subdivision 5; 256D.49, subdivision 3; <br/>
<a id="pl.2.20"></a><var>2.20</var>256G.02, subdivision 6; 256I.03, subdivision 7; 256I.05, subdivisions 1a, 7c; <br/>
<a id="pl.2.21"></a><var>2.21</var>256J.08, subdivision 73a; 256J.20, subdivision 3; 256J.24, subdivisions 5a, <br/>
<a id="pl.2.22"></a><var>2.22</var>10; 256J.26, by adding a subdivision; 256J.37, subdivision 3a, by adding a <br/>
<a id="pl.2.23"></a><var>2.23</var>subdivision; 256J.38, subdivision 1; 256J.45, subdivision 3; 256J.49, subdivision <br/>
<a id="pl.2.24"></a><var>2.24</var>13; 256J.575, subdivisions 3, 6, 7; 256J.621; 256J.626, subdivision 6; 256J.751, <br/>
<a id="pl.2.25"></a><var>2.25</var>by adding a subdivision; 256J.95, subdivision 12; 256L.04, subdivision 10a, <br/>
<a id="pl.2.26"></a><var>2.26</var>by adding a subdivision; 256L.05, subdivision 1, by adding subdivisions; <br/>
<a id="pl.2.27"></a><var>2.27</var>256L.11, subdivisions 1, 7; 256L.12, subdivision 9; 256L.17, subdivision 3; <br/>
<a id="pl.2.28"></a><var>2.28</var>259.67, by adding a subdivision; 270A.09, by adding a subdivision; 295.52, <br/>
<a id="pl.2.29"></a><var>2.29</var>by adding a subdivision; 327.14, by adding a subdivision; 327.15; 327.16; <br/>
<a id="pl.2.30"></a><var>2.30</var>327.20, subdivision 1, by adding a subdivision; 393.07, subdivision 10; 501B.89, <br/>
<a id="pl.2.31"></a><var>2.31</var>by adding a subdivision; 518A.53, subdivisions 1, 4, 10; 519.05; 604A.33, <br/>
<a id="pl.2.32"></a><var>2.32</var>subdivision 1; 609.232, subdivision 11; 626.556, subdivision 3c; 626.5572, <br/>
<a id="pl.2.33"></a><var>2.33</var>subdivisions 6, 13, 21; Laws 2003, First Special Session chapter 14, article <br/>
<a id="pl.2.34"></a><var>2.34</var>13C, section 2, subdivision 1, as amended; Laws 2007, chapter 147, article <br/>
<a id="pl.2.35"></a><var>2.35</var>19, section 3, subdivision 4, as amended; proposing coding for new law in <br/>
<a id="pl.2.36"></a><var>2.36</var>Minnesota Statutes, chapters 62A; 62Q; 156; 246B; 254B; 256; 256B; proposing <br/>
<a id="pl.2.37"></a><var>2.37</var>coding for new law as Minnesota Statutes, chapter 402A; repealing Minnesota <br/>
<a id="pl.2.38"></a><var>2.38</var>Statutes 2008, sections 62U.08; 103I.112; 144.9501, subdivision 17b; 148D.180, <br/>
<a id="pl.2.39"></a><var>2.39</var>subdivision 8; 246.51, subdivision 1; 246.53, subdivision 3; 256.962, subdivision <br/>
<a id="pl.2.40"></a><var>2.40</var>7; 256B.0655, subdivisions 1, 1a, 1c, 1d, 1e, 1f, 1g, 1h, 1i, 2, 3, 5, 6, 7, 8, 9, 10, <br/>
<a id="pl.2.41"></a><var>2.41</var>11, 12, 13; 256B.071, subdivisions 1, 2, 3, 4; 256B.092, subdivision 5a; 256B.19, <br/>
<a id="pl.2.42"></a><var>2.42</var>subdivision 1d; 256B.431, subdivision 23; 256D.46; 256I.06, subdivision 9; <br/>
<a id="pl.2.43"></a><var>2.43</var>256J.626, subdivision 7; 327.14, subdivisions 5, 6; Laws 1988, chapter 689, <br/>
<a id="pl.2.44"></a><var>2.44</var>section 251; Minnesota Rules, parts 4626.2015, subpart 9; 9100.0400, subparts <br/>
<a id="pl.2.45"></a><var>2.45</var>1, 3; 9100.0500; 9100.0600; 9500.1243, subpart 3; 9500.1261, subparts 3, 4, 5, <br/>
<a id="pl.2.46"></a><var>2.46</var>6; 9555.6125, subpart 4, item B.<br/>
<a id="pl.2.47"></a><var>2.47</var>May 10, 2009<br/>
<a id="pl.2.48"></a><var>2.48</var>The Honorable Margaret Anderson Kelliher<br/>
<a id="pl.2.49"></a><var>2.49</var>Speaker of the House of Representatives<br/>
<a id="pl.2.50"></a><var>2.50</var>The Honorable James P. Metzen<br/>
<a id="pl.2.51"></a><var>2.51</var>President of the Senate<br/>
<a id="pl.2.52"></a><var>2.52</var>We, the undersigned conferees for H. F. No. 1362 report that we have agreed upon <br/>
<a id="pl.2.53"></a><var>2.53</var>the items in dispute and recommend as follows:<br/>
<a id="pl.3.1"></a><var>3.1</var>That the Senate recede from its amendment and that H. F. No. 1362 be further <br/>
<a id="pl.3.2"></a><var>3.2</var>amended as follows:<br/>
<a id="pl.3.3"></a><var>3.3</var>Delete everything after the enacting clause and insert:<br/>
<br/>
<a id="bill.1.0.0"></a>

<a id="bill.1.1.0"></a><a id="pl.3.6"></a><var>3.6</var>    Section 1. Minnesota Statutes 2008, section 245A.10, subdivision 2, is amended to <br/>
<a id="pl.3.7"></a><var>3.7</var>read:<br/>
<a id="pl.3.8"></a><var>3.8</var>    Subd. 2. <b>County fees for background studies and licensing inspections.</b> (a) For <br/>
<a id="pl.3.9"></a><var>3.9</var>purposes of family and group family child care licensing under this chapter, a county <br/>
<a id="pl.3.10"></a><var>3.10</var>agency may charge a fee to an applicant or license holder to recover the actual cost of <br/>
<a id="pl.3.11"></a><var>3.11</var>background studies, but in any case not to exceed $100 annually. A county agency may <br/>
<a id="pl.3.12"></a><var>3.12</var>also charge a license fee to an applicant or license holder not to exceed $50 for a one-year <br/>
<a id="pl.3.13"></a><var>3.13</var>license or $100 for a two-year license.<br/>
<a id="pl.3.14"></a><var>3.14</var>    (b) A county agency may charge a fee to a legal nonlicensed child care provider or <br/>
<a id="pl.3.15"></a><var>3.15</var>applicant for authorization to recover the actual cost of background studies completed <br/>
<a id="pl.3.16"></a><var>3.16</var>under section 
         <statute_ref>119B.125</statute_ref>, but in any case not to exceed $100 annually. <br/>
<a id="pl.3.17"></a><var>3.17</var>    (c) Counties may elect to reduce or waive the fees in paragraph (a) or (b):<br/>
<a id="pl.3.18"></a><var>3.18</var>    (1) in cases of financial hardship;<br/>
<a id="pl.3.19"></a><var>3.19</var>    (2)  if the county has a shortage of providers in the county's area;<br/>
<a id="pl.3.20"></a><var>3.20</var>    (3) for new providers; or<br/>
<a id="pl.3.21"></a><var>3.21</var>    (4) for providers who have attained at least 16 hours of training before seeking <br/>
<a id="pl.3.22"></a><var>3.22</var>initial licensure.<br/>
<a id="pl.3.23"></a><var>3.23</var>    (d) Counties may allow providers to pay the applicant fees in paragraph (a) or (b) on <br/>
<a id="pl.3.24"></a><var>3.24</var>an installment basis for up to one year. If the provider is receiving child care assistance <br/>
<a id="pl.3.25"></a><var>3.25</var>payments from the state, the provider may have the fees under paragraph (a) or (b) <br/>
<a id="pl.3.26"></a><var>3.26</var>deducted from the child care assistance payments for up to one year and the state shall <br/>
<a id="pl.3.27"></a><var>3.27</var>reimburse the county for the county fees collected in this manner.<br/>
<a id="pl.3.28"></a><var>3.28</var>    (e) For purposes of adult foster care and child foster care licensing under this <br/>
<a id="pl.3.29"></a><var>3.29</var>chapter, a county agency may charge a fee to a corporate applicant or corporate license <br/>
<a id="pl.3.30"></a><var>3.30</var>holder to recover the actual cost of background studies. A county agency may also charge <br/>
<a id="pl.3.31"></a><var>3.31</var>a fee to a corporate applicant or corporate license holder to recover the actual cost of <br/>
<a id="pl.3.32"></a><var>3.32</var>licensing inspections, not to exceed $500 annually.<br/>
<a id="pl.3.33"></a><var>3.33</var>    (f) Counties may elect to reduce or waive the fees in paragraph (e) under the <br/>
<a id="pl.3.34"></a><var>3.34</var>following circumstances: <br/>
<a id="pl.3.35"></a><var>3.35</var>(1) in cases of financial hardship; <br/>
<a id="pl.4.1"></a><var>4.1</var>(2) if the county has a shortage of providers in the county's area; or<br/>
<a id="pl.4.2"></a><var>4.2</var>(3) for new providers.<br/>
<br/>
<a id="bill.1.2.0"></a><a id="pl.4.3"></a><var>4.3</var>    Sec. 2. Minnesota Statutes 2008, section 245A.10, subdivision 3, is amended to read:<br/>
<a id="pl.4.4"></a><var>4.4</var>    Subd. 3. <b>Application fee for initial license or certification.</b> (a) For fees required <br/>
<a id="pl.4.5"></a><var>4.5</var>under subdivision 1, an applicant for an initial license or certification issued by the <br/>
<a id="pl.4.6"></a><var>4.6</var>commissioner shall submit a $500 application fee with each new application required <br/>
<a id="pl.4.7"></a><var>4.7</var>under this subdivision. The application fee shall not be prorated, is nonrefundable, and <br/>
<a id="pl.4.8"></a><var>4.8</var>is in lieu of the annual license or certification fee that expires on December 31. The <br/>
<a id="pl.4.9"></a><var>4.9</var>commissioner shall not process an application until the application fee is paid.<br/>
<a id="pl.4.10"></a><var>4.10</var>(b) Except as provided in clauses (1) to (3), an applicant shall apply for a license <br/>
<a id="pl.4.11"></a><var>4.11</var>to provide services at a specific location.<br/>
<a id="pl.4.12"></a><var>4.12</var>(1) For a license to provide waivered residential-based habilitation services to <br/>
<a id="pl.4.13"></a><var>4.13</var>persons with developmental disabilities or related conditions under chapter 245B, an <br/>
<a id="pl.4.14"></a><var>4.14</var>applicant shall submit an application for each county in which the waivered services will <br/>
<a id="pl.4.15"></a><var>4.15</var>be provided. Upon licensure, the license holder may provide services to persons in that <br/>
<a id="pl.4.16"></a><var>4.16</var>county plus no more than three persons at any one time in each of up to ten additional <br/>
<a id="pl.4.17"></a><var>4.17</var>counties. A license holder in one county may not provide services under the home and <br/>
<a id="pl.4.18"></a><var>4.18</var>community-based waiver for persons with developmental disabilities to more than three <br/>
<a id="pl.4.19"></a><var>4.19</var>people in a second county without holding a separate license for that second county. <br/>
<a id="pl.4.20"></a><var>4.20</var>Applicants or licensees providing services under this clause to not more than three persons <br/>
<a id="pl.4.21"></a><var>4.21</var>remain subject to the inspection fees established in section 245A.10, subdivision 2, for <br/>
<a id="pl.4.22"></a><var>4.22</var>each location. The license issued by the commissioner must state the name of each <br/>
<a id="pl.4.23"></a><var>4.23</var>additional county where services are being provided to persons with developmental <br/>
<a id="pl.4.24"></a><var>4.24</var>disabilities. A license holder must notify the commissioner before making any changes <br/>
<a id="pl.4.25"></a><var>4.25</var>that would alter the license information listed under section 245A.04, subdivision 7, <br/>
<a id="pl.4.26"></a><var>4.26</var>paragraph (a), including any additional counties where persons with developmental <br/>
<a id="pl.4.27"></a><var>4.27</var>disabilities are being served.<br/>
<a id="pl.4.28"></a><var>4.28</var>(2) For a license to provide supported employment, crisis respite, or <br/>
<a id="pl.4.29"></a><var>4.29</var>semi-independent living services to persons with developmental disabilities or related <br/>
<a id="pl.4.30"></a><var>4.30</var>conditions under chapter 245B, an applicant shall submit a single application to provide <br/>
<a id="pl.4.31"></a><var>4.31</var>services statewide.<br/>
<a id="pl.4.32"></a><var>4.32</var>(3) For a license to provide independent living assistance for youth under section <br/>
<statute_ref><a id="pl.4.33"></a><var>4.33</var>245A.22
         </statute_ref>, an applicant shall submit a single application to provide services statewide. <br/>
<br/>
<a id="bill.1.3.0"></a><a id="pl.4.34"></a><var>4.34</var>    Sec. 3. Minnesota Statutes 2008, section 245A.11, subdivision 2a, is amended to read:<br/>
<a id="pl.5.1"></a><var>5.1</var>    Subd. 2a. <b>Adult foster care license capacity.</b> The commissioner shall issue adult <br/>
<a id="pl.5.2"></a><var>5.2</var>foster care licenses with a maximum licensed capacity of four beds, including nonstaff <br/>
<a id="pl.5.3"></a><var>5.3</var>roomers and boarders, except that the commissioner may issue a license with a capacity of <br/>
<a id="pl.5.4"></a><var>5.4</var>five beds, including roomers and boarders, according to paragraphs (a) to (e).<br/>
<a id="pl.5.5"></a><var>5.5</var>(a) An adult foster care license holder may have a maximum license capacity of five <br/>
<a id="pl.5.6"></a><var>5.6</var>if all persons in care are age 55 or over and do not have a serious and persistent mental <br/>
<a id="pl.5.7"></a><var>5.7</var>illness or a developmental disability.<br/>
<a id="pl.5.8"></a><var>5.8</var>(b) The commissioner may grant variances to paragraph (a) to allow a foster care <br/>
<a id="pl.5.9"></a><var>5.9</var>provider with a licensed capacity of five persons to admit an individual under the age of 55 <br/>
<a id="pl.5.10"></a><var>5.10</var>if the variance complies with section 
         <statute_ref>245A.04, subdivision 9</statute_ref>, and approval of the variance <br/>
<a id="pl.5.11"></a><var>5.11</var>is recommended by the county in which the licensed foster care provider is located.  <br/>
<a id="pl.5.12"></a><var>5.12</var>(c) The commissioner may grant variances to paragraph (a) to allow the use of a fifth <br/>
<a id="pl.5.13"></a><var>5.13</var>bed for emergency crisis services for a person with serious and persistent mental illness <br/>
<a id="pl.5.14"></a><var>5.14</var>or a developmental disability, regardless of age, if the variance complies with section <br/>
<statute_ref><a id="pl.5.15"></a><var>5.15</var>245A.04, subdivision 9
         </statute_ref>, and approval of the variance is recommended by the county in <br/>
<a id="pl.5.16"></a><var>5.16</var>which the licensed foster care provider is located.  <br/>
<a id="pl.5.17"></a><var>5.17</var>(d) Notwithstanding paragraph (a), If the 2009 legislature adopts a rate reduction <br/>
<a id="pl.5.18"></a><var>5.18</var>that impacts providers of adult foster care services, the commissioner may issue an adult <br/>
<a id="pl.5.19"></a><var>5.19</var>foster care license with a capacity of five adults if the fifth bed does not increase the <br/>
<a id="pl.5.20"></a><var>5.20</var>overall statewide capacity of licensed adult foster care beds in homes that are not the <br/>
<a id="pl.5.21"></a><var>5.21</var>primary residence of the license holder, over the licensed capacity in such homes on July <br/>
<a id="pl.5.22"></a><var>5.22</var>1, 2009, as identified in a plan submitted to the commissioner by the county, when the <br/>
<a id="pl.5.23"></a><var>5.23</var>capacity is recommended by the county licensing agency of the county in which the <br/>
<a id="pl.5.24"></a><var>5.24</var>facility is located and if the recommendation verifies that:<br/>
<a id="pl.5.25"></a><var>5.25</var>(1) the facility meets the physical environment requirements in the adult foster <br/>
<a id="pl.5.26"></a><var>5.26</var>care licensing rule;<br/>
<a id="pl.5.27"></a><var>5.27</var>(2) the five-bed living arrangement is specified for each resident in the resident's:<br/>
<a id="pl.5.28"></a><var>5.28</var>(i) individualized plan of care;<br/>
<a id="pl.5.29"></a><var>5.29</var>(ii) individual service plan under section 
         <statute_ref>256B.092, subdivision 1b</statute_ref>, if required; or  <br/>
<a id="pl.5.30"></a><var>5.30</var>(iii) individual resident placement agreement under Minnesota Rules, part <br/>
<a id="pl.5.31"></a><var>5.31</var>9555.5105, subpart 19, if required;<br/>
<a id="pl.5.32"></a><var>5.32</var>(3) the license holder obtains written and signed informed consent from each <br/>
<a id="pl.5.33"></a><var>5.33</var>resident or resident's legal representative documenting the resident's informed choice to <br/>
<a id="pl.5.34"></a><var>5.34</var>living in the home and that the resident's refusal to consent would not have resulted in <br/>
<a id="pl.5.35"></a><var>5.35</var>service termination; and<br/>
<a id="pl.5.36"></a><var>5.36</var>(4) the facility was licensed for adult foster care before March 1, 2003 2009.<br/>
<a id="pl.6.1"></a><var>6.1</var>(e) The commissioner shall not issue a new adult foster care license under paragraph <br/>
<a id="pl.6.2"></a><var>6.2</var>(d) after June 30, 2005 2011. The commissioner shall allow a facility with an adult foster <br/>
<a id="pl.6.3"></a><var>6.3</var>care license issued under paragraph (d) before June 30, 2005 2011, to continue with a <br/>
<a id="pl.6.4"></a><var>6.4</var>capacity of five adults if the license holder continues to comply with the requirements in <br/>
<a id="pl.6.5"></a><var>6.5</var>paragraph (d).<br/>
<a id="pl.6.6"></a><var>6.6</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2009.<br/>
<br/>
<a id="bill.1.4.0"></a><a id="pl.6.7"></a><var>6.7</var>    Sec. 4. Minnesota Statutes 2008, section 245A.11, is amended by adding a subdivision <br/>
<a id="pl.6.8"></a><var>6.8</var>to read:<br/>
<a id="pl.6.9"></a><var>6.9</var>    Subd. 7a. <b>Alternate overnight supervision technology; adult foster care license.</b><br/>
<a id="pl.6.10"></a><var>6.10</var>    (a) The commissioner may grant an applicant or license holder an adult foster care license <br/>
<a id="pl.6.11"></a><var>6.11</var>for a residence that does not have a caregiver in the residence during normal sleeping <br/>
<a id="pl.6.12"></a><var>6.12</var>hours as required under Minnesota Rules, part 9555.5105, subpart 37, item B, but uses <br/>
<a id="pl.6.13"></a><var>6.13</var>monitoring technology to alert the license holder when an incident occurs that may <br/>
<a id="pl.6.14"></a><var>6.14</var>jeopardize the health, safety, or rights of a foster care recipient. The applicant or license <br/>
<a id="pl.6.15"></a><var>6.15</var>holder must comply with all other requirements under Minnesota Rules, parts 9555.5105 <br/>
<a id="pl.6.16"></a><var>6.16</var>to 9555.6265, and the requirements under this subdivision. The license printed by the <br/>
<a id="pl.6.17"></a><var>6.17</var>commissioner must state in bold and large font:<br/>
<a id="pl.6.18"></a><var>6.18</var>    (1) that the facility is under electronic monitoring; and<br/>
<a id="pl.6.19"></a><var>6.19</var>    (2) the telephone number of the county's common entry point for making reports of <br/>
<a id="pl.6.20"></a><var>6.20</var>suspected maltreatment of vulnerable adults under section 626.557, subdivision 9.<br/>
<a id="pl.6.21"></a><var>6.21</var>(b) Applications for a license under this section must be submitted directly to <br/>
<a id="pl.6.22"></a><var>6.22</var>the Department of Human Services licensing division. The licensing division must <br/>
<a id="pl.6.23"></a><var>6.23</var>immediately notify the host county and lead county contract agency and the host county <br/>
<a id="pl.6.24"></a><var>6.24</var>licensing agency. The licensing division must collaborate with the county licensing <br/>
<a id="pl.6.25"></a><var>6.25</var>agency in the review of the application and the licensing of the program.<br/>
<a id="pl.6.26"></a><var>6.26</var>    (c) Before a license is issued by the commissioner, and for the duration of the <br/>
<a id="pl.6.27"></a><var>6.27</var>license, the applicant or license holder must establish, maintain, and document the <br/>
<a id="pl.6.28"></a><var>6.28</var>implementation of written policies and procedures addressing the requirements in <br/>
<a id="pl.6.29"></a><var>6.29</var>paragraphs (d) through (f).<br/>
<a id="pl.6.30"></a><var>6.30</var>    (d) The applicant or license holder must have policies and procedures that:<br/>
<a id="pl.6.31"></a><var>6.31</var>    (1) establish characteristics of target populations that will be admitted into the home, <br/>
<a id="pl.6.32"></a><var>6.32</var>and characteristics of populations that will not be accepted into the home;<br/>
<a id="pl.6.33"></a><var>6.33</var>    (2) explain the discharge process when a foster care recipient requires overnight <br/>
<a id="pl.6.34"></a><var>6.34</var>supervision or other services that cannot be provided by the license holder due to the <br/>
<a id="pl.6.35"></a><var>6.35</var>limited hours that the license holder is on-site;<br/>
<a id="pl.7.1"></a><var>7.1</var>    (3) describe the types of events to which the program will respond with a physical <br/>
<a id="pl.7.2"></a><var>7.2</var>presence when those events occur in the home during time when staff are not on-site, and <br/>
<a id="pl.7.3"></a><var>7.3</var>how the license holder's response plan meets the requirements in paragraph (e), clause <br/>
<a id="pl.7.4"></a><var>7.4</var>(1) or (2);<br/>
<a id="pl.7.5"></a><var>7.5</var>    (4) establish a process for documenting a review of the implementation and <br/>
<a id="pl.7.6"></a><var>7.6</var>effectiveness of the response protocol for the response required under paragraph (e), <br/>
<a id="pl.7.7"></a><var>7.7</var>clause (1) or (2). The documentation must include:<br/>
<a id="pl.7.8"></a><var>7.8</var>    (i) a description of the triggering incident;<br/>
<a id="pl.7.9"></a><var>7.9</var>    (ii) the date and time of the triggering incident;<br/>
<a id="pl.7.10"></a><var>7.10</var>    (iii) the time of the response or responses under paragraph (e), clause (1) or (2);<br/>
<a id="pl.7.11"></a><var>7.11</var>    (iv) whether the response met the resident's needs;<br/>
<a id="pl.7.12"></a><var>7.12</var>    (v) whether the existing policies and response protocols were followed; and<br/>
<a id="pl.7.13"></a><var>7.13</var>    (vi) whether the existing policies and protocols are adequate or need modification.<br/>
<a id="pl.7.14"></a><var>7.14</var>    When no physical presence response is completed for a three-month period, the <br/>
<a id="pl.7.15"></a><var>7.15</var>license holder's written policies and procedures must require a physical presence response <br/>
<a id="pl.7.16"></a><var>7.16</var>drill be to conducted for which the effectiveness of the response protocol under paragraph <br/>
<a id="pl.7.17"></a><var>7.17</var>(e), clause (1) or (2), will be reviewed and documented as required under this clause; and<br/>
<a id="pl.7.18"></a><var>7.18</var>    (5) establish that emergency and nonemergency phone numbers are posted in a <br/>
<a id="pl.7.19"></a><var>7.19</var>prominent location in a common area of the home where they can be easily observed by a <br/>
<a id="pl.7.20"></a><var>7.20</var>person responding to an incident who is not otherwise affiliated with the home.<br/>
<a id="pl.7.21"></a><var>7.21</var>    (e) The license holder must document and include in the license application which <br/>
<a id="pl.7.22"></a><var>7.22</var>response alternative under clause (1) or (2) is in place for responding to situations that <br/>
<a id="pl.7.23"></a><var>7.23</var>present a serious risk to the health, safety, or rights of people receiving foster care services <br/>
<a id="pl.7.24"></a><var>7.24</var>in the home:<br/>
<a id="pl.7.25"></a><var>7.25</var>    (1) response alternative (1) requires only the technology to provide an electronic <br/>
<a id="pl.7.26"></a><var>7.26</var>notification or alert to the license holder that an event is underway that requires a response. <br/>
<a id="pl.7.27"></a><var>7.27</var>Under this alternative, no more than ten minutes will pass before the license holder will be <br/>
<a id="pl.7.28"></a><var>7.28</var>physically present on-site to respond to the situation; or<br/>
<a id="pl.7.29"></a><var>7.29</var>    (2) response alternative (2) requires the electronic notification and alert system <br/>
<a id="pl.7.30"></a><var>7.30</var>under alternative (1), but more than ten minutes may pass before the license holder is <br/>
<a id="pl.7.31"></a><var>7.31</var>present on-site to respond to the situation. Under alternative (2), all of the following <br/>
<a id="pl.7.32"></a><var>7.32</var>conditions are met:<br/>
<a id="pl.7.33"></a><var>7.33</var>    (i) the license holder has a written description of the interactive technological <br/>
<a id="pl.7.34"></a><var>7.34</var>applications that will assist the licenser holder in communicating with and assessing the <br/>
<a id="pl.7.35"></a><var>7.35</var>needs related to care, health, and safety of the foster care recipients. This interactive <br/>
<a id="pl.7.36"></a><var>7.36</var>technology must permit the license holder to remotely assess the well being of the foster <br/>
<a id="pl.8.1"></a><var>8.1</var>care recipient without requiring the initiation of the foster care recipient. Requiring the <br/>
<a id="pl.8.2"></a><var>8.2</var>foster care recipient to initiate a telephone call does not meet this requirement;<br/>
<a id="pl.8.3"></a><var>8.3</var>(ii) the license holder documents how the remote license holder is qualified and <br/>
<a id="pl.8.4"></a><var>8.4</var>capable of meeting the needs of the foster care recipients and assessing foster care <br/>
<a id="pl.8.5"></a><var>8.5</var>recipients' needs under item (i) during the absence of the license holder on-site;<br/>
<a id="pl.8.6"></a><var>8.6</var>(iii) the license holder maintains written procedures to dispatch emergency response <br/>
<a id="pl.8.7"></a><var>8.7</var>personnel to the site in the event of an identified emergency; and<br/>
<a id="pl.8.8"></a><var>8.8</var>    (iv) each foster care recipient's individualized plan of care, individual service plan <br/>
<a id="pl.8.9"></a><var>8.9</var>under section 256B.092, subdivision 1b, if required, or individual resident placement <br/>
<a id="pl.8.10"></a><var>8.10</var>agreement under Minnesota Rules, part 9555.5105, subpart 19, if required, identifies the <br/>
<a id="pl.8.11"></a><var>8.11</var>maximum response time, which may be greater than ten minutes, for the license holder <br/>
<a id="pl.8.12"></a><var>8.12</var>to be on-site for that foster care recipient.<br/>
<a id="pl.8.13"></a><var>8.13</var>    (f) All placement agreements, individual service agreements, and plans applicable <br/>
<a id="pl.8.14"></a><var>8.14</var>to the foster care recipient must clearly state that the adult foster care license category is <br/>
<a id="pl.8.15"></a><var>8.15</var>a program without the presence of a caregiver in the residence during normal sleeping <br/>
<a id="pl.8.16"></a><var>8.16</var>hours; the protocols in place for responding to situations that present a serious risk to <br/>
<a id="pl.8.17"></a><var>8.17</var>health, safety, or rights of foster care recipients under paragraph (e), clause (1) or (2); and a <br/>
<a id="pl.8.18"></a><var>8.18</var>signed informed consent from each foster care recipient or the person's legal representative <br/>
<a id="pl.8.19"></a><var>8.19</var>documenting the person's or legal representative's agreement with placement in the <br/>
<a id="pl.8.20"></a><var>8.20</var>program. If electronic monitoring technology is used in the home, the informed consent <br/>
<a id="pl.8.21"></a><var>8.21</var>form must also explain the following:<br/>
<a id="pl.8.22"></a><var>8.22</var>    (1) how any electronic monitoring is incorporated into the alternative supervision <br/>
<a id="pl.8.23"></a><var>8.23</var>system;<br/>
<a id="pl.8.24"></a><var>8.24</var>    (2) the backup system for any electronic monitoring in times of electrical outages or <br/>
<a id="pl.8.25"></a><var>8.25</var>other equipment malfunctions;<br/>
<a id="pl.8.26"></a><var>8.26</var>    (3) how the license holder is trained on the use of the technology;<br/>
<a id="pl.8.27"></a><var>8.27</var>    (4) the event types and license holder response times established under paragraph (e);<br/>
<a id="pl.8.28"></a><var>8.28</var>    (5) how the license holder protects the foster care recipient's privacy related to <br/>
<a id="pl.8.29"></a><var>8.29</var>electronic monitoring and related to any electronically recorded data generated by the <br/>
<a id="pl.8.30"></a><var>8.30</var>monitoring system. A foster care recipient may not be removed from a program under <br/>
<a id="pl.8.31"></a><var>8.31</var>this subdivision for failure to consent to electronic monitoring. The consent form must <br/>
<a id="pl.8.32"></a><var>8.32</var>explain where and how the electronically recorded data is stored, with whom it will be <br/>
<a id="pl.8.33"></a><var>8.33</var>shared, and how long it is retained; and<br/>
<a id="pl.8.34"></a><var>8.34</var>    (6) the risks and benefits of the alternative overnight supervision system. <br/>
<a id="pl.9.1"></a><var>9.1</var>    The written explanations under clauses (1) to (6) may be accomplished through <br/>
<a id="pl.9.2"></a><var>9.2</var>cross-references to other policies and procedures as long as they are explained to the <br/>
<a id="pl.9.3"></a><var>9.3</var>person giving consent, and the person giving consent is offered a copy.<br/>
<a id="pl.9.4"></a><var>9.4</var>(g) Nothing in this section requires the applicant or license holder to develop or <br/>
<a id="pl.9.5"></a><var>9.5</var>maintain separate or duplicative polices, procedures, documentation, consent forms, or <br/>
<a id="pl.9.6"></a><var>9.6</var>individual plans that may be required for other licensing standards, if the requirements of <br/>
<a id="pl.9.7"></a><var>9.7</var>this section are incorporated into those documents.<br/>
<a id="pl.9.8"></a><var>9.8</var>(h) The commissioner may grant variances to the requirements of this section <br/>
<a id="pl.9.9"></a><var>9.9</var>according to section 245A.04, subdivision 9.<br/>
<a id="pl.9.10"></a><var>9.10</var>(i) For the purposes of paragraphs (d) through (h), license holder has the meaning <br/>
<a id="pl.9.11"></a><var>9.11</var>under section 245A.2, subdivision 9, and additionally includes all staff, volunteers, and <br/>
<a id="pl.9.12"></a><var>9.12</var>contractors affiliated with the license holder.<br/>
<a id="pl.9.13"></a><var>9.13</var>(j) For the purposes of paragraph (e), the terms "assess" and "assessing" mean to <br/>
<a id="pl.9.14"></a><var>9.14</var>remotely determine what action the license holder needs to take to protect the well-being <br/>
<a id="pl.9.15"></a><var>9.15</var>of the foster care recipient.<br/>
<br/>
<a id="bill.1.5.0"></a><a id="pl.9.16"></a><var>9.16</var>    Sec. 5. Minnesota Statutes 2008, section 245A.11, is amended by adding a subdivision <br/>
<a id="pl.9.17"></a><var>9.17</var>to read:<br/>
<a id="pl.9.18"></a><var>9.18</var>    Subd. 8b. <b>Adult foster care data privacy and security.</b> (a) An adult foster <br/>
<a id="pl.9.19"></a><var>9.19</var>care license holder who creates, collects, records, maintains, stores, or discloses any <br/>
<a id="pl.9.20"></a><var>9.20</var>individually identifiable recipient data, whether in an electronic or any other format, <br/>
<a id="pl.9.21"></a><var>9.21</var>must comply with the privacy and security provisions of applicable privacy laws and <br/>
<a id="pl.9.22"></a><var>9.22</var>regulations, including:<br/>
<a id="pl.9.23"></a><var>9.23</var>(1) the federal Health Insurance Portability and Accountability Act of 1996 <br/>
<a id="pl.9.24"></a><var>9.24</var>(HIPAA), Public Law 104-1; and the HIPAA Privacy Rule, Code of Federal Regulations, <br/>
<a id="pl.9.25"></a><var>9.25</var>title 45, part 160, and subparts A and E of part 164; and<br/>
<a id="pl.9.26"></a><var>9.26</var>(2) the Minnesota Government Data Practices Act as codified in chapter 13.<br/>
<a id="pl.9.27"></a><var>9.27</var>(b) For purposes of licensure, the license holder shall be monitored for compliance <br/>
<a id="pl.9.28"></a><var>9.28</var>with the following data privacy and security provisions:<br/>
<a id="pl.9.29"></a><var>9.29</var>(1) the license holder must control access to data on foster care recipients according <br/>
<a id="pl.9.30"></a><var>9.30</var>to the definitions of public and private data on individuals under section 13.02; <br/>
<a id="pl.9.31"></a><var>9.31</var>classification of the data on individuals as private under section 13.46, subdivision 2; <br/>
<a id="pl.9.32"></a><var>9.32</var>and control over the collection, storage, use, access, protection, and contracting related <br/>
<a id="pl.9.33"></a><var>9.33</var>to data according to section 13.05, in which the license holder is assigned the duties <br/>
<a id="pl.9.34"></a><var>9.34</var>of a government entity;<br/>
<a id="pl.10.1"></a><var>10.1</var>(2) the license holder must provide each foster care recipient with a notice that <br/>
<a id="pl.10.2"></a><var>10.2</var>meets the requirements under section 13.04, in which the license holder is assigned the <br/>
<a id="pl.10.3"></a><var>10.3</var>duties of the government entity, and that meets the requirements of Code of Federal <br/>
<a id="pl.10.4"></a><var>10.4</var>Regulations, title 45, part 164.52. The notice shall describe the purpose for collection of <br/>
<a id="pl.10.5"></a><var>10.5</var>the data, and to whom and why it may be disclosed pursuant to law. The notice must <br/>
<a id="pl.10.6"></a><var>10.6</var>inform the recipient that the license holder uses electronic monitoring and, if applicable, <br/>
<a id="pl.10.7"></a><var>10.7</var>that recording technology is used;<br/>
<a id="pl.10.8"></a><var>10.8</var>(3) the license holder must not install monitoring cameras in bathrooms;<br/>
<a id="pl.10.9"></a><var>10.9</var>(4) electronic monitoring cameras must not be concealed from the foster care <br/>
<a id="pl.10.10"></a><var>10.10</var>recipients; and<br/>
<a id="pl.10.11"></a><var>10.11</var>(5) electronic video and audio recordings of foster care recipients shall not be stored <br/>
<a id="pl.10.12"></a><var>10.12</var>by the license holder for more than five days.<br/>
<a id="pl.10.13"></a><var>10.13</var>(c) The commissioner shall develop, and make available to license holders and <br/>
<a id="pl.10.14"></a><var>10.14</var>county licensing workers, a checklist of the data privacy provisions to be monitored <br/>
<a id="pl.10.15"></a><var>10.15</var>for purposes of licensure.<br/>
<br/>
<a id="bill.1.6.0"></a><a id="pl.10.16"></a><var>10.16</var>    Sec. 6. Minnesota Statutes 2008, section 245A.16, subdivision 1, is amended to read:<br/>
<a id="pl.10.17"></a><var>10.17</var>    Subdivision 1. <b>Delegation of authority to agencies.</b> (a) County agencies and <br/>
<a id="pl.10.18"></a><var>10.18</var>private agencies that have been designated or licensed by the commissioner to perform <br/>
<a id="pl.10.19"></a><var>10.19</var>licensing functions and activities under section 
         <statute_ref>245A.04</statute_ref> and background studies for <br/>
<a id="pl.10.20"></a><var>10.20</var>adult foster care, family adult day services, and family child care, under chapter 245C; to <br/>
<a id="pl.10.21"></a><var>10.21</var>recommend denial of applicants under section 
         <statute_ref>245A.05</statute_ref>; to issue correction orders, to issue <br/>
<a id="pl.10.22"></a><var>10.22</var>variances, and recommend a conditional license under section 
         <statute_ref>245A.06</statute_ref>, or to recommend <br/>
<a id="pl.10.23"></a><var>10.23</var>suspending or revoking a license or issuing a fine under section 
         <statute_ref>245A.07</statute_ref>, shall comply <br/>
<a id="pl.10.24"></a><var>10.24</var>with rules and directives of the commissioner governing those functions and with this <br/>
<a id="pl.10.25"></a><var>10.25</var>section. The following variances are excluded from the delegation of variance authority <br/>
<a id="pl.10.26"></a><var>10.26</var>and may be issued only by the commissioner:<br/>
<a id="pl.10.27"></a><var>10.27</var>    (1) dual licensure of family child care and child foster care, dual licensure of child <br/>
<a id="pl.10.28"></a><var>10.28</var>and adult foster care, and adult foster care and family child care;<br/>
<a id="pl.10.29"></a><var>10.29</var>    (2) adult foster care maximum capacity;<br/>
<a id="pl.10.30"></a><var>10.30</var>    (3) adult foster care minimum age requirement;<br/>
<a id="pl.10.31"></a><var>10.31</var>    (4) child foster care maximum age requirement;<br/>
<a id="pl.10.32"></a><var>10.32</var>    (5) variances regarding disqualified individuals except that county agencies may <br/>
<a id="pl.10.33"></a><var>10.33</var>issue variances under section 
         <statute_ref>245C.30</statute_ref> regarding disqualified individuals when the county <br/>
<a id="pl.10.34"></a><var>10.34</var>is responsible for conducting a consolidated reconsideration according to sections 
         <statute_ref>245C.25</statute_ref> <br/>
<a id="pl.11.1"></a><var>11.1</var>and 
         <statute_ref>245C.27, subdivision 2</statute_ref>, clauses (a) and (b), of a county maltreatment determination <br/>
<a id="pl.11.2"></a><var>11.2</var>and a disqualification based on serious or recurring maltreatment; and<br/>
<a id="pl.11.3"></a><var>11.3</var>    (6) the required presence of a caregiver in the adult foster care residence during <br/>
<a id="pl.11.4"></a><var>11.4</var>normal sleeping hours.<br/>
<a id="pl.11.5"></a><var>11.5</var>    (b) County agencies must report information about disqualification reconsiderations <br/>
<a id="pl.11.6"></a><var>11.6</var>under sections 
         <statute_ref>245C.25</statute_ref> and 
         <statute_ref>245C.27, subdivision 2</statute_ref>, paragraphs (a) and (b), and variances <br/>
<a id="pl.11.7"></a><var>11.7</var>granted under paragraph (a), clause (5), to the commissioner at least monthly in a format <br/>
<a id="pl.11.8"></a><var>11.8</var>prescribed by the commissioner.<br/>
<a id="pl.11.9"></a><var>11.9</var>    (c) For family day care programs, the commissioner may authorize licensing reviews <br/>
<a id="pl.11.10"></a><var>11.10</var>every two years after a licensee has had at least one annual review.<br/>
<a id="pl.11.11"></a><var>11.11</var>    (d) For family adult day services programs, the commissioner may authorize <br/>
<a id="pl.11.12"></a><var>11.12</var>licensing reviews every two years after a licensee has had at least one annual review.<br/>
<a id="pl.11.13"></a><var>11.13</var>    (e) A license issued under this section may be issued for up to two years.<br/>
<br/>
<a id="bill.1.7.0"></a><a id="pl.11.14"></a><var>11.14</var>    Sec. 7. Minnesota Statutes 2008, section 245A.16, subdivision 3, is amended to read:<br/>
<a id="pl.11.15"></a><var>11.15</var>    Subd. 3. <b>Recommendations to commissioner.</b> The county or private agency <br/>
<a id="pl.11.16"></a><var>11.16</var>shall not make recommendations to the commissioner regarding licensure without first <br/>
<a id="pl.11.17"></a><var>11.17</var>conducting an inspection, and for adult foster care, family adult day services, and family <br/>
<a id="pl.11.18"></a><var>11.18</var>child care, a background study of the applicant under chapter 245C. The county or private <br/>
<a id="pl.11.19"></a><var>11.19</var>agency must forward its recommendation to the commissioner regarding the appropriate <br/>
<a id="pl.11.20"></a><var>11.20</var>licensing action within 20 working days of receipt of a completed application.<br/>
<br/>
<a id="bill.1.8.0"></a><a id="pl.11.21"></a><var>11.21</var>    Sec. 8. Minnesota Statutes 2008, section 245C.04, subdivision 1, is amended to read:<br/>
<a id="pl.11.22"></a><var>11.22</var>    Subdivision 1. <b>Licensed programs.</b> (a) The commissioner shall conduct a <br/>
<a id="pl.11.23"></a><var>11.23</var>background study of an individual required to be studied under section 
         <statute_ref>245C.03, <br/>
<a id="pl.11.24"></a><var>11.24</var>subdivision 1
         </statute_ref>, at least upon application for initial license for all license types. <br/>
<a id="pl.11.25"></a><var>11.25</var>    (b) The commissioner shall conduct a background study of an individual required to <br/>
<a id="pl.11.26"></a><var>11.26</var>be studied under section 
         <statute_ref>245C.03, subdivision 1</statute_ref>, at reapplication for a license for adult <br/>
<a id="pl.11.27"></a><var>11.27</var>foster care, family adult day services, and family child care. <br/>
<a id="pl.11.28"></a><var>11.28</var>    (c) The commissioner is not required to conduct a study of an individual at the time <br/>
<a id="pl.11.29"></a><var>11.29</var>of reapplication for a license if the individual's background study was completed by the <br/>
<a id="pl.11.30"></a><var>11.30</var>commissioner of human services for an adult foster care license holder that is also:<br/>
<a id="pl.11.31"></a><var>11.31</var>    (1) registered under chapter 144D; or<br/>
<a id="pl.11.32"></a><var>11.32</var>    (2) licensed to provide home and community-based services to people with <br/>
<a id="pl.11.33"></a><var>11.33</var>disabilities at the foster care location and the license holder does not reside in the foster <br/>
<a id="pl.11.34"></a><var>11.34</var>care residence; and<br/>
<a id="pl.12.1"></a><var>12.1</var>    (3) the following conditions are met:<br/>
<a id="pl.12.2"></a><var>12.2</var>    (i) a study of the individual was conducted either at the time of initial licensure or <br/>
<a id="pl.12.3"></a><var>12.3</var>when the individual became affiliated with the license holder;<br/>
<a id="pl.12.4"></a><var>12.4</var>    (ii) the individual has been continuously affiliated with the license holder since <br/>
<a id="pl.12.5"></a><var>12.5</var>the last study was conducted; and<br/>
<a id="pl.12.6"></a><var>12.6</var>    (iii) the last study of the individual was conducted on or after October 1, 1995.<br/>
<a id="pl.12.7"></a><var>12.7</var>    (d) From July 1, 2007, to June 30, 2009, the commissioner of human services shall <br/>
<a id="pl.12.8"></a><var>12.8</var>conduct a study of an individual required to be studied under section 
         <statute_ref>245C.03</statute_ref>, at the <br/>
<a id="pl.12.9"></a><var>12.9</var>time of reapplication for a child foster care license. The county or private agency shall <br/>
<a id="pl.12.10"></a><var>12.10</var>collect and forward to the commissioner the information required under section 
         <statute_ref>245C.05</statute_ref>, <br/>
<a id="pl.12.11"></a><var>12.11</var>subdivisions 1, paragraphs (a) and (b), and 5, paragraphs (a) and (b). The background <br/>
<a id="pl.12.12"></a><var>12.12</var>study conducted by the commissioner of human services under this paragraph must <br/>
<a id="pl.12.13"></a><var>12.13</var>include a review of the information required under section 
         <statute_ref>245C.08, subdivisions 1</statute_ref>, <br/>
<a id="pl.12.14"></a><var>12.14</var>paragraph (a), clauses (1) to (5), 3, and 4.<br/>
<a id="pl.12.15"></a><var>12.15</var>    (e) The commissioner of human services shall conduct a background study of an <br/>
<a id="pl.12.16"></a><var>12.16</var>individual specified under section 
         <statute_ref>245C.03, subdivision 1</statute_ref>, paragraph (a), clauses (2) <br/>
<a id="pl.12.17"></a><var>12.17</var>to (6), who is newly affiliated with a child foster care license holder. The county or <br/>
<a id="pl.12.18"></a><var>12.18</var>private agency shall collect and forward to the commissioner the information required <br/>
<a id="pl.12.19"></a><var>12.19</var>under section 
         <statute_ref>245C.05, subdivisions 1</statute_ref> and 5. The background study conducted by the <br/>
<a id="pl.12.20"></a><var>12.20</var>commissioner of human services under this paragraph must include a review of the <br/>
<a id="pl.12.21"></a><var>12.21</var>information required under section 
         <statute_ref>245C.08, subdivisions 1</statute_ref>, 3, and 4.<br/>
<a id="pl.12.22"></a><var>12.22</var>    (f) From January 1, 2010, to December 31, 2012, unless otherwise specified in <br/>
<a id="pl.12.23"></a><var>12.23</var>paragraph (c), the commissioner shall conduct a study of an individual required to be <br/>
<a id="pl.12.24"></a><var>12.24</var>studied under section 245C.03 at the time of reapplication for an adult foster care or family <br/>
<a id="pl.12.25"></a><var>12.25</var>adult day services license: (1) the county shall collect and forward to the commissioner <br/>
<a id="pl.12.26"></a><var>12.26</var>the information required under section 245C.05, subdivision 1, paragraphs (a) and (b), <br/>
<a id="pl.12.27"></a><var>12.27</var>and subdivision 5, paragraphs (a) and (b), for background studies conducted by the <br/>
<a id="pl.12.28"></a><var>12.28</var>commissioner for adult foster care and family adult day services when the license holder <br/>
<a id="pl.12.29"></a><var>12.29</var>resides in the adult foster care or family adult day services residence; (2) the license <br/>
<a id="pl.12.30"></a><var>12.30</var>holder shall collect and forward to the commissioner the information required under <br/>
<a id="pl.12.31"></a><var>12.31</var>section 245C.05, subdivisions 1, paragraphs (a) and (b); and 5, paragraphs (a) and (b), <br/>
<a id="pl.12.32"></a><var>12.32</var>for background studies conducted by the commissioner for adult foster care when the <br/>
<a id="pl.12.33"></a><var>12.33</var>license holder does not reside in the adult foster care residence; and (3) the background <br/>
<a id="pl.12.34"></a><var>12.34</var>study conducted by the commissioner under this paragraph must include a review of the <br/>
<a id="pl.12.35"></a><var>12.35</var>information required under section 245C.08, subdivision 1, paragraph (a), clauses (1) <br/>
<a id="pl.12.36"></a><var>12.36</var>to (5), and subdivisions 3 and 4.<br/>
<a id="pl.13.1"></a><var>13.1</var>(g) The commissioner shall conduct a background study of an individual specified <br/>
<a id="pl.13.2"></a><var>13.2</var>under section 245C.03, subdivision 1, paragraph (a), clauses (2) to (6), who is newly <br/>
<a id="pl.13.3"></a><var>13.3</var>affiliated with an adult foster care or family adult day services license holder: (1) the <br/>
<a id="pl.13.4"></a><var>13.4</var>county shall collect and forward to the commissioner the information required under <br/>
<a id="pl.13.5"></a><var>13.5</var>section 245C.05, subdivision 1, paragraphs (a) and (b), and subdivision 5, paragraphs (a) <br/>
<a id="pl.13.6"></a><var>13.6</var>and (b), for background studies conducted by the commissioner for adult foster care <br/>
<a id="pl.13.7"></a><var>13.7</var>and family adult day services when the license holder resides in the adult foster care or <br/>
<a id="pl.13.8"></a><var>13.8</var>family adult day services residence; (2) the license holder shall collect and forward to the <br/>
<a id="pl.13.9"></a><var>13.9</var>commissioner the information required under section 245C.05, subdivisions 1, paragraphs <br/>
<a id="pl.13.10"></a><var>13.10</var>(a) and (b); and 5, paragraphs (a) and (b), for background studies conducted by the <br/>
<a id="pl.13.11"></a><var>13.11</var>commissioner for adult foster care when the license holder does not reside in the adult <br/>
<a id="pl.13.12"></a><var>13.12</var>foster care residence; and (3) the background study conducted by the commissioner under <br/>
<a id="pl.13.13"></a><var>13.13</var>this paragraph must include a review of the information required under section 245C.08, <br/>
<a id="pl.13.14"></a><var>13.14</var>subdivision 1, paragraph (a), and subdivisions 3 and 4.<br/>
<a id="pl.13.15"></a><var>13.15</var> (h) Applicants for licensure, license holders, and other entities as provided in this <br/>
<a id="pl.13.16"></a><var>13.16</var>chapter must submit completed background study forms to the commissioner before <br/>
<a id="pl.13.17"></a><var>13.17</var>individuals specified in section 
         <statute_ref>245C.03, subdivision 1</statute_ref>, begin positions allowing direct <br/>
<a id="pl.13.18"></a><var>13.18</var>contact in any licensed program. <br/>
<a id="pl.13.19"></a><var>13.19</var>    (g) (i)  For purposes of this section, a physician licensed under chapter 147 is <br/>
<a id="pl.13.20"></a><var>13.20</var>considered to be continuously affiliated upon the license holder's receipt from the <br/>
<a id="pl.13.21"></a><var>13.21</var>commissioner of health or human services of the physician's background study results.<br/>
<br/>
<a id="bill.1.9.0"></a><a id="pl.13.22"></a><var>13.22</var>    Sec. 9. Minnesota Statutes 2008, section 245C.05, is amended by adding a subdivision <br/>
<a id="pl.13.23"></a><var>13.23</var>to read:<br/>
<a id="pl.13.24"></a><var>13.24</var>    Subd. 2b. <b>County agency to collect and forward information to the </b><br/>
<a id="pl.13.25"></a><var>13.25</var><b>commissioner.</b> For background studies related to adult foster care and family adult <br/>
<a id="pl.13.26"></a><var>13.26</var>day services when the license holder resides in the adult foster care or family adult <br/>
<a id="pl.13.27"></a><var>13.27</var>day services residence, the county agency must collect the information required under <br/>
<a id="pl.13.28"></a><var>13.28</var>subdivision 1 and forward it to the commissioner.<br/>
<br/>
<a id="bill.1.10.0"></a><a id="pl.13.29"></a><var>13.29</var>    Sec. 10. Minnesota Statutes 2008, section 245C.05, subdivision 4, is amended to read:<br/>
<a id="pl.13.30"></a><var>13.30</var>    Subd. 4. <b>Electronic transmission.</b> For background studies conducted by the <br/>
<a id="pl.13.31"></a><var>13.31</var>Department of Human Services, the commissioner shall implement a system for the <br/>
<a id="pl.13.32"></a><var>13.32</var>electronic transmission of:<br/>
<a id="pl.13.33"></a><var>13.33</var>    (1) background study information to the commissioner; <br/>
<a id="pl.13.34"></a><var>13.34</var>    (2) background study results to the license holder; and<br/>
<a id="pl.14.1"></a><var>14.1</var>    (3) background study results to county and private agencies for background studies <br/>
<a id="pl.14.2"></a><var>14.2</var>conducted by the commissioner for child foster care; and<br/>
<a id="pl.14.3"></a><var>14.3</var>(4) background study results to county agencies for background studies conducted <br/>
<a id="pl.14.4"></a><var>14.4</var>by the commissioner for adult foster care and family adult day services.<br/>
<br/>
<a id="bill.1.11.0"></a><a id="pl.14.5"></a><var>14.5</var>    Sec. 11. Minnesota Statutes 2008, section 245C.08, subdivision 2, is amended to read:<br/>
<a id="pl.14.6"></a><var>14.6</var>    Subd. 2. <b>Background studies conducted by a county agency.</b> (a) For a background <br/>
<a id="pl.14.7"></a><var>14.7</var>study conducted by a county agency for adult foster care, family adult day services, and <br/>
<a id="pl.14.8"></a><var>14.8</var>family child care services, the commissioner shall review:<br/>
<a id="pl.14.9"></a><var>14.9</var>    (1) information from the county agency's record of substantiated maltreatment <br/>
<a id="pl.14.10"></a><var>14.10</var>of adults and the maltreatment of minors;<br/>
<a id="pl.14.11"></a><var>14.11</var>    (2) information from juvenile courts as required in subdivision 4 for individuals <br/>
<a id="pl.14.12"></a><var>14.12</var>listed in section 
         <statute_ref>245C.03, subdivision 1</statute_ref>, clauses (2), (5), and (6); and<br/>
<a id="pl.14.13"></a><var>14.13</var>    (3) information from the Bureau of Criminal Apprehension.<br/>
<a id="pl.14.14"></a><var>14.14</var>    (b) If the individual has resided in the county for less than five years, the study shall <br/>
<a id="pl.14.15"></a><var>14.15</var>include the records specified under paragraph (a) for the previous county or counties of <br/>
<a id="pl.14.16"></a><var>14.16</var>residence for the past five years.<br/>
<a id="pl.14.17"></a><var>14.17</var>    (c) Notwithstanding expungement by a court, the county agency may consider <br/>
<a id="pl.14.18"></a><var>14.18</var>information obtained under paragraph (a), clause (3), unless the commissioner received <br/>
<a id="pl.14.19"></a><var>14.19</var>notice of the petition for expungement and the court order for expungement is directed <br/>
<a id="pl.14.20"></a><var>14.20</var>specifically to the commissioner.<br/>
<br/>
<a id="bill.1.12.0"></a><a id="pl.14.21"></a><var>14.21</var>    Sec. 12. Minnesota Statutes 2008, section 245C.10, is amended by adding a <br/>
<a id="pl.14.22"></a><var>14.22</var>subdivision to read:<br/>
<a id="pl.14.23"></a><var>14.23</var>    Subd. 5. <b>Adult foster care services.</b> The commissioner shall recover the cost of <br/>
<a id="pl.14.24"></a><var>14.24</var>background studies required under section 245C.03, subdivision 1, for the purposes of <br/>
<a id="pl.14.25"></a><var>14.25</var>adult foster care and family adult day services licensing, through a fee of no more than <br/>
<a id="pl.14.26"></a><var>14.26</var>$20 per study charged to the license holder. The fees collected under this subdivision are <br/>
<a id="pl.14.27"></a><var>14.27</var>appropriated to the commissioner for the purpose of conducting background studies.<br/>
<br/>
<a id="bill.1.13.0"></a><a id="pl.14.28"></a><var>14.28</var>    Sec. 13. Minnesota Statutes 2008, section 245C.10, is amended by adding a <br/>
<a id="pl.14.29"></a><var>14.29</var>subdivision to read:<br/>
<a id="pl.14.30"></a><var>14.30</var>    Subd. 8. <b>Private agencies.</b> The commissioner shall recover the cost of conducting <br/>
<a id="pl.14.31"></a><var>14.31</var>background studies under section 245C.33 for studies initiated by private agencies for the <br/>
<a id="pl.14.32"></a><var>14.32</var>purpose of adoption through a fee of no more than $70 per study charged to the private <br/>
<a id="pl.15.1"></a><var>15.1</var>agency. The fees collected under this subdivision are appropriated to the commissioner for <br/>
<a id="pl.15.2"></a><var>15.2</var>the purpose of conducting background studies.<br/>
<br/>
<a id="bill.1.14.0"></a><a id="pl.15.3"></a><var>15.3</var>    Sec. 14. Minnesota Statutes 2008, section 245C.17, is amended by adding a <br/>
<a id="pl.15.4"></a><var>15.4</var>subdivision to read:<br/>
<a id="pl.15.5"></a><var>15.5</var>    Subd. 6. <b>Notice to county agency.</b> For studies on individuals related to a license <br/>
<a id="pl.15.6"></a><var>15.6</var>to provide adult foster care and family adult day services, the commissioner shall also <br/>
<a id="pl.15.7"></a><var>15.7</var>provide a notice of the background study results to the county agency that initiated the <br/>
<a id="pl.15.8"></a><var>15.8</var>background study.<br/>
<br/>
<a id="bill.1.15.0"></a><a id="pl.15.9"></a><var>15.9</var>    Sec. 15. Minnesota Statutes 2008, section 245C.20, is amended to read:<br/>
<a id="pl.15.10"></a><var>15.10</var><b>245C.20 LICENSE HOLDER RECORD KEEPING.</b><br/>
<a id="pl.15.11"></a><var>15.11</var>A licensed program shall document the date the program initiates a background <br/>
<a id="pl.15.12"></a><var>15.12</var>study under this chapter in the program's personnel files. When a background study is <br/>
<a id="pl.15.13"></a><var>15.13</var>completed under this chapter, a licensed program shall maintain a notice that the study <br/>
<a id="pl.15.14"></a><var>15.14</var>was undertaken and completed in the program's personnel files. Except when background <br/>
<a id="pl.15.15"></a><var>15.15</var>studies are initiated through the commissioner's online system, if a licensed program <br/>
<a id="pl.15.16"></a><var>15.16</var>has not received a response from the commissioner under section 
         <statute_ref>245C.17</statute_ref> within 45 <br/>
<a id="pl.15.17"></a><var>15.17</var>days of initiation of the background study request, the licensed program must contact the <br/>
<a id="pl.15.18"></a><var>15.18</var>commissioner human services licensing division to inquire about the status of the study.   If <br/>
<a id="pl.15.19"></a><var>15.19</var>a license holder initiates a background study under the commissioner's online system, but <br/>
<a id="pl.15.20"></a><var>15.20</var>the background study subject's name does not appear in the list of active or recent studies <br/>
<a id="pl.15.21"></a><var>15.21</var>initiated by that license holder, the license holder must either contact the human services <br/>
<a id="pl.15.22"></a><var>15.22</var>licensing division or resubmit the background study information online for that individual.<br/>
<br/>
<a id="bill.1.16.0"></a><a id="pl.15.23"></a><var>15.23</var>    Sec. 16. Minnesota Statutes 2008, section 245C.21, subdivision 1a, is amended to read:<br/>
<a id="pl.15.24"></a><var>15.24</var>    Subd. 1a. <b>Submission of reconsideration request </b><b>to county or private agency</b><b>.</b> (a) <br/>
<a id="pl.15.25"></a><var>15.25</var>For disqualifications related to studies conducted by county agencies for family child care, <br/>
<a id="pl.15.26"></a><var>15.26</var>and for disqualifications related to studies conducted by the commissioner for child foster <br/>
<a id="pl.15.27"></a><var>15.27</var>care, adult foster care, and family adult day services, the individual shall submit the request <br/>
<a id="pl.15.28"></a><var>15.28</var>for reconsideration to the county or private agency that initiated the background study.<br/>
<a id="pl.15.29"></a><var>15.29</var>    (b) For disqualifications related to studies conducted by the commissioner for child <br/>
<a id="pl.15.30"></a><var>15.30</var>foster care, the individual shall submit the request for reconsideration to the private agency <br/>
<a id="pl.15.31"></a><var>15.31</var>that initiated the background study.<br/>
<a id="pl.16.1"></a><var>16.1</var>(c) A reconsideration request shall be submitted within 30 days of the individual's <br/>
<a id="pl.16.2"></a><var>16.2</var>receipt of the disqualification notice or the time frames specified in subdivision 2, <br/>
<a id="pl.16.3"></a><var>16.3</var>whichever time frame is shorter.<br/>
<a id="pl.16.4"></a><var>16.4</var>    (c) (d)  The county or private agency shall forward the individual's request for <br/>
<a id="pl.16.5"></a><var>16.5</var>reconsideration and provide the commissioner with a recommendation whether to set aside <br/>
<a id="pl.16.6"></a><var>16.6</var>the individual's disqualification.<br/>
<br/>
<a id="bill.1.17.0"></a><a id="pl.16.7"></a><var>16.7</var>    Sec. 17. Minnesota Statutes 2008, section 245C.23, subdivision 2, is amended to read:<br/>
<a id="pl.16.8"></a><var>16.8</var>    Subd. 2. <b>Commissioner's notice of disqualification that is not set aside.</b> (a) The <br/>
<a id="pl.16.9"></a><var>16.9</var>commissioner shall notify the license holder of the disqualification and order the license <br/>
<a id="pl.16.10"></a><var>16.10</var>holder to immediately remove the individual from any position allowing direct contact <br/>
<a id="pl.16.11"></a><var>16.11</var>with persons receiving services from the license holder if:<br/>
<a id="pl.16.12"></a><var>16.12</var>    (1) the individual studied does not submit a timely request for reconsideration <br/>
<a id="pl.16.13"></a><var>16.13</var>under section 
         <statute_ref>245C.21</statute_ref>;<br/>
<a id="pl.16.14"></a><var>16.14</var>    (2) the individual submits a timely request for reconsideration, but the commissioner <br/>
<a id="pl.16.15"></a><var>16.15</var>does not set aside the disqualification for that license holder under section 
         <statute_ref>245C.22</statute_ref>;<br/>
<a id="pl.16.16"></a><var>16.16</var>    (3) an individual who has a right to request a hearing under sections 
         <statute_ref>245C.27</statute_ref> and <br/>
<statute_ref><a id="pl.16.17"></a><var>16.17</var>256.045
         </statute_ref>, or 
         <statute_ref>245C.28</statute_ref> and chapter 14 for a disqualification that has not been set aside, does <br/>
<a id="pl.16.18"></a><var>16.18</var>not request a hearing within the specified time; or<br/>
<a id="pl.16.19"></a><var>16.19</var>    (4) an individual submitted a timely request for a hearing under sections 
         <statute_ref>245C.27</statute_ref> <br/>
<a id="pl.16.20"></a><var>16.20</var>and 
         <statute_ref>256.045</statute_ref>, or 
         <statute_ref>245C.28</statute_ref> and chapter 14, but the commissioner does not set aside the <br/>
<a id="pl.16.21"></a><var>16.21</var>disqualification under section 
         <statute_ref>245A.08, subdivision 5</statute_ref>, or 
         <statute_ref>256.045</statute_ref>.<br/>
<a id="pl.16.22"></a><var>16.22</var>    (b) If the commissioner does not set aside the disqualification under section 
         <statute_ref>245C.22</statute_ref>, <br/>
<a id="pl.16.23"></a><var>16.23</var>and the license holder was previously ordered under section 
         <statute_ref>245C.17</statute_ref> to immediately <br/>
<a id="pl.16.24"></a><var>16.24</var>remove the disqualified individual from direct contact with persons receiving services or <br/>
<a id="pl.16.25"></a><var>16.25</var>to ensure that the individual is under continuous, direct supervision when providing direct <br/>
<a id="pl.16.26"></a><var>16.26</var>contact services, the order remains in effect pending the outcome of a hearing under <br/>
<a id="pl.16.27"></a><var>16.27</var>sections 
         <statute_ref>245C.27</statute_ref> and 
         <statute_ref>256.045</statute_ref>, or 
         <statute_ref>245C.28</statute_ref> and chapter 14.<br/>
<a id="pl.16.28"></a><var>16.28</var>    (c) For background studies related to child foster care, the commissioner shall <br/>
<a id="pl.16.29"></a><var>16.29</var>also notify the county or private agency that initiated the study of the results of the <br/>
<a id="pl.16.30"></a><var>16.30</var>reconsideration.<br/>
<a id="pl.16.31"></a><var>16.31</var>(d) For background studies related to adult foster care and family adult day services, <br/>
<a id="pl.16.32"></a><var>16.32</var>the commissioner shall also notify the county that initiated the study of the results of <br/>
<a id="pl.16.33"></a><var>16.33</var>the reconsideration.<br/>
<br/>
<a id="bill.1.18.0"></a><a id="pl.17.1"></a><var>17.1</var>    Sec. 18. Minnesota Statutes 2008, section 256B.092, is amended by adding a <br/>
<a id="pl.17.2"></a><var>17.2</var>subdivision to read:<br/>
<a id="pl.17.3"></a><var>17.3</var>    Subd. 5b. <b>Revised per diem based on legislated rate reduction.</b> Notwithstanding <br/>
<a id="pl.17.4"></a><var>17.4</var>section 252.28, subdivision 3, paragraph (d), if the 2009 legislature adopts a rate reduction <br/>
<a id="pl.17.5"></a><var>17.5</var>that impacts payment to providers of adult foster care services, the commissioner may <br/>
<a id="pl.17.6"></a><var>17.6</var>issue adult foster care licenses that permit a capacity of five adults. The application for a <br/>
<a id="pl.17.7"></a><var>17.7</var>five-bed license must meet the requirements of section 245A.11, subdivision 2a. Prior to <br/>
<a id="pl.17.8"></a><var>17.8</var>admission of the fifth recipient of adult foster care services, the county must negotiate a <br/>
<a id="pl.17.9"></a><var>17.9</var>revised per diem rate for room and board and waiver services that reflects the legislated <br/>
<a id="pl.17.10"></a><var>17.10</var>rate reduction and results in an overall average per diem reduction for all foster care <br/>
<a id="pl.17.11"></a><var>17.11</var>recipients in that home. The revised per diem must allow the provider to maintain, as <br/>
<a id="pl.17.12"></a><var>17.12</var>much as possible, the level of services or enhanced services provided in the residence, <br/>
<a id="pl.17.13"></a><var>17.13</var>while mitigating the losses of the legislated rate reduction.<br/>
<a id="pl.17.14"></a><var>17.14</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2009.<br/>
<br/>
<a id="bill.1.19.0"></a><a id="pl.17.15"></a><var>17.15</var>    Sec. 19. Minnesota Statutes 2008, section 256B.49, subdivision 17, is amended to read:<br/>
<a id="pl.17.16"></a><var>17.16</var>    Subd. 17. <b>Cost of services and supports.</b> (a) The commissioner shall ensure <br/>
<a id="pl.17.17"></a><var>17.17</var>that the average per capita expenditures estimated in any fiscal year for home and <br/>
<a id="pl.17.18"></a><var>17.18</var>community-based waiver recipients does not exceed the average per capita expenditures <br/>
<a id="pl.17.19"></a><var>17.19</var>that would have been made to provide institutional services for recipients in the absence <br/>
<a id="pl.17.20"></a><var>17.20</var>of the waiver.<br/>
<a id="pl.17.21"></a><var>17.21</var>(b) The commissioner shall implement on January 1, 2002, one or more aggregate, <br/>
<a id="pl.17.22"></a><var>17.22</var>need-based methods for allocating to local agencies the home and community-based <br/>
<a id="pl.17.23"></a><var>17.23</var>waivered service resources available to support recipients with disabilities in need of <br/>
<a id="pl.17.24"></a><var>17.24</var>the level of care provided in a nursing facility or a hospital. The commissioner shall <br/>
<a id="pl.17.25"></a><var>17.25</var>allocate resources to single counties and county partnerships in a manner that reflects <br/>
<a id="pl.17.26"></a><var>17.26</var>consideration of:<br/>
<a id="pl.17.27"></a><var>17.27</var>(1) an incentive-based payment process for achieving outcomes;<br/>
<a id="pl.17.28"></a><var>17.28</var>(2) the need for a state-level risk pool;<br/>
<a id="pl.17.29"></a><var>17.29</var>(3) the need for retention of management responsibility at the state agency level; and<br/>
<a id="pl.17.30"></a><var>17.30</var>(4) a phase-in strategy as appropriate.<br/>
<a id="pl.17.31"></a><var>17.31</var>(c) Until the allocation methods described in paragraph (b) are implemented, the <br/>
<a id="pl.17.32"></a><var>17.32</var>annual allowable reimbursement level of home and community-based waiver services <br/>
<a id="pl.17.33"></a><var>17.33</var>shall be the greater of:<br/>
<a id="pl.18.1"></a><var>18.1</var>(1) the statewide average payment amount which the recipient is assigned under the <br/>
<a id="pl.18.2"></a><var>18.2</var>waiver reimbursement system in place on June 30, 2001, modified by the percentage of <br/>
<a id="pl.18.3"></a><var>18.3</var>any provider rate increase appropriated for home and community-based services; or<br/>
<a id="pl.18.4"></a><var>18.4</var>(2) an amount approved by the commissioner based on the recipient's extraordinary <br/>
<a id="pl.18.5"></a><var>18.5</var>needs that cannot be met within the current allowable reimbursement level. The <br/>
<a id="pl.18.6"></a><var>18.6</var>increased reimbursement level must be necessary to allow the recipient to be discharged <br/>
<a id="pl.18.7"></a><var>18.7</var>from an institution or to prevent imminent placement in an institution. The additional <br/>
<a id="pl.18.8"></a><var>18.8</var>reimbursement may be used to secure environmental modifications; assistive technology <br/>
<a id="pl.18.9"></a><var>18.9</var>and equipment; and increased costs for supervision, training, and support services <br/>
<a id="pl.18.10"></a><var>18.10</var>necessary to address the recipient's extraordinary needs. The commissioner may approve <br/>
<a id="pl.18.11"></a><var>18.11</var>an increased reimbursement level for up to one year of the recipient's relocation from an <br/>
<a id="pl.18.12"></a><var>18.12</var>institution or up to six months of a determination that a current waiver recipient is at <br/>
<a id="pl.18.13"></a><var>18.13</var>imminent risk of being placed in an institution.<br/>
<a id="pl.18.14"></a><var>18.14</var>(d) Beginning July 1, 2001, medically necessary private duty nursing services will be <br/>
<a id="pl.18.15"></a><var>18.15</var>authorized under this section as complex and regular care according to sections 
         <statute_ref>256B.0651</statute_ref> <br/>
<a id="pl.18.16"></a><var>18.16</var>and 
         <statute_ref>256B.0653</statute_ref> to 
         <statute_ref>256B.0656</statute_ref>. The rate established by the commissioner for registered <br/>
<a id="pl.18.17"></a><var>18.17</var>nurse or licensed practical nurse services under any home and community-based waiver as <br/>
<a id="pl.18.18"></a><var>18.18</var>of January 1, 2001, shall not be reduced.<br/>
<a id="pl.18.19"></a><var>18.19</var>(e) Notwithstanding section 252.28, subdivision 3, paragraph (d), if the 2009 <br/>
<a id="pl.18.20"></a><var>18.20</var>legislature adopts a rate reduction that impacts payment to providers of adult foster care <br/>
<a id="pl.18.21"></a><var>18.21</var>services, the commissioner may issue adult foster care licenses that permit a capacity of <br/>
<a id="pl.18.22"></a><var>18.22</var>five adults. The application for a five-bed license must meet the requirements of section <br/>
<a id="pl.18.23"></a><var>18.23</var>245A.11, subdivision 2a. Prior to admission of the fifth recipient of adult foster care <br/>
<a id="pl.18.24"></a><var>18.24</var>services, the county must negotiate a revised per diem rate for room and board and waiver <br/>
<a id="pl.18.25"></a><var>18.25</var>services that reflects the legislated rate reduction and results in an overall average per <br/>
<a id="pl.18.26"></a><var>18.26</var>diem reduction for all foster care recipients in that home. The revised per diem must allow <br/>
<a id="pl.18.27"></a><var>18.27</var>the provider to maintain, as much as possible, the level of services or enhanced services <br/>
<a id="pl.18.28"></a><var>18.28</var>provided in the residence, while mitigating the losses of the legislated rate reduction.<br/>
<a id="pl.18.29"></a><var>18.29</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2009.<br/>
<br/>
<a id="bill.1.20.0"></a><a id="pl.18.30"></a><var>18.30</var>    Sec. 20. <b>WAIVER.</b><br/>
<a id="pl.18.31"></a><var>18.31</var>By December 1, 2009, the commissioner shall request all federal approvals and <br/>
<a id="pl.18.32"></a><var>18.32</var>waiver amendments to the disability home and community-based waivers to allow properly <br/>
<a id="pl.18.33"></a><var>18.33</var>licensed adult foster care homes to provide residential services for up to five individuals.<br/>
<a id="pl.18.34"></a><var>18.34</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2009.<br/>
<br/>
<a id="bill.1.21.0"></a><a id="pl.19.1"></a><var>19.1</var>    Sec. 21. <b> REPEALER.</b><br/>
<a id="pl.19.2"></a><var>19.2</var>(a) Minnesota Statutes 2008, section 245C.11, subdivisions 1 and 2, are repealed.<br/>
<a id="pl.19.3"></a><var>19.3</var>(b) Minnesota Statutes 2008, section 256B.092, subdivision 5a, is repealed effective <br/>
<a id="pl.19.4"></a><var>19.4</var>July 1, 2009.<br/>
<a id="pl.19.5"></a><var>19.5</var>(c) Minnesota Rules, part 9555.6125, subpart 4, item B, is repealed.<br/>
<br/>
<a id="bill.2.0.0"></a>

<a id="bill.2.1.0"></a><a id="pl.19.8"></a><var>19.8</var>    Section 1. Minnesota Statutes 2008, section 119B.09, subdivision 7, is amended to read:<br/>
<a id="pl.19.9"></a><var>19.9</var>    Subd. 7. <b>Date of eligibility for assistance.</b> (a) The date of eligibility for child <br/>
<a id="pl.19.10"></a><var>19.10</var>care assistance under this chapter is the later of the date the application was signed; the <br/>
<a id="pl.19.11"></a><var>19.11</var>beginning date of employment, education, or training; the date the infant is born for <br/>
<a id="pl.19.12"></a><var>19.12</var>applicants to the at-home infant care program; or the date a determination has been made <br/>
<a id="pl.19.13"></a><var>19.13</var>that the applicant is a participant in employment and training services under Minnesota <br/>
<a id="pl.19.14"></a><var>19.14</var>Rules, part 3400.0080, or chapter 256J.<br/>
<a id="pl.19.15"></a><var>19.15</var>    (b) Payment ceases for a family under the at-home infant child care program when a <br/>
<a id="pl.19.16"></a><var>19.16</var>family has used a total of 12 months of assistance as specified under section 
         <statute_ref>119B.035</statute_ref>. <br/>
<a id="pl.19.17"></a><var>19.17</var>Payment of child care assistance for employed persons on MFIP is effective the date of <br/>
<a id="pl.19.18"></a><var>19.18</var>employment or the date of MFIP eligibility, whichever is later. Payment of child care <br/>
<a id="pl.19.19"></a><var>19.19</var>assistance for MFIP or DWP participants in employment and training services is effective <br/>
<a id="pl.19.20"></a><var>19.20</var>the date of commencement of the services or the date of MFIP or DWP eligibility, <br/>
<a id="pl.19.21"></a><var>19.21</var>whichever is later. Payment of child care assistance for transition year child care must be <br/>
<a id="pl.19.22"></a><var>19.22</var>made retroactive to the date of eligibility for transition year child care. <br/>
<a id="pl.19.23"></a><var>19.23</var>(c) Notwithstanding paragraph (b), payment of child care assistance for participants <br/>
<a id="pl.19.24"></a><var>19.24</var>eligible under section 119B.05 may only be made retroactive for a maximum of six <br/>
<a id="pl.19.25"></a><var>19.25</var>months from the date of application for child care assistance.<br/>
<a id="pl.19.26"></a><var>19.26</var><b>EFFECTIVE DATE.</b>This section is effective October 1, 2009.<br/>
<br/>
<a id="bill.2.2.0"></a><a id="pl.19.27"></a><var>19.27</var>    Sec. 2. Minnesota Statutes 2008, section 119B.13, subdivision 6, is amended to read:<br/>
<a id="pl.19.28"></a><var>19.28</var>    Subd. 6. <b>Provider payments.</b> (a) Counties or the state shall make vendor payments <br/>
<a id="pl.19.29"></a><var>19.29</var>to the child care provider or pay the parent directly for eligible child care expenses.<br/>
<a id="pl.19.30"></a><var>19.30</var>(b) If payments for child care assistance are made to providers, the provider shall <br/>
<a id="pl.19.31"></a><var>19.31</var>bill the county for services provided within ten days of the end of the service period. If <br/>
<a id="pl.19.32"></a><var>19.32</var>bills are submitted within ten days of the end of the service period, a county or the state <br/>
<a id="pl.19.33"></a><var>19.33</var>shall issue payment to the provider of child care under the child care fund within 30 days <br/>
<a id="pl.20.1"></a><var>20.1</var>of receiving a bill from the provider. Counties or the state may establish policies that <br/>
<a id="pl.20.2"></a><var>20.2</var>make payments on a more frequent basis.<br/>
<a id="pl.20.3"></a><var>20.3</var>(c) All bills If a provider has received an authorization of care and been issued a <br/>
<a id="pl.20.4"></a><var>20.4</var>billing form for an eligible family, the bill must be submitted within 60 days of the last <br/>
<a id="pl.20.5"></a><var>20.5</var>date of service on the bill. A county may pay a bill submitted more than 60 days after <br/>
<a id="pl.20.6"></a><var>20.6</var>the last date of service if the provider shows good cause why the bill was not submitted <br/>
<a id="pl.20.7"></a><var>20.7</var>within 60 days. Good cause must be defined in the county's child care fund plan under <br/>
<a id="pl.20.8"></a><var>20.8</var>section 
         <statute_ref>119B.08, subdivision 3</statute_ref>, and the definition of good cause must include county <br/>
<a id="pl.20.9"></a><var>20.9</var>error. A county may not pay any bill submitted more than a year after the last date of <br/>
<a id="pl.20.10"></a><var>20.10</var>service on the bill. <br/>
<a id="pl.20.11"></a><var>20.11</var>(d) If a provider provided care for a time period without receiving an authorization <br/>
<a id="pl.20.12"></a><var>20.12</var>of care and a billing form for an eligible family, payment of child care assistance may only <br/>
<a id="pl.20.13"></a><var>20.13</var>be made retroactively for a maximum of six months from the date the provider is issued <br/>
<a id="pl.20.14"></a><var>20.14</var>an authorization of care and billing form.<br/>
<a id="pl.20.15"></a><var>20.15</var>(e) A county may stop payment issued to a provider or may refuse to pay a bill <br/>
<a id="pl.20.16"></a><var>20.16</var>submitted by a provider if:<br/>
<a id="pl.20.17"></a><var>20.17</var>(1) the provider admits to intentionally giving the county materially false information <br/>
<a id="pl.20.18"></a><var>20.18</var>on the provider's billing forms; or<br/>
<a id="pl.20.19"></a><var>20.19</var>(2) a county finds by a preponderance of the evidence that the provider intentionally <br/>
<a id="pl.20.20"></a><var>20.20</var>gave the county materially false information on the provider's billing forms.<br/>
<a id="pl.20.21"></a><var>20.21</var>(e) (f) A county's payment policies must be included in the county's child care plan <br/>
<a id="pl.20.22"></a><var>20.22</var>under section 
         <statute_ref>119B.08, subdivision 3</statute_ref>. If payments are made by the state, in addition to <br/>
<a id="pl.20.23"></a><var>20.23</var>being in compliance with this subdivision, the payments must be made in compliance <br/>
<a id="pl.20.24"></a><var>20.24</var>with section 
         <statute_ref>16A.124</statute_ref>. <br/>
<a id="pl.20.25"></a><var>20.25</var><b>EFFECTIVE DATE.</b>This section is effective October 1, 2009.<br/>
<br/>
<a id="bill.2.3.0"></a><a id="pl.20.26"></a><var>20.26</var>    Sec. 3. Minnesota Statutes 2008, section 119B.21, subdivision 5, is amended to read:<br/>
<a id="pl.20.27"></a><var>20.27</var>    Subd. 5. <b>Child care services grants.</b> (a) A child care resource and referral program <br/>
<a id="pl.20.28"></a><var>20.28</var>designated under section 
         <statute_ref>119B.19, subdivision 1a</statute_ref>, may award child care services grants <br/>
<a id="pl.20.29"></a><var>20.29</var>for: <br/>
<a id="pl.20.30"></a><var>20.30</var>    (1) creating new licensed child care facilities and expanding existing facilities, <br/>
<a id="pl.20.31"></a><var>20.31</var>including, but not limited to, supplies, equipment, facility renovation, and remodeling;<br/>
<a id="pl.20.32"></a><var>20.32</var>    (2) improving licensed child care facility programs;<br/>
<a id="pl.20.33"></a><var>20.33</var>    (3) staff training and development services including, but not limited to, in-service <br/>
<a id="pl.20.34"></a><var>20.34</var>training, curriculum development, accreditation, certification, consulting, resource <br/>
<a id="pl.21.1"></a><var>21.1</var>centers, program and resource materials, supporting effective teacher-child interactions, <br/>
<a id="pl.21.2"></a><var>21.2</var>child-focused teaching, and content-driven classroom instruction;<br/>
<a id="pl.21.3"></a><var>21.3</var>    (4) interim financing;<br/>
<a id="pl.21.4"></a><var>21.4</var>    (5) capacity building through the purchase of appropriate technology to create, <br/>
<a id="pl.21.5"></a><var>21.5</var>enhance, and maintain business management systems;<br/>
<a id="pl.21.6"></a><var>21.6</var>    (6) emergency assistance for child care programs;<br/>
<a id="pl.21.7"></a><var>21.7</var>    (7) new programs or projects for the creation, expansion, or improvement of <br/>
<a id="pl.21.8"></a><var>21.8</var>programs that serve ethnic immigrant and refugee communities; and<br/>
<a id="pl.21.9"></a><var>21.9</var>    (8) targeted recruitment initiatives to expand and build the capacity of the child <br/>
<a id="pl.21.10"></a><var>21.10</var>care system and to improve the quality of care provided by legal nonlicensed child care <br/>
<a id="pl.21.11"></a><var>21.11</var>providers.<br/>
<a id="pl.21.12"></a><var>21.12</var>    (b) A child care resource and referral program designated under section 
         <statute_ref>119B.19, <br/>
<a id="pl.21.13"></a><var>21.13</var>subdivision 1a
         </statute_ref>, may award child care services grants to: <br/>
<a id="pl.21.14"></a><var>21.14</var>    (1) licensed providers;<br/>
<a id="pl.21.15"></a><var>21.15</var>    (2) providers in the process of being licensed;<br/>
<a id="pl.21.16"></a><var>21.16</var>    (3) corporations or public agencies that develop or provide child care services;<br/>
<a id="pl.21.17"></a><var>21.17</var>    (4) school-age care programs;<br/>
<a id="pl.21.18"></a><var>21.18</var>    (5) legal nonlicensed or family, friend, and neighbor care providers; or<br/>
<a id="pl.21.19"></a><var>21.19</var>    (6) any combination of clauses (1) to (5).<br/>
<a id="pl.21.20"></a><var>21.20</var>    (c) A recipient of a child care services grant for facility improvements, interim <br/>
<a id="pl.21.21"></a><var>21.21</var>financing, or staff training and development must provide a 25 percent local match.<br/>
<a id="pl.21.22"></a><var>21.22</var>(d) Beginning July 1, 2009, grants under this subdivision shall be increasingly <br/>
<a id="pl.21.23"></a><var>21.23</var>awarded for activities that improve provider quality, including activities under paragraph <br/>
<a id="pl.21.24"></a><var>21.24</var>(a), clauses (1) to (3) and (7).<br/>
<br/>
<a id="bill.2.4.0"></a><a id="pl.21.25"></a><var>21.25</var>    Sec. 4. Minnesota Statutes 2008, section 119B.21, subdivision 10, is amended to read:<br/>
<a id="pl.21.26"></a><var>21.26</var>    Subd. 10. <b>Family child care technical assistance grants.</b> (a) A child care resource <br/>
<a id="pl.21.27"></a><var>21.27</var>and referral organization designated under section 
         <statute_ref>119B.19, subdivision 1a</statute_ref>, may award <br/>
<a id="pl.21.28"></a><var>21.28</var>technical assistance grants of up to $1,000. These grants may be used for: <br/>
<a id="pl.21.29"></a><var>21.29</var>    (1) facility improvements, including, but not limited to, improvements to meet <br/>
<a id="pl.21.30"></a><var>21.30</var>licensing requirements;<br/>
<a id="pl.21.31"></a><var>21.31</var>    (2) improvements to expand a child care facility or program;<br/>
<a id="pl.21.32"></a><var>21.32</var>    (3) toys, materials, and equipment to improve the learning environment;<br/>
<a id="pl.21.33"></a><var>21.33</var>    (4) technology and software to create, enhance, and maintain business management <br/>
<a id="pl.21.34"></a><var>21.34</var>systems;<br/>
<a id="pl.21.35"></a><var>21.35</var>    (5) start-up costs;<br/>
<a id="pl.22.1"></a><var>22.1</var>    (6) staff training and development; and<br/>
<a id="pl.22.2"></a><var>22.2</var>    (7) other uses approved by the commissioner.<br/>
<a id="pl.22.3"></a><var>22.3</var>    (b) A child care resource and referral program may award family child care technical <br/>
<a id="pl.22.4"></a><var>22.4</var>assistance grants to:<br/>
<a id="pl.22.5"></a><var>22.5</var>    (1) licensed family child care providers; <br/>
<a id="pl.22.6"></a><var>22.6</var>    (2) child care providers in the process of becoming licensed; or<br/>
<a id="pl.22.7"></a><var>22.7</var>    (3) legal nonlicensed or family, friend, and neighbor care providers.<br/>
<a id="pl.22.8"></a><var>22.8</var>    (c) A local match is not required for a family child care technical assistance grant.<br/>
<a id="pl.22.9"></a><var>22.9</var>(d) Beginning July 1, 2009, grants under this subdivision shall be increasingly <br/>
<a id="pl.22.10"></a><var>22.10</var>awarded for activities that improve provider quality, including activities under paragraph <br/>
<a id="pl.22.11"></a><var>22.11</var>(a), clauses (1), (3), and (6).<br/>
<br/>
<a id="bill.2.5.0"></a><a id="pl.22.12"></a><var>22.12</var>    Sec. 5. Minnesota Statutes 2008, section 119B.231, subdivision 2, is amended to read:<br/>
<a id="pl.22.13"></a><var>22.13</var>    Subd. 2. <b>Provider eligibility.</b> (a) To be considered for an SRSA, a provider shall <br/>
<a id="pl.22.14"></a><var>22.14</var>apply to the commissioner or have been chosen as an SRSA provider prior to June 30, <br/>
<a id="pl.22.15"></a><var>22.15</var>2009, and have complied with all requirements of the SRSA agreement. Priority for funds <br/>
<a id="pl.22.16"></a><var>22.16</var>is given to providers who had agreements prior to June 30, 2009. If sufficient funds are <br/>
<a id="pl.22.17"></a><var>22.17</var>available, the commissioner shall make applications available to additional providers. To <br/>
<a id="pl.22.18"></a><var>22.18</var>be eligible to apply for an SRSA, a provider shall:<br/>
<a id="pl.22.19"></a><var>22.19</var>    (1) be eligible for child care assistance payments under chapter 119B;<br/>
<a id="pl.22.20"></a><var>22.20</var>    (2) have at least 25 percent of the children enrolled with the provider subsidized <br/>
<a id="pl.22.21"></a><var>22.21</var>through the child care assistance program;<br/>
<a id="pl.22.22"></a><var>22.22</var>    (3) provide full-time, full-year child care services; and<br/>
<a id="pl.22.23"></a><var>22.23</var>    (4) serve at least one child who is subsidized through the child care assistance <br/>
<a id="pl.22.24"></a><var>22.24</var>program and who is expected to enter kindergarten within the following 30 months have <br/>
<a id="pl.22.25"></a><var>22.25</var>obtained a level 3 or 4 star rating under the voluntary Parent Aware quality rating system.<br/>
<a id="pl.22.26"></a><var>22.26</var>    (b) The commissioner may waive the 25 percent requirement in paragraph (a), <br/>
<a id="pl.22.27"></a><var>22.27</var>clause (2), if necessary to achieve geographic distribution of SRSA providers and diversity <br/>
<a id="pl.22.28"></a><var>22.28</var>of types of care provided by SRSA providers.<br/>
<a id="pl.22.29"></a><var>22.29</var>    (c) An eligible provider who would like to enter into an SRSA with the commissioner <br/>
<a id="pl.22.30"></a><var>22.30</var>shall submit an SRSA application. To determine whether to enter into an SRSA with a <br/>
<a id="pl.22.31"></a><var>22.31</var>provider, the commissioner shall evaluate the following factors:<br/>
<a id="pl.22.32"></a><var>22.32</var>    (1) the qualifications of the provider and the provider's staff provider's Parent <br/>
<a id="pl.22.33"></a><var>22.33</var>Aware rating score;<br/>
<a id="pl.22.34"></a><var>22.34</var>    (2) the provider's staff-child ratios;<br/>
<a id="pl.22.35"></a><var>22.35</var>    (3) the provider's curriculum;<br/>
<a id="pl.23.1"></a><var>23.1</var>    (4) the provider's current or planned parent education activities;<br/>
<a id="pl.23.2"></a><var>23.2</var>    (5) (2) the provider's current or planned social service and employment linkages;<br/>
<a id="pl.23.3"></a><var>23.3</var>    (6) the provider's child development assessment plan;<br/>
<a id="pl.23.4"></a><var>23.4</var>    (7) (3) the geographic distribution needed for SRSA providers;<br/>
<a id="pl.23.5"></a><var>23.5</var>    (8) (4) the inclusion of a variety of child care delivery models; and<br/>
<a id="pl.23.6"></a><var>23.6</var>    (9) (5) other related factors determined by the commissioner.<br/>
<br/>
<a id="bill.2.6.0"></a><a id="pl.23.7"></a><var>23.7</var>    Sec. 6. Minnesota Statutes 2008, section 119B.231, subdivision 3, is amended to read:<br/>
<a id="pl.23.8"></a><var>23.8</var>    Subd. 3. <b>Family and child eligibility.</b> (a) A family eligible to choose an SRSA <br/>
<a id="pl.23.9"></a><var>23.9</var>provider for their children shall:<br/>
<a id="pl.23.10"></a><var>23.10</var>    (1) be eligible to receive child care assistance under any provision in chapter 119B <br/>
<a id="pl.23.11"></a><var>23.11</var>except section 
         <statute_ref>119B.035</statute_ref>;<br/>
<a id="pl.23.12"></a><var>23.12</var>    (2) be in an authorized activity for an average of at least 35 hours per week when <br/>
<a id="pl.23.13"></a><var>23.13</var>initial eligibility is determined; and<br/>
<a id="pl.23.14"></a><var>23.14</var>    (3) include a child who has not yet entered kindergarten.<br/>
<a id="pl.23.15"></a><var>23.15</var>    (b) A family who is determined to be eligible to choose an SRSA provider remains <br/>
<a id="pl.23.16"></a><var>23.16</var>eligible to be paid at a higher rate through the SRSA provider when the following <br/>
<a id="pl.23.17"></a><var>23.17</var>conditions exist:<br/>
<a id="pl.23.18"></a><var>23.18</var>    (1) the child attends child care with the SRSA provider a minimum of 25 hours per <br/>
<a id="pl.23.19"></a><var>23.19</var>week, on average;<br/>
<a id="pl.23.20"></a><var>23.20</var>    (2) the family has a child who has not yet entered kindergarten; and<br/>
<a id="pl.23.21"></a><var>23.21</var>    (3) the family maintains eligibility under chapter 119B except section 
         <statute_ref>119B.035</statute_ref>.<br/>
<a id="pl.23.22"></a><var>23.22</var>    (c) For the 12 months After initial eligibility has been determined, a decrease in the <br/>
<a id="pl.23.23"></a><var>23.23</var>family's authorized activities to an average of less than 35 hours per week does not result <br/>
<a id="pl.23.24"></a><var>23.24</var>in ineligibility for the SRSA rate. A family must continue to maintain eligibility under this <br/>
<a id="pl.23.25"></a><var>23.25</var>chapter and be in an authorized activity.<br/>
<a id="pl.23.26"></a><var>23.26</var>    (d) A family that moves between counties but continues to use the same SRSA <br/>
<a id="pl.23.27"></a><var>23.27</var>provider shall continue to receive SRSA funding for the increased payments.<br/>
<br/>
<a id="bill.2.7.0"></a><a id="pl.23.28"></a><var>23.28</var>    Sec. 7. Minnesota Statutes 2008, section 119B.231, subdivision 4, is amended to read:<br/>
<a id="pl.23.29"></a><var>23.29</var>    Subd. 4. <b>Requirements of providers.</b> An SRSA must include assessment, <br/>
<a id="pl.23.30"></a><var>23.30</var>evaluation, and reporting requirements that promote the goals of improved school <br/>
<a id="pl.23.31"></a><var>23.31</var>readiness and movement toward appropriate child development milestones. A provider <br/>
<a id="pl.23.32"></a><var>23.32</var>who enters into an SRSA shall comply with all SRSA requirements, including the <br/>
<a id="pl.23.33"></a><var>23.33</var>assessment, evaluation, and reporting requirements in the SRSA. Providers who have been <br/>
<a id="pl.23.34"></a><var>23.34</var>selected previously for SRSAs must begin the process to obtain a rating using Parent <br/>
<a id="pl.24.1"></a><var>24.1</var>Aware according to timelines established by the commissioner. If the initial Parent Aware <br/>
<a id="pl.24.2"></a><var>24.2</var>rating is less than three stars, the provider must submit a plan to improve the rating. If <br/>
<a id="pl.24.3"></a><var>24.3</var>a 3 or 4 star rating is not obtained within established timelines, the commissioner may <br/>
<a id="pl.24.4"></a><var>24.4</var>consider continuation of the agreement, depending upon the progress made and other <br/>
<a id="pl.24.5"></a><var>24.5</var>factors. Providers who apply and are selected for a new SRSA agreement on or after July <br/>
<a id="pl.24.6"></a><var>24.6</var>1, 2009, must have a level 3 or 4 star rating under the voluntary Parent Aware quality <br/>
<a id="pl.24.7"></a><var>24.7</var>rating system at the time the SRSA agreement is signed.<br/>
<br/>
<a id="bill.2.8.0"></a><a id="pl.24.8"></a><var>24.8</var>    Sec. 8. Minnesota Statutes 2008, section 145A.17, is amended by adding a subdivision <br/>
<a id="pl.24.9"></a><var>24.9</var>to read:<br/>
<a id="pl.24.10"></a><var>24.10</var>    Subd. 4a. <b>Home visitors as MFIP employment and training service providers.</b><br/>
<a id="pl.24.11"></a><var>24.11</var>The county social service agency and the local public health department may mutually <br/>
<a id="pl.24.12"></a><var>24.12</var>agree to utilize home visitors under this section as MFIP employment and training service <br/>
<a id="pl.24.13"></a><var>24.13</var>providers under section 256J.49, subdivision 4, for MFIP participants who are: (1) ill or <br/>
<a id="pl.24.14"></a><var>24.14</var>incapacitated under section 256J.425, subdivision 2; or (2) minor caregivers under section <br/>
<a id="pl.24.15"></a><var>24.15</var>256J.54. The county social service agency and the local public health department may <br/>
<a id="pl.24.16"></a><var>24.16</var>also mutually agree to utilize home visitors to provide outreach to MFIP families who are <br/>
<a id="pl.24.17"></a><var>24.17</var>being sanctioned or who have been terminated from MFIP due to the 60-month time limit.<br/>
<br/>
<a id="bill.2.9.0"></a><a id="pl.24.18"></a><var>24.18</var>    Sec. 9. Minnesota Statutes 2008, section 256.045, subdivision 3, is amended to read:<br/>
<a id="pl.24.19"></a><var>24.19</var>    Subd. 3. <b>State agency hearings.</b> (a) State agency hearings are available for the <br/>
<a id="pl.24.20"></a><var>24.20</var>following: <br/>
<a id="pl.24.21"></a><var>24.21</var>    (1) any person applying for, receiving or having received public assistance, medical <br/>
<a id="pl.24.22"></a><var>24.22</var>care, or a program of social services granted by the state agency or a county agency or <br/>
<a id="pl.24.23"></a><var>24.23</var>the federal Food Stamp Act whose application for assistance is denied, not acted upon <br/>
<a id="pl.24.24"></a><var>24.24</var>with reasonable promptness, or whose assistance is suspended, reduced, terminated, or <br/>
<a id="pl.24.25"></a><var>24.25</var>claimed to have been incorrectly paid;<br/>
<a id="pl.24.26"></a><var>24.26</var>    (2) any patient or relative aggrieved by an order of the commissioner under section <br/>
<statute_ref><a id="pl.24.27"></a><var>24.27</var>252.27
         </statute_ref>; <br/>
<a id="pl.24.28"></a><var>24.28</var>    (3) a party aggrieved by a ruling of a prepaid health plan;<br/>
<a id="pl.24.29"></a><var>24.29</var>    (4) except as provided under chapter 245C, any individual or facility determined by <br/>
<a id="pl.24.30"></a><var>24.30</var>a lead agency to have maltreated a vulnerable adult under section 
         <statute_ref>626.557</statute_ref> after they have <br/>
<a id="pl.24.31"></a><var>24.31</var>exercised their right to administrative reconsideration under section 
         <statute_ref>626.557</statute_ref>;<br/>
<a id="pl.24.32"></a><var>24.32</var>    (5) any person whose claim for foster care payment according to a placement of the <br/>
<a id="pl.24.33"></a><var>24.33</var>child resulting from a child protection assessment under section 
         <statute_ref>626.556</statute_ref> is denied or not <br/>
<a id="pl.24.34"></a><var>24.34</var>acted upon with reasonable promptness, regardless of funding source;<br/>
<a id="pl.25.1"></a><var>25.1</var>    (6) any person to whom a right of appeal according to this section is given by other <br/>
<a id="pl.25.2"></a><var>25.2</var>provision of law;<br/>
<a id="pl.25.3"></a><var>25.3</var>    (7) an applicant aggrieved by an adverse decision to an application for a hardship <br/>
<a id="pl.25.4"></a><var>25.4</var>waiver under section 
         <statute_ref>256B.15</statute_ref>;<br/>
<a id="pl.25.5"></a><var>25.5</var>    (8) an applicant aggrieved by an adverse decision to an application or redetermination <br/>
<a id="pl.25.6"></a><var>25.6</var>for a Medicare Part D prescription drug subsidy under section 
         <statute_ref>256B.04, subdivision 4a</statute_ref>; <br/>
<a id="pl.25.7"></a><var>25.7</var>    (9) except as provided under chapter 245A, an individual or facility determined <br/>
<a id="pl.25.8"></a><var>25.8</var>to have maltreated a minor under section 
         <statute_ref>626.556</statute_ref>, after the individual or facility has <br/>
<a id="pl.25.9"></a><var>25.9</var>exercised the right to administrative reconsideration under section 
         <statute_ref>626.556</statute_ref>; or <br/>
<a id="pl.25.10"></a><var>25.10</var>    (10) except as provided under chapter 245C, an individual disqualified under sections <br/>
<statute_ref><a id="pl.25.11"></a><var>25.11</var>245C.14
         </statute_ref> and 
         <statute_ref>245C.15</statute_ref>, on the basis of serious or recurring maltreatment; a preponderance <br/>
<a id="pl.25.12"></a><var>25.12</var>of the evidence that the individual has committed an act or acts that meet the definition <br/>
<a id="pl.25.13"></a><var>25.13</var>of any of the crimes listed in section 
         <statute_ref>245C.15, subdivisions 1 to 4</statute_ref>; or for failing to make <br/>
<a id="pl.25.14"></a><var>25.14</var>reports required under section 
         <statute_ref>626.556, subdivision 3</statute_ref>, or 
         <statute_ref>626.557, subdivision 3</statute_ref>. Hearings <br/>
<a id="pl.25.15"></a><var>25.15</var>regarding a maltreatment determination under clause (4) or (9) and a disqualification under <br/>
<a id="pl.25.16"></a><var>25.16</var>this clause in which the basis for a disqualification is serious or recurring maltreatment, <br/>
<a id="pl.25.17"></a><var>25.17</var>which has not been set aside under sections 
         <statute_ref>245C.22</statute_ref> and 
         <statute_ref>245C.23</statute_ref>, shall be consolidated <br/>
<a id="pl.25.18"></a><var>25.18</var>into a single fair hearing. In such cases, the scope of review by the human services referee <br/>
<a id="pl.25.19"></a><var>25.19</var>shall include both the maltreatment determination and the disqualification. The failure to <br/>
<a id="pl.25.20"></a><var>25.20</var>exercise the right to an administrative reconsideration shall not be a bar to a hearing under <br/>
<a id="pl.25.21"></a><var>25.21</var>this section if federal law provides an individual the right to a hearing to dispute a finding <br/>
<a id="pl.25.22"></a><var>25.22</var>of maltreatment. Individuals and organizations specified in this section may contest the <br/>
<a id="pl.25.23"></a><var>25.23</var>specified action, decision, or final disposition before the state agency by submitting a <br/>
<a id="pl.25.24"></a><var>25.24</var>written request for a hearing to the state agency within 30 days after receiving written <br/>
<a id="pl.25.25"></a><var>25.25</var>notice of the action, decision, or final disposition, or within 90 days of such written notice <br/>
<a id="pl.25.26"></a><var>25.26</var>if the applicant, recipient, patient, or relative shows good cause why the request was not <br/>
<a id="pl.25.27"></a><var>25.27</var>submitted within the 30-day time limit.; or<br/>
<a id="pl.25.28"></a><var>25.28</var>    (11) any person with an outstanding debt resulting from receipt of public assistance, <br/>
<a id="pl.25.29"></a><var>25.29</var>medical care, or the federal Food Stamp Act who is contesting a setoff claim by the <br/>
<a id="pl.25.30"></a><var>25.30</var>Department of Human Services or a county agency. The scope of the appeal is the validity <br/>
<a id="pl.25.31"></a><var>25.31</var>of the claimant agency's intention to request a setoff of a refund under chapter 270A <br/>
<a id="pl.25.32"></a><var>25.32</var>against the debt.<br/>
<a id="pl.25.33"></a><var>25.33</var>    (b) The hearing for an individual or facility under paragraph (a), clause (4), (9), or <br/>
<a id="pl.25.34"></a><var>25.34</var>(10), is the only administrative appeal to the final agency determination specifically, <br/>
<a id="pl.25.35"></a><var>25.35</var>including a challenge to the accuracy and completeness of data under section 
         <statute_ref>13.04</statute_ref>. <br/>
<a id="pl.25.36"></a><var>25.36</var>Hearings requested under paragraph (a), clause (4), apply only to incidents of maltreatment <br/>
<a id="pl.26.1"></a><var>26.1</var>that occur on or after October 1, 1995. Hearings requested by nursing assistants in nursing <br/>
<a id="pl.26.2"></a><var>26.2</var>homes alleged to have maltreated a resident prior to October 1, 1995, shall be held as a <br/>
<a id="pl.26.3"></a><var>26.3</var>contested case proceeding under the provisions of chapter 14. Hearings requested under <br/>
<a id="pl.26.4"></a><var>26.4</var>paragraph (a), clause (9), apply only to incidents of maltreatment that occur on or after <br/>
<a id="pl.26.5"></a><var>26.5</var>July 1, 1997. A hearing for an individual or facility under paragraph (a), clause (9), is <br/>
<a id="pl.26.6"></a><var>26.6</var>only available when there is no juvenile court or adult criminal action pending. If such <br/>
<a id="pl.26.7"></a><var>26.7</var>action is filed in either court while an administrative review is pending, the administrative <br/>
<a id="pl.26.8"></a><var>26.8</var>review must be suspended until the judicial actions are completed. If the juvenile court <br/>
<a id="pl.26.9"></a><var>26.9</var>action or criminal charge is dismissed or the criminal action overturned, the matter may be <br/>
<a id="pl.26.10"></a><var>26.10</var>considered in an administrative hearing.<br/>
<a id="pl.26.11"></a><var>26.11</var>    (c) For purposes of this section, bargaining unit grievance procedures are not an <br/>
<a id="pl.26.12"></a><var>26.12</var>administrative appeal.<br/>
<a id="pl.26.13"></a><var>26.13</var>    (d) The scope of hearings involving claims to foster care payments under paragraph <br/>
<a id="pl.26.14"></a><var>26.14</var>(a), clause (5), shall be limited to the issue of whether the county is legally responsible <br/>
<a id="pl.26.15"></a><var>26.15</var>for a child's placement under court order or voluntary placement agreement and, if so, <br/>
<a id="pl.26.16"></a><var>26.16</var>the correct amount of foster care payment to be made on the child's behalf and shall not <br/>
<a id="pl.26.17"></a><var>26.17</var>include review of the propriety of the county's child protection determination or child <br/>
<a id="pl.26.18"></a><var>26.18</var>placement decision.<br/>
<a id="pl.26.19"></a><var>26.19</var>    (e) A vendor of medical care as defined in section 
         <statute_ref>256B.02, subdivision 7</statute_ref>, or a <br/>
<a id="pl.26.20"></a><var>26.20</var>vendor under contract with a county agency to provide social services is not a party and <br/>
<a id="pl.26.21"></a><var>26.21</var>may not request a hearing under this section, except if assisting a recipient as provided in <br/>
<a id="pl.26.22"></a><var>26.22</var>subdivision 4.<br/>
<a id="pl.26.23"></a><var>26.23</var>    (f) An applicant or recipient is not entitled to receive social services beyond the <br/>
<a id="pl.26.24"></a><var>26.24</var>services prescribed under chapter 256M or other social services the person is eligible <br/>
<a id="pl.26.25"></a><var>26.25</var>for under state law.<br/>
<a id="pl.26.26"></a><var>26.26</var>    (g) The commissioner may summarily affirm the county or state agency's proposed <br/>
<a id="pl.26.27"></a><var>26.27</var>action without a hearing when the sole issue is an automatic change due to a change in <br/>
<a id="pl.26.28"></a><var>26.28</var>state or federal law.<br/>
<br/>
<a id="bill.2.10.0"></a><a id="pl.26.29"></a><var>26.29</var>    Sec. 10. Minnesota Statutes 2008, section 256.983, subdivision 1, is amended to read:<br/>
<a id="pl.26.30"></a><var>26.30</var>    Subdivision 1. <b>Programs established.</b> Within the limits of available appropriations, <br/>
<a id="pl.26.31"></a><var>26.31</var>the commissioner of human services shall require the maintenance of budget neutral <br/>
<a id="pl.26.32"></a><var>26.32</var>fraud prevention investigation programs in the counties participating in the fraud <br/>
<a id="pl.26.33"></a><var>26.33</var>prevention investigation project established under this section. If funds are sufficient, <br/>
<a id="pl.26.34"></a><var>26.34</var>the commissioner may also extend fraud prevention investigation programs to other <br/>
<a id="pl.26.35"></a><var>26.35</var>counties provided the expansion is budget neutral to the state. Under any expansion, the <br/>
<a id="pl.27.1"></a><var>27.1</var>commissioner has the final authority in decisions regarding the creation and realignment <br/>
<a id="pl.27.2"></a><var>27.2</var>of individual county or regional operations.<br/>
<br/>
<a id="bill.2.11.0"></a><a id="pl.27.3"></a><var>27.3</var>    Sec. 11. Minnesota Statutes 2008, section 256I.03, subdivision 7, is amended to read:<br/>
<a id="pl.27.4"></a><var>27.4</var>    Subd. 7. <b>Countable income.</b> "Countable income" means all income received by an <br/>
<a id="pl.27.5"></a><var>27.5</var>applicant or recipient less any applicable exclusions or disregards. For a recipient of any <br/>
<a id="pl.27.6"></a><var>27.6</var>cash benefit from the SSI program, countable income means the SSI benefit limit in effect <br/>
<a id="pl.27.7"></a><var>27.7</var>at the time the person is in a GRH setting less $20, less the medical assistance personal <br/>
<a id="pl.27.8"></a><var>27.8</var>needs allowance. If the SSI limit has been reduced for a person due to events occurring <br/>
<a id="pl.27.9"></a><var>27.9</var>prior to the persons entering the GRH setting, countable income means actual income less <br/>
<a id="pl.27.10"></a><var>27.10</var>any applicable exclusions and disregards.<br/>
<a id="pl.27.11"></a><var>27.11</var><b>EFFECTIVE DATE.</b>This section is effective April 1, 2010.<br/>
<br/>
<a id="bill.2.12.0"></a><a id="pl.27.12"></a><var>27.12</var>    Sec. 12. Minnesota Statutes 2008, section 256I.05, subdivision 7c, is amended to read:<br/>
<a id="pl.27.13"></a><var>27.13</var>    Subd. 7c. <b>Demonstration project.</b> The commissioner is authorized to pursue the <br/>
<a id="pl.27.14"></a><var>27.14</var>expansion of a demonstration project under federal food stamp regulation for the purpose <br/>
<a id="pl.27.15"></a><var>27.15</var>of gaining additional federal reimbursement of food and nutritional costs currently paid by <br/>
<a id="pl.27.16"></a><var>27.16</var>the state group residential housing program. The commissioner shall seek approval no <br/>
<a id="pl.27.17"></a><var>27.17</var>later than January 1, 2004 October 1, 2009. Any reimbursement received is nondedicated <br/>
<a id="pl.27.18"></a><var>27.18</var>revenue to the general fund.<br/>
<br/>
<a id="bill.2.13.0"></a><a id="pl.27.19"></a><var>27.19</var>    Sec. 13. Minnesota Statutes 2008, section 256J.24, subdivision 5, is amended to read:<br/>
<a id="pl.27.20"></a><var>27.20</var>    Subd. 5. <b>MFIP transitional standard.</b> The MFIP transitional standard is based <br/>
<a id="pl.27.21"></a><var>27.21</var>on the number of persons in the assistance unit eligible for both food and cash assistance <br/>
<a id="pl.27.22"></a><var>27.22</var>unless the restrictions in subdivision 6 on the birth of a child apply. The following table <br/>
<a id="pl.27.23"></a><var>27.23</var>represents the transitional standards effective October 1, 2007 April 1, 2009.<br/>
<table>
<col width="50px"/>
<col width="20"/>
<col width="17.5"/>
<col width="17.5"/>
<col width="10"/>
<tr>
<td><a id="pl.27.24"></a><var>27.24</var><br/>
</td>
<td align="center">Number of Eligible People<br/>
</td>
<td align="center">Transitional Standard<br/>
</td>
<td align="center">Cash Portion<br/>
</td>
<td align="center">Food Portion<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="10"/>
<col width="22.5"/>
<col width="17"/>
<col width="12.5"/>
<col width="3"/>
<tr>
<td><a id="pl.27.25"></a><var>27.25</var><br/>
</td>
<td align="right">1<br/>
</td>
<td align="right">$391 $428:<br/>
</td>
<td align="right">$250<br/>
</td>
<td align="right">$141 $178<br/>
</td>
<td align="right"></td>
</tr>
<tr>
<td><a id="pl.27.26"></a><var>27.26</var><br/>
</td>
<td align="right">2<br/>
</td>
<td align="right">$698 $764:<br/>
</td>
<td align="right">$437<br/>
</td>
<td align="right">$261$327<br/>
</td>
<td align="right"></td>
</tr>
<tr>
<td><a id="pl.27.27"></a><var>27.27</var><br/>
</td>
<td align="right">3<br/>
</td>
<td align="right">$910$1,005:<br/>
</td>
<td align="right">$532<br/>
</td>
<td align="right">$378$473<br/>
</td>
<td align="right"></td>
</tr>
<tr>
<td><a id="pl.27.28"></a><var>27.28</var><br/>
</td>
<td align="right">4<br/>
</td>
<td align="right">$1,091 $1,217:<br/>
</td>
<td align="right">$621<br/>
</td>
<td align="right">$470 $596<br/>
</td>
<td align="right"></td>
</tr>
<tr>
<td><a id="pl.27.29"></a><var>27.29</var><br/>
</td>
<td align="right">5<br/>
</td>
<td align="right">$1,245 $1,393:<br/>
</td>
<td align="right">$697<br/>
</td>
<td align="right">$548 $696<br/>
</td>
<td align="right"></td>
</tr>
<tr>
<td><a id="pl.27.30"></a><var>27.30</var><br/>
</td>
<td align="right">6<br/>
</td>
<td align="right">$1,425$1,602:<br/>
</td>
<td align="right">$773<br/>
</td>
<td align="right">$652 $829<br/>
</td>
<td align="right"></td>
</tr>
<tr>
<td><a id="pl.28.1"></a><var>28.1</var><br/>
</td>
<td align="right">7<br/>
</td>
<td align="right">$1,553 $1,748:<br/>
</td>
<td align="right">$850<br/>
</td>
<td align="right">$703$898<br/>
</td>
<td align="right"></td>
</tr>
<tr>
<td><a id="pl.28.2"></a><var>28.2</var><br/>
</td>
<td align="right">8<br/>
</td>
<td align="right">$1,713 $1,934:<br/>
</td>
<td align="right">$916<br/>
</td>
<td align="right">$797$1,018<br/>
</td>
<td align="right"></td>
</tr>
<tr>
<td><a id="pl.28.3"></a><var>28.3</var><br/>
</td>
<td align="right">9<br/>
</td>
<td align="right">$1,871 $2,119:<br/>
</td>
<td align="right">$980<br/>
</td>
<td align="right">$891$1,139<br/>
</td>
<td align="right"></td>
</tr>
<tr>
<td><a id="pl.28.4"></a><var>28.4</var><br/>
</td>
<td align="right">10<br/>
</td>
<td align="right">$2,024 $2,298:<br/>
</td>
<td align="right">$1,035<br/>
</td>
<td align="right">$989 $1,263<br/>
</td>
<td align="right"></td>
</tr>
<tr>
<td><a id="pl.28.5"></a><var>28.5</var><br/>
</td>
<td align="right">over 10<br/>
</td>
<td align="right">add $151 $178:<br/>
</td>
<td align="right">$53<br/>
</td>
<td align="right">$98 $125<br/>
</td>
<td align="right"></td>
</tr>
<tr>
<td><a id="pl.28.6"></a><var>28.6</var><br/>
</td>
<td align="left" colspan="2">per additional member.<br/>
</td>
<td align="right"></td>
<td align="right"></td>
<td align="right"></td>
</tr>
</table><a id="pl.28.7"></a><var>28.7</var>    The commissioner shall annually publish in the State Register the transitional <br/>
<a id="pl.28.8"></a><var>28.8</var>standard for an assistance unit sizes 1 to 10 including a breakdown of the cash and food <br/>
<a id="pl.28.9"></a><var>28.9</var>portions.<br/>
<a id="pl.28.10"></a><var>28.10</var><b>EFFECTIVE DATE.</b>This section is effective retroactively from April 1, 2009.<br/>
<br/>
<a id="bill.2.14.0"></a><a id="pl.28.11"></a><var>28.11</var>    Sec. 14. Minnesota Statutes 2008, section 256J.425, subdivision 2, is amended to read:<br/>
<a id="pl.28.12"></a><var>28.12</var>    Subd. 2. <b>Ill or incapacitated.</b> (a) An assistance unit subject to the time limit in <br/>
<a id="pl.28.13"></a><var>28.13</var>section 
         <statute_ref>256J.42, subdivision 1</statute_ref>, is eligible to receive months of assistance under a hardship <br/>
<a id="pl.28.14"></a><var>28.14</var>extension if the participant who reached the time limit belongs to any of the following <br/>
<a id="pl.28.15"></a><var>28.15</var>groups:<br/>
<a id="pl.28.16"></a><var>28.16</var>(1) participants who are suffering from an illness, injury, or incapacity which <br/>
<a id="pl.28.17"></a><var>28.17</var>has been certified by a qualified professional when the illness, injury, or incapacity is <br/>
<a id="pl.28.18"></a><var>28.18</var>expected to continue for more than 30 days and prevents the person from obtaining or <br/>
<a id="pl.28.19"></a><var>28.19</var>retaining employment severely limits the person's ability to obtain or maintain suitable <br/>
<a id="pl.28.20"></a><var>28.20</var>employment. These participants must follow the treatment recommendations of the <br/>
<a id="pl.28.21"></a><var>28.21</var>qualified professional certifying the illness, injury, or incapacity;<br/>
<a id="pl.28.22"></a><var>28.22</var>(2) participants whose presence in the home is required as a caregiver because of <br/>
<a id="pl.28.23"></a><var>28.23</var>the illness, injury, or incapacity of another member in the assistance unit, a relative in the <br/>
<a id="pl.28.24"></a><var>28.24</var>household, or a foster child in the household when the illness or incapacity and the need <br/>
<a id="pl.28.25"></a><var>28.25</var>for a person to provide assistance in the home has been certified by a qualified professional <br/>
<a id="pl.28.26"></a><var>28.26</var>and is expected to continue for more than 30 days; or<br/>
<a id="pl.28.27"></a><var>28.27</var>(3) caregivers with a child or an adult in the household who meets the disability or <br/>
<a id="pl.28.28"></a><var>28.28</var>medical criteria for home care services under section 
         <statute_ref>256B.0651, subdivision 1</statute_ref>, paragraph <br/>
<a id="pl.28.29"></a><var>28.29</var>(c), or a home and community-based waiver services program under chapter 256B, or <br/>
<a id="pl.28.30"></a><var>28.30</var>meets the criteria for severe emotional disturbance under section 
         <statute_ref>245.4871, subdivision <br/>
<a id="pl.28.31"></a><var>28.31</var>6
         </statute_ref>, or for serious and persistent mental illness under section 
         <statute_ref>245.462, subdivision 20</statute_ref>, <br/>
<a id="pl.28.32"></a><var>28.32</var>paragraph (c). Caregivers in this category are presumed to be prevented from obtaining <br/>
<a id="pl.28.33"></a><var>28.33</var>or retaining employment.<br/>
<a id="pl.29.1"></a><var>29.1</var>(b) An assistance unit receiving assistance under a hardship extension under this <br/>
<a id="pl.29.2"></a><var>29.2</var>subdivision may continue to receive assistance as long as the participant meets the criteria <br/>
<a id="pl.29.3"></a><var>29.3</var>in paragraph (a), clause (1), (2), or (3).<br/>
<br/>
<a id="bill.2.15.0"></a><a id="pl.29.4"></a><var>29.4</var>    Sec. 15. Minnesota Statutes 2008, section 256J.425, subdivision 3, is amended to read:<br/>
<a id="pl.29.5"></a><var>29.5</var>    Subd. 3. <b>Hard-to-employ participants.</b> (a) An assistance unit subject to the time <br/>
<a id="pl.29.6"></a><var>29.6</var>limit in section 
         <statute_ref>256J.42, subdivision 1</statute_ref>, is eligible to receive months of assistance under <br/>
<a id="pl.29.7"></a><var>29.7</var>a hardship extension if the participant who reached the time limit belongs to any of the <br/>
<a id="pl.29.8"></a><var>29.8</var>following groups: <br/>
<a id="pl.29.9"></a><var>29.9</var>(1) a person who is diagnosed by a licensed physician, psychological practitioner, <br/>
<a id="pl.29.10"></a><var>29.10</var>or other qualified professional, as developmentally disabled or mentally ill, and that <br/>
<a id="pl.29.11"></a><var>29.11</var>condition prevents the person from obtaining or retaining unsubsidized employment the <br/>
<a id="pl.29.12"></a><var>29.12</var>condition severely limits the person's ability to obtain or maintain suitable employment;<br/>
<a id="pl.29.13"></a><var>29.13</var>(2) a person who:<br/>
<a id="pl.29.14"></a><var>29.14</var>(i) has been assessed by a vocational specialist or the county agency to be <br/>
<a id="pl.29.15"></a><var>29.15</var>unemployable for purposes of this subdivision; or<br/>
<a id="pl.29.16"></a><var>29.16</var>(ii) has an IQ below 80 who has been assessed by a vocational specialist or a county <br/>
<a id="pl.29.17"></a><var>29.17</var>agency to be employable, but not at a level that makes the participant eligible for an <br/>
<a id="pl.29.18"></a><var>29.18</var>extension under subdivision 4 the condition severely limits the person's ability to obtain or <br/>
<a id="pl.29.19"></a><var>29.19</var>maintain suitable employment. The determination of IQ level must be made by a qualified <br/>
<a id="pl.29.20"></a><var>29.20</var>professional. In the case of a non-English-speaking person: (A) the determination must <br/>
<a id="pl.29.21"></a><var>29.21</var>be made by a qualified professional with experience conducting culturally appropriate <br/>
<a id="pl.29.22"></a><var>29.22</var>assessments, whenever possible; (B) the county may accept reports that identify an <br/>
<a id="pl.29.23"></a><var>29.23</var>IQ range as opposed to a specific score; (C) these reports must include a statement of <br/>
<a id="pl.29.24"></a><var>29.24</var>confidence in the results;<br/>
<a id="pl.29.25"></a><var>29.25</var>(3) a person who is determined by a qualified professional to be learning disabled, <br/>
<a id="pl.29.26"></a><var>29.26</var>and the disability condition severely limits the person's ability to obtain, perform, or <br/>
<a id="pl.29.27"></a><var>29.27</var>maintain suitable employment. For purposes of the initial approval of a learning disability <br/>
<a id="pl.29.28"></a><var>29.28</var>extension, the determination must have been made or confirmed within the previous 12 <br/>
<a id="pl.29.29"></a><var>29.29</var>months. In the case of a non-English-speaking person: (i) the determination must be made <br/>
<a id="pl.29.30"></a><var>29.30</var>by a qualified professional with experience conducting culturally appropriate assessments, <br/>
<a id="pl.29.31"></a><var>29.31</var>whenever possible; and (ii) these reports must include a statement of confidence in the <br/>
<a id="pl.29.32"></a><var>29.32</var>results. If a rehabilitation plan for a participant extended as learning disabled is developed <br/>
<a id="pl.29.33"></a><var>29.33</var>or approved by the county agency, the plan must be incorporated into the employment <br/>
<a id="pl.29.34"></a><var>29.34</var>plan. However, a rehabilitation plan does not replace the requirement to develop and <br/>
<a id="pl.29.35"></a><var>29.35</var>comply with an employment plan under section 
         <statute_ref>256J.521</statute_ref>; or <br/>
<a id="pl.30.1"></a><var>30.1</var>(4) a person who has been granted a family violence waiver, and who is complying <br/>
<a id="pl.30.2"></a><var>30.2</var>with an employment plan under section 
         <statute_ref>256J.521, subdivision 3</statute_ref>. <br/>
<a id="pl.30.3"></a><var>30.3</var>(b) For purposes of this section, "severely limits the person's ability to obtain or <br/>
<a id="pl.30.4"></a><var>30.4</var>maintain suitable employment" means that a qualified professional has determined that the <br/>
<a id="pl.30.5"></a><var>30.5</var>person's condition prevents the person from working 20 or more hours per week.<br/>
<br/>
<a id="bill.2.16.0"></a><a id="pl.30.6"></a><var>30.6</var>    Sec. 16. Minnesota Statutes 2008, section 256J.49, subdivision 1, is amended to read:<br/>
<a id="pl.30.7"></a><var>30.7</var>    Subdivision 1. <b>Scope.</b> The terms used in sections 
         <statute_ref>256J.50</statute_ref> 256J.425 to 
         <statute_ref>256J.72</statute_ref> have <br/>
<a id="pl.30.8"></a><var>30.8</var>the meanings given them in this section.  <br/>
<br/>
<a id="bill.2.17.0"></a><a id="pl.30.9"></a><var>30.9</var>    Sec. 17. Minnesota Statutes 2008, section 256J.49, subdivision 4, is amended to read:<br/>
<a id="pl.30.10"></a><var>30.10</var>    Subd. 4. <b>Employment and training service provider.</b> "Employment and training <br/>
<a id="pl.30.11"></a><var>30.11</var>service provider" means:<br/>
<a id="pl.30.12"></a><var>30.12</var>(1) a public, private, or nonprofit agency with which a county has contracted to <br/>
<a id="pl.30.13"></a><var>30.13</var>provide employment and training services and which is included in the county's service <br/>
<a id="pl.30.14"></a><var>30.14</var>agreement submitted under section 
         <statute_ref>256J.626, subdivision 4</statute_ref>; or<br/>
<a id="pl.30.15"></a><var>30.15</var>(2) a county agency, if the county has opted to provide employment and training <br/>
<a id="pl.30.16"></a><var>30.16</var>services and the county has indicated that fact in the service agreement submitted under <br/>
<a id="pl.30.17"></a><var>30.17</var>section 
         <statute_ref>256J.626, subdivision 4</statute_ref>; or<br/>
<a id="pl.30.18"></a><var>30.18</var>(3) a local public health department under section 145A.17, subdivision 3a, that a <br/>
<a id="pl.30.19"></a><var>30.19</var>county has designated to provide employment and training services and is included in the <br/>
<a id="pl.30.20"></a><var>30.20</var>county's service agreement submitted under section 256J.626, subdivision 4.<br/>
<a id="pl.30.21"></a><var>30.21</var>Notwithstanding section 
         <statute_ref>116L.871</statute_ref>, an employment and training services provider <br/>
<a id="pl.30.22"></a><var>30.22</var>meeting this definition may deliver employment and training services under this chapter.<br/>
<br/>
<a id="bill.2.18.0"></a><a id="pl.30.23"></a><var>30.23</var>    Sec. 18. Minnesota Statutes 2008, section 256J.521, subdivision 2, is amended to read:<br/>
<a id="pl.30.24"></a><var>30.24</var>    Subd. 2. <b>Employment plan; contents.</b> (a) Based on the assessment under <br/>
<a id="pl.30.25"></a><var>30.25</var>subdivision 1, the job counselor and the participant must develop an employment plan <br/>
<a id="pl.30.26"></a><var>30.26</var>that includes participation in activities and hours that meet the requirements of section <br/>
<statute_ref><a id="pl.30.27"></a><var>30.27</var>256J.55, subdivision 1
         </statute_ref>. The purpose of the employment plan is to identify for each <br/>
<a id="pl.30.28"></a><var>30.28</var>participant the most direct path to unsubsidized employment and any subsequent steps that <br/>
<a id="pl.30.29"></a><var>30.29</var>support long-term economic stability. The employment plan should be developed using <br/>
<a id="pl.30.30"></a><var>30.30</var>the highest level of activity appropriate for the participant. Activities must be chosen from <br/>
<a id="pl.30.31"></a><var>30.31</var>clauses (1) to (6), which are listed in order of preference. Notwithstanding this order of <br/>
<a id="pl.30.32"></a><var>30.32</var>preference for activities, priority must be given for activities related to a family violence <br/>
<a id="pl.30.33"></a><var>30.33</var>waiver when developing the employment plan. The employment plan must also list the <br/>
<a id="pl.31.1"></a><var>31.1</var>specific steps the participant will take to obtain employment, including steps necessary <br/>
<a id="pl.31.2"></a><var>31.2</var>for the participant to progress from one level of activity to another, and a timetable for <br/>
<a id="pl.31.3"></a><var>31.3</var>completion of each step. Levels of activity include:<br/>
<a id="pl.31.4"></a><var>31.4</var>    (1) unsubsidized employment;<br/>
<a id="pl.31.5"></a><var>31.5</var>    (2) job search;<br/>
<a id="pl.31.6"></a><var>31.6</var>    (3) subsidized employment or unpaid work experience;<br/>
<a id="pl.31.7"></a><var>31.7</var>    (4) unsubsidized employment and job readiness education or job skills training;<br/>
<a id="pl.31.8"></a><var>31.8</var>    (5) unsubsidized employment or unpaid work experience and activities related to <br/>
<a id="pl.31.9"></a><var>31.9</var>a family violence waiver or preemployment needs; and<br/>
<a id="pl.31.10"></a><var>31.10</var>    (6) activities related to a family violence waiver or preemployment needs.<br/>
<a id="pl.31.11"></a><var>31.11</var>    (b) Participants who are determined to possess sufficient skills such that the <br/>
<a id="pl.31.12"></a><var>31.12</var>participant is likely to succeed in obtaining unsubsidized employment must job search at <br/>
<a id="pl.31.13"></a><var>31.13</var>least 30 hours per week for up to six weeks and accept any offer of suitable employment. <br/>
<a id="pl.31.14"></a><var>31.14</var>The remaining hours necessary to meet the requirements of section 
         <statute_ref>256J.55, subdivision <br/>
<a id="pl.31.15"></a><var>31.15</var>1
         </statute_ref>, may be met through participation in other work activities under section 
         <statute_ref>256J.49, <br/>
<a id="pl.31.16"></a><var>31.16</var>subdivision 13
         </statute_ref>. The participant's employment plan must specify, at a minimum: (1) <br/>
<a id="pl.31.17"></a><var>31.17</var>whether the job search is supervised or unsupervised; (2) support services that will <br/>
<a id="pl.31.18"></a><var>31.18</var>be provided; and (3) how frequently the participant must report to the job counselor. <br/>
<a id="pl.31.19"></a><var>31.19</var>Participants who are unable to find suitable employment after six weeks must meet <br/>
<a id="pl.31.20"></a><var>31.20</var>with the job counselor to determine whether other activities in paragraph (a) should be <br/>
<a id="pl.31.21"></a><var>31.21</var>incorporated into the employment plan. Job search activities which are continued after six <br/>
<a id="pl.31.22"></a><var>31.22</var>weeks must be structured and supervised. <br/>
<a id="pl.31.23"></a><var>31.23</var>    (c) Beginning July 1, 2004, activities and hourly requirements in the employment <br/>
<a id="pl.31.24"></a><var>31.24</var>plan may be adjusted as necessary to accommodate the personal and family circumstances <br/>
<a id="pl.31.25"></a><var>31.25</var>of participants identified under section 
<statute_ref>256J.561, subdivision 2</statute_ref>, paragraph (d). Participants <br/>
<a id="pl.31.26"></a><var>31.26</var>who no longer meet the provisions of section 
<statute_ref>256J.561, subdivision 2</statute_ref>, paragraph (d), <br/>
<a id="pl.31.27"></a><var>31.27</var>must meet with the job counselor within ten days of the determination to revise the <br/>
<a id="pl.31.28"></a><var>31.28</var>employment plan. <br/>
<a id="pl.31.29"></a><var>31.29</var>    (d) Participants who are determined to have barriers to obtaining or retaining <br/>
<a id="pl.31.30"></a><var>31.30</var>employment that will not be overcome during six weeks of job search under paragraph (b) <br/>
<a id="pl.31.31"></a><var>31.31</var>must work with the job counselor to develop an employment plan that addresses those <br/>
<a id="pl.31.32"></a><var>31.32</var>barriers by incorporating appropriate activities from paragraph (a), clauses (1) to (6). <br/>
<a id="pl.31.33"></a><var>31.33</var>The employment plan must include enough hours to meet the participation requirements <br/>
<a id="pl.31.34"></a><var>31.34</var>in section 
         <statute_ref>256J.55, subdivision 1</statute_ref>, unless a compelling reason to require fewer hours <br/>
<a id="pl.31.35"></a><var>31.35</var>is noted in the participant's file. <br/>
<a id="pl.32.1"></a><var>32.1</var>    (e) (d) The job counselor and the participant must sign the employment plan to <br/>
<a id="pl.32.2"></a><var>32.2</var>indicate agreement on the contents.<br/>
<a id="pl.32.3"></a><var>32.3</var>    (f) (e) Except as provided under paragraph (g) (f), failure to develop or comply with <br/>
<a id="pl.32.4"></a><var>32.4</var>activities in the plan, or voluntarily quitting suitable employment without good cause, will <br/>
<a id="pl.32.5"></a><var>32.5</var>result in the imposition of a sanction under section 
         <statute_ref>256J.46</statute_ref>. <br/>
<a id="pl.32.6"></a><var>32.6</var>    (g) (f) When a participant fails to meet the agreed upon hours of participation in paid <br/>
<a id="pl.32.7"></a><var>32.7</var>employment because the participant is not eligible for holiday pay and the participant's <br/>
<a id="pl.32.8"></a><var>32.8</var>place of employment is closed for a holiday, the job counselor shall not impose a sanction <br/>
<a id="pl.32.9"></a><var>32.9</var>or increase the hours of participation in any other activity, including paid employment, to <br/>
<a id="pl.32.10"></a><var>32.10</var>offset the hours that were missed due to the holiday.<br/>
<a id="pl.32.11"></a><var>32.11</var>    (h) (g) Employment plans must be reviewed at least every three months to determine <br/>
<a id="pl.32.12"></a><var>32.12</var>whether activities and hourly requirements should be revised. The job counselor is <br/>
<a id="pl.32.13"></a><var>32.13</var>encouraged to allow participants who are participating in at least 20 hours of work <br/>
<a id="pl.32.14"></a><var>32.14</var>activities to also participate in education and training activities in order to meet the federal <br/>
<a id="pl.32.15"></a><var>32.15</var>hourly participation rates.<br/>
<br/>
<a id="bill.2.19.0"></a><a id="pl.32.16"></a><var>32.16</var>    Sec. 19. Minnesota Statutes 2008, section 256J.545, is amended to read:<br/>
<a id="pl.32.17"></a><var>32.17</var><b>256J.545 FAMILY VIOLENCE WAIVER CRITERIA.</b><br/>
<a id="pl.32.18"></a><var>32.18</var>    (a) In order to qualify for a family violence waiver, an individual must provide <br/>
<a id="pl.32.19"></a><var>32.19</var>documentation of past or current family violence which may prevent the individual from <br/>
<a id="pl.32.20"></a><var>32.20</var>participating in certain employment activities. <br/>
<a id="pl.32.21"></a><var>32.21</var>    (b) The following items may be considered acceptable documentation or verification <br/>
<a id="pl.32.22"></a><var>32.22</var>of family violence:<br/>
<a id="pl.32.23"></a><var>32.23</var>    (1) police, government agency, or court records;<br/>
<a id="pl.32.24"></a><var>32.24</var>    (2) a statement from a battered women's shelter staff with knowledge of the <br/>
<a id="pl.32.25"></a><var>32.25</var>circumstances or credible evidence that supports the sworn statement;<br/>
<a id="pl.32.26"></a><var>32.26</var>    (3) a statement from a sexual assault or domestic violence advocate with knowledge <br/>
<a id="pl.32.27"></a><var>32.27</var>of the circumstances or credible evidence that supports the sworn statement; or<br/>
<a id="pl.32.28"></a><var>32.28</var>    (4) a statement from professionals from whom the applicant or recipient has sought <br/>
<a id="pl.32.29"></a><var>32.29</var>assistance for the abuse.<br/>
<a id="pl.32.30"></a><var>32.30</var>    (c) A claim of family violence may also be documented by a sworn statement from <br/>
<a id="pl.32.31"></a><var>32.31</var>the applicant or participant and a sworn statement from any other person with knowledge <br/>
<a id="pl.32.32"></a><var>32.32</var>of the circumstances or credible evidence that supports the client's statement.<br/>
<br/>
<a id="bill.2.20.0"></a><a id="pl.32.33"></a><var>32.33</var>    Sec. 20. Minnesota Statutes 2008, section 256J.561, subdivision 2, is amended to read:<br/>
<a id="pl.33.1"></a><var>33.1</var>    Subd. 2. <b>Participation requirements.</b> (a) All MFIP caregivers, except caregivers <br/>
<a id="pl.33.2"></a><var>33.2</var>who meet the criteria in subdivision 3, must participate in employment services develop an <br/>
<a id="pl.33.3"></a><var>33.3</var>individualized employment plan that identifies the activities the participant is required to <br/>
<a id="pl.33.4"></a><var>33.4</var>participate in and the required hours of participation. Except as specified in paragraphs (b) <br/>
<a id="pl.33.5"></a><var>33.5</var>to (d), the employment plan must meet the requirements of section 
<statute_ref>256J.521, subdivision <br/>
<a id="pl.33.6"></a><var>33.6</var>2
</statute_ref>, contain allowable work activities, as defined in section 
<statute_ref>256J.49, subdivision 13</statute_ref>, and, <br/>
<a id="pl.33.7"></a><var>33.7</var>include at a minimum, the number of participation hours required under section 
<statute_ref>256J.55, <br/>
<a id="pl.33.8"></a><var>33.8</var>subdivision 1
</statute_ref>.<br/>
<a id="pl.33.9"></a><var>33.9</var>(b) Minor caregivers and caregivers who are less than age 20 who have not <br/>
<a id="pl.33.10"></a><var>33.10</var>completed high school or obtained a GED are required to comply with section 
<statute_ref>256J.54</statute_ref>.<br/>
<a id="pl.33.11"></a><var>33.11</var>(c) A participant who has a family violence waiver shall develop and comply with <br/>
<a id="pl.33.12"></a><var>33.12</var>an employment plan under section 
<statute_ref>256J.521, subdivision 3</statute_ref>.<br/>
<a id="pl.33.13"></a><var>33.13</var>(d) As specified in section 
<statute_ref>256J.521, subdivision 2</statute_ref>, paragraph (c), a participant who <br/>
<a id="pl.33.14"></a><var>33.14</var>meets any one of the following criteria may work with the job counselor to develop an <br/>
<a id="pl.33.15"></a><var>33.15</var>employment plan that contains less than the number of participation hours under section <br/>
<a id="pl.33.16"></a><var>33.16</var><statute_ref>256J.55, subdivision 1</statute_ref>. Employment plans for participants covered under this paragraph <br/>
<a id="pl.33.17"></a><var>33.17</var>must be tailored to recognize the special circumstances of caregivers and families <br/>
<a id="pl.33.18"></a><var>33.18</var>including limitations due to illness or disability and caregiving needs:<br/>
<a id="pl.33.19"></a><var>33.19</var>(1) a participant who is age 60 or older;<br/>
<a id="pl.33.20"></a><var>33.20</var>(2) a participant who has been diagnosed by a qualified professional as suffering <br/>
<a id="pl.33.21"></a><var>33.21</var>from an illness or incapacity that is expected to last for 30 days or more, including a <br/>
<a id="pl.33.22"></a><var>33.22</var>pregnant participant who is determined to be unable to obtain or retain employment due <br/>
<a id="pl.33.23"></a><var>33.23</var>to the pregnancy; or<br/>
<a id="pl.33.24"></a><var>33.24</var>(3) a participant who is determined by a qualified professional as being needed in <br/>
<a id="pl.33.25"></a><var>33.25</var>the home to care for an ill or incapacitated family member, including caregivers with a <br/>
<a id="pl.33.26"></a><var>33.26</var>child or an adult in the household who meets the disability or medical criteria for home <br/>
<a id="pl.33.27"></a><var>33.27</var>care services under section 
<statute_ref>256B.0651, subdivision 1</statute_ref>, paragraph (c), or a home and <br/>
<a id="pl.33.28"></a><var>33.28</var>community-based waiver services program under chapter 256B, or meets the criteria for <br/>
<a id="pl.33.29"></a><var>33.29</var>severe emotional disturbance under section 
<statute_ref>245.4871, subdivision 6</statute_ref>, or for serious and <br/>
<a id="pl.33.30"></a><var>33.30</var>persistent mental illness under section 
<statute_ref>245.462, subdivision 20</statute_ref>, paragraph (c).<br/>
<a id="pl.33.31"></a><var>33.31</var>(e) For participants covered under paragraphs (c) and (d), the county shall review <br/>
<a id="pl.33.32"></a><var>33.32</var>the participant's employment services status every three months to determine whether <br/>
<a id="pl.33.33"></a><var>33.33</var>conditions have changed. When it is determined that the participant's status is no longer <br/>
<a id="pl.33.34"></a><var>33.34</var>covered under paragraph (c) or (d), the county shall notify the participant that a new or <br/>
<a id="pl.33.35"></a><var>33.35</var>revised employment plan is needed. The participant and job counselor shall meet within <br/>
<a id="pl.33.36"></a><var>33.36</var>ten days of the determination to revise the employment plan.<br/>
<a id="pl.34.1"></a><var>34.1</var>(b) Participants who meet the eligibility requirements in section 256J.575, <br/>
<a id="pl.34.2"></a><var>34.2</var>subdivision 3, must develop a family stabilization services plan that meets the <br/>
<a id="pl.34.3"></a><var>34.3</var>requirements in section 256J.575, subdivision 5.<br/>
<a id="pl.34.4"></a><var>34.4</var>(c) Minor caregivers and caregivers who are less than age 20 who have not <br/>
<a id="pl.34.5"></a><var>34.5</var>completed high school or obtained a GED must develop an education plan that meets the <br/>
<a id="pl.34.6"></a><var>34.6</var>requirements in section 256J.54.<br/>
<a id="pl.34.7"></a><var>34.7</var>(d) Participants with a family violence waiver must develop an employment plan <br/>
<a id="pl.34.8"></a><var>34.8</var>that meets the requirements in section 256J.521, which cover the provisions in section <br/>
<a id="pl.34.9"></a><var>34.9</var>256J.575, subdivision 5.<br/>
<a id="pl.34.10"></a><var>34.10</var>(e) All other participants must develop an employment plan that meets the <br/>
<a id="pl.34.11"></a><var>34.11</var>requirements of section 
<statute_ref>256J.521, subdivision 2</statute_ref>, and contains allowable work activities, <br/>
<a id="pl.34.12"></a><var>34.12</var>as defined in section 
<statute_ref>256J.49, subdivision 13</statute_ref>. The employment plan must include, at a <br/>
<a id="pl.34.13"></a><var>34.13</var>minimum, the number of participation hours required under section 
<statute_ref>256J.55, subdivision 1</statute_ref>.<br/>
<br/>
<a id="bill.2.21.0"></a><a id="pl.34.14"></a><var>34.14</var>    Sec. 21. Minnesota Statutes 2008, section 256J.561, subdivision 3, is amended to read:<br/>
<a id="pl.34.15"></a><var>34.15</var>    Subd. 3. <b>Child under 12 </b><b>weeks</b><b> months</b><b> of age.</b> (a) A participant who has a <br/>
<a id="pl.34.16"></a><var>34.16</var>natural born child who is less than 12 weeks months of age who meets the criteria in this <br/>
<a id="pl.34.17"></a><var>34.17</var>subdivision is not required to participate in employment services until the child reaches <br/>
<a id="pl.34.18"></a><var>34.18</var>12 weeks months of age. To be eligible for this provision, the assistance unit must not <br/>
<a id="pl.34.19"></a><var>34.19</var>have already used this provision or the previously allowed child under age one exemption. <br/>
<a id="pl.34.20"></a><var>34.20</var>However, an assistance unit that has an approved child under age one exemption at the <br/>
<a id="pl.34.21"></a><var>34.21</var>time this provision becomes effective may continue to use that exemption until the child <br/>
<a id="pl.34.22"></a><var>34.22</var>reaches one year of age.<br/>
<a id="pl.34.23"></a><var>34.23</var>(b) The provision in paragraph (a) ends the first full month after the child reaches <br/>
<a id="pl.34.24"></a><var>34.24</var>12 weeks months of age. This provision is available only once in a caregiver's lifetime. <br/>
<a id="pl.34.25"></a><var>34.25</var>In a two-parent household, only one parent shall be allowed to use this provision. The <br/>
<a id="pl.34.26"></a><var>34.26</var>participant and job counselor must meet within ten days after the child reaches 12 weeks <br/>
<a id="pl.34.27"></a><var>34.27</var>months of age to revise the participant's employment plan.<br/>
<a id="pl.34.28"></a><var>34.28</var><b>EFFECTIVE DATE.</b>This section is effective March 1, 2010.<br/>
<br/>
<a id="bill.2.22.0"></a><a id="pl.34.29"></a><var>34.29</var>    Sec. 22. Minnesota Statutes 2008, section 256J.57, subdivision 1, is amended to read:<br/>
<a id="pl.34.30"></a><var>34.30</var>    Subdivision 1. <b>Good cause for failure to comply.</b> The county agency shall not <br/>
<a id="pl.34.31"></a><var>34.31</var>impose the sanction under section 
         <statute_ref>256J.46</statute_ref> if it determines that the participant has good <br/>
<a id="pl.34.32"></a><var>34.32</var>cause for failing to comply with the requirements of sections 
         <statute_ref>256J.515</statute_ref> to 
         <statute_ref>256J.57</statute_ref>. Good <br/>
<a id="pl.34.33"></a><var>34.33</var>cause exists when: <br/>
<a id="pl.34.34"></a><var>34.34</var>(1) appropriate child care is not available;<br/>
<a id="pl.35.1"></a><var>35.1</var>(2) the job does not meet the definition of suitable employment;<br/>
<a id="pl.35.2"></a><var>35.2</var>(3) the participant is ill or injured;<br/>
<a id="pl.35.3"></a><var>35.3</var>(4) a member of the assistance unit, a relative in the household, or a foster child in <br/>
<a id="pl.35.4"></a><var>35.4</var>the household is ill and needs care by the participant that prevents the participant from <br/>
<a id="pl.35.5"></a><var>35.5</var>complying with the employment plan;<br/>
<a id="pl.35.6"></a><var>35.6</var>(5) the participant is unable to secure necessary transportation;<br/>
<a id="pl.35.7"></a><var>35.7</var>(6) the participant is in an emergency situation that prevents compliance with the <br/>
<a id="pl.35.8"></a><var>35.8</var>employment plan;<br/>
<a id="pl.35.9"></a><var>35.9</var>(7) the schedule of compliance with the employment plan conflicts with judicial <br/>
<a id="pl.35.10"></a><var>35.10</var>proceedings;<br/>
<a id="pl.35.11"></a><var>35.11</var>(8) a mandatory MFIP meeting is scheduled during a time that conflicts with a <br/>
<a id="pl.35.12"></a><var>35.12</var>judicial proceeding or a meeting related to a juvenile court matter, or a participant's work <br/>
<a id="pl.35.13"></a><var>35.13</var>schedule;<br/>
<a id="pl.35.14"></a><var>35.14</var>(9) the participant is already participating in acceptable work activities;<br/>
<a id="pl.35.15"></a><var>35.15</var>(10) the employment plan requires an educational program for a caregiver under age <br/>
<a id="pl.35.16"></a><var>35.16</var>20, but the educational program is not available;<br/>
<a id="pl.35.17"></a><var>35.17</var>(11) activities identified in the employment plan are not available;<br/>
<a id="pl.35.18"></a><var>35.18</var>(12) the participant is willing to accept suitable employment, but suitable <br/>
<a id="pl.35.19"></a><var>35.19</var>employment is not available; or<br/>
<a id="pl.35.20"></a><var>35.20</var>(13) the participant documents other verifiable impediments to compliance with the <br/>
<a id="pl.35.21"></a><var>35.21</var>employment plan beyond the participant's control; or<br/>
<a id="pl.35.22"></a><var>35.22</var>(14) the documentation needed to determine if a participant is eligible for family <br/>
<a id="pl.35.23"></a><var>35.23</var>stabilization services is not available, but there is information that the participant may <br/>
<a id="pl.35.24"></a><var>35.24</var>qualify and the participant is cooperating with the county or employment service provider's <br/>
<a id="pl.35.25"></a><var>35.25</var>efforts to obtain the documentation necessary to determine eligibility.<br/>
<a id="pl.35.26"></a><var>35.26</var>The job counselor shall work with the participant to reschedule mandatory meetings <br/>
<a id="pl.35.27"></a><var>35.27</var>for individuals who fall under clauses (1), (3), (4), (5), (6), (7), and (8).<br/>
<br/>
<a id="bill.2.23.0"></a><a id="pl.35.28"></a><var>35.28</var>    Sec. 23. Minnesota Statutes 2008, section 256J.575, subdivision 3, is amended to read:<br/>
<a id="pl.35.29"></a><var>35.29</var>    Subd. 3. <b>Eligibility.</b> (a) The following MFIP or diversionary work program (DWP) <br/>
<a id="pl.35.30"></a><var>35.30</var>participants are eligible for the services under this section:<br/>
<a id="pl.35.31"></a><var>35.31</var>    (1) a participant who meets the requirements for or has been granted a hardship <br/>
<a id="pl.35.32"></a><var>35.32</var>extension under section 
         <statute_ref>256J.425, subdivision 2</statute_ref> or 3, except that it is not necessary for <br/>
<a id="pl.35.33"></a><var>35.33</var>the participant to have reached or be approaching 60 months of eligibility for this section <br/>
<a id="pl.35.34"></a><var>35.34</var>to apply;<br/>
<a id="pl.36.1"></a><var>36.1</var>    (2) a participant who is applying for Supplemental Security Income or Social <br/>
<a id="pl.36.2"></a><var>36.2</var>Security disability insurance; and<br/>
<a id="pl.36.3"></a><var>36.3</var>    (3) a participant who is a noncitizen who has been in the United States for 12 or <br/>
<a id="pl.36.4"></a><var>36.4</var>fewer months; and<br/>
<a id="pl.36.5"></a><var>36.5</var>(4) a participant who is age 60 or older.<br/>
<a id="pl.36.6"></a><var>36.6</var>    (b) Families must meet all other eligibility requirements for MFIP established in <br/>
<a id="pl.36.7"></a><var>36.7</var>this chapter. Families are eligible for financial assistance to the same extent as if they <br/>
<a id="pl.36.8"></a><var>36.8</var>were participating in MFIP.<br/>
<a id="pl.36.9"></a><var>36.9</var>    (c) A participant under paragraph (a), clause (3), must be provided with English as a <br/>
<a id="pl.36.10"></a><var>36.10</var>second language opportunities and skills training for up to 12 months. After 12 months, <br/>
<a id="pl.36.11"></a><var>36.11</var>the case manager and participant must determine whether the participant should continue <br/>
<a id="pl.36.12"></a><var>36.12</var>with English as a second language classes or skills training, or both, and continue to <br/>
<a id="pl.36.13"></a><var>36.13</var>receive family stabilization services.<br/>
<a id="pl.36.14"></a><var>36.14</var>(d) If a county agency or employment services provider has information that <br/>
<a id="pl.36.15"></a><var>36.15</var>an MFIP participant may meet the eligibility criteria set forth in this subdivision, the <br/>
<a id="pl.36.16"></a><var>36.16</var>county agency or employment services provider must assist the participant in obtaining <br/>
<a id="pl.36.17"></a><var>36.17</var>the documentation necessary to determine eligibility. Until necessary documentation is <br/>
<a id="pl.36.18"></a><var>36.18</var>obtained, the participant must be treated as an eligible participant under subdivisions 5 to 7.<br/>
<a id="pl.36.19"></a><var>36.19</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2009, except the amendment <br/>
<a id="pl.36.20"></a><var>36.20</var>to paragraph (a) striking "or diversionary work program (DWP)" is effective March 1, <br/>
<a id="pl.36.21"></a><var>36.21</var>2010.<br/>
<br/>
<a id="bill.2.24.0"></a><a id="pl.36.22"></a><var>36.22</var>    Sec. 24. Minnesota Statutes 2008, section 256J.575, subdivision 4, is amended to read:<br/>
<a id="pl.36.23"></a><var>36.23</var>    Subd. 4. <b>Universal participation.</b> All caregivers must participate in family <br/>
<a id="pl.36.24"></a><var>36.24</var>stabilization services as defined in subdivision 2, except for caregivers exempt under <br/>
<a id="pl.36.25"></a><var>36.25</var>section 256J.561, subdivision 3.<br/>
<a id="pl.36.26"></a><var>36.26</var><b>EFFECTIVE DATE.</b>This section is effective March 1, 2010.<br/>
<br/>
<a id="bill.2.25.0"></a><a id="pl.36.27"></a><var>36.27</var>    Sec. 25. Minnesota Statutes 2008, section 256J.575, subdivision 6, is amended to read:<br/>
<a id="pl.36.28"></a><var>36.28</var>    Subd. 6. <b>Cooperation with services requirements.</b> (a) To be eligible, A participant <br/>
<a id="pl.36.29"></a><var>36.29</var>who is eligible for family stabilization services under this section shall comply with <br/>
<a id="pl.36.30"></a><var>36.30</var>paragraphs (b) to (d).<br/>
<a id="pl.36.31"></a><var>36.31</var>    (b) Participants shall engage in family stabilization plan services for the appropriate <br/>
<a id="pl.36.32"></a><var>36.32</var>number of hours per week that the activities are scheduled and available, unless good <br/>
<a id="pl.36.33"></a><var>36.33</var>cause exists for not doing so, as defined in section 
         <statute_ref>256J.57, subdivision 1</statute_ref>. The appropriate <br/>
<a id="pl.36.34"></a><var>36.34</var>number of hours must be based on the participant's plan.<br/>
<a id="pl.37.1"></a><var>37.1</var>    (c) The case manager shall review the participant's progress toward the goals in the <br/>
<a id="pl.37.2"></a><var>37.2</var>family stabilization plan every six months to determine whether conditions have changed, <br/>
<a id="pl.37.3"></a><var>37.3</var>including whether revisions to the plan are needed.<br/>
<a id="pl.37.4"></a><var>37.4</var>    (d) A participant's requirement to comply with any or all family stabilization plan <br/>
<a id="pl.37.5"></a><var>37.5</var>requirements under this subdivision is excused when the case management services, <br/>
<a id="pl.37.6"></a><var>37.6</var>training and educational services, or family support services identified in the participant's <br/>
<a id="pl.37.7"></a><var>37.7</var>family stabilization plan are unavailable for reasons beyond the control of the participant, <br/>
<a id="pl.37.8"></a><var>37.8</var>including when money appropriated is not sufficient to provide the services.<br/>
<br/>
<a id="bill.2.26.0"></a><a id="pl.37.9"></a><var>37.9</var>    Sec. 26. Minnesota Statutes 2008, section 256J.575, subdivision 7, is amended to read:<br/>
<a id="pl.37.10"></a><var>37.10</var>    Subd. 7. <b>Sanctions.</b> (a) The county agency or employment services provider must <br/>
<a id="pl.37.11"></a><var>37.11</var>follow the requirements of this subdivision at the time the county agency or employment <br/>
<a id="pl.37.12"></a><var>37.12</var>services provider has information that an MFIP recipient may meet the eligibility criteria <br/>
<a id="pl.37.13"></a><var>37.13</var>in subdivision 3. <br/>
<a id="pl.37.14"></a><var>37.14</var>(b) The financial assistance grant of a participating family is reduced according to <br/>
<a id="pl.37.15"></a><var>37.15</var>section 
         <statute_ref>256J.46</statute_ref>, if a participating adult fails without good cause to comply or continue <br/>
<a id="pl.37.16"></a><var>37.16</var>to comply with the family stabilization plan requirements in this subdivision, unless <br/>
<a id="pl.37.17"></a><var>37.17</var>compliance has been excused under subdivision 6, paragraph (d).<br/>
<a id="pl.37.18"></a><var>37.18</var>    (b) (c) Given the purpose of the family stabilization services  in this section and the <br/>
<a id="pl.37.19"></a><var>37.19</var>nature of the underlying family circumstances that act as barriers to both employment and <br/>
<a id="pl.37.20"></a><var>37.20</var>full compliance with program requirements, there must be a review by the county agency <br/>
<a id="pl.37.21"></a><var>37.21</var>prior to imposing a sanction to determine whether the plan was appropriated to the needs <br/>
<a id="pl.37.22"></a><var>37.22</var>of the participant and family, and. There must be a current assessment by a behavioral <br/>
<a id="pl.37.23"></a><var>37.23</var>health or medical professional confirming that the participant in all ways had the ability to <br/>
<a id="pl.37.24"></a><var>37.24</var>comply with the plan, as confirmed by a behavioral health or medical professional.<br/>
<a id="pl.37.25"></a><var>37.25</var>    (c) (d) Prior to the imposition of a sanction, the county agency or employment <br/>
<a id="pl.37.26"></a><var>37.26</var>services provider shall review the participant's case to determine if the family stabilization <br/>
<a id="pl.37.27"></a><var>37.27</var>plan is still appropriate and meet with the participant face-to-face. The participant may <br/>
<a id="pl.37.28"></a><var>37.28</var>bring an advocate The county agency or employment services provider must inform the <br/>
<a id="pl.37.29"></a><var>37.29</var>participant of the right to bring an advocate to the face-to-face meeting. <br/>
<a id="pl.37.30"></a><var>37.30</var>    During the face-to-face meeting, the county agency shall:<br/>
<a id="pl.37.31"></a><var>37.31</var>    (1) determine whether the continued noncompliance can be explained and mitigated <br/>
<a id="pl.37.32"></a><var>37.32</var>by providing a needed family stabilization service, as defined in subdivision 2, paragraph <br/>
<a id="pl.37.33"></a><var>37.33</var>(d);<br/>
<a id="pl.37.34"></a><var>37.34</var>    (2) determine whether the participant qualifies for a good cause exception under <br/>
<a id="pl.37.35"></a><var>37.35</var>section 
         <statute_ref>256J.57</statute_ref>, or if the sanction is for noncooperation with child support requirements, <br/>
<a id="pl.38.1"></a><var>38.1</var>determine if the participant qualifies for a good cause exemption under section 
         <statute_ref>256.741</statute_ref>, <br/>
<a id="pl.38.2"></a><var>38.2</var>subdivision 10;<br/>
<a id="pl.38.3"></a><var>38.3</var>    (3) determine whether activities in the family stabilization plan are appropriate <br/>
<a id="pl.38.4"></a><var>38.4</var>based on the family's circumstances;<br/>
<a id="pl.38.5"></a><var>38.5</var>    (4) explain the consequences of continuing noncompliance;<br/>
<a id="pl.38.6"></a><var>38.6</var>    (5) identify other resources that may be available to the participant to meet the <br/>
<a id="pl.38.7"></a><var>38.7</var>needs of the family; and<br/>
<a id="pl.38.8"></a><var>38.8</var>    (6) inform the participant of the right to appeal under section 
         <statute_ref>256J.40</statute_ref>.<br/>
<a id="pl.38.9"></a><var>38.9</var>    If the lack of an identified activity or service can explain the noncompliance, the <br/>
<a id="pl.38.10"></a><var>38.10</var>county shall work with the participant to provide the identified activity.<br/>
<a id="pl.38.11"></a><var>38.11</var>    (d) If the participant fails to come to the face-to-face meeting, the case manager or a <br/>
<a id="pl.38.12"></a><var>38.12</var>designee shall attempt at least one home visit. If a face-to-face meeting is not conducted, <br/>
<a id="pl.38.13"></a><var>38.13</var>the county agency shall send the participant a written notice that includes the information <br/>
<a id="pl.38.14"></a><var>38.14</var>under paragraph (c).<br/>
<a id="pl.38.15"></a><var>38.15</var>    (e) After the requirements of paragraphs (c) and (d) are met and prior to imposition <br/>
<a id="pl.38.16"></a><var>38.16</var>of a sanction, the county agency shall provide a notice of intent to sanction under section <br/>
<statute_ref><a id="pl.38.17"></a><var>38.17</var>256J.57, subdivision 2
         </statute_ref>, and, when applicable, a notice of adverse action under section <br/>
<statute_ref><a id="pl.38.18"></a><var>38.18</var>256J.31
         </statute_ref>.<br/>
<a id="pl.38.19"></a><var>38.19</var>    (f) Section 
         <statute_ref>256J.57</statute_ref> applies to this section except to the extent that it is modified <br/>
<a id="pl.38.20"></a><var>38.20</var>by this subdivision.<br/>
<br/>
<a id="bill.2.27.0"></a><a id="pl.38.21"></a><var>38.21</var>    Sec. 27. Minnesota Statutes 2008, section 256J.621, is amended to read:<br/>
<a id="pl.38.22"></a><var>38.22</var><b>256J.621 WORK PARTICIPATION CASH BENEFITS.</b><br/>
<a id="pl.38.23"></a><var>38.23</var>    (a) Effective October 1, 2009, upon exiting the diversionary work program (DWP) <br/>
<a id="pl.38.24"></a><var>38.24</var>or upon terminating the Minnesota family investment program with earnings, a participant <br/>
<a id="pl.38.25"></a><var>38.25</var>who is employed may be eligible for work participation cash benefits of $75 $50 per <br/>
<a id="pl.38.26"></a><var>38.26</var>month to assist in meeting the family's basic needs as the participant continues to move <br/>
<a id="pl.38.27"></a><var>38.27</var>toward self-sufficiency.<br/>
<a id="pl.38.28"></a><var>38.28</var>    (b) To be eligible for work participation cash benefits, the participant shall not <br/>
<a id="pl.38.29"></a><var>38.29</var>receive MFIP or diversionary work program assistance during the month and the <br/>
<a id="pl.38.30"></a><var>38.30</var>participant or participants must meet the following work requirements:<br/>
<a id="pl.38.31"></a><var>38.31</var>    (1) if the participant is a single caregiver and has a child under six years of age, the <br/>
<a id="pl.38.32"></a><var>38.32</var>participant must be employed at least 87 hours per month;<br/>
<a id="pl.38.33"></a><var>38.33</var>    (2) if the participant is a single caregiver and does not have a child under six years of <br/>
<a id="pl.38.34"></a><var>38.34</var>age, the participant must be employed at least 130 hours per month; or<br/>
<a id="pl.39.1"></a><var>39.1</var>    (3) if the household is a two-parent family, at least one of the parents must be <br/>
<a id="pl.39.2"></a><var>39.2</var>employed an average of at least 130 hours per month.<br/>
<a id="pl.39.3"></a><var>39.3</var>    Whenever a participant exits the diversionary work program or is terminated from <br/>
<a id="pl.39.4"></a><var>39.4</var>MFIP and meets the other criteria in this section, work participation cash benefits are <br/>
<a id="pl.39.5"></a><var>39.5</var>available for up to 24 consecutive months.<br/>
<a id="pl.39.6"></a><var>39.6</var>    (c) Expenditures on the program are maintenance of effort state funds under <br/>
<a id="pl.39.7"></a><var>39.7</var>a separate state program for participants under paragraph (b), clauses (1) and (2). <br/>
<a id="pl.39.8"></a><var>39.8</var>Expenditures for participants under paragraph (b), clause (3), are nonmaintenance of effort <br/>
<a id="pl.39.9"></a><var>39.9</var>funds. Months in which a participant receives work participation cash benefits under this <br/>
<a id="pl.39.10"></a><var>39.10</var>section do not count toward the participant's MFIP 60-month time limit.<br/>
<br/>
<a id="bill.2.28.0"></a><a id="pl.39.11"></a><var>39.11</var>    Sec. 28. Minnesota Statutes 2008, section 256J.626, subdivision 7, is amended to read:<br/>
<a id="pl.39.12"></a><var>39.12</var>    Subd. 7. <b>Performance base funds.</b> (a) For the purpose of this section, the following <br/>
<a id="pl.39.13"></a><var>39.13</var>terms have the meanings given.<br/>
<a id="pl.39.14"></a><var>39.14</var>(1) "Caseload Reduction Credit" (CRC) means the measure of how much Minnesota <br/>
<a id="pl.39.15"></a><var>39.15</var>TANF and separate state program caseload has fallen relative to federal fiscal year 2005 <br/>
<a id="pl.39.16"></a><var>39.16</var>based on caseload data from October 1 to September 30.<br/>
<a id="pl.39.17"></a><var>39.17</var>(2) "TANF participation rate target" means a 50 percent participation rate reduced by <br/>
<a id="pl.39.18"></a><var>39.18</var>the CRC for the previous year.<br/>
<a id="pl.39.19"></a><var>39.19</var>(b) For calendar year 2009 2010 and yearly thereafter, each county and tribe will be <br/>
<a id="pl.39.20"></a><var>39.20</var>allocated 95 percent of their initial calendar year allocation. Counties and tribes will be <br/>
<a id="pl.39.21"></a><var>39.21</var>allocated additional funds based on performance as follows:<br/>
<a id="pl.39.22"></a><var>39.22</var>    (1) a county or tribe that achieves a 50 percent the TANF participation rate target <br/>
<a id="pl.39.23"></a><var>39.23</var>or a five percentage point improvement over the previous year's TANF participation rate <br/>
<a id="pl.39.24"></a><var>39.24</var>under section 
         <statute_ref>256J.751, subdivision 2</statute_ref>, clause (7), as averaged across 12 consecutive <br/>
<a id="pl.39.25"></a><var>39.25</var>months for the most recent year for which the measurements are available, will receive an <br/>
<a id="pl.39.26"></a><var>39.26</var>additional allocation equal to 2.5 percent of its initial allocation; and<br/>
<a id="pl.39.27"></a><var>39.27</var>    (2) a county or tribe that performs within or above its range of expected performance <br/>
<a id="pl.39.28"></a><var>39.28</var>on the annualized three-year self-support index under section 
         <statute_ref>256J.751, subdivision 2</statute_ref>, <br/>
<a id="pl.39.29"></a><var>39.29</var>clause (6), will receive an additional allocation equal to 2.5 percent of its initial allocation; <br/>
<a id="pl.39.30"></a><var>39.30</var>and<br/>
<a id="pl.39.31"></a><var>39.31</var>    (3) a county or tribe that does not achieve a 50 percent the TANF participation rate <br/>
<a id="pl.39.32"></a><var>39.32</var>target or a five percentage point improvement over the previous year's TANF participation <br/>
<a id="pl.39.33"></a><var>39.33</var>rate under section 
         <statute_ref>256J.751, subdivision 2</statute_ref>, clause (7), as averaged across 12 consecutive <br/>
<a id="pl.39.34"></a><var>39.34</var>months for the most recent year for which the measurements are available, will not <br/>
<a id="pl.40.1"></a><var>40.1</var>receive an additional 2.5 percent of its initial allocation until after negotiating a multiyear <br/>
<a id="pl.40.2"></a><var>40.2</var>improvement plan with the commissioner; or <br/>
<a id="pl.40.3"></a><var>40.3</var>    (4) a county or tribe that does not perform within or above its range of expected <br/>
<a id="pl.40.4"></a><var>40.4</var>performance on the annualized three-year self-support index under section 
         <statute_ref>256J.751, <br/>
<a id="pl.40.5"></a><var>40.5</var>subdivision 2
         </statute_ref>, clause (6), will not receive an additional allocation equal to 2.5 percent <br/>
<a id="pl.40.6"></a><var>40.6</var>of its initial allocation until after negotiating a multiyear improvement plan with the <br/>
<a id="pl.40.7"></a><var>40.7</var>commissioner.<br/>
<a id="pl.40.8"></a><var>40.8</var>    (b) (c) For calendar year 2009 and yearly thereafter, performance-based funds for <br/>
<a id="pl.40.9"></a><var>40.9</var>a federally approved tribal TANF program in which the state and tribe have in place <br/>
<a id="pl.40.10"></a><var>40.10</var>a contract under section 
         <statute_ref>256.01</statute_ref>, addressing consolidated funding, will be allocated as <br/>
<a id="pl.40.11"></a><var>40.11</var>follows:<br/>
<a id="pl.40.12"></a><var>40.12</var>    (1) a tribe that achieves the participation rate approved in its federal TANF plan <br/>
<a id="pl.40.13"></a><var>40.13</var>using the average of 12 consecutive months for the most recent year for which the <br/>
<a id="pl.40.14"></a><var>40.14</var>measurements are available, will receive an additional allocation equal to 2.5 percent of <br/>
<a id="pl.40.15"></a><var>40.15</var>its initial allocation; and<br/>
<a id="pl.40.16"></a><var>40.16</var>    (2) a tribe that performs within or above its range of expected performance on the <br/>
<a id="pl.40.17"></a><var>40.17</var>annualized three-year self-support index under section 
         <statute_ref>256J.751, subdivision 2</statute_ref>, clause (6), <br/>
<a id="pl.40.18"></a><var>40.18</var>will receive an additional allocation equal to 2.5 percent of its initial allocation; or <br/>
<a id="pl.40.19"></a><var>40.19</var>    (3) a tribe that does not achieve the participation rate approved in its federal TANF <br/>
<a id="pl.40.20"></a><var>40.20</var>plan using the average of 12 consecutive months for the most recent year for which the <br/>
<a id="pl.40.21"></a><var>40.21</var>measurements are available, will not receive an additional allocation equal to 2.5 percent <br/>
<a id="pl.40.22"></a><var>40.22</var>of its initial allocation until after negotiating a multiyear improvement plan with the <br/>
<a id="pl.40.23"></a><var>40.23</var>commissioner; or<br/>
<a id="pl.40.24"></a><var>40.24</var>    (4) a tribe that does not perform within or above its range of expected performance <br/>
<a id="pl.40.25"></a><var>40.25</var>on the annualized three-year self-support index under section 
         <statute_ref>256J.751, subdivision <br/>
<a id="pl.40.26"></a><var>40.26</var>2
         </statute_ref>, clause (6), will not receive an additional allocation equal to 2.5 percent until after <br/>
<a id="pl.40.27"></a><var>40.27</var>negotiating a multiyear improvement plan with the commissioner.<br/>
<a id="pl.40.28"></a><var>40.28</var>    (c) (d) Funds remaining unallocated after the performance-based allocations <br/>
<a id="pl.40.29"></a><var>40.29</var>in paragraph (a) (b) are available to the commissioner for innovation projects under <br/>
<a id="pl.40.30"></a><var>40.30</var>subdivision 5.<br/>
<a id="pl.40.31"></a><var>40.31</var>    (d) (1) If available funds are insufficient to meet county and tribal allocations under <br/>
<a id="pl.40.32"></a><var>40.32</var>paragraph (a) (b), the commissioner may make available for allocation funds that are <br/>
<a id="pl.40.33"></a><var>40.33</var>unobligated and available from the innovation projects through the end of the current <br/>
<a id="pl.40.34"></a><var>40.34</var>biennium.<br/>
<a id="pl.40.35"></a><var>40.35</var>    (2) If after the application of clause (1) funds remain insufficient to meet county <br/>
<a id="pl.40.36"></a><var>40.36</var>and tribal allocations under paragraph (a) (b), the commissioner must proportionally <br/>
<a id="pl.41.1"></a><var>41.1</var>reduce the allocation of each county and tribe with respect to their maximum allocation <br/>
<a id="pl.41.2"></a><var>41.2</var>available under paragraph (a) (b).<br/>
<br/>
<a id="bill.2.29.0"></a><a id="pl.41.3"></a><var>41.3</var>    Sec. 29. Minnesota Statutes 2008, section 256J.95, subdivision 3, is amended to read:<br/>
<a id="pl.41.4"></a><var>41.4</var>    Subd. 3. <b>Eligibility for diversionary work program.</b> (a) Except for the categories <br/>
<a id="pl.41.5"></a><var>41.5</var>of family units listed below, all family units who apply for cash benefits and who <br/>
<a id="pl.41.6"></a><var>41.6</var>meet MFIP eligibility as required in sections 
         <statute_ref>256J.11</statute_ref> to 
         <statute_ref>256J.15</statute_ref> are eligible and must <br/>
<a id="pl.41.7"></a><var>41.7</var>participate in the diversionary work program. Family units that are not eligible for the <br/>
<a id="pl.41.8"></a><var>41.8</var>diversionary work program include:<br/>
<a id="pl.41.9"></a><var>41.9</var>    (1) child only cases;<br/>
<a id="pl.41.10"></a><var>41.10</var>    (2) a single-parent family unit that includes a child under 12 weeks months of age. <br/>
<a id="pl.41.11"></a><var>41.11</var>A parent is eligible for this exception once in a parent's lifetime and is not eligible if <br/>
<a id="pl.41.12"></a><var>41.12</var>the parent has already used the previously allowed child under age one exemption from <br/>
<a id="pl.41.13"></a><var>41.13</var>MFIP employment services;<br/>
<a id="pl.41.14"></a><var>41.14</var>    (3) a minor parent without a high school diploma or its equivalent;<br/>
<a id="pl.41.15"></a><var>41.15</var>    (4) an 18- or 19-year-old caregiver without a high school diploma or its equivalent <br/>
<a id="pl.41.16"></a><var>41.16</var>who chooses to have an employment plan with an education option;<br/>
<a id="pl.41.17"></a><var>41.17</var>    (5) a caregiver age 60 or over;<br/>
<a id="pl.41.18"></a><var>41.18</var>    (6) family units with a caregiver who received DWP benefits in the 12 months prior <br/>
<a id="pl.41.19"></a><var>41.19</var>to the month the family applied for DWP, except as provided in paragraph (c);<br/>
<a id="pl.41.20"></a><var>41.20</var>    (7) family units with a caregiver who received MFIP within the 12 months prior to <br/>
<a id="pl.41.21"></a><var>41.21</var>the month the family unit applied for DWP;<br/>
<a id="pl.41.22"></a><var>41.22</var>    (8) a family unit with a caregiver who received 60 or more months of TANF <br/>
<a id="pl.41.23"></a><var>41.23</var>assistance; <br/>
<a id="pl.41.24"></a><var>41.24</var>    (9) a family unit with a caregiver who is disqualified from DWP or MFIP due to <br/>
<a id="pl.41.25"></a><var>41.25</var>fraud; and<br/>
<a id="pl.41.26"></a><var>41.26</var>    (10) refugees and asylees as defined in Code of Federal Regulations, title 45, part <br/>
<a id="pl.41.27"></a><var>41.27</var>400, subpart d, section 
         <statute_ref>400.43</statute_ref>, who arrived in the United States in the 12 months prior to <br/>
<a id="pl.41.28"></a><var>41.28</var>the date of application for family cash assistance.<br/>
<a id="pl.41.29"></a><var>41.29</var>    (b) A two-parent family must participate in DWP unless both caregivers meet the <br/>
<a id="pl.41.30"></a><var>41.30</var>criteria for an exception under paragraph (a), clauses (1) through (5), or the family unit <br/>
<a id="pl.41.31"></a><var>41.31</var>includes a parent who meets the criteria in paragraph (a), clause (6), (7), (8), (9), or (10).<br/>
<a id="pl.41.32"></a><var>41.32</var>    (c) Once DWP eligibility is determined, the four months run consecutively. If a <br/>
<a id="pl.41.33"></a><var>41.33</var>participant leaves the program for any reason and reapplies during the four-month period, <br/>
<a id="pl.41.34"></a><var>41.34</var>the county must redetermine eligibility for DWP.<br/>
<a id="pl.41.35"></a><var>41.35</var><b>EFFECTIVE DATE.</b>This section is effective March 1, 2010.<br/>
<br/>
<a id="bill.2.30.0"></a><a id="pl.42.1"></a><var>42.1</var>    Sec. 30. Minnesota Statutes 2008, section 256J.95, subdivision 11, is amended to read:<br/>
<a id="pl.42.2"></a><var>42.2</var>    Subd. 11. <b>Universal participation required.</b> (a) All DWP caregivers, except <br/>
<a id="pl.42.3"></a><var>42.3</var>caregivers who meet the criteria in paragraph (d), are required to participate in DWP <br/>
<a id="pl.42.4"></a><var>42.4</var>employment services. Except as specified in paragraphs (b) and (c), employment plans <br/>
<a id="pl.42.5"></a><var>42.5</var>under DWP must, at a minimum, meet the requirements in section 
         <statute_ref>256J.55, subdivision 1</statute_ref>.<br/>
<a id="pl.42.6"></a><var>42.6</var>(b) A caregiver who is a member of a two-parent family that is required to participate <br/>
<a id="pl.42.7"></a><var>42.7</var>in DWP who would otherwise be ineligible for DWP under subdivision 3 may be allowed <br/>
<a id="pl.42.8"></a><var>42.8</var>to develop an employment plan under section 
         <statute_ref>256J.521, subdivision 2</statute_ref>, paragraph (c), that <br/>
<a id="pl.42.9"></a><var>42.9</var>may contain alternate activities and reduced hours.<br/>
<a id="pl.42.10"></a><var>42.10</var>(c) A participant who is a victim of family violence shall be allowed to develop an <br/>
<a id="pl.42.11"></a><var>42.11</var>employment plan under section 
         <statute_ref>256J.521, subdivision 3</statute_ref>. A claim of family violence must <br/>
<a id="pl.42.12"></a><var>42.12</var>be documented by the applicant or participant by providing a sworn statement which is <br/>
<a id="pl.42.13"></a><var>42.13</var>supported by collateral documentation in section 
         <statute_ref>256J.545, paragraph (b)</statute_ref>.<br/>
<a id="pl.42.14"></a><var>42.14</var>(d) One parent in a two-parent family unit that has a natural born child under 12 <br/>
<a id="pl.42.15"></a><var>42.15</var>weeks months of age is not required to have an employment plan until the child reaches 12 <br/>
<a id="pl.42.16"></a><var>42.16</var>weeks months of age unless the family unit has already used the exclusion under section <br/>
<statute_ref><a id="pl.42.17"></a><var>42.17</var>256J.561, subdivision 3
         </statute_ref>, or the previously allowed child under age one exemption under <br/>
<a id="pl.42.18"></a><var>42.18</var>section 
         <statute_ref>256J.56, paragraph (a)</statute_ref>, clause (5).<br/>
<a id="pl.42.19"></a><var>42.19</var>(e) The provision in paragraph (d) ends the first full month after the child reaches 12 <br/>
<a id="pl.42.20"></a><var>42.20</var>weeks months of age. This provision is allowable only once in a caregiver's lifetime. In a <br/>
<a id="pl.42.21"></a><var>42.21</var>two-parent household, only one parent shall be allowed to use this category.<br/>
<a id="pl.42.22"></a><var>42.22</var>(f) The participant and job counselor must meet within ten working days after the <br/>
<a id="pl.42.23"></a><var>42.23</var>child reaches 12 weeks months of age to revise the participant's employment plan. The <br/>
<a id="pl.42.24"></a><var>42.24</var>employment plan for a family unit that has a child under 12 weeks months of age that has <br/>
<a id="pl.42.25"></a><var>42.25</var>already used the exclusion in section 
         <statute_ref>256J.561</statute_ref> or the previously allowed child under <br/>
<a id="pl.42.26"></a><var>42.26</var>age one exemption under section 
         <statute_ref>256J.56, paragraph (a)</statute_ref>, clause (5), must be tailored to <br/>
<a id="pl.42.27"></a><var>42.27</var>recognize the caregiving needs of the parent.<br/>
<a id="pl.42.28"></a><var>42.28</var><b>EFFECTIVE DATE.</b>This section is effective March 1, 2010.<br/>
<br/>
<a id="bill.2.31.0"></a><a id="pl.42.29"></a><var>42.29</var>    Sec. 31. Minnesota Statutes 2008, section 256J.95, subdivision 12, is amended to read:<br/>
<a id="pl.42.30"></a><var>42.30</var>    Subd. 12. <b>Conversion or referral to MFIP.</b> (a) If at any time during the DWP <br/>
<a id="pl.42.31"></a><var>42.31</var>application process or during the four-month DWP eligibility period, it is determined that <br/>
<a id="pl.42.32"></a><var>42.32</var>a participant is unlikely to benefit from the diversionary work program, the county shall <br/>
<a id="pl.42.33"></a><var>42.33</var>convert or refer the participant to MFIP as specified in paragraph (d). Participants who are <br/>
<a id="pl.42.34"></a><var>42.34</var>determined to be unlikely to benefit from the diversionary work program must develop <br/>
<a id="pl.42.35"></a><var>42.35</var>and sign an employment plan. Participants who meet any one of the criteria in paragraph <br/>
<a id="pl.43.1"></a><var>43.1</var>(b) shall be considered to be unlikely to benefit from DWP, provided the necessary <br/>
<a id="pl.43.2"></a><var>43.2</var>documentation is available to support the determination.<br/>
<a id="pl.43.3"></a><var>43.3</var>(b) A participant who: meets the eligibility requirements under section 256J.575, <br/>
<a id="pl.43.4"></a><var>43.4</var>subdivision 3, must be considered to be unlikely to benefit from DWP, provided the <br/>
<a id="pl.43.5"></a><var>43.5</var>necessary documentation is available to support the determination.<br/>
<a id="pl.43.6"></a><var>43.6</var>(1) has been determined by a qualified professional as being unable to obtain or retain <br/>
<a id="pl.43.7"></a><var>43.7</var>employment due to an illness, injury, or incapacity that is expected to last at least 60 days;<br/>
<a id="pl.43.8"></a><var>43.8</var>(2) is required in the home as a caregiver because of the illness, injury, or incapacity, <br/>
<a id="pl.43.9"></a><var>43.9</var>of a family member, or a relative in the household, or a foster child, and the illness, injury, <br/>
<a id="pl.43.10"></a><var>43.10</var>or incapacity and the need for a person to provide assistance in the home has been certified <br/>
<a id="pl.43.11"></a><var>43.11</var>by a qualified professional and is expected to continue more than 60 days;<br/>
<a id="pl.43.12"></a><var>43.12</var>(3) is determined by a qualified professional as being needed in the home to care for <br/>
<a id="pl.43.13"></a><var>43.13</var>a child or adult meeting the special medical criteria in section 
<statute_ref>256J.561, subdivision 2</statute_ref>, <br/>
<a id="pl.43.14"></a><var>43.14</var>paragraph (d), clause (3); <br/>
<a id="pl.43.15"></a><var>43.15</var>(4) is pregnant and is determined by a qualified professional as being unable to <br/>
<a id="pl.43.16"></a><var>43.16</var>obtain or retain employment due to the pregnancy; or<br/>
<a id="pl.43.17"></a><var>43.17</var>(5) has applied for SSI or SSDI.<br/>
<a id="pl.43.18"></a><var>43.18</var>(c) In a two-parent family unit, both parents must be if one parent is determined <br/>
<a id="pl.43.19"></a><var>43.19</var>to be unlikely to benefit from the diversionary work program before, the family unit <br/>
<a id="pl.43.20"></a><var>43.20</var>can must be converted or referred to MFIP.<br/>
<a id="pl.43.21"></a><var>43.21</var>(d) A participant who is determined to be unlikely to benefit from the diversionary <br/>
<a id="pl.43.22"></a><var>43.22</var>work program shall be converted to MFIP and, if the determination was made within 30 <br/>
<a id="pl.43.23"></a><var>43.23</var>days of the initial application for benefits, no additional application form is required. <br/>
<a id="pl.43.24"></a><var>43.24</var>A participant who is determined to be unlikely to benefit from the diversionary work <br/>
<a id="pl.43.25"></a><var>43.25</var>program shall be referred to MFIP and, if the determination is made more than 30 <br/>
<a id="pl.43.26"></a><var>43.26</var>days after the initial application, the participant must submit a program change request <br/>
<a id="pl.43.27"></a><var>43.27</var>form. The county agency shall process the program change request form by the first of <br/>
<a id="pl.43.28"></a><var>43.28</var>the following month to ensure that no gap in benefits is due to delayed action by the <br/>
<a id="pl.43.29"></a><var>43.29</var>county agency. In processing the program change request form, the county must follow <br/>
<a id="pl.43.30"></a><var>43.30</var>section 
         <statute_ref>256J.32, subdivision 1</statute_ref>, except that the county agency shall not require additional <br/>
<a id="pl.43.31"></a><var>43.31</var>verification of the information in the case file from the DWP application unless the <br/>
<a id="pl.43.32"></a><var>43.32</var>information in the case file is inaccurate, questionable, or no longer current. <br/>
<a id="pl.43.33"></a><var>43.33</var>(e) The county shall not request a combined application form for a participant who <br/>
<a id="pl.43.34"></a><var>43.34</var>has exhausted the four months of the diversionary work program, has continued need for <br/>
<a id="pl.43.35"></a><var>43.35</var>cash and food assistance, and has completed, signed, and submitted a program change <br/>
<a id="pl.43.36"></a><var>43.36</var>request form within 30 days of the fourth month of the diversionary work program. The <br/>
<a id="pl.44.1"></a><var>44.1</var>county must process the program change request according to section 
         <statute_ref>256J.32, subdivision <br/>
<a id="pl.44.2"></a><var>44.2</var>1
         </statute_ref>, except that the county agency shall not require additional verification of information <br/>
<a id="pl.44.3"></a><var>44.3</var>in the case file unless the information is inaccurate, questionable, or no longer current. <br/>
<a id="pl.44.4"></a><var>44.4</var>When a participant does not request MFIP within 30 days of the diversionary work <br/>
<a id="pl.44.5"></a><var>44.5</var>program benefits being exhausted, a new combined application form must be completed <br/>
<a id="pl.44.6"></a><var>44.6</var>for any subsequent request for MFIP. <br/>
<a id="pl.44.7"></a><var>44.7</var><b>EFFECTIVE DATE.</b>This section is effective March 1, 2010.<br/>
<br/>
<a id="bill.2.32.0"></a><a id="pl.44.8"></a><var>44.8</var>    Sec. 32. Minnesota Statutes 2008, section 256J.95, subdivision 13, is amended to read:<br/>
<a id="pl.44.9"></a><var>44.9</var>    Subd. 13. <b>Immediate referral to employment services.</b> Within one working day of <br/>
<a id="pl.44.10"></a><var>44.10</var>determination that the applicant is eligible for the diversionary work program, but before <br/>
<a id="pl.44.11"></a><var>44.11</var>benefits are issued to or on behalf of the family unit, the county shall refer all caregivers to <br/>
<a id="pl.44.12"></a><var>44.12</var>employment services. The referral to the DWP employment services must be in writing <br/>
<a id="pl.44.13"></a><var>44.13</var>and must contain the following information:<br/>
<a id="pl.44.14"></a><var>44.14</var>(1) notification that, as part of the application process, applicants are required to <br/>
<a id="pl.44.15"></a><var>44.15</var>develop an employment plan or the DWP application will be denied;<br/>
<a id="pl.44.16"></a><var>44.16</var>(2) the employment services provider name and phone number;<br/>
<a id="pl.44.17"></a><var>44.17</var>(3) the date, time, and location of the scheduled employment services interview;<br/>
<a id="pl.44.18"></a><var>44.18</var>(4) the immediate availability of supportive services, including, but not limited to, <br/>
<a id="pl.44.19"></a><var>44.19</var>child care, transportation, and other work-related aid; and<br/>
<a id="pl.44.20"></a><var>44.20</var>(5) (4) the rights, responsibilities, and obligations of participants in the program, <br/>
<a id="pl.44.21"></a><var>44.21</var>including, but not limited to, the grounds for good cause, the consequences of refusing or <br/>
<a id="pl.44.22"></a><var>44.22</var>failing to participate fully with program requirements, and the appeal process.<br/>
<br/>
<a id="bill.2.33.0"></a><a id="pl.44.23"></a><var>44.23</var>    Sec. 33. Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision <br/>
<a id="pl.44.24"></a><var>44.24</var>to read:<br/>
<a id="pl.44.25"></a><var>44.25</var>    Subd. 3b. <b>Extension; adoption finalized after age 16.</b> A child who has attained the <br/>
<a id="pl.44.26"></a><var>44.26</var>age of 16 prior to finalization of their adoption is eligible for extension of the adoption <br/>
<a id="pl.44.27"></a><var>44.27</var>assistance agreement to the date the child attains age 21 if the child is:<br/>
<a id="pl.44.28"></a><var>44.28</var>    (1) completing a secondary education program or a program leading to an equivalent <br/>
<a id="pl.44.29"></a><var>44.29</var>credential;<br/>
<a id="pl.44.30"></a><var>44.30</var>    (2) enrolled in an institution which provides postsecondary or vocational education;<br/>
<a id="pl.44.31"></a><var>44.31</var>    (3) participating in a program or activity designed to promote or remove barriers to <br/>
<a id="pl.44.32"></a><var>44.32</var>employment;<br/>
<a id="pl.44.33"></a><var>44.33</var>    (4) employed for at least 80 hours per month; or<br/>
<a id="pl.45.1"></a><var>45.1</var>    (5) incapable of doing any of the activities described in clauses (1) to (4) due to a <br/>
<a id="pl.45.2"></a><var>45.2</var>medical condition which incapability is supported by regularly updated information in <br/>
<a id="pl.45.3"></a><var>45.3</var>the case plan of the child.<br/>
<a id="pl.45.4"></a><var>45.4</var><b>EFFECTIVE DATE.</b>This section is effective October 1, 2010.<br/>
<br/>
<a id="bill.2.34.0"></a><a id="pl.45.5"></a><var>45.5</var>    Sec. 34. Minnesota Statutes 2008, section 270A.09, is amended by adding a <br/>
<a id="pl.45.6"></a><var>45.6</var>subdivision to read:<br/>
<a id="pl.45.7"></a><var>45.7</var>    Subd. 1b. <b>Department of Human Services claims.</b> Notwithstanding subdivision 1, <br/>
<a id="pl.45.8"></a><var>45.8</var>any debtor contesting a setoff claim by the Department of Human Services or a county <br/>
<a id="pl.45.9"></a><var>45.9</var>agency whose claim relates to a debt resulting from receipt of public assistance, medical <br/>
<a id="pl.45.10"></a><var>45.10</var>care, or the federal Food Stamp Act shall have a hearing conducted in the same manner as <br/>
<a id="pl.45.11"></a><var>45.11</var>an appeal under sections 256.045 and 256.0451.<br/>
<br/>
<a id="bill.2.35.0"></a><a id="pl.45.12"></a><var>45.12</var>    Sec. 35. <b>AMERICAN INDIAN CHILD WELFARE PROJECTS.</b><br/>
<a id="pl.45.13"></a><var>45.13</var>Notwithstanding Minnesota Statutes, section 16A.28, the commissioner of human <br/>
<a id="pl.45.14"></a><var>45.14</var>services shall extend payment of state fiscal year 2009 funds in state fiscal year 2010 <br/>
<a id="pl.45.15"></a><var>45.15</var>to tribes participating in the American Indian child welfare projects under Minnesota <br/>
<a id="pl.45.16"></a><var>45.16</var>Statutes, section 256.01, subdivision 14b. Future extensions of payment for a tribe <br/>
<a id="pl.45.17"></a><var>45.17</var>participating in the Indian child welfare projects under Minnesota Statutes, section 256.01, <br/>
<a id="pl.45.18"></a><var>45.18</var>subdivision 14b, must be granted according to the commissioner's authority under <br/>
<a id="pl.45.19"></a><var>45.19</var>Minnesota Statutes, section 16A.28.<br/>
<br/>
<a id="bill.2.36.0"></a><a id="pl.45.20"></a><var>45.20</var>    Sec. 36. <b> REPEALER.</b><br/>
<a id="pl.45.21"></a><var>45.21</var>Minnesota Statutes 2008, section 256I.06, subdivision 9, is repealed.<br/>
<br/>
<a id="bill.3.0.0"></a>

<a id="bill.3.1.0"></a><a id="pl.45.24"></a><var>45.24</var>    Section 1. Minnesota Statutes 2008, section 246.50, subdivision 5, is amended to read:<br/>
<a id="pl.45.25"></a><var>45.25</var>    Subd. 5. <b>Cost of care.</b> "Cost of care" means the commissioner's charge for services <br/>
<a id="pl.45.26"></a><var>45.26</var>provided to any person admitted to a state facility.<br/>
<a id="pl.45.27"></a><var>45.27</var>For purposes of this subdivision, "charge for services" means the cost of services, <br/>
<a id="pl.45.28"></a><var>45.28</var>treatment, maintenance, bonds issued for capital improvements, depreciation of buildings <br/>
<a id="pl.45.29"></a><var>45.29</var>and equipment, and indirect costs related to the operation of state facilities. The <br/>
<a id="pl.45.30"></a><var>45.30</var>commissioner may determine the charge for services on an anticipated average per diem <br/>
<a id="pl.45.31"></a><var>45.31</var>basis as an all inclusive charge per facility, per disability group, or per treatment program. <br/>
<a id="pl.45.32"></a><var>45.32</var>The commissioner may determine a charge per service, using a method that includes direct <br/>
<a id="pl.46.1"></a><var>46.1</var>and indirect costs usual and customary fee charged for services provided to clients. The <br/>
<a id="pl.46.2"></a><var>46.2</var>usual and customary fee shall be established in a manner required to appropriately bill <br/>
<a id="pl.46.3"></a><var>46.3</var>services to all payers and shall include the costs related to the operations of any program <br/>
<a id="pl.46.4"></a><var>46.4</var>offered by the state.<br/>
<br/>
<a id="bill.3.2.0"></a><a id="pl.46.5"></a><var>46.5</var>    Sec. 2. Minnesota Statutes 2008, section 246.50, is amended by adding a subdivision <br/>
<a id="pl.46.6"></a><var>46.6</var>to read:<br/>
<a id="pl.46.7"></a><var>46.7</var>    Subd. 10. <b>State-operated community-based program.</b>  "State-operated <br/>
<a id="pl.46.8"></a><var>46.8</var>community-based program" means any program operated in the community including <br/>
<a id="pl.46.9"></a><var>46.9</var>community behavioral health hospitals, crisis centers, residential facilities, outpatient <br/>
<a id="pl.46.10"></a><var>46.10</var>services, and other community-based services developed and operated by the state and <br/>
<a id="pl.46.11"></a><var>46.11</var>under the commissioner's control.<br/>
<br/>
<a id="bill.3.3.0"></a><a id="pl.46.12"></a><var>46.12</var>    Sec. 3. Minnesota Statutes 2008, section 246.50, is amended by adding a subdivision <br/>
<a id="pl.46.13"></a><var>46.13</var>to read:<br/>
<a id="pl.46.14"></a><var>46.14</var>    Subd. 11. <b>Health plan company.</b> "Health plan company" has the meaning given it <br/>
<a id="pl.46.15"></a><var>46.15</var>in section 62Q.01, subdivision 4, and also includes a demonstration provider as defined in <br/>
<a id="pl.46.16"></a><var>46.16</var>section 256B.69, subdivision 2, paragraph (b), a county or group of counties participating <br/>
<a id="pl.46.17"></a><var>46.17</var>in county-based purchasing according to section 256B.692, and a children's mental health <br/>
<a id="pl.46.18"></a><var>46.18</var>collaborative under contract to provide medical assistance for individuals enrolled in <br/>
<a id="pl.46.19"></a><var>46.19</var>the prepaid medical assistance and MinnesotaCare programs under sections 245.493 to <br/>
<a id="pl.46.20"></a><var>46.20</var>245.495.<br/>
<br/>
<a id="bill.3.4.0"></a><a id="pl.46.21"></a><var>46.21</var>    Sec. 4. Minnesota Statutes 2008, section 246.51, is amended by adding a subdivision <br/>
<a id="pl.46.22"></a><var>46.22</var>to read:<br/>
<a id="pl.46.23"></a><var>46.23</var>    Subd. 1a. <b>Clients in state-operated community-based programs; determination.</b><br/>
<a id="pl.46.24"></a><var>46.24</var>The commissioner shall determine available health plan coverage from a health plan <br/>
<a id="pl.46.25"></a><var>46.25</var>company for services provided to clients admitted to a state-operated community-based <br/>
<a id="pl.46.26"></a><var>46.26</var>program. If the health plan coverage requires a co-pay or deductible, or if there is no <br/>
<a id="pl.46.27"></a><var>46.27</var>available health plan coverage, the commissioner shall determine or redetermine, what <br/>
<a id="pl.46.28"></a><var>46.28</var>part of the noncovered cost of care, if any, the client is able to pay. If the client is unable to <br/>
<a id="pl.46.29"></a><var>46.29</var>pay the uncovered cost of care, the commissioner shall determine the client's relatives' <br/>
<a id="pl.46.30"></a><var>46.30</var>ability to pay. The client and relatives shall provide to the commissioner documents and <br/>
<a id="pl.46.31"></a><var>46.31</var>proof necessary to determine the client and relatives' ability to pay. Failure to provide the <br/>
<a id="pl.46.32"></a><var>46.32</var>commissioner with sufficient information to determine ability to pay may make the client <br/>
<a id="pl.46.33"></a><var>46.33</var>or relatives liable for the full cost of care until the time when sufficient information is <br/>
<a id="pl.47.1"></a><var>47.1</var>provided. If it is determined that the responsible party does not have the ability to pay, <br/>
<a id="pl.47.2"></a><var>47.2</var>the commissioner shall waive payment of the portion that exceeds ability to pay under <br/>
<a id="pl.47.3"></a><var>47.3</var>the determination.<br/>
<br/>
<a id="bill.3.5.0"></a><a id="pl.47.4"></a><var>47.4</var>    Sec. 5. Minnesota Statutes 2008, section 246.51, is amended by adding a subdivision <br/>
<a id="pl.47.5"></a><var>47.5</var>to read:<br/>
<a id="pl.47.6"></a><var>47.6</var>    Subd. 1b. <b>Clients served by regional treatment centers or nursing homes; </b><br/>
<a id="pl.47.7"></a><var>47.7</var><b>determination.</b> The commissioner shall determine or redetermine, if necessary, what part <br/>
<a id="pl.47.8"></a><var>47.8</var>of the cost of care, if any, a client served in regional treatment centers or nursing homes <br/>
<a id="pl.47.9"></a><var>47.9</var>operated by state-operated services, is able to pay. If the client is unable to pay the full cost <br/>
<a id="pl.47.10"></a><var>47.10</var>of care, the commissioner shall determine if the client's relatives have the ability to pay. <br/>
<a id="pl.47.11"></a><var>47.11</var>The client and relatives shall provide to the commissioner documents and proof necessary <br/>
<a id="pl.47.12"></a><var>47.12</var>to determine the client and relatives' ability to pay. Failure to provide the commissioner <br/>
<a id="pl.47.13"></a><var>47.13</var>with sufficient information to determine ability to pay may make the client or relatives <br/>
<a id="pl.47.14"></a><var>47.14</var>liable for the full cost of care until the time when sufficient information is provided. No <br/>
<a id="pl.47.15"></a><var>47.15</var>parent shall be liable for the cost of care given a client at a regional treatment center after <br/>
<a id="pl.47.16"></a><var>47.16</var>the client has reached the age of 18 years.<br/>
<br/>
<a id="bill.3.6.0"></a><a id="pl.47.17"></a><var>47.17</var>    Sec. 6. Minnesota Statutes 2008, section 246.511, is amended to read:<br/>
<a id="pl.47.18"></a><var>47.18</var><b>246.511 RELATIVE RESPONSIBILITY.</b><br/>
<a id="pl.47.19"></a><var>47.19</var>Except for chemical dependency services paid for with funds provided under chapter <br/>
<a id="pl.47.20"></a><var>47.20</var>254B, a client's relatives shall not, pursuant to the commissioner's authority under section <br/>
<statute_ref><a id="pl.47.21"></a><var>47.21</var>246.51
         </statute_ref>, be ordered to pay more than ten percent of the cost of the following: (1) for <br/>
<a id="pl.47.22"></a><var>47.22</var>services provided in a community-based service, the noncovered cost of care as determined <br/>
<a id="pl.47.23"></a><var>47.23</var>under the ability to pay determination; and (2) for services provided at a regional treatment <br/>
<a id="pl.47.24"></a><var>47.24</var>center operated by state-operated services, 20 percent of the cost of care, unless they <br/>
<a id="pl.47.25"></a><var>47.25</var>reside outside the state. Parents of children in state facilities shall have their responsibility <br/>
<a id="pl.47.26"></a><var>47.26</var>to pay determined according to section 
         <statute_ref>252.27, subdivision 2</statute_ref>, or in rules adopted under <br/>
<a id="pl.47.27"></a><var>47.27</var>chapter 254B if the cost of care is paid under chapter 254B. The commissioner may <br/>
<a id="pl.47.28"></a><var>47.28</var>accept voluntary payments in excess of ten 20 percent. The commissioner may require <br/>
<a id="pl.47.29"></a><var>47.29</var>full payment of the full per capita cost of care in state facilities for clients whose parent, <br/>
<a id="pl.47.30"></a><var>47.30</var>parents, spouse, guardian, or conservator do not reside in Minnesota.  <br/>
<br/>
<a id="bill.3.7.0"></a><a id="pl.47.31"></a><var>47.31</var>    Sec. 7. Minnesota Statutes 2008, section 246.52, is amended to read:<br/>
<a id="pl.47.32"></a><var>47.32</var><b>246.52 PAYMENT FOR CARE; ORDER; ACTION.</b><br/>
<a id="pl.48.1"></a><var>48.1</var>The commissioner shall issue an order to the client or the guardian of the estate, if <br/>
<a id="pl.48.2"></a><var>48.2</var>there be one, and relatives determined able to pay requiring them to pay monthly to the <br/>
<a id="pl.48.3"></a><var>48.3</var>state of Minnesota the amounts so determined the total of which shall not exceed the full <br/>
<a id="pl.48.4"></a><var>48.4</var>cost of care. Such order shall specifically state the commissioner's determination and shall <br/>
<a id="pl.48.5"></a><var>48.5</var>be conclusive unless appealed from as herein provided. When a client or relative fails to <br/>
<a id="pl.48.6"></a><var>48.6</var>pay the amount due hereunder the attorney general, upon request of the commissioner, <br/>
<a id="pl.48.7"></a><var>48.7</var>may institute, or direct the appropriate county attorney to institute, civil action to recover <br/>
<a id="pl.48.8"></a><var>48.8</var>such amount.<br/>
<br/>
<a id="bill.3.8.0"></a><a id="pl.48.9"></a><var>48.9</var>    Sec. 8. Minnesota Statutes 2008, section 246.54, subdivision 2, is amended to read:<br/>
<a id="pl.48.10"></a><var>48.10</var>    Subd. 2. <b>Exceptions.</b> (a) Subdivision 1 does not apply to services provided at the <br/>
<a id="pl.48.11"></a><var>48.11</var>Minnesota Security Hospital, the Minnesota sex offender program, or the Minnesota <br/>
<a id="pl.48.12"></a><var>48.12</var>extended treatment options program. For services at these facilities, a county's payment <br/>
<a id="pl.48.13"></a><var>48.13</var>shall be made from the county's own sources of revenue and payments shall be paid as <br/>
<a id="pl.48.14"></a><var>48.14</var>follows: payments to the state from the county shall equal ten percent of the cost of care, <br/>
<a id="pl.48.15"></a><var>48.15</var>as determined by the commissioner, for each day, or the portion thereof, that the client <br/>
<a id="pl.48.16"></a><var>48.16</var>spends at the facility. If payments received by the state under sections 
         <statute_ref>246.50</statute_ref> to 
         <statute_ref>246.53</statute_ref> <br/>
<a id="pl.48.17"></a><var>48.17</var>exceed 90 percent of the cost of care, the county shall be responsible for paying the state <br/>
<a id="pl.48.18"></a><var>48.18</var>only the remaining amount. The county shall not be entitled to reimbursement from the <br/>
<a id="pl.48.19"></a><var>48.19</var>client, the client's estate, or from the client's relatives, except as provided in section 
         <statute_ref>246.53</statute_ref>. <br/>
<a id="pl.48.20"></a><var>48.20</var>    (b) Regardless of the facility to which the client is committed, subdivision 1 does <br/>
<a id="pl.48.21"></a><var>48.21</var>not apply to the following individuals:<br/>
<a id="pl.48.22"></a><var>48.22</var>    (1) clients who are committed as mentally ill and dangerous under section 
         <statute_ref>253B.02</statute_ref>, <br/>
<a id="pl.48.23"></a><var>48.23</var>subdivision 17;<br/>
<a id="pl.48.24"></a><var>48.24</var>    (2) clients who are committed as sexual psychopathic personalities under section <br/>
<statute_ref><a id="pl.48.25"></a><var>48.25</var>253B.02, subdivision 18b
         </statute_ref>; and<br/>
<a id="pl.48.26"></a><var>48.26</var>    (3) clients who are committed as sexually dangerous persons under section 
         <statute_ref>253B.02</statute_ref>, <br/>
<a id="pl.48.27"></a><var>48.27</var>subdivision 18c.<br/>
<a id="pl.48.28"></a><var>48.28</var>    For each of the individuals in clauses (1) to (3), the payment by the county to the state <br/>
<a id="pl.48.29"></a><var>48.29</var>shall equal ten percent of the cost of care for each day as determined by the commissioner.<br/>
<br/>
<a id="bill.3.9.0"></a><a id="pl.48.30"></a><var>48.30</var>    Sec. 9. Minnesota Statutes 2008, section 246B.01, is amended by adding a subdivision <br/>
<a id="pl.48.31"></a><var>48.31</var>to read:<br/>
<a id="pl.48.32"></a><var>48.32</var>    Subd. 1a. <b>Client.</b> "Client" means a person who is admitted to the Minnesota sex <br/>
<a id="pl.48.33"></a><var>48.33</var>offender program or subject to a court hold order under section 253B.185 for the purpose <br/>
<a id="pl.49.1"></a><var>49.1</var>of assessment, diagnosis, care, treatment, supervision, or other services provided by the <br/>
<a id="pl.49.2"></a><var>49.2</var>Minnesota sex offender program.<br/>
<br/>
<a id="bill.3.10.0"></a><a id="pl.49.3"></a><var>49.3</var>    Sec. 10. Minnesota Statutes 2008, section 246B.01, is amended by adding a <br/>
<a id="pl.49.4"></a><var>49.4</var>subdivision to read:<br/>
<a id="pl.49.5"></a><var>49.5</var>    Subd. 1b. <b>Client's county.</b> "Client's county" means the county of the client's <br/>
<a id="pl.49.6"></a><var>49.6</var>legal settlement for poor relief purposes at the time of commitment. If the client has no <br/>
<a id="pl.49.7"></a><var>49.7</var>legal settlement for poor relief in this state, it means the county of commitment, except <br/>
<a id="pl.49.8"></a><var>49.8</var>that when a client with no legal settlement for poor relief is committed while serving a <br/>
<a id="pl.49.9"></a><var>49.9</var>sentence at a penal institution, it means the county from which the client was sentenced.<br/>
<br/>
<a id="bill.3.11.0"></a><a id="pl.49.10"></a><var>49.10</var>    Sec. 11. Minnesota Statutes 2008, section 246B.01, is amended by adding a subdivision <br/>
<a id="pl.49.11"></a><var>49.11</var>to read:<br/>
<a id="pl.49.12"></a><var>49.12</var>    Subd. 2a. <b>Cost of care.</b> "Cost of care" means the commissioner's charge for housing <br/>
<a id="pl.49.13"></a><var>49.13</var>and treatment services provided to any person admitted to the Minnesota sex offender <br/>
<a id="pl.49.14"></a><var>49.14</var>program.<br/>
<a id="pl.49.15"></a><var>49.15</var>For purposes of this subdivision, "charge for housing and treatment services" means <br/>
<a id="pl.49.16"></a><var>49.16</var>the cost of services, treatment, maintenance, bonds issued for capital improvements, <br/>
<a id="pl.49.17"></a><var>49.17</var>depreciation of buildings and equipment, and indirect costs related to the operation of <br/>
<a id="pl.49.18"></a><var>49.18</var>state facilities. The commissioner may determine the charge for services on an anticipated <br/>
<a id="pl.49.19"></a><var>49.19</var>average per diem basis as an all-inclusive charge per facility.<br/>
<br/>
<a id="bill.3.12.0"></a><a id="pl.49.20"></a><var>49.20</var>    Sec. 12. Minnesota Statutes 2008, section 246B.01, is amended by adding a <br/>
<a id="pl.49.21"></a><var>49.21</var>subdivision to read:<br/>
<a id="pl.49.22"></a><var>49.22</var>    Subd. 2b. <b>Local social services agency.</b> "Local social services agency" means the <br/>
<a id="pl.49.23"></a><var>49.23</var>local social services agency of the client's county as defined in subdivision 1b and of the <br/>
<a id="pl.49.24"></a><var>49.24</var>county of commitment, and any other local social services agency possessing information <br/>
<a id="pl.49.25"></a><var>49.25</var>regarding, or requested by the commissioner to investigate, the financial circumstances <br/>
<a id="pl.49.26"></a><var>49.26</var>of a client.<br/>
<br/>
<a id="bill.3.13.0"></a><a id="pl.49.27"></a><var>49.27</var>    Sec. 13. <b>[246B.07] PAYMENT FOR CARE AND TREATMENT: </b><br/>
<a id="pl.49.28"></a><var>49.28</var><b>DETERMINATION.</b><br/>
<a id="pl.49.29"></a><var>49.29</var>    Subdivision 1. <b>Procedures.</b> The commissioner shall determine or redetermine, if <br/>
<a id="pl.49.30"></a><var>49.30</var>necessary, what amount of the cost of care, if any, the client is able to pay. The client shall <br/>
<a id="pl.49.31"></a><var>49.31</var>provide to the commissioner documents and proof necessary to determine the ability to <br/>
<a id="pl.49.32"></a><var>49.32</var>pay. Failure to provide the commissioner with sufficient information to determine ability <br/>
<a id="pl.50.1"></a><var>50.1</var>to pay may make the client liable for the full cost of care until the time when sufficient <br/>
<a id="pl.50.2"></a><var>50.2</var>information is provided.<br/>
<a id="pl.50.3"></a><var>50.3</var>    Subd. 2. <b>Rules.</b> The commissioner shall use the standards in section 246.51, <br/>
<a id="pl.50.4"></a><var>50.4</var>subdivision 2, to determine the client's liability for the care provided by the Minnesota sex <br/>
<a id="pl.50.5"></a><var>50.5</var>offender program.<br/>
<a id="pl.50.6"></a><var>50.6</var>    Subd. 3. <b>Applicability.</b> The commissioner may recover, under sections 246B.07 to <br/>
<a id="pl.50.7"></a><var>50.7</var>246B.10, the cost of any care provided by the Minnesota sex offender program.<br/>
<br/>
<a id="bill.3.14.0"></a><a id="pl.50.8"></a><var>50.8</var>    Sec. 14. <b>[246B.08] PAYMENT FOR CARE; ORDER; ACTION.</b><br/>
<a id="pl.50.9"></a><var>50.9</var>The commissioner shall issue an order to the client or the guardian of the estate, if <br/>
<a id="pl.50.10"></a><var>50.10</var>there is one, requiring the client or guardian to pay to the state the amounts determined, the <br/>
<a id="pl.50.11"></a><var>50.11</var>total of which must not exceed the full cost of care. The order must specifically state the <br/>
<a id="pl.50.12"></a><var>50.12</var>commissioner's determination and must be conclusive, unless appealed. If a client fails to <br/>
<a id="pl.50.13"></a><var>50.13</var>pay the amount due, the attorney general, upon request of the commissioner, may institute, <br/>
<a id="pl.50.14"></a><var>50.14</var>or direct the appropriate county attorney to institute a civil action to recover the amount.<br/>
<br/>
<a id="bill.3.15.0"></a><a id="pl.50.15"></a><var>50.15</var>    Sec. 15. <b>[246B.09] CLAIM AGAINST ESTATE OF DECEASED CLIENT.</b><br/>
<a id="pl.50.16"></a><var>50.16</var>    Subdivision 1. <b>Client's estate.</b> Upon the death of a client, or a former client, the <br/>
<a id="pl.50.17"></a><var>50.17</var>total cost of care provided to the client, less the amount actually paid toward the cost of <br/>
<a id="pl.50.18"></a><var>50.18</var>care by the client, must be filed by the commissioner as a claim against the estate of the <br/>
<a id="pl.50.19"></a><var>50.19</var>client with the court having jurisdiction to probate the estate, and all proceeds collected <br/>
<a id="pl.50.20"></a><var>50.20</var>by the state in the case must be divided between the state and county in proportion to <br/>
<a id="pl.50.21"></a><var>50.21</var>the cost of care each has borne.<br/>
<a id="pl.50.22"></a><var>50.22</var>    Subd. 2. <b>Preferred status.</b> An estate claim in subdivision 1 must be considered an <br/>
<a id="pl.50.23"></a><var>50.23</var>expense of the last illness for purposes of section 524.3-805.<br/>
<a id="pl.50.24"></a><var>50.24</var>If the commissioner determines that the property or estate of a client is not more <br/>
<a id="pl.50.25"></a><var>50.25</var>than needed to care for and maintain the spouse and minor or dependent children of a <br/>
<a id="pl.50.26"></a><var>50.26</var>deceased client, the commissioner has the power to compromise the claim of the state in a <br/>
<a id="pl.50.27"></a><var>50.27</var>manner deemed just and proper.<br/>
<a id="pl.50.28"></a><var>50.28</var>    Subd. 3. <b>Exception from statute of limitations.</b> Any statute of limitations that <br/>
<a id="pl.50.29"></a><var>50.29</var>limits the commissioner in recovering the cost of care obligation incurred by a client or <br/>
<a id="pl.50.30"></a><var>50.30</var>former client must not apply to any claim against an estate made under this section to <br/>
<a id="pl.50.31"></a><var>50.31</var>recover cost of care.<br/>
<br/>
<a id="bill.3.16.0"></a><a id="pl.50.32"></a><var>50.32</var>    Sec. 16. <b>[246B.10] LIABILITY OF COUNTY; REIMBURSEMENT.</b><br/>
<a id="pl.51.1"></a><var>51.1</var>The client's county shall pay to the state a portion of the cost of care provided in <br/>
<a id="pl.51.2"></a><var>51.2</var>the Minnesota sex offender program to a client who has legally settled in that county. A <br/>
<a id="pl.51.3"></a><var>51.3</var>county's payment must be made from the county's own sources of revenue and payments <br/>
<a id="pl.51.4"></a><var>51.4</var>must equal ten percent of the cost of care, as determined by the commissioner, for each <br/>
<a id="pl.51.5"></a><var>51.5</var>day or portion of a day, that the client spends at the facility. If payments received by the <br/>
<a id="pl.51.6"></a><var>51.6</var>state under this chapter exceed 90 percent of the cost of care, the county is responsible <br/>
<a id="pl.51.7"></a><var>51.7</var>for paying the state the remaining amount. The county is not entitled to reimbursement <br/>
<a id="pl.51.8"></a><var>51.8</var>from the client, the client's estate, or from the client's relatives, except as provided in <br/>
<a id="pl.51.9"></a><var>51.9</var>section 246B.07.<br/>
<br/>
<a id="bill.3.17.0"></a><a id="pl.51.10"></a><var>51.10</var>    Sec. 17. Minnesota Statutes 2008, section 252.025, subdivision 7, is amended to read:<br/>
<a id="pl.51.11"></a><var>51.11</var>    Subd. 7. <b>Minnesota extended treatment options.</b> The commissioner shall develop <br/>
<a id="pl.51.12"></a><var>51.12</var>by July 1, 1997, the Minnesota extended treatment options to serve Minnesotans who have <br/>
<a id="pl.51.13"></a><var>51.13</var>developmental disabilities and exhibit severe behaviors which present a risk to public <br/>
<a id="pl.51.14"></a><var>51.14</var>safety. This program is statewide and must provide specialized residential services in <br/>
<a id="pl.51.15"></a><var>51.15</var>Cambridge and an array of community support community-based services statewide with <br/>
<a id="pl.51.16"></a><var>51.16</var>sufficient levels of care and a sufficient number of specialists to ensure that individuals <br/>
<a id="pl.51.17"></a><var>51.17</var>referred to the program receive the appropriate care. The individuals working in the <br/>
<a id="pl.51.18"></a><var>51.18</var>community-based services under this section are state employees supervised by the <br/>
<a id="pl.51.19"></a><var>51.19</var>commissioner of human services. No layoffs shall occur as a result of restructuring <br/>
<a id="pl.51.20"></a><var>51.20</var>under this section.<br/>
<br/>
<a id="bill.3.18.0"></a><a id="pl.51.21"></a><var>51.21</var>    Sec. 18. <b>REQUIRING THE DEVELOPMENT OF COMMUNITY-BASED </b><br/>
<a id="pl.51.22"></a><var>51.22</var><b>MENTAL HEALTH SERVICES FOR PATIENTS COMMITTED TO THE </b><br/>
<a id="pl.51.23"></a><var>51.23</var><b>ANOKA-METRO REGIONAL TREATMENT CENTER.</b><br/>
<a id="pl.51.24"></a><var>51.24</var>In consultation with community partners, the commissioner of human services <br/>
<a id="pl.51.25"></a><var>51.25</var>shall develop an array of community-based services to transform the current services <br/>
<a id="pl.51.26"></a><var>51.26</var>now provided to patients at the Anoka-Metro Regional Treatment Center. The <br/>
<a id="pl.51.27"></a><var>51.27</var>community-based services may be provided in facilities with 16 or fewer beds, and must <br/>
<a id="pl.51.28"></a><var>51.28</var>provide the appropriate level of care for the patients being admitted to the facilities. The <br/>
<a id="pl.51.29"></a><var>51.29</var>planning for this transition must be completed by October 1, 2009, with an initial report <br/>
<a id="pl.51.30"></a><var>51.30</var>to the committee chairs of health and human services by November 30, 2009, and a <br/>
<a id="pl.51.31"></a><var>51.31</var>semiannual report on progress until the transition is completed. The commissioner of <br/>
<a id="pl.51.32"></a><var>51.32</var>human services shall solicit interest from stakeholders and potential community partners. <br/>
<a id="pl.51.33"></a><var>51.33</var>The individuals working in the community-based services facilities under this section are <br/>
<a id="pl.52.1"></a><var>52.1</var>state employees supervised by the commissioner of human services. No layoffs shall <br/>
<a id="pl.52.2"></a><var>52.2</var>occur as a result of restructuring under this section.<br/>
<br/>
<a id="bill.3.19.0"></a><a id="pl.52.3"></a><var>52.3</var>    Sec. 19. <b> REPEALER.</b><br/>
<a id="pl.52.4"></a><var>52.4</var>Minnesota Statutes 2008, sections 246.51, subdivision 1; and 246.53, subdivision <br/>
<a id="pl.52.5"></a><var>52.5</var>3, are repealed.<br/>
<br/>
<a id="bill.4.0.0"></a>

<a id="bill.4.1.0"></a><a id="pl.52.8"></a><var>52.8</var>    Section 1. Minnesota Statutes 2008, section 62J.495, is amended to read:<br/>
<a id="pl.52.9"></a><var>52.9</var><b>62J.495 HEALTH INFORMATION TECHNOLOGY AND </b><br/>
<a id="pl.52.10"></a><var>52.10</var><b>INFRASTRUCTURE.</b><br/>
<a id="pl.52.11"></a><var>52.11</var>    Subdivision 1. <b>Implementation.</b> By January 1, 2015, all hospitals and health care <br/>
<a id="pl.52.12"></a><var>52.12</var>providers must have in place an interoperable electronic health records system within their <br/>
<a id="pl.52.13"></a><var>52.13</var>hospital system or clinical practice setting. The commissioner of health, in consultation <br/>
<a id="pl.52.14"></a><var>52.14</var>with the e-Health Information Technology and Infrastructure Advisory Committee, <br/>
<a id="pl.52.15"></a><var>52.15</var>shall develop a statewide plan to meet this goal, including uniform standards to be used <br/>
<a id="pl.52.16"></a><var>52.16</var>for the interoperable system for sharing and synchronizing patient data across systems. <br/>
<a id="pl.52.17"></a><var>52.17</var>The standards must be compatible with federal efforts. The uniform standards must be <br/>
<a id="pl.52.18"></a><var>52.18</var>developed by January 1, 2009, with a status report on the development of these standards <br/>
<a id="pl.52.19"></a><var>52.19</var>submitted to the legislature by January 15, 2008 and updated on an ongoing basis. The <br/>
<a id="pl.52.20"></a><var>52.20</var>commissioner shall include an update on standards development as part of an annual <br/>
<a id="pl.52.21"></a><var>52.21</var>report to the legislature.<br/>
<a id="pl.52.22"></a><var>52.22</var>    Subd. 1a. <b>Definitions.</b> (a) "Certified electronic health record technology" means an <br/>
<a id="pl.52.23"></a><var>52.23</var>electronic health record that is certified pursuant to section 3001(c)(5) of the HITECH <br/>
<a id="pl.52.24"></a><var>52.24</var>Act to meet the standards and implementation specifications adopted under section 3004 <br/>
<a id="pl.52.25"></a><var>52.25</var>as applicable.<br/>
<a id="pl.52.26"></a><var>52.26</var>(b) "Commissioner" means the commissioner of health.<br/>
<a id="pl.52.27"></a><var>52.27</var>(c) "Pharmaceutical electronic data intermediary" means any entity that provides <br/>
<a id="pl.52.28"></a><var>52.28</var>the infrastructure to connect computer systems or other electronic devices utilized <br/>
<a id="pl.52.29"></a><var>52.29</var>by prescribing practitioners with those used by pharmacies, health plans, third party <br/>
<a id="pl.52.30"></a><var>52.30</var>administrators, and pharmacy benefit manager in order to facilitate the secure transmission <br/>
<a id="pl.52.31"></a><var>52.31</var>of electronic prescriptions, refill authorization requests, communications, and other <br/>
<a id="pl.52.32"></a><var>52.32</var>prescription-related information between such entities.<br/>
<a id="pl.52.33"></a><var>52.33</var>(d) "HITECH Act" means the Health Information Technology for Economic and <br/>
<a id="pl.52.34"></a><var>52.34</var>Clinical Health Act in division A, title XIII and division B, title IV of the American <br/>
<a id="pl.53.1"></a><var>53.1</var>Recovery and Reinvestment Act of 2009, including federal regulations adopted under <br/>
<a id="pl.53.2"></a><var>53.2</var>that act.<br/>
<a id="pl.53.3"></a><var>53.3</var>(e) "Interoperable electronic health record" means an electronic health record that <br/>
<a id="pl.53.4"></a><var>53.4</var>securely exchanges health information with another electronic health record system that <br/>
<a id="pl.53.5"></a><var>53.5</var>meets national requirements for certification under the HITECH Act.<br/>
<a id="pl.53.6"></a><var>53.6</var>(f) "Qualified electronic health record" means an electronic record of health-related <br/>
<a id="pl.53.7"></a><var>53.7</var>information on an individual that includes patient demographic and clinical health <br/>
<a id="pl.53.8"></a><var>53.8</var>information and has the capacity to:<br/>
<a id="pl.53.9"></a><var>53.9</var>(1) provide clinical decision support;<br/>
<a id="pl.53.10"></a><var>53.10</var>(2) support physician order entry;<br/>
<a id="pl.53.11"></a><var>53.11</var>(3) capture and query information relevant to health care quality; and<br/>
<a id="pl.53.12"></a><var>53.12</var>(4) exchange electronic health information with, and integrate such information <br/>
<a id="pl.53.13"></a><var>53.13</var>from, other sources.<br/>
<a id="pl.53.14"></a><var>53.14</var>    Subd. 2. <b>E-</b><b>Health </b><b>Information Technology and Infrastructure</b><b> Advisory </b><br/>
<a id="pl.53.15"></a><var>53.15</var><b>Committee.</b> (a) The commissioner shall establish a an e-Health Information Technology <br/>
<a id="pl.53.16"></a><var>53.16</var>and Infrastructure Advisory Committee governed by section 
         <statute_ref>15.059</statute_ref> to advise the <br/>
<a id="pl.53.17"></a><var>53.17</var>commissioner on the following matters:<br/>
<a id="pl.53.18"></a><var>53.18</var>    (1) assessment of the adoption and effective use of health information technology by <br/>
<a id="pl.53.19"></a><var>53.19</var>the state, licensed health care providers and facilities, and local public health agencies;<br/>
<a id="pl.53.20"></a><var>53.20</var>    (2) recommendations for implementing a statewide interoperable health information <br/>
<a id="pl.53.21"></a><var>53.21</var>infrastructure, to include estimates of necessary resources, and for determining standards <br/>
<a id="pl.53.22"></a><var>53.22</var>for administrative clinical data exchange, clinical support programs, patient privacy <br/>
<a id="pl.53.23"></a><var>53.23</var>requirements, and maintenance of the security and confidentiality of individual patient <br/>
<a id="pl.53.24"></a><var>53.24</var>data; <br/>
<a id="pl.53.25"></a><var>53.25</var>    (3) recommendations for encouraging use of innovative health care applications <br/>
<a id="pl.53.26"></a><var>53.26</var>using information technology and systems to improve patient care and reduce the cost <br/>
<a id="pl.53.27"></a><var>53.27</var>of care, including applications relating to disease management and personal health <br/>
<a id="pl.53.28"></a><var>53.28</var>management that enable remote monitoring of patients' conditions, especially those with <br/>
<a id="pl.53.29"></a><var>53.29</var>chronic conditions; and <br/>
<a id="pl.53.30"></a><var>53.30</var>    (4) other related issues as requested by the commissioner.<br/>
<a id="pl.53.31"></a><var>53.31</var>    (b) The members of the e-Health Information Technology and Infrastructure <br/>
<a id="pl.53.32"></a><var>53.32</var>Advisory Committee shall include the commissioners, or commissioners' designees, of <br/>
<a id="pl.53.33"></a><var>53.33</var>health, human services, administration, and commerce and additional members to be <br/>
<a id="pl.53.34"></a><var>53.34</var>appointed by the commissioner to include persons representing Minnesota's local public <br/>
<a id="pl.53.35"></a><var>53.35</var>health agencies, licensed hospitals and other licensed facilities and providers, private <br/>
<a id="pl.53.36"></a><var>53.36</var>purchasers, the medical and nursing professions, health insurers and health plans, the <br/>
<a id="pl.54.1"></a><var>54.1</var>state quality improvement organization, academic and research institutions, consumer <br/>
<a id="pl.54.2"></a><var>54.2</var>advisory organizations with an interest and expertise in health information technology, and <br/>
<a id="pl.54.3"></a><var>54.3</var>other stakeholders as identified by the Health Information Technology and Infrastructure <br/>
<a id="pl.54.4"></a><var>54.4</var>Advisory Committee commissioner to fulfill the requirements of section 3013, paragraph <br/>
<a id="pl.54.5"></a><var>54.5</var>(g) of the HITECH Act.<br/>
<a id="pl.54.6"></a><var>54.6</var>    (c) The commissioner shall prepare and issue an annual report not later than January <br/>
<a id="pl.54.7"></a><var>54.7</var>30 of each year outlining progress to date in implementing a statewide health information <br/>
<a id="pl.54.8"></a><var>54.8</var>infrastructure and recommending future projects action on policy and necessary resources <br/>
<a id="pl.54.9"></a><var>54.9</var>to continue the promotion of adoption and effective use of health information technology.<br/>
<a id="pl.54.10"></a><var>54.10</var>(d) Notwithstanding section 
         <statute_ref>15.059</statute_ref>, this subdivision expires June 30, 2015.<br/>
<a id="pl.54.11"></a><var>54.11</var>    Subd. 3. <b>Interoperable electronic health record requirements.</b> (a) To meet the <br/>
<a id="pl.54.12"></a><var>54.12</var>requirements of subdivision 1, hospitals and health care providers must meet the following <br/>
<a id="pl.54.13"></a><var>54.13</var>criteria when implementing an interoperable electronic health records system within their <br/>
<a id="pl.54.14"></a><var>54.14</var>hospital system or clinical practice setting.<br/>
<a id="pl.54.15"></a><var>54.15</var>(a) The electronic health record must be a qualified electronic health record.<br/>
<a id="pl.54.16"></a><var>54.16</var>    (b) The electronic health record must be certified by the Certification Commission <br/>
<a id="pl.54.17"></a><var>54.17</var>for Healthcare Information Technology, or its successor Office of the National Coordinator <br/>
<a id="pl.54.18"></a><var>54.18</var>pursuant to the HITECH Act. This criterion only applies to hospitals and health care <br/>
<a id="pl.54.19"></a><var>54.19</var>providers whose practice setting is a practice setting covered by the Certification <br/>
<a id="pl.54.20"></a><var>54.20</var>Commission for Healthcare Information Technology certifications only if a certified <br/>
<a id="pl.54.21"></a><var>54.21</var>electronic health record product for the provider's particular practice setting is available. <br/>
<a id="pl.54.22"></a><var>54.22</var>This criterion shall be considered met if a hospital or health care provider is using an <br/>
<a id="pl.54.23"></a><var>54.23</var>electronic health records system that has been certified within the last three years, even if a <br/>
<a id="pl.54.24"></a><var>54.24</var>more current version of the system has been certified within the three-year period.<br/>
<a id="pl.54.25"></a><var>54.25</var>(c) The electronic health record must meet the standards established according to <br/>
<a id="pl.54.26"></a><var>54.26</var>section 3004 of the HITECH Act as applicable.<br/>
<a id="pl.54.27"></a><var>54.27</var>(d) The electronic health record must have the ability to generate information on <br/>
<a id="pl.54.28"></a><var>54.28</var>clinical quality measures and other measures reported under sections 4101, 4102, and <br/>
<a id="pl.54.29"></a><var>54.29</var>4201 of the HITECH Act.<br/>
<a id="pl.54.30"></a><var>54.30</var>    (c) (e) A health care provider who is a prescriber or dispenser of controlled <br/>
<a id="pl.54.31"></a><var>54.31</var>substances legend drugs must have an electronic health record system that meets the <br/>
<a id="pl.54.32"></a><var>54.32</var>requirements of section 
         <statute_ref>62J.497</statute_ref>.<br/>
<a id="pl.54.33"></a><var>54.33</var>    Subd. 4. <b>Coordination with national HIT activities.</b> (a) The commissioner, <br/>
<a id="pl.54.34"></a><var>54.34</var>in consultation with the e-Health Advisory Committee, shall update the statewide <br/>
<a id="pl.54.35"></a><var>54.35</var>implementation plan required under subdivision 2 and released June 2008, to be consistent <br/>
<a id="pl.54.36"></a><var>54.36</var>with the updated Federal HIT Strategic Plan released by the Office of the National <br/>
<a id="pl.55.1"></a><var>55.1</var>Coordinator in accordance with section 3001 of the HITECH Act.  The statewide plan <br/>
<a id="pl.55.2"></a><var>55.2</var>shall meet the requirements for a plan required under section 3013 of the HITECH Act.<br/>
<a id="pl.55.3"></a><var>55.3</var>(b) The commissioner, in consultation with the e-Health Advisory Committee, shall <br/>
<a id="pl.55.4"></a><var>55.4</var>work to ensure coordination between state, regional, and national efforts to support and <br/>
<a id="pl.55.5"></a><var>55.5</var>accelerate efforts to effectively use health information technology to improve the quality <br/>
<a id="pl.55.6"></a><var>55.6</var>and coordination of health care and continuity of patient care among health care providers, <br/>
<a id="pl.55.7"></a><var>55.7</var>to reduce medical errors, to improve population health, to reduce health disparities, and <br/>
<a id="pl.55.8"></a><var>55.8</var>to reduce chronic disease.  The commissioner's coordination efforts shall include but not <br/>
<a id="pl.55.9"></a><var>55.9</var>be limited to:<br/>
<a id="pl.55.10"></a><var>55.10</var>(1) assisting in the development and support of health information technology <br/>
<a id="pl.55.11"></a><var>55.11</var>regional extension centers established under section 3012(c) of the HITECH Act to <br/>
<a id="pl.55.12"></a><var>55.12</var>provide technical assistance and disseminate best practices; and<br/>
<a id="pl.55.13"></a><var>55.13</var>(2) providing supplemental information to the best practices gathered by regional <br/>
<a id="pl.55.14"></a><var>55.14</var>centers to ensure that the information is relayed in a meaningful way to the Minnesota <br/>
<a id="pl.55.15"></a><var>55.15</var>health care community.<br/>
<a id="pl.55.16"></a><var>55.16</var>(c) The commissioner, in consultation with the e-Health Advisory Committee, shall <br/>
<a id="pl.55.17"></a><var>55.17</var>monitor national activity related to health information technology and shall coordinate <br/>
<a id="pl.55.18"></a><var>55.18</var>statewide input on policy development.  The commissioner shall coordinate statewide <br/>
<a id="pl.55.19"></a><var>55.19</var>responses to proposed federal health information technology regulations in order to ensure <br/>
<a id="pl.55.20"></a><var>55.20</var>that the needs of the Minnesota health care community are adequately and efficiently <br/>
<a id="pl.55.21"></a><var>55.21</var>addressed in the proposed regulations. The commissioner's responses may include, but <br/>
<a id="pl.55.22"></a><var>55.22</var>are not limited to:<br/>
<a id="pl.55.23"></a><var>55.23</var>(1) reviewing and evaluating any standard, implementation specification, or <br/>
<a id="pl.55.24"></a><var>55.24</var>certification criteria proposed by the national HIT standards committee;<br/>
<a id="pl.55.25"></a><var>55.25</var>(2) reviewing and evaluating policy proposed by the national HIT policy <br/>
<a id="pl.55.26"></a><var>55.26</var>committee relating to the implementation of a nationwide health information technology <br/>
<a id="pl.55.27"></a><var>55.27</var>infrastructure;<br/>
<a id="pl.55.28"></a><var>55.28</var>(3) monitoring and responding to activity related to the development of quality <br/>
<a id="pl.55.29"></a><var>55.29</var>measures and other measures as required by section 4101 of the HITECH Act. Any <br/>
<a id="pl.55.30"></a><var>55.30</var>response related to quality measures shall consider and address the quality efforts required <br/>
<a id="pl.55.31"></a><var>55.31</var>under chapter 62U; and<br/>
<a id="pl.55.32"></a><var>55.32</var>(4) monitoring and responding to national activity related to privacy, security, and <br/>
<a id="pl.55.33"></a><var>55.33</var>data stewardship of electronic health information and individually identifiable health <br/>
<a id="pl.55.34"></a><var>55.34</var>information.<br/>
<a id="pl.55.35"></a><var>55.35</var>(d) To the extent that the state is either required or allowed to apply, or designate an <br/>
<a id="pl.55.36"></a><var>55.36</var>entity to apply for or carry out activities and programs under section 3013 of the HITECH <br/>
<a id="pl.56.1"></a><var>56.1</var>Act, the commissioner of health, in consultation with the e-Health Advisory Committee <br/>
<a id="pl.56.2"></a><var>56.2</var>and the commissioner of human services, shall be the lead applicant or sole designating <br/>
<a id="pl.56.3"></a><var>56.3</var>authority. The commissioner shall make such designations consistent with the goals and <br/>
<a id="pl.56.4"></a><var>56.4</var>objectives of sections 62J.495 to 62J.497, and sections 62J.50 to 62J.61.<br/>
<a id="pl.56.5"></a><var>56.5</var>(e) The commissioner of human services shall apply for funding necessary to <br/>
<a id="pl.56.6"></a><var>56.6</var>administer the incentive payments to providers authorized under title IV of the American <br/>
<a id="pl.56.7"></a><var>56.7</var>Recovery and Reinvestment Act.<br/>
<a id="pl.56.8"></a><var>56.8</var>(f) The commissioner shall include in the report to the legislature information on the <br/>
<a id="pl.56.9"></a><var>56.9</var>activities of this subdivision and provide recommendations on any relevant policy changes <br/>
<a id="pl.56.10"></a><var>56.10</var>that should be considered in Minnesota.<br/>
<a id="pl.56.11"></a><var>56.11</var>    Subd. 5. <b>Collection of data for assessment and eligibility determination.</b> (a) <br/>
<a id="pl.56.12"></a><var>56.12</var>The commissioner of health, in consultation with the commissioner of human services, <br/>
<a id="pl.56.13"></a><var>56.13</var>may require providers, dispensers, group purchasers, and pharmaceutical electronic data <br/>
<a id="pl.56.14"></a><var>56.14</var>intermediaries to submit data in a form and manner specified by the commissioner to <br/>
<a id="pl.56.15"></a><var>56.15</var>assess the status of adoption, effective use, and interoperability of electronic health <br/>
<a id="pl.56.16"></a><var>56.16</var>records for the purpose of:<br/>
<a id="pl.56.17"></a><var>56.17</var>(1) demonstrating Minnesota's progress on goals established by the Office of the <br/>
<a id="pl.56.18"></a><var>56.18</var>National Coordinator to accelerate the adoption and effective use of health information <br/>
<a id="pl.56.19"></a><var>56.19</var>technology established under the HITECH Act;<br/>
<a id="pl.56.20"></a><var>56.20</var>(2) assisting the Center for Medicare and Medicaid Services and Department of <br/>
<a id="pl.56.21"></a><var>56.21</var>Human Services in determining eligibility of health care professionals and hospitals <br/>
<a id="pl.56.22"></a><var>56.22</var>to receive federal incentives for the adoption and effective use of health information <br/>
<a id="pl.56.23"></a><var>56.23</var>technology under the HITECH Act or other federal incentive programs;<br/>
<a id="pl.56.24"></a><var>56.24</var>(3) assisting the Office of the National Coordinator in completing required <br/>
<a id="pl.56.25"></a><var>56.25</var>assessments of the impact of the implementation and effective use of health information <br/>
<a id="pl.56.26"></a><var>56.26</var>technology in achieving goals identified in the national strategic plan, and completing <br/>
<a id="pl.56.27"></a><var>56.27</var>studies required by the HITECH Act;<br/>
<a id="pl.56.28"></a><var>56.28</var>(4) providing the data necessary to assist the Office of the National Coordinator in <br/>
<a id="pl.56.29"></a><var>56.29</var>conducting evaluations of regional extension centers as required by the HITECH Act; and<br/>
<a id="pl.56.30"></a><var>56.30</var>(5) other purposes as necessary to support the implementation of the HITECH Act.<br/>
<a id="pl.56.31"></a><var>56.31</var>(b) The commissioner shall coordinate with the commissioner of human services <br/>
<a id="pl.56.32"></a><var>56.32</var>and other state agencies in the collection of data required under this section to:<br/>
<a id="pl.56.33"></a><var>56.33</var>(1) avoid duplicative reporting requirements;<br/>
<a id="pl.56.34"></a><var>56.34</var>(2) maximize efficiencies in the development of reports on state activities as <br/>
<a id="pl.56.35"></a><var>56.35</var>required by HITECH; and<br/>
<a id="pl.57.1"></a><var>57.1</var>(3) determine health professional and hospital eligibility for incentives available <br/>
<a id="pl.57.2"></a><var>57.2</var>under the HITECH Act.<br/>
<a id="pl.57.3"></a><var>57.3</var>(c) The commissioner must not collect data or publish analyses that identify, or could <br/>
<a id="pl.57.4"></a><var>57.4</var>potentially identify, individual patients. The commissioner must not collect individual <br/>
<a id="pl.57.5"></a><var>57.5</var>data in identified or de-identified form.<br/>
<br/>
<a id="bill.4.2.0"></a><a id="pl.57.6"></a><var>57.6</var>    Sec. 2. Minnesota Statutes 2008, section 62J.496, is amended to read:<br/>
<a id="pl.57.7"></a><var>57.7</var><b>62J.496 ELECTRONIC HEALTH RECORD SYSTEM REVOLVING </b><br/>
<a id="pl.57.8"></a><var>57.8</var><b>ACCOUNT AND LOAN PROGRAM.</b><br/>
<a id="pl.57.9"></a><var>57.9</var>    Subdivision 1. <b>Account establishment.</b> (a) An account is established to: provide <br/>
<a id="pl.57.10"></a><var>57.10</var>loans to eligible borrowers to assist in financing the installation or support of an <br/>
<a id="pl.57.11"></a><var>57.11</var>interoperable health record system. The system must provide for the interoperable <br/>
<a id="pl.57.12"></a><var>57.12</var>exchange of health care information between the applicant and, at a minimum, a hospital <br/>
<a id="pl.57.13"></a><var>57.13</var>system, pharmacy, and a health care clinic or other physician group.<br/>
<a id="pl.57.14"></a><var>57.14</var>(1) finance the purchase of certified electronic health records or qualified electronic <br/>
<a id="pl.57.15"></a><var>57.15</var>health records as defined in section 62J.495, subdivision 1a;<br/>
<a id="pl.57.16"></a><var>57.16</var>(2) enhance the utilization of electronic health record technology, which may include <br/>
<a id="pl.57.17"></a><var>57.17</var>costs associated with upgrading the technology to meet the criteria necessary to be a <br/>
<a id="pl.57.18"></a><var>57.18</var>certified electronic health record or a qualified electronic health record;<br/>
<a id="pl.57.19"></a><var>57.19</var>(3) train personnel in the use of electronic health record technology; and<br/>
<a id="pl.57.20"></a><var>57.20</var>(4) improve the secure electronic exchange of health information.<br/>
<a id="pl.57.21"></a><var>57.21</var>(b) Amounts deposited in the account, including any grant funds obtained through <br/>
<a id="pl.57.22"></a><var>57.22</var>federal or other sources, loan repayments, and interest earned on the amounts shall be <br/>
<a id="pl.57.23"></a><var>57.23</var>used only for awarding loans or loan guarantees, as a source of reserve and security for <br/>
<a id="pl.57.24"></a><var>57.24</var>leveraged loans, or for the administration of the account.<br/>
<a id="pl.57.25"></a><var>57.25</var>(c) The commissioner may accept contributions to the account from private sector <br/>
<a id="pl.57.26"></a><var>57.26</var>entities subject to the following provisions:<br/>
<a id="pl.57.27"></a><var>57.27</var>(1) the contributing entity may not specify the recipient or recipients of any loan <br/>
<a id="pl.57.28"></a><var>57.28</var>issued under this subdivision;<br/>
<a id="pl.57.29"></a><var>57.29</var>(2) the commissioner shall make public the identity of any private contributor to the <br/>
<a id="pl.57.30"></a><var>57.30</var>loan fund, as well as the amount of the contribution provided; and<br/>
<a id="pl.57.31"></a><var>57.31</var>(3) the commissioner may issue letters of commendation or make other awards that <br/>
<a id="pl.57.32"></a><var>57.32</var>have no financial value to any such entity.<br/>
<a id="pl.57.33"></a><var>57.33</var>A contributing entity may not specify that the recipient or recipients of any loan use <br/>
<a id="pl.57.34"></a><var>57.34</var>specific products or services, nor may the contributing entity imply that a contribution is <br/>
<a id="pl.57.35"></a><var>57.35</var>an endorsement of any specific product or service.<br/>
<a id="pl.58.1"></a><var>58.1</var>(d) The commissioner may use the loan funds to reimburse private sector entities <br/>
<a id="pl.58.2"></a><var>58.2</var>for any contribution made to the loan fund. Reimbursement to private entities may not <br/>
<a id="pl.58.3"></a><var>58.3</var>exceed the principle amount contributed to the loan fund.<br/>
<a id="pl.58.4"></a><var>58.4</var>(e) The commissioner may use funds deposited in the account to guarantee, or <br/>
<a id="pl.58.5"></a><var>58.5</var>purchase insurance for, a local obligation if the guarantee or purchase would improve <br/>
<a id="pl.58.6"></a><var>58.6</var>credit market access or reduce the interest rate applicable to the obligation involved.<br/>
<a id="pl.58.7"></a><var>58.7</var>(f) The commissioner may use funds deposited in the account as a source of revenue <br/>
<a id="pl.58.8"></a><var>58.8</var>or security for the payment of principal and interest on revenue or bonds issued by the <br/>
<a id="pl.58.9"></a><var>58.9</var>state if the proceeds of the sale of the bonds will be deposited into the loan fund.<br/>
<a id="pl.58.10"></a><var>58.10</var>    Subd. 2. <b>Eligibility.</b> (a) "Eligible borrower" means one of the following:<br/>
<a id="pl.58.11"></a><var>58.11</var>(1) federally qualified health centers;<br/>
<a id="pl.58.12"></a><var>58.12</var>    (1) (2) community clinics, as defined under section 
         <statute_ref>145.9268</statute_ref>;<br/>
<a id="pl.58.13"></a><var>58.13</var>    (2) (3) nonprofit or local unit of government hospitals eligible for rural hospital <br/>
<a id="pl.58.14"></a><var>58.14</var>capital improvement grants, as defined  in section 
<statute_ref>144.148</statute_ref> licensed under sections 144.50 <br/>
<a id="pl.58.15"></a><var>58.15</var>to 144.56;<br/>
<a id="pl.58.16"></a><var>58.16</var>    (3) physician clinics located in a community with a population of less than 50,000 <br/>
<a id="pl.58.17"></a><var>58.17</var>according to United States Census Bureau statistics and outside the seven-county <br/>
<a id="pl.58.18"></a><var>58.18</var>metropolitan area;<br/>
<a id="pl.58.19"></a><var>58.19</var>(4) individual or small group physician practices that are focused primarily on <br/>
<a id="pl.58.20"></a><var>58.20</var>primary care;<br/>
<a id="pl.58.21"></a><var>58.21</var>    (4) (5) nursing facilities licensed under sections 
         <statute_ref>144A.01</statute_ref> to 
         <statute_ref>144A.27</statute_ref>; and<br/>
<a id="pl.58.22"></a><var>58.22</var>(6) local public health departments as defined in chapter 145A; and<br/>
<a id="pl.58.23"></a><var>58.23</var>    (5) (7) other providers of health or health care services approved by the <br/>
<a id="pl.58.24"></a><var>58.24</var>commissioner for which interoperable electronic health record capability would improve <br/>
<a id="pl.58.25"></a><var>58.25</var>quality of care, patient safety, or community health.<br/>
<a id="pl.58.26"></a><var>58.26</var> (b) The commissioner shall administer the loan fund to prioritize support and <br/>
<a id="pl.58.27"></a><var>58.27</var>assistance to:<br/>
<a id="pl.58.28"></a><var>58.28</var>(1) critical access hospitals;<br/>
<a id="pl.58.29"></a><var>58.29</var>(2) federally qualified health centers;<br/>
<a id="pl.58.30"></a><var>58.30</var>(3) entities that serve uninsured, underinsured, and medically underserved <br/>
<a id="pl.58.31"></a><var>58.31</var>individuals, regardless of whether such area is urban or rural; and<br/>
<a id="pl.58.32"></a><var>58.32</var>(4) individual or small group practices that are primarily focused on primary care.<br/>
<a id="pl.58.33"></a><var>58.33</var>    (b) To be eligible for a loan under this section, the (c) An eligible applicant must <br/>
<a id="pl.58.34"></a><var>58.34</var>submit a loan application to the commissioner of health on forms prescribed by the <br/>
<a id="pl.58.35"></a><var>58.35</var>commissioner. The application must include, at a minimum:<br/>
<a id="pl.59.1"></a><var>59.1</var>    (1) the amount of the loan requested and a description of the purpose or project <br/>
<a id="pl.59.2"></a><var>59.2</var>for which the loan proceeds will be used;<br/>
<a id="pl.59.3"></a><var>59.3</var>    (2) a quote from a vendor;<br/>
<a id="pl.59.4"></a><var>59.4</var>    (3) a description of the health care entities and other groups participating in the <br/>
<a id="pl.59.5"></a><var>59.5</var>project;<br/>
<a id="pl.59.6"></a><var>59.6</var>    (4) evidence of financial stability and a demonstrated ability to repay the loan; and<br/>
<a id="pl.59.7"></a><var>59.7</var>    (5) a description of how the system to be financed interconnects interoperates or <br/>
<a id="pl.59.8"></a><var>59.8</var>plans in the future to interconnect interoperate with other health care entities and provider <br/>
<a id="pl.59.9"></a><var>59.9</var>groups located in the same geographical area;<br/>
<a id="pl.59.10"></a><var>59.10</var>(6) a plan on how the certified electronic health record technology will be maintained <br/>
<a id="pl.59.11"></a><var>59.11</var>and supported over time; and<br/>
<a id="pl.59.12"></a><var>59.12</var>(7) any other requirements for applications included or developed pursuant to <br/>
<a id="pl.59.13"></a><var>59.13</var>section 3014 of the HITECH Act.<br/>
<a id="pl.59.14"></a><var>59.14</var>    Subd. 3. <b>Loans.</b> (a) The commissioner of health may make a no interest loan or <br/>
<a id="pl.59.15"></a><var>59.15</var>low interest loan to a provider or provider group who is eligible under subdivision 2 <br/>
<a id="pl.59.16"></a><var>59.16</var>on a first-come, first-served basis provided that the applicant is able to comply with this <br/>
<a id="pl.59.17"></a><var>59.17</var>section consistent with the priorities established in subdivision 2. The total accumulative <br/>
<a id="pl.59.18"></a><var>59.18</var>loan principal must not exceed $1,500,000 $3,000,000 per loan. The interest rate for each <br/>
<a id="pl.59.19"></a><var>59.19</var>loan, if imposed, shall not exceed the current market interest rate. The commissioner of <br/>
<a id="pl.59.20"></a><var>59.20</var>health has discretion over the size, interest rate, and number of loans made. Nothing in <br/>
<a id="pl.59.21"></a><var>59.21</var>this section shall require the commissioner to make a loan to an eligible borrower under <br/>
<a id="pl.59.22"></a><var>59.22</var>subdivision 2.<br/>
<a id="pl.59.23"></a><var>59.23</var>    (b) The commissioner of health may prescribe forms and establish an application <br/>
<a id="pl.59.24"></a><var>59.24</var>process and, notwithstanding section 
         <statute_ref>16A.1283</statute_ref>, may impose a reasonable nonrefundable <br/>
<a id="pl.59.25"></a><var>59.25</var>application fee to cover the cost of administering the loan program. Any application <br/>
<a id="pl.59.26"></a><var>59.26</var>fees imposed and collected under the electronic health records system revolving account <br/>
<a id="pl.59.27"></a><var>59.27</var>and loan program in this section are appropriated to the commissioner of health for the <br/>
<a id="pl.59.28"></a><var>59.28</var>duration of the loan program. The commissioner may apply for and use all federal funds <br/>
<a id="pl.59.29"></a><var>59.29</var>available through the HITECH Act to administer the loan program.<br/>
<a id="pl.59.30"></a><var>59.30</var>    (c) For loans approved prior to July 1, 2009, the borrower must begin repaying the <br/>
<a id="pl.59.31"></a><var>59.31</var>principal no later than two years from the date of the loan. Loans must be amortized no <br/>
<a id="pl.59.32"></a><var>59.32</var>later than six years from the date of the loan.<br/>
<a id="pl.59.33"></a><var>59.33</var>(d) For loans granted on January 1, 2010, or thereafter, the borrower must begin <br/>
<a id="pl.59.34"></a><var>59.34</var>repaying the principle no later than one year from the date of the loan.  Loans must be <br/>
<a id="pl.59.35"></a><var>59.35</var>amortized no later than six years after the date of the loan.<br/>
<a id="pl.60.1"></a><var>60.1</var>    (d) Repayments (e) All repayments and interest paid on each loan must be credited <br/>
<a id="pl.60.2"></a><var>60.2</var>to the account.<br/>
<a id="pl.60.3"></a><var>60.3</var>(f) The loan agreement shall include the assurances that borrower meets requirements <br/>
<a id="pl.60.4"></a><var>60.4</var>included or developed pursuant to section 3014 of the HITECH Act. The requirements <br/>
<a id="pl.60.5"></a><var>60.5</var>shall include, but are not limited to:<br/>
<a id="pl.60.6"></a><var>60.6</var>(1) submitting reports on quality measures in compliance with regulations adopted <br/>
<a id="pl.60.7"></a><var>60.7</var>by the federal government;<br/>
<a id="pl.60.8"></a><var>60.8</var>(2) demonstrating that any certified electronic health record technology purchased, <br/>
<a id="pl.60.9"></a><var>60.9</var>improved, or otherwise financially supported by this loan program is used to exchange <br/>
<a id="pl.60.10"></a><var>60.10</var>health information in a manner that, in accordance with law and standards applicable to <br/>
<a id="pl.60.11"></a><var>60.11</var>the exchange of information, improves the quality of health care;<br/>
<a id="pl.60.12"></a><var>60.12</var>(3) including a plan on how the borrower intends to maintain and support the <br/>
<a id="pl.60.13"></a><var>60.13</var>certified electronic health record technology over time and the resources expected to be <br/>
<a id="pl.60.14"></a><var>60.14</var>used to maintain and support the technology purchased with the loan; and<br/>
<a id="pl.60.15"></a><var>60.15</var>(4) complying with other requirements the secretary may require to use loans funds <br/>
<a id="pl.60.16"></a><var>60.16</var>under the HITECH Act.<br/>
<a id="pl.60.17"></a><var>60.17</var>    Subd. 4. <b>Data classification.</b> Data collected by the commissioner of health on the <br/>
<a id="pl.60.18"></a><var>60.18</var>application to determine eligibility under subdivision 2 and to monitor borrowers' default <br/>
<a id="pl.60.19"></a><var>60.19</var>risk or collect payments owed under subdivision 3 are (1) private data on individuals as <br/>
<a id="pl.60.20"></a><var>60.20</var>defined in section 
         <statute_ref>13.02, subdivision 12</statute_ref>; and (2) nonpublic data as defined in section <br/>
<statute_ref><a id="pl.60.21"></a><var>60.21</var>13.02, subdivision 9
         </statute_ref>. The names of borrowers and the amounts of the loans granted <br/>
<a id="pl.60.22"></a><var>60.22</var>are public data.<br/>
<br/>
<a id="bill.4.3.0"></a><a id="pl.60.23"></a><var>60.23</var>    Sec. 3. Minnesota Statutes 2008, section 62J.497, subdivision 1, is amended to read:<br/>
<a id="pl.60.24"></a><var>60.24</var>    Subdivision 1. <b>Definitions.</b> For the purposes of this section, the following terms <br/>
<a id="pl.60.25"></a><var>60.25</var>have the meanings given.<br/>
<a id="pl.60.26"></a><var>60.26</var>(a) "Backward compatible" means that the newer version of a data transmission <br/>
<a id="pl.60.27"></a><var>60.27</var>standard would retain, at a minimum, the full functionality of the versions previously <br/>
<a id="pl.60.28"></a><var>60.28</var>adopted, and would permit the successful completion of the applicable transactions with <br/>
<a id="pl.60.29"></a><var>60.29</var>entities that continue to use the older versions.<br/>
<a id="pl.60.30"></a><var>60.30</var>    (a) (b) "Dispense" or "dispensing" has the meaning given in section 
         <statute_ref>151.01, <br/>
<a id="pl.60.31"></a><var>60.31</var>subdivision 
         </statute_ref>30. Dispensing does not include the direct administering of a controlled <br/>
<a id="pl.60.32"></a><var>60.32</var>substance to a patient by a licensed health care professional.<br/>
<a id="pl.60.33"></a><var>60.33</var>    (b) (c) "Dispenser" means a person authorized by law to dispense a controlled <br/>
<a id="pl.60.34"></a><var>60.34</var>substance, pursuant to a valid prescription.<br/>
<a id="pl.61.1"></a><var>61.1</var>    (c) (d) "Electronic media" has the meaning given under Code of Federal Regulations, <br/>
<a id="pl.61.2"></a><var>61.2</var>title 45, part 
         <statute_ref>160.103</statute_ref>.<br/>
<a id="pl.61.3"></a><var>61.3</var>    (d) (e) "E-prescribing" means the transmission using electronic media of prescription <br/>
<a id="pl.61.4"></a><var>61.4</var>or prescription-related information between a prescriber, dispenser, pharmacy benefit <br/>
<a id="pl.61.5"></a><var>61.5</var>manager, or group purchaser, either directly or through an intermediary, including <br/>
<a id="pl.61.6"></a><var>61.6</var>an e-prescribing network. E-prescribing includes, but is not limited to, two-way <br/>
<a id="pl.61.7"></a><var>61.7</var>transmissions between the point of care and the dispenser and two-way transmissions <br/>
<a id="pl.61.8"></a><var>61.8</var>related to eligibility, formulary, and medication history information.<br/>
<a id="pl.61.9"></a><var>61.9</var>    (e) (f) "Electronic prescription drug program" means a program that provides for <br/>
<a id="pl.61.10"></a><var>61.10</var>e-prescribing.<br/>
<a id="pl.61.11"></a><var>61.11</var>    (f) (g) "Group purchaser" has the meaning given in section 
         <statute_ref>62J.03, subdivision 6</statute_ref>.<br/>
<a id="pl.61.12"></a><var>61.12</var>    (g) (h) "HL7 messages" means a standard approved by the standards development <br/>
<a id="pl.61.13"></a><var>61.13</var>organization known as Health Level Seven.<br/>
<a id="pl.61.14"></a><var>61.14</var>    (h) (i) "National Provider Identifier" or "NPI" means the identifier described under <br/>
<a id="pl.61.15"></a><var>61.15</var>Code of Federal Regulations, title 45, part 
         <statute_ref>162.406</statute_ref>.<br/>
<a id="pl.61.16"></a><var>61.16</var>    (i) (j) "NCPDP" means the National Council for Prescription Drug Programs, Inc.<br/>
<a id="pl.61.17"></a><var>61.17</var>    (j) (k) "NCPDP Formulary and Benefits Standard" means the National Council for <br/>
<a id="pl.61.18"></a><var>61.18</var>Prescription Drug Programs Formulary and Benefits Standard, Implementation Guide, <br/>
<a id="pl.61.19"></a><var>61.19</var>Version 1, Release 0, October 2005.<br/>
<a id="pl.61.20"></a><var>61.20</var>    (k) (l) "NCPDP SCRIPT Standard" means the National Council for Prescription <br/>
<a id="pl.61.21"></a><var>61.21</var>Drug Programs Prescriber/Pharmacist Interface SCRIPT Standard, Implementation <br/>
<a id="pl.61.22"></a><var>61.22</var>Guide Version 8, Release 1 (Version 8.1), October 2005, or the most recent standard <br/>
<a id="pl.61.23"></a><var>61.23</var>adopted by the Centers for Medicare and Medicaid Services for e-prescribing under <br/>
<a id="pl.61.24"></a><var>61.24</var>Medicare Part D as required by section 1860D-4(e)(4)(D) of the Social Security Act, and <br/>
<a id="pl.61.25"></a><var>61.25</var>regulations adopted under it. The standards shall be implemented according to the Centers <br/>
<a id="pl.61.26"></a><var>61.26</var>for Medicare and Medicaid Services schedule for compliance. Subsequently released <br/>
<a id="pl.61.27"></a><var>61.27</var>versions of the NCPDP SCRIPT Standard may be used, provided that the new version <br/>
<a id="pl.61.28"></a><var>61.28</var>of the standard is backward compatible to the current version adopted by the Centers for <br/>
<a id="pl.61.29"></a><var>61.29</var>Medicare and Medicaid Services.<br/>
<a id="pl.61.30"></a><var>61.30</var>    (l) (m) "Pharmacy" has the meaning given in section 
         <statute_ref>151.01, subdivision 2</statute_ref>.<br/>
<a id="pl.61.31"></a><var>61.31</var>    (m) (n) "Prescriber" means a licensed health care professional who is authorized to <br/>
<a id="pl.61.32"></a><var>61.32</var>prescribe a controlled substance under section 
<statute_ref>152.12, subdivision 1</statute_ref>. practitioner, other <br/>
<a id="pl.61.33"></a><var>61.33</var>than a veterinarian, as defined in section 151.01, subdivision 23.<br/>
<a id="pl.61.34"></a><var>61.34</var>    (n) (o) "Prescription-related information" means information regarding eligibility for <br/>
<a id="pl.61.35"></a><var>61.35</var>drug benefits, medication history, or related health or drug information.<br/>
<a id="pl.62.1"></a><var>62.1</var>    (o) (p) "Provider" or "health care provider" has the meaning given in section 
         <statute_ref>62J.03</statute_ref>, <br/>
<a id="pl.62.2"></a><var>62.2</var>subdivision 8.<br/>
<br/>
<a id="bill.4.4.0"></a><a id="pl.62.3"></a><var>62.3</var>    Sec. 4. Minnesota Statutes 2008, section 62J.497, subdivision 2, is amended to read:<br/>
<a id="pl.62.4"></a><var>62.4</var>    Subd. 2. <b>Requirements for electronic prescribing.</b> (a) Effective January 1, 2011, <br/>
<a id="pl.62.5"></a><var>62.5</var>all providers, group purchasers, prescribers, and dispensers must establish and, maintain, <br/>
<a id="pl.62.6"></a><var>62.6</var>and use an electronic prescription drug program that complies. This program must comply <br/>
<a id="pl.62.7"></a><var>62.7</var>with the applicable standards in this section for transmitting, directly or through an <br/>
<a id="pl.62.8"></a><var>62.8</var>intermediary, prescriptions and prescription-related information using electronic media.<br/>
<a id="pl.62.9"></a><var>62.9</var>    (b) Nothing in this section requires providers, group purchasers, prescribers, or <br/>
<a id="pl.62.10"></a><var>62.10</var>dispensers to conduct the transactions described in this section. If transactions described in <br/>
<a id="pl.62.11"></a><var>62.11</var>this section are conducted, they must be done electronically using the standards described <br/>
<a id="pl.62.12"></a><var>62.12</var>in this section. Nothing in this section requires providers, group purchasers, prescribers, <br/>
<a id="pl.62.13"></a><var>62.13</var>or dispensers to electronically conduct transactions that are expressly prohibited by other <br/>
<a id="pl.62.14"></a><var>62.14</var>sections or federal law.<br/>
<a id="pl.62.15"></a><var>62.15</var>    (c) Providers, group purchasers, prescribers, and dispensers must use either HL7 <br/>
<a id="pl.62.16"></a><var>62.16</var>messages or the NCPDP SCRIPT Standard to transmit prescriptions or prescription-related <br/>
<a id="pl.62.17"></a><var>62.17</var>information internally when the sender and the recipient are part of the same legal entity. If <br/>
<a id="pl.62.18"></a><var>62.18</var>an entity sends prescriptions outside the entity, it must use the NCPDP SCRIPT Standard <br/>
<a id="pl.62.19"></a><var>62.19</var>or other applicable standards required by this section. Any pharmacy within an entity <br/>
<a id="pl.62.20"></a><var>62.20</var>must be able to receive electronic prescription transmittals from outside the entity using <br/>
<a id="pl.62.21"></a><var>62.21</var>the adopted NCPDP SCRIPT Standard. This exemption does not supersede any Health <br/>
<a id="pl.62.22"></a><var>62.22</var>Insurance Portability and Accountability Act (HIPAA) requirement that may require the <br/>
<a id="pl.62.23"></a><var>62.23</var>use of a HIPAA transaction standard within an organization.<br/>
<a id="pl.62.24"></a><var>62.24</var>    (d) Entities transmitting prescriptions or prescription-related information where the <br/>
<a id="pl.62.25"></a><var>62.25</var>prescriber is required by law to issue a prescription for a patient to a nonprescribing <br/>
<a id="pl.62.26"></a><var>62.26</var>provider that in turn forwards the prescription to a dispenser are exempt from the <br/>
<a id="pl.62.27"></a><var>62.27</var>requirement to use the NCPDP SCRIPT Standard when transmitting prescriptions or <br/>
<a id="pl.62.28"></a><var>62.28</var>prescription-related information.<br/>
<br/>
<a id="bill.4.5.0"></a><a id="pl.62.29"></a><var>62.29</var>    Sec. 5. Minnesota Statutes 2008, section 62J.497, is amended by adding a subdivision <br/>
<a id="pl.62.30"></a><var>62.30</var>to read:<br/>
<a id="pl.62.31"></a><var>62.31</var>    Subd. 4. <b>Development and use of uniform formulary exception form.</b> (a) The <br/>
<a id="pl.62.32"></a><var>62.32</var>commissioner of health, in consultation with the Minnesota Administrative Uniformity <br/>
<a id="pl.62.33"></a><var>62.33</var>Committee, shall develop by July 1, 2009, or six weeks after enactment of this subdivision, <br/>
<a id="pl.62.34"></a><var>62.34</var>whichever is later, a uniform formulary exception form that allows health care providers <br/>
<a id="pl.63.1"></a><var>63.1</var>to request exceptions from group purchaser formularies using a uniform form. Upon <br/>
<a id="pl.63.2"></a><var>63.2</var>development of the form, all health care providers must submit requests for formulary <br/>
<a id="pl.63.3"></a><var>63.3</var>exceptions using the uniform form, and all group purchasers must accept this form from <br/>
<a id="pl.63.4"></a><var>63.4</var>health care providers.<br/>
<a id="pl.63.5"></a><var>63.5</var>    (b) No later than January 1, 2011, the uniform formulary exception form must be <br/>
<a id="pl.63.6"></a><var>63.6</var>accessible and submitted by health care providers, and accepted and processed by group <br/>
<a id="pl.63.7"></a><var>63.7</var>purchasers, through secure electronic transmissions. Facsimile shall not be considered <br/>
<a id="pl.63.8"></a><var>63.8</var>secure electronic transmissions.<br/>
<br/>
<a id="bill.4.6.0"></a><a id="pl.63.9"></a><var>63.9</var>    Sec. 6. Minnesota Statutes 2008, section 62J.497, is amended by adding a subdivision <br/>
<a id="pl.63.10"></a><var>63.10</var>to read:<br/>
<a id="pl.63.11"></a><var>63.11</var>    Subd. 5. <b>Electronic drug prior authorization standardization and transmission.</b><br/>
<a id="pl.63.12"></a><var>63.12</var>    (a) The commissioner of health, in consultation with the Minnesota e-Health Advisory <br/>
<a id="pl.63.13"></a><var>63.13</var>Committee and the Minnesota Administrative Uniformity Committee, shall, by February <br/>
<a id="pl.63.14"></a><var>63.14</var>15, 2010, identify an outline on how best to standardize drug prior authorization request <br/>
<a id="pl.63.15"></a><var>63.15</var>transactions between providers and group purchasers with the goal of maximizing <br/>
<a id="pl.63.16"></a><var>63.16</var>administrative simplification and efficiency in preparation for electronic transmissions.<br/>
<a id="pl.63.17"></a><var>63.17</var>    (b) No later than January 1, 2011, drug prior authorization requests must be <br/>
<a id="pl.63.18"></a><var>63.18</var>accessible and submitted by health care providers, and accepted and processed by group <br/>
<a id="pl.63.19"></a><var>63.19</var>purchasers, electronically through secure electronic transmissions. Facsimile shall not be <br/>
<a id="pl.63.20"></a><var>63.20</var>considered electronic transmission.<br/>
<br/>
<a id="bill.4.7.0"></a><a id="pl.63.21"></a><var>63.21</var>    Sec. 7. <b>[62Q.676] MEDICATION THERAPY MANAGEMENT.</b><br/>
<a id="pl.63.22"></a><var>63.22</var>    A pharmacy benefit manager that provides prescription drug services must make <br/>
<a id="pl.63.23"></a><var>63.23</var>available medication therapy management services for enrollees taking four or more <br/>
<a id="pl.63.24"></a><var>63.24</var>prescriptions to treat or prevent two or more chronic medical conditions. For purposes <br/>
<a id="pl.63.25"></a><var>63.25</var>of this section, "medication therapy management" means the provision of the following <br/>
<a id="pl.63.26"></a><var>63.26</var>pharmaceutical care services by, or under the supervision of, a licensed pharmacist to <br/>
<a id="pl.63.27"></a><var>63.27</var>optimize the therapeutic outcomes of the patient's medications:<br/>
<a id="pl.63.28"></a><var>63.28</var>    (1) performing a comprehensive medication review to identify, resolve, and prevent <br/>
<a id="pl.63.29"></a><var>63.29</var>medication-related problems, including adverse drug events;<br/>
<a id="pl.63.30"></a><var>63.30</var>    (2) communicating essential information to the patient's other primary care <br/>
<a id="pl.63.31"></a><var>63.31</var>providers; and<br/>
<a id="pl.63.32"></a><var>63.32</var>    (3) providing verbal education and training designed to enhance patient <br/>
<a id="pl.63.33"></a><var>63.33</var>understanding and appropriate use of the patient's medications.<br/>
<a id="pl.64.1"></a><var>64.1</var>    Nothing in this section shall be construed to expand or modify the scope of practice <br/>
<a id="pl.64.2"></a><var>64.2</var>of the pharmacist as defined in section 151.01, subdivision 27.<br/>
<br/>
<a id="bill.4.8.0"></a><a id="pl.64.3"></a><var>64.3</var>    Sec. 8. Minnesota Statutes 2008, section 144.122, is amended to read:<br/>
<a id="pl.64.4"></a><var>64.4</var><b>144.122 LICENSE, PERMIT, AND SURVEY FEES.</b><br/>
<a id="pl.64.5"></a><var>64.5</var>    (a) The state commissioner of health, by rule, may prescribe procedures and fees <br/>
<a id="pl.64.6"></a><var>64.6</var>for filing with the commissioner as prescribed by statute and for the issuance of original <br/>
<a id="pl.64.7"></a><var>64.7</var>and renewal permits, licenses, registrations, and certifications issued under authority of <br/>
<a id="pl.64.8"></a><var>64.8</var>the commissioner. The expiration dates of the various licenses, permits, registrations, <br/>
<a id="pl.64.9"></a><var>64.9</var>and certifications as prescribed by the rules shall be plainly marked thereon. Fees may <br/>
<a id="pl.64.10"></a><var>64.10</var>include application and examination fees and a penalty fee for renewal applications <br/>
<a id="pl.64.11"></a><var>64.11</var>submitted after the expiration date of the previously issued permit, license, registration, <br/>
<a id="pl.64.12"></a><var>64.12</var>and certification. The commissioner may also prescribe, by rule, reduced fees for permits, <br/>
<a id="pl.64.13"></a><var>64.13</var>licenses, registrations, and certifications when the application therefor is submitted <br/>
<a id="pl.64.14"></a><var>64.14</var>during the last three months of the permit, license, registration, or certification period. <br/>
<a id="pl.64.15"></a><var>64.15</var>Fees proposed to be prescribed in the rules shall be first approved by the Department of <br/>
<a id="pl.64.16"></a><var>64.16</var>Finance. All fees proposed to be prescribed in rules shall be reasonable. The fees shall be <br/>
<a id="pl.64.17"></a><var>64.17</var>in an amount so that the total fees collected by the commissioner will, where practical, <br/>
<a id="pl.64.18"></a><var>64.18</var>approximate the cost to the commissioner in administering the program. All fees collected <br/>
<a id="pl.64.19"></a><var>64.19</var>shall be deposited in the state treasury and credited to the state government special revenue <br/>
<a id="pl.64.20"></a><var>64.20</var>fund unless otherwise specifically appropriated by law for specific purposes.<br/>
<a id="pl.64.21"></a><var>64.21</var>    (b) The commissioner may charge a fee for voluntary certification of medical <br/>
<a id="pl.64.22"></a><var>64.22</var>laboratories and environmental laboratories, and for environmental and medical laboratory <br/>
<a id="pl.64.23"></a><var>64.23</var>services provided by the department, without complying with paragraph (a) or chapter 14. <br/>
<a id="pl.64.24"></a><var>64.24</var>Fees charged for environment and medical laboratory services provided by the department <br/>
<a id="pl.64.25"></a><var>64.25</var>must be approximately equal to the costs of providing the services.<br/>
<a id="pl.64.26"></a><var>64.26</var>    (c) The commissioner may develop a schedule of fees for diagnostic evaluations <br/>
<a id="pl.64.27"></a><var>64.27</var>conducted at clinics held by the services for children with disabilities program. All <br/>
<a id="pl.64.28"></a><var>64.28</var>receipts generated by the program are annually appropriated to the commissioner for use <br/>
<a id="pl.64.29"></a><var>64.29</var>in the maternal and child health program.<br/>
<a id="pl.64.30"></a><var>64.30</var>    (d) The commissioner shall set license fees for hospitals and nursing homes that are <br/>
<a id="pl.64.31"></a><var>64.31</var>not boarding care homes at the following levels:<br/>
<table>
<col width="50px"/>
<col width="32.5"/>
<col width="32.5"/>
<tr>
<td><a id="pl.65.1"></a><var>65.1</var><br/>
<a id="pl.65.2"></a><var>65.2</var><br/>
<a id="pl.65.3"></a><var>65.3</var><br/>
<a id="pl.65.4"></a><var>65.4</var><br/>
</td>
<td align="left" valign="top">Joint Commission on Accreditation of <br/>
                  		Healthcare Organizations (JCAHO) and <br/>
                  		American Osteopathic Association (AOA) <br/>
                  		hospitals<br/>
</td>
<td align="left" valign="top">$7,555$7,655 plus $13$16 per bed<br/>
</td>
</tr>
<tr>
<td><a id="pl.65.5"></a><var>65.5</var><br/>
</td>
<td align="left">Non-JCAHO and non-AOA hospitals<br/>
</td>
<td align="left">$5,180$5,280 plus $247$250 per bed<br/>
</td>
</tr>
<tr>
<td><a id="pl.65.6"></a><var>65.6</var><br/>
</td>
<td align="left">Nursing home<br/>
</td>
<td align="left">$183 plus $91 per bed<br/>
</td>
</tr>
</table><a id="pl.65.7"></a><var>65.7</var>    The commissioner shall set license fees for outpatient surgical centers, boarding care <br/>
<a id="pl.65.8"></a><var>65.8</var>homes, and supervised living facilities at the following levels:<br/>
<table>
<col width="50px"/>
<col width="32.5"/>
<col width="32.5"/>
<tr>
<td><a id="pl.65.9"></a><var>65.9</var><br/>
</td>
<td align="left">Outpatient surgical centers<br/>
</td>
<td align="left">$3,349$3,712<br/>
</td>
</tr>
<tr>
<td><a id="pl.65.10"></a><var>65.10</var><br/>
</td>
<td align="left">Boarding care homes<br/>
</td>
<td align="left">$183 plus $91 per bed<br/>
</td>
</tr>
<tr>
<td><a id="pl.65.11"></a><var>65.11</var><br/>
</td>
<td align="left">Supervised living facilities<br/>
</td>
<td align="left">$183 plus $91 per bed.<br/>
</td>
</tr>
</table><a id="pl.65.12"></a><var>65.12</var>    (e) Unless prohibited by federal law, the commissioner of health shall charge <br/>
<a id="pl.65.13"></a><var>65.13</var>applicants the following fees to cover the cost of any initial certification surveys required <br/>
<a id="pl.65.14"></a><var>65.14</var>to determine a provider's eligibility to participate in the Medicare or Medicaid program:<br/>
<table>
<col width="50px"/>
<col width="30"/>
<col width="13.5"/>
<col width="6.5"/>
<tr>
<td><a id="pl.65.15"></a><var>65.15</var><br/>
</td>
<td align="left">Prospective payment surveys for hospitals<br/>
</td>
<td align="right">$<br/>
</td>
<td align="right">900<br/>
</td>
</tr>
<tr>
<td><a id="pl.65.16"></a><var>65.16</var><br/>
</td>
<td align="left">Swing bed surveys for nursing homes<br/>
</td>
<td align="right">$<br/>
</td>
<td align="right">1,200<br/>
</td>
</tr>
<tr>
<td><a id="pl.65.17"></a><var>65.17</var><br/>
</td>
<td align="left">Psychiatric hospitals<br/>
</td>
<td align="right">$<br/>
</td>
<td align="right">1,400<br/>
</td>
</tr>
<tr>
<td><a id="pl.65.18"></a><var>65.18</var><br/>
</td>
<td align="left">Rural health facilities<br/>
</td>
<td align="right">$<br/>
</td>
<td align="right">1,100<br/>
</td>
</tr>
<tr>
<td><a id="pl.65.19"></a><var>65.19</var><br/>
</td>
<td align="left">Portable x-ray providers<br/>
</td>
<td align="right">$<br/>
</td>
<td align="right">500<br/>
</td>
</tr>
<tr>
<td><a id="pl.65.20"></a><var>65.20</var><br/>
</td>
<td align="left">Home health agencies<br/>
</td>
<td align="right">$<br/>
</td>
<td align="right">1,800<br/>
</td>
</tr>
<tr>
<td><a id="pl.65.21"></a><var>65.21</var><br/>
</td>
<td align="left">Outpatient therapy agencies<br/>
</td>
<td align="right">$<br/>
</td>
<td align="right">800<br/>
</td>
</tr>
<tr>
<td><a id="pl.65.22"></a><var>65.22</var><br/>
</td>
<td align="left">End stage renal dialysis providers<br/>
</td>
<td align="right">$<br/>
</td>
<td align="right">2,100<br/>
</td>
</tr>
<tr>
<td><a id="pl.65.23"></a><var>65.23</var><br/>
</td>
<td align="left">Independent therapists<br/>
</td>
<td align="right">$<br/>
</td>
<td align="right">800<br/>
</td>
</tr>
<tr>
<td><a id="pl.65.24"></a><var>65.24</var><br/>
</td>
<td align="left">Comprehensive rehabilitation outpatient facilities<br/>
</td>
<td align="right" valign="top">$<br/>
</td>
<td align="right" valign="top">1,200<br/>
</td>
</tr>
<tr>
<td><a id="pl.65.25"></a><var>65.25</var><br/>
</td>
<td align="left">Hospice providers<br/>
</td>
<td align="right">$<br/>
</td>
<td align="right">1,700<br/>
</td>
</tr>
<tr>
<td><a id="pl.65.26"></a><var>65.26</var><br/>
</td>
<td align="left">Ambulatory surgical providers<br/>
</td>
<td align="right">$<br/>
</td>
<td align="right">1,800<br/>
</td>
</tr>
<tr>
<td><a id="pl.65.27"></a><var>65.27</var><br/>
</td>
<td align="left">Hospitals<br/>
</td>
<td align="right">$<br/>
</td>
<td align="right" valign="bottom">4,200<br/>
</td>
</tr>
<tr>
<td><a id="pl.65.28"></a><var>65.28</var><br/>
<a id="pl.65.29"></a><var>65.29</var><br/>
<a id="pl.65.30"></a><var>65.30</var><br/>
</td>
<td align="left" valign="top">Other provider categories or additional<br/>
                  		resurveys required to complete initial<br/>
                  		certification<br/>
</td>
<td colspan="2" valign="top">Actual surveyor costs: average <br/>
                  		surveyor cost x number of hours <br/>
                  		for the survey process.<br/>
</td>
</tr>
</table><a id="pl.66.1"></a><var>66.1</var>    These fees shall be submitted at the time of the application for federal certification <br/>
<a id="pl.66.2"></a><var>66.2</var>and shall not be refunded. All fees collected after the date that the imposition of fees is not <br/>
<a id="pl.66.3"></a><var>66.3</var>prohibited by federal law shall be deposited in the state treasury and credited to the state <br/>
<a id="pl.66.4"></a><var>66.4</var>government special revenue fund.<br/>
<br/>
<a id="bill.4.9.0"></a><a id="pl.66.5"></a><var>66.5</var>    Sec. 9. Minnesota Statutes 2008, section 144.226, subdivision 4, is amended to read:<br/>
<a id="pl.66.6"></a><var>66.6</var>    Subd. 4. <b>Vital records surcharge.</b> (a) In addition to any fee prescribed under <br/>
<a id="pl.66.7"></a><var>66.7</var>subdivision 1, there is a nonrefundable surcharge of $2 for each certified and noncertified <br/>
<a id="pl.66.8"></a><var>66.8</var>birth, stillbirth, or death record, and for a certification that the record cannot be found. <br/>
<a id="pl.66.9"></a><var>66.9</var>The local or state registrar shall forward this amount to the commissioner of finance to <br/>
<a id="pl.66.10"></a><var>66.10</var>be deposited into the state government special revenue fund. This surcharge shall not be <br/>
<a id="pl.66.11"></a><var>66.11</var>charged under those circumstances in which no fee for a birth, stillbirth, or death record is <br/>
<a id="pl.66.12"></a><var>66.12</var>permitted under subdivision 1, paragraph (a).<br/>
<a id="pl.66.13"></a><var>66.13</var>(b) Effective August 1, 2005, to June 30, 2009, the surcharge in paragraph (a) shall <br/>
<a id="pl.66.14"></a><var>66.14</var>be is $4.<br/>
<br/>
<a id="bill.4.10.0"></a><a id="pl.66.15"></a><var>66.15</var>    Sec. 10. Minnesota Statutes 2008, section 148.6445, is amended by adding a <br/>
<a id="pl.66.16"></a><var>66.16</var>subdivision to read:<br/>
<a id="pl.66.17"></a><var>66.17</var>    Subd. 2a. <b>Duplicate license fee.</b> The fee for a duplicate license is $25.<br/>
<br/>
<a id="bill.5.0.0"></a>

<a id="bill.5.1.0"></a><a id="pl.66.20"></a><var>66.20</var>    Section 1. Minnesota Statutes 2008, section 60A.092, subdivision 2, is amended to <br/>
<a id="pl.66.21"></a><var>66.21</var>read:<br/>
<a id="pl.66.22"></a><var>66.22</var>    Subd. 2. <b>Licensed assuming insurer.</b> Reinsurance is ceded to an assuming insurer <br/>
<a id="pl.66.23"></a><var>66.23</var>if the assuming insurer is licensed to transact insurance or reinsurance in this state. For <br/>
<a id="pl.66.24"></a><var>66.24</var>purposes of reinsuring any health risk, an insurer is defined under section 62A.63.<br/>
<br/>
<a id="bill.5.2.0"></a><a id="pl.66.25"></a><var>66.25</var>    Sec. 2. Minnesota Statutes 2008, section 62D.03, subdivision 4, is amended to read:<br/>
<a id="pl.66.26"></a><var>66.26</var>    Subd. 4. <b>Application requirements.</b> Each application for a certificate of authority <br/>
<a id="pl.66.27"></a><var>66.27</var>shall be verified by an officer or authorized representative of the applicant, and shall be <br/>
<a id="pl.66.28"></a><var>66.28</var>in a form prescribed by the commissioner of health. Each application shall include the <br/>
<a id="pl.66.29"></a><var>66.29</var>following:<br/>
<a id="pl.66.30"></a><var>66.30</var>(a) a copy of the basic organizational document, if any, of the applicant and of <br/>
<a id="pl.66.31"></a><var>66.31</var>each major participating entity; such as the articles of incorporation, or other applicable <br/>
<a id="pl.66.32"></a><var>66.32</var>documents, and all amendments thereto;<br/>
<a id="pl.67.1"></a><var>67.1</var>(b) a copy of the bylaws, rules and regulations, or similar document, if any, and all <br/>
<a id="pl.67.2"></a><var>67.2</var>amendments thereto which regulate the conduct of the affairs of the applicant and of <br/>
<a id="pl.67.3"></a><var>67.3</var>each major participating entity;<br/>
<a id="pl.67.4"></a><var>67.4</var>(c) a list of the names, addresses, and official positions of the following:<br/>
<a id="pl.67.5"></a><var>67.5</var>(1) all members of the board of directors, or governing body of the local government <br/>
<a id="pl.67.6"></a><var>67.6</var>unit, and the principal officers and shareholders of the applicant organization; and<br/>
<a id="pl.67.7"></a><var>67.7</var>(2) all members of the board of directors, or governing body of the local government <br/>
<a id="pl.67.8"></a><var>67.8</var>unit, and the principal officers of the major participating entity and each shareholder <br/>
<a id="pl.67.9"></a><var>67.9</var>beneficially owning more than ten percent of any voting stock of the major participating <br/>
<a id="pl.67.10"></a><var>67.10</var>entity;<br/>
<a id="pl.67.11"></a><var>67.11</var>The commissioner may by rule identify persons included in the term "principal <br/>
<a id="pl.67.12"></a><var>67.12</var>officers";<br/>
<a id="pl.67.13"></a><var>67.13</var>(d) a full disclosure of the extent and nature of any contract or financial arrangements <br/>
<a id="pl.67.14"></a><var>67.14</var>between the following:<br/>
<a id="pl.67.15"></a><var>67.15</var>(1) the health maintenance organization and the persons listed in clause (c)(1);<br/>
<a id="pl.67.16"></a><var>67.16</var>(2) the health maintenance organization and the persons listed in clause (c)(2);<br/>
<a id="pl.67.17"></a><var>67.17</var>(3) each major participating entity and the persons listed in clause (c)(1) concerning <br/>
<a id="pl.67.18"></a><var>67.18</var>any financial relationship with the health maintenance organization; and<br/>
<a id="pl.67.19"></a><var>67.19</var>(4) each major participating entity and the persons listed in clause (c)(2) concerning <br/>
<a id="pl.67.20"></a><var>67.20</var>any financial relationship with the health maintenance organization;<br/>
<a id="pl.67.21"></a><var>67.21</var>(e) the name and address of each participating entity and the agreed upon duration of <br/>
<a id="pl.67.22"></a><var>67.22</var>each contract or agreement;<br/>
<a id="pl.67.23"></a><var>67.23</var>(f) a copy of the form of each contract binding the participating entities and the <br/>
<a id="pl.67.24"></a><var>67.24</var>health maintenance organization. Contractual provisions shall be consistent with the <br/>
<a id="pl.67.25"></a><var>67.25</var>purposes of sections 
         <statute_ref>62D.01</statute_ref> to 
         <statute_ref>62D.30</statute_ref>, in regard to the services to be performed under the <br/>
<a id="pl.67.26"></a><var>67.26</var>contract, the manner in which payment for services is determined, the nature and extent <br/>
<a id="pl.67.27"></a><var>67.27</var>of responsibilities to be retained by the health maintenance organization, the nature and <br/>
<a id="pl.67.28"></a><var>67.28</var>extent of risk sharing permissible, and contractual termination provisions; <br/>
<a id="pl.67.29"></a><var>67.29</var>(g) a copy of each contract binding major participating entities and the health <br/>
<a id="pl.67.30"></a><var>67.30</var>maintenance organization. Contract information filed with the commissioner shall be <br/>
<a id="pl.67.31"></a><var>67.31</var>confidential and subject to the provisions of section 
         <statute_ref>13.37, subdivision 1</statute_ref>, clause (b), upon <br/>
<a id="pl.67.32"></a><var>67.32</var>the request of the health maintenance organization. <br/>
<a id="pl.67.33"></a><var>67.33</var>Upon initial filing of each contract, the health maintenance organization shall file <br/>
<a id="pl.67.34"></a><var>67.34</var>a separate document detailing the projected annual expenses to the major participating <br/>
<a id="pl.67.35"></a><var>67.35</var>entity in performing the contract and the projected annual revenues received by the entity <br/>
<a id="pl.67.36"></a><var>67.36</var>from the health maintenance organization for such performance. The commissioner <br/>
<a id="pl.68.1"></a><var>68.1</var>shall disapprove any contract with a major participating entity if the contract will result <br/>
<a id="pl.68.2"></a><var>68.2</var>in an unreasonable expense under section 
         <statute_ref>62D.19</statute_ref>. The commissioner shall approve or <br/>
<a id="pl.68.3"></a><var>68.3</var>disapprove a contract within 30 days of filing. <br/>
<a id="pl.68.4"></a><var>68.4</var>Within 120 days of the anniversary of the implementation of each contract, the <br/>
<a id="pl.68.5"></a><var>68.5</var>health maintenance organization shall file a document detailing the actual expenses <br/>
<a id="pl.68.6"></a><var>68.6</var>incurred and reported by the major participating entity in performing the contract in the <br/>
<a id="pl.68.7"></a><var>68.7</var>preceding year and the actual revenues received from the health maintenance organization <br/>
<a id="pl.68.8"></a><var>68.8</var>by the entity in payment for the performance;<br/>
<a id="pl.68.9"></a><var>68.9</var>(h) a statement generally describing the health maintenance organization, its health <br/>
<a id="pl.68.10"></a><var>68.10</var>maintenance contracts and separate health service contracts, facilities, and personnel, <br/>
<a id="pl.68.11"></a><var>68.11</var>including a statement describing the manner in which the applicant proposes to provide <br/>
<a id="pl.68.12"></a><var>68.12</var>enrollees with comprehensive health maintenance services and separate health services;<br/>
<a id="pl.68.13"></a><var>68.13</var>(i) a copy of the form of each evidence of coverage to be issued to the enrollees;<br/>
<a id="pl.68.14"></a><var>68.14</var>(j) a copy of the form of each individual or group health maintenance contract <br/>
<a id="pl.68.15"></a><var>68.15</var>and each separate health service contract which is to be issued to enrollees or their <br/>
<a id="pl.68.16"></a><var>68.16</var>representatives;<br/>
<a id="pl.68.17"></a><var>68.17</var>(k) financial statements showing the applicant's assets, liabilities, and sources of <br/>
<a id="pl.68.18"></a><var>68.18</var>financial support. If the applicant's financial affairs are audited by independent certified <br/>
<a id="pl.68.19"></a><var>68.19</var>public accountants, a copy of the applicant's most recent certified financial statement <br/>
<a id="pl.68.20"></a><var>68.20</var>may be deemed to satisfy this requirement;<br/>
<a id="pl.68.21"></a><var>68.21</var>(l) a description of the proposed method of marketing the plan, a schedule of <br/>
<a id="pl.68.22"></a><var>68.22</var>proposed charges, and a financial plan which includes a three-year projection of the <br/>
<a id="pl.68.23"></a><var>68.23</var>expenses and income and other sources of future capital;<br/>
<a id="pl.68.24"></a><var>68.24</var>(m) a statement reasonably describing the geographic area or areas to be served and <br/>
<a id="pl.68.25"></a><var>68.25</var>the type or types of enrollees to be served;<br/>
<a id="pl.68.26"></a><var>68.26</var>(n) a description of the complaint procedures to be utilized as required under section <br/>
<statute_ref><a id="pl.68.27"></a><var>68.27</var>62D.11
         </statute_ref>; <br/>
<a id="pl.68.28"></a><var>68.28</var>(o) a description of the procedures and programs to be implemented to meet the <br/>
<a id="pl.68.29"></a><var>68.29</var>requirements of section 
         <statute_ref>62D.04, subdivision 1</statute_ref>, clauses (b) and (c) and to monitor the <br/>
<a id="pl.68.30"></a><var>68.30</var>quality of health care provided to enrollees; <br/>
<a id="pl.68.31"></a><var>68.31</var>(p) a description of the mechanism by which enrollees will be afforded an <br/>
<a id="pl.68.32"></a><var>68.32</var>opportunity to participate in matters of policy and operation under section 
         <statute_ref>62D.06</statute_ref>; <br/>
<a id="pl.68.33"></a><var>68.33</var>(q) a copy of any agreement between the health maintenance organization and <br/>
<a id="pl.68.34"></a><var>68.34</var>an insurer or, including any  nonprofit health service corporation or another health <br/>
<a id="pl.68.35"></a><var>68.35</var>maintenance organization, regarding reinsurance, stop-loss coverage, insolvency <br/>
<a id="pl.69.1"></a><var>69.1</var>coverage, or any other type of coverage for potential costs of health services, as authorized <br/>
<a id="pl.69.2"></a><var>69.2</var>in sections 
         <statute_ref>62D.04, subdivision 1</statute_ref>, clause (f), 
         <statute_ref>62D.05, subdivision 3</statute_ref>, and 
         <statute_ref>62D.13</statute_ref>; <br/>
<a id="pl.69.3"></a><var>69.3</var>(r) a copy of the conflict of interest policy which applies to all members of the board <br/>
<a id="pl.69.4"></a><var>69.4</var>of directors and the principal officers of the health maintenance organization, as described <br/>
<a id="pl.69.5"></a><var>69.5</var>in section 
         <statute_ref>62D.04, subdivision 1</statute_ref>, paragraph (g). All currently licensed health maintenance <br/>
<a id="pl.69.6"></a><var>69.6</var>organizations shall also file a conflict of interest policy with the commissioner within 60 <br/>
<a id="pl.69.7"></a><var>69.7</var>days after August 1, 1990, or at a later date if approved by the commissioner; <br/>
<a id="pl.69.8"></a><var>69.8</var>(s) a copy of the statement that describes the health maintenance organization's prior <br/>
<a id="pl.69.9"></a><var>69.9</var>authorization administrative procedures; and<br/>
<a id="pl.69.10"></a><var>69.10</var>(t) other information as the commissioner of health may reasonably require to be <br/>
<a id="pl.69.11"></a><var>69.11</var>provided.<br/>
<br/>
<a id="bill.5.3.0"></a><a id="pl.69.12"></a><var>69.12</var>    Sec. 3. Minnesota Statutes 2008, section 62D.05, subdivision 3, is amended to read:<br/>
<a id="pl.69.13"></a><var>69.13</var>    Subd. 3. <b>Contracts; health services.</b> A health maintenance organization may <br/>
<a id="pl.69.14"></a><var>69.14</var>contract with providers of health care services to render the services the health maintenance <br/>
<a id="pl.69.15"></a><var>69.15</var>organization has promised to provide under the terms of its health maintenance contracts, <br/>
<a id="pl.69.16"></a><var>69.16</var>may, subject to section 
         <statute_ref>62D.12, subdivision 11</statute_ref>, enter into separate prepaid dental contracts, <br/>
<a id="pl.69.17"></a><var>69.17</var>or other separate health service contracts, may, subject to the limitations of section <br/>
<statute_ref><a id="pl.69.18"></a><var>69.18</var>62D.04, subdivision 1
         </statute_ref>, clause (f), contract with insurance companies and, including <br/>
<a id="pl.69.19"></a><var>69.19</var> nonprofit health service plan corporations or other health maintenance organizations, <br/>
<a id="pl.69.20"></a><var>69.20</var>for insurance, indemnity or reimbursement of its cost of providing health care services <br/>
<a id="pl.69.21"></a><var>69.21</var>for enrollees or against the risks incurred by the health maintenance organization, may <br/>
<a id="pl.69.22"></a><var>69.22</var>contract with insurance companies and nonprofit health service plan corporations for <br/>
<a id="pl.69.23"></a><var>69.23</var>insolvency insurance coverage, and may contract with insurance companies and nonprofit <br/>
<a id="pl.69.24"></a><var>69.24</var>health service plan corporations to insure or cover the enrollees' costs and expenses in the <br/>
<a id="pl.69.25"></a><var>69.25</var>health maintenance organization, including the customary prepayment amount and any <br/>
<a id="pl.69.26"></a><var>69.26</var>co-payment obligations, and may contract to provide reinsurance or insolvency insurance <br/>
<a id="pl.69.27"></a><var>69.27</var>coverage to health insurers or nonprofit health service plan corporations.  <br/>
<br/>
<a id="bill.5.4.0"></a><a id="pl.69.28"></a><var>69.28</var>    Sec. 4. Minnesota Statutes 2008, section 62J.692, subdivision 7, is amended to read:<br/>
<a id="pl.69.29"></a><var>69.29</var>    Subd. 7. <b>Transfers from the commissioner of human services.</b> (a) The amount <br/>
<a id="pl.69.30"></a><var>69.30</var>transferred according to section 
<statute_ref>256B.69, subdivision 5c</statute_ref>, paragraph (a), clause (1), shall <br/>
<a id="pl.69.31"></a><var>69.31</var>be distributed by the commissioner annually to clinical medical education programs that <br/>
<a id="pl.69.32"></a><var>69.32</var>meet the qualifications of subdivision 3 based on the formula in subdivision 4, paragraph <br/>
<a id="pl.69.33"></a><var>69.33</var>(a) Of the amount transferred according to section 256B.69, subdivision 5c, paragraph (a), <br/>
<a id="pl.69.34"></a><var>69.34</var>clauses (1) to (4), $21,714,000 shall be distributed as follows:<br/>
<a id="pl.70.1"></a><var>70.1</var>(1) $2,157,000 shall be distributed by the commissioner to the University of <br/>
<a id="pl.70.2"></a><var>70.2</var>Minnesota Board of Regents for the purposes described in sections 137.38 to 137.40;<br/>
<a id="pl.70.3"></a><var>70.3</var>(2) $1,035,360 shall be distributed by the commissioner to the Hennepin County <br/>
<a id="pl.70.4"></a><var>70.4</var>Medical Center for clinical medical education;<br/>
<a id="pl.70.5"></a><var>70.5</var>(3) $17,400,000 shall be distributed by the commissioner to the University of <br/>
<a id="pl.70.6"></a><var>70.6</var>Minnesota Board of Regents for purposes of medial education;<br/>
<a id="pl.70.7"></a><var>70.7</var>(4) $1,121,640 shall be distributed by the commissioner to clinical medical education <br/>
<a id="pl.70.8"></a><var>70.8</var>dental innovation grants in accordance with subdivision 7a; and<br/>
<a id="pl.70.9"></a><var>70.9</var>(5) the remainder of the amount transferred according to section 256B.69, <br/>
<a id="pl.70.10"></a><var>70.10</var>subdivision 5c, clauses (1) to (4), shall be distributed by the commissioner annually to <br/>
<a id="pl.70.11"></a><var>70.11</var>clinical medical education programs that meet the qualifications of subdivision 3 based on <br/>
<a id="pl.70.12"></a><var>70.12</var>the formula in subdivision 4, paragraph (a).<br/>
<a id="pl.70.13"></a><var>70.13</var>(b) Fifty percent of the amount transferred according to section 
<statute_ref>256B.69, subdivision <br/>
<a id="pl.70.14"></a><var>70.14</var>5c
</statute_ref>, paragraph (a), clause (2), shall be distributed by the commissioner to the University of <br/>
<a id="pl.70.15"></a><var>70.15</var>Minnesota Board of Regents for the purposes described in sections 
<statute_ref>137.38</statute_ref> to 
<statute_ref>137.40</statute_ref>. Of <br/>
<a id="pl.70.16"></a><var>70.16</var>the remaining amount transferred according to section 
<statute_ref>256B.69, subdivision 5c</statute_ref>, paragraph <br/>
<a id="pl.70.17"></a><var>70.17</var>(a), clause (2), 24 percent of the amount shall be distributed by the commissioner to <br/>
<a id="pl.70.18"></a><var>70.18</var>the Hennepin County Medical Center for clinical medical education. The remaining 26 <br/>
<a id="pl.70.19"></a><var>70.19</var>percent of the amount transferred shall be distributed by the commissioner in accordance <br/>
<a id="pl.70.20"></a><var>70.20</var>with subdivision 7a. If the federal approval is not obtained for the matching funds under <br/>
<a id="pl.70.21"></a><var>70.21</var>section 
<statute_ref>256B.69, subdivision 5c</statute_ref>, paragraph (a), clause (2), 100 percent of the amount <br/>
<a id="pl.70.22"></a><var>70.22</var>transferred under this paragraph shall be distributed by the commissioner to the University <br/>
<a id="pl.70.23"></a><var>70.23</var>of Minnesota Board of Regents for the purposes described in sections 
<statute_ref>137.38</statute_ref> to 
<statute_ref>137.40</statute_ref>.<br/>
<a id="pl.70.24"></a><var>70.24</var>(c) The amount transferred according to section 
<statute_ref>256B.69, subdivision 5c</statute_ref>, paragraph <br/>
<a id="pl.70.25"></a><var>70.25</var>(a), clauses (3) and (4), shall be distributed by the commissioner upon receipt to the <br/>
<a id="pl.70.26"></a><var>70.26</var>University of Minnesota Board of Regents for the purposes of clinical graduate medical <br/>
<a id="pl.70.27"></a><var>70.27</var>education.<br/>
<br/>
<a id="bill.5.5.0"></a><a id="pl.70.28"></a><var>70.28</var>    Sec. 5. Minnesota Statutes 2008, section 256.01, subdivision 2b, is amended to read:<br/>
<a id="pl.70.29"></a><var>70.29</var>    Subd. 2b.  <b>Performance payments.</b> (a) The commissioner shall develop and <br/>
<a id="pl.70.30"></a><var>70.30</var>implement a pay-for-performance system to provide performance payments to eligible <br/>
<a id="pl.70.31"></a><var>70.31</var>medical groups and clinics that demonstrate optimum care in serving individuals <br/>
<a id="pl.70.32"></a><var>70.32</var>with chronic diseases who are enrolled in health care programs administered by the <br/>
<a id="pl.70.33"></a><var>70.33</var>commissioner under chapters 256B, 256D, and 256L. The commissioner may receive any <br/>
<a id="pl.70.34"></a><var>70.34</var>federal matching money that is made available through the medical assistance program <br/>
<a id="pl.70.35"></a><var>70.35</var>for managed care oversight contracted through vendors, including consumer surveys, <br/>
<a id="pl.71.1"></a><var>71.1</var>studies, and external quality reviews as required by the federal Balanced Budget Act of <br/>
<a id="pl.71.2"></a><var>71.2</var>1997, Code of Federal Regulations, title 42, part 438-managed care, subpart E-external <br/>
<a id="pl.71.3"></a><var>71.3</var>quality review. Any federal money received for managed care oversight is appropriated <br/>
<a id="pl.71.4"></a><var>71.4</var>to the commissioner for this purpose. The commissioner may expend the federal money <br/>
<a id="pl.71.5"></a><var>71.5</var>received in either year of the biennium. <br/>
<a id="pl.71.6"></a><var>71.6</var>    (b) Effective July 1, 2008, or upon federal approval, whichever is later, the <br/>
<a id="pl.71.7"></a><var>71.7</var>commissioner shall develop and implement a patient incentive health program to provide <br/>
<a id="pl.71.8"></a><var>71.8</var>incentives and rewards to patients who are enrolled in health care programs administered <br/>
<a id="pl.71.9"></a><var>71.9</var>by the commissioner under chapters 256B, 256D, and 256L, and who have agreed to and <br/>
<a id="pl.71.10"></a><var>71.10</var>have met personal health goals established with the patients' primary care providers to <br/>
<a id="pl.71.11"></a><var>71.11</var>manage a chronic disease or condition, including but not limited to diabetes, high blood <br/>
<a id="pl.71.12"></a><var>71.12</var>pressure, and coronary artery disease. <br/>
<br/>
<a id="bill.5.6.0"></a><a id="pl.71.13"></a><var>71.13</var>    Sec. 6. Minnesota Statutes 2008, section 256.01, is amended by adding a subdivision <br/>
<a id="pl.71.14"></a><var>71.14</var>to read:<br/>
<a id="pl.71.15"></a><var>71.15</var>    Subd. 18a. <b>Public Assistance Reporting Information System.</b> (a) Effective <br/>
<a id="pl.71.16"></a><var>71.16</var>October 1, 2009, the commissioner shall comply with the federal requirements in Public <br/>
<a id="pl.71.17"></a><var>71.17</var>Law 110-379 in implementing the Public Assistance Reporting Information System <br/>
<a id="pl.71.18"></a><var>71.18</var>(PARIS) to determine eligibility for all individuals applying for:<br/>
<a id="pl.71.19"></a><var>71.19</var>(1) health care benefits under chapters 256B, 256D, and 256L; and<br/>
<a id="pl.71.20"></a><var>71.20</var>(2) public benefits under chapters 119B, 256D, 256I, and the supplemental nutrition <br/>
<a id="pl.71.21"></a><var>71.21</var>assistance program.<br/>
<a id="pl.71.22"></a><var>71.22</var>(b) The commissioner shall determine eligibility under paragraph (a) by performing <br/>
<a id="pl.71.23"></a><var>71.23</var>data matches, including matching with medical assistance, cash, child care, and <br/>
<a id="pl.71.24"></a><var>71.24</var>supplemental assistance programs operated by other states.<br/>
<a id="pl.71.25"></a><var>71.25</var><b>EFFECTIVE DATE.</b>This section is effective October 1, 2009.<br/>
<br/>
<a id="bill.5.7.0"></a><a id="pl.71.26"></a><var>71.26</var>    Sec. 7. Minnesota Statutes 2008, section 256.01, is amended by adding a subdivision <br/>
<a id="pl.71.27"></a><var>71.27</var>to read:<br/>
<a id="pl.71.28"></a><var>71.28</var>    Subd. 18b. <b>Protections for American Indians.</b> Effective February 18, 2009, the <br/>
<a id="pl.71.29"></a><var>71.29</var>commissioner shall comply with the federal requirements in the American Recovery and <br/>
<a id="pl.71.30"></a><var>71.30</var>Reinvestment Act of 2009, Public Law 111-5, section 5006, regarding American Indians.<br/>
<br/>
<a id="bill.5.8.0"></a><a id="pl.71.31"></a><var>71.31</var>    Sec. 8. Minnesota Statutes 2008, section 256.962, subdivision 2, is amended to read:<br/>
<a id="pl.72.1"></a><var>72.1</var>    Subd. 2. <b>Outreach grants.</b> (a) The commissioner shall award grants to public and <br/>
<a id="pl.72.2"></a><var>72.2</var>private organizations, regional collaboratives, and regional health care outreach centers <br/>
<a id="pl.72.3"></a><var>72.3</var>for outreach activities, including, but not limited to: <br/>
<a id="pl.72.4"></a><var>72.4</var>    (1) providing information, applications, and assistance in obtaining coverage <br/>
<a id="pl.72.5"></a><var>72.5</var>through Minnesota public health care programs;<br/>
<a id="pl.72.6"></a><var>72.6</var>    (2) collaborating with public and private entities such as hospitals, providers, health <br/>
<a id="pl.72.7"></a><var>72.7</var>plans, legal aid offices, pharmacies, insurance agencies, and faith-based organizations to <br/>
<a id="pl.72.8"></a><var>72.8</var>develop outreach activities and partnerships to ensure the distribution of information <br/>
<a id="pl.72.9"></a><var>72.9</var>and applications and provide assistance in obtaining coverage through Minnesota health <br/>
<a id="pl.72.10"></a><var>72.10</var>care programs; and<br/>
<a id="pl.72.11"></a><var>72.11</var>    (3) providing or collaborating with public and private entities to provide multilingual <br/>
<a id="pl.72.12"></a><var>72.12</var>and culturally specific information and assistance to applicants in areas of high <br/>
<a id="pl.72.13"></a><var>72.13</var>uninsurance in the state or populations with high rates of uninsurance; and<br/>
<a id="pl.72.14"></a><var>72.14</var>(4) targeting geographic areas with high rates of (i) eligible but unenrolled children, <br/>
<a id="pl.72.15"></a><var>72.15</var>including children who reside in rural areas, or (ii) racial and ethnic minorities and health <br/>
<a id="pl.72.16"></a><var>72.16</var>disparity populations.<br/>
<a id="pl.72.17"></a><var>72.17</var>    (b) The commissioner shall ensure that all outreach materials are available in <br/>
<a id="pl.72.18"></a><var>72.18</var>languages other than English.<br/>
<a id="pl.72.19"></a><var>72.19</var>    (c) The commissioner shall establish an outreach trainer program to provide <br/>
<a id="pl.72.20"></a><var>72.20</var>training to designated individuals from the community and public and private entities on <br/>
<a id="pl.72.21"></a><var>72.21</var>application assistance in order for these individuals to provide training to others in the <br/>
<a id="pl.72.22"></a><var>72.22</var>community on an as-needed basis.<br/>
<br/>
<a id="bill.5.9.0"></a><a id="pl.72.23"></a><var>72.23</var>    Sec. 9. Minnesota Statutes 2008, section 256.962, subdivision 6, is amended to read:<br/>
<a id="pl.72.24"></a><var>72.24</var>    Subd. 6. <b>School districts</b><b> and charter schools</b><b>.</b> (a) At the beginning of each school <br/>
<a id="pl.72.25"></a><var>72.25</var>year, a school district  or charter school shall provide information to each student on the <br/>
<a id="pl.72.26"></a><var>72.26</var>availability of health care coverage through the Minnesota health care programs and how <br/>
<a id="pl.72.27"></a><var>72.27</var>to obtain an application for the Minnesota health care programs.<br/>
<a id="pl.72.28"></a><var>72.28</var>    (b) For each child who is determined to be eligible for the free and reduced-price <br/>
<a id="pl.72.29"></a><var>72.29</var>school lunch program, the district shall provide the child's family with information on how <br/>
<a id="pl.72.30"></a><var>72.30</var>to obtain an application for the Minnesota health care programs and application assistance.<br/>
<a id="pl.72.31"></a><var>72.31</var>    (c) A school district or charter school shall also ensure that applications and <br/>
<a id="pl.72.32"></a><var>72.32</var>information on application assistance are available at early childhood education sites and <br/>
<a id="pl.72.33"></a><var>72.33</var>public schools located within the district's jurisdiction.<br/>
<a id="pl.72.34"></a><var>72.34</var>    (d) (c) Each district shall designate an enrollment specialist to provide application <br/>
<a id="pl.72.35"></a><var>72.35</var>assistance and follow-up services with families who have indicated an interest in receiving <br/>
<a id="pl.73.1"></a><var>73.1</var>information or an application for the Minnesota health care program. A district is eligible <br/>
<a id="pl.73.2"></a><var>73.2</var>for the application assistance bonus described in subdivision 5.<br/>
<a id="pl.73.3"></a><var>73.3</var>    (e) Each (d) If a school district or charter school maintains a district Web site, the <br/>
<a id="pl.73.4"></a><var>73.4</var>school district or charter school shall provide on their its Web site a link to information on <br/>
<a id="pl.73.5"></a><var>73.5</var>how to obtain an application and application assistance.<br/>
<br/>
<a id="bill.5.10.0"></a><a id="pl.73.6"></a><var>73.6</var>    Sec. 10. <b>[256.964] DENTAL CARE PILOT PROJECTS.</b><br/>
<a id="pl.73.7"></a><var>73.7</var>The commissioner shall authorize pilot projects to reduce the total cost to the state <br/>
<a id="pl.73.8"></a><var>73.8</var>for dental services provided to enrollees of the state public health care programs by <br/>
<a id="pl.73.9"></a><var>73.9</var>reducing hospital emergency room costs for preventable or nonemergency dental services. <br/>
<a id="pl.73.10"></a><var>73.10</var>As part of the project, a community dental clinic or dental provider, in collaboration with a <br/>
<a id="pl.73.11"></a><var>73.11</var>hospital emergency room, shall provide urgent care dental services as an alternative to the <br/>
<a id="pl.73.12"></a><var>73.12</var>hospital emergency room for nonemergency dental care. The project participants shall <br/>
<a id="pl.73.13"></a><var>73.13</var>establish a process to divert a patient presenting at the emergency room for nonemergency <br/>
<a id="pl.73.14"></a><var>73.14</var>dental care to the dental community clinic or to an appropriate dental provider. The <br/>
<a id="pl.73.15"></a><var>73.15</var>commissioner may establish special payment rates for urgent care services provided and <br/>
<a id="pl.73.16"></a><var>73.16</var>may change or waive existing payment policies in order to adequately reimburse providers <br/>
<a id="pl.73.17"></a><var>73.17</var>for providing cost-effective alternative services in an outpatient or urgent care setting. <br/>
<a id="pl.73.18"></a><var>73.18</var>The commissioner may establish a project in conjunction with the initiative authorized <br/>
<a id="pl.73.19"></a><var>73.19</var>under section 256.963.<br/>
<br/>
<a id="bill.5.11.0"></a><a id="pl.73.20"></a><var>73.20</var>    Sec. 11. Minnesota Statutes 2008, section 256.969, subdivision 2b, is amended to read:<br/>
<a id="pl.73.21"></a><var>73.21</var>    Subd. 2b. <b>Operating payment rates.</b> In determining operating payment rates for <br/>
<a id="pl.73.22"></a><var>73.22</var>admissions occurring on or after the rate year beginning January 1, 1991, and every two <br/>
<a id="pl.73.23"></a><var>73.23</var>years after, or more frequently as determined by the commissioner, the commissioner <br/>
<a id="pl.73.24"></a><var>73.24</var>shall obtain operating data from an updated base year and establish operating payment <br/>
<a id="pl.73.25"></a><var>73.25</var>rates per admission for each hospital based on the cost-finding methods and allowable <br/>
<a id="pl.73.26"></a><var>73.26</var>costs of the Medicare program in effect during the base year. Rates under the general <br/>
<a id="pl.73.27"></a><var>73.27</var>assistance medical care, medical assistance, and MinnesotaCare programs shall not be <br/>
<a id="pl.73.28"></a><var>73.28</var>rebased to more current data on January 1, 1997, January 1, 2005, and for the first 24 <br/>
<a id="pl.73.29"></a><var>73.29</var>months of the rebased period beginning January 1, 2009, and for the first three months of <br/>
<a id="pl.73.30"></a><var>73.30</var>the rebased period beginning January 1, 2011. From April 1, 2011, to March 31, 2012, <br/>
<a id="pl.73.31"></a><var>73.31</var>rates shall be rebased at 39.2 percent of the full value of the rebasing percentage change. <br/>
<a id="pl.73.32"></a><var>73.32</var>Effective April 1, 2012, rates shall be rebased at full value. The base year operating <br/>
<a id="pl.73.33"></a><var>73.33</var>payment rate per admission is standardized by the case mix index and adjusted by the <br/>
<a id="pl.73.34"></a><var>73.34</var>hospital cost index, relative values, and disproportionate population adjustment. The <br/>
<a id="pl.74.1"></a><var>74.1</var>cost and charge data used to establish operating rates shall only reflect inpatient services <br/>
<a id="pl.74.2"></a><var>74.2</var>covered by medical assistance and shall not include property cost information and costs <br/>
<a id="pl.74.3"></a><var>74.3</var>recognized in outlier payments.<br/>
<br/>
<a id="bill.5.12.0"></a><a id="pl.74.4"></a><var>74.4</var>    Sec. 12. Minnesota Statutes 2008, section 256.969, subdivision 3a, is amended to read:<br/>
<a id="pl.74.5"></a><var>74.5</var>    Subd. 3a. <b>Payments.</b> (a) Acute care hospital billings under the medical <br/>
<a id="pl.74.6"></a><var>74.6</var>assistance program must not be submitted until the recipient is discharged. However, <br/>
<a id="pl.74.7"></a><var>74.7</var>the commissioner shall establish monthly interim payments for inpatient hospitals that <br/>
<a id="pl.74.8"></a><var>74.8</var>have individual patient lengths of stay over 30 days regardless of diagnostic category. <br/>
<a id="pl.74.9"></a><var>74.9</var>Except as provided in section 
         <statute_ref>256.9693</statute_ref>, medical assistance reimbursement for treatment <br/>
<a id="pl.74.10"></a><var>74.10</var>of mental illness shall be reimbursed based on diagnostic classifications. Individual <br/>
<a id="pl.74.11"></a><var>74.11</var>hospital payments established under this section and sections 
         <statute_ref>256.9685</statute_ref>, 
         <statute_ref>256.9686</statute_ref>, and <br/>
<statute_ref><a id="pl.74.12"></a><var>74.12</var>256.9695
         </statute_ref>, in addition to third party and recipient liability, for discharges occurring during <br/>
<a id="pl.74.13"></a><var>74.13</var>the rate year shall not exceed, in aggregate, the charges for the medical assistance covered <br/>
<a id="pl.74.14"></a><var>74.14</var>inpatient services paid for the same period of time to the hospital. This payment limitation <br/>
<a id="pl.74.15"></a><var>74.15</var>shall be calculated separately for medical assistance and general assistance medical <br/>
<a id="pl.74.16"></a><var>74.16</var>care services. The limitation on general assistance medical care shall be effective for <br/>
<a id="pl.74.17"></a><var>74.17</var>admissions occurring on or after July 1, 1991. Services that have rates established under <br/>
<a id="pl.74.18"></a><var>74.18</var>subdivision 11 or 12, must be limited separately from other services. After consulting with <br/>
<a id="pl.74.19"></a><var>74.19</var>the affected hospitals, the commissioner may consider related hospitals one entity and <br/>
<a id="pl.74.20"></a><var>74.20</var>may merge the payment rates while maintaining separate provider numbers. The operating <br/>
<a id="pl.74.21"></a><var>74.21</var>and property base rates per admission or per day shall be derived from the best Medicare <br/>
<a id="pl.74.22"></a><var>74.22</var>and claims data available when rates are established. The commissioner shall determine <br/>
<a id="pl.74.23"></a><var>74.23</var>the best Medicare and claims data, taking into consideration variables of recency of the <br/>
<a id="pl.74.24"></a><var>74.24</var>data, audit disposition, settlement status, and the ability to set rates in a timely manner. <br/>
<a id="pl.74.25"></a><var>74.25</var>The commissioner shall notify hospitals of payment rates by December 1 of the year <br/>
<a id="pl.74.26"></a><var>74.26</var>preceding the rate year. The rate setting data must reflect the admissions data used to <br/>
<a id="pl.74.27"></a><var>74.27</var>establish relative values. Base year changes from 1981 to the base year established for the <br/>
<a id="pl.74.28"></a><var>74.28</var>rate year beginning January 1, 1991, and for subsequent rate years, shall not be limited <br/>
<a id="pl.74.29"></a><var>74.29</var>to the limits ending June 30, 1987, on the maximum rate of increase under subdivision <br/>
<a id="pl.74.30"></a><var>74.30</var>1. The commissioner may adjust base year cost, relative value, and case mix index data <br/>
<a id="pl.74.31"></a><var>74.31</var>to exclude the costs of services that have been discontinued by the October 1 of the year <br/>
<a id="pl.74.32"></a><var>74.32</var>preceding the rate year or that are paid separately from inpatient services. Inpatient stays <br/>
<a id="pl.74.33"></a><var>74.33</var>that encompass portions of two or more rate years shall have payments established based <br/>
<a id="pl.74.34"></a><var>74.34</var>on payment rates in effect at the time of admission unless the date of admission preceded <br/>
<a id="pl.74.35"></a><var>74.35</var>the rate year in effect by six months or more. In this case, operating payment rates for <br/>
<a id="pl.75.1"></a><var>75.1</var>services rendered during the rate year in effect and established based on the date of <br/>
<a id="pl.75.2"></a><var>75.2</var>admission shall be adjusted to the rate year in effect by the hospital cost index.<br/>
<a id="pl.75.3"></a><var>75.3</var>    (b) For fee-for-service admissions occurring on or after July 1, 2002, the total <br/>
<a id="pl.75.4"></a><var>75.4</var>payment, before third-party liability and spenddown, made to hospitals for inpatient <br/>
<a id="pl.75.5"></a><var>75.5</var>services is reduced by .5 percent from the current statutory rates.<br/>
<a id="pl.75.6"></a><var>75.6</var>    (c) In addition to the reduction in paragraph (b), the total payment for fee-for-service <br/>
<a id="pl.75.7"></a><var>75.7</var>admissions occurring on or after July 1, 2003, made to hospitals for inpatient services <br/>
<a id="pl.75.8"></a><var>75.8</var>before third-party liability and spenddown, is reduced five percent from the current <br/>
<a id="pl.75.9"></a><var>75.9</var>statutory rates. Mental health services within diagnosis related groups 424 to 432, and <br/>
<a id="pl.75.10"></a><var>75.10</var>facilities defined under subdivision 16 are excluded from this paragraph.<br/>
<a id="pl.75.11"></a><var>75.11</var>    (d) In addition to the reduction in paragraphs (b) and (c), the total payment for <br/>
<a id="pl.75.12"></a><var>75.12</var>fee-for-service admissions occurring on or after July 1, 2005, made to hospitals for <br/>
<a id="pl.75.13"></a><var>75.13</var>inpatient services before third-party liability and spenddown, is reduced 6.0 percent <br/>
<a id="pl.75.14"></a><var>75.14</var>from the current statutory rates. Mental health services within diagnosis related groups <br/>
<a id="pl.75.15"></a><var>75.15</var>424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph. <br/>
<a id="pl.75.16"></a><var>75.16</var>Notwithstanding section 
         <statute_ref>256.9686, subdivision 7</statute_ref>, for purposes of this paragraph, medical <br/>
<a id="pl.75.17"></a><var>75.17</var>assistance does not include general assistance medical care. Payments made to managed <br/>
<a id="pl.75.18"></a><var>75.18</var>care plans shall be reduced for services provided on or after January 1, 2006, to reflect <br/>
<a id="pl.75.19"></a><var>75.19</var>this reduction.<br/>
<a id="pl.75.20"></a><var>75.20</var>    (e) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for <br/>
<a id="pl.75.21"></a><var>75.21</var>fee-for-service admissions occurring on or after July 1, 2008, through June 30, 2009, made <br/>
<a id="pl.75.22"></a><var>75.22</var>to hospitals for inpatient services before third-party liability and spenddown, is reduced <br/>
<a id="pl.75.23"></a><var>75.23</var>3.46 percent from the current statutory rates. Mental health services with diagnosis related <br/>
<a id="pl.75.24"></a><var>75.24</var>groups 424 to 432 and facilities defined under subdivision 16 are excluded from this <br/>
<a id="pl.75.25"></a><var>75.25</var>paragraph. Payments made to managed care plans shall be reduced for services provided <br/>
<a id="pl.75.26"></a><var>75.26</var>on or after January 1, 2009, through June 30, 2009, to reflect this reduction.<br/>
<a id="pl.75.27"></a><var>75.27</var>    (f) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for <br/>
<a id="pl.75.28"></a><var>75.28</var>fee-for-service admissions occurring on or after July 1, 2009, through June 30, 2010, made <br/>
<a id="pl.75.29"></a><var>75.29</var>to hospitals for inpatient services before third-party liability and spenddown, is reduced <br/>
<a id="pl.75.30"></a><var>75.30</var>1.9 percent from the current statutory rates. Mental health services with diagnosis related <br/>
<a id="pl.75.31"></a><var>75.31</var>groups 424 to 432 and facilities defined under subdivision 16 are excluded from this <br/>
<a id="pl.75.32"></a><var>75.32</var>paragraph. Payments made to managed care plans shall be reduced for services provided <br/>
<a id="pl.75.33"></a><var>75.33</var>on or after July 1, 2009, through June 30, 2010, to reflect this reduction.<br/>
<a id="pl.75.34"></a><var>75.34</var>    (g) In addition to the reductions in paragraphs (b), (c), and (d), the total payment <br/>
<a id="pl.75.35"></a><var>75.35</var>for fee-for-service admissions occurring on or after July 1, 2010, made to hospitals for <br/>
<a id="pl.75.36"></a><var>75.36</var>inpatient services before third-party liability and spenddown, is reduced 1.79 percent <br/>
<a id="pl.76.1"></a><var>76.1</var>from the current statutory rates. Mental health services with diagnosis related groups <br/>
<a id="pl.76.2"></a><var>76.2</var>424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph. <br/>
<a id="pl.76.3"></a><var>76.3</var>Payments made to managed care plans shall be reduced for services provided on or after <br/>
<a id="pl.76.4"></a><var>76.4</var>July 1, 2010, to reflect this reduction.<br/>
<a id="pl.76.5"></a><var>76.5</var>(h) In addition to the reductions in paragraphs (b), (c), (d), (f), and (g), the total <br/>
<a id="pl.76.6"></a><var>76.6</var>payment for fee-for-service admissions occurring on or after July 1, 2009, made to <br/>
<a id="pl.76.7"></a><var>76.7</var>hospitals for inpatient services before third-party liability and spenddown, is reduced <br/>
<a id="pl.76.8"></a><var>76.8</var>one percent from the current statutory rates. Facilities defined under subdivision 16 are <br/>
<a id="pl.76.9"></a><var>76.9</var>excluded from this paragraph. Payments made to managed care plans shall be reduced for <br/>
<a id="pl.76.10"></a><var>76.10</var>services provided on or after October 1, 2009, to reflect this reduction.<br/>
<br/>
<a id="bill.5.13.0"></a><a id="pl.76.11"></a><var>76.11</var>    Sec. 13. Minnesota Statutes 2008, section 256.969, is amended by adding a subdivision <br/>
<a id="pl.76.12"></a><var>76.12</var>to read:<br/>
<a id="pl.76.13"></a><var>76.13</var>    Subd. 3b. <b>Nonpayment for hospital-acquired conditions and for certain </b><br/>
<a id="pl.76.14"></a><var>76.14</var><b>treatments.</b> (a) The commissioner must not make medical assistance payments to a <br/>
<a id="pl.76.15"></a><var>76.15</var>hospital for any costs of care that result from a condition listed in paragraph (c), if the <br/>
<a id="pl.76.16"></a><var>76.16</var>condition was hospital acquired. <br/>
<a id="pl.76.17"></a><var>76.17</var>    (b) For purposes of this subdivision, a condition is hospital acquired if it is not <br/>
<a id="pl.76.18"></a><var>76.18</var>identified by the hospital as present on admission. For purposes of this subdivision, <br/>
<a id="pl.76.19"></a><var>76.19</var>medical assistance includes general assistance medical care and MinnesotaCare.<br/>
<a id="pl.76.20"></a><var>76.20</var>(c) The prohibition in paragraph (a) applies to payment for each hospital-acquired <br/>
<a id="pl.76.21"></a><var>76.21</var>condition listed in this paragraph that is represented by an ICD-9-CM diagnosis code and <br/>
<a id="pl.76.22"></a><var>76.22</var>is designated as a complicating condition or a major complicating condition:<br/>
<a id="pl.76.23"></a><var>76.23</var>(1) foreign object retained after surgery (ICD-9-CM codes 998.4 or 998.7);<br/>
<a id="pl.76.24"></a><var>76.24</var>(2) air embolism (ICD-9-CM code 999.1);<br/>
<a id="pl.76.25"></a><var>76.25</var>(3) blood incompatibility (ICD-9-CM code 999.6);<br/>
<a id="pl.76.26"></a><var>76.26</var>(4) pressure ulcers stage III or IV (ICD-9-CM codes 707.23 or 707.24);<br/>
<a id="pl.76.27"></a><var>76.27</var>(5) falls and trauma, including fracture, dislocation, intracranial injury, crushing <br/>
<a id="pl.76.28"></a><var>76.28</var>injury, burn, and electric shock (ICD-9-CM codes with these ranges on the complicating <br/>
<a id="pl.76.29"></a><var>76.29</var>condition and major complicating condition list: 800-829; 830-839; 850-854; 925-929; <br/>
<a id="pl.76.30"></a><var>76.30</var>940-949; and 991-994);<br/>
<a id="pl.76.31"></a><var>76.31</var>(6) catheter-associated urinary tract infection (ICD-9-CM code 996.64);<br/>
<a id="pl.76.32"></a><var>76.32</var>(7) vascular catheter-associated infection (ICD-9-CM code 999.31);<br/>
<a id="pl.76.33"></a><var>76.33</var>(8) manifestations of poor glycemic control (ICD-9-CM codes 249.10; 249.11; <br/>
<a id="pl.76.34"></a><var>76.34</var>249.20; 249.21; 250.10; 250.11; 250.12; 250.13; 250.20; 250.21; 250.22; 250.23; and <br/>
<a id="pl.76.35"></a><var>76.35</var>251.0);<br/>
<a id="pl.77.1"></a><var>77.1</var>(9) surgical site infection (ICD-9-CM codes 996.67 or 998.59) following certain <br/>
<a id="pl.77.2"></a><var>77.2</var>orthopedic procedures (procedure codes 81.01; 81.02; 81.03; 81.04; 81.05; 81.06; 81.07; <br/>
<a id="pl.77.3"></a><var>77.3</var>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 <br/>
<a id="pl.77.4"></a><var>77.4</var>81.85);<br/>
<a id="pl.77.5"></a><var>77.5</var>(10) surgical site infection (ICD-9-CM code 998.59) following bariatric surgery <br/>
<a id="pl.77.6"></a><var>77.6</var>(procedure codes 44.38; 44.39; or 44.95) for a principal diagnosis of morbid obesity <br/>
<a id="pl.77.7"></a><var>77.7</var>(ICD-9-CM code 278.01);<br/>
<a id="pl.77.8"></a><var>77.8</var>(11) surgical site infection, mediastinitis (ICD-9-CM code 519.2) following coronary <br/>
<a id="pl.77.9"></a><var>77.9</var>artery bypass graft (procedure codes 36.10 to 36.19); and<br/>
<a id="pl.77.10"></a><var>77.10</var>(12) deep vein thrombosis (ICD-9-CM codes 453.40 to 453.42) or pulmonary <br/>
<a id="pl.77.11"></a><var>77.11</var>embolism (ICD-9-CM codes 415.11 or 415.91) following total knee replacement <br/>
<a id="pl.77.12"></a><var>77.12</var>(procedure code 81.54) or hip replacement (procedure codes 00.85 to 00.87 or 81.51 <br/>
<a id="pl.77.13"></a><var>77.13</var>to 81.52).<br/>
<a id="pl.77.14"></a><var>77.14</var>(d) The prohibition in paragraph (a) applies to any additional payments that result <br/>
<a id="pl.77.15"></a><var>77.15</var>from a hospital-acquired condition listed in paragraph (c), including, but not limited to, <br/>
<a id="pl.77.16"></a><var>77.16</var>additional treatment or procedures, readmission to the facility after discharge, increased <br/>
<a id="pl.77.17"></a><var>77.17</var>length of stay, change to a higher diagnostic category, or transfer to another hospital. In <br/>
<a id="pl.77.18"></a><var>77.18</var>the event of a transfer to another hospital, the hospital where the condition listed under <br/>
<a id="pl.77.19"></a><var>77.19</var>paragraph (c) was acquired is responsible for any costs incurred at the hospital to which <br/>
<a id="pl.77.20"></a><var>77.20</var>the patient is transferred.<br/>
<a id="pl.77.21"></a><var>77.21</var>(e) A hospital shall not bill a recipient of services for any payment disallowed under <br/>
<a id="pl.77.22"></a><var>77.22</var>this subdivision.<br/>
<br/>
<a id="bill.5.14.0"></a><a id="pl.77.23"></a><var>77.23</var>    Sec. 14. Minnesota Statutes 2008, section 256.969, is amended by adding a subdivision <br/>
<a id="pl.77.24"></a><var>77.24</var>to read:<br/>
<a id="pl.77.25"></a><var>77.25</var>    Subd. 28. <b>Temporary rate increase for qualifying hospitals.</b> For the period <br/>
<a id="pl.77.26"></a><var>77.26</var>from April 1, 2009, to September 30, 2010, for each hospital with a medical assistance <br/>
<a id="pl.77.27"></a><var>77.27</var>utilization rate equal to or greater than 25 percent during the base year, the commissioner <br/>
<a id="pl.77.28"></a><var>77.28</var>shall provide an equal percentage rate increase for each medical assistance admission. The <br/>
<a id="pl.77.29"></a><var>77.29</var>commissioner shall estimate the percentage rate increase using as the state share of the <br/>
<a id="pl.77.30"></a><var>77.30</var>increase the amount available under section 256B.199, paragraph (d). The commissioner <br/>
<a id="pl.77.31"></a><var>77.31</var>shall settle up payments to qualifying hospitals based on actual payments under that <br/>
<a id="pl.77.32"></a><var>77.32</var>section and actual hospital admissions.<br/>
<a id="pl.77.33"></a><var>77.33</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br/>
<br/>
<a id="bill.5.15.0"></a><a id="pl.78.1"></a><var>78.1</var>    Sec. 15. Minnesota Statutes 2008, section 256.969, is amended by adding a subdivision <br/>
<a id="pl.78.2"></a><var>78.2</var>to read:<br/>
<a id="pl.78.3"></a><var>78.3</var>    Subd. 29. <b>Reimbursement for the fee increase for the early hearing detection </b><br/>
<a id="pl.78.4"></a><var>78.4</var><b>and intervention program.</b> For services provided on or after July 1, 2010, in addition to <br/>
<a id="pl.78.5"></a><var>78.5</var>any other payment under this section, the commissioner shall reimburse hospitals for the <br/>
<a id="pl.78.6"></a><var>78.6</var>increase in the fee for the early hearing detection and intervention program described in <br/>
<a id="pl.78.7"></a><var>78.7</var>section 144.125, subdivision 1, paid by the hospital for public program recipients.<br/>
<br/>
<a id="bill.5.16.0"></a><a id="pl.78.8"></a><var>78.8</var>    Sec. 16. <b>[256B.032] ELIGIBLE VENDORS OF MEDICAL CARE.</b><br/>
<a id="pl.78.9"></a><var>78.9</var>(a) Effective January 1, 2011, the commissioner shall establish performance <br/>
<a id="pl.78.10"></a><var>78.10</var>thresholds for health care providers included in the provider peer grouping system <br/>
<a id="pl.78.11"></a><var>78.11</var>developed by the commissioner of health under section 62U.04. The thresholds shall be <br/>
<a id="pl.78.12"></a><var>78.12</var>set at the 10th percentile of the combined cost and quality measure used for provider peer <br/>
<a id="pl.78.13"></a><var>78.13</var>grouping, and separate thresholds shall be set for hospital and physician services.<br/>
<a id="pl.78.14"></a><var>78.14</var>(b) Beginning January 1, 2012, any health care provider with a combined cost and <br/>
<a id="pl.78.15"></a><var>78.15</var>quality score below the threshold set in paragraph (a) shall be prohibited from enrolling <br/>
<a id="pl.78.16"></a><var>78.16</var>as a vendor of medical care in the medical assistance, general assistance medical care, <br/>
<a id="pl.78.17"></a><var>78.17</var>or MinnesotaCare programs, and shall not be eligible for direct payments under those <br/>
<a id="pl.78.18"></a><var>78.18</var>programs or for payments made by managed care plans under their contracts with the <br/>
<a id="pl.78.19"></a><var>78.19</var>commissioner under section 256B.69 or 256L.12. A health care provider that is prohibited <br/>
<a id="pl.78.20"></a><var>78.20</var>from enrolling as a vendor or receiving payments under this paragraph may reenroll <br/>
<a id="pl.78.21"></a><var>78.21</var>effective January 1 of any subsequent year if the provider's most recent combined cost and <br/>
<a id="pl.78.22"></a><var>78.22</var>quality score exceeds the threshold established in paragraph (a).<br/>
<a id="pl.78.23"></a><var>78.23</var>(c) Notwithstanding paragraph (b), a provider may continue to participate as a vendor <br/>
<a id="pl.78.24"></a><var>78.24</var>or as part of a managed care plan provider network if the commissioner determines that a <br/>
<a id="pl.78.25"></a><var>78.25</var>contract with the provider is necessary to ensure adequate access to health care services.<br/>
<a id="pl.78.26"></a><var>78.26</var>(d) By January 15, 2013, the commissioner shall report to the legislature on the <br/>
<a id="pl.78.27"></a><var>78.27</var>impact of this section. The commissioner's report shall include information on:<br/>
<a id="pl.78.28"></a><var>78.28</var>(1) the providers falling below the thresholds as of January 1, 2012;<br/>
<a id="pl.78.29"></a><var>78.29</var>(2) the volume of services and cost of care provided to enrollees in the medical <br/>
<a id="pl.78.30"></a><var>78.30</var>assistance, general assistance medical care, or MinnesotaCare programs in the 12 months <br/>
<a id="pl.78.31"></a><var>78.31</var>prior to January 1, 2012, by providers falling below the thresholds;<br/>
<a id="pl.78.32"></a><var>78.32</var>(3) providers who fell below the thresholds but continued to be eligible vendors <br/>
<a id="pl.78.33"></a><var>78.33</var>under paragraph (c);<br/>
<a id="pl.78.34"></a><var>78.34</var>(4) the estimated cost savings achieved by not contracting with providers who do <br/>
<a id="pl.78.35"></a><var>78.35</var>not meet the performance thresholds; and<br/>
<a id="pl.79.1"></a><var>79.1</var>(5) recommendations for increasing the threshold levels of performance over time.<br/>
<br/>
<a id="bill.5.17.0"></a><a id="pl.79.2"></a><var>79.2</var>    Sec. 17. Minnesota Statutes 2008, section 256B.056, subdivision 3c, is amended to <br/>
<a id="pl.79.3"></a><var>79.3</var>read:<br/>
<a id="pl.79.4"></a><var>79.4</var>    Subd. 3c. <b>Asset limitations for families and children.</b> A household of two or more <br/>
<a id="pl.79.5"></a><var>79.5</var>persons must not own more than $20,000 in total net assets, and a household of one <br/>
<a id="pl.79.6"></a><var>79.6</var>person must not own more than $10,000 in total net assets. In addition to these maximum <br/>
<a id="pl.79.7"></a><var>79.7</var>amounts, an eligible individual or family may accrue interest on these amounts, but they <br/>
<a id="pl.79.8"></a><var>79.8</var>must be reduced to the maximum at the time of an eligibility redetermination. The value of <br/>
<a id="pl.79.9"></a><var>79.9</var>assets that are not considered in determining eligibility for medical assistance for families <br/>
<a id="pl.79.10"></a><var>79.10</var>and children is the value of those assets excluded under the AFDC state plan as of July 16, <br/>
<a id="pl.79.11"></a><var>79.11</var>1996, as required by the Personal Responsibility and Work Opportunity Reconciliation <br/>
<a id="pl.79.12"></a><var>79.12</var>Act of 1996 (PRWORA), Public Law 104-193, with the following exceptions:<br/>
<a id="pl.79.13"></a><var>79.13</var>(1) household goods and personal effects are not considered;<br/>
<a id="pl.79.14"></a><var>79.14</var>(2) capital and operating assets of a trade or business up to $200,000 are not <br/>
<a id="pl.79.15"></a><var>79.15</var>considered, except that a bank account that contains personal income or assets, or is used to <br/>
<a id="pl.79.16"></a><var>79.16</var>pay personal expenses, is not considered a capital or operating asset of a trade or business;<br/>
<a id="pl.79.17"></a><var>79.17</var>(3) one motor vehicle is excluded for each person of legal driving age who is <br/>
<a id="pl.79.18"></a><var>79.18</var>employed or seeking employment;<br/>
<a id="pl.79.19"></a><var>79.19</var>(4) one burial plot and all other burial expenses equal to the supplemental security <br/>
<a id="pl.79.20"></a><var>79.20</var>income program asset limit are not considered for each individual;<br/>
<a id="pl.79.21"></a><var>79.21</var>(5) court-ordered settlements up to $10,000 are not considered;<br/>
<a id="pl.79.22"></a><var>79.22</var>(6) individual retirement accounts and funds are not considered; and<br/>
<a id="pl.79.23"></a><var>79.23</var>(7) assets owned by children are not considered.<br/>
<a id="pl.79.24"></a><var>79.24</var>The assets specified in clause (2) must be disclosed to the local agency at the time of <br/>
<a id="pl.79.25"></a><var>79.25</var>application and at the time of an eligibility redetermination, and must be verified upon <br/>
<a id="pl.79.26"></a><var>79.26</var>request of the local agency.<br/>
<a id="pl.79.27"></a><var>79.27</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2011, or upon federal <br/>
<a id="pl.79.28"></a><var>79.28</var>approval, whichever is later.<br/>
<br/>
<a id="bill.5.18.0"></a><a id="pl.79.29"></a><var>79.29</var>    Sec. 18. Minnesota Statutes 2008, section 256B.056, subdivision 3d, is amended to <br/>
<a id="pl.79.30"></a><var>79.30</var>read:<br/>
<a id="pl.79.31"></a><var>79.31</var>    Subd. 3d. <b>Reduction of excess assets.</b> Assets in excess of the limits in subdivisions <br/>
<a id="pl.79.32"></a><var>79.32</var>3 to 3c may be reduced to allowable limits as follows:<br/>
<a id="pl.79.33"></a><var>79.33</var>(a) Assets may be reduced in any of the three calendar months before the month <br/>
<a id="pl.79.34"></a><var>79.34</var>of application in which the applicant seeks coverage by:<br/>
<a id="pl.80.1"></a><var>80.1</var>(1) designating burial funds up to $1,500 for each applicant, spouse, and MA-eligible <br/>
<a id="pl.80.2"></a><var>80.2</var>dependent child; and<br/>
<a id="pl.80.3"></a><var>80.3</var>(2) paying health service bills for health services that are incurred in the retroactive <br/>
<a id="pl.80.4"></a><var>80.4</var>period for which the applicant seeks eligibility, starting with the oldest bill. After assets <br/>
<a id="pl.80.5"></a><var>80.5</var>are reduced to allowable limits, eligibility begins with the next dollar of MA-covered <br/>
<a id="pl.80.6"></a><var>80.6</var>health services incurred in the retroactive period. Applicants reducing assets under this <br/>
<a id="pl.80.7"></a><var>80.7</var>subdivision who also have excess income shall first spend excess assets to pay health <br/>
<a id="pl.80.8"></a><var>80.8</var>service bills and may meet the income spenddown on remaining bills.<br/>
<a id="pl.80.9"></a><var>80.9</var>(b) Assets may be reduced beginning the month of application by:<br/>
<a id="pl.80.10"></a><var>80.10</var>(1) paying bills for health services that are incurred during the period specified in <br/>
<a id="pl.80.11"></a><var>80.11</var>Minnesota Rules, part 9505.0090, subpart 2, that would otherwise be paid by medical <br/>
<a id="pl.80.12"></a><var>80.12</var>assistance; and. After assets are reduced to allowable limits, eligibility begins with the <br/>
<a id="pl.80.13"></a><var>80.13</var>next dollar of medical assistance covered health services incurred in the period. Applicants <br/>
<a id="pl.80.14"></a><var>80.14</var>reducing assets under this subdivision who also have excess income shall first spend excess <br/>
<a id="pl.80.15"></a><var>80.15</var>assets to pay health service bills and may meet the income spenddown on remaining bills.<br/>
<a id="pl.80.16"></a><var>80.16</var>(2) using any means other than a transfer of assets for less than fair market value as <br/>
<a id="pl.80.17"></a><var>80.17</var>defined in section 
<statute_ref>256B.0595, subdivision 1</statute_ref>, paragraph (b).<br/>
<a id="pl.80.18"></a><var>80.18</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2011.<br/>
<br/>
<a id="bill.5.19.0"></a><a id="pl.80.19"></a><var>80.19</var>    Sec. 19. Minnesota Statutes 2008, section 256B.057, is amended by adding a <br/>
<a id="pl.80.20"></a><var>80.20</var>subdivision to read:<br/>
<a id="pl.80.21"></a><var>80.21</var>    Subd. 11. <b>Treatment for colorectal cancer.</b> (a) Medical assistance shall be paid for <br/>
<a id="pl.80.22"></a><var>80.22</var>an individual who:<br/>
<a id="pl.80.23"></a><var>80.23</var>(1) has been screened for colorectal cancer by the colorectal cancer prevention <br/>
<a id="pl.80.24"></a><var>80.24</var>demonstration project;<br/>
<a id="pl.80.25"></a><var>80.25</var>(2) according to the individual's treating health professional, needs treatment for <br/>
<a id="pl.80.26"></a><var>80.26</var>colorectal cancer;<br/>
<a id="pl.80.27"></a><var>80.27</var>(3) meets income eligibility guidelines for the colorectal cancer prevention <br/>
<a id="pl.80.28"></a><var>80.28</var>demonstration project;<br/>
<a id="pl.80.29"></a><var>80.29</var>(4) is under the age of 65; and<br/>
<a id="pl.80.30"></a><var>80.30</var>(5) is not otherwise eligible for medical assistance or covered under creditable <br/>
<a id="pl.80.31"></a><var>80.31</var>coverage as defined under United States Code, title 42, section 300gg(a).<br/>
<a id="pl.80.32"></a><var>80.32</var>(b) Medical assistance provided under this subdivision shall be limited to services <br/>
<a id="pl.80.33"></a><var>80.33</var>provided during the period that the individual receives treatment for colorectal cancer.<br/>
<a id="pl.81.1"></a><var>81.1</var>(c) An individual meeting the criteria in paragraph (a) is eligible for medical <br/>
<a id="pl.81.2"></a><var>81.2</var>assistance without meeting the eligibility criteria relating to income and assets in section <br/>
<a id="pl.81.3"></a><var>81.3</var>256B.056, subdivisions 1a to 5b.<br/>
<a id="pl.81.4"></a><var>81.4</var>(d) This subdivision expires December 31, 2010.<br/>
<br/>
<a id="bill.5.20.0"></a><a id="pl.81.5"></a><var>81.5</var>    Sec. 20. Minnesota Statutes 2008, section 256B.0575, is amended to read:<br/>
<a id="pl.81.6"></a><var>81.6</var><b>256B.0575 AVAILABILITY OF INCOME FOR INSTITUTIONALIZED </b><br/>
<a id="pl.81.7"></a><var>81.7</var><b>PERSONS.</b><br/>
<a id="pl.81.8"></a><var>81.8</var>    Subdivision 1. <b>Income deductions.</b> When an institutionalized person is determined <br/>
<a id="pl.81.9"></a><var>81.9</var>eligible for medical assistance, the income that exceeds the deductions in paragraphs (a) <br/>
<a id="pl.81.10"></a><var>81.10</var>and (b) must be applied to the cost of institutional care.<br/>
<a id="pl.81.11"></a><var>81.11</var>(a) The following amounts must be deducted from the institutionalized person's <br/>
<a id="pl.81.12"></a><var>81.12</var>income in the following order:<br/>
<a id="pl.81.13"></a><var>81.13</var>(1) the personal needs allowance under section 
         <statute_ref>256B.35</statute_ref> or, for a veteran who <br/>
<a id="pl.81.14"></a><var>81.14</var>does not have a spouse or child, or a surviving spouse of a veteran having no child, the <br/>
<a id="pl.81.15"></a><var>81.15</var>amount of an improved pension received from the veteran's administration not exceeding <br/>
<a id="pl.81.16"></a><var>81.16</var>$90 per month;<br/>
<a id="pl.81.17"></a><var>81.17</var>(2) the personal allowance for disabled individuals under section 
         <statute_ref>256B.36</statute_ref>;<br/>
<a id="pl.81.18"></a><var>81.18</var>(3) if the institutionalized person has a legally appointed guardian or conservator, <br/>
<a id="pl.81.19"></a><var>81.19</var>five percent of the recipient's gross monthly income up to $100 as reimbursement for <br/>
<a id="pl.81.20"></a><var>81.20</var>guardianship or conservatorship services;<br/>
<a id="pl.81.21"></a><var>81.21</var>(4) a monthly income allowance determined under section 
         <statute_ref>256B.058, subdivision <br/>
<a id="pl.81.22"></a><var>81.22</var>2
         </statute_ref>, but only to the extent income of the institutionalized spouse is made available to the <br/>
<a id="pl.81.23"></a><var>81.23</var>community spouse;<br/>
<a id="pl.81.24"></a><var>81.24</var>(5) a monthly allowance for children under age 18 which, together with the net <br/>
<a id="pl.81.25"></a><var>81.25</var>income of the children, would provide income equal to the medical assistance standard <br/>
<a id="pl.81.26"></a><var>81.26</var>for families and children according to section 
         <statute_ref>256B.056, subdivision 4</statute_ref>, for a family size <br/>
<a id="pl.81.27"></a><var>81.27</var>that includes only the minor children. This deduction applies only if the children do not <br/>
<a id="pl.81.28"></a><var>81.28</var>live with the community spouse and only to the extent that the deduction is not included <br/>
<a id="pl.81.29"></a><var>81.29</var>in the personal needs allowance under section 
         <statute_ref>256B.35, subdivision 1</statute_ref>, as child support <br/>
<a id="pl.81.30"></a><var>81.30</var>garnished under a court order;<br/>
<a id="pl.81.31"></a><var>81.31</var>(6) a monthly family allowance for other family members, equal to one-third of the <br/>
<a id="pl.81.32"></a><var>81.32</var>difference between 122 percent of the federal poverty guidelines and the monthly income <br/>
<a id="pl.81.33"></a><var>81.33</var>for that family member;<br/>
<a id="pl.82.1"></a><var>82.1</var>(7) reparations payments made by the Federal Republic of Germany and reparations <br/>
<a id="pl.82.2"></a><var>82.2</var>payments made by the Netherlands for victims of Nazi persecution between 1940 and <br/>
<a id="pl.82.3"></a><var>82.3</var>1945;<br/>
<a id="pl.82.4"></a><var>82.4</var>(8) all other exclusions from income for institutionalized persons as mandated by <br/>
<a id="pl.82.5"></a><var>82.5</var>federal law; and<br/>
<a id="pl.82.6"></a><var>82.6</var>(9) amounts for reasonable expenses, as specified in subdivision 2, incurred for <br/>
<a id="pl.82.7"></a><var>82.7</var>necessary medical or remedial care for the institutionalized person that are recognized <br/>
<a id="pl.82.8"></a><var>82.8</var>under state law, not medical assistance covered expenses, and that are not subject to <br/>
<a id="pl.82.9"></a><var>82.9</var>payment by a third party.<br/>
<a id="pl.82.10"></a><var>82.10</var>Reasonable expenses are limited to expenses that have not been previously used as a <br/>
<a id="pl.82.11"></a><var>82.11</var>deduction from income and are incurred during the enrollee's current period of eligibility, <br/>
<a id="pl.82.12"></a><var>82.12</var>including retroactive months associated with the current period of eligibility, for medical <br/>
<a id="pl.82.13"></a><var>82.13</var>assistance payment of long-term care services.<br/>
<a id="pl.82.14"></a><var>82.14</var>For purposes of clause (6), "other family member" means a person who resides <br/>
<a id="pl.82.15"></a><var>82.15</var>with the community spouse and who is a minor or dependent child, dependent parent, or <br/>
<a id="pl.82.16"></a><var>82.16</var>dependent sibling of either spouse. "Dependent" means a person who could be claimed as <br/>
<a id="pl.82.17"></a><var>82.17</var>a dependent for federal income tax purposes under the Internal Revenue Code.<br/>
<a id="pl.82.18"></a><var>82.18</var>(b) Income shall be allocated to an institutionalized person for a period of up to three <br/>
<a id="pl.82.19"></a><var>82.19</var>calendar months, in an amount equal to the medical assistance standard for a family <br/>
<a id="pl.82.20"></a><var>82.20</var>size of one if:<br/>
<a id="pl.82.21"></a><var>82.21</var>(1) a physician certifies that the person is expected to reside in the long-term care <br/>
<a id="pl.82.22"></a><var>82.22</var>facility for three calendar months or less;<br/>
<a id="pl.82.23"></a><var>82.23</var>(2) if the person has expenses of maintaining a residence in the community; and<br/>
<a id="pl.82.24"></a><var>82.24</var>(3) if one of the following circumstances apply:<br/>
<a id="pl.82.25"></a><var>82.25</var>(i) the person was not living together with a spouse or a family member as defined in <br/>
<a id="pl.82.26"></a><var>82.26</var>paragraph (a) when the person entered a long-term care facility; or<br/>
<a id="pl.82.27"></a><var>82.27</var>(ii) the person and the person's spouse become institutionalized on the same date, in <br/>
<a id="pl.82.28"></a><var>82.28</var>which case the allocation shall be applied to the income of one of the spouses.<br/>
<a id="pl.82.29"></a><var>82.29</var>For purposes of this paragraph, a person is determined to be residing in a licensed nursing <br/>
<a id="pl.82.30"></a><var>82.30</var>home, regional treatment center, or medical institution if the person is expected to remain <br/>
<a id="pl.82.31"></a><var>82.31</var>for a period of one full calendar month or more.<br/>
<a id="pl.82.32"></a><var>82.32</var>    Subd. 2. <b>Reasonable expenses.</b> For the purposes of subdivision 1, paragraph (a), <br/>
<a id="pl.82.33"></a><var>82.33</var>clause (9), reasonable expenses are limited to expenses that have not been previously used <br/>
<a id="pl.82.34"></a><var>82.34</var>as a deduction from income and were not:<br/>
<a id="pl.82.35"></a><var>82.35</var>    (1) for long-term care expenses incurred during a period of ineligibility as defined in <br/>
<a id="pl.82.36"></a><var>82.36</var>section 256B.0595, subdivision 2;<br/>
<a id="pl.83.1"></a><var>83.1</var>    (2) incurred more than three months before the month of application associated with <br/>
<a id="pl.83.2"></a><var>83.2</var>the current period of eligibility;<br/>
<a id="pl.83.3"></a><var>83.3</var>    (3) for expenses incurred by a recipient that are duplicative of services that are <br/>
<a id="pl.83.4"></a><var>83.4</var>covered under chapter 256B; or<br/>
<a id="pl.83.5"></a><var>83.5</var>    (4) nursing facility expenses incurred without a timely assessment as required under <br/>
<a id="pl.83.6"></a><var>83.6</var>section 256B.0911.<br/>
<br/>
<a id="bill.5.21.0"></a><a id="pl.83.7"></a><var>83.7</var>    Sec. 21. Minnesota Statutes 2008, section 256B.0595, subdivision 1, is amended to <br/>
<a id="pl.83.8"></a><var>83.8</var>read:<br/>
<a id="pl.83.9"></a><var>83.9</var>    Subdivision 1.  <b>Prohibited transfers.</b> (a) For transfers of assets made on or before <br/>
<a id="pl.83.10"></a><var>83.10</var>August 10, 1993, if an institutionalized person or the institutionalized person's spouse has <br/>
<a id="pl.83.11"></a><var>83.11</var>given away, sold, or disposed of, for less than fair market value, any asset or interest <br/>
<a id="pl.83.12"></a><var>83.12</var>therein, except assets other than the homestead that are excluded under the supplemental <br/>
<a id="pl.83.13"></a><var>83.13</var>security program, within 30 months before or any time after the date of institutionalization <br/>
<a id="pl.83.14"></a><var>83.14</var>if the person has been determined eligible for medical assistance, or within 30 months <br/>
<a id="pl.83.15"></a><var>83.15</var>before or any time after the date of the first approved application for medical assistance <br/>
<a id="pl.83.16"></a><var>83.16</var>if the person has not yet been determined eligible for medical assistance, the person is <br/>
<a id="pl.83.17"></a><var>83.17</var>ineligible for long-term care services for the period of time determined under subdivision <br/>
<a id="pl.83.18"></a><var>83.18</var>2. <br/>
<a id="pl.83.19"></a><var>83.19</var>    (b) Effective for transfers made after August 10, 1993, an institutionalized person, an <br/>
<a id="pl.83.20"></a><var>83.20</var>institutionalized person's spouse, or any person, court, or administrative body with legal <br/>
<a id="pl.83.21"></a><var>83.21</var>authority to act in place of, on behalf of, at the direction of, or upon the request of the <br/>
<a id="pl.83.22"></a><var>83.22</var>institutionalized person or institutionalized person's spouse, may not give away, sell, or <br/>
<a id="pl.83.23"></a><var>83.23</var>dispose of, for less than fair market value, any asset or interest therein, except assets other <br/>
<a id="pl.83.24"></a><var>83.24</var>than the homestead that are excluded under the Supplemental Security Income program, <br/>
<a id="pl.83.25"></a><var>83.25</var>for the purpose of establishing or maintaining medical assistance eligibility. This applies <br/>
<a id="pl.83.26"></a><var>83.26</var>to all transfers, including those made by a community spouse after the month in which <br/>
<a id="pl.83.27"></a><var>83.27</var>the institutionalized spouse is determined eligible for medical assistance. For purposes of <br/>
<a id="pl.83.28"></a><var>83.28</var>determining eligibility for long-term care services, any transfer of such assets within 36 <br/>
<a id="pl.83.29"></a><var>83.29</var>months before or any time after an institutionalized person requests medical assistance <br/>
<a id="pl.83.30"></a><var>83.30</var>payment of long-term care services, or 36 months before or any time after a medical <br/>
<a id="pl.83.31"></a><var>83.31</var>assistance recipient becomes an institutionalized person, for less than fair market value <br/>
<a id="pl.83.32"></a><var>83.32</var>may be considered. Any such transfer is presumed to have been made for the purpose <br/>
<a id="pl.83.33"></a><var>83.33</var>of establishing or maintaining medical assistance eligibility and the institutionalized <br/>
<a id="pl.83.34"></a><var>83.34</var>person is ineligible for long-term care services for the period of time determined under <br/>
<a id="pl.83.35"></a><var>83.35</var>subdivision 2, unless the institutionalized person furnishes convincing evidence to <br/>
<a id="pl.84.1"></a><var>84.1</var>establish that the transaction was exclusively for another purpose, or unless the transfer is <br/>
<a id="pl.84.2"></a><var>84.2</var>permitted under subdivision 3 or 4.  In the case of payments from a trust or portions of a <br/>
<a id="pl.84.3"></a><var>84.3</var>trust that are considered transfers of assets under federal law, or in the case of any other <br/>
<a id="pl.84.4"></a><var>84.4</var>disposal of assets made on or after February 8, 2006, any transfers made within 60 months <br/>
<a id="pl.84.5"></a><var>84.5</var>before or any time after an institutionalized person requests medical assistance payment of <br/>
<a id="pl.84.6"></a><var>84.6</var>long-term care services and within 60 months before or any time after a medical assistance <br/>
<a id="pl.84.7"></a><var>84.7</var>recipient becomes an institutionalized person, may be considered. <br/>
<a id="pl.84.8"></a><var>84.8</var>    (c) This section applies to transfers, for less than fair market value, of income <br/>
<a id="pl.84.9"></a><var>84.9</var>or assets, including assets that are considered income in the month received, such as <br/>
<a id="pl.84.10"></a><var>84.10</var>inheritances, court settlements, and retroactive benefit payments or income to which the <br/>
<a id="pl.84.11"></a><var>84.11</var>institutionalized person or the institutionalized person's spouse is entitled but does not <br/>
<a id="pl.84.12"></a><var>84.12</var>receive due to action by the institutionalized person, the institutionalized person's spouse, <br/>
<a id="pl.84.13"></a><var>84.13</var>or any person, court, or administrative body with legal authority to act in place of, on <br/>
<a id="pl.84.14"></a><var>84.14</var>behalf of, at the direction of, or upon the request of the institutionalized person or the <br/>
<a id="pl.84.15"></a><var>84.15</var>institutionalized person's spouse. <br/>
<a id="pl.84.16"></a><var>84.16</var>    (d) This section applies to payments for care or personal services provided by a <br/>
<a id="pl.84.17"></a><var>84.17</var>relative, unless the compensation was stipulated in a notarized, written agreement which <br/>
<a id="pl.84.18"></a><var>84.18</var>was in existence when the service was performed, the care or services directly benefited <br/>
<a id="pl.84.19"></a><var>84.19</var>the person, and the payments made represented reasonable compensation for the care <br/>
<a id="pl.84.20"></a><var>84.20</var>or services provided. A notarized written agreement is not required if payment for the <br/>
<a id="pl.84.21"></a><var>84.21</var>services was made within 60 days after the service was provided. <br/>
<a id="pl.84.22"></a><var>84.22</var>    (e) This section applies to the portion of any asset or interest that an institutionalized <br/>
<a id="pl.84.23"></a><var>84.23</var>person, an institutionalized person's spouse, or any person, court, or administrative body <br/>
<a id="pl.84.24"></a><var>84.24</var>with legal authority to act in place of, on behalf of, at the direction of, or upon the request <br/>
<a id="pl.84.25"></a><var>84.25</var>of the institutionalized person or the institutionalized person's spouse, transfers to any <br/>
<a id="pl.84.26"></a><var>84.26</var>annuity that exceeds the value of the benefit likely to be returned to the institutionalized <br/>
<a id="pl.84.27"></a><var>84.27</var>person or institutionalized person's spouse while alive, based on estimated life expectancy <br/>
<a id="pl.84.28"></a><var>84.28</var>as determined according to the current actuarial tables published by the Office of the <br/>
<a id="pl.84.29"></a><var>84.29</var>Chief Actuary of the Social Security Administration. The commissioner may adopt rules <br/>
<a id="pl.84.30"></a><var>84.30</var>reducing life expectancies based on the need for long-term care. This section applies to an <br/>
<a id="pl.84.31"></a><var>84.31</var>annuity purchased on or after March 1, 2002, that: <br/>
<a id="pl.84.32"></a><var>84.32</var>    (1) is not purchased from an insurance company or financial institution that is <br/>
<a id="pl.84.33"></a><var>84.33</var>subject to licensing or regulation by the Minnesota Department of Commerce or a similar <br/>
<a id="pl.84.34"></a><var>84.34</var>regulatory agency of another state; <br/>
<a id="pl.84.35"></a><var>84.35</var>    (2) does not pay out principal and interest in equal monthly installments; or <br/>
<a id="pl.84.36"></a><var>84.36</var>    (3) does not begin payment at the earliest possible date after annuitization. <br/>
<a id="pl.85.1"></a><var>85.1</var>    (f) Effective for transactions, including the purchase of an annuity, occurring on or <br/>
<a id="pl.85.2"></a><var>85.2</var>after February 8, 2006, by or on behalf of an institutionalized person who has applied for <br/>
<a id="pl.85.3"></a><var>85.3</var>or is receiving long-term care services or the institutionalized person's spouse shall be <br/>
<a id="pl.85.4"></a><var>85.4</var>treated as the disposal of an asset for less than fair market value unless the department is <br/>
<a id="pl.85.5"></a><var>85.5</var>named a preferred remainder beneficiary  as described in section 
         <statute_ref>256B.056, subdivision <br/>
<a id="pl.85.6"></a><var>85.6</var>11
         </statute_ref>. Any subsequent change to the designation of the department as a preferred remainder <br/>
<a id="pl.85.7"></a><var>85.7</var>beneficiary shall result in the annuity being treated as a disposal of assets for less than <br/>
<a id="pl.85.8"></a><var>85.8</var>fair market value. The amount of such transfer shall be the maximum amount the <br/>
<a id="pl.85.9"></a><var>85.9</var>institutionalized person or the institutionalized person's spouse could receive from the <br/>
<a id="pl.85.10"></a><var>85.10</var>annuity or similar financial instrument. Any change in the amount of the income or <br/>
<a id="pl.85.11"></a><var>85.11</var>principal being withdrawn from the annuity or other similar financial instrument at the <br/>
<a id="pl.85.12"></a><var>85.12</var>time of the most recent disclosure shall be deemed to be a transfer of assets for less than <br/>
<a id="pl.85.13"></a><var>85.13</var>fair market value unless the institutionalized person or the institutionalized person's spouse <br/>
<a id="pl.85.14"></a><var>85.14</var>demonstrates that the transaction was for fair market value. In the event a distribution <br/>
<a id="pl.85.15"></a><var>85.15</var>of income or principal has been improperly distributed or disbursed from an annuity or <br/>
<a id="pl.85.16"></a><var>85.16</var>other retirement planning instrument of an institutionalized person or the institutionalized <br/>
<a id="pl.85.17"></a><var>85.17</var>person's spouse, a cause of action exists against the individual receiving the improper <br/>
<a id="pl.85.18"></a><var>85.18</var>distribution for the cost of medical assistance services provided or the amount of the <br/>
<a id="pl.85.19"></a><var>85.19</var>improper distribution, whichever is less. <br/>
<a id="pl.85.20"></a><var>85.20</var>    (g) Effective for transactions, including the purchase of an annuity, occurring on <br/>
<a id="pl.85.21"></a><var>85.21</var>or after February 8, 2006, by or on behalf of an institutionalized person applying for or <br/>
<a id="pl.85.22"></a><var>85.22</var>receiving long-term care services shall be treated as a disposal of assets for less than fair <br/>
<a id="pl.85.23"></a><var>85.23</var>market value unless it is: <br/>
<a id="pl.85.24"></a><var>85.24</var>    (i) an annuity described in subsection (b) or (q) of section 408 of the Internal <br/>
<a id="pl.85.25"></a><var>85.25</var>Revenue Code of 1986; or <br/>
<a id="pl.85.26"></a><var>85.26</var>    (ii) purchased with proceeds from: <br/>
<a id="pl.85.27"></a><var>85.27</var>    (A) an account or trust described in subsection (a), (c), or (p) of section 408 of the <br/>
<a id="pl.85.28"></a><var>85.28</var>Internal Revenue Code; <br/>
<a id="pl.85.29"></a><var>85.29</var>    (B) a simplified employee pension within the meaning of section 408(k) of the <br/>
<a id="pl.85.30"></a><var>85.30</var>Internal Revenue Code; or <br/>
<a id="pl.85.31"></a><var>85.31</var>    (C) a Roth IRA described in section 408A of the Internal Revenue Code; or <br/>
<a id="pl.85.32"></a><var>85.32</var>    (iii) an annuity that is irrevocable and nonassignable; is actuarially sound as <br/>
<a id="pl.85.33"></a><var>85.33</var>determined in accordance with actuarial publications of the Office of the Chief Actuary of <br/>
<a id="pl.85.34"></a><var>85.34</var>the Social Security Administration; and provides for payments in equal amounts during <br/>
<a id="pl.85.35"></a><var>85.35</var>the term of the annuity, with no deferral and no balloon payments made.<br/>
<a id="pl.86.1"></a><var>86.1</var>     (h) For purposes of this section, long-term care services include services in a nursing <br/>
<a id="pl.86.2"></a><var>86.2</var>facility, services that are eligible for payment according to section 
         <statute_ref>256B.0625, subdivision <br/>
<a id="pl.86.3"></a><var>86.3</var>2
         </statute_ref>, because they are provided in a swing bed, intermediate care facility for persons with <br/>
<a id="pl.86.4"></a><var>86.4</var>developmental disabilities, and home and community-based services provided pursuant <br/>
<a id="pl.86.5"></a><var>86.5</var>to sections 
         <statute_ref>256B.0915</statute_ref>, 
         <statute_ref>256B.092</statute_ref>, and 
         <statute_ref>256B.49</statute_ref>. For purposes of this subdivision and <br/>
<a id="pl.86.6"></a><var>86.6</var>subdivisions 2, 3, and 4, "institutionalized person" includes a person who is an inpatient <br/>
<a id="pl.86.7"></a><var>86.7</var>in a nursing facility or in a swing bed, or intermediate care facility for persons with <br/>
<a id="pl.86.8"></a><var>86.8</var>developmental disabilities or who is receiving home and community-based services under <br/>
<a id="pl.86.9"></a><var>86.9</var>sections 
         <statute_ref>256B.0915</statute_ref>, 
         <statute_ref>256B.092</statute_ref>, and 
         <statute_ref>256B.49</statute_ref>. <br/>
<a id="pl.86.10"></a><var>86.10</var>    (i) This section applies to funds used to purchase a promissory note, loan, or <br/>
<a id="pl.86.11"></a><var>86.11</var>mortgage unless the note, loan, or mortgage: <br/>
<a id="pl.86.12"></a><var>86.12</var>    (1) has a repayment term that is actuarially sound; <br/>
<a id="pl.86.13"></a><var>86.13</var>    (2) provides for payments to be made in equal amounts during the term of the loan, <br/>
<a id="pl.86.14"></a><var>86.14</var>with no deferral and no balloon payments made; and <br/>
<a id="pl.86.15"></a><var>86.15</var>    (3) prohibits the cancellation of the balance upon the death of the lender. <br/>
<a id="pl.86.16"></a><var>86.16</var>    In the case of a promissory note, loan, or mortgage that does not meet an exception <br/>
<a id="pl.86.17"></a><var>86.17</var>in clauses (1) to (3), the value of such note, loan, or mortgage shall be the outstanding <br/>
<a id="pl.86.18"></a><var>86.18</var>balance due as of the date of the institutionalized person's request for medical assistance <br/>
<a id="pl.86.19"></a><var>86.19</var>payment of long-term care services. <br/>
<a id="pl.86.20"></a><var>86.20</var>    (j) This section applies to the purchase of a life estate interest in another person's <br/>
<a id="pl.86.21"></a><var>86.21</var>home unless the purchaser resides in the home for a period of at least one year after the <br/>
<a id="pl.86.22"></a><var>86.22</var>date of purchase. <br/>
<a id="pl.86.23"></a><var>86.23</var>(k) This section applies to transfers into a pooled trust that qualifies under United <br/>
<a id="pl.86.24"></a><var>86.24</var>States Code, title 42, section 1396p(d)(4)(C), by:<br/>
<a id="pl.86.25"></a><var>86.25</var>(1) a person age 65 or older or the person's spouse; or<br/>
<a id="pl.86.26"></a><var>86.26</var>(2) any person, court, or administrative body with legal authority to act in place <br/>
<a id="pl.86.27"></a><var>86.27</var>of, on behalf of, at the direction of, or upon the request of a person age 65 or older or <br/>
<a id="pl.86.28"></a><var>86.28</var>the person's spouse.<br/>
<br/>
<a id="bill.5.22.0"></a><a id="pl.86.29"></a><var>86.29</var>    Sec. 22. Minnesota Statutes 2008, section 256B.0595, subdivision 2, is amended to <br/>
<a id="pl.86.30"></a><var>86.30</var>read:<br/>
<a id="pl.86.31"></a><var>86.31</var>    Subd. 2.  <b>Period of ineligibility</b><b> for long-term care services</b><b>.</b> (a) For any <br/>
<a id="pl.86.32"></a><var>86.32</var>uncompensated transfer occurring on or before August 10, 1993, the number of months <br/>
<a id="pl.86.33"></a><var>86.33</var>of ineligibility for long-term care services shall be the lesser of 30 months, or the <br/>
<a id="pl.86.34"></a><var>86.34</var>uncompensated transfer amount divided by the average medical assistance rate for nursing <br/>
<a id="pl.86.35"></a><var>86.35</var>facility services in the state in effect on the date of application. The amount used to <br/>
<a id="pl.87.1"></a><var>87.1</var>calculate the average medical assistance payment rate shall be adjusted each July 1 to <br/>
<a id="pl.87.2"></a><var>87.2</var>reflect payment rates for the previous calendar year. The period of ineligibility begins <br/>
<a id="pl.87.3"></a><var>87.3</var>with the month in which the assets were transferred. If the transfer was not reported to <br/>
<a id="pl.87.4"></a><var>87.4</var>the local agency at the time of application, and the applicant received long-term care <br/>
<a id="pl.87.5"></a><var>87.5</var>services during what would have been the period of ineligibility if the transfer had been <br/>
<a id="pl.87.6"></a><var>87.6</var>reported, a cause of action exists against the transferee for the cost of long-term care <br/>
<a id="pl.87.7"></a><var>87.7</var>services provided during the period of ineligibility, or for the uncompensated amount of <br/>
<a id="pl.87.8"></a><var>87.8</var>the transfer, whichever is less. The uncompensated transfer amount is the fair market <br/>
<a id="pl.87.9"></a><var>87.9</var>value of the asset at the time it was given away, sold, or disposed of, less the amount of <br/>
<a id="pl.87.10"></a><var>87.10</var>compensation received. <br/>
<a id="pl.87.11"></a><var>87.11</var>    (b) For uncompensated transfers made after August 10, 1993, the number of months <br/>
<a id="pl.87.12"></a><var>87.12</var>of ineligibility for long-term care services shall be the total uncompensated value of the <br/>
<a id="pl.87.13"></a><var>87.13</var>resources transferred divided by the average medical assistance rate for nursing facility <br/>
<a id="pl.87.14"></a><var>87.14</var>services in the state in effect on the date of application. The amount used to calculate <br/>
<a id="pl.87.15"></a><var>87.15</var>the average medical assistance payment rate shall be adjusted each July 1 to reflect <br/>
<a id="pl.87.16"></a><var>87.16</var>payment rates for the previous calendar year. The period of ineligibility begins with the <br/>
<a id="pl.87.17"></a><var>87.17</var>first day of the month after the month in which the assets were transferred except that <br/>
<a id="pl.87.18"></a><var>87.18</var>if one or more uncompensated transfers are made during a period of ineligibility, the <br/>
<a id="pl.87.19"></a><var>87.19</var>total assets transferred during the ineligibility period shall be combined and a penalty <br/>
<a id="pl.87.20"></a><var>87.20</var>period calculated to begin on the first day of the month after the month in which the first <br/>
<a id="pl.87.21"></a><var>87.21</var>uncompensated transfer was made. If the transfer was reported to the local agency after <br/>
<a id="pl.87.22"></a><var>87.22</var>the date that advance notice of a period of ineligibility that affects the next month could <br/>
<a id="pl.87.23"></a><var>87.23</var>be provided to the recipient and the recipient received medical assistance services or the <br/>
<a id="pl.87.24"></a><var>87.24</var>transfer was not reported to the local agency, and the applicant or recipient received <br/>
<a id="pl.87.25"></a><var>87.25</var>medical assistance services during what would have been the period of ineligibility if <br/>
<a id="pl.87.26"></a><var>87.26</var>the transfer had been reported, a cause of action exists against the transferee for that <br/>
<a id="pl.87.27"></a><var>87.27</var>portion of long-term care services provided during the period of ineligibility, or for the <br/>
<a id="pl.87.28"></a><var>87.28</var>uncompensated amount of the transfer, whichever is less. The uncompensated transfer <br/>
<a id="pl.87.29"></a><var>87.29</var>amount is the fair market value of the asset at the time it was given away, sold, or disposed <br/>
<a id="pl.87.30"></a><var>87.30</var>of, less the amount of compensation received. Effective for transfers made on or after <br/>
<a id="pl.87.31"></a><var>87.31</var>March 1, 1996, involving persons who apply for medical assistance on or after April 13, <br/>
<a id="pl.87.32"></a><var>87.32</var>1996, no cause of action exists for a transfer unless: <br/>
<a id="pl.87.33"></a><var>87.33</var>    (1) the transferee knew or should have known that the transfer was being made by a <br/>
<a id="pl.87.34"></a><var>87.34</var>person who was a resident of a long-term care facility or was receiving that level of care in <br/>
<a id="pl.87.35"></a><var>87.35</var>the community at the time of the transfer; <br/>
<a id="pl.88.1"></a><var>88.1</var>    (2) the transferee knew or should have known that the transfer was being made to <br/>
<a id="pl.88.2"></a><var>88.2</var>assist the person to qualify for or retain medical assistance eligibility; or <br/>
<a id="pl.88.3"></a><var>88.3</var>    (3) the transferee actively solicited the transfer with intent to assist the person to <br/>
<a id="pl.88.4"></a><var>88.4</var>qualify for or retain eligibility for medical assistance. <br/>
<a id="pl.88.5"></a><var>88.5</var>    (c) For uncompensated transfers made on or after February 8, 2006, the period <br/>
<a id="pl.88.6"></a><var>88.6</var>of ineligibility: <br/>
<a id="pl.88.7"></a><var>88.7</var>    (1) for uncompensated transfers by or on behalf of individuals receiving medical <br/>
<a id="pl.88.8"></a><var>88.8</var>assistance payment of long-term care services, begins the first day of the month following <br/>
<a id="pl.88.9"></a><var>88.9</var>advance notice of the penalty period of ineligibility, but no later than the first day of the <br/>
<a id="pl.88.10"></a><var>88.10</var>month that follows three full calendar months from the date of the report or discovery <br/>
<a id="pl.88.11"></a><var>88.11</var>of the transfer; or <br/>
<a id="pl.88.12"></a><var>88.12</var>    (2) for uncompensated transfers by individuals requesting medical assistance <br/>
<a id="pl.88.13"></a><var>88.13</var>payment of long-term care services, begins the date on which the individual is eligible <br/>
<a id="pl.88.14"></a><var>88.14</var>for medical assistance under the Medicaid state plan and would otherwise be receiving <br/>
<a id="pl.88.15"></a><var>88.15</var>long-term care services based on an approved application for such care but for the <br/>
<a id="pl.88.16"></a><var>88.16</var>application of the penalty period of ineligibility resulting from the uncompensated <br/>
<a id="pl.88.17"></a><var>88.17</var>transfer; and <br/>
<a id="pl.88.18"></a><var>88.18</var>    (3) cannot begin during any other period of ineligibility. <br/>
<a id="pl.88.19"></a><var>88.19</var>    (d) If a calculation of a penalty period of ineligibility results in a partial month, <br/>
<a id="pl.88.20"></a><var>88.20</var>payments for long-term care services shall be reduced in an amount equal to the fraction. <br/>
<a id="pl.88.21"></a><var>88.21</var>    (e) In the case of multiple fractional transfers of assets in more than one month for <br/>
<a id="pl.88.22"></a><var>88.22</var>less than fair market value on or after February 8, 2006, the period of ineligibility is <br/>
<a id="pl.88.23"></a><var>88.23</var>calculated by treating the total, cumulative, uncompensated value of all assets transferred <br/>
<a id="pl.88.24"></a><var>88.24</var>during all months on or after February 8, 2006, as one transfer. <br/>
<a id="pl.88.25"></a><var>88.25</var>    (f) A period of ineligibility established under paragraph (c) may be eliminated if <br/>
<a id="pl.88.26"></a><var>88.26</var>all of the assets transferred for less than fair market value used to calculate the period of <br/>
<a id="pl.88.27"></a><var>88.27</var>ineligibility, or cash equal to the value of the assets at the time of the transfer, are returned <br/>
<a id="pl.88.28"></a><var>88.28</var>within 12 months after the date the period of ineligibility began. A period of ineligibility <br/>
<a id="pl.88.29"></a><var>88.29</var>must not be adjusted if less than the full amount of the transferred assets or the full cash <br/>
<a id="pl.88.30"></a><var>88.30</var>value of the transferred assets are returned.<br/>
<a id="pl.88.31"></a><var>88.31</var><b>EFFECTIVE DATE.</b>This section is effective for periods of ineligibility established <br/>
<a id="pl.88.32"></a><var>88.32</var>on or after January 1, 2011.<br/>
<br/>
<a id="bill.5.23.0"></a><a id="pl.88.33"></a><var>88.33</var>    Sec. 23. Minnesota Statutes 2008, section 256B.06, subdivision 4, is amended to read:<br/>
<a id="pl.88.34"></a><var>88.34</var>    Subd. 4.  <b>Citizenship requirements.</b> (a) Eligibility for medical assistance is limited <br/>
<a id="pl.88.35"></a><var>88.35</var>to citizens of the United States, qualified noncitizens as defined in this subdivision, and <br/>
<a id="pl.89.1"></a><var>89.1</var>other persons residing lawfully in the United States. Citizens or nationals of the United <br/>
<a id="pl.89.2"></a><var>89.2</var>States must cooperate in obtaining satisfactory documentary evidence of citizenship or <br/>
<a id="pl.89.3"></a><var>89.3</var>nationality according to the requirements of the federal Deficit Reduction Act of 2005, <br/>
<a id="pl.89.4"></a><var>89.4</var>Public Law 109-171. <br/>
<a id="pl.89.5"></a><var>89.5</var>(b) "Qualified noncitizen" means a person who meets one of the following <br/>
<a id="pl.89.6"></a><var>89.6</var>immigration criteria: <br/>
<a id="pl.89.7"></a><var>89.7</var>(1) admitted for lawful permanent residence according to United States Code, title 8; <br/>
<a id="pl.89.8"></a><var>89.8</var>(2) admitted to the United States as a refugee according to United States Code, <br/>
<a id="pl.89.9"></a><var>89.9</var>title 8, section 1157; <br/>
<a id="pl.89.10"></a><var>89.10</var>(3) granted asylum according to United States Code, title 8, section 1158; <br/>
<a id="pl.89.11"></a><var>89.11</var>(4) granted withholding of deportation according to United States Code, title 8, <br/>
<a id="pl.89.12"></a><var>89.12</var>section 1253(h); <br/>
<a id="pl.89.13"></a><var>89.13</var>(5) paroled for a period of at least one year according to United States Code, title 8, <br/>
<a id="pl.89.14"></a><var>89.14</var>section 1182(d)(5); <br/>
<a id="pl.89.15"></a><var>89.15</var>(6) granted conditional entrant status according to United States Code, title 8, <br/>
<a id="pl.89.16"></a><var>89.16</var>section 1153(a)(7); <br/>
<a id="pl.89.17"></a><var>89.17</var>(7) determined to be a battered noncitizen by the United States Attorney General <br/>
<a id="pl.89.18"></a><var>89.18</var>according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, <br/>
<a id="pl.89.19"></a><var>89.19</var>title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200; <br/>
<a id="pl.89.20"></a><var>89.20</var>(8) is a child of a noncitizen determined to be a battered noncitizen by the United <br/>
<a id="pl.89.21"></a><var>89.21</var>States Attorney General according to the Illegal Immigration Reform and Immigrant <br/>
<a id="pl.89.22"></a><var>89.22</var>Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill, <br/>
<a id="pl.89.23"></a><var>89.23</var>Public Law 104-200; or <br/>
<a id="pl.89.24"></a><var>89.24</var>(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public <br/>
<a id="pl.89.25"></a><var>89.25</var>Law 96-422, the Refugee Education Assistance Act of 1980. <br/>
<a id="pl.89.26"></a><var>89.26</var>(c) All qualified noncitizens who were residing in the United States before August <br/>
<a id="pl.89.27"></a><var>89.27</var>22, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for <br/>
<a id="pl.89.28"></a><var>89.28</var>medical assistance with federal financial participation. <br/>
<a id="pl.89.29"></a><var>89.29</var>(d) All qualified noncitizens who entered the United States on or after August 22, <br/>
<a id="pl.89.30"></a><var>89.30</var>1996, and who otherwise meet the eligibility requirements of this chapter, are eligible for <br/>
<a id="pl.89.31"></a><var>89.31</var>medical assistance with federal financial participation through November 30, 1996. <br/>
<a id="pl.89.32"></a><var>89.32</var>Beginning December 1, 1996, qualified noncitizens who entered the United States <br/>
<a id="pl.89.33"></a><var>89.33</var>on or after August 22, 1996, and who otherwise meet the eligibility requirements of this <br/>
<a id="pl.89.34"></a><var>89.34</var>chapter are eligible for medical assistance with federal participation for five years if they <br/>
<a id="pl.89.35"></a><var>89.35</var>meet one of the following criteria: <br/>
<a id="pl.90.1"></a><var>90.1</var>(i) refugees admitted to the United States according to United States Code, title 8, <br/>
<a id="pl.90.2"></a><var>90.2</var>section 1157; <br/>
<a id="pl.90.3"></a><var>90.3</var>(ii) persons granted asylum according to United States Code, title 8, section 1158; <br/>
<a id="pl.90.4"></a><var>90.4</var>(iii) persons granted withholding of deportation according to United States Code, <br/>
<a id="pl.90.5"></a><var>90.5</var>title 8, section 1253(h); <br/>
<a id="pl.90.6"></a><var>90.6</var>(iv) veterans of the United States armed forces with an honorable discharge for <br/>
<a id="pl.90.7"></a><var>90.7</var>a reason other than noncitizen status, their spouses and unmarried minor dependent <br/>
<a id="pl.90.8"></a><var>90.8</var>children; or <br/>
<a id="pl.90.9"></a><var>90.9</var>(v) persons on active duty in the United States armed forces, other than for training, <br/>
<a id="pl.90.10"></a><var>90.10</var>their spouses and unmarried minor dependent children. <br/>
<a id="pl.90.11"></a><var>90.11</var>Beginning December 1, 1996, qualified noncitizens who do not meet one of the <br/>
<a id="pl.90.12"></a><var>90.12</var>criteria in items (i) to (v) are eligible for medical assistance without federal financial <br/>
<a id="pl.90.13"></a><var>90.13</var>participation as described in paragraph (j). <br/>
<a id="pl.90.14"></a><var>90.14</var>Notwithstanding paragraph (j), beginning July 1, 2010, children and pregnant <br/>
<a id="pl.90.15"></a><var>90.15</var>women who are qualified noncitizens, as described in paragraph (b), are eligible for <br/>
<a id="pl.90.16"></a><var>90.16</var>medical assistance with federal financial participation as provided by the federal Children's <br/>
<a id="pl.90.17"></a><var>90.17</var>Health Insurance Program Reauthorization Act of 2009, Public Law 111-3.<br/>
<a id="pl.90.18"></a><var>90.18</var>(e) Noncitizens who are not qualified noncitizens as defined in paragraph (b), who <br/>
<a id="pl.90.19"></a><var>90.19</var>are lawfully present in the United States, as defined in Code of Federal Regulations, title <br/>
<a id="pl.90.20"></a><var>90.20</var>8, section 
         <statute_ref>103.12</statute_ref>, and who otherwise meet the eligibility requirements of this chapter, are <br/>
<a id="pl.90.21"></a><var>90.21</var>eligible for medical assistance under clauses (1) to (3). These individuals must cooperate <br/>
<a id="pl.90.22"></a><var>90.22</var>with the United States Citizenship and Immigration Services to pursue any applicable <br/>
<a id="pl.90.23"></a><var>90.23</var>immigration status, including citizenship, that would qualify them for medical assistance <br/>
<a id="pl.90.24"></a><var>90.24</var>with federal financial participation. <br/>
<a id="pl.90.25"></a><var>90.25</var>(1) Persons who were medical assistance recipients on August 22, 1996, are eligible <br/>
<a id="pl.90.26"></a><var>90.26</var>for medical assistance with federal financial participation through December 31, 1996. <br/>
<a id="pl.90.27"></a><var>90.27</var>(2) Beginning January 1, 1997, persons described in clause (1) are eligible for <br/>
<a id="pl.90.28"></a><var>90.28</var>medical assistance without federal financial participation as described in paragraph (j). <br/>
<a id="pl.90.29"></a><var>90.29</var>(3) Beginning December 1, 1996, persons residing in the United States prior to <br/>
<a id="pl.90.30"></a><var>90.30</var>August 22, 1996, who were not receiving medical assistance and persons who arrived on <br/>
<a id="pl.90.31"></a><var>90.31</var>or after August 22, 1996, are eligible for medical assistance without federal financial <br/>
<a id="pl.90.32"></a><var>90.32</var>participation as described in paragraph (j). <br/>
<a id="pl.90.33"></a><var>90.33</var>(f) Nonimmigrants who otherwise meet the eligibility requirements of this chapter <br/>
<a id="pl.90.34"></a><var>90.34</var>are eligible for the benefits as provided in paragraphs (g) to (i). For purposes of this <br/>
<a id="pl.90.35"></a><var>90.35</var>subdivision, a "nonimmigrant" is a person in one of the classes listed in United States <br/>
<a id="pl.90.36"></a><var>90.36</var>Code, title 8, section 1101(a)(15). <br/>
<a id="pl.91.1"></a><var>91.1</var>(g) Payment shall also be made for care and services that are furnished to noncitizens, <br/>
<a id="pl.91.2"></a><var>91.2</var>regardless of immigration status, who otherwise meet the eligibility requirements of <br/>
<a id="pl.91.3"></a><var>91.3</var>this chapter, if such care and services are necessary for the treatment of an emergency <br/>
<a id="pl.91.4"></a><var>91.4</var>medical condition, except for organ transplants and related care and services and routine <br/>
<a id="pl.91.5"></a><var>91.5</var>prenatal care. <br/>
<a id="pl.91.6"></a><var>91.6</var>(h) For purposes of this subdivision, the term "emergency medical condition" means <br/>
<a id="pl.91.7"></a><var>91.7</var>a medical condition that meets the requirements of United States Code, title 42, section <br/>
<a id="pl.91.8"></a><var>91.8</var>1396b(v). <br/>
<a id="pl.91.9"></a><var>91.9</var>(i) Beginning July 1, 2009, pregnant noncitizens who are undocumented, <br/>
<a id="pl.91.10"></a><var>91.10</var>nonimmigrants, or eligible for medical assistance as described in paragraph (j), lawfully <br/>
<a id="pl.91.11"></a><var>91.11</var>present as designated in paragraph (e) and who are not covered by a group health plan <br/>
<a id="pl.91.12"></a><var>91.12</var>or health insurance coverage according to Code of Federal Regulations, title 42, section <br/>
<a id="pl.91.13"></a><var>91.13</var>457.310, and who otherwise meet the eligibility requirements of this chapter, are eligible <br/>
<a id="pl.91.14"></a><var>91.14</var>for medical assistance through the period of pregnancy, including labor and delivery, <br/>
<a id="pl.91.15"></a><var>91.15</var>and 60 days postpartum, to the extent federal funds are available under title XXI of the <br/>
<a id="pl.91.16"></a><var>91.16</var>Social Security Act, and the state children's health insurance program, followed by 60 <br/>
<a id="pl.91.17"></a><var>91.17</var>days postpartum without federal financial participation. <br/>
<a id="pl.91.18"></a><var>91.18</var>(j) Qualified noncitizens as described in paragraph (d), and all other noncitizens <br/>
<a id="pl.91.19"></a><var>91.19</var>lawfully residing in the United States as described in paragraph (e), who are ineligible <br/>
<a id="pl.91.20"></a><var>91.20</var>for medical assistance with federal financial participation and who otherwise meet the <br/>
<a id="pl.91.21"></a><var>91.21</var>eligibility requirements of chapter 256B and of this paragraph, are eligible for medical <br/>
<a id="pl.91.22"></a><var>91.22</var>assistance without federal financial participation. Qualified noncitizens as described <br/>
<a id="pl.91.23"></a><var>91.23</var>in paragraph (d) are only eligible for medical assistance without federal financial <br/>
<a id="pl.91.24"></a><var>91.24</var>participation for five years from their date of entry into the United States. <br/>
<a id="pl.91.25"></a><var>91.25</var>(k) Beginning October 1, 2003, persons who are receiving care and rehabilitation <br/>
<a id="pl.91.26"></a><var>91.26</var>services from a nonprofit center established to serve victims of torture and are otherwise <br/>
<a id="pl.91.27"></a><var>91.27</var>ineligible for medical assistance under this chapter are eligible for medical assistance <br/>
<a id="pl.91.28"></a><var>91.28</var>without federal financial participation. These individuals are eligible only for the period <br/>
<a id="pl.91.29"></a><var>91.29</var>during which they are receiving services from the center. Individuals eligible under this <br/>
<a id="pl.91.30"></a><var>91.30</var>paragraph shall not be required to participate in prepaid medical assistance. <br/>
<a id="pl.91.31"></a><var>91.31</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2009.<br/>
<br/>
<a id="bill.5.24.0"></a><a id="pl.91.32"></a><var>91.32</var>    Sec. 24. Minnesota Statutes 2008, section 256B.06, subdivision 5, is amended to read:<br/>
<a id="pl.91.33"></a><var>91.33</var>    Subd. 5. <b>Deeming of sponsor income and resources.</b> When determining eligibility <br/>
<a id="pl.91.34"></a><var>91.34</var>for any federal or state funded medical assistance under this section, the income <br/>
<a id="pl.91.35"></a><var>91.35</var>and resources of all noncitizens shall be deemed to include their sponsors' income <br/>
<a id="pl.92.1"></a><var>92.1</var>and resources as required under the Personal Responsibility and Work Opportunity <br/>
<a id="pl.92.2"></a><var>92.2</var>Reconciliation Act of 1996, title IV, Public Law 104-193, sections 421 and 422, and <br/>
<a id="pl.92.3"></a><var>92.3</var>subsequently set out in federal rules. This section is effective May 1, 1997. Beginning <br/>
<a id="pl.92.4"></a><var>92.4</var>July 1, 2010, sponsor deeming does not apply to pregnant women and children who are <br/>
<a id="pl.92.5"></a><var>92.5</var>qualified noncitizens, as described in section 256B.06, subdivision 4, paragraph (b).<br/>
<a id="pl.92.6"></a><var>92.6</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2010.<br/>
<br/>
<a id="bill.5.25.0"></a><a id="pl.92.7"></a><var>92.7</var>    Sec. 25. Minnesota Statutes 2008, section 256B.0625, subdivision 3, is amended to <br/>
<a id="pl.92.8"></a><var>92.8</var>read:<br/>
<a id="pl.92.9"></a><var>92.9</var>    Subd. 3. <b>Physicians' services.</b> (a) Medical assistance covers physicians' services.<br/>
<a id="pl.92.10"></a><var>92.10</var>(b)  Rates paid for anesthesiology services provided by physicians shall be according <br/>
<a id="pl.92.11"></a><var>92.11</var>to the formula utilized in the Medicare program and shall use a conversion factor "at <br/>
<a id="pl.92.12"></a><var>92.12</var>percentile of calendar year set by legislature.," except that rates paid to physicians for the <br/>
<a id="pl.92.13"></a><var>92.13</var>medical direction of a certified registered nurse anesthetist shall be the same as the rate <br/>
<a id="pl.92.14"></a><var>92.14</var>paid to the certified registered nurse anesthetist under medical direction.<br/>
<br/>
<a id="bill.5.26.0"></a><a id="pl.92.15"></a><var>92.15</var>    Sec. 26. Minnesota Statutes 2008, section 256B.0625, subdivision 3c, is amended to <br/>
<a id="pl.92.16"></a><var>92.16</var>read:<br/>
<a id="pl.92.17"></a><var>92.17</var>    Subd. 3c.  <b>Health Services Policy Committee.</b> (a) The commissioner, after <br/>
<a id="pl.92.18"></a><var>92.18</var>receiving recommendations from professional physician associations, professional <br/>
<a id="pl.92.19"></a><var>92.19</var>associations representing licensed nonphysician health care professionals, and consumer <br/>
<a id="pl.92.20"></a><var>92.20</var>groups, shall establish a 13-member Health Services Policy Committee, which consists of <br/>
<a id="pl.92.21"></a><var>92.21</var>12 voting members and one nonvoting member. The Health Services Policy Committee <br/>
<a id="pl.92.22"></a><var>92.22</var>shall advise the commissioner regarding health services pertaining to the administration <br/>
<a id="pl.92.23"></a><var>92.23</var>of health care benefits covered under the medical assistance, general assistance medical <br/>
<a id="pl.92.24"></a><var>92.24</var>care, and MinnesotaCare programs. The Health Services Policy Committee shall meet at <br/>
<a id="pl.92.25"></a><var>92.25</var>least quarterly. The Health Services Policy Committee shall annually elect a physician <br/>
<a id="pl.92.26"></a><var>92.26</var>chair from among its members, who shall work directly with the commissioner's medical <br/>
<a id="pl.92.27"></a><var>92.27</var>director, to establish the agenda for each meeting. The Health Services Policy Committee <br/>
<a id="pl.92.28"></a><var>92.28</var>shall also recommend criteria for verifying centers of excellence for specific aspects of <br/>
<a id="pl.92.29"></a><var>92.29</var>medical care where a specific set of combined services, a volume of patients necessary to <br/>
<a id="pl.92.30"></a><var>92.30</var>maintain a high level of competency, or a specific level of technical capacity is associated <br/>
<a id="pl.92.31"></a><var>92.31</var>with improved health outcomes. <br/>
<a id="pl.92.32"></a><var>92.32</var>(b) The commissioner shall establish a dental subcommittee to operate under the <br/>
<a id="pl.92.33"></a><var>92.33</var>Health Services Policy Committee. The dental subcommittee consists of general dentists, <br/>
<a id="pl.92.34"></a><var>92.34</var>dental specialists, safety net providers, dental hygienists, health plan company and <br/>
<a id="pl.93.1"></a><var>93.1</var>county and public health representatives, health researchers, consumers, and a designee <br/>
<a id="pl.93.2"></a><var>93.2</var>of the commissioner of health. The dental subcommittee shall advise the commissioner <br/>
<a id="pl.93.3"></a><var>93.3</var>regarding:<br/>
<a id="pl.93.4"></a><var>93.4</var>(1) the critical access dental program under section 256B.76, subdivision 4, including <br/>
<a id="pl.93.5"></a><var>93.5</var>but not limited to criteria for designating and terminating critical access dental providers;<br/>
<a id="pl.93.6"></a><var>93.6</var>(2) any changes to the critical access dental provider program necessary to comply <br/>
<a id="pl.93.7"></a><var>93.7</var>with program expenditure limits;<br/>
<a id="pl.93.8"></a><var>93.8</var>(3) dental coverage policy based on evidence, quality, continuity of care, and best <br/>
<a id="pl.93.9"></a><var>93.9</var>practices;<br/>
<a id="pl.93.10"></a><var>93.10</var>(4) the development of dental delivery models; and<br/>
<a id="pl.93.11"></a><var>93.11</var>(5) dental services to be added or eliminated from subdivision 9, paragraph (b).<br/>
<a id="pl.93.12"></a><var>93.12</var>(c) The Health Services Policy Committee shall study approaches to making <br/>
<a id="pl.93.13"></a><var>93.13</var>provider reimbursement under the medical assistance, MinnesotaCare, and general <br/>
<a id="pl.93.14"></a><var>93.14</var>assistance medical care programs contingent on patient participation in a patient-centered <br/>
<a id="pl.93.15"></a><var>93.15</var>decision-making process, and shall evaluate the impact of these approaches on health <br/>
<a id="pl.93.16"></a><var>93.16</var>care quality, patient satisfaction, and health care costs. The committee shall present <br/>
<a id="pl.93.17"></a><var>93.17</var>findings and recommendations to the commissioner and the legislative committees with <br/>
<a id="pl.93.18"></a><var>93.18</var>jurisdiction over health care by January 15, 2010.<br/>
<a id="pl.93.19"></a><var>93.19</var>(d) The Health Services Policy Committee shall monitor and track the practice <br/>
<a id="pl.93.20"></a><var>93.20</var>patterns of physicians providing services to medical assistance, MinnesotaCare, and <br/>
<a id="pl.93.21"></a><var>93.21</var>general assistance medical care enrollees under fee-for-service, managed care, and <br/>
<a id="pl.93.22"></a><var>93.22</var>county-based purchasing. The committee shall focus on services or specialties for which <br/>
<a id="pl.93.23"></a><var>93.23</var>there is a high variation in utilization across physicians, or which are associated with <br/>
<a id="pl.93.24"></a><var>93.24</var>high medical costs. The commissioner, based upon the findings of the committee, shall <br/>
<a id="pl.93.25"></a><var>93.25</var>regularly notify physicians whose practice patterns indicate higher than average utilization <br/>
<a id="pl.93.26"></a><var>93.26</var>or costs. Managed care and county-based purchasing plans shall provide the committee <br/>
<a id="pl.93.27"></a><var>93.27</var>with utilization and cost data necessary to implement this paragraph.<br/>
<a id="pl.93.28"></a><var>93.28</var>    (e) The Health Services Policy Committee shall review caesarean section rates <br/>
<a id="pl.93.29"></a><var>93.29</var>for the fee-for-service medical assistance population. The committee may develop best <br/>
<a id="pl.93.30"></a><var>93.30</var>practices policies related to the minimization of caesarean sections, including but not <br/>
<a id="pl.93.31"></a><var>93.31</var>limited to standards and guidelines for health care providers and health care facilities.<br/>
<br/>
<a id="bill.5.27.0"></a><a id="pl.93.32"></a><var>93.32</var>    Sec. 27. Minnesota Statutes 2008, section 256B.0625, subdivision 9, is amended to <br/>
<a id="pl.93.33"></a><var>93.33</var>read:<br/>
<a id="pl.94.1"></a><var>94.1</var>    Subd. 9. <b>Dental services.</b> (a) Medical assistance covers dental services. Dental <br/>
<a id="pl.94.2"></a><var>94.2</var>services include, with prior authorization, fixed bridges that are cost-effective for persons <br/>
<a id="pl.94.3"></a><var>94.3</var>who cannot use removable dentures because of their medical condition.<br/>
<a id="pl.94.4"></a><var>94.4</var>(b) Medical assistance dental coverage for nonpregnant adults is limited to the <br/>
<a id="pl.94.5"></a><var>94.5</var>following services:<br/>
<a id="pl.94.6"></a><var>94.6</var>(1) comprehensive exams, limited to once every five years;<br/>
<a id="pl.94.7"></a><var>94.7</var>(2) periodic exams, limited to one per year;<br/>
<a id="pl.94.8"></a><var>94.8</var>(3) limited exams;<br/>
<a id="pl.94.9"></a><var>94.9</var>(4) bitewing x-rays, limited to one per year;<br/>
<a id="pl.94.10"></a><var>94.10</var>(5) periapical x-rays;<br/>
<a id="pl.94.11"></a><var>94.11</var>(6) panoramic x-rays, limited to one every five years, and only if provided in <br/>
<a id="pl.94.12"></a><var>94.12</var>conjunction with a posterior extraction or scheduled outpatient facility procedure, or as <br/>
<a id="pl.94.13"></a><var>94.13</var>medically necessary for the diagnosis and follow-up of oral and maxillofacial pathology <br/>
<a id="pl.94.14"></a><var>94.14</var>and trauma. Panoramic x-rays may be taken once every two years for patients who cannot <br/>
<a id="pl.94.15"></a><var>94.15</var>cooperate for intraoral film due to a developmental disability or medical condition that <br/>
<a id="pl.94.16"></a><var>94.16</var>does not allow for intraoral film placement;<br/>
<a id="pl.94.17"></a><var>94.17</var>(7) prophylaxis, limited to one per year;<br/>
<a id="pl.94.18"></a><var>94.18</var>(8) application of fluoride varnish, limited to one per year;<br/>
<a id="pl.94.19"></a><var>94.19</var>(9) posterior fillings, all at the amalgam rate;<br/>
<a id="pl.94.20"></a><var>94.20</var>(10) anterior fillings;<br/>
<a id="pl.94.21"></a><var>94.21</var>(11) endodontics, limited to root canals on the anterior and premolars only;<br/>
<a id="pl.94.22"></a><var>94.22</var>(12) removable prostheses, each dental arch limited to one every six years;<br/>
<a id="pl.94.23"></a><var>94.23</var>(13) oral surgery, limited to extractions, biopsies, and incision and drainage of <br/>
<a id="pl.94.24"></a><var>94.24</var>abscesses;<br/>
<a id="pl.94.25"></a><var>94.25</var>(14) palliative treatment and sedative fillings for relief of pain; and<br/>
<a id="pl.94.26"></a><var>94.26</var>(15) full-mouth debridement, limited to one every five years.<br/>
<a id="pl.94.27"></a><var>94.27</var>(c) In addition to the services specified in paragraph (b), medical assistance <br/>
<a id="pl.94.28"></a><var>94.28</var>covers the following services for adults, if provided in an outpatient hospital setting or <br/>
<a id="pl.94.29"></a><var>94.29</var>freestanding ambulatory surgical center as part of outpatient dental surgery:<br/>
<a id="pl.94.30"></a><var>94.30</var>(1) periodontics, limited to periodontal scaling and root planing once every two <br/>
<a id="pl.94.31"></a><var>94.31</var>years;<br/>
<a id="pl.94.32"></a><var>94.32</var>(2) general anesthesia; and<br/>
<a id="pl.94.33"></a><var>94.33</var>(3) full-mouth survey once every five years.<br/>
<a id="pl.94.34"></a><var>94.34</var>(d) Medical assistance covers dental services for children that are medically <br/>
<a id="pl.94.35"></a><var>94.35</var>necessary. The following guidelines apply:<br/>
<a id="pl.94.36"></a><var>94.36</var>(1) posterior fillings are paid at the amalgam rate;<br/>
<a id="pl.95.1"></a><var>95.1</var>(2) application of sealants once every five years per permanent molar; and<br/>
<a id="pl.95.2"></a><var>95.2</var>(3) application of fluoride varnish once every six months.<br/>
<a id="pl.95.3"></a><var>95.3</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2010.<br/>
<br/>
<a id="bill.5.28.0"></a><a id="pl.95.4"></a><var>95.4</var>    Sec. 28. Minnesota Statutes 2008, section 256B.0625, subdivision 11, is amended to <br/>
<a id="pl.95.5"></a><var>95.5</var>read:<br/>
<a id="pl.95.6"></a><var>95.6</var>    Subd. 11. <b>Nurse anesthetist services.</b> Medical assistance covers nurse anesthetist <br/>
<a id="pl.95.7"></a><var>95.7</var>services. Rates paid for anesthesiology services provided by a certified registered nurse <br/>
<a id="pl.95.8"></a><var>95.8</var>anesthetists anesthetist under the direction of a physician shall be according to the formula <br/>
<a id="pl.95.9"></a><var>95.9</var>utilized in the Medicare program and shall use the conversion factor that is used by <br/>
<a id="pl.95.10"></a><var>95.10</var>the Medicare program. Rates paid for anesthesiology services provided by a certified <br/>
<a id="pl.95.11"></a><var>95.11</var>registered nurse anesthetist who is not directed by a physician shall be the same rate as <br/>
<a id="pl.95.12"></a><var>95.12</var>paid under subdivision 3, paragraph (b).<br/>
<br/>
<a id="bill.5.29.0"></a><a id="pl.95.13"></a><var>95.13</var>    Sec. 29. Minnesota Statutes 2008, section 256B.0625, subdivision 13, is amended to <br/>
<a id="pl.95.14"></a><var>95.14</var>read:<br/>
<a id="pl.95.15"></a><var>95.15</var>    Subd. 13. <b>Drugs.</b> (a) Medical assistance covers drugs, except for fertility drugs <br/>
<a id="pl.95.16"></a><var>95.16</var>when specifically used to enhance fertility, if prescribed by a licensed practitioner and <br/>
<a id="pl.95.17"></a><var>95.17</var>dispensed by a licensed pharmacist, by a physician enrolled in the medical assistance <br/>
<a id="pl.95.18"></a><var>95.18</var>program as a dispensing physician, or by a physician, physician assistant,  or a nurse <br/>
<a id="pl.95.19"></a><var>95.19</var>practitioner employed by or under contract with a community health board as defined in <br/>
<a id="pl.95.20"></a><var>95.20</var>section 
         <statute_ref>145A.02, subdivision 5</statute_ref>, for the purposes of communicable disease control.<br/>
<a id="pl.95.21"></a><var>95.21</var>(b) The dispensed quantity of a prescription drug must not exceed a 34-day supply, <br/>
<a id="pl.95.22"></a><var>95.22</var>unless authorized by the commissioner.<br/>
<a id="pl.95.23"></a><var>95.23</var>(c) Medical assistance covers the following over-the-counter drugs when prescribed <br/>
<a id="pl.95.24"></a><var>95.24</var>by a licensed practitioner or by a licensed pharmacist who meets standards established by <br/>
<a id="pl.95.25"></a><var>95.25</var>the commissioner, in consultation with the board of pharmacy: antacids, acetaminophen, <br/>
<a id="pl.95.26"></a><var>95.26</var>family planning products, aspirin, insulin, products for the treatment of lice, vitamins for <br/>
<a id="pl.95.27"></a><var>95.27</var>adults with documented vitamin deficiencies, vitamins for children under the age of seven <br/>
<a id="pl.95.28"></a><var>95.28</var>and pregnant or nursing women, and any other over-the-counter drug identified by the <br/>
<a id="pl.95.29"></a><var>95.29</var>commissioner, in consultation with the formulary committee, as necessary, appropriate, <br/>
<a id="pl.95.30"></a><var>95.30</var>and cost-effective for the treatment of certain specified chronic diseases, conditions, <br/>
<a id="pl.95.31"></a><var>95.31</var>or disorders, and this determination shall not be subject to the requirements of chapter <br/>
<a id="pl.95.32"></a><var>95.32</var>14. A pharmacist may prescribe over-the-counter medications as provided under this <br/>
<a id="pl.95.33"></a><var>95.33</var>paragraph for purposes of receiving reimbursement under Medicaid. When prescribing <br/>
<a id="pl.95.34"></a><var>95.34</var>over-the-counter drugs under this paragraph, licensed pharmacists must consult with the <br/>
<a id="pl.96.1"></a><var>96.1</var>recipient to determine necessity, provide drug counseling, review drug therapy for potential <br/>
<a id="pl.96.2"></a><var>96.2</var>adverse interactions, and make referrals as needed to other health care professionals.<br/>
<a id="pl.96.3"></a><var>96.3</var>(d) Effective January 1, 2006, medical assistance shall not cover drugs that <br/>
<a id="pl.96.4"></a><var>96.4</var>are coverable under Medicare Part D as defined in the Medicare Prescription Drug, <br/>
<a id="pl.96.5"></a><var>96.5</var>Improvement, and Modernization Act of 2003, Public Law 108-173, section 1860D-2(e), <br/>
<a id="pl.96.6"></a><var>96.6</var>for individuals eligible for drug coverage as defined in the Medicare Prescription <br/>
<a id="pl.96.7"></a><var>96.7</var>Drug, Improvement, and Modernization Act of 2003, Public Law 108-173, section <br/>
<a id="pl.96.8"></a><var>96.8</var>1860D-1(a)(3)(A). For these individuals, medical assistance may cover drugs from the <br/>
<a id="pl.96.9"></a><var>96.9</var>drug classes listed in United States Code, title 42, section 1396r-8(d)(2), subject to this <br/>
<a id="pl.96.10"></a><var>96.10</var>subdivision and subdivisions 13a to 13g, except that drugs listed in United States Code, <br/>
<a id="pl.96.11"></a><var>96.11</var>title 42, section 1396r-8(d)(2)(E), shall not be covered.<br/>
<br/>
<a id="bill.5.30.0"></a><a id="pl.96.12"></a><var>96.12</var>    Sec. 30. Minnesota Statutes 2008, section 256B.0625, subdivision 13e, is amended to <br/>
<a id="pl.96.13"></a><var>96.13</var>read:<br/>
<a id="pl.96.14"></a><var>96.14</var>    Subd. 13e. <b>Payment rates.</b> (a) The basis for determining the amount of payment <br/>
<a id="pl.96.15"></a><var>96.15</var>shall be the lower of the actual acquisition costs of the drugs plus a fixed dispensing fee; <br/>
<a id="pl.96.16"></a><var>96.16</var>the maximum allowable cost set by the federal government or by the commissioner plus <br/>
<a id="pl.96.17"></a><var>96.17</var>the fixed dispensing fee; or the usual and customary price charged to the public. The <br/>
<a id="pl.96.18"></a><var>96.18</var>amount of payment basis must be reduced to reflect all discount amounts applied to the <br/>
<a id="pl.96.19"></a><var>96.19</var>charge by any provider/insurer agreement or contract for submitted charges to medical <br/>
<a id="pl.96.20"></a><var>96.20</var>assistance programs. The net submitted charge may not be greater than the patient liability <br/>
<a id="pl.96.21"></a><var>96.21</var>for the service. The pharmacy dispensing fee shall be $3.65, except that the dispensing fee <br/>
<a id="pl.96.22"></a><var>96.22</var>for intravenous solutions which must be compounded by the pharmacist shall be $8 per <br/>
<a id="pl.96.23"></a><var>96.23</var>bag, $14 per bag for cancer chemotherapy products, and $30 per bag for total parenteral <br/>
<a id="pl.96.24"></a><var>96.24</var>nutritional products dispensed in one liter quantities, or $44 per bag for total parenteral <br/>
<a id="pl.96.25"></a><var>96.25</var>nutritional products dispensed in quantities greater than one liter. Actual acquisition <br/>
<a id="pl.96.26"></a><var>96.26</var>cost includes quantity and other special discounts except time and cash discounts. <br/>
<a id="pl.96.27"></a><var>96.27</var>Effective July 1, 2008 2009, the actual acquisition cost of a drug shall be estimated by the <br/>
<a id="pl.96.28"></a><var>96.28</var>commissioner, at average wholesale price minus 14 15 percent. The actual acquisition <br/>
<a id="pl.96.29"></a><var>96.29</var>cost of antihemophilic factor drugs shall be estimated at the average wholesale price <br/>
<a id="pl.96.30"></a><var>96.30</var>minus 30 percent. The maximum allowable cost of a multisource drug may be set by the <br/>
<a id="pl.96.31"></a><var>96.31</var>commissioner and it shall be comparable to, but no higher than, the maximum amount <br/>
<a id="pl.96.32"></a><var>96.32</var>paid by other third-party payors in this state who have maximum allowable cost programs. <br/>
<a id="pl.96.33"></a><var>96.33</var>Establishment of the amount of payment for drugs shall not be subject to the requirements <br/>
<a id="pl.96.34"></a><var>96.34</var>of the Administrative Procedure Act.<br/>
<a id="pl.97.1"></a><var>97.1</var>    (b) An additional dispensing fee of $.30 may be added to the dispensing fee paid <br/>
<a id="pl.97.2"></a><var>97.2</var>to pharmacists for legend drug prescriptions dispensed to residents of long-term care <br/>
<a id="pl.97.3"></a><var>97.3</var>facilities when a unit dose blister card system, approved by the department, is used. Under <br/>
<a id="pl.97.4"></a><var>97.4</var>this type of dispensing system, the pharmacist must dispense a 30-day supply of drug. <br/>
<a id="pl.97.5"></a><var>97.5</var>The National Drug Code (NDC) from the drug container used to fill the blister card must <br/>
<a id="pl.97.6"></a><var>97.6</var>be identified on the claim to the department. The unit dose blister card containing the <br/>
<a id="pl.97.7"></a><var>97.7</var>drug must meet the packaging standards set forth in Minnesota Rules, part 6800.2700, <br/>
<a id="pl.97.8"></a><var>97.8</var>that govern the return of unused drugs to the pharmacy for reuse. The pharmacy provider <br/>
<a id="pl.97.9"></a><var>97.9</var>will be required to credit the department for the actual acquisition cost of all unused <br/>
<a id="pl.97.10"></a><var>97.10</var>drugs that are eligible for reuse. Over-the-counter medications must be dispensed in the <br/>
<a id="pl.97.11"></a><var>97.11</var>manufacturer's unopened package. The commissioner may permit the drug clozapine to be <br/>
<a id="pl.97.12"></a><var>97.12</var>dispensed in a quantity that is less than a 30-day supply.<br/>
<a id="pl.97.13"></a><var>97.13</var>    (c) Whenever a generically equivalent product is available, payment shall be on the <br/>
<a id="pl.97.14"></a><var>97.14</var>basis of the actual acquisition cost of the generic drug, or on the maximum allowable cost <br/>
<a id="pl.97.15"></a><var>97.15</var>established by the commissioner.<br/>
<a id="pl.97.16"></a><var>97.16</var>    (d) The basis for determining the amount of payment for drugs administered in an <br/>
<a id="pl.97.17"></a><var>97.17</var>outpatient setting shall be the lower of the usual and customary cost submitted by the <br/>
<a id="pl.97.18"></a><var>97.18</var>provider or the amount established for Medicare by the United States Department of <br/>
<a id="pl.97.19"></a><var>97.19</var>Health and Human Services pursuant to title XVIII, section 1847a of the federal Social <br/>
<a id="pl.97.20"></a><var>97.20</var>Security Act.<br/>
<a id="pl.97.21"></a><var>97.21</var>    (e) The commissioner may negotiate lower reimbursement rates for specialty <br/>
<a id="pl.97.22"></a><var>97.22</var>pharmacy products than the rates specified in paragraph (a). The commissioner may <br/>
<a id="pl.97.23"></a><var>97.23</var>require individuals enrolled in the health care programs administered by the department <br/>
<a id="pl.97.24"></a><var>97.24</var>to obtain specialty pharmacy products from providers with whom the commissioner has <br/>
<a id="pl.97.25"></a><var>97.25</var>negotiated lower reimbursement rates. Specialty pharmacy products are defined as those <br/>
<a id="pl.97.26"></a><var>97.26</var>used by a small number of recipients or recipients with complex and chronic diseases <br/>
<a id="pl.97.27"></a><var>97.27</var>that require expensive and challenging drug regimens. Examples of these conditions <br/>
<a id="pl.97.28"></a><var>97.28</var>include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis <br/>
<a id="pl.97.29"></a><var>97.29</var>C, growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms <br/>
<a id="pl.97.30"></a><var>97.30</var>of cancer. Specialty pharmaceutical products include injectable and infusion therapies, <br/>
<a id="pl.97.31"></a><var>97.31</var>biotechnology drugs, high-cost therapies, and therapies that require complex care. The <br/>
<a id="pl.97.32"></a><var>97.32</var>commissioner shall consult with the formulary committee to develop a list of specialty <br/>
<a id="pl.97.33"></a><var>97.33</var>pharmacy products subject to this paragraph. In consulting with the formulary committee <br/>
<a id="pl.97.34"></a><var>97.34</var>in developing this list, the commissioner shall take into consideration the population <br/>
<a id="pl.97.35"></a><var>97.35</var>served by specialty pharmacy products, the current delivery system and standard of care in <br/>
<a id="pl.98.1"></a><var>98.1</var>the state, and access to care issues. The commissioner shall have the discretion to adjust <br/>
<a id="pl.98.2"></a><var>98.2</var>the reimbursement rate to prevent access to care issues.<br/>
<br/>
<a id="bill.5.31.0"></a><a id="pl.98.3"></a><var>98.3</var>    Sec. 31. Minnesota Statutes 2008, section 256B.0625, subdivision 13h, is amended to <br/>
<a id="pl.98.4"></a><var>98.4</var>read:<br/>
<a id="pl.98.5"></a><var>98.5</var>    Subd. 13h.  <b>Medication therapy management services.</b> (a) Medical assistance <br/>
<a id="pl.98.6"></a><var>98.6</var>and general assistance medical care cover medication therapy management services for <br/>
<a id="pl.98.7"></a><var>98.7</var>a recipient taking four or more prescriptions to treat or prevent two or more chronic <br/>
<a id="pl.98.8"></a><var>98.8</var>medical conditions, or a recipient with a drug therapy problem that is identified or prior <br/>
<a id="pl.98.9"></a><var>98.9</var>authorized by the commissioner that has resulted or is likely to result in significant <br/>
<a id="pl.98.10"></a><var>98.10</var>nondrug program costs. The commissioner may cover medical therapy management <br/>
<a id="pl.98.11"></a><var>98.11</var>services under MinnesotaCare if the commissioner determines this is cost-effective. For <br/>
<a id="pl.98.12"></a><var>98.12</var>purposes of this subdivision, "medication therapy management" means the provision <br/>
<a id="pl.98.13"></a><var>98.13</var>of the following pharmaceutical care services by a licensed pharmacist to optimize the <br/>
<a id="pl.98.14"></a><var>98.14</var>therapeutic outcomes of the patient's medications: <br/>
<a id="pl.98.15"></a><var>98.15</var>    (1) performing or obtaining necessary assessments of the patient's health status; <br/>
<a id="pl.98.16"></a><var>98.16</var>    (2) formulating a medication treatment plan; <br/>
<a id="pl.98.17"></a><var>98.17</var>    (3) monitoring and evaluating the patient's response to therapy, including safety <br/>
<a id="pl.98.18"></a><var>98.18</var>and effectiveness; <br/>
<a id="pl.98.19"></a><var>98.19</var>    (4) performing a comprehensive medication review to identify, resolve, and prevent <br/>
<a id="pl.98.20"></a><var>98.20</var>medication-related problems, including adverse drug events; <br/>
<a id="pl.98.21"></a><var>98.21</var>    (5) documenting the care delivered and communicating essential information to <br/>
<a id="pl.98.22"></a><var>98.22</var>the patient's other primary care providers; <br/>
<a id="pl.98.23"></a><var>98.23</var>    (6) providing verbal education and training designed to enhance patient <br/>
<a id="pl.98.24"></a><var>98.24</var>understanding and appropriate use of the patient's medications; <br/>
<a id="pl.98.25"></a><var>98.25</var>    (7) providing information, support services, and resources designed to enhance <br/>
<a id="pl.98.26"></a><var>98.26</var>patient adherence with the patient's therapeutic regimens; and <br/>
<a id="pl.98.27"></a><var>98.27</var>    (8) coordinating and integrating medication therapy management services within the <br/>
<a id="pl.98.28"></a><var>98.28</var>broader health care management services being provided to the patient. <br/>
<a id="pl.98.29"></a><var>98.29</var>Nothing in this subdivision shall be construed to expand or modify the scope of practice of <br/>
<a id="pl.98.30"></a><var>98.30</var>the pharmacist as defined in section 
         <statute_ref>151.01, subdivision 27</statute_ref>. <br/>
<a id="pl.98.31"></a><var>98.31</var>    (b) To be eligible for reimbursement for services under this subdivision, a pharmacist <br/>
<a id="pl.98.32"></a><var>98.32</var>must meet the following requirements: <br/>
<a id="pl.98.33"></a><var>98.33</var>    (1) have a valid license issued under chapter 151; <br/>
<a id="pl.98.34"></a><var>98.34</var>    (2) have graduated from an accredited college of pharmacy on or after May 1996, or <br/>
<a id="pl.98.35"></a><var>98.35</var>completed a structured and comprehensive education program approved by the Board of <br/>
<a id="pl.99.1"></a><var>99.1</var>Pharmacy and the American Council of Pharmaceutical Education for the provision and <br/>
<a id="pl.99.2"></a><var>99.2</var>documentation of pharmaceutical care management services that has both clinical and <br/>
<a id="pl.99.3"></a><var>99.3</var>didactic elements; <br/>
<a id="pl.99.4"></a><var>99.4</var>    (3) be practicing in an ambulatory care setting as part of a multidisciplinary team or <br/>
<a id="pl.99.5"></a><var>99.5</var>have developed a structured patient care process that is offered in a private or semiprivate <br/>
<a id="pl.99.6"></a><var>99.6</var>patient care area that is separate from the commercial business that also occurs in the <br/>
<a id="pl.99.7"></a><var>99.7</var>setting, or in home settings, excluding long-term care and group homes, if the service is <br/>
<a id="pl.99.8"></a><var>99.8</var>ordered by the provider-directed care coordination team; and <br/>
<a id="pl.99.9"></a><var>99.9</var>    (4) make use of an electronic patient record system that meets state standards. <br/>
<a id="pl.99.10"></a><var>99.10</var>    (c) For purposes of reimbursement for medication therapy management services, <br/>
<a id="pl.99.11"></a><var>99.11</var>the commissioner may enroll individual pharmacists as medical assistance and general <br/>
<a id="pl.99.12"></a><var>99.12</var>assistance medical care providers. The commissioner may also establish contact <br/>
<a id="pl.99.13"></a><var>99.13</var>requirements between the pharmacist and recipient, including limiting the number of <br/>
<a id="pl.99.14"></a><var>99.14</var>reimbursable consultations per recipient. <br/>
<a id="pl.99.15"></a><var>99.15</var>    (d) The commissioner, after receiving recommendations from professional medical <br/>
<a id="pl.99.16"></a><var>99.16</var>associations, professional pharmacy associations, and consumer groups, shall convene <br/>
<a id="pl.99.17"></a><var>99.17</var>an 11-member Medication Therapy Management Advisory Committee to advise <br/>
<a id="pl.99.18"></a><var>99.18</var>the commissioner on the implementation and administration of medication therapy <br/>
<a id="pl.99.19"></a><var>99.19</var>management services. The committee shall be comprised of: two licensed physicians; <br/>
<a id="pl.99.20"></a><var>99.20</var>two licensed pharmacists; two consumer representatives; two health plan company <br/>
<a id="pl.99.21"></a><var>99.21</var>representatives; and three members with expertise in the area of medication therapy <br/>
<a id="pl.99.22"></a><var>99.22</var>management, who may be licensed physicians or licensed pharmacists. The committee is <br/>
<a id="pl.99.23"></a><var>99.23</var>governed by section 
<statute_ref>15.059</statute_ref>, except that committee members do not receive compensation <br/>
<a id="pl.99.24"></a><var>99.24</var>or reimbursement for expenses. The advisory committee expires on June 30, 2007. <br/>
<a id="pl.99.25"></a><var>99.25</var>    (e) The commissioner shall evaluate the effect of medication therapy management <br/>
<a id="pl.99.26"></a><var>99.26</var>on quality of care, patient outcomes, and program costs, and shall include a description <br/>
<a id="pl.99.27"></a><var>99.27</var>of any savings generated in the medical assistance and general assistance medical care <br/>
<a id="pl.99.28"></a><var>99.28</var>programs that can be attributable to this coverage. The evaluation shall be submitted to <br/>
<a id="pl.99.29"></a><var>99.29</var>the legislature by December 15, 2007. The commissioner may contract with a vendor <br/>
<a id="pl.99.30"></a><var>99.30</var>or an academic institution that has expertise in evaluating health care outcomes for the <br/>
<a id="pl.99.31"></a><var>99.31</var>purpose of completing the evaluation. <br/>
<a id="pl.99.32"></a><var>99.32</var>(d) The commissioner shall establish a pilot project for an intensive medication <br/>
<a id="pl.99.33"></a><var>99.33</var>therapy management program for patients identified by the commissioner with multiple <br/>
<a id="pl.99.34"></a><var>99.34</var>chronic conditions and a high number of medications who are at high risk of preventable <br/>
<a id="pl.99.35"></a><var>99.35</var>hospitalizations, emergency room use, medication complications, and suboptimal <br/>
<a id="pl.99.36"></a><var>99.36</var>treatment outcomes due to medication-related problems. For purposes of the pilot <br/>
<a id="pl.100.1"></a><var>100.1</var>project, medication therapy management services may be provided in a patient's home <br/>
<a id="pl.100.2"></a><var>100.2</var>or community setting, in addition to other authorized settings. The commissioner may <br/>
<a id="pl.100.3"></a><var>100.3</var>waive existing payment policies and establish special payment rates for the pilot project. <br/>
<a id="pl.100.4"></a><var>100.4</var>The pilot project must be designed to produce a net savings to the state compared to the <br/>
<a id="pl.100.5"></a><var>100.5</var>estimated costs that would otherwise be incurred for similar patients without the program.<br/>
<br/>
<a id="bill.5.32.0"></a><a id="pl.100.6"></a><var>100.6</var>    Sec. 32. Minnesota Statutes 2008, section 256B.0625, subdivision 17, is amended to <br/>
<a id="pl.100.7"></a><var>100.7</var>read:<br/>
<a id="pl.100.8"></a><var>100.8</var>    Subd. 17. <b>Transportation costs.</b> (a) Medical assistance covers medical <br/>
<a id="pl.100.9"></a><var>100.9</var>transportation costs incurred solely for obtaining emergency medical care or transportation <br/>
<a id="pl.100.10"></a><var>100.10</var>costs incurred by eligible persons in obtaining emergency or nonemergency medical <br/>
<a id="pl.100.11"></a><var>100.11</var>care when paid directly to an ambulance company, common carrier, or other recognized <br/>
<a id="pl.100.12"></a><var>100.12</var>providers of transportation services. Medical transportation must be provided by:<br/>
<a id="pl.100.13"></a><var>100.13</var>(1) an ambulance, as defined in section 144E.001, subdivision 2;<br/>
<a id="pl.100.14"></a><var>100.14</var>(2) special transportation; or<br/>
<a id="pl.100.15"></a><var>100.15</var>(3) common carrier including, but not limited to, bus, taxicab, other commercial <br/>
<a id="pl.100.16"></a><var>100.16</var>carrier, or private automobile.<br/>
<a id="pl.100.17"></a><var>100.17</var>(b) Medical assistance covers special transportation, as defined in Minnesota Rules, <br/>
<a id="pl.100.18"></a><var>100.18</var>part 9505.0315, subpart 1, item F, if the recipient has a physical or mental impairment that <br/>
<a id="pl.100.19"></a><var>100.19</var>would prohibit the recipient from safely accessing and using a bus, taxi, other commercial <br/>
<a id="pl.100.20"></a><var>100.20</var>transportation, or private automobile.<br/>
<a id="pl.100.21"></a><var>100.21</var>The commissioner may use an order by the recipient's attending physician to certify that <br/>
<a id="pl.100.22"></a><var>100.22</var>the recipient requires special transportation services. Special transportation includes <br/>
<a id="pl.100.23"></a><var>100.23</var>providers shall perform driver-assisted service to services for eligible individuals. <br/>
<a id="pl.100.24"></a><var>100.24</var>Driver-assisted service includes passenger pickup at and return to the individual's <br/>
<a id="pl.100.25"></a><var>100.25</var>residence or place of business, assistance with admittance of the individual to the medical <br/>
<a id="pl.100.26"></a><var>100.26</var>facility, and assistance in passenger securement or in securing of wheelchairs or stretchers <br/>
<a id="pl.100.27"></a><var>100.27</var>in the vehicle. Special transportation providers must obtain written documentation <br/>
<a id="pl.100.28"></a><var>100.28</var>from the health care service provider who is serving the recipient being transported, <br/>
<a id="pl.100.29"></a><var>100.29</var>identifying the time that the recipient arrived. Special transportation providers may not <br/>
<a id="pl.100.30"></a><var>100.30</var>bill for separate base rates for the continuation of a trip beyond the original destination. <br/>
<a id="pl.100.31"></a><var>100.31</var>Special transportation providers must take recipients to the nearest appropriate health <br/>
<a id="pl.100.32"></a><var>100.32</var>care provider, using the most direct route available. The maximum minimum medical <br/>
<a id="pl.100.33"></a><var>100.33</var>assistance reimbursement rates for special transportation services are:<br/>
<a id="pl.100.34"></a><var>100.34</var>(1) (i) $17 for the base rate and $1.35 per mile for special transportation services to <br/>
<a id="pl.100.35"></a><var>100.35</var>eligible persons who need a wheelchair-accessible van;<br/>
<a id="pl.101.1"></a><var>101.1</var>(2) (ii)  $11.50 for the base rate and $1.30 per mile for special transportation services <br/>
<a id="pl.101.2"></a><var>101.2</var>to eligible persons who do not need a wheelchair-accessible van; and<br/>
<a id="pl.101.3"></a><var>101.3</var>(3) (iii)  $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, <br/>
<a id="pl.101.4"></a><var>101.4</var>for special transportation services to eligible persons who need a stretcher-accessible <br/>
<a id="pl.101.5"></a><var>101.5</var>vehicle;<br/>
<a id="pl.101.6"></a><var>101.6</var>(2) the base rates for special transportation services in areas defined under RUCA <br/>
<a id="pl.101.7"></a><var>101.7</var>to be super rural shall be equal to the reimbursement rate established in clause (1) plus <br/>
<a id="pl.101.8"></a><var>101.8</var>11.3 percent; and<br/>
<a id="pl.101.9"></a><var>101.9</var>(3) for special transportation services in areas defined under RUCA to be rural <br/>
<a id="pl.101.10"></a><var>101.10</var>or super rural areas:<br/>
<a id="pl.101.11"></a><var>101.11</var>(i) for a trip equal to 17 miles or less, mileage reimbursement shall be equal to 125 <br/>
<a id="pl.101.12"></a><var>101.12</var>percent of the respective mileage rate in clause (1); and<br/>
<a id="pl.101.13"></a><var>101.13</var>(ii) for a trip between 18 and 50 miles, mileage reimbursement shall be equal to <br/>
<a id="pl.101.14"></a><var>101.14</var>112.5 percent of the respective mileage rate in clause (1).<br/>
<a id="pl.101.15"></a><var>101.15</var>(c) For purposes of reimbursement rates for special transportation services under <br/>
<a id="pl.101.16"></a><var>101.16</var>paragraph (b), the zip code of the recipient's place of residence shall determine whether <br/>
<a id="pl.101.17"></a><var>101.17</var>the urban, rural, or super rural reimbursement rate applies.<br/>
<a id="pl.101.18"></a><var>101.18</var>(d) For purposes of this subdivision, "rural urban commuting area" or "RUCA" <br/>
<a id="pl.101.19"></a><var>101.19</var>means a census-tract based classification system under which a geographical area is <br/>
<a id="pl.101.20"></a><var>101.20</var>determined to be urban, rural, or super rural.<br/>
<br/>
<a id="bill.5.33.0"></a><a id="pl.101.21"></a><var>101.21</var>    Sec. 33. Minnesota Statutes 2008, section 256B.0625, subdivision 17a, is amended to <br/>
<a id="pl.101.22"></a><var>101.22</var>read:<br/>
<a id="pl.101.23"></a><var>101.23</var>    Subd. 17a. <b>Payment for ambulance services.</b> Medical assistance covers <br/>
<a id="pl.101.24"></a><var>101.24</var>ambulance services. Providers shall bill ambulance services according to Medicare <br/>
<a id="pl.101.25"></a><var>101.25</var>criteria. Nonemergency ambulance services shall not be paid as emergencies. Effective <br/>
<a id="pl.101.26"></a><var>101.26</var>for services rendered on or after July 1, 2001, medical assistance payments for ambulance <br/>
<a id="pl.101.27"></a><var>101.27</var>services shall be paid at the Medicare reimbursement rate or at the medical assistance <br/>
<a id="pl.101.28"></a><var>101.28</var>payment rate in effect on July 1, 2000, whichever is greater.<br/>
<br/>
<a id="bill.5.34.0"></a><a id="pl.101.29"></a><var>101.29</var>    Sec. 34. Minnesota Statutes 2008, section 256B.0625, is amended by adding a <br/>
<a id="pl.101.30"></a><var>101.30</var>subdivision to read:<br/>
<a id="pl.101.31"></a><var>101.31</var>    Subd. 18b. <b>Broker dispatching prohibition.</b> The commissioner shall not use a <br/>
<a id="pl.101.32"></a><var>101.32</var>broker or coordinator for any purpose related to transportation services under subdivision <br/>
<a id="pl.101.33"></a><var>101.33</var>18.<br/>
<br/>
<a id="bill.5.35.0"></a><a id="pl.102.1"></a><var>102.1</var>    Sec. 35. Minnesota Statutes 2008, section 256B.0625, is amended by adding a <br/>
<a id="pl.102.2"></a><var>102.2</var>subdivision to read:<br/>
<a id="pl.102.3"></a><var>102.3</var>    Subd. 25a. <b>Prior authorization of diagnostic imaging services.</b> (a) Effective <br/>
<a id="pl.102.4"></a><var>102.4</var>January 1, 2010, the commissioner shall require prior authorization or decision support <br/>
<a id="pl.102.5"></a><var>102.5</var>for the ordering providers at the time the service is ordered for the following outpatient <br/>
<a id="pl.102.6"></a><var>102.6</var>diagnostic imaging services: computerized tomography (CT), magnetic resonance <br/>
<a id="pl.102.7"></a><var>102.7</var>imaging (MRI), magnetic resonance angiography (MRA), positive emission tomography <br/>
<a id="pl.102.8"></a><var>102.8</var>(PET), cardiac imaging and ultrasound diagnostic imaging.<br/>
<a id="pl.102.9"></a><var>102.9</var>(b) Prior authorization under this subdivision is not required for diagnostic imaging <br/>
<a id="pl.102.10"></a><var>102.10</var>services performed as part of a hospital emergency room visit, inpatient hospitalization, or <br/>
<a id="pl.102.11"></a><var>102.11</var>if concurrent with or on the same day as an urgent care facility visit.<br/>
<a id="pl.102.12"></a><var>102.12</var>(c) This subdivision does not apply to services provided to recipients who are <br/>
<a id="pl.102.13"></a><var>102.13</var>enrolled in Medicare, the prepaid medical assistance program, the prepaid general <br/>
<a id="pl.102.14"></a><var>102.14</var>assistance medical care program, or the MinnesotaCare program.<br/>
<a id="pl.102.15"></a><var>102.15</var>(d) The commissioner may contract with a private entity to provide the prior <br/>
<a id="pl.102.16"></a><var>102.16</var>authorization or decision support required under this subdivision. The contracting entity <br/>
<a id="pl.102.17"></a><var>102.17</var>must incorporate clinical guidelines that are based on evidence-based medical literature, if <br/>
<a id="pl.102.18"></a><var>102.18</var>available. By January 1, 2012, the contracting entity shall report to the commissioner the <br/>
<a id="pl.102.19"></a><var>102.19</var>results of prior authorization or decision support.<br/>
<br/>
<a id="bill.5.36.0"></a><a id="pl.102.20"></a><var>102.20</var>    Sec. 36. Minnesota Statutes 2008, section 256B.0625, subdivision 26, is amended to <br/>
<a id="pl.102.21"></a><var>102.21</var>read:<br/>
<a id="pl.102.22"></a><var>102.22</var>    Subd. 26. <b>Special education services.</b> (a) Medical assistance covers medical <br/>
<a id="pl.102.23"></a><var>102.23</var>services identified in a recipient's individualized education plan and covered under the <br/>
<a id="pl.102.24"></a><var>102.24</var>medical assistance state plan. Covered services include occupational therapy, physical <br/>
<a id="pl.102.25"></a><var>102.25</var>therapy, speech-language therapy, clinical psychological services, nursing services, <br/>
<a id="pl.102.26"></a><var>102.26</var>school psychological services, school social work services, personal care assistants <br/>
<a id="pl.102.27"></a><var>102.27</var>serving as management aides, assistive technology devices, transportation services, <br/>
<a id="pl.102.28"></a><var>102.28</var>health assessments, and other services covered under the medical assistance state plan. <br/>
<a id="pl.102.29"></a><var>102.29</var>Mental health services eligible for medical assistance reimbursement must be provided or <br/>
<a id="pl.102.30"></a><var>102.30</var>coordinated through a children's mental health collaborative where a collaborative exists if <br/>
<a id="pl.102.31"></a><var>102.31</var>the child is included in the collaborative operational target population. The provision or <br/>
<a id="pl.102.32"></a><var>102.32</var>coordination of services does not require that the individual education plan be developed <br/>
<a id="pl.102.33"></a><var>102.33</var>by the collaborative.<br/>
<a id="pl.102.34"></a><var>102.34</var>The services may be provided by a Minnesota school district that is enrolled as a <br/>
<a id="pl.102.35"></a><var>102.35</var>medical assistance provider or its subcontractor, and only if the services meet all the <br/>
<a id="pl.103.1"></a><var>103.1</var>requirements otherwise applicable if the service had been provided by a provider other <br/>
<a id="pl.103.2"></a><var>103.2</var>than a school district, in the following areas: medical necessity, physician's orders, <br/>
<a id="pl.103.3"></a><var>103.3</var>documentation, personnel qualifications, and prior authorization requirements. The <br/>
<a id="pl.103.4"></a><var>103.4</var>nonfederal share of costs for services provided under this subdivision is the responsibility <br/>
<a id="pl.103.5"></a><var>103.5</var>of the local school district as provided in section 
         <statute_ref>125A.74</statute_ref>. Services listed in a child's <br/>
<a id="pl.103.6"></a><var>103.6</var>individual education plan are eligible for medical assistance reimbursement only if those <br/>
<a id="pl.103.7"></a><var>103.7</var>services meet criteria for federal financial participation under the Medicaid program. <br/>
<a id="pl.103.8"></a><var>103.8</var>(b) Approval of health-related services for inclusion in the individual education plan <br/>
<a id="pl.103.9"></a><var>103.9</var>does not require prior authorization for purposes of reimbursement under this chapter. <br/>
<a id="pl.103.10"></a><var>103.10</var>The commissioner may require physician review and approval of the plan not more than <br/>
<a id="pl.103.11"></a><var>103.11</var>once annually or upon any modification of the individual education plan that reflects a <br/>
<a id="pl.103.12"></a><var>103.12</var>change in health-related services.<br/>
<a id="pl.103.13"></a><var>103.13</var>(c) Services of a speech-language pathologist provided under this section are covered <br/>
<a id="pl.103.14"></a><var>103.14</var>notwithstanding Minnesota Rules, part 9505.0390, subpart 1, item L, if the person:<br/>
<a id="pl.103.15"></a><var>103.15</var>(1) holds a masters degree in speech-language pathology;<br/>
<a id="pl.103.16"></a><var>103.16</var>(2) is licensed by the Minnesota Board of Teaching as an educational <br/>
<a id="pl.103.17"></a><var>103.17</var>speech-language pathologist; and<br/>
<a id="pl.103.18"></a><var>103.18</var>(3) either has a certificate of clinical competence from the American Speech and <br/>
<a id="pl.103.19"></a><var>103.19</var>Hearing Association, has completed the equivalent educational requirements and work <br/>
<a id="pl.103.20"></a><var>103.20</var>experience necessary for the certificate or has completed the academic program and is <br/>
<a id="pl.103.21"></a><var>103.21</var>acquiring supervised work experience to qualify for the certificate.<br/>
<a id="pl.103.22"></a><var>103.22</var>(d) Medical assistance coverage for medically necessary services provided under <br/>
<a id="pl.103.23"></a><var>103.23</var>other subdivisions in this section may not be denied solely on the basis that the same or <br/>
<a id="pl.103.24"></a><var>103.24</var>similar services are covered under this subdivision.<br/>
<a id="pl.103.25"></a><var>103.25</var>(e) The commissioner shall develop and implement package rates, bundled rates, or <br/>
<a id="pl.103.26"></a><var>103.26</var>per diem rates for special education services under which separately covered services are <br/>
<a id="pl.103.27"></a><var>103.27</var>grouped together and billed as a unit in order to reduce administrative complexity.<br/>
<a id="pl.103.28"></a><var>103.28</var>(f) The commissioner shall develop a cost-based payment structure for payment <br/>
<a id="pl.103.29"></a><var>103.29</var>of these services. The commissioner shall reimburse claims submitted based on an <br/>
<a id="pl.103.30"></a><var>103.30</var>interim rate, and shall settle at a final rate once the department has determined it. The <br/>
<a id="pl.103.31"></a><var>103.31</var>commissioner shall notify the school district of the final rate. The school district has 60 <br/>
<a id="pl.103.32"></a><var>103.32</var>days to appeal the final rate. To appeal the final rate, the school district shall file a written <br/>
<a id="pl.103.33"></a><var>103.33</var>appeal request to the commissioner within 60 days of the date the final rate determination <br/>
<a id="pl.103.34"></a><var>103.34</var>was mailed. The appeal request shall specify (1) the disputed items and (2) the name and <br/>
<a id="pl.103.35"></a><var>103.35</var>address of the person to contact regarding the appeal.<br/>
<a id="pl.104.1"></a><var>104.1</var>(g) Effective July 1, 2000, medical assistance services provided under an individual <br/>
<a id="pl.104.2"></a><var>104.2</var>education plan or an individual family service plan by local school districts shall not count <br/>
<a id="pl.104.3"></a><var>104.3</var>against medical assistance authorization thresholds for that child.<br/>
<a id="pl.104.4"></a><var>104.4</var>(h) Nursing services as defined in section 
         <statute_ref>148.171, subdivision 15</statute_ref>, and provided <br/>
<a id="pl.104.5"></a><var>104.5</var>as an individual education plan health-related service, are eligible for medical assistance <br/>
<a id="pl.104.6"></a><var>104.6</var>payment if they are otherwise a covered service under the medical assistance program. <br/>
<a id="pl.104.7"></a><var>104.7</var>Medical assistance covers the administration of prescription medications by a licensed <br/>
<a id="pl.104.8"></a><var>104.8</var>nurse who is employed by or under contract with a school district when the administration <br/>
<a id="pl.104.9"></a><var>104.9</var>of medications is identified in the child's individualized education plan. The simple <br/>
<a id="pl.104.10"></a><var>104.10</var>administration of medications alone is not covered under medical assistance when <br/>
<a id="pl.104.11"></a><var>104.11</var>administered by a provider other than a school district or when it is not identified in the <br/>
<a id="pl.104.12"></a><var>104.12</var>child's individualized education plan. <br/>
<br/>
<a id="bill.5.37.0"></a><a id="pl.104.13"></a><var>104.13</var>    Sec. 37. Minnesota Statutes 2008, section 256B.08, is amended by adding a <br/>
<a id="pl.104.14"></a><var>104.14</var>subdivision to read:<br/>
<a id="pl.104.15"></a><var>104.15</var>    Subd. 4. <b>Data from Social Security.</b> The commissioner shall accept data from the <br/>
<a id="pl.104.16"></a><var>104.16</var>Social Security Administration in accordance with United States Code, title 42, section <br/>
<a id="pl.104.17"></a><var>104.17</var>1396U-5(a).<br/>
<a id="pl.104.18"></a><var>104.18</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2010.<br/>
<br/>
<a id="bill.5.38.0"></a><a id="pl.104.19"></a><var>104.19</var>    Sec. 38. Minnesota Statutes 2008, section 256B.15, subdivision 1, is amended to read:<br/>
<a id="pl.104.20"></a><var>104.20</var>    Subdivision 1. <b>Policy and applicability.</b> (a) It is the policy of this state that <br/>
<a id="pl.104.21"></a><var>104.21</var>individuals or couples, either or both of whom participate in the medical assistance <br/>
<a id="pl.104.22"></a><var>104.22</var>program, use their own assets to pay their share of the total cost of their care during or <br/>
<a id="pl.104.23"></a><var>104.23</var>after their enrollment in the program according to applicable federal law and the laws of <br/>
<a id="pl.104.24"></a><var>104.24</var>this state. The following provisions apply:<br/>
<a id="pl.104.25"></a><var>104.25</var>    (1) subdivisions 1c to 1k shall not apply to claims arising under this section which <br/>
<a id="pl.104.26"></a><var>104.26</var>are presented under section 
         <statute_ref>525.313</statute_ref>;<br/>
<a id="pl.104.27"></a><var>104.27</var>    (2) the provisions of subdivisions 1c to 1k expanding the interests included in an <br/>
<a id="pl.104.28"></a><var>104.28</var>estate for purposes of recovery under this section give effect to the provisions of United <br/>
<a id="pl.104.29"></a><var>104.29</var>States Code, title 42, section 1396p, governing recoveries, but do not give rise to any <br/>
<a id="pl.104.30"></a><var>104.30</var>express or implied liens in favor of any other parties not named in these provisions;<br/>
<a id="pl.104.31"></a><var>104.31</var>    (3) the continuation of a recipient's life estate or joint tenancy interest in real <br/>
<a id="pl.104.32"></a><var>104.32</var>property after the recipient's death for the purpose of recovering medical assistance under <br/>
<a id="pl.104.33"></a><var>104.33</var>this section modifies common law principles holding that these interests terminate on <br/>
<a id="pl.104.34"></a><var>104.34</var>the death of the holder;<br/>
<a id="pl.105.1"></a><var>105.1</var>    (4) all laws, rules, and regulations governing or involved with a recovery of medical <br/>
<a id="pl.105.2"></a><var>105.2</var>assistance shall be liberally construed to accomplish their intended purposes;<br/>
<a id="pl.105.3"></a><var>105.3</var>    (5) a deceased recipient's life estate and joint tenancy interests continued under this <br/>
<a id="pl.105.4"></a><var>105.4</var>section shall be owned by the remaindermen or surviving joint tenants as their interests <br/>
<a id="pl.105.5"></a><var>105.5</var>may appear on the date of the recipient's death. They shall not be merged into the <br/>
<a id="pl.105.6"></a><var>105.6</var>remainder interest or the interests of the surviving joint tenants by reason of ownership. <br/>
<a id="pl.105.7"></a><var>105.7</var>They shall be subject to the provisions of this section. Any conveyance, transfer, sale, <br/>
<a id="pl.105.8"></a><var>105.8</var>assignment, or encumbrance by a remainderman, a surviving joint tenant, or their heirs, <br/>
<a id="pl.105.9"></a><var>105.9</var>successors, and assigns shall be deemed to include all of their interest in the deceased <br/>
<a id="pl.105.10"></a><var>105.10</var>recipient's life estate or joint tenancy interest continued under this section; and<br/>
<a id="pl.105.11"></a><var>105.11</var>    (6) the provisions of subdivisions 1c to 1k continuing a recipient's joint tenancy <br/>
<a id="pl.105.12"></a><var>105.12</var>interests in real property after the recipient's death do not apply to a homestead owned <br/>
<a id="pl.105.13"></a><var>105.13</var>of record, on the date the recipient dies, by the recipient and the recipient's spouse as <br/>
<a id="pl.105.14"></a><var>105.14</var>joint tenants with a right of survivorship. Homestead means the real property occupied <br/>
<a id="pl.105.15"></a><var>105.15</var>by the surviving joint tenant spouse as their sole residence on the date the recipient dies <br/>
<a id="pl.105.16"></a><var>105.16</var>and classified and taxed to the recipient and surviving joint tenant spouse as homestead <br/>
<a id="pl.105.17"></a><var>105.17</var>property for property tax purposes in the calendar year in which the recipient dies. For <br/>
<a id="pl.105.18"></a><var>105.18</var>purposes of this exemption, real property the recipient and their surviving joint tenant <br/>
<a id="pl.105.19"></a><var>105.19</var>spouse purchase solely with the proceeds from the sale of their prior homestead, own <br/>
<a id="pl.105.20"></a><var>105.20</var>of record as joint tenants, and qualify as homestead property under section 
         <statute_ref>273.124</statute_ref> in <br/>
<a id="pl.105.21"></a><var>105.21</var>the calendar year in which the recipient dies and prior to the recipient's death shall be <br/>
<a id="pl.105.22"></a><var>105.22</var>deemed to be real property classified and taxed to the recipient and their surviving joint <br/>
<a id="pl.105.23"></a><var>105.23</var>tenant spouse as homestead property in the calendar year in which the recipient dies. <br/>
<a id="pl.105.24"></a><var>105.24</var>The surviving spouse, or any person with personal knowledge of the facts, may provide <br/>
<a id="pl.105.25"></a><var>105.25</var>an affidavit describing the homestead property affected by this clause and stating facts <br/>
<a id="pl.105.26"></a><var>105.26</var>showing compliance with this clause. The affidavit shall be prima facie evidence of the <br/>
<a id="pl.105.27"></a><var>105.27</var>facts it states.<br/>
<a id="pl.105.28"></a><var>105.28</var>    (b) For purposes of this section, "medical assistance" includes the medical assistance <br/>
<a id="pl.105.29"></a><var>105.29</var>program under this chapter and the general assistance medical care program under chapter <br/>
<a id="pl.105.30"></a><var>105.30</var>256D and alternative care for nonmedical assistance recipients under section 
         <statute_ref>256B.0913</statute_ref>.<br/>
<a id="pl.105.31"></a><var>105.31</var>    (c) For purposes of this section, beginning January 1, 2010, "medical assistance" <br/>
<a id="pl.105.32"></a><var>105.32</var>does not include Medicare cost-sharing benefits in accordance with United States Code, <br/>
<a id="pl.105.33"></a><var>105.33</var>title 42, section 1396p.<br/>
<a id="pl.105.34"></a><var>105.34</var>    (d) All provisions in this subdivision, and subdivisions 1d, 1f, 1g, 1h, 1i, and 1j, <br/>
<a id="pl.105.35"></a><var>105.35</var>related to the continuation of a recipient's life estate or joint tenancy interests in real <br/>
<a id="pl.105.36"></a><var>105.36</var>property after the recipient's death for the purpose of recovering medical assistance, are <br/>
<a id="pl.106.1"></a><var>106.1</var>effective only for life estates and joint tenancy interests established on or after August 1, <br/>
<a id="pl.106.2"></a><var>106.2</var>2003. For purposes of this paragraph, medical assistance does not include alternative care.<br/>
<br/>
<a id="bill.5.39.0"></a><a id="pl.106.3"></a><var>106.3</var>    Sec. 39. Minnesota Statutes 2008, section 256B.15, subdivision 1a, is amended to read:<br/>
<a id="pl.106.4"></a><var>106.4</var>    Subd. 1a. <b>Estates subject to claims.</b> (a) If a person receives any medical assistance <br/>
<a id="pl.106.5"></a><var>106.5</var>hereunder, on the person's death, if single, or on the death of the survivor of a married <br/>
<a id="pl.106.6"></a><var>106.6</var>couple, either or both of whom received medical assistance, or as otherwise provided <br/>
<a id="pl.106.7"></a><var>106.7</var>for in this section, the total amount paid for medical assistance rendered for the person <br/>
<a id="pl.106.8"></a><var>106.8</var>and spouse shall be filed as a claim against the estate of the person or the estate of the <br/>
<a id="pl.106.9"></a><var>106.9</var>surviving spouse in the court having jurisdiction to probate the estate or to issue a decree <br/>
<a id="pl.106.10"></a><var>106.10</var>of descent according to sections 
         <statute_ref>525.31</statute_ref> to 
         <statute_ref>525.313</statute_ref>. <br/>
<a id="pl.106.11"></a><var>106.11</var>(b) For the purposes of this section, the person's estate must consist of:<br/>
<a id="pl.106.12"></a><var>106.12</var>(1) the person's probate estate;<br/>
<a id="pl.106.13"></a><var>106.13</var>(2) all of the person's interests or proceeds of those interests in real property the <br/>
<a id="pl.106.14"></a><var>106.14</var>person owned as a life tenant or as a joint tenant with a right of survivorship at the time of <br/>
<a id="pl.106.15"></a><var>106.15</var>the person's death;<br/>
<a id="pl.106.16"></a><var>106.16</var>(3) all of the person's interests or proceeds of those interests in securities the person <br/>
<a id="pl.106.17"></a><var>106.17</var>owned in beneficiary form as provided under sections 524.6-301 to 524.6-311 at the time <br/>
<a id="pl.106.18"></a><var>106.18</var>of the person's death, to the extent the interests or proceeds of those interests become part <br/>
<a id="pl.106.19"></a><var>106.19</var>of the probate estate under section 524.6-307;<br/>
<a id="pl.106.20"></a><var>106.20</var>(4) all of the person's interests in joint accounts, multiple-party accounts, and <br/>
<a id="pl.106.21"></a><var>106.21</var>pay-on-death accounts, brokerage accounts, investment accounts, or the proceeds of <br/>
<a id="pl.106.22"></a><var>106.22</var>those accounts, as provided under sections 524.6-201 to 524.6-214 at the time of the <br/>
<a id="pl.106.23"></a><var>106.23</var>person's death to the extent the interests become part of the probate estate under section <br/>
<a id="pl.106.24"></a><var>106.24</var>524.6-207; and<br/>
<a id="pl.106.25"></a><var>106.25</var>(5) assets conveyed to a survivor, heir, or assign of the person through survivorship, <br/>
<a id="pl.106.26"></a><var>106.26</var>living trust, or other arrangements.<br/>
<a id="pl.106.27"></a><var>106.27</var>(c) For the purpose of this section and recovery in a surviving spouse's estate for <br/>
<a id="pl.106.28"></a><var>106.28</var>medical assistance paid for a predeceased spouse, the estate must consist of all of the legal <br/>
<a id="pl.106.29"></a><var>106.29</var>title and interests the deceased individual's predeceased spouse had in jointly owned or <br/>
<a id="pl.106.30"></a><var>106.30</var>marital property at the time of the spouse's death, as defined in subdivision 2b, and the <br/>
<a id="pl.106.31"></a><var>106.31</var>proceeds of those interests, that passed to the deceased individual or another individual, a <br/>
<a id="pl.106.32"></a><var>106.32</var>survivor, an heir, or an assign of the predeceased spouse through a joint tenancy, tenancy <br/>
<a id="pl.106.33"></a><var>106.33</var>in common, survivorship, life estate, living trust, or other arrangement. A deceased <br/>
<a id="pl.106.34"></a><var>106.34</var>recipient who, at death, owned the property jointly with the surviving spouse shall have <br/>
<a id="pl.106.35"></a><var>106.35</var>an interest in the entire property.<br/>
<a id="pl.107.1"></a><var>107.1</var>(d) For the purpose of recovery in a single person's estate or the estate of a survivor <br/>
<a id="pl.107.2"></a><var>107.2</var>of a married couple, "other arrangement" includes any other means by which title to all or <br/>
<a id="pl.107.3"></a><var>107.3</var>any part of the jointly owned or marital property or interest passed from the predeceased <br/>
<a id="pl.107.4"></a><var>107.4</var>spouse to another including, but not limited to, transfers between spouses which are <br/>
<a id="pl.107.5"></a><var>107.5</var>permitted, prohibited, or penalized for purposes of medical assistance.<br/>
<a id="pl.107.6"></a><var>107.6</var>(e) A claim shall be filed if medical assistance was rendered for either or both <br/>
<a id="pl.107.7"></a><var>107.7</var>persons under one of the following circumstances:<br/>
<a id="pl.107.8"></a><var>107.8</var>(a) (1) the person was over 55 years of age, and received services under this chapter;<br/>
<a id="pl.107.9"></a><var>107.9</var>(b) (2) the person resided in a medical institution for six months or longer, received <br/>
<a id="pl.107.10"></a><var>107.10</var>services under this chapter, and, at the time of institutionalization or application for <br/>
<a id="pl.107.11"></a><var>107.11</var>medical assistance, whichever is later, the person could not have reasonably been expected <br/>
<a id="pl.107.12"></a><var>107.12</var>to be discharged and returned home, as certified in writing by the person's treating <br/>
<a id="pl.107.13"></a><var>107.13</var>physician. For purposes of this section only, a "medical institution" means a skilled <br/>
<a id="pl.107.14"></a><var>107.14</var>nursing facility, intermediate care facility, intermediate care facility for persons with <br/>
<a id="pl.107.15"></a><var>107.15</var>developmental disabilities, nursing facility, or inpatient hospital; or<br/>
<a id="pl.107.16"></a><var>107.16</var>(c) (3) the person received general assistance medical care services under chapter <br/>
<a id="pl.107.17"></a><var>107.17</var>256D.<br/>
<a id="pl.107.18"></a><var>107.18</var>(f) The claim shall be considered an expense of the last illness of the decedent for the <br/>
<a id="pl.107.19"></a><var>107.19</var>purpose of section 
         <statute_ref>524.3-805</statute_ref>. Notwithstanding any law or rule to the contrary, a state or <br/>
<a id="pl.107.20"></a><var>107.20</var>county agency with a claim under this section must be a creditor under section 524.6-307. <br/>
<a id="pl.107.21"></a><var>107.21</var>Any statute of limitations that purports to limit any county agency or the state agency, <br/>
<a id="pl.107.22"></a><var>107.22</var>or both, to recover for medical assistance granted hereunder shall not apply to any claim <br/>
<a id="pl.107.23"></a><var>107.23</var>made hereunder for reimbursement for any medical assistance granted hereunder. Notice <br/>
<a id="pl.107.24"></a><var>107.24</var>of the claim shall be given to all heirs and devisees of the decedent whose identity can be <br/>
<a id="pl.107.25"></a><var>107.25</var>ascertained with reasonable diligence. The notice must include procedures and instructions <br/>
<a id="pl.107.26"></a><var>107.26</var>for making an application for a hardship waiver under subdivision 5; time frames for <br/>
<a id="pl.107.27"></a><var>107.27</var>submitting an application and determination; and information regarding appeal rights and <br/>
<a id="pl.107.28"></a><var>107.28</var>procedures. Counties are entitled to one-half of the nonfederal share of medical assistance <br/>
<a id="pl.107.29"></a><var>107.29</var>collections from estates that are directly attributable to county effort. Counties are entitled <br/>
<a id="pl.107.30"></a><var>107.30</var>to ten percent of the collections for alternative care directly attributable to county effort. <br/>
<br/>
<a id="bill.5.40.0"></a><a id="pl.107.31"></a><var>107.31</var>    Sec. 40. Minnesota Statutes 2008, section 256B.15, subdivision 1h, is amended to read:<br/>
<a id="pl.107.32"></a><var>107.32</var>    Subd. 1h.  <b>Estates of specific persons receiving medical assistance.</b> (a) For <br/>
<a id="pl.107.33"></a><var>107.33</var>purposes of this section, paragraphs (b) to (k) (j) apply if a person received medical <br/>
<a id="pl.107.34"></a><var>107.34</var>assistance for which a claim may be filed under this section and died single, or the <br/>
<a id="pl.108.1"></a><var>108.1</var>surviving spouse of the couple and was not survived by any of the persons described <br/>
<a id="pl.108.2"></a><var>108.2</var>in subdivisions 3 and 4. <br/>
<a id="pl.108.3"></a><var>108.3</var>    (b) For purposes of this section, the person's estate consists of: (1) the person's <br/>
<a id="pl.108.4"></a><var>108.4</var>probate estate; (2) all of the person's interests or proceeds of those interests in real property <br/>
<a id="pl.108.5"></a><var>108.5</var>the person owned as a life tenant or as a joint tenant with a right of survivorship at the <br/>
<a id="pl.108.6"></a><var>108.6</var>time of the person's death; (3) all of the person's interests or proceeds of those interests in <br/>
<a id="pl.108.7"></a><var>108.7</var>securities the person owned in beneficiary form as provided under sections 
<statute_ref>524.6-301</statute_ref> to <br/>
<a id="pl.108.8"></a><var>108.8</var><statute_ref>524.6-311</statute_ref> at the time of the person's death, to the extent they become part of the probate <br/>
<a id="pl.108.9"></a><var>108.9</var>estate under section 
<statute_ref>524.6-307</statute_ref>; (4) all of the person's interests in joint accounts, multiple <br/>
<a id="pl.108.10"></a><var>108.10</var>party accounts, and pay on death accounts, or the proceeds of those accounts, as provided <br/>
<a id="pl.108.11"></a><var>108.11</var>under sections 
<statute_ref>524.6-201</statute_ref> to 
<statute_ref>524.6-214</statute_ref> at the time of the person's death to the extent <br/>
<a id="pl.108.12"></a><var>108.12</var>they become part of the probate estate under section 
<statute_ref>524.6-207</statute_ref>; and (5) the person's <br/>
<a id="pl.108.13"></a><var>108.13</var>legal title or interest at the time of the person's death in real property transferred under <br/>
<a id="pl.108.14"></a><var>108.14</var>a transfer on death deed under section 
<statute_ref>507.071</statute_ref>, or in the proceeds from the subsequent <br/>
<a id="pl.108.15"></a><var>108.15</var>sale of the person's interest in the real property. Notwithstanding any law or rule to the <br/>
<a id="pl.108.16"></a><var>108.16</var>contrary, a state or county agency with a claim under this section shall be a creditor under <br/>
<a id="pl.108.17"></a><var>108.17</var>section 
<statute_ref>524.6-307</statute_ref>. <br/>
<a id="pl.108.18"></a><var>108.18</var>    (c) (b) Notwithstanding any law or rule to the contrary, the person's life estate or joint <br/>
<a id="pl.108.19"></a><var>108.19</var>tenancy interest in real property not subject to a medical assistance lien under sections <br/>
<statute_ref><a id="pl.108.20"></a><var>108.20</var>514.980
         </statute_ref> to 
         <statute_ref>514.985</statute_ref> on the date of the person's death shall not end upon the person's death <br/>
<a id="pl.108.21"></a><var>108.21</var>and shall continue as provided in this subdivision. The life estate in the person's estate <br/>
<a id="pl.108.22"></a><var>108.22</var>shall be that portion of the interest in the real property subject to the life estate that is equal <br/>
<a id="pl.108.23"></a><var>108.23</var>to the life estate percentage factor for the life estate as listed in the Life Estate Mortality <br/>
<a id="pl.108.24"></a><var>108.24</var>Table of the health care program's manual for a person who was the age of the medical <br/>
<a id="pl.108.25"></a><var>108.25</var>assistance recipient on the date of the person's death. The joint tenancy interest in real <br/>
<a id="pl.108.26"></a><var>108.26</var>property in the estate shall be equal to the fractional interest the person would have owned <br/>
<a id="pl.108.27"></a><var>108.27</var>in the jointly held interest in the property had they and the other owners held title to the <br/>
<a id="pl.108.28"></a><var>108.28</var>property as tenants in common on the date the person died. <br/>
<a id="pl.108.29"></a><var>108.29</var>    (d) (c) The court upon its own motion, or upon motion by the personal representative <br/>
<a id="pl.108.30"></a><var>108.30</var>or any interested party, may enter an order directing the remaindermen or surviving joint <br/>
<a id="pl.108.31"></a><var>108.31</var>tenants and their spouses, if any, to sign all documents, take all actions, and otherwise <br/>
<a id="pl.108.32"></a><var>108.32</var>fully cooperate with the personal representative and the court to liquidate the decedent's <br/>
<a id="pl.108.33"></a><var>108.33</var>life estate or joint tenancy interests in the estate and deliver the cash or the proceeds of <br/>
<a id="pl.108.34"></a><var>108.34</var>those interests to the personal representative and provide for any legal and equitable <br/>
<a id="pl.108.35"></a><var>108.35</var>sanctions as the court deems appropriate to enforce and carry out the order, including an <br/>
<a id="pl.108.36"></a><var>108.36</var>award of reasonable attorney fees. <br/>
<a id="pl.109.1"></a><var>109.1</var>    (e) (d) The personal representative may make, execute, and deliver any conveyances <br/>
<a id="pl.109.2"></a><var>109.2</var>or other documents necessary to convey the decedent's life estate or joint tenancy interest <br/>
<a id="pl.109.3"></a><var>109.3</var>in the estate that are necessary to liquidate and reduce to cash the decedent's interest or <br/>
<a id="pl.109.4"></a><var>109.4</var>for any other purposes. <br/>
<a id="pl.109.5"></a><var>109.5</var>    (f) (e) Subject to administration, all costs, including reasonable attorney fees, <br/>
<a id="pl.109.6"></a><var>109.6</var>directly and immediately related to liquidating the decedent's life estate or joint tenancy <br/>
<a id="pl.109.7"></a><var>109.7</var>interest in the decedent's estate, shall be paid from the gross proceeds of the liquidation <br/>
<a id="pl.109.8"></a><var>109.8</var>allocable to the decedent's interest and the net proceeds shall be turned over to the personal <br/>
<a id="pl.109.9"></a><var>109.9</var>representative and applied to payment of the claim presented under this section. <br/>
<a id="pl.109.10"></a><var>109.10</var>    (g) (f) The personal representative shall bring a motion in the district court in which <br/>
<a id="pl.109.11"></a><var>109.11</var>the estate is being probated to compel the remaindermen or surviving joint tenants to <br/>
<a id="pl.109.12"></a><var>109.12</var>account for and deliver to the personal representative all or any part of the proceeds of any <br/>
<a id="pl.109.13"></a><var>109.13</var>sale, mortgage, transfer, conveyance, or any disposition of real property allocable to the <br/>
<a id="pl.109.14"></a><var>109.14</var>decedent's life estate or joint tenancy interest in the decedent's estate, and do everything <br/>
<a id="pl.109.15"></a><var>109.15</var>necessary to liquidate and reduce to cash the decedent's interest and turn the proceeds of <br/>
<a id="pl.109.16"></a><var>109.16</var>the sale or other disposition over to the personal representative. The court may grant any <br/>
<a id="pl.109.17"></a><var>109.17</var>legal or equitable relief including, but not limited to, ordering a partition of real estate <br/>
<a id="pl.109.18"></a><var>109.18</var>under chapter 558 necessary to make the value of the decedent's life estate or joint tenancy <br/>
<a id="pl.109.19"></a><var>109.19</var>interest available to the estate for payment of a claim under this section. <br/>
<a id="pl.109.20"></a><var>109.20</var>    (h) (g) Subject to administration, the personal representative shall use all of the cash <br/>
<a id="pl.109.21"></a><var>109.21</var>or proceeds of interests to pay an allowable claim under this section. The remaindermen <br/>
<a id="pl.109.22"></a><var>109.22</var>or surviving joint tenants and their spouses, if any, may enter into a written agreement <br/>
<a id="pl.109.23"></a><var>109.23</var>with the personal representative or the claimant to settle and satisfy obligations imposed at <br/>
<a id="pl.109.24"></a><var>109.24</var>any time before or after a claim is filed. <br/>
<a id="pl.109.25"></a><var>109.25</var>    (i) (h) The personal representative may, at their discretion, provide any or all of the <br/>
<a id="pl.109.26"></a><var>109.26</var>other owners, remaindermen, or surviving joint tenants with an affidavit terminating the <br/>
<a id="pl.109.27"></a><var>109.27</var>decedent's estate's interest in real property the decedent owned as a life tenant or as a joint <br/>
<a id="pl.109.28"></a><var>109.28</var>tenant with others, if the personal representative determines in good faith that neither the <br/>
<a id="pl.109.29"></a><var>109.29</var>decedent nor any of the decedent's predeceased spouses received any medical assistance <br/>
<a id="pl.109.30"></a><var>109.30</var>for which a claim could be filed under this section, or if the personal representative has <br/>
<a id="pl.109.31"></a><var>109.31</var>filed an affidavit with the court that the estate has other assets sufficient to pay a claim, as <br/>
<a id="pl.109.32"></a><var>109.32</var>presented, or if there is a written agreement under paragraph (h) (g), or if the claim, as <br/>
<a id="pl.109.33"></a><var>109.33</var>allowed, has been paid in full or to the full extent of the assets the estate has available <br/>
<a id="pl.109.34"></a><var>109.34</var>to pay it. The affidavit may be recorded in the office of the county recorder or filed in <br/>
<a id="pl.109.35"></a><var>109.35</var>the Office of the Registrar of Titles for the county in which the real property is located. <br/>
<a id="pl.109.36"></a><var>109.36</var>Except as provided in section 
         <statute_ref>514.981, subdivision 6</statute_ref>, when recorded or filed, the affidavit <br/>
<a id="pl.110.1"></a><var>110.1</var>shall terminate the decedent's interest in real estate the decedent owned as a life tenant or a <br/>
<a id="pl.110.2"></a><var>110.2</var>joint tenant with others. The affidavit shall:<br/>
<a id="pl.110.3"></a><var>110.3</var>(1) be signed by the personal representative;<br/>
<a id="pl.110.4"></a><var>110.4</var>(2) identify the decedent and the interest being terminated;<br/>
<a id="pl.110.5"></a><var>110.5</var>(3) give recording information sufficient to identify the instrument that created the <br/>
<a id="pl.110.6"></a><var>110.6</var>interest in real property being terminated;<br/>
<a id="pl.110.7"></a><var>110.7</var>(4) legally describe the affected real property;<br/>
<a id="pl.110.8"></a><var>110.8</var>(5) state that the personal representative has determined that neither the decedent <br/>
<a id="pl.110.9"></a><var>110.9</var>nor any of the decedent's predeceased spouses received any medical assistance for which <br/>
<a id="pl.110.10"></a><var>110.10</var>a claim could be filed under this section;<br/>
<a id="pl.110.11"></a><var>110.11</var>(6) state that the decedent's estate has other assets sufficient to pay the claim, as <br/>
<a id="pl.110.12"></a><var>110.12</var>presented, or that there is a written agreement between the personal representative and <br/>
<a id="pl.110.13"></a><var>110.13</var>the claimant and the other owners or remaindermen or other joint tenants to satisfy the <br/>
<a id="pl.110.14"></a><var>110.14</var>obligations imposed under this subdivision; and<br/>
<a id="pl.110.15"></a><var>110.15</var>(7) state that the affidavit is being given to terminate the estate's interest under this <br/>
<a id="pl.110.16"></a><var>110.16</var>subdivision, and any other contents as may be appropriate.<br/>
<a id="pl.110.17"></a><var>110.17</var>The recorder or registrar of titles shall accept the affidavit for recording or filing. The <br/>
<a id="pl.110.18"></a><var>110.18</var>affidavit shall be effective as provided in this section and shall constitute notice even if it <br/>
<a id="pl.110.19"></a><var>110.19</var>does not include recording information sufficient to identify the instrument creating the <br/>
<a id="pl.110.20"></a><var>110.20</var>interest it terminates. The affidavit shall be conclusive evidence of the stated facts. <br/>
<a id="pl.110.21"></a><var>110.21</var>    (j) (i) The holder of a lien arising under subdivision 1c shall release the lien at <br/>
<a id="pl.110.22"></a><var>110.22</var>the holder's expense against an interest terminated under paragraph (h) (g) to the extent <br/>
<a id="pl.110.23"></a><var>110.23</var>of the termination. <br/>
<a id="pl.110.24"></a><var>110.24</var>    (k) (j) If a lien arising under subdivision 1c is not released under paragraph (j) (i), <br/>
<a id="pl.110.25"></a><var>110.25</var>prior to closing the estate, the personal representative shall deed the interest subject to the <br/>
<a id="pl.110.26"></a><var>110.26</var>lien to the remaindermen or surviving joint tenants as their interests may appear. Upon <br/>
<a id="pl.110.27"></a><var>110.27</var>recording or filing, the deed shall work a merger of the recipient's life estate or joint <br/>
<a id="pl.110.28"></a><var>110.28</var>tenancy interest, subject to the lien, into the remainder interest or interest the decedent and <br/>
<a id="pl.110.29"></a><var>110.29</var>others owned jointly. The lien shall attach to and run with the property to the extent of <br/>
<a id="pl.110.30"></a><var>110.30</var>the decedent's interest at the time of the decedent's death. <br/>
<br/>
<a id="bill.5.41.0"></a><a id="pl.110.31"></a><var>110.31</var>    Sec. 41. Minnesota Statutes 2008, section 256B.15, subdivision 2, is amended to read:<br/>
<a id="pl.110.32"></a><var>110.32</var>    Subd. 2. <b>Limitations on claims.</b> The claim shall include only the total amount <br/>
<a id="pl.110.33"></a><var>110.33</var>of medical assistance rendered after age 55 or during a period of institutionalization <br/>
<a id="pl.110.34"></a><var>110.34</var>described in subdivision 1a, clause (b) paragraph (e), and the total amount of general <br/>
<a id="pl.110.35"></a><var>110.35</var>assistance medical care rendered, and shall not include interest. Claims that have been <br/>
<a id="pl.111.1"></a><var>111.1</var>allowed but not paid shall bear interest according to section 
         <statute_ref>524.3-806, paragraph (d)</statute_ref>. A <br/>
<a id="pl.111.2"></a><var>111.2</var>claim against the estate of a surviving spouse who did not receive medical assistance, for <br/>
<a id="pl.111.3"></a><var>111.3</var>medical assistance rendered for the predeceased spouse, shall be payable from the full <br/>
<a id="pl.111.4"></a><var>111.4</var>value of all of the predeceased spouse's assets and interests which are part of the surviving <br/>
<a id="pl.111.5"></a><var>111.5</var>spouse's estate under subdivisions 1a and 2b. Recovery of medical assistance expenses in <br/>
<a id="pl.111.6"></a><var>111.6</var>the nonrecipient surviving spouse's estate is limited to the value of the assets of the estate <br/>
<a id="pl.111.7"></a><var>111.7</var>that were marital property or jointly owned property at any time during the marriage. The <br/>
<a id="pl.111.8"></a><var>111.8</var>claim is not payable from the value of assets or proceeds of assets in the estate attributable <br/>
<a id="pl.111.9"></a><var>111.9</var>to a predeceased spouse whom the individual married after the death of the predeceased <br/>
<a id="pl.111.10"></a><var>111.10</var>recipient spouse for whom the claim is filed or from assets and the proceeds of assets in the <br/>
<a id="pl.111.11"></a><var>111.11</var>estate which the nonrecipient decedent spouse acquired with assets which were not marital <br/>
<a id="pl.111.12"></a><var>111.12</var>property or jointly owned property after the death of the predeceased recipient spouse. <br/>
<a id="pl.111.13"></a><var>111.13</var>Claims for alternative care shall be net of all premiums paid under section 
         <statute_ref>256B.0913, <br/>
<a id="pl.111.14"></a><var>111.14</var>subdivision 12
         </statute_ref>, on or after July 1, 2003, and shall be limited to services provided on or <br/>
<a id="pl.111.15"></a><var>111.15</var>after July 1, 2003. Claims against marital property shall be limited to claims against <br/>
<a id="pl.111.16"></a><var>111.16</var>recipients who died on or after July 1, 2009.<br/>
<br/>
<a id="bill.5.42.0"></a><a id="pl.111.17"></a><var>111.17</var>    Sec. 42. Minnesota Statutes 2008, section 256B.15, is amended by adding a <br/>
<a id="pl.111.18"></a><var>111.18</var>subdivision to read:<br/>
<a id="pl.111.19"></a><var>111.19</var>    Subd. 2b. <b>Controlling provisions.</b> (a) For purposes of this subdivision and <br/>
<a id="pl.111.20"></a><var>111.20</var>subdivisions 1a and 2, paragraphs (b) to (d) apply.<br/>
<a id="pl.111.21"></a><var>111.21</var>(b) At the time of death of a recipient spouse and solely for purpose of recovery of <br/>
<a id="pl.111.22"></a><var>111.22</var>medical assistance benefits received, a predeceased recipient spouse shall have a legal <br/>
<a id="pl.111.23"></a><var>111.23</var>title or interest in the undivided whole of all of the property which the recipient and the <br/>
<a id="pl.111.24"></a><var>111.24</var>recipient's surviving spouse owned jointly or which was marital property at any time <br/>
<a id="pl.111.25"></a><var>111.25</var>during their marriage regardless of the form of ownership and regardless of whether <br/>
<a id="pl.111.26"></a><var>111.26</var>it was owned or titled in the names of one or both the recipient and the recipient's <br/>
<a id="pl.111.27"></a><var>111.27</var>spouse. Title and interest in the property of a predeceased recipient spouse shall not end <br/>
<a id="pl.111.28"></a><var>111.28</var>or extinguish upon the person's death and shall continue for the purpose of allowing <br/>
<a id="pl.111.29"></a><var>111.29</var>recovery of medical assistance in the estate of the surviving spouse. Upon the death of <br/>
<a id="pl.111.30"></a><var>111.30</var>the predeceased recipient spouse, title and interest in the predeceased spouse's property <br/>
<a id="pl.111.31"></a><var>111.31</var>shall vest in the surviving spouse by operation of law and without the necessity for any <br/>
<a id="pl.111.32"></a><var>111.32</var>probate or decree of descent proceedings and shall continue to exist after the death of the <br/>
<a id="pl.111.33"></a><var>111.33</var>predeceased spouse and the surviving spouse to permit recovery of medical assistance. <br/>
<a id="pl.111.34"></a><var>111.34</var>The recipient spouse and the surviving spouse of a deceased recipient spouse shall not <br/>
<a id="pl.112.1"></a><var>112.1</var>encumber, disclaim, transfer, alienate, hypothecate, or otherwise divest themselves of <br/>
<a id="pl.112.2"></a><var>112.2</var>these interests before or upon death.<br/>
<a id="pl.112.3"></a><var>112.3</var>(c) For purposes of this section, "marital property" includes any and all real or <br/>
<a id="pl.112.4"></a><var>112.4</var>personal property of any kind or interests in such property the predeceased recipient <br/>
<a id="pl.112.5"></a><var>112.5</var>spouse and their spouse, or either of them, owned at the time of their marriage to each <br/>
<a id="pl.112.6"></a><var>112.6</var>other or acquired during their marriage regardless of whether it was owned or titled in <br/>
<a id="pl.112.7"></a><var>112.7</var>the names of one or both of them. If either or both spouses of a married couple received <br/>
<a id="pl.112.8"></a><var>112.8</var>medical assistance, all property owned during the marriage or which either or both spouses <br/>
<a id="pl.112.9"></a><var>112.9</var>acquired during their marriage shall be presumed to be marital property for purposes of <br/>
<a id="pl.112.10"></a><var>112.10</var>recovering medical assistance unless there is clear and convincing evidence to the contrary.<br/>
<a id="pl.112.11"></a><var>112.11</var>(d) The agency responsible for the claim for medical assistance for a recipient spouse <br/>
<a id="pl.112.12"></a><var>112.12</var>may, at its discretion, release specific real and personal property from the provisions of <br/>
<a id="pl.112.13"></a><var>112.13</var>this section. The release shall extinguish the interest created under paragraph (b) in the <br/>
<a id="pl.112.14"></a><var>112.14</var>land it describes upon filing or recording. The release need not be attested, certified, or <br/>
<a id="pl.112.15"></a><var>112.15</var>acknowledged as a condition of filing or recording and shall be filed or recorded in the <br/>
<a id="pl.112.16"></a><var>112.16</var>office of the county recorder or registrar of titles, as appropriate, in the county where the <br/>
<a id="pl.112.17"></a><var>112.17</var>real property is located. The party to whom the release is given shall be responsible for <br/>
<a id="pl.112.18"></a><var>112.18</var>paying all fees and costs necessary to record and file the release. If the property described <br/>
<a id="pl.112.19"></a><var>112.19</var>in the release is registered property, the registrar of titles shall accept it for recording and <br/>
<a id="pl.112.20"></a><var>112.20</var>shall record it on the certificate of title for each parcel of property described in the release. <br/>
<a id="pl.112.21"></a><var>112.21</var>If the property described in the release is abstract property, the recorder shall accept it <br/>
<a id="pl.112.22"></a><var>112.22</var>for filing and file it in the county's grantor-grantee indexes and any tract index the county <br/>
<a id="pl.112.23"></a><var>112.23</var>maintains for each parcel of property described in the release.<br/>
<br/>
<a id="bill.5.43.0"></a><a id="pl.112.24"></a><var>112.24</var>    Sec. 43. Minnesota Statutes 2008, section 256B.15, is amended by adding a <br/>
<a id="pl.112.25"></a><var>112.25</var>subdivision to read:<br/>
<a id="pl.112.26"></a><var>112.26</var>    Subd. 9. <b>Commissioner's intervention.</b> The commissioner shall be permitted to <br/>
<a id="pl.112.27"></a><var>112.27</var>intervene as a party in any proceeding involving recovery of medical assistance upon <br/>
<a id="pl.112.28"></a><var>112.28</var>filing a notice of intervention and serving such notice on the other parties.<br/>
<br/>
<a id="bill.5.44.0"></a><a id="pl.112.29"></a><var>112.29</var>    Sec. 44. <b>[256B.196] INTERGOVERNMENTAL TRANSFERS; HOSPITAL </b><br/>
<a id="pl.112.30"></a><var>112.30</var><b>PAYMENTS.</b><br/>
<a id="pl.112.31"></a><var>112.31</var>    Subdivision 1. <b>Federal approval required.</b> This section is contingent on federal <br/>
<a id="pl.112.32"></a><var>112.32</var>approval of the intergovernmental transfers and payments authorized under this section. <br/>
<a id="pl.112.33"></a><var>112.33</var>This section is also contingent on current payment by the government entities of the <br/>
<a id="pl.112.34"></a><var>112.34</var>intergovernmental transfers under this section.<br/>
<a id="pl.113.1"></a><var>113.1</var>    Subd. 2. <b>Commissioner's duties.</b> (a) For the purposes of this subdivision and <br/>
<a id="pl.113.2"></a><var>113.2</var>subdivision 3, the commissioner shall determine the fee-for-service outpatient hospital <br/>
<a id="pl.113.3"></a><var>113.3</var>services upper payment limit for nonstate government hospitals. The commissioner shall <br/>
<a id="pl.113.4"></a><var>113.4</var>then determine the amount of a supplemental payment to Hennepin County Medical <br/>
<a id="pl.113.5"></a><var>113.5</var>Center and Regions Hospital for these services that would increase medical assistance <br/>
<a id="pl.113.6"></a><var>113.6</var>spending in this category to the aggregate upper payment limit for all nonstate government <br/>
<a id="pl.113.7"></a><var>113.7</var>hospitals in Minnesota. In making this determination, the commissioner shall allot the <br/>
<a id="pl.113.8"></a><var>113.8</var>available increases between Hennepin County Medical Center and Regions Hospital <br/>
<a id="pl.113.9"></a><var>113.9</var>based on the ratio of medical assistance fee-for-service outpatient hospital payments to <br/>
<a id="pl.113.10"></a><var>113.10</var>the two facilities. The commissioner shall adjust this allotment as necessary based on <br/>
<a id="pl.113.11"></a><var>113.11</var>federal approvals, the amount of intergovernmental transfers received from Hennepin and <br/>
<a id="pl.113.12"></a><var>113.12</var>Ramsey Counties, and other factors, in order to maximize the additional total payments. <br/>
<a id="pl.113.13"></a><var>113.13</var>The commissioner shall inform Hennepin County and Ramsey County of the periodic <br/>
<a id="pl.113.14"></a><var>113.14</var>intergovernmental transfers necessary to match federal Medicaid payments available <br/>
<a id="pl.113.15"></a><var>113.15</var>under this subdivision in order to make supplementary medical assistance payments to <br/>
<a id="pl.113.16"></a><var>113.16</var>Hennepin County Medical Center and Regions Hospital equal to an amount that when <br/>
<a id="pl.113.17"></a><var>113.17</var>combined with existing medical assistance payments to nonstate governmental hospitals <br/>
<a id="pl.113.18"></a><var>113.18</var>would increase total payments to hospitals in this category for outpatient services to <br/>
<a id="pl.113.19"></a><var>113.19</var>the aggregate upper payment limit for all hospitals in this category in Minnesota. Upon <br/>
<a id="pl.113.20"></a><var>113.20</var>receipt of these periodic transfers, the commissioner shall make supplementary payments <br/>
<a id="pl.113.21"></a><var>113.21</var>to Hennepin County Medical Center and Regions Hospital.<br/>
<a id="pl.113.22"></a><var>113.22</var>(b) For the purposes of this subdivision and subdivision 3, the commissioner shall <br/>
<a id="pl.113.23"></a><var>113.23</var>determine an upper payment limit for physicians affiliated with Hennepin County Medical <br/>
<a id="pl.113.24"></a><var>113.24</var>Center and with Regions Hospital. The upper payment limit shall be based on the average <br/>
<a id="pl.113.25"></a><var>113.25</var>commercial rate or be determined using another method acceptable to the Centers for <br/>
<a id="pl.113.26"></a><var>113.26</var>Medicare and Medicaid Services. The commissioner shall inform Hennepin County and <br/>
<a id="pl.113.27"></a><var>113.27</var>Ramsey County of the periodic intergovernmental transfers necessary to match the federal <br/>
<a id="pl.113.28"></a><var>113.28</var>Medicaid payments available under this subdivision in order to make supplementary <br/>
<a id="pl.113.29"></a><var>113.29</var>payments to physicians affiliated with Hennepin County Medical Center and Regions <br/>
<a id="pl.113.30"></a><var>113.30</var>Hospital equal to the difference between the established medical assistance payment for <br/>
<a id="pl.113.31"></a><var>113.31</var>physician services and the upper payment limit. Upon receipt of these periodic transfers, <br/>
<a id="pl.113.32"></a><var>113.32</var>the commissioner shall make supplementary payments to physicians of Hennepin Faculty <br/>
<a id="pl.113.33"></a><var>113.33</var>Associates and HealthPartners.<br/>
<a id="pl.113.34"></a><var>113.34</var>(c) Beginning January 1, 2010, Hennepin County and Ramsey County shall make <br/>
<a id="pl.113.35"></a><var>113.35</var>monthly intergovernmental transfers to the commissioner in the following amounts: <br/>
<a id="pl.113.36"></a><var>113.36</var>$133,333 by Hennepin County and $100,000 by Ramsey County. The commissioner shall <br/>
<a id="pl.114.1"></a><var>114.1</var>increase the medical assistance capitation payments to Metropolitan Health Plan and <br/>
<a id="pl.114.2"></a><var>114.2</var>HealthPartners by an amount equal to the annual value of the monthly transfers plus <br/>
<a id="pl.114.3"></a><var>114.3</var>federal financial participation.<br/>
<a id="pl.114.4"></a><var>114.4</var>(d) The commissioner shall inform Hennepin County and Ramsey County on an <br/>
<a id="pl.114.5"></a><var>114.5</var>ongoing basis of the need for any changes needed in the intergovernmental transfers <br/>
<a id="pl.114.6"></a><var>114.6</var>in order to continue the payments under paragraphs (a) to (c), at their maximum level, <br/>
<a id="pl.114.7"></a><var>114.7</var>including increases in upper payment limits, changes in the federal Medicaid match, and <br/>
<a id="pl.114.8"></a><var>114.8</var>other factors.<br/>
<a id="pl.114.9"></a><var>114.9</var>(e) The payments in paragraphs (a) to (c) shall be implemented independently of <br/>
<a id="pl.114.10"></a><var>114.10</var>each other, subject to federal approval and to the receipt of transfers under subdivision 3.<br/>
<a id="pl.114.11"></a><var>114.11</var>    Subd. 3. <b>Intergovernmental transfers.</b> Based on the determination by the <br/>
<a id="pl.114.12"></a><var>114.12</var>commissioner under subdivision 2, Hennepin County and Ramsey County shall make <br/>
<a id="pl.114.13"></a><var>114.13</var>periodic intergovernmental transfers to the commissioner for the purposes of subdivision <br/>
<a id="pl.114.14"></a><var>114.14</var>2, paragraphs (a) to (c). All of the intergovernmental transfers made by Hennepin County <br/>
<a id="pl.114.15"></a><var>114.15</var>shall be used to match federal payments to Hennepin County Medical Center under <br/>
<a id="pl.114.16"></a><var>114.16</var>subdivision 2, paragraph (a); to physicians affiliated with Hennepin Faculty Associates <br/>
<a id="pl.114.17"></a><var>114.17</var>under subdivision 2, paragraph (b); and to Metropolitan Health Plan under subdivision <br/>
<a id="pl.114.18"></a><var>114.18</var>2, paragraph (c). All of the intergovernmental transfers made by Ramsey County shall <br/>
<a id="pl.114.19"></a><var>114.19</var>be used to match federal payments to Regions Hospital under subdivision 2, paragraph <br/>
<a id="pl.114.20"></a><var>114.20</var>(a); to physicians affiliated with HealthPartners under subdivision 2, paragraph (b); and to <br/>
<a id="pl.114.21"></a><var>114.21</var>HealthPartners under subdivision 2, paragraph (c).<br/>
<a id="pl.114.22"></a><var>114.22</var>    Subd. 4. <b>Adjustments permitted.</b> (a) The commissioner may adjust the <br/>
<a id="pl.114.23"></a><var>114.23</var>intergovernmental transfers under subdivision 3 and the payments under subdivision <br/>
<a id="pl.114.24"></a><var>114.24</var>2, based on the commissioner's determination of Medicare upper payment limits, <br/>
<a id="pl.114.25"></a><var>114.25</var>hospital-specific charge limits, hospital-specific limitations on disproportionate share <br/>
<a id="pl.114.26"></a><var>114.26</var>payments, medical inflation, actuarial certification, and cost-effectiveness for purposes <br/>
<a id="pl.114.27"></a><var>114.27</var>of federal waivers. Any adjustments must be made on a proportional basis. The <br/>
<a id="pl.114.28"></a><var>114.28</var>commissioner may make adjustments under this subdivision only after consultation <br/>
<a id="pl.114.29"></a><var>114.29</var>with the affected counties and hospitals. All payments under subdivision 2 and all <br/>
<a id="pl.114.30"></a><var>114.30</var>intergovernmental transfers under subdivision 3 are limited to amounts available after all <br/>
<a id="pl.114.31"></a><var>114.31</var>other base rates, adjustments, and supplemental payments in chapter 256B are calculated.<br/>
<a id="pl.114.32"></a><var>114.32</var>(b) The ratio of medical assistance payments specified in subdivision 2 to the <br/>
<a id="pl.114.33"></a><var>114.33</var>voluntary intergovernmental transfers specified in subdivision 3 shall not be reduced <br/>
<a id="pl.114.34"></a><var>114.34</var>except as provided under paragraph (a).<br/>
<a id="pl.115.1"></a><var>115.1</var>    Subd. 5. <b>Recession period.</b> Each type of intergovernmental transfer in subdivision <br/>
<a id="pl.115.2"></a><var>115.2</var>2, paragraphs (a) to (d), for payment periods from October 1, 2008, through December <br/>
<a id="pl.115.3"></a><var>115.3</var>31, 2010, is voluntary on the part of Hennepin and Ramsey Counties, meaning that the <br/>
<a id="pl.115.4"></a><var>115.4</var>transfer must be agreed to, in writing, by the counties prior to any payments being issued. <br/>
<a id="pl.115.5"></a><var>115.5</var>One agreement on each type of transfer shall cover the entire recession period.<br/>
<br/>
<a id="bill.5.45.0"></a><a id="pl.115.6"></a><var>115.6</var>    Sec. 45. Minnesota Statutes 2008, section 256B.199, is amended to read:<br/>
<a id="pl.115.7"></a><var>115.7</var><b>256B.199 PAYMENTS REPORTED BY GOVERNMENTAL ENTITIES.</b><br/>
<a id="pl.115.8"></a><var>115.8</var>    (a) Effective July 1, 2007, the commissioner shall apply for federal matching funds <br/>
<a id="pl.115.9"></a><var>115.9</var>for the expenditures in paragraphs (b) and (c).<br/>
<a id="pl.115.10"></a><var>115.10</var>    (b) The commissioner shall apply for federal matching funds for certified public <br/>
<a id="pl.115.11"></a><var>115.11</var>expenditures as follows:<br/>
<a id="pl.115.12"></a><var>115.12</var>    (1) Hennepin County, Hennepin County Medical Center, Ramsey County, Regions <br/>
<a id="pl.115.13"></a><var>115.13</var>Hospital, the University of Minnesota, and Fairview-University Medical Center shall <br/>
<a id="pl.115.14"></a><var>115.14</var>report quarterly to the commissioner beginning June 1, 2007, payments made during the <br/>
<a id="pl.115.15"></a><var>115.15</var>second previous quarter that may qualify for reimbursement under federal law;<br/>
<a id="pl.115.16"></a><var>115.16</var>     (2) based on these reports, the commissioner shall apply for federal matching <br/>
<a id="pl.115.17"></a><var>115.17</var>funds. These funds are appropriated to the commissioner for the payments under section <br/>
<statute_ref><a id="pl.115.18"></a><var>115.18</var>256.969, subdivision 27
         </statute_ref>; and<br/>
<a id="pl.115.19"></a><var>115.19</var>     (3) by May 1 of each year, beginning May 1, 2007, the commissioner shall inform <br/>
<a id="pl.115.20"></a><var>115.20</var>the nonstate entities listed in paragraph (a) of the amount of federal disproportionate share <br/>
<a id="pl.115.21"></a><var>115.21</var>hospital payment money expected to be available in the current federal fiscal year.<br/>
<a id="pl.115.22"></a><var>115.22</var>    (c) The commissioner shall apply for federal matching funds for general assistance <br/>
<a id="pl.115.23"></a><var>115.23</var>medical care expenditures as follows:<br/>
<a id="pl.115.24"></a><var>115.24</var>    (1) for hospital services occurring on or after July 1, 2007, general assistance medical <br/>
<a id="pl.115.25"></a><var>115.25</var>care expenditures for fee-for-service inpatient and outpatient hospital payments made by <br/>
<a id="pl.115.26"></a><var>115.26</var>the department shall be used to apply for federal matching funds, except as limited below:<br/>
<a id="pl.115.27"></a><var>115.27</var>    (i) only those general assistance medical care expenditures made to an individual <br/>
<a id="pl.115.28"></a><var>115.28</var>hospital that would not cause the hospital to exceed its individual hospital limits under <br/>
<a id="pl.115.29"></a><var>115.29</var>section 1923 of the Social Security Act may be considered; and<br/>
<a id="pl.115.30"></a><var>115.30</var>    (ii) general assistance medical care expenditures may be considered only to the extent <br/>
<a id="pl.115.31"></a><var>115.31</var>of Minnesota's aggregate allotment under section 1923 of the Social Security Act; and<br/>
<a id="pl.115.32"></a><var>115.32</var>    (2) all hospitals must provide any necessary expenditure, cost, and revenue <br/>
<a id="pl.115.33"></a><var>115.33</var>information required by the commissioner as necessary for purposes of obtaining federal <br/>
<a id="pl.115.34"></a><var>115.34</var>Medicaid matching funds for general assistance medical care expenditures.<br/>
<a id="pl.116.1"></a><var>116.1</var>(d) For the period from April 1, 2009, to September 30, 2010, the commissioner shall <br/>
<a id="pl.116.2"></a><var>116.2</var>apply for additional federal matching funds available as disproportionate share hospital <br/>
<a id="pl.116.3"></a><var>116.3</var>payments under the American Recovery and Reinvestment Act of 2009. These funds shall <br/>
<a id="pl.116.4"></a><var>116.4</var>be made available as the state share of payments under section 256.969, subdivision 28. <br/>
<a id="pl.116.5"></a><var>116.5</var>The entities required to report certified public expenditures under paragraph (b), clause <br/>
<a id="pl.116.6"></a><var>116.6</var>(1), shall report additional certified public expenditures as necessary under this paragraph.<br/>
<a id="pl.116.7"></a><var>116.7</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br/>
<br/>
<a id="bill.5.46.0"></a><a id="pl.116.8"></a><var>116.8</var>    Sec. 46. Minnesota Statutes 2008, section 256B.69, subdivision 5a, is amended to read:<br/>
<a id="pl.116.9"></a><var>116.9</var>    Subd. 5a. <b>Managed care contracts.</b> (a) Managed care contracts under this section <br/>
<a id="pl.116.10"></a><var>116.10</var>and sections 
         <statute_ref>256L.12</statute_ref> and 
         <statute_ref>256D.03</statute_ref>, shall be entered into or renewed on a calendar year <br/>
<a id="pl.116.11"></a><var>116.11</var>basis beginning January 1, 1996. Managed care contracts which were in effect on June <br/>
<a id="pl.116.12"></a><var>116.12</var>30, 1995, and set to renew on July 1, 1995, shall be renewed for the period July 1, 1995 <br/>
<a id="pl.116.13"></a><var>116.13</var>through December 31, 1995 at the same terms that were in effect on June 30, 1995. The <br/>
<a id="pl.116.14"></a><var>116.14</var>commissioner may issue separate contracts with requirements specific to services to <br/>
<a id="pl.116.15"></a><var>116.15</var>medical assistance recipients age 65 and older.<br/>
<a id="pl.116.16"></a><var>116.16</var>    (b) A prepaid health plan providing covered health services for eligible persons <br/>
<a id="pl.116.17"></a><var>116.17</var>pursuant to chapters 256B, 256D, and 256L, is responsible for complying with the terms <br/>
<a id="pl.116.18"></a><var>116.18</var>of its contract with the commissioner. Requirements applicable to managed care programs <br/>
<a id="pl.116.19"></a><var>116.19</var>under chapters 256B, 256D, and 256L, established after the effective date of a contract <br/>
<a id="pl.116.20"></a><var>116.20</var>with the commissioner take effect when the contract is next issued or renewed.<br/>
<a id="pl.116.21"></a><var>116.21</var>    (c) Effective for services rendered on or after January 1, 2003, the commissioner shall <br/>
<a id="pl.116.22"></a><var>116.22</var>withhold five percent of managed care plan payments under this section and county-based <br/>
<a id="pl.116.23"></a><var>116.23</var>purchasing plan's payment rate under section 256B.692 for the prepaid medical assistance <br/>
<a id="pl.116.24"></a><var>116.24</var>and general assistance medical care programs pending completion of performance targets. <br/>
<a id="pl.116.25"></a><var>116.25</var>Each performance target must be quantifiable, objective, measurable, and reasonably <br/>
<a id="pl.116.26"></a><var>116.26</var>attainable, except in the case of a performance target based on a federal or state law or rule. <br/>
<a id="pl.116.27"></a><var>116.27</var>Criteria for assessment of each performance target must be outlined in writing prior to the <br/>
<a id="pl.116.28"></a><var>116.28</var>contract effective date. The managed care plan must demonstrate, to the commissioner's <br/>
<a id="pl.116.29"></a><var>116.29</var>satisfaction, that the data submitted regarding attainment of the performance target is <br/>
<a id="pl.116.30"></a><var>116.30</var>accurate. The commissioner shall periodically change the administrative measures used <br/>
<a id="pl.116.31"></a><var>116.31</var>as performance targets in order to improve plan performance across a broader range of <br/>
<a id="pl.116.32"></a><var>116.32</var>administrative services. The performance targets must include measurement of plan <br/>
<a id="pl.116.33"></a><var>116.33</var>efforts to contain spending on health care services and administrative activities. The <br/>
<a id="pl.116.34"></a><var>116.34</var>commissioner may adopt plan-specific performance targets that take into account factors <br/>
<a id="pl.116.35"></a><var>116.35</var>affecting only one plan, including characteristics of the plan's enrollee population. The <br/>
<a id="pl.117.1"></a><var>117.1</var>withheld funds must be returned no sooner than July of the following year if performance <br/>
<a id="pl.117.2"></a><var>117.2</var>targets in the contract are achieved. The commissioner may exclude special demonstration <br/>
<a id="pl.117.3"></a><var>117.3</var>projects under subdivision 23. A managed care plan or a county-based purchasing plan <br/>
<a id="pl.117.4"></a><var>117.4</var>under section 
<statute_ref>256B.692</statute_ref> may include as admitted assets under section 
<statute_ref>62D.044</statute_ref> any amount <br/>
<a id="pl.117.5"></a><var>117.5</var>withheld under this paragraph that is reasonably expected to be returned.<br/>
<a id="pl.117.6"></a><var>117.6</var>    (d)(1) Effective for services rendered on or after January 1, 2009, through December <br/>
<a id="pl.117.7"></a><var>117.7</var>31, 2009, the commissioner shall withhold three percent of managed care plan payments <br/>
<a id="pl.117.8"></a><var>117.8</var>under this section and county-based purchasing plan payments under section 256B.692 for <br/>
<a id="pl.117.9"></a><var>117.9</var>the prepaid medical assistance and general assistance medical care programs. The withheld <br/>
<a id="pl.117.10"></a><var>117.10</var>funds must be returned no sooner than July 1 and no later than July 31 of the following <br/>
<a id="pl.117.11"></a><var>117.11</var>year. The commissioner may exclude special demonstration projects under subdivision 23.<br/>
<a id="pl.117.12"></a><var>117.12</var>    (2) A managed care plan or a county-based purchasing plan under section 
<statute_ref>256B.692 <br/>
<a id="pl.117.13"></a><var>117.13</var></statute_ref>may include as admitted assets under section 
<statute_ref>62D.044</statute_ref> any amount withheld under <br/>
<a id="pl.117.14"></a><var>117.14</var>this paragraph. The return of the withhold under this paragraph is not subject to the <br/>
<a id="pl.117.15"></a><var>117.15</var>requirements of paragraph (c).<br/>
<a id="pl.117.16"></a><var>117.16</var>(e) Effective for services rendered on or after January 1, 2010, through December <br/>
<a id="pl.117.17"></a><var>117.17</var>31, 2010, the commissioner shall withhold 3.5 percent of managed care plan payments <br/>
<a id="pl.117.18"></a><var>117.18</var>under this section and county-based purchasing plan payments under section 256B.692 <br/>
<a id="pl.117.19"></a><var>117.19</var>for the prepaid medical assistance program. The withheld funds must be returned no <br/>
<a id="pl.117.20"></a><var>117.20</var>sooner than July 1 and no later than July 31 of the following year. The commissioner may <br/>
<a id="pl.117.21"></a><var>117.21</var>exclude special demonstration projects under subdivision 23. <br/>
<a id="pl.117.22"></a><var>117.22</var>(f) Effective for services rendered on or after January 1, 2011, through December 31, <br/>
<a id="pl.117.23"></a><var>117.23</var>2011, the commissioner shall withhold four percent of managed care plan payments under <br/>
<a id="pl.117.24"></a><var>117.24</var>this section and county-based purchasing plan payments under section 256B.692 for the <br/>
<a id="pl.117.25"></a><var>117.25</var>prepaid medical assistance program. The withheld funds must be returned no sooner than <br/>
<a id="pl.117.26"></a><var>117.26</var>July 1 and no later than July 31 of the following year. The commissioner may exclude <br/>
<a id="pl.117.27"></a><var>117.27</var>special demonstration projects under subdivision 23. <br/>
<a id="pl.117.28"></a><var>117.28</var>(g) Effective for services rendered on or after January 1, 2012, through December <br/>
<a id="pl.117.29"></a><var>117.29</var>31, 2012, the commissioner shall withhold 4.5 percent of managed care plan payments <br/>
<a id="pl.117.30"></a><var>117.30</var>under this section and county-based purchasing plan payments under section 256B.692 <br/>
<a id="pl.117.31"></a><var>117.31</var>for the prepaid medical assistance program. The withheld funds must be returned no <br/>
<a id="pl.117.32"></a><var>117.32</var>sooner than July 1 and no later than July 31 of the following year. The commissioner may <br/>
<a id="pl.117.33"></a><var>117.33</var>exclude special demonstration projects under subdivision 23.<br/>
<a id="pl.117.34"></a><var>117.34</var>(h) Effective for services rendered on or after January 1, 2013, through December <br/>
<a id="pl.117.35"></a><var>117.35</var>31, 2013, the commissioner shall withhold 4.5 percent of managed care plan payments <br/>
<a id="pl.117.36"></a><var>117.36</var>under this section and county-based purchasing plan payments under section 256B.692 <br/>
<a id="pl.118.1"></a><var>118.1</var>for the prepaid medical assistance program. The withheld funds must be returned no <br/>
<a id="pl.118.2"></a><var>118.2</var>sooner than July 1 and no later than July 31 of the following year. The commissioner may <br/>
<a id="pl.118.3"></a><var>118.3</var>exclude special demonstration projects under subdivision 23.<br/>
<a id="pl.118.4"></a><var>118.4</var>(i) Effective for services rendered on or after January 1, 2014, the commissioner <br/>
<a id="pl.118.5"></a><var>118.5</var>shall withhold three percent of managed care plan payments under this section and <br/>
<a id="pl.118.6"></a><var>118.6</var>county-based purchasing plan payments under section 256B.692 for the prepaid medical <br/>
<a id="pl.118.7"></a><var>118.7</var>assistance and prepaid general assistance medical care programs. The withheld funds must <br/>
<a id="pl.118.8"></a><var>118.8</var>be returned no sooner than July 1 and no later than July 31 of the following year. The <br/>
<a id="pl.118.9"></a><var>118.9</var>commissioner may exclude special demonstration projects under subdivision 23.<br/>
<a id="pl.118.10"></a><var>118.10</var>(j) A managed care plan or a county-based purchasing plan under section 256B.692 <br/>
<a id="pl.118.11"></a><var>118.11</var>may include as admitted assets under section 62D.044 any amount withheld under this <br/>
<a id="pl.118.12"></a><var>118.12</var>section that is reasonably expected to be returned.<br/>
<br/>
<a id="bill.5.47.0"></a><a id="pl.118.13"></a><var>118.13</var>    Sec. 47. Minnesota Statutes 2008, section 256B.69, subdivision 5c, is amended to read:<br/>
<a id="pl.118.14"></a><var>118.14</var>    Subd. 5c. <b>Medical education and research fund.</b> (a) Except as provided in <br/>
<a id="pl.118.15"></a><var>118.15</var>paragraph (c), the commissioner of human services shall transfer each year to the medical <br/>
<a id="pl.118.16"></a><var>118.16</var>education and research fund established under section 
         <statute_ref>62J.692</statute_ref>, the following: <br/>
<a id="pl.118.17"></a><var>118.17</var>(1) an amount equal to the reduction in the prepaid medical assistance and prepaid <br/>
<a id="pl.118.18"></a><var>118.18</var>general assistance medical care payments as specified in this clause. Until January 1, <br/>
<a id="pl.118.19"></a><var>118.19</var>2002, the county medical assistance and general assistance medical care capitation base <br/>
<a id="pl.118.20"></a><var>118.20</var>rate prior to plan specific adjustments and after the regional rate adjustments under section <br/>
<statute_ref><a id="pl.118.21"></a><var>118.21</var>256B.69, subdivision 5b
         </statute_ref>, is reduced 6.3 percent for Hennepin County, two percent for <br/>
<a id="pl.118.22"></a><var>118.22</var>the remaining metropolitan counties, and no reduction for nonmetropolitan Minnesota <br/>
<a id="pl.118.23"></a><var>118.23</var>counties; and after January 1, 2002, the county medical assistance and general assistance <br/>
<a id="pl.118.24"></a><var>118.24</var>medical care capitation base rate prior to plan specific adjustments is reduced 6.3 percent <br/>
<a id="pl.118.25"></a><var>118.25</var>for Hennepin County, two percent for the remaining metropolitan counties, and 1.6 percent <br/>
<a id="pl.118.26"></a><var>118.26</var>for nonmetropolitan Minnesota counties. Nursing facility and elderly waiver payments <br/>
<a id="pl.118.27"></a><var>118.27</var>and demonstration project payments operating under subdivision 23 are excluded from <br/>
<a id="pl.118.28"></a><var>118.28</var>this reduction. The amount calculated under this clause shall not be adjusted for periods <br/>
<a id="pl.118.29"></a><var>118.29</var>already paid due to subsequent changes to the capitation payments; <br/>
<a id="pl.118.30"></a><var>118.30</var>(2) beginning July 1, 2003, $2,157,000 $4,314,000 from the capitation rates paid <br/>
<a id="pl.118.31"></a><var>118.31</var>under this section plus any federal matching funds on this amount;<br/>
<a id="pl.118.32"></a><var>118.32</var>(3) beginning July 1, 2002, an additional $12,700,000 from the capitation rates <br/>
<a id="pl.118.33"></a><var>118.33</var>paid under this section; and<br/>
<a id="pl.118.34"></a><var>118.34</var>(4) beginning July 1, 2003, an additional $4,700,000 from the capitation rates paid <br/>
<a id="pl.118.35"></a><var>118.35</var>under this section.<br/>
<a id="pl.119.1"></a><var>119.1</var>(b) This subdivision shall be effective upon approval of a federal waiver which <br/>
<a id="pl.119.2"></a><var>119.2</var>allows federal financial participation in the medical education and research fund. Effective <br/>
<a id="pl.119.3"></a><var>119.3</var>July 1, 2009, and thereafter, the transfers required by paragraph (a), clauses (1) to (4), <br/>
<a id="pl.119.4"></a><var>119.4</var>shall not exceed the total amount transferred for fiscal year 2009. Any excess shall first <br/>
<a id="pl.119.5"></a><var>119.5</var>reduce the amounts otherwise required to be transferred under paragraph (a), clauses <br/>
<a id="pl.119.6"></a><var>119.6</var>(2) to (4). Any excess following this reduction shall proportionally reduce the transfers <br/>
<a id="pl.119.7"></a><var>119.7</var>under paragraph (a), clause (1).<br/>
<a id="pl.119.8"></a><var>119.8</var>(c) Effective July 1, 2003, the amount reduced from the prepaid general assistance <br/>
<a id="pl.119.9"></a><var>119.9</var>medical care payments under paragraph (a), clause (1), shall be transferred to the general <br/>
<a id="pl.119.10"></a><var>119.10</var>fund.<br/>
<a id="pl.119.11"></a><var>119.11</var>(d) Beginning July 1, 2009, of the amounts in paragraph (a), the commissioner shall <br/>
<a id="pl.119.12"></a><var>119.12</var>transfer $21,714,000 each fiscal year to the medical education and research fund. The <br/>
<a id="pl.119.13"></a><var>119.13</var>balance of the transfers under paragraph (a) shall be transferred to the medical education <br/>
<a id="pl.119.14"></a><var>119.14</var>and research fund no earlier than July 1 of the following fiscal year.<br/>
<br/>
<a id="bill.5.48.0"></a><a id="pl.119.15"></a><var>119.15</var>    Sec. 48. Minnesota Statutes 2008, section 256B.69, subdivision 5f, is amended to read:<br/>
<a id="pl.119.16"></a><var>119.16</var>    Subd. 5f. <b>Capitation rates.</b> (a) Beginning July 1, 2002, the capitation rates paid <br/>
<a id="pl.119.17"></a><var>119.17</var>under this section are increased by $12,700,000 per year. Beginning July 1, 2003, the <br/>
<a id="pl.119.18"></a><var>119.18</var>capitation rates paid under this section are increased by $4,700,000 per year.<br/>
<a id="pl.119.19"></a><var>119.19</var>(b) Beginning July 1, 2009, the capitation rates paid under this section are increased <br/>
<a id="pl.119.20"></a><var>119.20</var>each year by the lesser of $21,714,000 or an amount equal to the difference between the <br/>
<a id="pl.119.21"></a><var>119.21</var>estimated value of the reductions described in subdivision 5c, paragraph (a), clause (1), <br/>
<a id="pl.119.22"></a><var>119.22</var>and the amount of the limit described in subdivision 5c, paragraph (b).<br/>
<br/>
<a id="bill.5.49.0"></a><a id="pl.119.23"></a><var>119.23</var>    Sec. 49. Minnesota Statutes 2008, section 256B.69, subdivision 23, is amended to read:<br/>
<a id="pl.119.24"></a><var>119.24</var>    Subd. 23. <b>Alternative services; elderly and disabled persons.</b> (a) The <br/>
<a id="pl.119.25"></a><var>119.25</var>commissioner may implement demonstration projects to create alternative integrated <br/>
<a id="pl.119.26"></a><var>119.26</var>delivery systems for acute and long-term care services to elderly persons and persons <br/>
<a id="pl.119.27"></a><var>119.27</var>with disabilities as defined in section 
         <statute_ref>256B.77, subdivision 7a</statute_ref>, that provide increased <br/>
<a id="pl.119.28"></a><var>119.28</var>coordination, improve access to quality services, and mitigate future cost increases. <br/>
<a id="pl.119.29"></a><var>119.29</var>The commissioner may seek federal authority to combine Medicare and Medicaid <br/>
<a id="pl.119.30"></a><var>119.30</var>capitation payments for the purpose of such demonstrations and may contract with <br/>
<a id="pl.119.31"></a><var>119.31</var>Medicare-approved special needs plans to provide Medicaid services. Medicare funds and <br/>
<a id="pl.119.32"></a><var>119.32</var>services shall be administered according to the terms and conditions of the federal contract <br/>
<a id="pl.119.33"></a><var>119.33</var>and demonstration provisions. For the purpose of administering medical assistance funds, <br/>
<a id="pl.119.34"></a><var>119.34</var>demonstrations under this subdivision are subject to subdivisions 1 to 22. The provisions <br/>
<a id="pl.120.1"></a><var>120.1</var>of Minnesota Rules, parts 
         <statute_ref>9500.1450</statute_ref> to 
         <statute_ref>9500.1464</statute_ref>, apply to these demonstrations, <br/>
<a id="pl.120.2"></a><var>120.2</var>with the exceptions of parts 
         <statute_ref>9500.1452</statute_ref>, subpart 2, item B; and 
         <statute_ref>9500.1457</statute_ref>, subpart 1, <br/>
<a id="pl.120.3"></a><var>120.3</var>items B and C, which do not apply to persons enrolling in demonstrations under this <br/>
<a id="pl.120.4"></a><var>120.4</var>section. An initial open enrollment period may be provided. Persons who disenroll from <br/>
<a id="pl.120.5"></a><var>120.5</var>demonstrations under this subdivision remain subject to Minnesota Rules, parts 9500.1450 <br/>
<a id="pl.120.6"></a><var>120.6</var>to 9500.1464. When a person is enrolled in a health plan under these demonstrations and <br/>
<a id="pl.120.7"></a><var>120.7</var>the health plan's participation is subsequently terminated for any reason, the person shall <br/>
<a id="pl.120.8"></a><var>120.8</var>be provided an opportunity to select a new health plan and shall have the right to change <br/>
<a id="pl.120.9"></a><var>120.9</var>health plans within the first 60 days of enrollment in the second health plan. Persons <br/>
<a id="pl.120.10"></a><var>120.10</var>required to participate in health plans under this section who fail to make a choice of <br/>
<a id="pl.120.11"></a><var>120.11</var>health plan shall not be randomly assigned to health plans under these demonstrations. <br/>
<a id="pl.120.12"></a><var>120.12</var>Notwithstanding section 
         <statute_ref>256L.12, subdivision 5</statute_ref>, and Minnesota Rules, part 
         <statute_ref>9505.5220</statute_ref>, <br/>
<a id="pl.120.13"></a><var>120.13</var>subpart 1, item A, if adopted, for the purpose of demonstrations under this subdivision, <br/>
<a id="pl.120.14"></a><var>120.14</var>the commissioner may contract with managed care organizations, including counties, to <br/>
<a id="pl.120.15"></a><var>120.15</var>serve only elderly persons eligible for medical assistance, elderly and disabled persons, or <br/>
<a id="pl.120.16"></a><var>120.16</var>disabled persons only. For persons with a primary diagnosis of developmental disability, <br/>
<a id="pl.120.17"></a><var>120.17</var>serious and persistent mental illness, or serious emotional disturbance, the commissioner <br/>
<a id="pl.120.18"></a><var>120.18</var>must ensure that the county authority has approved the demonstration and contracting <br/>
<a id="pl.120.19"></a><var>120.19</var>design. Enrollment in these projects for persons with disabilities shall be voluntary. The <br/>
<a id="pl.120.20"></a><var>120.20</var>commissioner shall not implement any demonstration project under this subdivision for <br/>
<a id="pl.120.21"></a><var>120.21</var>persons with a primary diagnosis of developmental disabilities, serious and persistent <br/>
<a id="pl.120.22"></a><var>120.22</var>mental illness, or serious emotional disturbance, without approval of the county board of <br/>
<a id="pl.120.23"></a><var>120.23</var>the county in which the demonstration is being implemented.<br/>
<a id="pl.120.24"></a><var>120.24</var>    (b) Notwithstanding chapter 245B, sections 
         <statute_ref>252.40</statute_ref> to 
         <statute_ref>252.46</statute_ref>, 
         <statute_ref>256B.092</statute_ref>, 
         <statute_ref>256B.501</statute_ref> <br/>
<a id="pl.120.25"></a><var>120.25</var>to 
         <statute_ref>256B.5015</statute_ref>, and Minnesota Rules, parts 9525.0004 to 9525.0036, 9525.1200 to <br/>
<a id="pl.120.26"></a><var>120.26</var>9525.1330, 9525.1580, and 9525.1800 to 9525.1930, the commissioner may implement <br/>
<a id="pl.120.27"></a><var>120.27</var>under this section projects for persons with developmental disabilities. The commissioner <br/>
<a id="pl.120.28"></a><var>120.28</var>may capitate payments for ICF/MR services, waivered services for developmental <br/>
<a id="pl.120.29"></a><var>120.29</var>disabilities, including case management services, day training and habilitation and <br/>
<a id="pl.120.30"></a><var>120.30</var>alternative active treatment services, and other services as approved by the state and by the <br/>
<a id="pl.120.31"></a><var>120.31</var>federal government. Case management and active treatment must be individualized and <br/>
<a id="pl.120.32"></a><var>120.32</var>developed in accordance with a person-centered plan. Costs under these projects may not <br/>
<a id="pl.120.33"></a><var>120.33</var>exceed costs that would have been incurred under fee-for-service. Beginning July 1, 2003, <br/>
<a id="pl.120.34"></a><var>120.34</var>and until four years after the pilot project implementation date, subcontractor participation <br/>
<a id="pl.120.35"></a><var>120.35</var>in the long-term care developmental disability pilot is limited to a nonprofit long-term <br/>
<a id="pl.120.36"></a><var>120.36</var>care system providing ICF/MR services, home and community-based waiver services, <br/>
<a id="pl.121.1"></a><var>121.1</var>and in-home services to no more than 120 consumers with developmental disabilities in <br/>
<a id="pl.121.2"></a><var>121.2</var>Carver, Hennepin, and Scott Counties. The commissioner shall report to the legislature <br/>
<a id="pl.121.3"></a><var>121.3</var>prior to expansion of the developmental disability pilot project. This paragraph expires <br/>
<a id="pl.121.4"></a><var>121.4</var>four years after the implementation date of the pilot project.<br/>
<a id="pl.121.5"></a><var>121.5</var>    (c) Before implementation of a demonstration project for disabled persons, the <br/>
<a id="pl.121.6"></a><var>121.6</var>commissioner must provide information to appropriate committees of the house of <br/>
<a id="pl.121.7"></a><var>121.7</var>representatives and senate and must involve representatives of affected disability groups <br/>
<a id="pl.121.8"></a><var>121.8</var>in the design of the demonstration projects.<br/>
<a id="pl.121.9"></a><var>121.9</var>    (d) A nursing facility reimbursed under the alternative reimbursement methodology <br/>
<a id="pl.121.10"></a><var>121.10</var>in section 
         <statute_ref>256B.434</statute_ref> may, in collaboration with a hospital, clinic, or other health care entity <br/>
<a id="pl.121.11"></a><var>121.11</var>provide services under paragraph (a). The commissioner shall amend the state plan and <br/>
<a id="pl.121.12"></a><var>121.12</var>seek any federal waivers necessary to implement this paragraph.<br/>
<a id="pl.121.13"></a><var>121.13</var>    (e) The commissioner, in consultation with the commissioners of commerce and <br/>
<a id="pl.121.14"></a><var>121.14</var>health, may approve and implement programs for all-inclusive care for the elderly (PACE) <br/>
<a id="pl.121.15"></a><var>121.15</var>according to federal laws and regulations governing that program and state laws or rules <br/>
<a id="pl.121.16"></a><var>121.16</var>applicable to participating providers. The process for approval of these programs shall <br/>
<a id="pl.121.17"></a><var>121.17</var>begin only after the commissioner receives grant money in an amount sufficient to cover <br/>
<a id="pl.121.18"></a><var>121.18</var>the state share of the administrative and actuarial costs to implement the programs during <br/>
<a id="pl.121.19"></a><var>121.19</var>state fiscal years 2006 and 2007. Grant amounts for this purpose shall be deposited in an <br/>
<a id="pl.121.20"></a><var>121.20</var>account in the special revenue fund and are appropriated to the commissioner to be used <br/>
<a id="pl.121.21"></a><var>121.21</var>solely for the purpose of PACE administrative and actuarial costs. A PACE provider is <br/>
<a id="pl.121.22"></a><var>121.22</var>not required to be licensed or certified as a health plan company as defined in section <br/>
<statute_ref><a id="pl.121.23"></a><var>121.23</var>62Q.01, subdivision 4
         </statute_ref>. Persons age 55 and older who have been screened by the county <br/>
<a id="pl.121.24"></a><var>121.24</var>and found to be eligible for services under the elderly waiver or community alternatives <br/>
<a id="pl.121.25"></a><var>121.25</var>for disabled individuals or who are already eligible for Medicaid but meet level of <br/>
<a id="pl.121.26"></a><var>121.26</var>care criteria for receipt of waiver services may choose to enroll in the PACE program. <br/>
<a id="pl.121.27"></a><var>121.27</var>Medicare and Medicaid services will be provided according to this subdivision and <br/>
<a id="pl.121.28"></a><var>121.28</var>federal Medicare and Medicaid requirements governing PACE providers and programs. <br/>
<a id="pl.121.29"></a><var>121.29</var>PACE enrollees will receive Medicaid home and community-based services through the <br/>
<a id="pl.121.30"></a><var>121.30</var>PACE provider as an alternative to services for which they would otherwise be eligible <br/>
<a id="pl.121.31"></a><var>121.31</var>through home and community-based waiver programs and Medicaid State Plan Services. <br/>
<a id="pl.121.32"></a><var>121.32</var>The commissioner shall establish Medicaid rates for PACE providers that do not exceed <br/>
<a id="pl.121.33"></a><var>121.33</var>costs that would have been incurred under fee-for-service or other relevant managed care <br/>
<a id="pl.121.34"></a><var>121.34</var>programs operated by the state.<br/>
<a id="pl.121.35"></a><var>121.35</var>    (f) The commissioner shall seek federal approval to expand the Minnesota disability <br/>
<a id="pl.121.36"></a><var>121.36</var>health options (MnDHO) program established under this subdivision in stages, first to <br/>
<a id="pl.122.1"></a><var>122.1</var>regional population centers outside the seven-county metro area and then to all areas of <br/>
<a id="pl.122.2"></a><var>122.2</var>the state. Until July 1, 2009, expansion for MnDHO projects that include home and <br/>
<a id="pl.122.3"></a><var>122.3</var>community-based services is limited to the two projects and service areas in effect on <br/>
<a id="pl.122.4"></a><var>122.4</var>March 1, 2006.  Enrollment in integrated MnDHO programs that include home and <br/>
<a id="pl.122.5"></a><var>122.5</var>community-based services shall remain voluntary. Costs for home and community-based <br/>
<a id="pl.122.6"></a><var>122.6</var>services included under MnDHO must not exceed costs that would have been incurred <br/>
<a id="pl.122.7"></a><var>122.7</var>under the fee-for-service program. Notwithstanding whether expansion occurs under <br/>
<a id="pl.122.8"></a><var>122.8</var>this paragraph, in determining MnDHO payment rates and risk adjustment methods for <br/>
<a id="pl.122.9"></a><var>122.9</var>contract years starting in 2012, the commissioner must consider the methods used to <br/>
<a id="pl.122.10"></a><var>122.10</var>determine county allocations for home and community-based program participants. If <br/>
<a id="pl.122.11"></a><var>122.11</var>necessary to reduce MnDHO rates to comply with the provision regarding MnDHO costs <br/>
<a id="pl.122.12"></a><var>122.12</var>for home and community-based services, the commissioner shall achieve the reduction by <br/>
<a id="pl.122.13"></a><var>122.13</var>maintaining the base rate for contract years 2010 and 2011 for services provided under the <br/>
<a id="pl.122.14"></a><var>122.14</var>community alternatives for disabled individuals waiver at the same level as for contract <br/>
<a id="pl.122.15"></a><var>122.15</var>year 2009. The commissioner may apply other reductions to MnDHO rates to implement <br/>
<a id="pl.122.16"></a><var>122.16</var>decreases in provider payment rates required by state law. In developing program <br/>
<a id="pl.122.17"></a><var>122.17</var>specifications for expansion of integrated programs, the commissioner shall involve and <br/>
<a id="pl.122.18"></a><var>122.18</var>consult the state-level stakeholder group established in subdivision 28, paragraph (d), <br/>
<a id="pl.122.19"></a><var>122.19</var>including consultation on whether and how to include home and community-based waiver <br/>
<a id="pl.122.20"></a><var>122.20</var>programs. Plans for further expansion of MnDHO projects shall be presented to the chairs <br/>
<a id="pl.122.21"></a><var>122.21</var>of the house of representatives and senate committees with jurisdiction over health and <br/>
<a id="pl.122.22"></a><var>122.22</var>human services policy and finance by February 1, 2007.<br/>
<a id="pl.122.23"></a><var>122.23</var>    (g) Notwithstanding section 
         <statute_ref>256B.0261</statute_ref>, health plans providing services under this <br/>
<a id="pl.122.24"></a><var>122.24</var>section are responsible for home care targeted case management and relocation targeted <br/>
<a id="pl.122.25"></a><var>122.25</var>case management. Services must be provided according to the terms of the waivers and <br/>
<a id="pl.122.26"></a><var>122.26</var>contracts approved by the federal government.<br/>
<br/>
<a id="bill.5.50.0"></a><a id="pl.122.27"></a><var>122.27</var>    Sec. 50. <b>[256B.756] REIMBURSEMENT RATES FOR BIRTHS.</b><br/>
<a id="pl.122.28"></a><var>122.28</var>    Subdivision 1. <b>Facility rate.</b> (a) Notwithstanding section 256.969, effective for <br/>
<a id="pl.122.29"></a><var>122.29</var>services provided on or after October 1, 2009, the facility payment rate for the following <br/>
<a id="pl.122.30"></a><var>122.30</var>diagnosis-related groups, as they fall within the diagnostic categories: (1) 371 cesarean <br/>
<a id="pl.122.31"></a><var>122.31</var>section without complicating diagnosis; (2) 372 vaginal delivery with complicating <br/>
<a id="pl.122.32"></a><var>122.32</var>diagnosis; and (3) 373 vaginal delivery without complicating diagnosis, shall be calculated <br/>
<a id="pl.122.33"></a><var>122.33</var>as provided in paragraph (b).<br/>
<a id="pl.122.34"></a><var>122.34</var>(b) The commissioner shall calculate a single rate for all of the diagnostic related <br/>
<a id="pl.122.35"></a><var>122.35</var>groups specified in paragraph (a) consistent with an increase in the proportion of births <br/>
<a id="pl.123.1"></a><var>123.1</var>by vaginal delivery and a reduction in the percentage of births by cesarean section. The <br/>
<a id="pl.123.2"></a><var>123.2</var>calculated single rate must be based on an expected increase in the number of vaginal <br/>
<a id="pl.123.3"></a><var>123.3</var>births and expected reduction in the number of cesarean section such that the reduction <br/>
<a id="pl.123.4"></a><var>123.4</var>in cesarean sections is less than or equal to one standard deviation below the average in <br/>
<a id="pl.123.5"></a><var>123.5</var>the frequency of cesarean births for Minnesota health care program clients at hospitals <br/>
<a id="pl.123.6"></a><var>123.6</var>performing greater than 50 deliveries per year.<br/>
<a id="pl.123.7"></a><var>123.7</var>(c) The rates described in this subdivision do not include newborn care.<br/>
<a id="pl.123.8"></a><var>123.8</var>    Subd. 2. <b>Provider rate.</b> Notwithstanding section 256B.76, effective for services <br/>
<a id="pl.123.9"></a><var>123.9</var>provided on or after October 1, 2009, the payment rate for professional services related <br/>
<a id="pl.123.10"></a><var>123.10</var>to labor, delivery, and antepartum and postpartum care when provided for any of the <br/>
<a id="pl.123.11"></a><var>123.11</var>diagnostic categories identified in subdivision 1, paragraph (a), shall be calculated using <br/>
<a id="pl.123.12"></a><var>123.12</var>the methodology specified in subdivision 1, paragraph (b).<br/>
<a id="pl.123.13"></a><var>123.13</var>    Subd. 3. <b>Health plans.</b> Payments to managed care and county-based purchasing <br/>
<a id="pl.123.14"></a><var>123.14</var>plans under sections 256B.69, 256B.692, or 256L.12 shall be reduced for services <br/>
<a id="pl.123.15"></a><var>123.15</var>provided on or after October 1, 2009, to reflect the adjustments in subdivisions 1 and 2.<br/>
<a id="pl.123.16"></a><var>123.16</var>    Subd. 4. <b>Prior authorization.</b> Prior authorization shall not be required before <br/>
<a id="pl.123.17"></a><var>123.17</var>reimbursement is paid for a cesarean section delivery.<br/>
<br/>
<a id="bill.5.51.0"></a><a id="pl.123.18"></a><var>123.18</var>    Sec. 51. Minnesota Statutes 2008, section 256B.76, subdivision 1, is amended to read:<br/>
<a id="pl.123.19"></a><var>123.19</var>    Subdivision 1. <b>Physician reimbursement. </b> (a) Effective for services rendered on <br/>
<a id="pl.123.20"></a><var>123.20</var>or after October 1, 1992, the commissioner shall make payments for physician services <br/>
<a id="pl.123.21"></a><var>123.21</var>as follows:<br/>
<a id="pl.123.22"></a><var>123.22</var>    (1) payment for level one Centers for Medicare and Medicaid Services' common <br/>
<a id="pl.123.23"></a><var>123.23</var>procedural coding system codes titled "office and other outpatient services," "preventive <br/>
<a id="pl.123.24"></a><var>123.24</var>medicine new and established patient," "delivery, antepartum, and postpartum care," <br/>
<a id="pl.123.25"></a><var>123.25</var>"critical care," cesarean delivery and pharmacologic management provided to psychiatric <br/>
<a id="pl.123.26"></a><var>123.26</var>patients, and level three codes for enhanced services for prenatal high risk, shall be paid <br/>
<a id="pl.123.27"></a><var>123.27</var>at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June <br/>
<a id="pl.123.28"></a><var>123.28</var>30, 1992. If the rate on any procedure code within these categories is different than the <br/>
<a id="pl.123.29"></a><var>123.29</var>rate that would have been paid under the methodology in section 
         <statute_ref>256B.74, subdivision 2</statute_ref>, <br/>
<a id="pl.123.30"></a><var>123.30</var>then the larger rate shall be paid; <br/>
<a id="pl.123.31"></a><var>123.31</var>    (2) payments for all other services shall be paid at the lower of (i) submitted charges, <br/>
<a id="pl.123.32"></a><var>123.32</var>or (ii) 15.4 percent above the rate in effect on June 30, 1992; and<br/>
<a id="pl.123.33"></a><var>123.33</var>    (3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th <br/>
<a id="pl.123.34"></a><var>123.34</var>percentile of 1989, less the percent in aggregate necessary to equal the above increases <br/>
<a id="pl.124.1"></a><var>124.1</var>except that payment rates for home health agency services shall be the rates in effect <br/>
<a id="pl.124.2"></a><var>124.2</var>on September 30, 1992.<br/>
<a id="pl.124.3"></a><var>124.3</var>    (b) Effective for services rendered on or after January 1, 2000, payment rates for <br/>
<a id="pl.124.4"></a><var>124.4</var>physician and professional services shall be increased by three percent over the rates <br/>
<a id="pl.124.5"></a><var>124.5</var>in effect on December 31, 1999, except for home health agency and family planning <br/>
<a id="pl.124.6"></a><var>124.6</var>agency services. The increases in this paragraph shall be implemented January 1, 2000, <br/>
<a id="pl.124.7"></a><var>124.7</var>for managed care.<br/>
<a id="pl.124.8"></a><var>124.8</var>(c) Effective for services rendered on or after July 1, 2009, payment rates for <br/>
<a id="pl.124.9"></a><var>124.9</var>physician and professional services shall be reduced by five percent over the rates in effect <br/>
<a id="pl.124.10"></a><var>124.10</var>on June 30, 2009. This reduction does not apply to office or other outpatient services <br/>
<a id="pl.124.11"></a><var>124.11</var>(procedure codes 99201 to 99215), preventive medicine services (procedure codes 99381 <br/>
<a id="pl.124.12"></a><var>124.12</var>to 99412) and family planning services billed by the following primary care specialties: <br/>
<a id="pl.124.13"></a><var>124.13</var>general practice, internal medicine, pediatrics, geriatrics, family practice, or by an <br/>
<a id="pl.124.14"></a><var>124.14</var>advanced practice registered nurse or physician assistant practicing in pediatrics, geriatrics, <br/>
<a id="pl.124.15"></a><var>124.15</var>or family practice. This reduction does not apply to federally qualified health centers, <br/>
<a id="pl.124.16"></a><var>124.16</var>rural health centers, and Indian health services. Effective October 1, 2009, payments <br/>
<a id="pl.124.17"></a><var>124.17</var>made to managed care plans and county-based purchasing plans under sections 256B.69, <br/>
<a id="pl.124.18"></a><var>124.18</var>256B.692, and 256L.12 shall reflect the payment reduction described in this paragraph.<br/>
<br/>
<a id="bill.5.52.0"></a><a id="pl.124.19"></a><var>124.19</var>    Sec. 52. <b>[256B.766] REIMBURSEMENT FOR BASIC CARE SERVICES.</b><br/>
<a id="pl.124.20"></a><var>124.20</var>(a) Effective for services provided on or after July 1, 2009, total payments for basic <br/>
<a id="pl.124.21"></a><var>124.21</var>care services, shall be reduced by three percent, prior to third-party liability and spenddown <br/>
<a id="pl.124.22"></a><var>124.22</var>calculation. Payments made to managed care plans and county-based purchasing plans <br/>
<a id="pl.124.23"></a><var>124.23</var>shall be reduced for services provided on or after October 1, 2009, to reflect this reduction.<br/>
<a id="pl.124.24"></a><var>124.24</var>(b) This section does not apply to physician and professional services, inpatient <br/>
<a id="pl.124.25"></a><var>124.25</var>hospital services, family planning services, mental health services, dental services, <br/>
<a id="pl.124.26"></a><var>124.26</var>prescription drugs, and medical transportation.<br/>
<br/>
<a id="bill.5.53.0"></a><a id="pl.124.27"></a><var>124.27</var>    Sec. 53. Minnesota Statutes 2008, section 256D.03, subdivision 4, is amended to read:<br/>
<a id="pl.124.28"></a><var>124.28</var>    Subd. 4. <b>General assistance medical care; services.</b> (a)(i) For a person who is <br/>
<a id="pl.124.29"></a><var>124.29</var>eligible under subdivision 3, paragraph (a), clause (2), item (i), general assistance medical <br/>
<a id="pl.124.30"></a><var>124.30</var>care covers, except as provided in paragraph (c):<br/>
<a id="pl.124.31"></a><var>124.31</var>    (1) inpatient hospital services;<br/>
<a id="pl.124.32"></a><var>124.32</var>    (2) outpatient hospital services;<br/>
<a id="pl.124.33"></a><var>124.33</var>    (3) services provided by Medicare certified rehabilitation agencies;<br/>
<a id="pl.125.1"></a><var>125.1</var>    (4) prescription drugs and other products recommended through the process <br/>
<a id="pl.125.2"></a><var>125.2</var>established in section 
         <statute_ref>256B.0625, subdivision 13</statute_ref>;<br/>
<a id="pl.125.3"></a><var>125.3</var>    (5) equipment necessary to administer insulin and diagnostic supplies and equipment <br/>
<a id="pl.125.4"></a><var>125.4</var>for diabetics to monitor blood sugar level;<br/>
<a id="pl.125.5"></a><var>125.5</var>    (6) eyeglasses and eye examinations provided by a physician or optometrist;<br/>
<a id="pl.125.6"></a><var>125.6</var>    (7) hearing aids;<br/>
<a id="pl.125.7"></a><var>125.7</var>    (8) prosthetic devices;<br/>
<a id="pl.125.8"></a><var>125.8</var>    (9) laboratory and X-ray services;<br/>
<a id="pl.125.9"></a><var>125.9</var>    (10) physician's services;<br/>
<a id="pl.125.10"></a><var>125.10</var>    (11) medical transportation except special transportation;<br/>
<a id="pl.125.11"></a><var>125.11</var>    (12) chiropractic services as covered under the medical assistance program;<br/>
<a id="pl.125.12"></a><var>125.12</var>    (13) podiatric services;<br/>
<a id="pl.125.13"></a><var>125.13</var>    (14) dental services as covered under the medical assistance program;<br/>
<a id="pl.125.14"></a><var>125.14</var>    (15) mental health services covered under chapter 256B;<br/>
<a id="pl.125.15"></a><var>125.15</var>    (16) prescribed medications for persons who have been diagnosed as mentally ill as <br/>
<a id="pl.125.16"></a><var>125.16</var>necessary to prevent more restrictive institutionalization;<br/>
<a id="pl.125.17"></a><var>125.17</var>    (17) medical supplies and equipment, and Medicare premiums, coinsurance and <br/>
<a id="pl.125.18"></a><var>125.18</var>deductible payments;<br/>
<a id="pl.125.19"></a><var>125.19</var>    (18) medical equipment not specifically listed in this paragraph when the use of <br/>
<a id="pl.125.20"></a><var>125.20</var>the equipment will prevent the need for costlier services that are reimbursable under <br/>
<a id="pl.125.21"></a><var>125.21</var>this subdivision;<br/>
<a id="pl.125.22"></a><var>125.22</var>    (19) services performed by a certified pediatric nurse practitioner, a certified family <br/>
<a id="pl.125.23"></a><var>125.23</var>nurse practitioner, a certified adult nurse practitioner, a certified obstetric/gynecological <br/>
<a id="pl.125.24"></a><var>125.24</var>nurse practitioner, a certified neonatal nurse practitioner, or a certified geriatric nurse <br/>
<a id="pl.125.25"></a><var>125.25</var>practitioner in independent practice, if (1) the service is otherwise covered under this <br/>
<a id="pl.125.26"></a><var>125.26</var>chapter as a physician service, (2) the service provided on an inpatient basis is not included <br/>
<a id="pl.125.27"></a><var>125.27</var>as part of the cost for inpatient services included in the operating payment rate, and (3) the <br/>
<a id="pl.125.28"></a><var>125.28</var>service is within the scope of practice of the nurse practitioner's license as a registered <br/>
<a id="pl.125.29"></a><var>125.29</var>nurse, as defined in section 
         <statute_ref>148.171</statute_ref>;<br/>
<a id="pl.125.30"></a><var>125.30</var>    (20) services of a certified public health nurse or a registered nurse practicing in <br/>
<a id="pl.125.31"></a><var>125.31</var>a public health nursing clinic that is a department of, or that operates under the direct <br/>
<a id="pl.125.32"></a><var>125.32</var>authority of, a unit of government, if the service is within the scope of practice of the <br/>
<a id="pl.125.33"></a><var>125.33</var>public health nurse's license as a registered nurse, as defined in section 
         <statute_ref>148.171</statute_ref>;<br/>
<a id="pl.125.34"></a><var>125.34</var>    (21) telemedicine consultations, to the extent they are covered under section <br/>
<statute_ref><a id="pl.125.35"></a><var>125.35</var>256B.0625, subdivision 3b
         </statute_ref>; <br/>
<a id="pl.126.1"></a><var>126.1</var>    (22) care coordination and patient education services provided by a community <br/>
<a id="pl.126.2"></a><var>126.2</var>health worker according to section 
         <statute_ref>256B.0625, subdivision 49</statute_ref>; and<br/>
<a id="pl.126.3"></a><var>126.3</var>    (23) regardless of the number of employees that an enrolled health care provider <br/>
<a id="pl.126.4"></a><var>126.4</var>may have, sign language interpreter services when provided by an enrolled health care <br/>
<a id="pl.126.5"></a><var>126.5</var>provider during the course of providing a direct, person-to-person covered health care <br/>
<a id="pl.126.6"></a><var>126.6</var>service to an enrolled recipient who has a hearing loss and uses interpreting services.<br/>
<a id="pl.126.7"></a><var>126.7</var>    (ii) Effective October 1, 2003, for a person who is eligible under subdivision 3, <br/>
<a id="pl.126.8"></a><var>126.8</var>paragraph (a), clause (2), item (ii), general assistance medical care coverage is limited <br/>
<a id="pl.126.9"></a><var>126.9</var>to inpatient hospital services, including physician services provided during the inpatient <br/>
<a id="pl.126.10"></a><var>126.10</var>hospital stay. A $1,000 deductible is required for each inpatient hospitalization.<br/>
<a id="pl.126.11"></a><var>126.11</var>    (b) Effective August 1, 2005, sex reassignment surgery is not covered under this <br/>
<a id="pl.126.12"></a><var>126.12</var>subdivision.<br/>
<a id="pl.126.13"></a><var>126.13</var>    (c) In order to contain costs, the commissioner of human services shall select <br/>
<a id="pl.126.14"></a><var>126.14</var>vendors of medical care who can provide the most economical care consistent with high <br/>
<a id="pl.126.15"></a><var>126.15</var>medical standards and shall where possible contract with organizations on a prepaid <br/>
<a id="pl.126.16"></a><var>126.16</var>capitation basis to provide these services. The commissioner shall consider proposals by <br/>
<a id="pl.126.17"></a><var>126.17</var>counties and vendors for prepaid health plans, competitive bidding programs, block grants, <br/>
<a id="pl.126.18"></a><var>126.18</var>or other vendor payment mechanisms designed to provide services in an economical <br/>
<a id="pl.126.19"></a><var>126.19</var>manner or to control utilization, with safeguards to ensure that necessary services are <br/>
<a id="pl.126.20"></a><var>126.20</var>provided. Before implementing prepaid programs in counties with a county operated or <br/>
<a id="pl.126.21"></a><var>126.21</var>affiliated public teaching hospital or a hospital or clinic operated by the University of <br/>
<a id="pl.126.22"></a><var>126.22</var>Minnesota, the commissioner shall consider the risks the prepaid program creates for the <br/>
<a id="pl.126.23"></a><var>126.23</var>hospital and allow the county or hospital the opportunity to participate in the program in a <br/>
<a id="pl.126.24"></a><var>126.24</var>manner that reflects the risk of adverse selection and the nature of the patients served by <br/>
<a id="pl.126.25"></a><var>126.25</var>the hospital, provided the terms of participation in the program are competitive with the <br/>
<a id="pl.126.26"></a><var>126.26</var>terms of other participants considering the nature of the population served. Payment for <br/>
<a id="pl.126.27"></a><var>126.27</var>services provided pursuant to this subdivision shall be as provided to medical assistance <br/>
<a id="pl.126.28"></a><var>126.28</var>vendors of these services under sections 
         <statute_ref>256B.02, subdivision 8</statute_ref>, and 
         <statute_ref>256B.0625</statute_ref>. For <br/>
<a id="pl.126.29"></a><var>126.29</var>payments made during fiscal year 1990 and later years, the commissioner shall consult <br/>
<a id="pl.126.30"></a><var>126.30</var>with an independent actuary in establishing prepayment rates, but shall retain final control <br/>
<a id="pl.126.31"></a><var>126.31</var>over the rate methodology.<br/>
<a id="pl.126.32"></a><var>126.32</var>    (d) Effective January 1, 2008, drug coverage under general assistance medical <br/>
<a id="pl.126.33"></a><var>126.33</var>care is limited to prescription drugs that:<br/>
<a id="pl.126.34"></a><var>126.34</var>    (i) are covered under the medical assistance program as described in section <br/>
<statute_ref><a id="pl.126.35"></a><var>126.35</var>256B.0625, subdivisions 13
         </statute_ref> and 13d; and<br/>
<a id="pl.127.1"></a><var>127.1</var>    (ii) are provided by manufacturers that have fully executed general assistance <br/>
<a id="pl.127.2"></a><var>127.2</var>medical care rebate agreements with the commissioner and comply with the agreements. <br/>
<a id="pl.127.3"></a><var>127.3</var>Prescription drug coverage under general assistance medical care must conform to <br/>
<a id="pl.127.4"></a><var>127.4</var>coverage under the medical assistance program according to section 
         <statute_ref>256B.0625</statute_ref>, <br/>
<a id="pl.127.5"></a><var>127.5</var>subdivisions 13 to 13g.<br/>
<a id="pl.127.6"></a><var>127.6</var>     (e) Recipients eligible under subdivision 3, paragraph (a), shall pay the following <br/>
<a id="pl.127.7"></a><var>127.7</var>co-payments for services provided on or after October 1, 2003, and before January 1, 2009:<br/>
<a id="pl.127.8"></a><var>127.8</var>    (1) $25 for eyeglasses;<br/>
<a id="pl.127.9"></a><var>127.9</var>    (2) $25 for nonemergency visits to a hospital-based emergency room;<br/>
<a id="pl.127.10"></a><var>127.10</var>    (3) $3 per brand-name drug prescription and $1 per generic drug prescription, <br/>
<a id="pl.127.11"></a><var>127.11</var>subject to a $12 per month maximum for prescription drug co-payments. No co-payments <br/>
<a id="pl.127.12"></a><var>127.12</var>shall apply to antipsychotic drugs when used for the treatment of mental illness; and<br/>
<a id="pl.127.13"></a><var>127.13</var>    (4) 50 percent coinsurance on restorative dental services.<br/>
<a id="pl.127.14"></a><var>127.14</var>    (f) Recipients eligible under subdivision 3, paragraph (a), shall include the following <br/>
<a id="pl.127.15"></a><var>127.15</var>co-payments for services provided on or after January 1, 2009: <br/>
<a id="pl.127.16"></a><var>127.16</var>    (1) $25 for nonemergency visits to a hospital-based emergency room; and<br/>
<a id="pl.127.17"></a><var>127.17</var>    (2) $3 per brand-name drug prescription and $1 per generic drug prescription, <br/>
<a id="pl.127.18"></a><var>127.18</var>subject to a $7 per month maximum for prescription drug co-payments. No co-payments <br/>
<a id="pl.127.19"></a><var>127.19</var>shall apply to antipsychotic drugs when used for the treatment of mental illness.<br/>
<a id="pl.127.20"></a><var>127.20</var>    (g) MS 2007 Supp [Expired]<br/>
<a id="pl.127.21"></a><var>127.21</var>    (h) Effective January 1, 2009, co-payments shall be limited to one per day per <br/>
<a id="pl.127.22"></a><var>127.22</var>provider for nonemergency visits to a hospital-based emergency room. Recipients of <br/>
<a id="pl.127.23"></a><var>127.23</var>general assistance medical care are responsible for all co-payments in this subdivision. <br/>
<a id="pl.127.24"></a><var>127.24</var>The general assistance medical care reimbursement to the provider shall be reduced by the <br/>
<a id="pl.127.25"></a><var>127.25</var>amount of the co-payment, except that reimbursement for prescription drugs shall not be <br/>
<a id="pl.127.26"></a><var>127.26</var>reduced once a recipient has reached the $7 per month maximum for prescription drug <br/>
<a id="pl.127.27"></a><var>127.27</var>co-payments. The provider collects the co-payment from the recipient. Providers may not <br/>
<a id="pl.127.28"></a><var>127.28</var>deny services to recipients who are unable to pay the co-payment.<br/>
<a id="pl.127.29"></a><var>127.29</var>    (i) General assistance medical care reimbursement to fee-for-service providers <br/>
<a id="pl.127.30"></a><var>127.30</var>and payments to managed care plans shall not be increased as a result of the removal of <br/>
<a id="pl.127.31"></a><var>127.31</var>the co-payments effective January 1, 2009.<br/>
<a id="pl.127.32"></a><var>127.32</var>    (j) Any county may, from its own resources, provide medical payments for which <br/>
<a id="pl.127.33"></a><var>127.33</var>state payments are not made.<br/>
<a id="pl.127.34"></a><var>127.34</var>    (k) Chemical dependency services that are reimbursed under chapter 254B must not <br/>
<a id="pl.127.35"></a><var>127.35</var>be reimbursed under general assistance medical care.<br/>
<a id="pl.128.1"></a><var>128.1</var>    (l) The maximum payment for new vendors enrolled in the general assistance <br/>
<a id="pl.128.2"></a><var>128.2</var>medical care program after the base year shall be determined from the average usual and <br/>
<a id="pl.128.3"></a><var>128.3</var>customary charge of the same vendor type enrolled in the base year.<br/>
<a id="pl.128.4"></a><var>128.4</var>    (m) The conditions of payment for services under this subdivision are the same <br/>
<a id="pl.128.5"></a><var>128.5</var>as the conditions specified in rules adopted under chapter 256B governing the medical <br/>
<a id="pl.128.6"></a><var>128.6</var>assistance program, unless otherwise provided by statute or rule.<br/>
<a id="pl.128.7"></a><var>128.7</var>     (n) Inpatient and outpatient payments shall be reduced by five percent, effective July <br/>
<a id="pl.128.8"></a><var>128.8</var>1, 2003. This reduction is in addition to the five percent reduction effective July 1, 2003, <br/>
<a id="pl.128.9"></a><var>128.9</var>and incorporated by reference in paragraph (l).<br/>
<a id="pl.128.10"></a><var>128.10</var>    (o) Payments for all other health services except inpatient, outpatient, and pharmacy <br/>
<a id="pl.128.11"></a><var>128.11</var>services shall be reduced by five percent, effective July 1, 2003.<br/>
<a id="pl.128.12"></a><var>128.12</var>    (p) Payments to managed care plans shall be reduced by five percent for services <br/>
<a id="pl.128.13"></a><var>128.13</var>provided on or after October 1, 2003.<br/>
<a id="pl.128.14"></a><var>128.14</var>    (q) A hospital receiving a reduced payment as a result of this section may apply the <br/>
<a id="pl.128.15"></a><var>128.15</var>unpaid balance toward satisfaction of the hospital's bad debts.<br/>
<a id="pl.128.16"></a><var>128.16</var>    (r) Fee-for-service payments for nonpreventive visits shall be reduced by $3 for <br/>
<a id="pl.128.17"></a><var>128.17</var>services provided on or after January 1, 2006. For purposes of this subdivision, a visit <br/>
<a id="pl.128.18"></a><var>128.18</var>means an episode of service which is required because of a recipient's symptoms, <br/>
<a id="pl.128.19"></a><var>128.19</var>diagnosis, or established illness, and which is delivered in an ambulatory setting by <br/>
<a id="pl.128.20"></a><var>128.20</var>a physician or physician ancillary, chiropractor, podiatrist, advance practice nurse, <br/>
<a id="pl.128.21"></a><var>128.21</var>audiologist, optician, or optometrist.<br/>
<a id="pl.128.22"></a><var>128.22</var>    (s) Payments to managed care plans shall not be increased as a result of the removal <br/>
<a id="pl.128.23"></a><var>128.23</var>of the $3 nonpreventive visit co-payment effective January 1, 2006.<br/>
<a id="pl.128.24"></a><var>128.24</var>    (t) Payments for mental health services added as covered benefits after December <br/>
<a id="pl.128.25"></a><var>128.25</var>31, 2007, are not subject to the reductions in paragraphs (l), (n), (o), and (p).<br/>
<a id="pl.128.26"></a><var>128.26</var>(u) Effective for services provided on or after July 1, 2009, total payment rates for <br/>
<a id="pl.128.27"></a><var>128.27</var>basic care services shall be reduced by three percent, in accordance with section 256B.766. <br/>
<a id="pl.128.28"></a><var>128.28</var>Payments made to managed care plans shall be reduced for services provided on or after <br/>
<a id="pl.128.29"></a><var>128.29</var>October 1, 2009, to reflect this reduction.<br/>
<a id="pl.128.30"></a><var>128.30</var>(v) Effective for services provided on or after July 1, 2009, payment rates for <br/>
<a id="pl.128.31"></a><var>128.31</var>physician and professional services shall be reduced as described under section 256B.76, <br/>
<a id="pl.128.32"></a><var>128.32</var>subdivision 1, paragraph (c). Payments made to managed care plans shall be reduced for <br/>
<a id="pl.128.33"></a><var>128.33</var>services provided on or after October 1, 2009, to reflect this reduction.<br/>
<br/>
<a id="bill.5.54.0"></a><a id="pl.128.34"></a><var>128.34</var>    Sec. 54. Minnesota Statutes 2008, section 256L.03, is amended by adding a subdivision <br/>
<a id="pl.128.35"></a><var>128.35</var>to read:<br/>
<a id="pl.129.1"></a><var>129.1</var>    Subd. 3b. <b>Chiropractic services.</b> MinnesotaCare covers the following chiropractic <br/>
<a id="pl.129.2"></a><var>129.2</var>services: medically necessary exams, manual manipulation of the spine, and x-rays.<br/>
<a id="pl.129.3"></a><var>129.3</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2010.<br/>
<br/>
<a id="bill.5.55.0"></a><a id="pl.129.4"></a><var>129.4</var>    Sec. 55. Minnesota Statutes 2008, section 256L.04, subdivision 1, is amended to read:<br/>
<a id="pl.129.5"></a><var>129.5</var>    Subdivision 1. <b>Families with children.</b> (a) Families with children with family <br/>
<a id="pl.129.6"></a><var>129.6</var>income equal to or less than 275 percent of the federal poverty guidelines for the <br/>
<a id="pl.129.7"></a><var>129.7</var>applicable family size shall be eligible for MinnesotaCare according to this section. All <br/>
<a id="pl.129.8"></a><var>129.8</var>other provisions of sections 
         <statute_ref>256L.01</statute_ref> to 
         <statute_ref>256L.18</statute_ref>, including the insurance-related barriers <br/>
<a id="pl.129.9"></a><var>129.9</var>to enrollment under section 
         <statute_ref>256L.07</statute_ref>, shall apply unless otherwise specified. <br/>
<a id="pl.129.10"></a><var>129.10</var>    (b) Parents who enroll in the MinnesotaCare program must also enroll their children, <br/>
<a id="pl.129.11"></a><var>129.11</var>if the children are eligible. Children may be enrolled separately without enrollment by <br/>
<a id="pl.129.12"></a><var>129.12</var>parents. However, if one parent in the household enrolls, both parents must enroll, unless <br/>
<a id="pl.129.13"></a><var>129.13</var>other insurance is available. If one child from a family is enrolled, all children must <br/>
<a id="pl.129.14"></a><var>129.14</var>be enrolled, unless other insurance is available. If one spouse in a household enrolls, <br/>
<a id="pl.129.15"></a><var>129.15</var>the other spouse in the household must also enroll, unless other insurance is available. <br/>
<a id="pl.129.16"></a><var>129.16</var>Families cannot choose to enroll only certain uninsured members.<br/>
<a id="pl.129.17"></a><var>129.17</var>    (c) Beginning October 1, 2003, the dependent sibling definition no longer applies <br/>
<a id="pl.129.18"></a><var>129.18</var>to the MinnesotaCare program. These persons are no longer counted in the parental <br/>
<a id="pl.129.19"></a><var>129.19</var>household and may apply as a separate household.<br/>
<a id="pl.129.20"></a><var>129.20</var>    (d) Beginning July 1, 2003, or upon federal approval, whichever is later, parents are <br/>
<a id="pl.129.21"></a><var>129.21</var>not eligible for MinnesotaCare if their gross income exceeds $57,500.<br/>
<a id="pl.129.22"></a><var>129.22</var>    (e) Children formerly enrolled in medical assistance and automatically deemed <br/>
<a id="pl.129.23"></a><var>129.23</var>eligible for MinnesotaCare according to section 
         <statute_ref>256B.057, subdivision 2c</statute_ref>, are exempt <br/>
<a id="pl.129.24"></a><var>129.24</var>from the requirements of this section until renewal.<br/>
<a id="pl.129.25"></a><var>129.25</var>(f) Children deemed eligible for MinnesotaCare under section 256L.07, subdivision <br/>
<a id="pl.129.26"></a><var>129.26</var>8, are exempt from the eligibility requirements of this subdivision.<br/>
<br/>
<a id="bill.5.56.0"></a><a id="pl.129.27"></a><var>129.27</var>    Sec. 56. Minnesota Statutes 2008, section 256L.04, is amended by adding a subdivision <br/>
<a id="pl.129.28"></a><var>129.28</var>to read:<br/>
<a id="pl.129.29"></a><var>129.29</var>    Subd. 1b. <b>Children with family income greater than 275 percent of federal </b><br/>
<a id="pl.129.30"></a><var>129.30</var><b>poverty guidelines.</b> Children with family income greater than 275 percent of federal <br/>
<a id="pl.129.31"></a><var>129.31</var>poverty guidelines for the applicable family size shall be eligible for MinnesotaCare. All <br/>
<a id="pl.129.32"></a><var>129.32</var>other provisions of sections 256L.01 to 256L.18, including the insurance-related barriers <br/>
<a id="pl.129.33"></a><var>129.33</var>to enrollment under section 256L.07, shall apply unless otherwise specified.<br/>
<a id="pl.130.1"></a><var>130.1</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2009, or upon federal <br/>
<a id="pl.130.2"></a><var>130.2</var>approval, whichever is later.<br/>
<br/>
<a id="bill.5.57.0"></a><a id="pl.130.3"></a><var>130.3</var>    Sec. 57. Minnesota Statutes 2008, section 256L.04, subdivision 7a, is amended to read:<br/>
<a id="pl.130.4"></a><var>130.4</var>    Subd. 7a. <b>Ineligibility.</b> Applicants Adults whose income is greater than the limits <br/>
<a id="pl.130.5"></a><var>130.5</var>established under this section may not enroll in the MinnesotaCare program.<br/>
<a id="pl.130.6"></a><var>130.6</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2009, or upon federal <br/>
<a id="pl.130.7"></a><var>130.7</var>approval, whichever is later.<br/>
<br/>
<a id="bill.5.58.0"></a><a id="pl.130.8"></a><var>130.8</var>    Sec. 58. Minnesota Statutes 2008, section 256L.04, subdivision 10a, is amended to <br/>
<a id="pl.130.9"></a><var>130.9</var>read:<br/>
<a id="pl.130.10"></a><var>130.10</var>    Subd. 10a. <b>Sponsor's income and resources deemed available; documentation.</b><br/>
<a id="pl.130.11"></a><var>130.11</var>When determining eligibility for any federal or state benefits under sections 
         <statute_ref>256L.01</statute_ref> to <br/>
<statute_ref><a id="pl.130.12"></a><var>130.12</var>256L.18
         </statute_ref>, the income and resources of all noncitizens whose sponsor signed an affidavit of <br/>
<a id="pl.130.13"></a><var>130.13</var>support as defined under United States Code, title 8, section 1183a, shall be deemed to <br/>
<a id="pl.130.14"></a><var>130.14</var>include their sponsors' income and resources as defined in the Personal Responsibility <br/>
<a id="pl.130.15"></a><var>130.15</var>and Work Opportunity Reconciliation Act of 1996, title IV, Public Law 104-193, sections <br/>
<a id="pl.130.16"></a><var>130.16</var>421 and 422, and subsequently set out in federal rules. To be eligible for the program, <br/>
<a id="pl.130.17"></a><var>130.17</var>noncitizens must provide documentation of their immigration status. Beginning July <br/>
<a id="pl.130.18"></a><var>130.18</var>1, 2010, or upon federal approval, whichever is later, sponsor deeming does not apply <br/>
<a id="pl.130.19"></a><var>130.19</var>to pregnant women and children who are qualified noncitizens, as described in section <br/>
<a id="pl.130.20"></a><var>130.20</var>256B.06, subdivision 4, paragraph (b).<br/>
<a id="pl.130.21"></a><var>130.21</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2010, or upon federal <br/>
<a id="pl.130.22"></a><var>130.22</var>approval, whichever is later. The commissioner shall notify the revisor of statutes when <br/>
<a id="pl.130.23"></a><var>130.23</var>federal approval has been obtained.<br/>
<br/>
<a id="bill.5.59.0"></a><a id="pl.130.24"></a><var>130.24</var>    Sec. 59. Minnesota Statutes 2008, section 256L.05, subdivision 1, is amended to read:<br/>
<a id="pl.130.25"></a><var>130.25</var>    Subdivision 1. <b>Application </b><b>assistance </b><b>and information availability.</b> (a) <br/>
<a id="pl.130.26"></a><var>130.26</var>Applications and application assistance must be made available at provider offices, local <br/>
<a id="pl.130.27"></a><var>130.27</var>human services agencies, school districts, public and private elementary schools in which <br/>
<a id="pl.130.28"></a><var>130.28</var>25 percent or more of the students receive free or reduced price lunches, community health <br/>
<a id="pl.130.29"></a><var>130.29</var>offices, Women, Infants and Children (WIC) program sites, Head Start program sites, <br/>
<a id="pl.130.30"></a><var>130.30</var>public housing councils, crisis nurseries, child care centers, early childhood education <br/>
<a id="pl.130.31"></a><var>130.31</var>and preschool program sites, legal aid offices, and libraries. These sites may accept <br/>
<a id="pl.130.32"></a><var>130.32</var>applications and forward the forms to the commissioner or local county human services <br/>
<a id="pl.131.1"></a><var>131.1</var>agencies that choose to participate as an enrollment site. Otherwise, applicants may apply <br/>
<a id="pl.131.2"></a><var>131.2</var>directly to the commissioner or to participating local county human services agencies. <br/>
<a id="pl.131.3"></a><var>131.3</var>(b) Application assistance must be available for applicants choosing to file an <br/>
<a id="pl.131.4"></a><var>131.4</var>online application.<br/>
<br/>
<a id="bill.5.60.0"></a><a id="pl.131.5"></a><var>131.5</var>    Sec. 60. Minnesota Statutes 2008, section 256L.05, is amended by adding a subdivision <br/>
<a id="pl.131.6"></a><var>131.6</var>to read:<br/>
<a id="pl.131.7"></a><var>131.7</var>    Subd. 1c. <b>Open enrollment and streamlined application and enrollment </b><br/>
<a id="pl.131.8"></a><var>131.8</var><b>process.</b> (a) The commissioner and local agencies working in partnership must develop a <br/>
<a id="pl.131.9"></a><var>131.9</var>streamlined and efficient application and enrollment process for medical assistance and <br/>
<a id="pl.131.10"></a><var>131.10</var>MinnesotaCare enrollees that meets the criteria specified in this subdivision.<br/>
<a id="pl.131.11"></a><var>131.11</var>(b) The commissioners of human services and education shall provide <br/>
<a id="pl.131.12"></a><var>131.12</var>recommendations to the legislature by January 15, 2010, on the creation of an open <br/>
<a id="pl.131.13"></a><var>131.13</var>enrollment process for medical assistance and MinnesotaCare that is coordinated with <br/>
<a id="pl.131.14"></a><var>131.14</var>the public education system. The recommendations must:<br/>
<a id="pl.131.15"></a><var>131.15</var>(1) be developed in consultation with medical assistance and MinnesotaCare <br/>
<a id="pl.131.16"></a><var>131.16</var>enrollees and representatives from organizations that advocate on behalf of children and <br/>
<a id="pl.131.17"></a><var>131.17</var>families, low-income persons and minority populations, counties, school administrators <br/>
<a id="pl.131.18"></a><var>131.18</var>and nurses, health plans, and health care providers;<br/>
<a id="pl.131.19"></a><var>131.19</var> (2) be based on enrollment and renewal procedures best practices, including express <br/>
<a id="pl.131.20"></a><var>131.20</var>lane eligibility as required under subdivision 1d;<br/>
<a id="pl.131.21"></a><var>131.21</var>(3) simplify the enrollment and renewal processes wherever possible; and<br/>
<a id="pl.131.22"></a><var>131.22</var>(4) establish a process:<br/>
<a id="pl.131.23"></a><var>131.23</var>(i) to disseminate information on medical assistance and MinnesotaCare to all <br/>
<a id="pl.131.24"></a><var>131.24</var>children in the public education system, including prekindergarten programs; and<br/>
<a id="pl.131.25"></a><var>131.25</var>(ii) for the commissioner of human services to enroll children and other household <br/>
<a id="pl.131.26"></a><var>131.26</var>members who are eligible.<br/>
<a id="pl.131.27"></a><var>131.27</var>The commissioner of human services in coordination with the commissioner of <br/>
<a id="pl.131.28"></a><var>131.28</var>education shall implement an open enrollment process by August 1, 2010, to be effective <br/>
<a id="pl.131.29"></a><var>131.29</var>beginning with the 2010-2011 school year.<br/>
<a id="pl.131.30"></a><var>131.30</var>(c) The commissioner and local agencies shall develop an online application process <br/>
<a id="pl.131.31"></a><var>131.31</var>for medical assistance and MinnesotaCare.<br/>
<a id="pl.131.32"></a><var>131.32</var>(d) The commissioner shall develop an application that is easily understandable <br/>
<a id="pl.131.33"></a><var>131.33</var>and does not exceed four pages in length.<br/>
<a id="pl.132.1"></a><var>132.1</var>(e) The commissioner of human services shall present to the legislature, by January <br/>
<a id="pl.132.2"></a><var>132.2</var>15, 2010, an implementation plan for the open enrollment period and online application <br/>
<a id="pl.132.3"></a><var>132.3</var>process.<br/>
<a id="pl.132.4"></a><var>132.4</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2010, or upon federal <br/>
<a id="pl.132.5"></a><var>132.5</var>approval, which must be requested by the commissioner, whichever is later.<br/>
<br/>
<a id="bill.5.61.0"></a><a id="pl.132.6"></a><var>132.6</var>    Sec. 61. Minnesota Statutes 2008, section 256L.05, subdivision 3, is amended to read:<br/>
<a id="pl.132.7"></a><var>132.7</var>    Subd. 3. <b>Effective date of coverage.</b> (a) The effective date of coverage is the <br/>
<a id="pl.132.8"></a><var>132.8</var>first day of the month following the month in which eligibility is approved and the first <br/>
<a id="pl.132.9"></a><var>132.9</var>premium payment has been received. As provided in section 
         <statute_ref>256B.057</statute_ref>, coverage for <br/>
<a id="pl.132.10"></a><var>132.10</var>newborns is automatic from the date of birth and must be coordinated with other health <br/>
<a id="pl.132.11"></a><var>132.11</var>coverage. The effective date of coverage for eligible newly adoptive children added to a <br/>
<a id="pl.132.12"></a><var>132.12</var>family receiving covered health services is the month of placement. The effective date <br/>
<a id="pl.132.13"></a><var>132.13</var>of coverage for other new members added to the family is the first day of the month <br/>
<a id="pl.132.14"></a><var>132.14</var>following the month in which the change is reported. All eligibility criteria must be met <br/>
<a id="pl.132.15"></a><var>132.15</var>by the family at the time the new family member is added. The income of the new family <br/>
<a id="pl.132.16"></a><var>132.16</var>member is included with the family's gross income and the adjusted premium begins in <br/>
<a id="pl.132.17"></a><var>132.17</var>the month the new family member is added.<br/>
<a id="pl.132.18"></a><var>132.18</var>(b) The initial premium must be received by the last working day of the month for <br/>
<a id="pl.132.19"></a><var>132.19</var>coverage to begin the first day of the following month.<br/>
<a id="pl.132.20"></a><var>132.20</var>(c) Benefits are not available until the day following discharge if an enrollee is <br/>
<a id="pl.132.21"></a><var>132.21</var>hospitalized on the first day of coverage.<br/>
<a id="pl.132.22"></a><var>132.22</var>(d) Notwithstanding any other law to the contrary, benefits under sections 
         <statute_ref>256L.01</statute_ref> to <br/>
<statute_ref><a id="pl.132.23"></a><var>132.23</var>256L.18
         </statute_ref> are secondary to a plan of insurance or benefit program under which an eligible <br/>
<a id="pl.132.24"></a><var>132.24</var>person may have coverage and the commissioner shall use cost avoidance techniques to <br/>
<a id="pl.132.25"></a><var>132.25</var>ensure coordination of any other health coverage for eligible persons. The commissioner <br/>
<a id="pl.132.26"></a><var>132.26</var>shall identify eligible persons who may have coverage or benefits under other plans of <br/>
<a id="pl.132.27"></a><var>132.27</var>insurance or who become eligible for medical assistance.<br/>
<a id="pl.132.28"></a><var>132.28</var>(e) The effective date of coverage for single adults and households with no children <br/>
<a id="pl.132.29"></a><var>132.29</var>formerly enrolled in general assistance medical care and enrolled in MinnesotaCare <br/>
<a id="pl.132.30"></a><var>132.30</var>according to section 
         <statute_ref>256D.03, subdivision 3</statute_ref>, is the first day of the month following the <br/>
<a id="pl.132.31"></a><var>132.31</var>last day of general assistance medical care coverage.<br/>
<a id="pl.132.32"></a><var>132.32</var>(f) The effective date of coverage for children eligible under section 256L.07, <br/>
<a id="pl.132.33"></a><var>132.33</var>subdivision 8, is the first day of the month following the date of termination from foster <br/>
<a id="pl.132.34"></a><var>132.34</var>care or release from a juvenile residential correctional facility.<br/>
<a id="pl.133.1"></a><var>133.1</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2009, or upon federal <br/>
<a id="pl.133.2"></a><var>133.2</var>approval, whichever is later.<br/>
<br/>
<a id="bill.5.62.0"></a><a id="pl.133.3"></a><var>133.3</var>    Sec. 62. Minnesota Statutes 2008, section 256L.05, subdivision 3a, is amended to read:<br/>
<a id="pl.133.4"></a><var>133.4</var>    Subd. 3a. <b>Renewal of eligibility.</b> (a) Beginning July 1, 2007, an enrollee's eligibility <br/>
<a id="pl.133.5"></a><var>133.5</var>must be renewed every 12 months. The 12-month period begins in the month after the <br/>
<a id="pl.133.6"></a><var>133.6</var>month the application is approved.<br/>
<a id="pl.133.7"></a><var>133.7</var>    (b) Each new period of eligibility must take into account any changes in <br/>
<a id="pl.133.8"></a><var>133.8</var>circumstances that impact eligibility and premium amount. An enrollee must provide all <br/>
<a id="pl.133.9"></a><var>133.9</var>the information needed to redetermine eligibility by the first day of the month that ends <br/>
<a id="pl.133.10"></a><var>133.10</var>the eligibility period. If there is no change in circumstances, the enrollee may renew <br/>
<a id="pl.133.11"></a><var>133.11</var>eligibility at designated locations that include community clinics and health care providers' <br/>
<a id="pl.133.12"></a><var>133.12</var>offices. The designated sites shall forward the renewal forms to the commissioner. The <br/>
<a id="pl.133.13"></a><var>133.13</var>commissioner may establish criteria and timelines for sites to forward applications to the <br/>
<a id="pl.133.14"></a><var>133.14</var>commissioner or county agencies. The premium for the new period of eligibility must be <br/>
<a id="pl.133.15"></a><var>133.15</var>received as provided in section 
         <statute_ref>256L.06</statute_ref> in order for eligibility to continue.<br/>
<a id="pl.133.16"></a><var>133.16</var>    (c) For single adults and households with no children formerly enrolled in general <br/>
<a id="pl.133.17"></a><var>133.17</var>assistance medical care and enrolled in MinnesotaCare according to section 
         <statute_ref>256D.03, <br/>
<a id="pl.133.18"></a><var>133.18</var>subdivision 3
         </statute_ref>, the first period of eligibility begins the month the enrollee submitted the <br/>
<a id="pl.133.19"></a><var>133.19</var>application or renewal for general assistance medical care.<br/>
<a id="pl.133.20"></a><var>133.20</var>    (d) An enrollee Notwithstanding paragraph (e), an enrollee who fails to submit <br/>
<a id="pl.133.21"></a><var>133.21</var>renewal forms and related documentation necessary for verification of continued eligibility <br/>
<a id="pl.133.22"></a><var>133.22</var>in a timely manner shall remain eligible for one additional month beyond the end of the <br/>
<a id="pl.133.23"></a><var>133.23</var>current eligibility period before being disenrolled. The enrollee remains responsible for <br/>
<a id="pl.133.24"></a><var>133.24</var>MinnesotaCare premiums for the additional month.<br/>
<a id="pl.133.25"></a><var>133.25</var>(e) Children in families with family income equal to or below 275 percent of federal <br/>
<a id="pl.133.26"></a><var>133.26</var>poverty guidelines who fail to submit renewal forms and related documentation necessary <br/>
<a id="pl.133.27"></a><var>133.27</var>for verification of continued eligibility in a timely manner shall remain eligible for the <br/>
<a id="pl.133.28"></a><var>133.28</var>program. The commissioner shall use the means described in subdivision 2 or any other <br/>
<a id="pl.133.29"></a><var>133.29</var>means available to verify family income. If the commissioner determines that there has <br/>
<a id="pl.133.30"></a><var>133.30</var>been a change in income in which premium payment is required to remain enrolled, the <br/>
<a id="pl.133.31"></a><var>133.31</var>commissioner shall notify the family of the premium payment, and that the children <br/>
<a id="pl.133.32"></a><var>133.32</var>will be disenrolled if the premium payment is not received effective the first day of the <br/>
<a id="pl.133.33"></a><var>133.33</var>calendar month following the calendar month for which the premium is due.<br/>
<a id="pl.133.34"></a><var>133.34</var>(f) For children enrolled in MinnesotaCare under section 256L.07, subdivision 8, the <br/>
<a id="pl.133.35"></a><var>133.35</var>first period of renewal begins the month the enrollee turns 21 years of age.<br/>
<a id="pl.134.1"></a><var>134.1</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2009, or upon federal <br/>
<a id="pl.134.2"></a><var>134.2</var>approval, whichever is later.<br/>
<br/>
<a id="bill.5.63.0"></a><a id="pl.134.3"></a><var>134.3</var>    Sec. 63. Minnesota Statutes 2008, section 256L.07, subdivision 1, is amended to read:<br/>
<a id="pl.134.4"></a><var>134.4</var>    Subdivision 1. <b>General requirements.</b> (a) Children enrolled in the original <br/>
<a id="pl.134.5"></a><var>134.5</var>children's health plan as of September 30, 1992, children who enrolled in the <br/>
<a id="pl.134.6"></a><var>134.6</var>MinnesotaCare program after September 30, 1992, pursuant to Laws 1992, chapter 549, <br/>
<a id="pl.134.7"></a><var>134.7</var>article 4, section 17, and children who have family gross incomes that are equal to or <br/>
<a id="pl.134.8"></a><var>134.8</var>less than 150 200 percent of the federal poverty guidelines are eligible without meeting <br/>
<a id="pl.134.9"></a><var>134.9</var>the requirements of subdivision 2 and the four-month requirement in subdivision 3, as <br/>
<a id="pl.134.10"></a><var>134.10</var>long as they maintain continuous coverage in the MinnesotaCare program or medical <br/>
<a id="pl.134.11"></a><var>134.11</var>assistance. Children who apply for MinnesotaCare on or after the implementation date <br/>
<a id="pl.134.12"></a><var>134.12</var>of the employer-subsidized health coverage program as described in Laws 1998, chapter <br/>
<a id="pl.134.13"></a><var>134.13</var>407, article 5, section 45, who have family gross incomes that are equal to or less than 150 <br/>
<a id="pl.134.14"></a><var>134.14</var>percent of the federal poverty guidelines, must meet the requirements of subdivision 2 to <br/>
<a id="pl.134.15"></a><var>134.15</var>be eligible for MinnesotaCare.<br/>
<a id="pl.134.16"></a><var>134.16</var>    Families Parents enrolled in MinnesotaCare under section 
         <statute_ref>256L.04, subdivision 1</statute_ref>, <br/>
<a id="pl.134.17"></a><var>134.17</var>whose income increases above 275 percent of the federal poverty guidelines, are no longer <br/>
<a id="pl.134.18"></a><var>134.18</var>eligible for the program and shall be disenrolled by the commissioner. Beginning January <br/>
<a id="pl.134.19"></a><var>134.19</var>1, 2008, individuals enrolled in MinnesotaCare under section 
         <statute_ref>256L.04, subdivision <br/>
<a id="pl.134.20"></a><var>134.20</var>7
         </statute_ref>, whose income increases above 200 percent of the federal poverty guidelines or 250 <br/>
<a id="pl.134.21"></a><var>134.21</var>percent of the federal poverty guidelines on or after July 1, 2009, are no longer eligible for <br/>
<a id="pl.134.22"></a><var>134.22</var>the program and shall be disenrolled by the commissioner. For persons disenrolled under <br/>
<a id="pl.134.23"></a><var>134.23</var>this subdivision, MinnesotaCare coverage terminates the last day of the calendar month <br/>
<a id="pl.134.24"></a><var>134.24</var>following the month in which the commissioner determines that the income of a family or <br/>
<a id="pl.134.25"></a><var>134.25</var>individual exceeds program income limits.<br/>
<a id="pl.134.26"></a><var>134.26</var>    (b) Notwithstanding paragraph (a), Children may remain enrolled in MinnesotaCare <br/>
<a id="pl.134.27"></a><var>134.27</var>if ten percent of their gross individual or gross family income as defined in section <br/>
<statute_ref><a id="pl.134.28"></a><var>134.28</var>256L.01, subdivision 4
         </statute_ref>, is less than the annual premium for a policy with a $500 <br/>
<a id="pl.134.29"></a><var>134.29</var>deductible available through the Minnesota Comprehensive Health Association. Children <br/>
<a id="pl.134.30"></a><var>134.30</var>who are no longer eligible for MinnesotaCare under this clause shall be given a 12-month <br/>
<a id="pl.134.31"></a><var>134.31</var>notice period from the date that ineligibility is determined before disenrollment greater <br/>
<a id="pl.134.32"></a><var>134.32</var>than 275 percent of federal poverty guidelines. The premium for children remaining <br/>
<a id="pl.134.33"></a><var>134.33</var>eligible under this clause paragraph shall be the maximum premium determined under <br/>
<a id="pl.134.34"></a><var>134.34</var>section 
         <statute_ref>256L.15, subdivision 2</statute_ref>, paragraph (b).<br/>
<a id="pl.135.1"></a><var>135.1</var>    (c) Notwithstanding paragraphs paragraph (a) and (b), parents are not eligible for <br/>
<a id="pl.135.2"></a><var>135.2</var>MinnesotaCare if gross household income exceeds $57,500 for the 12-month period <br/>
<a id="pl.135.3"></a><var>135.3</var>of eligibility.<br/>
<a id="pl.135.4"></a><var>135.4</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2009, or upon federal <br/>
<a id="pl.135.5"></a><var>135.5</var>approval, whichever is later.<br/>
<br/>
<a id="bill.5.64.0"></a><a id="pl.135.6"></a><var>135.6</var>    Sec. 64. Minnesota Statutes 2008, section 256L.07, subdivision 2, is amended to read:<br/>
<a id="pl.135.7"></a><var>135.7</var>    Subd. 2. <b>Must not have access to employer-subsidized coverage.</b> (a) To be <br/>
<a id="pl.135.8"></a><var>135.8</var>eligible, a family or individual must not have access to subsidized health coverage through <br/>
<a id="pl.135.9"></a><var>135.9</var>an employer and must not have had access to employer-subsidized coverage through <br/>
<a id="pl.135.10"></a><var>135.10</var>a current employer for 18 months prior to application or reapplication. A family or <br/>
<a id="pl.135.11"></a><var>135.11</var>individual whose employer-subsidized coverage is lost due to an employer terminating <br/>
<a id="pl.135.12"></a><var>135.12</var>health care coverage as an employee benefit during the previous 18 months is not eligible.<br/>
<a id="pl.135.13"></a><var>135.13</var>(b) This subdivision does not apply to a family or individual who was enrolled <br/>
<a id="pl.135.14"></a><var>135.14</var>in MinnesotaCare within six months or less of reapplication and who no longer has <br/>
<a id="pl.135.15"></a><var>135.15</var>employer-subsidized coverage due to the employer terminating health care coverage as an <br/>
<a id="pl.135.16"></a><var>135.16</var>employee benefit. This subdivision does not apply to children with family gross incomes <br/>
<a id="pl.135.17"></a><var>135.17</var>that are equal to or less than 200 percent of federal poverty guidelines.<br/>
<a id="pl.135.18"></a><var>135.18</var>(c) For purposes of this requirement, subsidized health coverage means health <br/>
<a id="pl.135.19"></a><var>135.19</var>coverage for which the employer pays at least 50 percent of the cost of coverage for <br/>
<a id="pl.135.20"></a><var>135.20</var>the employee or dependent, or a higher percentage as specified by the commissioner. <br/>
<a id="pl.135.21"></a><var>135.21</var>Children are eligible for employer-subsidized coverage through either parent, including <br/>
<a id="pl.135.22"></a><var>135.22</var>the noncustodial parent. The commissioner must treat employer contributions to Internal <br/>
<a id="pl.135.23"></a><var>135.23</var>Revenue Code Section 125 plans and any other employer benefits intended to pay <br/>
<a id="pl.135.24"></a><var>135.24</var>health care costs as qualified employer subsidies toward the cost of health coverage for <br/>
<a id="pl.135.25"></a><var>135.25</var>employees for purposes of this subdivision.<br/>
<a id="pl.135.26"></a><var>135.26</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2009, or upon federal <br/>
<a id="pl.135.27"></a><var>135.27</var>approval, whichever is later.<br/>
<br/>
<a id="bill.5.65.0"></a><a id="pl.135.28"></a><var>135.28</var>    Sec. 65. Minnesota Statutes 2008, section 256L.07, subdivision 3, is amended to read:<br/>
<a id="pl.135.29"></a><var>135.29</var>    Subd. 3. <b>Other health coverage.</b> (a) Families and individuals enrolled in the <br/>
<a id="pl.135.30"></a><var>135.30</var>MinnesotaCare program must have no health coverage while enrolled or for at least four <br/>
<a id="pl.135.31"></a><var>135.31</var>months prior to application and renewal. Children with family gross incomes equal to or <br/>
<a id="pl.135.32"></a><var>135.32</var>greater than 200 percent of federal poverty guidelines, and adults, must have had no health <br/>
<a id="pl.135.33"></a><var>135.33</var>coverage for at least four months prior to application and renewal. Children enrolled in the <br/>
<a id="pl.135.34"></a><var>135.34</var>original children's health plan and children in families with income equal to or less than <br/>
<a id="pl.136.1"></a><var>136.1</var>150 200 percent of the federal poverty guidelines, who have other health insurance, are <br/>
<a id="pl.136.2"></a><var>136.2</var>eligible if the coverage:<br/>
<a id="pl.136.3"></a><var>136.3</var>(1) lacks two or more of the following:<br/>
<a id="pl.136.4"></a><var>136.4</var>(i) basic hospital insurance;<br/>
<a id="pl.136.5"></a><var>136.5</var>(ii) medical-surgical insurance;<br/>
<a id="pl.136.6"></a><var>136.6</var>(iii) prescription drug coverage;<br/>
<a id="pl.136.7"></a><var>136.7</var>(iv) dental coverage; or<br/>
<a id="pl.136.8"></a><var>136.8</var>(v) vision coverage;<br/>
<a id="pl.136.9"></a><var>136.9</var>(2) requires a deductible of $100 or more per person per year; or<br/>
<a id="pl.136.10"></a><var>136.10</var>(3) lacks coverage because the child has exceeded the maximum coverage for a <br/>
<a id="pl.136.11"></a><var>136.11</var>particular diagnosis or the policy excludes a particular diagnosis.<br/>
<a id="pl.136.12"></a><var>136.12</var>The commissioner may change this eligibility criterion for sliding scale premiums <br/>
<a id="pl.136.13"></a><var>136.13</var>in order to remain within the limits of available appropriations. The requirement of no <br/>
<a id="pl.136.14"></a><var>136.14</var>health coverage does not apply to newborns.<br/>
<a id="pl.136.15"></a><var>136.15</var>(b) Medical assistance, general assistance medical care, and the Civilian Health and <br/>
<a id="pl.136.16"></a><var>136.16</var>Medical Program of the Uniformed Service, CHAMPUS, or other coverage provided under <br/>
<a id="pl.136.17"></a><var>136.17</var>United States Code, title 10, subtitle A, part II, chapter 55, are not considered insurance or <br/>
<a id="pl.136.18"></a><var>136.18</var>health coverage for purposes of the four-month requirement described in this subdivision.<br/>
<a id="pl.136.19"></a><var>136.19</var>(c) For purposes of this subdivision, an applicant or enrollee who is entitled to <br/>
<a id="pl.136.20"></a><var>136.20</var>Medicare Part A or enrolled in Medicare Part B coverage under title XVIII of the Social <br/>
<a id="pl.136.21"></a><var>136.21</var>Security Act, United States Code, title 42, sections 1395c to 1395w-152, is considered to <br/>
<a id="pl.136.22"></a><var>136.22</var>have health coverage. An applicant or enrollee who is entitled to premium-free Medicare <br/>
<a id="pl.136.23"></a><var>136.23</var>Part A may not refuse to apply for or enroll in Medicare coverage to establish eligibility <br/>
<a id="pl.136.24"></a><var>136.24</var>for MinnesotaCare.<br/>
<a id="pl.136.25"></a><var>136.25</var>(d) Applicants who were recipients of medical assistance or general assistance <br/>
<a id="pl.136.26"></a><var>136.26</var>medical care within one month of application must meet the provisions of this subdivision <br/>
<a id="pl.136.27"></a><var>136.27</var>and subdivision 2.<br/>
<a id="pl.136.28"></a><var>136.28</var>(e) Cost-effective health insurance that was paid for by medical assistance is not <br/>
<a id="pl.136.29"></a><var>136.29</var>considered health coverage for purposes of the four-month requirement under this <br/>
<a id="pl.136.30"></a><var>136.30</var>section, except if the insurance continued after medical assistance no longer considered it <br/>
<a id="pl.136.31"></a><var>136.31</var>cost-effective or after medical assistance closed.<br/>
<a id="pl.136.32"></a><var>136.32</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2009, or upon federal <br/>
<a id="pl.136.33"></a><var>136.33</var>approval, whichever is later.<br/>
<br/>
<a id="bill.5.66.0"></a><a id="pl.136.34"></a><var>136.34</var>    Sec. 66. Minnesota Statutes 2008, section 256L.07, is amended by adding a subdivision <br/>
<a id="pl.136.35"></a><var>136.35</var>to read:<br/>
<a id="pl.137.1"></a><var>137.1</var>    Subd. 8. <b>Automatic eligibility for certain children.</b> Any child who was residing <br/>
<a id="pl.137.2"></a><var>137.2</var>in foster care or a juvenile residential correctional facility on the child's 18th birthday is <br/>
<a id="pl.137.3"></a><var>137.3</var>automatically deemed eligible for MinnesotaCare upon termination or release until the <br/>
<a id="pl.137.4"></a><var>137.4</var>child reaches the age of 21, and is exempt from the requirements of this section and <br/>
<a id="pl.137.5"></a><var>137.5</var>section 256L.15. To be enrolled under this section, a child must complete an initial <br/>
<a id="pl.137.6"></a><var>137.6</var>application for MinnesotaCare. The commissioner shall contact individuals enrolled <br/>
<a id="pl.137.7"></a><var>137.7</var>under this section annually to ensure the individual continues to reside in the state and is <br/>
<a id="pl.137.8"></a><var>137.8</var>interested in continuing MinnesotaCare coverage.<br/>
<a id="pl.137.9"></a><var>137.9</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2009, or upon federal <br/>
<a id="pl.137.10"></a><var>137.10</var>approval, whichever is later.<br/>
<br/>
<a id="bill.5.67.0"></a><a id="pl.137.11"></a><var>137.11</var>    Sec. 67. Minnesota Statutes 2008, section 256L.11, subdivision 1, is amended to read:<br/>
<a id="pl.137.12"></a><var>137.12</var>    Subdivision 1. <b>Medical assistance rate to be used.</b> (a) Payment to providers under <br/>
<a id="pl.137.13"></a><var>137.13</var>sections 
         <statute_ref>256L.01</statute_ref> to 
         <statute_ref>256L.11</statute_ref> shall be at the same rates and conditions established for <br/>
<a id="pl.137.14"></a><var>137.14</var>medical assistance, except as provided in subdivisions 2 to 6. <br/>
<a id="pl.137.15"></a><var>137.15</var>(b) Effective for services provided on or after July 1, 2009, total payments for basic <br/>
<a id="pl.137.16"></a><var>137.16</var>care services shall be reduced by three percent, in accordance with section 256B.766. <br/>
<a id="pl.137.17"></a><var>137.17</var>Payments made to managed care plans shall be reduced for services provided on or after <br/>
<a id="pl.137.18"></a><var>137.18</var>October 1, 2009, to reflect this reduction.<br/>
<br/>
<a id="bill.5.68.0"></a><a id="pl.137.19"></a><var>137.19</var>    Sec. 68. Minnesota Statutes 2008, section 256L.15, subdivision 2, is amended to read:<br/>
<a id="pl.137.20"></a><var>137.20</var>    Subd. 2. <b>Sliding fee scale; monthly gross individual or family income.</b> (a) The <br/>
<a id="pl.137.21"></a><var>137.21</var>commissioner shall establish a sliding fee scale to determine the percentage of monthly <br/>
<a id="pl.137.22"></a><var>137.22</var>gross individual or family income that households at different income levels must pay to <br/>
<a id="pl.137.23"></a><var>137.23</var>obtain coverage through the MinnesotaCare program. The sliding fee scale must be based <br/>
<a id="pl.137.24"></a><var>137.24</var>on the enrollee's monthly gross individual or family income. The sliding fee scale must <br/>
<a id="pl.137.25"></a><var>137.25</var>contain separate tables based on enrollment of one, two, or three or more persons. Until <br/>
<a id="pl.137.26"></a><var>137.26</var>June 30, 2009, the sliding fee scale begins with a premium of 1.5 percent of monthly gross <br/>
<a id="pl.137.27"></a><var>137.27</var>individual or family income for individuals or families with incomes below the limits for <br/>
<a id="pl.137.28"></a><var>137.28</var>the medical assistance program for families and children in effect on January 1, 1999, and <br/>
<a id="pl.137.29"></a><var>137.29</var>proceeds through the following evenly spaced steps: 1.8, 2.3, 3.1, 3.8, 4.8, 5.9, 7.4, and <br/>
<a id="pl.137.30"></a><var>137.30</var>8.8 percent. These percentages are matched to evenly spaced income steps ranging from <br/>
<a id="pl.137.31"></a><var>137.31</var>the medical assistance income limit for families and children in effect on January 1, 1999, <br/>
<a id="pl.137.32"></a><var>137.32</var>to 275 percent of the federal poverty guidelines for the applicable family size, up to a <br/>
<a id="pl.137.33"></a><var>137.33</var>family size of five. The sliding fee scale for a family of five must be used for families of <br/>
<a id="pl.137.34"></a><var>137.34</var>more than five. The sliding fee scale and percentages are not subject to the provisions of <br/>
<a id="pl.138.1"></a><var>138.1</var>chapter 14. If a family or individual reports increased income after enrollment, premiums <br/>
<a id="pl.138.2"></a><var>138.2</var>shall be adjusted at the time the change in income is reported.<br/>
<a id="pl.138.3"></a><var>138.3</var>    (b) Children in families whose gross income is above 275 percent of the federal <br/>
<a id="pl.138.4"></a><var>138.4</var>poverty guidelines shall pay the maximum premium. The maximum premium is defined <br/>
<a id="pl.138.5"></a><var>138.5</var>as a base charge for one, two, or three or more enrollees so that if all MinnesotaCare <br/>
<a id="pl.138.6"></a><var>138.6</var>cases paid the maximum premium, the total revenue would equal the total cost of <br/>
<a id="pl.138.7"></a><var>138.7</var>MinnesotaCare medical coverage and administration. In this calculation, administrative <br/>
<a id="pl.138.8"></a><var>138.8</var>costs shall be assumed to equal ten percent of the total. The costs of medical coverage <br/>
<a id="pl.138.9"></a><var>138.9</var>for pregnant women and children under age two and the enrollees in these groups shall <br/>
<a id="pl.138.10"></a><var>138.10</var>be excluded from the total. The maximum premium for two enrollees shall be twice the <br/>
<a id="pl.138.11"></a><var>138.11</var>maximum premium for one, and the maximum premium for three or more enrollees shall <br/>
<a id="pl.138.12"></a><var>138.12</var>be three times the maximum premium for one.<br/>
<a id="pl.138.13"></a><var>138.13</var>    (c) Beginning July 1, 2009, MinnesotaCare enrollees shall pay premiums according <br/>
<a id="pl.138.14"></a><var>138.14</var>to the premium scale specified in paragraph (d) with the exception that children in families <br/>
<a id="pl.138.15"></a><var>138.15</var>with income at or below 150 200 percent of the federal poverty guidelines shall pay <br/>
<a id="pl.138.16"></a><var>138.16</var>a monthly premium of $4 no premiums. For purposes of paragraph (d), "minimum" <br/>
<a id="pl.138.17"></a><var>138.17</var>means a monthly premium of $4.<br/>
<a id="pl.138.18"></a><var>138.18</var>    (d) The following premium scale is established for individuals and families with <br/>
<a id="pl.138.19"></a><var>138.19</var>gross family incomes of 300 percent of the federal poverty guidelines or less:<br/>
<table>
<col width="50px"/>
<col width=""/>
<col width=""/>
<tr>
<td><a id="pl.138.20"></a><var>138.20</var><br/>
<a id="pl.138.21"></a><var>138.21</var><br/>
</td>
<td><b>Federal Poverty Guideline Range</b><br/>
</td>
<td><b>Percent of Average Gross Monthly </b><br/>
<b>Income</b><br/>
</td>
</tr>
<tr>
<td><a id="pl.138.22"></a><var>138.22</var><br/>
</td>
<td>0-45%<br/>
</td>
<td>minimum<br/>
</td>
</tr>
<tr>
<td><a id="pl.138.23"></a><var>138.23</var><br/>
</td>
<td>46-54%<br/>
</td>
<td>1.1%<br/>
</td>
</tr>
<tr>
<td><a id="pl.138.24"></a><var>138.24</var><br/>
</td>
<td>55-81%<br/>
</td>
<td>1.6%<br/>
</td>
</tr>
<tr>
<td><a id="pl.138.25"></a><var>138.25</var><br/>
</td>
<td>82-109%<br/>
</td>
<td>2.2%<br/>
</td>
</tr>
<tr>
<td><a id="pl.138.26"></a><var>138.26</var><br/>
</td>
<td>110-136%<br/>
</td>
<td>2.9%<br/>
</td>
</tr>
<tr>
<td><a id="pl.138.27"></a><var>138.27</var><br/>
</td>
<td>137-164%<br/>
</td>
<td>3.6%<br/>
</td>
</tr>
<tr>
<td><a id="pl.138.28"></a><var>138.28</var><br/>
</td>
<td>165-191%<br/>
</td>
<td>4.6%<br/>
</td>
</tr>
<tr>
<td><a id="pl.138.29"></a><var>138.29</var><br/>
</td>
<td>192-219%<br/>
</td>
<td>5.6%<br/>
</td>
</tr>
<tr>
<td><a id="pl.138.30"></a><var>138.30</var><br/>
</td>
<td>220-248%<br/>
</td>
<td>6.5%<br/>
</td>
</tr>
<tr>
<td><a id="pl.138.31"></a><var>138.31</var><br/>
</td>
<td>249-274%<br/>
</td>
<td>7.2%<br/>
</td>
</tr>
<tr>
<td><a id="pl.138.32"></a><var>138.32</var><br/>
</td>
<td>275-300%<br/>
</td>
<td>8.0%<br/>
</td>
</tr>
</table><a id="pl.139.1"></a><var>139.1</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2009, or upon federal <br/>
<a id="pl.139.2"></a><var>139.2</var>approval, whichever is later.<br/>
<br/>
<a id="bill.5.69.0"></a><a id="pl.139.3"></a><var>139.3</var>    Sec. 69. Minnesota Statutes 2008, section 256L.15, subdivision 3, is amended to read:<br/>
<a id="pl.139.4"></a><var>139.4</var>    Subd. 3. <b>Exceptions to sliding scale.</b> Children in families with income at or below <br/>
<a id="pl.139.5"></a><var>139.5</var>150 200 percent of the federal poverty guidelines shall pay a no monthly premium of <br/>
<a id="pl.139.6"></a><var>139.6</var>$4 premiums.<br/>
<a id="pl.139.7"></a><var>139.7</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2009, or upon federal <br/>
<a id="pl.139.8"></a><var>139.8</var>approval, whichever is later.<br/>
<br/>
<a id="bill.5.70.0"></a><a id="pl.139.9"></a><var>139.9</var>    Sec. 70. Minnesota Statutes 2008, section 256L.17, subdivision 3, is amended to read:<br/>
<a id="pl.139.10"></a><var>139.10</var>    Subd. 3. <b>Documentation.</b> (a) The commissioner of human services shall require <br/>
<a id="pl.139.11"></a><var>139.11</var>individuals and families, at the time of application or renewal, to indicate on a checkoff <br/>
<a id="pl.139.12"></a><var>139.12</var>form developed by the commissioner whether they satisfy the MinnesotaCare asset <br/>
<a id="pl.139.13"></a><var>139.13</var>requirement. <br/>
<a id="pl.139.14"></a><var>139.14</var>    (b) The commissioner may require individuals and families to provide any <br/>
<a id="pl.139.15"></a><var>139.15</var>information the commissioner determines necessary to verify compliance with the asset <br/>
<a id="pl.139.16"></a><var>139.16</var>requirement, if the commissioner determines that there is reason to believe that an <br/>
<a id="pl.139.17"></a><var>139.17</var>individual or family has assets that exceed the program limit.<br/>
<br/>
<a id="bill.5.71.0"></a><a id="pl.139.18"></a><var>139.18</var>    Sec. 71. Minnesota Statutes 2008, section 256L.17, subdivision 5, is amended to read:<br/>
<a id="pl.139.19"></a><var>139.19</var>    Subd. 5. <b>Exemption.</b> This section does not apply to pregnant women or children. <br/>
<a id="pl.139.20"></a><var>139.20</var>For purposes of this subdivision, a woman is considered pregnant for 60 days postpartum.<br/>
<br/>
<a id="bill.5.72.0"></a><a id="pl.139.21"></a><var>139.21</var>    Sec. 72. Minnesota Statutes 2008, section 501B.89, is amended by adding a <br/>
<a id="pl.139.22"></a><var>139.22</var>subdivision to read:<br/>
<a id="pl.139.23"></a><var>139.23</var>    Subd. 4. <b>Annual filing requirement for supplemental needs trusts.</b> (a) A trustee <br/>
<a id="pl.139.24"></a><var>139.24</var>of a trust under subdivision 3 and United States Code, title 42, section 1396p(d)(4)(A) or <br/>
<a id="pl.139.25"></a><var>139.25</var>(C), shall submit to the commissioner of human services, at the time of a beneficiary's <br/>
<a id="pl.139.26"></a><var>139.26</var>request for medical assistance, the following information about the trust:<br/>
<a id="pl.139.27"></a><var>139.27</var>(1) a copy of the trust instrument; and<br/>
<a id="pl.139.28"></a><var>139.28</var>(2) an inventory of the beneficiary's trust account assets and the value of those assets.<br/>
<a id="pl.139.29"></a><var>139.29</var>(b) A trustee of a trust under subdivision 3 and United States Code, title 42, section <br/>
<a id="pl.139.30"></a><var>139.30</var>1396p(d)(4)(A) or (C), shall submit an accounting of the beneficiary's trust account to the <br/>
<a id="pl.139.31"></a><var>139.31</var>commissioner of human services at least annually until the trust, or the beneficiary's <br/>
<a id="pl.139.32"></a><var>139.32</var>interest in the trust, terminates. Accountings are due on the anniversary of the execution <br/>
<a id="pl.140.1"></a><var>140.1</var>date of the trust unless another annual date is established by the terms of the trust. The <br/>
<a id="pl.140.2"></a><var>140.2</var>accounting must include the following information for the accounting period:<br/>
<a id="pl.140.3"></a><var>140.3</var>(1) an inventory of trust assets and the value of those assets at the beginning of the <br/>
<a id="pl.140.4"></a><var>140.4</var>accounting period;<br/>
<a id="pl.140.5"></a><var>140.5</var>(2) additions to the trust during the accounting period and the source of those <br/>
<a id="pl.140.6"></a><var>140.6</var>additions;<br/>
<a id="pl.140.7"></a><var>140.7</var>(3) itemized distributions from the trust during the accounting period, including the <br/>
<a id="pl.140.8"></a><var>140.8</var>purpose of the distributions and to whom the distributions were made;<br/>
<a id="pl.140.9"></a><var>140.9</var>(4) an inventory of trust assets and the value of those assets at the end of the <br/>
<a id="pl.140.10"></a><var>140.10</var>accounting period; and<br/>
<a id="pl.140.11"></a><var>140.11</var>(5) changes to the trust instrument during the accounting period.<br/>
<a id="pl.140.12"></a><var>140.12</var>(c) For the purpose of paragraph (b), an accounting period is 12 months unless an <br/>
<a id="pl.140.13"></a><var>140.13</var>accounting period of a different length is permitted by the commissioner.<br/>
<a id="pl.140.14"></a><var>140.14</var><b>EFFECTIVE DATE.</b>This section is effective for applications for medical <br/>
<a id="pl.140.15"></a><var>140.15</var>assistance and renewals of medical assistance submitted on or after July 1, 2009.<br/>
<br/>
<a id="bill.5.73.0"></a><a id="pl.140.16"></a><var>140.16</var>    Sec. 73. Minnesota Statutes 2008, section 519.05, is amended to read:<br/>
<a id="pl.140.17"></a><var>140.17</var><b>519.05 LIABILITY OF HUSBAND AND WIFE.</b><br/>
<a id="pl.140.18"></a><var>140.18</var>(a) A spouse is not liable to a creditor for any debts of the other spouse. Where <br/>
<a id="pl.140.19"></a><var>140.19</var>husband and wife are living together, they shall be jointly and severally liable for <br/>
<a id="pl.140.20"></a><var>140.20</var>necessary medical services that have been furnished to either spouse, including any claims <br/>
<a id="pl.140.21"></a><var>140.21</var>arising under section 246.53, 256B.15, 256D.16, or 261.04, and necessary household <br/>
<a id="pl.140.22"></a><var>140.22</var>articles and supplies furnished to and used by the family. Notwithstanding this paragraph, <br/>
<a id="pl.140.23"></a><var>140.23</var>in a proceeding under chapter 518 the court may apportion such debt between the spouses.<br/>
<a id="pl.140.24"></a><var>140.24</var>(b) Either spouse may close a credit card account or other unsecured consumer line <br/>
<a id="pl.140.25"></a><var>140.25</var>of credit on which both spouses are contractually liable, by giving written notice to the <br/>
<a id="pl.140.26"></a><var>140.26</var>creditor.<br/>
<br/>
<a id="bill.5.74.0"></a><a id="pl.140.27"></a><var>140.27</var>    Sec. 74. Laws 2003, First Special Session chapter 14, article 13C, section 2, subdivision <br/>
<a id="pl.140.28"></a><var>140.28</var>1, as amended by Laws 2004, chapter 272, article 2, section 2, is amended to read:<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.140.29"></a><var>140.29</var><br/>
</td>
<td colspan="3">Subdivision 1.<b>Total Appropriation</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>3,848,049,000</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>4,135,780,000</b><br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="95px"/>
<col width="96px"/>
<tr>
<td><a id="pl.140.30"></a><var>140.30</var><br/>
</td>
<td align="center" colspan="3">Summary by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.140.31"></a><var>140.31</var><br/>
</td>
<td>General<br/>
</td>
<td align="center">3,301,811,000<br/>
</td>
<td align="center">3,561,055,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.141.1"></a><var>141.1</var><br/>
<a id="pl.141.2"></a><var>141.2</var><br/>
</td>
<td>State Government <br/>
                  		Special Revenue<br/>
</td>
<td align="right">534,000<br/>
</td>
<td align="right">534,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.141.3"></a><var>141.3</var><br/>
</td>
<td>Health Care Access<br/>
</td>
<td align="right">273,723,000<br/>
</td>
<td align="right">302,272,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.141.4"></a><var>141.4</var><br/>
</td>
<td>Federal TANF<br/>
</td>
<td align="right">270,425,000<br/>
</td>
<td align="right">270,363,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.141.5"></a><var>141.5</var><br/>
</td>
<td>Lottery Cash Flow<br/>
</td>
<td align="right">1,556,000<br/>
</td>
<td align="right">1,556,000<br/>
</td>
</tr>
</table><a id="pl.141.6"></a><var>141.6</var><b>Federal Contingency Appropriation.</b> (a) <br/>
<a id="pl.141.7"></a><var>141.7</var>Federal Medicaid funds made available <br/>
<a id="pl.141.8"></a><var>141.8</var>under title IV of the federal Jobs and Growth <br/>
<a id="pl.141.9"></a><var>141.9</var>Tax Relief Reconciliation Act of 2003 <br/>
<a id="pl.141.10"></a><var>141.10</var>are appropriated to the commissioner of <br/>
<a id="pl.141.11"></a><var>141.11</var>human services for use in the state's medical <br/>
<a id="pl.141.12"></a><var>141.12</var>assistance and MinnesotaCare programs. <br/>
<a id="pl.141.13"></a><var>141.13</var>The commissioners of human services and <br/>
<a id="pl.141.14"></a><var>141.14</var>finance shall report to the legislative advisory <br/>
<a id="pl.141.15"></a><var>141.15</var>committee on the additional federal Medicaid <br/>
<a id="pl.141.16"></a><var>141.16</var>matching funds that will be available to the <br/>
<a id="pl.141.17"></a><var>141.17</var>state.<br/>
<a id="pl.141.18"></a><var>141.18</var>(b) Because of the availability of these funds, <br/>
<a id="pl.141.19"></a><var>141.19</var>the following policies shall become effective:<br/>
<a id="pl.141.20"></a><var>141.20</var>(1) medical assistance and MinnesotaCare <br/>
<a id="pl.141.21"></a><var>141.21</var>eligibility and local financial participation <br/>
<a id="pl.141.22"></a><var>141.22</var>changes provided for in this act may be <br/>
<a id="pl.141.23"></a><var>141.23</var>implemented prior to September 2, 2003, or <br/>
<a id="pl.141.24"></a><var>141.24</var>may be delayed as necessary to maximize <br/>
<a id="pl.141.25"></a><var>141.25</var>the use of federal funds received under <br/>
<a id="pl.141.26"></a><var>141.26</var>title IV of the Jobs and Growth Tax Relief <br/>
<a id="pl.141.27"></a><var>141.27</var>Reconciliation Act of 2003;<br/>
<a id="pl.141.28"></a><var>141.28</var>(2) the aggregate cap on the services <br/>
<a id="pl.141.29"></a><var>141.29</var>identified in Minnesota Statutes, section <br/>
<statute_ref><a id="pl.141.30"></a><var>141.30</var>256L.035
         </statute_ref>, paragraph (a), clause (3), shall <br/>
<a id="pl.141.31"></a><var>141.31</var>be increased from $2,000 to $5,000. This <br/>
<a id="pl.141.32"></a><var>141.32</var>increase shall expire at the end of fiscal year <br/>
<a id="pl.141.33"></a><var>141.33</var>2007. Funds may be transferred from the <br/>
<a id="pl.142.1"></a><var>142.1</var>general fund to the health care access fund as <br/>
<a id="pl.142.2"></a><var>142.2</var>necessary to implement this provision; and<br/>
<a id="pl.142.3"></a><var>142.3</var>(3) the following payment shifts shall not be <br/>
<a id="pl.142.4"></a><var>142.4</var>implemented:<br/>
<a id="pl.142.5"></a><var>142.5</var>(i) MFIP payment shift found in subdivision <br/>
<a id="pl.142.6"></a><var>142.6</var>11;<br/>
<a id="pl.142.7"></a><var>142.7</var>(ii) the county payment shift found in <br/>
<a id="pl.142.8"></a><var>142.8</var>subdivision 1; and<br/>
<a id="pl.142.9"></a><var>142.9</var>(iii) the delay in medical assistance <br/>
<a id="pl.142.10"></a><var>142.10</var>and general assistance medical care <br/>
<a id="pl.142.11"></a><var>142.11</var>fee-for-service payments found in <br/>
<a id="pl.142.12"></a><var>142.12</var>subdivision 6.<br/>
<a id="pl.142.13"></a><var>142.13</var>(c) Notwithstanding section 14, paragraphs <br/>
<a id="pl.142.14"></a><var>142.14</var>(a) and (b) shall expire June 30, 2007.<br/>
<a id="pl.142.15"></a><var>142.15</var><b>Receipts for Systems Projects.</b> <br/>
<a id="pl.142.16"></a><var>142.16</var>Appropriations and federal receipts for <br/>
<a id="pl.142.17"></a><var>142.17</var>information system projects for MAXIS, <br/>
<a id="pl.142.18"></a><var>142.18</var>PRISM, MMIS, and SSIS must be deposited <br/>
<a id="pl.142.19"></a><var>142.19</var>in the state system account authorized in <br/>
<a id="pl.142.20"></a><var>142.20</var>Minnesota Statutes, section 
         <statute_ref>256.014</statute_ref>. Money <br/>
<a id="pl.142.21"></a><var>142.21</var>appropriated for computer projects approved <br/>
<a id="pl.142.22"></a><var>142.22</var>by the Minnesota office of technology, <br/>
<a id="pl.142.23"></a><var>142.23</var>funded by the legislature, and approved <br/>
<a id="pl.142.24"></a><var>142.24</var>by the commissioner of finance may be <br/>
<a id="pl.142.25"></a><var>142.25</var>transferred from one project to another <br/>
<a id="pl.142.26"></a><var>142.26</var>and from development to operations as the <br/>
<a id="pl.142.27"></a><var>142.27</var>commissioner of human services considers <br/>
<a id="pl.142.28"></a><var>142.28</var>necessary. Any unexpended balance in <br/>
<a id="pl.142.29"></a><var>142.29</var>the appropriation for these projects does <br/>
<a id="pl.142.30"></a><var>142.30</var>not cancel but is available for ongoing <br/>
<a id="pl.142.31"></a><var>142.31</var>development and operations.<br/>
<a id="pl.142.32"></a><var>142.32</var><b>Gifts.</b> Notwithstanding Minnesota Statutes, <br/>
<a id="pl.142.33"></a><var>142.33</var>chapter 7, the commissioner may accept <br/>
<a id="pl.142.34"></a><var>142.34</var>on behalf of the state additional funding <br/>
<a id="pl.143.1"></a><var>143.1</var>from sources other than state funds for the <br/>
<a id="pl.143.2"></a><var>143.2</var>purpose of financing the cost of assistance <br/>
<a id="pl.143.3"></a><var>143.3</var>program grants or nongrant administration. <br/>
<a id="pl.143.4"></a><var>143.4</var>All additional funding is appropriated to the <br/>
<a id="pl.143.5"></a><var>143.5</var>commissioner for use as designated by the <br/>
<a id="pl.143.6"></a><var>143.6</var>grantor of funding.<br/>
<a id="pl.143.7"></a><var>143.7</var><b>Systems Continuity.</b> In the event of <br/>
<a id="pl.143.8"></a><var>143.8</var>disruption of technical systems or computer <br/>
<a id="pl.143.9"></a><var>143.9</var>operations, the commissioner may use <br/>
<a id="pl.143.10"></a><var>143.10</var>available grant appropriations to ensure <br/>
<a id="pl.143.11"></a><var>143.11</var>continuity of payments for maintaining the <br/>
<a id="pl.143.12"></a><var>143.12</var>health, safety, and well-being of clients <br/>
<a id="pl.143.13"></a><var>143.13</var>served by programs administered by the <br/>
<a id="pl.143.14"></a><var>143.14</var>department of human services. Grant funds <br/>
<a id="pl.143.15"></a><var>143.15</var>must be used in a manner consistent with the <br/>
<a id="pl.143.16"></a><var>143.16</var>original intent of the appropriation.<br/>
<a id="pl.143.17"></a><var>143.17</var><b>Nonfederal Share Transfers.</b> The <br/>
<a id="pl.143.18"></a><var>143.18</var>nonfederal share of activities for which <br/>
<a id="pl.143.19"></a><var>143.19</var>federal administrative reimbursement is <br/>
<a id="pl.143.20"></a><var>143.20</var>appropriated to the commissioner may be <br/>
<a id="pl.143.21"></a><var>143.21</var>transferred to the special revenue fund.<br/>
<a id="pl.143.22"></a><var>143.22</var><b>TANF Funds Appropriated to Other </b><br/>
<a id="pl.143.23"></a><var>143.23</var><b>Entities.</b> Any expenditures from the TANF <br/>
<a id="pl.143.24"></a><var>143.24</var>block grant shall be expended in accordance <br/>
<a id="pl.143.25"></a><var>143.25</var>with the requirements and limitations of part <br/>
<a id="pl.143.26"></a><var>143.26</var>A of title IV of the Social Security Act, as <br/>
<a id="pl.143.27"></a><var>143.27</var>amended, and any other applicable federal <br/>
<a id="pl.143.28"></a><var>143.28</var>requirement or limitation. Prior to any <br/>
<a id="pl.143.29"></a><var>143.29</var>expenditure of these funds, the commissioner <br/>
<a id="pl.143.30"></a><var>143.30</var>shall assure that funds are expended in <br/>
<a id="pl.143.31"></a><var>143.31</var>compliance with the requirements and <br/>
<a id="pl.143.32"></a><var>143.32</var>limitations of federal law and that any <br/>
<a id="pl.143.33"></a><var>143.33</var>reporting requirements of federal law are <br/>
<a id="pl.143.34"></a><var>143.34</var>met. It shall be the responsibility of any entity <br/>
<a id="pl.143.35"></a><var>143.35</var>to which these funds are appropriated to <br/>
<a id="pl.144.1"></a><var>144.1</var>implement a memorandum of understanding <br/>
<a id="pl.144.2"></a><var>144.2</var>with the commissioner that provides the <br/>
<a id="pl.144.3"></a><var>144.3</var>necessary assurance of compliance prior to <br/>
<a id="pl.144.4"></a><var>144.4</var>any expenditure of funds. The commissioner <br/>
<a id="pl.144.5"></a><var>144.5</var>shall receipt TANF funds appropriated <br/>
<a id="pl.144.6"></a><var>144.6</var>to other state agencies and coordinate all <br/>
<a id="pl.144.7"></a><var>144.7</var>related interagency accounting transactions <br/>
<a id="pl.144.8"></a><var>144.8</var>necessary to implement these appropriations. <br/>
<a id="pl.144.9"></a><var>144.9</var>Unexpended TANF funds appropriated to <br/>
<a id="pl.144.10"></a><var>144.10</var>any state, local, or nonprofit entity cancel <br/>
<a id="pl.144.11"></a><var>144.11</var>at the end of the state fiscal year unless <br/>
<a id="pl.144.12"></a><var>144.12</var>appropriating language permits otherwise.<br/>
<a id="pl.144.13"></a><var>144.13</var><b>TANF Funds Transferred to Other Federal </b><br/>
<a id="pl.144.14"></a><var>144.14</var><b>Grants.</b> The commissioner must authorize <br/>
<a id="pl.144.15"></a><var>144.15</var>transfers from TANF to other federal block <br/>
<a id="pl.144.16"></a><var>144.16</var>grants so that funds are available to meet the <br/>
<a id="pl.144.17"></a><var>144.17</var>annual expenditure needs as appropriated. <br/>
<a id="pl.144.18"></a><var>144.18</var>Transfers may be authorized prior to the <br/>
<a id="pl.144.19"></a><var>144.19</var>expenditure year with the agreement of the <br/>
<a id="pl.144.20"></a><var>144.20</var>receiving entity. Transferred funds must be <br/>
<a id="pl.144.21"></a><var>144.21</var>expended in the year for which the funds <br/>
<a id="pl.144.22"></a><var>144.22</var>were appropriated unless appropriation <br/>
<a id="pl.144.23"></a><var>144.23</var>language permits otherwise. In accelerating <br/>
<a id="pl.144.24"></a><var>144.24</var>transfer authorizations, the commissioner <br/>
<a id="pl.144.25"></a><var>144.25</var>must aim to preserve the future potential <br/>
<a id="pl.144.26"></a><var>144.26</var>transfer capacity from TANF to other block <br/>
<a id="pl.144.27"></a><var>144.27</var>grants.<br/>
<a id="pl.144.28"></a><var>144.28</var><b>TANF Maintenance of Effort.</b> (a) In <br/>
<a id="pl.144.29"></a><var>144.29</var>order to meet the basic maintenance of <br/>
<a id="pl.144.30"></a><var>144.30</var>effort (MOE) requirements of the TANF <br/>
<a id="pl.144.31"></a><var>144.31</var>block grant specified under Code of Federal <br/>
<a id="pl.144.32"></a><var>144.32</var>Regulations, title 45, section 
         <statute_ref>263.1</statute_ref>, the <br/>
<a id="pl.144.33"></a><var>144.33</var>commissioner may only report nonfederal <br/>
<a id="pl.144.34"></a><var>144.34</var>money expended for allowable activities <br/>
<a id="pl.144.35"></a><var>144.35</var>listed in the following clauses as TANF/MOE <br/>
<a id="pl.144.36"></a><var>144.36</var>expenditures:<br/>
<a id="pl.145.1"></a><var>145.1</var>(1) MFIP cash, diversionary work program, <br/>
<a id="pl.145.2"></a><var>145.2</var>and food assistance benefits under Minnesota <br/>
<a id="pl.145.3"></a><var>145.3</var>Statutes, chapter 256J;<br/>
<a id="pl.145.4"></a><var>145.4</var>(2) the child care assistance programs <br/>
<a id="pl.145.5"></a><var>145.5</var>under Minnesota Statutes, sections 
         <statute_ref>119B.03</statute_ref> <br/>
<a id="pl.145.6"></a><var>145.6</var>and 
         <statute_ref>119B.05</statute_ref>, and county child care <br/>
<a id="pl.145.7"></a><var>145.7</var>administrative costs under Minnesota <br/>
<a id="pl.145.8"></a><var>145.8</var>Statutes, section 
         <statute_ref>119B.15</statute_ref>;<br/>
<a id="pl.145.9"></a><var>145.9</var>(3) state and county MFIP administrative <br/>
<a id="pl.145.10"></a><var>145.10</var>costs under Minnesota Statutes, chapters <br/>
<a id="pl.145.11"></a><var>145.11</var>256J and 256K;<br/>
<a id="pl.145.12"></a><var>145.12</var>(4) state, county, and tribal MFIP <br/>
<a id="pl.145.13"></a><var>145.13</var>employment services under Minnesota <br/>
<a id="pl.145.14"></a><var>145.14</var>Statutes, chapters 256J and 256K;<br/>
<a id="pl.145.15"></a><var>145.15</var>(5) expenditures made on behalf of <br/>
<a id="pl.145.16"></a><var>145.16</var>noncitizen MFIP recipients who qualify <br/>
<a id="pl.145.17"></a><var>145.17</var>for the medical assistance without federal <br/>
<a id="pl.145.18"></a><var>145.18</var>financial participation program under <br/>
<a id="pl.145.19"></a><var>145.19</var>Minnesota Statutes, section 
         <statute_ref>256B.06, <br/>
<a id="pl.145.20"></a><var>145.20</var>subdivision 4
         </statute_ref>, paragraphs (d), (e), and (j); <br/>
<a id="pl.145.21"></a><var>145.21</var>and<br/>
<a id="pl.145.22"></a><var>145.22</var>(6) qualifying working family credit <br/>
<a id="pl.145.23"></a><var>145.23</var>expenditures under Minnesota Statutes, <br/>
<a id="pl.145.24"></a><var>145.24</var>section 
         <statute_ref>290.0671</statute_ref>.<br/>
<a id="pl.145.25"></a><var>145.25</var>(b) The commissioner shall ensure that <br/>
<a id="pl.145.26"></a><var>145.26</var>sufficient qualified nonfederal expenditures <br/>
<a id="pl.145.27"></a><var>145.27</var>are made each year to meet the state's <br/>
<a id="pl.145.28"></a><var>145.28</var>TANF/MOE requirements. For the activities <br/>
<a id="pl.145.29"></a><var>145.29</var>listed in paragraph (a), clauses (2) to <br/>
<a id="pl.145.30"></a><var>145.30</var>(6), the commissioner may only report <br/>
<a id="pl.145.31"></a><var>145.31</var>expenditures that are excluded from the <br/>
<a id="pl.145.32"></a><var>145.32</var>definition of assistance under Code of <br/>
<a id="pl.145.33"></a><var>145.33</var>Federal Regulations, title 45, section 
         <statute_ref>260.31</statute_ref>.<br/>
<a id="pl.146.1"></a><var>146.1</var>(c) By August 31 of each year, the <br/>
<a id="pl.146.2"></a><var>146.2</var>commissioner shall make a preliminary <br/>
<a id="pl.146.3"></a><var>146.3</var>calculation to determine the likelihood <br/>
<a id="pl.146.4"></a><var>146.4</var>that the state will meet its annual federal <br/>
<a id="pl.146.5"></a><var>146.5</var>work participation requirement under Code <br/>
<a id="pl.146.6"></a><var>146.6</var>of Federal Regulations, title 45, sections <br/>
<statute_ref><a id="pl.146.7"></a><var>146.7</var>261.21
         </statute_ref> and 
         <statute_ref>261.23</statute_ref>, after adjustment for any <br/>
<a id="pl.146.8"></a><var>146.8</var>caseload reduction credit under Code of <br/>
<a id="pl.146.9"></a><var>146.9</var>Federal Regulations, title 45, section 
         <statute_ref>261.41</statute_ref>. <br/>
<a id="pl.146.10"></a><var>146.10</var>If the commissioner determines that the <br/>
<a id="pl.146.11"></a><var>146.11</var>state will meet its federal work participation <br/>
<a id="pl.146.12"></a><var>146.12</var>rate for the federal fiscal year ending that <br/>
<a id="pl.146.13"></a><var>146.13</var>September, the commissioner may reduce the <br/>
<a id="pl.146.14"></a><var>146.14</var>expenditure under paragraph (a), clause (1), <br/>
<a id="pl.146.15"></a><var>146.15</var>to the extent allowed under Code of Federal <br/>
<a id="pl.146.16"></a><var>146.16</var>Regulations, title 45, section 263.1(a)(2).<br/>
<a id="pl.146.17"></a><var>146.17</var>(d) For fiscal years beginning with state <br/>
<a id="pl.146.18"></a><var>146.18</var>fiscal year 2003, the commissioner shall <br/>
<a id="pl.146.19"></a><var>146.19</var>assure that the maintenance of effort used <br/>
<a id="pl.146.20"></a><var>146.20</var>by the commissioner of finance for the <br/>
<a id="pl.146.21"></a><var>146.21</var>February and November forecasts required <br/>
<a id="pl.146.22"></a><var>146.22</var>under Minnesota Statutes, section 
         <statute_ref>16A.103</statute_ref>, <br/>
<a id="pl.146.23"></a><var>146.23</var>contains expenditures under paragraph (a), <br/>
<a id="pl.146.24"></a><var>146.24</var>clause (1), equal to at least 25 percent of <br/>
<a id="pl.146.25"></a><var>146.25</var>the total required under Code of Federal <br/>
<a id="pl.146.26"></a><var>146.26</var>Regulations, title 45, section 
         <statute_ref>263.1</statute_ref>.<br/>
<a id="pl.146.27"></a><var>146.27</var>(e) If nonfederal expenditures for the <br/>
<a id="pl.146.28"></a><var>146.28</var>programs and purposes listed in paragraph <br/>
<a id="pl.146.29"></a><var>146.29</var>(a) are insufficient to meet the state's <br/>
<a id="pl.146.30"></a><var>146.30</var>TANF/MOE requirements, the commissioner <br/>
<a id="pl.146.31"></a><var>146.31</var>shall recommend additional allowable <br/>
<a id="pl.146.32"></a><var>146.32</var>sources of nonfederal expenditures to the <br/>
<a id="pl.146.33"></a><var>146.33</var>legislature, if the legislature is or will be in <br/>
<a id="pl.146.34"></a><var>146.34</var>session to take action to specify additional <br/>
<a id="pl.146.35"></a><var>146.35</var>sources of nonfederal expenditures for <br/>
<a id="pl.146.36"></a><var>146.36</var>TANF/MOE before a federal penalty is <br/>
<a id="pl.147.1"></a><var>147.1</var>imposed. The commissioner shall otherwise <br/>
<a id="pl.147.2"></a><var>147.2</var>provide notice to the legislative commission <br/>
<a id="pl.147.3"></a><var>147.3</var>on planning and fiscal policy under paragraph <br/>
<a id="pl.147.4"></a><var>147.4</var>(g).<br/>
<a id="pl.147.5"></a><var>147.5</var>(f) If the commissioner uses authority <br/>
<a id="pl.147.6"></a><var>147.6</var>granted under section 11, or similar authority <br/>
<a id="pl.147.7"></a><var>147.7</var>granted by a subsequent legislature, to <br/>
<a id="pl.147.8"></a><var>147.8</var>meet the state's TANF/MOE requirement <br/>
<a id="pl.147.9"></a><var>147.9</var>in a reporting period, the commissioner <br/>
<a id="pl.147.10"></a><var>147.10</var>shall inform the chairs of the appropriate <br/>
<a id="pl.147.11"></a><var>147.11</var>legislative committees about all transfers <br/>
<a id="pl.147.12"></a><var>147.12</var>made under that authority for this purpose.<br/>
<a id="pl.147.13"></a><var>147.13</var>(g) If the commissioner determines that <br/>
<a id="pl.147.14"></a><var>147.14</var>nonfederal expenditures under paragraph <br/>
<a id="pl.147.15"></a><var>147.15</var>(a) are insufficient to meet TANF/MOE <br/>
<a id="pl.147.16"></a><var>147.16</var>expenditure requirements, and if the <br/>
<a id="pl.147.17"></a><var>147.17</var>legislature is not or will not be in <br/>
<a id="pl.147.18"></a><var>147.18</var>session to take timely action to avoid a <br/>
<a id="pl.147.19"></a><var>147.19</var>federal penalty, the commissioner may <br/>
<a id="pl.147.20"></a><var>147.20</var>report nonfederal expenditures from <br/>
<a id="pl.147.21"></a><var>147.21</var>other allowable sources as TANF/MOE <br/>
<a id="pl.147.22"></a><var>147.22</var>expenditures after the requirements of this <br/>
<a id="pl.147.23"></a><var>147.23</var>paragraph are met. The commissioner <br/>
<a id="pl.147.24"></a><var>147.24</var>may report nonfederal expenditures <br/>
<a id="pl.147.25"></a><var>147.25</var>in addition to those specified under <br/>
<a id="pl.147.26"></a><var>147.26</var>paragraph (a) as nonfederal TANF/MOE <br/>
<a id="pl.147.27"></a><var>147.27</var>expenditures, but only ten days after the <br/>
<a id="pl.147.28"></a><var>147.28</var>commissioner of finance has first submitted <br/>
<a id="pl.147.29"></a><var>147.29</var>the commissioner's recommendations for <br/>
<a id="pl.147.30"></a><var>147.30</var>additional allowable sources of nonfederal <br/>
<a id="pl.147.31"></a><var>147.31</var>TANF/MOE expenditures to the members of <br/>
<a id="pl.147.32"></a><var>147.32</var>the legislative commission on planning and <br/>
<a id="pl.147.33"></a><var>147.33</var>fiscal policy for their review.<br/>
<a id="pl.147.34"></a><var>147.34</var>(h) The commissioner of finance shall not <br/>
<a id="pl.147.35"></a><var>147.35</var>incorporate any changes in federal TANF <br/>
<a id="pl.148.1"></a><var>148.1</var>expenditures or nonfederal expenditures for <br/>
<a id="pl.148.2"></a><var>148.2</var>TANF/MOE that may result from reporting <br/>
<a id="pl.148.3"></a><var>148.3</var>additional allowable sources of nonfederal <br/>
<a id="pl.148.4"></a><var>148.4</var>TANF/MOE expenditures under the interim <br/>
<a id="pl.148.5"></a><var>148.5</var>procedures in paragraph (g) into the February <br/>
<a id="pl.148.6"></a><var>148.6</var>or November forecasts required under <br/>
<a id="pl.148.7"></a><var>148.7</var>Minnesota Statutes, section 
         <statute_ref>16A.103</statute_ref>, unless <br/>
<a id="pl.148.8"></a><var>148.8</var>the commissioner of finance has approved <br/>
<a id="pl.148.9"></a><var>148.9</var>the additional sources of expenditures under <br/>
<a id="pl.148.10"></a><var>148.10</var>paragraph (g).<br/>
<a id="pl.148.11"></a><var>148.11</var>(i) Minnesota Statutes, section 
         <statute_ref>256.011, <br/>
<a id="pl.148.12"></a><var>148.12</var>subdivision 3
         </statute_ref>, which requires that federal <br/>
<a id="pl.148.13"></a><var>148.13</var>grants or aids secured or obtained under that <br/>
<a id="pl.148.14"></a><var>148.14</var>subdivision be used to reduce any direct <br/>
<a id="pl.148.15"></a><var>148.15</var>appropriations provided by law, do not apply <br/>
<a id="pl.148.16"></a><var>148.16</var>if the grants or aids are federal TANF funds.<br/>
<a id="pl.148.17"></a><var>148.17</var>(j) Notwithstanding section 14, paragraph <br/>
<a id="pl.148.18"></a><var>148.18</var>(a), clauses (1) to (6), and paragraphs (b) to <br/>
<a id="pl.148.19"></a><var>148.19</var>(j) expire June 30, 2007.<br/>
<a id="pl.148.20"></a><var>148.20</var><b>Working Family Credit Expenditures as </b><br/>
<a id="pl.148.21"></a><var>148.21</var><b>TANF MOE.</b> The commissioner may claim <br/>
<a id="pl.148.22"></a><var>148.22</var>as TANF maintenance of effort up to the <br/>
<a id="pl.148.23"></a><var>148.23</var>following amounts of working family credit <br/>
<a id="pl.148.24"></a><var>148.24</var>expenditures for the following fiscal years:<br/>
<a id="pl.148.25"></a><var>148.25</var>(1) fiscal year 2004, $7,013,000;<br/>
<a id="pl.148.26"></a><var>148.26</var>(2) fiscal year 2005, $25,133,000;<br/>
<a id="pl.148.27"></a><var>148.27</var>(3) fiscal year 2006, $6,942,000; and<br/>
<a id="pl.148.28"></a><var>148.28</var>(4) fiscal year 2007, $6,707,000.<br/>
<a id="pl.148.29"></a><var>148.29</var><b>Fiscal Year 2003 Appropriations </b><br/>
<a id="pl.148.30"></a><var>148.30</var><b>Carryforward.</b> Effective the day following <br/>
<a id="pl.148.31"></a><var>148.31</var>final enactment, notwithstanding Minnesota <br/>
<a id="pl.148.32"></a><var>148.32</var>Statutes, section 
         <statute_ref>16A.28</statute_ref>, or any other law to <br/>
<a id="pl.148.33"></a><var>148.33</var>the contrary, state agencies and constitutional <br/>
<a id="pl.148.34"></a><var>148.34</var>offices may carry forward unexpended <br/>
<a id="pl.149.1"></a><var>149.1</var>and unencumbered nongrant operating <br/>
<a id="pl.149.2"></a><var>149.2</var>balances from fiscal year 2003 general fund <br/>
<a id="pl.149.3"></a><var>149.3</var>appropriations into fiscal year 2004 to offset <br/>
<a id="pl.149.4"></a><var>149.4</var>general budget reductions.<br/>
<a id="pl.149.5"></a><var>149.5</var><b>Transfer of Grant Balances.</b> Effective <br/>
<a id="pl.149.6"></a><var>149.6</var>the day following final enactment, the <br/>
<a id="pl.149.7"></a><var>149.7</var>commissioner of human services, with <br/>
<a id="pl.149.8"></a><var>149.8</var>the approval of the commissioner of <br/>
<a id="pl.149.9"></a><var>149.9</var>finance and after notification of the chair <br/>
<a id="pl.149.10"></a><var>149.10</var>of the senate health, human services and <br/>
<a id="pl.149.11"></a><var>149.11</var>corrections budget division and the chair <br/>
<a id="pl.149.12"></a><var>149.12</var>of the house of representatives health <br/>
<a id="pl.149.13"></a><var>149.13</var>and human services finance committee, <br/>
<a id="pl.149.14"></a><var>149.14</var>may transfer unencumbered appropriation <br/>
<a id="pl.149.15"></a><var>149.15</var>balances for the biennium ending June 30, <br/>
<a id="pl.149.16"></a><var>149.16</var>2003, in fiscal year 2003 among the MFIP, <br/>
<a id="pl.149.17"></a><var>149.17</var>MFIP child care assistance under Minnesota <br/>
<a id="pl.149.18"></a><var>149.18</var>Statutes, section 
         <statute_ref>119B.05</statute_ref>, general assistance, <br/>
<a id="pl.149.19"></a><var>149.19</var>general assistance medical care, medical <br/>
<a id="pl.149.20"></a><var>149.20</var>assistance, Minnesota supplemental aid, <br/>
<a id="pl.149.21"></a><var>149.21</var>and group residential housing programs, <br/>
<a id="pl.149.22"></a><var>149.22</var>and the entitlement portion of the chemical <br/>
<a id="pl.149.23"></a><var>149.23</var>dependency consolidated treatment fund, and <br/>
<a id="pl.149.24"></a><var>149.24</var>between fiscal years of the biennium.<br/>
<a id="pl.149.25"></a><var>149.25</var><b>TANF Appropriation Cancellation.</b> <br/>
<a id="pl.149.26"></a><var>149.26</var>Notwithstanding the provisions of Laws <br/>
<a id="pl.149.27"></a><var>149.27</var>2000, chapter 488, article 1, section 16, <br/>
<a id="pl.149.28"></a><var>149.28</var>any prior appropriations of TANF funds <br/>
<a id="pl.149.29"></a><var>149.29</var>to the department of trade and economic <br/>
<a id="pl.149.30"></a><var>149.30</var>development or to the job skills partnership <br/>
<a id="pl.149.31"></a><var>149.31</var>board or any transfers of TANF funds from <br/>
<a id="pl.149.32"></a><var>149.32</var>another agency to the department of trade <br/>
<a id="pl.149.33"></a><var>149.33</var>and economic development or to the job <br/>
<a id="pl.149.34"></a><var>149.34</var>skills partnership board are not available <br/>
<a id="pl.149.35"></a><var>149.35</var>until expended, and if unobligated as of June <br/>
<a id="pl.150.1"></a><var>150.1</var>30, 2003, these appropriations or transfers <br/>
<a id="pl.150.2"></a><var>150.2</var>shall cancel to the TANF fund.<br/>
<a id="pl.150.3"></a><var>150.3</var><b>Shift County Payment.</b> The commissioner <br/>
<a id="pl.150.4"></a><var>150.4</var>shall make up to 100 percent of the <br/>
<a id="pl.150.5"></a><var>150.5</var>calendar year 2005 payments to counties for <br/>
<a id="pl.150.6"></a><var>150.6</var>developmental disabilities semi-independent <br/>
<a id="pl.150.7"></a><var>150.7</var>living services grants, developmental <br/>
<a id="pl.150.8"></a><var>150.8</var>disabilities family support grants, and <br/>
<a id="pl.150.9"></a><var>150.9</var>adult mental health grants from fiscal year <br/>
<a id="pl.150.10"></a><var>150.10</var>2006 appropriations. This is a onetime <br/>
<a id="pl.150.11"></a><var>150.11</var>payment shift. Calendar year 2006 and future <br/>
<a id="pl.150.12"></a><var>150.12</var>payments for these grants are not affected by <br/>
<a id="pl.150.13"></a><var>150.13</var>this shift. This provision expires June 30, <br/>
<a id="pl.150.14"></a><var>150.14</var>2006.<br/>
<a id="pl.150.15"></a><var>150.15</var><b>Capitation Rate Increase.</b> Of the health care <br/>
<a id="pl.150.16"></a><var>150.16</var>access fund appropriations to the University <br/>
<a id="pl.150.17"></a><var>150.17</var>of Minnesota in the higher education <br/>
<a id="pl.150.18"></a><var>150.18</var>omnibus appropriation bill, $2,157,000 in <br/>
<a id="pl.150.19"></a><var>150.19</var>fiscal year 2004 and $2,157,000 in fiscal year <br/>
<a id="pl.150.20"></a><var>150.20</var>2005 are to be used to increase the capitation <br/>
<a id="pl.150.21"></a><var>150.21</var>payments under for fiscal years beginning <br/>
<a id="pl.150.22"></a><var>150.22</var>July 1, 2003, and thereafter, $2,157,000 each <br/>
<a id="pl.150.23"></a><var>150.23</var>year shall be transferred to the commissioner <br/>
<a id="pl.150.24"></a><var>150.24</var>for purposes of Minnesota Statutes, section <br/>
<statute_ref><a id="pl.150.25"></a><var>150.25</var>256B.69
         </statute_ref>. Notwithstanding the provisions of <br/>
<a id="pl.150.26"></a><var>150.26</var>section 14, this provision shall not expire.<br/>
<br/>
<a id="bill.5.75.0"></a><a id="pl.150.27"></a><var>150.27</var>    Sec. 75. <b>ASTHMA COVERAGE DEMONSTRATION PROJECT.</b><br/>
<a id="pl.150.28"></a><var>150.28</var>    Subdivision 1. <b>Medical assistance coverage.</b> The commissioner of human services <br/>
<a id="pl.150.29"></a><var>150.29</var>shall establish a demonstration project to provide additional medical assistance coverage <br/>
<a id="pl.150.30"></a><var>150.30</var>for a maximum of 200 American Indian children in Minneapolis, St. Paul, and Duluth <br/>
<a id="pl.150.31"></a><var>150.31</var>who are burdened by health disparities associated with the cumulative health impact of <br/>
<a id="pl.150.32"></a><var>150.32</var>toxic environmental exposures. Under this demonstration project, the additional medical <br/>
<a id="pl.150.33"></a><var>150.33</var>assistance coverage for this population must include, but is not limited to, the following <br/>
<a id="pl.150.34"></a><var>150.34</var>durable medical equipment: high efficiency particulate air (HEPA) cleaners, HEPA <br/>
<a id="pl.150.35"></a><var>150.35</var>vacuum cleaners, allergy bed and pillow encasements, high filtration filters for forced air <br/>
<a id="pl.151.1"></a><var>151.1</var>gas furnaces, and dehumidifiers with medical tubing to connect the appliance to a floor <br/>
<a id="pl.151.2"></a><var>151.2</var>drain, if the listed item is medically necessary to reduce asthma symptoms. Provision <br/>
<a id="pl.151.3"></a><var>151.3</var>of these items must be preceded by a home environmental assessment for triggers of <br/>
<a id="pl.151.4"></a><var>151.4</var>asthma and in-home asthma education on the proper medical management of asthma by a <br/>
<a id="pl.151.5"></a><var>151.5</var>Certified Asthma Educator or public health nurse with asthma management training.<br/>
<a id="pl.151.6"></a><var>151.6</var>    Subd. 2. <b>Report.</b> (a) Two years following implementation of the medical assistance <br/>
<a id="pl.151.7"></a><var>151.7</var>coverage demonstration project established under this section, the commissioner of health, <br/>
<a id="pl.151.8"></a><var>151.8</var>in collaboration with the Department of Human Services, must report to the legislature <br/>
<a id="pl.151.9"></a><var>151.9</var>on the number of asthma-related hospital admittances that occurred in the population of <br/>
<a id="pl.151.10"></a><var>151.10</var>children described in subdivision 1, before and after implementation of the demonstration <br/>
<a id="pl.151.11"></a><var>151.11</var>project, and whether the demonstration project had an impact on asthma-related school <br/>
<a id="pl.151.12"></a><var>151.12</var>absenteeism for this population of children.<br/>
<a id="pl.151.13"></a><var>151.13</var>(b) The commissioner of health must seek nonstate funding to conduct this report. <br/>
<a id="pl.151.14"></a><var>151.14</var>The reporting requirement is contingent upon the availability of nonstate funds.<br/>
<br/>
<a id="bill.5.76.0"></a><a id="pl.151.15"></a><var>151.15</var>    Sec. 76. <b>CLAIMS AND UTILIZATION DATA.</b><br/>
<a id="pl.151.16"></a><var>151.16</var>The commissioner of human services, in consultation with the Health Services <br/>
<a id="pl.151.17"></a><var>151.17</var>Policy Committee, shall develop and provide to the legislature by December 15, 2009, a <br/>
<a id="pl.151.18"></a><var>151.18</var>methodology and any draft legislation necessary to allow for the release, upon request, of <br/>
<a id="pl.151.19"></a><var>151.19</var>summary data as defined in Minnesota Statutes, section 13.02, subdivision 19, on claims <br/>
<a id="pl.151.20"></a><var>151.20</var>and utilization for medical assistance, general assistance medical care, and MinnesotaCare <br/>
<a id="pl.151.21"></a><var>151.21</var>enrollees at no charge to the University of Minnesota Medical School, the Mayo Medical <br/>
<a id="pl.151.22"></a><var>151.22</var>School, Northwestern Health Sciences University, the Institute for Clinical Systems <br/>
<a id="pl.151.23"></a><var>151.23</var>Improvement, and other research institutions, to conduct analyses of health care outcomes <br/>
<a id="pl.151.24"></a><var>151.24</var>and treatment effectiveness, provided the research institutions do not release private or <br/>
<a id="pl.151.25"></a><var>151.25</var>nonpublic data, or data for which dissemination is prohibited by law.<br/>
<br/>
<a id="bill.5.77.0"></a><a id="pl.151.26"></a><var>151.26</var>    Sec. 77. <b>ADMINISTRATION OF PUBLICLY FUNDED HEALTH CARE </b><br/>
<a id="pl.151.27"></a><var>151.27</var><b>PROGRAMS.</b><br/>
<a id="pl.151.28"></a><var>151.28</var>(a) The commissioner of human services, in cooperation with the representatives <br/>
<a id="pl.151.29"></a><var>151.29</var>of county human services agencies and with input from organizations that advocate on <br/>
<a id="pl.151.30"></a><var>151.30</var>behalf of families and children, shall develop a plan that, to the extent feasible, seeks to <br/>
<a id="pl.151.31"></a><var>151.31</var>align standards, income and asset methodologies, and procedures for families and children <br/>
<a id="pl.151.32"></a><var>151.32</var>under medical assistance and MinnesotaCare. The commissioner shall evaluate the impact <br/>
<a id="pl.151.33"></a><var>151.33</var>of different approaches toward alignment on the number of potential medical assistance <br/>
<a id="pl.151.34"></a><var>151.34</var>and MinnesotaCare enrollees who are families and children, and on administrative, health <br/>
<a id="pl.152.1"></a><var>152.1</var>care, and other costs to the state. The commissioner shall present recommendations to the <br/>
<a id="pl.152.2"></a><var>152.2</var>legislative committees with jurisdiction over health care by September 15, 2010.<br/>
<a id="pl.152.3"></a><var>152.3</var>(b) The commissioner shall report in detail to the chair of the Health Care and <br/>
<a id="pl.152.4"></a><var>152.4</var>Human Services Finance Committee of the house of representatives and to the chair of <br/>
<a id="pl.152.5"></a><var>152.5</var>the Health and Human Services Division of the Finance Committee of the senate, prior <br/>
<a id="pl.152.6"></a><var>152.6</var>to entering into any contracts involving counties for streamlined electronic enrollment <br/>
<a id="pl.152.7"></a><var>152.7</var>and eligibility determinations for publicly funded health care programs, if such contracts <br/>
<a id="pl.152.8"></a><var>152.8</var>would require payment from either the general fund, or the health care access fund, as <br/>
<a id="pl.152.9"></a><var>152.9</var>described in Minnesota Statutes, sections 295.58 and 297I.05.<br/>
<br/>
<a id="bill.5.78.0"></a><a id="pl.152.10"></a><var>152.10</var>    Sec. 78. <b>COBRA PREMIUM STATE SUBSIDY.</b><br/>
<a id="pl.152.11"></a><var>152.11</var>    Subdivision 1. <b>Eligibility.</b> (a) An individual and the individual's qualified <br/>
<a id="pl.152.12"></a><var>152.12</var>beneficiaries shall be eligible for a state premium subsidy equal to 35 percent of the <br/>
<a id="pl.152.13"></a><var>152.13</var>premiums the individual is required to pay for the continuation of health care coverage <br/>
<a id="pl.152.14"></a><var>152.14</var>under COBRA, if the individual and the individual's qualified beneficiaries:<br/>
<a id="pl.152.15"></a><var>152.15</var>(1) are eligible for the 65 percent COBRA continuation premium subsidy for health <br/>
<a id="pl.152.16"></a><var>152.16</var>care coverage under the American Recovery and Reinvestment Act of 2009;<br/>
<a id="pl.152.17"></a><var>152.17</var>(2) elect COBRA continuation health care coverage; and<br/>
<a id="pl.152.18"></a><var>152.18</var>(3) are eligible for medical assistance under Minnesota Statutes, chapter 256B; <br/>
<a id="pl.152.19"></a><var>152.19</var>general assistance medical care under Minnesota Statutes, section 256D.03; or <br/>
<a id="pl.152.20"></a><var>152.20</var>MinnesotaCare under Minnesota Statutes, chapter 256L, except for the four-month barrier <br/>
<a id="pl.152.21"></a><var>152.21</var>requirement under Minnesota Statutes, section 256L.07, subdivision 3.<br/>
<a id="pl.152.22"></a><var>152.22</var>(b) Eligibility for the state subsidy shall continue for as long as the individual <br/>
<a id="pl.152.23"></a><var>152.23</var>remains eligible for the COBRA premium subsidies provided under the American <br/>
<a id="pl.152.24"></a><var>152.24</var>Recovery and Reinvestment Act of 2009.<br/>
<a id="pl.152.25"></a><var>152.25</var>    Subd. 2. <b>Subsidy.</b> (a) The commissioner of human services shall pay 35 percent of <br/>
<a id="pl.152.26"></a><var>152.26</var>the COBRA premiums that the individual must pay for continuation health care coverage <br/>
<a id="pl.152.27"></a><var>152.27</var>for the individual and the individual's qualified beneficiaries, if the individual and the <br/>
<a id="pl.152.28"></a><var>152.28</var>individual's qualified beneficiaries meet the requirements in subdivision 1.<br/>
<a id="pl.152.29"></a><var>152.29</var>(b) The state subsidy payment required under this section shall be made directly to <br/>
<a id="pl.152.30"></a><var>152.30</var>the entity to which the individual is required to make COBRA premium payments.<br/>
<a id="pl.152.31"></a><var>152.31</var>(c) If any eligible individual has paid either the full amount of the COBRA premiums <br/>
<a id="pl.152.32"></a><var>152.32</var>or 35 percent of the COBRA premiums before the date of enactment of this section, the <br/>
<a id="pl.152.33"></a><var>152.33</var>individual is not entitled to a reimbursement of any premium paid.<br/>
<a id="pl.152.34"></a><var>152.34</var>    Subd. 3. <b>Notification.</b> (a) All employers and plan administrators who are required to <br/>
<a id="pl.152.35"></a><var>152.35</var>provide notice to all qualified individuals under the American Recovery and Reinvestment <br/>
<a id="pl.153.1"></a><var>153.1</var>Act of 2009 must include information to qualified individuals residing in Minnesota of <br/>
<a id="pl.153.2"></a><var>153.2</var>the availability of the state subsidy available under this section. The notice shall include <br/>
<a id="pl.153.3"></a><var>153.3</var>the eligibility requirements for the state subsidy and that the individual must apply to the <br/>
<a id="pl.153.4"></a><var>153.4</var>commissioner of human services to receive the state subsidy.<br/>
<a id="pl.153.5"></a><var>153.5</var>(b) The commissioner of employment and economic development must inform an <br/>
<a id="pl.153.6"></a><var>153.6</var>applicant for unemployment benefits of the availability of a state subsidy if the applicant <br/>
<a id="pl.153.7"></a><var>153.7</var>elects COBRA continuation coverage and the applicant meets the eligibility requirements <br/>
<a id="pl.153.8"></a><var>153.8</var>of this section.<br/>
<a id="pl.153.9"></a><var>153.9</var>    Subd. 4. <b>Exemption.</b> Any individual who receives a state subsidy under this <br/>
<a id="pl.153.10"></a><var>153.10</var>section is exempt from the four-month requirement under Minnesota Statutes, section <br/>
<a id="pl.153.11"></a><var>153.11</var>256L.07, subdivision 3, if the individual or the individual's qualified beneficiaries apply <br/>
<a id="pl.153.12"></a><var>153.12</var>for MinnesotaCare after the individual no longer receives COBRA continuation coverage.<br/>
<a id="pl.153.13"></a><var>153.13</var>    Subd. 5. <b>Expiration.</b> This section expires December 31, 2010.<br/>
<br/>
<a id="bill.5.79.0"></a><a id="pl.153.14"></a><var>153.14</var>    Sec. 79. <b>FEDERAL APPROVAL.</b><br/>
<a id="pl.153.15"></a><var>153.15</var>The commissioner of human services shall resubmit for federal approval the <br/>
<a id="pl.153.16"></a><var>153.16</var>elimination of depreciation for self-employed farmers in determining income eligibility <br/>
<a id="pl.153.17"></a><var>153.17</var>for MinnesotaCare passed in Laws 2007, chapter 147, article 5, section 19.<br/>
<br/>
<a id="bill.5.80.0"></a><a id="pl.153.18"></a><var>153.18</var>    Sec. 80. <b>REPEALER.</b><br/>
<a id="pl.153.19"></a><var>153.19</var>Minnesota Statutes 2008, sections 256.962, subdivision 7; and 256L.17, subdivision <br/>
<a id="pl.153.20"></a><var>153.20</var>6, are repealed.<br/>
<br/>
<a id="bill.6.0.0"></a>

<a id="bill.6.1.0"></a><a id="pl.153.23"></a><var>153.23</var>    Section 1. Minnesota Statutes 2008, section 144A.46, subdivision 1, is amended to <br/>
<a id="pl.153.24"></a><var>153.24</var>read:<br/>
<a id="pl.153.25"></a><var>153.25</var>    Subdivision 1.  <b>License required.</b> (a) A home care provider may not operate in the <br/>
<a id="pl.153.26"></a><var>153.26</var>state without a current license issued by the commissioner of health. A home care provider <br/>
<a id="pl.153.27"></a><var>153.27</var>may hold a separate license for each class of home care licensure. <br/>
<a id="pl.153.28"></a><var>153.28</var>    (b) Within ten days after receiving an application for a license, the commissioner <br/>
<a id="pl.153.29"></a><var>153.29</var>shall acknowledge receipt of the application in writing. The acknowledgment must <br/>
<a id="pl.153.30"></a><var>153.30</var>indicate whether the application appears to be complete or whether additional information <br/>
<a id="pl.153.31"></a><var>153.31</var>is required before the application will be considered complete. Within 90 days after <br/>
<a id="pl.153.32"></a><var>153.32</var>receiving a complete application, the commissioner shall either grant or deny the license. <br/>
<a id="pl.153.33"></a><var>153.33</var>If an applicant is not granted or denied a license within 90 days after submitting a <br/>
<a id="pl.154.1"></a><var>154.1</var>complete application, the license must be deemed granted. An applicant whose license has <br/>
<a id="pl.154.2"></a><var>154.2</var>been deemed granted must provide written notice to the commissioner before providing a <br/>
<a id="pl.154.3"></a><var>154.3</var>home care service. <br/>
<a id="pl.154.4"></a><var>154.4</var>    (c) Each application for a home care provider license, or for a renewal of a license, <br/>
<a id="pl.154.5"></a><var>154.5</var>shall be accompanied by a fee to be set by the commissioner under section 
         <statute_ref>144.122</statute_ref>. <br/>
<a id="pl.154.6"></a><var>154.6</var>    (d) The commissioner of health, in consultation with the commissioner of human <br/>
<a id="pl.154.7"></a><var>154.7</var>services, shall provide recommendations to the legislature by February 15, 2009, for <br/>
<a id="pl.154.8"></a><var>154.8</var>provider standards for personal care assistant services as described in section 
         <statute_ref>256B.0655</statute_ref> <br/>
<a id="pl.154.9"></a><var>154.9</var>256B.0659. <br/>
<br/>
<a id="bill.6.2.0"></a><a id="pl.154.10"></a><var>154.10</var>    Sec. 2. Minnesota Statutes 2008, section 176.011, subdivision 9, is amended to read:<br/>
<a id="pl.154.11"></a><var>154.11</var>    Subd. 9.  <b>Employee.</b> "Employee" means any person who performs services for <br/>
<a id="pl.154.12"></a><var>154.12</var>another for hire including the following: <br/>
<a id="pl.154.13"></a><var>154.13</var>(1) an alien; <br/>
<a id="pl.154.14"></a><var>154.14</var>(2) a minor; <br/>
<a id="pl.154.15"></a><var>154.15</var>(3) a sheriff, deputy sheriff, police officer, firefighter, county highway engineer, and <br/>
<a id="pl.154.16"></a><var>154.16</var>peace officer while engaged in the enforcement of peace or in the pursuit or capture of a <br/>
<a id="pl.154.17"></a><var>154.17</var>person charged with or suspected of crime; <br/>
<a id="pl.154.18"></a><var>154.18</var>(4) a person requested or commanded to aid an officer in arresting or retaking a <br/>
<a id="pl.154.19"></a><var>154.19</var>person who has escaped from lawful custody, or in executing legal process, in which <br/>
<a id="pl.154.20"></a><var>154.20</var>cases, for purposes of calculating compensation under this chapter, the daily wage of the <br/>
<a id="pl.154.21"></a><var>154.21</var>person shall be the prevailing wage for similar services performed by paid employees; <br/>
<a id="pl.154.22"></a><var>154.22</var>(5) a county assessor; <br/>
<a id="pl.154.23"></a><var>154.23</var>(6) an elected or appointed official of the state, or of a county, city, town, school <br/>
<a id="pl.154.24"></a><var>154.24</var>district, or governmental subdivision in the state. An officer of a political subdivision <br/>
<a id="pl.154.25"></a><var>154.25</var>elected or appointed for a regular term of office, or to complete the unexpired portion of a <br/>
<a id="pl.154.26"></a><var>154.26</var>regular term, shall be included only after the governing body of the political subdivision <br/>
<a id="pl.154.27"></a><var>154.27</var>has adopted an ordinance or resolution to that effect; <br/>
<a id="pl.154.28"></a><var>154.28</var>(7) an executive officer of a corporation, except those executive officers excluded <br/>
<a id="pl.154.29"></a><var>154.29</var>by section 
         <statute_ref>176.041</statute_ref>; <br/>
<a id="pl.154.30"></a><var>154.30</var>(8) a voluntary uncompensated worker, other than an inmate, rendering services in <br/>
<a id="pl.154.31"></a><var>154.31</var>state institutions under the commissioners of human services and corrections similar to <br/>
<a id="pl.154.32"></a><var>154.32</var>those of officers and employees of the institutions, and whose services have been accepted <br/>
<a id="pl.154.33"></a><var>154.33</var>or contracted for by the commissioner of human services or corrections as authorized by <br/>
<a id="pl.154.34"></a><var>154.34</var>law. In the event of injury or death of the worker, the daily wage of the worker, for the <br/>
<a id="pl.154.35"></a><var>154.35</var>purpose of calculating compensation under this chapter, shall be the usual wage paid at <br/>
<a id="pl.155.1"></a><var>155.1</var>the time of the injury or death for similar services in institutions where the services are <br/>
<a id="pl.155.2"></a><var>155.2</var>performed by paid employees; <br/>
<a id="pl.155.3"></a><var>155.3</var>(9) a voluntary uncompensated worker engaged in emergency management as <br/>
<a id="pl.155.4"></a><var>155.4</var>defined in section 
         <statute_ref>12.03, subdivision 4</statute_ref>, who is: <br/>
<a id="pl.155.5"></a><var>155.5</var>(i) registered with the state or any political subdivision of it, according to the <br/>
<a id="pl.155.6"></a><var>155.6</var>procedures set forth in the state or political subdivision emergency operations plan; and <br/>
<a id="pl.155.7"></a><var>155.7</var>(ii) acting under the direction and control of, and within the scope of duties approved <br/>
<a id="pl.155.8"></a><var>155.8</var>by, the state or political subdivision. <br/>
<a id="pl.155.9"></a><var>155.9</var>The daily wage of the worker, for the purpose of calculating compensation under this <br/>
<a id="pl.155.10"></a><var>155.10</var>chapter, shall be the usual wage paid at the time of the injury or death for similar services <br/>
<a id="pl.155.11"></a><var>155.11</var>performed by paid employees; <br/>
<a id="pl.155.12"></a><var>155.12</var>(10) a voluntary uncompensated worker participating in a program established by a <br/>
<a id="pl.155.13"></a><var>155.13</var>local social services agency. For purposes of this clause, "local social services agency" <br/>
<a id="pl.155.14"></a><var>155.14</var>means any agency established under section 
         <statute_ref>393.01</statute_ref>. In the event of injury or death of the <br/>
<a id="pl.155.15"></a><var>155.15</var>worker, the wage of the worker, for the purpose of calculating compensation under this <br/>
<a id="pl.155.16"></a><var>155.16</var>chapter, shall be the usual wage paid in the county at the time of the injury or death for <br/>
<a id="pl.155.17"></a><var>155.17</var>similar services performed by paid employees working a normal day and week; <br/>
<a id="pl.155.18"></a><var>155.18</var>(11) a voluntary uncompensated worker accepted by the commissioner of natural <br/>
<a id="pl.155.19"></a><var>155.19</var>resources who is rendering services as a volunteer pursuant to section 
         <statute_ref>84.089</statute_ref>. The daily <br/>
<a id="pl.155.20"></a><var>155.20</var>wage of the worker for the purpose of calculating compensation under this chapter, shall <br/>
<a id="pl.155.21"></a><var>155.21</var>be the usual wage paid at the time of injury or death for similar services performed by <br/>
<a id="pl.155.22"></a><var>155.22</var>paid employees; <br/>
<a id="pl.155.23"></a><var>155.23</var>(12) a voluntary uncompensated worker in the building and construction industry <br/>
<a id="pl.155.24"></a><var>155.24</var>who renders services for joint labor-management nonprofit community service projects. <br/>
<a id="pl.155.25"></a><var>155.25</var>The daily wage of the worker for the purpose of calculating compensation under this <br/>
<a id="pl.155.26"></a><var>155.26</var>chapter shall be the usual wage paid at the time of injury or death for similar services <br/>
<a id="pl.155.27"></a><var>155.27</var>performed by paid employees; <br/>
<a id="pl.155.28"></a><var>155.28</var>(13) a member of the military forces, as defined in section 
         <statute_ref>190.05</statute_ref>, while in state <br/>
<a id="pl.155.29"></a><var>155.29</var>active service, as defined in section 
         <statute_ref>190.05, subdivision 5a</statute_ref>. The daily wage of the member <br/>
<a id="pl.155.30"></a><var>155.30</var>for the purpose of calculating compensation under this chapter shall be based on the <br/>
<a id="pl.155.31"></a><var>155.31</var>member's usual earnings in civil life. If there is no evidence of previous occupation or <br/>
<a id="pl.155.32"></a><var>155.32</var>earning, the trier of fact shall consider the member's earnings as a member of the military <br/>
<a id="pl.155.33"></a><var>155.33</var>forces; <br/>
<a id="pl.155.34"></a><var>155.34</var>(14) a voluntary uncompensated worker, accepted by the director of the Minnesota <br/>
<a id="pl.155.35"></a><var>155.35</var>Historical Society, rendering services as a volunteer, pursuant to chapter 138. The daily <br/>
<a id="pl.155.36"></a><var>155.36</var>wage of the worker, for the purposes of calculating compensation under this chapter, <br/>
<a id="pl.156.1"></a><var>156.1</var>shall be the usual wage paid at the time of injury or death for similar services performed <br/>
<a id="pl.156.2"></a><var>156.2</var>by paid employees; <br/>
<a id="pl.156.3"></a><var>156.3</var>(15) a voluntary uncompensated worker, other than a student, who renders services <br/>
<a id="pl.156.4"></a><var>156.4</var>at the Minnesota State Academy for the Deaf or the Minnesota State Academy for the <br/>
<a id="pl.156.5"></a><var>156.5</var>Blind, and whose services have been accepted or contracted for by the commissioner of <br/>
<a id="pl.156.6"></a><var>156.6</var>education, as authorized by law. In the event of injury or death of the worker, the daily <br/>
<a id="pl.156.7"></a><var>156.7</var>wage of the worker, for the purpose of calculating compensation under this chapter, shall <br/>
<a id="pl.156.8"></a><var>156.8</var>be the usual wage paid at the time of the injury or death for similar services performed in <br/>
<a id="pl.156.9"></a><var>156.9</var>institutions by paid employees; <br/>
<a id="pl.156.10"></a><var>156.10</var>(16) a voluntary uncompensated worker, other than a resident of the veterans home, <br/>
<a id="pl.156.11"></a><var>156.11</var>who renders services at a Minnesota veterans home, and whose services have been <br/>
<a id="pl.156.12"></a><var>156.12</var>accepted or contracted for by the commissioner of veterans affairs, as authorized by law. <br/>
<a id="pl.156.13"></a><var>156.13</var>In the event of injury or death of the worker, the daily wage of the worker, for the purpose <br/>
<a id="pl.156.14"></a><var>156.14</var>of calculating compensation under this chapter, shall be the usual wage paid at the time of <br/>
<a id="pl.156.15"></a><var>156.15</var>the injury or death for similar services performed in institutions by paid employees; <br/>
<a id="pl.156.16"></a><var>156.16</var>(17) a worker performing services under section 
         <statute_ref>256B.0655</statute_ref> 256B.0659 for a <br/>
<a id="pl.156.17"></a><var>156.17</var>recipient in the home of the recipient or in the community under section 
         <statute_ref>256B.0625, <br/>
<a id="pl.156.18"></a><var>156.18</var>subdivision 19a
         </statute_ref>, who is paid from government funds through a fiscal intermediary under <br/>
<a id="pl.156.19"></a><var>156.19</var>section 
         <statute_ref>256B.0655, subdivision </statute_ref>7 256B.0659, subdivision 33. For purposes of maintaining <br/>
<a id="pl.156.20"></a><var>156.20</var>workers' compensation insurance, the employer of the worker is as designated in law <br/>
<a id="pl.156.21"></a><var>156.21</var>by the commissioner of the Department of Human Services, notwithstanding any other <br/>
<a id="pl.156.22"></a><var>156.22</var>law to the contrary;<br/>
<a id="pl.156.23"></a><var>156.23</var>(18) students enrolled in and regularly attending the Medical School of the <br/>
<a id="pl.156.24"></a><var>156.24</var>University of Minnesota in the graduate school program or the postgraduate program. The <br/>
<a id="pl.156.25"></a><var>156.25</var>students shall not be considered employees for any other purpose. In the event of the <br/>
<a id="pl.156.26"></a><var>156.26</var>student's injury or death, the weekly wage of the student for the purpose of calculating <br/>
<a id="pl.156.27"></a><var>156.27</var>compensation under this chapter, shall be the annualized educational stipend awarded to <br/>
<a id="pl.156.28"></a><var>156.28</var>the student, divided by 52 weeks. The institution in which the student is enrolled shall <br/>
<a id="pl.156.29"></a><var>156.29</var>be considered the "employer" for the limited purpose of determining responsibility for <br/>
<a id="pl.156.30"></a><var>156.30</var>paying benefits under this chapter; <br/>
<a id="pl.156.31"></a><var>156.31</var>(19) a faculty member of the University of Minnesota employed for an academic <br/>
<a id="pl.156.32"></a><var>156.32</var>year is also an employee for the period between that academic year and the succeeding <br/>
<a id="pl.156.33"></a><var>156.33</var>academic year if: <br/>
<a id="pl.156.34"></a><var>156.34</var>(a) the member has a contract or reasonable assurance of a contract from the <br/>
<a id="pl.156.35"></a><var>156.35</var>University of Minnesota for the succeeding academic year; and <br/>
<a id="pl.157.1"></a><var>157.1</var>(b) the personal injury for which compensation is sought arises out of and in the <br/>
<a id="pl.157.2"></a><var>157.2</var>course of activities related to the faculty member's employment by the University of <br/>
<a id="pl.157.3"></a><var>157.3</var>Minnesota; <br/>
<a id="pl.157.4"></a><var>157.4</var>(20) a worker who performs volunteer ambulance driver or attendant services is an <br/>
<a id="pl.157.5"></a><var>157.5</var>employee of the political subdivision, nonprofit hospital, nonprofit corporation, or other <br/>
<a id="pl.157.6"></a><var>157.6</var>entity for which the worker performs the services. The daily wage of the worker for the <br/>
<a id="pl.157.7"></a><var>157.7</var>purpose of calculating compensation under this chapter shall be the usual wage paid at the <br/>
<a id="pl.157.8"></a><var>157.8</var>time of injury or death for similar services performed by paid employees; <br/>
<a id="pl.157.9"></a><var>157.9</var>(21) a voluntary uncompensated worker, accepted by the commissioner of <br/>
<a id="pl.157.10"></a><var>157.10</var>administration, rendering services as a volunteer at the Department of Administration. In <br/>
<a id="pl.157.11"></a><var>157.11</var>the event of injury or death of the worker, the daily wage of the worker, for the purpose of <br/>
<a id="pl.157.12"></a><var>157.12</var>calculating compensation under this chapter, shall be the usual wage paid at the time of the <br/>
<a id="pl.157.13"></a><var>157.13</var>injury or death for similar services performed in institutions by paid employees; <br/>
<a id="pl.157.14"></a><var>157.14</var>(22) a voluntary uncompensated worker rendering service directly to the Pollution <br/>
<a id="pl.157.15"></a><var>157.15</var>Control Agency. The daily wage of the worker for the purpose of calculating compensation <br/>
<a id="pl.157.16"></a><var>157.16</var>payable under this chapter is the usual going wage paid at the time of injury or death for <br/>
<a id="pl.157.17"></a><var>157.17</var>similar services if the services are performed by paid employees; <br/>
<a id="pl.157.18"></a><var>157.18</var>(23) a voluntary uncompensated worker while volunteering services as a first <br/>
<a id="pl.157.19"></a><var>157.19</var>responder or as a member of a law enforcement assistance organization while acting <br/>
<a id="pl.157.20"></a><var>157.20</var>under the supervision and authority of a political subdivision. The daily wage of the <br/>
<a id="pl.157.21"></a><var>157.21</var>worker for the purpose of calculating compensation payable under this chapter is the <br/>
<a id="pl.157.22"></a><var>157.22</var>usual going wage paid at the time of injury or death for similar services if the services <br/>
<a id="pl.157.23"></a><var>157.23</var>are performed by paid employees; <br/>
<a id="pl.157.24"></a><var>157.24</var>(24) a voluntary uncompensated member of the civil air patrol rendering service on <br/>
<a id="pl.157.25"></a><var>157.25</var>the request and under the authority of the state or any of its political subdivisions. The <br/>
<a id="pl.157.26"></a><var>157.26</var>daily wage of the member for the purposes of calculating compensation payable under this <br/>
<a id="pl.157.27"></a><var>157.27</var>chapter is the usual going wage paid at the time of injury or death for similar services if <br/>
<a id="pl.157.28"></a><var>157.28</var>the services are performed by paid employees; and <br/>
<a id="pl.157.29"></a><var>157.29</var>(25) a Minnesota Responds Medical Reserve Corps volunteer, as provided in <br/>
<a id="pl.157.30"></a><var>157.30</var>sections 
         <statute_ref>145A.04</statute_ref> and 
         <statute_ref>145A.06</statute_ref>, responding at the request of or engaged in training <br/>
<a id="pl.157.31"></a><var>157.31</var>conducted by the commissioner of health. The daily wage of the volunteer for the purposes <br/>
<a id="pl.157.32"></a><var>157.32</var>of calculating compensation payable under this chapter is established in section 
         <statute_ref>145A.06</statute_ref>. <br/>
<a id="pl.157.33"></a><var>157.33</var>A person who qualifies under this clause and who may also qualify under another clause <br/>
<a id="pl.157.34"></a><var>157.34</var>of this subdivision shall receive benefits in accordance with this clause. <br/>
<a id="pl.157.35"></a><var>157.35</var>If it is difficult to determine the daily wage as provided in this subdivision, the trier <br/>
<a id="pl.157.36"></a><var>157.36</var>of fact may determine the wage upon which the compensation is payable. <br/>
<br/>
<a id="bill.6.3.0"></a><a id="pl.158.1"></a><var>158.1</var>    Sec. 3. Minnesota Statutes 2008, section 245C.03, subdivision 2, is amended to read:<br/>
<a id="pl.158.2"></a><var>158.2</var>    Subd. 2. <b>Personal care provider organizations.</b> The commissioner shall conduct <br/>
<a id="pl.158.3"></a><var>158.3</var>background studies on any individual required under sections 
         <statute_ref>256B.0651</statute_ref> and 
<statute_ref>256B.0653</statute_ref> <br/>
<a id="pl.158.4"></a><var>158.4</var>to 
         <statute_ref>256B.0656</statute_ref> and 256B.0659 to have a background study completed under this chapter.<br/>
<br/>
<a id="bill.6.4.0"></a><a id="pl.158.5"></a><var>158.5</var>    Sec. 4. Minnesota Statutes 2008, section 245C.04, subdivision 3, is amended to read:<br/>
<a id="pl.158.6"></a><var>158.6</var>    Subd. 3. <b>Personal care provider organizations.</b> (a) The commissioner shall <br/>
<a id="pl.158.7"></a><var>158.7</var>conduct a background study of an individual required to be studied under section 
         <statute_ref>245C.03, <br/>
<a id="pl.158.8"></a><var>158.8</var>subdivision 2
         </statute_ref>, at least upon application for initial enrollment under sections 
         <statute_ref>256B.0651</statute_ref> <br/>
<a id="pl.158.9"></a><var>158.9</var>and 
<statute_ref>256B.0653</statute_ref> to 
         <statute_ref>256B.0656</statute_ref> and 256B.0659.<br/>
<a id="pl.158.10"></a><var>158.10</var>(b) Organizations required to initiate background studies under sections 
         <statute_ref>256B.0651</statute_ref> <br/>
<a id="pl.158.11"></a><var>158.11</var>and 
<statute_ref>256B.0653</statute_ref> to 
         <statute_ref>256B.0656</statute_ref> and 256B.0659 for individuals described in section 
         <statute_ref>245C.03, <br/>
<a id="pl.158.12"></a><var>158.12</var>subdivision 2
         </statute_ref>, must submit a completed background study form to the commissioner <br/>
<a id="pl.158.13"></a><var>158.13</var>before those individuals begin a position allowing direct contact with persons served <br/>
<a id="pl.158.14"></a><var>158.14</var>by the organization.<br/>
<br/>
<a id="bill.6.5.0"></a><a id="pl.158.15"></a><var>158.15</var>    Sec. 5. Minnesota Statutes 2008, section 245C.10, subdivision 3, is amended to read:<br/>
<a id="pl.158.16"></a><var>158.16</var>    Subd. 3. <b>Personal care provider organizations.</b> The commissioner shall recover <br/>
<a id="pl.158.17"></a><var>158.17</var>the cost of background studies initiated by a personal care provider organization under <br/>
<a id="pl.158.18"></a><var>158.18</var>sections 
         <statute_ref>256B.0651</statute_ref> and 
<statute_ref>256B.0653</statute_ref> to 
         <statute_ref>256B.0656</statute_ref> and 256B.0659 through a fee of no <br/>
<a id="pl.158.19"></a><var>158.19</var>more than $20 per study charged to the organization responsible for submitting the <br/>
<a id="pl.158.20"></a><var>158.20</var>background study form. The fees collected under this subdivision are appropriated to the <br/>
<a id="pl.158.21"></a><var>158.21</var>commissioner for the purpose of conducting background studies.<br/>
<br/>
<a id="bill.6.6.0"></a><a id="pl.158.22"></a><var>158.22</var>    Sec. 6. Minnesota Statutes 2008, section 256B.04, subdivision 16, is amended to read:<br/>
<a id="pl.158.23"></a><var>158.23</var>    Subd. 16.  <b>Personal care services.</b> (a) Notwithstanding any contrary language in <br/>
<a id="pl.158.24"></a><var>158.24</var>this paragraph, the commissioner of human services and the commissioner of health shall <br/>
<a id="pl.158.25"></a><var>158.25</var>jointly promulgate rules to be applied to the licensure of personal care services provided <br/>
<a id="pl.158.26"></a><var>158.26</var>under the medical assistance program. The rules shall consider standards for personal care <br/>
<a id="pl.158.27"></a><var>158.27</var>services that are based on the World Institute on Disability's recommendations regarding <br/>
<a id="pl.158.28"></a><var>158.28</var>personal care services. These rules shall at a minimum consider the standards and <br/>
<a id="pl.158.29"></a><var>158.29</var>requirements adopted by the commissioner of health under section 
         <statute_ref>144A.45</statute_ref>, which the <br/>
<a id="pl.158.30"></a><var>158.30</var>commissioner of human services determines are applicable to the provision of personal <br/>
<a id="pl.158.31"></a><var>158.31</var>care services, in addition to other standards or modifications which the commissioner of <br/>
<a id="pl.158.32"></a><var>158.32</var>human services determines are appropriate. <br/>
<a id="pl.159.1"></a><var>159.1</var>The commissioner of human services shall establish an advisory group including <br/>
<a id="pl.159.2"></a><var>159.2</var>personal care consumers and providers to provide advice regarding which standards or <br/>
<a id="pl.159.3"></a><var>159.3</var>modifications should be adopted. The advisory group membership must include not less <br/>
<a id="pl.159.4"></a><var>159.4</var>than 15 members, of which at least 60 percent must be consumers of personal care services <br/>
<a id="pl.159.5"></a><var>159.5</var>and representatives of recipients with various disabilities and diagnoses and ages. At least <br/>
<a id="pl.159.6"></a><var>159.6</var>51 percent of the members of the advisory group must be recipients of personal care. <br/>
<a id="pl.159.7"></a><var>159.7</var>The commissioner of human services may contract with the commissioner of health <br/>
<a id="pl.159.8"></a><var>159.8</var>to enforce the jointly promulgated licensure rules for personal care service providers. <br/>
<a id="pl.159.9"></a><var>159.9</var>Prior to final promulgation of the joint rule the commissioner of human services <br/>
<a id="pl.159.10"></a><var>159.10</var>shall report preliminary findings along with any comments of the advisory group and a <br/>
<a id="pl.159.11"></a><var>159.11</var>plan for monitoring and enforcement by the Department of Health to the legislature by <br/>
<a id="pl.159.12"></a><var>159.12</var>February 15, 1992. <br/>
<a id="pl.159.13"></a><var>159.13</var>Limits on the extent of personal care services that may be provided to an individual <br/>
<a id="pl.159.14"></a><var>159.14</var>must be based on the cost-effectiveness of the services in relation to the costs of inpatient <br/>
<a id="pl.159.15"></a><var>159.15</var>hospital care, nursing home care, and other available types of care. The rules must <br/>
<a id="pl.159.16"></a><var>159.16</var>provide, at a minimum: <br/>
<a id="pl.159.17"></a><var>159.17</var>(1) that agencies be selected to contract with or employ and train staff to provide and <br/>
<a id="pl.159.18"></a><var>159.18</var>supervise the provision of personal care services; <br/>
<a id="pl.159.19"></a><var>159.19</var>(2) that agencies employ or contract with a qualified applicant that a qualified <br/>
<a id="pl.159.20"></a><var>159.20</var>recipient proposes to the agency as the recipient's choice of assistant; <br/>
<a id="pl.159.21"></a><var>159.21</var>(3) that agencies bill the medical assistance program for a personal care service <br/>
<a id="pl.159.22"></a><var>159.22</var>by a personal care assistant and supervision by a qualified professional supervising the <br/>
<a id="pl.159.23"></a><var>159.23</var>personal care assistant unless the recipient selects the fiscal agent option under section <br/>
<statute_ref><a id="pl.159.24"></a><var>159.24</var>256B.0655, subdivision 7
</statute_ref> 256B.0659, subdivision 33; <br/>
<a id="pl.159.25"></a><var>159.25</var>(4) that agencies establish a grievance mechanism; and <br/>
<a id="pl.159.26"></a><var>159.26</var>(5) that agencies have a quality assurance program. <br/>
<a id="pl.159.27"></a><var>159.27</var>(b) The commissioner may waive the requirement for the provision of personal care <br/>
<a id="pl.159.28"></a><var>159.28</var>services through an agency in a particular county, when there are less than two agencies <br/>
<a id="pl.159.29"></a><var>159.29</var>providing services in that county and shall waive the requirement for personal care <br/>
<a id="pl.159.30"></a><var>159.30</var>assistants required to join an agency for the first time during 1993 when personal care <br/>
<a id="pl.159.31"></a><var>159.31</var>services are provided under a relative hardship waiver under Minnesota Statutes 1992, <br/>
<a id="pl.159.32"></a><var>159.32</var>section 
         <statute_ref>256B.0627, subdivision 4</statute_ref>, paragraph (b), clause (7), and at least two agencies <br/>
<a id="pl.159.33"></a><var>159.33</var>providing personal care services have refused to employ or contract with the independent <br/>
<a id="pl.159.34"></a><var>159.34</var>personal care assistant. <br/>
<br/>
<a id="bill.6.7.0"></a><a id="pl.159.35"></a><var>159.35</var>    Sec. 7. Minnesota Statutes 2008, section 256B.055, subdivision 12, is amended to read:<br/>
<a id="pl.160.1"></a><var>160.1</var>    Subd. 12.  <b>Disabled children.</b> (a) A person is eligible for medical assistance if the <br/>
<a id="pl.160.2"></a><var>160.2</var>person is under age 19 and qualifies as a disabled individual under United States Code, <br/>
<a id="pl.160.3"></a><var>160.3</var>title 42, section 1382c(a), and would be eligible for medical assistance under the state <br/>
<a id="pl.160.4"></a><var>160.4</var>plan if residing in a medical institution, and the child requires a level of care provided in <br/>
<a id="pl.160.5"></a><var>160.5</var>a hospital, nursing facility, or intermediate care facility for persons with developmental <br/>
<a id="pl.160.6"></a><var>160.6</var>disabilities, for whom home care is appropriate, provided that the cost to medical <br/>
<a id="pl.160.7"></a><var>160.7</var>assistance under this section is not more than the amount that medical assistance would pay <br/>
<a id="pl.160.8"></a><var>160.8</var>for if the child resides in an institution. After the child is determined to be eligible under <br/>
<a id="pl.160.9"></a><var>160.9</var>this section, the commissioner shall review the child's disability under United States Code, <br/>
<a id="pl.160.10"></a><var>160.10</var>title 42, section 1382c(a) and level of care defined under this section no more often than <br/>
<a id="pl.160.11"></a><var>160.11</var>annually and may elect, based on the recommendation of health care professionals under <br/>
<a id="pl.160.12"></a><var>160.12</var>contract with the state medical review team, to extend the review of disability and level of <br/>
<a id="pl.160.13"></a><var>160.13</var>care up to a maximum of four years. The commissioner's decision on the frequency of <br/>
<a id="pl.160.14"></a><var>160.14</var>continuing review of disability and level of care is not subject to administrative appeal <br/>
<a id="pl.160.15"></a><var>160.15</var>under section 
         <statute_ref>256.045</statute_ref>. The county agency shall send a notice of disability review to the <br/>
<a id="pl.160.16"></a><var>160.16</var>enrollee six months prior to the date the recertification of disability is due. Nothing in this <br/>
<a id="pl.160.17"></a><var>160.17</var>subdivision shall be construed as affecting other redeterminations of medical assistance <br/>
<a id="pl.160.18"></a><var>160.18</var>eligibility under this chapter and annual cost-effective reviews under this section. <br/>
<a id="pl.160.19"></a><var>160.19</var>    (b) For purposes of this subdivision, "hospital" means an institution as defined <br/>
<a id="pl.160.20"></a><var>160.20</var>in section 
         <statute_ref>144.696, subdivision 3</statute_ref>, 
         <statute_ref>144.55, subdivision 3</statute_ref>, or Minnesota Rules, part <br/>
<a id="pl.160.21"></a><var>160.21</var>4640.3600, and licensed pursuant to sections 
         <statute_ref>144.50</statute_ref> to 
         <statute_ref>144.58</statute_ref>. For purposes of this <br/>
<a id="pl.160.22"></a><var>160.22</var>subdivision, a child requires a level of care provided in a hospital if the child is determined <br/>
<a id="pl.160.23"></a><var>160.23</var>by the commissioner to need an extensive array of health services, including mental health <br/>
<a id="pl.160.24"></a><var>160.24</var>services, for an undetermined period of time, whose health condition requires frequent <br/>
<a id="pl.160.25"></a><var>160.25</var>monitoring and treatment by a health care professional or by a person supervised by a <br/>
<a id="pl.160.26"></a><var>160.26</var>health care professional, who would reside in a hospital or require frequent hospitalization <br/>
<a id="pl.160.27"></a><var>160.27</var>if these services were not provided, and the daily care needs are more complex than <br/>
<a id="pl.160.28"></a><var>160.28</var>a nursing facility level of care. <br/>
<a id="pl.160.29"></a><var>160.29</var>    A child with serious emotional disturbance requires a level of care provided in a <br/>
<a id="pl.160.30"></a><var>160.30</var>hospital if the commissioner determines that the individual requires 24-hour supervision <br/>
<a id="pl.160.31"></a><var>160.31</var>because the person exhibits recurrent or frequent suicidal or homicidal ideation or <br/>
<a id="pl.160.32"></a><var>160.32</var>behavior, recurrent or frequent psychosomatic disorders or somatopsychic disorders that <br/>
<a id="pl.160.33"></a><var>160.33</var>may become life threatening, recurrent or frequent severe socially unacceptable behavior <br/>
<a id="pl.160.34"></a><var>160.34</var>associated with psychiatric disorder, ongoing and chronic psychosis or severe, ongoing <br/>
<a id="pl.160.35"></a><var>160.35</var>and chronic developmental problems requiring continuous skilled observation, or severe <br/>
<a id="pl.161.1"></a><var>161.1</var>disabling symptoms for which office-centered outpatient treatment is not adequate, and <br/>
<a id="pl.161.2"></a><var>161.2</var>which overall severely impact the individual's ability to function. <br/>
<a id="pl.161.3"></a><var>161.3</var>    (c) For purposes of this subdivision, "nursing facility" means a facility which <br/>
<a id="pl.161.4"></a><var>161.4</var>provides nursing care as defined in section 
         <statute_ref>144A.01, subdivision 5</statute_ref>, licensed pursuant to <br/>
<a id="pl.161.5"></a><var>161.5</var>sections 
         <statute_ref>144A.02</statute_ref> to 
         <statute_ref>144A.10</statute_ref>, which is appropriate if a person is in active restorative <br/>
<a id="pl.161.6"></a><var>161.6</var>treatment; is in need of special treatments provided or supervised by a licensed nurse; or <br/>
<a id="pl.161.7"></a><var>161.7</var>has unpredictable episodes of active disease processes requiring immediate judgment <br/>
<a id="pl.161.8"></a><var>161.8</var>by a licensed nurse. For purposes of this subdivision, a child requires the level of care <br/>
<a id="pl.161.9"></a><var>161.9</var>provided in a nursing facility if the child is determined by the commissioner to meet <br/>
<a id="pl.161.10"></a><var>161.10</var>the requirements of the preadmission screening assessment document under section <br/>
<statute_ref><a id="pl.161.11"></a><var>161.11</var>256B.0911
         </statute_ref> and the home care independent rating document under section 
<statute_ref>256B.0655, <br/>
<a id="pl.161.12"></a><var>161.12</var>subdivision 4
</statute_ref>, clause (3), adjusted to address age-appropriate standards for children age 18 <br/>
<a id="pl.161.13"></a><var>161.13</var>and under, pursuant to section
<statute_ref>256B.0655, subdivision 3</statute_ref>. <br/>
<a id="pl.161.14"></a><var>161.14</var>    (d) For purposes of this subdivision, "intermediate care facility for persons with <br/>
<a id="pl.161.15"></a><var>161.15</var>developmental disabilities" or "ICF/MR" means a program licensed to provide services to <br/>
<a id="pl.161.16"></a><var>161.16</var>persons with developmental disabilities under section 
         <statute_ref>252.28</statute_ref>, and chapter 245A, and a <br/>
<a id="pl.161.17"></a><var>161.17</var>physical plant licensed as a supervised living facility under chapter 144, which together <br/>
<a id="pl.161.18"></a><var>161.18</var>are certified by the Minnesota Department of Health as meeting the standards in Code of <br/>
<a id="pl.161.19"></a><var>161.19</var>Federal Regulations, title 42, part 483, for an intermediate care facility which provides <br/>
<a id="pl.161.20"></a><var>161.20</var>services for persons with developmental disabilities who require 24-hour supervision <br/>
<a id="pl.161.21"></a><var>161.21</var>and active treatment for medical, behavioral, or habilitation needs. For purposes of this <br/>
<a id="pl.161.22"></a><var>161.22</var>subdivision, a child requires a level of care provided in an ICF/MR if the commissioner <br/>
<a id="pl.161.23"></a><var>161.23</var>finds that the child has a developmental disability in accordance with section 
         <statute_ref>256B.092</statute_ref>, <br/>
<a id="pl.161.24"></a><var>161.24</var>is in need of a 24-hour plan of care and active treatment similar to persons with <br/>
<a id="pl.161.25"></a><var>161.25</var>developmental disabilities, and there is a reasonable indication that the child will need <br/>
<a id="pl.161.26"></a><var>161.26</var>ICF/MR services. <br/>
<a id="pl.161.27"></a><var>161.27</var>    (e) For purposes of this subdivision, a person requires the level of care provided <br/>
<a id="pl.161.28"></a><var>161.28</var>in a nursing facility if the person requires 24-hour monitoring or supervision and a plan <br/>
<a id="pl.161.29"></a><var>161.29</var>of mental health treatment because of specific symptoms or functional impairments <br/>
<a id="pl.161.30"></a><var>161.30</var>associated with a serious mental illness or disorder diagnosis, which meet severity criteria <br/>
<a id="pl.161.31"></a><var>161.31</var>for mental health established by the commissioner and published in March 1997 as <br/>
<a id="pl.161.32"></a><var>161.32</var>the Minnesota Mental Health Level of Care for Children and Adolescents with Severe <br/>
<a id="pl.161.33"></a><var>161.33</var>Emotional Disorders. <br/>
<a id="pl.161.34"></a><var>161.34</var>    (f) The determination of the level of care needed by the child shall be made by <br/>
<a id="pl.161.35"></a><var>161.35</var>the commissioner based on information supplied to the commissioner by the parent or <br/>
<a id="pl.161.36"></a><var>161.36</var>guardian, the child's physician or physicians, and other professionals as requested by the <br/>
<a id="pl.162.1"></a><var>162.1</var>commissioner. The commissioner shall establish a screening team to conduct the level of <br/>
<a id="pl.162.2"></a><var>162.2</var>care determinations according to this subdivision. <br/>
<a id="pl.162.3"></a><var>162.3</var>    (g) If a child meets the conditions in paragraph (b), (c), (d), or (e), the commissioner <br/>
<a id="pl.162.4"></a><var>162.4</var>must assess the case to determine whether: <br/>
<a id="pl.162.5"></a><var>162.5</var>    (1) the child qualifies as a disabled individual under United States Code, title 42, <br/>
<a id="pl.162.6"></a><var>162.6</var>section 1382c(a), and would be eligible for medical assistance if residing in a medical <br/>
<a id="pl.162.7"></a><var>162.7</var>institution; and <br/>
<a id="pl.162.8"></a><var>162.8</var>    (2) the cost of medical assistance services for the child, if eligible under this <br/>
<a id="pl.162.9"></a><var>162.9</var>subdivision, would not be more than the cost to medical assistance if the child resides in a <br/>
<a id="pl.162.10"></a><var>162.10</var>medical institution to be determined as follows: <br/>
<a id="pl.162.11"></a><var>162.11</var>    (i) for a child who requires a level of care provided in an ICF/MR, the cost of <br/>
<a id="pl.162.12"></a><var>162.12</var>care for the child in an institution shall be determined using the average payment rate <br/>
<a id="pl.162.13"></a><var>162.13</var>established for the regional treatment centers that are certified as ICF's/MR; <br/>
<a id="pl.162.14"></a><var>162.14</var>    (ii) for a child who requires a level of care provided in an inpatient hospital setting <br/>
<a id="pl.162.15"></a><var>162.15</var>according to paragraph (b), cost-effectiveness shall be determined according to Minnesota <br/>
<a id="pl.162.16"></a><var>162.16</var>Rules, part 9505.3520, items F and G; and <br/>
<a id="pl.162.17"></a><var>162.17</var>    (iii) for a child who requires a level of care provided in a nursing facility according <br/>
<a id="pl.162.18"></a><var>162.18</var>to paragraph (c) or (e), cost-effectiveness shall be determined according to Minnesota <br/>
<a id="pl.162.19"></a><var>162.19</var>Rules, part 9505.3040, except that the nursing facility average rate shall be adjusted to <br/>
<a id="pl.162.20"></a><var>162.20</var>reflect rates which would be paid for children under age 16. The commissioner may <br/>
<a id="pl.162.21"></a><var>162.21</var>authorize an amount up to the amount medical assistance would pay for a child referred to <br/>
<a id="pl.162.22"></a><var>162.22</var>the commissioner by the preadmission screening team under section 
         <statute_ref>256B.0911</statute_ref>. <br/>
<a id="pl.162.23"></a><var>162.23</var>    (h) Children eligible for medical assistance services under section 
         <statute_ref>256B.055, <br/>
<a id="pl.162.24"></a><var>162.24</var>subdivision 12
         </statute_ref>, as of June 30, 1995, must be screened according to the criteria in this <br/>
<a id="pl.162.25"></a><var>162.25</var>subdivision prior to January 1, 1996. Children found to be ineligible may not be removed <br/>
<a id="pl.162.26"></a><var>162.26</var>from the program until January 1, 1996. <br/>
<br/>
<a id="bill.6.8.0"></a><a id="pl.162.27"></a><var>162.27</var>    Sec. 8. Minnesota Statutes 2008, section 256B.0621, subdivision 2, is amended to read:<br/>
<a id="pl.162.28"></a><var>162.28</var>    Subd. 2. <b>Targeted case management; definitions.</b> For purposes of subdivisions 3 <br/>
<a id="pl.162.29"></a><var>162.29</var>to 10, the following terms have the meanings given them:<br/>
<a id="pl.162.30"></a><var>162.30</var>    (1) "home care service recipients" means those individuals receiving the following <br/>
<a id="pl.162.31"></a><var>162.31</var>services under sections 
         <statute_ref>256B.0651</statute_ref> to 
         <statute_ref>256B.0656</statute_ref> and 256B.0659: skilled nursing visits, <br/>
<a id="pl.162.32"></a><var>162.32</var>home health aide visits, private duty nursing, personal care assistants, or therapies <br/>
<a id="pl.162.33"></a><var>162.33</var>provided through a home health agency;<br/>
<a id="pl.163.1"></a><var>163.1</var>    (2) "home care targeted case management" means the provision of targeted case <br/>
<a id="pl.163.2"></a><var>163.2</var>management services for the purpose of assisting home care service recipients to gain <br/>
<a id="pl.163.3"></a><var>163.3</var>access to needed services and supports so that they may remain in the community;<br/>
<a id="pl.163.4"></a><var>163.4</var>    (3) "institutions" means hospitals, consistent with Code of Federal Regulations, title <br/>
<a id="pl.163.5"></a><var>163.5</var>42, section 
         <statute_ref>440.10</statute_ref>; regional treatment center inpatient services, consistent with section <br/>
<statute_ref><a id="pl.163.6"></a><var>163.6</var>245.474
         </statute_ref>; nursing facilities; and intermediate care facilities for persons with developmental <br/>
<a id="pl.163.7"></a><var>163.7</var>disabilities;<br/>
<a id="pl.163.8"></a><var>163.8</var>    (4) "relocation targeted case management" includes the provision of both county <br/>
<a id="pl.163.9"></a><var>163.9</var>targeted case management and public or private vendor service coordination services <br/>
<a id="pl.163.10"></a><var>163.10</var>for the purpose of assisting recipients to gain access to needed services and supports if <br/>
<a id="pl.163.11"></a><var>163.11</var>they choose to move from an institution to the community. Relocation targeted case <br/>
<a id="pl.163.12"></a><var>163.12</var>management may be provided during the lesser of:<br/>
<a id="pl.163.13"></a><var>163.13</var>    (i) the last 180 consecutive days of an eligible recipient's institutional stay; or<br/>
<a id="pl.163.14"></a><var>163.14</var>    (ii) the limits and conditions which apply to federal Medicaid funding for this <br/>
<a id="pl.163.15"></a><var>163.15</var>service; and<br/>
<a id="pl.163.16"></a><var>163.16</var>    (5) "targeted case management" means case management services provided to help <br/>
<a id="pl.163.17"></a><var>163.17</var>recipients gain access to needed medical, social, educational, and other services and <br/>
<a id="pl.163.18"></a><var>163.18</var>supports.<br/>
<br/>
<a id="bill.6.9.0"></a><a id="pl.163.19"></a><var>163.19</var>    Sec. 9. Minnesota Statutes 2008, section 256B.0652, subdivision 3, is amended to read:<br/>
<a id="pl.163.20"></a><var>163.20</var>    Subd. 3. <b>Assessment and prior authorization process.</b> Effective January 1, 1996, <br/>
<a id="pl.163.21"></a><var>163.21</var>for purposes of providing informed choice, coordinating of local planning decisions, and <br/>
<a id="pl.163.22"></a><var>163.22</var>streamlining administrative requirements, the assessment and prior authorization process <br/>
<a id="pl.163.23"></a><var>163.23</var>for persons receiving both home care and home and community-based waivered services <br/>
<a id="pl.163.24"></a><var>163.24</var>for persons with developmental disabilities shall meet the requirements of sections <br/>
<statute_ref><a id="pl.163.25"></a><var>163.25</var>256B.0651
         </statute_ref> and 
<statute_ref>256B.0653</statute_ref> to 
         <statute_ref>256B.0656</statute_ref> and 256B.0659 with the following exceptions:<br/>
<a id="pl.163.26"></a><var>163.26</var>(a) Upon request for home care services and subsequent assessment by the public <br/>
<a id="pl.163.27"></a><var>163.27</var>health nurse under sections 
         <statute_ref>256B.0651</statute_ref> and 
<statute_ref>256B.0653</statute_ref> to 
         <statute_ref>256B.0656</statute_ref> and 256B.0659, <br/>
<a id="pl.163.28"></a><var>163.28</var>the public health nurse shall participate in the screening process, as appropriate, and, <br/>
<a id="pl.163.29"></a><var>163.29</var>if home care services are determined to be necessary, participate in the development <br/>
<a id="pl.163.30"></a><var>163.30</var>of a service plan coordinating the need for home care and home and community-based <br/>
<a id="pl.163.31"></a><var>163.31</var>waivered services with the assigned county case manager, the recipient of services, and <br/>
<a id="pl.163.32"></a><var>163.32</var>the recipient's legal representative, if any.<br/>
<a id="pl.163.33"></a><var>163.33</var>(b) The public health nurse shall give prior authorization for home care services <br/>
<a id="pl.163.34"></a><var>163.34</var>to the extent that home care services are:<br/>
<a id="pl.163.35"></a><var>163.35</var>(1) medically necessary;<br/>
<a id="pl.164.1"></a><var>164.1</var>(2) chosen by the recipient and their legal representative, if any, from the array of <br/>
<a id="pl.164.2"></a><var>164.2</var>home care and home and community-based waivered services available;<br/>
<a id="pl.164.3"></a><var>164.3</var>(3) coordinated with other services to be received by the recipient as described <br/>
<a id="pl.164.4"></a><var>164.4</var>in the service plan; and<br/>
<a id="pl.164.5"></a><var>164.5</var>(4) provided within the county's reimbursement limits for home care and home and <br/>
<a id="pl.164.6"></a><var>164.6</var>community-based waivered services for persons with developmental disabilities.<br/>
<a id="pl.164.7"></a><var>164.7</var>(c) If the public health agency is or may be the provider of home care services to the <br/>
<a id="pl.164.8"></a><var>164.8</var>recipient, the public health agency shall provide the commissioner of human services with <br/>
<a id="pl.164.9"></a><var>164.9</var>a written plan that specifies how the assessment and prior authorization process will be <br/>
<a id="pl.164.10"></a><var>164.10</var>held separate and distinct from the provision of services.<br/>
<br/>
<a id="bill.6.10.0"></a><a id="pl.164.11"></a><var>164.11</var>    Sec. 10. Minnesota Statutes 2008, section 256B.0657, subdivision 2, is amended to <br/>
<a id="pl.164.12"></a><var>164.12</var>read:<br/>
<a id="pl.164.13"></a><var>164.13</var>    Subd. 2. <b>Eligibility.</b> (a) The self-directed supports option is available to a person <br/>
<a id="pl.164.14"></a><var>164.14</var>who:<br/>
<a id="pl.164.15"></a><var>164.15</var>    (1) is a recipient of medical assistance as determined under sections 
         <statute_ref>256B.055</statute_ref>, <br/>
<statute_ref><a id="pl.164.16"></a><var>164.16</var>256B.056
         </statute_ref>, and 
         <statute_ref>256B.057, subdivision 9</statute_ref>;<br/>
<a id="pl.164.17"></a><var>164.17</var>    (2) is eligible for personal care assistant services under section 
         <statute_ref>256B.0655</statute_ref> <br/>
<a id="pl.164.18"></a><var>164.18</var>256B.0659;<br/>
<a id="pl.164.19"></a><var>164.19</var>    (3) lives in the person's own apartment or home, which is not owned, operated, or <br/>
<a id="pl.164.20"></a><var>164.20</var>controlled by a provider of services not related by blood or marriage;<br/>
<a id="pl.164.21"></a><var>164.21</var>    (4) has the ability to hire, fire, supervise, establish staff compensation for, and <br/>
<a id="pl.164.22"></a><var>164.22</var>manage the individuals providing services, and to choose and obtain items, related <br/>
<a id="pl.164.23"></a><var>164.23</var>services, and supports as described in the participant's plan. If the recipient is not able to <br/>
<a id="pl.164.24"></a><var>164.24</var>carry out these functions but has a legal guardian or parent to carry them out, the guardian <br/>
<a id="pl.164.25"></a><var>164.25</var>or parent may fulfill these functions on behalf of the recipient; and<br/>
<a id="pl.164.26"></a><var>164.26</var>    (5) has not been excluded or disenrolled by the commissioner.<br/>
<a id="pl.164.27"></a><var>164.27</var>    (b) The commissioner may disenroll or exclude recipients, including guardians and <br/>
<a id="pl.164.28"></a><var>164.28</var>parents, under the following circumstances:<br/>
<a id="pl.164.29"></a><var>164.29</var>    (1) recipients who have been restricted by the Primary Care Utilization Review <br/>
<a id="pl.164.30"></a><var>164.30</var>Committee may be excluded for a specified time period; <br/>
<a id="pl.164.31"></a><var>164.31</var>    (2) recipients who exit the self-directed supports option during the recipient's <br/>
<a id="pl.164.32"></a><var>164.32</var>service plan year shall not access the self-directed supports option for the remainder of <br/>
<a id="pl.164.33"></a><var>164.33</var>that service plan year; and<br/>
<a id="pl.164.34"></a><var>164.34</var>    (3) when the department determines that the recipient cannot manage recipient <br/>
<a id="pl.164.35"></a><var>164.35</var>responsibilities under the program.<br/>
<br/>
<a id="bill.6.11.0"></a><a id="pl.165.1"></a><var>165.1</var>    Sec. 11. Minnesota Statutes 2008, section 256B.0657, subdivision 6, is amended to <br/>
<a id="pl.165.2"></a><var>165.2</var>read:<br/>
<a id="pl.165.3"></a><var>165.3</var>    Subd. 6. <b>Services covered.</b> (a) Services covered under the self-directed supports <br/>
<a id="pl.165.4"></a><var>165.4</var>option include:<br/>
<a id="pl.165.5"></a><var>165.5</var>    (1) personal care assistant services under section 
         <statute_ref>256B.0655</statute_ref> 256B.0659; and <br/>
<a id="pl.165.6"></a><var>165.6</var>    (2) items, related services, and supports, including assistive technology, that increase <br/>
<a id="pl.165.7"></a><var>165.7</var>independence or substitute for human assistance to the extent expenditures would <br/>
<a id="pl.165.8"></a><var>165.8</var>otherwise be used for human assistance.<br/>
<a id="pl.165.9"></a><var>165.9</var>    (b) Items, supports, and related services purchased under this option shall not be <br/>
<a id="pl.165.10"></a><var>165.10</var>considered home care services for the purposes of section 
         <statute_ref>144A.43</statute_ref>.<br/>
<br/>
<a id="bill.6.12.0"></a><a id="pl.165.11"></a><var>165.11</var>    Sec. 12. Minnesota Statutes 2008, section 256B.0657, subdivision 8, is amended to <br/>
<a id="pl.165.12"></a><var>165.12</var>read:<br/>
<a id="pl.165.13"></a><var>165.13</var>    Subd. 8. <b>Self-directed budget requirements.</b> The budget for the provision of the <br/>
<a id="pl.165.14"></a><var>165.14</var>self-directed service option shall be equal to the greater of either:<br/>
<a id="pl.165.15"></a><var>165.15</var>    (1) the annual amount of personal care assistant services under section 
         <statute_ref>256B.0655</statute_ref> <br/>
<a id="pl.165.16"></a><var>165.16</var>256B.0659 that the recipient has used in the most recent 12-month period; or <br/>
<a id="pl.165.17"></a><var>165.17</var>    (2) the amount determined using the consumer support grant methodology under <br/>
<a id="pl.165.18"></a><var>165.18</var>section 
         <statute_ref>256.476, subdivision 11</statute_ref>, except that the budget amount shall include the federal <br/>
<a id="pl.165.19"></a><var>165.19</var>and nonfederal share of the average service costs.<br/>
<br/>
<a id="bill.6.13.0"></a><a id="pl.165.20"></a><var>165.20</var>    Sec. 13. Minnesota Statutes 2008, section 256B.49, subdivision 17, is amended to read:<br/>
<a id="pl.165.21"></a><var>165.21</var>    Subd. 17. <b>Cost of services and supports.</b> (a) The commissioner shall ensure <br/>
<a id="pl.165.22"></a><var>165.22</var>that the average per capita expenditures estimated in any fiscal year for home and <br/>
<a id="pl.165.23"></a><var>165.23</var>community-based waiver recipients does not exceed the average per capita expenditures <br/>
<a id="pl.165.24"></a><var>165.24</var>that would have been made to provide institutional services for recipients in the absence <br/>
<a id="pl.165.25"></a><var>165.25</var>of the waiver.<br/>
<a id="pl.165.26"></a><var>165.26</var>(b) The commissioner shall implement on January 1, 2002, one or more aggregate, <br/>
<a id="pl.165.27"></a><var>165.27</var>need-based methods for allocating to local agencies the home and community-based <br/>
<a id="pl.165.28"></a><var>165.28</var>waivered service resources available to support recipients with disabilities in need of <br/>
<a id="pl.165.29"></a><var>165.29</var>the level of care provided in a nursing facility or a hospital. The commissioner shall <br/>
<a id="pl.165.30"></a><var>165.30</var>allocate resources to single counties and county partnerships in a manner that reflects <br/>
<a id="pl.165.31"></a><var>165.31</var>consideration of:<br/>
<a id="pl.165.32"></a><var>165.32</var>(1) an incentive-based payment process for achieving outcomes;<br/>
<a id="pl.165.33"></a><var>165.33</var>(2) the need for a state-level risk pool;<br/>
<a id="pl.165.34"></a><var>165.34</var>(3) the need for retention of management responsibility at the state agency level; and<br/>
<a id="pl.166.1"></a><var>166.1</var>(4) a phase-in strategy as appropriate.<br/>
<a id="pl.166.2"></a><var>166.2</var>(c) Until the allocation methods described in paragraph (b) are implemented, the <br/>
<a id="pl.166.3"></a><var>166.3</var>annual allowable reimbursement level of home and community-based waiver services <br/>
<a id="pl.166.4"></a><var>166.4</var>shall be the greater of:<br/>
<a id="pl.166.5"></a><var>166.5</var>(1) the statewide average payment amount which the recipient is assigned under the <br/>
<a id="pl.166.6"></a><var>166.6</var>waiver reimbursement system in place on June 30, 2001, modified by the percentage of <br/>
<a id="pl.166.7"></a><var>166.7</var>any provider rate increase appropriated for home and community-based services; or<br/>
<a id="pl.166.8"></a><var>166.8</var>(2) an amount approved by the commissioner based on the recipient's extraordinary <br/>
<a id="pl.166.9"></a><var>166.9</var>needs that cannot be met within the current allowable reimbursement level. The <br/>
<a id="pl.166.10"></a><var>166.10</var>increased reimbursement level must be necessary to allow the recipient to be discharged <br/>
<a id="pl.166.11"></a><var>166.11</var>from an institution or to prevent imminent placement in an institution. The additional <br/>
<a id="pl.166.12"></a><var>166.12</var>reimbursement may be used to secure environmental modifications; assistive technology <br/>
<a id="pl.166.13"></a><var>166.13</var>and equipment; and increased costs for supervision, training, and support services <br/>
<a id="pl.166.14"></a><var>166.14</var>necessary to address the recipient's extraordinary needs. The commissioner may approve <br/>
<a id="pl.166.15"></a><var>166.15</var>an increased reimbursement level for up to one year of the recipient's relocation from an <br/>
<a id="pl.166.16"></a><var>166.16</var>institution or up to six months of a determination that a current waiver recipient is at <br/>
<a id="pl.166.17"></a><var>166.17</var>imminent risk of being placed in an institution.<br/>
<a id="pl.166.18"></a><var>166.18</var>(d) Beginning July 1, 2001, medically necessary private duty nursing services <br/>
<a id="pl.166.19"></a><var>166.19</var>will be authorized under this section as complex and regular care according to sections <br/>
<statute_ref><a id="pl.166.20"></a><var>166.20</var>256B.0651
         </statute_ref> and 
<statute_ref>256B.0653</statute_ref> to 
         <statute_ref>256B.0656</statute_ref> and 256B.0659. The rate established by the <br/>
<a id="pl.166.21"></a><var>166.21</var>commissioner for registered nurse or licensed practical nurse services under any home and <br/>
<a id="pl.166.22"></a><var>166.22</var>community-based waiver as of January 1, 2001, shall not be reduced.<br/>
<br/>
<a id="bill.6.14.0"></a><a id="pl.166.23"></a><var>166.23</var>    Sec. 14. Minnesota Statutes 2008, section 256B.501, subdivision 4a, is amended to <br/>
<a id="pl.166.24"></a><var>166.24</var>read:<br/>
<a id="pl.166.25"></a><var>166.25</var>    Subd. 4a. <b>Inclusion of home care costs in waiver rates.</b> The commissioner <br/>
<a id="pl.166.26"></a><var>166.26</var>shall adjust the limits of the established average daily reimbursement rates for waivered <br/>
<a id="pl.166.27"></a><var>166.27</var>services to include the cost of home care services that may be provided to waivered <br/>
<a id="pl.166.28"></a><var>166.28</var>services recipients. This adjustment must be used to maintain or increase services and <br/>
<a id="pl.166.29"></a><var>166.29</var>shall not be used by county agencies for inflation increases for waivered services vendors. <br/>
<a id="pl.166.30"></a><var>166.30</var>Home care services referenced in this section are those listed in section 
         <statute_ref>256B.0651, <br/>
<a id="pl.166.31"></a><var>166.31</var>subdivision 2
         </statute_ref>. The average daily reimbursement rates established in accordance with <br/>
<a id="pl.166.32"></a><var>166.32</var>the provisions of this subdivision apply only to the combined average, daily costs of <br/>
<a id="pl.166.33"></a><var>166.33</var>waivered and home care services and do not change home care limitations under sections <br/>
<statute_ref><a id="pl.166.34"></a><var>166.34</var>256B.0651
         </statute_ref> and 
<statute_ref>256B.0653</statute_ref> to 
         <statute_ref>256B.0656</statute_ref> and 256B.0659. Waivered services recipients <br/>
<a id="pl.167.1"></a><var>167.1</var>receiving home care as of June 30, 1992, shall not have the amount of their services <br/>
<a id="pl.167.2"></a><var>167.2</var>reduced as a result of this section.<br/>
<br/>
<a id="bill.6.15.0"></a><a id="pl.167.3"></a><var>167.3</var>    Sec. 15. Minnesota Statutes 2008, section 256G.02, subdivision 6, is amended to read:<br/>
<a id="pl.167.4"></a><var>167.4</var>    Subd. 6. <b>Excluded time.</b> "Excluded time" means:<br/>
<a id="pl.167.5"></a><var>167.5</var>(a) any period an applicant spends in a hospital, sanitarium, nursing home, shelter <br/>
<a id="pl.167.6"></a><var>167.6</var>other than an emergency shelter, halfway house, foster home, semi-independent living <br/>
<a id="pl.167.7"></a><var>167.7</var>domicile or services program, residential facility offering care, board and lodging facility <br/>
<a id="pl.167.8"></a><var>167.8</var>or other institution for the hospitalization or care of human beings, as defined in section <br/>
<statute_ref><a id="pl.167.9"></a><var>167.9</var>144.50
         </statute_ref>, 
         <statute_ref>144A.01</statute_ref>, or 
         <statute_ref>245A.02, subdivision 14</statute_ref>; maternity home, battered women's shelter, <br/>
<a id="pl.167.10"></a><var>167.10</var>or correctional facility; or any facility based on an emergency hold under sections <br/>
<statute_ref><a id="pl.167.11"></a><var>167.11</var>253B.05, subdivisions 1 and 2
         </statute_ref>, and 
         <statute_ref>253B.07, subdivision 6</statute_ref>;<br/>
<a id="pl.167.12"></a><var>167.12</var>(b) any period an applicant spends on a placement basis in a training and habilitation <br/>
<a id="pl.167.13"></a><var>167.13</var>program, including a rehabilitation facility or work or employment program as defined <br/>
<a id="pl.167.14"></a><var>167.14</var>in section 
         <statute_ref>268A.01</statute_ref>; or receiving personal care assistant services pursuant to section <br/>
<statute_ref><a id="pl.167.15"></a><var>167.15</var>256B.0655, subdivision 2
</statute_ref> 256B.0659; semi-independent living services provided under <br/>
<a id="pl.167.16"></a><var>167.16</var>section 
         <statute_ref>252.275</statute_ref>, and Minnesota Rules, parts 9525.0500 to 9525.0660; day training and <br/>
<a id="pl.167.17"></a><var>167.17</var>habilitation programs and assisted living services; and<br/>
<a id="pl.167.18"></a><var>167.18</var>(c) any placement for a person with an indeterminate commitment, including <br/>
<a id="pl.167.19"></a><var>167.19</var>independent living.<br/>
<br/>
<a id="bill.6.16.0"></a><a id="pl.167.20"></a><var>167.20</var>    Sec. 16. Minnesota Statutes 2008, section 256I.05, subdivision 1a, is amended to read:<br/>
<a id="pl.167.21"></a><var>167.21</var>    Subd. 1a. <b>Supplementary service rates.</b> (a) Subject to the provisions of section <br/>
<statute_ref><a id="pl.167.22"></a><var>167.22</var>256I.04, subdivision 3
         </statute_ref>, the county agency may negotiate a payment not to exceed $426.37 <br/>
<a id="pl.167.23"></a><var>167.23</var>for other services necessary to provide room and board provided by the group residence <br/>
<a id="pl.167.24"></a><var>167.24</var>if the residence is licensed by or registered by the Department of Health, or licensed by <br/>
<a id="pl.167.25"></a><var>167.25</var>the Department of Human Services to provide services in addition to room and board, <br/>
<a id="pl.167.26"></a><var>167.26</var>and if the provider of services is not also concurrently receiving funding for services for <br/>
<a id="pl.167.27"></a><var>167.27</var>a recipient under a home and community-based waiver under title XIX of the Social <br/>
<a id="pl.167.28"></a><var>167.28</var>Security Act; or funding from the medical assistance program under section 
         <statute_ref>256B.0655, <br/>
<a id="pl.167.29"></a><var>167.29</var>subdivision 2
</statute_ref> 256B.0659, for personal care services for residents in the setting; or residing <br/>
<a id="pl.167.30"></a><var>167.30</var>in a setting which receives funding under Minnesota Rules, parts 9535.2000 to 9535.3000. <br/>
<a id="pl.167.31"></a><var>167.31</var>If funding is available for other necessary services through a home and community-based <br/>
<a id="pl.167.32"></a><var>167.32</var>waiver, or personal care services under section 
         <statute_ref>256B.0655, subdivision 2</statute_ref> 256B.0659, <br/>
<a id="pl.167.33"></a><var>167.33</var>then the GRH rate is limited to the rate set in subdivision 1. Unless otherwise provided <br/>
<a id="pl.167.34"></a><var>167.34</var>in law, in no case may the supplementary service rate exceed $426.37. The registration <br/>
<a id="pl.168.1"></a><var>168.1</var>and licensure requirement does not apply to establishments which are exempt from state <br/>
<a id="pl.168.2"></a><var>168.2</var>licensure because they are located on Indian reservations and for which the tribe has <br/>
<a id="pl.168.3"></a><var>168.3</var>prescribed health and safety requirements. Service payments under this section may be <br/>
<a id="pl.168.4"></a><var>168.4</var>prohibited under rules to prevent the supplanting of federal funds with state funds. The <br/>
<a id="pl.168.5"></a><var>168.5</var>commissioner shall pursue the feasibility of obtaining the approval of the Secretary of <br/>
<a id="pl.168.6"></a><var>168.6</var>Health and Human Services to provide home and community-based waiver services under <br/>
<a id="pl.168.7"></a><var>168.7</var>title XIX of the Social Security Act for residents who are not eligible for an existing home <br/>
<a id="pl.168.8"></a><var>168.8</var>and community-based waiver due to a primary diagnosis of mental illness or chemical <br/>
<a id="pl.168.9"></a><var>168.9</var>dependency and shall apply for a waiver if it is determined to be cost-effective.<br/>
<a id="pl.168.10"></a><var>168.10</var>(b) The commissioner is authorized to make cost-neutral transfers from the GRH <br/>
<a id="pl.168.11"></a><var>168.11</var>fund for beds under this section to other funding programs administered by the department <br/>
<a id="pl.168.12"></a><var>168.12</var>after consultation with the county or counties in which the affected beds are located. <br/>
<a id="pl.168.13"></a><var>168.13</var>The commissioner may also make cost-neutral transfers from the GRH fund to county <br/>
<a id="pl.168.14"></a><var>168.14</var>human service agencies for beds permanently removed from the GRH census under a plan <br/>
<a id="pl.168.15"></a><var>168.15</var>submitted by the county agency and approved by the commissioner. The commissioner <br/>
<a id="pl.168.16"></a><var>168.16</var>shall report the amount of any transfers under this provision annually to the legislature.<br/>
<a id="pl.168.17"></a><var>168.17</var>(c) The provisions of paragraph (b) do not apply to a facility that has its <br/>
<a id="pl.168.18"></a><var>168.18</var>reimbursement rate established under section 
         <statute_ref>256B.431, subdivision 4</statute_ref>, paragraph (c).<br/>
<br/>
<a id="bill.6.17.0"></a><a id="pl.168.19"></a><var>168.19</var>    Sec. 17. Minnesota Statutes 2008, section 256J.45, subdivision 3, is amended to read:<br/>
<a id="pl.168.20"></a><var>168.20</var>    Subd. 3. <b>Good cause exemptions for not attending orientation.</b> (a) The county <br/>
<a id="pl.168.21"></a><var>168.21</var>agency shall not impose the sanction under section 
         <statute_ref>256J.46</statute_ref> if it determines that the <br/>
<a id="pl.168.22"></a><var>168.22</var>participant has good cause for failing to attend orientation. Good cause exists when:<br/>
<a id="pl.168.23"></a><var>168.23</var>(1) appropriate child care is not available;<br/>
<a id="pl.168.24"></a><var>168.24</var>(2) the participant is ill or injured;<br/>
<a id="pl.168.25"></a><var>168.25</var>(3) a family member is ill and needs care by the participant that prevents the <br/>
<a id="pl.168.26"></a><var>168.26</var>participant from attending orientation. For a caregiver with a child or adult in the <br/>
<a id="pl.168.27"></a><var>168.27</var>household who meets the disability or medical criteria for home care services under <br/>
<a id="pl.168.28"></a><var>168.28</var>section 
         <statute_ref>256B.0655, subdivision 1c</statute_ref> 256B.0659, or a home and community-based waiver <br/>
<a id="pl.168.29"></a><var>168.29</var>services program under chapter 256B, or meets the criteria for severe emotional <br/>
<a id="pl.168.30"></a><var>168.30</var>disturbance under section 
         <statute_ref>245.4871, subdivision 6</statute_ref>, or for serious and persistent mental <br/>
<a id="pl.168.31"></a><var>168.31</var>illness under section 
         <statute_ref>245.462, subdivision 20</statute_ref>, paragraph (c), good cause also exists when <br/>
<a id="pl.168.32"></a><var>168.32</var>an interruption in the provision of those services occurs which prevents the participant <br/>
<a id="pl.168.33"></a><var>168.33</var>from attending orientation;<br/>
<a id="pl.168.34"></a><var>168.34</var>(4) the caregiver is unable to secure necessary transportation;<br/>
<a id="pl.168.35"></a><var>168.35</var>(5) the caregiver is in an emergency situation that prevents orientation attendance;<br/>
<a id="pl.169.1"></a><var>169.1</var>(6) the orientation conflicts with the caregiver's work, training, or school schedule; or<br/>
<a id="pl.169.2"></a><var>169.2</var>(7) the caregiver documents other verifiable impediments to orientation attendance <br/>
<a id="pl.169.3"></a><var>169.3</var>beyond the caregiver's control.<br/>
<a id="pl.169.4"></a><var>169.4</var>(b) Counties must work with clients to provide child care and transportation <br/>
<a id="pl.169.5"></a><var>169.5</var>necessary to ensure a caregiver has every opportunity to attend orientation.<br/>
<br/>
<a id="bill.6.18.0"></a><a id="pl.169.6"></a><var>169.6</var>    Sec. 18. Minnesota Statutes 2008, section 604A.33, subdivision 1, is amended to read:<br/>
<a id="pl.169.7"></a><var>169.7</var>    Subdivision 1. <b>Application.</b> This section applies to residential treatment programs <br/>
<a id="pl.169.8"></a><var>169.8</var>for children or group homes for children licensed under chapter 245A, residential <br/>
<a id="pl.169.9"></a><var>169.9</var>services and programs for juveniles licensed under section 
         <statute_ref>241.021</statute_ref>, providers licensed <br/>
<a id="pl.169.10"></a><var>169.10</var>pursuant to sections 
         <statute_ref>144A.01</statute_ref> to 
         <statute_ref>144A.33</statute_ref> or sections 
         <statute_ref>144A.43</statute_ref> to 
         <statute_ref> 144A.47</statute_ref>, personal care <br/>
<a id="pl.169.11"></a><var>169.11</var>provider organizations under section 
         <statute_ref>256B.0655, subdivision 1g</statute_ref> 256B.0659, providers <br/>
<a id="pl.169.12"></a><var>169.12</var>of day training and habilitation services under sections 
         <statute_ref>252.40</statute_ref> to 
         <statute_ref>252.46</statute_ref>, board and <br/>
<a id="pl.169.13"></a><var>169.13</var>lodging facilities licensed under chapter 157, intermediate care facilities for persons with <br/>
<a id="pl.169.14"></a><var>169.14</var>developmental disabilities, and other facilities licensed to provide residential services to <br/>
<a id="pl.169.15"></a><var>169.15</var>persons with developmental disabilities.<br/>
<br/>
<a id="bill.6.19.0"></a><a id="pl.169.16"></a><var>169.16</var>    Sec. 19. Minnesota Statutes 2008, section 609.232, subdivision 11, is amended to read:<br/>
<a id="pl.169.17"></a><var>169.17</var>    Subd. 11. <b>Vulnerable adult.</b> "Vulnerable adult" means any person 18 years of <br/>
<a id="pl.169.18"></a><var>169.18</var>age or older who:<br/>
<a id="pl.169.19"></a><var>169.19</var>(1) is a resident inpatient of a facility;<br/>
<a id="pl.169.20"></a><var>169.20</var>(2) receives services at or from a facility required to be licensed to serve adults <br/>
<a id="pl.169.21"></a><var>169.21</var>under sections 
         <statute_ref>245A.01</statute_ref> to 
         <statute_ref>245A.15</statute_ref>, except that a person receiving outpatient services for <br/>
<a id="pl.169.22"></a><var>169.22</var>treatment of chemical dependency or mental illness, or one who is committed as a sexual <br/>
<a id="pl.169.23"></a><var>169.23</var>psychopathic personality or as a sexually dangerous person under chapter 253B, is not <br/>
<a id="pl.169.24"></a><var>169.24</var>considered a vulnerable adult unless the person meets the requirements of clause (4);<br/>
<a id="pl.169.25"></a><var>169.25</var>(3) receives services from a home care provider required to be licensed under section <br/>
<statute_ref><a id="pl.169.26"></a><var>169.26</var>144A.46
         </statute_ref>; or from a person or organization that exclusively offers, provides, or arranges <br/>
<a id="pl.169.27"></a><var>169.27</var>for personal care assistant services under the medical assistance program as authorized <br/>
<a id="pl.169.28"></a><var>169.28</var>under sections 
         <statute_ref>256B.04, subdivision 16</statute_ref>, 
         <statute_ref>256B.0625, subdivision 19a</statute_ref>, 
         <statute_ref>256B.0651</statute_ref>, and <br/>
<a id="pl.169.29"></a><var>169.29</var><statute_ref>256B.0653</statute_ref> to 
         <statute_ref>256B.0656</statute_ref> and 256B.0659; or<br/>
<a id="pl.169.30"></a><var>169.30</var>(4) regardless of residence or whether any type of service is received, possesses a <br/>
<a id="pl.169.31"></a><var>169.31</var>physical or mental infirmity or other physical, mental, or emotional dysfunction:<br/>
<a id="pl.169.32"></a><var>169.32</var>(i) that impairs the individual's ability to provide adequately for the individual's <br/>
<a id="pl.169.33"></a><var>169.33</var>own care without assistance, including the provision of food, shelter, clothing, health <br/>
<a id="pl.169.34"></a><var>169.34</var>care, or supervision; and<br/>
<a id="pl.170.1"></a><var>170.1</var>(ii) because of the dysfunction or infirmity and the need for assistance, the individual <br/>
<a id="pl.170.2"></a><var>170.2</var>has an impaired ability to protect the individual from maltreatment.<br/>
<br/>
<a id="bill.6.20.0"></a><a id="pl.170.3"></a><var>170.3</var>    Sec. 20. Minnesota Statutes 2008, section 626.5572, subdivision 6, is amended to read:<br/>
<a id="pl.170.4"></a><var>170.4</var>    Subd. 6. <b>Facility.</b> (a) "Facility" means a hospital or other entity required to be <br/>
<a id="pl.170.5"></a><var>170.5</var>licensed under sections 
         <statute_ref>144.50</statute_ref> to 
         <statute_ref>144.58</statute_ref>; a nursing home required to be licensed to <br/>
<a id="pl.170.6"></a><var>170.6</var>serve adults under section 
         <statute_ref>144A.02</statute_ref>; a residential or nonresidential facility required to <br/>
<a id="pl.170.7"></a><var>170.7</var>be licensed to serve adults under sections 
         <statute_ref>245A.01</statute_ref> to 
         <statute_ref>245A.16</statute_ref>; a home care provider <br/>
<a id="pl.170.8"></a><var>170.8</var>licensed or required to be licensed under section 
         <statute_ref>144A.46</statute_ref>; a hospice provider licensed <br/>
<a id="pl.170.9"></a><var>170.9</var>under sections 
         <statute_ref>144A.75</statute_ref> to 
         <statute_ref>144A.755</statute_ref>; or a person or organization that exclusively offers, <br/>
<a id="pl.170.10"></a><var>170.10</var>provides, or arranges for personal care assistant services under the medical assistance <br/>
<a id="pl.170.11"></a><var>170.11</var>program as authorized under sections 
         <statute_ref>256B.04, subdivision 16</statute_ref>, 
         <statute_ref>256B.0625, subdivision <br/>
<a id="pl.170.12"></a><var>170.12</var>19a
         </statute_ref>, 
         <statute_ref>256B.0651</statute_ref>, and 
<statute_ref>256B.0653</statute_ref> to 
         <statute_ref>256B.0656</statute_ref>, and 256B.0659.<br/>
<a id="pl.170.13"></a><var>170.13</var>(b) For home care providers and personal care attendants, the term "facility" refers <br/>
<a id="pl.170.14"></a><var>170.14</var>to the provider or person or organization that exclusively offers, provides, or arranges for <br/>
<a id="pl.170.15"></a><var>170.15</var>personal care services, and does not refer to the client's home or other location at which <br/>
<a id="pl.170.16"></a><var>170.16</var>services are rendered.<br/>
<br/>
<a id="bill.6.21.0"></a><a id="pl.170.17"></a><var>170.17</var>    Sec. 21. Minnesota Statutes 2008, section 626.5572, subdivision 21, is amended to <br/>
<a id="pl.170.18"></a><var>170.18</var>read:<br/>
<a id="pl.170.19"></a><var>170.19</var>    Subd. 21.  <b>Vulnerable adult.</b> "Vulnerable adult" means any person 18 years of <br/>
<a id="pl.170.20"></a><var>170.20</var>age or older who: <br/>
<a id="pl.170.21"></a><var>170.21</var>    (1) is a resident or inpatient of a facility; <br/>
<a id="pl.170.22"></a><var>170.22</var>    (2) receives services at or from a facility required to be licensed to serve adults <br/>
<a id="pl.170.23"></a><var>170.23</var>under sections 
         <statute_ref>245A.01</statute_ref> to 
         <statute_ref>245A.15</statute_ref>, except that a person receiving outpatient services for <br/>
<a id="pl.170.24"></a><var>170.24</var>treatment of chemical dependency or mental illness, or one who is served in the Minnesota <br/>
<a id="pl.170.25"></a><var>170.25</var>sex offender program on a court-hold order for commitment, or is committed as a sexual <br/>
<a id="pl.170.26"></a><var>170.26</var>psychopathic personality or as a sexually dangerous person under chapter 253B, is not <br/>
<a id="pl.170.27"></a><var>170.27</var>considered a vulnerable adult unless the person meets the requirements of clause (4); <br/>
<a id="pl.170.28"></a><var>170.28</var>    (3) receives services from a home care provider required to be licensed under section <br/>
<statute_ref><a id="pl.170.29"></a><var>170.29</var>144A.46
         </statute_ref>; or from a person or organization that exclusively offers, provides, or arranges <br/>
<a id="pl.170.30"></a><var>170.30</var>for personal care assistant services under the medical assistance program as authorized <br/>
<a id="pl.170.31"></a><var>170.31</var>under sections 
         <statute_ref>256B.04, subdivision 16</statute_ref>, 
         <statute_ref>256B.0625, subdivision 19a</statute_ref>, 
         <statute_ref>256B.0651</statute_ref>, and <br/>
<statute_ref><a id="pl.170.32"></a><var>170.32</var>256B.0653
         </statute_ref> to 
         <statute_ref>256B.0656</statute_ref>, and 256B.0659; or <br/>
<a id="pl.170.33"></a><var>170.33</var>    (4) regardless of residence or whether any type of service is received, possesses a <br/>
<a id="pl.170.34"></a><var>170.34</var>physical or mental infirmity or other physical, mental, or emotional dysfunction: <br/>
<a id="pl.171.1"></a><var>171.1</var>    (i) that impairs the individual's ability to provide adequately for the individual's <br/>
<a id="pl.171.2"></a><var>171.2</var>own care without assistance, including the provision of food, shelter, clothing, health <br/>
<a id="pl.171.3"></a><var>171.3</var>care, or supervision; and <br/>
<a id="pl.171.4"></a><var>171.4</var>    (ii) because of the dysfunction or infirmity and the need for assistance, the individual <br/>
<a id="pl.171.5"></a><var>171.5</var>has an impaired ability to protect the individual from maltreatment. <br/>
<br/>
<a id="bill.7.0.0"></a>

<a id="bill.7.1.0"></a><a id="pl.171.8"></a><var>171.8</var>    Section 1. Minnesota Statutes 2008, section 245.462, subdivision 18, is amended to <br/>
<a id="pl.171.9"></a><var>171.9</var>read:<br/>
<a id="pl.171.10"></a><var>171.10</var>    Subd. 18. <b>Mental health professional.</b> "Mental health professional" means a <br/>
<a id="pl.171.11"></a><var>171.11</var>person providing clinical services in the treatment of mental illness who is qualified in at <br/>
<a id="pl.171.12"></a><var>171.12</var>least one of the following ways:<br/>
<a id="pl.171.13"></a><var>171.13</var>    (1) in psychiatric nursing: a registered nurse who is licensed under sections 
         <statute_ref>148.171</statute_ref> <br/>
<a id="pl.171.14"></a><var>171.14</var>to 
         <statute_ref>148.285</statute_ref>; and:<br/>
<a id="pl.171.15"></a><var>171.15</var>    (i) who is certified as a clinical specialist or as a nurse practitioner in adult or family <br/>
<a id="pl.171.16"></a><var>171.16</var>psychiatric and mental health nursing by a national nurse certification organization; or<br/>
<a id="pl.171.17"></a><var>171.17</var>    (ii) who has a master's degree in nursing or one of the behavioral sciences or related <br/>
<a id="pl.171.18"></a><var>171.18</var>fields from an accredited college or university or its equivalent, with at least 4,000 hours <br/>
<a id="pl.171.19"></a><var>171.19</var>of post-master's supervised experience in the delivery of clinical services in the treatment <br/>
<a id="pl.171.20"></a><var>171.20</var>of mental illness;<br/>
<a id="pl.171.21"></a><var>171.21</var>    (2) in clinical social work: a person licensed as an independent clinical social worker <br/>
<a id="pl.171.22"></a><var>171.22</var>under chapter 148D, or a person with a master's degree in social work from an accredited <br/>
<a id="pl.171.23"></a><var>171.23</var>college or university, with at least 4,000 hours of post-master's supervised experience in <br/>
<a id="pl.171.24"></a><var>171.24</var>the delivery of clinical services in the treatment of mental illness;<br/>
<a id="pl.171.25"></a><var>171.25</var>    (3) in psychology: an individual licensed by the Board of Psychology under sections <br/>
<statute_ref><a id="pl.171.26"></a><var>171.26</var>148.88
         </statute_ref> to 
         <statute_ref>148.98</statute_ref> who has stated to the Board of Psychology competencies in the diagnosis <br/>
<a id="pl.171.27"></a><var>171.27</var>and treatment of mental illness;<br/>
<a id="pl.171.28"></a><var>171.28</var>    (4) in psychiatry: a physician licensed under chapter 147 and certified by the <br/>
<a id="pl.171.29"></a><var>171.29</var>American Board of Psychiatry and Neurology or eligible for board certification in <br/>
<a id="pl.171.30"></a><var>171.30</var>psychiatry;<br/>
<a id="pl.171.31"></a><var>171.31</var>    (5) in marriage and family therapy: the mental health professional must be a <br/>
<a id="pl.171.32"></a><var>171.32</var>marriage and family therapist licensed under sections 
         <statute_ref>148B.29</statute_ref> to 
         <statute_ref>148B.39</statute_ref> with at least <br/>
<a id="pl.171.33"></a><var>171.33</var>two years of post-master's supervised experience in the delivery of clinical services in <br/>
<a id="pl.171.34"></a><var>171.34</var>the treatment of mental illness; or<br/>
<a id="pl.172.1"></a><var>172.1</var>    (6) in licensed professional clinical counseling, the mental health professional <br/>
<a id="pl.172.2"></a><var>172.2</var>shall be a licensed professional clinical counselor under section 148B.5301 with at least <br/>
<a id="pl.172.3"></a><var>172.3</var>4,000 hours of postmaster's supervised experience in the delivery of clinical services in <br/>
<a id="pl.172.4"></a><var>172.4</var>the treatment of mental illness; or<br/>
<a id="pl.172.5"></a><var>172.5</var>    (7) in allied fields: a person with a master's degree from an accredited college or <br/>
<a id="pl.172.6"></a><var>172.6</var>university in one of the behavioral sciences or related fields, with at least 4,000 hours of <br/>
<a id="pl.172.7"></a><var>172.7</var>post-master's supervised experience in the delivery of clinical services in the treatment of <br/>
<a id="pl.172.8"></a><var>172.8</var>mental illness.<br/>
<br/>
<a id="bill.7.2.0"></a><a id="pl.172.9"></a><var>172.9</var>    Sec. 2. Minnesota Statutes 2008, section 245.470, subdivision 1, is amended to read:<br/>
<a id="pl.172.10"></a><var>172.10</var>    Subdivision 1. <b>Availability of outpatient services.</b> (a) County boards must provide <br/>
<a id="pl.172.11"></a><var>172.11</var>or contract for enough outpatient services within the county to meet the needs of adults <br/>
<a id="pl.172.12"></a><var>172.12</var>with mental illness residing in the county. Services may be provided directly by the <br/>
<a id="pl.172.13"></a><var>172.13</var>county through county-operated mental health centers or mental health clinics approved <br/>
<a id="pl.172.14"></a><var>172.14</var>by the commissioner under section 
         <statute_ref>245.69, subdivision 2</statute_ref>; by contract with privately <br/>
<a id="pl.172.15"></a><var>172.15</var>operated mental health centers or mental health clinics approved by the commissioner <br/>
<a id="pl.172.16"></a><var>172.16</var>under section 
         <statute_ref>245.69, subdivision 2</statute_ref>; by contract with hospital mental health outpatient <br/>
<a id="pl.172.17"></a><var>172.17</var>programs certified by the Joint Commission on Accreditation of Hospital Organizations; <br/>
<a id="pl.172.18"></a><var>172.18</var>or by contract with a licensed mental health professional as defined in section 
         <statute_ref>245.462, <br/>
<a id="pl.172.19"></a><var>172.19</var>subdivision 18
         </statute_ref>, clauses (1) to (4) (6). Clients may be required to pay a fee according to <br/>
<a id="pl.172.20"></a><var>172.20</var>section 
         <statute_ref>245.481</statute_ref>. Outpatient services include:  <br/>
<a id="pl.172.21"></a><var>172.21</var>    (1) conducting diagnostic assessments;<br/>
<a id="pl.172.22"></a><var>172.22</var>    (2) conducting psychological testing;<br/>
<a id="pl.172.23"></a><var>172.23</var>    (3) developing or modifying individual treatment plans;<br/>
<a id="pl.172.24"></a><var>172.24</var>    (4) making referrals and recommending placements as appropriate;<br/>
<a id="pl.172.25"></a><var>172.25</var>    (5) treating an adult's mental health needs through therapy;<br/>
<a id="pl.172.26"></a><var>172.26</var>    (6) prescribing and managing medication and evaluating the effectiveness of <br/>
<a id="pl.172.27"></a><var>172.27</var>prescribed medication; and<br/>
<a id="pl.172.28"></a><var>172.28</var>    (7) preventing placement in settings that are more intensive, costly, or restrictive <br/>
<a id="pl.172.29"></a><var>172.29</var>than necessary and appropriate to meet client needs.<br/>
<a id="pl.172.30"></a><var>172.30</var>    (b) County boards may request a waiver allowing outpatient services to be provided <br/>
<a id="pl.172.31"></a><var>172.31</var>in a nearby trade area if it is determined that the client can best be served outside the <br/>
<a id="pl.172.32"></a><var>172.32</var>county.<br/>
<br/>
<a id="bill.7.3.0"></a><a id="pl.172.33"></a><var>172.33</var>    Sec. 3. Minnesota Statutes 2008, section 245.4871, subdivision 27, is amended to read:<br/>
<a id="pl.173.1"></a><var>173.1</var>    Subd. 27. <b>Mental health professional.</b> "Mental health professional" means a <br/>
<a id="pl.173.2"></a><var>173.2</var>person providing clinical services in the diagnosis and treatment of children's emotional <br/>
<a id="pl.173.3"></a><var>173.3</var>disorders. A mental health professional must have training and experience in working with <br/>
<a id="pl.173.4"></a><var>173.4</var>children consistent with the age group to which the mental health professional is assigned. <br/>
<a id="pl.173.5"></a><var>173.5</var>A mental health professional must be qualified in at least one of the following ways:<br/>
<a id="pl.173.6"></a><var>173.6</var>    (1) in psychiatric nursing, the mental health professional must be a registered nurse <br/>
<a id="pl.173.7"></a><var>173.7</var>who is licensed under sections 
         <statute_ref>148.171</statute_ref> to 
         <statute_ref>148.285</statute_ref> and who is certified as a clinical <br/>
<a id="pl.173.8"></a><var>173.8</var>specialist in child and adolescent psychiatric or mental health nursing by a national nurse <br/>
<a id="pl.173.9"></a><var>173.9</var>certification organization or who has a master's degree in nursing or one of the behavioral <br/>
<a id="pl.173.10"></a><var>173.10</var>sciences or related fields from an accredited college or university or its equivalent, with <br/>
<a id="pl.173.11"></a><var>173.11</var>at least 4,000 hours of post-master's supervised experience in the delivery of clinical <br/>
<a id="pl.173.12"></a><var>173.12</var>services in the treatment of mental illness;<br/>
<a id="pl.173.13"></a><var>173.13</var>    (2) in clinical social work, the mental health professional must be a person licensed <br/>
<a id="pl.173.14"></a><var>173.14</var>as an independent clinical social worker under chapter 148D, or a person with a master's <br/>
<a id="pl.173.15"></a><var>173.15</var>degree in social work from an accredited college or university, with at least 4,000 hours of <br/>
<a id="pl.173.16"></a><var>173.16</var>post-master's supervised experience in the delivery of clinical services in the treatment <br/>
<a id="pl.173.17"></a><var>173.17</var>of mental disorders;<br/>
<a id="pl.173.18"></a><var>173.18</var>    (3) in psychology, the mental health professional must be an individual licensed by <br/>
<a id="pl.173.19"></a><var>173.19</var>the board of psychology under sections 
         <statute_ref>148.88</statute_ref> to 
         <statute_ref>148.98</statute_ref> who has stated to the board of <br/>
<a id="pl.173.20"></a><var>173.20</var>psychology competencies in the diagnosis and treatment of mental disorders;<br/>
<a id="pl.173.21"></a><var>173.21</var>    (4) in psychiatry, the mental health professional must be a physician licensed under <br/>
<a id="pl.173.22"></a><var>173.22</var>chapter 147 and certified by the American board of psychiatry and neurology or eligible <br/>
<a id="pl.173.23"></a><var>173.23</var>for board certification in psychiatry;<br/>
<a id="pl.173.24"></a><var>173.24</var>    (5) in marriage and family therapy, the mental health professional must be a <br/>
<a id="pl.173.25"></a><var>173.25</var>marriage and family therapist licensed under sections 
         <statute_ref>148B.29</statute_ref> to 
         <statute_ref>148B.39</statute_ref> with at least <br/>
<a id="pl.173.26"></a><var>173.26</var>two years of post-master's supervised experience in the delivery of clinical services in the <br/>
<a id="pl.173.27"></a><var>173.27</var>treatment of mental disorders or emotional disturbances; or<br/>
<a id="pl.173.28"></a><var>173.28</var>    (6) in licensed professional clinical counseling, the mental health professional shall <br/>
<a id="pl.173.29"></a><var>173.29</var>be a licensed professional clinical counselor under section 148B.5301 with at least 4,000 <br/>
<a id="pl.173.30"></a><var>173.30</var>hours of postmaster's supervised experience in the delivery of clinical services in the <br/>
<a id="pl.173.31"></a><var>173.31</var>treatment of mental disorders or emotional disturbances; or<br/>
<a id="pl.173.32"></a><var>173.32</var>    (7) in allied fields, the mental health professional must be a person with a master's <br/>
<a id="pl.173.33"></a><var>173.33</var>degree from an accredited college or university in one of the behavioral sciences or related <br/>
<a id="pl.173.34"></a><var>173.34</var>fields, with at least 4,000 hours of post-master's supervised experience in the delivery of <br/>
<a id="pl.173.35"></a><var>173.35</var>clinical services in the treatment of emotional disturbances.<br/>
<br/>
<a id="bill.7.4.0"></a><a id="pl.174.1"></a><var>174.1</var>    Sec. 4. Minnesota Statutes 2008, section 245.488, subdivision 1, is amended to read:<br/>
<a id="pl.174.2"></a><var>174.2</var>    Subdivision 1. <b>Availability of outpatient services.</b> (a) County boards must provide <br/>
<a id="pl.174.3"></a><var>174.3</var>or contract for enough outpatient services within the county to meet the needs of each <br/>
<a id="pl.174.4"></a><var>174.4</var>child with emotional disturbance residing in the county and the child's family. Services <br/>
<a id="pl.174.5"></a><var>174.5</var>may be provided directly by the county through county-operated mental health centers or <br/>
<a id="pl.174.6"></a><var>174.6</var>mental health clinics approved by the commissioner under section 
         <statute_ref>245.69, subdivision 2</statute_ref>; <br/>
<a id="pl.174.7"></a><var>174.7</var>by contract with privately operated mental health centers or mental health clinics approved <br/>
<a id="pl.174.8"></a><var>174.8</var>by the commissioner under section 
         <statute_ref>245.69, subdivision 2</statute_ref>; by contract with hospital <br/>
<a id="pl.174.9"></a><var>174.9</var>mental health outpatient programs certified by the Joint Commission on Accreditation <br/>
<a id="pl.174.10"></a><var>174.10</var>of Hospital Organizations; or by contract with a licensed mental health professional as <br/>
<a id="pl.174.11"></a><var>174.11</var>defined in section 
         <statute_ref>245.4871, subdivision 27</statute_ref>, clauses (1) to (4) (6). A child or a child's <br/>
<a id="pl.174.12"></a><var>174.12</var>parent may be required to pay a fee based in accordance with section 
         <statute_ref>245.481</statute_ref>. Outpatient <br/>
<a id="pl.174.13"></a><var>174.13</var>services include:  <br/>
<a id="pl.174.14"></a><var>174.14</var>    (1) conducting diagnostic assessments;<br/>
<a id="pl.174.15"></a><var>174.15</var>    (2) conducting psychological testing;<br/>
<a id="pl.174.16"></a><var>174.16</var>    (3) developing or modifying individual treatment plans;<br/>
<a id="pl.174.17"></a><var>174.17</var>    (4) making referrals and recommending placements as appropriate;<br/>
<a id="pl.174.18"></a><var>174.18</var>    (5) treating the child's mental health needs through therapy; and<br/>
<a id="pl.174.19"></a><var>174.19</var>    (6) prescribing and managing medication and evaluating the effectiveness of <br/>
<a id="pl.174.20"></a><var>174.20</var>prescribed medication.<br/>
<a id="pl.174.21"></a><var>174.21</var>    (b) County boards may request a waiver allowing outpatient services to be provided <br/>
<a id="pl.174.22"></a><var>174.22</var>in a nearby trade area if it is determined that the child requires necessary and appropriate <br/>
<a id="pl.174.23"></a><var>174.23</var>services that are only available outside the county.<br/>
<a id="pl.174.24"></a><var>174.24</var>    (c) Outpatient services offered by the county board to prevent placement must be at <br/>
<a id="pl.174.25"></a><var>174.25</var>the level of treatment appropriate to the child's diagnostic assessment.<br/>
<br/>
<a id="bill.7.5.0"></a><a id="pl.174.26"></a><var>174.26</var>    Sec. 5. Minnesota Statutes 2008, section 254A.02, is amended by adding a subdivision <br/>
<a id="pl.174.27"></a><var>174.27</var>to read:<br/>
<a id="pl.174.28"></a><var>174.28</var>    Subd. 8a. <b>Placing authority.</b> "Placing authority" means a county, prepaid health <br/>
<a id="pl.174.29"></a><var>174.29</var>plan, or tribal governing board governed by Minnesota Rules, parts 9530.6600 to <br/>
<a id="pl.174.30"></a><var>174.30</var>9530.6655.<br/>
<br/>
<a id="bill.7.6.0"></a><a id="pl.174.31"></a><var>174.31</var>    Sec. 6. Minnesota Statutes 2008, section 254A.16, is amended by adding a subdivision <br/>
<a id="pl.174.32"></a><var>174.32</var>to read:<br/>
<a id="pl.174.33"></a><var>174.33</var>    Subd. 6. <b>Monitoring.</b> The commissioner shall gather and placing authorities shall <br/>
<a id="pl.174.34"></a><var>174.34</var>provide information to measure compliance with Minnesota Rules, parts 9530.6600 to <br/>
<a id="pl.175.1"></a><var>175.1</var>9530.6655. The commissioner shall specify the format for data collection to facilitate <br/>
<a id="pl.175.2"></a><var>175.2</var>tracking, aggregating, and using the information.<br/>
<br/>
<a id="bill.7.7.0"></a><a id="pl.175.3"></a><var>175.3</var>    Sec. 7. Minnesota Statutes 2008, section 254B.03, subdivision 1, is amended to read:<br/>
<a id="pl.175.4"></a><var>175.4</var>    Subdivision 1. <b>Local agency duties.</b> (a) Every local agency shall provide chemical <br/>
<a id="pl.175.5"></a><var>175.5</var>dependency services to persons residing within its jurisdiction who meet criteria <br/>
<a id="pl.175.6"></a><var>175.6</var>established by the commissioner for placement in a chemical dependency residential or <br/>
<a id="pl.175.7"></a><var>175.7</var>nonresidential treatment service. Chemical dependency money must be administered <br/>
<a id="pl.175.8"></a><var>175.8</var>by the local agencies according to law and rules adopted by the commissioner under <br/>
<a id="pl.175.9"></a><var>175.9</var>sections 
         <statute_ref>14.001</statute_ref> to 
         <statute_ref>14.69</statute_ref>. <br/>
<a id="pl.175.10"></a><var>175.10</var>    (b) In order to contain costs, the county board shall, with the approval of the <br/>
<a id="pl.175.11"></a><var>175.11</var>commissioner of human services, shall select eligible vendors of chemical dependency <br/>
<a id="pl.175.12"></a><var>175.12</var>services who can provide economical and appropriate treatment. Unless the local agency <br/>
<a id="pl.175.13"></a><var>175.13</var>is a social services department directly administered by a county or human services board, <br/>
<a id="pl.175.14"></a><var>175.14</var>the local agency shall not be an eligible vendor under section 
         <statute_ref>254B.05</statute_ref>. The commissioner <br/>
<a id="pl.175.15"></a><var>175.15</var>may approve proposals from county boards to provide services in an economical manner <br/>
<a id="pl.175.16"></a><var>175.16</var>or to control utilization, with safeguards to ensure that necessary services are provided. <br/>
<a id="pl.175.17"></a><var>175.17</var>If a county implements a demonstration or experimental medical services funding plan, <br/>
<a id="pl.175.18"></a><var>175.18</var>the commissioner shall transfer the money as appropriate. If a county selects a vendor <br/>
<a id="pl.175.19"></a><var>175.19</var>located in another state, the county shall ensure that the vendor is in compliance with the <br/>
<a id="pl.175.20"></a><var>175.20</var>rules governing licensure of programs located in the state. <br/>
<a id="pl.175.21"></a><var>175.21</var>    (c) A culturally specific vendor that provides assessments under a variance under <br/>
<a id="pl.175.22"></a><var>175.22</var>Minnesota Rules, part 9530.6610, shall be allowed to provide assessment services to <br/>
<a id="pl.175.23"></a><var>175.23</var>persons not covered by the variance.<br/>
<a id="pl.175.24"></a><var>175.24</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2011.<br/>
<br/>
<a id="bill.7.8.0"></a><a id="pl.175.25"></a><var>175.25</var>    Sec. 8. Minnesota Statutes 2008, section 254B.03, subdivision 3, is amended to read:<br/>
<a id="pl.175.26"></a><var>175.26</var>    Subd. 3. <b>Local agencies to pay state for county share.</b>  Local agencies shall pay <br/>
<a id="pl.175.27"></a><var>175.27</var>the state for the county share of the services authorized by the local agency, except when <br/>
<a id="pl.175.28"></a><var>175.28</var>the payment is made according to section 254B.09, subdivision 8.<br/>
<br/>
<a id="bill.7.9.0"></a><a id="pl.175.29"></a><var>175.29</var>    Sec. 9. Minnesota Statutes 2008, section 254B.03, is amended by adding a subdivision <br/>
<a id="pl.175.30"></a><var>175.30</var>to read:<br/>
<a id="pl.175.31"></a><var>175.31</var>    Subd. 9. <b>Commissioner to select vendors and set rates.</b> (a) Effective July 1, 2011, <br/>
<a id="pl.175.32"></a><var>175.32</var>the commissioner shall:<br/>
<a id="pl.175.33"></a><var>175.33</var>(1) enter into agreements with eligible vendors that:<br/>
<a id="pl.176.1"></a><var>176.1</var>(i) meet the standards in section 254B.05, subdivision 1;<br/>
<a id="pl.176.2"></a><var>176.2</var>(ii) have good standing in all applicable licensure; and<br/>
<a id="pl.176.3"></a><var>176.3</var>(iii) have a current approved provider agreement as a Minnesota health care program <br/>
<a id="pl.176.4"></a><var>176.4</var>provider; and<br/>
<a id="pl.176.5"></a><var>176.5</var>(2) set rates for services reimbursed under this chapter.<br/>
<a id="pl.176.6"></a><var>176.6</var>(b) When setting rates, the commissioner shall consider the complexity and the <br/>
<a id="pl.176.7"></a><var>176.7</var>acuity of the problems presented by the client.<br/>
<a id="pl.176.8"></a><var>176.8</var>(c) When rates set under this section and rates set under section 254B.09, subdivision <br/>
<a id="pl.176.9"></a><var>176.9</var>8, apply to the same treatment placement, section 254B.09, subdivision 8, supersedes.<br/>
<br/>
<a id="bill.7.10.0"></a><a id="pl.176.10"></a><var>176.10</var>    Sec. 10. Minnesota Statutes 2008, section 254B.05, subdivision 1, is amended to read:<br/>
<a id="pl.176.11"></a><var>176.11</var>    Subdivision 1. <b>Licensure required.</b> Programs licensed by the commissioner are <br/>
<a id="pl.176.12"></a><var>176.12</var>eligible vendors. Hospitals may apply for and receive licenses to be eligible vendors, <br/>
<a id="pl.176.13"></a><var>176.13</var>notwithstanding the provisions of section 
         <statute_ref>245A.03</statute_ref>. American Indian programs located on <br/>
<a id="pl.176.14"></a><var>176.14</var>federally recognized tribal lands that provide chemical dependency primary treatment, <br/>
<a id="pl.176.15"></a><var>176.15</var>extended care, transitional residence, or outpatient treatment services, and are licensed by <br/>
<a id="pl.176.16"></a><var>176.16</var>tribal government are eligible vendors. Detoxification programs are not eligible vendors. <br/>
<a id="pl.176.17"></a><var>176.17</var>Programs that are not licensed as a chemical dependency residential or nonresidential <br/>
<a id="pl.176.18"></a><var>176.18</var>treatment program by the commissioner or by tribal government are not eligible vendors. <br/>
<a id="pl.176.19"></a><var>176.19</var>To be eligible for payment under the Consolidated Chemical Dependency Treatment Fund, <br/>
<a id="pl.176.20"></a><var>176.20</var>a vendor of a chemical dependency service must participate in the Drug and Alcohol <br/>
<a id="pl.176.21"></a><var>176.21</var>Abuse Normative Evaluation System and the treatment accountability plan.  <br/>
<a id="pl.176.22"></a><var>176.22</var>Effective January 1, 2000, vendors of room and board are eligible for chemical <br/>
<a id="pl.176.23"></a><var>176.23</var>dependency fund payment if the vendor:<br/>
<a id="pl.176.24"></a><var>176.24</var>(1) is certified by the county or tribal governing body as having has rules prohibiting <br/>
<a id="pl.176.25"></a><var>176.25</var>residents bringing chemicals into the facility or using chemicals while residing in the <br/>
<a id="pl.176.26"></a><var>176.26</var>facility and provide consequences for infractions of those rules;<br/>
<a id="pl.176.27"></a><var>176.27</var>(2) has a current contract with a county or tribal governing body;<br/>
<a id="pl.176.28"></a><var>176.28</var>(3) is determined to meet applicable health and safety requirements;<br/>
<a id="pl.176.29"></a><var>176.29</var>(4) is not a jail or prison; and<br/>
<a id="pl.176.30"></a><var>176.30</var>(5) is not concurrently receiving funds under chapter 256I for the recipient.<br/>
<a id="pl.176.31"></a><var>176.31</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2011.<br/>
<br/>
<a id="bill.7.11.0"></a><a id="pl.176.32"></a><var>176.32</var>    Sec. 11. Minnesota Statutes 2008, section 254B.09, subdivision 2, is amended to read:<br/>
<a id="pl.176.33"></a><var>176.33</var>    Subd. 2. <b>American Indian agreements.</b> The commissioner may enter into <br/>
<a id="pl.176.34"></a><var>176.34</var>agreements with federally recognized tribal units to pay for chemical dependency <br/>
<a id="pl.177.1"></a><var>177.1</var>treatment services provided under Laws 1986, chapter 394, sections 8 to 20. The <br/>
<a id="pl.177.2"></a><var>177.2</var>agreements must clarify how the governing body of the tribal unit fulfills local agency <br/>
<a id="pl.177.3"></a><var>177.3</var>responsibilities regarding:<br/>
<a id="pl.177.4"></a><var>177.4</var>(1) selection of eligible vendors under section 
<statute_ref>254B.03, subdivision 1</statute_ref>;  <br/>
<a id="pl.177.5"></a><var>177.5</var>(2) negotiation of agreements that establish vendor services and rates for programs <br/>
<a id="pl.177.6"></a><var>177.6</var>located on the tribal governing body's reservation;<br/>
<a id="pl.177.7"></a><var>177.7</var>(3) (1) the form and manner of invoicing; and<br/>
<a id="pl.177.8"></a><var>177.8</var>(4) (2) provide that only invoices for eligible vendors according to section 
         <statute_ref>254B.05</statute_ref> <br/>
<a id="pl.177.9"></a><var>177.9</var>will be included in invoices sent to the commissioner for payment, to the extent that <br/>
<a id="pl.177.10"></a><var>177.10</var>money allocated under subdivisions 4 and 5 is used.  <br/>
<a id="pl.177.11"></a><var>177.11</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2011.<br/>
<br/>
<a id="bill.7.12.0"></a><a id="pl.177.12"></a><var>177.12</var>    Sec. 12. <b>[254B.11] MAXIMUM RATES.</b><br/>
<a id="pl.177.13"></a><var>177.13</var>The commissioner shall publish maximum rates for vendors of the consolidated <br/>
<a id="pl.177.14"></a><var>177.14</var>chemical dependency treatment fund by July 1 of each year for implementation the <br/>
<a id="pl.177.15"></a><var>177.15</var>following January 1. Rates for calendar year 2010 must not exceed 185 percent of the <br/>
<a id="pl.177.16"></a><var>177.16</var>average rate on January 1, 2009, for each group of vendors with similar attributes. Unless <br/>
<a id="pl.177.17"></a><var>177.17</var>a new rate methodology is developed under section 254B.12, rates for services provided on <br/>
<a id="pl.177.18"></a><var>177.18</var>and after July 1, 2011, must not exceed 160 percent of the average rate on January 1, 2009, <br/>
<a id="pl.177.19"></a><var>177.19</var>for each group of vendors with similar attributes. Payment for services provided by Indian <br/>
<a id="pl.177.20"></a><var>177.20</var>Health Services or by agencies operated by Indian tribes for medical assistance-eligible <br/>
<a id="pl.177.21"></a><var>177.21</var>individuals must be governed by the applicable federal rate methodology.<br/>
<br/>
<a id="bill.7.13.0"></a><a id="pl.177.22"></a><var>177.22</var>    Sec. 13. <b>[254B.12] RATE METHODOLOGY.</b><br/>
<a id="pl.177.23"></a><var>177.23</var>The commissioner shall, with broad-based stakeholder input, develop a <br/>
<a id="pl.177.24"></a><var>177.24</var>recommendation and present a report to the 2011 legislature, including proposed <br/>
<a id="pl.177.25"></a><var>177.25</var>legislation for a new rate methodology for the consolidated chemical dependency <br/>
<a id="pl.177.26"></a><var>177.26</var>treatment fund. The new methodology must replace county-negotiated rates with a <br/>
<a id="pl.177.27"></a><var>177.27</var>uniform statewide methodology that must include a graduated reimbursement scale based <br/>
<a id="pl.177.28"></a><var>177.28</var>on the patients' level of acuity and complexity.<br/>
<br/>
<a id="bill.7.14.0"></a><a id="pl.177.29"></a><var>177.29</var>    Sec. 14. Minnesota Statutes 2008, section 256B.0622, subdivision 2, is amended to <br/>
<a id="pl.177.30"></a><var>177.30</var>read:<br/>
<a id="pl.177.31"></a><var>177.31</var>    Subd. 2. <b>Definitions.</b> For purposes of this section, the following terms have the <br/>
<a id="pl.177.32"></a><var>177.32</var>meanings given them.<br/>
<a id="pl.178.1"></a><var>178.1</var>    (a) "Intensive nonresidential rehabilitative mental health services" means adult <br/>
<a id="pl.178.2"></a><var>178.2</var>rehabilitative mental health services as defined in section 
         <statute_ref>256B.0623, subdivision 2</statute_ref>, <br/>
<a id="pl.178.3"></a><var>178.3</var>paragraph (a), except that these services are provided by a multidisciplinary staff using <br/>
<a id="pl.178.4"></a><var>178.4</var>a total team approach consistent with assertive community treatment, the Fairweather <br/>
<a id="pl.178.5"></a><var>178.5</var>Lodge treatment model, as defined by the standards established by the National Coalition <br/>
<a id="pl.178.6"></a><var>178.6</var>for Community Living, and other evidence-based practices, and directed to recipients with <br/>
<a id="pl.178.7"></a><var>178.7</var>a serious mental illness who require intensive services.<br/>
<a id="pl.178.8"></a><var>178.8</var>    (b) "Intensive residential rehabilitative mental health services" means short-term, <br/>
<a id="pl.178.9"></a><var>178.9</var>time-limited services provided in a residential setting to recipients who are in need of <br/>
<a id="pl.178.10"></a><var>178.10</var>more restrictive settings and are at risk of significant functional deterioration if they do <br/>
<a id="pl.178.11"></a><var>178.11</var>not receive these services. Services are designed to develop and enhance psychiatric <br/>
<a id="pl.178.12"></a><var>178.12</var>stability, personal and emotional adjustment, self-sufficiency, and skills to live in a more <br/>
<a id="pl.178.13"></a><var>178.13</var>independent setting. Services must be directed toward a targeted discharge date with <br/>
<a id="pl.178.14"></a><var>178.14</var>specified client outcomes and must be consistent with the Fairweather Lodge treatment <br/>
<a id="pl.178.15"></a><var>178.15</var>model as defined in paragraph (a), and other evidence-based practices.<br/>
<a id="pl.178.16"></a><var>178.16</var>    (c) "Evidence-based practices" are nationally recognized mental health services that <br/>
<a id="pl.178.17"></a><var>178.17</var>are proven by substantial research to be effective in helping individuals with serious <br/>
<a id="pl.178.18"></a><var>178.18</var>mental illness obtain specific treatment goals.<br/>
<a id="pl.178.19"></a><var>178.19</var>    (d) "Overnight staff" means a member of the intensive residential rehabilitative <br/>
<a id="pl.178.20"></a><var>178.20</var>mental health treatment team who is responsible during hours when recipients are <br/>
<a id="pl.178.21"></a><var>178.21</var>typically asleep.<br/>
<a id="pl.178.22"></a><var>178.22</var>    (e) "Treatment team" means all staff who provide services under this section to <br/>
<a id="pl.178.23"></a><var>178.23</var>recipients. At a minimum, this includes the clinical supervisor, mental health professionals <br/>
<a id="pl.178.24"></a><var>178.24</var>as defined in section 
         <statute_ref>245.462, subdivision 18</statute_ref>, clauses (1) to (5) (6); mental health <br/>
<a id="pl.178.25"></a><var>178.25</var>practitioners as defined in section 
         <statute_ref>245.462, subdivision 17</statute_ref>; mental health rehabilitation <br/>
<a id="pl.178.26"></a><var>178.26</var>workers under section 
         <statute_ref>256B.0623, subdivision 5</statute_ref>, clause (3); and certified peer specialists <br/>
<a id="pl.178.27"></a><var>178.27</var>under section 
         <statute_ref>256B.0615</statute_ref>.<br/>
<br/>
<a id="bill.7.15.0"></a><a id="pl.178.28"></a><var>178.28</var>    Sec. 15. Minnesota Statutes 2008, section 256B.0623, subdivision 5, is amended to <br/>
<a id="pl.178.29"></a><var>178.29</var>read:<br/>
<a id="pl.178.30"></a><var>178.30</var>    Subd. 5. <b>Qualifications of provider staff.</b> Adult rehabilitative mental health <br/>
<a id="pl.178.31"></a><var>178.31</var>services must be provided by qualified individual provider staff of a certified provider <br/>
<a id="pl.178.32"></a><var>178.32</var>entity. Individual provider staff must be qualified under one of the following criteria:<br/>
<a id="pl.178.33"></a><var>178.33</var>    (1) a mental health professional as defined in section 
         <statute_ref>245.462, subdivision 18</statute_ref>, <br/>
<a id="pl.178.34"></a><var>178.34</var>clauses (1) to (5) (6). If the recipient has a current diagnostic assessment by a licensed <br/>
<a id="pl.178.35"></a><var>178.35</var>mental health professional as defined in section 
         <statute_ref>245.462, subdivision 18</statute_ref>, clauses (1) to (5) <br/>
<a id="pl.179.1"></a><var>179.1</var>(6), recommending receipt of adult mental health rehabilitative services, the definition of <br/>
<a id="pl.179.2"></a><var>179.2</var>mental health professional for purposes of this section includes a person who is qualified <br/>
<a id="pl.179.3"></a><var>179.3</var>under section 
         <statute_ref>245.462, subdivision 18</statute_ref>, clause (6) (7), and who holds a current and valid <br/>
<a id="pl.179.4"></a><var>179.4</var>national certification as a certified rehabilitation counselor or certified psychosocial <br/>
<a id="pl.179.5"></a><var>179.5</var>rehabilitation practitioner; <br/>
<a id="pl.179.6"></a><var>179.6</var>    (2) a mental health practitioner as defined in section 
         <statute_ref>245.462, subdivision 17</statute_ref>. The <br/>
<a id="pl.179.7"></a><var>179.7</var>mental health practitioner must work under the clinical supervision of a mental health <br/>
<a id="pl.179.8"></a><var>179.8</var>professional; <br/>
<a id="pl.179.9"></a><var>179.9</var>    (3) a certified peer specialist under section 
         <statute_ref>256B.0615</statute_ref>. The certified peer specialist <br/>
<a id="pl.179.10"></a><var>179.10</var>must work under the clinical supervision of a mental health professional; or<br/>
<a id="pl.179.11"></a><var>179.11</var>    (4) a mental health rehabilitation worker. A mental health rehabilitation worker <br/>
<a id="pl.179.12"></a><var>179.12</var>means a staff person working under the direction of a mental health practitioner or mental <br/>
<a id="pl.179.13"></a><var>179.13</var>health professional and under the clinical supervision of a mental health professional in <br/>
<a id="pl.179.14"></a><var>179.14</var>the implementation of rehabilitative mental health services as identified in the recipient's <br/>
<a id="pl.179.15"></a><var>179.15</var>individual treatment plan who:<br/>
<a id="pl.179.16"></a><var>179.16</var>    (i) is at least 21 years of age;<br/>
<a id="pl.179.17"></a><var>179.17</var>    (ii) has a high school diploma or equivalent;<br/>
<a id="pl.179.18"></a><var>179.18</var>    (iii) has successfully completed 30 hours of training during the past two years in all <br/>
<a id="pl.179.19"></a><var>179.19</var>of the following areas: recipient rights, recipient-centered individual treatment planning, <br/>
<a id="pl.179.20"></a><var>179.20</var>behavioral terminology, mental illness, co-occurring mental illness and substance abuse, <br/>
<a id="pl.179.21"></a><var>179.21</var>psychotropic medications and side effects, functional assessment, local community <br/>
<a id="pl.179.22"></a><var>179.22</var>resources, adult vulnerability, recipient confidentiality; and<br/>
<a id="pl.179.23"></a><var>179.23</var>    (iv) meets the qualifications in subitem (A) or (B):<br/>
<a id="pl.179.24"></a><var>179.24</var>    (A) has an associate of arts degree in one of the behavioral sciences or human <br/>
<a id="pl.179.25"></a><var>179.25</var>services, or is a registered nurse without a bachelor's degree, or who within the previous <br/>
<a id="pl.179.26"></a><var>179.26</var>ten years has:<br/>
<a id="pl.179.27"></a><var>179.27</var>    (1) three years of personal life experience with serious and persistent mental illness;<br/>
<a id="pl.179.28"></a><var>179.28</var>    (2) three years of life experience as a primary caregiver to an adult with a serious <br/>
<a id="pl.179.29"></a><var>179.29</var>mental illness or traumatic brain injury; or<br/>
<a id="pl.179.30"></a><var>179.30</var>    (3) 4,000 hours of supervised paid work experience in the delivery of mental health <br/>
<a id="pl.179.31"></a><var>179.31</var>services to adults with a serious mental illness or traumatic brain injury; or<br/>
<a id="pl.179.32"></a><var>179.32</var>    (B)(1) is fluent in the non-English language or competent in the culture of the <br/>
<a id="pl.179.33"></a><var>179.33</var>ethnic group to which at least 20 percent of the mental health rehabilitation worker's <br/>
<a id="pl.179.34"></a><var>179.34</var>clients belong;<br/>
<a id="pl.179.35"></a><var>179.35</var>    (2) receives during the first 2,000 hours of work, monthly documented individual <br/>
<a id="pl.179.36"></a><var>179.36</var>clinical supervision by a mental health professional;<br/>
<a id="pl.180.1"></a><var>180.1</var>    (3) has 18 hours of documented field supervision by a mental health professional <br/>
<a id="pl.180.2"></a><var>180.2</var>or practitioner during the first 160 hours of contact work with recipients, and at least six <br/>
<a id="pl.180.3"></a><var>180.3</var>hours of field supervision quarterly during the following year;<br/>
<a id="pl.180.4"></a><var>180.4</var>    (4) has review and cosignature of charting of recipient contacts during field <br/>
<a id="pl.180.5"></a><var>180.5</var>supervision by a mental health professional or practitioner; and<br/>
<a id="pl.180.6"></a><var>180.6</var>    (5) has 40 hours of additional continuing education on mental health topics during <br/>
<a id="pl.180.7"></a><var>180.7</var>the first year of employment.<br/>
<br/>
<a id="bill.7.16.0"></a><a id="pl.180.8"></a><var>180.8</var>    Sec. 16. Minnesota Statutes 2008, section 256B.0624, subdivision 5, is amended to <br/>
<a id="pl.180.9"></a><var>180.9</var>read:<br/>
<a id="pl.180.10"></a><var>180.10</var>    Subd. 5. <b>Mobile crisis intervention staff qualifications.</b> For provision of adult <br/>
<a id="pl.180.11"></a><var>180.11</var>mental health mobile crisis intervention services, a mobile crisis intervention team is <br/>
<a id="pl.180.12"></a><var>180.12</var>comprised of at least two mental health professionals as defined in section 
         <statute_ref>245.462, <br/>
<a id="pl.180.13"></a><var>180.13</var>subdivision 18
         </statute_ref>, clauses (1) to (5) (6), or a combination of at least one mental health <br/>
<a id="pl.180.14"></a><var>180.14</var>professional and one mental health practitioner as defined in section 
         <statute_ref>245.462, subdivision <br/>
<a id="pl.180.15"></a><var>180.15</var>17
         </statute_ref>, with the required mental health crisis training and under the clinical supervision of <br/>
<a id="pl.180.16"></a><var>180.16</var>a mental health professional on the team. The team must have at least two people with <br/>
<a id="pl.180.17"></a><var>180.17</var>at least one member providing on-site crisis intervention services when needed. Team <br/>
<a id="pl.180.18"></a><var>180.18</var>members must be experienced in mental health assessment, crisis intervention techniques, <br/>
<a id="pl.180.19"></a><var>180.19</var>and clinical decision-making under emergency conditions and have knowledge of local <br/>
<a id="pl.180.20"></a><var>180.20</var>services and resources. The team must recommend and coordinate the team's services <br/>
<a id="pl.180.21"></a><var>180.21</var>with appropriate local resources such as the county social services agency, mental health <br/>
<a id="pl.180.22"></a><var>180.22</var>services, and local law enforcement when necessary. <br/>
<br/>
<a id="bill.7.17.0"></a><a id="pl.180.23"></a><var>180.23</var>    Sec. 17. Minnesota Statutes 2008, section 256B.0624, subdivision 8, is amended to <br/>
<a id="pl.180.24"></a><var>180.24</var>read:<br/>
<a id="pl.180.25"></a><var>180.25</var>    Subd. 8. <b>Adult crisis stabilization staff qualifications.</b> (a) Adult mental health <br/>
<a id="pl.180.26"></a><var>180.26</var>crisis stabilization services must be provided by qualified individual staff of a qualified <br/>
<a id="pl.180.27"></a><var>180.27</var>provider entity. Individual provider staff must have the following qualifications:<br/>
<a id="pl.180.28"></a><var>180.28</var>    (1) be a mental health professional as defined in section 
         <statute_ref>245.462, subdivision 18</statute_ref>, <br/>
<a id="pl.180.29"></a><var>180.29</var>clauses (1) to (5) (6); <br/>
<a id="pl.180.30"></a><var>180.30</var>    (2) be a mental health practitioner as defined in section 
         <statute_ref>245.462, subdivision 17</statute_ref>. <br/>
<a id="pl.180.31"></a><var>180.31</var>The mental health practitioner must work under the clinical supervision of a mental health <br/>
<a id="pl.180.32"></a><var>180.32</var>professional; or <br/>
<a id="pl.180.33"></a><var>180.33</var>    (3) be a mental health rehabilitation worker who meets the criteria in section <br/>
<statute_ref><a id="pl.180.34"></a><var>180.34</var>256B.0623, subdivision 5
         </statute_ref>, clause (3); works under the direction of a mental health <br/>
<a id="pl.181.1"></a><var>181.1</var>practitioner as defined in section 
         <statute_ref>245.462, subdivision 17</statute_ref>, or under direction of a <br/>
<a id="pl.181.2"></a><var>181.2</var>mental health professional; and works under the clinical supervision of a mental health <br/>
<a id="pl.181.3"></a><var>181.3</var>professional. <br/>
<a id="pl.181.4"></a><var>181.4</var>    (b) Mental health practitioners and mental health rehabilitation workers must have <br/>
<a id="pl.181.5"></a><var>181.5</var>completed at least 30 hours of training in crisis intervention and stabilization during <br/>
<a id="pl.181.6"></a><var>181.6</var>the past two years.<br/>
<br/>
<a id="bill.7.18.0"></a><a id="pl.181.7"></a><var>181.7</var>    Sec. 18. Minnesota Statutes 2008, section 256B.0625, subdivision 42, is amended to <br/>
<a id="pl.181.8"></a><var>181.8</var>read:<br/>
<a id="pl.181.9"></a><var>181.9</var>    Subd. 42. <b>Mental health professional.</b> Notwithstanding Minnesota Rules, part <br/>
<a id="pl.181.10"></a><var>181.10</var>9505.0175, subpart 28, the definition of a mental health professional shall include a person <br/>
<a id="pl.181.11"></a><var>181.11</var>who is qualified as specified in section 
         <statute_ref>245.462, subdivision 18</statute_ref>, clause clauses  (5) and (6); <br/>
<a id="pl.181.12"></a><var>181.12</var>or 
         <statute_ref>245.4871, subdivision 27</statute_ref>, clause clauses  (5) and (6), for the purpose of this section and <br/>
<a id="pl.181.13"></a><var>181.13</var>Minnesota Rules, parts 9505.0170 to 9505.0475. <br/>
<br/>
<a id="bill.7.19.0"></a><a id="pl.181.14"></a><var>181.14</var>    Sec. 19. Minnesota Statutes 2008, section 256B.0943, subdivision 1, is amended to <br/>
<a id="pl.181.15"></a><var>181.15</var>read:<br/>
<a id="pl.181.16"></a><var>181.16</var>    Subdivision 1. <b>Definitions.</b> For purposes of this section, the following terms have <br/>
<a id="pl.181.17"></a><var>181.17</var>the meanings given them.<br/>
<a id="pl.181.18"></a><var>181.18</var>    (a) "Children's therapeutic services and supports" means the flexible package of <br/>
<a id="pl.181.19"></a><var>181.19</var>mental health services for children who require varying therapeutic and rehabilitative <br/>
<a id="pl.181.20"></a><var>181.20</var>levels of intervention. The services are time-limited interventions that are delivered using <br/>
<a id="pl.181.21"></a><var>181.21</var>various treatment modalities and combinations of services designed to reach treatment <br/>
<a id="pl.181.22"></a><var>181.22</var>outcomes identified in the individual treatment plan.<br/>
<a id="pl.181.23"></a><var>181.23</var>    (b) "Clinical supervision" means the overall responsibility of the mental health <br/>
<a id="pl.181.24"></a><var>181.24</var>professional for the control and direction of individualized treatment planning, service <br/>
<a id="pl.181.25"></a><var>181.25</var>delivery, and treatment review for each client. A mental health professional who is an <br/>
<a id="pl.181.26"></a><var>181.26</var>enrolled Minnesota health care program provider accepts full professional responsibility <br/>
<a id="pl.181.27"></a><var>181.27</var>for a supervisee's actions and decisions, instructs the supervisee in the supervisee's work, <br/>
<a id="pl.181.28"></a><var>181.28</var>and oversees or directs the supervisee's work.<br/>
<a id="pl.181.29"></a><var>181.29</var>    (c) "County board" means the county board of commissioners or board established <br/>
<a id="pl.181.30"></a><var>181.30</var>under sections 
         <statute_ref>402.01</statute_ref> to 
         <statute_ref>402.10</statute_ref> or 
         <statute_ref>471.59</statute_ref>.  <br/>
<a id="pl.181.31"></a><var>181.31</var>    (d) "Crisis assistance" has the meaning given in section 
         <statute_ref>245.4871, subdivision 9a</statute_ref>.  <br/>
<a id="pl.181.32"></a><var>181.32</var>    (e) "Culturally competent provider" means a provider who understands and can <br/>
<a id="pl.181.33"></a><var>181.33</var>utilize to a client's benefit the client's culture when providing services to the client. A <br/>
<a id="pl.181.34"></a><var>181.34</var>provider may be culturally competent because the provider is of the same cultural or <br/>
<a id="pl.182.1"></a><var>182.1</var>ethnic group as the client or the provider has developed the knowledge and skills through <br/>
<a id="pl.182.2"></a><var>182.2</var>training and experience to provide services to culturally diverse clients.<br/>
<a id="pl.182.3"></a><var>182.3</var>    (f) "Day treatment program" for children means a site-based structured program <br/>
<a id="pl.182.4"></a><var>182.4</var>consisting of group psychotherapy for more than three individuals and other intensive <br/>
<a id="pl.182.5"></a><var>182.5</var>therapeutic services provided by a multidisciplinary team, under the clinical supervision <br/>
<a id="pl.182.6"></a><var>182.6</var>of a mental health professional.<br/>
<a id="pl.182.7"></a><var>182.7</var>    (g) "Diagnostic assessment" has the meaning given in section 
         <statute_ref>245.4871, subdivision <br/>
<a id="pl.182.8"></a><var>182.8</var>11
         </statute_ref>.  <br/>
<a id="pl.182.9"></a><var>182.9</var>    (h) "Direct service time" means the time that a mental health professional, mental <br/>
<a id="pl.182.10"></a><var>182.10</var>health practitioner, or mental health behavioral aide spends face-to-face with a client <br/>
<a id="pl.182.11"></a><var>182.11</var>and the client's family. Direct service time includes time in which the provider obtains <br/>
<a id="pl.182.12"></a><var>182.12</var>a client's history or provides service components of children's therapeutic services and <br/>
<a id="pl.182.13"></a><var>182.13</var>supports. Direct service time does not include time doing work before and after providing <br/>
<a id="pl.182.14"></a><var>182.14</var>direct services, including scheduling, maintaining clinical records, consulting with others <br/>
<a id="pl.182.15"></a><var>182.15</var>about the client's mental health status, preparing reports, receiving clinical supervision <br/>
<a id="pl.182.16"></a><var>182.16</var>directly related to the client's psychotherapy session, and revising the client's individual <br/>
<a id="pl.182.17"></a><var>182.17</var>treatment plan.<br/>
<a id="pl.182.18"></a><var>182.18</var>    (i) "Direction of mental health behavioral aide" means the activities of a mental <br/>
<a id="pl.182.19"></a><var>182.19</var>health professional or mental health practitioner in guiding the mental health behavioral <br/>
<a id="pl.182.20"></a><var>182.20</var>aide in providing services to a client. The direction of a mental health behavioral aide <br/>
<a id="pl.182.21"></a><var>182.21</var>must be based on the client's individualized treatment plan and meet the requirements in <br/>
<a id="pl.182.22"></a><var>182.22</var>subdivision 6, paragraph (b), clause (5).<br/>
<a id="pl.182.23"></a><var>182.23</var>    (j) "Emotional disturbance" has the meaning given in section 
         <statute_ref>245.4871, subdivision <br/>
<a id="pl.182.24"></a><var>182.24</var>15
         </statute_ref>. For persons at least age 18 but under age 21, mental illness has the meaning given in <br/>
<a id="pl.182.25"></a><var>182.25</var>section 
         <statute_ref>245.462, subdivision 20</statute_ref>, paragraph (a).  <br/>
<a id="pl.182.26"></a><var>182.26</var>    (k) "Individual behavioral plan" means a plan of intervention, treatment, and <br/>
<a id="pl.182.27"></a><var>182.27</var>services for a child written by a mental health professional or mental health practitioner, <br/>
<a id="pl.182.28"></a><var>182.28</var>under the clinical supervision of a mental health professional, to guide the work of the <br/>
<a id="pl.182.29"></a><var>182.29</var>mental health behavioral aide.<br/>
<a id="pl.182.30"></a><var>182.30</var>    (l) "Individual treatment plan" has the meaning given in section 
         <statute_ref>245.4871, <br/>
<a id="pl.182.31"></a><var>182.31</var>subdivision 21
         </statute_ref>.  <br/>
<a id="pl.182.32"></a><var>182.32</var>    (m) "Mental health professional" means an individual as defined in section 
         <statute_ref>245.4871, <br/>
<a id="pl.182.33"></a><var>182.33</var>subdivision 27
         </statute_ref>, clauses (1) to (5) (6), or tribal vendor as defined in section 
         <statute_ref>256B.02, <br/>
<a id="pl.182.34"></a><var>182.34</var>subdivision 7
         </statute_ref>, paragraph (b).  <br/>
<a id="pl.182.35"></a><var>182.35</var>    (n) "Preschool program" means a day program licensed under Minnesota Rules, <br/>
<a id="pl.182.36"></a><var>182.36</var>parts 9503.0005 to 9503.0175, and enrolled as a children's therapeutic services and <br/>
<a id="pl.183.1"></a><var>183.1</var>supports provider to provide a structured treatment program to a child who is at least 33 <br/>
<a id="pl.183.2"></a><var>183.2</var>months old but who has not yet attended the first day of kindergarten.<br/>
<a id="pl.183.3"></a><var>183.3</var>    (o) "Skills training" means individual, family, or group training designed to improve <br/>
<a id="pl.183.4"></a><var>183.4</var>the basic functioning of the child with emotional disturbance and the child's family in the <br/>
<a id="pl.183.5"></a><var>183.5</var>activities of daily living and community living, and to improve the social functioning of the <br/>
<a id="pl.183.6"></a><var>183.6</var>child and the child's family in areas important to the child's maintaining or reestablishing <br/>
<a id="pl.183.7"></a><var>183.7</var>residency in the community. Individual, family, and group skills training must:<br/>
<a id="pl.183.8"></a><var>183.8</var>    (1) consist of activities designed to promote skill development of the child and the <br/>
<a id="pl.183.9"></a><var>183.9</var>child's family in the use of age-appropriate daily living skills, interpersonal and family <br/>
<a id="pl.183.10"></a><var>183.10</var>relationships, and leisure and recreational services;<br/>
<a id="pl.183.11"></a><var>183.11</var>    (2) consist of activities that will assist the family's understanding of normal child <br/>
<a id="pl.183.12"></a><var>183.12</var>development and to use parenting skills that will help the child with emotional disturbance <br/>
<a id="pl.183.13"></a><var>183.13</var>achieve the goals outlined in the child's individual treatment plan; and<br/>
<a id="pl.183.14"></a><var>183.14</var>    (3) promote family preservation and unification, promote the family's integration <br/>
<a id="pl.183.15"></a><var>183.15</var>with the community, and reduce the use of unnecessary out-of-home placement or <br/>
<a id="pl.183.16"></a><var>183.16</var>institutionalization of children with emotional disturbance.<br/>
<br/>
<a id="bill.7.20.0"></a><a id="pl.183.17"></a><var>183.17</var>    Sec. 20. Minnesota Statutes 2008, section 256B.0625, subdivision 47, is amended to <br/>
<a id="pl.183.18"></a><var>183.18</var>read:<br/>
<a id="pl.183.19"></a><var>183.19</var>    Subd. 47. <b>Treatment foster care services.</b> Effective July 1, 2007 2011, and subject <br/>
<a id="pl.183.20"></a><var>183.20</var>to federal approval, medical assistance covers treatment foster care services according to <br/>
<a id="pl.183.21"></a><var>183.21</var>section 
         <statute_ref>256B.0946</statute_ref>.<br/>
<br/>
<a id="bill.7.21.0"></a><a id="pl.183.22"></a><var>183.22</var>    Sec. 21. Minnesota Statutes 2008, section 256B.0943, subdivision 12, is amended to <br/>
<a id="pl.183.23"></a><var>183.23</var>read:<br/>
<a id="pl.183.24"></a><var>183.24</var>    Subd. 12. <b>Excluded services.</b> The following services are not eligible for medical <br/>
<a id="pl.183.25"></a><var>183.25</var>assistance payment as children's therapeutic services and supports:<br/>
<a id="pl.183.26"></a><var>183.26</var>    (1) service components of children's therapeutic services and supports <br/>
<a id="pl.183.27"></a><var>183.27</var>simultaneously provided by more than one provider entity unless prior authorization is <br/>
<a id="pl.183.28"></a><var>183.28</var>obtained;<br/>
<a id="pl.183.29"></a><var>183.29</var>    (2) treatment by multiple providers within the same agency at the same clock time;<br/>
<a id="pl.183.30"></a><var>183.30</var>(3) children's therapeutic services and supports provided in violation of medical <br/>
<a id="pl.183.31"></a><var>183.31</var>assistance policy in Minnesota Rules, part 9505.0220;<br/>
<a id="pl.183.32"></a><var>183.32</var>    (3) (4) mental health behavioral aide services provided by a personal care assistant <br/>
<a id="pl.183.33"></a><var>183.33</var>who is not qualified as a mental health behavioral aide and employed by a certified <br/>
<a id="pl.183.34"></a><var>183.34</var>children's therapeutic services and supports provider entity;<br/>
<a id="pl.184.1"></a><var>184.1</var>    (4) (5) service components of CTSS that are the responsibility of a residential or <br/>
<a id="pl.184.2"></a><var>184.2</var>program license holder, including foster care providers under the terms of a service <br/>
<a id="pl.184.3"></a><var>184.3</var>agreement or administrative rules governing licensure; <br/>
<a id="pl.184.4"></a><var>184.4</var>    (5) (6) adjunctive activities that may be offered by a provider entity but are not <br/>
<a id="pl.184.5"></a><var>184.5</var>otherwise covered by medical assistance, including:<br/>
<a id="pl.184.6"></a><var>184.6</var>    (i) a service that is primarily recreation oriented or that is provided in a setting that <br/>
<a id="pl.184.7"></a><var>184.7</var>is not medically supervised. This includes sports activities, exercise groups, activities <br/>
<a id="pl.184.8"></a><var>184.8</var>such as craft hours, leisure time, social hours, meal or snack time, trips to community <br/>
<a id="pl.184.9"></a><var>184.9</var>activities, and tours;<br/>
<a id="pl.184.10"></a><var>184.10</var>    (ii) a social or educational service that does not have or cannot reasonably be <br/>
<a id="pl.184.11"></a><var>184.11</var>expected to have a therapeutic outcome related to the client's emotional disturbance;<br/>
<a id="pl.184.12"></a><var>184.12</var>    (iii) consultation with other providers or service agency staff about the care or <br/>
<a id="pl.184.13"></a><var>184.13</var>progress of a client;<br/>
<a id="pl.184.14"></a><var>184.14</var>    (iv) prevention or education programs provided to the community; and<br/>
<a id="pl.184.15"></a><var>184.15</var>    (v) treatment for clients with primary diagnoses of alcohol or other drug abuse; and<br/>
<a id="pl.184.16"></a><var>184.16</var>    (6) (7) activities that are not direct service time.<br/>
<br/>
<a id="bill.7.22.0"></a><a id="pl.184.17"></a><var>184.17</var>    Sec. 22. Minnesota Statutes 2008, section 256B.0944, is amended by adding a <br/>
<a id="pl.184.18"></a><var>184.18</var>subdivision to read:<br/>
<a id="pl.184.19"></a><var>184.19</var>    Subd. 4a. <b>Alternative provider standards.</b> If a provider entity demonstrates that, <br/>
<a id="pl.184.20"></a><var>184.20</var>due to geographic or other barriers, it is not feasible to provide mobile crisis intervention <br/>
<a id="pl.184.21"></a><var>184.21</var>services 24 hours a day, seven days a week, according to the standards in subdivision 4, <br/>
<a id="pl.184.22"></a><var>184.22</var>paragraph (b), clause (1), the commissioner may approve a crisis response provider based <br/>
<a id="pl.184.23"></a><var>184.23</var>on an alternative plan proposed by a provider entity. The alternative plan must:<br/>
<a id="pl.184.24"></a><var>184.24</var>(1) result in increased access and a reduction in disparities in the availability of <br/>
<a id="pl.184.25"></a><var>184.25</var>crisis services; and<br/>
<a id="pl.184.26"></a><var>184.26</var>(2) provide mobile services outside of the usual nine-to-five office hours and on <br/>
<a id="pl.184.27"></a><var>184.27</var>weekends and holidays.<br/>
<br/>
<a id="bill.7.23.0"></a><a id="pl.184.28"></a><var>184.28</var>    Sec. 23. Minnesota Statutes 2008, section 256B.0947, subdivision 1, is amended to <br/>
<a id="pl.184.29"></a><var>184.29</var>read:<br/>
<a id="pl.184.30"></a><var>184.30</var>    Subdivision 1. <b>Scope.</b> Subject to federal approval Effective November 1, 2010, and <br/>
<a id="pl.184.31"></a><var>184.31</var>subject to federal approval, medical assistance covers medically necessary, intensive <br/>
<a id="pl.184.32"></a><var>184.32</var>nonresidential rehabilitative mental health services as defined in subdivision 2, for <br/>
<a id="pl.184.33"></a><var>184.33</var>recipients as defined in subdivision 3, when the services are provided by an entity meeting <br/>
<a id="pl.184.34"></a><var>184.34</var>the standards in this section.<br/>
<br/>
<a id="bill.7.24.0"></a><a id="pl.185.1"></a><var>185.1</var>    Sec. 24. Minnesota Statutes 2008, section 256J.08, subdivision 73a, is amended to read:<br/>
<a id="pl.185.2"></a><var>185.2</var>    Subd. 73a. <b>Qualified professional.</b> (a) For physical illness, injury, or incapacity, <br/>
<a id="pl.185.3"></a><var>185.3</var>a "qualified professional" means a licensed physician, a physician's assistant, a nurse <br/>
<a id="pl.185.4"></a><var>185.4</var>practitioner, or a licensed chiropractor.<br/>
<a id="pl.185.5"></a><var>185.5</var>    (b) For developmental disability and intelligence testing, a "qualified professional" <br/>
<a id="pl.185.6"></a><var>185.6</var>means an individual qualified by training and experience to administer the tests necessary <br/>
<a id="pl.185.7"></a><var>185.7</var>to make determinations, such as tests of intellectual functioning, assessments of adaptive <br/>
<a id="pl.185.8"></a><var>185.8</var>behavior, adaptive skills, and developmental functioning. These professionals include <br/>
<a id="pl.185.9"></a><var>185.9</var>licensed psychologists, certified school psychologists, or certified psychometrists working <br/>
<a id="pl.185.10"></a><var>185.10</var>under the supervision of a licensed psychologist.<br/>
<a id="pl.185.11"></a><var>185.11</var>    (c) For learning disabilities, a "qualified professional" means a licensed psychologist <br/>
<a id="pl.185.12"></a><var>185.12</var>or school psychologist with experience determining learning disabilities.<br/>
<a id="pl.185.13"></a><var>185.13</var>    (d) For mental health, a "qualified professional" means a licensed physician or a <br/>
<a id="pl.185.14"></a><var>185.14</var>qualified mental health professional. A "qualified mental health professional" means:<br/>
<a id="pl.185.15"></a><var>185.15</var>    (1) for children, in psychiatric nursing, a registered nurse who is licensed under <br/>
<a id="pl.185.16"></a><var>185.16</var>sections 
         <statute_ref>148.171</statute_ref> to 
         <statute_ref>148.285</statute_ref>, and who is certified as a clinical specialist in child <br/>
<a id="pl.185.17"></a><var>185.17</var>and adolescent psychiatric or mental health nursing by a national nurse certification <br/>
<a id="pl.185.18"></a><var>185.18</var>organization or who has a master's degree in nursing or one of the behavioral sciences <br/>
<a id="pl.185.19"></a><var>185.19</var>or related fields from an accredited college or university or its equivalent, with at least <br/>
<a id="pl.185.20"></a><var>185.20</var>4,000 hours of post-master's supervised experience in the delivery of clinical services in <br/>
<a id="pl.185.21"></a><var>185.21</var>the treatment of mental illness;<br/>
<a id="pl.185.22"></a><var>185.22</var>    (2) for adults, in psychiatric nursing, a registered nurse who is licensed under <br/>
<a id="pl.185.23"></a><var>185.23</var>sections 
         <statute_ref>148.171</statute_ref> to 
         <statute_ref>148.285</statute_ref>, and who is certified as a clinical specialist in adult psychiatric <br/>
<a id="pl.185.24"></a><var>185.24</var>and mental health nursing by a national nurse certification organization or who has a <br/>
<a id="pl.185.25"></a><var>185.25</var>master's degree in nursing or one of the behavioral sciences or related fields from an <br/>
<a id="pl.185.26"></a><var>185.26</var>accredited college or university or its equivalent, with at least 4,000 hours of post-master's <br/>
<a id="pl.185.27"></a><var>185.27</var>supervised experience in the delivery of clinical services in the treatment of mental illness;<br/>
<a id="pl.185.28"></a><var>185.28</var>    (3) in clinical social work, a person licensed as an independent clinical social worker <br/>
<a id="pl.185.29"></a><var>185.29</var>under chapter 148D, or a person with a master's degree in social work from an accredited <br/>
<a id="pl.185.30"></a><var>185.30</var>college or university, with at least 4,000 hours of post-master's supervised experience in <br/>
<a id="pl.185.31"></a><var>185.31</var>the delivery of clinical services in the treatment of mental illness;<br/>
<a id="pl.185.32"></a><var>185.32</var>    (4) in psychology, an individual licensed by the Board of Psychology under sections <br/>
<statute_ref><a id="pl.185.33"></a><var>185.33</var>148.88
         </statute_ref> to 
         <statute_ref>148.98</statute_ref>, who has stated to the Board of Psychology competencies in the <br/>
<a id="pl.185.34"></a><var>185.34</var>diagnosis and treatment of mental illness;<br/>
<a id="pl.186.1"></a><var>186.1</var>    (5) in psychiatry, a physician licensed under chapter 147 and certified by the <br/>
<a id="pl.186.2"></a><var>186.2</var>American Board of Psychiatry and Neurology or eligible for board certification in <br/>
<a id="pl.186.3"></a><var>186.3</var>psychiatry; and<br/>
<a id="pl.186.4"></a><var>186.4</var>    (6) in marriage and family therapy, the mental health professional must be a <br/>
<a id="pl.186.5"></a><var>186.5</var>marriage and family therapist licensed under sections 
         <statute_ref>148B.29</statute_ref> to 
         <statute_ref>148B.39</statute_ref>, with at least <br/>
<a id="pl.186.6"></a><var>186.6</var>two years of post-master's supervised experience in the delivery of clinical services in the <br/>
<a id="pl.186.7"></a><var>186.7</var>treatment of mental illness; and<br/>
<a id="pl.186.8"></a><var>186.8</var>    (7) in licensed professional clinical counseling, the mental health professional <br/>
<a id="pl.186.9"></a><var>186.9</var>shall be a licensed professional clinical counselor under section 148B.5301 with at least <br/>
<a id="pl.186.10"></a><var>186.10</var>4,000 hours of postmaster's supervised experience in the delivery of clinical services in <br/>
<a id="pl.186.11"></a><var>186.11</var>the treatment of mental illness.<br/>
<br/>
<a id="bill.7.25.0"></a><a id="pl.186.12"></a><var>186.12</var>    Sec. 25. <b>AUTISM SPECTRUM DISORDER TASK FORCE.</b><br/>
<a id="pl.186.13"></a><var>186.13</var>(a) The Autism Spectrum Disorder Task Force is composed of 15 members, <br/>
<a id="pl.186.14"></a><var>186.14</var>appointed as follows:<br/>
<a id="pl.186.15"></a><var>186.15</var>(1) two members of the senate appointed by the Subcommittee on Committees of the <br/>
<a id="pl.186.16"></a><var>186.16</var>Committee on Rules and Administration, one of whom must be a member of the minority;<br/>
<a id="pl.186.17"></a><var>186.17</var>(2) two members of the house of representatives, one from the majority party, <br/>
<a id="pl.186.18"></a><var>186.18</var>appointed by the speaker of the house, and one from the minority party, appointed by <br/>
<a id="pl.186.19"></a><var>186.19</var>the minority leader;<br/>
<a id="pl.186.20"></a><var>186.20</var>    (3) two members appointed by the legislature, with regard to geographic diversity in <br/>
<a id="pl.186.21"></a><var>186.21</var>the state, who are parents of children with autism spectrum disorder (ASD); one member <br/>
<a id="pl.186.22"></a><var>186.22</var>shall be appointed by the senate Subcommittee on Committees of the Committee on <br/>
<a id="pl.186.23"></a><var>186.23</var>Rules and Administration making appointments for the senate; and one member shall be <br/>
<a id="pl.186.24"></a><var>186.24</var>appointed by the speaker of the house making the appointments for the house;<br/>
<a id="pl.186.25"></a><var>186.25</var>(4) one member appointed by the Minnesota chapter of the American Academy of <br/>
<a id="pl.186.26"></a><var>186.26</var>Pediatrics who is a general primary care pediatrician; <br/>
<a id="pl.186.27"></a><var>186.27</var>(5) one member appointed by the Minnesota Academy of Family Physicians who is <br/>
<a id="pl.186.28"></a><var>186.28</var>a family practice physician;<br/>
<a id="pl.186.29"></a><var>186.29</var>(6) one member appointed by the Minnesota Psychological Association who is a <br/>
<a id="pl.186.30"></a><var>186.30</var>neuropsychologist;<br/>
<a id="pl.186.31"></a><var>186.31</var>(7) one member appointed by the directors of public school student support services;<br/>
<a id="pl.186.32"></a><var>186.32</var>(8) one member appointed by the Somali American Autism Foundation;<br/>
<a id="pl.186.33"></a><var>186.33</var>(9) one member appointed by the ARC of Minnesota;<br/>
<a id="pl.186.34"></a><var>186.34</var>(10) one member appointed by the Autism Society of Minnesota;<br/>
<a id="pl.187.1"></a><var>187.1</var>(11) one member appointed by the Parent Advocacy Coalition for Educational <br/>
<a id="pl.187.2"></a><var>187.2</var>Rights; and<br/>
<a id="pl.187.3"></a><var>187.3</var>(12) one member appointed by the Minnesota Council of Health Plans.<br/>
<a id="pl.187.4"></a><var>187.4</var>Appointments must be made by September 1, 2009. The Legislative Coordinating <br/>
<a id="pl.187.5"></a><var>187.5</var>Commission shall provide meeting space for the task force. The senate member appointed <br/>
<a id="pl.187.6"></a><var>187.6</var>by the minority leader of the senate shall convene the first meeting of the task force no <br/>
<a id="pl.187.7"></a><var>187.7</var>later than October 1, 2009. The task force shall elect a chair at the first meeting.<br/>
<a id="pl.187.8"></a><var>187.8</var>(b) If federal or state funding is available, the commissioners of education, <br/>
<a id="pl.187.9"></a><var>187.9</var>employment and economic development, health, and human services shall provide <br/>
<a id="pl.187.10"></a><var>187.10</var>assistance to the task force.<br/>
<a id="pl.187.11"></a><var>187.11</var>(c) The task force shall develop recommendations and report on the following topics:<br/>
<a id="pl.187.12"></a><var>187.12</var>(1) ways to improve services provided by all state and political subdivisions;<br/>
<a id="pl.187.13"></a><var>187.13</var>(2) sources of public and private funding available for treatment and ways to <br/>
<a id="pl.187.14"></a><var>187.14</var>improve efficiency in the use of these funds;<br/>
<a id="pl.187.15"></a><var>187.15</var>(3) methods to improve coordination in the delivery of service between public <br/>
<a id="pl.187.16"></a><var>187.16</var>and private agencies, health providers, and schools, and to address any geographic <br/>
<a id="pl.187.17"></a><var>187.17</var>discrepancies in the delivery of services;<br/>
<a id="pl.187.18"></a><var>187.18</var>(4) increasing the availability of and the training for medical providers and educators <br/>
<a id="pl.187.19"></a><var>187.19</var>who identify and provide services to individuals with ASD; and<br/>
<a id="pl.187.20"></a><var>187.20</var>(5) treatment options supported by peer-reviewed, established scientific research <br/>
<a id="pl.187.21"></a><var>187.21</var>for individuals with ASD.<br/>
<a id="pl.187.22"></a><var>187.22</var>(d) The task force shall coordinate with existing efforts at the Departments of <br/>
<a id="pl.187.23"></a><var>187.23</var>Education, Health, Human Services, and Employment and Economic Development <br/>
<a id="pl.187.24"></a><var>187.24</var>related to ASD.<br/>
<a id="pl.187.25"></a><var>187.25</var>(e) By January 15 of each year, the task force shall provide a report regarding its <br/>
<a id="pl.187.26"></a><var>187.26</var>findings and consideration of the topics listed under paragraph (c), and the action taken <br/>
<a id="pl.187.27"></a><var>187.27</var>under paragraph (d), including draft legislation if necessary, to the chairs and ranking <br/>
<a id="pl.187.28"></a><var>187.28</var>minority members of the legislative committees with jurisdiction over health and human <br/>
<a id="pl.187.29"></a><var>187.29</var>services.<br/>
<a id="pl.187.30"></a><var>187.30</var>(f) This section expires June 30, 2011.<br/>
<br/>
<a id="bill.7.26.0"></a><a id="pl.187.31"></a><var>187.31</var>    Sec. 26. <b>STATE-COUNTY CHEMICAL HEALTH CARE HOME PILOT </b><br/>
<a id="pl.187.32"></a><var>187.32</var><b>PROJECT.</b><br/>
<a id="pl.187.33"></a><var>187.33</var>    Subdivision 1. <b>Establishment; purpose.</b> There is established a state-county <br/>
<a id="pl.187.34"></a><var>187.34</var>chemical health care home pilot project. The purpose of the pilot project is for the <br/>
<a id="pl.187.35"></a><var>187.35</var>Department of Human Services and counties to authentically and creatively work in <br/>
<a id="pl.188.1"></a><var>188.1</var>partnership to redesign the current chemical health service delivery system in a way <br/>
<a id="pl.188.2"></a><var>188.2</var>that promotes greater accountability, productivity, and results in the delivery of state <br/>
<a id="pl.188.3"></a><var>188.3</var>chemical dependency services. The pilot project or projects must look to provide <br/>
<a id="pl.188.4"></a><var>188.4</var>appropriate flexibility in a way that ensures timely access to needed services as well <br/>
<a id="pl.188.5"></a><var>188.5</var>as better aligning systems and services to offer the most appropriate level of chemical <br/>
<a id="pl.188.6"></a><var>188.6</var>health care services to the client. This may include, but is not limited to, looking into new <br/>
<a id="pl.188.7"></a><var>188.7</var>governance agreements, performance agreements, or service level agreements. Pilot <br/>
<a id="pl.188.8"></a><var>188.8</var>projects must maintain eligibility requirements for the consolidated chemical dependency <br/>
<a id="pl.188.9"></a><var>188.9</var>treatment fund, continue to meet the requirements of Minnesota Rules, parts 9530.6600 to <br/>
<a id="pl.188.10"></a><var>188.10</var>9530.6655 (also known as Rule 25) and Minnesota Rules, parts 9530.6405 to 9530.6505 <br/>
<a id="pl.188.11"></a><var>188.11</var>(also known as Rule 31), and must not put at risk current and future federal funding toward <br/>
<a id="pl.188.12"></a><var>188.12</var>chemical health-related services in the state of Minnesota. <br/>
<a id="pl.188.13"></a><var>188.13</var>    Subd. 2. <b>Workgroup; report.</b> A workgroup must be convened on or before July <br/>
<a id="pl.188.14"></a><var>188.14</var>15, 2009, consisting of representatives from the Department of Human Services and <br/>
<a id="pl.188.15"></a><var>188.15</var>potential participating counties to develop draft proposals for pilot projects meeting the <br/>
<a id="pl.188.16"></a><var>188.16</var>requirements of this section. The workgroup shall report back to the legislative committees <br/>
<a id="pl.188.17"></a><var>188.17</var>with jurisdiction over chemical health by January 15, 2010, for potential approval of one <br/>
<a id="pl.188.18"></a><var>188.18</var>metro and one nonmetro county pilot project to be implemented beginning July 10, 2010.<br/>
<a id="pl.188.19"></a><var>188.19</var>    Subd. 3. <b>Report.</b> The Department of Human Services shall evaluate the efficacy and <br/>
<a id="pl.188.20"></a><var>188.20</var>feasibility of the pilot projects and report the results of that evaluation to the legislative <br/>
<a id="pl.188.21"></a><var>188.21</var>committees having jurisdiction over chemical health by June 30, 2011. Expansion of pilot <br/>
<a id="pl.188.22"></a><var>188.22</var>projects may occur only if the department's report finds the pilot projects effective.<br/>
<a id="pl.188.23"></a><var>188.23</var>    Subd. 4. <b>Expiration.</b> This section expires June 30, 2012.<br/>
<a id="pl.188.24"></a><var>188.24</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br/>
<br/>
<a id="bill.8.0.0"></a>

<a id="bill.8.1.0"></a><a id="pl.188.27"></a><var>188.27</var>    Section 1. Minnesota Statutes 2008, section 144.0724, subdivision 2, is amended to <br/>
<a id="pl.188.28"></a><var>188.28</var>read:<br/>
<a id="pl.188.29"></a><var>188.29</var>    Subd. 2. <b>Definitions.</b> For purposes of this section, the following terms have the <br/>
<a id="pl.188.30"></a><var>188.30</var>meanings given.<br/>
<a id="pl.188.31"></a><var>188.31</var>(a) "Assessment reference date" means the last day of the minimum data set <br/>
<a id="pl.188.32"></a><var>188.32</var>observation period. The date sets the designated endpoint of the common observation <br/>
<a id="pl.188.33"></a><var>188.33</var>period, and all minimum data set items refer back in time from that point.<br/>
<a id="pl.189.1"></a><var>189.1</var>(b) "Case mix index" means the weighting factors assigned to the RUG-III <br/>
<a id="pl.189.2"></a><var>189.2</var>classifications.<br/>
<a id="pl.189.3"></a><var>189.3</var>(c) "Index maximization" means classifying a resident who could be assigned to <br/>
<a id="pl.189.4"></a><var>189.4</var>more than one category, to the category with the highest case mix index.<br/>
<a id="pl.189.5"></a><var>189.5</var>(d) "Minimum data set" means the assessment instrument specified by the Centers for <br/>
<a id="pl.189.6"></a><var>189.6</var>Medicare and Medicaid Services and designated by the Minnesota Department of Health.<br/>
<a id="pl.189.7"></a><var>189.7</var>(e) "Representative" means a person who is the resident's guardian or conservator, <br/>
<a id="pl.189.8"></a><var>189.8</var>the person authorized to pay the nursing home expenses of the resident, a representative <br/>
<a id="pl.189.9"></a><var>189.9</var>of the nursing home ombudsman's office whose assistance has been requested, or any <br/>
<a id="pl.189.10"></a><var>189.10</var>other individual designated by the resident.<br/>
<a id="pl.189.11"></a><var>189.11</var>(f) "Resource utilization groups" or "RUG" means the system for grouping a nursing <br/>
<a id="pl.189.12"></a><var>189.12</var>facility's residents according to their clinical and functional status identified in data <br/>
<a id="pl.189.13"></a><var>189.13</var>supplied by the facility's minimum data set.<br/>
<a id="pl.189.14"></a><var>189.14</var>(g) "Activities of daily living" means grooming, dressing, bathing, transferring, <br/>
<a id="pl.189.15"></a><var>189.15</var>mobility, positioning, eating, and toileting.<br/>
<a id="pl.189.16"></a><var>189.16</var>(h) "Nursing facility level of care determination" means the assessment process <br/>
<a id="pl.189.17"></a><var>189.17</var>that results in a determination of a resident's or prospective resident's need for nursing <br/>
<a id="pl.189.18"></a><var>189.18</var>facility level of care as established in subdivision 11 for purposes of medical assistance <br/>
<a id="pl.189.19"></a><var>189.19</var>payment of long-term care services for:<br/>
<a id="pl.189.20"></a><var>189.20</var>(1) nursing facility services under section 256B.434 or 256B.441;<br/>
<a id="pl.189.21"></a><var>189.21</var>(2) elderly waiver services under section 256B.0915;<br/>
<a id="pl.189.22"></a><var>189.22</var>(3) CADI and TBI waiver services under section 256B.49; and<br/>
<a id="pl.189.23"></a><var>189.23</var>(4) state payment of alternative care services under section 256B.0913.<br/>
<a id="pl.189.24"></a><var>189.24</var><b>EFFECTIVE DATE.</b>The section is effective January 1, 2011.<br/>
<br/>
<a id="bill.8.2.0"></a><a id="pl.189.25"></a><var>189.25</var>    Sec. 2. Minnesota Statutes 2008, section 144.0724, subdivision 4, is amended to read:<br/>
<a id="pl.189.26"></a><var>189.26</var>    Subd. 4. <b>Resident assessment schedule.</b> (a) A facility must conduct and <br/>
<a id="pl.189.27"></a><var>189.27</var>electronically submit to the commissioner of health case mix assessments that conform <br/>
<a id="pl.189.28"></a><var>189.28</var>with the assessment schedule defined by Code of Federal Regulations, title 42, section <br/>
<statute_ref><a id="pl.189.29"></a><var>189.29</var>483.20
         </statute_ref>, and published by the United States Department of Health and Human Services, <br/>
<a id="pl.189.30"></a><var>189.30</var>Centers for Medicare and Medicaid Services, in the Long Term Care Assessment <br/>
<a id="pl.189.31"></a><var>189.31</var>Instrument User's Manual, version 2.0, October 1995, and subsequent clarifications made <br/>
<a id="pl.189.32"></a><var>189.32</var>in the Long-Term Care Assessment Instrument Questions and Answers, version 2.0, <br/>
<a id="pl.189.33"></a><var>189.33</var>August 1996. The commissioner of health may substitute successor manuals or question <br/>
<a id="pl.189.34"></a><var>189.34</var>and answer documents published by the United States Department of Health and Human <br/>
<a id="pl.190.1"></a><var>190.1</var>Services, Centers for Medicare and Medicaid Services, to replace or supplement the <br/>
<a id="pl.190.2"></a><var>190.2</var>current version of the manual or document.<br/>
<a id="pl.190.3"></a><var>190.3</var>(b) The assessments used to determine a case mix classification for reimbursement <br/>
<a id="pl.190.4"></a><var>190.4</var>include the following:<br/>
<a id="pl.190.5"></a><var>190.5</var>(1) a new admission assessment must be completed by day 14 following admission;<br/>
<a id="pl.190.6"></a><var>190.6</var>(2) an annual assessment must be completed within 366 days of the last <br/>
<a id="pl.190.7"></a><var>190.7</var>comprehensive assessment;<br/>
<a id="pl.190.8"></a><var>190.8</var>(3) a significant change assessment must be completed within 14 days of the <br/>
<a id="pl.190.9"></a><var>190.9</var>identification of a significant change; and<br/>
<a id="pl.190.10"></a><var>190.10</var>(4) the second quarterly assessment following either a new admission assessment, <br/>
<a id="pl.190.11"></a><var>190.11</var>an annual assessment, or a significant change assessment, and all quarterly assessments <br/>
<a id="pl.190.12"></a><var>190.12</var>beginning October 1, 2006. Each quarterly assessment must be completed within 92 <br/>
<a id="pl.190.13"></a><var>190.13</var>days of the previous assessment.<br/>
<a id="pl.190.14"></a><var>190.14</var>(c) In addition to the assessments listed in paragraph (b), the assessments used to <br/>
<a id="pl.190.15"></a><var>190.15</var>determine nursing facility level of care include the following:<br/>
<a id="pl.190.16"></a><var>190.16</var>(1) preadmission screening completed under section 256B.0911, subdivision 4a, <br/>
<a id="pl.190.17"></a><var>190.17</var>by a county, tribe, or managed care organization under contract with the Department <br/>
<a id="pl.190.18"></a><var>190.18</var>of Human Services; and<br/>
<a id="pl.190.19"></a><var>190.19</var>(2) a face-to-face long-term care consultation assessment completed under section <br/>
<a id="pl.190.20"></a><var>190.20</var>256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or managed care organization <br/>
<a id="pl.190.21"></a><var>190.21</var>under contract with the Department of Human Services.<br/>
<a id="pl.190.22"></a><var>190.22</var><b>EFFECTIVE DATE.</b>The section is effective January 1, 2011.<br/>
<br/>
<a id="bill.8.3.0"></a><a id="pl.190.23"></a><var>190.23</var>    Sec. 3. Minnesota Statutes 2008, section 144.0724, subdivision 8, is amended to read:<br/>
<a id="pl.190.24"></a><var>190.24</var>    Subd. 8. <b>Request for reconsideration of resident classifications.</b> (a) The resident, <br/>
<a id="pl.190.25"></a><var>190.25</var>or resident's representative, or the nursing facility or boarding care home may request that <br/>
<a id="pl.190.26"></a><var>190.26</var>the commissioner of health reconsider the assigned reimbursement classification. The <br/>
<a id="pl.190.27"></a><var>190.27</var>request for reconsideration must be submitted in writing to the commissioner within <br/>
<a id="pl.190.28"></a><var>190.28</var>30 days of the day the resident or the resident's representative receives the resident <br/>
<a id="pl.190.29"></a><var>190.29</var>classification notice. The request for reconsideration must include the name of the <br/>
<a id="pl.190.30"></a><var>190.30</var>resident, the name and address of the facility in which the resident resides, the reasons for <br/>
<a id="pl.190.31"></a><var>190.31</var>the reconsideration, the requested classification changes, and documentation supporting <br/>
<a id="pl.190.32"></a><var>190.32</var>the requested classification. The documentation accompanying the reconsideration request <br/>
<a id="pl.190.33"></a><var>190.33</var>is limited to documentation which establishes that the needs of the resident at the time of <br/>
<a id="pl.190.34"></a><var>190.34</var>the assessment justify a classification which is different than the classification established <br/>
<a id="pl.190.35"></a><var>190.35</var>by the commissioner of health.<br/>
<a id="pl.191.1"></a><var>191.1</var>(b) Upon request, the nursing facility must give the resident or the resident's <br/>
<a id="pl.191.2"></a><var>191.2</var>representative a copy of the assessment form and the other documentation that was given <br/>
<a id="pl.191.3"></a><var>191.3</var>to the commissioner of health to support the assessment findings. The nursing facility <br/>
<a id="pl.191.4"></a><var>191.4</var>shall also provide access to and a copy of other information from the resident's record that <br/>
<a id="pl.191.5"></a><var>191.5</var>has been requested by or on behalf of the resident to support a resident's reconsideration <br/>
<a id="pl.191.6"></a><var>191.6</var>request. A copy of any requested material must be provided within three working days of <br/>
<a id="pl.191.7"></a><var>191.7</var>receipt of a written request for the information. If a facility fails to provide the material <br/>
<a id="pl.191.8"></a><var>191.8</var>within this time, it is subject to the issuance of a correction order and penalty assessment <br/>
<a id="pl.191.9"></a><var>191.9</var>under sections 
         <statute_ref>144.653</statute_ref> and 
         <statute_ref>144A.10</statute_ref>. Notwithstanding those sections, any correction order <br/>
<a id="pl.191.10"></a><var>191.10</var>issued under this subdivision must require that the nursing facility immediately comply <br/>
<a id="pl.191.11"></a><var>191.11</var>with the request for information and that as of the date of the issuance of the correction <br/>
<a id="pl.191.12"></a><var>191.12</var>order, the facility shall forfeit to the state a $100 fine for the first day of noncompliance, and <br/>
<a id="pl.191.13"></a><var>191.13</var>an increase in the $100 fine by $50 increments for each day the noncompliance continues. <br/>
<a id="pl.191.14"></a><var>191.14</var>(c) In addition to the information required under paragraphs (a) and (b), a <br/>
<a id="pl.191.15"></a><var>191.15</var>reconsideration request from a nursing facility must contain the following information: (i) <br/>
<a id="pl.191.16"></a><var>191.16</var>the date the reimbursement classification notices were received by the facility; (ii) the date <br/>
<a id="pl.191.17"></a><var>191.17</var>the classification notices were distributed to the resident or the resident's representative; <br/>
<a id="pl.191.18"></a><var>191.18</var>and (iii) a copy of a notice sent to the resident or to the resident's representative. This <br/>
<a id="pl.191.19"></a><var>191.19</var>notice must inform the resident or the resident's representative that a reconsideration of the <br/>
<a id="pl.191.20"></a><var>191.20</var>resident's classification is being requested, the reason for the request, that the resident's <br/>
<a id="pl.191.21"></a><var>191.21</var>rate will change if the request is approved by the commissioner, the extent of the change, <br/>
<a id="pl.191.22"></a><var>191.22</var>that copies of the facility's request and supporting documentation are available for review, <br/>
<a id="pl.191.23"></a><var>191.23</var>and that the resident also has the right to request a reconsideration. If the facility fails to <br/>
<a id="pl.191.24"></a><var>191.24</var>provide the required information with the reconsideration request, the request must be <br/>
<a id="pl.191.25"></a><var>191.25</var>denied, and the facility may not make further reconsideration requests on that specific <br/>
<a id="pl.191.26"></a><var>191.26</var>reimbursement classification.<br/>
<a id="pl.191.27"></a><var>191.27</var>(d) Reconsideration by the commissioner must be made by individuals not involved <br/>
<a id="pl.191.28"></a><var>191.28</var>in reviewing the assessment, audit, or reconsideration that established the disputed <br/>
<a id="pl.191.29"></a><var>191.29</var>classification. The reconsideration must be based upon the initial assessment and upon the <br/>
<a id="pl.191.30"></a><var>191.30</var>information provided to the commissioner under paragraphs (a) and (b). If necessary for <br/>
<a id="pl.191.31"></a><var>191.31</var>evaluating the reconsideration request, the commissioner may conduct on-site reviews. <br/>
<a id="pl.191.32"></a><var>191.32</var>Within 15 working days of receiving the request for reconsideration, the commissioner <br/>
<a id="pl.191.33"></a><var>191.33</var>shall affirm or modify the original resident classification. The original classification <br/>
<a id="pl.191.34"></a><var>191.34</var>must be modified if the commissioner determines that the assessment resulting in the <br/>
<a id="pl.191.35"></a><var>191.35</var>classification did not accurately reflect the needs or assessment characteristics of the <br/>
<a id="pl.191.36"></a><var>191.36</var>resident at the time of the assessment. The resident and the nursing facility or boarding <br/>
<a id="pl.192.1"></a><var>192.1</var>care home shall be notified within five working days after the decision is made. A decision <br/>
<a id="pl.192.2"></a><var>192.2</var>by the commissioner under this subdivision is the final administrative decision of the <br/>
<a id="pl.192.3"></a><var>192.3</var>agency for the party requesting reconsideration.<br/>
<a id="pl.192.4"></a><var>192.4</var>(e) The resident classification established by the commissioner shall be the <br/>
<a id="pl.192.5"></a><var>192.5</var>classification that applies to the resident while the request for reconsideration is pending. <br/>
<a id="pl.192.6"></a><var>192.6</var>If a request for reconsideration applies to an assessment used to determine nursing facility <br/>
<a id="pl.192.7"></a><var>192.7</var>level of care under subdivision 4, paragraph (c), the resident shall continue to be eligible <br/>
<a id="pl.192.8"></a><var>192.8</var>for nursing facility level of care while the request for reconsideration is pending.<br/>
<a id="pl.192.9"></a><var>192.9</var>(f) The commissioner may request additional documentation regarding a <br/>
<a id="pl.192.10"></a><var>192.10</var>reconsideration necessary to make an accurate reconsideration determination.<br/>
<a id="pl.192.11"></a><var>192.11</var><b>EFFECTIVE DATE.</b>The section is effective January 1, 2011.<br/>
<br/>
<a id="bill.8.4.0"></a><a id="pl.192.12"></a><var>192.12</var>    Sec. 4. Minnesota Statutes 2008, section 144.0724, is amended by adding a subdivision <br/>
<a id="pl.192.13"></a><var>192.13</var>to read:<br/>
<a id="pl.192.14"></a><var>192.14</var>    Subd. 11. <b>Nursing facility level of care.</b> (a) For purposes of medical assistance <br/>
<a id="pl.192.15"></a><var>192.15</var>payment of long-term care services, a recipient must be determined, using assessments <br/>
<a id="pl.192.16"></a><var>192.16</var>defined in subdivision 4, to meet one of the following nursing facility level of care criteria:<br/>
<a id="pl.192.17"></a><var>192.17</var>(1) the person needs the assistance of another person or constant supervision to begin <br/>
<a id="pl.192.18"></a><var>192.18</var>and complete at least four of the following activities of living: bathing, bed mobility, <br/>
<a id="pl.192.19"></a><var>192.19</var>dressing, eating, grooming, toileting, transferring, and walking; <br/>
<a id="pl.192.20"></a><var>192.20</var>(2) the person needs the assistance of another person or constant supervision to begin <br/>
<a id="pl.192.21"></a><var>192.21</var>and complete toileting, transferring, or positioning and the assistance cannot be scheduled;<br/>
<a id="pl.192.22"></a><var>192.22</var>(3) the person has significant difficulty with memory, using information, daily <br/>
<a id="pl.192.23"></a><var>192.23</var>decision making, or behavioral needs that require intervention;<br/>
<a id="pl.192.24"></a><var>192.24</var>(4) the person has had a qualifying nursing facility stay of at least 90 days; or<br/>
<a id="pl.192.25"></a><var>192.25</var>(5) the person is determined to be at risk for nursing facility admission or <br/>
<a id="pl.192.26"></a><var>192.26</var>readmission through a face-to-face long-term care consultation assessment as specified <br/>
<a id="pl.192.27"></a><var>192.27</var>in section 256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or managed care <br/>
<a id="pl.192.28"></a><var>192.28</var>organization under contract with the Department of Human Services. The person is <br/>
<a id="pl.192.29"></a><var>192.29</var>considered at risk under this clause if the person currently lives alone or will live alone <br/>
<a id="pl.192.30"></a><var>192.30</var>upon discharge and also meets one of the following criteria:<br/>
<a id="pl.192.31"></a><var>192.31</var>(i) the person has experienced a fall resulting in a fracture;<br/>
<a id="pl.192.32"></a><var>192.32</var>(ii) the person has been determined to be at risk of maltreatment or neglect, <br/>
<a id="pl.192.33"></a><var>192.33</var>including self-neglect; or<br/>
<a id="pl.192.34"></a><var>192.34</var>(iii) the person has a sensory impairment that substantially impacts functional ability <br/>
<a id="pl.192.35"></a><var>192.35</var>and maintenance of a community residence.<br/>
<a id="pl.193.1"></a><var>193.1</var>(b) The assessment used to establish medical assistance payment for nursing facility <br/>
<a id="pl.193.2"></a><var>193.2</var>services must be the most recent assessment performed under subdivision 4, paragraph <br/>
<a id="pl.193.3"></a><var>193.3</var>(b), that occurred no more than 90 calendar days before the effective date of medical <br/>
<a id="pl.193.4"></a><var>193.4</var>assistance eligibility for payment of long-term care services. In no case shall medical <br/>
<a id="pl.193.5"></a><var>193.5</var>assistance payment for long-term care services occur prior to the date of the determination <br/>
<a id="pl.193.6"></a><var>193.6</var>of nursing facility level of care.<br/>
<a id="pl.193.7"></a><var>193.7</var>(c) The assessment used to establish medical assistance payment for long-term care <br/>
<a id="pl.193.8"></a><var>193.8</var>services provided under sections 256B.0915 and 256B.49 and alternative care payment <br/>
<a id="pl.193.9"></a><var>193.9</var>for services provided under section 256B.0913 must be the most recent face-to-face <br/>
<a id="pl.193.10"></a><var>193.10</var>assessment performed under section 256B.0911, subdivision 3a, that occurred no more <br/>
<a id="pl.193.11"></a><var>193.11</var>than 60 calendar days before the effective date of medical assistance eligibility for <br/>
<a id="pl.193.12"></a><var>193.12</var>payment of long-term care services.<br/>
<a id="pl.193.13"></a><var>193.13</var><b>EFFECTIVE DATE.</b>The section is effective January 1, 2011.<br/>
<br/>
<a id="bill.8.5.0"></a><a id="pl.193.14"></a><var>193.14</var>    Sec. 5. Minnesota Statutes 2008, section 144.0724, is amended by adding a subdivision <br/>
<a id="pl.193.15"></a><var>193.15</var>to read:<br/>
<a id="pl.193.16"></a><var>193.16</var>    Subd. 12. <b>Appeal of nursing facility level of care determination.</b> A resident or <br/>
<a id="pl.193.17"></a><var>193.17</var>prospective resident whose level of care determination results in a denial of long-term care <br/>
<a id="pl.193.18"></a><var>193.18</var>services can appeal the determination as outlined in section 256B.0911, subdivision 3a, <br/>
<a id="pl.193.19"></a><var>193.19</var>paragraph (h), clause (7).<br/>
<a id="pl.193.20"></a><var>193.20</var><b>EFFECTIVE DATE.</b>The section is effective January 1, 2011.<br/>
<br/>
<a id="bill.8.6.0"></a><a id="pl.193.21"></a><var>193.21</var>    Sec. 6. Minnesota Statutes 2008, section 144A.073, is amended by adding a <br/>
<a id="pl.193.22"></a><var>193.22</var>subdivision to read:<br/>
<a id="pl.193.23"></a><var>193.23</var>    Subd. 12. <b>Extension of approval of moratorium exception projects.</b><br/>
<a id="pl.193.24"></a><var>193.24</var>Notwithstanding subdivision 3, the commissioner of health shall extend project approval <br/>
<a id="pl.193.25"></a><var>193.25</var>by an additional 18 months for an approved proposal for an exception to the nursing home <br/>
<a id="pl.193.26"></a><var>193.26</var>licensure and certification moratorium if the proposal was approved under this section <br/>
<a id="pl.193.27"></a><var>193.27</var>between July 1, 2007, and June 30, 2009.<br/>
<br/>
<a id="bill.8.7.0"></a><a id="pl.193.28"></a><var>193.28</var>    Sec. 7. Minnesota Statutes 2008, section 144A.44, subdivision 2, is amended to read:<br/>
<a id="pl.193.29"></a><var>193.29</var>    Subd. 2. <b>Interpretation and enforcement of rights.</b> These rights are established <br/>
<a id="pl.193.30"></a><var>193.30</var>for the benefit of persons who receive home care services. "Home care services" means <br/>
<a id="pl.193.31"></a><var>193.31</var>home care services as defined in section 
         <statute_ref>144A.43, subdivision 3</statute_ref>, and unlicensed personal <br/>
<a id="pl.193.32"></a><var>193.32</var>care assistance services, including services covered by medical assistance under section <br/>
<a id="pl.193.33"></a><var>193.33</var>256B.0625, subdivision 19a. A home care provider may not require a person to surrender <br/>
<a id="pl.194.1"></a><var>194.1</var>these rights as a condition of receiving services. A guardian or conservator or, when there <br/>
<a id="pl.194.2"></a><var>194.2</var>is no guardian or conservator, a designated person, may seek to enforce these rights. This <br/>
<a id="pl.194.3"></a><var>194.3</var>statement of rights does not replace or diminish other rights and liberties that may exist <br/>
<a id="pl.194.4"></a><var>194.4</var>relative to persons receiving home care services, persons providing home care services, or <br/>
<a id="pl.194.5"></a><var>194.5</var>providers licensed under Laws 1987, chapter 378. A copy of these rights must be provided <br/>
<a id="pl.194.6"></a><var>194.6</var>to an individual at the time home care services, including personal care assistance <br/>
<a id="pl.194.7"></a><var>194.7</var>services, are initiated. The copy shall also contain the address and phone number of the <br/>
<a id="pl.194.8"></a><var>194.8</var>Office of Health Facility Complaints and the Office of Ombudsman for Long-Term Care <br/>
<a id="pl.194.9"></a><var>194.9</var>and a brief statement describing how to file a complaint with these offices. Information <br/>
<a id="pl.194.10"></a><var>194.10</var>about how to contact the Office of Ombudsman for Long-Term Care shall be included in <br/>
<a id="pl.194.11"></a><var>194.11</var>notices of change in client fees and in notices where home care providers initiate transfer <br/>
<a id="pl.194.12"></a><var>194.12</var>or discontinuation of services. <br/>
<br/>
<a id="bill.8.8.0"></a><a id="pl.194.13"></a><var>194.13</var>    Sec. 8. Minnesota Statutes 2008, section 245A.03, is amended by adding a subdivision <br/>
<a id="pl.194.14"></a><var>194.14</var>to read:<br/>
<a id="pl.194.15"></a><var>194.15</var>    Subd. 7. <b>Licensing moratorium.</b> (a) The commissioner shall not issue an <br/>
<a id="pl.194.16"></a><var>194.16</var>initial license for child foster care licensed under Minnesota Rules, parts 2960.3000 to <br/>
<a id="pl.194.17"></a><var>194.17</var>2960.3340, or adult foster care licensed under Minnesota Rules, parts 9555.5105 to <br/>
<a id="pl.194.18"></a><var>194.18</var>9555.6265, under this chapter for a physical location that will not be the primary residence <br/>
<a id="pl.194.19"></a><var>194.19</var>of the license holder for the entire period of licensure. If a license is issued during this <br/>
<a id="pl.194.20"></a><var>194.20</var>moratorium, and the license holder changes the license holder's primary residence away <br/>
<a id="pl.194.21"></a><var>194.21</var>from the physical location of the foster care license, the commissioner shall revoke the <br/>
<a id="pl.194.22"></a><var>194.22</var>license according to section 245A.07. Exceptions to the moratorium include:<br/>
<a id="pl.194.23"></a><var>194.23</var>(1) foster care settings that are required to be registered under chapter 144D;<br/>
<a id="pl.194.24"></a><var>194.24</var>(2) foster care licenses replacing foster care licenses in existence on the effective <br/>
<a id="pl.194.25"></a><var>194.25</var>date of this section and determined to be needed by the commissioner under paragraph (b);<br/>
<a id="pl.194.26"></a><var>194.26</var>(3) new foster care licenses determined to be needed by the commissioner under <br/>
<a id="pl.194.27"></a><var>194.27</var>paragraph (b) for the closure of a nursing facility, ICF/MR, or regional treatment center;<br/>
<a id="pl.194.28"></a><var>194.28</var>(4) new foster care licenses determined to be needed by the commissioner under <br/>
<a id="pl.194.29"></a><var>194.29</var>paragraph (b) for persons requiring hospital level care; or<br/>
<a id="pl.194.30"></a><var>194.30</var>(5) new foster care licenses determined to be needed by the commissioner for the <br/>
<a id="pl.194.31"></a><var>194.31</var>transition of people from personal care assistance to the home and community-based <br/>
<a id="pl.194.32"></a><var>194.32</var>services.<br/>
<a id="pl.194.33"></a><var>194.33</var>(b) The commissioner shall determine the need for newly licensed foster care homes <br/>
<a id="pl.194.34"></a><var>194.34</var>as defined under this subdivision. As part of the determination, the commissioner shall <br/>
<a id="pl.194.35"></a><var>194.35</var>consider the availability of foster care capacity in the area which the licensee seeks to <br/>
<a id="pl.195.1"></a><var>195.1</var>operate, and the recommendation of the local county board. The determination by the <br/>
<a id="pl.195.2"></a><var>195.2</var>commissioner must be final. A determination of need is not required for a change in <br/>
<a id="pl.195.3"></a><var>195.3</var>ownership at the same address.<br/>
<a id="pl.195.4"></a><var>195.4</var>    (c) Residential settings that would otherwise be subject to the moratorium established <br/>
<a id="pl.195.5"></a><var>195.5</var>in paragraph (a), that are in the process of receiving an adult or child foster care license as <br/>
<a id="pl.195.6"></a><var>195.6</var>of July 1, 2009, shall be allowed to continue to complete the process of receiving an adult <br/>
<a id="pl.195.7"></a><var>195.7</var>or child foster care license. For this paragraph, all of the following conditions must be met <br/>
<a id="pl.195.8"></a><var>195.8</var>to be considered in process of receiving an adult or child foster care license:<br/>
<a id="pl.195.9"></a><var>195.9</var>    (1) participants have made decisions to move into the residential setting, including <br/>
<a id="pl.195.10"></a><var>195.10</var>documentation in each participant's care plan;<br/>
<a id="pl.195.11"></a><var>195.11</var>    (2) the provider has purchased housing or has made a financial investment in the <br/>
<a id="pl.195.12"></a><var>195.12</var>property;<br/>
<a id="pl.195.13"></a><var>195.13</var>    (3) the lead agency has approved the plans, including costs for the residential setting <br/>
<a id="pl.195.14"></a><var>195.14</var>for each individual;<br/>
<a id="pl.195.15"></a><var>195.15</var>    (4) the completion of the licensing process, including all necessary inspections, is <br/>
<a id="pl.195.16"></a><var>195.16</var>the only remaining component prior to being able to provide services; and<br/>
<a id="pl.195.17"></a><var>195.17</var>    (5) the needs of the individuals cannot be met within the existing capacity in that <br/>
<a id="pl.195.18"></a><var>195.18</var>county.<br/>
<a id="pl.195.19"></a><var>195.19</var>To qualify for the process under this paragraph, the lead agency must submit <br/>
<a id="pl.195.20"></a><var>195.20</var>documentation to the commissioner by August 1, 2009, that all of the above criteria are <br/>
<a id="pl.195.21"></a><var>195.21</var>met.<br/>
<a id="pl.195.22"></a><var>195.22</var>(d) The commissioner shall study the effects of the license moratorium under this <br/>
<a id="pl.195.23"></a><var>195.23</var>subdivision and shall report back to the legislature by January 15, 2011.<br/>
<a id="pl.195.24"></a><var>195.24</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br/>
<br/>
<a id="bill.8.9.0"></a><a id="pl.195.25"></a><var>195.25</var>    Sec. 9. Minnesota Statutes 2008, section 245A.11, is amended by adding a subdivision <br/>
<a id="pl.195.26"></a><var>195.26</var>to read:<br/>
<a id="pl.195.27"></a><var>195.27</var>    Subd. 8. <b>Community residential setting license.</b> (a) The commissioner shall <br/>
<a id="pl.195.28"></a><var>195.28</var>establish provider standards for residential support services that integrate service standards <br/>
<a id="pl.195.29"></a><var>195.29</var>and the residential setting under one license. The commissioner shall propose statutory <br/>
<a id="pl.195.30"></a><var>195.30</var>language and an implementation plan for licensing requirements for residential support <br/>
<a id="pl.195.31"></a><var>195.31</var>services to the legislature by January 15, 2011.<br/>
<a id="pl.195.32"></a><var>195.32</var>(b) Providers licensed under chapter 245B, and providing, contracting, or arranging <br/>
<a id="pl.195.33"></a><var>195.33</var>for services in settings licensed as adult foster care under Minnesota Rules, parts <br/>
<a id="pl.195.34"></a><var>195.34</var>9555.5105 to 9555.6265, or child foster care under Minnesota Rules, parts 2960.3000 to <br/>
<a id="pl.196.1"></a><var>196.1</var>2960.3340; and meeting the provisions of section 256B.092, subdivision 11, paragraph <br/>
<a id="pl.196.2"></a><var>196.2</var>(b), must be required to obtain a community residential setting license.<br/>
<br/>
<a id="bill.8.10.0"></a><a id="pl.196.3"></a><var>196.3</var>    Sec. 10. Minnesota Statutes 2008, section 252.46, is amended by adding a subdivision <br/>
<a id="pl.196.4"></a><var>196.4</var>to read:<br/>
<a id="pl.196.5"></a><var>196.5</var>    Subd. 1a. <b>Day training and habilitation rates.</b> The commissioner shall establish <br/>
<a id="pl.196.6"></a><var>196.6</var>a statewide rate-setting methodology for all day training and habilitation services. The <br/>
<a id="pl.196.7"></a><var>196.7</var>rate-setting methodology must abide by the principles of transparency and equitability <br/>
<a id="pl.196.8"></a><var>196.8</var>across the state. The methodology must involve a uniform process of structuring rates for <br/>
<a id="pl.196.9"></a><var>196.9</var>each service and must promote quality and participant choice.<br/>
<br/>
<a id="bill.8.11.0"></a><a id="pl.196.10"></a><var>196.10</var>    Sec. 11. Minnesota Statutes 2008, section 252.50, subdivision 1, is amended to read:<br/>
<a id="pl.196.11"></a><var>196.11</var>    Subdivision 1.  <b>Community-based programs established.</b> The commissioner <br/>
<a id="pl.196.12"></a><var>196.12</var>shall establish a system of state-operated, community-based programs for persons with <br/>
<a id="pl.196.13"></a><var>196.13</var>developmental disabilities. For purposes of this section, "state-operated, community-based <br/>
<a id="pl.196.14"></a><var>196.14</var>program" means a program administered by the state to provide treatment and habilitation <br/>
<a id="pl.196.15"></a><var>196.15</var>in noninstitutional community settings to persons with developmental disabilities. <br/>
<a id="pl.196.16"></a><var>196.16</var>Employees of the programs, except clients who work within and benefit from these <br/>
<a id="pl.196.17"></a><var>196.17</var>treatment and habilitation programs, must be state employees under chapters 43A and <br/>
<a id="pl.196.18"></a><var>196.18</var>179A. Although any clients who work within and benefit from these treatment and <br/>
<a id="pl.196.19"></a><var>196.19</var>habilitation programs are not employees under chapters 43A and 179A, the Department <br/>
<a id="pl.196.20"></a><var>196.20</var>of Human Services may consider clients who work within and benefit from these <br/>
<a id="pl.196.21"></a><var>196.21</var>programs employees for federal tax purposes. The establishment of state-operated, <br/>
<a id="pl.196.22"></a><var>196.22</var>community-based programs must be within the context of a comprehensive definition of <br/>
<a id="pl.196.23"></a><var>196.23</var>the role of state-operated services in the state. The role of state-operated services must <br/>
<a id="pl.196.24"></a><var>196.24</var>be defined within the context of a comprehensive system of services for persons with <br/>
<a id="pl.196.25"></a><var>196.25</var>developmental disabilities. State-operated, community-based programs may include, but <br/>
<a id="pl.196.26"></a><var>196.26</var>are not limited to, community group homes, foster care, supportive living services, day <br/>
<a id="pl.196.27"></a><var>196.27</var>training and habilitation programs, and respite care arrangements. The commissioner <br/>
<a id="pl.196.28"></a><var>196.28</var>may operate the pilot projects established under Laws 1985, First Special Session <br/>
<a id="pl.196.29"></a><var>196.29</var>chapter 9, article 1, section 2, subdivision 6, and shall, within the limits of available <br/>
<a id="pl.196.30"></a><var>196.30</var>appropriations, establish additional state-operated, community-based programs for <br/>
<a id="pl.196.31"></a><var>196.31</var>persons with developmental disabilities. State-operated, community-based programs may <br/>
<a id="pl.196.32"></a><var>196.32</var>accept admissions from regional treatment centers, from the person's own home, or from <br/>
<a id="pl.196.33"></a><var>196.33</var>community programs. State-operated, community-based programs offering day program <br/>
<a id="pl.196.34"></a><var>196.34</var>services may be provided for persons with developmental disabilities who are living in <br/>
<a id="pl.197.1"></a><var>197.1</var>state-operated, community-based residential programs until July 1, 2000. No later than <br/>
<a id="pl.197.2"></a><var>197.2</var>1994, the commissioner, together with family members, counties, advocates, employee <br/>
<a id="pl.197.3"></a><var>197.3</var>representatives, and other interested parties, shall begin planning so that by July 1, 2000, <br/>
<a id="pl.197.4"></a><var>197.4</var>state-operated, community-based residential facilities will be in compliance with section <br/>
<statute_ref><a id="pl.197.5"></a><var>197.5</var>252.41, subdivision 9
         </statute_ref>. <br/>
<br/>
<a id="bill.8.12.0"></a><a id="pl.197.6"></a><var>197.6</var>    Sec. 12. Minnesota Statutes 2008, section 256.01, is amended by adding a subdivision <br/>
<a id="pl.197.7"></a><var>197.7</var>to read:<br/>
<a id="pl.197.8"></a><var>197.8</var>    Subd. 29. <b>State medical review team.</b> (a) To ensure the timely processing of <br/>
<a id="pl.197.9"></a><var>197.9</var>determinations of disability by the commissioner's state medical review team under <br/>
<a id="pl.197.10"></a><var>197.10</var>sections 256B.055, subdivision 7, paragraph (b), 256B.057, subdivision 9, paragraph <br/>
<a id="pl.197.11"></a><var>197.11</var>(j), and 256B.055, subdivision 12, the commissioner shall review all medical evidence <br/>
<a id="pl.197.12"></a><var>197.12</var>submitted by county agencies with a referral and seek additional information from <br/>
<a id="pl.197.13"></a><var>197.13</var>providers, applicants, and enrollees to support the determination of disability where <br/>
<a id="pl.197.14"></a><var>197.14</var>necessary. Disability shall be determined according to the rules of title XVI and title <br/>
<a id="pl.197.15"></a><var>197.15</var>XIX of the Social Security Act and pertinent rules and policies of the Social Security <br/>
<a id="pl.197.16"></a><var>197.16</var>Administration.<br/>
<a id="pl.197.17"></a><var>197.17</var>    (b) Prior to a denial or withdrawal of a requested determination of disability due <br/>
<a id="pl.197.18"></a><var>197.18</var>to insufficient evidence, the commissioner shall (1) ensure that the missing evidence is <br/>
<a id="pl.197.19"></a><var>197.19</var>necessary and appropriate to a determination of disability, and (2) assist applicants and <br/>
<a id="pl.197.20"></a><var>197.20</var>enrollees to obtain the evidence, including, but not limited to, medical examinations <br/>
<a id="pl.197.21"></a><var>197.21</var>and electronic medical records.<br/>
<a id="pl.197.22"></a><var>197.22</var>(c) The commissioner shall provide the chairs of the legislative committees with <br/>
<a id="pl.197.23"></a><var>197.23</var>jurisdiction over health and human services finance and budget the following information <br/>
<a id="pl.197.24"></a><var>197.24</var>on the activities of the state medical review team by February 1, 2010, and annually <br/>
<a id="pl.197.25"></a><var>197.25</var>thereafter:<br/>
<a id="pl.197.26"></a><var>197.26</var>(1) the number of applications to the state medical review team that were denied, <br/>
<a id="pl.197.27"></a><var>197.27</var>approved, or withdrawn;<br/>
<a id="pl.197.28"></a><var>197.28</var>(2) the average length of time from receipt of the application to a decision;<br/>
<a id="pl.197.29"></a><var>197.29</var>(3) the number of appeals and appeal results;<br/>
<a id="pl.197.30"></a><var>197.30</var>(4) for applicants, their age, health coverage at the time of application, hospitalization <br/>
<a id="pl.197.31"></a><var>197.31</var>history within three months of application, and whether an application for Social Security <br/>
<a id="pl.197.32"></a><var>197.32</var>or Supplemental Security Income benefits is pending; and <br/>
<a id="pl.197.33"></a><var>197.33</var>(5) specific information on the medical certification, licensure, or other credentials <br/>
<a id="pl.197.34"></a><var>197.34</var>of the person or persons performing the medical review determinations and length of <br/>
<a id="pl.197.35"></a><var>197.35</var>time in that position.<br/>
<br/>
<a id="bill.8.13.0"></a><a id="pl.198.1"></a><var>198.1</var>    Sec. 13. <b>[256.0281] INTERAGENCY DATA EXCHANGE.</b><br/>
<a id="pl.198.2"></a><var>198.2</var>The Department of Human Services, the Department of Health, and the Office of the <br/>
<a id="pl.198.3"></a><var>198.3</var>Ombudsman for Mental Health and Developmental Disabilities may establish interagency <br/>
<a id="pl.198.4"></a><var>198.4</var>agreements governing the electronic exchange of data on providers and individuals <br/>
<a id="pl.198.5"></a><var>198.5</var>collected, maintained, or used by each agency when such exchange is outlined by each <br/>
<a id="pl.198.6"></a><var>198.6</var>agency in an interagency agreement to accomplish the purposes in clauses (1) to (4):<br/>
<a id="pl.198.7"></a><var>198.7</var>(1) to improve provider enrollment processes for home and community-based <br/>
<a id="pl.198.8"></a><var>198.8</var>services and state plan home care services;<br/>
<a id="pl.198.9"></a><var>198.9</var>(2) to improve quality management of providers between state agencies;<br/>
<a id="pl.198.10"></a><var>198.10</var>(3) to establish and maintain provider eligibility to participate as providers under <br/>
<a id="pl.198.11"></a><var>198.11</var>Minnesota health care programs; or<br/>
<a id="pl.198.12"></a><var>198.12</var>(4) to meet the quality assurance reporting requirements under federal law under <br/>
<a id="pl.198.13"></a><var>198.13</var>section 1915(c) of the Social Security Act related to home and community-based waiver <br/>
<a id="pl.198.14"></a><var>198.14</var>programs.<br/>
<a id="pl.198.15"></a><var>198.15</var>Each interagency agreement must include provisions to ensure anonymity of individuals, <br/>
<a id="pl.198.16"></a><var>198.16</var>including mandated reporters, and must outline the specific uses of and access to shared <br/>
<a id="pl.198.17"></a><var>198.17</var>data within each agency. Electronic interfaces between source data systems developed <br/>
<a id="pl.198.18"></a><var>198.18</var>under these interagency agreements must incorporate these provisions as well as other <br/>
<a id="pl.198.19"></a><var>198.19</var>HIPPA provisions related to individual data.<br/>
<br/>
<a id="bill.8.14.0"></a><a id="pl.198.20"></a><var>198.20</var>    Sec. 14. Minnesota Statutes 2008, section 256.476, subdivision 5, is amended to read:<br/>
<a id="pl.198.21"></a><var>198.21</var>    Subd. 5.  <b>Reimbursement, allocations, and reporting.</b> (a) For the purpose of <br/>
<a id="pl.198.22"></a><var>198.22</var>transferring persons to the consumer support grant program from the family support <br/>
<a id="pl.198.23"></a><var>198.23</var>program and personal care assistant services, home health aide services, or private duty <br/>
<a id="pl.198.24"></a><var>198.24</var>nursing services, the amount of funds transferred by the commissioner between the <br/>
<a id="pl.198.25"></a><var>198.25</var>family support program account, the medical assistance account, or the consumer support <br/>
<a id="pl.198.26"></a><var>198.26</var>grant account shall be based on each county's participation in transferring persons to the <br/>
<a id="pl.198.27"></a><var>198.27</var>consumer support grant program from those programs and services. <br/>
<a id="pl.198.28"></a><var>198.28</var>    (b) At the beginning of each fiscal year, county allocations for consumer support <br/>
<a id="pl.198.29"></a><var>198.29</var>grants shall be based on: <br/>
<a id="pl.198.30"></a><var>198.30</var>    (1) the number of persons to whom the county board expects to provide consumer <br/>
<a id="pl.198.31"></a><var>198.31</var>supports grants; <br/>
<a id="pl.198.32"></a><var>198.32</var>    (2) their eligibility for current program and services; <br/>
<a id="pl.198.33"></a><var>198.33</var>    (3) the amount of nonfederal dollars monthly grant levels allowed under subdivision <br/>
<a id="pl.198.34"></a><var>198.34</var>11; and <br/>
<a id="pl.199.1"></a><var>199.1</var>    (4) projected dates when persons will start receiving grants. County allocations shall <br/>
<a id="pl.199.2"></a><var>199.2</var>be adjusted periodically by the commissioner based on the actual transfer of persons or <br/>
<a id="pl.199.3"></a><var>199.3</var>service openings, and the nonfederal dollars monthly grant levels associated with those <br/>
<a id="pl.199.4"></a><var>199.4</var>persons or service openings, to the consumer support grant program. <br/>
<a id="pl.199.5"></a><var>199.5</var>    (c) The amount of funds transferred by the commissioner from the medical <br/>
<a id="pl.199.6"></a><var>199.6</var>assistance account for an individual may be changed if it is determined by the county or its <br/>
<a id="pl.199.7"></a><var>199.7</var>agent that the individual's need for support has changed. <br/>
<a id="pl.199.8"></a><var>199.8</var>    (d) The authority to utilize funds transferred to the consumer support grant account <br/>
<a id="pl.199.9"></a><var>199.9</var>for the purposes of implementing and administering the consumer support grant program <br/>
<a id="pl.199.10"></a><var>199.10</var>will not be limited or constrained by the spending authority provided to the program <br/>
<a id="pl.199.11"></a><var>199.11</var>of origination. <br/>
<a id="pl.199.12"></a><var>199.12</var>    (e) The commissioner may use up to five percent of each county's allocation, as <br/>
<a id="pl.199.13"></a><var>199.13</var>adjusted, for payments for administrative expenses, to be paid as a proportionate addition <br/>
<a id="pl.199.14"></a><var>199.14</var>to reported direct service expenditures. <br/>
<a id="pl.199.15"></a><var>199.15</var>    (f) The county allocation for each person or the person's legal representative or other <br/>
<a id="pl.199.16"></a><var>199.16</var>authorized representative cannot exceed the amount allowed under subdivision 11. <br/>
<a id="pl.199.17"></a><var>199.17</var>    (g) The commissioner may recover, suspend, or withhold payments if the county <br/>
<a id="pl.199.18"></a><var>199.18</var>board, local agency, or grantee does not comply with the requirements of this section. <br/>
<a id="pl.199.19"></a><var>199.19</var>    (h) Grant funds unexpended by consumers shall return to the state once a year. The <br/>
<a id="pl.199.20"></a><var>199.20</var>annual return of unexpended grant funds shall occur in the quarter following the end of <br/>
<a id="pl.199.21"></a><var>199.21</var>the state fiscal year. <br/>
<br/>
<a id="bill.8.15.0"></a><a id="pl.199.22"></a><var>199.22</var>    Sec. 15. Minnesota Statutes 2008, section 256.476, subdivision 11, is amended to read:<br/>
<a id="pl.199.23"></a><var>199.23</var>    Subd. 11. <b>Consumer support grant program after July 1, 2001.</b> (a) Effective <br/>
<a id="pl.199.24"></a><var>199.24</var>July 1, 2001, the commissioner shall allocate consumer support grant resources to <br/>
<a id="pl.199.25"></a><var>199.25</var>serve additional individuals based on a review of Medicaid authorization and payment <br/>
<a id="pl.199.26"></a><var>199.26</var>information of persons eligible for a consumer support grant from the most recent fiscal <br/>
<a id="pl.199.27"></a><var>199.27</var>year. The commissioner shall use the following methodology to calculate maximum <br/>
<a id="pl.199.28"></a><var>199.28</var>allowable monthly consumer support grant levels:<br/>
<a id="pl.199.29"></a><var>199.29</var>    (1) For individuals whose program of origination is medical assistance home care <br/>
<a id="pl.199.30"></a><var>199.30</var>under sections 
         <statute_ref>256B.0651</statute_ref> and 
         <statute_ref>256B.0653</statute_ref> to 
         <statute_ref>256B.0656</statute_ref>, the maximum allowable monthly <br/>
<a id="pl.199.31"></a><var>199.31</var>grant levels are calculated by:<br/>
<a id="pl.199.32"></a><var>199.32</var>    (i) determining the nonfederal share 50 percent of the average service authorization <br/>
<a id="pl.199.33"></a><var>199.33</var>for each home care rating;<br/>
<a id="pl.199.34"></a><var>199.34</var>    (ii) calculating the overall ratio of actual payments to service authorizations by <br/>
<a id="pl.199.35"></a><var>199.35</var>program;<br/>
<a id="pl.200.1"></a><var>200.1</var>    (iii) applying the overall ratio to the average service authorization level of each <br/>
<a id="pl.200.2"></a><var>200.2</var>home care rating;<br/>
<a id="pl.200.3"></a><var>200.3</var>    (iv) adjusting the result for any authorized rate increases provided by the legislature; <br/>
<a id="pl.200.4"></a><var>200.4</var>and<br/>
<a id="pl.200.5"></a><var>200.5</var>    (v) adjusting the result for the average monthly utilization per recipient.<br/>
<a id="pl.200.6"></a><var>200.6</var>    (2) The commissioner may review and evaluate the methodology to reflect changes <br/>
<a id="pl.200.7"></a><var>200.7</var>in the home care program's overall ratio of actual payments to service authorizations <br/>
<a id="pl.200.8"></a><var>200.8</var>programs.<br/>
<a id="pl.200.9"></a><var>200.9</var>    (b) Effective January 1, 2004, persons previously receiving exception grants will <br/>
<a id="pl.200.10"></a><var>200.10</var>have their grants calculated using the methodology in paragraph (a), clause (1). If a person <br/>
<a id="pl.200.11"></a><var>200.11</var>currently receiving an exception grant wishes to have their home care rating reevaluated, <br/>
<a id="pl.200.12"></a><var>200.12</var>they may request an assessment as defined in section 
<statute_ref>256B.0651, subdivision 1</statute_ref>, paragraph <br/>
<a id="pl.200.13"></a><var>200.13</var>(b).<br/>
<br/>
<a id="bill.8.16.0"></a><a id="pl.200.14"></a><var>200.14</var>    Sec. 16. Minnesota Statutes 2008, section 256.975, subdivision 7, is amended to read:<br/>
<a id="pl.200.15"></a><var>200.15</var>    Subd. 7. <b>Consumer information and assistance</b><b> and long-term care options </b><br/>
<a id="pl.200.16"></a><var>200.16</var><b>counseling</b><b>; </b><b>senior linkage</b><b> Senior LinkAge Line</b><b>.</b> (a) The Minnesota Board on Aging <br/>
<a id="pl.200.17"></a><var>200.17</var>shall operate a statewide information and assistance service to aid older Minnesotans and <br/>
<a id="pl.200.18"></a><var>200.18</var>their families in making informed choices about long-term care options and health care <br/>
<a id="pl.200.19"></a><var>200.19</var>benefits. Language services to persons with limited English language skills may be made <br/>
<a id="pl.200.20"></a><var>200.20</var>available. The service, known as Senior LinkAge Line, must be available during business <br/>
<a id="pl.200.21"></a><var>200.21</var>hours through a statewide toll-free number and must also be available through the Internet.<br/>
<a id="pl.200.22"></a><var>200.22</var>    (b) The service must assist provide long-term care options counseling by assisting <br/>
<a id="pl.200.23"></a><var>200.23</var>older adults, caregivers, and providers in accessing information  and options counseling <br/>
<a id="pl.200.24"></a><var>200.24</var>about choices in long-term care services that are purchased through private providers or <br/>
<a id="pl.200.25"></a><var>200.25</var>available through public options. The service must:<br/>
<a id="pl.200.26"></a><var>200.26</var>    (1) develop a comprehensive database that includes detailed listings in both <br/>
<a id="pl.200.27"></a><var>200.27</var>consumer- and provider-oriented formats;<br/>
<a id="pl.200.28"></a><var>200.28</var>    (2) make the database accessible on the Internet and through other telecommunication <br/>
<a id="pl.200.29"></a><var>200.29</var>and media-related tools;<br/>
<a id="pl.200.30"></a><var>200.30</var>    (3) link callers to interactive long-term care screening tools and make these tools <br/>
<a id="pl.200.31"></a><var>200.31</var>available through the Internet by integrating the tools with the database;<br/>
<a id="pl.200.32"></a><var>200.32</var>    (4) develop community education materials with a focus on planning for long-term <br/>
<a id="pl.200.33"></a><var>200.33</var>care and evaluating independent living, housing, and service options;<br/>
<a id="pl.200.34"></a><var>200.34</var>    (5) conduct an outreach campaign to assist older adults and their caregivers in <br/>
<a id="pl.200.35"></a><var>200.35</var>finding information on the Internet and through other means of communication;<br/>
<a id="pl.201.1"></a><var>201.1</var>    (6) implement a messaging system for overflow callers and respond to these callers <br/>
<a id="pl.201.2"></a><var>201.2</var>by the next business day;<br/>
<a id="pl.201.3"></a><var>201.3</var>    (7) link callers with county human services and other providers to receive more <br/>
<a id="pl.201.4"></a><var>201.4</var>in-depth assistance and consultation related to long-term care options;<br/>
<a id="pl.201.5"></a><var>201.5</var>    (8) link callers with quality profiles for nursing facilities and other providers <br/>
<a id="pl.201.6"></a><var>201.6</var>developed by the commissioner of health; and<br/>
<a id="pl.201.7"></a><var>201.7</var>    (9) incorporate information about housing with services and consumer rights <br/>
<a id="pl.201.8"></a><var>201.8</var>within the MinnesotaHelp.info network long-term care database to facilitate consumer <br/>
<a id="pl.201.9"></a><var>201.9</var>comparison of services and costs among housing with services establishments and with <br/>
<a id="pl.201.10"></a><var>201.10</var>other in-home services and to support financial self-sufficiency as long as possible. <br/>
<a id="pl.201.11"></a><var>201.11</var>Housing with services establishments and their arranged home care providers shall provide <br/>
<a id="pl.201.12"></a><var>201.12</var>information to the commissioner of human services that is consistent with information <br/>
<a id="pl.201.13"></a><var>201.13</var>required by the commissioner of health under section 
         <statute_ref>144G.06</statute_ref>, the Uniform Consumer <br/>
<a id="pl.201.14"></a><var>201.14</var>Information Guide. The commissioner of human services shall provide the data to the <br/>
<a id="pl.201.15"></a><var>201.15</var>Minnesota Board on Aging for inclusion in the MinnesotaHelp.info network long-term <br/>
<a id="pl.201.16"></a><var>201.16</var>care database.;<br/>
<a id="pl.201.17"></a><var>201.17</var>(10) provide long-term care options counseling. Long-term care options counselors <br/>
<a id="pl.201.18"></a><var>201.18</var>shall:<br/>
<a id="pl.201.19"></a><var>201.19</var>(i) for individuals not eligible for case management under a public program or public <br/>
<a id="pl.201.20"></a><var>201.20</var>funding source, provide interactive decision support under which consumers, family <br/>
<a id="pl.201.21"></a><var>201.21</var>members, or other helpers are supported in their deliberations to determine appropriate <br/>
<a id="pl.201.22"></a><var>201.22</var>long-term care choices in the context of the consumer's needs, preferences, values, and <br/>
<a id="pl.201.23"></a><var>201.23</var>individual circumstances, including implementing a community support plan;<br/>
<a id="pl.201.24"></a><var>201.24</var>(ii) provide Web-based educational information and collateral written materials to <br/>
<a id="pl.201.25"></a><var>201.25</var>familiarize consumers, family members, or other helpers with the long-term care basics, <br/>
<a id="pl.201.26"></a><var>201.26</var>issues to be considered, and the range of options available in the community;<br/>
<a id="pl.201.27"></a><var>201.27</var>(iii) provide long-term care futures planning, which means providing assistance to <br/>
<a id="pl.201.28"></a><var>201.28</var>individuals who anticipate having long-term care needs to develop a plan for the more <br/>
<a id="pl.201.29"></a><var>201.29</var>distant future; and<br/>
<a id="pl.201.30"></a><var>201.30</var>(iv) provide expertise in benefits and financing options for long-term care, including <br/>
<a id="pl.201.31"></a><var>201.31</var>Medicare, long-term care insurance, tax or employer-based incentives, reverse mortgages, <br/>
<a id="pl.201.32"></a><var>201.32</var>private pay options, and ways to access low or no-cost services or benefits through <br/>
<a id="pl.201.33"></a><var>201.33</var>volunteer-based or charitable programs; and<br/>
<a id="pl.201.34"></a><var>201.34</var>(11) using risk management and support planning protocols, provide long-term care <br/>
<a id="pl.201.35"></a><var>201.35</var>options counseling to current residents of nursing homes deemed appropriate for discharge <br/>
<a id="pl.201.36"></a><var>201.36</var>by the commissioner. In order to meet this requirement, the commissioner shall provide <br/>
<a id="pl.202.1"></a><var>202.1</var>designated Senior LinkAge Line contact centers with a list of nursing home residents <br/>
<a id="pl.202.2"></a><var>202.2</var>appropriate for discharge planning via a secure Web portal. Senior LinkAge Line shall <br/>
<a id="pl.202.3"></a><var>202.3</var>provide these residents, if they indicate a preference to receive long-term care options <br/>
<a id="pl.202.4"></a><var>202.4</var>counseling, with initial assessment, review of risk factors, independent living support <br/>
<a id="pl.202.5"></a><var>202.5</var>consultation, or referral to:<br/>
<a id="pl.202.6"></a><var>202.6</var>(i) services under section 256B.0911, subdivision 3;<br/>
<a id="pl.202.7"></a><var>202.7</var>(ii) designated care coordinators of contracted entities under section 256B.035 for <br/>
<a id="pl.202.8"></a><var>202.8</var>persons who are enrolled in a managed care plan; or<br/>
<a id="pl.202.9"></a><var>202.9</var>(iii) the long-term care consultation team for those who are appropriate for relocation <br/>
<a id="pl.202.10"></a><var>202.10</var>service coordination due to high-risk factors or psychological or physical disability.<br/>
<a id="pl.202.11"></a><var>202.11</var>    (c) The Minnesota Board on Aging shall conduct an evaluation of the effectiveness <br/>
<a id="pl.202.12"></a><var>202.12</var>of the statewide information and assistance, and submit this evaluation to the legislature <br/>
<a id="pl.202.13"></a><var>202.13</var>by December 1, 2002. The evaluation must include an analysis of funding adequacy, gaps <br/>
<a id="pl.202.14"></a><var>202.14</var>in service delivery, continuity in information between the service and identified linkages, <br/>
<a id="pl.202.15"></a><var>202.15</var>and potential use of private funding to enhance the service.<br/>
<br/>
<a id="bill.8.17.0"></a><a id="pl.202.16"></a><var>202.16</var>    Sec. 17. Minnesota Statutes 2008, section 256B.055, subdivision 7, is amended to read:<br/>
<a id="pl.202.17"></a><var>202.17</var>    Subd. 7. <b>Aged, blind, or disabled persons.</b> (a) Medical assistance may be paid for <br/>
<a id="pl.202.18"></a><var>202.18</var>a person who meets the categorical eligibility requirements of the supplemental security <br/>
<a id="pl.202.19"></a><var>202.19</var>income program or, who would meet those requirements except for excess income or <br/>
<a id="pl.202.20"></a><var>202.20</var>assets, and who meets the other eligibility requirements of this section.<br/>
<a id="pl.202.21"></a><var>202.21</var>(b) Following a determination that the applicant is not aged or blind and does not <br/>
<a id="pl.202.22"></a><var>202.22</var>meet any other category of eligibility for medical assistance and has not been determined <br/>
<a id="pl.202.23"></a><var>202.23</var>disabled by the Social Security Administration, applicants under this subdivision shall be <br/>
<a id="pl.202.24"></a><var>202.24</var>referred to the commissioner's state medical review team for a determination of disability. <br/>
<br/>
<a id="bill.8.18.0"></a><a id="pl.202.25"></a><var>202.25</var>    Sec. 18. Minnesota Statutes 2008, section 256B.0625, subdivision 6a, is amended to <br/>
<a id="pl.202.26"></a><var>202.26</var>read:<br/>
<a id="pl.202.27"></a><var>202.27</var>    Subd. 6a. <b>Home health services.</b> Home health services are those services specified <br/>
<a id="pl.202.28"></a><var>202.28</var>in Minnesota Rules, part 9505.0295 and sections 256B.0651 and 256B.0653. Medical <br/>
<a id="pl.202.29"></a><var>202.29</var>assistance covers home health services at a recipient's home residence. Medical assistance <br/>
<a id="pl.202.30"></a><var>202.30</var>does not cover home health services for residents of a hospital, nursing facility, or <br/>
<a id="pl.202.31"></a><var>202.31</var>intermediate care facility, unless the commissioner of human services has prior authorized <br/>
<a id="pl.202.32"></a><var>202.32</var>skilled nurse visits for less than 90 days for a resident at an intermediate care facility for <br/>
<a id="pl.202.33"></a><var>202.33</var>persons with developmental disabilities, to prevent an admission to a hospital or nursing <br/>
<a id="pl.202.34"></a><var>202.34</var>facility or unless a resident who is otherwise eligible is on leave from the facility and the <br/>
<a id="pl.203.1"></a><var>203.1</var>facility either pays for the home health services or forgoes the facility per diem for the <br/>
<a id="pl.203.2"></a><var>203.2</var>leave days that home health services are used. Home health services must be provided by <br/>
<a id="pl.203.3"></a><var>203.3</var>a Medicare certified home health agency. All nursing and home health aide services must <br/>
<a id="pl.203.4"></a><var>203.4</var>be provided according to sections 
         <statute_ref>256B.0651</statute_ref> to 
         <statute_ref>256B.0656</statute_ref> 
<statute_ref>256B.0653</statute_ref>.<br/>
<br/>
<a id="bill.8.19.0"></a><a id="pl.203.5"></a><var>203.5</var>    Sec. 19. Minnesota Statutes 2008, section 256B.0625, subdivision 7, is amended to <br/>
<a id="pl.203.6"></a><var>203.6</var>read:<br/>
<a id="pl.203.7"></a><var>203.7</var>    Subd. 7. <b>Private duty nursing.</b> Medical assistance covers private duty nursing <br/>
<a id="pl.203.8"></a><var>203.8</var>services in a recipient's home. Recipients who are authorized to receive private duty <br/>
<a id="pl.203.9"></a><var>203.9</var>nursing services in their home may use approved hours outside of the home during hours <br/>
<a id="pl.203.10"></a><var>203.10</var>when normal life activities take them outside of their home. To use private duty nursing <br/>
<a id="pl.203.11"></a><var>203.11</var>services at school, the recipient or responsible party must provide written authorization in <br/>
<a id="pl.203.12"></a><var>203.12</var>the care plan identifying the chosen provider and the daily amount of services to be used at <br/>
<a id="pl.203.13"></a><var>203.13</var>school. Medical assistance does not cover private duty nursing services for residents of a <br/>
<a id="pl.203.14"></a><var>203.14</var>hospital, nursing facility, intermediate care facility, or a health care facility licensed by the <br/>
<a id="pl.203.15"></a><var>203.15</var>commissioner of health, except as authorized in section 
         <statute_ref>256B.64</statute_ref> for ventilator-dependent <br/>
<a id="pl.203.16"></a><var>203.16</var>recipients in hospitals or unless a resident who is otherwise eligible is on leave from the <br/>
<a id="pl.203.17"></a><var>203.17</var>facility and the facility either pays for the private duty nursing services or forgoes the <br/>
<a id="pl.203.18"></a><var>203.18</var>facility per diem for the leave days that private duty nursing services are used. Total hours <br/>
<a id="pl.203.19"></a><var>203.19</var>of service and payment allowed for services outside the home cannot exceed that which is <br/>
<a id="pl.203.20"></a><var>203.20</var>otherwise allowed in an in-home setting according to sections 
         <statute_ref>256B.0651</statute_ref> and 
         <statute_ref>256B.0653</statute_ref> <br/>
<statute_ref><a id="pl.203.21"></a><var>203.21</var>256B.0654 
</statute_ref>to 
         <statute_ref>256B.0656</statute_ref>. All private duty nursing services must be provided according to <br/>
<a id="pl.203.22"></a><var>203.22</var>the limits established under sections 
         <statute_ref>256B.0651</statute_ref> and 
         <statute_ref>256B.0653</statute_ref> to 
         <statute_ref>256B.0656</statute_ref>. Private <br/>
<a id="pl.203.23"></a><var>203.23</var>duty nursing services may not be reimbursed if the nurse is the  family foster care provider <br/>
<a id="pl.203.24"></a><var>203.24</var>of a recipient who is under age 18, unless allowed under section 256B.0654, subdivision 4.<br/>
<br/>
<a id="bill.8.20.0"></a><a id="pl.203.25"></a><var>203.25</var>    Sec. 20. Minnesota Statutes 2008, section 256B.0625, subdivision 19a, is amended to <br/>
<a id="pl.203.26"></a><var>203.26</var>read:<br/>
<a id="pl.203.27"></a><var>203.27</var>    Subd. 19a. <b>Personal care </b><b>assistant</b><b> assistance </b><b> services.</b> Medical assistance covers <br/>
<a id="pl.203.28"></a><var>203.28</var>personal care assistant assistance  services in a recipient's home. Effective January 1, <br/>
<a id="pl.203.29"></a><var>203.29</var>2010, to qualify for personal care assistant assistance  services, a recipient must require <br/>
<a id="pl.203.30"></a><var>203.30</var>assistance and be determined dependent in one activity of daily living as defined in section <br/>
<a id="pl.203.31"></a><var>203.31</var>256B.0659, subdivision 1, paragraph (b), or in a Level I behavior as defined in section <br/>
<a id="pl.203.32"></a><var>203.32</var>256B.0659, subdivision 1, paragraph (c). Beginning July 1, 2011, to qualify for personal <br/>
<a id="pl.203.33"></a><var>203.33</var>care assistance services, a recipient must require assistance and be determined dependent <br/>
<a id="pl.203.34"></a><var>203.34</var>in at least two activities of daily living as defined in section 256B.0659. Recipients or <br/>
<a id="pl.204.1"></a><var>204.1</var>responsible parties must be able to identify the recipient's needs, direct and evaluate task <br/>
<a id="pl.204.2"></a><var>204.2</var>accomplishment, and provide for health and safety. Approved hours may be used outside <br/>
<a id="pl.204.3"></a><var>204.3</var>the home when normal life activities take them outside the home. To use personal care <br/>
<a id="pl.204.4"></a><var>204.4</var>assistant assistance  services at school, the recipient or responsible party must provide <br/>
<a id="pl.204.5"></a><var>204.5</var>written authorization in the care plan identifying the chosen provider and the daily amount <br/>
<a id="pl.204.6"></a><var>204.6</var>of services to be used at school. Total hours for services, whether actually performed <br/>
<a id="pl.204.7"></a><var>204.7</var>inside or outside the recipient's home, cannot exceed that which is otherwise allowed for <br/>
<a id="pl.204.8"></a><var>204.8</var>personal care assistant assistance  services in an in-home setting according to sections <br/>
<statute_ref><a id="pl.204.9"></a><var>204.9</var>256B.0651
         </statute_ref> and 
<statute_ref>256B.0653</statute_ref> to 
         <statute_ref>256B.0656</statute_ref>. Medical assistance does not cover personal care <br/>
<a id="pl.204.10"></a><var>204.10</var>assistant assistance  services for residents of a hospital, nursing facility, intermediate care <br/>
<a id="pl.204.11"></a><var>204.11</var>facility, health care facility licensed by the commissioner of health, or unless a resident <br/>
<a id="pl.204.12"></a><var>204.12</var>who is otherwise eligible is on leave from the facility and the facility either pays for the <br/>
<a id="pl.204.13"></a><var>204.13</var>personal care assistant assistance  services or forgoes the facility per diem for the leave <br/>
<a id="pl.204.14"></a><var>204.14</var>days that personal care assistant assistance  services are used. All personal care assistant <br/>
<a id="pl.204.15"></a><var>204.15</var>assistance  services must be provided according to sections 
         <statute_ref>256B.0651</statute_ref> and 
<statute_ref>256B.0653</statute_ref> <br/>
<a id="pl.204.16"></a><var>204.16</var>to 
         <statute_ref>256B.0656</statute_ref>. Personal care assistant assistance  services may not be reimbursed if the <br/>
<a id="pl.204.17"></a><var>204.17</var>personal care assistant is the spouse or legal paid guardian of the recipient or the parent of <br/>
<a id="pl.204.18"></a><var>204.18</var>a recipient under age 18, or the responsible party or the family foster care provider of a <br/>
<a id="pl.204.19"></a><var>204.19</var>recipient who cannot direct the recipient's own care unless, in the case of a foster care <br/>
<a id="pl.204.20"></a><var>204.20</var>provider, a county or state case manager visits the recipient as needed, but not less than <br/>
<a id="pl.204.21"></a><var>204.21</var>every six months, to monitor the health and safety of the recipient and to ensure the goals <br/>
<a id="pl.204.22"></a><var>204.22</var>of the care plan are met. Parents of adult recipients, adult children of the recipient or <br/>
<a id="pl.204.23"></a><var>204.23</var>adult siblings of the recipient may be reimbursed for personal care assistant services, <br/>
<a id="pl.204.24"></a><var>204.24</var>if they are granted a waiver under sections 
<statute_ref>256B.0651</statute_ref> and 
<statute_ref>256B.0653</statute_ref> to 
<statute_ref>256B.0656</statute_ref>. <br/>
<a id="pl.204.25"></a><var>204.25</var>Notwithstanding the provisions of section 
         <statute_ref>256B.0655, subdivision 2</statute_ref>, paragraph (b), clause <br/>
<a id="pl.204.26"></a><var>204.26</var>(4) 256B.0659, the noncorporate legal unpaid guardian or conservator of an adult, who is <br/>
<a id="pl.204.27"></a><var>204.27</var>not the responsible party and not the personal care provider organization, may be granted a <br/>
<a id="pl.204.28"></a><var>204.28</var>hardship waiver under sections 
<statute_ref>256B.0651</statute_ref> and 
<statute_ref>256B.0653</statute_ref> to 
<statute_ref>256B.0656</statute_ref>, to be reimbursed <br/>
<a id="pl.204.29"></a><var>204.29</var>to provide personal care assistant assistance  services to the recipient if the guardian or <br/>
<a id="pl.204.30"></a><var>204.30</var>conservator meets all criteria for a personal care assistant according to section 
<statute_ref>256B.0659</statute_ref>, <br/>
<a id="pl.204.31"></a><var>204.31</var>and shall not be considered to have a service provider interest for purposes of participation <br/>
<a id="pl.204.32"></a><var>204.32</var>on the screening team under section 
         <statute_ref>256B.092, subdivision 7</statute_ref>.<br/>
<br/>
<a id="bill.8.21.0"></a><a id="pl.204.33"></a><var>204.33</var>    Sec. 21. Minnesota Statutes 2008, section 256B.0625, subdivision 19c, is amended to <br/>
<a id="pl.204.34"></a><var>204.34</var>read:<br/>
<a id="pl.205.1"></a><var>205.1</var>    Subd. 19c. <b>Personal care.</b> Medical assistance covers personal care assistant <br/>
<a id="pl.205.2"></a><var>205.2</var>assistance  services provided by an individual who is qualified to provide the services <br/>
<a id="pl.205.3"></a><var>205.3</var>according to subdivision 19a and sections 
         <statute_ref>256B.0651</statute_ref> and 
<statute_ref>256B.0653</statute_ref> to 
         <statute_ref>256B.0656</statute_ref>, <br/>
<a id="pl.205.4"></a><var>205.4</var>where the services have a statement of need by a physician, provided in accordance with <br/>
<a id="pl.205.5"></a><var>205.5</var>a plan, and are supervised by the recipient or a qualified professional. The physician's <br/>
<a id="pl.205.6"></a><var>205.6</var>statement of need for personal care assistant services shall be documented on a form <br/>
<a id="pl.205.7"></a><var>205.7</var>approved by the commissioner and include the diagnosis or condition of the person that <br/>
<a id="pl.205.8"></a><var>205.8</var>results in a need for personal care assistant services and be updated when the person's <br/>
<a id="pl.205.9"></a><var>205.9</var>medical condition requires a change, but at least annually if the need for personal care <br/>
<a id="pl.205.10"></a><var>205.10</var>assistant services is ongoing.<br/>
<a id="pl.205.11"></a><var>205.11</var>"Qualified professional" means a mental health professional as defined in section 
         <statute_ref>245.462, <br/>
<a id="pl.205.12"></a><var>205.12</var>subdivision 18
         </statute_ref>, or 
         <statute_ref>245.4871, subdivision 27</statute_ref>; or a registered nurse as defined in sections <br/>
<statute_ref><a id="pl.205.13"></a><var>205.13</var>148.171
         </statute_ref> to 
         <statute_ref>148.285</statute_ref>, or a licensed social worker as defined in section 
         <statute_ref>148B.21, or a <br/>
<a id="pl.205.14"></a><var>205.14</var>qualified developmental disabilities specialist undersection 245B.07, subdivision 4
</statute_ref>. <br/>
<a id="pl.205.15"></a><var>205.15</var>As part of the assessment, the county public health nurse will assist the recipient or <br/>
<a id="pl.205.16"></a><var>205.16</var>responsible party to identify the most appropriate person to provide supervision of the <br/>
<a id="pl.205.17"></a><var>205.17</var>personal care assistant. The qualified professional shall perform the duties described <br/>
<a id="pl.205.18"></a><var>205.18</var>required in Minnesota Rules, part 9505.0335, subpart 4 section 256B.0659.<br/>
<br/>
<a id="bill.8.22.0"></a><a id="pl.205.19"></a><var>205.19</var>    Sec. 22. Minnesota Statutes 2008, section 256B.0641, subdivision 3, is amended to <br/>
<a id="pl.205.20"></a><var>205.20</var>read:<br/>
<a id="pl.205.21"></a><var>205.21</var>    Subd. 3. <b>Facility in receivership.</b> Subdivision 2 does not apply to the change of <br/>
<a id="pl.205.22"></a><var>205.22</var>ownership of a facility to a nonrelated organization while the facility to be sold, transferred <br/>
<a id="pl.205.23"></a><var>205.23</var>or reorganized is in receivership under section 144A.14, 144A.15, 
<statute_ref>245A.12,</statute_ref> or 
         <statute_ref>245A.13</statute_ref>, <br/>
<a id="pl.205.24"></a><var>205.24</var>and the commissioner during the receivership has not determined the need to place <br/>
<a id="pl.205.25"></a><var>205.25</var>residents of the facility into a newly constructed or newly established facility. Nothing <br/>
<a id="pl.205.26"></a><var>205.26</var>in this subdivision limits the liability of a former owner.<br/>
<br/>
<a id="bill.8.23.0"></a><a id="pl.205.27"></a><var>205.27</var>    Sec. 23. Minnesota Statutes 2008, section 256B.0651, is amended to read:<br/>
<a id="pl.205.28"></a><var>205.28</var><b>256B.0651 HOME CARE SERVICES.</b><br/>
<a id="pl.205.29"></a><var>205.29</var>    Subdivision 1. <b>Definitions.</b> (a) "Activities of daily living" includes eating, toileting, <br/>
<a id="pl.205.30"></a><var>205.30</var>grooming, dressing, bathing, transferring, mobility, and positioning For the purposes of <br/>
<a id="pl.205.31"></a><var>205.31</var>sections 256B.0651 to 256B.0656 and 256B.0659, the terms in paragraphs (b) to (g) <br/>
<a id="pl.205.32"></a><var>205.32</var>have the meanings given.<br/>
<a id="pl.205.33"></a><var>205.33</var>(b) "Activities of daily living" has the meaning given in section 256B.0659, <br/>
<a id="pl.205.34"></a><var>205.34</var>subdivision 1, paragraph (b).<br/>
<a id="pl.206.1"></a><var>206.1</var>(c) "Assessment" means a review and evaluation of a recipient's need for home care <br/>
<a id="pl.206.2"></a><var>206.2</var>services conducted in person. Assessments for home health agency services shall be <br/>
<a id="pl.206.3"></a><var>206.3</var>conducted by a home health agency nurse. Assessments for medical assistance home care <br/>
<a id="pl.206.4"></a><var>206.4</var>services for developmental disability and alternative care services for developmentally <br/>
<a id="pl.206.5"></a><var>206.5</var>disabled home and community-based waivered recipients may be conducted by the county <br/>
<a id="pl.206.6"></a><var>206.6</var>public health nurse to ensure coordination and avoid duplication. Assessments must be <br/>
<a id="pl.206.7"></a><var>206.7</var>completed on forms provided by the commissioner within 30 days of a request for home <br/>
<a id="pl.206.8"></a><var>206.8</var>care services by a recipient or responsible party.<br/>
<a id="pl.206.9"></a><var>206.9</var>(c) (d) "Home care services" means a health service, determined by the commissioner <br/>
<a id="pl.206.10"></a><var>206.10</var>as medically necessary, that is ordered by a physician and documented in a service plan <br/>
<a id="pl.206.11"></a><var>206.11</var>that is reviewed by the physician at least once every 60 days for the provision of home <br/>
<a id="pl.206.12"></a><var>206.12</var>health services, or private duty nursing, or at least once every 365 days for personal care. <br/>
<a id="pl.206.13"></a><var>206.13</var>Home care services are provided to the recipient at the recipient's residence that is a <br/>
<a id="pl.206.14"></a><var>206.14</var>place other than a hospital or long-term care facility or as specified in section 
<statute_ref>256B.0625</statute_ref> <br/>
<a id="pl.206.15"></a><var>206.15</var>means medical assistance covered services that are home health agency services, including <br/>
<a id="pl.206.16"></a><var>206.16</var>skilled nurse visits; home health aide visits; physical therapy, occupational therapy, <br/>
<a id="pl.206.17"></a><var>206.17</var>respiratory therapy, and language-speech pathology therapy; private duty nursing; and <br/>
<a id="pl.206.18"></a><var>206.18</var>personal care assistance.<br/>
<a id="pl.206.19"></a><var>206.19</var>(e) "Home residence," effective January 1, 2010, means a residence owned or rented <br/>
<a id="pl.206.20"></a><var>206.20</var>by the recipient either alone, with roommates of the recipient's choosing, or with an unpaid <br/>
<a id="pl.206.21"></a><var>206.21</var>responsible party or legal representative; or a family foster home where the license holder <br/>
<a id="pl.206.22"></a><var>206.22</var>lives with the recipient and is not paid to provide home care services for the recipient <br/>
<a id="pl.206.23"></a><var>206.23</var>except as allowed under sections 256B.0651, subdivision 9, and 256B.0654, subdivision 4.<br/>
<a id="pl.206.24"></a><var>206.24</var>(d) (f) "Medically necessary" has the meaning given in Minnesota Rules, parts <br/>
<a id="pl.206.25"></a><var>206.25</var>9505.0170 to 9505.0475.<br/>
<a id="pl.206.26"></a><var>206.26</var>(e) "Telehomecare" means the use of telecommunications technology by a home <br/>
<a id="pl.206.27"></a><var>206.27</var>health care professional to deliver home health care services, within the professional's <br/>
<a id="pl.206.28"></a><var>206.28</var>scope of practice, to a patient located at a site other than the site where the practitioner <br/>
<a id="pl.206.29"></a><var>206.29</var>is located.<br/>
<a id="pl.206.30"></a><var>206.30</var>(g) "Ventilator-dependent" means an individual who receives mechanical ventilation <br/>
<a id="pl.206.31"></a><var>206.31</var>for life support at least six hours per day and is expected to be or has been dependent on a <br/>
<a id="pl.206.32"></a><var>206.32</var>ventilator for at least 30 consecutive days.<br/>
<a id="pl.206.33"></a><var>206.33</var>    Subd. 2. <b>Services covered.</b> Home care services covered under this section and <br/>
<a id="pl.206.34"></a><var>206.34</var>sections 
         <statute_ref>256B.0653</statute_ref> 256B.0652  to 
         <statute_ref>256B.0656 and 256B.0659</statute_ref> include:<br/>
<a id="pl.206.35"></a><var>206.35</var>(1) nursing services under section sections
<statute_ref>256B.0625, subdivision 6a, and <br/>
<a id="pl.206.36"></a><var>206.36</var>256B.0653
</statute_ref>;<br/>
<a id="pl.207.1"></a><var>207.1</var>(2) private duty nursing services under section sections
<statute_ref>256B.0625, subdivision <br/>
<a id="pl.207.2"></a><var>207.2</var>7
         </statute_ref>, and 256B.0654;<br/>
<a id="pl.207.3"></a><var>207.3</var>(3) home health services under section sections
<statute_ref>256B.0625, subdivision 6a, and <br/>
<a id="pl.207.4"></a><var>207.4</var>256B.0653
</statute_ref>;<br/>
<a id="pl.207.5"></a><var>207.5</var>(4) personal care assistant assistance  services under section sections
<statute_ref>256B.0625, <br/>
<a id="pl.207.6"></a><var>207.6</var>subdivision 19a
         </statute_ref>, and 256B.0659;<br/>
<a id="pl.207.7"></a><var>207.7</var>(5) supervision of personal care assistant assistance  services provided by a qualified <br/>
<a id="pl.207.8"></a><var>207.8</var>professional under section sections
<statute_ref>256B.0625, subdivision 19a</statute_ref>, and 256B.0659;<br/>
<a id="pl.207.9"></a><var>207.9</var>(6) qualified professional of personal care assistant services under the fiscal <br/>
<a id="pl.207.10"></a><var>207.10</var>intermediary option as specified in section 
<statute_ref>256B.0655, subdivision 7</statute_ref>;<br/>
<a id="pl.207.11"></a><var>207.11</var>(7) face-to-face assessments by county public health nurses for services under <br/>
<a id="pl.207.12"></a><var>207.12</var>section sections
<statute_ref>256B.0625, subdivision 19a</statute_ref>, 256B.0655, and 256B.0659; and<br/>
<a id="pl.207.13"></a><var>207.13</var>(8) (7) service updates and review of temporary increases for personal care assistant <br/>
<a id="pl.207.14"></a><var>207.14</var>assistance  services by the county public health nurse for services under section sections <br/>
<statute_ref><a id="pl.207.15"></a><var>207.15</var>256B.0625, subdivision 19a
         </statute_ref>, and 256B.0659.<br/>
<a id="pl.207.16"></a><var>207.16</var>    Subd. 3. <b>Noncovered home care services.</b> The following home care services are <br/>
<a id="pl.207.17"></a><var>207.17</var>not eligible for payment under medical assistance:<br/>
<a id="pl.207.18"></a><var>207.18</var>(1) skilled nurse visits for the sole purpose of supervision of the home health aide;<br/>
<a id="pl.207.19"></a><var>207.19</var>(2) a skilled nursing visit:<br/>
<a id="pl.207.20"></a><var>207.20</var>(i) only for the purpose of monitoring medication compliance with an established <br/>
<a id="pl.207.21"></a><var>207.21</var>medication program for a recipient; or<br/>
<a id="pl.207.22"></a><var>207.22</var>(ii) to administer or assist with medication administration, including injections, <br/>
<a id="pl.207.23"></a><var>207.23</var>prefilling syringes for injections, or oral medication set-up of an adult recipient, when as <br/>
<a id="pl.207.24"></a><var>207.24</var>determined and documented by the registered nurse, the need can be met by an available <br/>
<a id="pl.207.25"></a><var>207.25</var>pharmacy or the recipient is physically and mentally able to self-administer or prefill <br/>
<a id="pl.207.26"></a><var>207.26</var>a medication;<br/>
<a id="pl.207.27"></a><var>207.27</var>(3) home care services to a recipient who is eligible for covered services under the <br/>
<a id="pl.207.28"></a><var>207.28</var>Medicare program or any other insurance held by the recipient;<br/>
<a id="pl.207.29"></a><var>207.29</var>(4) services to other members of the recipient's household;<br/>
<a id="pl.207.30"></a><var>207.30</var>(5) a visit made by a skilled nurse solely to train other home health agency workers;<br/>
<a id="pl.207.31"></a><var>207.31</var>(6) any home care service included in the daily rate of the community-based <br/>
<a id="pl.207.32"></a><var>207.32</var>residential facility where the recipient is residing;<br/>
<a id="pl.207.33"></a><var>207.33</var>(7) nursing and rehabilitation therapy services that are reasonably accessible to a <br/>
<a id="pl.207.34"></a><var>207.34</var>recipient outside the recipient's place of residence, excluding the assessment, counseling <br/>
<a id="pl.207.35"></a><var>207.35</var>and education, and personal assistant care;<br/>
<a id="pl.208.1"></a><var>208.1</var>(8) any home health agency service, excluding personal care assistant services and <br/>
<a id="pl.208.2"></a><var>208.2</var>private duty nursing services, which are performed in a place other than the recipient's <br/>
<a id="pl.208.3"></a><var>208.3</var>residence; and<br/>
<a id="pl.208.4"></a><var>208.4</var>(9) Medicare evaluation or administrative nursing visits on dual-eligible recipients <br/>
<a id="pl.208.5"></a><var>208.5</var>that do not qualify for Medicare visit billing.<br/>
<a id="pl.208.6"></a><var>208.6</var>(1) services provided in a nursing facility, hospital, or intermediate care facility with <br/>
<a id="pl.208.7"></a><var>208.7</var>exceptions in section 256B.0653;<br/>
<a id="pl.208.8"></a><var>208.8</var>(2) services for the sole purpose of monitoring medication compliance with an <br/>
<a id="pl.208.9"></a><var>208.9</var>established medication program for a recipient;<br/>
<a id="pl.208.10"></a><var>208.10</var>(3) home care services for covered services under the Medicare program or any other <br/>
<a id="pl.208.11"></a><var>208.11</var>insurance held by the recipient;<br/>
<a id="pl.208.12"></a><var>208.12</var>(4) services to other members of the recipient's household;<br/>
<a id="pl.208.13"></a><var>208.13</var>(5) any home care service included in the daily rate of the community-based <br/>
<a id="pl.208.14"></a><var>208.14</var>residential facility where the recipient is residing;<br/>
<a id="pl.208.15"></a><var>208.15</var>(6) nursing and rehabilitation therapy services that are reasonably accessible to a <br/>
<a id="pl.208.16"></a><var>208.16</var>recipient outside the recipient's place of residence, excluding the assessment, counseling <br/>
<a id="pl.208.17"></a><var>208.17</var>and education, and personal assistance care; or<br/>
<a id="pl.208.18"></a><var>208.18</var>(7) Medicare evaluation or administrative nursing visits on dual-eligible recipients <br/>
<a id="pl.208.19"></a><var>208.19</var>that do not qualify for Medicare visit billing.<br/>
<a id="pl.208.20"></a><var>208.20</var>    Subd. 4. <b>Prior</b><b> Authorization; exceptions.</b> All home care services above the limits <br/>
<a id="pl.208.21"></a><var>208.21</var>in subdivision 11 must receive the commissioner's prior authorization before services <br/>
<a id="pl.208.22"></a><var>208.22</var>begin, except when:<br/>
<a id="pl.208.23"></a><var>208.23</var>(1) the home care services were required to treat an emergency medical condition <br/>
<a id="pl.208.24"></a><var>208.24</var>that if not immediately treated could cause a recipient serious physical or mental disability, <br/>
<a id="pl.208.25"></a><var>208.25</var>continuation of severe pain, or death. The provider must request retroactive authorization <br/>
<a id="pl.208.26"></a><var>208.26</var>no later than five working days after giving the initial service. The provider must be able <br/>
<a id="pl.208.27"></a><var>208.27</var>to substantiate the emergency by documentation such as reports, notes, and admission or <br/>
<a id="pl.208.28"></a><var>208.28</var>discharge histories;<br/>
<a id="pl.208.29"></a><var>208.29</var>(2) the home care services were provided on or after the date on which the recipient's <br/>
<a id="pl.208.30"></a><var>208.30</var>eligibility began, but before the date on which the recipient was notified that the case was <br/>
<a id="pl.208.31"></a><var>208.31</var>opened. Authorization will be considered if the request is submitted by the provider <br/>
<a id="pl.208.32"></a><var>208.32</var>within 20 working days of the date the recipient was notified that the case was opened; <br/>
<a id="pl.208.33"></a><var>208.33</var>a recipient's medical assistance eligibility has lapsed, is then retroactively reinstated, <br/>
<a id="pl.208.34"></a><var>208.34</var>and an authorization for home care services is completed based on the date of a current <br/>
<a id="pl.208.35"></a><var>208.35</var>assessment, eligibility, and request for authorization;<br/>
<a id="pl.209.1"></a><var>209.1</var>(3) a third-party payor for home care services has denied or adjusted a payment. <br/>
<a id="pl.209.2"></a><var>209.2</var>Authorization requests must be submitted by the provider within 20 working days of the <br/>
<a id="pl.209.3"></a><var>209.3</var>notice of denial or adjustment. A copy of the notice must be included with the request;<br/>
<a id="pl.209.4"></a><var>209.4</var>(4) the commissioner has determined that a county or state human services agency <br/>
<a id="pl.209.5"></a><var>209.5</var>has made an error; or<br/>
<a id="pl.209.6"></a><var>209.6</var>(5) the professional nurse determines an immediate need for up to 40 skilled nursing <br/>
<a id="pl.209.7"></a><var>209.7</var>or home health aide visits per calendar year and submits a request for authorization within <br/>
<a id="pl.209.8"></a><var>209.8</var>20 working days of the initial service date, and medical assistance is determined to be <br/>
<a id="pl.209.9"></a><var>209.9</var>the appropriate payer. if a recipient enrolled in managed care experiences a temporary <br/>
<a id="pl.209.10"></a><var>209.10</var>disenrollment from a health plan, the commissioner shall accept the current health plan <br/>
<a id="pl.209.11"></a><var>209.11</var>authorization for personal care assistance services for up to 60 days. The request must <br/>
<a id="pl.209.12"></a><var>209.12</var>be received within the first 30 days of the disenrollment. If the recipient's reenrollment <br/>
<a id="pl.209.13"></a><var>209.13</var>in managed care is after the 60 days and before 90 days, the provider shall request an <br/>
<a id="pl.209.14"></a><var>209.14</var>additional 30-day extension of the current health plan authorization, for a total limit of <br/>
<a id="pl.209.15"></a><var>209.15</var>90 days from the time of disenrollment.<br/>
<a id="pl.209.16"></a><var>209.16</var>    Subd. 5. <b>Retroactive authorization.</b> A request for retroactive authorization will be <br/>
<a id="pl.209.17"></a><var>209.17</var>evaluated according to the same criteria applied to prior authorization requests.<br/>
<a id="pl.209.18"></a><var>209.18</var>    Subd. 6. <b>Prior</b><b> Authorization.</b> (a) The commissioner, or the commissioner's <br/>
<a id="pl.209.19"></a><var>209.19</var>designee, shall review the assessment, service update, request for temporary services, <br/>
<a id="pl.209.20"></a><var>209.20</var>request for flexible use option, service plan, and any additional information that is <br/>
<a id="pl.209.21"></a><var>209.21</var>submitted. The commissioner shall, within 30 days after receiving a complete request, <br/>
<a id="pl.209.22"></a><var>209.22</var>assessment, and service plan, authorize home care services as follows: provided in this <br/>
<a id="pl.209.23"></a><var>209.23</var>section.<br/>
<a id="pl.209.24"></a><var>209.24</var>(a) <b>Home health services.</b> (b) All Home health services provided by a home health <br/>
<a id="pl.209.25"></a><var>209.25</var>aide including skilled nurse visits and home health aide visits must be prior authorized <br/>
<a id="pl.209.26"></a><var>209.26</var>by the commissioner or the commissioner's designee. Prior Authorization must be based <br/>
<a id="pl.209.27"></a><var>209.27</var>on medical necessity and cost-effectiveness when compared with other care options. <br/>
<a id="pl.209.28"></a><var>209.28</var>The commissioner must receive the request for authorization of skilled nurse visits and <br/>
<a id="pl.209.29"></a><var>209.29</var>home health aide visits within 20 working days of the start of service. When home health <br/>
<a id="pl.209.30"></a><var>209.30</var>services are used in combination with personal care and private duty nursing, the cost of <br/>
<a id="pl.209.31"></a><var>209.31</var>all home care services shall be considered for cost-effectiveness. The commissioner shall <br/>
<a id="pl.209.32"></a><var>209.32</var>limit home health aide visits to no more than one visit each per day. The commissioner, or <br/>
<a id="pl.209.33"></a><var>209.33</var>the commissioner's designee, may authorize up to two skilled nurse visits per day.<br/>
<a id="pl.209.34"></a><var>209.34</var>(b) <b>Ventilator-dependent recipients.</b> (c) If the recipient is ventilator-dependent, the <br/>
<a id="pl.209.35"></a><var>209.35</var>monthly medical assistance authorization for home care services shall not exceed what the <br/>
<a id="pl.209.36"></a><var>209.36</var>commissioner would pay for care at the highest cost hospital designated as a long-term <br/>
<a id="pl.210.1"></a><var>210.1</var>hospital under the Medicare program. For purposes of this paragraph, home care services <br/>
<a id="pl.210.2"></a><var>210.2</var>means all direct care services provided in the home that would be included in the payment <br/>
<a id="pl.210.3"></a><var>210.3</var>for care at the long-term hospital. "Ventilator-dependent" means an individual who <br/>
<a id="pl.210.4"></a><var>210.4</var>receives mechanical ventilation for life support at least six hours per day and is expected <br/>
<a id="pl.210.5"></a><var>210.5</var>to be or has been dependent for at least 30 consecutive days. Recipients who meet the <br/>
<a id="pl.210.6"></a><var>210.6</var>definition of ventilator dependent and the EN home care rating and utilize a combination <br/>
<a id="pl.210.7"></a><var>210.7</var>of home care services are limited up to a total of 24 hours of home care services per day. <br/>
<a id="pl.210.8"></a><var>210.8</var>Additional hours may be authorized when a recipient's assessment indicates a need for two <br/>
<a id="pl.210.9"></a><var>210.9</var>staff to perform activities. Additional time is limited to four hours per day.<br/>
<a id="pl.210.10"></a><var>210.10</var>    Subd. 7. <b>Prior</b><b> Authorization; time limits.</b> (a) The commissioner or the <br/>
<a id="pl.210.11"></a><var>210.11</var>commissioner's designee shall determine the time period for which a prior an authorization <br/>
<a id="pl.210.12"></a><var>210.12</var>shall be effective and, if flexible use has been requested, whether to allow the flexible use <br/>
<a id="pl.210.13"></a><var>210.13</var>option. If the recipient continues to require home care services beyond the duration of <br/>
<a id="pl.210.14"></a><var>210.14</var>the prior authorization, the home care provider must request a new prior authorization. <br/>
<a id="pl.210.15"></a><var>210.15</var>A personal care provider agency must request a new personal care assistant assistance <br/>
<a id="pl.210.16"></a><var>210.16</var> services assessment, or service update if allowed, at least 60 days prior to the end of <br/>
<a id="pl.210.17"></a><var>210.17</var>the current prior authorization time period. The request for the assessment must be <br/>
<a id="pl.210.18"></a><var>210.18</var>made on a form approved by the commissioner. Under no circumstances, other than the <br/>
<a id="pl.210.19"></a><var>210.19</var>exceptions in subdivision 4, shall a prior An authorization must be valid prior to the date <br/>
<a id="pl.210.20"></a><var>210.20</var>the commissioner receives the request or for no more than 12 months.<br/>
<a id="pl.210.21"></a><var>210.21</var>(b) The amount and type of personal care assistance services authorized based <br/>
<a id="pl.210.22"></a><var>210.22</var>upon the assessment and service plan must remain in effect for the recipient whether <br/>
<a id="pl.210.23"></a><var>210.23</var>the recipient chooses a different provider or enrolls or disenrolls from a managed care <br/>
<a id="pl.210.24"></a><var>210.24</var>plan under section 256B.0659, unless the service needs of the recipient change and new <br/>
<a id="pl.210.25"></a><var>210.25</var>assessment is warranted under section 256B.0655, subdivision 1b. <br/>
<a id="pl.210.26"></a><var>210.26</var>(c) A recipient who appeals a reduction in previously authorized home care <br/>
<a id="pl.210.27"></a><var>210.27</var>services may continue previously authorized services, other than temporary services <br/>
<a id="pl.210.28"></a><var>210.28</var>under subdivision 8, pending an appeal under section 
         <statute_ref>256.045</statute_ref>. The commissioner must <br/>
<a id="pl.210.29"></a><var>210.29</var>provide ensure that the recipient has a copy of the most recent service plan that contains <br/>
<a id="pl.210.30"></a><var>210.30</var> a detailed explanation of why the authorized services which areas of covered personal <br/>
<a id="pl.210.31"></a><var>210.31</var>care assistance tasks are reduced in amount from those requested by the home care <br/>
<a id="pl.210.32"></a><var>210.32</var>provider, and provide notice of the amount of time per day reduced, and the reasons for <br/>
<a id="pl.210.33"></a><var>210.33</var>the reduction in the recipient's notice of denial, termination, or reduction.<br/>
<a id="pl.210.34"></a><var>210.34</var>    Subd. 8. <b>Prior</b><b> Authorization requests; temporary services.</b> The agency nurse, <br/>
<a id="pl.210.35"></a><var>210.35</var>the independently enrolled private duty nurse, or county public health nurse may request <br/>
<a id="pl.210.36"></a><var>210.36</var>a temporary authorization for home care services by telephone. The commissioner may <br/>
<a id="pl.211.1"></a><var>211.1</var>approve a temporary level of home care services based on the assessment, and service <br/>
<a id="pl.211.2"></a><var>211.2</var>or care plan information, and primary payer coverage determination information as <br/>
<a id="pl.211.3"></a><var>211.3</var>required. Authorization for a temporary level of home care services including nurse <br/>
<a id="pl.211.4"></a><var>211.4</var>supervision is limited to the time specified by the commissioner, but shall not exceed <br/>
<a id="pl.211.5"></a><var>211.5</var>45 days, unless extended because the county public health nurse has not completed the <br/>
<a id="pl.211.6"></a><var>211.6</var>required assessment and service plan, or the commissioner's determination has not been <br/>
<a id="pl.211.7"></a><var>211.7</var>made. The level of services authorized under this provision shall have no bearing on a <br/>
<a id="pl.211.8"></a><var>211.8</var>future prior authorization.<br/>
<a id="pl.211.9"></a><var>211.9</var>    Subd. 9. <b>Prior</b><b> Authorization for foster care setting.</b> (a) Home care services <br/>
<a id="pl.211.10"></a><var>211.10</var>provided in an adult or child foster care setting must receive prior authorization by the <br/>
<a id="pl.211.11"></a><var>211.11</var>department commissioner according to the limits established in subdivision 11.<br/>
<a id="pl.211.12"></a><var>211.12</var>(b) The commissioner may not authorize:<br/>
<a id="pl.211.13"></a><var>211.13</var>(1) home care services that are the responsibility of the foster care provider under <br/>
<a id="pl.211.14"></a><var>211.14</var>the terms of the foster care placement agreement, difficulty of care rate as of January 1, <br/>
<a id="pl.211.15"></a><var>211.15</var>2010, and administrative rules;<br/>
<a id="pl.211.16"></a><var>211.16</var>(2) personal care assistant assistance  services when the foster care license holder is <br/>
<a id="pl.211.17"></a><var>211.17</var>also the personal care provider or personal care assistant unless the recipient can direct the <br/>
<a id="pl.211.18"></a><var>211.18</var>recipient's own care, or case management is provided as required in section 
<statute_ref>256B.0625, <br/>
<a id="pl.211.19"></a><var>211.19</var>subdivision 19a
</statute_ref>, unless the foster home is the licensed provider's primary residence as <br/>
<a id="pl.211.20"></a><var>211.20</var>defined in section 256B.0625, subdivision 19a; or<br/>
<a id="pl.211.21"></a><var>211.21</var>(3) personal care assistant services when the responsible party is an employee of, or <br/>
<a id="pl.211.22"></a><var>211.22</var>under contract with, or has any direct or indirect financial relationship with the personal <br/>
<a id="pl.211.23"></a><var>211.23</var>care provider or personal care assistant, unless case management is provided as required <br/>
<a id="pl.211.24"></a><var>211.24</var>in section 
<statute_ref>256B.0625, subdivision 19a</statute_ref>; or<br/>
<a id="pl.211.25"></a><var>211.25</var>(4) (3) personal care assistant and private duty nursing services when the number <br/>
<a id="pl.211.26"></a><var>211.26</var>of foster care residents licensed capacity is greater than four unless the county responsible <br/>
<a id="pl.211.27"></a><var>211.27</var>for the recipient's foster placement made the placement prior to April 1, 1992, requests <br/>
<a id="pl.211.28"></a><var>211.28</var>that personal care assistant and private duty nursing services be provided, and case <br/>
<a id="pl.211.29"></a><var>211.29</var>management is provided as required in section 
<statute_ref>256B.0625, subdivision 19a</statute_ref>.<br/>
<a id="pl.211.30"></a><var>211.30</var>    Subd. 10. <b>Limitation on payments.</b> Medical assistance payments for home care <br/>
<a id="pl.211.31"></a><var>211.31</var>services shall be limited according to subdivisions 4 to 12 and sections 
<statute_ref>256B.0654, <br/>
<a id="pl.211.32"></a><var>211.32</var>subdivision 2
</statute_ref>, and 
<statute_ref>256B.0655, subdivisions 3 and 4</statute_ref>.<br/>
<a id="pl.211.33"></a><var>211.33</var>    Subd. 11. <b>Limits on services without </b><b>prior</b><b> authorization.</b> A recipient may receive <br/>
<a id="pl.211.34"></a><var>211.34</var>the following home care services during a calendar year:<br/>
<a id="pl.212.1"></a><var>212.1</var>(1) up to two face-to-face assessments to determine a recipient's need for personal <br/>
<a id="pl.212.2"></a><var>212.2</var>care assistant assistance  services;<br/>
<a id="pl.212.3"></a><var>212.3</var>(2) one service update done to determine a recipient's need for personal care assistant <br/>
<a id="pl.212.4"></a><var>212.4</var>assistance  services; and<br/>
<a id="pl.212.5"></a><var>212.5</var>(3) up to nine face-to-face skilled nurse visits.<br/>
<a id="pl.212.6"></a><var>212.6</var>    Subd. 12. <b>Approval of home care services.</b> The commissioner or the <br/>
<a id="pl.212.7"></a><var>212.7</var>commissioner's designee shall determine the medical necessity of home care services, <br/>
<a id="pl.212.8"></a><var>212.8</var>the level of caregiver according to subdivision 2, and the institutional comparison <br/>
<a id="pl.212.9"></a><var>212.9</var>according to subdivisions 4 to 12 and sections 
         <statute_ref>256B.0654, subdivision 2</statute_ref>, and
<statute_ref>256B.0655, <br/>
<a id="pl.212.10"></a><var>212.10</var>subdivisions 3 and 4
         </statute_ref>, and 256B.0659, the cost-effectiveness of services, and the amount, <br/>
<a id="pl.212.11"></a><var>212.11</var>scope, and duration of home care services reimbursable by medical assistance, based <br/>
<a id="pl.212.12"></a><var>212.12</var>on the assessment, primary payer coverage determination information as required, the <br/>
<a id="pl.212.13"></a><var>212.13</var>service plan, the recipient's age, the cost of services, the recipient's medical condition, and <br/>
<a id="pl.212.14"></a><var>212.14</var>diagnosis or disability. The commissioner may publish additional criteria for determining <br/>
<a id="pl.212.15"></a><var>212.15</var>medical necessity according to section 
         <statute_ref>256B.04</statute_ref>.<br/>
<a id="pl.212.16"></a><var>212.16</var>    Subd. 13. <b>Recovery of excessive payments.</b> The commissioner shall seek <br/>
<a id="pl.212.17"></a><var>212.17</var>monetary recovery from providers of payments made for services which exceed the limits <br/>
<a id="pl.212.18"></a><var>212.18</var>established in this section and sections 
         <statute_ref>256B.0653</statute_ref> to 
         <statute_ref>256B.0656</statute_ref>, and 256B.0659. This <br/>
<a id="pl.212.19"></a><var>212.19</var>subdivision does not apply to services provided to a recipient at the previously authorized <br/>
<a id="pl.212.20"></a><var>212.20</var>level pending an appeal under section 
         <statute_ref>256.045, subdivision 10</statute_ref>.<br/>
<a id="pl.212.21"></a><var>212.21</var>    Subd. 14. <b>Referrals to Medicare providers required.</b> Home care providers that <br/>
<a id="pl.212.22"></a><var>212.22</var>do not participate in or accept Medicare assignment must refer and document the referral <br/>
<a id="pl.212.23"></a><var>212.23</var>of dual-eligible recipients to Medicare providers when Medicare is determined to be the <br/>
<a id="pl.212.24"></a><var>212.24</var>appropriate payer for services and supplies and equipment. Providers must be terminated <br/>
<a id="pl.212.25"></a><var>212.25</var>from participation in the medical assistance program for failure to make these referrals.<br/>
<a id="pl.212.26"></a><var>212.26</var>    Subd. 15. <b>Quality assurance for program integrity.</b> The commissioner shall <br/>
<a id="pl.212.27"></a><var>212.27</var>establish an ongoing quality assurance process for home care services to monitor program <br/>
<a id="pl.212.28"></a><var>212.28</var>integrity, including provider standards and training, consumer surveys, and random <br/>
<a id="pl.212.29"></a><var>212.29</var>reviews of documentation.<br/>
<a id="pl.212.30"></a><var>212.30</var>    Subd. 16. <b>Oversight of enrolled providers.</b> The commissioner has the authority to <br/>
<a id="pl.212.31"></a><var>212.31</var>request proof of documentation of meeting provider standards, quality standards of care, <br/>
<a id="pl.212.32"></a><var>212.32</var>correct billing practices, and other information. Failure to comply with or to provide access <br/>
<a id="pl.212.33"></a><var>212.33</var>and information to demonstrate compliance with laws, rules, or policies may result in <br/>
<a id="pl.212.34"></a><var>212.34</var>suspension, denial, or termination of the provider agency's enrollment with the department.<br/>
<br/>
<a id="bill.8.24.0"></a><a id="pl.213.1"></a><var>213.1</var>    Sec. 24. Minnesota Statutes 2008, section 256B.0652, is amended to read:<br/>
<a id="pl.213.2"></a><var>213.2</var><b>256B.0652 </b><b>PRIOR</b><b> AUTHORIZATION AND REVIEW OF HOME CARE </b><br/>
<a id="pl.213.3"></a><var>213.3</var><b>SERVICES.</b><br/>
<a id="pl.213.4"></a><var>213.4</var>    Subdivision 1. <b>State coordination.</b> The commissioner shall supervise the <br/>
<a id="pl.213.5"></a><var>213.5</var>coordination of the prior authorization and review of home care services that are <br/>
<a id="pl.213.6"></a><var>213.6</var>reimbursed by medical assistance.<br/>
<a id="pl.213.7"></a><var>213.7</var>    Subd. 2. <b>Duties.</b> (a) The commissioner may contract with or employ qualified <br/>
<a id="pl.213.8"></a><var>213.8</var>registered nurses and necessary support staff, or contract with qualified agencies, to <br/>
<a id="pl.213.9"></a><var>213.9</var>provide home care prior authorization and review services for medical assistance <br/>
<a id="pl.213.10"></a><var>213.10</var>recipients who are receiving home care services.<br/>
<a id="pl.213.11"></a><var>213.11</var>(b) Reimbursement for the prior authorization function shall be made through the <br/>
<a id="pl.213.12"></a><var>213.12</var>medical assistance administrative authority. The state shall pay the nonfederal share. <br/>
<a id="pl.213.13"></a><var>213.13</var>The functions will be to:<br/>
<a id="pl.213.14"></a><var>213.14</var>(1) assess the recipient's individual need for services required to be cared for safely <br/>
<a id="pl.213.15"></a><var>213.15</var>in the community;<br/>
<a id="pl.213.16"></a><var>213.16</var>(2) ensure that a service care plan that meets the recipient's needs is developed <br/>
<a id="pl.213.17"></a><var>213.17</var>by the appropriate agency or individual;<br/>
<a id="pl.213.18"></a><var>213.18</var>(3) ensure cost-effectiveness and nonduplication of medical assistance home care <br/>
<a id="pl.213.19"></a><var>213.19</var>services;<br/>
<a id="pl.213.20"></a><var>213.20</var>(4) recommend the approval or denial of the use of medical assistance funds to pay <br/>
<a id="pl.213.21"></a><var>213.21</var>for home care services;<br/>
<a id="pl.213.22"></a><var>213.22</var>(5) reassess the recipient's need for and level of home care services at a frequency <br/>
<a id="pl.213.23"></a><var>213.23</var>determined by the commissioner; and<br/>
<a id="pl.213.24"></a><var>213.24</var>(6) conduct on-site assessments when determined necessary by the commissioner <br/>
<a id="pl.213.25"></a><var>213.25</var>and recommend changes to care plans that will provide more efficient and appropriate <br/>
<a id="pl.213.26"></a><var>213.26</var>home care; and<br/>
<a id="pl.213.27"></a><var>213.27</var>(7) on the department's Web site:<br/>
<a id="pl.213.28"></a><var>213.28</var>(i) provide a link to MinnesotaHelp.info for a list of enrolled home care agencies <br/>
<a id="pl.213.29"></a><var>213.29</var>with the following information: main office address, contact information for the agency, <br/>
<a id="pl.213.30"></a><var>213.30</var>counties in which services are provided, type of home care services provided, whether <br/>
<a id="pl.213.31"></a><var>213.31</var>the personal care assistance choice option is offered, types of qualified professionals <br/>
<a id="pl.213.32"></a><var>213.32</var>employed, number of personal care assistants employed, and data on staff turnover; and<br/>
<a id="pl.213.33"></a><var>213.33</var>(ii) post data on home care services including information from both fee-for-service <br/>
<a id="pl.213.34"></a><var>213.34</var>and managed care plans on recipients as available.<br/>
<a id="pl.213.35"></a><var>213.35</var>(c) In addition, the commissioner or the commissioner's designee may:<br/>
<a id="pl.214.1"></a><var>214.1</var>(1) review care plans, service plans,  and reimbursement data for utilization of <br/>
<a id="pl.214.2"></a><var>214.2</var>services that exceed community-based standards for home care, inappropriate home care <br/>
<a id="pl.214.3"></a><var>214.3</var>services, medical necessity, home care services that do not meet quality of care standards, <br/>
<a id="pl.214.4"></a><var>214.4</var>or unauthorized services and make appropriate referrals within the department or to other <br/>
<a id="pl.214.5"></a><var>214.5</var>appropriate entities based on the findings;<br/>
<a id="pl.214.6"></a><var>214.6</var>(2) assist the recipient in obtaining services necessary to allow the recipient to <br/>
<a id="pl.214.7"></a><var>214.7</var>remain safely in or return to the community;<br/>
<a id="pl.214.8"></a><var>214.8</var>(3) coordinate home care services with other medical assistance services under <br/>
<a id="pl.214.9"></a><var>214.9</var>section 
         <statute_ref>256B.0625</statute_ref>;<br/>
<a id="pl.214.10"></a><var>214.10</var>(4) assist the recipient with problems related to the provision of home care services;<br/>
<a id="pl.214.11"></a><var>214.11</var>(5) assure the quality of home care services; and<br/>
<a id="pl.214.12"></a><var>214.12</var>(6) assure that all liable third-party payers including, but not limited to, Medicare <br/>
<a id="pl.214.13"></a><var>214.13</var>have been used prior to medical assistance for home care services, including but not <br/>
<a id="pl.214.14"></a><var>214.14</var>limited to, home health agency, elected hospice benefit, waivered services, alternative care <br/>
<a id="pl.214.15"></a><var>214.15</var>program services, and personal care services.<br/>
<a id="pl.214.16"></a><var>214.16</var>(d) For the purposes of this section, "home care services" means medical assistance <br/>
<a id="pl.214.17"></a><var>214.17</var>services defined under section 
         <statute_ref>256B.0625, subdivisions 6a, 7, and 19a</statute_ref>.<br/>
<a id="pl.214.18"></a><var>214.18</var>    Subd. 3. <b>Assessment and </b><b>prior</b><b> authorization process</b><b> for persons receiving </b><br/>
<a id="pl.214.19"></a><var>214.19</var><b>personal care assistance and developmental disabilities services</b><b>.</b> Effective January 1, <br/>
<a id="pl.214.20"></a><var>214.20</var>1996, For purposes of providing informed choice, coordinating of local planning decisions, <br/>
<a id="pl.214.21"></a><var>214.21</var>and streamlining administrative requirements, the assessment and prior authorization <br/>
<a id="pl.214.22"></a><var>214.22</var>process for persons receiving both home care and home and community-based waivered <br/>
<a id="pl.214.23"></a><var>214.23</var>services for persons with developmental disabilities shall meet the requirements of <br/>
<a id="pl.214.24"></a><var>214.24</var>sections 
         <statute_ref>256B.0651</statute_ref> and 
         <statute_ref>256B.0653</statute_ref> to 
         <statute_ref>256B.0656</statute_ref> with the following exceptions:<br/>
<a id="pl.214.25"></a><var>214.25</var>(a) Upon request for home care services and subsequent assessment by the public <br/>
<a id="pl.214.26"></a><var>214.26</var>health nurse under sections 
         <statute_ref>256B.0651</statute_ref> and 
         <statute_ref>256B.0653</statute_ref> to 
         <statute_ref>256B.0656</statute_ref>, the public health <br/>
<a id="pl.214.27"></a><var>214.27</var>nurse shall participate in the screening process, as appropriate, and, if home care <br/>
<a id="pl.214.28"></a><var>214.28</var>services are determined to be necessary, participate in the development of a service plan <br/>
<a id="pl.214.29"></a><var>214.29</var>coordinating the need for home care and home and community-based waivered services <br/>
<a id="pl.214.30"></a><var>214.30</var>with the assigned county case manager, the recipient of services, and the recipient's legal <br/>
<a id="pl.214.31"></a><var>214.31</var>representative, if any.<br/>
<a id="pl.214.32"></a><var>214.32</var>(b) The public health nurse shall give prior authorization for home care services <br/>
<a id="pl.214.33"></a><var>214.33</var>to the extent that home care services are:<br/>
<a id="pl.214.34"></a><var>214.34</var>(1) medically necessary;<br/>
<a id="pl.214.35"></a><var>214.35</var>(2) chosen by the recipient and their legal representative, if any, from the array of <br/>
<a id="pl.214.36"></a><var>214.36</var>home care and home and community-based waivered services available;<br/>
<a id="pl.215.1"></a><var>215.1</var>(3) coordinated with other services to be received by the recipient as described <br/>
<a id="pl.215.2"></a><var>215.2</var>in the service plan; and<br/>
<a id="pl.215.3"></a><var>215.3</var>(4) provided within the county's reimbursement limits for home care and home and <br/>
<a id="pl.215.4"></a><var>215.4</var>community-based waivered services for persons with developmental disabilities.<br/>
<a id="pl.215.5"></a><var>215.5</var>(c) If the public health agency is or may be the provider of home care services to the <br/>
<a id="pl.215.6"></a><var>215.6</var>recipient, the public health agency shall provide the commissioner of human services with <br/>
<a id="pl.215.7"></a><var>215.7</var>a written plan that specifies how the assessment and prior authorization process will be <br/>
<a id="pl.215.8"></a><var>215.8</var>held separate and distinct from the provision of services.<br/>
<br/>
<a id="bill.8.25.0"></a><a id="pl.215.9"></a><var>215.9</var>    Sec. 25. Minnesota Statutes 2008, section 256B.0653, is amended to read:<br/>
<a id="pl.215.10"></a><var>215.10</var><b>256B.0653 HOME HEALTH AGENCY </b><b>COVERED</b><b> SERVICES.</b><br/>
<a id="pl.215.11"></a><var>215.11</var>    Subdivision 1. <b>Homecare; skilled nurse visits</b><b> Scope</b><b>.</b>  "Skilled nurse visits" are <br/>
<a id="pl.215.12"></a><var>215.12</var>provided in a recipient's residence under a plan of care or service plan that specifies a level <br/>
<a id="pl.215.13"></a><var>215.13</var>of care which the nurse is qualified to provide. These services are:<br/>
<a id="pl.215.14"></a><var>215.14</var>(1) nursing services according to the written plan of care or service plan and accepted <br/>
<a id="pl.215.15"></a><var>215.15</var>standards of medical and nursing practice in accordance with chapter 148;<br/>
<a id="pl.215.16"></a><var>215.16</var>(2) services which due to the recipient's medical condition may only be safely and <br/>
<a id="pl.215.17"></a><var>215.17</var>effectively provided by a registered nurse or a licensed practical nurse;<br/>
<a id="pl.215.18"></a><var>215.18</var>(3) assessments performed only by a registered nurse; and<br/>
<a id="pl.215.19"></a><var>215.19</var>(4) teaching and training the recipient, the recipient's family, or other caregivers <br/>
<a id="pl.215.20"></a><var>215.20</var>requiring the skills of a registered nurse or licensed practical nurse. This section applies to <br/>
<a id="pl.215.21"></a><var>215.21</var>home health agency services including, home health aide, skilled nursing visits, physical <br/>
<a id="pl.215.22"></a><var>215.22</var>therapy, occupational therapy, respiratory therapy, and speech language pathology therapy.<br/>
<a id="pl.215.23"></a><var>215.23</var>    Subd. 2. <b>Telehomecare; skilled nurse visits</b><b> Definitions</b><b>.</b>  Medical assistance <br/>
<a id="pl.215.24"></a><var>215.24</var>covers skilled nurse visits according to section 
<statute_ref>256B.0625, subdivision 6a</statute_ref>, provided via <br/>
<a id="pl.215.25"></a><var>215.25</var>telehomecare, for services which do not require hands-on care between the home care <br/>
<a id="pl.215.26"></a><var>215.26</var>nurse and recipient. The provision of telehomecare must be made via live, two-way <br/>
<a id="pl.215.27"></a><var>215.27</var>interactive audiovisual technology and may be augmented by utilizing store-and-forward <br/>
<a id="pl.215.28"></a><var>215.28</var>technologies. Store-and-forward technology includes telehomecare services that do not <br/>
<a id="pl.215.29"></a><var>215.29</var>occur in real time via synchronous transmissions, and that do not require a face-to-face <br/>
<a id="pl.215.30"></a><var>215.30</var>encounter with the recipient for all or any part of any such telehomecare visit. Individually <br/>
<a id="pl.215.31"></a><var>215.31</var>identifiable patient data obtained through real-time or store-and-forward technology must <br/>
<a id="pl.215.32"></a><var>215.32</var>be maintained as health records according to sections 144.291 to 144.298. If the video <br/>
<a id="pl.215.33"></a><var>215.33</var>is used for research, training, or other purposes unrelated to the care of the patient, the <br/>
<a id="pl.215.34"></a><var>215.34</var>identity of the patient must be concealed. A communication between the home care nurse <br/>
<a id="pl.215.35"></a><var>215.35</var>and recipient that consists solely of a telephone conversation, facsimile, electronic mail, or <br/>
<a id="pl.216.1"></a><var>216.1</var>a consultation between two health care practitioners, is not to be considered a telehomecare <br/>
<a id="pl.216.2"></a><var>216.2</var>visit. Multiple daily skilled nurse visits provided via telehomecare are allowed. Coverage <br/>
<a id="pl.216.3"></a><var>216.3</var>of telehomecare is limited to two visits per day. All skilled nurse visits provided via <br/>
<a id="pl.216.4"></a><var>216.4</var>telehomecare must be prior authorized by the commissioner or the commissioner's <br/>
<a id="pl.216.5"></a><var>216.5</var>designee and will be covered at the same allowable rate as skilled nurse visits provided <br/>
<a id="pl.216.6"></a><var>216.6</var>in-person. For the purposes of this section, the following terms have the meanings given.<br/>
<a id="pl.216.7"></a><var>216.7</var>(a) "Assessment" means an evaluation of the recipient's medical need for home <br/>
<a id="pl.216.8"></a><var>216.8</var>health agency services by a registered nurse or appropriate therapist that is conducted <br/>
<a id="pl.216.9"></a><var>216.9</var>within 30 days of a request.<br/>
<a id="pl.216.10"></a><var>216.10</var>(b) "Home care therapies" means occupational, physical, and respiratory therapy <br/>
<a id="pl.216.11"></a><var>216.11</var>and speech-language pathology services provided in the home by a Medicare certified <br/>
<a id="pl.216.12"></a><var>216.12</var>home health agency.<br/>
<a id="pl.216.13"></a><var>216.13</var>(c) "Home health agency services" means services delivered in the recipient's home <br/>
<a id="pl.216.14"></a><var>216.14</var>residence, except as specified in section 256B.0625, by a home health agency to a recipient <br/>
<a id="pl.216.15"></a><var>216.15</var>with medical needs due to illness, disability, or physical conditions.<br/>
<a id="pl.216.16"></a><var>216.16</var>(d) "Home health aide" means an employee of a home health agency who completes <br/>
<a id="pl.216.17"></a><var>216.17</var>medically oriented tasks written in the plan of care for a recipient.<br/>
<a id="pl.216.18"></a><var>216.18</var>(e) "Home health agency" means a home care provider agency that is <br/>
<a id="pl.216.19"></a><var>216.19</var>Medicare-certified.<br/>
<a id="pl.216.20"></a><var>216.20</var>(f) "Occupational therapy services" mean the services defined in Minnesota Rules, <br/>
<a id="pl.216.21"></a><var>216.21</var>part 9505.0390.<br/>
<a id="pl.216.22"></a><var>216.22</var>(g) "Physical therapy services" mean the services defined in Minnesota Rules, part <br/>
<a id="pl.216.23"></a><var>216.23</var>9505.0390.<br/>
<a id="pl.216.24"></a><var>216.24</var>(h) "Respiratory therapy services" mean the services defined in chapter 147C and <br/>
<a id="pl.216.25"></a><var>216.25</var>Minnesota Rules, part 4668.0003, subpart 37.<br/>
<a id="pl.216.26"></a><var>216.26</var>(i) "Speech-language pathology services" mean the services defined in Minnesota <br/>
<a id="pl.216.27"></a><var>216.27</var>Rules, part 9505.0390.<br/>
<a id="pl.216.28"></a><var>216.28</var>(j) "Skilled nurse visit" means a professional nursing visit to complete nursing tasks <br/>
<a id="pl.216.29"></a><var>216.29</var>required due to a recipient's medical condition that can only be safely provided by a <br/>
<a id="pl.216.30"></a><var>216.30</var>professional nurse to restore and maintain optimal health.<br/>
<a id="pl.216.31"></a><var>216.31</var>(k) "Store-and-forward technology" means telehomecare services that do not occur <br/>
<a id="pl.216.32"></a><var>216.32</var>in real time via synchronous transmissions such as diabetic and vital sign monitoring.<br/>
<a id="pl.216.33"></a><var>216.33</var>(l) "Telehomecare" means the use of telecommunications technology via <br/>
<a id="pl.216.34"></a><var>216.34</var>live, two-way interactive audiovisual technology which may be augmented by <br/>
<a id="pl.216.35"></a><var>216.35</var>store-and-forward technology.<br/>
<a id="pl.217.1"></a><var>217.1</var>(m) "Telehomecare skilled nurse visit" means a visit by a professional nurse to <br/>
<a id="pl.217.2"></a><var>217.2</var>deliver a skilled nurse visit to a recipient located at a site other than the site where the <br/>
<a id="pl.217.3"></a><var>217.3</var>nurse is located and is used in combination with face-to-face skilled nurse visits to <br/>
<a id="pl.217.4"></a><var>217.4</var>adequately meet the recipient's needs.<br/>
<a id="pl.217.5"></a><var>217.5</var>    Subd. 3. <b>Therapies through home health agencies</b><b> Home health aide visits</b><b>.</b><br/>
<a id="pl.217.6"></a><var>217.6</var>(a) Medical assistance covers physical therapy and related services, including specialized <br/>
<a id="pl.217.7"></a><var>217.7</var>maintenance therapy. Services provided by a physical therapy assistant shall be <br/>
<a id="pl.217.8"></a><var>217.8</var>reimbursed at the same rate as services performed by a physical therapist when the <br/>
<a id="pl.217.9"></a><var>217.9</var>services of the physical therapy assistant are provided under the direction of a physical <br/>
<a id="pl.217.10"></a><var>217.10</var>therapist who is on the premises. Services provided by a physical therapy assistant that are <br/>
<a id="pl.217.11"></a><var>217.11</var>provided under the direction of a physical therapist who is not on the premises shall be <br/>
<a id="pl.217.12"></a><var>217.12</var>reimbursed at 65 percent of the physical therapist rate. Direction of the physical therapy <br/>
<a id="pl.217.13"></a><var>217.13</var>assistant must be provided by the physical therapist as described in Minnesota Rules, part <br/>
<a id="pl.217.14"></a><var>217.14</var>9505.0390, subpart 1, item B. The physical therapist and physical therapist assistant may <br/>
<a id="pl.217.15"></a><var>217.15</var>not both bill for services provided to a recipient on the same day.<br/>
<a id="pl.217.16"></a><var>217.16</var>(b) Medical assistance covers occupational therapy and related services, including <br/>
<a id="pl.217.17"></a><var>217.17</var>specialized maintenance therapy. Services provided by an occupational therapy assistant <br/>
<a id="pl.217.18"></a><var>217.18</var>shall be reimbursed at the same rate as services performed by an occupational therapist <br/>
<a id="pl.217.19"></a><var>217.19</var>when the services of the occupational therapy assistant are provided under the direction of <br/>
<a id="pl.217.20"></a><var>217.20</var>the occupational therapist who is on the premises. Services provided by an occupational <br/>
<a id="pl.217.21"></a><var>217.21</var>therapy assistant under the direction of an occupational therapist who is not on the <br/>
<a id="pl.217.22"></a><var>217.22</var>premises shall be reimbursed at 65 percent of the occupational therapist rate. Direction <br/>
<a id="pl.217.23"></a><var>217.23</var>of the occupational therapy assistant must be provided by the occupational therapist as <br/>
<a id="pl.217.24"></a><var>217.24</var>described in Minnesota Rules, part 9505.0390, subpart 1, item B. The occupational <br/>
<a id="pl.217.25"></a><var>217.25</var>therapist and occupational therapist assistant may not both bill for services provided <br/>
<a id="pl.217.26"></a><var>217.26</var>to a recipient on the same day.<br/>
<a id="pl.217.27"></a><var>217.27</var>(a) Home health aide visits must be provided by a certified home health aide <br/>
<a id="pl.217.28"></a><var>217.28</var>using a written plan of care that is updated in compliance with Medicare regulations. <br/>
<a id="pl.217.29"></a><var>217.29</var>A home health aide shall provide hands-on personal care, perform simple procedures <br/>
<a id="pl.217.30"></a><var>217.30</var>as an extension of therapy or nursing services, and assist in instrumental activities of <br/>
<a id="pl.217.31"></a><var>217.31</var>daily living as defined in section 256B.0659. Home health aide visits must be provided <br/>
<a id="pl.217.32"></a><var>217.32</var>in the recipient's home.<br/>
<a id="pl.217.33"></a><var>217.33</var>(b) All home health aide visits must have authorization under section 256B.0652. <br/>
<a id="pl.217.34"></a><var>217.34</var>The commissioner shall limit home health aide visits to no more than one visit per day <br/>
<a id="pl.217.35"></a><var>217.35</var>per recipient.<br/>
<a id="pl.218.1"></a><var>218.1</var>(c) Home health aides must be supervised by a registered nurse or an appropriate <br/>
<a id="pl.218.2"></a><var>218.2</var>therapist when providing services that are an extension of therapy.<br/>
<a id="pl.218.3"></a><var>218.3</var>    Subd. 4. <b>Skilled nurse visit services.</b> (a) Skilled nurse visit services must be <br/>
<a id="pl.218.4"></a><var>218.4</var>provided by a registered nurse or a licensed practical nurse under the supervision of a <br/>
<a id="pl.218.5"></a><var>218.5</var>registered nurse, according to the written plan of care and accepted standards of medical <br/>
<a id="pl.218.6"></a><var>218.6</var>and nursing practice according to chapter 148. Skilled nurse visit services must be ordered <br/>
<a id="pl.218.7"></a><var>218.7</var>by a physician and documented in a plan of care that is reviewed and approved by the <br/>
<a id="pl.218.8"></a><var>218.8</var>ordering physician at least once every 60 days. All skilled nurse visits must be medically <br/>
<a id="pl.218.9"></a><var>218.9</var>necessary and provided in the recipient's home residence except as allowed under section <br/>
<a id="pl.218.10"></a><var>218.10</var>256B.0625, subdivision 6a.<br/>
<a id="pl.218.11"></a><var>218.11</var>(b) Skilled nurse visits include face-to-face and telehomecare visits with a limit of <br/>
<a id="pl.218.12"></a><var>218.12</var>up to two visits per day per recipient. All visits must be based on assessed needs.<br/>
<a id="pl.218.13"></a><var>218.13</var>(c) Telehomecare skilled nurse visits are allowed when the recipient's health status <br/>
<a id="pl.218.14"></a><var>218.14</var>can be accurately measured and assessed without a need for a face-to-face, hands-on <br/>
<a id="pl.218.15"></a><var>218.15</var>encounter. All telehomecare skilled nurse visits must have authorization and are paid at <br/>
<a id="pl.218.16"></a><var>218.16</var>the same allowable rates as face-to-face skilled nurse visits.<br/>
<a id="pl.218.17"></a><var>218.17</var>(d) The provision of telehomecare must be made via live, two-way interactive <br/>
<a id="pl.218.18"></a><var>218.18</var>audiovisual technology and may be augmented by utilizing store-and-forward <br/>
<a id="pl.218.19"></a><var>218.19</var>technologies. Individually identifiable patient data obtained through real-time or <br/>
<a id="pl.218.20"></a><var>218.20</var>store-and-forward technology must be maintained as health records according to sections <br/>
<a id="pl.218.21"></a><var>218.21</var>144.291 to 144.298. If the video is used for research, training, or other purposes unrelated <br/>
<a id="pl.218.22"></a><var>218.22</var>to the care of the patient, the identity of the patient must be concealed.<br/>
<a id="pl.218.23"></a><var>218.23</var>(e) Authorization for skilled nurse visits must be completed under section <br/>
<a id="pl.218.24"></a><var>218.24</var>256B.0652. A total of nine face-to-face skilled nurses visits per calendar year do not <br/>
<a id="pl.218.25"></a><var>218.25</var>require authorization. All telehomecare skilled nurse visits require authorization.<br/>
<a id="pl.218.26"></a><var>218.26</var>    Subd. 5. <b>Home care therapies.</b> (a) Home care therapies include the following: <br/>
<a id="pl.218.27"></a><var>218.27</var>physical therapy, occupational therapy, respiratory therapy, and speech and language <br/>
<a id="pl.218.28"></a><var>218.28</var>pathology therapy services.<br/>
<a id="pl.218.29"></a><var>218.29</var>(b) Home care therapies must be:<br/>
<a id="pl.218.30"></a><var>218.30</var>(1) provided in the recipient's residence after it has been determined the recipient is <br/>
<a id="pl.218.31"></a><var>218.31</var>unable to access outpatient therapy;<br/>
<a id="pl.218.32"></a><var>218.32</var>(2) prescribed, ordered, or referred by a physician and documented in a plan of care <br/>
<a id="pl.218.33"></a><var>218.33</var>and reviewed, according to Minnesota Rules, part 9505.0390;<br/>
<a id="pl.218.34"></a><var>218.34</var>(3) assessed by an appropriate therapist; and<br/>
<a id="pl.218.35"></a><var>218.35</var>(4) provided by a Medicare-certified home health agency enrolled as a Medicaid <br/>
<a id="pl.218.36"></a><var>218.36</var>provider agency.<br/>
<a id="pl.219.1"></a><var>219.1</var>(c) Restorative and specialized maintenance therapies must be provided according to <br/>
<a id="pl.219.2"></a><var>219.2</var>Minnesota Rules, part 9505.0390. Physical and occupational therapy assistants may be <br/>
<a id="pl.219.3"></a><var>219.3</var>used as allowed under Minnesota Rules, part 9505.0390, subpart 1, item B.<br/>
<a id="pl.219.4"></a><var>219.4</var>(d) For both physical and occupational therapies, the therapist and the therapist's <br/>
<a id="pl.219.5"></a><var>219.5</var>assistant may not both bill for services provided to a recipient on the same day.<br/>
<a id="pl.219.6"></a><var>219.6</var>    Subd. 6. <b>Noncovered home health agency services.</b> The following are not eligible <br/>
<a id="pl.219.7"></a><var>219.7</var>for payment under medical assistance as a home health agency service:<br/>
<a id="pl.219.8"></a><var>219.8</var>(1) telehomecare skilled nurses services that is communication between the home <br/>
<a id="pl.219.9"></a><var>219.9</var>care nurse and recipient that consists solely of a telephone conversation, facsimile, <br/>
<a id="pl.219.10"></a><var>219.10</var>electronic mail, or a consultation between two health care practitioners;<br/>
<a id="pl.219.11"></a><var>219.11</var>(2) the following skilled nurse visits:<br/>
<a id="pl.219.12"></a><var>219.12</var>(i) for the purpose of monitoring medication compliance with an established <br/>
<a id="pl.219.13"></a><var>219.13</var>medication program for a recipient;<br/>
<a id="pl.219.14"></a><var>219.14</var>(ii) administering or assisting with medication administration, including injections, <br/>
<a id="pl.219.15"></a><var>219.15</var>prefilling syringes for injections, or oral medication setup of an adult recipient, when, <br/>
<a id="pl.219.16"></a><var>219.16</var>as determined and documented by the registered nurse, the need can be met by an <br/>
<a id="pl.219.17"></a><var>219.17</var>available pharmacy or the recipient or a family member is physically and mentally able <br/>
<a id="pl.219.18"></a><var>219.18</var>to self-administer or prefill a medication;<br/>
<a id="pl.219.19"></a><var>219.19</var>(iii) services done for the sole purpose of supervision of the home health aide or <br/>
<a id="pl.219.20"></a><var>219.20</var>personal care assistant;<br/>
<a id="pl.219.21"></a><var>219.21</var>(iv) services done for the sole purpose to train other home health agency workers;<br/>
<a id="pl.219.22"></a><var>219.22</var>(v) services done for the sole purpose of blood samples or lab draw when the <br/>
<a id="pl.219.23"></a><var>219.23</var>recipient is able to access these services outside the home; and<br/>
<a id="pl.219.24"></a><var>219.24</var>(vi) Medicare evaluation or administrative nursing visits required by Medicare;<br/>
<a id="pl.219.25"></a><var>219.25</var>(3) home health aide visits when the following activities are the sole purpose for the <br/>
<a id="pl.219.26"></a><var>219.26</var>visit: companionship, socialization, household tasks, transportation, and education; and<br/>
<a id="pl.219.27"></a><var>219.27</var>(4) home care therapies provided in other settings such as a clinic, day program, or as <br/>
<a id="pl.219.28"></a><var>219.28</var>an inpatient or when the recipient can access therapy outside of the recipient's residence.<br/>
<br/>
<a id="bill.8.26.0"></a><a id="pl.219.29"></a><var>219.29</var>    Sec. 26. Minnesota Statutes 2008, section 256B.0654, is amended to read:<br/>
<a id="pl.219.30"></a><var>219.30</var><b>256B.0654 PRIVATE DUTY NURSING.</b><br/>
<a id="pl.219.31"></a><var>219.31</var>    Subdivision 1. <b>Definitions.</b> (a) "Assessment" means a review and evaluation of a <br/>
<a id="pl.219.32"></a><var>219.32</var>recipient's need for home care services conducted in person. Assessments for private duty <br/>
<a id="pl.219.33"></a><var>219.33</var>nursing shall be conducted by a registered private duty nurse. Assessments for medical <br/>
<a id="pl.219.34"></a><var>219.34</var>assistance home care services for developmental disabilities and alternative care services <br/>
<a id="pl.220.1"></a><var>220.1</var>for developmentally disabled home and community-based waivered recipients may be <br/>
<a id="pl.220.2"></a><var>220.2</var>conducted by the county public health nurse to ensure coordination and avoid duplication.<br/>
<a id="pl.220.3"></a><var>220.3</var>(b) (a) "Complex and regular private duty nursing care" means:<br/>
<a id="pl.220.4"></a><var>220.4</var>(1) complex care is private duty nursing services provided to recipients who are <br/>
<a id="pl.220.5"></a><var>220.5</var>ventilator dependent or for whom a physician has certified that were it not for private duty <br/>
<a id="pl.220.6"></a><var>220.6</var>nursing the recipient would meet the criteria for inpatient hospital intensive care unit <br/>
<a id="pl.220.7"></a><var>220.7</var>(ICU) level of care; and<br/>
<a id="pl.220.8"></a><var>220.8</var>(2) regular care is private duty nursing provided to all other recipients.<br/>
<a id="pl.220.9"></a><var>220.9</var>(b) "Private duty nursing" means ongoing professional nursing services by a <br/>
<a id="pl.220.10"></a><var>220.10</var>registered or licensed practical nurse including assessment, professional nursing tasks, and <br/>
<a id="pl.220.11"></a><var>220.11</var>education, based on an assessment and physician orders to maintain or restore optimal <br/>
<a id="pl.220.12"></a><var>220.12</var>health of the recipient.<br/>
<a id="pl.220.13"></a><var>220.13</var>(c) "Private duty nursing agency" means a medical assistance enrolled provider <br/>
<a id="pl.220.14"></a><var>220.14</var>licensed under chapter 144A to provide private duty nursing services.<br/>
<a id="pl.220.15"></a><var>220.15</var>(d) "Regular private duty nursing" means nursing services provided to a recipient <br/>
<a id="pl.220.16"></a><var>220.16</var>who is considered stable and not at an inpatient hospital intensive care unit level of care, <br/>
<a id="pl.220.17"></a><var>220.17</var>but may have episodes of instability that are not life threatening.<br/>
<a id="pl.220.18"></a><var>220.18</var>(e) "Shared private duty nursing" means the provision of nursing services by a <br/>
<a id="pl.220.19"></a><var>220.19</var>private duty nurse to two recipients at the same time and in the same setting.<br/>
<a id="pl.220.20"></a><var>220.20</var>    Subd. 2. <b>Authorization; </b><b>private duty nursing services.</b> (a) All private duty <br/>
<a id="pl.220.21"></a><var>220.21</var>nursing services shall be prior authorized by the commissioner or the commissioner's <br/>
<a id="pl.220.22"></a><var>220.22</var>designee. Prior Authorization for private duty nursing services shall be based on <br/>
<a id="pl.220.23"></a><var>220.23</var>medical necessity and cost-effectiveness when compared with alternative care options. <br/>
<a id="pl.220.24"></a><var>220.24</var>The commissioner may authorize medically necessary private duty nursing services in <br/>
<a id="pl.220.25"></a><var>220.25</var>quarter-hour units when:<br/>
<a id="pl.220.26"></a><var>220.26</var>(1) the recipient requires more individual and continuous care than can be provided <br/>
<a id="pl.220.27"></a><var>220.27</var>during a skilled nurse visit; or<br/>
<a id="pl.220.28"></a><var>220.28</var>(2) the cares are outside of the scope of services that can be provided by a home <br/>
<a id="pl.220.29"></a><var>220.29</var>health aide or personal care assistant.<br/>
<a id="pl.220.30"></a><var>220.30</var>(b) The commissioner may authorize:<br/>
<a id="pl.220.31"></a><var>220.31</var>(1) up to two times the average amount of direct care hours provided in nursing <br/>
<a id="pl.220.32"></a><var>220.32</var>facilities statewide for case mix classification "K" as established by the annual cost report <br/>
<a id="pl.220.33"></a><var>220.33</var>submitted to the department by nursing facilities in May 1992;<br/>
<a id="pl.220.34"></a><var>220.34</var>(2) private duty nursing in combination with other home care services up to the total <br/>
<a id="pl.220.35"></a><var>220.35</var>cost allowed under section 
         <statute_ref>256B.0655, subdivision 4</statute_ref>;<br/>
<a id="pl.221.1"></a><var>221.1</var>(3) up to 16 hours per day if the recipient requires more nursing than the maximum <br/>
<a id="pl.221.2"></a><var>221.2</var>number of direct care hours as established in clause (1) and the recipient meets the hospital <br/>
<a id="pl.221.3"></a><var>221.3</var>admission criteria established under Minnesota Rules, parts 9505.0501 to 9505.0540.<br/>
<a id="pl.221.4"></a><var>221.4</var>(c) The commissioner may authorize up to 16 hours per day of medically necessary <br/>
<a id="pl.221.5"></a><var>221.5</var>private duty nursing services or up to 24 hours per day of medically necessary private duty <br/>
<a id="pl.221.6"></a><var>221.6</var>nursing services until such time as the commissioner is able to make a determination of <br/>
<a id="pl.221.7"></a><var>221.7</var>eligibility for recipients who are cooperatively applying for home care services under <br/>
<a id="pl.221.8"></a><var>221.8</var>the community alternative care program developed under section 
         <statute_ref>256B.49</statute_ref>, or until it is <br/>
<a id="pl.221.9"></a><var>221.9</var>determined by the appropriate regulatory agency that a health benefit plan is or is not <br/>
<a id="pl.221.10"></a><var>221.10</var>required to pay for appropriate medically necessary health care services. Recipients <br/>
<a id="pl.221.11"></a><var>221.11</var>or their representatives must cooperatively assist the commissioner in obtaining this <br/>
<a id="pl.221.12"></a><var>221.12</var>determination. Recipients who are eligible for the community alternative care program <br/>
<a id="pl.221.13"></a><var>221.13</var>may not receive more hours of nursing under this section and sections 
         <statute_ref>256B.0651</statute_ref>, <br/>
<statute_ref><a id="pl.221.14"></a><var>221.14</var>256B.0653
         </statute_ref>, 
         <statute_ref>256B.0655</statute_ref>, and
<statute_ref>256B.0656, and 256B.0659</statute_ref> than would otherwise be <br/>
<a id="pl.221.15"></a><var>221.15</var>authorized under section 
         <statute_ref>256B.49</statute_ref>.<br/>
<a id="pl.221.16"></a><var>221.16</var>    Subd. 2a. <b>Private duty nursing services.</b> (a) Private duty nursing services must <br/>
<a id="pl.221.17"></a><var>221.17</var>be used:<br/>
<a id="pl.221.18"></a><var>221.18</var>(1) in the recipient's home or outside the home when normal life activities require;<br/>
<a id="pl.221.19"></a><var>221.19</var>(2) when the recipient requires more individual and continuous care than can be <br/>
<a id="pl.221.20"></a><var>221.20</var>provided during a skilled nurse visit; and<br/>
<a id="pl.221.21"></a><var>221.21</var>(3) when the care required is outside of the scope of services that can be provided by <br/>
<a id="pl.221.22"></a><var>221.22</var>a home health aide or personal care assistant.<br/>
<a id="pl.221.23"></a><var>221.23</var>(b) Private duty nursing services must be:<br/>
<a id="pl.221.24"></a><var>221.24</var>(1) assessed by a registered nurse on a form approved by the commissioner;<br/>
<a id="pl.221.25"></a><var>221.25</var>(2) ordered by a physician and documented in a plan of care that is reviewed by the <br/>
<a id="pl.221.26"></a><var>221.26</var>physician at least once every 60 days; and<br/>
<a id="pl.221.27"></a><var>221.27</var>(3) authorized by the commissioner under section 256B.0652.<br/>
<a id="pl.221.28"></a><var>221.28</var>    Subd. 2b. <b>Noncovered private duty nursing services.</b> Private duty nursing <br/>
<a id="pl.221.29"></a><var>221.29</var>services do not cover the following:<br/>
<a id="pl.221.30"></a><var>221.30</var>(1) nursing services by a nurse who is the family foster care provider of a person <br/>
<a id="pl.221.31"></a><var>221.31</var>who has not reached 18 years of age unless allowed under subdivision 4;<br/>
<a id="pl.221.32"></a><var>221.32</var>(2) nursing services to more than two persons receiving shared private duty nursing <br/>
<a id="pl.221.33"></a><var>221.33</var>services from a private duty nurse in a single setting; and<br/>
<a id="pl.221.34"></a><var>221.34</var>(3) nursing services provided by a registered nurse or licensed practical nurse who is <br/>
<a id="pl.221.35"></a><var>221.35</var>the recipient's legal guardian or related to the recipient as spouse, parent, or family foster <br/>
<a id="pl.222.1"></a><var>222.1</var>parent whether by blood, marriage, or adoption except as specified in section 256B.0652, <br/>
<a id="pl.222.2"></a><var>222.2</var>subdivision 4.<br/>
<a id="pl.222.3"></a><var>222.3</var>    Subd. 3. <b>Shared private duty nursing </b><b>care</b><b> option.</b> (a) Medical assistance <br/>
<a id="pl.222.4"></a><var>222.4</var>payments for shared private duty nursing services by a private duty nurse shall be limited <br/>
<a id="pl.222.5"></a><var>222.5</var>according to this subdivision. For the purposes of this section and sections 
<statute_ref>256B.0651</statute_ref>, <br/>
<a id="pl.222.6"></a><var>222.6</var><statute_ref>256B.0653</statute_ref>, 
<statute_ref>256B.0655</statute_ref>, and 
<statute_ref>256B.0656</statute_ref>, "private duty nursing agency" means an agency <br/>
<a id="pl.222.7"></a><var>222.7</var>licensed under chapter 144A to provide private duty nursing services. Unless otherwise <br/>
<a id="pl.222.8"></a><var>222.8</var>provided in this subdivision, all other statutory and regulatory provisions relating to <br/>
<a id="pl.222.9"></a><var>222.9</var>private duty nursing services apply to shared private duty nursing services. Nothing in <br/>
<a id="pl.222.10"></a><var>222.10</var>this subdivision shall be construed to reduce the total number of private duty nursing <br/>
<a id="pl.222.11"></a><var>222.11</var>hours authorized for an individual recipient.<br/>
<a id="pl.222.12"></a><var>222.12</var>(b) Recipients of private duty nursing services may share nursing staff and the <br/>
<a id="pl.222.13"></a><var>222.13</var>commissioner shall provide a rate methodology for shared private duty nursing. For two <br/>
<a id="pl.222.14"></a><var>222.14</var>persons sharing nursing care, the rate paid to a provider shall not exceed 1.5 times the <br/>
<a id="pl.222.15"></a><var>222.15</var>regular private duty nursing rates paid for serving a single individual by a registered nurse <br/>
<a id="pl.222.16"></a><var>222.16</var>or licensed practical nurse. These rates apply only to situations in which both recipients <br/>
<a id="pl.222.17"></a><var>222.17</var>are present and receive shared private duty nursing care on the date for which the service <br/>
<a id="pl.222.18"></a><var>222.18</var>is billed. No more than two persons may receive shared private duty nursing services <br/>
<a id="pl.222.19"></a><var>222.19</var>from a private duty nurse in a single setting.<br/>
<a id="pl.222.20"></a><var>222.20</var>(c) (b) Shared private duty nursing care is the provision of nursing services by a <br/>
<a id="pl.222.21"></a><var>222.21</var>private duty nurse to two medical assistance eligible recipients at the same time and in <br/>
<a id="pl.222.22"></a><var>222.22</var>the same setting. This subdivision does not apply when a private duty nurse is caring for <br/>
<a id="pl.222.23"></a><var>222.23</var>multiple recipients in more than one setting.<br/>
<a id="pl.222.24"></a><var>222.24</var>(c) For the purposes of this subdivision, "setting" means:<br/>
<a id="pl.222.25"></a><var>222.25</var>(1) the home residence or foster care home of one of the individual recipients as <br/>
<a id="pl.222.26"></a><var>222.26</var>defined in section 256B.0651; or<br/>
<a id="pl.222.27"></a><var>222.27</var>(2) a child care program licensed under chapter 245A or operated by a local school <br/>
<a id="pl.222.28"></a><var>222.28</var>district or private school; or<br/>
<a id="pl.222.29"></a><var>222.29</var>(3) an adult day care service licensed under chapter 245A; or<br/>
<a id="pl.222.30"></a><var>222.30</var>(4) outside the home residence or foster care home of one of the recipients when <br/>
<a id="pl.222.31"></a><var>222.31</var>normal life activities take the recipients outside the home.<br/>
<a id="pl.222.32"></a><var>222.32</var>This subdivision does not apply when a private duty nurse is caring for multiple <br/>
<a id="pl.222.33"></a><var>222.33</var>recipients in more than one setting.<br/>
<a id="pl.222.34"></a><var>222.34</var>(d) The private duty nursing agency must offer the recipient the option of shared or <br/>
<a id="pl.222.35"></a><var>222.35</var>one-on-one private duty nursing services. The recipient may withdraw from participating <br/>
<a id="pl.222.36"></a><var>222.36</var>in a shared service arrangement at any time.<br/>
<a id="pl.223.1"></a><var>223.1</var>(d) (e) The recipient or the recipient's legal representative, and the recipient's <br/>
<a id="pl.223.2"></a><var>223.2</var>physician, in conjunction with the home health care private duty nursing agency, shall <br/>
<a id="pl.223.3"></a><var>223.3</var>determine:<br/>
<a id="pl.223.4"></a><var>223.4</var>(1) whether shared private duty nursing care is an appropriate option based on the <br/>
<a id="pl.223.5"></a><var>223.5</var>individual needs and preferences of the recipient; and<br/>
<a id="pl.223.6"></a><var>223.6</var>(2) the amount of shared private duty nursing services authorized as part of the <br/>
<a id="pl.223.7"></a><var>223.7</var>overall authorization of nursing services.<br/>
<a id="pl.223.8"></a><var>223.8</var>(e) (f) The recipient or the recipient's legal representative, in conjunction with the <br/>
<a id="pl.223.9"></a><var>223.9</var>private duty nursing agency, shall approve the setting, grouping, and arrangement of <br/>
<a id="pl.223.10"></a><var>223.10</var>shared private duty nursing care based on the individual needs and preferences of the <br/>
<a id="pl.223.11"></a><var>223.11</var>recipients. Decisions on the selection of recipients to share services must be based on the <br/>
<a id="pl.223.12"></a><var>223.12</var>ages of the recipients, compatibility, and coordination of their care needs.<br/>
<a id="pl.223.13"></a><var>223.13</var>(f) (g) The following items must be considered by the recipient or the recipient's <br/>
<a id="pl.223.14"></a><var>223.14</var>legal representative and the private duty nursing agency, and documented in the recipient's <br/>
<a id="pl.223.15"></a><var>223.15</var>health service record:<br/>
<a id="pl.223.16"></a><var>223.16</var>(1) the additional training needed by the private duty nurse to provide care to <br/>
<a id="pl.223.17"></a><var>223.17</var>two recipients in the same setting and to ensure that the needs of the recipients are met <br/>
<a id="pl.223.18"></a><var>223.18</var>appropriately and safely;<br/>
<a id="pl.223.19"></a><var>223.19</var>(2) the setting in which the shared private duty nursing care will be provided;<br/>
<a id="pl.223.20"></a><var>223.20</var>(3) the ongoing monitoring and evaluation of the effectiveness and appropriateness <br/>
<a id="pl.223.21"></a><var>223.21</var>of the service and process used to make changes in service or setting;<br/>
<a id="pl.223.22"></a><var>223.22</var>(4) a contingency plan which accounts for absence of the recipient in a shared private <br/>
<a id="pl.223.23"></a><var>223.23</var>duty nursing setting due to illness or other circumstances;<br/>
<a id="pl.223.24"></a><var>223.24</var>(5) staffing backup contingencies in the event of employee illness or absence; and<br/>
<a id="pl.223.25"></a><var>223.25</var>(6) arrangements for additional assistance to respond to urgent or emergency care <br/>
<a id="pl.223.26"></a><var>223.26</var>needs of the recipients.<br/>
<a id="pl.223.27"></a><var>223.27</var>(g) The provider must offer the recipient or responsible party the option of shared or <br/>
<a id="pl.223.28"></a><var>223.28</var>one-on-one private duty nursing services. The recipient or responsible party can withdraw <br/>
<a id="pl.223.29"></a><var>223.29</var>from participating in a shared service arrangement at any time.<br/>
<a id="pl.223.30"></a><var>223.30</var>(h) The private duty nursing agency must document the following in the <br/>
<a id="pl.223.31"></a><var>223.31</var>health service record for each individual recipient sharing private duty nursing care <br/>
<a id="pl.223.32"></a><var>223.32</var>The documentation for shared private duty nursing must be on a form approved by <br/>
<a id="pl.223.33"></a><var>223.33</var>the commissioner for each individual recipient sharing private duty nursing. The <br/>
<a id="pl.223.34"></a><var>223.34</var>documentation must be part of the recipient's health service record and include:<br/>
<a id="pl.223.35"></a><var>223.35</var>(1) permission by the recipient or the recipient's legal representative for the <br/>
<a id="pl.223.36"></a><var>223.36</var>maximum number of shared nursing care hours per week chosen by the recipient and <br/>
<a id="pl.224.1"></a><var>224.1</var>permission for shared private duty nursing services provided in and outside the recipient's <br/>
<a id="pl.224.2"></a><var>224.2</var>home residence;<br/>
<a id="pl.224.3"></a><var>224.3</var>(2) permission by the recipient or the recipient's legal representative for shared <br/>
<a id="pl.224.4"></a><var>224.4</var>private duty nursing services provided outside the recipient's residence;<br/>
<a id="pl.224.5"></a><var>224.5</var>(3) permission by the recipient or the recipient's legal representative for others to <br/>
<a id="pl.224.6"></a><var>224.6</var>receive shared private duty nursing services in the recipient's residence;<br/>
<a id="pl.224.7"></a><var>224.7</var>(4) revocation by the recipient or the recipient's legal representative of for the shared <br/>
<a id="pl.224.8"></a><var>224.8</var>private duty nursing care authorization, or the shared care to be provided to others in the <br/>
<a id="pl.224.9"></a><var>224.9</var>recipient's residence, or the shared private duty nursing services to be provided outside <br/>
<a id="pl.224.10"></a><var>224.10</var>permission, or services provided to others in and outside the recipient's residence; and<br/>
<a id="pl.224.11"></a><var>224.11</var>(5) (3) daily documentation of the shared private duty nursing services provided by <br/>
<a id="pl.224.12"></a><var>224.12</var>each identified private duty nurse, including:<br/>
<a id="pl.224.13"></a><var>224.13</var>(i) the names of each recipient receiving shared private duty nursing services <br/>
<a id="pl.224.14"></a><var>224.14</var>together;<br/>
<a id="pl.224.15"></a><var>224.15</var>(ii) the setting for the shared services, including the starting and ending times that <br/>
<a id="pl.224.16"></a><var>224.16</var>the recipient received shared private duty nursing care; and<br/>
<a id="pl.224.17"></a><var>224.17</var>(iii) notes by the private duty nurse regarding changes in the recipient's condition, <br/>
<a id="pl.224.18"></a><var>224.18</var>problems that may arise from the sharing of private duty nursing services, and scheduling <br/>
<a id="pl.224.19"></a><var>224.19</var>and care issues.<br/>
<a id="pl.224.20"></a><var>224.20</var>(i) Unless otherwise provided in this subdivision, all other statutory and regulatory <br/>
<a id="pl.224.21"></a><var>224.21</var>provisions relating to private duty nursing services apply to shared private duty nursing <br/>
<a id="pl.224.22"></a><var>224.22</var>services.<br/>
<a id="pl.224.23"></a><var>224.23</var>Nothing in this subdivision shall be construed to reduce the total number of private <br/>
<a id="pl.224.24"></a><var>224.24</var>duty nursing hours authorized for an individual recipient under subdivision 2.<br/>
<a id="pl.224.25"></a><var>224.25</var>(i) The commissioner shall provide a rate methodology for shared private duty <br/>
<a id="pl.224.26"></a><var>224.26</var>nursing. For two persons sharing nursing care, the rate paid to a provider must not exceed <br/>
<a id="pl.224.27"></a><var>224.27</var>1.5 times the regular private duty nursing rates paid for serving a single individual by a <br/>
<a id="pl.224.28"></a><var>224.28</var>registered nurse or licensed practical nurse. These rates apply only to situations in which <br/>
<a id="pl.224.29"></a><var>224.29</var>both recipients are present and receive shared private duty nursing care on the date for <br/>
<a id="pl.224.30"></a><var>224.30</var>which the service is billed.<br/>
<a id="pl.224.31"></a><var>224.31</var>    Subd. 4. <b>Hardship criteria; private duty nursing.</b> (a) Payment is allowed for <br/>
<a id="pl.224.32"></a><var>224.32</var>extraordinary services that require specialized nursing skills and are provided by parents <br/>
<a id="pl.224.33"></a><var>224.33</var>of minor children, family foster parents, spouses, and legal guardians who are providing <br/>
<a id="pl.224.34"></a><var>224.34</var>private duty nursing care under the following conditions:<br/>
<a id="pl.224.35"></a><var>224.35</var>(1) the provision of these services is not legally required of the parents, spouses, <br/>
<a id="pl.224.36"></a><var>224.36</var>or legal guardians;<br/>
<a id="pl.225.1"></a><var>225.1</var>(2) the services are necessary to prevent hospitalization of the recipient; and<br/>
<a id="pl.225.2"></a><var>225.2</var>(3) the recipient is eligible for state plan home care or a home and community-based <br/>
<a id="pl.225.3"></a><var>225.3</var>waiver and one of the following hardship criteria are met:<br/>
<a id="pl.225.4"></a><var>225.4</var>(i) the parent, spouse, or legal guardian resigns from a part-time or full-time job to <br/>
<a id="pl.225.5"></a><var>225.5</var>provide nursing care for the recipient; or<br/>
<a id="pl.225.6"></a><var>225.6</var>(ii) the parent, spouse, or legal guardian goes from a full-time to a part-time job with <br/>
<a id="pl.225.7"></a><var>225.7</var>less compensation to provide nursing care for the recipient; or<br/>
<a id="pl.225.8"></a><var>225.8</var>(iii) the parent, spouse, or legal guardian takes a leave of absence without pay to <br/>
<a id="pl.225.9"></a><var>225.9</var>provide nursing care for the recipient; or<br/>
<a id="pl.225.10"></a><var>225.10</var>(iv) because of labor conditions, special language needs, or intermittent hours of <br/>
<a id="pl.225.11"></a><var>225.11</var>care needed, the parent, spouse, or legal guardian is needed in order to provide adequate <br/>
<a id="pl.225.12"></a><var>225.12</var>private duty nursing services to meet the medical needs of the recipient.<br/>
<a id="pl.225.13"></a><var>225.13</var>(b) Private duty nursing may be provided by a parent, spouse, family foster parent, <br/>
<a id="pl.225.14"></a><var>225.14</var>or legal guardian who is a nurse licensed in Minnesota. Private duty nursing services <br/>
<a id="pl.225.15"></a><var>225.15</var>provided by a parent, spouse, family foster parent, or legal guardian cannot be used in <br/>
<a id="pl.225.16"></a><var>225.16</var>lieu of nursing services covered and available under liable third-party payors, including <br/>
<a id="pl.225.17"></a><var>225.17</var>Medicare. The private duty nursing provided by a parent, spouse, family foster parent, or <br/>
<a id="pl.225.18"></a><var>225.18</var>legal guardian must be included in the service plan agreement. Authorized skilled nursing <br/>
<a id="pl.225.19"></a><var>225.19</var>services for a single recipient or recipients with the same residence and provided by the <br/>
<a id="pl.225.20"></a><var>225.20</var>parent, spouse, family foster parent, or legal guardian may not exceed 50 percent of the <br/>
<a id="pl.225.21"></a><var>225.21</var>total approved nursing hours, or eight hours per day, whichever is less, up to a maximum <br/>
<a id="pl.225.22"></a><var>225.22</var>of 40 hours per week. A parent or parents, spouse, family foster parent, or legal guardian <br/>
<a id="pl.225.23"></a><var>225.23</var>shall not provide more than 40 hours of services in a seven-day period. For parents, family <br/>
<a id="pl.225.24"></a><var>225.24</var>foster parents, and legal guardians, 40 hours is the total amount allowed regardless of the <br/>
<a id="pl.225.25"></a><var>225.25</var>number of children or adults who receive services. Nothing in this subdivision precludes <br/>
<a id="pl.225.26"></a><var>225.26</var>the parent's, spouse's, or legal guardian's obligation of assuming the nonreimbursed family <br/>
<a id="pl.225.27"></a><var>225.27</var>responsibilities of emergency backup caregiver and primary caregiver.<br/>
<a id="pl.225.28"></a><var>225.28</var>(c) A parent, family foster parent,  or a spouse may not be paid to provide private <br/>
<a id="pl.225.29"></a><var>225.29</var>duty nursing care if:<br/>
<a id="pl.225.30"></a><var>225.30</var>(1) the parent or spouse fails to pass a criminal background check according to <br/>
<a id="pl.225.31"></a><var>225.31</var>chapter 245C, or if;<br/>
<a id="pl.225.32"></a><var>225.32</var>(2) it has been determined by the home health  private duty nursing agency, the <br/>
<a id="pl.225.33"></a><var>225.33</var>case manager, or the physician that the private duty nursing care provided by the parent, <br/>
<a id="pl.225.34"></a><var>225.34</var>family foster parent, spouse, or legal guardian is unsafe; or<br/>
<a id="pl.225.35"></a><var>225.35</var>(3) the parent, family foster parent, spouse, or legal guardian do not follow physician <br/>
<a id="pl.225.36"></a><var>225.36</var>orders.<br/>
<a id="pl.226.1"></a><var>226.1</var>(d) For purposes of this section, "assessment" means a review and evaluation of a <br/>
<a id="pl.226.2"></a><var>226.2</var>recipient's need for home care services conducted in person. Assessments for private duty <br/>
<a id="pl.226.3"></a><var>226.3</var>nursing must be conducted by a registered nurse.<br/>
<br/>
<a id="bill.8.27.0"></a><a id="pl.226.4"></a><var>226.4</var>    Sec. 27. Minnesota Statutes 2008, section 256B.0655, subdivision 1b, is amended to <br/>
<a id="pl.226.5"></a><var>226.5</var>read:<br/>
<a id="pl.226.6"></a><var>226.6</var>    Subd. 1b. <b>Assessment.</b> "Assessment" means a review and evaluation of a recipient's <br/>
<a id="pl.226.7"></a><var>226.7</var>need for home care services conducted in person. Assessments for personal care assistant <br/>
<a id="pl.226.8"></a><var>226.8</var>services shall be conducted by the county public health nurse or a certified public <br/>
<a id="pl.226.9"></a><var>226.9</var>health nurse under contract with the county. A face-to-face An in-person assessment <br/>
<a id="pl.226.10"></a><var>226.10</var>must include: documentation of health status, determination of need, evaluation of <br/>
<a id="pl.226.11"></a><var>226.11</var>service effectiveness, identification of appropriate services, service plan development <br/>
<a id="pl.226.12"></a><var>226.12</var>or modification, coordination of services, referrals and follow-up to appropriate payers <br/>
<a id="pl.226.13"></a><var>226.13</var>and community resources, completion of required reports, recommendation of service <br/>
<a id="pl.226.14"></a><var>226.14</var>authorization, and consumer education. Once the need for personal care assistant <br/>
<a id="pl.226.15"></a><var>226.15</var>services is determined under this section or sections 
         <statute_ref>256B.0651</statute_ref>, 
         <statute_ref>256B.0653</statute_ref>, 
         <statute_ref>256B.0654</statute_ref>, <br/>
<a id="pl.226.16"></a><var>226.16</var>and 
         <statute_ref>256B.0656</statute_ref>, the county public health nurse or certified public health nurse under <br/>
<a id="pl.226.17"></a><var>226.17</var>contract with the county is responsible for communicating this recommendation to the <br/>
<a id="pl.226.18"></a><var>226.18</var>commissioner and the recipient. A face-to-face assessment for personal care assistant <br/>
<a id="pl.226.19"></a><var>226.19</var>services is conducted on those recipients who have never had a county public health <br/>
<a id="pl.226.20"></a><var>226.20</var>nurse assessment. A face-to-face An in-person assessment must occur at least annually or <br/>
<a id="pl.226.21"></a><var>226.21</var>when there is a significant change in the recipient's condition or when there is a change <br/>
<a id="pl.226.22"></a><var>226.22</var>in the need for personal care assistant services. A service update may substitute for <br/>
<a id="pl.226.23"></a><var>226.23</var>the annual face-to-face assessment when there is not a significant change in recipient <br/>
<a id="pl.226.24"></a><var>226.24</var>condition or a change in the need for personal care assistant service. A service update <br/>
<a id="pl.226.25"></a><var>226.25</var>may be completed by telephone, used when there is no need for an increase in personal <br/>
<a id="pl.226.26"></a><var>226.26</var>care assistant services, and used for two consecutive assessments if followed by a <br/>
<a id="pl.226.27"></a><var>226.27</var>face-to-face assessment. A service update must be completed on a form approved by the <br/>
<a id="pl.226.28"></a><var>226.28</var>commissioner. A service update or review for temporary increase includes a review of <br/>
<a id="pl.226.29"></a><var>226.29</var>initial baseline data, evaluation of service effectiveness, redetermination of service need, <br/>
<a id="pl.226.30"></a><var>226.30</var>modification of service plan and appropriate referrals, update of initial forms, obtaining <br/>
<a id="pl.226.31"></a><var>226.31</var>service authorization, and on going consumer education. Assessments must be completed <br/>
<a id="pl.226.32"></a><var>226.32</var>on forms provided by the commissioner within 30 days of a request for home care services <br/>
<a id="pl.226.33"></a><var>226.33</var>by a recipient or responsible party or personal care provider agency.<br/>
<br/>
<a id="bill.8.28.0"></a><a id="pl.227.1"></a><var>227.1</var>    Sec. 28. Minnesota Statutes 2008, section 256B.0655, subdivision 4, is amended to <br/>
<a id="pl.227.2"></a><var>227.2</var>read:<br/>
<a id="pl.227.3"></a><var>227.3</var>    Subd. 4. <b>Prior</b><b> Authorization</b><b>; personal care assistance and qualified </b><br/>
<a id="pl.227.4"></a><var>227.4</var><b>professional</b><b>.</b> The commissioner, or the commissioner's designee, shall review the <br/>
<a id="pl.227.5"></a><var>227.5</var>assessment, service update, request for temporary services, request for flexible use option, <br/>
<a id="pl.227.6"></a><var>227.6</var>service plan, and any additional information that is submitted. The commissioner shall, <br/>
<a id="pl.227.7"></a><var>227.7</var>within 30 days after receiving a complete request, assessment, and service plan, authorize <br/>
<a id="pl.227.8"></a><var>227.8</var>home care services as follows:<br/>
<a id="pl.227.9"></a><var>227.9</var>(1) (a) All personal care assistant assistance  services and, supervision by a <br/>
<a id="pl.227.10"></a><var>227.10</var>qualified professional, if requested by the recipient, and additional services beyond the <br/>
<a id="pl.227.11"></a><var>227.11</var>limits established in section 256B.0651, subdivision 11, must be prior authorized by <br/>
<a id="pl.227.12"></a><var>227.12</var>the commissioner or the commissioner's designee before services begin except for the <br/>
<a id="pl.227.13"></a><var>227.13</var>assessments established in section sections
<statute_ref>256B.0651, subdivision 11, and 256B.0911</statute_ref>. <br/>
<a id="pl.227.14"></a><var>227.14</var>The authorization for personal care assistance and qualified professional services under <br/>
<a id="pl.227.15"></a><var>227.15</var>section 256B.0659 must be completed within 30 days after receiving a complete request.<br/>
<a id="pl.227.16"></a><var>227.16</var>(b) The amount of personal care assistant assistance  services authorized must be <br/>
<a id="pl.227.17"></a><var>227.17</var>based on the recipient's home care rating. The home care rating shall be determined by <br/>
<a id="pl.227.18"></a><var>227.18</var>the commissioner or the commissioner's designee based on information submitted to the <br/>
<a id="pl.227.19"></a><var>227.19</var>commissioner identifying the following:<br/>
<a id="pl.227.20"></a><var>227.20</var>(1) total number of dependencies of activities of daily living as defined in section <br/>
<a id="pl.227.21"></a><var>227.21</var>256B.0659;<br/>
<a id="pl.227.22"></a><var>227.22</var>(2) number of complex health-related functions as defined in section 256B.0659; and<br/>
<a id="pl.227.23"></a><var>227.23</var>(3) number of behavior descriptions as defined in section 256B.0659.<br/>
<a id="pl.227.24"></a><var>227.24</var>(c) The methodology to determine total time for personal care assistance services for <br/>
<a id="pl.227.25"></a><var>227.25</var>each home care rating is based on the median paid units per day for each home care rating <br/>
<a id="pl.227.26"></a><var>227.26</var>from fiscal year 2007 data for the personal care assistance program. Each home care rating <br/>
<a id="pl.227.27"></a><var>227.27</var>has a base level of hours assigned. Additional time is added through the assessment and <br/>
<a id="pl.227.28"></a><var>227.28</var>identification of the following:<br/>
<a id="pl.227.29"></a><var>227.29</var>(1) 30 additional minutes per day for a dependency in each critical activity of daily <br/>
<a id="pl.227.30"></a><var>227.30</var>living as defined in section 256B.0659;<br/>
<a id="pl.227.31"></a><var>227.31</var>(2) 30 additional minutes per day for each complex health-related function as <br/>
<a id="pl.227.32"></a><var>227.32</var>defined in section 256B.0659; and<br/>
<a id="pl.227.33"></a><var>227.33</var>(3) 30 additional minutes per day for each behavior issue as defined in section <br/>
<a id="pl.227.34"></a><var>227.34</var>256B.0659.<br/>
<a id="pl.227.35"></a><var>227.35</var>(d) A limit of 96 units of qualified professional supervision may be authorized for <br/>
<a id="pl.227.36"></a><var>227.36</var>each recipient receiving personal care assistance services. A request to the commissioner <br/>
<a id="pl.228.1"></a><var>228.1</var>to exceed this total in a calendar year must be requested by the personal care provider <br/>
<a id="pl.228.2"></a><var>228.2</var>agency on a form approved by the commissioner.<br/>
<a id="pl.228.3"></a><var>228.3</var>A child may not be found to be dependent in an activity of daily living if because <br/>
<a id="pl.228.4"></a><var>228.4</var>of the child's age an adult would either perform the activity for the child or assist the <br/>
<a id="pl.228.5"></a><var>228.5</var>child with the activity and the amount of assistance needed is similar to the assistance <br/>
<a id="pl.228.6"></a><var>228.6</var>appropriate for a typical child of the same age. Based on medical necessity, the <br/>
<a id="pl.228.7"></a><var>228.7</var>commissioner may authorize:<br/>
<a id="pl.228.8"></a><var>228.8</var>(A) up to two times the average number of direct care hours provided in nursing <br/>
<a id="pl.228.9"></a><var>228.9</var>facilities for the recipient's comparable case mix level; or<br/>
<a id="pl.228.10"></a><var>228.10</var>(B) up to three times the average number of direct care hours provided in nursing <br/>
<a id="pl.228.11"></a><var>228.11</var>facilities for recipients who have complex medical needs or are dependent in at least seven <br/>
<a id="pl.228.12"></a><var>228.12</var>activities of daily living and need physical assistance with eating or have a neurological <br/>
<a id="pl.228.13"></a><var>228.13</var>diagnosis; or<br/>
<a id="pl.228.14"></a><var>228.14</var>(C) up to 60 percent of the average reimbursement rate, as of July 1, 1991, for care <br/>
<a id="pl.228.15"></a><var>228.15</var>provided in a regional treatment center for recipients who have Level I behavior, plus any <br/>
<a id="pl.228.16"></a><var>228.16</var>inflation adjustment as provided by the legislature for personal care service; or<br/>
<a id="pl.228.17"></a><var>228.17</var>(D) up to the amount the commissioner would pay, as of July 1, 1991, plus any <br/>
<a id="pl.228.18"></a><var>228.18</var>inflation adjustment provided for home care services, for care provided in a regional <br/>
<a id="pl.228.19"></a><var>228.19</var>treatment center for recipients referred to the commissioner by a regional treatment center <br/>
<a id="pl.228.20"></a><var>228.20</var>preadmission evaluation team. For purposes of this clause, home care services means <br/>
<a id="pl.228.21"></a><var>228.21</var>all services provided in the home or community that would be included in the payment <br/>
<a id="pl.228.22"></a><var>228.22</var>to a regional treatment center; or<br/>
<a id="pl.228.23"></a><var>228.23</var>(E) up to the amount medical assistance would reimburse for facility care for <br/>
<a id="pl.228.24"></a><var>228.24</var>recipients referred to the commissioner by a preadmission screening team established <br/>
<a id="pl.228.25"></a><var>228.25</var>under section 
<statute_ref>256B.0911</statute_ref> or 
<statute_ref>256B.092</statute_ref>; and<br/>
<a id="pl.228.26"></a><var>228.26</var>(F) a reasonable amount of time for the provision of supervision by a qualified <br/>
<a id="pl.228.27"></a><var>228.27</var>professional of personal care assistant services, if a qualified professional is requested by <br/>
<a id="pl.228.28"></a><var>228.28</var>the recipient or responsible party.<br/>
<a id="pl.228.29"></a><var>228.29</var>(2) The number of direct care hours shall be determined according to the annual cost <br/>
<a id="pl.228.30"></a><var>228.30</var>report submitted to the department by nursing facilities. The average number of direct care <br/>
<a id="pl.228.31"></a><var>228.31</var>hours, as established by May 1, 1992, shall be calculated and incorporated into the home <br/>
<a id="pl.228.32"></a><var>228.32</var>care limits on July 1, 1992. These limits shall be calculated to the nearest quarter hour.<br/>
<a id="pl.228.33"></a><var>228.33</var>(3) The home care rating shall be determined by the commissioner or the <br/>
<a id="pl.228.34"></a><var>228.34</var>commissioner's designee based on information submitted to the commissioner by the <br/>
<a id="pl.228.35"></a><var>228.35</var>county public health nurse on forms specified by the commissioner. The home care rating <br/>
<a id="pl.228.36"></a><var>228.36</var>shall be a combination of current assessment tools developed under sections 
<statute_ref>256B.0911</statute_ref> <br/>
<a id="pl.229.1"></a><var>229.1</var>and 
<statute_ref>256B.501</statute_ref> with an addition for seizure activity that will assess the frequency and <br/>
<a id="pl.229.2"></a><var>229.2</var>severity of seizure activity and with adjustments, additions, and clarifications that are <br/>
<a id="pl.229.3"></a><var>229.3</var>necessary to reflect the needs and conditions of recipients who need home care including <br/>
<a id="pl.229.4"></a><var>229.4</var>children and adults under 65 years of age. The commissioner shall establish these forms <br/>
<a id="pl.229.5"></a><var>229.5</var>and protocols under this section and sections 
<statute_ref>256B.0651</statute_ref>, 
<statute_ref>256B.0653</statute_ref>, 
<statute_ref>256B.0654</statute_ref>, and <br/>
<a id="pl.229.6"></a><var>229.6</var><statute_ref>256B.0656</statute_ref> and shall use an advisory group, including representatives of recipients, <br/>
<a id="pl.229.7"></a><var>229.7</var>providers, and counties, for consultation in establishing and revising the forms and <br/>
<a id="pl.229.8"></a><var>229.8</var>protocols.<br/>
<a id="pl.229.9"></a><var>229.9</var>(4) A recipient shall qualify as having complex medical needs if the care required is <br/>
<a id="pl.229.10"></a><var>229.10</var>difficult to perform and because of recipient's medical condition requires more time than <br/>
<a id="pl.229.11"></a><var>229.11</var>community-based standards allow or requires more skill than would ordinarily be required <br/>
<a id="pl.229.12"></a><var>229.12</var>and the recipient needs or has one or more of the following:<br/>
<a id="pl.229.13"></a><var>229.13</var>(A) daily tube feedings;<br/>
<a id="pl.229.14"></a><var>229.14</var>(B) daily parenteral therapy;<br/>
<a id="pl.229.15"></a><var>229.15</var>(C) wound or decubiti care;<br/>
<a id="pl.229.16"></a><var>229.16</var>(D) postural drainage, percussion, nebulizer treatments, suctioning, tracheotomy <br/>
<a id="pl.229.17"></a><var>229.17</var>care, oxygen, mechanical ventilation;<br/>
<a id="pl.229.18"></a><var>229.18</var>(E) catheterization;<br/>
<a id="pl.229.19"></a><var>229.19</var>(F) ostomy care;<br/>
<a id="pl.229.20"></a><var>229.20</var>(G) quadriplegia; or<br/>
<a id="pl.229.21"></a><var>229.21</var>(H) other comparable medical conditions or treatments the commissioner determines <br/>
<a id="pl.229.22"></a><var>229.22</var>would otherwise require institutional care.<br/>
<a id="pl.229.23"></a><var>229.23</var>(5) A recipient shall qualify as having Level I behavior if there is reasonable <br/>
<a id="pl.229.24"></a><var>229.24</var>supporting evidence that the recipient exhibits, or that without supervision, observation, or <br/>
<a id="pl.229.25"></a><var>229.25</var>redirection would exhibit, one or more of the following behaviors that cause, or have the <br/>
<a id="pl.229.26"></a><var>229.26</var>potential to cause:<br/>
<a id="pl.229.27"></a><var>229.27</var>(A) injury to the recipient's own body;<br/>
<a id="pl.229.28"></a><var>229.28</var>(B) physical injury to other people; or<br/>
<a id="pl.229.29"></a><var>229.29</var>(C) destruction of property.<br/>
<a id="pl.229.30"></a><var>229.30</var>(6) Time authorized for personal care relating to Level I behavior in paragraph <br/>
<a id="pl.229.31"></a><var>229.31</var>(5), clauses (A) to (C), shall be based on the predictability, frequency, and amount of <br/>
<a id="pl.229.32"></a><var>229.32</var>intervention required.<br/>
<a id="pl.229.33"></a><var>229.33</var>(7) A recipient shall qualify as having Level II behavior if the recipient exhibits on a <br/>
<a id="pl.229.34"></a><var>229.34</var>daily basis one or more of the following behaviors that interfere with the completion of <br/>
<a id="pl.229.35"></a><var>229.35</var>personal care assistant services under subdivision 2, paragraph (a):<br/>
<a id="pl.229.36"></a><var>229.36</var>(A) unusual or repetitive habits;<br/>
<a id="pl.230.1"></a><var>230.1</var>(B) withdrawn behavior; or<br/>
<a id="pl.230.2"></a><var>230.2</var>(C) offensive behavior.<br/>
<a id="pl.230.3"></a><var>230.3</var>(8) A recipient with a home care rating of Level II behavior in paragraph (7), clauses <br/>
<a id="pl.230.4"></a><var>230.4</var>(A) to (C), shall be rated as comparable to a recipient with complex medical needs under <br/>
<a id="pl.230.5"></a><var>230.5</var>paragraph (4). If a recipient has both complex medical needs and Level II behavior, the <br/>
<a id="pl.230.6"></a><var>230.6</var>home care rating shall be the next complex category up to the maximum rating under <br/>
<a id="pl.230.7"></a><var>230.7</var>paragraph (1), clause (B).<br/>
<a id="pl.230.8"></a><var>230.8</var><b>EFFECTIVE DATE.</b>The amendments to paragraphs (a) and (b) are effective <br/>
<a id="pl.230.9"></a><var>230.9</var>January 1, 2010.<br/>
<br/>
<a id="bill.8.29.0"></a><a id="pl.230.10"></a><var>230.10</var>    Sec. 29. Minnesota Statutes 2008, section 256B.0657, subdivision 8, is amended to <br/>
<a id="pl.230.11"></a><var>230.11</var>read:<br/>
<a id="pl.230.12"></a><var>230.12</var>    Subd. 8. <b>Self-directed budget requirements.</b> The budget for the provision of the <br/>
<a id="pl.230.13"></a><var>230.13</var>self-directed service option shall be equal to the greater of either established based on:<br/>
<a id="pl.230.14"></a><var>230.14</var>    (1) the annual amount of personal care assistant services under section 
<statute_ref>256B.0655</statute_ref> <br/>
<a id="pl.230.15"></a><var>230.15</var>that the recipient has used in the most recent 12-month period assessed personal care <br/>
<a id="pl.230.16"></a><var>230.16</var>assistance units, not to exceed the maximum number of personal care assistance units <br/>
<a id="pl.230.17"></a><var>230.17</var>available, as determined by section 256B.0655; or and <br/>
<a id="pl.230.18"></a><var>230.18</var>    (2) the amount determined using the consumer support grant methodology under <br/>
<a id="pl.230.19"></a><var>230.19</var>section 
<statute_ref>256.476, subdivision 11</statute_ref>, except that the budget amount shall include the federal <br/>
<a id="pl.230.20"></a><var>230.20</var>and nonfederal share of the average service costs. the personal care assistance unit rate:<br/>
<a id="pl.230.21"></a><var>230.21</var>    (i) with a reduction to the unit rate to pay for a program administrator as defined in <br/>
<a id="pl.230.22"></a><var>230.22</var>subdivision 10; and<br/>
<a id="pl.230.23"></a><var>230.23</var>    (ii) an additional adjustment to the unit rate as needed to ensure cost neutrality for <br/>
<a id="pl.230.24"></a><var>230.24</var>the state.<br/>
<br/>
<a id="bill.8.30.0"></a><a id="pl.230.25"></a><var>230.25</var>    Sec. 30. Minnesota Statutes 2008, section 256B.0657, is amended by adding a <br/>
<a id="pl.230.26"></a><var>230.26</var>subdivision to read:<br/>
<a id="pl.230.27"></a><var>230.27</var>    Subd. 12. <b>Enrollment and evaluation.</b> Enrollment in the self-directed supports <br/>
<a id="pl.230.28"></a><var>230.28</var>option is available to current personal care assistance recipients upon annual personal care <br/>
<a id="pl.230.29"></a><var>230.29</var>assistance reassessment, with a maximum enrollment of 1,000 people in the first fiscal <br/>
<a id="pl.230.30"></a><var>230.30</var>year of implementation and an additional 1,000 people in the second fiscal year.  The <br/>
<a id="pl.230.31"></a><var>230.31</var>commissioner shall evaluate the self-directed supports option during the first two years of <br/>
<a id="pl.230.32"></a><var>230.32</var>implementation and make any necessary changes prior to the option becoming available <br/>
<a id="pl.230.33"></a><var>230.33</var>statewide.<br/>
<br/>
<a id="bill.8.31.0"></a><a id="pl.231.1"></a><var>231.1</var>    Sec. 31. <b>[256B.0659] PERSONAL CARE ASSISTANCE PROGRAM.</b><br/>
<a id="pl.231.2"></a><var>231.2</var>    Subdivision 1. <b>Definitions.</b> (a) For the purposes of this section, the terms defined in <br/>
<a id="pl.231.3"></a><var>231.3</var>paragraphs (b) to (p) have the meanings given unless otherwise provided in text.<br/>
<a id="pl.231.4"></a><var>231.4</var>(b) "Activities of daily living" means grooming, dressing, bathing, transferring, <br/>
<a id="pl.231.5"></a><var>231.5</var>mobility, positioning, eating, and toileting.<br/>
<a id="pl.231.6"></a><var>231.6</var>(c) "Behavior," effective January 1, 2010, means a category to determine the home <br/>
<a id="pl.231.7"></a><var>231.7</var>care rating and is based on the criteria found in this section. "Level I behavior" means <br/>
<a id="pl.231.8"></a><var>231.8</var>physical aggression towards self, others, or destruction of property that requires the <br/>
<a id="pl.231.9"></a><var>231.9</var>immediate response of another person.<br/>
<a id="pl.231.10"></a><var>231.10</var>(d) "Complex health-related needs," effective January 1, 2010, means a category to <br/>
<a id="pl.231.11"></a><var>231.11</var>determine the home care rating and is based on the criteria found in this section.<br/>
<a id="pl.231.12"></a><var>231.12</var>(e) "Critical activities of daily living," effective January 1, 2010, means transferring, <br/>
<a id="pl.231.13"></a><var>231.13</var>mobility, eating, and toileting.<br/>
<a id="pl.231.14"></a><var>231.14</var>(f) "Dependency in activities of daily living" means a person requires assistance to <br/>
<a id="pl.231.15"></a><var>231.15</var>begin and complete one or more of the activities of daily living.<br/>
<a id="pl.231.16"></a><var>231.16</var>(g) "Health-related procedures and tasks" means procedures and tasks that can <br/>
<a id="pl.231.17"></a><var>231.17</var>be delegated or assigned by a licensed health care professional under state law to be <br/>
<a id="pl.231.18"></a><var>231.18</var>performed by a personal care assistant.<br/>
<a id="pl.231.19"></a><var>231.19</var>(h) "Instrumental activities of daily living" means activities to include meal planning <br/>
<a id="pl.231.20"></a><var>231.20</var>and preparation; basic assistance with paying bills; shopping for food, clothing, and <br/>
<a id="pl.231.21"></a><var>231.21</var>other essential items; performing household tasks integral to the personal care assistance <br/>
<a id="pl.231.22"></a><var>231.22</var>services; communication by telephone and other media; and traveling, including to <br/>
<a id="pl.231.23"></a><var>231.23</var>medical appointments and to participate in the community.<br/>
<a id="pl.231.24"></a><var>231.24</var>(i) "Managing employee" has the same definition as Code of Federal Regulations, <br/>
<a id="pl.231.25"></a><var>231.25</var>title 42, section 455.<br/>
<a id="pl.231.26"></a><var>231.26</var>(j) "Qualified professional" means a professional providing supervision of personal <br/>
<a id="pl.231.27"></a><var>231.27</var>care assistance services and staff as defined in section 256B.0625, subdivision 19c.<br/>
<a id="pl.231.28"></a><var>231.28</var>(k) "Personal care assistance provider agency" means a medical assistance enrolled <br/>
<a id="pl.231.29"></a><var>231.29</var>provider that provides or assists with providing personal care assistance services and <br/>
<a id="pl.231.30"></a><var>231.30</var>includes personal care assistance provider organizations, personal care assistance choice <br/>
<a id="pl.231.31"></a><var>231.31</var>agency, class A licensed nursing agency, and Medicare-certified home health agency.<br/>
<a id="pl.231.32"></a><var>231.32</var>(l) "Personal care assistant" or "PCA" means an individual employed by a personal <br/>
<a id="pl.231.33"></a><var>231.33</var>care assistance agency who provides personal care assistance services.<br/>
<a id="pl.231.34"></a><var>231.34</var>(m) "Personal care assistance care plan" means a written description of personal <br/>
<a id="pl.231.35"></a><var>231.35</var>care assistance services developed by the personal care assistance provider according <br/>
<a id="pl.231.36"></a><var>231.36</var>to the service plan.<br/>
<a id="pl.232.1"></a><var>232.1</var>(n) "Responsible party" means an individual who is capable of providing the support <br/>
<a id="pl.232.2"></a><var>232.2</var>necessary to assist the recipient to live in the community.<br/>
<a id="pl.232.3"></a><var>232.3</var>(o) "Self-administered medication" means medication taken orally, by injection or <br/>
<a id="pl.232.4"></a><var>232.4</var>insertion, or applied topically without the need for assistance.<br/>
<a id="pl.232.5"></a><var>232.5</var>(p) "Service plan" means a written summary of the assessment and description of the <br/>
<a id="pl.232.6"></a><var>232.6</var>services needed by the recipient.<br/>
<a id="pl.232.7"></a><var>232.7</var>    Subd. 2. <b>Personal care assistance services; covered services.</b> (a) The personal <br/>
<a id="pl.232.8"></a><var>232.8</var>care assistance services eligible for payment include services and supports furnished <br/>
<a id="pl.232.9"></a><var>232.9</var>to an individual, as needed, to assist in:<br/>
<a id="pl.232.10"></a><var>232.10</var>(1) activities of daily living;<br/>
<a id="pl.232.11"></a><var>232.11</var>(2) health-related procedures and tasks;<br/>
<a id="pl.232.12"></a><var>232.12</var>(3) observation and redirection of behaviors; and<br/>
<a id="pl.232.13"></a><var>232.13</var>(4) instrumental activities of daily living.<br/>
<a id="pl.232.14"></a><var>232.14</var>(b) Activities of daily living include the following covered services:<br/>
<a id="pl.232.15"></a><var>232.15</var>(1) dressing, including assistance with choosing, application, and changing of <br/>
<a id="pl.232.16"></a><var>232.16</var>clothing and application of special appliances, wraps, or clothing;<br/>
<a id="pl.232.17"></a><var>232.17</var>(2) grooming, including assistance with basic hair care, oral care, shaving, applying <br/>
<a id="pl.232.18"></a><var>232.18</var>cosmetics and deodorant, and care of eyeglasses and hearing aids. Nail care is included, <br/>
<a id="pl.232.19"></a><var>232.19</var>except for recipients who are diabetic or have poor circulation;<br/>
<a id="pl.232.20"></a><var>232.20</var>(3) bathing, including assistance with basic personal hygiene and skin care;<br/>
<a id="pl.232.21"></a><var>232.21</var>(4) eating, including assistance with hand washing and application of orthotics <br/>
<a id="pl.232.22"></a><var>232.22</var>required for eating, transfers, and feeding;<br/>
<a id="pl.232.23"></a><var>232.23</var>(5) transfers, including assistance with transferring the recipient from one seating or <br/>
<a id="pl.232.24"></a><var>232.24</var>reclining area to another;<br/>
<a id="pl.232.25"></a><var>232.25</var>(6) mobility, including assistance with ambulation, including use of a wheelchair. <br/>
<a id="pl.232.26"></a><var>232.26</var>Mobility does not include providing transportation for a recipient;<br/>
<a id="pl.232.27"></a><var>232.27</var>(7) positioning, including assistance with positioning or turning a recipient for <br/>
<a id="pl.232.28"></a><var>232.28</var>necessary care and comfort; and<br/>
<a id="pl.232.29"></a><var>232.29</var>(8) toileting, including assistance with helping recipient with bowel or bladder <br/>
<a id="pl.232.30"></a><var>232.30</var>elimination and care including transfers, mobility, positioning, feminine hygiene, use of <br/>
<a id="pl.232.31"></a><var>232.31</var>toileting equipment or supplies, cleansing the perineal area, inspection of the skin, and <br/>
<a id="pl.232.32"></a><var>232.32</var>adjusting clothing.<br/>
<a id="pl.232.33"></a><var>232.33</var>(c) Health-related procedures and tasks include the following covered services:<br/>
<a id="pl.232.34"></a><var>232.34</var>(1) range of motion and passive exercise to maintain a recipient's strength and <br/>
<a id="pl.232.35"></a><var>232.35</var>muscle functioning;<br/>
<a id="pl.233.1"></a><var>233.1</var>(2) assistance with self-administered medication as defined by this section, including <br/>
<a id="pl.233.2"></a><var>233.2</var>reminders to take medication, bringing medication to the recipient, and assistance with <br/>
<a id="pl.233.3"></a><var>233.3</var>opening medication under the direction of the recipient or responsible party;<br/>
<a id="pl.233.4"></a><var>233.4</var>(3) interventions for seizure disorders, including monitoring and observation; and<br/>
<a id="pl.233.5"></a><var>233.5</var>(4) other activities considered within the scope of the personal care service and <br/>
<a id="pl.233.6"></a><var>233.6</var>meeting the definition of health-related procedures and tasks under this section.<br/>
<a id="pl.233.7"></a><var>233.7</var>(d) A personal care assistant may provide health-related procedures and tasks <br/>
<a id="pl.233.8"></a><var>233.8</var>associated with the complex health-related needs of a recipient if the procedures and <br/>
<a id="pl.233.9"></a><var>233.9</var>tasks meet the definition of health-related procedures and tasks under this section and the <br/>
<a id="pl.233.10"></a><var>233.10</var>personal care assistant is trained by a qualified professional and demonstrates competency <br/>
<a id="pl.233.11"></a><var>233.11</var>to safely complete the procedures and tasks. Delegation of health-related procedures and <br/>
<a id="pl.233.12"></a><var>233.12</var>tasks and all training must be documented in the personal care assistance care plan and the <br/>
<a id="pl.233.13"></a><var>233.13</var>recipient's and personal care assistant's files.<br/>
<a id="pl.233.14"></a><var>233.14</var>(e) Effective January 1, 2010, for a personal care assistant to provide the <br/>
<a id="pl.233.15"></a><var>233.15</var>health-related procedures and tasks of tracheostomy suctioning and services to recipients <br/>
<a id="pl.233.16"></a><var>233.16</var>on ventilator support there must be:<br/>
<a id="pl.233.17"></a><var>233.17</var>(1) delegation and training by a registered nurse, certified or licensed respiratory <br/>
<a id="pl.233.18"></a><var>233.18</var>therapist, or a physician;<br/>
<a id="pl.233.19"></a><var>233.19</var>(2) utilization of clean rather than sterile procedure;<br/>
<a id="pl.233.20"></a><var>233.20</var>(3) specialized training about the health-related procedures and tasks and equipment, <br/>
<a id="pl.233.21"></a><var>233.21</var>including ventilator operation and maintenance;<br/>
<a id="pl.233.22"></a><var>233.22</var>(4) individualized training regarding the needs of the recipient; and<br/>
<a id="pl.233.23"></a><var>233.23</var>(5) supervision by a qualified professional who is a registered nurse.<br/>
<a id="pl.233.24"></a><var>233.24</var>(f) Effective January 1, 2010, a personal care assistant may observe and redirect the <br/>
<a id="pl.233.25"></a><var>233.25</var>recipient for episodes where there is a need for redirection due to behaviors. Training of <br/>
<a id="pl.233.26"></a><var>233.26</var>the personal care assistant must occur based on the needs of the recipient, the personal <br/>
<a id="pl.233.27"></a><var>233.27</var>care assistance care plan, and any other support services provided.<br/>
<a id="pl.233.28"></a><var>233.28</var>(g) Instrumental activities of daily living under subdivision 1, paragraph (h).<br/>
<a id="pl.233.29"></a><var>233.29</var>    Subd. 3. <b>Noncovered personal care assistance services.</b> (a) Personal care <br/>
<a id="pl.233.30"></a><var>233.30</var>assistance services are not eligible for medical assistance payment under this section <br/>
<a id="pl.233.31"></a><var>233.31</var>when provided:<br/>
<a id="pl.233.32"></a><var>233.32</var>(1) by the recipient's spouse, parent of a recipient under the age of 18, paid legal <br/>
<a id="pl.233.33"></a><var>233.33</var>guardian, licensed foster provider, except as allowed under section 256B.0651, subdivision <br/>
<a id="pl.233.34"></a><var>233.34</var>9a, or responsible party;<br/>
<a id="pl.233.35"></a><var>233.35</var>(2) in lieu of other staffing options in a residential or child care setting;<br/>
<a id="pl.233.36"></a><var>233.36</var>(3) solely as a child care or babysitting service; or<br/>
<a id="pl.234.1"></a><var>234.1</var>(4) without authorization by the commissioner or the commissioner's designee.<br/>
<a id="pl.234.2"></a><var>234.2</var>(b) The following personal care services are not eligible for medical assistance <br/>
<a id="pl.234.3"></a><var>234.3</var>payment under this section when provided in residential settings:<br/>
<a id="pl.234.4"></a><var>234.4</var>(1) effective January 1, 2010, when the provider of home care services who is not <br/>
<a id="pl.234.5"></a><var>234.5</var>related by blood, marriage, or adoption owns or otherwise controls the living arrangement, <br/>
<a id="pl.234.6"></a><var>234.6</var>including licensed or unlicensed services; or<br/>
<a id="pl.234.7"></a><var>234.7</var>(2) when personal care assistance services are the responsibility of a residential or <br/>
<a id="pl.234.8"></a><var>234.8</var>program license holder under the terms of a service agreement and administrative rules.<br/>
<a id="pl.234.9"></a><var>234.9</var>(c) Other specific tasks not covered under paragraph (a) or (b) that are not eligible <br/>
<a id="pl.234.10"></a><var>234.10</var>for medical assistance reimbursement for personal care assistance services under this <br/>
<a id="pl.234.11"></a><var>234.11</var>section include:<br/>
<a id="pl.234.12"></a><var>234.12</var>(1) sterile procedures;<br/>
<a id="pl.234.13"></a><var>234.13</var>(2) injections of fluids and medications into veins, muscles, or skin;<br/>
<a id="pl.234.14"></a><var>234.14</var>(3) home maintenance or chore services;<br/>
<a id="pl.234.15"></a><var>234.15</var>(4) homemaker services not an integral part of assessed personal care assistance <br/>
<a id="pl.234.16"></a><var>234.16</var>services needed by a recipient;<br/>
<a id="pl.234.17"></a><var>234.17</var>(5) application of restraints or implementation of procedures under section 245.825;<br/>
<a id="pl.234.18"></a><var>234.18</var>(6) instrumental activities of daily living for children under the age of 18; and<br/>
<a id="pl.234.19"></a><var>234.19</var>(7) assessments for personal care assistance services by personal care assistance <br/>
<a id="pl.234.20"></a><var>234.20</var>provider agencies or by independently enrolled registered nurses.<br/>
<a id="pl.234.21"></a><var>234.21</var>    Subd. 4. <b>Assessment for personal care assistance services.</b> (a) An assessment <br/>
<a id="pl.234.22"></a><var>234.22</var>as defined in section 256B.0655, subdivision 1b, must be completed for personal care <br/>
<a id="pl.234.23"></a><var>234.23</var>assistance services.<br/>
<a id="pl.234.24"></a><var>234.24</var>(b) The following limitations apply to the assessment:<br/>
<a id="pl.234.25"></a><var>234.25</var>(1) a person must be assessed as dependent in an activity of daily living based <br/>
<a id="pl.234.26"></a><var>234.26</var>on the person's need, on a daily basis, for:<br/>
<a id="pl.234.27"></a><var>234.27</var>(i) cueing and constant supervision to complete the task; or<br/>
<a id="pl.234.28"></a><var>234.28</var>(ii) hands-on assistance to complete the task; and<br/>
<a id="pl.234.29"></a><var>234.29</var>(2) a child may not be found to be dependent in an activity of daily living if because <br/>
<a id="pl.234.30"></a><var>234.30</var>of the child's age an adult would either perform the activity for the child or assist the child <br/>
<a id="pl.234.31"></a><var>234.31</var>with the activity. Assistance needed is the assistance appropriate for a typical child of <br/>
<a id="pl.234.32"></a><var>234.32</var>the same age.<br/>
<a id="pl.234.33"></a><var>234.33</var>(c) Assessment for complex health-related needs must meet the criteria in this <br/>
<a id="pl.234.34"></a><var>234.34</var>paragraph. During the assessment process, a recipient qualifies as having complex <br/>
<a id="pl.234.35"></a><var>234.35</var>health-related needs if the recipient has one or more of the interventions that are ordered by <br/>
<a id="pl.234.36"></a><var>234.36</var>a physician, specified in a personal care assistance care plan, and found in the following:<br/>
<a id="pl.235.1"></a><var>235.1</var>(1) tube feedings requiring:<br/>
<a id="pl.235.2"></a><var>235.2</var>(i) a gastro/jejunostomy tube; or<br/>
<a id="pl.235.3"></a><var>235.3</var>(ii) continuous tube feeding lasting longer than 12 hours per day;<br/>
<a id="pl.235.4"></a><var>235.4</var>(2) wounds described as:<br/>
<a id="pl.235.5"></a><var>235.5</var>    (i) stage III or stage IV;<br/>
<a id="pl.235.6"></a><var>235.6</var>    (ii) multiple wounds;<br/>
<a id="pl.235.7"></a><var>235.7</var>    (iii) requiring sterile or clean dressing changes or a wound vac; or<br/>
<a id="pl.235.8"></a><var>235.8</var>    (iv) open lesions such as burns, fistulas, tube sites, or ostomy sites that require <br/>
<a id="pl.235.9"></a><var>235.9</var>specialized care;<br/>
<a id="pl.235.10"></a><var>235.10</var>    (3) parenteral therapy described as:<br/>
<a id="pl.235.11"></a><var>235.11</var>    (i) IV therapy more than two times per week lasting longer than four hours for <br/>
<a id="pl.235.12"></a><var>235.12</var>each treatment; or<br/>
<a id="pl.235.13"></a><var>235.13</var>    (ii) total parenteral nutrition (TPN) daily;<br/>
<a id="pl.235.14"></a><var>235.14</var>    (4) respiratory interventions including:<br/>
<a id="pl.235.15"></a><var>235.15</var>    (i) oxygen required more than eight hours per day;<br/>
<a id="pl.235.16"></a><var>235.16</var>    (ii) respiratory vest more than one time per day;<br/>
<a id="pl.235.17"></a><var>235.17</var>    (iii) bronchial drainage treatments more than two times per day;<br/>
<a id="pl.235.18"></a><var>235.18</var>    (iv) sterile or clean suctioning more than six times per day;<br/>
<a id="pl.235.19"></a><var>235.19</var>    (v) dependence on another to apply respiratory ventilation augmentation devises <br/>
<a id="pl.235.20"></a><var>235.20</var>such as BiPAP and CPAP; and<br/>
<a id="pl.235.21"></a><var>235.21</var>    (vi) ventilator dependence under section 256B.0652;<br/>
<a id="pl.235.22"></a><var>235.22</var>    (5) insertion and maintenance of catheter including:<br/>
<a id="pl.235.23"></a><var>235.23</var>(i) sterile catheter changes more than one time per month;<br/>
<a id="pl.235.24"></a><var>235.24</var>(ii) clean self-catheterization more than six times per day; or<br/>
<a id="pl.235.25"></a><var>235.25</var>(iii) bladder irrigations;<br/>
<a id="pl.235.26"></a><var>235.26</var>(6) bowel program more than two times per week requiring more than 30 minutes to <br/>
<a id="pl.235.27"></a><var>235.27</var>perform each time;<br/>
<a id="pl.235.28"></a><var>235.28</var>(7) neurological intervention including:<br/>
<a id="pl.235.29"></a><var>235.29</var>(i) seizures more than two times per week and requiring significant physical <br/>
<a id="pl.235.30"></a><var>235.30</var>assistance to maintain safety; or<br/>
<a id="pl.235.31"></a><var>235.31</var>(ii) swallowing disorders diagnosed by a physician and requiring specialized <br/>
<a id="pl.235.32"></a><var>235.32</var>assistance from another on a daily basis; and<br/>
<a id="pl.235.33"></a><var>235.33</var>(8) other congenital or acquired diseases creating a need for significantly increased <br/>
<a id="pl.235.34"></a><var>235.34</var>direct hands-on assistance and interventions in six to eight activities of daily living.<br/>
<a id="pl.236.1"></a><var>236.1</var>(d) An assessment of behaviors must meet the criteria in this paragraph. A recipient <br/>
<a id="pl.236.2"></a><var>236.2</var>qualifies as having a need for assistance due to behaviors if the recipient's behavior requires <br/>
<a id="pl.236.3"></a><var>236.3</var>assistance at least four times per week and shows one or more of the following behaviors:<br/>
<a id="pl.236.4"></a><var>236.4</var>(1) physical aggression towards self or others, or destruction of property that requires <br/>
<a id="pl.236.5"></a><var>236.5</var>the immediate response of another person;<br/>
<a id="pl.236.6"></a><var>236.6</var>(2) increased vulnerability due to cognitive deficits or socially inappropriate <br/>
<a id="pl.236.7"></a><var>236.7</var>behavior; or<br/>
<a id="pl.236.8"></a><var>236.8</var>(3) verbally aggressive and resistive to care.<br/>
<a id="pl.236.9"></a><var>236.9</var>    Subd. 5. <b>Service, support planning, and referral.</b> (a) The assessor, with the <br/>
<a id="pl.236.10"></a><var>236.10</var>recipient or responsible party, shall review the assessment information and determine <br/>
<a id="pl.236.11"></a><var>236.11</var>referrals for other payers, services, and community supports as appropriate.<br/>
<a id="pl.236.12"></a><var>236.12</var>(b) The recipient must be referred for evaluation, services, or supports that are <br/>
<a id="pl.236.13"></a><var>236.13</var>appropriate to help meet the recipient's needs including, but not limited to, the following <br/>
<a id="pl.236.14"></a><var>236.14</var>circumstances:<br/>
<a id="pl.236.15"></a><var>236.15</var>(1) when there is another payer who is responsible to provide the service to meet <br/>
<a id="pl.236.16"></a><var>236.16</var>the recipient's needs;<br/>
<a id="pl.236.17"></a><var>236.17</var>(2) when the recipient qualifies for assistance due to mental illness or behaviors <br/>
<a id="pl.236.18"></a><var>236.18</var>under this section, a referral for a mental health diagnostic and functional assessment <br/>
<a id="pl.236.19"></a><var>236.19</var>must be completed, or referral must be made for other specific mental health services or <br/>
<a id="pl.236.20"></a><var>236.20</var>other community services;<br/>
<a id="pl.236.21"></a><var>236.21</var>(3) when the recipient is eligible for medical assistance and meets medical assistance <br/>
<a id="pl.236.22"></a><var>236.22</var>eligibility for a home health aide or skilled nurse visit;<br/>
<a id="pl.236.23"></a><var>236.23</var>(4) when the recipient would benefit from an evaluation for another service; and<br/>
<a id="pl.236.24"></a><var>236.24</var>(5) when there is a more appropriate service to meet the assessed needs.<br/>
<a id="pl.236.25"></a><var>236.25</var>    (c) The reimbursement rates for public health nurse visits that relate to the provision <br/>
<a id="pl.236.26"></a><var>236.26</var>of personal care assistance services under this section and section 
<statute_ref>256B.0625, subdivision <br/>
<a id="pl.236.27"></a><var>236.27</var>19a
</statute_ref>, are:<br/>
<a id="pl.236.28"></a><var>236.28</var>    (1) $210.50 for a face-to-face assessment visit;<br/>
<a id="pl.236.29"></a><var>236.29</var>    (2) $105.25 for each service update; and<br/>
<a id="pl.236.30"></a><var>236.30</var>    (3) $105.25 for each request for a temporary service increase.<br/>
<a id="pl.236.31"></a><var>236.31</var>    (d) The rates specified in paragraph (c) must be adjusted to reflect provider rate <br/>
<a id="pl.236.32"></a><var>236.32</var>increases for personal care assistance services that are approved by the legislature for the <br/>
<a id="pl.236.33"></a><var>236.33</var>fiscal year ending June 30, 2000, and subsequent fiscal years. Any requirements applied <br/>
<a id="pl.236.34"></a><var>236.34</var>by the legislature to provider rate increases for personal care assistance services also <br/>
<a id="pl.236.35"></a><var>236.35</var>apply to adjustments under this paragraph.<br/>
<a id="pl.237.1"></a><var>237.1</var>    (e) Effective July 1, 2008, the payment rate for an assessment under this section and <br/>
<a id="pl.237.2"></a><var>237.2</var>section 
<statute_ref>256B.0651</statute_ref> shall be reduced by 25 percent when the assessment is not completed <br/>
<a id="pl.237.3"></a><var>237.3</var>on time and the service agreement documentation is not submitted in time to continue <br/>
<a id="pl.237.4"></a><var>237.4</var>services. The commissioner shall reduce the amount of the claim for those assessments <br/>
<a id="pl.237.5"></a><var>237.5</var>that are not submitted on time.<br/>
<a id="pl.237.6"></a><var>237.6</var>    Subd. 6. <b>Service plan.</b> The service plan must be completed by the assessor with the <br/>
<a id="pl.237.7"></a><var>237.7</var>recipient and responsible party on a form determined by the commissioner and include <br/>
<a id="pl.237.8"></a><var>237.8</var>a summary of the assessment with a description of the need, authorized amount, and <br/>
<a id="pl.237.9"></a><var>237.9</var>expected outcomes and goals of personal care assistance services. The recipient and <br/>
<a id="pl.237.10"></a><var>237.10</var>the provider chosen by the recipient or responsible party must be given a copy of the <br/>
<a id="pl.237.11"></a><var>237.11</var>completed service plan within ten working days of the assessment. The recipient or <br/>
<a id="pl.237.12"></a><var>237.12</var>responsible party must be given information by the assessor about the options in the <br/>
<a id="pl.237.13"></a><var>237.13</var>personal care assistance program to allow for review and decision making.<br/>
<a id="pl.237.14"></a><var>237.14</var>    Subd. 7. <b>Personal care assistance care plan.</b> (a) Each recipient must have a <br/>
<a id="pl.237.15"></a><var>237.15</var>current personal care assistance care plan based on the service plan in subdivision 6 that is <br/>
<a id="pl.237.16"></a><var>237.16</var>developed by the qualified professional with the recipient and responsible party. A copy of <br/>
<a id="pl.237.17"></a><var>237.17</var>the most current personal care assistance care plan is required to be in the recipient's home <br/>
<a id="pl.237.18"></a><var>237.18</var>and in the recipient's file at the provider agency.<br/>
<a id="pl.237.19"></a><var>237.19</var>(b) The personal care assistance care plan must have the following components:<br/>
<a id="pl.237.20"></a><var>237.20</var>(1) start and end date of the care plan;<br/>
<a id="pl.237.21"></a><var>237.21</var>(2) recipient demographic information, including name and telephone number;<br/>
<a id="pl.237.22"></a><var>237.22</var>(3) emergency numbers, procedures, and a description of measures to address <br/>
<a id="pl.237.23"></a><var>237.23</var>identified safety and vulnerability issues, including a backup staffing plan;<br/>
<a id="pl.237.24"></a><var>237.24</var>(4) name of responsible party and instructions for contact;<br/>
<a id="pl.237.25"></a><var>237.25</var>(5) description of the recipient's individualized needs for assistance with activities of <br/>
<a id="pl.237.26"></a><var>237.26</var>daily living, instrumental activities of daily living, health-related tasks, and behaviors; and<br/>
<a id="pl.237.27"></a><var>237.27</var>(6) dated signatures of recipient or responsible party and qualified professional.<br/>
<a id="pl.237.28"></a><var>237.28</var>(c) The personal care assistance care plan must have instructions and comments <br/>
<a id="pl.237.29"></a><var>237.29</var>about the recipient's needs for assistance and any special instructions or procedures <br/>
<a id="pl.237.30"></a><var>237.30</var>required. The month-to-month plan for the use of personal care assistance services is part <br/>
<a id="pl.237.31"></a><var>237.31</var>of the personal care assistance care plan. The personal care assistance care plan must <br/>
<a id="pl.237.32"></a><var>237.32</var>be completed within the first week after start of services with a personal care provider <br/>
<a id="pl.237.33"></a><var>237.33</var>agency and must be updated as needed when there is a change in need for personal care <br/>
<a id="pl.237.34"></a><var>237.34</var>assistance services. A new personal care assistance care plan is required annually at the <br/>
<a id="pl.237.35"></a><var>237.35</var>time of the reassessment.<br/>
<a id="pl.238.1"></a><var>238.1</var>    Subd. 8. <b>Communication with recipient's physician.</b> The personal care assistance <br/>
<a id="pl.238.2"></a><var>238.2</var>program requires communication with the recipient's physician about a recipient's assessed <br/>
<a id="pl.238.3"></a><var>238.3</var>needs for personal care assistance services. The commissioner shall work with the state <br/>
<a id="pl.238.4"></a><var>238.4</var>medical director to develop options for communication with the recipient's physician.<br/>
<a id="pl.238.5"></a><var>238.5</var>    Subd. 9. <b>Responsible party; generally.</b> (a) "Responsible party," effective January <br/>
<a id="pl.238.6"></a><var>238.6</var>1, 2010, means an individual who is capable of providing the support necessary to assist <br/>
<a id="pl.238.7"></a><var>238.7</var>the recipient to live in the community.<br/>
<a id="pl.238.8"></a><var>238.8</var>(b) A responsible party must be 18 years of age, actively participate in planning and <br/>
<a id="pl.238.9"></a><var>238.9</var>directing of personal care assistance services, and attend all assessments for the recipient.<br/>
<a id="pl.238.10"></a><var>238.10</var>(c) A responsible party must not be the:<br/>
<a id="pl.238.11"></a><var>238.11</var>(1) personal care assistant;<br/>
<a id="pl.238.12"></a><var>238.12</var>(2) home care provider agency owner or staff; or<br/>
<a id="pl.238.13"></a><var>238.13</var>(3) county staff acting as part of employment.<br/>
<a id="pl.238.14"></a><var>238.14</var>(d) A licensed family foster parent who lives with the recipient may be the <br/>
<a id="pl.238.15"></a><var>238.15</var>responsible party as long as the family foster parent meets the other responsible party <br/>
<a id="pl.238.16"></a><var>238.16</var>requirements.<br/>
<a id="pl.238.17"></a><var>238.17</var>(e) A responsible party is required when:<br/>
<a id="pl.238.18"></a><var>238.18</var>(1) the person is a minor according to section 524.5-102, subdivision 10;<br/>
<a id="pl.238.19"></a><var>238.19</var>(2) the person is an incapacitated adult according to section 524.5-102, subdivision <br/>
<a id="pl.238.20"></a><var>238.20</var>6, resulting in a court-appointed guardian; or<br/>
<a id="pl.238.21"></a><var>238.21</var>(3) the assessment according to section 256B.0655, subdivision 1b, determines that <br/>
<a id="pl.238.22"></a><var>238.22</var>the recipient is in need of a responsible party to direct the recipient's care.<br/>
<a id="pl.238.23"></a><var>238.23</var>(f) There may be two persons designated as the responsible party for reasons such <br/>
<a id="pl.238.24"></a><var>238.24</var>as divided households and court-ordered custodies. Each person named as responsible <br/>
<a id="pl.238.25"></a><var>238.25</var>party must meet the program criteria and responsibilities.<br/>
<a id="pl.238.26"></a><var>238.26</var>(g) The recipient or the recipient's legal representative shall appoint a responsible <br/>
<a id="pl.238.27"></a><var>238.27</var>party if necessary to direct and supervise the care provided to the recipient. The <br/>
<a id="pl.238.28"></a><var>238.28</var>responsible party must be identified at the time of assessment and listed on the recipient's <br/>
<a id="pl.238.29"></a><var>238.29</var>service agreement and personal care assistance care plan.<br/>
<a id="pl.238.30"></a><var>238.30</var>    Subd. 10. <b>Responsible party; duties; delegation.</b> (a) A responsible party shall <br/>
<a id="pl.238.31"></a><var>238.31</var>enter into a written agreement with a personal care assistance provider agency, on a form <br/>
<a id="pl.238.32"></a><var>238.32</var>determined by the commissioner, to perform the following duties:<br/>
<a id="pl.238.33"></a><var>238.33</var>(1) be available while care is provided in a method agreed upon by the individual <br/>
<a id="pl.238.34"></a><var>238.34</var>or the individual's legal representative and documented in the recipient's personal care <br/>
<a id="pl.238.35"></a><var>238.35</var>assistance care plan;<br/>
<a id="pl.239.1"></a><var>239.1</var>(2) monitor personal care assistance services to ensure the recipient's personal care <br/>
<a id="pl.239.2"></a><var>239.2</var>assistance care plan is being followed; and<br/>
<a id="pl.239.3"></a><var>239.3</var>(3) review and sign personal care assistance time sheets after services are provided <br/>
<a id="pl.239.4"></a><var>239.4</var>to provide verification of the personal care assistance services.<br/>
<a id="pl.239.5"></a><var>239.5</var>Failure to provide the support required by the recipient must result in a referral to the <br/>
<a id="pl.239.6"></a><var>239.6</var>county common entry point.<br/>
<a id="pl.239.7"></a><var>239.7</var>(b) Responsible parties who are parents of minors or guardians of minors or <br/>
<a id="pl.239.8"></a><var>239.8</var>incapacitated persons may delegate the responsibility to another adult who is not the <br/>
<a id="pl.239.9"></a><var>239.9</var>personal care assistant during a temporary absence of at least 24 hours but not more <br/>
<a id="pl.239.10"></a><var>239.10</var>than six months. The person delegated as a responsible party must be able to meet the <br/>
<a id="pl.239.11"></a><var>239.11</var>definition of the responsible party, except that the delegated responsible party is required <br/>
<a id="pl.239.12"></a><var>239.12</var>to reside with the recipient only while serving as the responsible party. The responsible <br/>
<a id="pl.239.13"></a><var>239.13</var>party must ensure that the delegate performs the functions of the responsible party, is <br/>
<a id="pl.239.14"></a><var>239.14</var>identified at the time of the assessment, and is listed on the personal care assistance <br/>
<a id="pl.239.15"></a><var>239.15</var>care plan. The responsible party must communicate to the personal care assistance <br/>
<a id="pl.239.16"></a><var>239.16</var>provider agency about the need for a delegate responsible party, including the name of the <br/>
<a id="pl.239.17"></a><var>239.17</var>delegated responsible party, dates the delegated responsible party will be living with the <br/>
<a id="pl.239.18"></a><var>239.18</var>recipient, and contact numbers.<br/>
<a id="pl.239.19"></a><var>239.19</var>    Subd. 11. <b>Personal care assistant; requirements.</b> (a) A personal care assistant <br/>
<a id="pl.239.20"></a><var>239.20</var>must meet the following requirements:<br/>
<a id="pl.239.21"></a><var>239.21</var>(1) be at least 18 years of age with the exception of persons who are 16 or 17 years <br/>
<a id="pl.239.22"></a><var>239.22</var>of age with these additional requirements:<br/>
<a id="pl.239.23"></a><var>239.23</var>(i) supervision by a qualified professional every 60 days; and<br/>
<a id="pl.239.24"></a><var>239.24</var>(ii) employment by only one personal care assistance provider agency responsible <br/>
<a id="pl.239.25"></a><var>239.25</var>for compliance with current labor laws;<br/>
<a id="pl.239.26"></a><var>239.26</var>(2) be employed by a personal care assistance provider agency;<br/>
<a id="pl.239.27"></a><var>239.27</var>(3) enroll with the department as a personal care assistant after clearing a background <br/>
<a id="pl.239.28"></a><var>239.28</var>study. Before a personal care assistant provides services, the personal care assistance <br/>
<a id="pl.239.29"></a><var>239.29</var>provider agency must initiate a background study on the personal care assistant under <br/>
<a id="pl.239.30"></a><var>239.30</var>chapter 245C, and the personal care assistance provider agency must have received a <br/>
<a id="pl.239.31"></a><var>239.31</var>notice from the commissioner that the personal care assistant is:<br/>
<a id="pl.239.32"></a><var>239.32</var>(i) not disqualified under section 245C.14; or<br/>
<a id="pl.239.33"></a><var>239.33</var>(ii) is disqualified, but the personal care assistant has received a set aside of the <br/>
<a id="pl.239.34"></a><var>239.34</var>disqualification under section 245C.22;<br/>
<a id="pl.239.35"></a><var>239.35</var>(4) be able to effectively communicate with the recipient and personal care <br/>
<a id="pl.239.36"></a><var>239.36</var>assistance provider agency;<br/>
<a id="pl.240.1"></a><var>240.1</var>(5) be able to provide covered personal care assistance services according to the <br/>
<a id="pl.240.2"></a><var>240.2</var>recipient's personal care assistance care plan, respond appropriately to recipient needs, <br/>
<a id="pl.240.3"></a><var>240.3</var>and report changes in the recipient's condition to the supervising qualified professional <br/>
<a id="pl.240.4"></a><var>240.4</var>or physician;<br/>
<a id="pl.240.5"></a><var>240.5</var>(6) not be a consumer of personal care assistance services;<br/>
<a id="pl.240.6"></a><var>240.6</var>(7) maintain daily written records including, but not limited to, time sheets under <br/>
<a id="pl.240.7"></a><var>240.7</var>subdivision 12;<br/>
<a id="pl.240.8"></a><var>240.8</var>(8) effective January 1, 2010, complete standardized training as determined by the <br/>
<a id="pl.240.9"></a><var>240.9</var>commissioner before completing enrollment. Personal care assistant training must include <br/>
<a id="pl.240.10"></a><var>240.10</var>successful completion of the following training components: basic first aid, vulnerable <br/>
<a id="pl.240.11"></a><var>240.11</var>adult, child maltreatment, OSHA universal precautions, basic roles and responsibilities of <br/>
<a id="pl.240.12"></a><var>240.12</var>personal care assistants including information about assistance with lifting and transfers <br/>
<a id="pl.240.13"></a><var>240.13</var>for recipients, emergency preparedness, orientation to positive behavioral practices, fraud <br/>
<a id="pl.240.14"></a><var>240.14</var>issues, and completion of time sheets. Upon completion of the training components, <br/>
<a id="pl.240.15"></a><var>240.15</var>the personal care assistant must demonstrate the competency to provide assistance to <br/>
<a id="pl.240.16"></a><var>240.16</var>recipients;<br/>
<a id="pl.240.17"></a><var>240.17</var>(9) complete training and orientation on the needs of the recipient within the first <br/>
<a id="pl.240.18"></a><var>240.18</var>seven days after the services begin; and<br/>
<a id="pl.240.19"></a><var>240.19</var>(10) be limited to providing and being paid for up to 310 hours per month of personal <br/>
<a id="pl.240.20"></a><var>240.20</var>care assistance services regardless of the number of recipients being served or the number <br/>
<a id="pl.240.21"></a><var>240.21</var>of personal care assistance provider agencies enrolled with.<br/>
<a id="pl.240.22"></a><var>240.22</var>(b) A legal guardian may be a personal care assistant if the guardian is not being paid <br/>
<a id="pl.240.23"></a><var>240.23</var>for the guardian services and meets the criteria for personal care assistants in paragraph (a).<br/>
<a id="pl.240.24"></a><var>240.24</var>(c) Effective January 1, 2010, persons who do not qualify as a personal care assistant <br/>
<a id="pl.240.25"></a><var>240.25</var>include parents and stepparents of minors, spouses, paid legal guardians, family foster <br/>
<a id="pl.240.26"></a><var>240.26</var>care providers, except as otherwise allowed in section 256B.0625, subdivision 19a, or <br/>
<a id="pl.240.27"></a><var>240.27</var>staff of a residential setting.<br/>
<a id="pl.240.28"></a><var>240.28</var>    Subd. 12. <b>Documentation of personal care assistance services provided.</b> (a) <br/>
<a id="pl.240.29"></a><var>240.29</var>Personal care assistance services for a recipient must be documented daily by each personal <br/>
<a id="pl.240.30"></a><var>240.30</var>care assistant, on a time sheet form approved by the commissioner. All documentation <br/>
<a id="pl.240.31"></a><var>240.31</var>may be Web-based, electronic, or paper documentation. The completed form must be <br/>
<a id="pl.240.32"></a><var>240.32</var>submitted on a monthly basis to the provider and kept in the recipient's health record.<br/>
<a id="pl.240.33"></a><var>240.33</var>(b) The activity documentation must correspond to the personal care assistance care <br/>
<a id="pl.240.34"></a><var>240.34</var>plan and be reviewed by the qualified professional.<br/>
<a id="pl.241.1"></a><var>241.1</var>(c) The personal care assistant time sheet must be on a form approved by the <br/>
<a id="pl.241.2"></a><var>241.2</var>commissioner documenting time the personal care assistant provides services in the home. <br/>
<a id="pl.241.3"></a><var>241.3</var>The following criteria must be included in the time sheet:<br/>
<a id="pl.241.4"></a><var>241.4</var>(1) full name of personal care assistant and individual provider number;<br/>
<a id="pl.241.5"></a><var>241.5</var>(2) provider name and telephone numbers;<br/>
<a id="pl.241.6"></a><var>241.6</var>(3) full name of recipient;<br/>
<a id="pl.241.7"></a><var>241.7</var>(4) consecutive dates, including month, day, and year, and arrival and departure <br/>
<a id="pl.241.8"></a><var>241.8</var>time with a.m. or p.m. notations;<br/>
<a id="pl.241.9"></a><var>241.9</var>(5) signatures of recipient or the responsible party;<br/>
<a id="pl.241.10"></a><var>241.10</var>(6) personal signature of the personal care assistant;<br/>
<a id="pl.241.11"></a><var>241.11</var>(7) any shared care provided, if applicable;<br/>
<a id="pl.241.12"></a><var>241.12</var>(8) a statement that it is a federal crime to provide false information on personal <br/>
<a id="pl.241.13"></a><var>241.13</var>care service billings for medical assistance payments; and<br/>
<a id="pl.241.14"></a><var>241.14</var>(9) dates and location of recipient stays in a hospital, care facility, or incarceration.<br/>
<a id="pl.241.15"></a><var>241.15</var>    Subd. 13. <b>Qualified professional; qualifications.</b> (a) The qualified professional <br/>
<a id="pl.241.16"></a><var>241.16</var>must be employed by a personal care assistance provider agency and meet the definition <br/>
<a id="pl.241.17"></a><var>241.17</var>under section 256B.0625, subdivision 19c. Before a qualified professional provides <br/>
<a id="pl.241.18"></a><var>241.18</var>services, the personal care assistance provider agency must initiate a background study on <br/>
<a id="pl.241.19"></a><var>241.19</var>the qualified professional under chapter 245C, and the personal care assistance provider <br/>
<a id="pl.241.20"></a><var>241.20</var>agency must have received a notice from the commissioner that the qualified professional:<br/>
<a id="pl.241.21"></a><var>241.21</var>(1) is not disqualified under section 245C.14; or<br/>
<a id="pl.241.22"></a><var>241.22</var>(2) is disqualified, but the qualified professional has received a set aside of the <br/>
<a id="pl.241.23"></a><var>241.23</var>disqualification under section 245C.22.<br/>
<a id="pl.241.24"></a><var>241.24</var>(b) The qualified professional shall perform the duties of training, supervision, and <br/>
<a id="pl.241.25"></a><var>241.25</var>evaluation of the personal care assistance staff and evaluation of the effectiveness of <br/>
<a id="pl.241.26"></a><var>241.26</var>personal care assistance services. The qualified professional shall:<br/>
<a id="pl.241.27"></a><var>241.27</var>(1) develop and monitor with the recipient a personal care assistance care plan based <br/>
<a id="pl.241.28"></a><var>241.28</var>on the service plan and individualized needs of the recipient;<br/>
<a id="pl.241.29"></a><var>241.29</var>(2) develop and monitor with the recipient a monthly plan for the use of personal <br/>
<a id="pl.241.30"></a><var>241.30</var>care assistance services;<br/>
<a id="pl.241.31"></a><var>241.31</var>(3) review documentation of personal care assistance services provided;<br/>
<a id="pl.241.32"></a><var>241.32</var>(4) provide training and ensure competency for the personal care assistant in the <br/>
<a id="pl.241.33"></a><var>241.33</var>individual needs of the recipient; and<br/>
<a id="pl.241.34"></a><var>241.34</var>(5) document all training, communication, evaluations, and needed actions to <br/>
<a id="pl.241.35"></a><var>241.35</var>improve performance of the personal care assistants.<br/>
<a id="pl.242.1"></a><var>242.1</var>(c) The qualified professional shall complete the provider training with basic <br/>
<a id="pl.242.2"></a><var>242.2</var>information about the personal care assistance program approved by the commissioner <br/>
<a id="pl.242.3"></a><var>242.3</var>within six months of the date hired by a personal care assistance provider agency. <br/>
<a id="pl.242.4"></a><var>242.4</var>Qualified professionals who have completed the required trainings as an employee with a <br/>
<a id="pl.242.5"></a><var>242.5</var>personal care assistance provider agency do not need to repeat the required trainings if they <br/>
<a id="pl.242.6"></a><var>242.6</var>are hired by another agency, if they have completed the training within the last three years.<br/>
<a id="pl.242.7"></a><var>242.7</var>    Subd. 14. <b>Qualified professional; duties.</b> (a) Effective January 1, 2010, all personal <br/>
<a id="pl.242.8"></a><var>242.8</var>care assistants must be supervised by a qualified professional.<br/>
<a id="pl.242.9"></a><var>242.9</var>(b) Through direct training, observation, return demonstrations, and consultation <br/>
<a id="pl.242.10"></a><var>242.10</var>with the staff and the recipient, the qualified professional must ensure and document <br/>
<a id="pl.242.11"></a><var>242.11</var>that the personal care assistant is:<br/>
<a id="pl.242.12"></a><var>242.12</var>(1) capable of providing the required personal care assistance services;<br/>
<a id="pl.242.13"></a><var>242.13</var>(2) knowledgeable about the plan of personal care assistance services before services <br/>
<a id="pl.242.14"></a><var>242.14</var>are performed; and<br/>
<a id="pl.242.15"></a><var>242.15</var>(3) able to identify conditions that should be immediately brought to the attention of <br/>
<a id="pl.242.16"></a><var>242.16</var>the qualified professional.<br/>
<a id="pl.242.17"></a><var>242.17</var>(c) The qualified professional shall evaluate the personal care assistant within the <br/>
<a id="pl.242.18"></a><var>242.18</var>first 14 days of starting to provide services for a recipient except for the personal care <br/>
<a id="pl.242.19"></a><var>242.19</var>assistance choice option under subdivision 19, paragraph (a), clause (4). The qualified <br/>
<a id="pl.242.20"></a><var>242.20</var>professional shall evaluate the personal care assistance services for a recipient through <br/>
<a id="pl.242.21"></a><var>242.21</var>direct observation of a personal care assistant's work:<br/>
<a id="pl.242.22"></a><var>242.22</var>(1) at least every 90 days thereafter for the first year of a recipient's services; and<br/>
<a id="pl.242.23"></a><var>242.23</var>(2) every 120 days after the first year of a recipient's service or whenever needed for <br/>
<a id="pl.242.24"></a><var>242.24</var>response to a recipient's request for increased supervision of the personal care assistance <br/>
<a id="pl.242.25"></a><var>242.25</var>staff.<br/>
<a id="pl.242.26"></a><var>242.26</var>(d) Communication with the recipient is a part of the evaluation process of the <br/>
<a id="pl.242.27"></a><var>242.27</var>personal care assistance staff.<br/>
<a id="pl.242.28"></a><var>242.28</var>(e) At each supervisory visit, the qualified professional shall evaluate personal care <br/>
<a id="pl.242.29"></a><var>242.29</var>assistance services including the following information:<br/>
<a id="pl.242.30"></a><var>242.30</var>(1) satisfaction level of the recipient with personal care assistance services;<br/>
<a id="pl.242.31"></a><var>242.31</var>(2) review of the month-to-month plan for use of personal care assistance services;<br/>
<a id="pl.242.32"></a><var>242.32</var>(3) review of documentation of personal care assistance services provided;<br/>
<a id="pl.242.33"></a><var>242.33</var>(4) whether the personal care assistance services are meeting the goals of the service <br/>
<a id="pl.242.34"></a><var>242.34</var>as stated in the personal care assistance care plan and service plan;<br/>
<a id="pl.242.35"></a><var>242.35</var>(5) a written record of the results of the evaluation and actions taken to correct any <br/>
<a id="pl.242.36"></a><var>242.36</var>deficiencies in the work of a personal care assistant; and<br/>
<a id="pl.243.1"></a><var>243.1</var>(6) revision of the personal care assistance care plan as necessary in consultation <br/>
<a id="pl.243.2"></a><var>243.2</var>with the recipient or responsible party, to meet the needs of the recipient.<br/>
<a id="pl.243.3"></a><var>243.3</var>(f) The qualified professional shall complete the required documentation in the <br/>
<a id="pl.243.4"></a><var>243.4</var>agency recipient and employee files and the recipient's home, including the following <br/>
<a id="pl.243.5"></a><var>243.5</var>documentation:<br/>
<a id="pl.243.6"></a><var>243.6</var>(1) the personal care assistance care plan based on the service plan and individualized <br/>
<a id="pl.243.7"></a><var>243.7</var>needs of the recipient;<br/>
<a id="pl.243.8"></a><var>243.8</var>(2) a month-to-month plan for use of personal care assistance services;<br/>
<a id="pl.243.9"></a><var>243.9</var>(3) changes in need of the recipient requiring a change to the level of service and the <br/>
<a id="pl.243.10"></a><var>243.10</var>personal care assistance care plan;<br/>
<a id="pl.243.11"></a><var>243.11</var>(4) evaluation results of supervision visits and identified issues with personal care <br/>
<a id="pl.243.12"></a><var>243.12</var>assistance staff with actions taken;<br/>
<a id="pl.243.13"></a><var>243.13</var>(5) all communication with the recipient and personal care assistance staff; and<br/>
<a id="pl.243.14"></a><var>243.14</var>(6) hands-on training or individualized training for the care of the recipient.<br/>
<a id="pl.243.15"></a><var>243.15</var>(g) The documentation in paragraph (f) must be done on agency forms.<br/>
<a id="pl.243.16"></a><var>243.16</var>(h) The services that are not eligible for payment as qualified professional services <br/>
<a id="pl.243.17"></a><var>243.17</var>include:<br/>
<a id="pl.243.18"></a><var>243.18</var>(1) direct professional nursing tasks that could be assessed and authorized as skilled <br/>
<a id="pl.243.19"></a><var>243.19</var>nursing tasks;<br/>
<a id="pl.243.20"></a><var>243.20</var>(2) supervision of personal care assistance completed by telephone;<br/>
<a id="pl.243.21"></a><var>243.21</var>(3) agency administrative activities;<br/>
<a id="pl.243.22"></a><var>243.22</var>(4) training other than the individualized training required to provide care for a <br/>
<a id="pl.243.23"></a><var>243.23</var>recipient; and<br/>
<a id="pl.243.24"></a><var>243.24</var>(5) any other activity that is not described in this section.<br/>
<a id="pl.243.25"></a><var>243.25</var>    Subd. 15. <b>Flexible use.</b> (a) "Flexible use" means the scheduled use of authorized <br/>
<a id="pl.243.26"></a><var>243.26</var>hours of personal care assistance services, which vary within a service authorization <br/>
<a id="pl.243.27"></a><var>243.27</var>period covering no more than six months, in order to more effectively meet the needs and <br/>
<a id="pl.243.28"></a><var>243.28</var>schedule of the recipient. Each 12-month service agreement is divided into two six-month <br/>
<a id="pl.243.29"></a><var>243.29</var>authorization date spans. No more than 75 percent of the total authorized units for a <br/>
<a id="pl.243.30"></a><var>243.30</var>12-month service agreement may be used in a six-month date span.<br/>
<a id="pl.243.31"></a><var>243.31</var>(b) Authorization of flexible use occurs during the authorization process under <br/>
<a id="pl.243.32"></a><var>243.32</var>section 256B.0652. The flexible use of authorized hours does not increase the total <br/>
<a id="pl.243.33"></a><var>243.33</var>amount of authorized hours available to a recipient. The commissioner shall not authorize <br/>
<a id="pl.243.34"></a><var>243.34</var>additional personal care assistance services to supplement a service authorization that <br/>
<a id="pl.243.35"></a><var>243.35</var>is exhausted before the end date under a flexible service use plan, unless the assessor <br/>
<a id="pl.243.36"></a><var>243.36</var>determines a change in condition and a need for increased services is established. <br/>
<a id="pl.244.1"></a><var>244.1</var>Authorized hours not used within the six-month period must not be carried over to another <br/>
<a id="pl.244.2"></a><var>244.2</var>time period.<br/>
<a id="pl.244.3"></a><var>244.3</var>(c) A recipient who has terminated personal care assistance services before the end <br/>
<a id="pl.244.4"></a><var>244.4</var>of the 12-month authorization period must not receive additional hours upon reapplying <br/>
<a id="pl.244.5"></a><var>244.5</var>during the same 12-month authorization period, except if a change in condition is <br/>
<a id="pl.244.6"></a><var>244.6</var>documented. Services must be prorated for the remainder of the 12-month authorization <br/>
<a id="pl.244.7"></a><var>244.7</var>period based on the first six-month assessment.<br/>
<a id="pl.244.8"></a><var>244.8</var>(d) The recipient, responsible party, and qualified professional must develop a <br/>
<a id="pl.244.9"></a><var>244.9</var>written month-to-month plan of the projected use of personal care assistance services that <br/>
<a id="pl.244.10"></a><var>244.10</var>is part of the personal care assistance care plan and ensures:<br/>
<a id="pl.244.11"></a><var>244.11</var>(1) that the health and safety needs of the recipient are met throughout both date <br/>
<a id="pl.244.12"></a><var>244.12</var>spans of the authorization period; and<br/>
<a id="pl.244.13"></a><var>244.13</var>(2) that the total authorized amount of personal care assistance services for each date <br/>
<a id="pl.244.14"></a><var>244.14</var>span must not be used before the end of each date span in the authorization period.<br/>
<a id="pl.244.15"></a><var>244.15</var>(e) The personal care assistance provider agency shall monitor the use of personal <br/>
<a id="pl.244.16"></a><var>244.16</var>care assistance services to ensure health and safety needs of the recipient are met <br/>
<a id="pl.244.17"></a><var>244.17</var>throughout both date spans of the authorization period. The commissioner or the <br/>
<a id="pl.244.18"></a><var>244.18</var>commissioner's designee shall provide written notice to the provider and the recipient or <br/>
<a id="pl.244.19"></a><var>244.19</var>responsible party when a recipient is at risk of exceeding the personal care assistance <br/>
<a id="pl.244.20"></a><var>244.20</var>services prior to the end of the six-month period.<br/>
<a id="pl.244.21"></a><var>244.21</var>(f) Misuse and abuse of the flexible use of personal care assistance services resulting <br/>
<a id="pl.244.22"></a><var>244.22</var>in the overuse of units in a manner where the recipient will not have enough units to meet <br/>
<a id="pl.244.23"></a><var>244.23</var>their needs for assistance and ensure health and safety for the entire six-month date span <br/>
<a id="pl.244.24"></a><var>244.24</var>may lead to an action by the commissioner. The commissioner may take action including, <br/>
<a id="pl.244.25"></a><var>244.25</var>but not limited to: (1) restricting recipients to service authorizations of no more than one <br/>
<a id="pl.244.26"></a><var>244.26</var>month in duration; (2) requiring the recipient to have a responsible party; and (3) requiring <br/>
<a id="pl.244.27"></a><var>244.27</var>a qualified professional to monitor and report services on a monthly basis.<br/>
<a id="pl.244.28"></a><var>244.28</var>    Subd. 16. <b>Shared services.</b> (a) Medical assistance payments for shared personal <br/>
<a id="pl.244.29"></a><var>244.29</var>care assistance services are limited according to this subdivision.<br/>
<a id="pl.244.30"></a><var>244.30</var>(b) Shared service is the provision of personal care assistance services by a personal <br/>
<a id="pl.244.31"></a><var>244.31</var>care assistant to two or three recipients, eligible for medical assistance, who voluntarily <br/>
<a id="pl.244.32"></a><var>244.32</var>enter into an agreement to receive services at the same time and in the same setting.<br/>
<a id="pl.244.33"></a><var>244.33</var>(c) For the purposes of this subdivision, "setting" means:<br/>
<a id="pl.244.34"></a><var>244.34</var>(1) the home residence or family foster care home of one or more of the individual <br/>
<a id="pl.244.35"></a><var>244.35</var>recipients; or<br/>
<a id="pl.245.1"></a><var>245.1</var>(2) a child care program licensed under chapter 245A or operated by a local school <br/>
<a id="pl.245.2"></a><var>245.2</var>district or private school.<br/>
<a id="pl.245.3"></a><var>245.3</var>(d) Shared personal care assistance services follow the same criteria for covered <br/>
<a id="pl.245.4"></a><var>245.4</var>services as subdivision 2.<br/>
<a id="pl.245.5"></a><var>245.5</var>(e) Noncovered shared personal care assistance services include the following:<br/>
<a id="pl.245.6"></a><var>245.6</var>(1) services for more than three recipients by one personal care assistant at one time;<br/>
<a id="pl.245.7"></a><var>245.7</var>(2) staff requirements for child care programs under chapter 245C;<br/>
<a id="pl.245.8"></a><var>245.8</var>(3) caring for multiple recipients in more than one setting;<br/>
<a id="pl.245.9"></a><var>245.9</var>(4) additional units of personal care assistance based on the selection of the option; <br/>
<a id="pl.245.10"></a><var>245.10</var>and<br/>
<a id="pl.245.11"></a><var>245.11</var>(5) use of more than one personal care assistance provider agency for the shared <br/>
<a id="pl.245.12"></a><var>245.12</var>care services.<br/>
<a id="pl.245.13"></a><var>245.13</var>(f) The option of shared personal care assistance is elected by the recipient or the <br/>
<a id="pl.245.14"></a><var>245.14</var>responsible party with the assistance of the assessor. The option must be determined <br/>
<a id="pl.245.15"></a><var>245.15</var>appropriate based on the ages of the recipients, compatibility, and coordination of their <br/>
<a id="pl.245.16"></a><var>245.16</var>assessed care needs. The recipient or the responsible party, in conjunction with the <br/>
<a id="pl.245.17"></a><var>245.17</var>qualified professional, shall arrange the setting and grouping of shared services based <br/>
<a id="pl.245.18"></a><var>245.18</var>on the individual needs and preferences of the recipients. The personal care assistance <br/>
<a id="pl.245.19"></a><var>245.19</var>provider agency shall offer the recipient or the responsible party the option of shared or <br/>
<a id="pl.245.20"></a><var>245.20</var>one-on-one personal care assistance services or a combination of both. The recipient or <br/>
<a id="pl.245.21"></a><var>245.21</var>the responsible party may withdraw from participating in a shared services arrangement at <br/>
<a id="pl.245.22"></a><var>245.22</var>any time.<br/>
<a id="pl.245.23"></a><var>245.23</var>(g) Authorization for the shared service option must be determined by the <br/>
<a id="pl.245.24"></a><var>245.24</var>commissioner based on the criteria that the shared service is appropriate to meet all of the <br/>
<a id="pl.245.25"></a><var>245.25</var>recipients' needs and their health and safety is maintained. The authorization of shared <br/>
<a id="pl.245.26"></a><var>245.26</var>services is part of the overall authorization of personal care assistance services. Nothing <br/>
<a id="pl.245.27"></a><var>245.27</var>in this subdivision must be construed to reduce the total number of hours authorized for <br/>
<a id="pl.245.28"></a><var>245.28</var>an individual recipient.<br/>
<a id="pl.245.29"></a><var>245.29</var>(h) A personal care assistant providing shared personal care assistance services must:<br/>
<a id="pl.245.30"></a><var>245.30</var>(1) receive training specific for each recipient served; and<br/>
<a id="pl.245.31"></a><var>245.31</var>(2) follow all required documentation requirements for time and services provided.<br/>
<a id="pl.245.32"></a><var>245.32</var>(i) A qualified professional shall:<br/>
<a id="pl.245.33"></a><var>245.33</var>(1) evaluate the ability of the personal care assistant to provide services for all of <br/>
<a id="pl.245.34"></a><var>245.34</var>the recipients in a shared setting;<br/>
<a id="pl.246.1"></a><var>246.1</var>(2) visit the shared setting as services are being provided at least once every six <br/>
<a id="pl.246.2"></a><var>246.2</var>months or whenever needed for response to a recipient's request for increased supervision <br/>
<a id="pl.246.3"></a><var>246.3</var>of the personal care assistance staff;<br/>
<a id="pl.246.4"></a><var>246.4</var>(3) provide ongoing monitoring and evaluation of the effectiveness and <br/>
<a id="pl.246.5"></a><var>246.5</var>appropriateness of the shared services;<br/>
<a id="pl.246.6"></a><var>246.6</var>(4) develop a contingency plan with each of the recipients which accounts for <br/>
<a id="pl.246.7"></a><var>246.7</var>absence of the recipient in a share services setting due to illness or other circumstances;<br/>
<a id="pl.246.8"></a><var>246.8</var>(5) obtain permission from each of the recipients who are sharing a personal care <br/>
<a id="pl.246.9"></a><var>246.9</var>assistant for number of shared hours for services provided inside and outside the home <br/>
<a id="pl.246.10"></a><var>246.10</var>residence; and<br/>
<a id="pl.246.11"></a><var>246.11</var>(6) document the training completed by the personal care assistants specific to the <br/>
<a id="pl.246.12"></a><var>246.12</var>shared setting and recipients sharing services.<br/>
<a id="pl.246.13"></a><var>246.13</var>    Subd. 17. <b>Shared services; rates.</b> The commissioner shall provide a rate system for <br/>
<a id="pl.246.14"></a><var>246.14</var>shared personal care assistance services. For two persons sharing services, the rate paid <br/>
<a id="pl.246.15"></a><var>246.15</var>to a provider must not exceed one and one-half times the rate paid for serving a single <br/>
<a id="pl.246.16"></a><var>246.16</var>individual, and for three persons sharing services, the rate paid to a provider must not <br/>
<a id="pl.246.17"></a><var>246.17</var>exceed twice the rate paid for serving a single individual. These rates apply only when all <br/>
<a id="pl.246.18"></a><var>246.18</var>of the criteria for the shared care personal care assistance service have been met.<br/>
<a id="pl.246.19"></a><var>246.19</var>    Subd. 18. <b>Personal care assistance choice option; generally.</b> (a) The <br/>
<a id="pl.246.20"></a><var>246.20</var>commissioner may allow a recipient of personal care assistance services to use a fiscal <br/>
<a id="pl.246.21"></a><var>246.21</var>intermediary to assist the recipient in paying and accounting for medically necessary <br/>
<a id="pl.246.22"></a><var>246.22</var>covered personal care assistance services. Unless otherwise provided in this section, all <br/>
<a id="pl.246.23"></a><var>246.23</var>other statutory and regulatory provisions relating to personal care assistance services apply <br/>
<a id="pl.246.24"></a><var>246.24</var>to a recipient using the personal care assistance choice option.<br/>
<a id="pl.246.25"></a><var>246.25</var>(b) Personal care assistance choice is an option of the personal care assistance <br/>
<a id="pl.246.26"></a><var>246.26</var>program that allows the recipient who receives personal care assistance services to be <br/>
<a id="pl.246.27"></a><var>246.27</var>responsible for the hiring, training, scheduling, and firing of personal care assistants. This <br/>
<a id="pl.246.28"></a><var>246.28</var>program offers greater control and choice for the recipient in who provides the personal <br/>
<a id="pl.246.29"></a><var>246.29</var>care assistance service and when the service is scheduled. The recipient or the recipient's <br/>
<a id="pl.246.30"></a><var>246.30</var>responsible party must choose a personal care assistance choice provider agency as <br/>
<a id="pl.246.31"></a><var>246.31</var>a fiscal intermediary. This personal care assistance choice provider agency manages <br/>
<a id="pl.246.32"></a><var>246.32</var>payroll, invoices the state, is responsible for all payroll related taxes and insurance, and is <br/>
<a id="pl.246.33"></a><var>246.33</var>responsible for providing the consumer training and support in managing the recipient's <br/>
<a id="pl.246.34"></a><var>246.34</var>personal care assistance services.<br/>
<a id="pl.247.1"></a><var>247.1</var>    Subd. 19. <b>Personal care assistance choice option; qualifications; duties.</b> (a) <br/>
<a id="pl.247.2"></a><var>247.2</var>Under personal care assistance choice, the recipient or responsible party shall:<br/>
<a id="pl.247.3"></a><var>247.3</var>(1) recruit, hire, schedule, and terminate personal care assistants and a qualified <br/>
<a id="pl.247.4"></a><var>247.4</var>professional;<br/>
<a id="pl.247.5"></a><var>247.5</var>(2) develop a personal care assistance care plan based on the assessed needs <br/>
<a id="pl.247.6"></a><var>247.6</var>and addressing the health and safety of the recipient with the assistance of a qualified <br/>
<a id="pl.247.7"></a><var>247.7</var>professional as needed;<br/>
<a id="pl.247.8"></a><var>247.8</var>(3) orient and train the personal care assistant with assistance as needed from the <br/>
<a id="pl.247.9"></a><var>247.9</var>qualified professional;<br/>
<a id="pl.247.10"></a><var>247.10</var>(4) effective January 1, 2010, supervise and evaluate the personal care assistant with <br/>
<a id="pl.247.11"></a><var>247.11</var>the qualified professional, who is required to visit the recipient at least every 180 days;<br/>
<a id="pl.247.12"></a><var>247.12</var>(5) monitor and verify in writing and report to the personal care assistance choice <br/>
<a id="pl.247.13"></a><var>247.13</var>agency the number of hours worked by the personal care assistant and the qualified <br/>
<a id="pl.247.14"></a><var>247.14</var>professional;<br/>
<a id="pl.247.15"></a><var>247.15</var>(6) engage in an annual face-to-face reassessment to determine continuing eligibility <br/>
<a id="pl.247.16"></a><var>247.16</var>and service authorization; and<br/>
<a id="pl.247.17"></a><var>247.17</var>(7) use the same personal care assistance choice provider agency if shared personal <br/>
<a id="pl.247.18"></a><var>247.18</var>assistance care is being used.<br/>
<a id="pl.247.19"></a><var>247.19</var>(b) The personal care assistance choice provider agency shall:<br/>
<a id="pl.247.20"></a><var>247.20</var>(1) meet all personal care assistance provider agency standards;<br/>
<a id="pl.247.21"></a><var>247.21</var>(2) enter into a written agreement with the recipient, responsible party, and personal <br/>
<a id="pl.247.22"></a><var>247.22</var>care assistants;<br/>
<a id="pl.247.23"></a><var>247.23</var>(3) not be related as a parent, child, sibling, or spouse to the recipient, qualified <br/>
<a id="pl.247.24"></a><var>247.24</var>professional, or the personal care assistant; and<br/>
<a id="pl.247.25"></a><var>247.25</var>(4) ensure arm's-length transactions without undue influence or coercion with the <br/>
<a id="pl.247.26"></a><var>247.26</var>recipient and personal care assistant.<br/>
<a id="pl.247.27"></a><var>247.27</var>(c) The duties of the personal care assistance choice provider agency are to:<br/>
<a id="pl.247.28"></a><var>247.28</var>(1) be the employer of the personal care assistant and the qualified professional for <br/>
<a id="pl.247.29"></a><var>247.29</var>employment law and related regulations including, but not limited to, purchasing and <br/>
<a id="pl.247.30"></a><var>247.30</var>maintaining workers' compensation, unemployment insurance, surety and fidelity bonds, <br/>
<a id="pl.247.31"></a><var>247.31</var>and liability insurance, and submit any or all necessary documentation including, but not <br/>
<a id="pl.247.32"></a><var>247.32</var>limited to, workers' compensation and unemployment insurance;<br/>
<a id="pl.247.33"></a><var>247.33</var>(2) bill the medical assistance program for personal care assistance services and <br/>
<a id="pl.247.34"></a><var>247.34</var>qualified professional services;<br/>
<a id="pl.247.35"></a><var>247.35</var>(3) request and complete background studies that comply with the requirements for <br/>
<a id="pl.247.36"></a><var>247.36</var>personal care assistants and qualified professionals;<br/>
<a id="pl.248.1"></a><var>248.1</var>(4) pay the personal care assistant and qualified professional based on actual hours <br/>
<a id="pl.248.2"></a><var>248.2</var>of services provided;<br/>
<a id="pl.248.3"></a><var>248.3</var>(5) withhold and pay all applicable federal and state taxes;<br/>
<a id="pl.248.4"></a><var>248.4</var>(6) verify and keep records of hours worked by the personal care assistant and <br/>
<a id="pl.248.5"></a><var>248.5</var>qualified professional;<br/>
<a id="pl.248.6"></a><var>248.6</var>(7) make the arrangements and pay taxes and other benefits, if any; and comply with <br/>
<a id="pl.248.7"></a><var>248.7</var>any legal requirements for a Minnesota employer;<br/>
<a id="pl.248.8"></a><var>248.8</var>(8) enroll in the medical assistance program as a personal care assistance choice <br/>
<a id="pl.248.9"></a><var>248.9</var>agency; and<br/>
<a id="pl.248.10"></a><var>248.10</var>(9) enter into a written agreement as specified in subdivision 20 before services <br/>
<a id="pl.248.11"></a><var>248.11</var>are provided.<br/>
<a id="pl.248.12"></a><var>248.12</var>    Subd. 20. <b>Personal care assistance choice option; administration.</b> (a) Before <br/>
<a id="pl.248.13"></a><var>248.13</var>services commence under the personal care assistance choice option, and annually <br/>
<a id="pl.248.14"></a><var>248.14</var>thereafter, the personal care assistance choice provider agency, recipient, or responsible <br/>
<a id="pl.248.15"></a><var>248.15</var>party, each personal care assistant, and the qualified professional shall enter into a written <br/>
<a id="pl.248.16"></a><var>248.16</var>agreement. The agreement must include at a minimum:<br/>
<a id="pl.248.17"></a><var>248.17</var>(1) duties of the recipient, qualified professional, personal care assistant, and <br/>
<a id="pl.248.18"></a><var>248.18</var>personal care assistance choice provider agency;<br/>
<a id="pl.248.19"></a><var>248.19</var>(2) salary and benefits for the personal care assistant and the qualified professional;<br/>
<a id="pl.248.20"></a><var>248.20</var>(3) administrative fee of the personal care assistance choice provider agency and <br/>
<a id="pl.248.21"></a><var>248.21</var>services paid for with that fee, including background study fees;<br/>
<a id="pl.248.22"></a><var>248.22</var>(4) grievance procedures to respond to complaints;<br/>
<a id="pl.248.23"></a><var>248.23</var>(5) procedures for hiring and terminating the personal care assistant; and<br/>
<a id="pl.248.24"></a><var>248.24</var>(6) documentation requirements including, but not limited to, time sheets, activity <br/>
<a id="pl.248.25"></a><var>248.25</var>records, and the personal care assistance care plan.<br/>
<a id="pl.248.26"></a><var>248.26</var>(b) Effective January 1, 2010, except for the administrative fee of the personal care <br/>
<a id="pl.248.27"></a><var>248.27</var>assistance choice provider agency as reported on the written agreement, the remainder <br/>
<a id="pl.248.28"></a><var>248.28</var>of the rates paid to the personal care assistance choice provider agency must be used to <br/>
<a id="pl.248.29"></a><var>248.29</var>pay for the salary and benefits for the personal care assistant or the qualified professional. <br/>
<a id="pl.248.30"></a><var>248.30</var>The provider agency must use a minimum of 72.5 percent of the revenue generated by <br/>
<a id="pl.248.31"></a><var>248.31</var>the medical assistance rate for personal care assistance services for employee personal <br/>
<a id="pl.248.32"></a><var>248.32</var>care assistant wages and benefits.<br/>
<a id="pl.248.33"></a><var>248.33</var>(c) The commissioner shall deny, revoke, or suspend the authorization to use the <br/>
<a id="pl.248.34"></a><var>248.34</var>personal care assistance choice option if:<br/>
<a id="pl.248.35"></a><var>248.35</var>(1) it has been determined by the qualified professional or public health nurse that <br/>
<a id="pl.248.36"></a><var>248.36</var>the use of this option jeopardizes the recipient's health and safety;<br/>
<a id="pl.249.1"></a><var>249.1</var>(2) the parties have failed to comply with the written agreement specified in this <br/>
<a id="pl.249.2"></a><var>249.2</var>subdivision;<br/>
<a id="pl.249.3"></a><var>249.3</var>(3) the use of the option has led to abusive or fraudulent billing for personal care <br/>
<a id="pl.249.4"></a><var>249.4</var>assistance services; or<br/>
<a id="pl.249.5"></a><var>249.5</var>(4) the department terminates the personal care assistance choice option.<br/>
<a id="pl.249.6"></a><var>249.6</var>(d) The recipient or responsible party may appeal the commissioner's decision in <br/>
<a id="pl.249.7"></a><var>249.7</var>paragraph (c) according to section 256.045. The denial, revocation, or suspension to <br/>
<a id="pl.249.8"></a><var>249.8</var>use the personal care assistance choice option must not affect the recipient's authorized <br/>
<a id="pl.249.9"></a><var>249.9</var>level of personal care assistance services.<br/>
<a id="pl.249.10"></a><var>249.10</var>    Subd. 21. <b>Requirements for initial enrollment of personal care assistance </b><br/>
<a id="pl.249.11"></a><var>249.11</var><b>provider agencies.</b> (a) All personal care assistance provider agencies must provide, at the <br/>
<a id="pl.249.12"></a><var>249.12</var>time of enrollment as a personal care assistance provider agency in a format determined <br/>
<a id="pl.249.13"></a><var>249.13</var>by the commissioner, information and documentation that includes, but is not limited to, <br/>
<a id="pl.249.14"></a><var>249.14</var>the following:<br/>
<a id="pl.249.15"></a><var>249.15</var>(1) the personal care assistance provider agency's current contact information <br/>
<a id="pl.249.16"></a><var>249.16</var>including address, telephone number, and e-mail address;<br/>
<a id="pl.249.17"></a><var>249.17</var>(2) proof of surety bond coverage in the amount of $50,000 or ten percent of the <br/>
<a id="pl.249.18"></a><var>249.18</var>provider's payments from Medicaid in the previous year, whichever is less;<br/>
<a id="pl.249.19"></a><var>249.19</var>(3) proof of fidelity bond coverage in the amount of $20,000;<br/>
<a id="pl.249.20"></a><var>249.20</var>(4) proof of workers' compensation insurance coverage;<br/>
<a id="pl.249.21"></a><var>249.21</var>(5) a description of the personal care assistance provider agency's organization <br/>
<a id="pl.249.22"></a><var>249.22</var>identifying the names of all owners, managing employees, staff, board of directors, and <br/>
<a id="pl.249.23"></a><var>249.23</var>the affiliations of the directors, owners, or staff to other service providers;<br/>
<a id="pl.249.24"></a><var>249.24</var>(6) a copy of the personal care assistance provider agency's written policies and <br/>
<a id="pl.249.25"></a><var>249.25</var>procedures including: hiring of employees; training requirements; service delivery; <br/>
<a id="pl.249.26"></a><var>249.26</var>and employee and consumer safety including process for notification and resolution <br/>
<a id="pl.249.27"></a><var>249.27</var>of consumer grievances, identification and prevention of communicable diseases, and <br/>
<a id="pl.249.28"></a><var>249.28</var>employee misconduct;<br/>
<a id="pl.249.29"></a><var>249.29</var>(7) copies of all other forms the personal care assistance provider agency uses in <br/>
<a id="pl.249.30"></a><var>249.30</var>the course of daily business including, but not limited to:<br/>
<a id="pl.249.31"></a><var>249.31</var>(i) a copy of the personal care assistance provider agency's time sheet if the time <br/>
<a id="pl.249.32"></a><var>249.32</var>sheet varies from the standard time sheet for personal care assistance services approved <br/>
<a id="pl.249.33"></a><var>249.33</var>by the commissioner, and a letter requesting approval of the personal care assistance <br/>
<a id="pl.249.34"></a><var>249.34</var>provider agency's nonstandard time sheet;<br/>
<a id="pl.249.35"></a><var>249.35</var>(ii) the personal care assistance provider agency's template for the personal care <br/>
<a id="pl.249.36"></a><var>249.36</var>assistance care plan; and<br/>
<a id="pl.250.1"></a><var>250.1</var>(iii) the personal care assistance provider agency's template and the written <br/>
<a id="pl.250.2"></a><var>250.2</var>agreement in subdivision 20 for recipients using the personal care assistance choice <br/>
<a id="pl.250.3"></a><var>250.3</var>option, if applicable;<br/>
<a id="pl.250.4"></a><var>250.4</var>(8) a list of all trainings and classes that the personal care assistance provider agency <br/>
<a id="pl.250.5"></a><var>250.5</var>requires of its staff providing personal care assistance services;<br/>
<a id="pl.250.6"></a><var>250.6</var>(9) documentation that the personal care assistance provider agency and staff have <br/>
<a id="pl.250.7"></a><var>250.7</var>successfully completed all the training required by this section; <br/>
<a id="pl.250.8"></a><var>250.8</var>(10) documentation of the agency's marketing practices;<br/>
<a id="pl.250.9"></a><var>250.9</var>(11) disclosure of ownership, leasing, or management of all residential properties <br/>
<a id="pl.250.10"></a><var>250.10</var>that is used or could be used for providing home care services; and <br/>
<a id="pl.250.11"></a><var>250.11</var>(12) documentation that the agency will use the following percentages of revenue <br/>
<a id="pl.250.12"></a><var>250.12</var>generated from the medical assistance rate paid for personal care assistance services <br/>
<a id="pl.250.13"></a><var>250.13</var>for employee personal care assistant wages and benefits: 72.5 percent of revenue in the <br/>
<a id="pl.250.14"></a><var>250.14</var>personal care assistance choice option and 72.5 percent of revenue from other personal <br/>
<a id="pl.250.15"></a><var>250.15</var>care assistance providers.<br/>
<a id="pl.250.16"></a><var>250.16</var>(b) Personal care assistance provider agencies shall provide the information specified <br/>
<a id="pl.250.17"></a><var>250.17</var>in paragraph (a) to the commissioner at the time the personal care assistance provider <br/>
<a id="pl.250.18"></a><var>250.18</var>agency enrolls as a vendor or upon request from the commissioner. The commissioner <br/>
<a id="pl.250.19"></a><var>250.19</var>shall collect the information specified in paragraph (a) from all personal care assistance <br/>
<a id="pl.250.20"></a><var>250.20</var>providers beginning upon enactment of this section.<br/>
<a id="pl.250.21"></a><var>250.21</var>(c) All personal care assistance provider agencies shall complete mandatory training <br/>
<a id="pl.250.22"></a><var>250.22</var>as determined by the commissioner before enrollment as a provider. Personal care <br/>
<a id="pl.250.23"></a><var>250.23</var>assistance provider agencies are required to send all owners, qualified professionals <br/>
<a id="pl.250.24"></a><var>250.24</var>employed by the agency, and all other managing employees to the initial and subsequent <br/>
<a id="pl.250.25"></a><var>250.25</var>trainings. Personal care assistance provider agency billing staff shall complete training <br/>
<a id="pl.250.26"></a><var>250.26</var>about personal care assistance program financial management. This training is effective <br/>
<a id="pl.250.27"></a><var>250.27</var>upon enactment of this section. Any personal care assistance provider agency enrolled <br/>
<a id="pl.250.28"></a><var>250.28</var>before that date shall, if it has not already, complete the provider training within 18 months <br/>
<a id="pl.250.29"></a><var>250.29</var>of the effective date of this section. Any new owners, new qualified professionals, and new <br/>
<a id="pl.250.30"></a><var>250.30</var>managing employees are required to complete mandatory training as a requisite of hiring.<br/>
<a id="pl.250.31"></a><var>250.31</var>    Subd. 22. <b>Annual review for personal care providers.</b> (a) All personal care <br/>
<a id="pl.250.32"></a><var>250.32</var>assistance provider agencies shall resubmit, on an annual basis, the information specified <br/>
<a id="pl.250.33"></a><var>250.33</var>in subdivision 21, in a format determined by the commissioner, and provide a copy of the <br/>
<a id="pl.250.34"></a><var>250.34</var>personal care assistance provider agency's most current version of its grievance policies <br/>
<a id="pl.250.35"></a><var>250.35</var>and procedures along with a written record of grievances and resolutions of the grievances <br/>
<a id="pl.251.1"></a><var>251.1</var>that the personal care assistance provider agency has received in the previous year and any <br/>
<a id="pl.251.2"></a><var>251.2</var>other information requested by the commissioner.<br/>
<a id="pl.251.3"></a><var>251.3</var>(b) The commissioner shall send annual review notification to personal care <br/>
<a id="pl.251.4"></a><var>251.4</var>assistance provider agencies 30 days prior to renewal. The notification must:<br/>
<a id="pl.251.5"></a><var>251.5</var>(1) list the materials and information the personal care assistance provider agency is <br/>
<a id="pl.251.6"></a><var>251.6</var>required to submit;<br/>
<a id="pl.251.7"></a><var>251.7</var>(2) provide instructions on submitting information to the commissioner; and<br/>
<a id="pl.251.8"></a><var>251.8</var>(3) provide a due date by which the commissioner must receive the requested <br/>
<a id="pl.251.9"></a><var>251.9</var>information.<br/>
<a id="pl.251.10"></a><var>251.10</var>Personal care assistance provider agencies shall submit required documentation for <br/>
<a id="pl.251.11"></a><var>251.11</var>annual review within 30 days of notification from the commissioner. If no documentation <br/>
<a id="pl.251.12"></a><var>251.12</var>is submitted, the personal care assistance provider agency enrollment number must be <br/>
<a id="pl.251.13"></a><var>251.13</var>terminated or suspended.<br/>
<a id="pl.251.14"></a><var>251.14</var>(c) Personal care assistance provider agencies also currently licensed under <br/>
<a id="pl.251.15"></a><var>251.15</var>Minnesota Rules, part 4668.0012, as a class A provider or currently certified for <br/>
<a id="pl.251.16"></a><var>251.16</var>participation in Medicare as a home health agency are deemed in compliance with <br/>
<a id="pl.251.17"></a><var>251.17</var>the personal care assistance requirements for enrollment, annual review process, and <br/>
<a id="pl.251.18"></a><var>251.18</var>documentation.<br/>
<a id="pl.251.19"></a><var>251.19</var>    Subd. 23. <b>Enrollment requirements following termination.</b> (a) A terminated <br/>
<a id="pl.251.20"></a><var>251.20</var>personal care assistance provider agency, including all named individuals on the current <br/>
<a id="pl.251.21"></a><var>251.21</var>enrollment disclosure form and known or discovered affiliates of the personal care <br/>
<a id="pl.251.22"></a><var>251.22</var>assistance provider agency, is not eligible to enroll as a personal care assistance provider <br/>
<a id="pl.251.23"></a><var>251.23</var>agency for two years following the termination.<br/>
<a id="pl.251.24"></a><var>251.24</var>(b) After the two-year period in paragraph (a), if the provider seeks to reenroll <br/>
<a id="pl.251.25"></a><var>251.25</var>as a personal care assistance provider agency, the personal care assistance provider <br/>
<a id="pl.251.26"></a><var>251.26</var>agency must be placed on a one-year probation period, beginning after completion of <br/>
<a id="pl.251.27"></a><var>251.27</var>the following:<br/>
<a id="pl.251.28"></a><var>251.28</var>(1) the department's provider trainings under this section; and<br/>
<a id="pl.251.29"></a><var>251.29</var>(2) initial enrollment requirements under subdivision 21.<br/>
<a id="pl.251.30"></a><var>251.30</var>(c) During the probationary period the commissioner shall complete site visits and <br/>
<a id="pl.251.31"></a><var>251.31</var>request submission of documentation to review compliance with program policy.<br/>
<a id="pl.251.32"></a><var>251.32</var>    Subd. 24. <b>Personal care assistance provider agency; general duties.</b> A personal <br/>
<a id="pl.251.33"></a><var>251.33</var>care assistance provider agency shall:<br/>
<a id="pl.251.34"></a><var>251.34</var>(1) enroll as a Medicaid provider meeting all provider standards, including <br/>
<a id="pl.251.35"></a><var>251.35</var>completion of the required provider training;<br/>
<a id="pl.251.36"></a><var>251.36</var>(2) comply with general medical assistance coverage requirements;<br/>
<a id="pl.252.1"></a><var>252.1</var>(3) demonstrate compliance with law and policies of the personal care assistance <br/>
<a id="pl.252.2"></a><var>252.2</var>program to be determined by the commissioner;<br/>
<a id="pl.252.3"></a><var>252.3</var>(4) comply with background study requirements;<br/>
<a id="pl.252.4"></a><var>252.4</var>(5) verify and keep records of hours worked by the personal care assistant and <br/>
<a id="pl.252.5"></a><var>252.5</var>qualified professional;<br/>
<a id="pl.252.6"></a><var>252.6</var>(6) market agency services only through printed information in brochures and on <br/>
<a id="pl.252.7"></a><var>252.7</var>Web sites and not engage in any agency-initiated direct contact or marketing in person, by <br/>
<a id="pl.252.8"></a><var>252.8</var>phone, or other electronic means to potential recipients, guardians, or family members;<br/>
<a id="pl.252.9"></a><var>252.9</var>(7) pay the personal care assistant and qualified professional based on actual hours <br/>
<a id="pl.252.10"></a><var>252.10</var>of services provided;<br/>
<a id="pl.252.11"></a><var>252.11</var>(8) withhold and pay all applicable federal and state taxes;<br/>
<a id="pl.252.12"></a><var>252.12</var>(9) effective January 1, 2010, document that the agency uses a minimum of 72.5 <br/>
<a id="pl.252.13"></a><var>252.13</var>percent of the revenue generated by the medical assistance rate for personal care assistance <br/>
<a id="pl.252.14"></a><var>252.14</var>services for employee personal care assistant wages and benefits;<br/>
<a id="pl.252.15"></a><var>252.15</var>(10) make the arrangements and pay unemployment insurance, taxes, workers' <br/>
<a id="pl.252.16"></a><var>252.16</var>compensation, liability insurance, and other benefits, if any;<br/>
<a id="pl.252.17"></a><var>252.17</var>(11) enter into a written agreement under subdivision 20 before services are provided;<br/>
<a id="pl.252.18"></a><var>252.18</var>(12) report suspected neglect and abuse to the common entry point according to <br/>
<a id="pl.252.19"></a><var>252.19</var>section 256B.0651; <br/>
<a id="pl.252.20"></a><var>252.20</var>(13) provide the recipient with a copy of the home care bill of rights at start of <br/>
<a id="pl.252.21"></a><var>252.21</var>service; and<br/>
<a id="pl.252.22"></a><var>252.22</var>    (14) request reassessments at least 60 days prior to the end of the current <br/>
<a id="pl.252.23"></a><var>252.23</var>authorization for personal care assistance services, on forms provided by the commissioner.<br/>
<a id="pl.252.24"></a><var>252.24</var>    Subd. 25. <b>Personal care assistance provider agency; background studies.</b><br/>
<a id="pl.252.25"></a><var>252.25</var>Personal care assistance provider agencies enrolled to provide personal care assistance <br/>
<a id="pl.252.26"></a><var>252.26</var>services under the medical assistance program shall comply with the following:<br/>
<a id="pl.252.27"></a><var>252.27</var>(1) owners who have a five percent interest or more and all managing employees <br/>
<a id="pl.252.28"></a><var>252.28</var>are subject to a background study as provided in chapter 245C. This applies to currently <br/>
<a id="pl.252.29"></a><var>252.29</var>enrolled personal care assistance provider agencies and those agencies seeking enrollment <br/>
<a id="pl.252.30"></a><var>252.30</var>as a personal care assistance provider agency. Managing employee has the same meaning <br/>
<a id="pl.252.31"></a><var>252.31</var>as Code of Federal Regulations, title 42, section 455. An organization is barred from <br/>
<a id="pl.252.32"></a><var>252.32</var>enrollment if:<br/>
<a id="pl.252.33"></a><var>252.33</var>(i) the organization has not initiated background studies on owners and managing <br/>
<a id="pl.252.34"></a><var>252.34</var>employees; or<br/>
<a id="pl.252.35"></a><var>252.35</var>(ii) the organization has initiated background studies on owners and managing <br/>
<a id="pl.252.36"></a><var>252.36</var>employees, but the commissioner has sent the organization a notice that an owner or <br/>
<a id="pl.253.1"></a><var>253.1</var>managing employee of the organization has been disqualified under section 245C.14, <br/>
<a id="pl.253.2"></a><var>253.2</var>and the owner or managing employee has not received a set aside of the disqualification <br/>
<a id="pl.253.3"></a><var>253.3</var>under section 245C.22;<br/>
<a id="pl.253.4"></a><var>253.4</var>(2) a background study must be initiated and completed for all qualified <br/>
<a id="pl.253.5"></a><var>253.5</var>professionals; and<br/>
<a id="pl.253.6"></a><var>253.6</var>(3) a background study must be initiated and completed for all personal care <br/>
<a id="pl.253.7"></a><var>253.7</var>assistants.<br/>
<a id="pl.253.8"></a><var>253.8</var>    Subd. 26. <b>Personal care assistance provider agency; communicable disease </b><br/>
<a id="pl.253.9"></a><var>253.9</var><b>prevention.</b> A personal care assistance provider agency shall establish and implement <br/>
<a id="pl.253.10"></a><var>253.10</var>policies and procedures for prevention, control, and investigation of infections and <br/>
<a id="pl.253.11"></a><var>253.11</var>communicable diseases according to current nationally recognized infection control <br/>
<a id="pl.253.12"></a><var>253.12</var>practices or guidelines established by the United States Centers for Disease Control and <br/>
<a id="pl.253.13"></a><var>253.13</var>Prevention, as well as applicable regulations of other federal or state agencies.<br/>
<a id="pl.253.14"></a><var>253.14</var>    Subd. 27. <b>Personal care assistance provider agency; ventilator training.</b> The <br/>
<a id="pl.253.15"></a><var>253.15</var>personal care assistance provider agency is required to provide training for the personal <br/>
<a id="pl.253.16"></a><var>253.16</var>care assistant responsible for working with a recipient who is ventilator dependent. All <br/>
<a id="pl.253.17"></a><var>253.17</var>training must be administered by a respiratory therapist, nurse, or physician. Qualified <br/>
<a id="pl.253.18"></a><var>253.18</var>professional supervision by a nurse must be completed and documented on file in the <br/>
<a id="pl.253.19"></a><var>253.19</var>personal care assistant's employment record and the recipient's health record. If offering <br/>
<a id="pl.253.20"></a><var>253.20</var>personal care services to a ventilator-dependent recipient, the personal care assistance <br/>
<a id="pl.253.21"></a><var>253.21</var>provider agency shall demonstrate the ability to:<br/>
<a id="pl.253.22"></a><var>253.22</var>(1) train the personal care assistant;<br/>
<a id="pl.253.23"></a><var>253.23</var>(2) supervise the personal care assistant in ventilator operation and maintenance; and<br/>
<a id="pl.253.24"></a><var>253.24</var>(3) supervise the recipient and responsible party in ventilator operation and <br/>
<a id="pl.253.25"></a><var>253.25</var>maintenance.<br/>
<a id="pl.253.26"></a><var>253.26</var>    Subd. 28. <b>Personal care assistance provider agency; required documentation.</b><br/>
<a id="pl.253.27"></a><var>253.27</var>Required documentation must be completed and kept in the personal care assistance <br/>
<a id="pl.253.28"></a><var>253.28</var>provider agency file or the recipient's home residence. The required documentation <br/>
<a id="pl.253.29"></a><var>253.29</var>consists of:<br/>
<a id="pl.253.30"></a><var>253.30</var>(1) employee files, including:<br/>
<a id="pl.253.31"></a><var>253.31</var>(i) applications for employment;<br/>
<a id="pl.253.32"></a><var>253.32</var>(ii) background study requests and results;<br/>
<a id="pl.253.33"></a><var>253.33</var>(iii) orientation records about the agency policies;<br/>
<a id="pl.253.34"></a><var>253.34</var>(iv) trainings completed with demonstration of competence;<br/>
<a id="pl.253.35"></a><var>253.35</var>(v) supervisory visits;<br/>
<a id="pl.254.1"></a><var>254.1</var>(vi) evaluations of employment; and<br/>
<a id="pl.254.2"></a><var>254.2</var>(vii) signature on fraud statement;<br/>
<a id="pl.254.3"></a><var>254.3</var>(2) recipient files, including:<br/>
<a id="pl.254.4"></a><var>254.4</var>(i) demographics;<br/>
<a id="pl.254.5"></a><var>254.5</var>(ii) emergency contact information and emergency backup plan;<br/>
<a id="pl.254.6"></a><var>254.6</var>(iii) personal care assistance service plan;<br/>
<a id="pl.254.7"></a><var>254.7</var>(iv) personal care assistance care plan;<br/>
<a id="pl.254.8"></a><var>254.8</var>(v) month-to-month service use plan;<br/>
<a id="pl.254.9"></a><var>254.9</var>(vi) all communication records;<br/>
<a id="pl.254.10"></a><var>254.10</var>(vii) start of service information, including the written agreement with recipient; and<br/>
<a id="pl.254.11"></a><var>254.11</var>(viii) date the home care bill of rights was given to the recipient;<br/>
<a id="pl.254.12"></a><var>254.12</var>(3) agency policy manual, including:<br/>
<a id="pl.254.13"></a><var>254.13</var>(i) policies for employment and termination;<br/>
<a id="pl.254.14"></a><var>254.14</var>(ii) grievance policies with resolution of consumer grievances;<br/>
<a id="pl.254.15"></a><var>254.15</var>(iii) staff and consumer safety;<br/>
<a id="pl.254.16"></a><var>254.16</var>(iv) staff misconduct; and<br/>
<a id="pl.254.17"></a><var>254.17</var>(v) staff hiring, service delivery, staff and consumer safety, staff misconduct, and <br/>
<a id="pl.254.18"></a><var>254.18</var>resolution of consumer grievances; <br/>
<a id="pl.254.19"></a><var>254.19</var>(4) time sheets for each personal care assistant along with completed activity sheets <br/>
<a id="pl.254.20"></a><var>254.20</var>for each recipient served; and<br/>
<a id="pl.254.21"></a><var>254.21</var>(5) agency marketing and advertising materials and documentation of marketing <br/>
<a id="pl.254.22"></a><var>254.22</var>activities and costs.<br/>
<a id="pl.254.23"></a><var>254.23</var>    Subd. 29. <b>Transitional assistance.</b> The commissioner, counties, health plans, <br/>
<a id="pl.254.24"></a><var>254.24</var>tribes, and personal care assistance providers shall work together to provide transitional <br/>
<a id="pl.254.25"></a><var>254.25</var>assistance for recipients and families to come into compliance with the new requirements <br/>
<a id="pl.254.26"></a><var>254.26</var>of this section and ensure the personal care assistance services are not provided by the <br/>
<a id="pl.254.27"></a><var>254.27</var>housing provider.<br/>
<a id="pl.254.28"></a><var>254.28</var>    Subd. 30. <b>Notice of service changes to recipients.</b> The commissioner must provide:<br/>
<a id="pl.254.29"></a><var>254.29</var>(1) by October 31, 2009, information to recipients likely to be affected that (i) <br/>
<a id="pl.254.30"></a><var>254.30</var>describes the changes to the personal care assistance program that may result in the <br/>
<a id="pl.254.31"></a><var>254.31</var>loss of access to personal care assistance services, and (ii) includes resources to obtain <br/>
<a id="pl.254.32"></a><var>254.32</var>further information; and<br/>
<a id="pl.254.33"></a><var>254.33</var>(2) notice of changes in medical assistance home care services to each affected <br/>
<a id="pl.254.34"></a><var>254.34</var>recipient at least 30 days before the effective date of the change.<br/>
<a id="pl.254.35"></a><var>254.35</var>The notice shall include how to get further information on the changes, how to get help to <br/>
<a id="pl.254.36"></a><var>254.36</var>obtain other services, a list of community resources, and appeal rights. Notwithstanding <br/>
<a id="pl.255.1"></a><var>255.1</var>section 256.045, a recipient may request continued services pending appeal within the <br/>
<a id="pl.255.2"></a><var>255.2</var>time period allowed to request an appeal.<br/>
<a id="pl.255.3"></a><var>255.3</var><b>EFFECTIVE DATE.</b>Subdivisions 4, 22, and 27 are effective January 1, 2010.<br/>
<br/>
<a id="bill.8.32.0"></a><a id="pl.255.4"></a><var>255.4</var>    Sec. 32. Minnesota Statutes 2008, section 256B.0911, subdivision 1, is amended to <br/>
<a id="pl.255.5"></a><var>255.5</var>read:<br/>
<a id="pl.255.6"></a><var>255.6</var>    Subdivision 1. <b>Purpose and goal.</b> (a) The purpose of long-term care consultation <br/>
<a id="pl.255.7"></a><var>255.7</var>services is to assist persons with long-term or chronic care needs in making long-term <br/>
<a id="pl.255.8"></a><var>255.8</var>care decisions and selecting options that meet their needs and reflect their preferences. <br/>
<a id="pl.255.9"></a><var>255.9</var>The availability of, and access to, information and other types of assistance, including <br/>
<a id="pl.255.10"></a><var>255.10</var>assessment and support planning, is also intended to prevent or delay certified nursing <br/>
<a id="pl.255.11"></a><var>255.11</var>facility placements and to provide transition assistance after admission. Further, the goal <br/>
<a id="pl.255.12"></a><var>255.12</var>of these services is to contain costs associated with unnecessary certified nursing facility <br/>
<a id="pl.255.13"></a><var>255.13</var>admissions. Long-term consultation services must be available to any person regardless <br/>
<a id="pl.255.14"></a><var>255.14</var>of public program eligibility. The commissioners commissioner of human services and <br/>
<a id="pl.255.15"></a><var>255.15</var>health shall seek to maximize use of available federal and state funds and establish the <br/>
<a id="pl.255.16"></a><var>255.16</var>broadest program possible within the funding available.<br/>
<a id="pl.255.17"></a><var>255.17</var>(b) These services must be coordinated with services long-term care options <br/>
<a id="pl.255.18"></a><var>255.18</var>counseling provided under section 
         <statute_ref>256.975, subdivision 7</statute_ref>, and with services provided by <br/>
<a id="pl.255.19"></a><var>255.19</var>other public and private agencies in the community section 256.01, subdivision 24, for <br/>
<a id="pl.255.20"></a><var>255.20</var>telephone assistance and follow up and to offer a variety of cost-effective alternatives to <br/>
<a id="pl.255.21"></a><var>255.21</var>persons with disabilities and elderly persons. The county or tribal agency or managed <br/>
<a id="pl.255.22"></a><var>255.22</var>care plan providing long-term care consultation services shall encourage the use of <br/>
<a id="pl.255.23"></a><var>255.23</var>volunteers from families, religious organizations, social clubs, and similar civic and <br/>
<a id="pl.255.24"></a><var>255.24</var>service organizations to provide community-based services.<br/>
<br/>
<a id="bill.8.33.0"></a><a id="pl.255.25"></a><var>255.25</var>    Sec. 33. Minnesota Statutes 2008, section 256B.0911, subdivision 1a, is amended to <br/>
<a id="pl.255.26"></a><var>255.26</var>read:<br/>
<a id="pl.255.27"></a><var>255.27</var>    Subd. 1a. <b>Definitions.</b> For purposes of this section, the following definitions apply:<br/>
<a id="pl.255.28"></a><var>255.28</var>(a) "Long-term care consultation services" means:<br/>
<a id="pl.255.29"></a><var>255.29</var>(1) providing information and education to the general public regarding availability <br/>
<a id="pl.255.30"></a><var>255.30</var>of the services authorized under this section;<br/>
<a id="pl.255.31"></a><var>255.31</var>(2) an intake process that provides access to the services described in this section;<br/>
<a id="pl.255.32"></a><var>255.32</var>(3) assessment of the health, psychological, and social needs of referred individuals;<br/>
<a id="pl.255.33"></a><var>255.33</var>(4) assistance in identifying services needed to maintain an individual in the least <br/>
<a id="pl.255.34"></a><var>255.34</var>restrictive most inclusive environment;<br/>
<a id="pl.256.1"></a><var>256.1</var>(5) (2) providing recommendations on cost-effective community services that are <br/>
<a id="pl.256.2"></a><var>256.2</var>available to the individual;<br/>
<a id="pl.256.3"></a><var>256.3</var>(6) (3) development of an individual's person-centered community support plan;<br/>
<a id="pl.256.4"></a><var>256.4</var>(7) (4) providing information regarding eligibility for Minnesota health care <br/>
<a id="pl.256.5"></a><var>256.5</var>programs;<br/>
<a id="pl.256.6"></a><var>256.6</var>(5) face-to-face long-term care consultation assessments, which may be completed <br/>
<a id="pl.256.7"></a><var>256.7</var>in a hospital, nursing facility, intermediate care facility for persons with developmental <br/>
<a id="pl.256.8"></a><var>256.8</var>disabilities (ICF/DDs), regional treatment centers, or the person's current or planned <br/>
<a id="pl.256.9"></a><var>256.9</var>residence;<br/>
<a id="pl.256.10"></a><var>256.10</var>(8) preadmission (6) federally mandated screening to determine the need for <br/>
<a id="pl.256.11"></a><var>256.11</var>a nursing facility institutional level of care under section 256B.0911, subdivision 4, <br/>
<a id="pl.256.12"></a><var>256.12</var>paragraph (a);<br/>
<a id="pl.256.13"></a><var>256.13</var>(9) preliminary (7) determination of Minnesota health care programs home and <br/>
<a id="pl.256.14"></a><var>256.14</var>community-based waiver service eligibility including level of care determination for <br/>
<a id="pl.256.15"></a><var>256.15</var>individuals who need a nursing facility an institutional level of care as defined under <br/>
<a id="pl.256.16"></a><var>256.16</var>section 144.0724, subdivision 11, or 256B.092, service eligibility including state plan <br/>
<a id="pl.256.17"></a><var>256.17</var>home care services identified in section 256B.0625, subdivisions 6, 7, and 19, paragraphs <br/>
<a id="pl.256.18"></a><var>256.18</var>(a) and (c), based on assessment and support plan development with appropriate referrals <br/>
<a id="pl.256.19"></a><var>256.19</var>for final determination;<br/>
<a id="pl.256.20"></a><var>256.20</var>(10) (8) providing recommendations for nursing facility placement when there are <br/>
<a id="pl.256.21"></a><var>256.21</var>no cost-effective community services available; and<br/>
<a id="pl.256.22"></a><var>256.22</var>(11) (9) assistance to transition people back to community settings after facility <br/>
<a id="pl.256.23"></a><var>256.23</var>admission.<br/>
<a id="pl.256.24"></a><var>256.24</var>(b) "Long-term options counseling" means the services provided by the linkage <br/>
<a id="pl.256.25"></a><var>256.25</var>lines as mandated by sections 256.01 and 256.975, subdivision 7, and also includes <br/>
<a id="pl.256.26"></a><var>256.26</var>telephone assistance and follow up once a long-term care consultation assessment has <br/>
<a id="pl.256.27"></a><var>256.27</var>been completed. <br/>
<a id="pl.256.28"></a><var>256.28</var>(b) (c) "Minnesota health care programs" means the medical assistance program <br/>
<a id="pl.256.29"></a><var>256.29</var>under chapter 256B and the alternative care program under section 
         <statute_ref>256B.0913</statute_ref>.<br/>
<a id="pl.256.30"></a><var>256.30</var>(d) "Lead agencies" means counties or a collaboration of counties, tribes, and health <br/>
<a id="pl.256.31"></a><var>256.31</var>plans administering long-term care consultation assessment and support planning services.<br/>
<a id="pl.256.32"></a><var>256.32</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2011.<br/>
<br/>
<a id="bill.8.34.0"></a><a id="pl.256.33"></a><var>256.33</var>    Sec. 34. Minnesota Statutes 2008, section 256B.0911, is amended by adding a <br/>
<a id="pl.256.34"></a><var>256.34</var>subdivision to read:<br/>
<a id="pl.257.1"></a><var>257.1</var>    Subd. 2b. <b>Certified assessors.</b> (a) Beginning January 1, 2011, each lead agency <br/>
<a id="pl.257.2"></a><var>257.2</var>shall use certified assessors who have completed training and certification process <br/>
<a id="pl.257.3"></a><var>257.3</var>determined by the commissioner in subdivision 2c. Certified assessors shall demonstrate <br/>
<a id="pl.257.4"></a><var>257.4</var>best practices in assessment and support planning including person-centered planning <br/>
<a id="pl.257.5"></a><var>257.5</var>principals and have a common set of skills that must ensure consistency and equitable <br/>
<a id="pl.257.6"></a><var>257.6</var>access to services statewide. Assessors must be part of a multidisciplinary team of <br/>
<a id="pl.257.7"></a><var>257.7</var>professionals that includes public health nurses, social workers, and other professionals <br/>
<a id="pl.257.8"></a><var>257.8</var>as defined in paragraph (b). For persons with complex health care needs, a public health <br/>
<a id="pl.257.9"></a><var>257.9</var>nurse or registered nurse from a multidisciplinary team must be consulted.<br/>
<a id="pl.257.10"></a><var>257.10</var>(b) Certified assessors are persons with a minimum of a bachelor's degree in social <br/>
<a id="pl.257.11"></a><var>257.11</var>work, nursing with a public health nursing certificate, or other closely related field with at <br/>
<a id="pl.257.12"></a><var>257.12</var>least one year of home and community-based experience or a two-year registered nursing <br/>
<a id="pl.257.13"></a><var>257.13</var>degree with at least three years of home and community-based experience that have <br/>
<a id="pl.257.14"></a><var>257.14</var>received training and certification specific to assessment and consultation for long-term <br/>
<a id="pl.257.15"></a><var>257.15</var>care services in the state.<br/>
<br/>
<a id="bill.8.35.0"></a><a id="pl.257.16"></a><var>257.16</var>    Sec. 35. Minnesota Statutes 2008, section 256B.0911, is amended by adding a <br/>
<a id="pl.257.17"></a><var>257.17</var>subdivision to read:<br/>
<a id="pl.257.18"></a><var>257.18</var>    Subd. 2c. <b>Assessor training and certification.</b> The commissioner shall develop a <br/>
<a id="pl.257.19"></a><var>257.19</var>curriculum and an assessor certification process to begin no later than January 1, 2010. <br/>
<a id="pl.257.20"></a><var>257.20</var>All existing lead agency staff designated to provide the services defined in subdivision <br/>
<a id="pl.257.21"></a><var>257.21</var>1a must be certified by December 30, 2010. Each lead agency is required to ensure that <br/>
<a id="pl.257.22"></a><var>257.22</var>they have sufficient numbers of certified assessors to provide long-term consultation <br/>
<a id="pl.257.23"></a><var>257.23</var>assessment and support planning within the timelines and parameters of the service by <br/>
<a id="pl.257.24"></a><var>257.24</var>January 1, 2011. Certified assessors are required to be recertified every three years.<br/>
<br/>
<a id="bill.8.36.0"></a><a id="pl.257.25"></a><var>257.25</var>    Sec. 36. Minnesota Statutes 2008, section 256B.0911, subdivision 3, is amended to <br/>
<a id="pl.257.26"></a><var>257.26</var>read:<br/>
<a id="pl.257.27"></a><var>257.27</var>    Subd. 3. <b>Long-term care consultation team.</b> (a) Until January 1, 2011, a long-term <br/>
<a id="pl.257.28"></a><var>257.28</var>care consultation team shall be established by the county board of commissioners. Each <br/>
<a id="pl.257.29"></a><var>257.29</var>local consultation team shall consist of at least one social worker and at least one public <br/>
<a id="pl.257.30"></a><var>257.30</var>health nurse from their respective county agencies. The board may designate public <br/>
<a id="pl.257.31"></a><var>257.31</var>health or social services as the lead agency for long-term care consultation services. If a <br/>
<a id="pl.257.32"></a><var>257.32</var>county does not have a public health nurse available, it may request approval from the <br/>
<a id="pl.257.33"></a><var>257.33</var>commissioner to assign a county registered nurse with at least one year experience in <br/>
<a id="pl.258.1"></a><var>258.1</var>home care to participate on the team. Two or more counties may collaborate to establish <br/>
<a id="pl.258.2"></a><var>258.2</var>a joint local consultation team or teams.<br/>
<a id="pl.258.3"></a><var>258.3</var>(b) The team is responsible for providing long-term care consultation services to <br/>
<a id="pl.258.4"></a><var>258.4</var>all persons located in the county who request the services, regardless of eligibility for <br/>
<a id="pl.258.5"></a><var>258.5</var>Minnesota health care programs.<br/>
<a id="pl.258.6"></a><var>258.6</var>(c) The commissioner shall allow arrangements and make recommendations that <br/>
<a id="pl.258.7"></a><var>258.7</var>encourage counties to collaborate to establish joint local long-term care consultation teams <br/>
<a id="pl.258.8"></a><var>258.8</var>to ensure that long-term care consultations are done within the timelines and parameters <br/>
<a id="pl.258.9"></a><var>258.9</var>of the service. This includes integrated service models as required in subdivision 1, <br/>
<a id="pl.258.10"></a><var>258.10</var>paragraph (b).<br/>
<br/>
<a id="bill.8.37.0"></a><a id="pl.258.11"></a><var>258.11</var>    Sec. 37. Minnesota Statutes 2008, section 256B.0911, subdivision 3a, is amended to <br/>
<a id="pl.258.12"></a><var>258.12</var>read:<br/>
<a id="pl.258.13"></a><var>258.13</var>    Subd. 3a. <b>Assessment and support planning.</b> (a) Persons requesting assessment, <br/>
<a id="pl.258.14"></a><var>258.14</var>services planning, or other assistance intended to support community-based living, <br/>
<a id="pl.258.15"></a><var>258.15</var>including persons who need assessment in order to determine waiver or alternative <br/>
<a id="pl.258.16"></a><var>258.16</var>care program eligibility, must be visited by a long-term care consultation team within <br/>
<a id="pl.258.17"></a><var>258.17</var>ten working 15 calendar days after the date on which an assessment was requested or <br/>
<a id="pl.258.18"></a><var>258.18</var>recommended. After January 1, 2011, these requirements also apply to personal care <br/>
<a id="pl.258.19"></a><var>258.19</var>assistance services, private duty nursing, and home health agency services, on timelines <br/>
<a id="pl.258.20"></a><var>258.20</var>established in subdivision 5. Face-to-face  assessments must be conducted according <br/>
<a id="pl.258.21"></a><var>258.21</var>to paragraphs (b) to (i).<br/>
<a id="pl.258.22"></a><var>258.22</var>    (b) The county may utilize a team of either the social worker or public health nurse, <br/>
<a id="pl.258.23"></a><var>258.23</var>or both,. After January 1, 2011, lead agencies shall use certified assessors  to conduct the <br/>
<a id="pl.258.24"></a><var>258.24</var>assessment in a face-to-face interview. The consultation team members must confer <br/>
<a id="pl.258.25"></a><var>258.25</var>regarding the most appropriate care for each individual screened or assessed.<br/>
<a id="pl.258.26"></a><var>258.26</var>    (c) The long-term care consultation team must assess the health and social needs of <br/>
<a id="pl.258.27"></a><var>258.27</var>the person assessment must be comprehensive and include a person-centered assessment <br/>
<a id="pl.258.28"></a><var>258.28</var>of the health, psychological, functional, environmental, and social needs of referred <br/>
<a id="pl.258.29"></a><var>258.29</var>individuals and provide information necessary to develop a support plan that meets the <br/>
<a id="pl.258.30"></a><var>258.30</var>consumers needs, using an assessment form provided by the commissioner.<br/>
<a id="pl.258.31"></a><var>258.31</var>    (d) The team must conduct the assessment must be conducted in a face-to-face <br/>
<a id="pl.258.32"></a><var>258.32</var>interview with the person being assessed and the person's legal representative, if applicable <br/>
<a id="pl.258.33"></a><var>258.33</var>as required by legally executed documents, and other individuals as requested by the <br/>
<a id="pl.258.34"></a><var>258.34</var>person, who can provide information on the needs, strengths, and preferences of the <br/>
<a id="pl.259.1"></a><var>259.1</var>person necessary to develop a support plan that ensures the person's health and safety, but <br/>
<a id="pl.259.2"></a><var>259.2</var>who is not a provider of service or has any financial interest in the provision of services.<br/>
<a id="pl.259.3"></a><var>259.3</var>    (e) The team must provide the person, or the person's legal representative, must <br/>
<a id="pl.259.4"></a><var>259.4</var>be provided with written recommendations for facility- or community-based services. <br/>
<a id="pl.259.5"></a><var>259.5</var>The team must document or institutional care that include documentation that the most <br/>
<a id="pl.259.6"></a><var>259.6</var>cost-effective alternatives available were offered to the individual. For purposes of <br/>
<a id="pl.259.7"></a><var>259.7</var>this requirement, "cost-effective alternatives" means community services and living <br/>
<a id="pl.259.8"></a><var>259.8</var>arrangements that cost the same as or less than nursing facility institutional care.<br/>
<a id="pl.259.9"></a><var>259.9</var>    (f) If the person chooses to use community-based services, the team must provide <br/>
<a id="pl.259.10"></a><var>259.10</var>the person or the person's legal representative must be provided with a written community <br/>
<a id="pl.259.11"></a><var>259.11</var>support plan, regardless of whether the individual is eligible for Minnesota health care <br/>
<a id="pl.259.12"></a><var>259.12</var>programs. The A person may request assistance in developing a community support plan <br/>
<a id="pl.259.13"></a><var>259.13</var> identifying community supports without participating in a complete assessment. Upon <br/>
<a id="pl.259.14"></a><var>259.14</var>a request for assistance identifying community support, the person must be transferred <br/>
<a id="pl.259.15"></a><var>259.15</var>or referred to the services available under sections 256.975, subdivision 7, and 256.01, <br/>
<a id="pl.259.16"></a><var>259.16</var>subdivision 24, for telephone assistance and follow up.<br/>
<a id="pl.259.17"></a><var>259.17</var>    (g) The person has the right to make the final decision between nursing <br/>
<a id="pl.259.18"></a><var>259.18</var>facility institutional placement and community placement after the screening team's <br/>
<a id="pl.259.19"></a><var>259.19</var>recommendation recommendations have been provided, except as provided in subdivision <br/>
<a id="pl.259.20"></a><var>259.20</var>4a, paragraph (c).<br/>
<a id="pl.259.21"></a><var>259.21</var>    (h) The team must give the person receiving assessment or support planning, or <br/>
<a id="pl.259.22"></a><var>259.22</var>the person's legal representative, materials, and forms supplied by the commissioner <br/>
<a id="pl.259.23"></a><var>259.23</var>containing the following information:<br/>
<a id="pl.259.24"></a><var>259.24</var>    (1) the need for and purpose of preadmission screening if the person selects nursing <br/>
<a id="pl.259.25"></a><var>259.25</var>facility placement;<br/>
<a id="pl.259.26"></a><var>259.26</var>    (2) the role of the long-term care consultation assessment and support planning in <br/>
<a id="pl.259.27"></a><var>259.27</var>waiver and alternative care program eligibility determination;<br/>
<a id="pl.259.28"></a><var>259.28</var>    (3) information about Minnesota health care programs;<br/>
<a id="pl.259.29"></a><var>259.29</var>    (4) the person's freedom to accept or reject the recommendations of the team;<br/>
<a id="pl.259.30"></a><var>259.30</var>    (5) the person's right to confidentiality under the Minnesota Government Data <br/>
<a id="pl.259.31"></a><var>259.31</var>Practices Act, chapter 13;<br/>
<a id="pl.259.32"></a><var>259.32</var>    (6) the long-term care consultant's decision regarding the person's need for nursing <br/>
<a id="pl.259.33"></a><var>259.33</var>facility institutional level of care as determined under criteria established in section <br/>
<a id="pl.259.34"></a><var>259.34</var>144.0724, subdivision 11, or 256B.092; and<br/>
<a id="pl.260.1"></a><var>260.1</var>    (7) the person's right to appeal the decision regarding the need for nursing facility <br/>
<a id="pl.260.2"></a><var>260.2</var>level of care or the county's final decisions regarding public programs eligibility according <br/>
<a id="pl.260.3"></a><var>260.3</var>to section 
         <statute_ref>256.045, subdivision 3</statute_ref>.<br/>
<a id="pl.260.4"></a><var>260.4</var>    (i) Face-to-face assessment completed as part of eligibility determination for <br/>
<a id="pl.260.5"></a><var>260.5</var>the alternative care, elderly waiver, community alternatives for disabled individuals, <br/>
<a id="pl.260.6"></a><var>260.6</var>community alternative care, and traumatic brain injury waiver programs under sections <br/>
<statute_ref><a id="pl.260.7"></a><var>260.7</var>256B.0915
         </statute_ref>, 
         <statute_ref>256B.0917</statute_ref>, and 
         <statute_ref>256B.49</statute_ref> is valid to establish service eligibility for no more <br/>
<a id="pl.260.8"></a><var>260.8</var>than 60 calendar days after the date of assessment. The effective eligibility start date <br/>
<a id="pl.260.9"></a><var>260.9</var>for these programs can never be prior to the date of assessment. If an assessment was <br/>
<a id="pl.260.10"></a><var>260.10</var>completed more than 60 days before the effective waiver or alternative care program <br/>
<a id="pl.260.11"></a><var>260.11</var>eligibility start date, assessment and support plan information must be updated in a <br/>
<a id="pl.260.12"></a><var>260.12</var>face-to-face visit and documented in the department's Medicaid Management Information <br/>
<a id="pl.260.13"></a><var>260.13</var>System (MMIS). The effective date of program eligibility in this case cannot be prior to <br/>
<a id="pl.260.14"></a><var>260.14</var>the date the updated assessment is completed.<br/>
<br/>
<a id="bill.8.38.0"></a><a id="pl.260.15"></a><var>260.15</var>    Sec. 38. Minnesota Statutes 2008, section 256B.0911, subdivision 3b, is amended to <br/>
<a id="pl.260.16"></a><var>260.16</var>read:<br/>
<a id="pl.260.17"></a><var>260.17</var>    Subd. 3b. <b>Transition assistance.</b> (a) A long-term care consultation team shall <br/>
<a id="pl.260.18"></a><var>260.18</var>provide assistance to persons residing in a nursing facility, hospital, regional treatment <br/>
<a id="pl.260.19"></a><var>260.19</var>center, or intermediate care facility for persons with developmental disabilities who <br/>
<a id="pl.260.20"></a><var>260.20</var>request or are referred for assistance. Transition assistance must include assessment, <br/>
<a id="pl.260.21"></a><var>260.21</var>community support plan development, referrals to long-term care options counseling <br/>
<a id="pl.260.22"></a><var>260.22</var>under section 256B.975, subdivision 10, for community support plan implementation and <br/>
<a id="pl.260.23"></a><var>260.23</var>to Minnesota health care programs, and referrals to programs that provide assistance <br/>
<a id="pl.260.24"></a><var>260.24</var>with housing. Transition assistance must also include information about the Centers for <br/>
<a id="pl.260.25"></a><var>260.25</var>Independent Living and the Senior LinkAge Line, and about other organizations that <br/>
<a id="pl.260.26"></a><var>260.26</var>can provide assistance with relocation efforts, and information about contacting these <br/>
<a id="pl.260.27"></a><var>260.27</var>organizations to obtain their assistance and support. <br/>
<a id="pl.260.28"></a><var>260.28</var>    (b) The county shall develop transition processes with institutional social workers <br/>
<a id="pl.260.29"></a><var>260.29</var>and discharge planners to ensure that:<br/>
<a id="pl.260.30"></a><var>260.30</var>    (1) persons admitted to facilities receive information about transition assistance <br/>
<a id="pl.260.31"></a><var>260.31</var>that is available;<br/>
<a id="pl.260.32"></a><var>260.32</var>    (2) the assessment is completed for persons within ten working days of the date of <br/>
<a id="pl.260.33"></a><var>260.33</var>request or recommendation for assessment; and<br/>
<a id="pl.260.34"></a><var>260.34</var>    (3) there is a plan for transition and follow-up for the individual's return to the <br/>
<a id="pl.260.35"></a><var>260.35</var>community. The plan must require notification of other local agencies when a person <br/>
<a id="pl.261.1"></a><var>261.1</var>who may require assistance is screened by one county for admission to a facility located <br/>
<a id="pl.261.2"></a><var>261.2</var>in another county.<br/>
<a id="pl.261.3"></a><var>261.3</var>    (c) If a person who is eligible for a Minnesota health care program is admitted to a <br/>
<a id="pl.261.4"></a><var>261.4</var>nursing facility, the nursing facility must include a consultation team member or the case <br/>
<a id="pl.261.5"></a><var>261.5</var>manager in the discharge planning process.<br/>
<br/>
<a id="bill.8.39.0"></a><a id="pl.261.6"></a><var>261.6</var>    Sec. 39. Minnesota Statutes 2008, section 256B.0911, subdivision 3c, is amended to <br/>
<a id="pl.261.7"></a><var>261.7</var>read:<br/>
<a id="pl.261.8"></a><var>261.8</var>    Subd. 3c. <b>Transition to housing with services.</b> (a) Housing with services <br/>
<a id="pl.261.9"></a><var>261.9</var>establishments offering or providing assisted living under chapter 144G shall inform <br/>
<a id="pl.261.10"></a><var>261.10</var>all prospective residents of the availability of and contact information for transitional <br/>
<a id="pl.261.11"></a><var>261.11</var>consultation services under this subdivision prior to executing a lease or contract with the <br/>
<a id="pl.261.12"></a><var>261.12</var>prospective resident. The purpose of transitional long-term care consultation is to support <br/>
<a id="pl.261.13"></a><var>261.13</var>persons with current or anticipated long-term care needs in making informed choices <br/>
<a id="pl.261.14"></a><var>261.14</var>among options that include the most cost-effective and least restrictive settings, and to <br/>
<a id="pl.261.15"></a><var>261.15</var>delay spenddown to eligibility for publicly funded programs by connecting people to <br/>
<a id="pl.261.16"></a><var>261.16</var>alternative services in their homes before transition to housing with services. Regardless <br/>
<a id="pl.261.17"></a><var>261.17</var>of the consultation, prospective residents maintain the right to choose housing with <br/>
<a id="pl.261.18"></a><var>261.18</var>services or assisted living if that option is their preference.<br/>
<a id="pl.261.19"></a><var>261.19</var>    (b) Transitional consultation services are provided as determined by the <br/>
<a id="pl.261.20"></a><var>261.20</var>commissioner of human services in partnership with county long-term care consultation <br/>
<a id="pl.261.21"></a><var>261.21</var>units, and the Area Agencies on Aging, and are a combination of telephone-based <br/>
<a id="pl.261.22"></a><var>261.22</var>and in-person assistance provided under models developed by the commissioner. The <br/>
<a id="pl.261.23"></a><var>261.23</var>consultation shall be performed in a manner that provides objective and complete <br/>
<a id="pl.261.24"></a><var>261.24</var>information. Transitional consultation must be provided within five working days of the <br/>
<a id="pl.261.25"></a><var>261.25</var>request of the prospective resident as follows:<br/>
<a id="pl.261.26"></a><var>261.26</var>    (1) the consultation must be provided by a qualified professional as determined by <br/>
<a id="pl.261.27"></a><var>261.27</var>the commissioner;<br/>
<a id="pl.261.28"></a><var>261.28</var>    (2) the consultation must include a review of the prospective resident's reasons for <br/>
<a id="pl.261.29"></a><var>261.29</var>considering assisted living, the prospective resident's personal goals, a discussion of the <br/>
<a id="pl.261.30"></a><var>261.30</var>prospective resident's immediate and projected long-term care needs, and alternative <br/>
<a id="pl.261.31"></a><var>261.31</var>community services or assisted living settings that may meet the prospective resident's <br/>
<a id="pl.261.32"></a><var>261.32</var>needs; and<br/>
<a id="pl.261.33"></a><var>261.33</var>    (3) the prospective resident shall be informed of the availability of long-term care <br/>
<a id="pl.261.34"></a><var>261.34</var>consultation services described in subdivision 3a that are available at no charge to the <br/>
<a id="pl.261.35"></a><var>261.35</var>prospective resident to assist the prospective resident in assessment and planning to meet <br/>
<a id="pl.262.1"></a><var>262.1</var>the prospective resident's long-term care needs. The Senior LinkAge Line and long-term <br/>
<a id="pl.262.2"></a><var>262.2</var>care consultation team shall give the highest priority to referrals who are at highest risk of <br/>
<a id="pl.262.3"></a><var>262.3</var>nursing facility placement or as needed for determining eligibility.<br/>
<br/>
<a id="bill.8.40.0"></a><a id="pl.262.4"></a><var>262.4</var>    Sec. 40. Minnesota Statutes 2008, section 256B.0911, subdivision 4a, is amended to <br/>
<a id="pl.262.5"></a><var>262.5</var>read:<br/>
<a id="pl.262.6"></a><var>262.6</var>    Subd. 4a. <b>Preadmission screening activities related to nursing facility </b><br/>
<a id="pl.262.7"></a><var>262.7</var><b>admissions.</b> (a) All applicants to Medicaid certified nursing facilities, including certified <br/>
<a id="pl.262.8"></a><var>262.8</var>boarding care facilities, must be screened prior to admission regardless of income, assets, <br/>
<a id="pl.262.9"></a><var>262.9</var>or funding sources for nursing facility care, except as described in subdivision 4b. The <br/>
<a id="pl.262.10"></a><var>262.10</var>purpose of the screening is to determine the need for nursing facility level of care as <br/>
<a id="pl.262.11"></a><var>262.11</var>described in paragraph (d) and to complete activities required under federal law related to <br/>
<a id="pl.262.12"></a><var>262.12</var>mental illness and developmental disability as outlined in paragraph (b).<br/>
<a id="pl.262.13"></a><var>262.13</var>(b) A person who has a diagnosis or possible diagnosis of mental illness or <br/>
<a id="pl.262.14"></a><var>262.14</var>developmental disability must receive a preadmission screening before admission <br/>
<a id="pl.262.15"></a><var>262.15</var>regardless of the exemptions outlined in subdivision 4b, paragraph (b), to identify the need <br/>
<a id="pl.262.16"></a><var>262.16</var>for further evaluation and specialized services, unless the admission prior to screening is <br/>
<a id="pl.262.17"></a><var>262.17</var>authorized by the local mental health authority or the local developmental disabilities case <br/>
<a id="pl.262.18"></a><var>262.18</var>manager, or unless authorized by the county agency according to Public Law 101-508.<br/>
<a id="pl.262.19"></a><var>262.19</var>The following criteria apply to the preadmission screening:<br/>
<a id="pl.262.20"></a><var>262.20</var>(1) the county must use forms and criteria developed by the commissioner to identify <br/>
<a id="pl.262.21"></a><var>262.21</var>persons who require referral for further evaluation and determination of the need for <br/>
<a id="pl.262.22"></a><var>262.22</var>specialized services; and<br/>
<a id="pl.262.23"></a><var>262.23</var>(2) the evaluation and determination of the need for specialized services must be <br/>
<a id="pl.262.24"></a><var>262.24</var>done by:<br/>
<a id="pl.262.25"></a><var>262.25</var>(i) a qualified independent mental health professional, for persons with a primary or <br/>
<a id="pl.262.26"></a><var>262.26</var>secondary diagnosis of a serious mental illness; or<br/>
<a id="pl.262.27"></a><var>262.27</var>(ii) a qualified developmental disability professional, for persons with a primary or <br/>
<a id="pl.262.28"></a><var>262.28</var>secondary diagnosis of developmental disability. For purposes of this requirement, a <br/>
<a id="pl.262.29"></a><var>262.29</var>qualified developmental disability professional must meet the standards for a qualified <br/>
<a id="pl.262.30"></a><var>262.30</var>developmental disability professional under Code of Federal Regulations, title 42, section <br/>
<statute_ref><a id="pl.262.31"></a><var>262.31</var>483.430
         </statute_ref>.<br/>
<a id="pl.262.32"></a><var>262.32</var>(c) The local county mental health authority or the state developmental disability <br/>
<a id="pl.262.33"></a><var>262.33</var>authority under Public Law Numbers 100-203 and 101-508 may prohibit admission to a <br/>
<a id="pl.262.34"></a><var>262.34</var>nursing facility if the individual does not meet the nursing facility level of care criteria or <br/>
<a id="pl.262.35"></a><var>262.35</var>needs specialized services as defined in Public Law Numbers 100-203 and 101-508. For <br/>
<a id="pl.263.1"></a><var>263.1</var>purposes of this section, "specialized services" for a person with developmental disability <br/>
<a id="pl.263.2"></a><var>263.2</var>means active treatment as that term is defined under Code of Federal Regulations, title <br/>
<a id="pl.263.3"></a><var>263.3</var>42, section 
         <statute_ref>483.440</statute_ref> (a)(1).<br/>
<a id="pl.263.4"></a><var>263.4</var>(d) The determination of the need for nursing facility level of care must be made <br/>
<a id="pl.263.5"></a><var>263.5</var>according to criteria established in section 144.0724, subdivision 11, and 256B.092, <br/>
<a id="pl.263.6"></a><var>263.6</var>using forms developed by the commissioner. In assessing a person's needs, consultation <br/>
<a id="pl.263.7"></a><var>263.7</var>team members shall have a physician available for consultation and shall consider the <br/>
<a id="pl.263.8"></a><var>263.8</var>assessment of the individual's attending physician, if any. The individual's physician must <br/>
<a id="pl.263.9"></a><var>263.9</var>be included if the physician chooses to participate. Other personnel may be included on <br/>
<a id="pl.263.10"></a><var>263.10</var>the team as deemed appropriate by the county.<br/>
<a id="pl.263.11"></a><var>263.11</var><b>EFFECTIVE DATE.</b>The section is effective January 1, 2011.<br/>
<br/>
<a id="bill.8.41.0"></a><a id="pl.263.12"></a><var>263.12</var>    Sec. 41. Minnesota Statutes 2008, section 256B.0911, subdivision 5, is amended to <br/>
<a id="pl.263.13"></a><var>263.13</var>read:<br/>
<a id="pl.263.14"></a><var>263.14</var>    Subd. 5. <b>Administrative activity.</b> The commissioner shall minimize the number <br/>
<a id="pl.263.15"></a><var>263.15</var>of forms required in the provision of long-term care consultation services and shall <br/>
<a id="pl.263.16"></a><var>263.16</var>limit the screening document to items necessary for community support plan approval, <br/>
<a id="pl.263.17"></a><var>263.17</var>reimbursement, program planning, evaluation, and policy development streamline the <br/>
<a id="pl.263.18"></a><var>263.18</var>processes, including timelines for when assessments need to be completed, required to <br/>
<a id="pl.263.19"></a><var>263.19</var>provide the services in this section and shall implement integrated solutions to automate <br/>
<a id="pl.263.20"></a><var>263.20</var>the business processes to the extent necessary for community support plan approval, <br/>
<a id="pl.263.21"></a><var>263.21</var>reimbursement, program planning, evaluation, and policy development.<br/>
<br/>
<a id="bill.8.42.0"></a><a id="pl.263.22"></a><var>263.22</var>    Sec. 42. Minnesota Statutes 2008, section 256B.0911, subdivision 6, is amended to <br/>
<a id="pl.263.23"></a><var>263.23</var>read:<br/>
<a id="pl.263.24"></a><var>263.24</var>    Subd. 6. <b>Payment for long-term care consultation services.</b> (a) The total payment <br/>
<a id="pl.263.25"></a><var>263.25</var>for each county must be paid monthly by certified nursing facilities in the county. The <br/>
<a id="pl.263.26"></a><var>263.26</var>monthly amount to be paid by each nursing facility for each fiscal year must be determined <br/>
<a id="pl.263.27"></a><var>263.27</var>by dividing the county's annual allocation for long-term care consultation services by 12 <br/>
<a id="pl.263.28"></a><var>263.28</var>to determine the monthly payment and allocating the monthly payment to each nursing <br/>
<a id="pl.263.29"></a><var>263.29</var>facility based on the number of licensed beds in the nursing facility. Payments to counties <br/>
<a id="pl.263.30"></a><var>263.30</var>in which there is no certified nursing facility must be made by increasing the payment <br/>
<a id="pl.263.31"></a><var>263.31</var>rate of the two facilities located nearest to the county seat.<br/>
<a id="pl.263.32"></a><var>263.32</var>    (b) The commissioner shall include the total annual payment determined under <br/>
<a id="pl.263.33"></a><var>263.33</var>paragraph (a) for each nursing facility reimbursed under section 
         <statute_ref>256B.431</statute_ref> or 
         <statute_ref>256B.434</statute_ref> <br/>
<a id="pl.263.34"></a><var>263.34</var>according to section 
         <statute_ref>256B.431, subdivision 2b</statute_ref>, paragraph (g).<br/>
<a id="pl.264.1"></a><var>264.1</var>    (c) In the event of the layaway, delicensure and decertification, or removal from <br/>
<a id="pl.264.2"></a><var>264.2</var>layaway of 25 percent or more of the beds in a facility, the commissioner may adjust <br/>
<a id="pl.264.3"></a><var>264.3</var>the per diem payment amount in paragraph (b) and may adjust the monthly payment <br/>
<a id="pl.264.4"></a><var>264.4</var>amount in paragraph (a). The effective date of an adjustment made under this paragraph <br/>
<a id="pl.264.5"></a><var>264.5</var>shall be on or after the first day of the month following the effective date of the layaway, <br/>
<a id="pl.264.6"></a><var>264.6</var>delicensure and decertification, or removal from layaway.<br/>
<a id="pl.264.7"></a><var>264.7</var>    (d) Payments for long-term care consultation services are available to the county <br/>
<a id="pl.264.8"></a><var>264.8</var>or counties to cover staff salaries and expenses to provide the services described in <br/>
<a id="pl.264.9"></a><var>264.9</var>subdivision 1a. The county shall employ, or contract with other agencies to employ, within <br/>
<a id="pl.264.10"></a><var>264.10</var>the limits of available funding, sufficient personnel to provide long-term care consultation <br/>
<a id="pl.264.11"></a><var>264.11</var>services while meeting the state's long-term care outcomes and objectives as defined in <br/>
<a id="pl.264.12"></a><var>264.12</var>section 
         <statute_ref>256B.0917, subdivision 1</statute_ref>. The county shall be accountable for meeting local <br/>
<a id="pl.264.13"></a><var>264.13</var>objectives as approved by the commissioner in the biennial home and community-based <br/>
<a id="pl.264.14"></a><var>264.14</var>services quality assurance plan on a form provided by the commissioner.<br/>
<a id="pl.264.15"></a><var>264.15</var>    (e) Notwithstanding section 
         <statute_ref>256B.0641</statute_ref>, overpayments attributable to payment of the <br/>
<a id="pl.264.16"></a><var>264.16</var>screening costs under the medical assistance program may not be recovered from a facility.<br/>
<a id="pl.264.17"></a><var>264.17</var>    (f) The commissioner of human services shall amend the Minnesota medical <br/>
<a id="pl.264.18"></a><var>264.18</var>assistance plan to include reimbursement for the local consultation teams.<br/>
<a id="pl.264.19"></a><var>264.19</var>    (g) The county may bill, as case management services, assessments, support <br/>
<a id="pl.264.20"></a><var>264.20</var>planning, and follow-along provided to persons determined to be eligible for case <br/>
<a id="pl.264.21"></a><var>264.21</var>management under Minnesota health care programs. No individual or family member <br/>
<a id="pl.264.22"></a><var>264.22</var>shall be charged for an initial assessment or initial support plan development provided <br/>
<a id="pl.264.23"></a><var>264.23</var>under subdivision 3a or 3b.<br/>
<a id="pl.264.24"></a><var>264.24</var>(h) The commissioner shall develop an alternative payment methodology for <br/>
<a id="pl.264.25"></a><var>264.25</var>long-term care consultation services that includes the funding available under this <br/>
<a id="pl.264.26"></a><var>264.26</var>subdivision, and sections 256B.092 and 256B.0659. In developing the new payment <br/>
<a id="pl.264.27"></a><var>264.27</var>methodology, the commissioner shall consider the maximization of federal funding for <br/>
<a id="pl.264.28"></a><var>264.28</var>this activity.<br/>
<br/>
<a id="bill.8.43.0"></a><a id="pl.264.29"></a><var>264.29</var>    Sec. 43. Minnesota Statutes 2008, section 256B.0911, subdivision 7, is amended to <br/>
<a id="pl.264.30"></a><var>264.30</var>read:<br/>
<a id="pl.264.31"></a><var>264.31</var>    Subd. 7. <b>Reimbursement for certified nursing facilities.</b> (a) Medical assistance <br/>
<a id="pl.264.32"></a><var>264.32</var>reimbursement for nursing facilities shall be authorized for a medical assistance recipient <br/>
<a id="pl.264.33"></a><var>264.33</var>only if a preadmission screening has been conducted prior to admission or the county has <br/>
<a id="pl.264.34"></a><var>264.34</var>authorized an exemption. Medical assistance reimbursement for nursing facilities shall <br/>
<a id="pl.264.35"></a><var>264.35</var>not be provided for any recipient who the local screener has determined does not meet the <br/>
<a id="pl.265.1"></a><var>265.1</var>level of care criteria for nursing facility placement in section 144.0724, subdivision 11, or, <br/>
<a id="pl.265.2"></a><var>265.2</var>if indicated, has not had a level II OBRA evaluation as required under the federal Omnibus <br/>
<a id="pl.265.3"></a><var>265.3</var>Budget Reconciliation Act of 1987 completed unless an admission for a recipient with <br/>
<a id="pl.265.4"></a><var>265.4</var>mental illness is approved by the local mental health authority or an admission for a <br/>
<a id="pl.265.5"></a><var>265.5</var>recipient with developmental disability is approved by the state developmental disability <br/>
<a id="pl.265.6"></a><var>265.6</var>authority.<br/>
<a id="pl.265.7"></a><var>265.7</var>    (b) The nursing facility must not bill a person who is not a medical assistance <br/>
<a id="pl.265.8"></a><var>265.8</var>recipient for resident days that preceded the date of completion of screening activities as <br/>
<a id="pl.265.9"></a><var>265.9</var>required under subdivisions 4a, 4b, and 4c. The nursing facility must include unreimbursed <br/>
<a id="pl.265.10"></a><var>265.10</var>resident days in the nursing facility resident day totals reported to the commissioner.<br/>
<a id="pl.265.11"></a><var>265.11</var><b>EFFECTIVE DATE.</b>The section is effective January 1, 2011.<br/>
<br/>
<a id="bill.8.44.0"></a><a id="pl.265.12"></a><var>265.12</var>    Sec. 44. Minnesota Statutes 2008, section 256B.0913, subdivision 4, is amended to <br/>
<a id="pl.265.13"></a><var>265.13</var>read:<br/>
<a id="pl.265.14"></a><var>265.14</var>    Subd. 4. <b>Eligibility for funding for services for nonmedical assistance recipients.</b><br/>
<a id="pl.265.15"></a><var>265.15</var>    (a) Funding for services under the alternative care program is available to persons who <br/>
<a id="pl.265.16"></a><var>265.16</var>meet the following criteria:<br/>
<a id="pl.265.17"></a><var>265.17</var>    (1) the person has been determined by a community assessment under section <br/>
<statute_ref><a id="pl.265.18"></a><var>265.18</var>256B.0911
         </statute_ref> to be a person who would require the level of care provided in a nursing <br/>
<a id="pl.265.19"></a><var>265.19</var>facility, but for the provision of services under the alternative care program. Effective <br/>
<a id="pl.265.20"></a><var>265.20</var>January 1, 2011, this determination must be made according to the criteria established in <br/>
<a id="pl.265.21"></a><var>265.21</var>section 144.0724, subdivision 11;<br/>
<a id="pl.265.22"></a><var>265.22</var>    (2) the person is age 65 or older;<br/>
<a id="pl.265.23"></a><var>265.23</var>    (3) the person would be eligible for medical assistance within 135 days of admission <br/>
<a id="pl.265.24"></a><var>265.24</var>to a nursing facility;<br/>
<a id="pl.265.25"></a><var>265.25</var>    (4) the person is not ineligible for the payment of long-term care services by the <br/>
<a id="pl.265.26"></a><var>265.26</var>medical assistance program due to an asset transfer penalty under section 
         <statute_ref>256B.0595</statute_ref> or <br/>
<a id="pl.265.27"></a><var>265.27</var>equity interest in the home exceeding $500,000 as stated in section 
         <statute_ref>256B.056</statute_ref>;<br/>
<a id="pl.265.28"></a><var>265.28</var>    (5) the person needs long-term care services that are not funded through other state <br/>
<a id="pl.265.29"></a><var>265.29</var>or federal funding;<br/>
<a id="pl.265.30"></a><var>265.30</var>    (6) except for individuals described in clause (7), the monthly cost of the alternative <br/>
<a id="pl.265.31"></a><var>265.31</var>care services funded by the program for this person does not exceed 75 percent of the <br/>
<a id="pl.265.32"></a><var>265.32</var>monthly limit described under section 
         <statute_ref>256B.0915, subdivision 3a</statute_ref>. This monthly limit <br/>
<a id="pl.265.33"></a><var>265.33</var>does not prohibit the alternative care client from payment for additional services, but in no <br/>
<a id="pl.265.34"></a><var>265.34</var>case may the cost of additional services purchased under this section exceed the difference <br/>
<a id="pl.265.35"></a><var>265.35</var>between the client's monthly service limit defined under section 
         <statute_ref>256B.0915, subdivision <br/>
<a id="pl.266.1"></a><var>266.1</var>3
         </statute_ref>, and the alternative care program monthly service limit defined in this paragraph. If <br/>
<a id="pl.266.2"></a><var>266.2</var>care-related supplies and equipment or environmental modifications and adaptations are or <br/>
<a id="pl.266.3"></a><var>266.3</var>will be purchased for an alternative care services recipient, the costs may be prorated on a <br/>
<a id="pl.266.4"></a><var>266.4</var>monthly basis for up to 12 consecutive months beginning with the month of purchase. <br/>
<a id="pl.266.5"></a><var>266.5</var>If the monthly cost of a recipient's other alternative care services exceeds the monthly <br/>
<a id="pl.266.6"></a><var>266.6</var>limit established in this paragraph, the annual cost of the alternative care services shall be <br/>
<a id="pl.266.7"></a><var>266.7</var>determined. In this event, the annual cost of alternative care services shall not exceed 12 <br/>
<a id="pl.266.8"></a><var>266.8</var>times the monthly limit described in this paragraph; and<br/>
<a id="pl.266.9"></a><var>266.9</var>    (7) for individuals assigned a case mix classification A as described under section <br/>
<a id="pl.266.10"></a><var>266.10</var>256B.0915, subdivision 3a, paragraph (a), with (i) no dependencies in activities of daily <br/>
<a id="pl.266.11"></a><var>266.11</var>living, (ii) only one dependency in bathing, dressing, grooming, or walking, or (iii) a <br/>
<a id="pl.266.12"></a><var>266.12</var>dependency score of less than three if eating is the only dependency as determined by an <br/>
<a id="pl.266.13"></a><var>266.13</var>assessment performed under section 256B.0911, the monthly cost of alternative care <br/>
<a id="pl.266.14"></a><var>266.14</var>services funded by the program cannot exceed $600 per month for all new participants <br/>
<a id="pl.266.15"></a><var>266.15</var>enrolled in the program on or after July 1, 2009. This monthly limit shall be applied to <br/>
<a id="pl.266.16"></a><var>266.16</var>all other participants who meet this criteria at reassessment. This monthly limit shall be <br/>
<a id="pl.266.17"></a><var>266.17</var>increased annually as described in section 256B.0915, subdivision 3a, paragraph (a). This <br/>
<a id="pl.266.18"></a><var>266.18</var>monthly limit does not prohibit the alternative care client from payment for additional <br/>
<a id="pl.266.19"></a><var>266.19</var>services, but in no case may the cost of additional services purchased exceed the difference <br/>
<a id="pl.266.20"></a><var>266.20</var>between the client's monthly service limit defined in this clause and the limit described in <br/>
<a id="pl.266.21"></a><var>266.21</var>clause (6) for case mix classification A; and<br/>
<a id="pl.266.22"></a><var>266.22</var>(8) the person is making timely payments of the assessed monthly fee.<br/>
<a id="pl.266.23"></a><var>266.23</var>A person is ineligible if payment of the fee is over 60 days past due, unless the person <br/>
<a id="pl.266.24"></a><var>266.24</var>agrees to:<br/>
<a id="pl.266.25"></a><var>266.25</var>    (i) the appointment of a representative payee;<br/>
<a id="pl.266.26"></a><var>266.26</var>    (ii) automatic payment from a financial account;<br/>
<a id="pl.266.27"></a><var>266.27</var>    (iii) the establishment of greater family involvement in the financial management of <br/>
<a id="pl.266.28"></a><var>266.28</var>payments; or<br/>
<a id="pl.266.29"></a><var>266.29</var>    (iv) another method acceptable to the lead agency to ensure prompt fee payments.<br/>
<a id="pl.266.30"></a><var>266.30</var>    The lead agency may extend the client's eligibility as necessary while making <br/>
<a id="pl.266.31"></a><var>266.31</var>arrangements to facilitate payment of past-due amounts and future premium payments. <br/>
<a id="pl.266.32"></a><var>266.32</var>Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be <br/>
<a id="pl.266.33"></a><var>266.33</var>reinstated for a period of 30 days.<br/>
<a id="pl.266.34"></a><var>266.34</var>    (b) Alternative care funding under this subdivision is not available for a person <br/>
<a id="pl.266.35"></a><var>266.35</var>who is a medical assistance recipient or who would be eligible for medical assistance <br/>
<a id="pl.266.36"></a><var>266.36</var>without a spenddown or waiver obligation. A person whose initial application for medical <br/>
<a id="pl.267.1"></a><var>267.1</var>assistance and the elderly waiver program is being processed may be served under the <br/>
<a id="pl.267.2"></a><var>267.2</var>alternative care program for a period up to 60 days. If the individual is found to be eligible <br/>
<a id="pl.267.3"></a><var>267.3</var>for medical assistance, medical assistance must be billed for services payable under the <br/>
<a id="pl.267.4"></a><var>267.4</var>federally approved elderly waiver plan and delivered from the date the individual was <br/>
<a id="pl.267.5"></a><var>267.5</var>found eligible for the federally approved elderly waiver plan. Notwithstanding this <br/>
<a id="pl.267.6"></a><var>267.6</var>provision, alternative care funds may not be used to pay for any service the cost of which: <br/>
<a id="pl.267.7"></a><var>267.7</var>(i) is payable by medical assistance; (ii) is used by a recipient to meet a waiver obligation; <br/>
<a id="pl.267.8"></a><var>267.8</var>or (iii) is used to pay a medical assistance income spenddown for a person who is eligible <br/>
<a id="pl.267.9"></a><var>267.9</var>to participate in the federally approved elderly waiver program under the special income <br/>
<a id="pl.267.10"></a><var>267.10</var>standard provision.<br/>
<a id="pl.267.11"></a><var>267.11</var>    (c) Alternative care funding is not available for a person who resides in a licensed <br/>
<a id="pl.267.12"></a><var>267.12</var>nursing home, certified boarding care home, hospital, or intermediate care facility, except <br/>
<a id="pl.267.13"></a><var>267.13</var>for case management services which are provided in support of the discharge planning <br/>
<a id="pl.267.14"></a><var>267.14</var>process for a nursing home resident or certified boarding care home resident to assist with <br/>
<a id="pl.267.15"></a><var>267.15</var>a relocation process to a community-based setting.<br/>
<a id="pl.267.16"></a><var>267.16</var>    (d) Alternative care funding is not available for a person whose income is greater <br/>
<a id="pl.267.17"></a><var>267.17</var>than the maintenance needs allowance under section 
         <statute_ref>256B.0915, subdivision 1d</statute_ref>, but equal <br/>
<a id="pl.267.18"></a><var>267.18</var>to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal <br/>
<a id="pl.267.19"></a><var>267.19</var>year for which alternative care eligibility is determined, who would be eligible for the <br/>
<a id="pl.267.20"></a><var>267.20</var>elderly waiver with a waiver obligation.<br/>
<br/>
<a id="bill.8.45.0"></a><a id="pl.267.21"></a><var>267.21</var>    Sec. 45. Minnesota Statutes 2008, section 256B.0915, subdivision 3a, is amended to <br/>
<a id="pl.267.22"></a><var>267.22</var>read:<br/>
<a id="pl.267.23"></a><var>267.23</var>    Subd. 3a.  <b>Elderly waiver cost limits.</b> (a) The monthly limit for the cost of <br/>
<a id="pl.267.24"></a><var>267.24</var>waivered services to an individual elderly waiver client except for individuals described <br/>
<a id="pl.267.25"></a><var>267.25</var>in paragraph (b) shall be the weighted average monthly nursing facility rate of the case <br/>
<a id="pl.267.26"></a><var>267.26</var>mix resident class to which the elderly waiver client would be assigned under Minnesota <br/>
<a id="pl.267.27"></a><var>267.27</var>Rules, parts 9549.0050 to 9549.0059, less the recipient's maintenance needs allowance <br/>
<a id="pl.267.28"></a><var>267.28</var>as described in subdivision 1d, paragraph (a), until the first day of the state fiscal year in <br/>
<a id="pl.267.29"></a><var>267.29</var>which the resident assessment system as described in section 
         <statute_ref>256B.438</statute_ref> for nursing home <br/>
<a id="pl.267.30"></a><var>267.30</var>rate determination is implemented. Effective on the first day of the state fiscal year in <br/>
<a id="pl.267.31"></a><var>267.31</var>which the resident assessment system as described in section 
         <statute_ref>256B.438</statute_ref> for nursing home <br/>
<a id="pl.267.32"></a><var>267.32</var>rate determination is implemented and the first day of each subsequent state fiscal year, the <br/>
<a id="pl.267.33"></a><var>267.33</var>monthly limit for the cost of waivered services to an individual elderly waiver client shall <br/>
<a id="pl.267.34"></a><var>267.34</var>be the rate of the case mix resident class to which the waiver client would be assigned <br/>
<a id="pl.267.35"></a><var>267.35</var>under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect on the last day of the <br/>
<a id="pl.268.1"></a><var>268.1</var>previous state fiscal year, adjusted by the greater of any legislatively adopted home and <br/>
<a id="pl.268.2"></a><var>268.2</var>community-based services percentage rate increase or the average statewide percentage <br/>
<a id="pl.268.3"></a><var>268.3</var>increase in nursing facility payment rates. <br/>
<a id="pl.268.4"></a><var>268.4</var>    (b) The monthly limit for the cost of waivered services to an individual elderly <br/>
<a id="pl.268.5"></a><var>268.5</var>waiver client assigned to a case mix classification A under paragraph (a) with (1) no <br/>
<a id="pl.268.6"></a><var>268.6</var>dependencies in activities of daily living, (2) only one dependency in bathing, dressing, <br/>
<a id="pl.268.7"></a><var>268.7</var>grooming, or walking, or (3) a dependency score of less than three if eating is the only <br/>
<a id="pl.268.8"></a><var>268.8</var>dependency, shall be the lower of the case mix classification amount for case mix A as <br/>
<a id="pl.268.9"></a><var>268.9</var>determined under paragraph (a) or the case mix classification amount for case mix A <br/>
<a id="pl.268.10"></a><var>268.10</var>effective on October 1, 2008, per month for all new participants enrolled in the program <br/>
<a id="pl.268.11"></a><var>268.11</var>on or after July 1, 2009. This monthly limit shall be applied to all other participants who <br/>
<a id="pl.268.12"></a><var>268.12</var>meet this criteria at reassessment.<br/>
<a id="pl.268.13"></a><var>268.13</var>(c)  If extended medical supplies and equipment or environmental modifications are <br/>
<a id="pl.268.14"></a><var>268.14</var>or will be purchased for an elderly waiver client, the costs may be prorated for up to <br/>
<a id="pl.268.15"></a><var>268.15</var>12 consecutive months beginning with the month of purchase. If the monthly cost of a <br/>
<a id="pl.268.16"></a><var>268.16</var>recipient's waivered services exceeds the monthly limit established in paragraph (a) or (b), <br/>
<a id="pl.268.17"></a><var>268.17</var>the annual cost of all waivered services shall be determined. In this event, the annual cost <br/>
<a id="pl.268.18"></a><var>268.18</var>of all waivered services shall not exceed 12 times the monthly limit of waivered services <br/>
<a id="pl.268.19"></a><var>268.19</var>as described in paragraph (a) or (b). <br/>
<br/>
<a id="bill.8.46.0"></a><a id="pl.268.20"></a><var>268.20</var>    Sec. 46. Minnesota Statutes 2008, section 256B.0915, subdivision 3e, is amended to <br/>
<a id="pl.268.21"></a><var>268.21</var>read:<br/>
<a id="pl.268.22"></a><var>268.22</var>    Subd. 3e. <b>Customized living service rate.</b> (a) Payment for customized living <br/>
<a id="pl.268.23"></a><var>268.23</var>services shall be a monthly rate negotiated and authorized by the lead agency within the <br/>
<a id="pl.268.24"></a><var>268.24</var>parameters established by the commissioner. The payment agreement must delineate the <br/>
<a id="pl.268.25"></a><var>268.25</var>services that have been customized for each recipient and specify the amount of each <br/>
<a id="pl.268.26"></a><var>268.26</var>component service included in the recipient's customized living service to be provided <br/>
<a id="pl.268.27"></a><var>268.27</var>plan. The lead agency shall ensure that there is a documented need for all within the <br/>
<a id="pl.268.28"></a><var>268.28</var>parameters established by the commissioner for all component customized living services <br/>
<a id="pl.268.29"></a><var>268.29</var>authorized. Customized living services must not include rent or raw food costs.<br/>
<a id="pl.268.30"></a><var>268.30</var>(b) The negotiated payment rate must be based on the amount of component services <br/>
<a id="pl.268.31"></a><var>268.31</var>to be provided utilizing component rates established by the commissioner. Counties and <br/>
<a id="pl.268.32"></a><var>268.32</var>tribes shall use tools issued by the commissioner to develop and document customized <br/>
<a id="pl.268.33"></a><var>268.33</var>living service plans and rates.<br/>
<a id="pl.269.1"></a><var>269.1</var>Negotiated (c) Component service rates must not exceed payment rates for <br/>
<a id="pl.269.2"></a><var>269.2</var>comparable elderly waiver or medical assistance services and must reflect economies of <br/>
<a id="pl.269.3"></a><var>269.3</var>scale. Customized living services must not include rent or raw food costs.<br/>
<a id="pl.269.4"></a><var>269.4</var>    (b) (d) The individualized monthly negotiated authorized payment for the <br/>
<a id="pl.269.5"></a><var>269.5</var>customized living services service plan shall not exceed the nonfederal share, in effect <br/>
<a id="pl.269.6"></a><var>269.6</var>on July 1 of the state fiscal year for which the rate limit is being calculated, 50 percent <br/>
<a id="pl.269.7"></a><var>269.7</var>of the greater of either the statewide or any of the geographic groups' weighted average <br/>
<a id="pl.269.8"></a><var>269.8</var>monthly nursing facility rate of the case mix resident class to which the elderly waiver <br/>
<a id="pl.269.9"></a><var>269.9</var>eligible client would be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, <br/>
<a id="pl.269.10"></a><var>269.10</var>less the maintenance needs allowance as described in subdivision 1d, paragraph (a), until <br/>
<a id="pl.269.11"></a><var>269.11</var>the July 1 of the state fiscal year in which the resident assessment system as described <br/>
<a id="pl.269.12"></a><var>269.12</var>in section 
         <statute_ref>256B.438 </statute_ref>for nursing home rate determination is implemented. Effective on <br/>
<a id="pl.269.13"></a><var>269.13</var>July 1 of the state fiscal year in which the resident assessment system as described in <br/>
<a id="pl.269.14"></a><var>269.14</var>section 
         <statute_ref>256B.438 </statute_ref>for nursing home rate determination is implemented and July 1 of each <br/>
<a id="pl.269.15"></a><var>269.15</var>subsequent state fiscal year, the individualized monthly negotiated authorized payment <br/>
<a id="pl.269.16"></a><var>269.16</var>for the services described in this clause shall not exceed the limit described in this clause <br/>
<a id="pl.269.17"></a><var>269.17</var>which was in effect on June 30 of the previous state fiscal year and which has been <br/>
<a id="pl.269.18"></a><var>269.18</var>adjusted by the greater of any legislatively adopted home and community-based services <br/>
<a id="pl.269.19"></a><var>269.19</var>cost-of-living percentage increase or any legislatively adopted statewide percent rate <br/>
<a id="pl.269.20"></a><var>269.20</var>increase for nursing facilities updated annually based on legislatively adopted changes to <br/>
<a id="pl.269.21"></a><var>269.21</var>all service rate maximums for home and community-based service providers.<br/>
<a id="pl.269.22"></a><var>269.22</var>    (c) (e) Customized living services are delivered by a provider licensed by the <br/>
<a id="pl.269.23"></a><var>269.23</var>Department of Health as a class A or class F home care provider and provided in a <br/>
<a id="pl.269.24"></a><var>269.24</var>building that is registered as a housing with services establishment under chapter 144D.<br/>
<br/>
<a id="bill.8.47.0"></a><a id="pl.269.25"></a><var>269.25</var>    Sec. 47. Minnesota Statutes 2008, section 256B.0915, subdivision 3h, is amended to <br/>
<a id="pl.269.26"></a><var>269.26</var>read:<br/>
<a id="pl.269.27"></a><var>269.27</var>    Subd. 3h. <b>Service rate limits; 24-hour customized living services.</b> (a) The <br/>
<a id="pl.269.28"></a><var>269.28</var>payment rates rate  for 24-hour customized living services is a monthly rate negotiated <br/>
<a id="pl.269.29"></a><var>269.29</var>and authorized by the lead agency within the parameters established by the commissioner <br/>
<a id="pl.269.30"></a><var>269.30</var>of human services. The payment agreement must delineate the services that have been <br/>
<a id="pl.269.31"></a><var>269.31</var>customized for each recipient and specify the amount of each component service included <br/>
<a id="pl.269.32"></a><var>269.32</var>in each recipient's customized living service to be provided plan. The lead agency <br/>
<a id="pl.269.33"></a><var>269.33</var>shall ensure that there is a documented need within the parameters established by the <br/>
<a id="pl.269.34"></a><var>269.34</var>commissioner for all component customized living services authorized. The lead agency <br/>
<a id="pl.270.1"></a><var>270.1</var>shall not authorize 24-hour customized living services unless there is a documented need <br/>
<a id="pl.270.2"></a><var>270.2</var>for 24-hour supervision.<br/>
<a id="pl.270.3"></a><var>270.3</var>(b) For purposes of this section, "24-hour supervision" means that the recipient <br/>
<a id="pl.270.4"></a><var>270.4</var>requires assistance due to needs related to one or more of the following:<br/>
<a id="pl.270.5"></a><var>270.5</var>    (1) intermittent assistance with toileting, positioning,  or transferring;<br/>
<a id="pl.270.6"></a><var>270.6</var>    (2) cognitive or behavioral issues;<br/>
<a id="pl.270.7"></a><var>270.7</var>    (3) a medical condition that requires clinical monitoring; or<br/>
<a id="pl.270.8"></a><var>270.8</var>    (4) other conditions or needs as defined by the commissioner of human services for <br/>
<a id="pl.270.9"></a><var>270.9</var>all new participants enrolled in the program on or after January 1, 2011, and all other <br/>
<a id="pl.270.10"></a><var>270.10</var>participants at their first reassessment after January 1, 2011, dependency in at least two <br/>
<a id="pl.270.11"></a><var>270.11</var>of the following activities of daily living as determined by assessment under section <br/>
<a id="pl.270.12"></a><var>270.12</var>256B.0911: bathing; dressing; grooming; walking; or eating; and  needs medication <br/>
<a id="pl.270.13"></a><var>270.13</var>management and at least 50 hours of service per month. The lead agency shall ensure that <br/>
<a id="pl.270.14"></a><var>270.14</var>the frequency and mode of supervision of the recipient and the qualifications of staff <br/>
<a id="pl.270.15"></a><var>270.15</var>providing supervision are described and meet the needs of the recipient. Customized <br/>
<a id="pl.270.16"></a><var>270.16</var>living services must not include rent or raw food costs.<br/>
<a id="pl.270.17"></a><var>270.17</var>(c) The negotiated payment rate for 24-hour customized living services must be <br/>
<a id="pl.270.18"></a><var>270.18</var>based on the amount of component services to be provided utilizing component rates <br/>
<a id="pl.270.19"></a><var>270.19</var>established by the commissioner. Counties and tribes will use tools issued by the <br/>
<a id="pl.270.20"></a><var>270.20</var>commissioner to develop and document customized living plans and authorize rates.<br/>
<a id="pl.270.21"></a><var>270.21</var>Negotiated (d) Component service rates must not exceed payment rates for <br/>
<a id="pl.270.22"></a><var>270.22</var>comparable elderly waiver or medical assistance services and must reflect economies <br/>
<a id="pl.270.23"></a><var>270.23</var>of scale.<br/>
<a id="pl.270.24"></a><var>270.24</var>(e) The individually negotiated authorized 24-hour customized living payments, <br/>
<a id="pl.270.25"></a><var>270.25</var>in combination with the payment for other elderly waiver services, including case <br/>
<a id="pl.270.26"></a><var>270.26</var>management, must not exceed the recipient's community budget cap specified in <br/>
<a id="pl.270.27"></a><var>270.27</var>subdivision 3a. Customized living services must not include rent or raw food costs.<br/>
<a id="pl.270.28"></a><var>270.28</var>(f) The individually authorized 24-hour customized living payment rates shall not <br/>
<a id="pl.270.29"></a><var>270.29</var>exceed the 95 percentile of statewide monthly authorizations for 24-hour customized <br/>
<a id="pl.270.30"></a><var>270.30</var>living services in effect and in the Medicaid management information systems on March <br/>
<a id="pl.270.31"></a><var>270.31</var>31, 2009, for each case mix resident class under Minnesota Rules, parts 9549.0050 <br/>
<a id="pl.270.32"></a><var>270.32</var>to 9549.0059, to which elderly waiver service clients are assigned. When there are <br/>
<a id="pl.270.33"></a><var>270.33</var>fewer than 50 authorizations in effect in the case mix resident class, the commissioner <br/>
<a id="pl.270.34"></a><var>270.34</var>shall multiply the calculated service payment rate maximum for the A classification by <br/>
<a id="pl.270.35"></a><var>270.35</var>the standard weight for that classification under Minnesota Rules, parts 9549.0050 to <br/>
<a id="pl.270.36"></a><var>270.36</var>9549.0059, to determine the applicable payment rate maximum. Service payment rate <br/>
<a id="pl.271.1"></a><var>271.1</var>maximums shall be updated annually based on legislatively adopted changes to all service <br/>
<a id="pl.271.2"></a><var>271.2</var>rates for home and community-based service providers.<br/>
<a id="pl.271.3"></a><var>271.3</var>    (g) Notwithstanding the requirements of paragraphs (d) and (f), the commissioner <br/>
<a id="pl.271.4"></a><var>271.4</var>may establish alternative payment rate systems for 24-hour customized living services in <br/>
<a id="pl.271.5"></a><var>271.5</var>housing with services establishments which are freestanding buildings with a capacity of <br/>
<a id="pl.271.6"></a><var>271.6</var>16 or fewer, by applying a single hourly rate for covered component services provided <br/>
<a id="pl.271.7"></a><var>271.7</var>in either:<br/>
<a id="pl.271.8"></a><var>271.8</var>    (1) licensed corporate adult foster homes; or<br/>
<a id="pl.271.9"></a><var>271.9</var>    (2) specialized dementia care units which meet the requirements of section 144D.065 <br/>
<a id="pl.271.10"></a><var>271.10</var>and in which:<br/>
<a id="pl.271.11"></a><var>271.11</var>    (i) each resident is offered the option of having their own apartment; or<br/>
<a id="pl.271.12"></a><var>271.12</var>    (ii) the units are licensed as board and lodge establishments with maximum capacity <br/>
<a id="pl.271.13"></a><var>271.13</var>of eight residents, and which meet the requirements of Minnesota Rules, part 9555.6205, <br/>
<a id="pl.271.14"></a><var>271.14</var>subparts 1, 2, 3, and 4, item A.<br/>
<br/>
<a id="bill.8.48.0"></a><a id="pl.271.15"></a><var>271.15</var>    Sec. 48. Minnesota Statutes 2008, section 256B.0915, subdivision 5, is amended to <br/>
<a id="pl.271.16"></a><var>271.16</var>read:<br/>
<a id="pl.271.17"></a><var>271.17</var>    Subd. 5. <b>Assessments and reassessments for waiver clients.</b> (a) Each client <br/>
<a id="pl.271.18"></a><var>271.18</var>shall receive an initial assessment of strengths, informal supports, and need for services <br/>
<a id="pl.271.19"></a><var>271.19</var>in accordance with section 
         <statute_ref>256B.0911, subdivisions 3, 3a, and 3b</statute_ref>. A reassessment of a <br/>
<a id="pl.271.20"></a><var>271.20</var>client served under the elderly waiver must be conducted at least every 12 months and at <br/>
<a id="pl.271.21"></a><var>271.21</var>other times when the case manager determines that there has been significant change in <br/>
<a id="pl.271.22"></a><var>271.22</var>the client's functioning. This may include instances where the client is discharged from <br/>
<a id="pl.271.23"></a><var>271.23</var>the hospital. There must be a determination that the client requires nursing facility level of <br/>
<a id="pl.271.24"></a><var>271.24</var>care as defined in section 144.0724, subdivision 11, at initial and subsequent assessments <br/>
<a id="pl.271.25"></a><var>271.25</var>to initiate and maintain participation in the waiver program.<br/>
<a id="pl.271.26"></a><var>271.26</var>(b) Regardless of other assessments identified in section 144.0724, subdivision <br/>
<a id="pl.271.27"></a><var>271.27</var>4, as appropriate to determine nursing facility level of care for purposes of medical <br/>
<a id="pl.271.28"></a><var>271.28</var>assistance payment for nursing facility services, only face-to-face assessments conducted <br/>
<a id="pl.271.29"></a><var>271.29</var>according to section 256B.0911, subdivisions 3a and 3b, that result in a nursing facility <br/>
<a id="pl.271.30"></a><var>271.30</var>level of care determination will be accepted for purposes of initial and ongoing access to <br/>
<a id="pl.271.31"></a><var>271.31</var>waiver service payment.<br/>
<a id="pl.271.32"></a><var>271.32</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2011.<br/>
<br/>
<a id="bill.8.49.0"></a><a id="pl.271.33"></a><var>271.33</var>    Sec. 49. Minnesota Statutes 2008, section 256B.0915, is amended by adding a <br/>
<a id="pl.271.34"></a><var>271.34</var>subdivision to read:<br/>
<a id="pl.272.1"></a><var>272.1</var>    Subd. 10. <b>Waiver payment rates; managed care organizations.</b> The <br/>
<a id="pl.272.2"></a><var>272.2</var>commissioner shall adjust the elderly waiver capitation payment rates for managed care <br/>
<a id="pl.272.3"></a><var>272.3</var>organizations paid under section 256B.69, subdivisions 6a and 23, to reflect the maximum <br/>
<a id="pl.272.4"></a><var>272.4</var>service rate limits for customized living services and 24-hour customized living services <br/>
<a id="pl.272.5"></a><var>272.5</var>under subdivisions 3e and 3h for the contract period beginning October 1, 2009. Medical <br/>
<a id="pl.272.6"></a><var>272.6</var>assistance rates paid to customized living providers by managed care organizations <br/>
<a id="pl.272.7"></a><var>272.7</var>under this section shall not exceed the maximum service rate limits determined by the <br/>
<a id="pl.272.8"></a><var>272.8</var>commissioner under subdivisions 3e and 3h.<br/>
<br/>
<a id="bill.8.50.0"></a><a id="pl.272.9"></a><var>272.9</var>    Sec. 50. Minnesota Statutes 2008, section 256B.0916, subdivision 2, is amended to <br/>
<a id="pl.272.10"></a><var>272.10</var>read:<br/>
<a id="pl.272.11"></a><var>272.11</var>    Subd. 2. <b>Distribution of funds; partnerships.</b> (a) Beginning with fiscal year 2000, <br/>
<a id="pl.272.12"></a><var>272.12</var>the commissioner shall distribute all funding available for home and community-based <br/>
<a id="pl.272.13"></a><var>272.13</var>waiver services for persons with developmental disabilities to individual counties or to <br/>
<a id="pl.272.14"></a><var>272.14</var>groups of counties that form partnerships to jointly plan, administer, and authorize funding <br/>
<a id="pl.272.15"></a><var>272.15</var>for eligible individuals. The commissioner shall encourage counties to form partnerships <br/>
<a id="pl.272.16"></a><var>272.16</var>that have a sufficient number of recipients and funding to adequately manage the risk <br/>
<a id="pl.272.17"></a><var>272.17</var>and maximize use of available resources.<br/>
<a id="pl.272.18"></a><var>272.18</var>    (b) Counties must submit a request for funds and a plan for administering the <br/>
<a id="pl.272.19"></a><var>272.19</var>program as required by the commissioner. The plan must identify the number of clients to <br/>
<a id="pl.272.20"></a><var>272.20</var>be served, their ages, and their priority listing based on:<br/>
<a id="pl.272.21"></a><var>272.21</var>    (1) requirements in Minnesota Rules, part 9525.1880; and<br/>
<a id="pl.272.22"></a><var>272.22</var>    (2) unstable living situations due to the age or incapacity of the primary caregiver; <br/>
<a id="pl.272.23"></a><var>272.23</var>statewide priorities identified in section 256B.092, subdivision 12.<br/>
<a id="pl.272.24"></a><var>272.24</var>    (3) the need for services to avoid out-of-home placement of children;<br/>
<a id="pl.272.25"></a><var>272.25</var>    (4) the need to serve persons affected by private sector ICF/MR closures; and<br/>
<a id="pl.272.26"></a><var>272.26</var>    (5) the need to serve persons whose consumer support grant exception amount <br/>
<a id="pl.272.27"></a><var>272.27</var>was eliminated in 2004.<br/>
<a id="pl.272.28"></a><var>272.28</var>The plan must also identify changes made to improve services to eligible persons and to <br/>
<a id="pl.272.29"></a><var>272.29</var>improve program management.<br/>
<a id="pl.272.30"></a><var>272.30</var>    (c) In allocating resources to counties, priority must be given to groups of counties <br/>
<a id="pl.272.31"></a><var>272.31</var>that form partnerships to jointly plan, administer, and authorize funding for eligible <br/>
<a id="pl.272.32"></a><var>272.32</var>individuals and to counties determined by the commissioner to have sufficient waiver <br/>
<a id="pl.272.33"></a><var>272.33</var>capacity to maximize resource use.<br/>
<a id="pl.273.1"></a><var>273.1</var>    (d) Within 30 days after receiving the county request for funds and plans, the <br/>
<a id="pl.273.2"></a><var>273.2</var>commissioner shall provide a written response to the plan that includes the level of <br/>
<a id="pl.273.3"></a><var>273.3</var>resources available to serve additional persons.<br/>
<a id="pl.273.4"></a><var>273.4</var>    (e) Counties are eligible to receive medical assistance administrative reimbursement <br/>
<a id="pl.273.5"></a><var>273.5</var>for administrative costs under criteria established by the commissioner.<br/>
<br/>
<a id="bill.8.51.0"></a><a id="pl.273.6"></a><var>273.6</var>    Sec. 51. Minnesota Statutes 2008, section 256B.0917, is amended by adding a <br/>
<a id="pl.273.7"></a><var>273.7</var>subdivision to read:<br/>
<a id="pl.273.8"></a><var>273.8</var>    Subd. 14. <b>Essential community supports grants.</b> (a) The purpose of the essential <br/>
<a id="pl.273.9"></a><var>273.9</var>community supports grant program is to provide targeted services to persons 65 years and <br/>
<a id="pl.273.10"></a><var>273.10</var>older who need essential community support, but whose needs do not meet the level of <br/>
<a id="pl.273.11"></a><var>273.11</var>care required for nursing facility placement under section 144.0724, subdivision 11.<br/>
<a id="pl.273.12"></a><var>273.12</var>(b) Within the limits of the appropriation and not to exceed $400 per person per <br/>
<a id="pl.273.13"></a><var>273.13</var>month, funding must be available to a person who:<br/>
<a id="pl.273.14"></a><var>273.14</var>(1) is age 65 or older;<br/>
<a id="pl.273.15"></a><var>273.15</var>(2) is not eligible for medical assistance;<br/>
<a id="pl.273.16"></a><var>273.16</var>(3) would otherwise be financially eligible for the alternative care program under <br/>
<a id="pl.273.17"></a><var>273.17</var>section 256B.0913, subdivision 4;<br/>
<a id="pl.273.18"></a><var>273.18</var>(4) has received a community assessment under section 256B.0911, subdivision 3a <br/>
<a id="pl.273.19"></a><var>273.19</var>or 3b, and does not require the level of care provided in a nursing facility;<br/>
<a id="pl.273.20"></a><var>273.20</var>(5) has a community support plan; and<br/>
<a id="pl.273.21"></a><var>273.21</var>(6) has been determined by a community assessment under section 256B.0911, <br/>
<a id="pl.273.22"></a><var>273.22</var>subdivision 3a or 3b, to be a person who would require provision of at least one of the <br/>
<a id="pl.273.23"></a><var>273.23</var>following services, as defined in the approved elderly waiver plan, in order to maintain <br/>
<a id="pl.273.24"></a><var>273.24</var>their community residence:<br/>
<a id="pl.273.25"></a><var>273.25</var>(i) caregiver support;<br/>
<a id="pl.273.26"></a><var>273.26</var>(ii) homemaker;<br/>
<a id="pl.273.27"></a><var>273.27</var>(iii) chore; or<br/>
<a id="pl.273.28"></a><var>273.28</var>(iv) a personal emergency response device or system.<br/>
<a id="pl.273.29"></a><var>273.29</var>(c) The person receiving any of the essential community supports in this subdivision <br/>
<a id="pl.273.30"></a><var>273.30</var>must also receive service coordination as part of their community support plan.<br/>
<a id="pl.273.31"></a><var>273.31</var>(d) A person who has been determined to be eligible for an essential community <br/>
<a id="pl.273.32"></a><var>273.32</var>support grant must be reassessed at least annually and continue to meet the criteria in <br/>
<a id="pl.273.33"></a><var>273.33</var>paragraph (b) to remain eligible for an essential community support grant.<br/>
<a id="pl.274.1"></a><var>274.1</var>(e) The commissioner shall allocate grants to counties and tribes under contract with <br/>
<a id="pl.274.2"></a><var>274.2</var>the department based upon the historic use of the medical assistance elderly waiver and <br/>
<a id="pl.274.3"></a><var>274.3</var>alternative care grant programs and other criteria as determined by the commissioner.<br/>
<a id="pl.274.4"></a><var>274.4</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2011.<br/>
<br/>
<a id="bill.8.52.0"></a><a id="pl.274.5"></a><var>274.5</var>    Sec. 52. Minnesota Statutes 2008, section 256B.092, subdivision 8a, is amended to <br/>
<a id="pl.274.6"></a><var>274.6</var>read:<br/>
<a id="pl.274.7"></a><var>274.7</var>    Subd. 8a. <b>County concurrence.</b> (a) If the county of financial responsibility wishes <br/>
<a id="pl.274.8"></a><var>274.8</var>to place a person in another county for services, the county of financial responsibility shall <br/>
<a id="pl.274.9"></a><var>274.9</var>seek concurrence from the proposed county of service and the placement shall be made <br/>
<a id="pl.274.10"></a><var>274.10</var>cooperatively between the two counties. Arrangements shall be made between the two <br/>
<a id="pl.274.11"></a><var>274.11</var>counties for ongoing social service, including annual reviews of the person's individual <br/>
<a id="pl.274.12"></a><var>274.12</var>service plan. The county where services are provided may not make changes in the <br/>
<a id="pl.274.13"></a><var>274.13</var>person's service plan without approval by the county of financial responsibility.<br/>
<a id="pl.274.14"></a><var>274.14</var>(b) When a person has been screened and authorized for services in an intermediate <br/>
<a id="pl.274.15"></a><var>274.15</var>care facility for persons with developmental disabilities or for home and community-based <br/>
<a id="pl.274.16"></a><var>274.16</var>services for persons with developmental disabilities, the case manager shall assist that <br/>
<a id="pl.274.17"></a><var>274.17</var>person in identifying a service provider who is able to meet the needs of the person <br/>
<a id="pl.274.18"></a><var>274.18</var>according to the person's individual service plan. If the identified service is to be provided <br/>
<a id="pl.274.19"></a><var>274.19</var>in a county other than the county of financial responsibility, the county of financial <br/>
<a id="pl.274.20"></a><var>274.20</var>responsibility shall request concurrence of the county where the person is requesting to <br/>
<a id="pl.274.21"></a><var>274.21</var>receive the identified services. The county of service may refuse to concur if:<br/>
<a id="pl.274.22"></a><var>274.22</var>(1) it can demonstrate that the provider is unable to provide the services identified in <br/>
<a id="pl.274.23"></a><var>274.23</var>the person's individual service plan as services that are needed and are to be provided; or<br/>
<a id="pl.274.24"></a><var>274.24</var>(2) in the case of an intermediate care facility for persons with developmental <br/>
<a id="pl.274.25"></a><var>274.25</var>disabilities, there has been no authorization for admission by the admission review team <br/>
<a id="pl.274.26"></a><var>274.26</var>as required in section 
         <statute_ref>256B.0926</statute_ref>; or.<br/>
<a id="pl.274.27"></a><var>274.27</var>(3) in the case of home and community-based services for persons with <br/>
<a id="pl.274.28"></a><var>274.28</var>developmental disabilities, the county of service can demonstrate that the prospective <br/>
<a id="pl.274.29"></a><var>274.29</var>provider has failed to substantially comply with the terms of a past contract or has had a <br/>
<a id="pl.274.30"></a><var>274.30</var>prior contract terminated within the last 12 months for failure to provide adequate services, <br/>
<a id="pl.274.31"></a><var>274.31</var>or has received a notice of intent to terminate the contract.<br/>
<a id="pl.274.32"></a><var>274.32</var>(c) The county of service shall notify the county of financial responsibility of <br/>
<a id="pl.274.33"></a><var>274.33</var>concurrence or refusal to concur no later than 20 working days following receipt of the <br/>
<a id="pl.274.34"></a><var>274.34</var>written request. Unless other mutually acceptable arrangements are made by the involved <br/>
<a id="pl.274.35"></a><var>274.35</var>county agencies, the county of financial responsibility is responsible for costs of social <br/>
<a id="pl.275.1"></a><var>275.1</var>services and the costs associated with the development and maintenance of the placement. <br/>
<a id="pl.275.2"></a><var>275.2</var>The county of service may request that the county of financial responsibility purchase <br/>
<a id="pl.275.3"></a><var>275.3</var>case management services from the county of service or from a contracted provider <br/>
<a id="pl.275.4"></a><var>275.4</var>of case management when the county of financial responsibility is not providing case <br/>
<a id="pl.275.5"></a><var>275.5</var>management as defined in this section and rules adopted under this section, unless other <br/>
<a id="pl.275.6"></a><var>275.6</var>mutually acceptable arrangements are made by the involved county agencies. Standards <br/>
<a id="pl.275.7"></a><var>275.7</var>for payment limits under this section may be established by the commissioner. Financial <br/>
<a id="pl.275.8"></a><var>275.8</var>disputes between counties shall be resolved as provided in section 
         <statute_ref>256G.09</statute_ref>.<br/>
<br/>
<a id="bill.8.53.0"></a><a id="pl.275.9"></a><var>275.9</var>    Sec. 53. Minnesota Statutes 2008, section 256B.092, is amended by adding a <br/>
<a id="pl.275.10"></a><var>275.10</var>subdivision to read:<br/>
<a id="pl.275.11"></a><var>275.11</var>    Subd. 11. <b>Residential support services.</b> (a) Upon federal approval, there is <br/>
<a id="pl.275.12"></a><var>275.12</var>established a new service called residential support that is available on the CAC, CADI, <br/>
<a id="pl.275.13"></a><var>275.13</var>DD, and TBI waivers. Existing waiver service descriptions must be modified to the extent <br/>
<a id="pl.275.14"></a><var>275.14</var>necessary to ensure there is no duplication between other services. Residential support <br/>
<a id="pl.275.15"></a><var>275.15</var>services must be provided by vendors licensed as a community residential setting as <br/>
<a id="pl.275.16"></a><var>275.16</var>defined in section 245A.11, subdivision 8.<br/>
<a id="pl.275.17"></a><var>275.17</var>(b) Residential support services must meet the following criteria:<br/>
<a id="pl.275.18"></a><var>275.18</var>(1) providers of residential support services must own or control the residential site;<br/>
<a id="pl.275.19"></a><var>275.19</var>(2) the residential site must not be the primary residence of the license holder;<br/>
<a id="pl.275.20"></a><var>275.20</var>(3) the residential site must have a designated program supervisor responsible for <br/>
<a id="pl.275.21"></a><var>275.21</var>program oversight, development, and implementation of policies and procedures;<br/>
<a id="pl.275.22"></a><var>275.22</var>(4) the provider of residential support services must provide supervision, training, <br/>
<a id="pl.275.23"></a><var>275.23</var>and assistance as described in the person's community support plan; and<br/>
<a id="pl.275.24"></a><var>275.24</var>(5) the provider of residential support services must meet the requirements of <br/>
<a id="pl.275.25"></a><var>275.25</var>licensure and additional requirements of the person's community support plan.<br/>
<a id="pl.275.26"></a><var>275.26</var>(c) Providers of residential support services that meet the definition in paragraph (a) <br/>
<a id="pl.275.27"></a><var>275.27</var>must be registered using a process determined by the commissioner beginning July 1, 2009.<br/>
<br/>
<a id="bill.8.54.0"></a><a id="pl.275.28"></a><var>275.28</var>    Sec. 54. Minnesota Statutes 2008, section 256B.092, is amended by adding a <br/>
<a id="pl.275.29"></a><var>275.29</var>subdivision to read:<br/>
<a id="pl.275.30"></a><var>275.30</var>    Subd. 12. <b>Waivered services statewide priorities.</b> (a) The commissioner shall <br/>
<a id="pl.275.31"></a><var>275.31</var>establish statewide priorities for individuals on the waiting list for developmental <br/>
<a id="pl.275.32"></a><var>275.32</var>disabilities (DD) waiver services, as of January 1, 2010. The statewide priorities must <br/>
<a id="pl.275.33"></a><var>275.33</var>include, but are not limited to, individuals who continue to have a need for waiver services <br/>
<a id="pl.275.34"></a><var>275.34</var>after they have maximized the use of state plan services and other funding resources, <br/>
<a id="pl.276.1"></a><var>276.1</var>including natural supports, prior to accessing waiver services, and who meet at least one <br/>
<a id="pl.276.2"></a><var>276.2</var>of the following criteria:<br/>
<a id="pl.276.3"></a><var>276.3</var>(1) have unstable living situations due to the age, incapacity, or sudden loss of <br/>
<a id="pl.276.4"></a><var>276.4</var>the primary caregivers;<br/>
<a id="pl.276.5"></a><var>276.5</var>(2) are moving from an institution due to bed closures;<br/>
<a id="pl.276.6"></a><var>276.6</var>(3) experience a sudden closure of their current living arrangement;<br/>
<a id="pl.276.7"></a><var>276.7</var>(4) require protection from confirmed abuse, neglect, or exploitation;<br/>
<a id="pl.276.8"></a><var>276.8</var>(5) experience a sudden change in need that can  no longer be met through state plan <br/>
<a id="pl.276.9"></a><var>276.9</var>services or other funding resources alone; or<br/>
<a id="pl.276.10"></a><var>276.10</var>(6) meet other priorities established by the department.<br/>
<a id="pl.276.11"></a><var>276.11</var>(b) When allocating resources to lead agencies, the commissioner must take into <br/>
<a id="pl.276.12"></a><var>276.12</var>consideration the number of individuals waiting who meet statewide priorities and the <br/>
<a id="pl.276.13"></a><var>276.13</var>lead agencies' current use of waiver funds and existing service options.<br/>
<a id="pl.276.14"></a><var>276.14</var>(c) The commissioner shall evaluate the impact of the use of statewide priorities and <br/>
<a id="pl.276.15"></a><var>276.15</var>provide recommendations to the legislature on whether to continue the use of statewide <br/>
<a id="pl.276.16"></a><var>276.16</var>priorities in the November 1, 2011, annual report required by the commissioner in sections <br/>
<a id="pl.276.17"></a><var>276.17</var>256B.0916, subdivision 7, and 256B.49, subdivision 21.<br/>
<br/>
<a id="bill.8.55.0"></a><a id="pl.276.18"></a><var>276.18</var>    Sec. 55. <b>[256B.0948] FOSTER CARE RATE LIMITS.</b><br/>
<a id="pl.276.19"></a><var>276.19</var>The commissioner shall decrease by five percent rates for adult foster care and <br/>
<a id="pl.276.20"></a><var>276.20</var>supportive living services that are reimbursed under section 256B.092 or 256B.49, and <br/>
<a id="pl.276.21"></a><var>276.21</var>are above the 95th percentile of the statewide rates for the service. The reduction in rates <br/>
<a id="pl.276.22"></a><var>276.22</var>shall take into account the acuity of individuals served based on the methodology used to <br/>
<a id="pl.276.23"></a><var>276.23</var>allocate dollars to local lead agency budgets, and assure that affected service rates are not <br/>
<a id="pl.276.24"></a><var>276.24</var>reduced below the rate level represented by the above percentile due to this rate change. <br/>
<a id="pl.276.25"></a><var>276.25</var>Lead agency contracts for services specified in this section shall be amended to implement <br/>
<a id="pl.276.26"></a><var>276.26</var>these rate changes for services rendered on or after July 1, 2009. The commissioner shall <br/>
<a id="pl.276.27"></a><var>276.27</var>make corresponding reductions to waiver allocations and capitated rates.<br/>
<br/>
<a id="bill.8.56.0"></a><a id="pl.276.28"></a><var>276.28</var>    Sec. 56. Minnesota Statutes 2008, section 256B.37, subdivision 1, is amended to read:<br/>
<a id="pl.276.29"></a><var>276.29</var>    Subdivision 1. <b>Subrogation.</b> Upon furnishing medical assistance or alternative <br/>
<a id="pl.276.30"></a><var>276.30</var>care services under section 256B.0913 to any person who has private accident or health <br/>
<a id="pl.276.31"></a><var>276.31</var>care coverage, or receives or has a right to receive health or medical care from any <br/>
<a id="pl.276.32"></a><var>276.32</var>type of organization or entity, or has a cause of action arising out of an occurrence that <br/>
<a id="pl.276.33"></a><var>276.33</var>necessitated the payment of medical assistance, the state agency or the state agency's agent <br/>
<a id="pl.276.34"></a><var>276.34</var>shall be subrogated, to the extent of the cost of medical care furnished, to any rights the <br/>
<a id="pl.277.1"></a><var>277.1</var>person may have under the terms of the coverage, or against the organization or entity <br/>
<a id="pl.277.2"></a><var>277.2</var>providing or liable to provide health or medical care, or under the cause of action.<br/>
<a id="pl.277.3"></a><var>277.3</var>    The right of subrogation created in this section includes all portions of the cause <br/>
<a id="pl.277.4"></a><var>277.4</var>of action, notwithstanding any settlement allocation or apportionment that purports to <br/>
<a id="pl.277.5"></a><var>277.5</var>dispose of portions of the cause of action not subject to subrogation.<br/>
<br/>
<a id="bill.8.57.0"></a><a id="pl.277.6"></a><var>277.6</var>    Sec. 57. Minnesota Statutes 2008, section 256B.37, subdivision 5, is amended to read:<br/>
<a id="pl.277.7"></a><var>277.7</var>    Subd. 5. <b>Private benefits to be used first.</b> Private accident and health care coverage <br/>
<a id="pl.277.8"></a><var>277.8</var>including Medicare for medical services is primary coverage and must be exhausted before <br/>
<a id="pl.277.9"></a><var>277.9</var>medical assistance is or alternative care services are paid for medical services including <br/>
<a id="pl.277.10"></a><var>277.10</var>home health care, personal care assistant services, hospice, supplies and equipment, or <br/>
<a id="pl.277.11"></a><var>277.11</var>services covered under a Centers for Medicare and Medicaid Services waiver. When a <br/>
<a id="pl.277.12"></a><var>277.12</var>person who is otherwise eligible for medical assistance has private accident or health care <br/>
<a id="pl.277.13"></a><var>277.13</var>coverage, including Medicare or a prepaid health plan, the private health care benefits <br/>
<a id="pl.277.14"></a><var>277.14</var>available to the person must be used first and to the fullest extent.<br/>
<br/>
<a id="bill.8.58.0"></a><a id="pl.277.15"></a><var>277.15</var>    Sec. 58. Minnesota Statutes 2008, section 256B.434, subdivision 4, is amended to read:<br/>
<a id="pl.277.16"></a><var>277.16</var>    Subd. 4. <b>Alternate rates for nursing facilities.</b> (a) For nursing facilities which <br/>
<a id="pl.277.17"></a><var>277.17</var>have their payment rates determined under this section rather than section 
         <statute_ref>256B.431</statute_ref>, the <br/>
<a id="pl.277.18"></a><var>277.18</var>commissioner shall establish a rate under this subdivision. The nursing facility must enter <br/>
<a id="pl.277.19"></a><var>277.19</var>into a written contract with the commissioner.<br/>
<a id="pl.277.20"></a><var>277.20</var>    (b) A nursing facility's case mix payment rate for the first rate year of a facility's <br/>
<a id="pl.277.21"></a><var>277.21</var>contract under this section is the payment rate the facility would have received under <br/>
<a id="pl.277.22"></a><var>277.22</var>section 
         <statute_ref>256B.431</statute_ref>.<br/>
<a id="pl.277.23"></a><var>277.23</var>    (c) A nursing facility's case mix payment rates for the second and subsequent years <br/>
<a id="pl.277.24"></a><var>277.24</var>of a facility's contract under this section are the previous rate year's contract payment <br/>
<a id="pl.277.25"></a><var>277.25</var>rates plus an inflation adjustment and, for facilities reimbursed under this section or <br/>
<a id="pl.277.26"></a><var>277.26</var>section 
         <statute_ref>256B.431</statute_ref>, an adjustment to include the cost of any increase in Health Department <br/>
<a id="pl.277.27"></a><var>277.27</var>licensing fees for the facility taking effect on or after July 1, 2001. The index for the <br/>
<a id="pl.277.28"></a><var>277.28</var>inflation adjustment must be based on the change in the Consumer Price Index-All Items <br/>
<a id="pl.277.29"></a><var>277.29</var>(United States City average) (CPI-U) forecasted by the commissioner of finance's national <br/>
<a id="pl.277.30"></a><var>277.30</var>economic consultant, as forecasted in the fourth quarter of the calendar year preceding <br/>
<a id="pl.277.31"></a><var>277.31</var>the rate year. The inflation adjustment must be based on the 12-month period from the <br/>
<a id="pl.277.32"></a><var>277.32</var>midpoint of the previous rate year to the midpoint of the rate year for which the rate is <br/>
<a id="pl.277.33"></a><var>277.33</var>being determined. For the rate years beginning on July 1, 1999, July 1, 2000, July 1, 2001, <br/>
<a id="pl.277.34"></a><var>277.34</var>July 1, 2002, July 1, 2003, July 1, 2004, July 1, 2005, July 1, 2006, July 1, 2007, July 1, <br/>
<a id="pl.278.1"></a><var>278.1</var>2008, October 1, 2009, and October 1, 2010, October 1, 2011, and October 1, 2012. This <br/>
<a id="pl.278.2"></a><var>278.2</var>paragraph shall apply only to the property-related payment rate, except that adjustments <br/>
<a id="pl.278.3"></a><var>278.3</var>to include the cost of any increase in Health Department licensing fees taking effect on <br/>
<a id="pl.278.4"></a><var>278.4</var>or after July 1, 2001, shall be provided. Beginning in 2005, adjustment to the property <br/>
<a id="pl.278.5"></a><var>278.5</var>payment rate under this section and section 
         <statute_ref>256B.431</statute_ref> shall be effective on October 1. <br/>
<a id="pl.278.6"></a><var>278.6</var>In determining the amount of the property-related payment rate adjustment under this <br/>
<a id="pl.278.7"></a><var>278.7</var>paragraph, the commissioner shall determine the proportion of the facility's rates that are <br/>
<a id="pl.278.8"></a><var>278.8</var>property-related based on the facility's most recent cost report. <br/>
<a id="pl.278.9"></a><var>278.9</var>    (d) The commissioner shall develop additional incentive-based payments of up to <br/>
<a id="pl.278.10"></a><var>278.10</var>five percent above a facility's operating payment rate for achieving outcomes specified <br/>
<a id="pl.278.11"></a><var>278.11</var>in a contract. The commissioner may solicit contract amendments and implement those <br/>
<a id="pl.278.12"></a><var>278.12</var>which, on a competitive basis, best meet the state's policy objectives. The commissioner <br/>
<a id="pl.278.13"></a><var>278.13</var>shall limit the amount of any incentive payment and the number of contract amendments <br/>
<a id="pl.278.14"></a><var>278.14</var>under this paragraph to operate the incentive payments within funds appropriated for this <br/>
<a id="pl.278.15"></a><var>278.15</var>purpose. The contract amendments may specify various levels of payment for various <br/>
<a id="pl.278.16"></a><var>278.16</var>levels of performance. Incentive payments to facilities under this paragraph may be in the <br/>
<a id="pl.278.17"></a><var>278.17</var>form of time-limited rate adjustments or onetime supplemental payments. In establishing <br/>
<a id="pl.278.18"></a><var>278.18</var>the specified outcomes and related criteria, the commissioner shall consider the following <br/>
<a id="pl.278.19"></a><var>278.19</var>state policy objectives:<br/>
<a id="pl.278.20"></a><var>278.20</var>    (1) successful diversion or discharge of residents to the residents' prior home or other <br/>
<a id="pl.278.21"></a><var>278.21</var>community-based alternatives;<br/>
<a id="pl.278.22"></a><var>278.22</var>    (2) adoption of new technology to improve quality or efficiency; <br/>
<a id="pl.278.23"></a><var>278.23</var>    (3) improved quality as measured in the Nursing Home Report Card; <br/>
<a id="pl.278.24"></a><var>278.24</var>    (4) reduced acute care costs; and<br/>
<a id="pl.278.25"></a><var>278.25</var>    (5) any additional outcomes proposed by a nursing facility that the commissioner <br/>
<a id="pl.278.26"></a><var>278.26</var>finds desirable.<br/>
<a id="pl.278.27"></a><var>278.27</var>    (e) Notwithstanding the threshold in section 
         <statute_ref>256B.431, subdivision 16</statute_ref>, facilities that <br/>
<a id="pl.278.28"></a><var>278.28</var>take action to come into compliance with existing or pending requirements of the life <br/>
<a id="pl.278.29"></a><var>278.29</var>safety code provisions or federal regulations governing sprinkler systems must receive <br/>
<a id="pl.278.30"></a><var>278.30</var>reimbursement for the costs associated with compliance if all of the following conditions <br/>
<a id="pl.278.31"></a><var>278.31</var>are met:<br/>
<a id="pl.278.32"></a><var>278.32</var>    (1) the expenses associated with compliance occurred on or after January 1, 2005, <br/>
<a id="pl.278.33"></a><var>278.33</var>and before December 31, 2008;<br/>
<a id="pl.278.34"></a><var>278.34</var>    (2) the costs were not otherwise reimbursed under subdivision 4f or section <br/>
<statute_ref><a id="pl.278.35"></a><var>278.35</var>144A.071
         </statute_ref> or 
         <statute_ref>144A.073</statute_ref>; and<br/>
<a id="pl.279.1"></a><var>279.1</var>    (3) the total allowable costs reported under this paragraph are  less than the minimum <br/>
<a id="pl.279.2"></a><var>279.2</var>threshold established under section 
         <statute_ref>256B.431, subdivision 15</statute_ref>, paragraph (e), and <br/>
<a id="pl.279.3"></a><var>279.3</var>subdivision 16.<br/>
<a id="pl.279.4"></a><var>279.4</var>The commissioner shall use money appropriated for this purpose to provide to qualifying <br/>
<a id="pl.279.5"></a><var>279.5</var>nursing facilities a rate adjustment beginning October 1, 2007, and ending September 30, <br/>
<a id="pl.279.6"></a><var>279.6</var>2008. Nursing facilities that have spent money or anticipate the need to spend money <br/>
<a id="pl.279.7"></a><var>279.7</var>to satisfy the most recent life safety code requirements by (1) installing a sprinkler <br/>
<a id="pl.279.8"></a><var>279.8</var>system or (2) replacing all or portions of an existing sprinkler system may submit to the <br/>
<a id="pl.279.9"></a><var>279.9</var>commissioner by June 30, 2007, on a form provided by the commissioner the actual <br/>
<a id="pl.279.10"></a><var>279.10</var>costs of a completed project or the estimated costs, based on a project bid, of a planned <br/>
<a id="pl.279.11"></a><var>279.11</var>project. The commissioner shall calculate a rate adjustment equal to the allowable <br/>
<a id="pl.279.12"></a><var>279.12</var>costs of the project divided by the resident days reported for the report year ending <br/>
<a id="pl.279.13"></a><var>279.13</var>September 30, 2006. If the costs from all projects exceed the appropriation for this <br/>
<a id="pl.279.14"></a><var>279.14</var>purpose, the commissioner shall allocate the money appropriated on a pro rata basis <br/>
<a id="pl.279.15"></a><var>279.15</var>to the qualifying facilities by reducing the rate adjustment determined for each facility <br/>
<a id="pl.279.16"></a><var>279.16</var>by an equal percentage. Facilities that used estimated costs when requesting the rate <br/>
<a id="pl.279.17"></a><var>279.17</var>adjustment shall report to the commissioner by January 31, 2009, on the use of this <br/>
<a id="pl.279.18"></a><var>279.18</var>money on a form provided by the commissioner. If the nursing facility fails to provide <br/>
<a id="pl.279.19"></a><var>279.19</var>the report, the commissioner shall recoup the money paid to the facility for this purpose. <br/>
<a id="pl.279.20"></a><var>279.20</var>If the facility reports expenditures allowable under this subdivision that are less than <br/>
<a id="pl.279.21"></a><var>279.21</var>the amount received in the facility's annualized rate adjustment, the commissioner shall <br/>
<a id="pl.279.22"></a><var>279.22</var>recoup the difference.<br/>
<br/>
<a id="bill.8.59.0"></a><a id="pl.279.23"></a><var>279.23</var>    Sec. 59. Minnesota Statutes 2008, section 256B.434, is amended by adding a <br/>
<a id="pl.279.24"></a><var>279.24</var>subdivision to read:<br/>
<a id="pl.279.25"></a><var>279.25</var>    Subd. 21. <b>Payment of post-PERA pension benefit costs.</b> Nursing facilities that <br/>
<a id="pl.279.26"></a><var>279.26</var>convert or converted after September 30, 2006, from public to private ownership shall <br/>
<a id="pl.279.27"></a><var>279.27</var>have a portion of their post-PERA pension costs treated as a component of the historic <br/>
<a id="pl.279.28"></a><var>279.28</var>operating rate. Effective for the rate years beginning on or after October 1, 2009, and prior <br/>
<a id="pl.279.29"></a><var>279.29</var>to October 1, 2016, the commissioner shall determine the pension costs to be included <br/>
<a id="pl.279.30"></a><var>279.30</var>in the facility's base for determining rates under this section by using the following <br/>
<a id="pl.279.31"></a><var>279.31</var>formula: post-privatization pension benefit costs as a percent of salary shall be determined <br/>
<a id="pl.279.32"></a><var>279.32</var>from either the cost report for the first full reporting year after privatization or the most <br/>
<a id="pl.279.33"></a><var>279.33</var>recent report year available, whichever is later. This percentage shall be applied to the <br/>
<a id="pl.279.34"></a><var>279.34</var>salary costs of the alternative payment system base rate year to determine the allowable <br/>
<a id="pl.279.35"></a><var>279.35</var>amount of pension costs. The adjustments provided for in sections 256B.431, 256B.434, <br/>
<a id="pl.280.1"></a><var>280.1</var>256B.441, and any other law enacted after the base rate year and prior to the year for <br/>
<a id="pl.280.2"></a><var>280.2</var>which rates are being determined shall be applied to the allowable amount. The adjusted <br/>
<a id="pl.280.3"></a><var>280.3</var>allowable amount shall be added to the operating rate effective the first rate year PERA <br/>
<a id="pl.280.4"></a><var>280.4</var>ceases to remain as a pass-through component of the rate.<br/>
<br/>
<a id="bill.8.60.0"></a><a id="pl.280.5"></a><var>280.5</var>    Sec. 60. Minnesota Statutes 2008, section 256B.437, subdivision 6, is amended to read:<br/>
<a id="pl.280.6"></a><var>280.6</var>    Subd. 6. <b>Planned closure rate adjustment.</b> (a) The commissioner of human <br/>
<a id="pl.280.7"></a><var>280.7</var>services shall calculate the amount of the planned closure rate adjustment available under <br/>
<a id="pl.280.8"></a><var>280.8</var>subdivision 3, paragraph (b), for up to 5,140 beds according to clauses (1) to (4):<br/>
<a id="pl.280.9"></a><var>280.9</var>(1) the amount available is the net reduction of nursing facility beds multiplied <br/>
<a id="pl.280.10"></a><var>280.10</var>by $2,080;<br/>
<a id="pl.280.11"></a><var>280.11</var>(2) the total number of beds in the nursing facility or facilities receiving the planned <br/>
<a id="pl.280.12"></a><var>280.12</var>closure rate adjustment must be identified;<br/>
<a id="pl.280.13"></a><var>280.13</var>(3) capacity days are determined by multiplying the number determined under <br/>
<a id="pl.280.14"></a><var>280.14</var>clause (2) by 365; and<br/>
<a id="pl.280.15"></a><var>280.15</var>(4) the planned closure rate adjustment is the amount available in clause (1), divided <br/>
<a id="pl.280.16"></a><var>280.16</var>by capacity days determined under clause (3).<br/>
<a id="pl.280.17"></a><var>280.17</var>(b) A planned closure rate adjustment under this section is effective on the first day <br/>
<a id="pl.280.18"></a><var>280.18</var>of the month following completion of closure of the facility designated for closure in the <br/>
<a id="pl.280.19"></a><var>280.19</var>application and becomes part of the nursing facility's total operating payment rate.<br/>
<a id="pl.280.20"></a><var>280.20</var>(c) Applicants may use the planned closure rate adjustment to allow for a property <br/>
<a id="pl.280.21"></a><var>280.21</var>payment for a new nursing facility or an addition to an existing nursing facility or as an <br/>
<a id="pl.280.22"></a><var>280.22</var>operating payment rate adjustment. Applications approved under this subdivision are <br/>
<a id="pl.280.23"></a><var>280.23</var>exempt from other requirements for moratorium exceptions under section 
         <statute_ref>144A.073, <br/>
<a id="pl.280.24"></a><var>280.24</var>subdivisions 2 and 3
         </statute_ref>.<br/>
<a id="pl.280.25"></a><var>280.25</var>(d) Upon the request of a closing facility, the commissioner must allow the facility a <br/>
<a id="pl.280.26"></a><var>280.26</var>closure rate adjustment as provided under section 
         <statute_ref>144A.161, subdivision 10</statute_ref>.<br/>
<a id="pl.280.27"></a><var>280.27</var>(e) A facility that has received a planned closure rate adjustment may reassign it <br/>
<a id="pl.280.28"></a><var>280.28</var>to another facility that is under the same ownership at any time within three years of its <br/>
<a id="pl.280.29"></a><var>280.29</var>effective date. The amount of the adjustment shall be computed according to paragraph (a).<br/>
<a id="pl.280.30"></a><var>280.30</var>(f) If the per bed dollar amount specified in paragraph (a), clause (1), is increased, <br/>
<a id="pl.280.31"></a><var>280.31</var>the commissioner shall recalculate planned closure rate adjustments for facilities that <br/>
<a id="pl.280.32"></a><var>280.32</var>delicense beds under this section on or after July 1, 2001, to reflect the increase in the per <br/>
<a id="pl.280.33"></a><var>280.33</var>bed dollar amount. The recalculated planned closure rate adjustment shall be effective <br/>
<a id="pl.280.34"></a><var>280.34</var>from the date the per bed dollar amount is increased.<br/>
<a id="pl.281.1"></a><var>281.1</var>(g) For planned closures approved after June 30, 2009, the commissioner of human <br/>
<a id="pl.281.2"></a><var>281.2</var>services shall calculate the amount of the planned closure rate adjustment available under <br/>
<a id="pl.281.3"></a><var>281.3</var>subdivision 3, paragraph (b), according to paragraph (a), clauses (1) to (4).<br/>
<br/>
<a id="bill.8.61.0"></a><a id="pl.281.4"></a><var>281.4</var>    Sec. 61. Minnesota Statutes 2008, section 256B.441, subdivision 55, is amended to <br/>
<a id="pl.281.5"></a><var>281.5</var>read:<br/>
<a id="pl.281.6"></a><var>281.6</var>    Subd. 55. <b>Phase-in of rebased operating payment rates.</b>  (a) For the rate years <br/>
<a id="pl.281.7"></a><var>281.7</var>beginning October 1, 2008, to October 1, 2015, the operating payment rate calculated <br/>
<a id="pl.281.8"></a><var>281.8</var>under this section shall be phased in by blending the operating rate with the operating <br/>
<a id="pl.281.9"></a><var>281.9</var>payment rate determined under section 
         <statute_ref>256B.434</statute_ref>. For purposes of this subdivision, the <br/>
<a id="pl.281.10"></a><var>281.10</var>rate to be used that is determined under section 
         <statute_ref>256B.434</statute_ref> shall not include the portion of <br/>
<a id="pl.281.11"></a><var>281.11</var>the operating payment rate related to performance-based incentive payments under section <br/>
<statute_ref><a id="pl.281.12"></a><var>281.12</var>256B.434, subdivision 4
         </statute_ref>, paragraph (d). For the rate year beginning October 1, 2008, the <br/>
<a id="pl.281.13"></a><var>281.13</var>operating payment rate for each facility shall be 13 percent of the operating payment rate <br/>
<a id="pl.281.14"></a><var>281.14</var>from this section, and 87 percent of the operating payment rate from section 
         <statute_ref>256B.434</statute_ref>. <br/>
<a id="pl.281.15"></a><var>281.15</var>For the rate year period beginning October 1, 2009, through September 30, 2013, the <br/>
<a id="pl.281.16"></a><var>281.16</var>operating payment rate for each facility shall be 14 percent of the operating payment rate <br/>
<a id="pl.281.17"></a><var>281.17</var>from this section, and 86 percent of the operating payment rate from section 
         <statute_ref>256B.434</statute_ref>. <br/>
<a id="pl.281.18"></a><var>281.18</var>For the rate year beginning October 1, 2010, the operating payment rate for each facility <br/>
<a id="pl.281.19"></a><var>281.19</var>shall be 14 percent of the operating payment rate from this section, and 86 percent of the <br/>
<a id="pl.281.20"></a><var>281.20</var>operating payment rate from section 
<statute_ref>256B.434</statute_ref>. For the rate year beginning October 1, <br/>
<a id="pl.281.21"></a><var>281.21</var>2011, the operating payment rate for each facility shall be 31 percent of the operating <br/>
<a id="pl.281.22"></a><var>281.22</var>payment rate from this section, and 69 percent of the operating payment rate from section <br/>
<a id="pl.281.23"></a><var>281.23</var><statute_ref>256B.434</statute_ref>. For the rate year beginning October 1, 2012, the operating payment rate for <br/>
<a id="pl.281.24"></a><var>281.24</var>each facility shall be 48 percent of the operating payment rate from this section, and 52 <br/>
<a id="pl.281.25"></a><var>281.25</var>percent of the operating payment rate from section 
<statute_ref>256B.434</statute_ref>. For the rate year beginning <br/>
<a id="pl.281.26"></a><var>281.26</var>October 1, 2013, the operating payment rate for each facility shall be 65 percent of the <br/>
<a id="pl.281.27"></a><var>281.27</var>operating payment rate from this section, and 35 percent of the operating payment rate <br/>
<a id="pl.281.28"></a><var>281.28</var>from section 
         <statute_ref>256B.434</statute_ref>. For the rate year beginning October 1, 2014, the operating <br/>
<a id="pl.281.29"></a><var>281.29</var>payment rate for each facility shall be 82 percent of the operating payment rate from this <br/>
<a id="pl.281.30"></a><var>281.30</var>section, and 18 percent of the operating payment rate from section 
         <statute_ref>256B.434</statute_ref>. For the rate <br/>
<a id="pl.281.31"></a><var>281.31</var>year beginning October 1, 2015, the operating payment rate for each facility shall be the <br/>
<a id="pl.281.32"></a><var>281.32</var>operating payment rate determined under this section. The blending of operating payment <br/>
<a id="pl.281.33"></a><var>281.33</var>rates under this section shall be performed separately for each RUG's class.<br/>
<a id="pl.282.1"></a><var>282.1</var>    (b) For the rate year beginning October 1, 2008, the commissioner shall apply limits <br/>
<a id="pl.282.2"></a><var>282.2</var>to the operating payment rate increases under paragraph (a) by creating a minimum <br/>
<a id="pl.282.3"></a><var>282.3</var>percentage increase and a maximum percentage increase.<br/>
<a id="pl.282.4"></a><var>282.4</var>    (1) Each nursing facility that receives a blended October 1, 2008, operating payment <br/>
<a id="pl.282.5"></a><var>282.5</var>rate increase under paragraph (a) of less than one percent, when compared to its operating <br/>
<a id="pl.282.6"></a><var>282.6</var>payment rate on September 30, 2008, computed using rates with RUG's weight of 
         <statute_ref>1.00</statute_ref>, <br/>
<a id="pl.282.7"></a><var>282.7</var>shall receive a rate adjustment of one percent.<br/>
<a id="pl.282.8"></a><var>282.8</var>    (2) The commissioner shall determine a maximum percentage increase that will <br/>
<a id="pl.282.9"></a><var>282.9</var>result in savings equal to the cost of allowing the minimum increase in clause (1). Nursing <br/>
<a id="pl.282.10"></a><var>282.10</var>facilities with a blended October 1, 2008, operating payment rate increase under paragraph <br/>
<a id="pl.282.11"></a><var>282.11</var>(a) greater than the maximum percentage increase determined by the commissioner, when <br/>
<a id="pl.282.12"></a><var>282.12</var>compared to its operating payment rate on September 30, 2008, computed using rates with <br/>
<a id="pl.282.13"></a><var>282.13</var>a RUG's weight of 
         <statute_ref>1.00</statute_ref>, shall receive the maximum percentage increase.<br/>
<a id="pl.282.14"></a><var>282.14</var>    (3) Nursing facilities with a blended October 1, 2008, operating payment rate <br/>
<a id="pl.282.15"></a><var>282.15</var>increase under paragraph (a) greater than one percent and less than the maximum <br/>
<a id="pl.282.16"></a><var>282.16</var>percentage increase determined by the commissioner, when compared to its operating <br/>
<a id="pl.282.17"></a><var>282.17</var>payment rate on September 30, 2008, computed using rates with a RUG's weight of 
         <statute_ref>1.00</statute_ref>, <br/>
<a id="pl.282.18"></a><var>282.18</var>shall receive the blended October 1, 2008, operating payment rate increase determined <br/>
<a id="pl.282.19"></a><var>282.19</var>under paragraph (a).<br/>
<a id="pl.282.20"></a><var>282.20</var>    (4) The October 1, 2009, through October 1, 2015, operating payment rate for <br/>
<a id="pl.282.21"></a><var>282.21</var>facilities receiving the maximum percentage increase determined in clause (2) shall be <br/>
<a id="pl.282.22"></a><var>282.22</var>the amount determined under paragraph (a) less the difference between the amount <br/>
<a id="pl.282.23"></a><var>282.23</var>determined under paragraph (a) for October 1, 2008, and the amount allowed under clause <br/>
<a id="pl.282.24"></a><var>282.24</var>(2). This rate restriction does not apply to rate increases provided in any other section.<br/>
<a id="pl.282.25"></a><var>282.25</var>    (c) A portion of the funds received under this subdivision that are in excess of <br/>
<a id="pl.282.26"></a><var>282.26</var>operating payment rates that a facility would have received under section 
         <statute_ref>256B.434</statute_ref>, as <br/>
<a id="pl.282.27"></a><var>282.27</var>determined in accordance with clauses (1) to (3), shall be subject to the requirements in <br/>
<a id="pl.282.28"></a><var>282.28</var>section 
         <statute_ref>256B.434, subdivision 19</statute_ref>, paragraphs (b) to (h).<br/>
<a id="pl.282.29"></a><var>282.29</var>    (1) Determine the amount of additional funding available to a facility, which shall be <br/>
<a id="pl.282.30"></a><var>282.30</var>equal to total medical assistance resident days from the most recent reporting year times <br/>
<a id="pl.282.31"></a><var>282.31</var>the difference between the blended rate determined in paragraph (a) for the rate year being <br/>
<a id="pl.282.32"></a><var>282.32</var>computed and the blended rate for the prior year.<br/>
<a id="pl.282.33"></a><var>282.33</var>    (2) Determine the portion of all operating costs, for the most recent reporting year, <br/>
<a id="pl.282.34"></a><var>282.34</var>that are compensation related. If this value exceeds 75 percent, use 75 percent.<br/>
<a id="pl.282.35"></a><var>282.35</var>    (3) Subtract the amount determined in clause (2) from 75 percent.<br/>
<a id="pl.283.1"></a><var>283.1</var>    (4) The portion of the fund received under this subdivision that shall be subject to <br/>
<a id="pl.283.2"></a><var>283.2</var>the requirements in section 
         <statute_ref>256B.434, subdivision 19</statute_ref>, paragraphs (b) to (h), shall equal <br/>
<a id="pl.283.3"></a><var>283.3</var>the amount determined in clause (1) times the amount determined in clause (3).<br/>
<br/>
<a id="bill.8.62.0"></a><a id="pl.283.4"></a><var>283.4</var>    Sec. 62. Minnesota Statutes 2008, section 256B.441, subdivision 58, is amended to <br/>
<a id="pl.283.5"></a><var>283.5</var>read:<br/>
<a id="pl.283.6"></a><var>283.6</var>    Subd. 58. <b>Implementation delay.</b> Within six months prior to the effective date of <br/>
<a id="pl.283.7"></a><var>283.7</var>(1) rebasing of property payment rates under subdivision 1; (2) quality-based rate limits <br/>
<a id="pl.283.8"></a><var>283.8</var>under subdivision 50; and (3) the removal of planned closure rate adjustments and single <br/>
<a id="pl.283.9"></a><var>283.9</var>bed room incentives from external fixed costs under subdivision 53, the commissioner <br/>
<a id="pl.283.10"></a><var>283.10</var>shall compare the average operating cost for all facilities combined from the most recent <br/>
<a id="pl.283.11"></a><var>283.11</var>cost reports to the average medical assistance operating payment rates for all facilities <br/>
<a id="pl.283.12"></a><var>283.12</var>combined from the same time period. Each provision shall not go into effect until the <br/>
<a id="pl.283.13"></a><var>283.13</var>average medical assistance operating payment rate is at least 92 percent of the average <br/>
<a id="pl.283.14"></a><var>283.14</var>operating cost. The rebasing of property payment rates under subdivision 1, and the <br/>
<a id="pl.283.15"></a><var>283.15</var>removal of planned closure rate adjustments and single-bed room incentives from external <br/>
<a id="pl.283.16"></a><var>283.16</var>fixed costs under subdivision 53 shall not go into effect until 82 percent of the operating <br/>
<a id="pl.283.17"></a><var>283.17</var>payment rate from this section is phased in as described in subdivision 55.<br/>
<br/>
<a id="bill.8.63.0"></a><a id="pl.283.18"></a><var>283.18</var>    Sec. 63. Minnesota Statutes 2008, section 256B.441, is amended by adding a <br/>
<a id="pl.283.19"></a><var>283.19</var>subdivision to read:<br/>
<a id="pl.283.20"></a><var>283.20</var>    Subd. 59. <b>Single-bed payments for medical assistance recipients.</b> Effective <br/>
<a id="pl.283.21"></a><var>283.21</var>October 1, 2009, the amount paid for a private room under Minnesota Rules, part <br/>
<a id="pl.283.22"></a><var>283.22</var>9549.0070, subpart 3, is reduced from 115 percent to 111.5 percent.<br/>
<br/>
<a id="bill.8.64.0"></a><a id="pl.283.23"></a><var>283.23</var>    Sec. 64. Minnesota Statutes 2008, section 256B.49, is amended by adding a <br/>
<a id="pl.283.24"></a><var>283.24</var>subdivision to read:<br/>
<a id="pl.283.25"></a><var>283.25</var>    Subd. 11a. <b>Waivered services waiting list.</b> (a) The commissioner shall establish <br/>
<a id="pl.283.26"></a><var>283.26</var>statewide priorities for individuals on the waiting list for CAC, CADI, and TBI waiver <br/>
<a id="pl.283.27"></a><var>283.27</var>services, as of January 1, 2010. The statewide priorities must include, but are not limited <br/>
<a id="pl.283.28"></a><var>283.28</var>to, individuals who continue to have a need for waiver services after they have maximized <br/>
<a id="pl.283.29"></a><var>283.29</var>the use of state plan services and other funding resources, including natural supports, prior <br/>
<a id="pl.283.30"></a><var>283.30</var>to accessing waiver services, and who meet at least one of the following criteria:<br/>
<a id="pl.283.31"></a><var>283.31</var>(1) have unstable living situations due to the age, incapacity, or sudden loss of <br/>
<a id="pl.283.32"></a><var>283.32</var>the primary caregivers;<br/>
<a id="pl.283.33"></a><var>283.33</var>(2) are moving from an institution due to bed closures;<br/>
<a id="pl.284.1"></a><var>284.1</var>(3) experience a sudden closure of their current living arrangement;<br/>
<a id="pl.284.2"></a><var>284.2</var>(4) require protection from confirmed abuse, neglect, or exploitation;<br/>
<a id="pl.284.3"></a><var>284.3</var>(5) experience a sudden change in need that can  no longer be met through state plan <br/>
<a id="pl.284.4"></a><var>284.4</var>services or other funding resources alone; or<br/>
<a id="pl.284.5"></a><var>284.5</var>(6) meet other priorities established by the department.<br/>
<a id="pl.284.6"></a><var>284.6</var>(b) When allocating resources to lead agencies, the commissioner must take into <br/>
<a id="pl.284.7"></a><var>284.7</var>consideration the number of individuals waiting who meet statewide priorities and the <br/>
<a id="pl.284.8"></a><var>284.8</var>lead agencies' current use of waiver funds and existing service options.<br/>
<a id="pl.284.9"></a><var>284.9</var>(c) The commissioner shall evaluate the impact of the use of statewide priorities and <br/>
<a id="pl.284.10"></a><var>284.10</var>provide recommendations to the legislature on whether to continue the use of statewide <br/>
<a id="pl.284.11"></a><var>284.11</var>priorities in the November 1, 2011, annual report required by the commissioner in sections <br/>
<a id="pl.284.12"></a><var>284.12</var>256B.0916, subdivision 7, and 256B.49, subdivision 21.<br/>
<br/>
<a id="bill.8.65.0"></a><a id="pl.284.13"></a><var>284.13</var>    Sec. 65. Minnesota Statutes 2008, section 256B.49, subdivision 12, is amended to read:<br/>
<a id="pl.284.14"></a><var>284.14</var>    Subd. 12. <b>Informed choice.</b> Persons who are determined likely to require the level <br/>
<a id="pl.284.15"></a><var>284.15</var>of care provided in a nursing facility as determined under sections 144.0724, subdivision <br/>
<a id="pl.284.16"></a><var>284.16</var>11, and 256B.0911, or hospital shall be informed of the home and community-based <br/>
<a id="pl.284.17"></a><var>284.17</var>support alternatives to the provision of inpatient hospital services or nursing facility <br/>
<a id="pl.284.18"></a><var>284.18</var>services. Each person must be given the choice of either institutional or home and <br/>
<a id="pl.284.19"></a><var>284.19</var>community-based services using the provisions described in section 
         <statute_ref>256B.77, subdivision <br/>
<a id="pl.284.20"></a><var>284.20</var>2
         </statute_ref>, paragraph (p).<br/>
<a id="pl.284.21"></a><var>284.21</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2011.<br/>
<br/>
<a id="bill.8.66.0"></a><a id="pl.284.22"></a><var>284.22</var>    Sec. 66. Minnesota Statutes 2008, section 256B.49, subdivision 13, is amended to read:<br/>
<a id="pl.284.23"></a><var>284.23</var>    Subd. 13. <b>Case management.</b> (a) Each recipient of a home and community-based <br/>
<a id="pl.284.24"></a><var>284.24</var>waiver shall be provided case management services by qualified vendors as described <br/>
<a id="pl.284.25"></a><var>284.25</var>in the federally approved waiver application. The case management service activities <br/>
<a id="pl.284.26"></a><var>284.26</var>provided will include:<br/>
<a id="pl.284.27"></a><var>284.27</var>    (1) assessing the needs of the individual within 20 working days of a recipient's <br/>
<a id="pl.284.28"></a><var>284.28</var>request;<br/>
<a id="pl.284.29"></a><var>284.29</var>    (2) developing the written individual service plan within ten working days after the <br/>
<a id="pl.284.30"></a><var>284.30</var>assessment is completed;<br/>
<a id="pl.284.31"></a><var>284.31</var>    (3) informing the recipient or the recipient's legal guardian or conservator of service <br/>
<a id="pl.284.32"></a><var>284.32</var>options;<br/>
<a id="pl.284.33"></a><var>284.33</var>    (4) assisting the recipient in the identification of potential service providers;<br/>
<a id="pl.284.34"></a><var>284.34</var>    (5) assisting the recipient to access services;<br/>
<a id="pl.285.1"></a><var>285.1</var>    (6) coordinating, evaluating, and monitoring of the services identified in the service <br/>
<a id="pl.285.2"></a><var>285.2</var>plan;<br/>
<a id="pl.285.3"></a><var>285.3</var>    (7) completing the annual reviews of the service plan; and<br/>
<a id="pl.285.4"></a><var>285.4</var>    (8) informing the recipient or legal representative of the right to have assessments <br/>
<a id="pl.285.5"></a><var>285.5</var>completed and service plans developed within specified time periods, and to appeal county <br/>
<a id="pl.285.6"></a><var>285.6</var>action or inaction under section 
         <statute_ref>256.045, subdivision 3</statute_ref>, including the determination of <br/>
<a id="pl.285.7"></a><var>285.7</var>nursing facility level of care. <br/>
<a id="pl.285.8"></a><var>285.8</var>    (b) The case manager may delegate certain aspects of the case management service <br/>
<a id="pl.285.9"></a><var>285.9</var>activities to another individual provided there is oversight by the case manager. The case <br/>
<a id="pl.285.10"></a><var>285.10</var>manager may not delegate those aspects which require professional judgment including <br/>
<a id="pl.285.11"></a><var>285.11</var>assessments, reassessments, and care plan development.<br/>
<a id="pl.285.12"></a><var>285.12</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2011.<br/>
<br/>
<a id="bill.8.67.0"></a><a id="pl.285.13"></a><var>285.13</var>    Sec. 67. Minnesota Statutes 2008, section 256B.49, subdivision 14, is amended to read:<br/>
<a id="pl.285.14"></a><var>285.14</var>    Subd. 14. <b>Assessment and reassessment.</b> (a) Assessments of each recipient's <br/>
<a id="pl.285.15"></a><var>285.15</var>strengths, informal support systems, and need for services shall be completed within <br/>
<a id="pl.285.16"></a><var>285.16</var>20 working days of the recipient's request. Reassessment of each recipient's strengths, <br/>
<a id="pl.285.17"></a><var>285.17</var>support systems, and need for services shall be conducted at least every 12 months and at <br/>
<a id="pl.285.18"></a><var>285.18</var>other times when there has been a significant change in the recipient's functioning.<br/>
<a id="pl.285.19"></a><var>285.19</var>(b) There must be a determination that the client requires a hospital level of care or a <br/>
<a id="pl.285.20"></a><var>285.20</var>nursing facility level of care as defined in section 144.0724, subdivision 11, at initial and <br/>
<a id="pl.285.21"></a><var>285.21</var>subsequent assessments to initiate and maintain participation in the waiver program.<br/>
<a id="pl.285.22"></a><var>285.22</var>(c) Regardless of other assessments identified in section 144.0724, subdivision 4, as <br/>
<a id="pl.285.23"></a><var>285.23</var>appropriate to determine nursing facility level of care for purposes of medical assistance <br/>
<a id="pl.285.24"></a><var>285.24</var>payment for nursing facility services, only face-to-face assessments conducted according <br/>
<a id="pl.285.25"></a><var>285.25</var>to section 256B.0911, subdivisions 3a, 3b, and 4d, that result in a hospital level of care <br/>
<a id="pl.285.26"></a><var>285.26</var>determination or a nursing facility level of care determination must be accepted for <br/>
<a id="pl.285.27"></a><var>285.27</var>purposes of initial and ongoing access to waiver services payment.<br/>
<a id="pl.285.28"></a><var>285.28</var>(d) Persons with developmental disabilities who apply for services under the nursing <br/>
<a id="pl.285.29"></a><var>285.29</var>facility level waiver programs shall be screened for the appropriate level of care according <br/>
<a id="pl.285.30"></a><var>285.30</var>to section 
         <statute_ref>256B.092</statute_ref>.<br/>
<a id="pl.285.31"></a><var>285.31</var>(c) (e) Recipients who are found eligible for home and community-based services <br/>
<a id="pl.285.32"></a><var>285.32</var>under this section before their 65th birthday may remain eligible for these services after <br/>
<a id="pl.285.33"></a><var>285.33</var>their 65th birthday if they continue to meet all other eligibility factors.<br/>
<a id="pl.285.34"></a><var>285.34</var><b>EFFECTIVE DATE.</b>The section is effective January 1, 2011.<br/>
<br/>
<a id="bill.8.68.0"></a><a id="pl.286.1"></a><var>286.1</var>    Sec. 68. Minnesota Statutes 2008, section 256B.49, is amended by adding a <br/>
<a id="pl.286.2"></a><var>286.2</var>subdivision to read:<br/>
<a id="pl.286.3"></a><var>286.3</var>    Subd. 22. <b>Residential support services.</b> For the purposes of this section, the <br/>
<a id="pl.286.4"></a><var>286.4</var>provisions of section 256B.092, subdivision 11, are controlling.<br/>
<br/>
<a id="bill.8.69.0"></a><a id="pl.286.5"></a><var>286.5</var>    Sec. 69. <b>[256B.4912] HOME AND COMMUNITY-BASED WAIVERS; </b><br/>
<a id="pl.286.6"></a><var>286.6</var><b>PROVIDERS AND PAYMENT.</b><br/>
<a id="pl.286.7"></a><var>286.7</var>    Subdivision 1. <b>Provider qualifications.</b> For the home and community-based <br/>
<a id="pl.286.8"></a><var>286.8</var>waivers providing services to seniors and individuals with disabilities, the commissioner <br/>
<a id="pl.286.9"></a><var>286.9</var>shall establish:<br/>
<a id="pl.286.10"></a><var>286.10</var>(1) agreements with enrolled waiver service providers to ensure providers meet <br/>
<a id="pl.286.11"></a><var>286.11</var>qualifications defined in the waiver plans;<br/>
<a id="pl.286.12"></a><var>286.12</var>(2) regular reviews of provider qualifications; and<br/>
<a id="pl.286.13"></a><var>286.13</var>(3) processes to gather the necessary information to determine provider <br/>
<a id="pl.286.14"></a><var>286.14</var>qualifications.<br/>
<a id="pl.286.15"></a><var>286.15</var>By July 2010, staff that provide direct contact, as defined in section 245C.02, subdivision <br/>
<a id="pl.286.16"></a><var>286.16</var>11, that are employees of waiver service providers must meet the requirements of chapter <br/>
<a id="pl.286.17"></a><var>286.17</var>245C prior to providing waiver services and as part of ongoing enrollment. Upon federal <br/>
<a id="pl.286.18"></a><var>286.18</var>approval, this requirement must also apply to consumer-directed community supports.<br/>
<a id="pl.286.19"></a><var>286.19</var>    Subd. 2. <b>Rate-setting methodologies.</b> The commissioner shall establish <br/>
<a id="pl.286.20"></a><var>286.20</var>statewide rate-setting methodologies that meet federal waiver requirements for home <br/>
<a id="pl.286.21"></a><var>286.21</var>and community-based waiver services for individuals with disabilities. The rate-setting <br/>
<a id="pl.286.22"></a><var>286.22</var>methodologies must abide by the principles of transparency and equitability across the <br/>
<a id="pl.286.23"></a><var>286.23</var>state. The methodologies must involve a uniform process of structuring rates for each <br/>
<a id="pl.286.24"></a><var>286.24</var>service and must promote quality and participant choice.<br/>
<br/>
<a id="bill.8.70.0"></a><a id="pl.286.25"></a><var>286.25</var>    Sec. 70. Minnesota Statutes 2008, section 256B.5011, subdivision 2, is amended to <br/>
<a id="pl.286.26"></a><var>286.26</var>read:<br/>
<a id="pl.286.27"></a><var>286.27</var>    Subd. 2. <b>Contract provisions.</b> (a) The service contract with each intermediate <br/>
<a id="pl.286.28"></a><var>286.28</var>care facility must include provisions for:<br/>
<a id="pl.286.29"></a><var>286.29</var>(1) modifying payments when significant changes occur in the needs of the <br/>
<a id="pl.286.30"></a><var>286.30</var>consumers;<br/>
<a id="pl.286.31"></a><var>286.31</var>(2) the establishment and use of a quality improvement plan. Using criteria and <br/>
<a id="pl.286.32"></a><var>286.32</var>options for performance measures developed by the commissioner, each intermediate care <br/>
<a id="pl.286.33"></a><var>286.33</var>facility must identify a minimum of one performance measure on which to focus its efforts <br/>
<a id="pl.286.34"></a><var>286.34</var>for quality improvement during the contract period;<br/>
<a id="pl.287.1"></a><var>287.1</var>(3) appropriate and necessary statistical information required by the commissioner;<br/>
<a id="pl.287.2"></a><var>287.2</var>(4) (3) annual aggregate facility financial information; and<br/>
<a id="pl.287.3"></a><var>287.3</var>(5) (4) additional requirements for intermediate care facilities not meeting the <br/>
<a id="pl.287.4"></a><var>287.4</var>standards set forth in the service contract.<br/>
<a id="pl.287.5"></a><var>287.5</var>(b) The commissioner of human services and the commissioner of health, in <br/>
<a id="pl.287.6"></a><var>287.6</var>consultation with representatives from counties, advocacy organizations, and the provider <br/>
<a id="pl.287.7"></a><var>287.7</var>community, shall review the consolidated standards under chapter 245B and the supervised <br/>
<a id="pl.287.8"></a><var>287.8</var>living facility rule under Minnesota Rules, chapter 4665, to determine what provisions <br/>
<a id="pl.287.9"></a><var>287.9</var>in Minnesota Rules, chapter 4665, may be waived by the commissioner of health for <br/>
<a id="pl.287.10"></a><var>287.10</var>intermediate care facilities in order to enable facilities to implement the performance <br/>
<a id="pl.287.11"></a><var>287.11</var>measures in their contract and provide quality services to residents without a duplication <br/>
<a id="pl.287.12"></a><var>287.12</var>of or increase in regulatory requirements.<br/>
<br/>
<a id="bill.8.71.0"></a><a id="pl.287.13"></a><var>287.13</var>    Sec. 71. Minnesota Statutes 2008, section 256B.5012, is amended by adding a <br/>
<a id="pl.287.14"></a><var>287.14</var>subdivision to read:<br/>
<a id="pl.287.15"></a><var>287.15</var>    Subd. 8. <b>ICF/MR rate decreases effective July 1, 2009.</b> Effective July 1, 2009, <br/>
<a id="pl.287.16"></a><var>287.16</var>the commissioner shall decrease each facility reimbursed under this section operating <br/>
<a id="pl.287.17"></a><var>287.17</var>payment adjustments equal to 2.58 percent of the operating payment rates in effect on <br/>
<a id="pl.287.18"></a><var>287.18</var>June 30, 2009. For each facility, the commissioner shall implement the rate reduction, <br/>
<a id="pl.287.19"></a><var>287.19</var>based on occupied beds, using the percentage specified in this subdivision multiplied by <br/>
<a id="pl.287.20"></a><var>287.20</var>the total payment rate, including the variable rate but excluding the property-related <br/>
<a id="pl.287.21"></a><var>287.21</var>payment rate, in effect on the preceding date. The total rate reduction shall include the <br/>
<a id="pl.287.22"></a><var>287.22</var>adjustment provided in section 256B.502, subdivision 7.<br/>
<br/>
<a id="bill.8.72.0"></a><a id="pl.287.23"></a><var>287.23</var>    Sec. 72. Minnesota Statutes 2008, section 256B.69, subdivision 5a, is amended to read:<br/>
<a id="pl.287.24"></a><var>287.24</var>    Subd. 5a. <b>Managed care contracts.</b> (a) Managed care contracts under this section <br/>
<a id="pl.287.25"></a><var>287.25</var>and sections 
         <statute_ref>256L.12</statute_ref> and 
         <statute_ref>256D.03</statute_ref>, shall be entered into or renewed on a calendar year <br/>
<a id="pl.287.26"></a><var>287.26</var>basis beginning January 1, 1996. Managed care contracts which were in effect on June <br/>
<a id="pl.287.27"></a><var>287.27</var>30, 1995, and set to renew on July 1, 1995, shall be renewed for the period July 1, 1995 <br/>
<a id="pl.287.28"></a><var>287.28</var>through December 31, 1995 at the same terms that were in effect on June 30, 1995. The <br/>
<a id="pl.287.29"></a><var>287.29</var>commissioner may issue separate contracts with requirements specific to services to <br/>
<a id="pl.287.30"></a><var>287.30</var>medical assistance recipients age 65 and older.<br/>
<a id="pl.287.31"></a><var>287.31</var>    (b) A prepaid health plan providing covered health services for eligible persons <br/>
<a id="pl.287.32"></a><var>287.32</var>pursuant to chapters 256B, 256D, and 256L, is responsible for complying with the terms <br/>
<a id="pl.287.33"></a><var>287.33</var>of its contract with the commissioner. Requirements applicable to managed care programs <br/>
<a id="pl.288.1"></a><var>288.1</var>under chapters 256B, 256D, and 256L, established after the effective date of a contract <br/>
<a id="pl.288.2"></a><var>288.2</var>with the commissioner take effect when the contract is next issued or renewed.<br/>
<a id="pl.288.3"></a><var>288.3</var>    (c) Effective for services rendered on or after January 1, 2003, the commissioner <br/>
<a id="pl.288.4"></a><var>288.4</var>shall withhold five percent of managed care plan payments under this section for the <br/>
<a id="pl.288.5"></a><var>288.5</var>prepaid medical assistance and general assistance medical care programs pending <br/>
<a id="pl.288.6"></a><var>288.6</var>completion of performance targets. Each performance target must be quantifiable, <br/>
<a id="pl.288.7"></a><var>288.7</var>objective, measurable, and reasonably attainable, except in the case of a performance <br/>
<a id="pl.288.8"></a><var>288.8</var>target based on a federal or state law or rule. Criteria for assessment of each performance <br/>
<a id="pl.288.9"></a><var>288.9</var>target must be outlined in writing prior to the contract effective date. The managed <br/>
<a id="pl.288.10"></a><var>288.10</var>care plan must demonstrate, to the commissioner's satisfaction, that the data submitted <br/>
<a id="pl.288.11"></a><var>288.11</var>regarding attainment of the performance target is accurate. The commissioner shall <br/>
<a id="pl.288.12"></a><var>288.12</var>periodically change the administrative measures used as performance targets in order <br/>
<a id="pl.288.13"></a><var>288.13</var>to improve plan performance across a broader range of administrative services. The <br/>
<a id="pl.288.14"></a><var>288.14</var>performance targets must include measurement of plan efforts to contain spending <br/>
<a id="pl.288.15"></a><var>288.15</var>on health care services and administrative activities. The commissioner may adopt <br/>
<a id="pl.288.16"></a><var>288.16</var>plan-specific performance targets that take into account factors affecting only one plan, <br/>
<a id="pl.288.17"></a><var>288.17</var>including characteristics of the plan's enrollee population. The withheld funds must be <br/>
<a id="pl.288.18"></a><var>288.18</var>returned no sooner than July of the following year if performance targets in the contract <br/>
<a id="pl.288.19"></a><var>288.19</var>are achieved. The commissioner may exclude special demonstration projects under <br/>
<a id="pl.288.20"></a><var>288.20</var>subdivision 23. A managed care plan or a county-based purchasing plan under section <br/>
<statute_ref><a id="pl.288.21"></a><var>288.21</var>256B.692
         </statute_ref> may include as admitted assets under section 
         <statute_ref>62D.044</statute_ref> any amount withheld <br/>
<a id="pl.288.22"></a><var>288.22</var>under this paragraph that is reasonably expected to be returned.<br/>
<a id="pl.288.23"></a><var>288.23</var>    (d)(1) Effective for services rendered on or after January 1, 2009, the commissioner <br/>
<a id="pl.288.24"></a><var>288.24</var>shall withhold three percent of managed care plan payments under this section for the <br/>
<a id="pl.288.25"></a><var>288.25</var>prepaid medical assistance and general assistance medical care programs. The withheld <br/>
<a id="pl.288.26"></a><var>288.26</var>funds must be returned no sooner than July 1 and no later than July 31 of the following <br/>
<a id="pl.288.27"></a><var>288.27</var>year. The commissioner may exclude special demonstration projects under subdivision 23.<br/>
<a id="pl.288.28"></a><var>288.28</var>    (2) A managed care plan or a county-based purchasing plan under section 
         <statute_ref>256B.692 <br/>
</statute_ref><a id="pl.288.29"></a><var>288.29</var>may include as admitted assets under section 
         <statute_ref>62D.044</statute_ref> any amount withheld under <br/>
<a id="pl.288.30"></a><var>288.30</var>this paragraph. The return of the withhold under this paragraph is not subject to the <br/>
<a id="pl.288.31"></a><var>288.31</var>requirements of paragraph (c).<br/>
<a id="pl.288.32"></a><var>288.32</var>(e) Effective for services provided on or after January 1, 2010, the commissioner <br/>
<a id="pl.288.33"></a><var>288.33</var>shall require that managed care plans use the assessment and authorization processes, <br/>
<a id="pl.288.34"></a><var>288.34</var>forms, timelines, standards, documentation, and data reporting requirements, protocols, <br/>
<a id="pl.288.35"></a><var>288.35</var>billing processes, and policies consistent with medical assistance fee-for-service or the <br/>
<a id="pl.288.36"></a><var>288.36</var>Department of Human Services contract requirements consistent with medical assistance <br/>
<a id="pl.289.1"></a><var>289.1</var>fee-for-service or the Department of Human Services contract requirements for all <br/>
<a id="pl.289.2"></a><var>289.2</var>personal care assistance services under section 256B.0659.<br/>
<br/>
<a id="bill.8.73.0"></a><a id="pl.289.3"></a><var>289.3</var>    Sec. 73. Minnesota Statutes 2008, section 256D.44, subdivision 5, is amended to read:<br/>
<a id="pl.289.4"></a><var>289.4</var>    Subd. 5. <b>Special needs.</b> In addition to the state standards of assistance established in <br/>
<a id="pl.289.5"></a><var>289.5</var>subdivisions 1 to 4, payments are allowed for the following special needs of recipients of <br/>
<a id="pl.289.6"></a><var>289.6</var>Minnesota supplemental aid who are not residents of a nursing home, a regional treatment <br/>
<a id="pl.289.7"></a><var>289.7</var>center, or a group residential housing facility.<br/>
<a id="pl.289.8"></a><var>289.8</var>    (a) The county agency shall pay a monthly allowance for medically prescribed <br/>
<a id="pl.289.9"></a><var>289.9</var>diets if the cost of those additional dietary needs cannot be met through some other <br/>
<a id="pl.289.10"></a><var>289.10</var>maintenance benefit. The need for special diets or dietary items must be prescribed by <br/>
<a id="pl.289.11"></a><var>289.11</var>a licensed physician. Costs for special diets shall be determined as percentages of the <br/>
<a id="pl.289.12"></a><var>289.12</var>allotment for a one-person household under the thrifty food plan as defined by the United <br/>
<a id="pl.289.13"></a><var>289.13</var>States Department of Agriculture. The types of diets and the percentages of the thrifty <br/>
<a id="pl.289.14"></a><var>289.14</var>food plan that are covered are as follows:<br/>
<a id="pl.289.15"></a><var>289.15</var>    (1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;<br/>
<a id="pl.289.16"></a><var>289.16</var>    (2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent <br/>
<a id="pl.289.17"></a><var>289.17</var>of thrifty food plan;<br/>
<a id="pl.289.18"></a><var>289.18</var>    (3) controlled protein diet, less than 40 grams and requires special products, 125 <br/>
<a id="pl.289.19"></a><var>289.19</var>percent of thrifty food plan;<br/>
<a id="pl.289.20"></a><var>289.20</var>    (4) low cholesterol diet, 25 percent of thrifty food plan;<br/>
<a id="pl.289.21"></a><var>289.21</var>    (5) high residue diet, 20 percent of thrifty food plan;<br/>
<a id="pl.289.22"></a><var>289.22</var>    (6) pregnancy and lactation diet, 35 percent of thrifty food plan;<br/>
<a id="pl.289.23"></a><var>289.23</var>    (7) gluten-free diet, 25 percent of thrifty food plan;<br/>
<a id="pl.289.24"></a><var>289.24</var>    (8) lactose-free diet, 25 percent of thrifty food plan;<br/>
<a id="pl.289.25"></a><var>289.25</var>    (9) antidumping diet, 15 percent of thrifty food plan;<br/>
<a id="pl.289.26"></a><var>289.26</var>    (10) hypoglycemic diet, 15 percent of thrifty food plan; or<br/>
<a id="pl.289.27"></a><var>289.27</var>    (11) ketogenic diet, 25 percent of thrifty food plan.<br/>
<a id="pl.289.28"></a><var>289.28</var>    (b) Payment for nonrecurring special needs must be allowed for necessary home <br/>
<a id="pl.289.29"></a><var>289.29</var>repairs or necessary repairs or replacement of household furniture and appliances using <br/>
<a id="pl.289.30"></a><var>289.30</var>the payment standard of the AFDC program in effect on July 16, 1996, for these expenses, <br/>
<a id="pl.289.31"></a><var>289.31</var>as long as other funding sources are not available.<br/>
<a id="pl.289.32"></a><var>289.32</var>    (c) A fee for guardian or conservator service is allowed at a reasonable rate <br/>
<a id="pl.289.33"></a><var>289.33</var>negotiated by the county or approved by the court. This rate shall not exceed five percent <br/>
<a id="pl.289.34"></a><var>289.34</var>of the assistance unit's gross monthly income up to a maximum of $100 per month. If the <br/>
<a id="pl.289.35"></a><var>289.35</var>guardian or conservator is a member of the county agency staff, no fee is allowed.<br/>
<a id="pl.290.1"></a><var>290.1</var>    (d) The county agency shall continue to pay a monthly allowance of $68 for <br/>
<a id="pl.290.2"></a><var>290.2</var>restaurant meals for a person who was receiving a restaurant meal allowance on June 1, <br/>
<a id="pl.290.3"></a><var>290.3</var>1990, and who eats two or more meals in a restaurant daily. The allowance must continue <br/>
<a id="pl.290.4"></a><var>290.4</var>until the person has not received Minnesota supplemental aid for one full calendar month <br/>
<a id="pl.290.5"></a><var>290.5</var>or until the person's living arrangement changes and the person no longer meets the criteria <br/>
<a id="pl.290.6"></a><var>290.6</var>for the restaurant meal allowance, whichever occurs first.<br/>
<a id="pl.290.7"></a><var>290.7</var>    (e) A fee of ten percent of the recipient's gross income or $25, whichever is less, <br/>
<a id="pl.290.8"></a><var>290.8</var>is allowed for representative payee services provided by an agency that meets the <br/>
<a id="pl.290.9"></a><var>290.9</var>requirements under SSI regulations to charge a fee for representative payee services. This <br/>
<a id="pl.290.10"></a><var>290.10</var>special need is available to all recipients of Minnesota supplemental aid regardless of <br/>
<a id="pl.290.11"></a><var>290.11</var>their living arrangement.<br/>
<a id="pl.290.12"></a><var>290.12</var>    (f)(1) Notwithstanding the language in this subdivision, an amount equal to the <br/>
<a id="pl.290.13"></a><var>290.13</var>maximum allotment authorized by the federal Food Stamp Program for a single individual <br/>
<a id="pl.290.14"></a><var>290.14</var>which is in effect on the first day of July of each year will be added to the standards of <br/>
<a id="pl.290.15"></a><var>290.15</var>assistance established in subdivisions 1 to 4 for adults under the age of 65 who qualify <br/>
<a id="pl.290.16"></a><var>290.16</var>as shelter needy and are: (i) relocating from an institution, or an adult mental health <br/>
<a id="pl.290.17"></a><var>290.17</var>residential treatment program under section 
         <statute_ref>256B.0622</statute_ref>; (ii) eligible for the self-directed <br/>
<a id="pl.290.18"></a><var>290.18</var>supports option as defined under section 
         <statute_ref>256B.0657, subdivision 2</statute_ref>; or (iii) home and <br/>
<a id="pl.290.19"></a><var>290.19</var>community-based waiver recipients living in their own home or rented or leased apartment <br/>
<a id="pl.290.20"></a><var>290.20</var>which is not owned, operated, or controlled by a provider of service not related by blood <br/>
<a id="pl.290.21"></a><var>290.21</var>or marriage.<br/>
<a id="pl.290.22"></a><var>290.22</var>    (2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the <br/>
<a id="pl.290.23"></a><var>290.23</var>shelter needy benefit under this paragraph is considered a household of one. An eligible <br/>
<a id="pl.290.24"></a><var>290.24</var>individual who receives this benefit prior to age 65 may continue to receive the benefit <br/>
<a id="pl.290.25"></a><var>290.25</var>after the age of 65.<br/>
<a id="pl.290.26"></a><var>290.26</var>    (3) "Shelter needy" means that the assistance unit incurs monthly shelter costs that <br/>
<a id="pl.290.27"></a><var>290.27</var>exceed 40 percent of the assistance unit's gross income before the application of this <br/>
<a id="pl.290.28"></a><var>290.28</var>special needs standard. "Gross income" for the purposes of this section is the applicant's or <br/>
<a id="pl.290.29"></a><var>290.29</var>recipient's income as defined in section 
         <statute_ref>256D.35, subdivision 10</statute_ref>, or the standard specified <br/>
<a id="pl.290.30"></a><var>290.30</var>in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient of a federal or <br/>
<a id="pl.290.31"></a><var>290.31</var>state housing subsidy, that limits shelter costs to a percentage of gross income, shall not be <br/>
<a id="pl.290.32"></a><var>290.32</var>considered shelter needy for purposes of this paragraph.<br/>
<a id="pl.290.33"></a><var>290.33</var>(g) Notwithstanding this subdivision, recipients of home and community-based <br/>
<a id="pl.290.34"></a><var>290.34</var>services may relocate to services without 24-hour supervision and receive the equivalent <br/>
<a id="pl.290.35"></a><var>290.35</var>of the recipient's group residential housing allocation in Minnesota supplemental <br/>
<a id="pl.290.36"></a><var>290.36</var>assistance shelter needy funding if the cost of the services and housing is equal to or less <br/>
<a id="pl.291.1"></a><var>291.1</var>than provided to the recipient in home and community-based services and the relocation is <br/>
<a id="pl.291.2"></a><var>291.2</var>the recipient's choice and is approved by the recipient or guardian.<br/>
<a id="pl.291.3"></a><var>291.3</var>(h) To access housing and services as provided in paragraph (g), the recipient may <br/>
<a id="pl.291.4"></a><var>291.4</var>choose housing that may or may not be owned, operated, or controlled by the recipient's <br/>
<a id="pl.291.5"></a><var>291.5</var>service provider.<br/>
<a id="pl.291.6"></a><var>291.6</var>(i) The provisions in paragraphs (g) and (h) are effective to June 30, 2011. The <br/>
<a id="pl.291.7"></a><var>291.7</var>commissioner shall assess the development of publicly owned housing, other housing <br/>
<a id="pl.291.8"></a><var>291.8</var>alternatives, and whether a public equity housing fund may be established that would <br/>
<a id="pl.291.9"></a><var>291.9</var>maintain the state's interest, to the extent paid from group residential housing and <br/>
<a id="pl.291.10"></a><var>291.10</var>Minnesota supplemental aid shelter needy funds in provider-owned housing so that when <br/>
<a id="pl.291.11"></a><var>291.11</var>sold, the state would recover its share for a public equity fund to be used for future public <br/>
<a id="pl.291.12"></a><var>291.12</var>needs under this chapter. The commissioner shall report findings and recommendations to <br/>
<a id="pl.291.13"></a><var>291.13</var>the legislative committees and budget divisions with jurisdiction over health and human <br/>
<a id="pl.291.14"></a><var>291.14</var>services policy and financing by January 15, 2012. <br/>
<a id="pl.291.15"></a><var>291.15</var>(j) In selecting prospective services needed by recipients for whom home and <br/>
<a id="pl.291.16"></a><var>291.16</var>community-based services have been authorized, the recipient and the recipient's guardian <br/>
<a id="pl.291.17"></a><var>291.17</var>shall first consider alternatives to home and community-based services. Minnesota <br/>
<a id="pl.291.18"></a><var>291.18</var>supplemental aid shelter needy funding for recipients who utilize Minnesota supplemental <br/>
<a id="pl.291.19"></a><var>291.19</var>aid shelter needy funding as provided in this section shall remain permanent unless the <br/>
<a id="pl.291.20"></a><var>291.20</var>recipient with the recipient's guardian later chooses to access home and community-based <br/>
<a id="pl.291.21"></a><var>291.21</var>services.<br/>
<br/>
<a id="bill.8.74.0"></a><a id="pl.291.22"></a><var>291.22</var>    Sec. 74. Minnesota Statutes 2008, section 626.556, subdivision 3c, is amended to read:<br/>
<a id="pl.291.23"></a><var>291.23</var>    Subd. 3c. <b>Local welfare agency, Department of Human Services or Department </b><br/>
<a id="pl.291.24"></a><var>291.24</var><b>of Health responsible for assessing or investigating reports of maltreatment.</b> (a) <br/>
<a id="pl.291.25"></a><var>291.25</var>The county local welfare agency is the agency responsible for assessing or investigating <br/>
<a id="pl.291.26"></a><var>291.26</var>allegations of maltreatment in child foster care, family child care, and legally unlicensed <br/>
<a id="pl.291.27"></a><var>291.27</var>child care and in, juvenile correctional facilities licensed under section 241.021 located <br/>
<a id="pl.291.28"></a><var>291.28</var>in the local welfare agency's county, and unlicensed personal care assistance provider <br/>
<a id="pl.291.29"></a><var>291.29</var>organizations providing services and receiving reimbursements under chapter 256B. <br/>
<a id="pl.291.30"></a><var>291.30</var>(b) The Department of Human Services is the agency responsible for assessing or <br/>
<a id="pl.291.31"></a><var>291.31</var>investigating allegations of maltreatment in facilities licensed under chapters 245A and <br/>
<a id="pl.291.32"></a><var>291.32</var>245B, except for child foster care and family child care.<br/>
<a id="pl.291.33"></a><var>291.33</var>(c) The Department of Health is the agency responsible for assessing or investigating <br/>
<a id="pl.291.34"></a><var>291.34</var>allegations of child maltreatment in facilities licensed under sections  144.50 to  144.58, <br/>
<a id="pl.291.35"></a><var>291.35</var>and in unlicensed home health care  and 144A.46. <br/>
<a id="pl.292.1"></a><var>292.1</var>(d) The commissioners of human services, public safety, and education must <br/>
<a id="pl.292.2"></a><var>292.2</var>jointly submit a written report by January 15, 2007, to the education policy and finance <br/>
<a id="pl.292.3"></a><var>292.3</var>committees of the legislature recommending the most efficient and effective allocation <br/>
<a id="pl.292.4"></a><var>292.4</var>of agency responsibility for assessing or investigating reports of maltreatment and must <br/>
<a id="pl.292.5"></a><var>292.5</var>specifically address allegations of maltreatment that currently are not the responsibility <br/>
<a id="pl.292.6"></a><var>292.6</var>of a designated agency. <br/>
<br/>
<a id="bill.8.75.0"></a><a id="pl.292.7"></a><var>292.7</var>    Sec. 75. Minnesota Statutes 2008, section 626.5572, subdivision 13, is amended to <br/>
<a id="pl.292.8"></a><var>292.8</var>read:<br/>
<a id="pl.292.9"></a><var>292.9</var>    Subd. 13. <b>Lead agency.</b> "Lead agency" is the primary administrative agency <br/>
<a id="pl.292.10"></a><var>292.10</var>responsible for investigating reports made under section 
         <statute_ref>626.557</statute_ref>.  <br/>
<a id="pl.292.11"></a><var>292.11</var>(a) The Department of Health is the lead agency for the facilities which are licensed <br/>
<a id="pl.292.12"></a><var>292.12</var>or are required to be licensed as hospitals, home care providers, nursing homes, residential <br/>
<a id="pl.292.13"></a><var>292.13</var>care homes, or boarding care homes.<br/>
<a id="pl.292.14"></a><var>292.14</var>(b) The Department of Human Services is the lead agency for the programs licensed <br/>
<a id="pl.292.15"></a><var>292.15</var>or required to be licensed as adult day care, adult foster care, programs for people with <br/>
<a id="pl.292.16"></a><var>292.16</var>developmental disabilities, mental health programs, or chemical health programs, or <br/>
<a id="pl.292.17"></a><var>292.17</var>personal care provider organizations.<br/>
<a id="pl.292.18"></a><var>292.18</var>(c) The county social service agency or its designee is the lead agency for all <br/>
<a id="pl.292.19"></a><var>292.19</var>other reports, including reports involving vulnerable adults receiving services from an <br/>
<a id="pl.292.20"></a><var>292.20</var>unlicensed personal care provider organization under section 256B.0659.<br/>
<br/>
<a id="bill.8.76.0"></a><a id="pl.292.21"></a><var>292.21</var>    Sec. 76. <b>DEVELOPMENT OF ALTERNATIVE SERVICES.</b><br/>
<a id="pl.292.22"></a><var>292.22</var>The commissioner of human services, in consultation with advocates, consumers, <br/>
<a id="pl.292.23"></a><var>292.23</var>and legislators, shall develop alternative services to personal care assistance services for <br/>
<a id="pl.292.24"></a><var>292.24</var>persons with mental health and other behavioral challenges who can benefit from other <br/>
<a id="pl.292.25"></a><var>292.25</var>services that more appropriately meet their needs and assist them in living independently <br/>
<a id="pl.292.26"></a><var>292.26</var>in the community. In the development of these services, the commissioner shall:<br/>
<a id="pl.292.27"></a><var>292.27</var>(1) take into consideration ways in which these alternative services will qualify for <br/>
<a id="pl.292.28"></a><var>292.28</var>federal financial participation; and <br/>
<a id="pl.292.29"></a><var>292.29</var>(2) analyze a variety of alternatives, including but not limited to a 1915(i) state <br/>
<a id="pl.292.30"></a><var>292.30</var>plan option.<br/>
<a id="pl.292.31"></a><var>292.31</var>The commissioner shall report to the legislature by January 15, 2011, with plans for <br/>
<a id="pl.292.32"></a><var>292.32</var>implementation of these services by July 1, 2011.<br/>
<br/>
<a id="bill.8.77.0"></a><a id="pl.292.33"></a><var>292.33</var>    Sec. 77. <b>30-DAY NOTICE REQUIRED.</b><br/>
<a id="pl.293.1"></a><var>293.1</var>Notwithstanding any contrary provision in law, persons impacted by amendments <br/>
<a id="pl.293.2"></a><var>293.2</var>in this article to Minnesota Statutes, sections 256B.0625, subdivision 19c; 256B.0655, <br/>
<a id="pl.293.3"></a><var>293.3</var>subdivision 4; 256B.0659; and 256B.0911, subdivision 1, must be given a 30-day notice <br/>
<a id="pl.293.4"></a><var>293.4</var>of action by the commissioner. This section expires July 1, 2011.<br/>
<br/>
<a id="bill.8.78.0"></a><a id="pl.293.5"></a><var>293.5</var>    Sec. 78. <b>COLA COMPENSATION REQUIREMENTS.</b><br/>
<a id="pl.293.6"></a><var>293.6</var>Effective July 1, 2009, providers who received rate increases under Laws 2007, <br/>
<a id="pl.293.7"></a><var>293.7</var>chapter 147, article 7, section 71, as amended by Laws 2008, chapter 363, article 15, <br/>
<a id="pl.293.8"></a><var>293.8</var>section 17, and Minnesota Statutes, section 256B.5012, subdivision 7, for state fiscal years <br/>
<a id="pl.293.9"></a><var>293.9</var>2008 and 2009 are no longer required to continue or retain employee compensation or <br/>
<a id="pl.293.10"></a><var>293.10</var>wage-related increases required by those sections. This paragraph shall not apply to <br/>
<a id="pl.293.11"></a><var>293.11</var>employees covered by a collective bargaining agreement.<br/>
<br/>
<a id="bill.8.79.0"></a><a id="pl.293.12"></a><var>293.12</var>    Sec. 79. <b>PROVIDER RATE AND GRANT REDUCTIONS.</b><br/>
<a id="pl.293.13"></a><var>293.13</var>(a) The commissioner of human services shall decrease grants, allocations, <br/>
<a id="pl.293.14"></a><var>293.14</var>reimbursement rates, or rate limits, as applicable, by 2.58 percent effective July 1, 2009, <br/>
<a id="pl.293.15"></a><var>293.15</var>for services rendered on or after that date. County or tribal contracts for services specified <br/>
<a id="pl.293.16"></a><var>293.16</var>in this section must be amended to pass through these rate reductions within 60 days of <br/>
<a id="pl.293.17"></a><var>293.17</var>the effective date of the decrease and must be retroactive from the effective date of the <br/>
<a id="pl.293.18"></a><var>293.18</var>rate decrease.<br/>
<a id="pl.293.19"></a><var>293.19</var>(b) The annual rate decreases described in this section must be provided to:<br/>
<a id="pl.293.20"></a><var>293.20</var>(1) home and community-based waivered services for persons with developmental <br/>
<a id="pl.293.21"></a><var>293.21</var>disabilities or related conditions, including consumer-directed community supports, under <br/>
<a id="pl.293.22"></a><var>293.22</var>Minnesota Statutes, section 256B.501;<br/>
<a id="pl.293.23"></a><var>293.23</var>(2) home and community-based waivered services for the elderly, including <br/>
<a id="pl.293.24"></a><var>293.24</var>consumer-directed community supports, under Minnesota Statutes, section 256B.0915;<br/>
<a id="pl.293.25"></a><var>293.25</var>(3) waivered services under community alternatives for disabled individuals, <br/>
<a id="pl.293.26"></a><var>293.26</var>including consumer-directed community supports, under Minnesota Statutes, section <br/>
<a id="pl.293.27"></a><var>293.27</var>256B.49;<br/>
<a id="pl.293.28"></a><var>293.28</var>(4) community alternative care waivered services, including consumer-directed <br/>
<a id="pl.293.29"></a><var>293.29</var>community supports, under Minnesota Statutes, section 256B.49;<br/>
<a id="pl.293.30"></a><var>293.30</var>(5) traumatic brain injury waivered services, including consumer-directed <br/>
<a id="pl.293.31"></a><var>293.31</var>community supports, under Minnesota Statutes, section 256B.49;<br/>
<a id="pl.293.32"></a><var>293.32</var>(6) nursing services and home health services under Minnesota Statutes, section <br/>
<a id="pl.293.33"></a><var>293.33</var>256B.0625, subdivision 6a;<br/>
<a id="pl.293.34"></a><var>293.34</var>(7) personal care services and qualified professional supervision of personal care <br/>
<a id="pl.293.35"></a><var>293.35</var>services under Minnesota Statutes, section 256B.0625, subdivisions 6a and 19a;<br/>
<a id="pl.294.1"></a><var>294.1</var>(8) private duty nursing services under Minnesota Statutes, section 256B.0625, <br/>
<a id="pl.294.2"></a><var>294.2</var>subdivision 7;<br/>
<a id="pl.294.3"></a><var>294.3</var>(9) day training and habilitation services for adults with developmental disabilities <br/>
<a id="pl.294.4"></a><var>294.4</var>or related conditions under Minnesota Statutes, sections 252.40 to 252.46, including the <br/>
<a id="pl.294.5"></a><var>294.5</var>additional cost of rate adjustments on day training and habilitation services, provided as a <br/>
<a id="pl.294.6"></a><var>294.6</var>social service under Minnesota Statutes, section 256M.60;<br/>
<a id="pl.294.7"></a><var>294.7</var>(10) alternative care services under Minnesota Statutes, section 256B.0913;<br/>
<a id="pl.294.8"></a><var>294.8</var>(11) the group residential housing supplementary service rate under Minnesota <br/>
<a id="pl.294.9"></a><var>294.9</var>Statutes, section 256I.05, subdivision 1a;<br/>
<a id="pl.294.10"></a><var>294.10</var>(12) semi-independent living services (SILS) under Minnesota Statutes, section <br/>
<a id="pl.294.11"></a><var>294.11</var>252.275, including SILS funding under county social services grants formerly funded <br/>
<a id="pl.294.12"></a><var>294.12</var>under Minnesota Statutes, chapter 256I;<br/>
<a id="pl.294.13"></a><var>294.13</var>(13) community support services for deaf and hard-of-hearing adults with mental <br/>
<a id="pl.294.14"></a><var>294.14</var>illness who use or wish to use sign language as their primary means of communication <br/>
<a id="pl.294.15"></a><var>294.15</var>under Minnesota Statutes, section 256.01, subdivision 2; and deaf and hard-of-hearing <br/>
<a id="pl.294.16"></a><var>294.16</var>grants under Minnesota Statutes, sections 256C.233 and 256C.25; Laws 1985, chapter 9; <br/>
<a id="pl.294.17"></a><var>294.17</var>and Laws 1997, First Special Session chapter 5, section 20;<br/>
<a id="pl.294.18"></a><var>294.18</var>(14) physical therapy services under Minnesota Statutes, sections 256B.0625, <br/>
<a id="pl.294.19"></a><var>294.19</var>subdivision 8, and 256D.03, subdivision 4;<br/>
<a id="pl.294.20"></a><var>294.20</var>(15) occupational therapy services under Minnesota Statutes, sections 256B.0625, <br/>
<a id="pl.294.21"></a><var>294.21</var>subdivision 8a, and 256D.03, subdivision 4;<br/>
<a id="pl.294.22"></a><var>294.22</var>(16) speech-language therapy services under Minnesota Statutes, section 256D.03, <br/>
<a id="pl.294.23"></a><var>294.23</var>subdivision 4, and Minnesota Rules, part 9505.0390;<br/>
<a id="pl.294.24"></a><var>294.24</var>(17) respiratory therapy services under Minnesota Statutes, section 256D.03, <br/>
<a id="pl.294.25"></a><var>294.25</var>subdivision 4, and Minnesota Rules, part 9505.0295;<br/>
<a id="pl.294.26"></a><var>294.26</var>(18) consumer support grants under Minnesota Statutes, section 256.476;<br/>
<a id="pl.294.27"></a><var>294.27</var>(19) family support grants under Minnesota Statutes, section 252.32;<br/>
<a id="pl.294.28"></a><var>294.28</var>(20) aging grants under Minnesota Statutes, sections 256.975 to 256.977, 256B.0917, <br/>
<a id="pl.294.29"></a><var>294.29</var>and 256B.0928;<br/>
<a id="pl.294.30"></a><var>294.30</var>(21) disability linkage line grants under Minnesota Statutes, section 256.01, <br/>
<a id="pl.294.31"></a><var>294.31</var>subdivision 24; and<br/>
<a id="pl.294.32"></a><var>294.32</var>(22) housing access grants under Minnesota Statutes, section 256B.0658.<br/>
<a id="pl.294.33"></a><var>294.33</var>(c) A managed care plan receiving state payments for the services in this section <br/>
<a id="pl.294.34"></a><var>294.34</var>must include these decreases in their payments to providers effective on October 1 <br/>
<a id="pl.294.35"></a><var>294.35</var>following the effective date of the rate decrease.<br/>
<br/>
<a id="bill.8.80.0"></a><a id="pl.295.1"></a><var>295.1</var>    Sec. 80. <b>RECOMMENDATIONS FOR PERSONAL CARE ASSISTANCE </b><br/>
<a id="pl.295.2"></a><var>295.2</var><b>SERVICES CHANGES, CONSULTATION WITH STAKEHOLDERS, AND DATA </b><br/>
<a id="pl.295.3"></a><var>295.3</var><b>REPORTING.</b><br/>
<a id="pl.295.4"></a><var>295.4</var>The commissioner shall:<br/>
<a id="pl.295.5"></a><var>295.5</var>(1) consult with existing stakeholder groups convened under the commissioner's <br/>
<a id="pl.295.6"></a><var>295.6</var>authority, including the home and community-based expert services panel beginning in <br/>
<a id="pl.295.7"></a><var>295.7</var>August 2009 on implementation of the changes in the personal care assistance program, <br/>
<a id="pl.295.8"></a><var>295.8</var>assistance for recipients whose services and housing must change, alternative services <br/>
<a id="pl.295.9"></a><var>295.9</var>for those whose personal care assistance services are terminated or reduced, costs for <br/>
<a id="pl.295.10"></a><var>295.10</var>those whose services will change, data on the effects of the changes in the personal care <br/>
<a id="pl.295.11"></a><var>295.11</var>assistance program for recipients, and ongoing data on personal care assistance services <br/>
<a id="pl.295.12"></a><var>295.12</var>for public reporting; and<br/>
<a id="pl.295.13"></a><var>295.13</var>(2) report data on the training developed and delivered for all types of participants in <br/>
<a id="pl.295.14"></a><var>295.14</var>the personal care assistance program, audit and financial integrity measures and results, <br/>
<a id="pl.295.15"></a><var>295.15</var>information developed for consumers and responsible parties, available demographic, <br/>
<a id="pl.295.16"></a><var>295.16</var>health care service use, and housing information about individuals who no longer qualify <br/>
<a id="pl.295.17"></a><var>295.17</var>for personal care assistance, and quality assurance measures and results to the legislative <br/>
<a id="pl.295.18"></a><var>295.18</var>committees with jurisdiction over health and human services policy and finance by <br/>
<a id="pl.295.19"></a><var>295.19</var>January 15, 2010, and January 15, 2011.<br/>
<br/>
<a id="bill.8.81.0"></a><a id="pl.295.20"></a><var>295.20</var>    Sec. 81. <b>ESTABLISHING A SINGLE SET OF STANDARDS.</b><br/>
<a id="pl.295.21"></a><var>295.21</var>(a) The commissioner of human services shall consult with disability service <br/>
<a id="pl.295.22"></a><var>295.22</var>providers, advocates, counties, and consumer families to develop a single set of standards <br/>
<a id="pl.295.23"></a><var>295.23</var>governing services for people with disabilities receiving services under the home and <br/>
<a id="pl.295.24"></a><var>295.24</var>community-based waiver services program to replace all or portions of existing laws and <br/>
<a id="pl.295.25"></a><var>295.25</var>rules including, but not limited to, data practices, licensure of facilities and providers, <br/>
<a id="pl.295.26"></a><var>295.26</var>background studies, reporting of maltreatment of minors, reporting of maltreatment of <br/>
<a id="pl.295.27"></a><var>295.27</var>vulnerable adults, and the psychotropic medication checklist. The standards must:<br/>
<a id="pl.295.28"></a><var>295.28</var>(1) enable optimum consumer choice;<br/>
<a id="pl.295.29"></a><var>295.29</var>(2) be consumer driven;<br/>
<a id="pl.295.30"></a><var>295.30</var>(3) link services to individual needs and life goals;<br/>
<a id="pl.295.31"></a><var>295.31</var>(4) be based on quality assurance and individual outcomes; <br/>
<a id="pl.295.32"></a><var>295.32</var>(5) utilize the people closest to the recipient, who may include family, friends, and <br/>
<a id="pl.295.33"></a><var>295.33</var>health and service providers, in conjunction with the recipient's risk management plan to <br/>
<a id="pl.295.34"></a><var>295.34</var>assist the recipient or the recipient's guardian in making decisions that meet the recipient's <br/>
<a id="pl.295.35"></a><var>295.35</var>needs in a cost-effective manner and assure the recipient's health and safety;<br/>
<a id="pl.296.1"></a><var>296.1</var>(6) utilize person-centered planning; and<br/>
<a id="pl.296.2"></a><var>296.2</var>(7) maximize federal financial participation.<br/>
<a id="pl.296.3"></a><var>296.3</var>(b) The commissioner may consult with existing stakeholder groups convened under <br/>
<a id="pl.296.4"></a><var>296.4</var>the commissioner's authority, including the home and community-based expert services <br/>
<a id="pl.296.5"></a><var>296.5</var>panel established by the commissioner in 2008, to meet all or some of the requirements <br/>
<a id="pl.296.6"></a><var>296.6</var>of this section.<br/>
<a id="pl.296.7"></a><var>296.7</var>(c) The commissioner shall provide the reports and plans required by this section to <br/>
<a id="pl.296.8"></a><var>296.8</var>the legislative committees and budget divisions with jurisdiction over health and human <br/>
<a id="pl.296.9"></a><var>296.9</var>services policy and finance by January 15, 2012.<br/>
<br/>
<a id="bill.8.82.0"></a><a id="pl.296.10"></a><var>296.10</var>    Sec. 82. <b>COMMON SERVICE MENU FOR HOME AND COMMUNITY-BASED </b><br/>
<a id="pl.296.11"></a><var>296.11</var><b>WAIVER PROGRAMS.</b><br/>
<a id="pl.296.12"></a><var>296.12</var>The commissioner of human services shall confer with representatives of recipients, <br/>
<a id="pl.296.13"></a><var>296.13</var>advocacy groups, counties, providers, and health plans to develop and update a common <br/>
<a id="pl.296.14"></a><var>296.14</var>service menu for home and community-based waiver programs. The commissioner may <br/>
<a id="pl.296.15"></a><var>296.15</var>consult with existing stakeholder groups convened under the commissioner's authority to <br/>
<a id="pl.296.16"></a><var>296.16</var>meet all or some of the requirements of this section.<br/>
<br/>
<a id="bill.8.83.0"></a><a id="pl.296.17"></a><var>296.17</var>    Sec. 83. <b>INTERMEDIATE CARE FACILITIES FOR PERSONS WITH </b><br/>
<a id="pl.296.18"></a><var>296.18</var><b>DEVELOPMENTAL DISABILITIES REPORT.</b><br/>
<a id="pl.296.19"></a><var>296.19</var>The commissioner of human services shall consult with providers and advocates of <br/>
<a id="pl.296.20"></a><var>296.20</var>intermediate care facilities for persons with developmental disabilities to monitor progress <br/>
<a id="pl.296.21"></a><var>296.21</var>made in response to the commissioner's December 15, 2008, report to the legislature <br/>
<a id="pl.296.22"></a><var>296.22</var>regarding intermediate care facilities for persons with developmental disabilities.<br/>
<br/>
<a id="bill.8.84.0"></a><a id="pl.296.23"></a><var>296.23</var>    Sec. 84. <b>HOUSING OPTIONS.</b><br/>
<a id="pl.296.24"></a><var>296.24</var>The commissioner of human services, in consultation with the commissioner of <br/>
<a id="pl.296.25"></a><var>296.25</var>administration and the Minnesota Housing Finance Agency, and representatives of <br/>
<a id="pl.296.26"></a><var>296.26</var>counties, residents' advocacy groups, consumers of housing services, and provider <br/>
<a id="pl.296.27"></a><var>296.27</var>agencies shall explore ways to maximize the availability and affordability of housing <br/>
<a id="pl.296.28"></a><var>296.28</var>choices available to persons with disabilities or who need care assistance due to other <br/>
<a id="pl.296.29"></a><var>296.29</var>health challenges. A goal shall also be to minimize state physical plant costs in order to <br/>
<a id="pl.296.30"></a><var>296.30</var>serve more persons with appropriate program and care support. Consideration shall be <br/>
<a id="pl.296.31"></a><var>296.31</var>given to:<br/>
<a id="pl.296.32"></a><var>296.32</var>(1) improved access to rent subsidies;<br/>
<a id="pl.296.33"></a><var>296.33</var>(2) use of cooperatives, land trusts, and other limited equity ownership models;<br/>
<a id="pl.297.1"></a><var>297.1</var>(3) whether a public equity housing fund should be established that would maintain <br/>
<a id="pl.297.2"></a><var>297.2</var>the state's interest, to the extent paid from state funds, including group residential housing <br/>
<a id="pl.297.3"></a><var>297.3</var>and Minnesota supplemental aid shelter-needy funds in provider-owned housing, so that <br/>
<a id="pl.297.4"></a><var>297.4</var>when sold, the state would recover its share for a public equity fund to be used for future <br/>
<a id="pl.297.5"></a><var>297.5</var>public needs under this chapter;<br/>
<a id="pl.297.6"></a><var>297.6</var>(4) the desirability of the state acquiring an ownership interest or promoting the <br/>
<a id="pl.297.7"></a><var>297.7</var>use of publicly owned housing;<br/>
<a id="pl.297.8"></a><var>297.8</var>(5) promoting more choices in the market for accessible housing that meets the <br/>
<a id="pl.297.9"></a><var>297.9</var>needs of persons with physical challenges; and<br/>
<a id="pl.297.10"></a><var>297.10</var>(6) what consumer ownership models, if any, are appropriate.<br/>
<a id="pl.297.11"></a><var>297.11</var>The commissioner shall provide a written report on the findings of the evaluation of <br/>
<a id="pl.297.12"></a><var>297.12</var>housing options to the chairs and ranking minority members of the house of representatives <br/>
<a id="pl.297.13"></a><var>297.13</var>and senate standing committees with jurisdiction over health and human services policy <br/>
<a id="pl.297.14"></a><var>297.14</var>and funding by December 15, 2010. This report shall replace the November 1, 2010, <br/>
<a id="pl.297.15"></a><var>297.15</var>annual report by the commissioner required in Minnesota Statutes, sections 256B.0916, <br/>
<a id="pl.297.16"></a><var>297.16</var>subdivision 7, and 256B.49, subdivision 21.<br/>
<br/>
<a id="bill.8.85.0"></a><a id="pl.297.17"></a><var>297.17</var>    Sec. 85. <b>REVISOR'S INSTRUCTION.</b><br/>
<a id="pl.297.18"></a><var>297.18</var>    Subdivision 1. <b>Renumbering of Minnesota Statutes, section 256B.0652, </b><br/>
<a id="pl.297.19"></a><var>297.19</var><b>authorization and review of home care services.</b> (a) The revisor of statutes shall <br/>
<a id="pl.297.20"></a><var>297.20</var>renumber each section of Minnesota Statutes listed in column A with the number in <br/>
<a id="pl.297.21"></a><var>297.21</var>column B.<br/>
<table>
<col width="50px"/>
<col width=""/>
<col width=""/>
<tr>
<td><a id="pl.297.22"></a><var>297.22</var><br/>
</td>
<td>Column A<br/>
</td>
<td>Column B<br/>
</td>
</tr>
<tr>
<td><a id="pl.297.23"></a><var>297.23</var><br/>
</td>
<td>256B.0652, subdivision 3<br/>
</td>
<td>256B.0652, subdivision 14<br/>
</td>
</tr>
<tr>
<td><a id="pl.297.24"></a><var>297.24</var><br/>
</td>
<td>256B.0651, subdivision 6, paragraph (a)<br/>
</td>
<td>256B.0652, subdivision 3<br/>
</td>
</tr>
<tr>
<td><a id="pl.297.25"></a><var>297.25</var><br/>
</td>
<td>256B.0651, subdivision 6, paragraph (b)<br/>
</td>
<td>256B.0652, subdivision 4<br/>
</td>
</tr>
<tr>
<td><a id="pl.297.26"></a><var>297.26</var><br/>
</td>
<td>256B.0651, subdivision 6, paragraph (c)<br/>
</td>
<td>256B.0652, subdivision 7<br/>
</td>
</tr>
<tr>
<td><a id="pl.297.27"></a><var>297.27</var><br/>
</td>
<td>256B.0651, subdivision 7, paragraph (a)<br/>
</td>
<td>256B.0652, subdivision 8<br/>
</td>
</tr>
<tr>
<td><a id="pl.297.28"></a><var>297.28</var><br/>
</td>
<td>256B.0651, subdivision 7, paragraph (b)<br/>
</td>
<td>256B.0652, subdivision 14<br/>
</td>
</tr>
<tr>
<td><a id="pl.297.29"></a><var>297.29</var><br/>
</td>
<td>256B.0651, subdivision 8<br/>
</td>
<td>256B.0652, subdivision 9<br/>
</td>
</tr>
<tr>
<td><a id="pl.297.30"></a><var>297.30</var><br/>
</td>
<td>256B.0651, subdivision 9<br/>
</td>
<td>256B.0652, subdivision 10<br/>
</td>
</tr>
<tr>
<td><a id="pl.297.31"></a><var>297.31</var><br/>
</td>
<td>256B.0651, subdivision 11<br/>
</td>
<td>256B.0652, subdivision 11<br/>
</td>
</tr>
<tr>
<td><a id="pl.298.1"></a><var>298.1</var><br/>
</td>
<td>256B.0654, subdivision 2<br/>
</td>
<td>256B.0652, subdivision 5<br/>
</td>
</tr>
<tr>
<td><a id="pl.298.2"></a><var>298.2</var><br/>
</td>
<td>256B.0655, subdivision 4<br/>
</td>
<td>256B.0652, subdivision 6<br/>
</td>
</tr>
</table><a id="pl.298.3"></a><var>298.3</var>(b) The revisor of statutes shall make necessary cross-reference changes in statutes <br/>
<a id="pl.298.4"></a><var>298.4</var>and rules consistent with the renumbering in paragraph (a). The Department of Human <br/>
<a id="pl.298.5"></a><var>298.5</var>Services shall assist the revisor with any cross-reference changes. The revisor may make <br/>
<a id="pl.298.6"></a><var>298.6</var>changes necessary to correct the punctuation, grammar, or structure of the remaining text <br/>
<a id="pl.298.7"></a><var>298.7</var>to conform with the intent of the renumbering in paragraph (a).<br/>
<a id="pl.298.8"></a><var>298.8</var>    Subd. 2. <b>Renumbering personal care assistance services.</b> The revisor of statutes <br/>
<a id="pl.298.9"></a><var>298.9</var>shall replace any reference to Minnesota Statutes, section 256B.0655 with section <br/>
<a id="pl.298.10"></a><var>298.10</var>256B.0659, wherever it appears in statutes or rules. The revisor shall correct any cross <br/>
<a id="pl.298.11"></a><var>298.11</var>reference changes that are necessary as a result of this section. The Department of Human <br/>
<a id="pl.298.12"></a><var>298.12</var>Services shall assist the revisor in making these changes, and if necessary, shall draft a <br/>
<a id="pl.298.13"></a><var>298.13</var>corrections bill with changes for introduction in the 2010 legislative session. The revisor <br/>
<a id="pl.298.14"></a><var>298.14</var>may make changes to punctuation, grammar, or sentence structure to preserve the integrity <br/>
<a id="pl.298.15"></a><var>298.15</var>of statutes and effectuate the intention of this section.<br/>
<br/>
<a id="bill.8.86.0"></a><a id="pl.298.16"></a><var>298.16</var>    Sec. 86. <b> REPEALER.</b><br/>
<a id="pl.298.17"></a><var>298.17</var>(a) Minnesota Statutes 2008, sections 256B.0655, subdivisions 1, 1a, 1c, 1d, 1e, <br/>
<a id="pl.298.18"></a><var>298.18</var>1h, 1i, 3, 5, 6, 7, 8, 9, 10, 11, 12, and 13; and 256B.071, subdivisions 1, 2, 3, and 4, are <br/>
<a id="pl.298.19"></a><var>298.19</var>repealed.<br/>
<a id="pl.298.20"></a><var>298.20</var>(b) Minnesota Statutes 2008, sections 256B.19, subdivision 1d; and 256B.431, <br/>
<a id="pl.298.21"></a><var>298.21</var>subdivision 23, are repealed effective May 1, 2009.<br/>
<a id="pl.298.22"></a><var>298.22</var>(c) Minnesota Statutes 2008, section 256B.0655, subdivisions 1f, 1g, and 2, are <br/>
<a id="pl.298.23"></a><var>298.23</var>repealed effective January 1, 2010.<br/>
<br/>
<a id="bill.9.0.0"></a>

<a id="pl.298.26"></a><var>298.26</var><b>DELIVERY REFORM ACT</b><br/>

<a id="bill.9.1.0"></a><a id="pl.298.27"></a><var>298.27</var>    Section 1. <b>[402A.01] CITATION.</b><br/>
<a id="pl.298.28"></a><var>298.28</var>Sections 402A.01 to 402A.50 may be cited as the "State-County Results, <br/>
<a id="pl.298.29"></a><var>298.29</var>Accountability, and Service Delivery Reform Act."<br/>
<br/>
<a id="bill.9.2.0"></a><a id="pl.298.30"></a><var>298.30</var>    Sec. 2. <b>[402A.10] DEFINITIONS.</b><br/>
<a id="pl.298.31"></a><var>298.31</var>    Subdivision 1. <b>Terms defined.</b> For the purposes of this chapter, the terms defined <br/>
<a id="pl.298.32"></a><var>298.32</var>in this section have the meanings given.<br/>
<a id="pl.299.1"></a><var>299.1</var>    Subd. 2. <b>Commissioner.</b> "Commissioner" means the commissioner of human <br/>
<a id="pl.299.2"></a><var>299.2</var>services.<br/>
<a id="pl.299.3"></a><var>299.3</var>    Subd. 3. <b>Council.</b> "Council" means the State-County Results, Accountability, and <br/>
<a id="pl.299.4"></a><var>299.4</var>Service Delivery Redesign Council established in section 402A.20.<br/>
<a id="pl.299.5"></a><var>299.5</var>    Subd. 4. <b>Essential human services or essential services.</b> "Essential human <br/>
<a id="pl.299.6"></a><var>299.6</var>services" or "essential services" means assistance and services to recipients or potential <br/>
<a id="pl.299.7"></a><var>299.7</var>recipients of public welfare and other services delivered by counties that are mandated in <br/>
<a id="pl.299.8"></a><var>299.8</var>federal and state law that are to be available in all counties of the state.<br/>
<a id="pl.299.9"></a><var>299.9</var>    Subd. 5. <b>Service delivery authority.</b> "Service delivery authority" means a single <br/>
<a id="pl.299.10"></a><var>299.10</var>county, or group of counties operating by execution of a joint powers agreement under <br/>
<a id="pl.299.11"></a><var>299.11</var>section 471.59 or other contractual agreement, that has voluntarily chosen by resolution of <br/>
<a id="pl.299.12"></a><var>299.12</var>the county board of commissioners to participate in the redesign under this chapter.<br/>
<a id="pl.299.13"></a><var>299.13</var>    Subd. 6. <b>Steering committee.</b> "Steering committee" means the Steering Committee <br/>
<a id="pl.299.14"></a><var>299.14</var>on Performance and Outcome Reforms.<br/>
<a id="pl.299.15"></a><var>299.15</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br/>
<br/>
<a id="bill.9.3.0"></a><a id="pl.299.16"></a><var>299.16</var>    Sec. 3. <b>[402A.15] STEERING COMMITTEE ON PERFORMANCE AND </b><br/>
<a id="pl.299.17"></a><var>299.17</var><b>OUTCOME REFORMS.</b><br/>
<a id="pl.299.18"></a><var>299.18</var>    Subdivision 1. <b>Duties.</b> (a) The Steering Committee on Performance and Outcome <br/>
<a id="pl.299.19"></a><var>299.19</var>Reforms shall develop a uniform process to establish and review performance and <br/>
<a id="pl.299.20"></a><var>299.20</var>outcome standards for all essential human services based on the current level of resources <br/>
<a id="pl.299.21"></a><var>299.21</var>available, and to develop appropriate reporting measures and a uniform accountability <br/>
<a id="pl.299.22"></a><var>299.22</var>process for responding to a county's or human service authority's failure to make adequate <br/>
<a id="pl.299.23"></a><var>299.23</var>progress on achieving performance measures. The accountability process shall focus on <br/>
<a id="pl.299.24"></a><var>299.24</var>the performance measures rather than inflexible implementation requirements.<br/>
<a id="pl.299.25"></a><var>299.25</var>(b) The steering committee shall:<br/>
<a id="pl.299.26"></a><var>299.26</var>(1) by November 1, 2009, establish an agreed upon list of essential services;<br/>
<a id="pl.299.27"></a><var>299.27</var>(2) by February 15, 2010, develop and recommend to the legislature a uniform, <br/>
<a id="pl.299.28"></a><var>299.28</var>graduated process, in addition to the remedies identified in section 402A.18, for responding <br/>
<a id="pl.299.29"></a><var>299.29</var>to a county's failure to make adequate progress on achieving performance measures; and<br/>
<a id="pl.299.30"></a><var>299.30</var>(3) by December 15, 2012, for each essential service make recommendations to the <br/>
<a id="pl.299.31"></a><var>299.31</var>legislature regarding (1) performance measures and goals based on those measures for <br/>
<a id="pl.299.32"></a><var>299.32</var>each essential service, (2) a system for reporting on the performance measures and goals, <br/>
<a id="pl.299.33"></a><var>299.33</var>and (3) appropriate resources, including funding, needed to achieve those performance <br/>
<a id="pl.299.34"></a><var>299.34</var>measures and goals. The resource recommendations shall take into consideration program <br/>
<a id="pl.300.1"></a><var>300.1</var>demand and the unique differences of local areas in geography and the populations <br/>
<a id="pl.300.2"></a><var>300.2</var>served. Priority shall be given to services with the greatest variation in availability and <br/>
<a id="pl.300.3"></a><var>300.3</var>greatest administrative demands. By January 15 of each year starting January 15, 2011, <br/>
<a id="pl.300.4"></a><var>300.4</var>the steering committee shall report its recommendations to the governor and legislative <br/>
<a id="pl.300.5"></a><var>300.5</var>committees with jurisdiction over health and human services. As part of its report, the <br/>
<a id="pl.300.6"></a><var>300.6</var>steering committee shall, as appropriate, recommend statutory provisions, rules and <br/>
<a id="pl.300.7"></a><var>300.7</var>requirements, and reports that should be repealed or eliminated.<br/>
<a id="pl.300.8"></a><var>300.8</var>(c) As far as possible, the performance measures, reporting system, and funding <br/>
<a id="pl.300.9"></a><var>300.9</var>shall be consistent across program areas. The development of performance measures shall <br/>
<a id="pl.300.10"></a><var>300.10</var>consider the manner in which data will be collected and performance will be reported. <br/>
<a id="pl.300.11"></a><var>300.11</var>The steering committee shall consider state and local administrative costs related to <br/>
<a id="pl.300.12"></a><var>300.12</var>collecting data and reporting outcomes when developing performance measures. The <br/>
<a id="pl.300.13"></a><var>300.13</var>steering committee shall correlate the performance measures and goals to available <br/>
<a id="pl.300.14"></a><var>300.14</var>levels of resources, including state and local funding. The steering committee shall <br/>
<a id="pl.300.15"></a><var>300.15</var>take into consideration that the goal of implementing changes to program monitoring <br/>
<a id="pl.300.16"></a><var>300.16</var>and reporting the progress toward achieving outcomes is to significantly minimize the <br/>
<a id="pl.300.17"></a><var>300.17</var>cost of administrative requirements and to allow funds freed by reduced administrative <br/>
<a id="pl.300.18"></a><var>300.18</var>expenditures to be used to provide additional services, allow flexibility in service design <br/>
<a id="pl.300.19"></a><var>300.19</var>and management, and focus energies on achieving program and client outcomes.<br/>
<a id="pl.300.20"></a><var>300.20</var>(d) In making its recommendations, the steering committee shall consider input from <br/>
<a id="pl.300.21"></a><var>300.21</var>the council established in section 402A.20. The steering committee shall review the <br/>
<a id="pl.300.22"></a><var>300.22</var>measurable goals established in a memorandum of understanding entered into under <br/>
<a id="pl.300.23"></a><var>300.23</var>section 402A.30, subdivision 2, paragraph (b), and consider whether they may be applied <br/>
<a id="pl.300.24"></a><var>300.24</var>as statewide performance outcomes.<br/>
<a id="pl.300.25"></a><var>300.25</var>(e) The steering committee shall form work groups that include persons who provide <br/>
<a id="pl.300.26"></a><var>300.26</var>or receive essential services and representatives of organizations who advocate on behalf <br/>
<a id="pl.300.27"></a><var>300.27</var>of those persons.<br/>
<a id="pl.300.28"></a><var>300.28</var>(f) By December 15, 2009, the steering committee shall establish a three-year <br/>
<a id="pl.300.29"></a><var>300.29</var>schedule for completion of its work. The schedule shall be published on the Department of <br/>
<a id="pl.300.30"></a><var>300.30</var>Human Services Web site and reported to the legislative committees with jurisdiction over <br/>
<a id="pl.300.31"></a><var>300.31</var>health and human services. In addition, the commissioner shall post quarterly updates on <br/>
<a id="pl.300.32"></a><var>300.32</var>the progress of the steering committee on the Department of Human Services Web site.<br/>
<a id="pl.300.33"></a><var>300.33</var>    Subd. 2. <b>Composition.</b> (a) The steering committee shall include:<br/>
<a id="pl.300.34"></a><var>300.34</var>(1) the commissioner of human services, or designee, and two additional <br/>
<a id="pl.300.35"></a><var>300.35</var>representatives of the department;<br/>
<a id="pl.301.1"></a><var>301.1</var>(2) two county commissioners, representative of rural and urban counties, selected <br/>
<a id="pl.301.2"></a><var>301.2</var>by the Association of Minnesota Counties;<br/>
<a id="pl.301.3"></a><var>301.3</var>(3) two county directors of human services, representative of rural and urban <br/>
<a id="pl.301.4"></a><var>301.4</var>counties, selected by the Minnesota Association of County Social Service Administrators; <br/>
<a id="pl.301.5"></a><var>301.5</var>and<br/>
<a id="pl.301.6"></a><var>301.6</var>(4) three clients or client advocates representing different populations receiving <br/>
<a id="pl.301.7"></a><var>301.7</var>services from the Department of Human Services, who are appointed by the commissioner.<br/>
<a id="pl.301.8"></a><var>301.8</var>(b) The commissioner, or designee, and a county commissioner shall serve as <br/>
<a id="pl.301.9"></a><var>301.9</var>cochairs of the committee. The committee shall be convened within 60 days of final <br/>
<a id="pl.301.10"></a><var>301.10</var>enactment of this legislation.<br/>
<a id="pl.301.11"></a><var>301.11</var>(c) State agency staff shall serve as informational resources and staff to the steering <br/>
<a id="pl.301.12"></a><var>301.12</var>committee. Statewide county associations may assemble county program data as required.<br/>
<a id="pl.301.13"></a><var>301.13</var>(d) To promote information sharing and coordination between the steering committee <br/>
<a id="pl.301.14"></a><var>301.14</var>and council, one of the county representatives from paragraph (a), clause (2), and one of the <br/>
<a id="pl.301.15"></a><var>301.15</var>county representatives from paragraph (a), clause (3), must also serve as a representative <br/>
<a id="pl.301.16"></a><var>301.16</var>on the council under section 402A.20, subdivision 1, paragraph (b), clause (5) or (6).<br/>
<a id="pl.301.17"></a><var>301.17</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br/>
<br/>
<a id="bill.9.4.0"></a><a id="pl.301.18"></a><var>301.18</var>    Sec. 4. <b>[402A.18] COMMISSIONER POWER TO REMEDY FAILURE TO </b><br/>
<a id="pl.301.19"></a><var>301.19</var><b>MEET PERFORMANCE OUTCOMES.</b><br/>
<a id="pl.301.20"></a><var>301.20</var>    Subdivision 1. <b>Underperforming county; specific service.</b> If the commissioner <br/>
<a id="pl.301.21"></a><var>301.21</var>determines that a county or service delivery authority is deficient in achieving minimum <br/>
<a id="pl.301.22"></a><var>301.22</var>performance outcomes for a specific essential service, the commissioner may impose <br/>
<a id="pl.301.23"></a><var>301.23</var>the following remedies:<br/>
<a id="pl.301.24"></a><var>301.24</var>(1) voluntary incorporation of the administration and operation of the specific <br/>
<a id="pl.301.25"></a><var>301.25</var>essential service with an existing service delivery authority or another county. A <br/>
<a id="pl.301.26"></a><var>301.26</var>service delivery authority or county incorporating an underperforming county shall <br/>
<a id="pl.301.27"></a><var>301.27</var>not be financially liable for the costs associated with remedying performance outcome <br/>
<a id="pl.301.28"></a><var>301.28</var>deficiencies;<br/>
<a id="pl.301.29"></a><var>301.29</var>(2) mandatory incorporation of the administration and operation of the specific <br/>
<a id="pl.301.30"></a><var>301.30</var>essential service with an existing service delivery authority or another county. A <br/>
<a id="pl.301.31"></a><var>301.31</var>service delivery authority or county incorporating an underperforming county shall <br/>
<a id="pl.301.32"></a><var>301.32</var>not be financially liable for the costs associated with remedying performance outcome <br/>
<a id="pl.301.33"></a><var>301.33</var>deficiencies; or <br/>
<a id="pl.301.34"></a><var>301.34</var>(3) transfer of authority for program administration and operation of the specific <br/>
<a id="pl.301.35"></a><var>301.35</var>essential service to the commissioner.<br/>
<a id="pl.302.1"></a><var>302.1</var>    Subd. 2. <b>Underperforming county; more than one-half of service.</b> If the <br/>
<a id="pl.302.2"></a><var>302.2</var>commissioner determines that a county or service delivery authority is deficient in <br/>
<a id="pl.302.3"></a><var>302.3</var>achieving minimum performance outcomes for more than one-half of the defined essential <br/>
<a id="pl.302.4"></a><var>302.4</var>service, the commissioner may impose the following remedies:<br/>
<a id="pl.302.5"></a><var>302.5</var>(1) voluntary incorporation of the administration and operation of the specific <br/>
<a id="pl.302.6"></a><var>302.6</var>essential service with an existing service delivery authority or another county. A <br/>
<a id="pl.302.7"></a><var>302.7</var>service delivery authority or county incorporating an underperforming county shall <br/>
<a id="pl.302.8"></a><var>302.8</var>not be financially liable for the costs associated with remedying performance outcome <br/>
<a id="pl.302.9"></a><var>302.9</var>deficiencies;<br/>
<a id="pl.302.10"></a><var>302.10</var>(2) mandatory incorporation of the administration and operation of the specific <br/>
<a id="pl.302.11"></a><var>302.11</var>essential service with an existing service delivery authority or another county. A <br/>
<a id="pl.302.12"></a><var>302.12</var>service delivery authority or county incorporating an underperforming county shall <br/>
<a id="pl.302.13"></a><var>302.13</var>not be financially liable for the costs associated with remedying performance outcome <br/>
<a id="pl.302.14"></a><var>302.14</var>deficiencies; or <br/>
<a id="pl.302.15"></a><var>302.15</var>(3) transfer of authority for program administration and operation of the specific <br/>
<a id="pl.302.16"></a><var>302.16</var>essential service to the commissioner.<br/>
<a id="pl.302.17"></a><var>302.17</var>    Subd. 3. <b>Conditions prior to imposing remedies.</b> Before the commissioner may <br/>
<a id="pl.302.18"></a><var>302.18</var>impose the remedies authorized under this section, the following conditions must be met:<br/>
<a id="pl.302.19"></a><var>302.19</var>(1) the county or service delivery authority determined by the commissioner <br/>
<a id="pl.302.20"></a><var>302.20</var>to be deficient in achieving minimum performance outcomes has the opportunity, in <br/>
<a id="pl.302.21"></a><var>302.21</var>coordination with the council, to develop a program outcome improvement plan. The <br/>
<a id="pl.302.22"></a><var>302.22</var>program outcome improvement plan must be developed no later than six months from the <br/>
<a id="pl.302.23"></a><var>302.23</var>date of the deficiency determination; and<br/>
<a id="pl.302.24"></a><var>302.24</var>(2) the council has conducted an assessment of the program outcome improvement <br/>
<a id="pl.302.25"></a><var>302.25</var>plan to determine if the county or service delivery authority has made satisfactory progress <br/>
<a id="pl.302.26"></a><var>302.26</var>toward performance outcomes and has made a recommendation about remedies to the <br/>
<a id="pl.302.27"></a><var>302.27</var>commissioner. The review and recommendation must be made to the commissioner within <br/>
<a id="pl.302.28"></a><var>302.28</var>12 months from the date of the deficiency determination.<br/>
<br/>
<a id="bill.9.5.0"></a><a id="pl.302.29"></a><var>302.29</var>    Sec. 5. <b>[402A.20] COUNCIL.</b><br/>
<a id="pl.302.30"></a><var>302.30</var>    Subdivision 1. <b>Council.</b> (a) The State-County Results, Accountability, and Service <br/>
<a id="pl.302.31"></a><var>302.31</var>Delivery Redesign Council is established. Appointed council members must be appointed <br/>
<a id="pl.302.32"></a><var>302.32</var>by their respective agencies, associations, or governmental units by November 1, 2009. <br/>
<a id="pl.302.33"></a><var>302.33</var>The council shall be cochaired by the commissioner of human services, or designee, and a <br/>
<a id="pl.302.34"></a><var>302.34</var>county representative from paragraph (b), clause (4) or (5), appointed by the Association <br/>
<a id="pl.302.35"></a><var>302.35</var>of Minnesota Counties. Recommendations of the council must be approved by a majority <br/>
<a id="pl.303.1"></a><var>303.1</var>of the council members. The provisions of section 15.059 do not apply to this council, <br/>
<a id="pl.303.2"></a><var>303.2</var>and this council does not expire.<br/>
<a id="pl.303.3"></a><var>303.3</var>(b) The council must consist of the following members:<br/>
<a id="pl.303.4"></a><var>303.4</var>(1) two legislators appointed by the speaker of the house, one from the minority <br/>
<a id="pl.303.5"></a><var>303.5</var>and one from the majority;<br/>
<a id="pl.303.6"></a><var>303.6</var>(2) two legislators appointed by the Senate Rules Committee, one from the majority <br/>
<a id="pl.303.7"></a><var>303.7</var>and one from the minority;<br/>
<a id="pl.303.8"></a><var>303.8</var>(3) the commissioner of human services, or designee, and three employees from <br/>
<a id="pl.303.9"></a><var>303.9</var>the department;<br/>
<a id="pl.303.10"></a><var>303.10</var>(4) two county commissioners appointed by the Association of Minnesota Counties;<br/>
<a id="pl.303.11"></a><var>303.11</var>(5) two county representatives appointed by the Minnesota Association of County <br/>
<a id="pl.303.12"></a><var>303.12</var>Social Service Administrators; <br/>
<a id="pl.303.13"></a><var>303.13</var>(6) one representative appointed by AFSCME as a nonvoting member; and<br/>
<a id="pl.303.14"></a><var>303.14</var>(7) one representative appointed by the Teamsters as a nonvoting member.<br/>
<a id="pl.303.15"></a><var>303.15</var>(c) Administrative support to the council may be provided by the Association of <br/>
<a id="pl.303.16"></a><var>303.16</var>Minnesota Counties and affiliates.<br/>
<a id="pl.303.17"></a><var>303.17</var>(d) Member agencies and associations are responsible for initial and subsequent <br/>
<a id="pl.303.18"></a><var>303.18</var>appointments to the council.<br/>
<a id="pl.303.19"></a><var>303.19</var>    Subd. 2. <b>Council duties.</b> The council shall:<br/>
<a id="pl.303.20"></a><var>303.20</var>(1) provide review of the redesign process;<br/>
<a id="pl.303.21"></a><var>303.21</var>(2) certify, in accordance with section 402A.30, subdivision 4, the formation of <br/>
<a id="pl.303.22"></a><var>303.22</var>a service delivery authority, including the memorandum of understanding in section <br/>
<a id="pl.303.23"></a><var>303.23</var>402A.30, subdivision 2, paragraph (b);<br/>
<a id="pl.303.24"></a><var>303.24</var>(3) ensure the consistency of the memoranda of understanding entered into <br/>
<a id="pl.303.25"></a><var>303.25</var>under section 402A.30, subdivision 2, paragraph (b), with the performance standards <br/>
<a id="pl.303.26"></a><var>303.26</var>recommended by the steering committee and enacted by the legislature;<br/>
<a id="pl.303.27"></a><var>303.27</var>(4) ensure the consistency of the memoranda of understanding, to the extent <br/>
<a id="pl.303.28"></a><var>303.28</var>appropriate, or other memoranda of understanding entered into by other service delivery <br/>
<a id="pl.303.29"></a><var>303.29</var>authorities; <br/>
<a id="pl.303.30"></a><var>303.30</var>(5) establish a process to take public input on the service delivery framework <br/>
<a id="pl.303.31"></a><var>303.31</var>specified in the memorandum of understanding in section 402A.30, subdivision 2, <br/>
<a id="pl.303.32"></a><var>303.32</var>paragraph (b);<br/>
<a id="pl.303.33"></a><var>303.33</var>(6) form work groups as necessary to carry out the duties of the council under the <br/>
<a id="pl.303.34"></a><var>303.34</var>redesign;<br/>
<a id="pl.304.1"></a><var>304.1</var>(7) serve as a forum for resolving conflicts among participating counties or between <br/>
<a id="pl.304.2"></a><var>304.2</var>participating counties and the commissioner of human services, provided nothing in this <br/>
<a id="pl.304.3"></a><var>304.3</var>section is intended to create a formal binding legal process;<br/>
<a id="pl.304.4"></a><var>304.4</var>(8) engage in the program improvement process established in section 402A.18, <br/>
<a id="pl.304.5"></a><var>304.5</var>subdivision 3; and<br/>
<a id="pl.304.6"></a><var>304.6</var>(9) identify and recommend incentives for counties to participate in human services <br/>
<a id="pl.304.7"></a><var>304.7</var>authorities.<br/>
<a id="pl.304.8"></a><var>304.8</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br/>
<br/>
<a id="bill.9.6.0"></a><a id="pl.304.9"></a><var>304.9</var>    Sec. 6. <b>[402A.30] DESIGNATION OF SERVICE DELIVERY AUTHORITY.</b><br/>
<a id="pl.304.10"></a><var>304.10</var>    Subdivision 1. <b>Establishment.</b> After certification by the council and approval by <br/>
<a id="pl.304.11"></a><var>304.11</var>the commissioner, in accordance with subdivision 4, a county or consortium of counties <br/>
<a id="pl.304.12"></a><var>304.12</var>may establish a service delivery authority to redesign the delivery of some or all essential <br/>
<a id="pl.304.13"></a><var>304.13</var>services. Once a county or consortium of counties establishes a service delivery authority, <br/>
<a id="pl.304.14"></a><var>304.14</var>no county that is a participant in the service delivery authority may participate in or be <br/>
<a id="pl.304.15"></a><var>304.15</var>a member of any other service delivery authority. The service delivery authority may <br/>
<a id="pl.304.16"></a><var>304.16</var>allow an additional county or counties to join the service delivery authority subject to the <br/>
<a id="pl.304.17"></a><var>304.17</var>approval of the council and the commissioner.<br/>
<a id="pl.304.18"></a><var>304.18</var>    Subd. 2. <b>New state-county governance framework.</b> (a) To establish a service <br/>
<a id="pl.304.19"></a><var>304.19</var>delivery authority, each participating county and the state must enter into a binding <br/>
<a id="pl.304.20"></a><var>304.20</var>memorandum of understanding to establish a joint state-county service delivery <br/>
<a id="pl.304.21"></a><var>304.21</var>framework:<br/>
<a id="pl.304.22"></a><var>304.22</var>(b) The memorandum of understanding must:<br/>
<a id="pl.304.23"></a><var>304.23</var>(1) comply with current state and federal law except where waivers are approved <br/>
<a id="pl.304.24"></a><var>304.24</var>under clause (7);<br/>
<a id="pl.304.25"></a><var>304.25</var>(2) define the scope of essential services over which the service delivery authority <br/>
<a id="pl.304.26"></a><var>304.26</var>has jurisdiction;<br/>
<a id="pl.304.27"></a><var>304.27</var>(3) designate a single administrative structure to oversee the delivery of services over <br/>
<a id="pl.304.28"></a><var>304.28</var>which the service delivery authority has jurisdiction and identify a single administrative <br/>
<a id="pl.304.29"></a><var>304.29</var>agent for purposes of contact and communication with the department;<br/>
<a id="pl.304.30"></a><var>304.30</var>(4) define measurable performance and outcome goals in key operational areas <br/>
<a id="pl.304.31"></a><var>304.31</var>that the service delivery authority is expected to achieve, provided that the performance <br/>
<a id="pl.304.32"></a><var>304.32</var>goals must, at a minimum, satisfy performance outcomes recommended by the steering <br/>
<a id="pl.304.33"></a><var>304.33</var>committee and enacted into law;<br/>
<a id="pl.305.1"></a><var>305.1</var>(5) identify the state and local resources, including funding and administrative and <br/>
<a id="pl.305.2"></a><var>305.2</var>information technology support, and other requirements necessary for the service delivery <br/>
<a id="pl.305.3"></a><var>305.3</var>authority to achieve the performance and outcome goals;<br/>
<a id="pl.305.4"></a><var>305.4</var>(6) state the relief available to the service delivery authority if the resource <br/>
<a id="pl.305.5"></a><var>305.5</var>commitments identified in clause (5) are not met;<br/>
<a id="pl.305.6"></a><var>305.6</var>(7) identify in the agreement the waivers from statutory requirements that are needed <br/>
<a id="pl.305.7"></a><var>305.7</var>to ensure greater local control and flexibility to determine the most cost-effective means <br/>
<a id="pl.305.8"></a><var>305.8</var>of achieving specified measurable goals and the date by which the commissioner shall <br/>
<a id="pl.305.9"></a><var>305.9</var>grant the identified waivers;<br/>
<a id="pl.305.10"></a><var>305.10</var>(8) set forth a graduated accountability process and penalties for responding to a <br/>
<a id="pl.305.11"></a><var>305.11</var>county's failure to make adequate progress on achieving performance and outcome goals;<br/>
<a id="pl.305.12"></a><var>305.12</var>(9) set forth a reasonable level of targeted reductions in overhead and administrative <br/>
<a id="pl.305.13"></a><var>305.13</var>costs for each county participating in the service delivery authority; and<br/>
<a id="pl.305.14"></a><var>305.14</var>(10) set forth the terms under which a county may withdraw from participation.<br/>
<a id="pl.305.15"></a><var>305.15</var>The memorandum of understanding may be later amended to add additional services over <br/>
<a id="pl.305.16"></a><var>305.16</var>which the service delivery authority has jurisdiction.<br/>
<a id="pl.305.17"></a><var>305.17</var>(c) Nothing in this chapter precludes local governments from utilizing sections <br/>
<a id="pl.305.18"></a><var>305.18</var>465.81 and 465.82 to establish procedures for local governments to merge, with the <br/>
<a id="pl.305.19"></a><var>305.19</var>consent of the voters. Any agreement under paragraph (b) must be governed by this <br/>
<a id="pl.305.20"></a><var>305.20</var>chapter. Nothing in this chapter limits the authority of a county board to enter into <br/>
<a id="pl.305.21"></a><var>305.21</var>contractual agreements for services not covered by the provisions of a memorandum of <br/>
<a id="pl.305.22"></a><var>305.22</var>understanding establishing a service delivery authority with other agencies or with other <br/>
<a id="pl.305.23"></a><var>305.23</var>units of government.<br/>
<a id="pl.305.24"></a><var>305.24</var>    Subd. 3. <b>Duties.</b> The service delivery authority shall:<br/>
<a id="pl.305.25"></a><var>305.25</var>(1) within the scope of essential services set forth in the memorandum of <br/>
<a id="pl.305.26"></a><var>305.26</var>understanding establishing the authority, carry out the responsibilities required of local <br/>
<a id="pl.305.27"></a><var>305.27</var>agencies under chapter 393 and human services boards under chapter 402;<br/>
<a id="pl.305.28"></a><var>305.28</var>(2) manage the public resources devoted to human services and other public services <br/>
<a id="pl.305.29"></a><var>305.29</var>delivered or purchased by the counties that are subsidized or regulated by the Department <br/>
<a id="pl.305.30"></a><var>305.30</var>of Human Services under chapters 245 and 267;<br/>
<a id="pl.305.31"></a><var>305.31</var>(3) employ staff to assist in carrying out its duties;<br/>
<a id="pl.305.32"></a><var>305.32</var>(4) develop and maintain a continuity of operations plan to ensure the continued <br/>
<a id="pl.305.33"></a><var>305.33</var>operation or resumption of essential human services functions in the event of any business <br/>
<a id="pl.305.34"></a><var>305.34</var>interruption according to local, state, and federal emergency planning requirements;<br/>
<a id="pl.305.35"></a><var>305.35</var>(5) receive and expend funds received for the redesign process under the <br/>
<a id="pl.305.36"></a><var>305.36</var>memorandum of understanding;<br/>
<a id="pl.306.1"></a><var>306.1</var>(6) plan and deliver services directly or through contract with other governmental <br/>
<a id="pl.306.2"></a><var>306.2</var>or nongovernmental providers;<br/>
<a id="pl.306.3"></a><var>306.3</var>(7) rent, purchase, sell, and otherwise dispose of real and personal property as <br/>
<a id="pl.306.4"></a><var>306.4</var>necessary to carry out the redesign; and<br/>
<a id="pl.306.5"></a><var>306.5</var>(8) carry out any other service designated as a responsibility of a county.<br/>
<a id="pl.306.6"></a><var>306.6</var>    Subd. 4. <b>Process for establishing a service delivery authority.</b> (a) The county or <br/>
<a id="pl.306.7"></a><var>306.7</var>consortium of counties proposing to form a service delivery authority shall, in conjunction <br/>
<a id="pl.306.8"></a><var>306.8</var>with the commissioner, prevent a proposed memorandum of understanding to the council <br/>
<a id="pl.306.9"></a><var>306.9</var>accompanied by a resolution from the board of commissioners of each participating <br/>
<a id="pl.306.10"></a><var>306.10</var>county stating the county's intent to participate in a service delivery authority.<br/>
<a id="pl.306.11"></a><var>306.11</var>(b) The council shall certify a county or consortium of counties as a service delivery <br/>
<a id="pl.306.12"></a><var>306.12</var>authority if:<br/>
<a id="pl.306.13"></a><var>306.13</var>(1) the conditions in subdivision 2, paragraphs (a) and (b), are met; and<br/>
<a id="pl.306.14"></a><var>306.14</var>(2) the county or consortium of counties are:<br/>
<a id="pl.306.15"></a><var>306.15</var>(i) a single county with a population of 55,000 or more;<br/>
<a id="pl.306.16"></a><var>306.16</var>(ii) a consortium of counties with a total combined population of 55,000 or more and <br/>
<a id="pl.306.17"></a><var>306.17</var>the counties comprising the consortium are in reasonable geographic proximity; or<br/>
<a id="pl.306.18"></a><var>306.18</var>(iii) four or more counties in reasonable geographic proximity without regard <br/>
<a id="pl.306.19"></a><var>306.19</var>to population.<br/>
<a id="pl.306.20"></a><var>306.20</var>The council may recommend that the commissioner of human services exempt a <br/>
<a id="pl.306.21"></a><var>306.21</var>single county or multicounty service delivery authority from the minimum population <br/>
<a id="pl.306.22"></a><var>306.22</var>standard if that service delivery authority can demonstrate that it can otherwise meet <br/>
<a id="pl.306.23"></a><var>306.23</var>the requirements of this chapter.<br/>
<a id="pl.306.24"></a><var>306.24</var>(c) After the council has certified a county or consortium of counties as a service <br/>
<a id="pl.306.25"></a><var>306.25</var>delivery authority, the commissioner may enter into the memoranda of understanding with <br/>
<a id="pl.306.26"></a><var>306.26</var>the participating counties to form the service delivery authority.<br/>
<a id="pl.306.27"></a><var>306.27</var>    Subd. 5. <b>Single county service delivery authority.</b> For counties with populations <br/>
<a id="pl.306.28"></a><var>306.28</var>over 55,000, the board of county commissioners may be the service delivery authority and <br/>
<a id="pl.306.29"></a><var>306.29</var>retain existing authority under law.<br/>
<br/>
<a id="bill.9.7.0"></a><a id="pl.306.30"></a><var>306.30</var>    Sec. 7. <b>[402A.45] ESSENTIAL SERVICES OUTSIDE THE JURISDICTION OF </b><br/>
<a id="pl.306.31"></a><var>306.31</var><b>A SERVICE DELIVERY AUTHORITY.</b><br/>
<a id="pl.306.32"></a><var>306.32</var>(a) With the approval of the council, a county that is a participant in a service <br/>
<a id="pl.306.33"></a><var>306.33</var>delivery authority may enter into cooperative arrangements with other service delivery <br/>
<a id="pl.306.34"></a><var>306.34</var>authorities or other counties to provide essential services that are not within the jurisdiction <br/>
<a id="pl.306.35"></a><var>306.35</var>and duties of the service delivery authority.<br/>
<a id="pl.307.1"></a><var>307.1</var>(b) With the approval of the council, a service delivery authority may enter into a <br/>
<a id="pl.307.2"></a><var>307.2</var>cooperative arrangement with a nonparticipating county to provide an essential service <br/>
<a id="pl.307.3"></a><var>307.3</var>within the jurisdiction and duties of the service delivery authority.<br/>
<br/>
<a id="bill.9.8.0"></a><a id="pl.307.4"></a><var>307.4</var>    Sec. 8. <b>[402A.50] PRIVATE SECTOR FUNDING.</b><br/>
<a id="pl.307.5"></a><var>307.5</var>The council may support stakeholder agencies, if not otherwise prohibited by law, to <br/>
<a id="pl.307.6"></a><var>307.6</var>separately or jointly seek and receive funds to provide expert technical assistance to the <br/>
<a id="pl.307.7"></a><var>307.7</var>council, the council's work group, and any subwork groups for executing the provisions <br/>
<a id="pl.307.8"></a><var>307.8</var>of the redesign. <br/>
<br/>
<a id="bill.9.9.0"></a><a id="pl.307.9"></a><var>307.9</var>    Sec. 9. <b>APPROPRIATION.</b><br/>
<a id="pl.307.10"></a><var>307.10</var>$350,000 is appropriated for the biennium beginning July 1, 2009, from the general <br/>
<a id="pl.307.11"></a><var>307.11</var>fund to the State-County Results, Accountability, and Service Delivery Redesign Council, <br/>
<a id="pl.307.12"></a><var>307.12</var>for the purposes of the State-County Results, Accountability, and Service Delivery Reform <br/>
<a id="pl.307.13"></a><var>307.13</var>Act under Minnesota Statutes, sections 402A.01 to 402A.50. The council shall establish a <br/>
<a id="pl.307.14"></a><var>307.14</var>methodology for distributing funds to certified service delivery authorities for the purposes <br/>
<a id="pl.307.15"></a><var>307.15</var>of carrying out the requirements of the redesign.<br/>
<br/>
<a id="bill.10.0.0"></a>

<a id="bill.10.1.0"></a><a id="pl.307.18"></a><var>307.18</var>    Section 1. Minnesota Statutes 2008, section 103I.208, subdivision 2, is amended to <br/>
<a id="pl.307.19"></a><var>307.19</var>read:<br/>
<a id="pl.307.20"></a><var>307.20</var>    Subd. 2. <b>Permit fee.</b> The permit fee to be paid by a property owner is:<br/>
<a id="pl.307.21"></a><var>307.21</var>    (1) for a water supply well that is not in use under a maintenance permit, $175 <br/>
<a id="pl.307.22"></a><var>307.22</var>annually;<br/>
<a id="pl.307.23"></a><var>307.23</var>    (2) for construction of a monitoring well, $215, which includes the state core <br/>
<a id="pl.307.24"></a><var>307.24</var>function fee;<br/>
<a id="pl.307.25"></a><var>307.25</var>    (3) for a monitoring well that is unsealed under a maintenance permit, $175 annually;<br/>
<a id="pl.307.26"></a><var>307.26</var>    (4) for a monitoring well owned by a federal agency, state agency, or local unit of <br/>
<a id="pl.307.27"></a><var>307.27</var>government that is unsealed under a maintenance permit, $50 annually. "Local unit of <br/>
<a id="pl.307.28"></a><var>307.28</var>government" means a statutory or home rule charter city, town, county, or soil and water <br/>
<a id="pl.307.29"></a><var>307.29</var>conservation district, watershed district, an organization formed for the joint exercise of <br/>
<a id="pl.307.30"></a><var>307.30</var>powers under section 471.59, a board of health or community health board, or other <br/>
<a id="pl.307.31"></a><var>307.31</var>special purpose district or authority with local jurisdiction in water and related land <br/>
<a id="pl.307.32"></a><var>307.32</var>resources management;<br/>
<a id="pl.307.33"></a><var>307.33</var>(5) for monitoring wells used as a leak detection device at a single motor fuel retail <br/>
<a id="pl.307.34"></a><var>307.34</var>outlet, a single petroleum bulk storage site excluding tank farms, or a single agricultural <br/>
<a id="pl.308.1"></a><var>308.1</var>chemical facility site, the construction permit fee is $215, which includes the state core <br/>
<a id="pl.308.2"></a><var>308.2</var>function fee, per site regardless of the number of wells constructed on the site, and <br/>
<a id="pl.308.3"></a><var>308.3</var>the annual fee for a maintenance permit for unsealed monitoring wells is $175 per site <br/>
<a id="pl.308.4"></a><var>308.4</var>regardless of the number of monitoring wells located on site;<br/>
<a id="pl.308.5"></a><var>308.5</var>    (5) (6) for a groundwater thermal exchange device, in addition to the notification fee <br/>
<a id="pl.308.6"></a><var>308.6</var>for water supply wells, $215, which includes the state core function fee;<br/>
<a id="pl.308.7"></a><var>308.7</var>    (6) (7) for a vertical heat exchanger with less than ten tons of heating/cooling <br/>
<a id="pl.308.8"></a><var>308.8</var>capacity, $215;<br/>
<a id="pl.308.9"></a><var>308.9</var>(8) for a vertical heat exchanger with ten to 50 tons of heating/cooling capacity, $425;<br/>
<a id="pl.308.10"></a><var>308.10</var>(9) for a vertical heat exchanger with greater than 50 tons of heating/cooling <br/>
<a id="pl.308.11"></a><var>308.11</var>capacity, $650;<br/>
<a id="pl.308.12"></a><var>308.12</var>    (7) (10) for a dewatering well that is unsealed under a maintenance permit, $175 <br/>
<a id="pl.308.13"></a><var>308.13</var>annually for each dewatering well, except a dewatering project comprising more than five <br/>
<a id="pl.308.14"></a><var>308.14</var>dewatering wells shall be issued a single permit for $875 annually for dewatering wells <br/>
<a id="pl.308.15"></a><var>308.15</var>recorded on the permit; and<br/>
<a id="pl.308.16"></a><var>308.16</var>    (8) (11) for an elevator boring, $215 for each boring.<br/>
<br/>
<a id="bill.10.2.0"></a><a id="pl.308.17"></a><var>308.17</var>    Sec. 2. Minnesota Statutes 2008, section 144.121, subdivision 1a, is amended to read:<br/>
<a id="pl.308.18"></a><var>308.18</var>    Subd. 1a. <b>Fees for ionizing radiation-producing equipment.</b> (a) A facility with <br/>
<a id="pl.308.19"></a><var>308.19</var>ionizing radiation-producing equipment must pay an annual initial or annual renewal <br/>
<a id="pl.308.20"></a><var>308.20</var>registration fee consisting of a base facility fee of $66 $100 and an additional fee for <br/>
<a id="pl.308.21"></a><var>308.21</var>each radiation source, as follows:<br/>
<table>
<col width="50px"/>
<col width="7.5"/>
<col width="35"/>
<col width="2.5"/>
<col width="35"/>
<col width="12.5"/>
<tr>
<td><a id="pl.308.22"></a><var>308.22</var><br/>
</td>
<td align="right">(1)<br/>
</td>
<td>medical or veterinary equipment<br/>
</td>
<td></td>
<td align="right">$<br/>
</td>
<td>53100<br/>
</td>
</tr>
<tr>
<td><a id="pl.308.23"></a><var>308.23</var><br/>
</td>
<td align="right">(2)<br/>
</td>
<td>dental x-ray equipment<br/>
</td>
<td></td>
<td align="right">$<br/>
</td>
<td>3340<br/>
</td>
</tr>
<tr>
<td><a id="pl.308.24"></a><var>308.24</var><br/>
</td>
<td align="right">(3)<br/>
</td>
<td>accelerator<br/>
</td>
<td></td>
<td align="right">$<br/>
</td>
<td>66<br/>
</td>
</tr>
<tr>
<td><a id="pl.308.25"></a><var>308.25</var><br/>
</td>
<td align="right">(4)<br/>
</td>
<td>radiation therapy equipment<br/>
</td>
<td></td>
<td align="right">$<br/>
</td>
<td>66<br/>
</td>
</tr>
<tr>
<td><a id="pl.308.26"></a><var>308.26</var><br/>
<a id="pl.308.27"></a><var>308.27</var><br/>
</td>
<td align="right" valign="top">(5)(3)<br/>
</td>
<td>x-ray equipment not used on <br/>
                  		humans or animals<br/>
</td>
<td></td>
<td align="right" valign="top">$<br/>
</td>
<td valign="top">53100<br/>
</td>
</tr>
<tr>
<td><a id="pl.308.28"></a><var>308.28</var><br/>
<a id="pl.308.29"></a><var>308.29</var><br/>
<a id="pl.308.30"></a><var>308.30</var><br/>
</td>
<td align="right" valign="top">(6)(4)<br/>
</td>
<td valign="top">devices with sources of ionizing <br/>
                  		radiation not used on humans or <br/>
                  		animals<br/>
</td>
<td></td>
<td align="right" valign="top">$<br/>
</td>
<td valign="top">53100<br/>
</td>
</tr>
</table><a id="pl.308.31"></a><var>308.31</var>(b) A facility with radiation therapy and accelerator equipment must pay an annual <br/>
<a id="pl.308.32"></a><var>308.32</var>registration fee of $500. A facility with an industrial accelerator must pay an annual <br/>
<a id="pl.308.33"></a><var>308.33</var>registration fee of $150.<br/>
<a id="pl.309.1"></a><var>309.1</var>(c) Electron microscopy equipment is exempt from the registration fee requirements <br/>
<a id="pl.309.2"></a><var>309.2</var>of this section.<br/>
<br/>
<a id="bill.10.3.0"></a><a id="pl.309.3"></a><var>309.3</var>    Sec. 3. Minnesota Statutes 2008, section 144.121, subdivision 1b, is amended to read:<br/>
<a id="pl.309.4"></a><var>309.4</var>    Subd. 1b. <b>Penalty fee for late registration.</b> Applications for initial or renewal <br/>
<a id="pl.309.5"></a><var>309.5</var>registrations submitted to the commissioner after the time specified by the commissioner <br/>
<a id="pl.309.6"></a><var>309.6</var>shall be accompanied by a penalty fee of $20 an amount equal to 25 percent of the fee <br/>
<a id="pl.309.7"></a><var>309.7</var>due in addition to the fees prescribed in subdivision 1a.<br/>
<br/>
<a id="bill.10.4.0"></a><a id="pl.309.8"></a><var>309.8</var>    Sec. 4. Minnesota Statutes 2008, section 144.1222, subdivision 1a, is amended to read:<br/>
<a id="pl.309.9"></a><var>309.9</var>    Subd. 1a.  <b>Fees.</b> All plans and specifications for public pool and spa construction, <br/>
<a id="pl.309.10"></a><var>309.10</var>installation, or alteration or requests for a variance that are submitted to the commissioner <br/>
<a id="pl.309.11"></a><var>309.11</var>according to Minnesota Rules, part 4717.3975, shall be accompanied by the appropriate <br/>
<a id="pl.309.12"></a><var>309.12</var>fees. All public pool construction plans submitted for review after January 1, 2009, <br/>
<a id="pl.309.13"></a><var>309.13</var>must be certified by a professional engineer registered in the state of Minnesota. If the <br/>
<a id="pl.309.14"></a><var>309.14</var>commissioner determines, upon review of the plans, that inadequate fees were paid, the <br/>
<a id="pl.309.15"></a><var>309.15</var>necessary additional fees shall be paid before plan approval. For purposes of determining <br/>
<a id="pl.309.16"></a><var>309.16</var>fees, a project is defined as a proposal to construct or install a public pool, spa, special <br/>
<a id="pl.309.17"></a><var>309.17</var>purpose pool, or wading pool and all associated water treatment equipment and drains, <br/>
<a id="pl.309.18"></a><var>309.18</var>gutters, decks, water recreation features, spray pads, and those design and safety features <br/>
<a id="pl.309.19"></a><var>309.19</var>that are within five feet of any pool or spa. The commissioner shall charge the following <br/>
<a id="pl.309.20"></a><var>309.20</var>fees for plan review and inspection of public pools and spas and for requests for variance <br/>
<a id="pl.309.21"></a><var>309.21</var>from the public pool and spa rules: <br/>
<a id="pl.309.22"></a><var>309.22</var>    (1) each pool, $800 $1,500; <br/>
<a id="pl.309.23"></a><var>309.23</var>    (2) each spa pool, $500 $800; <br/>
<a id="pl.309.24"></a><var>309.24</var>    (3) each slide, $400 $600; <br/>
<a id="pl.309.25"></a><var>309.25</var>    (4) projects valued at $250,000 or more, the greater of the sum of the fees in clauses <br/>
<a id="pl.309.26"></a><var>309.26</var>(1), (2), and (3) or 0.5 percent of the documented estimated project cost to a maximum <br/>
<a id="pl.309.27"></a><var>309.27</var>fee of $10,000 $15,000; <br/>
<a id="pl.309.28"></a><var>309.28</var>    (5) alterations to an existing pool without changing the size or configuration of <br/>
<a id="pl.309.29"></a><var>309.29</var>the pool, $400 $600; <br/>
<a id="pl.309.30"></a><var>309.30</var>    (6) removal or replacement of pool disinfection equipment only, $75 $100; and <br/>
<a id="pl.309.31"></a><var>309.31</var>    (7) request for variance from the public pool and spa rules, $500. <br/>
<br/>
<a id="bill.10.5.0"></a><a id="pl.309.32"></a><var>309.32</var>    Sec. 5. Minnesota Statutes 2008, section 144.125, subdivision 1, is amended to read:<br/>
<a id="pl.310.1"></a><var>310.1</var>    Subdivision 1. <b>Duty to perform testing.</b> It is the duty of (1) the administrative <br/>
<a id="pl.310.2"></a><var>310.2</var>officer or other person in charge of each institution caring for infants 28 days or less <br/>
<a id="pl.310.3"></a><var>310.3</var>of age, (2) the person required in pursuance of the provisions of section 
         <statute_ref>144.215</statute_ref>, to <br/>
<a id="pl.310.4"></a><var>310.4</var>register the birth of a child, or (3) the nurse midwife or midwife in attendance at the <br/>
<a id="pl.310.5"></a><var>310.5</var>birth, to arrange to have administered to every infant or child in its care tests for heritable <br/>
<a id="pl.310.6"></a><var>310.6</var>and congenital disorders according to subdivision 2 and rules prescribed by the state <br/>
<a id="pl.310.7"></a><var>310.7</var>commissioner of health. Testing and the recording and reporting of test results shall be <br/>
<a id="pl.310.8"></a><var>310.8</var>performed at the times and in the manner prescribed by the commissioner of health. The <br/>
<a id="pl.310.9"></a><var>310.9</var>commissioner shall charge a fee so that the total of fees collected will approximate the <br/>
<a id="pl.310.10"></a><var>310.10</var>costs of conducting the tests and implementing and maintaining a system to follow-up <br/>
<a id="pl.310.11"></a><var>310.11</var>infants with heritable or congenital disorders, including hearing loss detected through the <br/>
<a id="pl.310.12"></a><var>310.12</var>early hearing detection and intervention program under section 
         <statute_ref>144.966</statute_ref>. The fee is $101 <br/>
<a id="pl.310.13"></a><var>310.13</var>per specimen. Effective July 1, 2010, the fee shall be increased to $106 per specimen. The <br/>
<a id="pl.310.14"></a><var>310.14</var>increased fee amount shall be deposited in the general fund. Costs associated with capital <br/>
<a id="pl.310.15"></a><var>310.15</var>expenditures and the development of new procedures may be prorated over a three-year <br/>
<a id="pl.310.16"></a><var>310.16</var>period when calculating the amount of the fees. <br/>
<a id="pl.310.17"></a><var>310.17</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2010.<br/>
<br/>
<a id="bill.10.6.0"></a><a id="pl.310.18"></a><var>310.18</var>    Sec. 6. Minnesota Statutes 2008, section 144.72, subdivision 1, is amended to read:<br/>
<a id="pl.310.19"></a><var>310.19</var>    Subdivision 1. <b>Permits</b><b> License required</b><b>.</b> The state commissioner of health is <br/>
<a id="pl.310.20"></a><var>310.20</var>authorized to issue permits for the operation of youth camps which are required to obtain <br/>
<a id="pl.310.21"></a><var>310.21</var>the permits a license according to chapter 157.<br/>
<br/>
<a id="bill.10.7.0"></a><a id="pl.310.22"></a><var>310.22</var>    Sec. 7. Minnesota Statutes 2008, section 144.72, subdivision 3, is amended to read:<br/>
<a id="pl.310.23"></a><var>310.23</var>    Subd. 3. <b>Issuance of </b><b>permits</b><b> license</b><b>.</b> If the commissioner should determine from <br/>
<a id="pl.310.24"></a><var>310.24</var>the application that the health and safety of the persons using the camp will be properly <br/>
<a id="pl.310.25"></a><var>310.25</var>safeguarded, the commissioner may, prior to actual inspection of the camp, issue the <br/>
<a id="pl.310.26"></a><var>310.26</var>permit license in writing. No fee shall be charged for the permit. The permit license shall <br/>
<a id="pl.310.27"></a><var>310.27</var>be posted in a conspicuous place on the premises occupied by the camp.<br/>
<br/>
<a id="bill.10.8.0"></a><a id="pl.310.28"></a><var>310.28</var>    Sec. 8. Minnesota Statutes 2008, section 144.9501, is amended by adding a subdivision <br/>
<a id="pl.310.29"></a><var>310.29</var>to read:<br/>
<a id="pl.310.30"></a><var>310.30</var>    Subd. 8a. <b>Disclosure pamphlet.</b> "Disclosure pamphlet" means the EPA pamphlet <br/>
<a id="pl.310.31"></a><var>310.31</var>titled "Renovate Right: Important Lead Hazard Information for Families, Child Care <br/>
<a id="pl.310.32"></a><var>310.32</var>Providers and Schools" developed under section 406(a) of the Toxic Substance Control <br/>
<a id="pl.310.33"></a><var>310.33</var>Act.<br/>
<br/>
<a id="bill.10.9.0"></a><a id="pl.311.1"></a><var>311.1</var>    Sec. 9. Minnesota Statutes 2008, section 144.9501, subdivision 22b, is amended to <br/>
<a id="pl.311.2"></a><var>311.2</var>read:<br/>
<a id="pl.311.3"></a><var>311.3</var>    Subd. 22b. <b>Lead sampling technician.</b> "Lead sampling technician" means an <br/>
<a id="pl.311.4"></a><var>311.4</var>individual who performs clearance inspections for nonabatement or nonorder lead hazard <br/>
<a id="pl.311.5"></a><var>311.5</var>reduction renovation sites, and lead dust sampling in other settings, or visual assessment <br/>
<a id="pl.311.6"></a><var>311.6</var>for deteriorated paint for nonabatement sites, and who is registered with the commissioner <br/>
<a id="pl.311.7"></a><var>311.7</var>under section 
         <statute_ref>144.9505</statute_ref>. <br/>
<br/>
<a id="bill.10.10.0"></a><a id="pl.311.8"></a><var>311.8</var>    Sec. 10. Minnesota Statutes 2008, section 144.9501, subdivision 26a, is amended to <br/>
<a id="pl.311.9"></a><var>311.9</var>read:<br/>
<a id="pl.311.10"></a><var>311.10</var>    Subd. 26a. <b>Regulated lead work.</b> (a) "Regulated lead work" means:<br/>
<a id="pl.311.11"></a><var>311.11</var>(1) abatement;<br/>
<a id="pl.311.12"></a><var>311.12</var>(2) interim controls;<br/>
<a id="pl.311.13"></a><var>311.13</var>(3) a clearance inspection;<br/>
<a id="pl.311.14"></a><var>311.14</var>(4) a lead hazard screen;<br/>
<a id="pl.311.15"></a><var>311.15</var>(5) a lead inspection;<br/>
<a id="pl.311.16"></a><var>311.16</var>(6) a lead risk assessment;<br/>
<a id="pl.311.17"></a><var>311.17</var>(7) lead project designer services;<br/>
<a id="pl.311.18"></a><var>311.18</var>(8) lead sampling technician services; or<br/>
<a id="pl.311.19"></a><var>311.19</var>(9) swab team services.;<br/>
<a id="pl.311.20"></a><var>311.20</var>(10) renovation activities; or<br/>
<a id="pl.311.21"></a><var>311.21</var>(11) activities performed to comply with lead orders issued by a board of health.<br/>
<a id="pl.311.22"></a><var>311.22</var>(b) Regulated lead work does not include abatement, interim controls, swab team <br/>
<a id="pl.311.23"></a><var>311.23</var>services, or renovation activities that disturb painted surfaces that total no more than:<br/>
<a id="pl.311.24"></a><var>311.24</var>(1) activities such as remodeling, renovation, installation, rehabilitation, or <br/>
<a id="pl.311.25"></a><var>311.25</var>landscaping activities, the primary intent of which is to remodel, repair, or restore a <br/>
<a id="pl.311.26"></a><var>311.26</var>structure or dwelling, rather than to permanently eliminate lead hazards, even though these <br/>
<a id="pl.311.27"></a><var>311.27</var>activities may incidentally result in a reduction in lead hazards; or<br/>
<a id="pl.311.28"></a><var>311.28</var>(2) interim control activities that are not performed as a result of a lead order and <br/>
<a id="pl.311.29"></a><var>311.29</var>that do not disturb painted surfaces that total more than:<br/>
<a id="pl.311.30"></a><var>311.30</var>(i) (1) 20 square feet (two square meters) on exterior surfaces; or<br/>
<a id="pl.311.31"></a><var>311.31</var>(ii) two (2) six square feet (0.2 0.6 square meters) in an interior room; or.<br/>
<a id="pl.311.32"></a><var>311.32</var>(iii) ten percent of the total surface area on an interior or exterior type of component <br/>
<a id="pl.311.33"></a><var>311.33</var>with a small surface area.<br/>
<br/>
<a id="bill.10.11.0"></a><a id="pl.312.1"></a><var>312.1</var>    Sec. 11. Minnesota Statutes 2008, section 144.9501, is amended by adding a <br/>
<a id="pl.312.2"></a><var>312.2</var>subdivision to read:<br/>
<a id="pl.312.3"></a><var>312.3</var>    Subd. 26b. <b>Renovation.</b> "Renovation" means the modification of any affected <br/>
<a id="pl.312.4"></a><var>312.4</var>property that results in the disturbance of painted surfaces, unless that activity is performed <br/>
<a id="pl.312.5"></a><var>312.5</var>as an abatement. A renovation performed for the purpose of converting a building or part <br/>
<a id="pl.312.6"></a><var>312.6</var>of a building into an affected property is a renovation under this subdivision.<br/>
<br/>
<a id="bill.10.12.0"></a><a id="pl.312.7"></a><var>312.7</var>    Sec. 12. Minnesota Statutes 2008, section 144.9505, subdivision 1g, is amended to <br/>
<a id="pl.312.8"></a><var>312.8</var>read:<br/>
<a id="pl.312.9"></a><var>312.9</var>    Subd. 1g. <b>Certified lead firm.</b> A person within the state intending to directly <br/>
<a id="pl.312.10"></a><var>312.10</var>perform or cause to be performed through subcontracting or similar delegation any <br/>
<a id="pl.312.11"></a><var>312.11</var>regulated lead work shall first obtain certification from the commissioner A person who <br/>
<a id="pl.312.12"></a><var>312.12</var>employs individuals to perform regulated lead work outside of the person's property must <br/>
<a id="pl.312.13"></a><var>312.13</var>obtain certification as a lead firm. The certificate must be in writing, contain an expiration <br/>
<a id="pl.312.14"></a><var>312.14</var>date, be signed by the commissioner, and give the name and address of the person to <br/>
<a id="pl.312.15"></a><var>312.15</var>whom it is issued. The certification fee is $100, is nonrefundable, and must be submitted <br/>
<a id="pl.312.16"></a><var>312.16</var>with each application. The certificate or a copy of the certificate must be readily available <br/>
<a id="pl.312.17"></a><var>312.17</var>at the worksite for review by the contracting entity, the commissioner, and other public <br/>
<a id="pl.312.18"></a><var>312.18</var>health officials charged with the health, safety, and welfare of the state's citizens.<br/>
<br/>
<a id="bill.10.13.0"></a><a id="pl.312.19"></a><var>312.19</var>    Sec. 13. Minnesota Statutes 2008, section 144.9505, subdivision 4, is amended to read:<br/>
<a id="pl.312.20"></a><var>312.20</var>    Subd. 4. <b>Notice of regulated lead work.</b> (a) At least five working days before <br/>
<a id="pl.312.21"></a><var>312.21</var>starting work at each regulated lead worksite, the person performing the regulated lead <br/>
<a id="pl.312.22"></a><var>312.22</var>work shall give written notice to the commissioner and the appropriate board of health.<br/>
<a id="pl.312.23"></a><var>312.23</var>(b) This provision does not apply to lead hazard screen, lead inspection, lead risk <br/>
<a id="pl.312.24"></a><var>312.24</var>assessment, lead sampling technician, renovation, or lead project design activities.<br/>
<br/>
<a id="bill.10.14.0"></a><a id="pl.312.25"></a><var>312.25</var>    Sec. 14. Minnesota Statutes 2008, section 144.9508, subdivision 2, is amended to read:<br/>
<a id="pl.312.26"></a><var>312.26</var>    Subd. 2. <b>Regulated lead work standards and methods.</b> (a) The commissioner <br/>
<a id="pl.312.27"></a><var>312.27</var>shall adopt rules establishing regulated lead work standards and methods in accordance <br/>
<a id="pl.312.28"></a><var>312.28</var>with the provisions of this section, for lead in paint, dust, drinking water, and soil in <br/>
<a id="pl.312.29"></a><var>312.29</var>a manner that protects public health and the environment for all residences, including <br/>
<a id="pl.312.30"></a><var>312.30</var>residences also used for a commercial purpose, child care facilities, playgrounds, and <br/>
<a id="pl.312.31"></a><var>312.31</var>schools.<br/>
<a id="pl.312.32"></a><var>312.32</var>(b) In the rules required by this section, the commissioner shall require lead hazard <br/>
<a id="pl.312.33"></a><var>312.33</var>reduction of intact paint only if the commissioner finds that the intact paint is on a <br/>
<a id="pl.313.1"></a><var>313.1</var>chewable or lead-dust producing surface that is a known source of actual lead exposure to <br/>
<a id="pl.313.2"></a><var>313.2</var>a specific individual. The commissioner shall prohibit methods that disperse lead dust into <br/>
<a id="pl.313.3"></a><var>313.3</var>the air that could accumulate to a level that would exceed the lead dust standard specified <br/>
<a id="pl.313.4"></a><var>313.4</var>under this section. The commissioner shall work cooperatively with the commissioner <br/>
<a id="pl.313.5"></a><var>313.5</var>of administration to determine which lead hazard reduction methods adopted under this <br/>
<a id="pl.313.6"></a><var>313.6</var>section may be used for lead-safe practices including prohibited practices, preparation, <br/>
<a id="pl.313.7"></a><var>313.7</var>disposal, and cleanup. The commissioner shall work cooperatively with the commissioner <br/>
<a id="pl.313.8"></a><var>313.8</var>of the Pollution Control Agency to develop disposal procedures. In adopting rules under <br/>
<a id="pl.313.9"></a><var>313.9</var>this section, the commissioner shall require the best available technology for regulated <br/>
<a id="pl.313.10"></a><var>313.10</var>lead work methods, paint stabilization, and repainting.<br/>
<a id="pl.313.11"></a><var>313.11</var>(c) The commissioner of health shall adopt regulated lead work standards and <br/>
<a id="pl.313.12"></a><var>313.12</var>methods for lead in bare soil in a manner to protect public health and the environment. <br/>
<a id="pl.313.13"></a><var>313.13</var>The commissioner shall adopt a maximum standard of 100 parts of lead per million in <br/>
<a id="pl.313.14"></a><var>313.14</var>bare soil. The commissioner shall set a soil replacement standard not to exceed 25 parts <br/>
<a id="pl.313.15"></a><var>313.15</var>of lead per million. Soil lead hazard reduction methods shall focus on erosion control <br/>
<a id="pl.313.16"></a><var>313.16</var>and covering of bare soil.<br/>
<a id="pl.313.17"></a><var>313.17</var>(d) The commissioner shall adopt regulated lead work standards and methods for <br/>
<a id="pl.313.18"></a><var>313.18</var>lead in dust in a manner to protect the public health and environment. Dust standards <br/>
<a id="pl.313.19"></a><var>313.19</var>shall use a weight of lead per area measure and include dust on the floor, on the window <br/>
<a id="pl.313.20"></a><var>313.20</var>sills, and on window wells. Lead hazard reduction methods for dust shall focus on dust <br/>
<a id="pl.313.21"></a><var>313.21</var>removal and other practices which minimize the formation of lead dust from paint, soil, or <br/>
<a id="pl.313.22"></a><var>313.22</var>other sources.<br/>
<a id="pl.313.23"></a><var>313.23</var>(e) The commissioner shall adopt lead hazard reduction standards and methods for <br/>
<a id="pl.313.24"></a><var>313.24</var>lead in drinking water both at the tap and public water supply system or private well <br/>
<a id="pl.313.25"></a><var>313.25</var>in a manner to protect the public health and the environment. The commissioner may <br/>
<a id="pl.313.26"></a><var>313.26</var>adopt the rules for controlling lead in drinking water as contained in Code of Federal <br/>
<a id="pl.313.27"></a><var>313.27</var>Regulations, title 40, part 141. Drinking water lead hazard reduction methods may include <br/>
<a id="pl.313.28"></a><var>313.28</var>an educational approach of minimizing lead exposure from lead in drinking water.<br/>
<a id="pl.313.29"></a><var>313.29</var>(f) The commissioner of the Pollution Control Agency shall adopt rules to ensure that <br/>
<a id="pl.313.30"></a><var>313.30</var>removal of exterior lead-based coatings from residences and steel structures by abrasive <br/>
<a id="pl.313.31"></a><var>313.31</var>blasting methods is conducted in a manner that protects health and the environment.<br/>
<a id="pl.313.32"></a><var>313.32</var>(g) All regulated lead work standards shall provide reasonable margins of safety that <br/>
<a id="pl.313.33"></a><var>313.33</var>are consistent with more than a summary review of scientific evidence and an emphasis on <br/>
<a id="pl.313.34"></a><var>313.34</var>overprotection rather than underprotection when the scientific evidence is ambiguous.<br/>
<a id="pl.313.35"></a><var>313.35</var>(h) No unit of local government shall have an ordinance or regulation governing <br/>
<a id="pl.313.36"></a><var>313.36</var>regulated lead work standards or methods for lead in paint, dust, drinking water, or soil <br/>
<a id="pl.314.1"></a><var>314.1</var>that require a different regulated lead work standard or method than the standards or <br/>
<a id="pl.314.2"></a><var>314.2</var>methods established under this section.<br/>
<a id="pl.314.3"></a><var>314.3</var>(i) Notwithstanding paragraph (h), the commissioner may approve the use by a unit <br/>
<a id="pl.314.4"></a><var>314.4</var>of local government of an innovative lead hazard reduction method which is consistent <br/>
<a id="pl.314.5"></a><var>314.5</var>in approach with methods established under this section.<br/>
<a id="pl.314.6"></a><var>314.6</var>(j) The commissioner shall adopt rules for issuing lead orders required under section <br/>
<statute_ref><a id="pl.314.7"></a><var>314.7</var>144.9504
         </statute_ref>, rules for notification of abatement or interim control activities requirements, <br/>
<a id="pl.314.8"></a><var>314.8</var>and other rules necessary to implement sections 
         <statute_ref>144.9501</statute_ref> to 
         <statute_ref>144.9512</statute_ref>. <br/>
<a id="pl.314.9"></a><var>314.9</var>(k) The commissioner shall adopt rules consistent with section 402(c)(3) of the <br/>
<a id="pl.314.10"></a><var>314.10</var>Toxic Substances Control Act to ensure that renovation in a pre-1978 affected property <br/>
<a id="pl.314.11"></a><var>314.11</var>where a child or pregnant female resides is conducted in a manner that protects health <br/>
<a id="pl.314.12"></a><var>314.12</var>and the environment.<br/>
<a id="pl.314.13"></a><var>314.13</var>(l) The commissioner shall adopt rules consistent with sections 406(a) and 406(b) of <br/>
<a id="pl.314.14"></a><var>314.14</var>the Toxic Substances Control Act.<br/>
<br/>
<a id="bill.10.15.0"></a><a id="pl.314.15"></a><var>314.15</var>    Sec. 15. Minnesota Statutes 2008, section 144.9508, subdivision 3, is amended to read:<br/>
<a id="pl.314.16"></a><var>314.16</var>    Subd. 3. <b>Licensure and certification.</b> The commissioner shall adopt rules to <br/>
<a id="pl.314.17"></a><var>314.17</var>license lead supervisors, lead workers, lead project designers, lead inspectors, and lead <br/>
<a id="pl.314.18"></a><var>314.18</var>risk assessors, and lead sampling technicians. The commissioner shall also adopt rules <br/>
<a id="pl.314.19"></a><var>314.19</var>requiring certification of firms that perform regulated lead work and rules requiring <br/>
<a id="pl.314.20"></a><var>314.20</var>registration of lead sampling technicians. The commissioner shall require periodic renewal <br/>
<a id="pl.314.21"></a><var>314.21</var>of licenses, and certificates, and registrations and shall establish the renewal periods.<br/>
<br/>
<a id="bill.10.16.0"></a><a id="pl.314.22"></a><var>314.22</var>    Sec. 16. Minnesota Statutes 2008, section 144.9508, subdivision 4, is amended to read:<br/>
<a id="pl.314.23"></a><var>314.23</var>    Subd. 4. <b>Lead training course.</b> The commissioner shall establish by rule <br/>
<a id="pl.314.24"></a><var>314.24</var>requirements for training course providers and the renewal period for each lead-related <br/>
<a id="pl.314.25"></a><var>314.25</var>training course required for certification or licensure. The commissioner shall establish <br/>
<a id="pl.314.26"></a><var>314.26</var>criteria in rules for the content and presentation of training courses intended to qualify <br/>
<a id="pl.314.27"></a><var>314.27</var>trainees for licensure under subdivision 3. The commissioner shall establish criteria <br/>
<a id="pl.314.28"></a><var>314.28</var>in rules for the content and presentation of training courses for lead interim control <br/>
<a id="pl.314.29"></a><var>314.29</var>workers renovation and lead sampling technicians. Training course permit fees shall be <br/>
<a id="pl.314.30"></a><var>314.30</var>nonrefundable and must be submitted with each application in the amount of $500 for an <br/>
<a id="pl.314.31"></a><var>314.31</var>initial training course, $250 for renewal of a permit for an initial training course, $250 for <br/>
<a id="pl.314.32"></a><var>314.32</var>a refresher training course, and $125 for renewal of a permit of a refresher training course.<br/>
<br/>
<a id="bill.10.17.0"></a><a id="pl.314.33"></a><var>314.33</var>    Sec. 17. Minnesota Statutes 2008, section 144.9512, subdivision 2, is amended to read:<br/>
<a id="pl.315.1"></a><var>315.1</var>    Subd. 2. <b>Grants; administration.</b> Within the limits of the available appropriation, <br/>
<a id="pl.315.2"></a><var>315.2</var>the commissioner shall make grants to a nonprofit organization currently operating the <br/>
<a id="pl.315.3"></a><var>315.3</var>CLEARCorps lead hazard reduction project organizations to train workers to provide lead <br/>
<a id="pl.315.4"></a><var>315.4</var>screening, education, outreach, and swab team services for residential property. Projects <br/>
<a id="pl.315.5"></a><var>315.5</var>that provide Americorps funding or positions, or leverage matching funds, as part of the <br/>
<a id="pl.315.6"></a><var>315.6</var>delivery of the services must be given priority for the grant funds.<br/>
<br/>
<a id="bill.10.18.0"></a><a id="pl.315.7"></a><var>315.7</var>    Sec. 18. Minnesota Statutes 2008, section 144.966, is amended by adding a subdivision <br/>
<a id="pl.315.8"></a><var>315.8</var>to read:<br/>
<a id="pl.315.9"></a><var>315.9</var>    Subd. 3a. <b>Support services to families.</b> The commissioner shall contract with <br/>
<a id="pl.315.10"></a><var>315.10</var>a nonprofit organization to provide support and assistance to families with children <br/>
<a id="pl.315.11"></a><var>315.11</var>who are deaf or have a hearing loss. The family support provided must include direct <br/>
<a id="pl.315.12"></a><var>315.12</var>parent-to-parent assistance and information on communication, educational, and medical <br/>
<a id="pl.315.13"></a><var>315.13</var>options. The commissioner shall give preference to a nonprofit organization that has the <br/>
<a id="pl.315.14"></a><var>315.14</var>ability to provide these services throughout the state.<br/>
<br/>
<a id="bill.10.19.0"></a><a id="pl.315.15"></a><var>315.15</var>    Sec. 19. Minnesota Statutes 2008, section 144.97, subdivision 2, is amended to read:<br/>
<a id="pl.315.16"></a><var>315.16</var>    Subd. 2. <b>Certification</b><b> Accreditation</b><b>.</b> "Certification" means written <br/>
<a id="pl.315.17"></a><var>315.17</var>acknowledgment of a laboratory's demonstrated capability to perform tests for a specific <br/>
<a id="pl.315.18"></a><var>315.18</var>purpose "Accreditation" means written acknowledgment that a laboratory has the <br/>
<a id="pl.315.19"></a><var>315.19</var>policies, procedures, equipment, and practices to produce reliable data in the analysis of <br/>
<a id="pl.315.20"></a><var>315.20</var>environmental samples.<br/>
<a id="pl.315.21"></a><var>315.21</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2009.<br/>
<br/>
<a id="bill.10.20.0"></a><a id="pl.315.22"></a><var>315.22</var>    Sec. 20. Minnesota Statutes 2008, section 144.97, subdivision 4, is amended to read:<br/>
<a id="pl.315.23"></a><var>315.23</var>    Subd. 4. <b>Contract</b><b> </b><b>Commercial </b><b>laboratory.</b> "Contract Commercial laboratory" <br/>
<a id="pl.315.24"></a><var>315.24</var>means a laboratory that performs tests on samples on a contract or fee-for-service basis.<br/>
<a id="pl.315.25"></a><var>315.25</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2009.<br/>
<br/>
<a id="bill.10.21.0"></a><a id="pl.315.26"></a><var>315.26</var>    Sec. 21. Minnesota Statutes 2008, section 144.97, is amended by adding a subdivision <br/>
<a id="pl.315.27"></a><var>315.27</var>to read:<br/>
<a id="pl.315.28"></a><var>315.28</var>    Subd. 5a. <b>Field of testing.</b> "Field of testing" means the combination of analyte, <br/>
<a id="pl.315.29"></a><var>315.29</var>method, matrix, and test category for which a laboratory may hold accreditation.<br/>
<a id="pl.315.30"></a><var>315.30</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2009.<br/>
<br/>
<a id="bill.10.22.0"></a><a id="pl.316.1"></a><var>316.1</var>    Sec. 22. Minnesota Statutes 2008, section 144.97, subdivision 6, is amended to read:<br/>
<a id="pl.316.2"></a><var>316.2</var>    Subd. 6. <b>Laboratory.</b> "Laboratory" means the state, a person, corporation, or other <br/>
<a id="pl.316.3"></a><var>316.3</var>entity, including governmental, that examines, analyzes, or tests samples in a specified <br/>
<a id="pl.316.4"></a><var>316.4</var>physical location.<br/>
<a id="pl.316.5"></a><var>316.5</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2009.<br/>
<br/>
<a id="bill.10.23.0"></a><a id="pl.316.6"></a><var>316.6</var>    Sec. 23. Minnesota Statutes 2008, section 144.97, is amended by adding a subdivision <br/>
<a id="pl.316.7"></a><var>316.7</var>to read:<br/>
<a id="pl.316.8"></a><var>316.8</var>    Subd. 8. <b>Test category.</b> "Test category" means the combination of program and <br/>
<a id="pl.316.9"></a><var>316.9</var>category as provided by section 144.98, subdivisions 3, paragraph (b), clauses (1) to (10), <br/>
<a id="pl.316.10"></a><var>316.10</var>and 3a, paragraph (a), clauses (1) to (5).<br/>
<a id="pl.316.11"></a><var>316.11</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2009.<br/>
<br/>
<a id="bill.10.24.0"></a><a id="pl.316.12"></a><var>316.12</var>    Sec. 24. Minnesota Statutes 2008, section 144.98, subdivision 1, is amended to read:<br/>
<a id="pl.316.13"></a><var>316.13</var>    Subdivision 1. <b>Authorization.</b> The commissioner of health may certify shall <br/>
<a id="pl.316.14"></a><var>316.14</var>accredit environmental laboratories that test environmental samples according to national <br/>
<a id="pl.316.15"></a><var>316.15</var>standards developed using a consensus process as established by Circular A-119, <br/>
<a id="pl.316.16"></a><var>316.16</var>published by the United States Office of Management and Budget.<br/>
<a id="pl.316.17"></a><var>316.17</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2009.<br/>
<br/>
<a id="bill.10.25.0"></a><a id="pl.316.18"></a><var>316.18</var>    Sec. 25. Minnesota Statutes 2008, section 144.98, subdivision 2, is amended to read:<br/>
<a id="pl.316.19"></a><var>316.19</var>    Subd. 2. <b>Rules</b><b> and standards</b><b>.</b> The commissioner may adopt rules to implement <br/>
<a id="pl.316.20"></a><var>316.20</var>this section, including: carry out the commissioner's responsibilities under the national <br/>
<a id="pl.316.21"></a><var>316.21</var>standards specified in subdivisions 1 and 2a.<br/>
<a id="pl.316.22"></a><var>316.22</var>(1) procedures, requirements, and fee adjustments for laboratory certification, <br/>
<a id="pl.316.23"></a><var>316.23</var>including provisional status and recertification;<br/>
<a id="pl.316.24"></a><var>316.24</var>(2) standards and fees for certificate approval, suspension, and revocation;<br/>
<a id="pl.316.25"></a><var>316.25</var>(3) standards for environmental samples;<br/>
<a id="pl.316.26"></a><var>316.26</var>(4) analysis methods that assure reliable test results;<br/>
<a id="pl.316.27"></a><var>316.27</var>(5) laboratory quality assurance, including internal quality control, proficiency <br/>
<a id="pl.316.28"></a><var>316.28</var>testing, and personnel training; and<br/>
<a id="pl.316.29"></a><var>316.29</var>(6) criteria for recognition of certification programs of other states and the federal <br/>
<a id="pl.316.30"></a><var>316.30</var>government.<br/>
<a id="pl.316.31"></a><var>316.31</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2009.<br/>
<br/>
<a id="bill.10.26.0"></a><a id="pl.317.1"></a><var>317.1</var>    Sec. 26. Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision <br/>
<a id="pl.317.2"></a><var>317.2</var>to read:<br/>
<a id="pl.317.3"></a><var>317.3</var>    Subd. 2a. <b>Standards.</b> The commissioner shall accredit laboratories according to <br/>
<a id="pl.317.4"></a><var>317.4</var>the most current environmental laboratory accreditation standards under subdivision 1 <br/>
<a id="pl.317.5"></a><var>317.5</var>and as accepted by the accreditation bodies recognized by the National Environmental <br/>
<a id="pl.317.6"></a><var>317.6</var>Laboratory Accreditation Program (NELAP) of the NELAC Institute.<br/>
<a id="pl.317.7"></a><var>317.7</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2009.<br/>
<br/>
<a id="bill.10.27.0"></a><a id="pl.317.8"></a><var>317.8</var>    Sec. 27. Minnesota Statutes 2008, section 144.98, subdivision 3, is amended to read:<br/>
<a id="pl.317.9"></a><var>317.9</var>    Subd. 3. <b>Annual </b><b>fees.</b> (a) An application for certification accreditation under <br/>
<a id="pl.317.10"></a><var>317.10</var>subdivision 1 6 must be accompanied by the biennial fee annual fees specified in this <br/>
<a id="pl.317.11"></a><var>317.11</var>subdivision. The fees are for annual fees include:<br/>
<a id="pl.317.12"></a><var>317.12</var>(1) base certification accreditation fee, $1,600 $1,500;<br/>
<a id="pl.317.13"></a><var>317.13</var>(2) sample preparation techniques fees fee, $100 $200 per technique; and<br/>
<a id="pl.317.14"></a><var>317.14</var>(3) an administrative fee for laboratories located outside this state, $3,750; and<br/>
<a id="pl.317.15"></a><var>317.15</var>(4) test category certification fees:.<br/>
<table>
<col width="50px"/>
<col width="52.5"/>
<col width="12.5"/>
<tr>
<td><a id="pl.317.16"></a><var>317.16</var><br/>
</td>
<td valign="top">Test Category<br/>
</td>
<td align="right" valign="top">Certification Fee<br/>
</td>
</tr>
<tr>
<td><a id="pl.317.17"></a><var>317.17</var><br/>
</td>
<td>Clean water program bacteriology<br/>
</td>
<td align="right">$800<br/>
</td>
</tr>
<tr>
<td><a id="pl.317.18"></a><var>317.18</var><br/>
</td>
<td>Safe drinking water program bacteriology<br/>
</td>
<td align="right">$800<br/>
</td>
</tr>
<tr>
<td><a id="pl.317.19"></a><var>317.19</var><br/>
</td>
<td>Clean water program inorganic chemistry<br/>
</td>
<td align="right">$800<br/>
</td>
</tr>
<tr>
<td><a id="pl.317.20"></a><var>317.20</var><br/>
</td>
<td>Safe drinking water program inorganic chemistry<br/>
</td>
<td align="right">$800<br/>
</td>
</tr>
<tr>
<td><a id="pl.317.21"></a><var>317.21</var><br/>
</td>
<td>Clean water program chemistry metals<br/>
</td>
<td align="right">$1,200<br/>
</td>
</tr>
<tr>
<td><a id="pl.317.22"></a><var>317.22</var><br/>
</td>
<td>Safe drinking water program chemistry metals<br/>
</td>
<td align="right">$1,200<br/>
</td>
</tr>
<tr>
<td><a id="pl.317.23"></a><var>317.23</var><br/>
</td>
<td>Resource conservation and recovery program chemistry metals<br/>
</td>
<td align="right">$1,200<br/>
</td>
</tr>
<tr>
<td><a id="pl.317.24"></a><var>317.24</var><br/>
</td>
<td>Clean water program volatile organic compounds<br/>
</td>
<td align="right">$1,500<br/>
</td>
</tr>
<tr>
<td><a id="pl.317.25"></a><var>317.25</var><br/>
</td>
<td>Safe drinking water program volatile organic compounds<br/>
</td>
<td align="right">$1,500<br/>
</td>
</tr>
<tr>
<td><a id="pl.317.26"></a><var>317.26</var><br/>
<a id="pl.317.27"></a><var>317.27</var><br/>
</td>
<td>Resource conservation and recovery program volatile organic <br/>
compounds<br/>
</td>
<td align="right">$1,500<br/>
</td>
</tr>
<tr>
<td><a id="pl.317.28"></a><var>317.28</var><br/>
</td>
<td>Underground storage tank program volatile organic compounds<br/>
</td>
<td align="right">$1,500<br/>
</td>
</tr>
<tr>
<td><a id="pl.317.29"></a><var>317.29</var><br/>
</td>
<td>Clean water program other organic compounds<br/>
</td>
<td align="right">$1,500<br/>
</td>
</tr>
<tr>
<td><a id="pl.317.30"></a><var>317.30</var><br/>
</td>
<td>Safe drinking water program other organic compounds<br/>
</td>
<td align="right">$1,500<br/>
</td>
</tr>
<tr>
<td><a id="pl.317.31"></a><var>317.31</var><br/>
</td>
<td>Resource conservation and recovery program other organic compounds<br/>
</td>
<td align="right">$1,500<br/>
</td>
</tr>
<tr>
<td><a id="pl.318.1"></a><var>318.1</var><br/>
</td>
<td>Clean water program radiochemistry<br/>
</td>
<td align="right">$2,500<br/>
</td>
</tr>
<tr>
<td><a id="pl.318.2"></a><var>318.2</var><br/>
</td>
<td>Safe drinking water program radiochemistry<br/>
</td>
<td align="right">$2,500<br/>
</td>
</tr>
<tr>
<td><a id="pl.318.3"></a><var>318.3</var><br/>
</td>
<td>Resource conservation and recovery program agricultural contaminants<br/>
</td>
<td align="right">$2,500<br/>
</td>
</tr>
<tr>
<td><a id="pl.318.4"></a><var>318.4</var><br/>
</td>
<td>Resource conservation and recovery program emerging contaminants<br/>
</td>
<td align="right">$2,500<br/>
</td>
</tr>
</table><a id="pl.318.5"></a><var>318.5</var>(b) Laboratories located outside of this state that require an on-site inspection shall be <br/>
<a id="pl.318.6"></a><var>318.6</var>assessed an additional $3,750 fee. For the programs in subdivision 3a, the commissioner <br/>
<a id="pl.318.7"></a><var>318.7</var>may accredit laboratories for fields of testing under the categories listed in clauses (1) to <br/>
<a id="pl.318.8"></a><var>318.8</var>(10) upon completion of the application requirements provided by subdivision 6 and <br/>
<a id="pl.318.9"></a><var>318.9</var>receipt of the fees for each category under each program that accreditation is requested. <br/>
<a id="pl.318.10"></a><var>318.10</var>The categories offered and related fees include:<br/>
<a id="pl.318.11"></a><var>318.11</var>(1) microbiology, $450;<br/>
<a id="pl.318.12"></a><var>318.12</var>(2) inorganics, $450;<br/>
<a id="pl.318.13"></a><var>318.13</var>(3) metals, $1,000;<br/>
<a id="pl.318.14"></a><var>318.14</var>(4) volatile organics, $1,300;<br/>
<a id="pl.318.15"></a><var>318.15</var>(5) other organics, $1,300;<br/>
<a id="pl.318.16"></a><var>318.16</var>(6) radiochemistry, $1,500;<br/>
<a id="pl.318.17"></a><var>318.17</var>(7) emerging contaminants, $1,500;<br/>
<a id="pl.318.18"></a><var>318.18</var>(8) agricultural contaminants, $1,250;<br/>
<a id="pl.318.19"></a><var>318.19</var>(9) toxicity (bioassay), $1,000; and<br/>
<a id="pl.318.20"></a><var>318.20</var>(10) physical characterization, $250.<br/>
<a id="pl.318.21"></a><var>318.21</var>(c) The total biennial certification annual fee includes the base fee, the sample <br/>
<a id="pl.318.22"></a><var>318.22</var>preparation techniques fees, the test category fees per program, and, when applicable, the <br/>
<a id="pl.318.23"></a><var>318.23</var>on-site inspection fee an administrative fee for out-of-state laboratories.<br/>
<a id="pl.318.24"></a><var>318.24</var>(d) Fees must be set so that the total fees support the laboratory certification program. <br/>
<a id="pl.318.25"></a><var>318.25</var>Direct costs of the certification service include program administration, inspections, the <br/>
<a id="pl.318.26"></a><var>318.26</var>agency's general support costs, and attorney general costs attributable to the fee function.<br/>
<a id="pl.318.27"></a><var>318.27</var>(e) A change fee shall be assessed if a laboratory requests additional analytes <br/>
<a id="pl.318.28"></a><var>318.28</var>or methods at any time other than when applying for or renewing its certification. The <br/>
<a id="pl.318.29"></a><var>318.29</var>change fee is equal to the test category certification fee for the analyte.<br/>
<a id="pl.318.30"></a><var>318.30</var>(f) A variance fee shall be assessed if a laboratory requests and is granted a variance <br/>
<a id="pl.318.31"></a><var>318.31</var>from a rule adopted under this section. The variance fee is $500 per variance.<br/>
<a id="pl.318.32"></a><var>318.32</var>(g) Refunds or credits shall not be made for analytes or methods requested but <br/>
<a id="pl.318.33"></a><var>318.33</var>not approved.<br/>
<a id="pl.318.34"></a><var>318.34</var>(h) Certification of a laboratory shall not be awarded until all fees are paid.<br/>
<br/>
<a id="bill.10.28.0"></a><a id="pl.319.1"></a><var>319.1</var>    Sec. 28. Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision <br/>
<a id="pl.319.2"></a><var>319.2</var>to read:<br/>
<a id="pl.319.3"></a><var>319.3</var>    Subd. 3a. <b>Available programs, categories, and analytes.</b> (a) The commissioner <br/>
<a id="pl.319.4"></a><var>319.4</var>shall accredit laboratories that test samples under the following programs:<br/>
<a id="pl.319.5"></a><var>319.5</var>(1) the clean water program, such as compliance monitoring under the federal Clean <br/>
<a id="pl.319.6"></a><var>319.6</var>Water Act, and ambient monitoring of surface and groundwater, or analysis of biological <br/>
<a id="pl.319.7"></a><var>319.7</var>tissue;<br/>
<a id="pl.319.8"></a><var>319.8</var>(2) the safe drinking water program, including compliance monitoring under the <br/>
<a id="pl.319.9"></a><var>319.9</var>federal Safe Drinking Water Act, and the state requirements for monitoring private wells;<br/>
<a id="pl.319.10"></a><var>319.10</var>(3) the resource conservation and recovery program, including federal and state <br/>
<a id="pl.319.11"></a><var>319.11</var>requirements for monitoring solid and hazardous wastes, biological tissue, leachates, and <br/>
<a id="pl.319.12"></a><var>319.12</var>groundwater monitoring wells not intended as drinking water sources;<br/>
<a id="pl.319.13"></a><var>319.13</var>(4) the underground storage tank program; and<br/>
<a id="pl.319.14"></a><var>319.14</var>(5) the clean air program, including air and emissions testing under the federal Clean <br/>
<a id="pl.319.15"></a><var>319.15</var>Air Act, and state and federal requirements for vapor intrusion monitoring.<br/>
<a id="pl.319.16"></a><var>319.16</var>(b) The commissioner shall maintain and publish a list of analytes available for <br/>
<a id="pl.319.17"></a><var>319.17</var>accreditation. The list must be reviewed at least once every six months and the changes <br/>
<a id="pl.319.18"></a><var>319.18</var>published in the State Register and posted on the program's Web site. The commissioner <br/>
<a id="pl.319.19"></a><var>319.19</var>shall publish the notification of changes and review comments on the changes no less than <br/>
<a id="pl.319.20"></a><var>319.20</var>30 days from the date the list is published.<br/>
<br/>
<a id="bill.10.29.0"></a><a id="pl.319.21"></a><var>319.21</var>    Sec. 29. Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision <br/>
<a id="pl.319.22"></a><var>319.22</var>to read:<br/>
<a id="pl.319.23"></a><var>319.23</var>    Subd. 3b. <b>Additional fees.</b> (a) Laboratories located outside of this state that require <br/>
<a id="pl.319.24"></a><var>319.24</var>an on-site assessment more frequent than once every two years must pay an additional <br/>
<a id="pl.319.25"></a><var>319.25</var>assessed fee of $3,000 per assessment for each additional on-site assessment conducted. <br/>
<a id="pl.319.26"></a><var>319.26</var>The laboratory must pay the fee within 15 business days of receiving the commissioner's <br/>
<a id="pl.319.27"></a><var>319.27</var>notification that an on-site assessment is required. The commissioner may conduct <br/>
<a id="pl.319.28"></a><var>319.28</var>additional on-site assessments to determine a laboratory's continued compliance with <br/>
<a id="pl.319.29"></a><var>319.29</var>the standards provided in subdivision 2a.<br/>
<a id="pl.319.30"></a><var>319.30</var>(b) A late fee of $200 shall be added to the annual fee for accredited laboratories <br/>
<a id="pl.319.31"></a><var>319.31</var>submitting renewal applications to the commissioner after November 1.<br/>
<a id="pl.319.32"></a><var>319.32</var>(c) A change fee shall be assessed if a laboratory requests additional fields of testing <br/>
<a id="pl.319.33"></a><var>319.33</var>at any time other than when initially applying for or renewing its accreditation. A change <br/>
<a id="pl.319.34"></a><var>319.34</var>fee does not apply for applications to add fields of testing for new analytes in response <br/>
<a id="pl.319.35"></a><var>319.35</var>to the published notice under subdivision 3a, paragraph (b), if the laboratory holds valid <br/>
<a id="pl.320.1"></a><var>320.1</var>accreditation for the changed test category and applies for additional analytes within the <br/>
<a id="pl.320.2"></a><var>320.2</var>same test category. The change fee is equal to the applicable test category fee for the <br/>
<a id="pl.320.3"></a><var>320.3</var>field of testing requested. An application that requests accreditation of multiple fields of <br/>
<a id="pl.320.4"></a><var>320.4</var>testing within a test category requires a single payment of the applicable test category fee <br/>
<a id="pl.320.5"></a><var>320.5</var>per application submitted.<br/>
<a id="pl.320.6"></a><var>320.6</var>(d) A variance fee shall be assessed if a laboratory requests a variance from a <br/>
<a id="pl.320.7"></a><var>320.7</var>standard provided in subdivision 2a. The variance fee is $500 per variance.<br/>
<a id="pl.320.8"></a><var>320.8</var>(e) The commissioner shall assess a fee for changes to laboratory information <br/>
<a id="pl.320.9"></a><var>320.9</var>regarding ownership, name, address, or personnel. Laboratories must submit changes <br/>
<a id="pl.320.10"></a><var>320.10</var>through the application process under subdivision 6. The information update fee is $250 <br/>
<a id="pl.320.11"></a><var>320.11</var>per application.<br/>
<a id="pl.320.12"></a><var>320.12</var>(f) Fees must be set so that the total fees support the laboratory accreditation <br/>
<a id="pl.320.13"></a><var>320.13</var>program. Direct costs of the accreditation service include program administration, <br/>
<a id="pl.320.14"></a><var>320.14</var>assessments, the agency's general support costs, and attorney general costs attributable <br/>
<a id="pl.320.15"></a><var>320.15</var>to the fee function.<br/>
<br/>
<a id="bill.10.30.0"></a><a id="pl.320.16"></a><var>320.16</var>    Sec. 30. Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision <br/>
<a id="pl.320.17"></a><var>320.17</var>to read:<br/>
<a id="pl.320.18"></a><var>320.18</var>    Subd. 3c. <b>Refunds and nonpayment.</b> Refunds or credits shall not be made for <br/>
<a id="pl.320.19"></a><var>320.19</var>applications received but not approved. Accreditation of a laboratory shall not be awarded <br/>
<a id="pl.320.20"></a><var>320.20</var>until all fees are paid.<br/>
<br/>
<a id="bill.10.31.0"></a><a id="pl.320.21"></a><var>320.21</var>    Sec. 31. Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision <br/>
<a id="pl.320.22"></a><var>320.22</var>to read:<br/>
<a id="pl.320.23"></a><var>320.23</var>    Subd. 6. <b>Application.</b> (a) Laboratories seeking accreditation must apply on a form <br/>
<a id="pl.320.24"></a><var>320.24</var>provided by the commissioner, include the laboratory's procedures and quality manual, <br/>
<a id="pl.320.25"></a><var>320.25</var>and pay the applicable fees.<br/>
<a id="pl.320.26"></a><var>320.26</var>(b) Laboratories may be fixed-base or mobile. The commissioner shall accredit <br/>
<a id="pl.320.27"></a><var>320.27</var>mobile laboratories individually and require a vehicle identification number, license <br/>
<a id="pl.320.28"></a><var>320.28</var>plate number, or other uniquely identifying information in addition to the application <br/>
<a id="pl.320.29"></a><var>320.29</var>requirements of paragraph (a).<br/>
<a id="pl.320.30"></a><var>320.30</var>(c) Laboratories maintained on separate properties, even though operated under the <br/>
<a id="pl.320.31"></a><var>320.31</var>same management or ownership, must apply separately. Laboratories with more than one <br/>
<a id="pl.320.32"></a><var>320.32</var>building on the same or adjoining properties do not need to submit a separate application.<br/>
<a id="pl.320.33"></a><var>320.33</var>(d) The commissioner may accredit laboratories located out-of-state. Accreditation <br/>
<a id="pl.320.34"></a><var>320.34</var>for out-of-state laboratories may be obtained directly from the commissioner following <br/>
<a id="pl.321.1"></a><var>321.1</var>the requirements in paragraph (a), or out-of-state laboratories may be accredited through <br/>
<a id="pl.321.2"></a><var>321.2</var>a reciprocal agreement if the laboratory:<br/>
<a id="pl.321.3"></a><var>321.3</var>(1) is accredited by a NELAP-recognized accreditation body for those fields of <br/>
<a id="pl.321.4"></a><var>321.4</var>testing in which the laboratory requests accreditation from the commissioner;<br/>
<a id="pl.321.5"></a><var>321.5</var>(2) submits an application and documentation according to this subdivision; and<br/>
<a id="pl.321.6"></a><var>321.6</var>(3) submits a current copy of the laboratory's unexpired accreditation from a <br/>
<a id="pl.321.7"></a><var>321.7</var>NELAP-recognized accreditation body showing the fields of accreditation for which the <br/>
<a id="pl.321.8"></a><var>321.8</var>laboratory is currently accredited.<br/>
<a id="pl.321.9"></a><var>321.9</var>(e) Under the conflict of interest determinations provided in section 43A.38, <br/>
<a id="pl.321.10"></a><var>321.10</var>subdivision 6, clause (a), the commissioner shall not accredit governmental laboratories <br/>
<a id="pl.321.11"></a><var>321.11</var>operated by agencies of the executive branch of the state. If accreditation is required, <br/>
<a id="pl.321.12"></a><var>321.12</var>laboratories operated by agencies of the executive branch of the state must apply for <br/>
<a id="pl.321.13"></a><var>321.13</var>accreditation through any other NELAP-recognized accreditation body.<br/>
<a id="pl.321.14"></a><var>321.14</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2009.<br/>
<br/>
<a id="bill.10.32.0"></a><a id="pl.321.15"></a><var>321.15</var>    Sec. 32. Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision <br/>
<a id="pl.321.16"></a><var>321.16</var>to read:<br/>
<a id="pl.321.17"></a><var>321.17</var>    Subd. 6a. <b>Implementation and effective date.</b> All laboratories must comply with <br/>
<a id="pl.321.18"></a><var>321.18</var>standards under this section by July 1, 2009. Fees under subdivisions 3 and 3b apply to <br/>
<a id="pl.321.19"></a><var>321.19</var>applications received and accreditations issued after June 30, 2009. Accreditations issued <br/>
<a id="pl.321.20"></a><var>321.20</var>on or before June 30, 2009, shall expire upon their current expiration date.<br/>
<br/>
<a id="bill.10.33.0"></a><a id="pl.321.21"></a><var>321.21</var>    Sec. 33. Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision <br/>
<a id="pl.321.22"></a><var>321.22</var>to read:<br/>
<a id="pl.321.23"></a><var>321.23</var>    Subd. 7. <b>Initial accreditation and annual accreditation renewal.</b> (a) The <br/>
<a id="pl.321.24"></a><var>321.24</var>commissioner shall issue or renew accreditation after receipt of the completed application <br/>
<a id="pl.321.25"></a><var>321.25</var>and documentation required in this section, provided the laboratory maintains compliance <br/>
<a id="pl.321.26"></a><var>321.26</var>with the standards specified in subdivision 2a, and attests to the compliance on the <br/>
<a id="pl.321.27"></a><var>321.27</var>application form.<br/>
<a id="pl.321.28"></a><var>321.28</var>(b) The commissioner shall prorate the fees in subdivision 3 for laboratories <br/>
<a id="pl.321.29"></a><var>321.29</var>applying for accreditation after December 31. The fees are prorated on a quarterly basis <br/>
<a id="pl.321.30"></a><var>321.30</var>beginning with the quarter in which the commissioner receives the completed application <br/>
<a id="pl.321.31"></a><var>321.31</var>from the laboratory.<br/>
<a id="pl.321.32"></a><var>321.32</var>(c) Applications for renewal of accreditation must be received by November 1 and <br/>
<a id="pl.321.33"></a><var>321.33</var>no earlier than October 1 of each year. The commissioner shall send annual renewal <br/>
<a id="pl.322.1"></a><var>322.1</var>notices to laboratories 90 days before expiration. Failure to receive a renewal notice does <br/>
<a id="pl.322.2"></a><var>322.2</var>not exempt laboratories from meeting the annual November 1 renewal date.<br/>
<a id="pl.322.3"></a><var>322.3</var>(d) The commissioner shall issue all accreditations for the calendar year for which <br/>
<a id="pl.322.4"></a><var>322.4</var>the application is made, and the accreditation shall expire on December 31 of that year.<br/>
<a id="pl.322.5"></a><var>322.5</var>(e) The accreditation of any laboratory that fails to submit a renewal application <br/>
<a id="pl.322.6"></a><var>322.6</var>and fees to the commissioner expires automatically on December 31 without notice or <br/>
<a id="pl.322.7"></a><var>322.7</var>further proceeding. Any person who operates a laboratory as accredited after expiration of <br/>
<a id="pl.322.8"></a><var>322.8</var>accreditation or without having submitted an application and paid the fees is in violation <br/>
<a id="pl.322.9"></a><var>322.9</var>of the provisions of this section and is subject to enforcement action under sections <br/>
<a id="pl.322.10"></a><var>322.10</var>144.989 to 144.993, the Health Enforcement Consolidation Act. A laboratory with expired <br/>
<a id="pl.322.11"></a><var>322.11</var>accreditation may reapply under subdivision 6.<br/>
<a id="pl.322.12"></a><var>322.12</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2009.<br/>
<br/>
<a id="bill.10.34.0"></a><a id="pl.322.13"></a><var>322.13</var>    Sec. 34. Minnesota Statutes 2008, section 144.99, subdivision 1, is amended to read:<br/>
<a id="pl.322.14"></a><var>322.14</var>    Subdivision 1. <b>Remedies available.</b> The provisions of chapters 103I and 157 and <br/>
<a id="pl.322.15"></a><var>322.15</var>sections 
         <statute_ref>115.71</statute_ref> to 
         <statute_ref>115.77</statute_ref>; 
         <statute_ref>144.12, subdivision 1, paragraphs (1), (2), (5), (6), (10), (12), <br/>
<a id="pl.322.16"></a><var>322.16</var>(13), (14), and (15)
         </statute_ref>; 
         <statute_ref>144.1201</statute_ref> to 
         <statute_ref>144.1204</statute_ref>; 
         <statute_ref>144.121</statute_ref>; 
         <statute_ref>144.1222</statute_ref>; 
         <statute_ref>144.35</statute_ref>; 
         <statute_ref>144.381</statute_ref> to <br/>
<statute_ref><a id="pl.322.17"></a><var>322.17</var>144.385
         </statute_ref>; 
         <statute_ref>144.411</statute_ref> to 
         <statute_ref>144.417</statute_ref>; 
         <statute_ref>144.495</statute_ref>; 
         <statute_ref>144.71</statute_ref> to 
         <statute_ref>144.74</statute_ref>; 
         <statute_ref>144.9501</statute_ref> to 
         <statute_ref>144.9512</statute_ref>; 144.97 <br/>
<a id="pl.322.18"></a><var>322.18</var>to 144.98;
<statute_ref>144.992</statute_ref>; 
         <statute_ref>326.70</statute_ref> to 
         <statute_ref>326.785</statute_ref>; 
         <statute_ref>327.10</statute_ref> to 
         <statute_ref>327.131</statute_ref>; and 
         <statute_ref>327.14</statute_ref> to 
         <statute_ref>327.28</statute_ref> and <br/>
<a id="pl.322.19"></a><var>322.19</var>all rules, orders, stipulation agreements, settlements, compliance agreements, licenses, <br/>
<a id="pl.322.20"></a><var>322.20</var>registrations, certificates, and permits adopted or issued by the department or under any <br/>
<a id="pl.322.21"></a><var>322.21</var>other law now in force or later enacted for the preservation of public health may, in <br/>
<a id="pl.322.22"></a><var>322.22</var>addition to provisions in other statutes, be enforced under this section. <br/>
<a id="pl.322.23"></a><var>322.23</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2009.<br/>
<br/>
<a id="bill.10.35.0"></a><a id="pl.322.24"></a><var>322.24</var>    Sec. 35. Minnesota Statutes 2008, section 153A.17, is amended to read:<br/>
<a id="pl.322.25"></a><var>322.25</var><b>153A.17 EXPENSES; FEES.</b><br/>
<a id="pl.322.26"></a><var>322.26</var>The expenses for administering the certification requirements including the <br/>
<a id="pl.322.27"></a><var>322.27</var>complaint handling system for hearing aid dispensers in sections 
<statute_ref>153A.14</statute_ref> and 
<statute_ref>153A.15</statute_ref> <br/>
<a id="pl.322.28"></a><var>322.28</var>and the Consumer Information Center under section 
<statute_ref>153A.18</statute_ref> must be paid from <br/>
<a id="pl.322.29"></a><var>322.29</var>initial application and examination fees, renewal fees, penalties, and fines. All fees <br/>
<a id="pl.322.30"></a><var>322.30</var>are nonrefundable. The certificate application fee is $350, the examination fee is $250 <br/>
<a id="pl.322.31"></a><var>322.31</var>for the written portion and $250 for the practical portion each time one or the other is <br/>
<a id="pl.322.32"></a><var>322.32</var>taken, and the trainee application fee is $200. The penalty fee for late submission of a <br/>
<a id="pl.322.33"></a><var>322.33</var>renewal application is $200. The fee for verification of certification to other jurisdictions <br/>
<a id="pl.322.34"></a><var>322.34</var>or entities is $25. All fees, penalties, and fines received must be deposited in the state <br/>
<a id="pl.323.1"></a><var>323.1</var>government special revenue fund. The commissioner may prorate the certification fee for <br/>
<a id="pl.323.2"></a><var>323.2</var>new applicants based on the number of quarters remaining in the annual certification <br/>
<a id="pl.323.3"></a><var>323.3</var>period. (a) The expenses for administering the certification requirements, including the <br/>
<a id="pl.323.4"></a><var>323.4</var>complaint handling system for hearing aid dispensers in sections 153A.14 and 153A.15, <br/>
<a id="pl.323.5"></a><var>323.5</var>and the Consumer Information Center under section 153A.18, must be paid from initial <br/>
<a id="pl.323.6"></a><var>323.6</var>application and examination fees, renewal fees, penalties, and fines. <br/>
<a id="pl.323.7"></a><var>323.7</var> (b) The fees are as follows:<br/>
<a id="pl.323.8"></a><var>323.8</var>(1) the initial and annual renewal certification application fee is $600;<br/>
<a id="pl.323.9"></a><var>323.9</var>(2) the initial examination fee for the written portion is $500, and for each time it <br/>
<a id="pl.323.10"></a><var>323.10</var>is taken, thereafter;<br/>
<a id="pl.323.11"></a><var>323.11</var>(3) the initial examination fee for the practical portion is $1,200, and $600 for each <br/>
<a id="pl.323.12"></a><var>323.12</var>time it is taken, thereafter; for individuals meeting the requirements of section 148.515, <br/>
<a id="pl.323.13"></a><var>323.13</var>subdivision 2, the fee for the practical portion of the hearing instrument dispensing <br/>
<a id="pl.323.14"></a><var>323.14</var>examination is $250 each time it is taken;<br/>
<a id="pl.323.15"></a><var>323.15</var>(4) the trainee application fee is $200;<br/>
<a id="pl.323.16"></a><var>323.16</var>(5) the penalty fee for late submission of a renewal application is $200; and <br/>
<a id="pl.323.17"></a><var>323.17</var>(6) the fee for verification of certification to other jurisdictions or entities is $25.<br/>
<a id="pl.323.18"></a><var>323.18</var>(c) The commissioner may prorate the certification fee for new applicants based on <br/>
<a id="pl.323.19"></a><var>323.19</var>the number of quarters remaining in the annual certification period.<br/>
<a id="pl.323.20"></a><var>323.20</var>(d) All fees are nonrefundable. All fees, penalties, and fines received must be <br/>
<a id="pl.323.21"></a><var>323.21</var>deposited in the state government special revenue fund.<br/>
<a id="pl.323.22"></a><var>323.22</var>(e) Beginning July 1, 2009, until June 30, 2016, a surcharge of $100 shall be paid <br/>
<a id="pl.323.23"></a><var>323.23</var>at the time of initial certification application or renewal to recover the commissioner's <br/>
<a id="pl.323.24"></a><var>323.24</var>accumulated direct expenditures for administering the requirements of this chapter.<br/>
<br/>
<a id="bill.10.36.0"></a><a id="pl.323.25"></a><var>323.25</var>    Sec. 36. Minnesota Statutes 2008, section 157.15, is amended by adding a subdivision <br/>
<a id="pl.323.26"></a><var>323.26</var>to read:<br/>
<a id="pl.323.27"></a><var>323.27</var>    Subd. 20. <b>Youth camp.</b> "Youth camp" has the meaning given in section 144.71, <br/>
<a id="pl.323.28"></a><var>323.28</var>subdivision 2.<br/>
<br/>
<a id="bill.10.37.0"></a><a id="pl.323.29"></a><var>323.29</var>    Sec. 37. Minnesota Statutes 2008, section 157.16, is amended to read:<br/>
<a id="pl.323.30"></a><var>323.30</var><b>157.16 LICENSES REQUIRED; FEES. </b><br/>
<a id="pl.323.31"></a><var>323.31</var>    Subdivision 1.  <b>License required annually.</b> A license is required annually for every <br/>
<a id="pl.323.32"></a><var>323.32</var>person, firm, or corporation engaged in the business of conducting a food and beverage <br/>
<a id="pl.323.33"></a><var>323.33</var>service establishment, youth camp, hotel, motel, lodging establishment, public pool, or <br/>
<a id="pl.323.34"></a><var>323.34</var>resort. Any person wishing to operate a place of business licensed in this section shall <br/>
<a id="pl.324.1"></a><var>324.1</var>first make application, pay the required fee specified in this section, and receive approval <br/>
<a id="pl.324.2"></a><var>324.2</var>for operation, including plan review approval. Seasonal and temporary food stands and <br/>
<a id="pl.324.3"></a><var>324.3</var>Special event food stands are not required to submit plans. Nonprofit organizations <br/>
<a id="pl.324.4"></a><var>324.4</var>operating a special event food stand with multiple locations at an annual one-day event <br/>
<a id="pl.324.5"></a><var>324.5</var>shall be issued only one license. Application shall be made on forms provided by the <br/>
<a id="pl.324.6"></a><var>324.6</var>commissioner and shall require the applicant to state the full name and address of the <br/>
<a id="pl.324.7"></a><var>324.7</var>owner of the building, structure, or enclosure, the lessee and manager of the food and <br/>
<a id="pl.324.8"></a><var>324.8</var>beverage service establishment, hotel, motel, lodging establishment, public pool, or resort; <br/>
<a id="pl.324.9"></a><var>324.9</var>the name under which the business is to be conducted; and any other information as may <br/>
<a id="pl.324.10"></a><var>324.10</var>be required by the commissioner to complete the application for license. <br/>
<a id="pl.324.11"></a><var>324.11</var>    Subd. 2.  <b>License renewal.</b> Initial and renewal licenses for all food and beverage <br/>
<a id="pl.324.12"></a><var>324.12</var>service establishments, youth camps, hotels, motels, lodging establishments, public pools, <br/>
<a id="pl.324.13"></a><var>324.13</var>and resorts shall be issued for the calendar year for which application is made and shall <br/>
<a id="pl.324.14"></a><var>324.14</var>expire on December 31 of such year on an annual basis. Any person who operates a place <br/>
<a id="pl.324.15"></a><var>324.15</var>of business after the expiration date of a license or without having submitted an application <br/>
<a id="pl.324.16"></a><var>324.16</var>and paid the fee shall be deemed to have violated the provisions of this chapter and shall <br/>
<a id="pl.324.17"></a><var>324.17</var>be subject to enforcement action, as provided in the Health Enforcement Consolidation <br/>
<a id="pl.324.18"></a><var>324.18</var>Act, sections 
         <statute_ref>144.989</statute_ref> to 
         <statute_ref>144.993</statute_ref>. In addition, a penalty of $50 $60 shall be added to the <br/>
<a id="pl.324.19"></a><var>324.19</var>total of the license fee for any food and beverage service establishment operating without <br/>
<a id="pl.324.20"></a><var>324.20</var>a license as a mobile food unit, a seasonal temporary or seasonal permanent food stand, or <br/>
<a id="pl.324.21"></a><var>324.21</var>a special event food stand, and a penalty of $100 $120 shall be added to the total of the <br/>
<a id="pl.324.22"></a><var>324.22</var>license fee for all restaurants, food carts, hotels, motels, lodging establishments, youth <br/>
<a id="pl.324.23"></a><var>324.23</var>camps, public pools, and resorts operating without a license for a period of up to 30 days. <br/>
<a id="pl.324.24"></a><var>324.24</var>A late fee of $300 $360 shall be added to the license fee for establishments operating more <br/>
<a id="pl.324.25"></a><var>324.25</var>than 30 days without a license. <br/>
<a id="pl.324.26"></a><var>324.26</var>    Subd. 2a.  <b>Food manager certification.</b> An applicant for certification or certification <br/>
<a id="pl.324.27"></a><var>324.27</var>renewal as a food manager must submit to the commissioner a $28 $35 nonrefundable <br/>
<a id="pl.324.28"></a><var>324.28</var>certification fee payable to the Department of Health. The commissioner shall issue a <br/>
<a id="pl.324.29"></a><var>324.29</var>duplicate certificate to replace a lost, destroyed, or mutilated certificate if the applicant <br/>
<a id="pl.324.30"></a><var>324.30</var>submits a completed application on a form provided by the commissioner for a duplicate <br/>
<a id="pl.324.31"></a><var>324.31</var>certificate and pays $20 to the department for the cost of duplication.<br/>
<a id="pl.324.32"></a><var>324.32</var>    Subd. 3.  <b>Establishment fees; definitions.</b> (a) The following fees are required <br/>
<a id="pl.324.33"></a><var>324.33</var>for food and beverage service establishments, youth camps, hotels, motels, lodging <br/>
<a id="pl.324.34"></a><var>324.34</var>establishments, public pools, and resorts licensed under this chapter. Food and beverage <br/>
<a id="pl.324.35"></a><var>324.35</var>service establishments must pay the highest applicable fee under paragraph (d), clause <br/>
<a id="pl.325.1"></a><var>325.1</var>(1), (2), (3), or (4), and establishments serving alcohol must pay the highest applicable <br/>
<a id="pl.325.2"></a><var>325.2</var>fee under paragraph (d), clause (6) or (7). The license fee for new operators previously <br/>
<a id="pl.325.3"></a><var>325.3</var>licensed under this chapter for the same calendar year is one-half of the appropriate annual <br/>
<a id="pl.325.4"></a><var>325.4</var>license fee, plus any penalty that may be required. The license fee for operators opening <br/>
<a id="pl.325.5"></a><var>325.5</var>on or after October 1 is one-half of the appropriate annual license fee, plus any penalty <br/>
<a id="pl.325.6"></a><var>325.6</var>that may be required. <br/>
<a id="pl.325.7"></a><var>325.7</var>    (b) All food and beverage service establishments, except special event food stands, <br/>
<a id="pl.325.8"></a><var>325.8</var>and all hotels, motels, lodging establishments, public pools, and resorts shall pay an <br/>
<a id="pl.325.9"></a><var>325.9</var>annual base fee of $150. <br/>
<a id="pl.325.10"></a><var>325.10</var>    (c) A special event food stand shall pay a flat fee of $40 $50 annually. "Special event <br/>
<a id="pl.325.11"></a><var>325.11</var>food stand" means a fee category where food is prepared or served in conjunction with <br/>
<a id="pl.325.12"></a><var>325.12</var>celebrations, county fairs, or special events from a special event food stand as defined <br/>
<a id="pl.325.13"></a><var>325.13</var>in section 
         <statute_ref>157.15</statute_ref>. <br/>
<a id="pl.325.14"></a><var>325.14</var>    (d) In addition to the base fee in paragraph (b), each food and beverage service <br/>
<a id="pl.325.15"></a><var>325.15</var>establishment, other than a special event food stand, and each hotel, motel, lodging <br/>
<a id="pl.325.16"></a><var>325.16</var>establishment, public pool, and resort shall pay an additional annual fee for each fee <br/>
<a id="pl.325.17"></a><var>325.17</var>category, additional food service, or required additional inspection specified in this <br/>
<a id="pl.325.18"></a><var>325.18</var>paragraph: <br/>
<a id="pl.325.19"></a><var>325.19</var>    (1) Limited food menu selection, $50 $60. "Limited food menu selection" means a <br/>
<a id="pl.325.20"></a><var>325.20</var>fee category that provides one or more of the following: <br/>
<a id="pl.325.21"></a><var>325.21</var>    (i) prepackaged food that receives heat treatment and is served in the package; <br/>
<a id="pl.325.22"></a><var>325.22</var>    (ii) frozen pizza that is heated and served; <br/>
<a id="pl.325.23"></a><var>325.23</var>    (iii) a continental breakfast such as rolls, coffee, juice, milk, and cold cereal; <br/>
<a id="pl.325.24"></a><var>325.24</var>    (iv) soft drinks, coffee, or nonalcoholic beverages; or <br/>
<a id="pl.325.25"></a><var>325.25</var>    (v) cleaning for eating, drinking, or cooking utensils, when the only food served <br/>
<a id="pl.325.26"></a><var>325.26</var>is prepared off site. <br/>
<a id="pl.325.27"></a><var>325.27</var>    (2) Small establishment, including boarding establishments, $100 $120. "Small <br/>
<a id="pl.325.28"></a><var>325.28</var>establishment" means a fee category that has no salad bar and meets one or more of <br/>
<a id="pl.325.29"></a><var>325.29</var>the following: <br/>
<a id="pl.325.30"></a><var>325.30</var>    (i) possesses food service equipment that consists of no more than a deep fat fryer, a <br/>
<a id="pl.325.31"></a><var>325.31</var>grill, two hot holding containers, and one or more microwave ovens; <br/>
<a id="pl.325.32"></a><var>325.32</var>    (ii) serves dipped ice cream or soft serve frozen desserts; <br/>
<a id="pl.325.33"></a><var>325.33</var>    (iii) serves breakfast in an owner-occupied bed and breakfast establishment; <br/>
<a id="pl.325.34"></a><var>325.34</var>    (iv) is a boarding establishment; or <br/>
<a id="pl.325.35"></a><var>325.35</var>    (v) meets the equipment criteria in clause (3), item (i) or (ii), and has a maximum <br/>
<a id="pl.325.36"></a><var>325.36</var>patron seating capacity of not more than 50. <br/>
<a id="pl.326.1"></a><var>326.1</var>    (3) Medium establishment, $260 $310. "Medium establishment" means a fee <br/>
<a id="pl.326.2"></a><var>326.2</var>category that meets one or more of the following: <br/>
<a id="pl.326.3"></a><var>326.3</var>    (i) possesses food service equipment that includes a range, oven, steam table, salad <br/>
<a id="pl.326.4"></a><var>326.4</var>bar, or salad preparation area; <br/>
<a id="pl.326.5"></a><var>326.5</var>    (ii) possesses food service equipment that includes more than one deep fat fryer, <br/>
<a id="pl.326.6"></a><var>326.6</var>one grill, or two hot holding containers; or <br/>
<a id="pl.326.7"></a><var>326.7</var>    (iii) is an establishment where food is prepared at one location and served at one or <br/>
<a id="pl.326.8"></a><var>326.8</var>more separate locations. <br/>
<a id="pl.326.9"></a><var>326.9</var>    Establishments meeting criteria in clause (2), item (v), are not included in this fee <br/>
<a id="pl.326.10"></a><var>326.10</var>category. <br/>
<a id="pl.326.11"></a><var>326.11</var>    (4) Large establishment, $460 $540. "Large establishment" means either: <br/>
<a id="pl.326.12"></a><var>326.12</var>    (i) a fee category that (A) meets the criteria in clause (3), items (i) or (ii), for a <br/>
<a id="pl.326.13"></a><var>326.13</var>medium establishment, (B) seats more than 175 people, and (C) offers the full menu <br/>
<a id="pl.326.14"></a><var>326.14</var>selection an average of five or more days a week during the weeks of operation; or <br/>
<a id="pl.326.15"></a><var>326.15</var>    (ii) a fee category that (A) meets the criteria in clause (3), item (iii), for a medium <br/>
<a id="pl.326.16"></a><var>326.16</var>establishment, and (B) prepares and serves 500 or more meals per day. <br/>
<a id="pl.326.17"></a><var>326.17</var>    (5) Other food and beverage service, including food carts, mobile food units, <br/>
<a id="pl.326.18"></a><var>326.18</var>seasonal temporary food stands, and seasonal permanent food stands, $50 $60. <br/>
<a id="pl.326.19"></a><var>326.19</var>    (6) Beer or wine table service, $50 $60. "Beer or wine table service" means a fee <br/>
<a id="pl.326.20"></a><var>326.20</var>category where the only alcoholic beverage service is beer or wine, served to customers <br/>
<a id="pl.326.21"></a><var>326.21</var>seated at tables. <br/>
<a id="pl.326.22"></a><var>326.22</var>    (7) Alcoholic beverage service, other than beer or wine table service, $135 $165. <br/>
<a id="pl.326.23"></a><var>326.23</var>    "Alcohol beverage service, other than beer or wine table service" means a fee <br/>
<a id="pl.326.24"></a><var>326.24</var>category where alcoholic mixed drinks are served or where beer or wine are served from <br/>
<a id="pl.326.25"></a><var>326.25</var>a bar. <br/>
<a id="pl.326.26"></a><var>326.26</var>    (8) Lodging per sleeping accommodation unit, $8 $10, including hotels, motels, <br/>
<a id="pl.326.27"></a><var>326.27</var>lodging establishments, and resorts, up to a maximum of $800 $1,000. "Lodging per <br/>
<a id="pl.326.28"></a><var>326.28</var>sleeping accommodation unit" means a fee category including the number of guest rooms, <br/>
<a id="pl.326.29"></a><var>326.29</var>cottages, or other rental units of a hotel, motel, lodging establishment, or resort; or the <br/>
<a id="pl.326.30"></a><var>326.30</var>number of beds in a dormitory. <br/>
<a id="pl.326.31"></a><var>326.31</var>    (9) First public pool, $180 $325; each additional public pool, $100 $175. "Public <br/>
<a id="pl.326.32"></a><var>326.32</var>pool" means a fee category that has the meaning given in section 
         <statute_ref>144.1222, subdivision 4</statute_ref>. <br/>
<a id="pl.326.33"></a><var>326.33</var>    (10) First spa, $110 $175; each additional spa, $50 $100. "Spa pool" means a fee <br/>
<a id="pl.326.34"></a><var>326.34</var>category that has the meaning given in Minnesota Rules, part 4717.0250, subpart 9. <br/>
<a id="pl.326.35"></a><var>326.35</var>    (11) Private sewer or water, $50 $60. "Individual private water" means a fee <br/>
<a id="pl.326.36"></a><var>326.36</var>category with a water supply other than a community public water supply as defined in <br/>
<a id="pl.327.1"></a><var>327.1</var>Minnesota Rules, chapter 4720. "Individual private sewer" means a fee category with an <br/>
<a id="pl.327.2"></a><var>327.2</var>individual sewage treatment system which uses subsurface treatment and disposal. <br/>
<a id="pl.327.3"></a><var>327.3</var>    (12) Additional food service, $130 $150. "Additional food service" means a location <br/>
<a id="pl.327.4"></a><var>327.4</var>at a food service establishment, other than the primary food preparation and service area, <br/>
<a id="pl.327.5"></a><var>327.5</var>used to prepare or serve food to the public. <br/>
<a id="pl.327.6"></a><var>327.6</var>    (13) Additional inspection fee, $300 $360. "Additional inspection fee" means a <br/>
<a id="pl.327.7"></a><var>327.7</var>fee to conduct the second inspection each year for elementary and secondary education <br/>
<a id="pl.327.8"></a><var>327.8</var>facility school lunch programs when required by the Richard B. Russell National School <br/>
<a id="pl.327.9"></a><var>327.9</var>Lunch Act. <br/>
<a id="pl.327.10"></a><var>327.10</var>    (e) A fee of $350 for review of the construction plans must accompany the initial <br/>
<a id="pl.327.11"></a><var>327.11</var>license application for restaurants, hotels, motels, lodging establishments, or resorts with <br/>
<a id="pl.327.12"></a><var>327.12</var>five or more sleeping units., seasonal food stands, and mobile food units. The fee for <br/>
<a id="pl.327.13"></a><var>327.13</var>this construction plan review is as follows: <br/>
<table>
<col width="50px"/>
<col width="15.5"/>
<col width="30"/>
<col width="5.5"/>
<tr>
<td><a id="pl.327.14"></a><var>327.14</var><br/>
</td>
<td align="left"><b>Service Area</b><br/>
</td>
<td align="left"><b>Type</b><br/>
</td>
<td align="right"><b>Fee</b><br/>
</td>
</tr>
<tr>
<td><a id="pl.327.15"></a><var>327.15</var><br/>
</td>
<td>Food<br/>
</td>
<td>limited food menu<br/>
</td>
<td align="right">$275<br/>
</td>
</tr>
<tr>
<td><a id="pl.327.16"></a><var>327.16</var><br/>
</td>
<td></td>
<td>small establishment<br/>
</td>
<td align="right">$400<br/>
</td>
</tr>
<tr>
<td><a id="pl.327.17"></a><var>327.17</var><br/>
</td>
<td></td>
<td>medium establishment<br/>
</td>
<td align="right">$450<br/>
</td>
</tr>
<tr>
<td><a id="pl.327.18"></a><var>327.18</var><br/>
</td>
<td></td>
<td>large food establishment<br/>
</td>
<td align="right">$500<br/>
</td>
</tr>
<tr>
<td><a id="pl.327.19"></a><var>327.19</var><br/>
</td>
<td></td>
<td>additional food service<br/>
</td>
<td align="right">$150<br/>
</td>
</tr>
<tr>
<td><a id="pl.327.20"></a><var>327.20</var><br/>
</td>
<td>Transient food service<br/>
</td>
<td>food cart<br/>
</td>
<td align="right">$250<br/>
</td>
</tr>
<tr>
<td><a id="pl.327.21"></a><var>327.21</var><br/>
</td>
<td></td>
<td>seasonal permanent food stand<br/>
</td>
<td align="right">$250<br/>
</td>
</tr>
<tr>
<td><a id="pl.327.22"></a><var>327.22</var><br/>
</td>
<td></td>
<td>seasonal temporary food stand<br/>
</td>
<td align="right">$250<br/>
</td>
</tr>
<tr>
<td><a id="pl.327.23"></a><var>327.23</var><br/>
</td>
<td></td>
<td>mobile food unit<br/>
</td>
<td align="right">$350<br/>
</td>
</tr>
<tr>
<td><a id="pl.327.24"></a><var>327.24</var><br/>
</td>
<td>Alcohol<br/>
</td>
<td>beer or wine table service<br/>
</td>
<td align="right">$150<br/>
</td>
</tr>
<tr>
<td><a id="pl.327.25"></a><var>327.25</var><br/>
</td>
<td></td>
<td>alcohol service from bar<br/>
</td>
<td align="right">$250<br/>
</td>
</tr>
<tr>
<td><a id="pl.327.26"></a><var>327.26</var><br/>
</td>
<td>Lodging<br/>
</td>
<td>less than 25 rooms<br/>
</td>
<td align="right">$375<br/>
</td>
</tr>
<tr>
<td><a id="pl.327.27"></a><var>327.27</var><br/>
</td>
<td></td>
<td>25 to less than 100 rooms<br/>
</td>
<td align="right">$400<br/>
</td>
</tr>
<tr>
<td><a id="pl.327.28"></a><var>327.28</var><br/>
</td>
<td></td>
<td>100 rooms or more<br/>
</td>
<td align="right">$500<br/>
</td>
</tr>
<tr>
<td><a id="pl.327.29"></a><var>327.29</var><br/>
</td>
<td></td>
<td>less than five cabins<br/>
</td>
<td align="right">$350<br/>
</td>
</tr>
<tr>
<td><a id="pl.327.30"></a><var>327.30</var><br/>
</td>
<td></td>
<td>five to less than ten cabins<br/>
</td>
<td align="right">$400<br/>
</td>
</tr>
<tr>
<td><a id="pl.327.31"></a><var>327.31</var><br/>
</td>
<td></td>
<td>ten cabins or more<br/>
</td>
<td align="right">$450<br/>
</td>
</tr>
</table><a id="pl.328.1"></a><var>328.1</var>    (f) When existing food and beverage service establishments, hotels, motels, lodging <br/>
<a id="pl.328.2"></a><var>328.2</var>establishments, or resorts, seasonal food stands, and mobile food units are extensively <br/>
<a id="pl.328.3"></a><var>328.3</var>remodeled, a fee of $250 must be submitted with the remodeling plans. A fee of $250 <br/>
<a id="pl.328.4"></a><var>328.4</var>must be submitted for new construction or remodeling for a restaurant with a limited food <br/>
<a id="pl.328.5"></a><var>328.5</var>menu selection, a seasonal permanent food stand, a mobile food unit, or a food cart, or for <br/>
<a id="pl.328.6"></a><var>328.6</var>a hotel, motel, resort, or lodging establishment addition of less than five sleeping units. <br/>
<a id="pl.328.7"></a><var>328.7</var>The fee for this construction plan review is as follows: <br/>
<table>
<col width="50px"/>
<col width="15.5"/>
<col width="30"/>
<col width="5.5"/>
<tr>
<td><a id="pl.328.8"></a><var>328.8</var><br/>
</td>
<td align="left"><b>Service Area</b><br/>
</td>
<td align="left"><b>Type</b><br/>
</td>
<td align="right"><b>Fee</b><br/>
</td>
</tr>
<tr>
<td><a id="pl.328.9"></a><var>328.9</var><br/>
</td>
<td>Food<br/>
</td>
<td>limited food menu<br/>
</td>
<td align="right">$250<br/>
</td>
</tr>
<tr>
<td><a id="pl.328.10"></a><var>328.10</var><br/>
</td>
<td></td>
<td>small establishment<br/>
</td>
<td align="right">$300<br/>
</td>
</tr>
<tr>
<td><a id="pl.328.11"></a><var>328.11</var><br/>
</td>
<td></td>
<td>medium establishment<br/>
</td>
<td align="right">$350<br/>
</td>
</tr>
<tr>
<td><a id="pl.328.12"></a><var>328.12</var><br/>
</td>
<td></td>
<td>large food establishment<br/>
</td>
<td align="right">$400<br/>
</td>
</tr>
<tr>
<td><a id="pl.328.13"></a><var>328.13</var><br/>
</td>
<td></td>
<td>additional food service<br/>
</td>
<td align="right">$150<br/>
</td>
</tr>
<tr>
<td><a id="pl.328.14"></a><var>328.14</var><br/>
</td>
<td>Transient food service<br/>
</td>
<td>food cart<br/>
</td>
<td align="right">$250<br/>
</td>
</tr>
<tr>
<td><a id="pl.328.15"></a><var>328.15</var><br/>
</td>
<td></td>
<td>seasonal permanent food stand<br/>
</td>
<td align="right">$250<br/>
</td>
</tr>
<tr>
<td><a id="pl.328.16"></a><var>328.16</var><br/>
</td>
<td></td>
<td>seasonal temporary food stand<br/>
</td>
<td align="right">$250<br/>
</td>
</tr>
<tr>
<td><a id="pl.328.17"></a><var>328.17</var><br/>
</td>
<td></td>
<td>mobile food unit<br/>
</td>
<td align="right">$250<br/>
</td>
</tr>
<tr>
<td><a id="pl.328.18"></a><var>328.18</var><br/>
</td>
<td>Alcohol<br/>
</td>
<td>beer or wine table service<br/>
</td>
<td align="right">$150<br/>
</td>
</tr>
<tr>
<td><a id="pl.328.19"></a><var>328.19</var><br/>
</td>
<td></td>
<td>alcohol service from bar<br/>
</td>
<td align="right">$250<br/>
</td>
</tr>
<tr>
<td><a id="pl.328.20"></a><var>328.20</var><br/>
</td>
<td>Lodging<br/>
</td>
<td>less than 25 rooms<br/>
</td>
<td align="right">$250<br/>
</td>
</tr>
<tr>
<td><a id="pl.328.21"></a><var>328.21</var><br/>
</td>
<td></td>
<td>25 to less than 100 rooms<br/>
</td>
<td align="right">$300<br/>
</td>
</tr>
<tr>
<td><a id="pl.328.22"></a><var>328.22</var><br/>
</td>
<td></td>
<td>100 rooms or more<br/>
</td>
<td align="right">$450<br/>
</td>
</tr>
<tr>
<td><a id="pl.328.23"></a><var>328.23</var><br/>
</td>
<td></td>
<td>less than five cabins<br/>
</td>
<td align="right">$250<br/>
</td>
</tr>
<tr>
<td><a id="pl.328.24"></a><var>328.24</var><br/>
</td>
<td></td>
<td>five to less than ten cabins<br/>
</td>
<td align="right">$350<br/>
</td>
</tr>
<tr>
<td><a id="pl.328.25"></a><var>328.25</var><br/>
</td>
<td></td>
<td>ten cabins or more<br/>
</td>
<td align="right">$400<br/>
</td>
</tr>
</table><a id="pl.328.26"></a><var>328.26</var>    (g) Seasonal temporary food stands and Special event food stands are not required to <br/>
<a id="pl.328.27"></a><var>328.27</var>submit construction or remodeling plans for review. <br/>
<a id="pl.328.28"></a><var>328.28</var>(h) Youth camps shall pay an annual single fee for food and lodging as follows:<br/>
<a id="pl.328.29"></a><var>328.29</var>(1) camps with up to 99 campers, $325;<br/>
<a id="pl.328.30"></a><var>328.30</var>(2) camps with 100 to 199 campers, $550; and<br/>
<a id="pl.328.31"></a><var>328.31</var>(3) camps with 200 or more campers; $750.<br/>
<a id="pl.329.1"></a><var>329.1</var>    Subd. 3a.  <b>Statewide hospitality fee.</b> Every person, firm, or corporation that <br/>
<a id="pl.329.2"></a><var>329.2</var>operates a licensed boarding establishment, food and beverage service establishment, <br/>
<a id="pl.329.3"></a><var>329.3</var>seasonal temporary or permanent food stand, special event food stand, mobile food unit, <br/>
<a id="pl.329.4"></a><var>329.4</var>food cart, resort, hotel, motel, or lodging establishment in Minnesota must submit to the <br/>
<a id="pl.329.5"></a><var>329.5</var>commissioner a $35 annual statewide hospitality fee for each licensed activity. The fee <br/>
<a id="pl.329.6"></a><var>329.6</var>for establishments licensed by the Department of Health is required at the same time the <br/>
<a id="pl.329.7"></a><var>329.7</var>licensure fee is due. For establishments licensed by local governments, the fee is due by <br/>
<a id="pl.329.8"></a><var>329.8</var>July 1 of each year. <br/>
<a id="pl.329.9"></a><var>329.9</var>    Subd. 4.  <b>Posting requirements.</b> Every food and beverage service establishment, <br/>
<a id="pl.329.10"></a><var>329.10</var>for-profit youth camp, hotel, motel, lodging establishment, public pool, or resort must have <br/>
<a id="pl.329.11"></a><var>329.11</var>the license posted in a conspicuous place at the establishment. Mobile food units, food <br/>
<a id="pl.329.12"></a><var>329.12</var>carts, and seasonal temporary food stands shall be issued decals with the initial license and <br/>
<a id="pl.329.13"></a><var>329.13</var>each calendar year with license renewals. The current license year decal must be placed on <br/>
<a id="pl.329.14"></a><var>329.14</var>the unit or stand in a location determined by the commissioner. Decals are not transferable. <br/>
<br/>
<a id="bill.10.38.0"></a><a id="pl.329.15"></a><var>329.15</var>    Sec. 38. Minnesota Statutes 2008, section 157.22, is amended to read:<br/>
<a id="pl.329.16"></a><var>329.16</var><b>157.22 EXEMPTIONS.</b><br/>
<a id="pl.329.17"></a><var>329.17</var>This chapter shall not be construed to does not apply to:<br/>
<a id="pl.329.18"></a><var>329.18</var>(1) interstate carriers under the supervision of the United States Department of <br/>
<a id="pl.329.19"></a><var>329.19</var>Health and Human Services;<br/>
<a id="pl.329.20"></a><var>329.20</var>(2) any building constructed and primarily used for religious worship;<br/>
<a id="pl.329.21"></a><var>329.21</var>(3) any building owned, operated, and used by a college or university in accordance <br/>
<a id="pl.329.22"></a><var>329.22</var>with health regulations promulgated by the college or university under chapter 14;<br/>
<a id="pl.329.23"></a><var>329.23</var>(4) any person, firm, or corporation whose principal mode of business is licensed <br/>
<a id="pl.329.24"></a><var>329.24</var>under sections 
         <statute_ref>28A.04</statute_ref> and 
         <statute_ref>28A.05</statute_ref>, is exempt at that premises from licensure as a food <br/>
<a id="pl.329.25"></a><var>329.25</var>or beverage establishment; provided that the holding of any license pursuant to sections <br/>
<statute_ref><a id="pl.329.26"></a><var>329.26</var>28A.04
         </statute_ref> and 
         <statute_ref>28A.05</statute_ref> shall not exempt any person, firm, or corporation from the applicable <br/>
<a id="pl.329.27"></a><var>329.27</var>provisions of this chapter or the rules of the state commissioner of health relating to <br/>
<a id="pl.329.28"></a><var>329.28</var>food and beverage service establishments;<br/>
<a id="pl.329.29"></a><var>329.29</var>(5) family day care homes and group family day care homes governed by sections <br/>
<statute_ref><a id="pl.329.30"></a><var>329.30</var>245A.01
         </statute_ref> to 
         <statute_ref>245A.16</statute_ref>;<br/>
<a id="pl.329.31"></a><var>329.31</var>(6) nonprofit senior citizen centers for the sale of home-baked goods;<br/>
<a id="pl.329.32"></a><var>329.32</var>(7) fraternal or patriotic organizations that are tax exempt under section 501(c)(3), <br/>
<a id="pl.329.33"></a><var>329.33</var>501(c)(4), 501(c)(6), 501(c)(7), 501(c)(10), or 501(c)(19) of the Internal Revenue Code of <br/>
<a id="pl.329.34"></a><var>329.34</var>1986, or organizations related to or affiliated with such fraternal or patriotic organizations. <br/>
<a id="pl.330.1"></a><var>330.1</var>Such organizations may organize events at which home-prepared food is donated by <br/>
<a id="pl.330.2"></a><var>330.2</var>organization members for sale at the events, provided:<br/>
<a id="pl.330.3"></a><var>330.3</var>(i) the event is not a circus, carnival, or fair;<br/>
<a id="pl.330.4"></a><var>330.4</var>(ii) the organization controls the admission of persons to the event, the event agenda, <br/>
<a id="pl.330.5"></a><var>330.5</var>or both; and<br/>
<a id="pl.330.6"></a><var>330.6</var>(iii) the organization's licensed kitchen is not used in any manner for the event;<br/>
<a id="pl.330.7"></a><var>330.7</var>(8) food not prepared at an establishment and brought in by individuals attending a <br/>
<a id="pl.330.8"></a><var>330.8</var>potluck event for consumption at the potluck event. An organization sponsoring a potluck <br/>
<a id="pl.330.9"></a><var>330.9</var>event under this clause may advertise the potluck event to the public through any means. <br/>
<a id="pl.330.10"></a><var>330.10</var>Individuals who are not members of an organization sponsoring a potluck event under this <br/>
<a id="pl.330.11"></a><var>330.11</var>clause may attend the potluck event and consume the food at the event. Licensed food <br/>
<a id="pl.330.12"></a><var>330.12</var>establishments other than schools cannot be sponsors of potluck events. A school may <br/>
<a id="pl.330.13"></a><var>330.13</var>sponsor and hold potluck events in areas of the school other than the school's kitchen, <br/>
<a id="pl.330.14"></a><var>330.14</var>provided that the school's kitchen is not used in any manner for the potluck event. For <br/>
<a id="pl.330.15"></a><var>330.15</var>purposes of this clause, "school" means a public school as defined in section 
         <statute_ref>120A.05, <br/>
<a id="pl.330.16"></a><var>330.16</var>subdivisions 9, 11, 13, and 17
         </statute_ref>, or a nonpublic school, church, or religious organization <br/>
<a id="pl.330.17"></a><var>330.17</var>at which a child is provided with instruction in compliance with sections 
         <statute_ref>120A.22</statute_ref> and <br/>
<statute_ref><a id="pl.330.18"></a><var>330.18</var>120A.24
         </statute_ref>. Potluck event food shall not be brought into a licensed food establishment <br/>
<a id="pl.330.19"></a><var>330.19</var>kitchen; and<br/>
<a id="pl.330.20"></a><var>330.20</var>(9) a home school in which a child is provided instruction at home; and<br/>
<a id="pl.330.21"></a><var>330.21</var>(10) concession stands operated in conjunction with school-sponsored events on <br/>
<a id="pl.330.22"></a><var>330.22</var>school property are exempt from the 21-day restriction.<br/>
<br/>
<a id="bill.10.39.0"></a><a id="pl.330.23"></a><var>330.23</var>    Sec. 39. Minnesota Statutes 2008, section 327.14, is amended by adding a subdivision <br/>
<a id="pl.330.24"></a><var>330.24</var>to read:<br/>
<a id="pl.330.25"></a><var>330.25</var>    Subd. 9. <b>Special event recreational camping area.</b> "Special event recreational <br/>
<a id="pl.330.26"></a><var>330.26</var>camping area" means a recreational camping area which operates no more than two times <br/>
<a id="pl.330.27"></a><var>330.27</var>annually and for no more than 14 consecutive days.<br/>
<br/>
<a id="bill.10.40.0"></a><a id="pl.330.28"></a><var>330.28</var>    Sec. 40. Minnesota Statutes 2008, section 327.15, is amended to read:<br/>
<a id="pl.330.29"></a><var>330.29</var><b>327.15 LICENSE REQUIRED; RENEWAL; </b><b>PLANS FOR EXPANSION</b><b> FEES</b><b>.</b><br/>
<a id="pl.330.30"></a><var>330.30</var>    Subdivision 1. <b>License required; plan review. </b> No person, firm or corporation shall <br/>
<a id="pl.330.31"></a><var>330.31</var>establish, maintain, conduct or operate a manufactured home park or recreational camping <br/>
<a id="pl.330.32"></a><var>330.32</var>area within this state without first obtaining a an annual license therefor from the state <br/>
<a id="pl.330.33"></a><var>330.33</var>Department of Health. Any person wishing to obtain a license shall submit an application, <br/>
<a id="pl.330.34"></a><var>330.34</var>pay the required fee specified in this section, and receive approval for operation, including <br/>
<a id="pl.331.1"></a><var>331.1</var>plan review approval. Application shall be made on forms provided by the commissioner <br/>
<a id="pl.331.2"></a><var>331.2</var>and shall require the applicant to state the full name and address of the owner of the <br/>
<a id="pl.331.3"></a><var>331.3</var>manufactured home park or recreational camping area, the name under which the business <br/>
<a id="pl.331.4"></a><var>331.4</var>is to be conducted, and any other information as may be required by the commissioner <br/>
<a id="pl.331.5"></a><var>331.5</var>to complete the application for license. Any person, firm, or corporation desiring to <br/>
<a id="pl.331.6"></a><var>331.6</var>operate either a manufactured home park or a recreational camping area on the same site <br/>
<a id="pl.331.7"></a><var>331.7</var>in connection with the other, need only obtain one license. A license shall expire and be <br/>
<a id="pl.331.8"></a><var>331.8</var>renewed as prescribed by the commissioner pursuant to section 
<statute_ref>144.122</statute_ref>. The license shall <br/>
<a id="pl.331.9"></a><var>331.9</var>state the number of manufactured home sites and recreational camping sites allowed <br/>
<a id="pl.331.10"></a><var>331.10</var>according to state commissioner of health approval. No renewal license shall be issued if <br/>
<a id="pl.331.11"></a><var>331.11</var>the number of sites specified in the application exceeds those of the original application <br/>
<a id="pl.331.12"></a><var>331.12</var>The number of licensed sites shall not be increased unless the plans for expansion or <br/>
<a id="pl.331.13"></a><var>331.13</var>the construction for expansion are first submitted and the expansion is approved by <br/>
<a id="pl.331.14"></a><var>331.14</var>the Department of Health. Any manufactured home park or recreational camping area <br/>
<a id="pl.331.15"></a><var>331.15</var>located in more than one municipality shall be dealt with as two separate manufactured <br/>
<a id="pl.331.16"></a><var>331.16</var>home parks or camping areas. The license shall be conspicuously displayed in the office <br/>
<a id="pl.331.17"></a><var>331.17</var>of the manufactured home park or camping area. The license is not transferable as to to <br/>
<a id="pl.331.18"></a><var>331.18</var>another person or  place. <br/>
<a id="pl.331.19"></a><var>331.19</var>    Subd. 2. <b>License renewal.</b> Initial and renewal licenses for all manufactured home <br/>
<a id="pl.331.20"></a><var>331.20</var>parks and recreational camping areas shall be issued annually and shall have an expiration <br/>
<a id="pl.331.21"></a><var>331.21</var>date included on the license. Any person who operates a manufactured home park or <br/>
<a id="pl.331.22"></a><var>331.22</var>recreational camping area after the expiration date of a license or without having submitted <br/>
<a id="pl.331.23"></a><var>331.23</var>an application and paid the fee shall be deemed to have violated the provisions of this <br/>
<a id="pl.331.24"></a><var>331.24</var>chapter and shall be subject to enforcement action, as provided in the Health Enforcement <br/>
<a id="pl.331.25"></a><var>331.25</var>Consolidation Act, sections 144.989 to 144.993. In addition, a penalty of $120 shall <br/>
<a id="pl.331.26"></a><var>331.26</var>be added to the total of the license fee for any manufactured home park or recreational <br/>
<a id="pl.331.27"></a><var>331.27</var>camping area operating without a license for a period of up to 30 days. A late fee of $360 <br/>
<a id="pl.331.28"></a><var>331.28</var>shall be added to the license fee for any manufactured home park or recreational camping <br/>
<a id="pl.331.29"></a><var>331.29</var>area operating more than 30 days without a license.<br/>
<a id="pl.331.30"></a><var>331.30</var>    Subd. 3. <b>Fees, manufactured home parks and recreational camping areas.</b> (a) <br/>
<a id="pl.331.31"></a><var>331.31</var>The following fees are required for manufactured home parks and recreational camping <br/>
<a id="pl.331.32"></a><var>331.32</var>areas licensed under this chapter. Recreational camping areas and manufactured home <br/>
<a id="pl.331.33"></a><var>331.33</var>parks shall pay the highest applicable fee under paragraph (c). The license fee for new <br/>
<a id="pl.331.34"></a><var>331.34</var>operators of a manufactured home park or recreational camping area previously licensed <br/>
<a id="pl.331.35"></a><var>331.35</var>under this chapter for the same calendar year is one-half of the appropriate annual license <br/>
<a id="pl.331.36"></a><var>331.36</var>fee, plus any penalty that may be required. The license fee for operators opening on <br/>
<a id="pl.332.1"></a><var>332.1</var>or after October 1 is one-half of the appropriate annual license fee, plus any penalty <br/>
<a id="pl.332.2"></a><var>332.2</var>that may be required.<br/>
<a id="pl.332.3"></a><var>332.3</var>(b) All manufactured home parks and recreational camping areas shall pay the <br/>
<a id="pl.332.4"></a><var>332.4</var>following annual base fee:<br/>
<a id="pl.332.5"></a><var>332.5</var>(1) a manufactured home park, $150; and<br/>
<a id="pl.332.6"></a><var>332.6</var>(2) a recreational camping area with:<br/>
<a id="pl.332.7"></a><var>332.7</var>(i) 24 or less sites, $50;<br/>
<a id="pl.332.8"></a><var>332.8</var>(ii) 25-99 sites, $212; and<br/>
<a id="pl.332.9"></a><var>332.9</var>(iii) 100 or more sites, $300.<br/>
<a id="pl.332.10"></a><var>332.10</var>In addition to the base fee, manufactured home parks and recreational camping areas shall <br/>
<a id="pl.332.11"></a><var>332.11</var>pay $4 for each licensed site. This paragraph does not apply to special event recreational <br/>
<a id="pl.332.12"></a><var>332.12</var>camping areas or to operators of a manufactured home park or a recreational camping area <br/>
<a id="pl.332.13"></a><var>332.13</var>licensed under section 157.16 for the same location.<br/>
<a id="pl.332.14"></a><var>332.14</var>(c) In addition to the fee in paragraph (b), each manufactured home park or <br/>
<a id="pl.332.15"></a><var>332.15</var>recreational camping area shall pay an additional annual fee for each fee category <br/>
<a id="pl.332.16"></a><var>332.16</var>specified in this paragraph:<br/>
<a id="pl.332.17"></a><var>332.17</var>(1) Manufactured home parks and recreational camping areas with public swimming <br/>
<a id="pl.332.18"></a><var>332.18</var>pools and spas shall pay the appropriate fees specified in section 157.16.<br/>
<a id="pl.332.19"></a><var>332.19</var>(2) Individual private sewer or water, $60. "Individual private water" means a fee <br/>
<a id="pl.332.20"></a><var>332.20</var>category with a water supply other than a community public water supply as defined in <br/>
<a id="pl.332.21"></a><var>332.21</var>Minnesota Rules, chapter 4720. "Individual private sewer" means a fee category with an <br/>
<a id="pl.332.22"></a><var>332.22</var>individual sewage treatment system which uses subsurface treatment and disposal.<br/>
<a id="pl.332.23"></a><var>332.23</var>(d) The following fees must accompany a plan review application for initial <br/>
<a id="pl.332.24"></a><var>332.24</var>construction of a manufactured home park or recreational camping area:<br/>
<a id="pl.332.25"></a><var>332.25</var>(1) for initial construction of less than 25 sites, $375;<br/>
<a id="pl.332.26"></a><var>332.26</var>(2) for initial construction of 25 to less than 100 sites, $400; and<br/>
<a id="pl.332.27"></a><var>332.27</var>(3) for initial construction of 100 or more sites, $500.<br/>
<a id="pl.332.28"></a><var>332.28</var>(e) The following fees must accompany a plan review application when an existing <br/>
<a id="pl.332.29"></a><var>332.29</var>manufactured home park or recreational camping area is expanded:<br/>
<a id="pl.332.30"></a><var>332.30</var>(1) for expansion of less than 25 sites, $250;<br/>
<a id="pl.332.31"></a><var>332.31</var>(2) for expansion of 25 and less than 100 sites, $300; and<br/>
<a id="pl.332.32"></a><var>332.32</var>(3) for expansion of 100 or more sites, $450.<br/>
<a id="pl.332.33"></a><var>332.33</var>    Subd. 4. <b>Fees, special event recreational camping areas.</b> (a) The following fees <br/>
<a id="pl.332.34"></a><var>332.34</var>are required for special event recreational camping areas licensed under this chapter.<br/>
<a id="pl.332.35"></a><var>332.35</var>(b) All special event recreational camping areas shall pay an annual fee of $150 plus <br/>
<a id="pl.332.36"></a><var>332.36</var>$1 for each licensed site.<br/>
<a id="pl.333.1"></a><var>333.1</var>(c) A special event recreational camping area shall pay a late fee of $360 for failing <br/>
<a id="pl.333.2"></a><var>333.2</var>to obtain a license prior to operating.<br/>
<a id="pl.333.3"></a><var>333.3</var>(d) The following fees must accompany a plan review application for initial <br/>
<a id="pl.333.4"></a><var>333.4</var>construction of a special event recreational camping area:<br/>
<a id="pl.333.5"></a><var>333.5</var>(1) for initial construction of less than 25 special event recreational camping sites, <br/>
<a id="pl.333.6"></a><var>333.6</var>$375;<br/>
<a id="pl.333.7"></a><var>333.7</var>(2) for initial construction of 25 to less than 100 sites, $400; and<br/>
<a id="pl.333.8"></a><var>333.8</var>(3) for initial construction of 100 or more sites, $500.<br/>
<a id="pl.333.9"></a><var>333.9</var>(e) The following fees must accompany a plan review application for expansion of a <br/>
<a id="pl.333.10"></a><var>333.10</var>special event recreational camping area:<br/>
<a id="pl.333.11"></a><var>333.11</var>(1) for expansion of less than 25 sites, $250;<br/>
<a id="pl.333.12"></a><var>333.12</var>(2) for expansion of 25 and less than 100 sites, $300; and<br/>
<a id="pl.333.13"></a><var>333.13</var>(3) for expansion of 100 or more sites, $450.<br/>
<br/>
<a id="bill.10.41.0"></a><a id="pl.333.14"></a><var>333.14</var>    Sec. 41. Minnesota Statutes 2008, section 327.16, is amended to read:<br/>
<a id="pl.333.15"></a><var>333.15</var><b>327.16 </b><b>LICENSE</b><b> PLAN REVIEW</b><b> APPLICATION.</b><br/>
<a id="pl.333.16"></a><var>333.16</var>    Subdivision 1. <b>Made to state Department of Health.</b> The plan review application <br/>
<a id="pl.333.17"></a><var>333.17</var>for license to operate and maintain a manufactured home park or recreational camping <br/>
<a id="pl.333.18"></a><var>333.18</var>area shall be made to the state Department of Health, at such office and in such manner <br/>
<a id="pl.333.19"></a><var>333.19</var>as may be prescribed by that department.<br/>
<a id="pl.333.20"></a><var>333.20</var>    Subd. 2. <b>Contents.</b> The applicant for a primary license or annual license shall make <br/>
<a id="pl.333.21"></a><var>333.21</var>application in writing plan review application shall be made upon a form provided by the <br/>
<a id="pl.333.22"></a><var>333.22</var>state Department of Health setting forth:<br/>
<a id="pl.333.23"></a><var>333.23</var>(1) The full name and address of the applicant or applicants, or names and addresses <br/>
<a id="pl.333.24"></a><var>333.24</var>of the partners if the applicant is a partnership, or the names and addresses of the officers <br/>
<a id="pl.333.25"></a><var>333.25</var>if the applicant is a corporation.<br/>
<a id="pl.333.26"></a><var>333.26</var>(2) A legal description of the site, lot, field, or tract of land upon which the applicant <br/>
<a id="pl.333.27"></a><var>333.27</var>proposes to operate and maintain a manufactured home park or recreational camping area.<br/>
<a id="pl.333.28"></a><var>333.28</var>(3) The proposed and existing facilities on and about the site, lot, field, or tract of <br/>
<a id="pl.333.29"></a><var>333.29</var>land for the proposed construction or alteration and maintaining of a sanitary community <br/>
<a id="pl.333.30"></a><var>333.30</var>building for toilets, urinals, sinks, wash basins, slop-sinks, showers, drains, laundry <br/>
<a id="pl.333.31"></a><var>333.31</var>facilities, source of water supply, sewage, garbage and waste disposal; except that no <br/>
<a id="pl.333.32"></a><var>333.32</var>toilet facilities shall be required in any manufactured home park which permits only <br/>
<a id="pl.333.33"></a><var>333.33</var>manufactured homes equipped with toilet facilities discharging to water carried sewage <br/>
<a id="pl.333.34"></a><var>333.34</var>disposal systems; and method of fire and storm protection.<br/>
<a id="pl.334.1"></a><var>334.1</var>(4) The proposed method of lighting the structures and site, lot, field, or tract of land <br/>
<a id="pl.334.2"></a><var>334.2</var>upon which the manufactured home park or recreational camping area is to be located.<br/>
<a id="pl.334.3"></a><var>334.3</var>(5) The calendar months of the year which the applicant will operate the <br/>
<a id="pl.334.4"></a><var>334.4</var>manufactured home park or recreational camping area.<br/>
<a id="pl.334.5"></a><var>334.5</var>(6) Plans and drawings for new construction or alteration, including buildings, wells, <br/>
<a id="pl.334.6"></a><var>334.6</var>plumbing and sewage disposal systems.<br/>
<a id="pl.334.7"></a><var>334.7</var>    Subd. 3. <b>Fees;</b><b> Approval.</b> The application for the primary license plan review shall <br/>
<a id="pl.334.8"></a><var>334.8</var>be submitted with all plans and specifications enumerated in subdivision 2, and payment <br/>
<a id="pl.334.9"></a><var>334.9</var>of a fee in an amount prescribed by the state commissioner of health pursuant to section <br/>
<a id="pl.334.10"></a><var>334.10</var><statute_ref>144.122</statute_ref> and shall be accompanied by an approved zoning permit from the municipality or <br/>
<a id="pl.334.11"></a><var>334.11</var>county wherein the park is to be located, or a statement from the municipality or county <br/>
<a id="pl.334.12"></a><var>334.12</var>that it does not require an approved zoning permit. The fee for the annual license shall be <br/>
<a id="pl.334.13"></a><var>334.13</var>in an amount prescribed by the state commissioner of health pursuant to section 
<statute_ref>144.122</statute_ref>. <br/>
<a id="pl.334.14"></a><var>334.14</var>All license fees paid to the commissioner of health shall be turned over to the state <br/>
<a id="pl.334.15"></a><var>334.15</var>treasury. The fee submitted for the primary license plan review shall be retained by the <br/>
<a id="pl.334.16"></a><var>334.16</var>state even though the proposed project is not approved and a license is denied. <br/>
<a id="pl.334.17"></a><var>334.17</var>When construction has been completed in accordance with approved plans and <br/>
<a id="pl.334.18"></a><var>334.18</var>specifications the state commissioner of health shall promptly cause the manufactured <br/>
<a id="pl.334.19"></a><var>334.19</var>home park or recreational camping area and appurtenances thereto to be inspected. When <br/>
<a id="pl.334.20"></a><var>334.20</var>the inspection and report has been made and the state commissioner of health finds that <br/>
<a id="pl.334.21"></a><var>334.21</var>all requirements of sections 
         <statute_ref>327.10</statute_ref>, 
         <statute_ref>327.11</statute_ref>, 
         <statute_ref>327.14</statute_ref> to 
         <statute_ref>327.28</statute_ref>, and such conditions of <br/>
<a id="pl.334.22"></a><var>334.22</var>health and safety as the state commissioner of health may require, have been met by <br/>
<a id="pl.334.23"></a><var>334.23</var>the applicant, the state commissioner of health shall forthwith issue the primary license <br/>
<a id="pl.334.24"></a><var>334.24</var>in the name of the state. <br/>
<a id="pl.334.25"></a><var>334.25</var>    Subd. 4. <b>Sanitary facilities</b><b> Compliance with current state law</b><b>.</b> During the <br/>
<a id="pl.334.26"></a><var>334.26</var>pendency of the application for such primary license any change in the sanitary or safety <br/>
<a id="pl.334.27"></a><var>334.27</var>facilities of the intended manufactured home park or recreational camping area shall be <br/>
<a id="pl.334.28"></a><var>334.28</var>immediately reported in writing to the state Department of Health through the office <br/>
<a id="pl.334.29"></a><var>334.29</var>through which the application was made. If no objection is made by the state Department <br/>
<a id="pl.334.30"></a><var>334.30</var>of Health to such change in such sanitary or safety facilities within 60 days of the date <br/>
<a id="pl.334.31"></a><var>334.31</var>such change is reported, it shall be deemed to have the approval of the state Department of <br/>
<a id="pl.334.32"></a><var>334.32</var>Health. Any manufactured home park or recreational camping area must be constructed <br/>
<a id="pl.334.33"></a><var>334.33</var>and operated according to all applicable state electrical, fire, plumbing, and building codes.<br/>
<a id="pl.334.34"></a><var>334.34</var>    Subd. 5. <b>Permit.</b> When the plans and specifications have been approved, the state <br/>
<a id="pl.334.35"></a><var>334.35</var>Department of Health shall issue an approval report permitting the applicant to construct <br/>
<a id="pl.335.1"></a><var>335.1</var>or make alterations upon a manufactured home park or recreational camping area and the <br/>
<a id="pl.335.2"></a><var>335.2</var>appurtenances thereto according to the plans and specifications presented.<br/>
<a id="pl.335.3"></a><var>335.3</var>Such approval does not relieve the applicant from securing building permits in <br/>
<a id="pl.335.4"></a><var>335.4</var>municipalities that require permits or from complying with any other municipal ordinance <br/>
<a id="pl.335.5"></a><var>335.5</var>or ordinances, applicable thereto, not in conflict with this statute.<br/>
<a id="pl.335.6"></a><var>335.6</var>    Subd. 6. <b>Denial of construction.</b> If the application to construct or make alterations <br/>
<a id="pl.335.7"></a><var>335.7</var>upon a manufactured home park or recreational camping area and the appurtenances <br/>
<a id="pl.335.8"></a><var>335.8</var>thereto or a primary license to operate and maintain the same is denied by the state <br/>
<a id="pl.335.9"></a><var>335.9</var>commissioner of health, the commissioner shall so state in writing giving the reason <br/>
<a id="pl.335.10"></a><var>335.10</var>or reasons for denying the application. If the objections can be corrected the applicant <br/>
<a id="pl.335.11"></a><var>335.11</var>may amend the application and resubmit it for approval, and if denied the applicant may <br/>
<a id="pl.335.12"></a><var>335.12</var>appeal from the decision of the state commissioner of health as provided in section <br/>
<statute_ref><a id="pl.335.13"></a><var>335.13</var>144.99, subdivision 10
         </statute_ref>. <br/>
<br/>
<a id="bill.10.42.0"></a><a id="pl.335.14"></a><var>335.14</var>    Sec. 42. Minnesota Statutes 2008, section 327.20, subdivision 1, is amended to read:<br/>
<a id="pl.335.15"></a><var>335.15</var>    Subdivision 1. <b>Rules.</b> No domestic animals or house pets of occupants of <br/>
<a id="pl.335.16"></a><var>335.16</var>manufactured home parks or recreational camping areas shall be allowed to run at large, <br/>
<a id="pl.335.17"></a><var>335.17</var>or commit any nuisances within the limits of a manufactured home park or recreational <br/>
<a id="pl.335.18"></a><var>335.18</var>camping area. Each manufactured home park or recreational camping area licensed under <br/>
<a id="pl.335.19"></a><var>335.19</var>the provisions of sections 
         <statute_ref>327.10</statute_ref>, 
         <statute_ref>327.11</statute_ref>, and
<statute_ref>327.14</statute_ref> to 
         <statute_ref>327.28</statute_ref> shall, among other things, <br/>
<a id="pl.335.20"></a><var>335.20</var>provide for the following, in the manner hereinafter specified: <br/>
<a id="pl.335.21"></a><var>335.21</var>    (1) A responsible attendant or caretaker shall be in charge of every manufactured <br/>
<a id="pl.335.22"></a><var>335.22</var>home park or recreational camping area at all times, who shall maintain the park or <br/>
<a id="pl.335.23"></a><var>335.23</var>area, and its facilities and equipment in a clean, orderly and sanitary condition. In any <br/>
<a id="pl.335.24"></a><var>335.24</var>manufactured home park containing more than 50 lots, the attendant, caretaker, or other <br/>
<a id="pl.335.25"></a><var>335.25</var>responsible park employee, shall be readily available at all times in case of emergency.<br/>
<a id="pl.335.26"></a><var>335.26</var>    (2) All manufactured home parks shall be well drained and be located so that the <br/>
<a id="pl.335.27"></a><var>335.27</var>drainage of the park area will not endanger any water supply. No wastewater from <br/>
<a id="pl.335.28"></a><var>335.28</var>manufactured homes or recreational camping vehicles shall be deposited on the surface of <br/>
<a id="pl.335.29"></a><var>335.29</var>the ground. All sewage and other water carried wastes shall be discharged into a municipal <br/>
<a id="pl.335.30"></a><var>335.30</var>sewage system whenever available. When a municipal sewage system is not available, a <br/>
<a id="pl.335.31"></a><var>335.31</var>sewage disposal system acceptable to the state commissioner of health shall be provided.<br/>
<a id="pl.335.32"></a><var>335.32</var>    (3) No manufactured home shall be located closer than three feet to the side lot lines <br/>
<a id="pl.335.33"></a><var>335.33</var>of a manufactured home park, if the abutting property is improved property, or closer than <br/>
<a id="pl.335.34"></a><var>335.34</var>ten feet to a public street or alley. Each individual site shall abut or face on a driveway <br/>
<a id="pl.335.35"></a><var>335.35</var>or clear unoccupied space of not less than 16 feet in width, which space shall have <br/>
<a id="pl.336.1"></a><var>336.1</var>unobstructed access to a public highway or alley. There shall be an open space of at least <br/>
<a id="pl.336.2"></a><var>336.2</var>ten feet between the sides of adjacent manufactured homes including their attachments <br/>
<a id="pl.336.3"></a><var>336.3</var>and at least three feet between manufactured homes when parked end to end. The space <br/>
<a id="pl.336.4"></a><var>336.4</var>between manufactured homes may be used for the parking of motor vehicles and other <br/>
<a id="pl.336.5"></a><var>336.5</var>property, if the vehicle or other property is parked at least ten feet from the nearest <br/>
<a id="pl.336.6"></a><var>336.6</var>adjacent manufactured home position. The requirements of this paragraph shall not apply <br/>
<a id="pl.336.7"></a><var>336.7</var>to recreational camping areas and variances may be granted by the state commissioner <br/>
<a id="pl.336.8"></a><var>336.8</var>of health in manufactured home parks when the variance is applied for in writing and in <br/>
<a id="pl.336.9"></a><var>336.9</var>the opinion of the commissioner the variance will not endanger the health, safety, and <br/>
<a id="pl.336.10"></a><var>336.10</var>welfare of manufactured home park occupants.<br/>
<a id="pl.336.11"></a><var>336.11</var>    (4) An adequate supply of water of safe, sanitary quality shall be furnished at each <br/>
<a id="pl.336.12"></a><var>336.12</var>manufactured home park or recreational camping area. The source of the water supply <br/>
<a id="pl.336.13"></a><var>336.13</var>shall first be approved by the state Department of Health.<br/>
<a id="pl.336.14"></a><var>336.14</var>    (5) All plumbing shall be installed in accordance with the rules of the state <br/>
<a id="pl.336.15"></a><var>336.15</var>commissioner of labor and industry and the provisions of the Minnesota Plumbing Code.<br/>
<a id="pl.336.16"></a><var>336.16</var>    (6) In the case of a manufactured home park with less than ten manufactured homes, <br/>
<a id="pl.336.17"></a><var>336.17</var>a plan for the sheltering or the safe evacuation to a safe place of shelter of the residents of <br/>
<a id="pl.336.18"></a><var>336.18</var>the park in times of severe weather conditions, such as tornadoes, high winds, and floods. <br/>
<a id="pl.336.19"></a><var>336.19</var>The shelter or evacuation plan shall be developed with the assistance and approval of <br/>
<a id="pl.336.20"></a><var>336.20</var>the municipality where the park is located and shall be posted at conspicuous locations <br/>
<a id="pl.336.21"></a><var>336.21</var>throughout the park. The park owner shall provide each resident with a copy of the <br/>
<a id="pl.336.22"></a><var>336.22</var>approved shelter or evacuation plan, as provided by section 
         <statute_ref>327C.01, subdivision 1c</statute_ref>. <br/>
<a id="pl.336.23"></a><var>336.23</var>Nothing in this paragraph requires the Department of Health to review or approve any <br/>
<a id="pl.336.24"></a><var>336.24</var>shelter or evacuation plan developed by a park. Failure of a municipality to approve a plan <br/>
<a id="pl.336.25"></a><var>336.25</var>submitted by a park shall not be grounds for action against the park by the Department of <br/>
<a id="pl.336.26"></a><var>336.26</var>Health if the park has made a good faith effort to develop the plan and obtain municipal <br/>
<a id="pl.336.27"></a><var>336.27</var>approval. <br/>
<a id="pl.336.28"></a><var>336.28</var>    (7) A manufactured home park with ten or more manufactured homes, licensed prior <br/>
<a id="pl.336.29"></a><var>336.29</var>to March 1, 1988, shall provide a safe place of shelter for park residents or a plan for the <br/>
<a id="pl.336.30"></a><var>336.30</var>evacuation of park residents to a safe place of shelter within a reasonable distance of the <br/>
<a id="pl.336.31"></a><var>336.31</var>park for use by park residents in times of severe weather, including tornadoes and high <br/>
<a id="pl.336.32"></a><var>336.32</var>winds. The shelter or evacuation plan must be approved by the municipality by March 1, <br/>
<a id="pl.336.33"></a><var>336.33</var>1989. The municipality may require the park owner to construct a shelter if it determines <br/>
<a id="pl.336.34"></a><var>336.34</var>that a safe place of shelter is not available within a reasonable distance from the park. A <br/>
<a id="pl.336.35"></a><var>336.35</var>copy of the municipal approval and the plan shall be submitted by the park owner to the <br/>
<a id="pl.337.1"></a><var>337.1</var>Department of Health. The park owner shall provide each resident with a copy of the <br/>
<a id="pl.337.2"></a><var>337.2</var>approved shelter or evacuation plan, as provided by section 
         <statute_ref>327C.01, subdivision 1c</statute_ref>. <br/>
<a id="pl.337.3"></a><var>337.3</var>    (8) A manufactured home park with ten or more manufactured homes, receiving <br/>
<a id="pl.337.4"></a><var>337.4</var>a primary an initial license after March 1, 1988, must provide the type of shelter required <br/>
<a id="pl.337.5"></a><var>337.5</var>by section 
         <statute_ref>327.205</statute_ref>, except that for manufactured home parks established as temporary, <br/>
<a id="pl.337.6"></a><var>337.6</var>emergency housing in a disaster area declared by the President of the United States or <br/>
<a id="pl.337.7"></a><var>337.7</var>the governor, an approved evacuation plan may be provided in lieu of a shelter for a <br/>
<a id="pl.337.8"></a><var>337.8</var>period not exceeding 18 months. <br/>
<a id="pl.337.9"></a><var>337.9</var>    (9) For the purposes of this subdivision, "park owner" and "resident" have the <br/>
<a id="pl.337.10"></a><var>337.10</var>meaning meanings given them in section 
         <statute_ref>327C.01</statute_ref>. <br/>
<br/>
<a id="bill.10.43.0"></a><a id="pl.337.11"></a><var>337.11</var>    Sec. 43. Minnesota Statutes 2008, section 327.20, is amended by adding a subdivision <br/>
<a id="pl.337.12"></a><var>337.12</var>to read:<br/>
<a id="pl.337.13"></a><var>337.13</var>    Subd. 4. <b>Special event recreational camping areas.</b> Each special event camping <br/>
<a id="pl.337.14"></a><var>337.14</var>area licensed under sections 327.10, 327.11, and 327.14 to 327.28 is subject to this section.<br/>
<a id="pl.337.15"></a><var>337.15</var>(1) Recreational camping vehicles and tents, including attachments, must be <br/>
<a id="pl.337.16"></a><var>337.16</var>separated from each other and other structures by at least seven feet.<br/>
<a id="pl.337.17"></a><var>337.17</var>(2) A minimum area of 300 square feet per site must be provided and the total <br/>
<a id="pl.337.18"></a><var>337.18</var>number of sites must not exceed one site for every 300 square feet of usable land area.<br/>
<a id="pl.337.19"></a><var>337.19</var>(3) Each site must abut or face a driveway or clear unoccupied space of at least 16 <br/>
<a id="pl.337.20"></a><var>337.20</var>feet in width, which space must have unobstructed access to a public roadway.<br/>
<a id="pl.337.21"></a><var>337.21</var>(4) If no approved on-site water supply system is available, hauled water may be <br/>
<a id="pl.337.22"></a><var>337.22</var>used, provided that persons using hauled water comply with Minnesota Rules, parts <br/>
<a id="pl.337.23"></a><var>337.23</var>4720.4000 to 4720.4600.<br/>
<a id="pl.337.24"></a><var>337.24</var>(5) Nonburied sewer lines may be permitted provided they are of approved materials, <br/>
<a id="pl.337.25"></a><var>337.25</var>watertight, and properly maintained.<br/>
<a id="pl.337.26"></a><var>337.26</var>(6) If a sanitary dumping station is not provided on-site, arrangements must be <br/>
<a id="pl.337.27"></a><var>337.27</var>made with a licensed sewage pumper to service recreational camping vehicle holding <br/>
<a id="pl.337.28"></a><var>337.28</var>tanks as needed.<br/>
<a id="pl.337.29"></a><var>337.29</var>(7) Toilet facilities must be provided consisting of toilets connected to an approved <br/>
<a id="pl.337.30"></a><var>337.30</var>sewage disposal system, portable toilets, or approved, properly constructed privies.<br/>
<a id="pl.337.31"></a><var>337.31</var>(8) Toilets must be provided in the ratio of one toilet for each sex for each 150 sites.<br/>
<a id="pl.337.32"></a><var>337.32</var>(9) Toilets must be not more than 400 feet from any site.<br/>
<a id="pl.337.33"></a><var>337.33</var>(10) If a central building or buildings are provided with running water, then toilets <br/>
<a id="pl.337.34"></a><var>337.34</var>and handwashing lavatories must be provided in the building or buildings that meet the <br/>
<a id="pl.337.35"></a><var>337.35</var>requirements of this subdivision.<br/>
<a id="pl.338.1"></a><var>338.1</var>(11) Showers, if provided, must be provided in the ratio of one shower for each sex <br/>
<a id="pl.338.2"></a><var>338.2</var>for each 250 sites. Showerheads must be provided, where running water is available, for <br/>
<a id="pl.338.3"></a><var>338.3</var>each camping event exceeding two nights.<br/>
<a id="pl.338.4"></a><var>338.4</var>(12) Central toilet and shower buildings, if provided, must be constructed with <br/>
<a id="pl.338.5"></a><var>338.5</var>adequate heating, ventilation, and lighting, and floors of impervious material sloped <br/>
<a id="pl.338.6"></a><var>338.6</var>to drain. Walls must be of a washable material. Permanent facilities must meet the <br/>
<a id="pl.338.7"></a><var>338.7</var>requirements of the Americans with Disabilities Act.<br/>
<a id="pl.338.8"></a><var>338.8</var>(13) An adequate number of durable, covered, watertight containers must be <br/>
<a id="pl.338.9"></a><var>338.9</var>provided for all garbage and refuse. Garbage and refuse must be collected as often as <br/>
<a id="pl.338.10"></a><var>338.10</var>necessary to prevent nuisance conditions.<br/>
<a id="pl.338.11"></a><var>338.11</var>(14) Campgrounds must be located in areas free of poison ivy or other noxious <br/>
<a id="pl.338.12"></a><var>338.12</var>weeds considered detrimental to health. Sites must not be located in areas of tall grass or <br/>
<a id="pl.338.13"></a><var>338.13</var>weeds and sites must be adequately drained.<br/>
<a id="pl.338.14"></a><var>338.14</var>(15) Campsites for recreational vehicles may not be located on inclines of greater <br/>
<a id="pl.338.15"></a><var>338.15</var>than eight percent grade or one inch drop per lineal foot.<br/>
<a id="pl.338.16"></a><var>338.16</var>(16) A responsible attendant or caretaker must be available on-site at all times during <br/>
<a id="pl.338.17"></a><var>338.17</var>the operation of any special event recreational camping area that has 50 or more sites.<br/>
<br/>
<a id="bill.10.44.0"></a><a id="pl.338.18"></a><var>338.18</var>    Sec. 44. <b>MINNESOTA COLORECTAL CANCER PREVENTION </b><br/>
<a id="pl.338.19"></a><var>338.19</var><b>DEMONSTRATION PROJECT.</b><br/>
<a id="pl.338.20"></a><var>338.20</var>    Subdivision 1. <b>Establishment.</b> The commissioner of health shall award grants <br/>
<a id="pl.338.21"></a><var>338.21</var>to Hennepin County Medical Center and MeritCare Bemidji for a colorectal screening <br/>
<a id="pl.338.22"></a><var>338.22</var>demonstration project to provide screening to uninsured and underinsured women and <br/>
<a id="pl.338.23"></a><var>338.23</var>men. The project shall expire December 31, 2010.<br/>
<a id="pl.338.24"></a><var>338.24</var>    Subd. 2. <b>Eligibility.</b> To be eligible for colorectal screening under this demonstration <br/>
<a id="pl.338.25"></a><var>338.25</var>project, an applicant must:<br/>
<a id="pl.338.26"></a><var>338.26</var>(1) be at least 50 years of age, or under the age of 50 and at high risk for colon cancer;<br/>
<a id="pl.338.27"></a><var>338.27</var>(2) be uninsured, or if insured, have coverage that does not cover the full cost of <br/>
<a id="pl.338.28"></a><var>338.28</var>colorectal cancer screenings;<br/>
<a id="pl.338.29"></a><var>338.29</var>(3) not be eligible for medical assistance, general assistance medical care, or <br/>
<a id="pl.338.30"></a><var>338.30</var>MinnesotaCare programs; and<br/>
<a id="pl.338.31"></a><var>338.31</var>(4) have a gross family income at or below 250 percent of the federal poverty level.<br/>
<a id="pl.338.32"></a><var>338.32</var>    Subd. 3. <b>Services.</b> Services provided under this project shall include:<br/>
<a id="pl.338.33"></a><var>338.33</var>(1) colorectal cancer screening, according to standard practices of medicine, or <br/>
<a id="pl.338.34"></a><var>338.34</var>guidelines provided by the Institute for Clinical Systems Improvement or the American <br/>
<a id="pl.338.35"></a><var>338.35</var>Cancer Society;<br/>
<a id="pl.339.1"></a><var>339.1</var>(2) follow-up services for abnormal tests; and<br/>
<a id="pl.339.2"></a><var>339.2</var>(3) diagnostic services to determine the extent and proper course of treatment.<br/>
<a id="pl.339.3"></a><var>339.3</var>    Subd. 4. <b>Project evaluation.</b> The commissioner of health shall evaluate the <br/>
<a id="pl.339.4"></a><var>339.4</var>demonstration project and make recommendations for increasing the number of persons in <br/>
<a id="pl.339.5"></a><var>339.5</var>Minnesota who receive recommended colon cancer screening. The commissioner of health <br/>
<a id="pl.339.6"></a><var>339.6</var>shall submit the evaluation and recommendations to the legislature by January 15, 2011.<br/>
<br/>
<a id="bill.10.45.0"></a><a id="pl.339.7"></a><var>339.7</var>    Sec. 45. <b>RESEARCH OF EXPOSURE PATHWAYS FOR </b><br/>
<a id="pl.339.8"></a><var>339.8</var><b>PERFLUOROCHEMICALS.</b><br/>
<a id="pl.339.9"></a><var>339.9</var>The commissioner of health shall study and report to the legislature by January <br/>
<a id="pl.339.10"></a><var>339.10</var>15, 2011, on the exposure pathways for perfluorochemicals, focusing on food sources <br/>
<a id="pl.339.11"></a><var>339.11</var>that might be affected by contact with contaminated water or air. This research will be <br/>
<a id="pl.339.12"></a><var>339.12</var>performed to the extent that nonstate funds and environmental health tracking funds are <br/>
<a id="pl.339.13"></a><var>339.13</var>available and include garden vegetables produced or consumed by a representative sample <br/>
<a id="pl.339.14"></a><var>339.14</var>of the population from the east metropolitan area including indigenous people and people <br/>
<a id="pl.339.15"></a><var>339.15</var>of color. In developing and performing the research, the commissioner must convene and <br/>
<a id="pl.339.16"></a><var>339.16</var>consult with a citizen advisory group consisting of residents from the east metropolitan <br/>
<a id="pl.339.17"></a><var>339.17</var>area, including indigenous people and people of color.<br/>
<br/>
<a id="bill.10.46.0"></a><a id="pl.339.18"></a><var>339.18</var>    Sec. 46. <b>FEASIBILITY PILOT PROJECT FOR CANCER SURVEILLANCE.</b><br/>
<a id="pl.339.19"></a><var>339.19</var>The commissioner of health must provide a grant to the Hennepin County Medical <br/>
<a id="pl.339.20"></a><var>339.20</var>Center for a one-year feasibility pilot project to collect occupational, residential, and <br/>
<a id="pl.339.21"></a><var>339.21</var>military service history data from newly diagnosed cancer patients at the Hennepin <br/>
<a id="pl.339.22"></a><var>339.22</var>County Medical Center's Cancer Center. Funding for this grant shall come from the <br/>
<a id="pl.339.23"></a><var>339.23</var>Department of Health's current resources for the Chronic Disease and Environmental <br/>
<a id="pl.339.24"></a><var>339.24</var>Epidemiology Section.<br/>
<a id="pl.339.25"></a><var>339.25</var>Under this pilot project, Hennepin County Medical Center will design an expansion <br/>
<a id="pl.339.26"></a><var>339.26</var>of its existing cancer registry to include the collection of additional data, including the <br/>
<a id="pl.339.27"></a><var>339.27</var>cancer patient's occupational, residential, and military service history. Patient consent is <br/>
<a id="pl.339.28"></a><var>339.28</var>required for collection of these additional data. The consent must be in writing and must <br/>
<a id="pl.339.29"></a><var>339.29</var>contain notice informing the patient about private and confidential data concerning the <br/>
<a id="pl.339.30"></a><var>339.30</var>patient pursuant to Minnesota Statutes, section 13.04, subdivision 2. The patient is entitled <br/>
<a id="pl.339.31"></a><var>339.31</var>to opt out of the project at any time. The data collection expansion may also include the <br/>
<a id="pl.339.32"></a><var>339.32</var>cancer patient's possible toxic environmental exposure history, if known. The purpose of <br/>
<a id="pl.339.33"></a><var>339.33</var>this pilot project is to determine the following:<br/>
<a id="pl.339.34"></a><var>339.34</var>(1) the feasibility of collecting these data on a statewide scale; <br/>
<a id="pl.340.1"></a><var>340.1</var>(2) the potential design of a self-administered patient questionnaire template; and <br/>
<a id="pl.340.2"></a><var>340.2</var>(3) necessary qualifications for staff who will collect these data. <br/>
<a id="pl.340.3"></a><var>340.3</var>Hennepin County Medical Center must report the results of this pilot project to the <br/>
<a id="pl.340.4"></a><var>340.4</var>legislature by October 1, 2010.<br/>
<br/>
<a id="bill.10.47.0"></a><a id="pl.340.5"></a><var>340.5</var>    Sec. 47. <b>SMOKING CESSATION.</b><br/>
<a id="pl.340.6"></a><var>340.6</var>The commissioner of health must prioritize smoking prevention and smoking <br/>
<a id="pl.340.7"></a><var>340.7</var>cessation activities in low-income, indigenous, and minority communities in their <br/>
<a id="pl.340.8"></a><var>340.8</var>collaborations with the organization specifically described in Minnesota Statutes, section <br/>
<a id="pl.340.9"></a><var>340.9</var>144.396, subdivision 8.<br/>
<br/>
<a id="bill.10.48.0"></a><a id="pl.340.10"></a><var>340.10</var>    Sec. 48. <b>MEDICAL RESPONSE UNIT REIMBURSEMENT PILOT PROGRAM.</b><br/>
<a id="pl.340.11"></a><var>340.11</var>(a) The Department of Public Safety or its contract designee shall collaborate <br/>
<a id="pl.340.12"></a><var>340.12</var>with the Minnesota Ambulance Association to create the parameters of the medical <br/>
<a id="pl.340.13"></a><var>340.13</var>response unit reimbursement pilot program, including determining criteria for baseline <br/>
<a id="pl.340.14"></a><var>340.14</var>data reporting.<br/>
<a id="pl.340.15"></a><var>340.15</var>(b) In conducting the pilot program, the Department of Public Safety must consult <br/>
<a id="pl.340.16"></a><var>340.16</var>with the Minnesota Ambulance Association, Minnesota Fire Chiefs Association, <br/>
<a id="pl.340.17"></a><var>340.17</var>Emergency Services Regulatory Board, and the Minnesota Council of Health Plans to:<br/>
<a id="pl.340.18"></a><var>340.18</var>(1) identify no more than five medical response units registered as medical response <br/>
<a id="pl.340.19"></a><var>340.19</var>units with the Minnesota Emergency Medical Services Regulatory Board according to <br/>
<a id="pl.340.20"></a><var>340.20</var>Minnesota Statutes, chapter 144E, to participate in the program;<br/>
<a id="pl.340.21"></a><var>340.21</var>(2) outline and develop criteria for reimbursement;<br/>
<a id="pl.340.22"></a><var>340.22</var>(3) determine the amount of reimbursement for each unit response; and<br/>
<a id="pl.340.23"></a><var>340.23</var>(4) collect program data to be analyzed for a final report.<br/>
<a id="pl.340.24"></a><var>340.24</var>(c) Further criteria for the medical response unit reimbursement pilot program <br/>
<a id="pl.340.25"></a><var>340.25</var>shall include:<br/>
<a id="pl.340.26"></a><var>340.26</var>(1) the pilot program will expire on December 31, 2010, or when the appropriation <br/>
<a id="pl.340.27"></a><var>340.27</var>is extended, whichever occurs first;<br/>
<a id="pl.340.28"></a><var>340.28</var>(2) a report shall be made to the legislature by March 1, 2011, by the Department <br/>
<a id="pl.340.29"></a><var>340.29</var>of Public Safety or its contractor as to the effectiveness and value of this reimbursement <br/>
<a id="pl.340.30"></a><var>340.30</var>pilot program to the emergency medical services delivery system, any actual or potential <br/>
<a id="pl.340.31"></a><var>340.31</var>savings to the health care system, and impact on patient outcomes;<br/>
<a id="pl.340.32"></a><var>340.32</var>(3) participating medical response units must adhere to the requirements of this <br/>
<a id="pl.340.33"></a><var>340.33</var>pilot program outlined in an agreement between the Department of Public Safety and <br/>
<a id="pl.340.34"></a><var>340.34</var>the medical response unit, including but not limited to, requirements relating to data <br/>
<a id="pl.340.35"></a><var>340.35</var>collection, response criteria, and patient outcomes and disposition;<br/>
<a id="pl.341.1"></a><var>341.1</var>(4) individual entities licensed to provide ambulance care under Minnesota Statutes, <br/>
<a id="pl.341.2"></a><var>341.2</var>chapter 144E, are not eligible for participation in this pilot program;<br/>
<a id="pl.341.3"></a><var>341.3</var>(5) if a participating medical response unit withdraws from the pilot program, the <br/>
<a id="pl.341.4"></a><var>341.4</var>Department of Public Safety in consultation with the Minnesota Ambulance Association <br/>
<a id="pl.341.5"></a><var>341.5</var>may choose another pilot site if funding is available;<br/>
<a id="pl.341.6"></a><var>341.6</var>(6) medical response units must coordinate their operations under this pilot project <br/>
<a id="pl.341.7"></a><var>341.7</var>with the ambulance service or services licensed to provide care in their first response <br/>
<a id="pl.341.8"></a><var>341.8</var>geographic areas;<br/>
<a id="pl.341.9"></a><var>341.9</var>(7) licensed ambulance services that participate with the medical response unit in <br/>
<a id="pl.341.10"></a><var>341.10</var>the pilot program assume no financial or legal liability for the actions of the participating <br/>
<a id="pl.341.11"></a><var>341.11</var>medical response unit; and<br/>
<a id="pl.341.12"></a><var>341.12</var>(8) the Department of Public Safety and its pilot program partners have no ongoing <br/>
<a id="pl.341.13"></a><var>341.13</var>responsibility to reimburse medical response units beyond the parameters of the pilot <br/>
<a id="pl.341.14"></a><var>341.14</var>program.<br/>
<br/>
<a id="bill.10.49.0"></a><a id="pl.341.15"></a><var>341.15</var>    Sec. 49. <b>REVIEW OF PROPOSED REGULATIONS FOR BODY ART </b><br/>
<a id="pl.341.16"></a><var>341.16</var><b>TECHNICIANS AND BODY ART ESTABLISHMENTS.</b><br/>
<a id="pl.341.17"></a><var>341.17</var>The commissioner of health shall review proposed regulatory legislation for <br/>
<a id="pl.341.18"></a><var>341.18</var>body art technicians and body art establishments and develop recommendations on the <br/>
<a id="pl.341.19"></a><var>341.19</var>proper level of regulation needed for body art technicians and establishments in order <br/>
<a id="pl.341.20"></a><var>341.20</var>to protect public health. The recommendations must include a review of how other <br/>
<a id="pl.341.21"></a><var>341.21</var>states comply with the American Association of Blood Banks standards, how regulatory <br/>
<a id="pl.341.22"></a><var>341.22</var>requirements affect currently operating body art establishments, and the appropriate level <br/>
<a id="pl.341.23"></a><var>341.23</var>of coordination between the state and local jurisdictions that currently regulate body art <br/>
<a id="pl.341.24"></a><var>341.24</var>establishments. The commissioner shall submit the results of the review and possible <br/>
<a id="pl.341.25"></a><var>341.25</var>regulatory recommendations for body art technicians and establishments to the chairs and <br/>
<a id="pl.341.26"></a><var>341.26</var>ranking minority members of the legislative committees with jurisdiction over health <br/>
<a id="pl.341.27"></a><var>341.27</var>care by January 15, 2010.<br/>
<br/>
<a id="bill.10.50.0"></a><a id="pl.341.28"></a><var>341.28</var>    Sec. 50. <b>HEARING AIDS; ENFORCEMENT.</b><br/>
<a id="pl.341.29"></a><var>341.29</var>Costs incurred by the Minnesota Department of Health for conducting investigations <br/>
<a id="pl.341.30"></a><var>341.30</var>of unlicensed hearing aid dispensers shall be apportioned between all licensed or <br/>
<a id="pl.341.31"></a><var>341.31</var>credentialed professions that dispense hearing aids.<br/>
<a id="pl.341.32"></a><var>341.32</var><b>EFFECTIVE DATE.</b>This section is effect July 1, 2011.<br/>
<br/>
<a id="bill.10.51.0"></a><a id="pl.341.33"></a><var>341.33</var>    Sec. 51. <b>REPEALER.</b><br/>
<a id="pl.342.1"></a><var>342.1</var>(a) Minnesota Statutes 2008, sections 103I.112; 144.9501, subdivision 17b; and <br/>
<a id="pl.342.2"></a><var>342.2</var>327.14, subdivisions 5 and 6, are repealed.<br/>
<a id="pl.342.3"></a><var>342.3</var>(b) Minnesota Rules, part 4626.2015, subpart 9, is repealed.<br/>
<br/>
<a id="bill.11.0.0"></a>

<a id="bill.11.1.0"></a><a id="pl.342.6"></a><var>342.6</var>    Section 1. Minnesota Statutes 2008, section 148D.180, subdivision 1, is amended to <br/>
<a id="pl.342.7"></a><var>342.7</var>read:<br/>
<a id="pl.342.8"></a><var>342.8</var>    Subdivision 1. <b>Application fees.</b> Application fees for licensure are as follows:<br/>
<a id="pl.342.9"></a><var>342.9</var>(1) for a licensed social worker, $45;<br/>
<a id="pl.342.10"></a><var>342.10</var>(2) for a licensed graduate social worker, $45;<br/>
<a id="pl.342.11"></a><var>342.11</var>(3) for a licensed independent social worker, $90 $45;<br/>
<a id="pl.342.12"></a><var>342.12</var>(4) for a licensed independent clinical social worker, $90 $45;<br/>
<a id="pl.342.13"></a><var>342.13</var>(5) for a temporary license, $50; and<br/>
<a id="pl.342.14"></a><var>342.14</var>(6) for a licensure by endorsement, $150 $85.<br/>
<a id="pl.342.15"></a><var>342.15</var>The fee for criminal background checks is the fee charged by the Bureau of Criminal <br/>
<a id="pl.342.16"></a><var>342.16</var>Apprehension. The criminal background check fee must be included with the application <br/>
<a id="pl.342.17"></a><var>342.17</var>fee as required pursuant to section 
         <statute_ref>148D.055</statute_ref>.<br/>
<br/>
<a id="bill.11.2.0"></a><a id="pl.342.18"></a><var>342.18</var>    Sec. 2. Minnesota Statutes 2008, section 148D.180, subdivision 2, is amended to read:<br/>
<a id="pl.342.19"></a><var>342.19</var>    Subd. 2. <b>License fees.</b> License fees are as follows:<br/>
<a id="pl.342.20"></a><var>342.20</var>(1) for a licensed social worker, $115.20 $81;<br/>
<a id="pl.342.21"></a><var>342.21</var>(2) for a licensed graduate social worker, $201.60 $144;<br/>
<a id="pl.342.22"></a><var>342.22</var>(3) for a licensed independent social worker, $302.40 $216;<br/>
<a id="pl.342.23"></a><var>342.23</var>(4) for a licensed independent clinical social worker, $331.20 $238.50;<br/>
<a id="pl.342.24"></a><var>342.24</var>(5) for an emeritus license, $43.20; and<br/>
<a id="pl.342.25"></a><var>342.25</var>(6) for a temporary leave fee, the same as the renewal fee specified in subdivision 3.<br/>
<a id="pl.342.26"></a><var>342.26</var>If the licensee's initial license term is less or more than 24 months, the required <br/>
<a id="pl.342.27"></a><var>342.27</var>license fees must be prorated proportionately.<br/>
<br/>
<a id="bill.11.3.0"></a><a id="pl.342.28"></a><var>342.28</var>    Sec. 3. Minnesota Statutes 2008, section 148D.180, subdivision 3, is amended to read:<br/>
<a id="pl.342.29"></a><var>342.29</var>    Subd. 3. <b>Renewal fees.</b> Renewal fees for licensure are as follows:<br/>
<a id="pl.342.30"></a><var>342.30</var>(1) for a licensed social worker, $115.20 $81;<br/>
<a id="pl.342.31"></a><var>342.31</var>(2) for a licensed graduate social worker, $201.60 $144;<br/>
<a id="pl.342.32"></a><var>342.32</var>(3) for a licensed independent social worker, $302.40 $216; and<br/>
<a id="pl.342.33"></a><var>342.33</var>(4) for a licensed independent clinical social worker, $331.20 $238.50.<br/>
<br/>
<a id="bill.11.4.0"></a><a id="pl.343.1"></a><var>343.1</var>    Sec. 4. Minnesota Statutes 2008, section 148D.180, subdivision 5, is amended to read:<br/>
<a id="pl.343.2"></a><var>343.2</var>    Subd. 5. <b>Late fees.</b> Late fees are as follows:<br/>
<a id="pl.343.3"></a><var>343.3</var>(1) renewal late fee, one-half one-fourth of the renewal fee specified in subdivision <br/>
<a id="pl.343.4"></a><var>343.4</var>3; and<br/>
<a id="pl.343.5"></a><var>343.5</var>(2) supervision plan late fee, $40.<br/>
<br/>
<a id="bill.11.5.0"></a><a id="pl.343.6"></a><var>343.6</var>    Sec. 5. Minnesota Statutes 2008, section 148E.180, subdivision 1, is amended to read:<br/>
<a id="pl.343.7"></a><var>343.7</var>    Subdivision 1. <b>Application fees.</b> Application fees for licensure are as follows:<br/>
<a id="pl.343.8"></a><var>343.8</var>    (1) for a licensed social worker, $45;<br/>
<a id="pl.343.9"></a><var>343.9</var>    (2) for a licensed graduate social worker, $45;<br/>
<a id="pl.343.10"></a><var>343.10</var>    (3) for a licensed independent social worker, $90 $45;<br/>
<a id="pl.343.11"></a><var>343.11</var>    (4) for a licensed independent clinical social worker, $90 $45;<br/>
<a id="pl.343.12"></a><var>343.12</var>    (5) for a temporary license, $50; and<br/>
<a id="pl.343.13"></a><var>343.13</var>    (6) for a licensure by endorsement, $150 $85.<br/>
<a id="pl.343.14"></a><var>343.14</var>    The fee for criminal background checks is the fee charged by the Bureau of Criminal <br/>
<a id="pl.343.15"></a><var>343.15</var>Apprehension. The criminal background check fee must be included with the application <br/>
<a id="pl.343.16"></a><var>343.16</var>fee as required according to section 
         <statute_ref>148E.055</statute_ref>.<br/>
<br/>
<a id="bill.11.6.0"></a><a id="pl.343.17"></a><var>343.17</var>    Sec. 6. Minnesota Statutes 2008, section 148E.180, subdivision 2, is amended to read:<br/>
<a id="pl.343.18"></a><var>343.18</var>    Subd. 2. <b>License fees.</b> License fees are as follows:<br/>
<a id="pl.343.19"></a><var>343.19</var>    (1) for a licensed social worker, $115.20 $81;<br/>
<a id="pl.343.20"></a><var>343.20</var>    (2) for a licensed graduate social worker, $201.60 $144;<br/>
<a id="pl.343.21"></a><var>343.21</var>    (3) for a licensed independent social worker, $302.40 $216;<br/>
<a id="pl.343.22"></a><var>343.22</var>    (4) for a licensed independent clinical social worker, $331.20 $238.50;<br/>
<a id="pl.343.23"></a><var>343.23</var>    (5) for an emeritus license, $43.20; and<br/>
<a id="pl.343.24"></a><var>343.24</var>    (6) for a temporary leave fee, the same as the renewal fee specified in subdivision 3.<br/>
<a id="pl.343.25"></a><var>343.25</var>    If the licensee's initial license term is less or more than 24 months, the required <br/>
<a id="pl.343.26"></a><var>343.26</var>license fees must be prorated proportionately.<br/>
<br/>
<a id="bill.11.7.0"></a><a id="pl.343.27"></a><var>343.27</var>    Sec. 7. Minnesota Statutes 2008, section 148E.180, subdivision 3, is amended to read:<br/>
<a id="pl.343.28"></a><var>343.28</var>    Subd. 3. <b>Renewal fees.</b> Renewal fees for licensure are as follows:<br/>
<a id="pl.343.29"></a><var>343.29</var>    (1) for a licensed social worker, $115.20 $81;<br/>
<a id="pl.343.30"></a><var>343.30</var>    (2) for a licensed graduate social worker, $201.60 $144;<br/>
<a id="pl.343.31"></a><var>343.31</var>    (3) for a licensed independent social worker, $302.40 $216; and<br/>
<a id="pl.343.32"></a><var>343.32</var>    (4) for a licensed independent clinical social worker, $331.20 $238.50.<br/>
<br/>
<a id="bill.11.8.0"></a><a id="pl.344.1"></a><var>344.1</var>    Sec. 8. Minnesota Statutes 2008, section 148E.180, subdivision 5, is amended to read:<br/>
<a id="pl.344.2"></a><var>344.2</var>    Subd. 5. <b>Late fees.</b> Late fees are as follows:<br/>
<a id="pl.344.3"></a><var>344.3</var>    (1) renewal late fee, one-half one-fourth of the renewal fee specified in subdivision <br/>
<a id="pl.344.4"></a><var>344.4</var>3; and<br/>
<a id="pl.344.5"></a><var>344.5</var>    (2) supervision plan late fee, $40.<br/>
<br/>
<a id="bill.11.9.0"></a><a id="pl.344.6"></a><var>344.6</var>    Sec. 9. Minnesota Statutes 2008, section 152.126, subdivision 1, is amended to read:<br/>
<a id="pl.344.7"></a><var>344.7</var>    Subdivision 1. <b>Definitions.</b> For purposes of this section, the terms defined in this <br/>
<a id="pl.344.8"></a><var>344.8</var>subdivision have the meanings given.<br/>
<a id="pl.344.9"></a><var>344.9</var>    (a) "Board" means the Minnesota State Board of Pharmacy established under <br/>
<a id="pl.344.10"></a><var>344.10</var>chapter 151.<br/>
<a id="pl.344.11"></a><var>344.11</var>    (b) "Controlled substances" means those substances listed in section 
         <statute_ref>152.02</statute_ref>, <br/>
<a id="pl.344.12"></a><var>344.12</var>subdivisions 3 and 4 to 5, and those substances defined by the board pursuant to section <br/>
<statute_ref><a id="pl.344.13"></a><var>344.13</var>152.02, subdivisions 7
         </statute_ref>, 8, and 12.<br/>
<a id="pl.344.14"></a><var>344.14</var>    (c) "Dispense" or "dispensing" has the meaning given in section 
         <statute_ref>151.01, subdivision <br/>
</statute_ref><a id="pl.344.15"></a><var>344.15</var>30. Dispensing does not include the direct administering of a controlled substance to a <br/>
<a id="pl.344.16"></a><var>344.16</var>patient by a licensed health care professional.<br/>
<a id="pl.344.17"></a><var>344.17</var>    (d) "Dispenser" means a person authorized by law to dispense a controlled substance, <br/>
<a id="pl.344.18"></a><var>344.18</var>pursuant to a valid prescription. For the purposes of this section, a dispenser does not <br/>
<a id="pl.344.19"></a><var>344.19</var>include a licensed hospital pharmacy that distributes controlled substances for inpatient <br/>
<a id="pl.344.20"></a><var>344.20</var>hospital care or a veterinarian who is dispensing prescriptions under section 
         <statute_ref>156.18</statute_ref>.<br/>
<a id="pl.344.21"></a><var>344.21</var>    (e) "Prescriber" means a licensed health care professional who is authorized to <br/>
<a id="pl.344.22"></a><var>344.22</var>prescribe a controlled substance under section 
         <statute_ref>152.12, subdivision 1</statute_ref>.<br/>
<a id="pl.344.23"></a><var>344.23</var>    (f) "Prescription" has the meaning given in section 
         <statute_ref>151.01, subdivision 16</statute_ref>.<br/>
<br/>
<a id="bill.11.10.0"></a><a id="pl.344.24"></a><var>344.24</var>    Sec. 10. Minnesota Statutes 2008, section 152.126, subdivision 2, is amended to read:<br/>
<a id="pl.344.25"></a><var>344.25</var>    Subd. 2. <b>Prescription electronic reporting system.</b> (a) The board shall establish <br/>
<a id="pl.344.26"></a><var>344.26</var>by January 1, 2010, an electronic system for reporting the information required under <br/>
<a id="pl.344.27"></a><var>344.27</var>subdivision 4 for all controlled substances dispensed within the state. <br/>
<a id="pl.344.28"></a><var>344.28</var>    (b) The board may contract with a vendor for the purpose of obtaining technical <br/>
<a id="pl.344.29"></a><var>344.29</var>assistance in the design, implementation, operation, and maintenance of the electronic <br/>
<a id="pl.344.30"></a><var>344.30</var>reporting system. The vendor's role shall be limited to providing technical support to the <br/>
<a id="pl.344.31"></a><var>344.31</var>board concerning the software, databases, and computer systems required to interface with <br/>
<a id="pl.344.32"></a><var>344.32</var>the existing systems currently used by pharmacies to dispense prescriptions and transmit <br/>
<a id="pl.344.33"></a><var>344.33</var>prescription data to other third parties.<br/>
<br/>
<a id="bill.11.11.0"></a><a id="pl.345.1"></a><var>345.1</var>    Sec. 11. Minnesota Statutes 2008, section 152.126, subdivision 6, is amended to read:<br/>
<a id="pl.345.2"></a><var>345.2</var>    Subd. 6. <b>Access to reporting system data.</b> (a) Except as indicated in this <br/>
<a id="pl.345.3"></a><var>345.3</var>subdivision, the data submitted to the board under subdivision 4 is private data on <br/>
<a id="pl.345.4"></a><var>345.4</var>individuals as defined in section 
         <statute_ref>13.02, subdivision 12</statute_ref>, and not subject to public disclosure.<br/>
<a id="pl.345.5"></a><var>345.5</var>    (b) Except as specified in subdivision 5, the following persons shall be considered <br/>
<a id="pl.345.6"></a><var>345.6</var>permissible users and may access the data submitted under subdivision 4 in the same or <br/>
<a id="pl.345.7"></a><var>345.7</var>similar manner, and for the same or similar purposes, as those persons who are authorized <br/>
<a id="pl.345.8"></a><var>345.8</var>to access similar private data on individuals under federal and state law:<br/>
<a id="pl.345.9"></a><var>345.9</var>    (1) a prescriber, to the extent the information relates specifically to a current patient, <br/>
<a id="pl.345.10"></a><var>345.10</var>to whom the prescriber is prescribing or considering prescribing any controlled substance;<br/>
<a id="pl.345.11"></a><var>345.11</var>    (2) a dispenser, to the extent the information relates specifically to a current patient <br/>
<a id="pl.345.12"></a><var>345.12</var>to whom that dispenser is dispensing or considering dispensing any controlled substance;<br/>
<a id="pl.345.13"></a><var>345.13</var>    (3) an individual who is the recipient of a controlled substance prescription for <br/>
<a id="pl.345.14"></a><var>345.14</var>which data was submitted under subdivision 4, or a guardian of the individual, parent or <br/>
<a id="pl.345.15"></a><var>345.15</var>guardian of a minor, or health care agent of the individual acting under a health care <br/>
<a id="pl.345.16"></a><var>345.16</var>directive under chapter 145C;<br/>
<a id="pl.345.17"></a><var>345.17</var>    (4) personnel of the board specifically assigned to conduct a bona fide investigation <br/>
<a id="pl.345.18"></a><var>345.18</var>of a specific licensee;<br/>
<a id="pl.345.19"></a><var>345.19</var>    (5) personnel of the board engaged in the collection of controlled substance <br/>
<a id="pl.345.20"></a><var>345.20</var>prescription information as part of the assigned duties and responsibilities under this <br/>
<a id="pl.345.21"></a><var>345.21</var>section;<br/>
<a id="pl.345.22"></a><var>345.22</var>    (6) authorized personnel of a vendor under contract with the board who are engaged <br/>
<a id="pl.345.23"></a><var>345.23</var>in the design, implementation, operation, and maintenance of the electronic reporting <br/>
<a id="pl.345.24"></a><var>345.24</var>system as part of the assigned duties and responsibilities of their employment, provided <br/>
<a id="pl.345.25"></a><var>345.25</var>that access to data is limited to the minimum amount necessary to test and maintain the <br/>
<a id="pl.345.26"></a><var>345.26</var>system databases carry out such duties and responsibilities;<br/>
<a id="pl.345.27"></a><var>345.27</var>    (7) federal, state, and local law enforcement authorities acting pursuant to a valid <br/>
<a id="pl.345.28"></a><var>345.28</var>search warrant; and<br/>
<a id="pl.345.29"></a><var>345.29</var>    (8) personnel of the medical assistance program assigned to use the data collected <br/>
<a id="pl.345.30"></a><var>345.30</var>under this section to identify recipients whose usage of controlled substances may warrant <br/>
<a id="pl.345.31"></a><var>345.31</var>restriction to a single primary care physician, a single outpatient pharmacy, or a single <br/>
<a id="pl.345.32"></a><var>345.32</var>hospital.<br/>
<a id="pl.345.33"></a><var>345.33</var>    For purposes of clause (3), access by an individual includes persons in the definition <br/>
<a id="pl.345.34"></a><var>345.34</var>of an individual under section 
         <statute_ref>13.02</statute_ref>.<br/>
<a id="pl.345.35"></a><var>345.35</var>    (c) Any permissible user identified in paragraph (b), who directly accesses <br/>
<a id="pl.345.36"></a><var>345.36</var>the data electronically, shall implement and maintain a comprehensive information <br/>
<a id="pl.346.1"></a><var>346.1</var>security program that contains administrative, technical, and physical safeguards that <br/>
<a id="pl.346.2"></a><var>346.2</var>are appropriate to the user's size and complexity, and the sensitivity of the personal <br/>
<a id="pl.346.3"></a><var>346.3</var>information obtained. The permissible user shall identify reasonably foreseeable internal <br/>
<a id="pl.346.4"></a><var>346.4</var>and external risks to the security, confidentiality, and integrity of personal information <br/>
<a id="pl.346.5"></a><var>346.5</var>that could result in the unauthorized disclosure, misuse, or other compromise of the <br/>
<a id="pl.346.6"></a><var>346.6</var>information and assess the sufficiency of any safeguards in place to control the risks.<br/>
<a id="pl.346.7"></a><var>346.7</var>    (d) The board shall not release data submitted under this section unless it is provided <br/>
<a id="pl.346.8"></a><var>346.8</var>with evidence, satisfactory to the board, that the person requesting the information is <br/>
<a id="pl.346.9"></a><var>346.9</var>entitled to receive the data.<br/>
<a id="pl.346.10"></a><var>346.10</var>    (e) The board shall not release the name of a prescriber without the written consent <br/>
<a id="pl.346.11"></a><var>346.11</var>of the prescriber or a valid search warrant or court order. The board shall provide a <br/>
<a id="pl.346.12"></a><var>346.12</var>mechanism for a prescriber to submit to the board a signed consent authorizing the release <br/>
<a id="pl.346.13"></a><var>346.13</var>of the prescriber's name when data containing the prescriber's name is requested.<br/>
<a id="pl.346.14"></a><var>346.14</var>    (f) The board shall maintain a log of all persons who access the data and shall ensure <br/>
<a id="pl.346.15"></a><var>346.15</var>that any permissible user complies with paragraph (c) prior to attaining direct access to <br/>
<a id="pl.346.16"></a><var>346.16</var>the data.<br/>
<a id="pl.346.17"></a><var>346.17</var>(g) Section 13.05, subdivision 6, shall apply to any contract the board enters into <br/>
<a id="pl.346.18"></a><var>346.18</var>pursuant to subdivision 2. A vendor shall not use data collected under this section for <br/>
<a id="pl.346.19"></a><var>346.19</var>any purpose not specified in this section.<br/>
<br/>
<a id="bill.11.12.0"></a><a id="pl.346.20"></a><var>346.20</var>    Sec. 12. <b> REPEALER.</b><br/>
<a id="pl.346.21"></a><var>346.21</var>Minnesota Statutes 2008, section 148D.180, subdivision 8, is repealed.<br/>
<br/>
<a id="bill.12.0.0"></a>

<a id="bill.12.1.0"></a><table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.346.24"></a><var>346.24</var><br/>
<a id="pl.346.25"></a><var>346.25</var><br/>
</td>
<td align="left" colspan="7" valign="bottom">Section 1. <b>SUMMARY OF APPROPRIATIONS; DEPARTMENT OF HUMAN </b><br/>
<b>SERVICES FORECAST ADJUSTMENT.</b><br/>
</td>
</tr>
</table><a id="pl.346.26"></a><var>346.26</var>    The dollar amounts shown are added to or, if shown in parentheses, are subtracted <br/>
<a id="pl.346.27"></a><var>346.27</var>from the appropriations in Laws 2008, chapter 363, from the general fund, or any other <br/>
<a id="pl.346.28"></a><var>346.28</var>fund named, to the Department of Human Services for the purposes specified in this <br/>
<a id="pl.346.29"></a><var>346.29</var>article, to be available for the fiscal year indicated for each purpose. The figure "2009" <br/>
<a id="pl.346.30"></a><var>346.30</var>used in this article means that the appropriation or appropriations listed are available <br/>
<a id="pl.346.31"></a><var>346.31</var>for the fiscal year ending June 30, 2009.<br/>
<br/>
<a id="bill.12.2.0"></a><table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.346.32"></a><var>346.32</var><br/>
<a id="pl.346.33"></a><var>346.33</var><br/>
</td>
<td align="left" colspan="3" valign="bottom">Sec. 2. <b>COMMISSIONER OF HUMAN </b><br/>
<b>SERVICES</b><br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.347.1"></a><var>347.1</var><br/>
</td>
<td align="left" colspan="3" valign="bottom">Subdivision 1.<b>Total Appropriation</b><br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
<td align="center" valign="bottom"><b>$</b><br/>
</td>
<td align="right" valign="bottom"><b>(478,994,000)</b><br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="95px"/>
<col width="96px"/>
<tr>
<td><a id="pl.347.2"></a><var>347.2</var><br/>
</td>
<td align="center" colspan="3" valign="bottom">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.347.3"></a><var>347.3</var><br/>
</td>
<td align="left" valign="bottom"></td>
<td align="center" valign="bottom"></td>
<td align="center" valign="bottom">2009<br/>
</td>
</tr>
<tr>
<td><a id="pl.347.4"></a><var>347.4</var><br/>
</td>
<td align="left" valign="bottom">General<br/>
</td>
<td align="right" valign="bottom"></td>
<td align="right" valign="bottom">(445,130,000)<br/>
</td>
</tr>
<tr>
<td><a id="pl.347.5"></a><var>347.5</var><br/>
</td>
<td align="left" valign="bottom">Health Care Access<br/>
</td>
<td align="right" valign="bottom"></td>
<td align="right" valign="bottom">(19,460,000)<br/>
</td>
</tr>
<tr>
<td><a id="pl.347.6"></a><var>347.6</var><br/>
</td>
<td align="left" valign="bottom">Federal TANF<br/>
</td>
<td align="right" valign="bottom"></td>
<td align="right" valign="bottom">(14,404,000)<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.347.7"></a><var>347.7</var><br/>
</td>
<td align="left" colspan="3" valign="bottom">Subd. 2.<b>Revenue and Pass-Through</b><br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="95px"/>
<col width="96px"/>
<tr>
<td><a id="pl.347.8"></a><var>347.8</var><br/>
</td>
<td align="left" valign="bottom">Federal TANF<br/>
</td>
<td align="right" valign="bottom"></td>
<td align="right" valign="bottom">1,107,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.347.9"></a><var>347.9</var><br/>
<a id="pl.347.10"></a><var>347.10</var><br/>
</td>
<td align="left" colspan="3" valign="bottom">Subd. 3.<b>Children and Economic Assistance </b><br/>
<b>Grants</b><br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="95px"/>
<col width="96px"/>
<tr>
<td><a id="pl.347.11"></a><var>347.11</var><br/>
</td>
<td align="left" valign="bottom">General<br/>
</td>
<td align="right" valign="bottom"></td>
<td align="right" valign="bottom">27,002,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.347.12"></a><var>347.12</var><br/>
</td>
<td align="left" valign="bottom">Federal TANF<br/>
</td>
<td align="right" valign="bottom"></td>
<td align="right" valign="bottom">(16,211,000)<br/>
</td>
</tr>
</table><a id="pl.347.13"></a><var>347.13</var>The amounts that may be spent from this <br/>
<a id="pl.347.14"></a><var>347.14</var>appropriation for each purpose are as follows:<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.347.15"></a><var>347.15</var><br/>
</td>
<td align="left" colspan="3" valign="bottom">(a) <b>MFIP/DWP Grants</b><br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.347.16"></a><var>347.16</var><br/>
</td>
<td align="left" valign="bottom">General<br/>
</td>
<td align="right" valign="bottom"></td>
<td align="right" valign="bottom">17,530,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.347.17"></a><var>347.17</var><br/>
</td>
<td align="left" valign="bottom">Federal TANF<br/>
</td>
<td align="right" valign="bottom"></td>
<td align="right" valign="bottom">(16,211,000)<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.347.18"></a><var>347.18</var><br/>
</td>
<td align="left" colspan="3" valign="bottom">(b) <b>MFIP Child Care Assistance Grants</b><br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom">4,933,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.347.19"></a><var>347.19</var><br/>
</td>
<td align="left" colspan="3" valign="bottom">(c) <b>General Assistance Grants</b><br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom">1,458,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.347.20"></a><var>347.20</var><br/>
</td>
<td align="left" colspan="3" valign="bottom">(d) <b>Minnesota Supplemental Aid Grants</b><br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom">513,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.347.21"></a><var>347.21</var><br/>
</td>
<td align="left" colspan="3" valign="bottom">(e) <b>Group Residential Housing Grants</b><br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom">2,568,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.347.22"></a><var>347.22</var><br/>
</td>
<td align="left" colspan="3" valign="bottom">Subd. 4.<b>Basic Health Care Grants</b><br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.347.23"></a><var>347.23</var><br/>
</td>
<td align="left" valign="bottom">General<br/>
</td>
<td align="right" valign="bottom"></td>
<td align="right" valign="bottom">(224,341,000)<br/>
</td>
</tr>
<tr>
<td><a id="pl.347.24"></a><var>347.24</var><br/>
</td>
<td align="left" valign="bottom">Health Care Access<br/>
</td>
<td align="right" valign="bottom"></td>
<td align="right" valign="bottom">(19,460,000)<br/>
</td>
</tr>
</table><a id="pl.348.1"></a><var>348.1</var>The amounts that may be spent from this <br/>
<a id="pl.348.2"></a><var>348.2</var>appropriation for each purpose are as follows:<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.348.3"></a><var>348.3</var><br/>
</td>
<td align="left" colspan="3" valign="bottom">(a) <b>MinnesotaCare</b><br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.348.4"></a><var>348.4</var><br/>
</td>
<td align="left" valign="bottom"> Health Care Access<br/>
</td>
<td align="right" valign="bottom"></td>
<td align="right" valign="bottom">(19,460,000)<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.348.5"></a><var>348.5</var><br/>
<a id="pl.348.6"></a><var>348.6</var><br/>
</td>
<td align="left" colspan="3" valign="bottom">(b) <b>MA Basic Health Care - Families and </b><br/>
<b>Children</b><br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom">(100,055,000)<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.348.7"></a><var>348.7</var><br/>
<a id="pl.348.8"></a><var>348.8</var><br/>
</td>
<td align="left" colspan="3" valign="bottom">(c) <b>MA Basic Health Care - Elderly and </b><br/>
<b>Disabled</b><br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom">(136,795,000)<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.348.9"></a><var>348.9</var><br/>
</td>
<td align="left" colspan="3" valign="bottom">(d) <b>General Assistance Medical Care</b><br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom">12,539,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.348.10"></a><var>348.10</var><br/>
</td>
<td align="left" colspan="3" valign="bottom">Subd. 5.<b>Continuing Care Grants</b><br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"><b>(247,791,000)</b><br/>
</td>
</tr>
</table><a id="pl.348.11"></a><var>348.11</var>The amounts that may be spent from this <br/>
<a id="pl.348.12"></a><var>348.12</var>appropriation for each purpose are as follows:<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.348.13"></a><var>348.13</var><br/>
</td>
<td align="left" colspan="3" valign="bottom">(a) <b>MA Long-Term Care Facilities</b><br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom">(59,204,000)<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.348.14"></a><var>348.14</var><br/>
</td>
<td align="left" colspan="3" valign="bottom">(b) <b>MA Long-Term Care Waivers</b><br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom">(168,927,000)<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.348.15"></a><var>348.15</var><br/>
</td>
<td align="left" colspan="3" valign="bottom">(c) <b>Chemical Dependency Entitlement Grants</b><br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom">(19,660,000)<br/>
</td>
</tr>
</table><br/>
<a id="bill.12.3.0"></a><a id="pl.348.16"></a><var>348.16</var>    Sec. 3. <b>EFFECTIVE DATE.</b><br/>
<a id="pl.348.17"></a><var>348.17</var>Sections 1 and 2 are effective the day following final enactment.<br/>
<br/>
<a id="bill.13.0.0"></a>

<a id="bill.13.1.0"></a><table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.348.20"></a><var>348.20</var><br/>
</td>
<td align="left" colspan="7">Section 1. <b>SUMMARY OF APPROPRIATIONS.</b><br/>
</td>
</tr>
</table><a id="pl.348.21"></a><var>348.21</var>    The amounts shown in this section summarize direct appropriations by fund made <br/>
<a id="pl.348.22"></a><var>348.22</var>in this article.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.348.23"></a><var>348.23</var><br/>
</td>
<td align="left"></td>
<td align="left"></td>
<td align="center"><b>2010</b><br/>
</td>
<td align="left"></td>
<td align="center"><b>2011</b><br/>
</td>
<td align="left"></td>
<td align="center"><b>Total</b><br/>
</td>
</tr>
<tr>
<td><a id="pl.348.24"></a><var>348.24</var><br/>
</td>
<td align="left">General<br/>
</td>
<td align="center">$<br/>
</td>
<td align="right">4,452,323,000<br/>
</td>
<td align="center">$<br/>
</td>
<td align="right">5,280,470,000<br/>
</td>
<td align="center">$<br/>
</td>
<td align="right">9,732,793,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.348.25"></a><var>348.25</var><br/>
<a id="pl.348.26"></a><var>348.26</var><br/>
</td>
<td align="left">State Government Special <br/>
Revenue<br/>
</td>
<td align="center"></td>
<td align="right">62,451,000<br/>
</td>
<td align="center"></td>
<td align="right">61,515,000<br/>
</td>
<td align="center"></td>
<td align="right">123,966,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.349.1"></a><var>349.1</var><br/>
</td>
<td align="left">Health Care Access<br/>
</td>
<td align="center"></td>
<td align="right">489,995,000<br/>
</td>
<td align="center"></td>
<td align="right">568,298,000<br/>
</td>
<td align="center"></td>
<td align="right">1,058,293,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.349.2"></a><var>349.2</var><br/>
</td>
<td align="left">Federal TANF<br/>
</td>
<td align="center"></td>
<td align="right">301,220,000<br/>
</td>
<td align="center"></td>
<td align="right">268,711,000<br/>
</td>
<td align="center"></td>
<td align="right">569,931,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.349.3"></a><var>349.3</var><br/>
</td>
<td align="left">Lottery Prize<br/>
</td>
<td align="center"></td>
<td align="right">1,665,000<br/>
</td>
<td align="center"></td>
<td align="right">1,665,000<br/>
</td>
<td align="center"></td>
<td align="right">3,330,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.349.4"></a><var>349.4</var><br/>
</td>
<td align="left">Federal Fund<br/>
</td>
<td align="center"></td>
<td align="right">110,000,000<br/>
</td>
<td align="center"></td>
<td align="right">0<br/>
</td>
<td align="center"></td>
<td align="right">110,000,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.349.5"></a><var>349.5</var><br/>
</td>
<td align="left"><b>Total</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>5,417,704,000</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>6,180,659,000</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>11,598,363,000</b><br/>
</td>
</tr>
</table><br/>
<a id="bill.13.2.0"></a><table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.349.6"></a><var>349.6</var><br/>
</td>
<td align="left" colspan="7">Sec. 2. <b>HEALTH AND HUMAN SERVICES APPROPRIATION.</b><br/>
</td>
</tr>
</table><a id="pl.349.7"></a><var>349.7</var>    The sums shown in the columns marked "Appropriations" are appropriated to the <br/>
<a id="pl.349.8"></a><var>349.8</var>agencies and for the purposes specified in this article. The appropriations are from the <br/>
<a id="pl.349.9"></a><var>349.9</var>general fund, or another named fund, and are available for the fiscal years indicated <br/>
<a id="pl.349.10"></a><var>349.10</var>for each purpose. The figures "2010" and "2011" used in this article mean that the <br/>
<a id="pl.349.11"></a><var>349.11</var>appropriations listed under them are available for the fiscal year ending June 30, 2010, or <br/>
<a id="pl.349.12"></a><var>349.12</var>June 30, 2011, respectively. "The first year" is fiscal year 2010. "The second year" is fiscal <br/>
<a id="pl.349.13"></a><var>349.13</var>year 2011. "The biennium" is fiscal years 2010 and 2011. Appropriations for the fiscal <br/>
<a id="pl.349.14"></a><var>349.14</var>year ending June 30, 2009, are effective the day following final enactment.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.349.15"></a><var>349.15</var><br/>
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left"></td>
<td align="center" colspan="4"><b>APPROPRIATIONS</b><br/>
</td>
</tr>
<tr>
<td><a id="pl.349.16"></a><var>349.16</var><br/>
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left"></td>
<td align="center" colspan="4"><b>Available for the Year</b><br/>
</td>
</tr>
<tr>
<td><a id="pl.349.17"></a><var>349.17</var><br/>
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left"></td>
<td align="center" colspan="4"><b>Ending June 30</b><br/>
</td>
</tr>
<tr>
<td><a id="pl.349.18"></a><var>349.18</var><br/>
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left"></td>
<td align="left"></td>
<td align="center"><b>2010</b><br/>
</td>
<td align="left"></td>
<td align="center"><b>2011</b><br/>
</td>
</tr>
</table><br/>
<a id="bill.13.3.0"></a><table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.349.19"></a><var>349.19</var><br/>
</td>
<td align="left" colspan="3">Sec. 3. <b>HUMAN SERVICES</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.349.20"></a><var>349.20</var><br/>
</td>
<td align="left" colspan="3">Subdivision 1.<b>Total Appropriation</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>5,230,100,000</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>5,997,715,000</b><br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="95px"/>
<col width="96px"/>
<tr>
<td><a id="pl.349.21"></a><var>349.21</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.349.22"></a><var>349.22</var><br/>
</td>
<td align="left"></td>
<td align="center">2010<br/>
</td>
<td align="center">2011<br/>
</td>
</tr>
<tr>
<td><a id="pl.349.23"></a><var>349.23</var><br/>
</td>
<td align="left">General<br/>
</td>
<td align="right">4,376,839,000<br/>
</td>
<td align="right">5,211,018,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.349.24"></a><var>349.24</var><br/>
<a id="pl.349.25"></a><var>349.25</var><br/>
</td>
<td align="left">State Government <br/>
Special Revenue<br/>
</td>
<td align="right">1,315,000<br/>
</td>
<td align="right">565,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.349.26"></a><var>349.26</var><br/>
</td>
<td align="left">Health Care Access<br/>
</td>
<td align="right">450,792,000<br/>
</td>
<td align="right">527,489,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.349.27"></a><var>349.27</var><br/>
</td>
<td align="left">Federal TANF<br/>
</td>
<td align="right">289,487,000<br/>
</td>
<td align="right">256,978,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.349.28"></a><var>349.28</var><br/>
</td>
<td align="left">Lottery Prize<br/>
</td>
<td align="right">1,665,000<br/>
</td>
<td align="right">1,665,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.349.29"></a><var>349.29</var><br/>
</td>
<td align="left">Federal Fund<br/>
</td>
<td align="right">110,000,000<br/>
</td>
<td align="right">0<br/>
</td>
</tr>
</table><a id="pl.350.1"></a><var>350.1</var><b>Receipts for Systems Projects.</b> <br/>
<a id="pl.350.2"></a><var>350.2</var>Appropriations and federal receipts for <br/>
<a id="pl.350.3"></a><var>350.3</var>information systems projects for MAXIS, <br/>
<a id="pl.350.4"></a><var>350.4</var>PRISM, MMIS, and SSIS must be deposited <br/>
<a id="pl.350.5"></a><var>350.5</var>in the state system account authorized in <br/>
<a id="pl.350.6"></a><var>350.6</var>Minnesota Statutes, section 256.014. Money <br/>
<a id="pl.350.7"></a><var>350.7</var>appropriated for computer projects approved <br/>
<a id="pl.350.8"></a><var>350.8</var>by the Minnesota Office of Enterprise <br/>
<a id="pl.350.9"></a><var>350.9</var>Technology, funded by the legislature, and <br/>
<a id="pl.350.10"></a><var>350.10</var>approved by the commissioner of finance, <br/>
<a id="pl.350.11"></a><var>350.11</var>may be transferred from one project to <br/>
<a id="pl.350.12"></a><var>350.12</var>another and from development to operations <br/>
<a id="pl.350.13"></a><var>350.13</var>as the commissioner of human services <br/>
<a id="pl.350.14"></a><var>350.14</var>considers necessary, except that any transfers <br/>
<a id="pl.350.15"></a><var>350.15</var>to one project that exceed $1,000,000 or <br/>
<a id="pl.350.16"></a><var>350.16</var>multiple transfers to one project that exceed <br/>
<a id="pl.350.17"></a><var>350.17</var>$1,000,000 in total require the express <br/>
<a id="pl.350.18"></a><var>350.18</var>approval of the legislature. The preceding <br/>
<a id="pl.350.19"></a><var>350.19</var>requirement for legislative approval does not <br/>
<a id="pl.350.20"></a><var>350.20</var>apply to transfers made to establish a project's <br/>
<a id="pl.350.21"></a><var>350.21</var>initial operating budget each year; instead, <br/>
<a id="pl.350.22"></a><var>350.22</var>the requirements of section 11, subdivision 2, <br/>
<a id="pl.350.23"></a><var>350.23</var>of this article apply to those transfers. Any <br/>
<a id="pl.350.24"></a><var>350.24</var>unexpended balance in the appropriation <br/>
<a id="pl.350.25"></a><var>350.25</var>for these projects does not cancel but is <br/>
<a id="pl.350.26"></a><var>350.26</var>available for ongoing development and <br/>
<a id="pl.350.27"></a><var>350.27</var>operations. Any computer project with a <br/>
<a id="pl.350.28"></a><var>350.28</var>total cost exceeding $1,000,000, including, <br/>
<a id="pl.350.29"></a><var>350.29</var>but not limited to, a replacement for the <br/>
<a id="pl.350.30"></a><var>350.30</var>proposed HealthMatch system, shall not be <br/>
<a id="pl.350.31"></a><var>350.31</var>commenced without the express approval of <br/>
<a id="pl.350.32"></a><var>350.32</var>the legislature.<br/>
<a id="pl.350.33"></a><var>350.33</var><b>HealthMatch Systems Project.</b> In fiscal <br/>
<a id="pl.350.34"></a><var>350.34</var>year 2010, $3,054,000 shall be transferred <br/>
<a id="pl.350.35"></a><var>350.35</var>from the HealthMatch account in the state <br/>
<a id="pl.351.1"></a><var>351.1</var>systems account in the special revenue fund <br/>
<a id="pl.351.2"></a><var>351.2</var>to the general fund.<br/>
<a id="pl.351.3"></a><var>351.3</var><b>Nonfederal Share Transfers.</b> The <br/>
<a id="pl.351.4"></a><var>351.4</var>nonfederal share of activities for which <br/>
<a id="pl.351.5"></a><var>351.5</var>federal administrative reimbursement is <br/>
<a id="pl.351.6"></a><var>351.6</var>appropriated to the commissioner may be <br/>
<a id="pl.351.7"></a><var>351.7</var>transferred to the special revenue fund.<br/>
<a id="pl.351.8"></a><var>351.8</var><b>TANF Maintenance of Effort.</b><br/>
<a id="pl.351.9"></a><var>351.9</var>(a) In order to meet the basic maintenance <br/>
<a id="pl.351.10"></a><var>351.10</var>of effort (MOE) requirements of the TANF <br/>
<a id="pl.351.11"></a><var>351.11</var>block grant specified under Code of Federal <br/>
<a id="pl.351.12"></a><var>351.12</var>Regulations, title 45, section 263.1, the <br/>
<a id="pl.351.13"></a><var>351.13</var>commissioner may only report nonfederal <br/>
<a id="pl.351.14"></a><var>351.14</var>money expended for allowable activities <br/>
<a id="pl.351.15"></a><var>351.15</var>listed in the following clauses as TANF/MOE <br/>
<a id="pl.351.16"></a><var>351.16</var>expenditures:<br/>
<a id="pl.351.17"></a><var>351.17</var>(1) MFIP cash, diversionary work program, <br/>
<a id="pl.351.18"></a><var>351.18</var>and food assistance benefits under Minnesota <br/>
<a id="pl.351.19"></a><var>351.19</var>Statutes, chapter 256J;<br/>
<a id="pl.351.20"></a><var>351.20</var>(2) the child care assistance programs <br/>
<a id="pl.351.21"></a><var>351.21</var>under Minnesota Statutes, sections 119B.03 <br/>
<a id="pl.351.22"></a><var>351.22</var>and 119B.05, and county child care <br/>
<a id="pl.351.23"></a><var>351.23</var>administrative costs under Minnesota <br/>
<a id="pl.351.24"></a><var>351.24</var>Statutes, section 119B.15;<br/>
<a id="pl.351.25"></a><var>351.25</var>(3) state and county MFIP administrative <br/>
<a id="pl.351.26"></a><var>351.26</var>costs under Minnesota Statutes, chapters <br/>
<a id="pl.351.27"></a><var>351.27</var>256J and 256K;<br/>
<a id="pl.351.28"></a><var>351.28</var>(4) state, county, and tribal MFIP <br/>
<a id="pl.351.29"></a><var>351.29</var>employment services under Minnesota <br/>
<a id="pl.351.30"></a><var>351.30</var>Statutes, chapters 256J and 256K;<br/>
<a id="pl.351.31"></a><var>351.31</var>(5) expenditures made on behalf of <br/>
<a id="pl.351.32"></a><var>351.32</var>noncitizen MFIP recipients who qualify <br/>
<a id="pl.351.33"></a><var>351.33</var>for the medical assistance without federal <br/>
<a id="pl.351.34"></a><var>351.34</var>financial participation program under <br/>
<a id="pl.352.1"></a><var>352.1</var>Minnesota Statutes, section 256B.06, <br/>
<a id="pl.352.2"></a><var>352.2</var>subdivision 4, paragraphs (d), (e), and (j); <br/>
<a id="pl.352.3"></a><var>352.3</var>and<br/>
<a id="pl.352.4"></a><var>352.4</var>(6) qualifying working family credit <br/>
<a id="pl.352.5"></a><var>352.5</var>expenditures under Minnesota Statutes, <br/>
<a id="pl.352.6"></a><var>352.6</var>section 290.0671.<br/>
<a id="pl.352.7"></a><var>352.7</var>(b) The commissioner shall ensure that <br/>
<a id="pl.352.8"></a><var>352.8</var>sufficient qualified nonfederal expenditures <br/>
<a id="pl.352.9"></a><var>352.9</var>are made each year to meet the state's <br/>
<a id="pl.352.10"></a><var>352.10</var>TANF/MOE requirements. For the activities <br/>
<a id="pl.352.11"></a><var>352.11</var>listed in paragraph (a), clauses (2) to <br/>
<a id="pl.352.12"></a><var>352.12</var>(6), the commissioner may only report <br/>
<a id="pl.352.13"></a><var>352.13</var>expenditures that are excluded from the <br/>
<a id="pl.352.14"></a><var>352.14</var>definition of assistance under Code of <br/>
<a id="pl.352.15"></a><var>352.15</var>Federal Regulations, title 45, section 260.31.<br/>
<a id="pl.352.16"></a><var>352.16</var>(c) For fiscal years beginning with state <br/>
<a id="pl.352.17"></a><var>352.17</var>fiscal year 2003, the commissioner shall <br/>
<a id="pl.352.18"></a><var>352.18</var>ensure that the maintenance of effort used <br/>
<a id="pl.352.19"></a><var>352.19</var>by the commissioner of finance for the <br/>
<a id="pl.352.20"></a><var>352.20</var>February and November forecasts required <br/>
<a id="pl.352.21"></a><var>352.21</var>under Minnesota Statutes, section 16A.103, <br/>
<a id="pl.352.22"></a><var>352.22</var>contains expenditures under paragraph (a), <br/>
<a id="pl.352.23"></a><var>352.23</var>clause (1), equal to at least 16 percent of <br/>
<a id="pl.352.24"></a><var>352.24</var>the total required under Code of Federal <br/>
<a id="pl.352.25"></a><var>352.25</var>Regulations, title 45, section 263.1.<br/>
<a id="pl.352.26"></a><var>352.26</var>(d) For the federal fiscal years beginning on <br/>
<a id="pl.352.27"></a><var>352.27</var>or after October 1, 2007, the commissioner <br/>
<a id="pl.352.28"></a><var>352.28</var>may not claim an amount of TANF/MOE in <br/>
<a id="pl.352.29"></a><var>352.29</var>excess of the 75 percent standard in Code <br/>
<a id="pl.352.30"></a><var>352.30</var>of Federal Regulations, title 45, section <br/>
<a id="pl.352.31"></a><var>352.31</var>263.1(a)(2), except:<br/>
<a id="pl.352.32"></a><var>352.32</var>(1) to the extent necessary to meet the 80 <br/>
<a id="pl.352.33"></a><var>352.33</var>percent standard under Code of Federal <br/>
<a id="pl.352.34"></a><var>352.34</var>Regulations, title 45, section 263.1(a)(1), <br/>
<a id="pl.352.35"></a><var>352.35</var>if it is determined by the commissioner <br/>
<a id="pl.353.1"></a><var>353.1</var>that the state will not meet the TANF work <br/>
<a id="pl.353.2"></a><var>353.2</var>participation target rate for the current year;<br/>
<a id="pl.353.3"></a><var>353.3</var>(2) to provide any additional amounts <br/>
<a id="pl.353.4"></a><var>353.4</var>under Code of Federal Regulations, title 45, <br/>
<a id="pl.353.5"></a><var>353.5</var>section 264.5, that relate to replacement of <br/>
<a id="pl.353.6"></a><var>353.6</var>TANF funds due to the operation of TANF <br/>
<a id="pl.353.7"></a><var>353.7</var>penalties; and<br/>
<a id="pl.353.8"></a><var>353.8</var>(3) to provide any additional amounts that <br/>
<a id="pl.353.9"></a><var>353.9</var>may contribute to avoiding or reducing <br/>
<a id="pl.353.10"></a><var>353.10</var>TANF work participation penalties through <br/>
<a id="pl.353.11"></a><var>353.11</var>the operation of the excess MOE provisions <br/>
<a id="pl.353.12"></a><var>353.12</var>of Code of Federal Regulations, title 45, <br/>
<a id="pl.353.13"></a><var>353.13</var>section 261.43(a)(2).<br/>
<a id="pl.353.14"></a><var>353.14</var>For the purposes of clauses (1) to (3), <br/>
<a id="pl.353.15"></a><var>353.15</var>the commissioner may supplement the <br/>
<a id="pl.353.16"></a><var>353.16</var>MOE claim with working family credit <br/>
<a id="pl.353.17"></a><var>353.17</var>expenditures to the extent such expenditures <br/>
<a id="pl.353.18"></a><var>353.18</var>or other qualified expenditures are otherwise <br/>
<a id="pl.353.19"></a><var>353.19</var>available after considering the expenditures <br/>
<a id="pl.353.20"></a><var>353.20</var>allowed in this section.<br/>
<a id="pl.353.21"></a><var>353.21</var>(e) Minnesota Statutes, section 256.011, <br/>
<a id="pl.353.22"></a><var>353.22</var>subdivision 3, which requires that federal <br/>
<a id="pl.353.23"></a><var>353.23</var>grants or aids secured or obtained under that <br/>
<a id="pl.353.24"></a><var>353.24</var>subdivision be used to reduce any direct <br/>
<a id="pl.353.25"></a><var>353.25</var>appropriations provided by law, do not apply <br/>
<a id="pl.353.26"></a><var>353.26</var>if the grants or aids are federal TANF funds.<br/>
<a id="pl.353.27"></a><var>353.27</var>(f) Notwithstanding any contrary provision <br/>
<a id="pl.353.28"></a><var>353.28</var>in this article, this provision expires June 30, <br/>
<a id="pl.353.29"></a><var>353.29</var>2013.<br/>
<a id="pl.353.30"></a><var>353.30</var><b>Working Family Credit Expenditures as </b><br/>
<a id="pl.353.31"></a><var>353.31</var><b>TANF/MOE.</b> The commissioner may claim <br/>
<a id="pl.353.32"></a><var>353.32</var>as TANF/MOE up to $6,707,000 per year of <br/>
<a id="pl.353.33"></a><var>353.33</var>working family credit expenditures for fiscal <br/>
<a id="pl.353.34"></a><var>353.34</var>year 2010 through fiscal year 2011.<br/>
<a id="pl.354.1"></a><var>354.1</var><b>Working Family Credit Expenditures </b><br/>
<a id="pl.354.2"></a><var>354.2</var><b>to be Claimed for TANF/MOE.</b> The <br/>
<a id="pl.354.3"></a><var>354.3</var>commissioner may count the following <br/>
<a id="pl.354.4"></a><var>354.4</var>amounts of working family credit expenditure <br/>
<a id="pl.354.5"></a><var>354.5</var>as TANF/MOE:<br/>
<a id="pl.354.6"></a><var>354.6</var>(1) fiscal year 2010, $30,217,000;<br/>
<a id="pl.354.7"></a><var>354.7</var>(2) fiscal year 2011, $55,596,000;<br/>
<a id="pl.354.8"></a><var>354.8</var>(3) fiscal year 2012, $28,519,000; and<br/>
<a id="pl.354.9"></a><var>354.9</var>(4) fiscal year 2013, $22,138,000.<br/>
<a id="pl.354.10"></a><var>354.10</var>Notwithstanding any contrary provision in <br/>
<a id="pl.354.11"></a><var>354.11</var>this article, this rider expires June 30, 2013.<br/>
<a id="pl.354.12"></a><var>354.12</var><b>TANF Transfer to Federal Child Care </b><br/>
<a id="pl.354.13"></a><var>354.13</var><b>and Development Fund.</b> The following <br/>
<a id="pl.354.14"></a><var>354.14</var>TANF fund amounts are appropriated to the <br/>
<a id="pl.354.15"></a><var>354.15</var>commissioner for the purposes of MFIP and <br/>
<a id="pl.354.16"></a><var>354.16</var>transition year child care under Minnesota <br/>
<a id="pl.354.17"></a><var>354.17</var>Statutes, section 119B.05:<br/>
<a id="pl.354.18"></a><var>354.18</var>(1) fiscal year 2010, $5,909,000;<br/>
<a id="pl.354.19"></a><var>354.19</var>(2) fiscal year 2011, $9,808,000;<br/>
<a id="pl.354.20"></a><var>354.20</var>(3) fiscal year 2012, $10,826,000; and<br/>
<a id="pl.354.21"></a><var>354.21</var>(4) fiscal year 2013, $4,026,000.<br/>
<a id="pl.354.22"></a><var>354.22</var>The commissioner shall authorize the <br/>
<a id="pl.354.23"></a><var>354.23</var>transfer of sufficient TANF funds to the <br/>
<a id="pl.354.24"></a><var>354.24</var>federal child care and development fund to <br/>
<a id="pl.354.25"></a><var>354.25</var>meet this appropriation and shall ensure that <br/>
<a id="pl.354.26"></a><var>354.26</var>all transferred funds are expended according <br/>
<a id="pl.354.27"></a><var>354.27</var>to federal child care and development fund <br/>
<a id="pl.354.28"></a><var>354.28</var>regulations.<br/>
<a id="pl.354.29"></a><var>354.29</var><b>Food Stamps Employment and Training.</b> <br/>
<a id="pl.354.30"></a><var>354.30</var>(a) The commissioner shall apply for and <br/>
<a id="pl.354.31"></a><var>354.31</var>claim the maximum allowable federal <br/>
<a id="pl.354.32"></a><var>354.32</var>matching funds under United States Code, <br/>
<a id="pl.355.1"></a><var>355.1</var>title 7, section 2025, paragraph (h), for <br/>
<a id="pl.355.2"></a><var>355.2</var>state expenditures made on behalf of family <br/>
<a id="pl.355.3"></a><var>355.3</var>stabilization services participants voluntarily <br/>
<a id="pl.355.4"></a><var>355.4</var>engaged in food stamp employment and <br/>
<a id="pl.355.5"></a><var>355.5</var>training activities, where appropriate.<br/>
<a id="pl.355.6"></a><var>355.6</var>(b) Notwithstanding Minnesota Statutes, <br/>
<a id="pl.355.7"></a><var>355.7</var>sections 256D.051, subdivisions 1a, 6b, <br/>
<a id="pl.355.8"></a><var>355.8</var>and 6c, and 256J.626, federal food stamps <br/>
<a id="pl.355.9"></a><var>355.9</var>employment and training funds received <br/>
<a id="pl.355.10"></a><var>355.10</var>as reimbursement of MFIP consolidated <br/>
<a id="pl.355.11"></a><var>355.11</var>fund grant expenditures for diversionary <br/>
<a id="pl.355.12"></a><var>355.12</var>work program participants and child <br/>
<a id="pl.355.13"></a><var>355.13</var>care assistance program expenditures for <br/>
<a id="pl.355.14"></a><var>355.14</var>two-parent families must be deposited in the <br/>
<a id="pl.355.15"></a><var>355.15</var>general fund. The amount of funds must be <br/>
<a id="pl.355.16"></a><var>355.16</var>limited to $3,350,000 in fiscal year 2010 <br/>
<a id="pl.355.17"></a><var>355.17</var>and $4,440,000 in fiscal years 2011 through <br/>
<a id="pl.355.18"></a><var>355.18</var>2013, contingent on approval by the federal <br/>
<a id="pl.355.19"></a><var>355.19</var>Food and Nutrition Service. <br/>
<a id="pl.355.20"></a><var>355.20</var>(c) Consistent with the receipt of these federal <br/>
<a id="pl.355.21"></a><var>355.21</var>funds, the commissioner may adjust the <br/>
<a id="pl.355.22"></a><var>355.22</var>level of working family credit expenditures <br/>
<a id="pl.355.23"></a><var>355.23</var>claimed as TANF maintenance of effort. <br/>
<a id="pl.355.24"></a><var>355.24</var>Notwithstanding any contrary provision in <br/>
<a id="pl.355.25"></a><var>355.25</var>this article, this rider expires June 30, 2013.<br/>
<a id="pl.355.26"></a><var>355.26</var><b>ARRA Food Support Administration.</b> <br/>
<a id="pl.355.27"></a><var>355.27</var>The funds available for food support <br/>
<a id="pl.355.28"></a><var>355.28</var>administration under the American Recovery <br/>
<a id="pl.355.29"></a><var>355.29</var>and Reinvestment Act (ARRA) of 2009 <br/>
<a id="pl.355.30"></a><var>355.30</var>are appropriated to the commissioner <br/>
<a id="pl.355.31"></a><var>355.31</var>to pay actual costs of implementing the <br/>
<a id="pl.355.32"></a><var>355.32</var>food support benefit increases, increased <br/>
<a id="pl.355.33"></a><var>355.33</var>eligibility determinations, and outreach. Of <br/>
<a id="pl.355.34"></a><var>355.34</var>these funds, 20 percent shall be allocated <br/>
<a id="pl.355.35"></a><var>355.35</var>to the commissioner and 80 percent shall <br/>
<a id="pl.356.1"></a><var>356.1</var>be allocated to counties. The commissioner <br/>
<a id="pl.356.2"></a><var>356.2</var>shall allocate the county portion based on <br/>
<a id="pl.356.3"></a><var>356.3</var>caseload. Reimbursement shall be based on <br/>
<a id="pl.356.4"></a><var>356.4</var>actual costs reported by counties through <br/>
<a id="pl.356.5"></a><var>356.5</var>existing processes. Tribal reimbursement <br/>
<a id="pl.356.6"></a><var>356.6</var>must be made from the state portion based <br/>
<a id="pl.356.7"></a><var>356.7</var>on a caseload factor equivalent to that of a <br/>
<a id="pl.356.8"></a><var>356.8</var>county.<br/>
<a id="pl.356.9"></a><var>356.9</var><b>ARRA Food Support Benefit Increases.</b> <br/>
<a id="pl.356.10"></a><var>356.10</var>The funds provided for food support benefit <br/>
<a id="pl.356.11"></a><var>356.11</var>increases under the Supplemental Nutrition <br/>
<a id="pl.356.12"></a><var>356.12</var>Assistance Program provisions of the <br/>
<a id="pl.356.13"></a><var>356.13</var>American Recovery and Reinvestment Act <br/>
<a id="pl.356.14"></a><var>356.14</var>(ARRA) of 2009 must be used for benefit <br/>
<a id="pl.356.15"></a><var>356.15</var>increases beginning July 1, 2009.<br/>
<a id="pl.356.16"></a><var>356.16</var><b>Emergency Fund for the TANF Program.</b> <br/>
<a id="pl.356.17"></a><var>356.17</var>TANF Emergency Contingency funds <br/>
<a id="pl.356.18"></a><var>356.18</var>available under the American Recovery <br/>
<a id="pl.356.19"></a><var>356.19</var>and Reinvestment Act of 2009 (Public Law <br/>
<a id="pl.356.20"></a><var>356.20</var>111-5) are appropriated to the commissioner. <br/>
<a id="pl.356.21"></a><var>356.21</var>The commissioner must request TANF <br/>
<a id="pl.356.22"></a><var>356.22</var>Emergency Contingency funds from the <br/>
<a id="pl.356.23"></a><var>356.23</var>Secretary of the Department of Health <br/>
<a id="pl.356.24"></a><var>356.24</var>and Human Services to the extent the <br/>
<a id="pl.356.25"></a><var>356.25</var>commissioner meets or expects to meet the <br/>
<a id="pl.356.26"></a><var>356.26</var>requirements of section 403(c) of the Social <br/>
<a id="pl.356.27"></a><var>356.27</var>Security Act. The commissioner must seek <br/>
<a id="pl.356.28"></a><var>356.28</var>to maximize such grants. The funds received <br/>
<a id="pl.356.29"></a><var>356.29</var>must  be used as appropriated. Each county <br/>
<a id="pl.356.30"></a><var>356.30</var>must maintain the county's current level of <br/>
<a id="pl.356.31"></a><var>356.31</var>emergency assistance funding under the <br/>
<a id="pl.356.32"></a><var>356.32</var>MFIP consolidated fund and use the funds <br/>
<a id="pl.356.33"></a><var>356.33</var>under this paragraph to supplement existing <br/>
<a id="pl.356.34"></a><var>356.34</var>emergency assistance funding levels.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.356.35"></a><var>356.35</var><br/>
</td>
<td align="left" colspan="3">Subd. 2.<b>Agency Management</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table><a id="pl.357.1"></a><var>357.1</var>The amounts that may be spent from the <br/>
<a id="pl.357.2"></a><var>357.2</var>appropriation for each purpose are as follows:<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.357.3"></a><var>357.3</var><br/>
</td>
<td align="left" colspan="3"><b>(a) Financial Operations</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="125px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.357.4"></a><var>357.4</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.357.5"></a><var>357.5</var><br/>
</td>
<td align="left">General<br/>
</td>
<td align="right">3,380,000<br/>
</td>
<td align="right">3,908,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.357.6"></a><var>357.6</var><br/>
</td>
<td align="left">Health Care Access<br/>
</td>
<td align="right">1,281,000<br/>
</td>
<td align="right">1,016,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.357.7"></a><var>357.7</var><br/>
</td>
<td align="left">Federal TANF<br/>
</td>
<td align="right">122,000<br/>
</td>
<td align="right">122,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.357.8"></a><var>357.8</var><br/>
</td>
<td align="left" colspan="3"><b>(b) Legal and Regulatory Operations</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.357.9"></a><var>357.9</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.357.10"></a><var>357.10</var><br/>
</td>
<td align="left">General<br/>
</td>
<td align="right">13,749,000<br/>
</td>
<td align="right">13,534,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.357.11"></a><var>357.11</var><br/>
<a id="pl.357.12"></a><var>357.12</var><br/>
</td>
<td align="left">State Government <br/>
Special Revenue<br/>
</td>
<td align="right">440,000<br/>
</td>
<td align="right">440,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.357.13"></a><var>357.13</var><br/>
</td>
<td align="left">Health Care Access<br/>
</td>
<td align="right">943,000<br/>
</td>
<td align="right">943,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.357.14"></a><var>357.14</var><br/>
</td>
<td align="left">Federal TANF<br/>
</td>
<td align="right">100,000<br/>
</td>
<td align="right">100,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.357.15"></a><var>357.15</var><br/>
</td>
<td align="left" colspan="3"><b>(c) Management Operations</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.357.16"></a><var>357.16</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.357.17"></a><var>357.17</var><br/>
</td>
<td align="left">General<br/>
</td>
<td align="right">4,334,000<br/>
</td>
<td align="right">4,562,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.357.18"></a><var>357.18</var><br/>
</td>
<td align="left">Health Care Access<br/>
</td>
<td align="right">242,000<br/>
</td>
<td align="right">242,000<br/>
</td>
</tr>
</table><a id="pl.357.19"></a><var>357.19</var><b>Lease Cost Reduction.</b> Base level funding <br/>
<a id="pl.357.20"></a><var>357.20</var>to the commissioner shall be reduced by <br/>
<a id="pl.357.21"></a><var>357.21</var>$381,000 in fiscal year 2010, and $153,000 <br/>
<a id="pl.357.22"></a><var>357.22</var>in fiscal year 2011, to reflect a reduction in <br/>
<a id="pl.357.23"></a><var>357.23</var>lease costs related to the Minnehaha Avenue <br/>
<a id="pl.357.24"></a><var>357.24</var>building.<br/>
<a id="pl.357.25"></a><var>357.25</var><b>Base Adjustment.</b> The general fund base is <br/>
<a id="pl.357.26"></a><var>357.26</var>increased by $153,000 in each of fiscal years <br/>
<a id="pl.357.27"></a><var>357.27</var>2012 and 2013.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.357.28"></a><var>357.28</var><br/>
</td>
<td align="left" colspan="3"><b>(d) Information Technology Operations</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.358.1"></a><var>358.1</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.358.2"></a><var>358.2</var><br/>
</td>
<td align="left">General<br/>
</td>
<td align="right">28,077,000<br/>
</td>
<td align="right">28,077,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.358.3"></a><var>358.3</var><br/>
</td>
<td align="left">Health Care Access<br/>
</td>
<td align="right">4,856,000<br/>
</td>
<td align="right">4,868,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.358.4"></a><var>358.4</var><br/>
<a id="pl.358.5"></a><var>358.5</var><br/>
</td>
<td align="left" colspan="3">Subd. 3.<b>Revenue and Pass-Through Revenue </b><br/>
<b>Expenditures</b><br/>
</td>
<td align="center"></td>
<td align="right">65,746,000<br/>
</td>
<td align="center"></td>
<td align="right">67,068,000<br/>
</td>
</tr>
</table><a id="pl.358.6"></a><var>358.6</var>This appropriation is from the federal TANF <br/>
<a id="pl.358.7"></a><var>358.7</var>fund.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.358.8"></a><var>358.8</var><br/>
<a id="pl.358.9"></a><var>358.9</var><br/>
</td>
<td colspan="3">Subd. 4.<b>Children and Economic Assistance </b><br/>
<b>Grants</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table><a id="pl.358.10"></a><var>358.10</var>The amounts that may be spent from this <br/>
<a id="pl.358.11"></a><var>358.11</var>appropriation for each purpose are as follows:<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.358.12"></a><var>358.12</var><br/>
</td>
<td colspan="3"><b>(a) MFIP/DWP Grants</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.358.13"></a><var>358.13</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.358.14"></a><var>358.14</var><br/>
</td>
<td>General<br/>
</td>
<td align="right">63,205,000<br/>
</td>
<td align="right">89,033,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.358.15"></a><var>358.15</var><br/>
</td>
<td>Federal TANF<br/>
</td>
<td align="right">100,404,000<br/>
</td>
<td align="right">85,789,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.358.16"></a><var>358.16</var><br/>
</td>
<td colspan="3"><b>(b) Support Services Grants</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.358.17"></a><var>358.17</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.358.18"></a><var>358.18</var><br/>
</td>
<td>General<br/>
</td>
<td align="right">8,715,000<br/>
</td>
<td align="right">12,498,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.358.19"></a><var>358.19</var><br/>
</td>
<td>Federal TANF<br/>
</td>
<td align="right">121,257,000<br/>
</td>
<td align="right">102,757,000<br/>
</td>
</tr>
</table><a id="pl.358.20"></a><var>358.20</var><b>MFIP Consolidated Fund.</b> The MFIP <br/>
<a id="pl.358.21"></a><var>358.21</var>consolidated fund TANF appropriation is <br/>
<a id="pl.358.22"></a><var>358.22</var>reduced by $1,854,000 in fiscal year 2011 <br/>
<a id="pl.358.23"></a><var>358.23</var>and fiscal year 2012.<br/>
<a id="pl.358.24"></a><var>358.24</var>Notwithstanding Minnesota Statutes, section <br/>
<a id="pl.358.25"></a><var>358.25</var>256J.626, subdivision 8, paragraph (b), the <br/>
<a id="pl.358.26"></a><var>358.26</var>commissioner shall reduce proportionately <br/>
<a id="pl.358.27"></a><var>358.27</var>the reimbursement to counties for <br/>
<a id="pl.358.28"></a><var>358.28</var>administrative expenses.<br/>
<a id="pl.359.1"></a><var>359.1</var><b>Subsidized Employment Funding Through </b><br/>
<a id="pl.359.2"></a><var>359.2</var><b>ARRA.</b> The commissioner is authorized to <br/>
<a id="pl.359.3"></a><var>359.3</var>apply for TANF emergency fund grants for <br/>
<a id="pl.359.4"></a><var>359.4</var>subsidized employment activities. Growth <br/>
<a id="pl.359.5"></a><var>359.5</var>in expenditures for subsidized employment <br/>
<a id="pl.359.6"></a><var>359.6</var>within the supported work program and the <br/>
<a id="pl.359.7"></a><var>359.7</var>MFIP consolidated fund over the amount <br/>
<a id="pl.359.8"></a><var>359.8</var>expended in the calendar quarters in the <br/>
<a id="pl.359.9"></a><var>359.9</var>TANF emergency fund base year shall be <br/>
<a id="pl.359.10"></a><var>359.10</var>used to leverage the TANF emergency fund <br/>
<a id="pl.359.11"></a><var>359.11</var>grants for subsidized employment and to <br/>
<a id="pl.359.12"></a><var>359.12</var>fund supported work. The commissioner <br/>
<a id="pl.359.13"></a><var>359.13</var>shall develop procedures to maximize <br/>
<a id="pl.359.14"></a><var>359.14</var>reimbursement of these expenditures over the <br/>
<a id="pl.359.15"></a><var>359.15</var>TANF emergency fund base year quarters, <br/>
<a id="pl.359.16"></a><var>359.16</var>and may contract directly with employers <br/>
<a id="pl.359.17"></a><var>359.17</var>and providers to maximize these TANF <br/>
<a id="pl.359.18"></a><var>359.18</var>emergency fund grants.<br/>
<a id="pl.359.19"></a><var>359.19</var><b>Supported Work.</b> Of the TANF <br/>
<a id="pl.359.20"></a><var>359.20</var>appropriation, $6,400,000 in fiscal year <br/>
<a id="pl.359.21"></a><var>359.21</var>2011 is to the commissioner for supported <br/>
<a id="pl.359.22"></a><var>359.22</var>work for MFIP recipients and is available <br/>
<a id="pl.359.23"></a><var>359.23</var>until expended. Supported work includes <br/>
<a id="pl.359.24"></a><var>359.24</var>paid transitional work experience and <br/>
<a id="pl.359.25"></a><var>359.25</var>a continuum of employment assistance, <br/>
<a id="pl.359.26"></a><var>359.26</var>including outreach and recruitment, <br/>
<a id="pl.359.27"></a><var>359.27</var>program orientation and intake, testing and <br/>
<a id="pl.359.28"></a><var>359.28</var>assessment, job development and marketing, <br/>
<a id="pl.359.29"></a><var>359.29</var>preworksite training, supported worksite <br/>
<a id="pl.359.30"></a><var>359.30</var>experience, job coaching, and postplacement <br/>
<a id="pl.359.31"></a><var>359.31</var>follow-up, in addition to extensive case <br/>
<a id="pl.359.32"></a><var>359.32</var>management and referral services.<br/>
<a id="pl.359.33"></a><var>359.33</var><b>Base Adjustment.</b> The general fund base <br/>
<a id="pl.359.34"></a><var>359.34</var>is reduced by $3,783,000 in each of fiscal <br/>
<a id="pl.359.35"></a><var>359.35</var>years 2012 and 2013. The TANF fund base <br/>
<a id="pl.360.1"></a><var>360.1</var>is increased by $9,704,000 in each of fiscal <br/>
<a id="pl.360.2"></a><var>360.2</var>years 2012 and 2013.<br/>
<a id="pl.360.3"></a><var>360.3</var><b>Integrated Services Program Funding.</b> <br/>
<a id="pl.360.4"></a><var>360.4</var>The TANF appropriation for integrated <br/>
<a id="pl.360.5"></a><var>360.5</var>services program funding is $1,250,000 in <br/>
<a id="pl.360.6"></a><var>360.6</var>fiscal year 2010 and $2,500,000 in fiscal year <br/>
<a id="pl.360.7"></a><var>360.7</var>2011.<br/>
<a id="pl.360.8"></a><var>360.8</var><b>TANF Emergency Fund; Nonrecurrent </b><br/>
<a id="pl.360.9"></a><var>360.9</var><b>Short-Term Benefits.</b> TANF emergency <br/>
<a id="pl.360.10"></a><var>360.10</var>contingency fund grants received due to <br/>
<a id="pl.360.11"></a><var>360.11</var>increases in expenditures for nonrecurrent <br/>
<a id="pl.360.12"></a><var>360.12</var>short-term benefits must be used to offset the <br/>
<a id="pl.360.13"></a><var>360.13</var>increase in these expenditures for counties <br/>
<a id="pl.360.14"></a><var>360.14</var>under the MFIP consolidated fund, under <br/>
<a id="pl.360.15"></a><var>360.15</var>Minnesota Statutes, section 256J.626, <br/>
<a id="pl.360.16"></a><var>360.16</var>and the diversionary work program. The <br/>
<a id="pl.360.17"></a><var>360.17</var>commissioner shall develop procedures <br/>
<a id="pl.360.18"></a><var>360.18</var>to maximize reimbursement of these <br/>
<a id="pl.360.19"></a><var>360.19</var>expenditures over the TANF emergency fund <br/>
<a id="pl.360.20"></a><var>360.20</var>base year quarters. Growth in expenditures <br/>
<a id="pl.360.21"></a><var>360.21</var>for the diversionary work program over the <br/>
<a id="pl.360.22"></a><var>360.22</var>amount expended in the calendar quarters in <br/>
<a id="pl.360.23"></a><var>360.23</var>the TANF emergency fund base year shall be <br/>
<a id="pl.360.24"></a><var>360.24</var>used to leverage these funds.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.360.25"></a><var>360.25</var><br/>
</td>
<td colspan="3"><b>(c) MFIP Child Care Assistance Grants</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.360.26"></a><var>360.26</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.360.27"></a><var>360.27</var><br/>
</td>
<td>General<br/>
</td>
<td align="right">61,171,000<br/>
</td>
<td align="right">65,214,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.360.28"></a><var>360.28</var><br/>
</td>
<td>Federal TANF<br/>
</td>
<td align="right">1,022,000<br/>
</td>
<td align="right">406,000<br/>
</td>
</tr>
</table><a id="pl.360.29"></a><var>360.29</var><b>ARRA Child Care Development Block </b><br/>
<a id="pl.360.30"></a><var>360.30</var><b>Grant Funds.</b> The funds available from the <br/>
<a id="pl.360.31"></a><var>360.31</var>child care development block grant under <br/>
<a id="pl.360.32"></a><var>360.32</var>ARRA must be used for MFIP child care to <br/>
<a id="pl.360.33"></a><var>360.33</var>the extent that those funds are not earmarked <br/>
<a id="pl.361.1"></a><var>361.1</var>for quality expansion or to improve the <br/>
<a id="pl.361.2"></a><var>361.2</var>quality of infant and toddler care.<br/>
<a id="pl.361.3"></a><var>361.3</var><b>Acceleration of ARRA Child Care and </b><br/>
<a id="pl.361.4"></a><var>361.4</var><b>Development Fund Expenditure.</b> The <br/>
<a id="pl.361.5"></a><var>361.5</var>commissioner must liquidate all child care <br/>
<a id="pl.361.6"></a><var>361.6</var>and development money available under <br/>
<a id="pl.361.7"></a><var>361.7</var>the American Recovery and Reinvestment <br/>
<a id="pl.361.8"></a><var>361.8</var>Act (ARRA) of 2009, Public Law 111-5, <br/>
<a id="pl.361.9"></a><var>361.9</var>by September 30, 2010. In order to expend <br/>
<a id="pl.361.10"></a><var>361.10</var>those funds by September 30, 2010, the <br/>
<a id="pl.361.11"></a><var>361.11</var>commissioner may redesignate and expend <br/>
<a id="pl.361.12"></a><var>361.12</var>the ARRA child care and development funds <br/>
<a id="pl.361.13"></a><var>361.13</var>appropriated in fiscal year 2011 for purposes <br/>
<a id="pl.361.14"></a><var>361.14</var>under this section for related purposes that <br/>
<a id="pl.361.15"></a><var>361.15</var>will allow liquidation by September 30, <br/>
<a id="pl.361.16"></a><var>361.16</var>2010. Child care and development funds <br/>
<a id="pl.361.17"></a><var>361.17</var>otherwise available to the commissioner <br/>
<a id="pl.361.18"></a><var>361.18</var>for those related purposes shall be used to <br/>
<a id="pl.361.19"></a><var>361.19</var>fund the purposes from which the ARRA <br/>
<a id="pl.361.20"></a><var>361.20</var>child care and development funds had been <br/>
<a id="pl.361.21"></a><var>361.21</var>redesignated.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.361.22"></a><var>361.22</var><br/>
<a id="pl.361.23"></a><var>361.23</var><br/>
</td>
<td colspan="3"><b>(d) Basic Sliding Fee Child Care Assistance </b><br/>
<b>Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">40,104,000<br/>
</td>
<td align="center"></td>
<td align="right">45,096,000<br/>
</td>
</tr>
</table><a id="pl.361.24"></a><var>361.24</var><b>Base Adjustment.</b> The general fund base is <br/>
<a id="pl.361.25"></a><var>361.25</var>decreased by $260,000 in each of fiscal years <br/>
<a id="pl.361.26"></a><var>361.26</var>2012 and 2013.<br/>
<a id="pl.361.27"></a><var>361.27</var><b>School Readiness Service Agreements.</b> <br/>
<a id="pl.361.28"></a><var>361.28</var>$261,000 in fiscal year 2010 and $261,000 <br/>
<a id="pl.361.29"></a><var>361.29</var>in fiscal year 2011 are from the federal <br/>
<a id="pl.361.30"></a><var>361.30</var>child care development funds received from <br/>
<a id="pl.361.31"></a><var>361.31</var>the American Recovery and Reinvestment <br/>
<a id="pl.361.32"></a><var>361.32</var>Act of 2009, Public Law 111-5, to the <br/>
<a id="pl.361.33"></a><var>361.33</var>commissioner of human services consistent <br/>
<a id="pl.361.34"></a><var>361.34</var>with federal regulations for the purpose of <br/>
<a id="pl.362.1"></a><var>362.1</var>school readiness service agreements under <br/>
<a id="pl.362.2"></a><var>362.2</var>Minnesota Statutes, section 119B.231. This <br/>
<a id="pl.362.3"></a><var>362.3</var>is a onetime appropriation. Any unexpended <br/>
<a id="pl.362.4"></a><var>362.4</var>balance the first year is available in the <br/>
<a id="pl.362.5"></a><var>362.5</var>second year.<br/>
<a id="pl.362.6"></a><var>362.6</var><b>Child Care Development Fund </b><br/>
<a id="pl.362.7"></a><var>362.7</var><b>Unexpended Balance.</b> In addition to <br/>
<a id="pl.362.8"></a><var>362.8</var>the amount provided in this section, the <br/>
<a id="pl.362.9"></a><var>362.9</var>commissioner shall expend $5,244,000 in <br/>
<a id="pl.362.10"></a><var>362.10</var>fiscal year 2010 from the federal child care <br/>
<a id="pl.362.11"></a><var>362.11</var>development fund unexpended balance <br/>
<a id="pl.362.12"></a><var>362.12</var>for basic sliding fee child care under <br/>
<a id="pl.362.13"></a><var>362.13</var>Minnesota Statutes, section 119B.03. The <br/>
<a id="pl.362.14"></a><var>362.14</var>commissioner shall ensure that all child <br/>
<a id="pl.362.15"></a><var>362.15</var>care and development funds are expended <br/>
<a id="pl.362.16"></a><var>362.16</var>according to the federal child care and <br/>
<a id="pl.362.17"></a><var>362.17</var>development fund regulations.<br/>
<a id="pl.362.18"></a><var>362.18</var><b>Basic Sliding Fee.</b> $7,045,000 in fiscal year <br/>
<a id="pl.362.19"></a><var>362.19</var>2010 and $6,974,000 in fiscal year 2011 are <br/>
<a id="pl.362.20"></a><var>362.20</var>from the federal child care development <br/>
<a id="pl.362.21"></a><var>362.21</var>funds received from the American Recovery <br/>
<a id="pl.362.22"></a><var>362.22</var>and Reinvestment Act of 2009, Public <br/>
<a id="pl.362.23"></a><var>362.23</var>Law 111-5, to the commissioner of human <br/>
<a id="pl.362.24"></a><var>362.24</var>services consistent with federal regulations <br/>
<a id="pl.362.25"></a><var>362.25</var>for the purpose of basic sliding fee child care <br/>
<a id="pl.362.26"></a><var>362.26</var>assistance under Minnesota Statutes, section <br/>
<a id="pl.362.27"></a><var>362.27</var>119B.03. This is a onetime appropriation. <br/>
<a id="pl.362.28"></a><var>362.28</var>Any unexpended balance the first year is <br/>
<a id="pl.362.29"></a><var>362.29</var>available in the second year.<br/>
<a id="pl.362.30"></a><var>362.30</var><b>Basic Sliding Fee Allocation for Calendar </b><br/>
<a id="pl.362.31"></a><var>362.31</var><b>Year 2010.</b> Notwithstanding Minnesota <br/>
<a id="pl.362.32"></a><var>362.32</var>Statutes, section 119B.03, subdivision 6, <br/>
<a id="pl.362.33"></a><var>362.33</var>in calendar year 2010, basic sliding fee <br/>
<a id="pl.362.34"></a><var>362.34</var>funds shall be distributed according to <br/>
<a id="pl.362.35"></a><var>362.35</var>this provision. Funds shall be allocated <br/>
<a id="pl.363.1"></a><var>363.1</var>first in amounts equal to each county's <br/>
<a id="pl.363.2"></a><var>363.2</var>guaranteed floor, according to Minnesota <br/>
<a id="pl.363.3"></a><var>363.3</var>Statutes, section 119B.03, subdivision 8, <br/>
<a id="pl.363.4"></a><var>363.4</var>with any remaining available funds allocated <br/>
<a id="pl.363.5"></a><var>363.5</var>according to the following formula:<br/>
<a id="pl.363.6"></a><var>363.6</var>(a) Up to one-fourth of the funds shall be <br/>
<a id="pl.363.7"></a><var>363.7</var>allocated in proportion to the number of <br/>
<a id="pl.363.8"></a><var>363.8</var>families participating in the transition year <br/>
<a id="pl.363.9"></a><var>363.9</var>child care program as reported during and <br/>
<a id="pl.363.10"></a><var>363.10</var>averaged over the most recent six months <br/>
<a id="pl.363.11"></a><var>363.11</var>completed at the time of the notice of <br/>
<a id="pl.363.12"></a><var>363.12</var>allocation. Funds in excess of the amount <br/>
<a id="pl.363.13"></a><var>363.13</var>necessary to serve all families in this category <br/>
<a id="pl.363.14"></a><var>363.14</var>shall be allocated according to paragraph (d).<br/>
<a id="pl.363.15"></a><var>363.15</var>(b) Up to three-fourths of the funds shall <br/>
<a id="pl.363.16"></a><var>363.16</var>be allocated in proportion to the average <br/>
<a id="pl.363.17"></a><var>363.17</var>of each county's most recent six months of <br/>
<a id="pl.363.18"></a><var>363.18</var>reported waiting list as defined in Minnesota <br/>
<a id="pl.363.19"></a><var>363.19</var>Statutes, section 119B.03, subdivision 2, and <br/>
<a id="pl.363.20"></a><var>363.20</var>the reinstatement list of those families whose <br/>
<a id="pl.363.21"></a><var>363.21</var>assistance was terminated with the approval <br/>
<a id="pl.363.22"></a><var>363.22</var>of the commissioner under Minnesota Rules, <br/>
<a id="pl.363.23"></a><var>363.23</var>part 3400.0183, subpart 1. Funds in excess <br/>
<a id="pl.363.24"></a><var>363.24</var>of the amount necessary to serve all families <br/>
<a id="pl.363.25"></a><var>363.25</var>in this category shall be allocated according <br/>
<a id="pl.363.26"></a><var>363.26</var>to paragraph (d).<br/>
<a id="pl.363.27"></a><var>363.27</var>(c) The amount necessary to serve all families <br/>
<a id="pl.363.28"></a><var>363.28</var>in paragraphs (a) and (b) shall be calculated <br/>
<a id="pl.363.29"></a><var>363.29</var>based on the basic sliding fee average cost of <br/>
<a id="pl.363.30"></a><var>363.30</var>care per family in the county with the highest <br/>
<a id="pl.363.31"></a><var>363.31</var>cost in the most recently completed calendar <br/>
<a id="pl.363.32"></a><var>363.32</var>year.<br/>
<a id="pl.363.33"></a><var>363.33</var>(d) Funds in excess of the amount necessary <br/>
<a id="pl.363.34"></a><var>363.34</var>to serve all families in paragraphs (a) and <br/>
<a id="pl.363.35"></a><var>363.35</var>(b) shall be allocated in proportion to each <br/>
<a id="pl.364.1"></a><var>364.1</var>county's total expenditures for the basic <br/>
<a id="pl.364.2"></a><var>364.2</var>sliding fee child care program reported <br/>
<a id="pl.364.3"></a><var>364.3</var>during the most recent fiscal year completed <br/>
<a id="pl.364.4"></a><var>364.4</var>at the time of the notice of allocation. To <br/>
<a id="pl.364.5"></a><var>364.5</var>the extent that funds are available, and <br/>
<a id="pl.364.6"></a><var>364.6</var>notwithstanding Minnesota Statutes, section <br/>
<a id="pl.364.7"></a><var>364.7</var>119B.03, subdivision 8, for the period <br/>
<a id="pl.364.8"></a><var>364.8</var>January 1, 2011, to December 31, 2011, each <br/>
<a id="pl.364.9"></a><var>364.9</var>county's guaranteed floor must be equal to its <br/>
<a id="pl.364.10"></a><var>364.10</var>original calendar year 2010 allocation.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.364.11"></a><var>364.11</var><br/>
</td>
<td colspan="3"><b>(e) Child Care Development Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">1,487,000<br/>
</td>
<td align="center"></td>
<td align="right">1,487,000<br/>
</td>
</tr>
</table><a id="pl.364.12"></a><var>364.12</var><b>Family, friends, and neighbor grants.</b> <br/>
<a id="pl.364.13"></a><var>364.13</var>$375,000 in fiscal year 2010 and $375,000 <br/>
<a id="pl.364.14"></a><var>364.14</var>in fiscal year 2011 are from the child <br/>
<a id="pl.364.15"></a><var>364.15</var>care development fund required targeted <br/>
<a id="pl.364.16"></a><var>364.16</var>quality funds for quality expansion and <br/>
<a id="pl.364.17"></a><var>364.17</var>infant/toddler from the American Recovery <br/>
<a id="pl.364.18"></a><var>364.18</var>and Reinvestment Act of 2009, Public <br/>
<a id="pl.364.19"></a><var>364.19</var>Law 111-5, to the commissioner of human <br/>
<a id="pl.364.20"></a><var>364.20</var>services for family, friends, and neighbor <br/>
<a id="pl.364.21"></a><var>364.21</var>grants under Minnesota Statutes, section <br/>
<a id="pl.364.22"></a><var>364.22</var>119B.232. This appropriation may be used <br/>
<a id="pl.364.23"></a><var>364.23</var>on programs receiving family, friends, and <br/>
<a id="pl.364.24"></a><var>364.24</var>neighbor grant funds as of June 30, 2009, <br/>
<a id="pl.364.25"></a><var>364.25</var>or on new programs or projects. This is a <br/>
<a id="pl.364.26"></a><var>364.26</var>onetime appropriation. Any unexpended <br/>
<a id="pl.364.27"></a><var>364.27</var>balance the first year is available in the <br/>
<a id="pl.364.28"></a><var>364.28</var>second year.<br/>
<a id="pl.364.29"></a><var>364.29</var><b>Voluntary quality rating system training, </b><br/>
<a id="pl.364.30"></a><var>364.30</var><b>coaching, consultation, and supports.</b> <br/>
<a id="pl.364.31"></a><var>364.31</var>$633,000 in fiscal year 2010 and $633,000 <br/>
<a id="pl.364.32"></a><var>364.32</var>in fiscal year 2011 are from the federal child <br/>
<a id="pl.364.33"></a><var>364.33</var>care development fund required targeted <br/>
<a id="pl.364.34"></a><var>364.34</var>quality funds for quality expansion and <br/>
<a id="pl.364.35"></a><var>364.35</var>infant/toddler from the American Recovery <br/>
<a id="pl.365.1"></a><var>365.1</var>and Reinvestment Act of 2009, Public <br/>
<a id="pl.365.2"></a><var>365.2</var>Law 111-5, to the commissioner of human <br/>
<a id="pl.365.3"></a><var>365.3</var>services consistent with federal regulations <br/>
<a id="pl.365.4"></a><var>365.4</var>for the purpose of providing grants to provide <br/>
<a id="pl.365.5"></a><var>365.5</var>statewide child-care provider training, <br/>
<a id="pl.365.6"></a><var>365.6</var>coaching, consultation, and supports to <br/>
<a id="pl.365.7"></a><var>365.7</var>prepare for the voluntary Minnesota quality <br/>
<a id="pl.365.8"></a><var>365.8</var>rating system rating tool. This is a onetime <br/>
<a id="pl.365.9"></a><var>365.9</var>appropriation. Any unexpended balance the <br/>
<a id="pl.365.10"></a><var>365.10</var>first year is available in the second year.<br/>
<a id="pl.365.11"></a><var>365.11</var><b>Voluntary quality rating system.</b> $184,000 <br/>
<a id="pl.365.12"></a><var>365.12</var>in fiscal year 2010 and $1,200,000 in fiscal <br/>
<a id="pl.365.13"></a><var>365.13</var>year 2011 are from the federal child care <br/>
<a id="pl.365.14"></a><var>365.14</var>development fund required targeted funds for <br/>
<a id="pl.365.15"></a><var>365.15</var>quality expansion and infant/toddler from the <br/>
<a id="pl.365.16"></a><var>365.16</var>American Recovery and Reinvestment Act of <br/>
<a id="pl.365.17"></a><var>365.17</var>2009, Public Law 111-5, to the commissioner <br/>
<a id="pl.365.18"></a><var>365.18</var>of human services consistent with federal <br/>
<a id="pl.365.19"></a><var>365.19</var>regulations for the purpose of implementing <br/>
<a id="pl.365.20"></a><var>365.20</var>the voluntary Parent Aware quality star <br/>
<a id="pl.365.21"></a><var>365.21</var>rating system pilot in coordination with the <br/>
<a id="pl.365.22"></a><var>365.22</var>Minnesota Early Learning Foundation. The <br/>
<a id="pl.365.23"></a><var>365.23</var>appropriation for the first year is to complete <br/>
<a id="pl.365.24"></a><var>365.24</var>and promote the voluntary Parent Aware <br/>
<a id="pl.365.25"></a><var>365.25</var>quality rating system pilot program through <br/>
<a id="pl.365.26"></a><var>365.26</var>June 30, 2010, and the appropriation for the <br/>
<a id="pl.365.27"></a><var>365.27</var>second year is to continue the voluntary <br/>
<a id="pl.365.28"></a><var>365.28</var>Minnesota quality rating system pilot <br/>
<a id="pl.365.29"></a><var>365.29</var>through June 30, 2011. This is a onetime <br/>
<a id="pl.365.30"></a><var>365.30</var>appropriation. Any unexpended balance the <br/>
<a id="pl.365.31"></a><var>365.31</var>first year is available in the second year.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.365.32"></a><var>365.32</var><br/>
</td>
<td colspan="3"><b>(f) Child Support Enforcement Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">3,705,000<br/>
</td>
<td align="center"></td>
<td align="right">3,705,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12.1"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.365.33"></a><var>365.33</var><br/>
</td>
<td colspan="3"><b>(g) Children's Services Grants</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.366.1"></a><var>366.1</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.366.2"></a><var>366.2</var><br/>
</td>
<td>General<br/>
</td>
<td align="right"> 48,333,000<br/>
</td>
<td align="right">50,498,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.366.3"></a><var>366.3</var><br/>
</td>
<td>Federal TANF<br/>
</td>
<td align="right">340,000<br/>
</td>
<td align="right">240,000<br/>
</td>
</tr>
</table><a id="pl.366.4"></a><var>366.4</var><b>Base Adjustment.</b> The general fund base is <br/>
<a id="pl.366.5"></a><var>366.5</var>decreased by $5,371,000 in fiscal year 2012 <br/>
<a id="pl.366.6"></a><var>366.6</var>and increased $8,737,000 in fiscal year 2013.<br/>
<a id="pl.366.7"></a><var>366.7</var><b>Privatized Adoption Grants.</b> Federal <br/>
<a id="pl.366.8"></a><var>366.8</var>reimbursement for privatized adoption grant <br/>
<a id="pl.366.9"></a><var>366.9</var>and foster care recruitment grant expenditures <br/>
<a id="pl.366.10"></a><var>366.10</var>is appropriated to the commissioner for <br/>
<a id="pl.366.11"></a><var>366.11</var>adoption grants and foster care and adoption <br/>
<a id="pl.366.12"></a><var>366.12</var>administrative purposes.<br/>
<a id="pl.366.13"></a><var>366.13</var><b>Adoption Assistance Incentive Grants.</b> <br/>
<a id="pl.366.14"></a><var>366.14</var>Federal funds available during fiscal year <br/>
<a id="pl.366.15"></a><var>366.15</var>2010 and fiscal year 2011 for the adoption <br/>
<a id="pl.366.16"></a><var>366.16</var>incentive grants are appropriated to the <br/>
<a id="pl.366.17"></a><var>366.17</var>commissioner for these purposes.<br/>
<a id="pl.366.18"></a><var>366.18</var><b>Adoption Assistance and Relative Custody </b><br/>
<a id="pl.366.19"></a><var>366.19</var><b>Assistance.</b> The commissioner may transfer <br/>
<a id="pl.366.20"></a><var>366.20</var>unencumbered appropriation balances for <br/>
<a id="pl.366.21"></a><var>366.21</var>adoption assistance and relative custody <br/>
<a id="pl.366.22"></a><var>366.22</var>assistance between fiscal years and between <br/>
<a id="pl.366.23"></a><var>366.23</var>programs.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.366.24"></a><var>366.24</var><br/>
</td>
<td colspan="3"><b>(h) Children and Community Services Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">67,663,000<br/>
</td>
<td align="center"></td>
<td align="right">67,542,000<br/>
</td>
</tr>
</table><a id="pl.366.25"></a><var>366.25</var><b>Targeted Case Management Temporary </b><br/>
<a id="pl.366.26"></a><var>366.26</var><b>Funding Adjustment.</b> The commissioner <br/>
<a id="pl.366.27"></a><var>366.27</var>shall recover from each county and tribe <br/>
<a id="pl.366.28"></a><var>366.28</var>receiving a targeted case management <br/>
<a id="pl.366.29"></a><var>366.29</var>temporary funding payment in fiscal year <br/>
<a id="pl.366.30"></a><var>366.30</var>2008 an amount equal to that payment. The <br/>
<a id="pl.366.31"></a><var>366.31</var>commissioner shall recover one-half of the <br/>
<a id="pl.366.32"></a><var>366.32</var>funds by February 1, 2010, and the remainder <br/>
<a id="pl.366.33"></a><var>366.33</var>by February 1, 2011. At the commissioner's <br/>
<a id="pl.367.1"></a><var>367.1</var>discretion and at the request of a county <br/>
<a id="pl.367.2"></a><var>367.2</var>or tribe, the commissioner may revise <br/>
<a id="pl.367.3"></a><var>367.3</var>the payment schedule, but full payment <br/>
<a id="pl.367.4"></a><var>367.4</var>must not be delayed beyond May 1, 2011. <br/>
<a id="pl.367.5"></a><var>367.5</var>The commissioner may use the recovery <br/>
<a id="pl.367.6"></a><var>367.6</var>procedure under Minnesota Statutes, section <br/>
<a id="pl.367.7"></a><var>367.7</var>256.017, to recover the funds. Recovered <br/>
<a id="pl.367.8"></a><var>367.8</var>funds must be deposited into the general <br/>
<a id="pl.367.9"></a><var>367.9</var>fund.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.367.10"></a><var>367.10</var><br/>
</td>
<td colspan="3"><b>(i) General Assistance Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">48,215,000<br/>
</td>
<td align="center"></td>
<td align="right">48,608,000<br/>
</td>
</tr>
</table><a id="pl.367.11"></a><var>367.11</var><b>General Assistance Standard.</b> The <br/>
<a id="pl.367.12"></a><var>367.12</var>commissioner shall set the monthly standard <br/>
<a id="pl.367.13"></a><var>367.13</var>of assistance for general assistance units <br/>
<a id="pl.367.14"></a><var>367.14</var>consisting of an adult recipient who is <br/>
<a id="pl.367.15"></a><var>367.15</var>childless and unmarried or living apart <br/>
<a id="pl.367.16"></a><var>367.16</var>from parents or a legal guardian at $203. <br/>
<a id="pl.367.17"></a><var>367.17</var>The commissioner may reduce this amount <br/>
<a id="pl.367.18"></a><var>367.18</var>according to Laws 1997, chapter 85, article <br/>
<a id="pl.367.19"></a><var>367.19</var>3, section 54.<br/>
<a id="pl.367.20"></a><var>367.20</var><b>Emergency General Assistance.</b> The <br/>
<a id="pl.367.21"></a><var>367.21</var>amount appropriated for emergency general <br/>
<a id="pl.367.22"></a><var>367.22</var>assistance funds is limited to no more <br/>
<a id="pl.367.23"></a><var>367.23</var>than $7,889,812 in fiscal year 2010 and <br/>
<a id="pl.367.24"></a><var>367.24</var>$7,889,812 in fiscal year 2011. Funds <br/>
<a id="pl.367.25"></a><var>367.25</var>to counties must be allocated by the <br/>
<a id="pl.367.26"></a><var>367.26</var>commissioner using the allocation method <br/>
<a id="pl.367.27"></a><var>367.27</var>specified in Minnesota Statutes, section <br/>
<a id="pl.367.28"></a><var>367.28</var>256D.06.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.367.29"></a><var>367.29</var><br/>
</td>
<td colspan="3"><b>(j) Minnesota Supplemental Aid Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">33,930,000<br/>
</td>
<td align="center"></td>
<td align="right">35,191,000<br/>
</td>
</tr>
</table><a id="pl.367.30"></a><var>367.30</var><b>Emergency Minnesota Supplemental </b><br/>
<a id="pl.367.31"></a><var>367.31</var><b>Aid Funds.</b> The amount appropriated for <br/>
<a id="pl.367.32"></a><var>367.32</var>emergency Minnesota supplemental aid <br/>
<a id="pl.367.33"></a><var>367.33</var>funds is limited to no more than $1,100,000 <br/>
<a id="pl.367.34"></a><var>367.34</var>in fiscal year 2010 and $1,100,000 in fiscal <br/>
<a id="pl.368.1"></a><var>368.1</var>year 2011. Funds to counties must be <br/>
<a id="pl.368.2"></a><var>368.2</var>allocated by the commissioner using the <br/>
<a id="pl.368.3"></a><var>368.3</var>allocation method specified in Minnesota <br/>
<a id="pl.368.4"></a><var>368.4</var>Statutes, section 256D.46.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.368.5"></a><var>368.5</var><br/>
</td>
<td colspan="3"><b>(k) Group Residential Housing Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">111,778,000<br/>
</td>
<td align="center"></td>
<td align="right">114,034,000<br/>
</td>
</tr>
</table><a id="pl.368.6"></a><var>368.6</var><b>Group Residential Housing Costs </b><br/>
<a id="pl.368.7"></a><var>368.7</var><b>Refinanced.</b> (a) Effective July 1, 2011, the <br/>
<a id="pl.368.8"></a><var>368.8</var>commissioner shall increase the home and <br/>
<a id="pl.368.9"></a><var>368.9</var>community-based service rates and county <br/>
<a id="pl.368.10"></a><var>368.10</var>allocations provided to programs for persons <br/>
<a id="pl.368.11"></a><var>368.11</var>with disabilities established under section <br/>
<a id="pl.368.12"></a><var>368.12</var>1915(c) of the Social Security Act to the <br/>
<a id="pl.368.13"></a><var>368.13</var>extent that these programs will be paying <br/>
<a id="pl.368.14"></a><var>368.14</var>for the costs above the rate established <br/>
<a id="pl.368.15"></a><var>368.15</var>in Minnesota Statutes, section 256I.05, <br/>
<a id="pl.368.16"></a><var>368.16</var>subdivision 1.<br/>
<a id="pl.368.17"></a><var>368.17</var>(b) For persons receiving services under <br/>
<a id="pl.368.18"></a><var>368.18</var>Minnesota Statutes, section 245A.02, who <br/>
<a id="pl.368.19"></a><var>368.19</var>reside in licensed adult foster care beds <br/>
<a id="pl.368.20"></a><var>368.20</var>for which a difficulty of care payment <br/>
<a id="pl.368.21"></a><var>368.21</var>was being made under Minnesota Statutes, <br/>
<a id="pl.368.22"></a><var>368.22</var>section 256I.05, subdivision 1c, paragraph <br/>
<a id="pl.368.23"></a><var>368.23</var>(b), counties may request an exception to <br/>
<a id="pl.368.24"></a><var>368.24</var>the individual's service authorization not to <br/>
<a id="pl.368.25"></a><var>368.25</var>exceed the difference between the client's <br/>
<a id="pl.368.26"></a><var>368.26</var>monthly service expenditures plus the <br/>
<a id="pl.368.27"></a><var>368.27</var>amount of the difficulty of care payment.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.368.28"></a><var>368.28</var><br/>
</td>
<td colspan="3"><b>(l) Children's Mental Health Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">16,885,000<br/>
</td>
<td align="center"></td>
<td align="right">16,882,000<br/>
</td>
</tr>
</table><a id="pl.368.29"></a><var>368.29</var><b>Funding Usage.</b> Up to 75 percent of a fiscal <br/>
<a id="pl.368.30"></a><var>368.30</var>year's appropriation for children's mental <br/>
<a id="pl.368.31"></a><var>368.31</var>health grants may be used to fund allocations <br/>
<a id="pl.368.32"></a><var>368.32</var>in that portion of the fiscal year ending <br/>
<a id="pl.368.33"></a><var>368.33</var>December 31.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.369.1"></a><var>369.1</var><br/>
<a id="pl.369.2"></a><var>369.2</var><br/>
</td>
<td colspan="3"><b>(m) Other Children and Economic Assistance </b><br/>
<b>Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">16,047,000<br/>
</td>
<td align="center"></td>
<td align="right">15,339,000<br/>
</td>
</tr>
</table><a id="pl.369.3"></a><var>369.3</var><b>Fraud Prevention Grants.</b> Of this <br/>
<a id="pl.369.4"></a><var>369.4</var>appropriation, $379,000 in fiscal year 2010 <br/>
<a id="pl.369.5"></a><var>369.5</var>and $379,000 in fiscal year 2011 is to the <br/>
<a id="pl.369.6"></a><var>369.6</var>commissioner for fraud prevention grants to <br/>
<a id="pl.369.7"></a><var>369.7</var>counties.<br/>
<a id="pl.369.8"></a><var>369.8</var><b>Homeless and Runaway Youth.</b> $218,000 <br/>
<a id="pl.369.9"></a><var>369.9</var>in fiscal year 2010 is for the Runaway <br/>
<a id="pl.369.10"></a><var>369.10</var>and Homeless Youth Act under Minnesota <br/>
<a id="pl.369.11"></a><var>369.11</var>Statutes, section 256K.45. Funds shall be <br/>
<a id="pl.369.12"></a><var>369.12</var>spent in each area of the continuum of care <br/>
<a id="pl.369.13"></a><var>369.13</var>to ensure that programs are meeting the <br/>
<a id="pl.369.14"></a><var>369.14</var>greatest need. Any unexpended balance in <br/>
<a id="pl.369.15"></a><var>369.15</var>the first year is available in the second year. <br/>
<a id="pl.369.16"></a><var>369.16</var>Beginning July 1, 2011, the base is increased <br/>
<a id="pl.369.17"></a><var>369.17</var>by $119,000 each year.<br/>
<a id="pl.369.18"></a><var>369.18</var><b>ARRA Homeless Youth Funds.</b> To the <br/>
<a id="pl.369.19"></a><var>369.19</var>extent permitted under federal law, the <br/>
<a id="pl.369.20"></a><var>369.20</var>commissioner shall designate $2,500,000 <br/>
<a id="pl.369.21"></a><var>369.21</var>of the Homeless Prevention and Rapid <br/>
<a id="pl.369.22"></a><var>369.22</var>Re-Housing Program funds provided under <br/>
<a id="pl.369.23"></a><var>369.23</var>the American Recovery and Reinvestment <br/>
<a id="pl.369.24"></a><var>369.24</var>Act of 2009, Public Law 111-5, for agencies <br/>
<a id="pl.369.25"></a><var>369.25</var>providing homelessness prevention and rapid <br/>
<a id="pl.369.26"></a><var>369.26</var>rehousing services to youth.<br/>
<a id="pl.369.27"></a><var>369.27</var><b>Supportive Housing Services.</b> $1,500,000 <br/>
<a id="pl.369.28"></a><var>369.28</var>each year is for supportive services under <br/>
<a id="pl.369.29"></a><var>369.29</var>Minnesota Statutes, section 256K.26. This is <br/>
<a id="pl.369.30"></a><var>369.30</var>a onetime appropriation. Beginning in fiscal <br/>
<a id="pl.369.31"></a><var>369.31</var>year 2012, the base is increased by $68,000 <br/>
<a id="pl.369.32"></a><var>369.32</var>per year.<br/>
<a id="pl.369.33"></a><var>369.33</var><b>Community Action Grants.</b> Community <br/>
<a id="pl.369.34"></a><var>369.34</var>action grants are reduced one time by <br/>
<a id="pl.370.1"></a><var>370.1</var>$1,764,000 each year. This reduction is due <br/>
<a id="pl.370.2"></a><var>370.2</var>to the availability of federal funds under the <br/>
<a id="pl.370.3"></a><var>370.3</var>American Recovery and Reinvestment Act.<br/>
<a id="pl.370.4"></a><var>370.4</var><b>Base Adjustment.</b> The general fund base <br/>
<a id="pl.370.5"></a><var>370.5</var>is increased by $773,000 in fiscal year 2012 <br/>
<a id="pl.370.6"></a><var>370.6</var>and $773,000 in fiscal year 2013.<br/>
<a id="pl.370.7"></a><var>370.7</var><b>Federal ARRA Funds for Existing </b><br/>
<a id="pl.370.8"></a><var>370.8</var><b>Programs.</b> (a) Federal funds received by the <br/>
<a id="pl.370.9"></a><var>370.9</var>commissioner for the emergency food and <br/>
<a id="pl.370.10"></a><var>370.10</var>shelter program from the American Recovery <br/>
<a id="pl.370.11"></a><var>370.11</var>and Reinvestment Act of 2009, Public <br/>
<a id="pl.370.12"></a><var>370.12</var>Law 111-5, but not previously approved <br/>
<a id="pl.370.13"></a><var>370.13</var>by the legislature are appropriated to the <br/>
<a id="pl.370.14"></a><var>370.14</var>commissioner for the purposes of the grant <br/>
<a id="pl.370.15"></a><var>370.15</var>program.<br/>
<a id="pl.370.16"></a><var>370.16</var>(b) Federal funds received by the <br/>
<a id="pl.370.17"></a><var>370.17</var>commissioner for the emergency shelter <br/>
<a id="pl.370.18"></a><var>370.18</var>grant program including the Homelessness <br/>
<a id="pl.370.19"></a><var>370.19</var>Prevention and Rapid Re-Housing <br/>
<a id="pl.370.20"></a><var>370.20</var>Program from the American Recovery and <br/>
<a id="pl.370.21"></a><var>370.21</var>Reinvestment Act of 2009, Public Law <br/>
<a id="pl.370.22"></a><var>370.22</var>111-5, are appropriated to the commissioner <br/>
<a id="pl.370.23"></a><var>370.23</var>for the purposes of the grant programs.<br/>
<a id="pl.370.24"></a><var>370.24</var>(c) Federal funds received by the <br/>
<a id="pl.370.25"></a><var>370.25</var>commissioner for the emergency food <br/>
<a id="pl.370.26"></a><var>370.26</var>assistance program from the American <br/>
<a id="pl.370.27"></a><var>370.27</var>Recovery and Reinvestment Act of 2009, <br/>
<a id="pl.370.28"></a><var>370.28</var>Public Law 111-5, are appropriated to the <br/>
<a id="pl.370.29"></a><var>370.29</var>commissioner for the purposes of the grant <br/>
<a id="pl.370.30"></a><var>370.30</var>program.<br/>
<a id="pl.370.31"></a><var>370.31</var>(d) Federal funds received by the <br/>
<a id="pl.370.32"></a><var>370.32</var>commissioner for senior congregate meals <br/>
<a id="pl.370.33"></a><var>370.33</var>and senior home-delivered meals from the <br/>
<a id="pl.370.34"></a><var>370.34</var>American Recovery and Reinvestment Act <br/>
<a id="pl.370.35"></a><var>370.35</var>of 2009, Public Law 111-5, are appropriated <br/>
<a id="pl.371.1"></a><var>371.1</var>to the commissioner for the Minnesota Board <br/>
<a id="pl.371.2"></a><var>371.2</var>on Aging, for purposes of the grant programs.<br/>
<a id="pl.371.3"></a><var>371.3</var>(e) Federal funds received by the <br/>
<a id="pl.371.4"></a><var>371.4</var>commissioner for the community services <br/>
<a id="pl.371.5"></a><var>371.5</var>block grant program from the American <br/>
<a id="pl.371.6"></a><var>371.6</var>Recovery and Reinvestment Act of 2009, <br/>
<a id="pl.371.7"></a><var>371.7</var>Public Law 111-5, are appropriated to the <br/>
<a id="pl.371.8"></a><var>371.8</var>commissioner for the purposes of the grant <br/>
<a id="pl.371.9"></a><var>371.9</var>program.<br/>
<a id="pl.371.10"></a><var>371.10</var><b>Long-Term Homeless Supportive </b><br/>
<a id="pl.371.11"></a><var>371.11</var><b>Service Fund Appropriation.</b> To the <br/>
<a id="pl.371.12"></a><var>371.12</var>extent permitted under federal law, the <br/>
<a id="pl.371.13"></a><var>371.13</var>commissioner shall designate $3,000,000 <br/>
<a id="pl.371.14"></a><var>371.14</var>of the Homelessness Prevention and Rapid <br/>
<a id="pl.371.15"></a><var>371.15</var>Re-Housing Program funds provided under <br/>
<a id="pl.371.16"></a><var>371.16</var>the American Recovery and Reinvestment <br/>
<a id="pl.371.17"></a><var>371.17</var>Act of 2009, Public Law, 111-5, to the <br/>
<a id="pl.371.18"></a><var>371.18</var>long-term homeless service fund under <br/>
<a id="pl.371.19"></a><var>371.19</var>Minnesota Statutes, section 256K.26. This <br/>
<a id="pl.371.20"></a><var>371.20</var>appropriation shall become available by July <br/>
<a id="pl.371.21"></a><var>371.21</var>1, 2009. This paragraph is effective the day <br/>
<a id="pl.371.22"></a><var>371.22</var>following final enactment.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.371.23"></a><var>371.23</var><br/>
<a id="pl.371.24"></a><var>371.24</var><br/>
</td>
<td align="left" colspan="3">Subd. 5.<b>Children and Economic Assistance </b><br/>
<b>Management</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table><a id="pl.371.25"></a><var>371.25</var>The amounts that may be spent from the <br/>
<a id="pl.371.26"></a><var>371.26</var>appropriation for each purpose are as follows:<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.371.27"></a><var>371.27</var><br/>
<a id="pl.371.28"></a><var>371.28</var><br/>
</td>
<td align="left" colspan="3"><b>(a) Children and Economic Assistance </b><br/>
<b>Administration</b><br/>
</td>
<td align="center"></td>
<td align="center"></td>
<td align="left"></td>
<td align="left"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.371.29"></a><var>371.29</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.371.30"></a><var>371.30</var><br/>
</td>
<td align="left">General<br/>
</td>
<td align="right">10,318,000<br/>
</td>
<td align="right">10,308,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.371.31"></a><var>371.31</var><br/>
</td>
<td align="left">Federal TANF<br/>
</td>
<td align="right">496,000<br/>
</td>
<td align="right">496,000<br/>
</td>
</tr>
</table><a id="pl.372.1"></a><var>372.1</var><b>Base Adjustment.</b> The federal TANF base <br/>
<a id="pl.372.2"></a><var>372.2</var>is increased by $700,000 in each of fiscal <br/>
<a id="pl.372.3"></a><var>372.3</var>years 2012 and 2013.<br/>
<a id="pl.372.4"></a><var>372.4</var><b>School Readiness Service Agreements.</b> <br/>
<a id="pl.372.5"></a><var>372.5</var>$406,000 in fiscal year 2010 and $406,000 <br/>
<a id="pl.372.6"></a><var>372.6</var>in fiscal year 2011 are from the federal <br/>
<a id="pl.372.7"></a><var>372.7</var>child care development funds received from <br/>
<a id="pl.372.8"></a><var>372.8</var>the American Recovery and Reinvestment <br/>
<a id="pl.372.9"></a><var>372.9</var>Act of 2009, Public Law 111-5, to the <br/>
<a id="pl.372.10"></a><var>372.10</var>commissioner of human services consistent <br/>
<a id="pl.372.11"></a><var>372.11</var>with federal regulations for the purpose of <br/>
<a id="pl.372.12"></a><var>372.12</var>school readiness service agreements under <br/>
<a id="pl.372.13"></a><var>372.13</var>Minnesota Statutes, section 119B.231. This <br/>
<a id="pl.372.14"></a><var>372.14</var>is a onetime appropriation. Any unexpended <br/>
<a id="pl.372.15"></a><var>372.15</var>balance the first year is available in the <br/>
<a id="pl.372.16"></a><var>372.16</var>second year.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.372.17"></a><var>372.17</var><br/>
<a id="pl.372.18"></a><var>372.18</var><br/>
</td>
<td align="left" colspan="3"><b>(b) Children and Economic Assistance </b><br/>
<b>Operations</b><br/>
</td>
<td align="center"></td>
<td align="center"></td>
<td align="left"></td>
<td align="left"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.372.19"></a><var>372.19</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.372.20"></a><var>372.20</var><br/>
</td>
<td align="left">General<br/>
</td>
<td align="right">33,590,000<br/>
</td>
<td align="right">33,423,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.372.21"></a><var>372.21</var><br/>
</td>
<td align="left">Health Care Access<br/>
</td>
<td align="right">361,000<br/>
</td>
<td align="right">361,000<br/>
</td>
</tr>
</table><a id="pl.372.22"></a><var>372.22</var><b>Financial Institution Data Match and </b><br/>
<a id="pl.372.23"></a><var>372.23</var><b>Payment of Fees.</b> The commissioner is <br/>
<a id="pl.372.24"></a><var>372.24</var>authorized to allocate up to $310,000 each <br/>
<a id="pl.372.25"></a><var>372.25</var>year in fiscal years 2010 and 2011 from the <br/>
<a id="pl.372.26"></a><var>372.26</var>PRISM special revenue account to make <br/>
<a id="pl.372.27"></a><var>372.27</var>payments to financial institutions in exchange <br/>
<a id="pl.372.28"></a><var>372.28</var>for performing data matches between account <br/>
<a id="pl.372.29"></a><var>372.29</var>information held by financial institutions <br/>
<a id="pl.372.30"></a><var>372.30</var>and the public authority's database of child <br/>
<a id="pl.372.31"></a><var>372.31</var>support obligors as authorized by Minnesota <br/>
<a id="pl.372.32"></a><var>372.32</var>Statutes, section 13B.06, subdivision 7.<br/>
<a id="pl.373.1"></a><var>373.1</var><b>School Readiness Service Agreements.</b> <br/>
<a id="pl.373.2"></a><var>373.2</var>$106,000 in fiscal year 2010 and $241,000 <br/>
<a id="pl.373.3"></a><var>373.3</var>in fiscal year 2011 are from the federal <br/>
<a id="pl.373.4"></a><var>373.4</var>child care development funds received from <br/>
<a id="pl.373.5"></a><var>373.5</var>the American Recovery and Reinvestment <br/>
<a id="pl.373.6"></a><var>373.6</var>Act of 2009, Public Law 111-5, to the <br/>
<a id="pl.373.7"></a><var>373.7</var>commissioner of human services consistent <br/>
<a id="pl.373.8"></a><var>373.8</var>with federal regulations for the purpose of <br/>
<a id="pl.373.9"></a><var>373.9</var>school readiness service agreements under <br/>
<a id="pl.373.10"></a><var>373.10</var>Minnesota Statutes, section 119B.231. This <br/>
<a id="pl.373.11"></a><var>373.11</var>is a onetime appropriation.<br/>
<a id="pl.373.12"></a><var>373.12</var><b>Use of Federal Stabilization Funds.</b> <br/>
<a id="pl.373.13"></a><var>373.13</var>$33,000,000 in fiscal year 2010 is <br/>
<a id="pl.373.14"></a><var>373.14</var>appropriated from the fiscal stabilization <br/>
<a id="pl.373.15"></a><var>373.15</var>account in the federal fund to the <br/>
<a id="pl.373.16"></a><var>373.16</var>commissioner. This appropriation must not <br/>
<a id="pl.373.17"></a><var>373.17</var>be used for any activity or service for which <br/>
<a id="pl.373.18"></a><var>373.18</var>federal reimbursement is claimed. This is a <br/>
<a id="pl.373.19"></a><var>373.19</var>onetime appropriation.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.373.20"></a><var>373.20</var><br/>
</td>
<td align="left" colspan="3">Subd. 6.<b>Basic Health Care Grants</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table><a id="pl.373.21"></a><var>373.21</var>The amounts that may be spent from this <br/>
<a id="pl.373.22"></a><var>373.22</var>appropriation for each purpose are as follows:<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.373.23"></a><var>373.23</var><br/>
</td>
<td align="left" colspan="3"><b>(a) MinnesotaCare Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">391,915,000<br/>
</td>
<td align="center"></td>
<td align="right">485,448,000<br/>
</td>
</tr>
</table><a id="pl.373.24"></a><var>373.24</var>This appropriation is from the health care <br/>
<a id="pl.373.25"></a><var>373.25</var>access fund.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.373.26"></a><var>373.26</var><br/>
<a id="pl.373.27"></a><var>373.27</var><br/>
</td>
<td align="left" colspan="3"><b>(b) MA Basic Health Care Grants - Families </b><br/>
<b>and Children</b><br/>
</td>
<td align="center"></td>
<td align="right">751,988,000<br/>
</td>
<td align="center"></td>
<td align="right">973,088,000<br/>
</td>
</tr>
</table><a id="pl.373.28"></a><var>373.28</var><b>Medical Education Research Costs </b><br/>
<a id="pl.373.29"></a><var>373.29</var><b>(MERC).</b> Of these funds, the commissioner <br/>
<a id="pl.373.30"></a><var>373.30</var>of human services shall transfer $38,000,000 <br/>
<a id="pl.373.31"></a><var>373.31</var>in fiscal year 2010 to the medical education <br/>
<a id="pl.373.32"></a><var>373.32</var>research fund. These funds must restore the <br/>
<a id="pl.373.33"></a><var>373.33</var>fiscal year 2009 unallotment of the transfers <br/>
<a id="pl.374.1"></a><var>374.1</var>under Minnesota Statutes, section 256B.69, <br/>
<a id="pl.374.2"></a><var>374.2</var>subdivision 5c, paragraph (a), for the July 1, <br/>
<a id="pl.374.3"></a><var>374.3</var>2008, through June 30, 2009, period.<br/>
<a id="pl.374.4"></a><var>374.4</var><b>Newborn Screening Fee.</b> Of the general <br/>
<a id="pl.374.5"></a><var>374.5</var>fund appropriation, $34,000 in fiscal <br/>
<a id="pl.374.6"></a><var>374.6</var>year 2011 is to the commissioner for the <br/>
<a id="pl.374.7"></a><var>374.7</var>hospital reimbursement increase described <br/>
<a id="pl.374.8"></a><var>374.8</var>under Minnesota Statutes, section 256.969, <br/>
<a id="pl.374.9"></a><var>374.9</var>subdivision 28.<br/>
<a id="pl.374.10"></a><var>374.10</var><b>Local Share Payment Modification </b><br/>
<a id="pl.374.11"></a><var>374.11</var><b>Required for ARRA Compliance.</b> <br/>
<a id="pl.374.12"></a><var>374.12</var>Effective from July 1, 2009, to December <br/>
<a id="pl.374.13"></a><var>374.13</var>31, 2010, Hennepin County's monthly <br/>
<a id="pl.374.14"></a><var>374.14</var>contribution to the nonfederal share of <br/>
<a id="pl.374.15"></a><var>374.15</var>medical assistance costs must be reduced <br/>
<a id="pl.374.16"></a><var>374.16</var>to the percentage required on September <br/>
<a id="pl.374.17"></a><var>374.17</var>1, 2008, to meet federal requirements for <br/>
<a id="pl.374.18"></a><var>374.18</var>enhanced federal match under the American <br/>
<a id="pl.374.19"></a><var>374.19</var>Reinvestment and Recovery Act (ARRA) <br/>
<a id="pl.374.20"></a><var>374.20</var>of 2009. Notwithstanding  the requirements <br/>
<a id="pl.374.21"></a><var>374.21</var>of Minnesota Statutes, section 256B.19, <br/>
<a id="pl.374.22"></a><var>374.22</var>subdivision 1c, paragraph (d), for the period <br/>
<a id="pl.374.23"></a><var>374.23</var>beginning July 1, 2009, to December 31, <br/>
<a id="pl.374.24"></a><var>374.24</var>2010, Hennepin County's monthly payment <br/>
<a id="pl.374.25"></a><var>374.25</var>under that provision is reduced to $434,688.<br/>
<a id="pl.374.26"></a><var>374.26</var><b>Capitation Payments.</b> Effective from <br/>
<a id="pl.374.27"></a><var>374.27</var>July 1, 2009, to December 31, 2010, <br/>
<a id="pl.374.28"></a><var>374.28</var>notwithstanding the provisions of Minnesota <br/>
<a id="pl.374.29"></a><var>374.29</var>Statutes 2008, section 256B.19, subdivision <br/>
<a id="pl.374.30"></a><var>374.30</var>1c, paragraph (c), the commissioner shall <br/>
<a id="pl.374.31"></a><var>374.31</var>increase capitation payments made to the <br/>
<a id="pl.374.32"></a><var>374.32</var>Metropolitan Health Plan under Minnesota <br/>
<a id="pl.374.33"></a><var>374.33</var>Statutes 2008, section 256B.69, by <br/>
<a id="pl.374.34"></a><var>374.34</var>$6,800,000 to recognize higher than average <br/>
<a id="pl.375.1"></a><var>375.1</var>medical education costs. The increased <br/>
<a id="pl.375.2"></a><var>375.2</var>amount includes federal matching funds.<br/>
<a id="pl.375.3"></a><var>375.3</var><b>Use of Savings.</b> Any savings derived <br/>
<a id="pl.375.4"></a><var>375.4</var>from implementation of the prohibition in <br/>
<a id="pl.375.5"></a><var>375.5</var>Minnesota Statutes, section 256B.032, on the <br/>
<a id="pl.375.6"></a><var>375.6</var>enrollment of low-quality, high-cost health <br/>
<a id="pl.375.7"></a><var>375.7</var>care providers as vendors of state health care <br/>
<a id="pl.375.8"></a><var>375.8</var>program services shall be used to offset on a <br/>
<a id="pl.375.9"></a><var>375.9</var>pro rata basis the reimbursement reductions <br/>
<a id="pl.375.10"></a><var>375.10</var>for basic care services in Minnesota Statutes, <br/>
<a id="pl.375.11"></a><var>375.11</var>section 256B.766.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.375.12"></a><var>375.12</var><br/>
<a id="pl.375.13"></a><var>375.13</var><br/>
</td>
<td align="left" colspan="3"><b>(c) MA Basic Health Care Grants - Elderly and </b><br/>
<b>Disabled</b><br/>
</td>
<td align="center"></td>
<td align="right">970,183,000<br/>
</td>
<td align="center"></td>
<td align="right">1,142,310,000<br/>
</td>
</tr>
</table><a id="pl.375.14"></a><var>375.14</var><b>Minnesota Disability Health Options. </b><br/>
<a id="pl.375.15"></a><var>375.15</var>Notwithstanding Minnesota Statutes, section <br/>
<a id="pl.375.16"></a><var>375.16</var>256B.69, subdivision 5a, paragraph (b), for <br/>
<a id="pl.375.17"></a><var>375.17</var>the period beginning July 1, 2009, to June <br/>
<a id="pl.375.18"></a><var>375.18</var>30, 2011, the monthly enrollment of persons <br/>
<a id="pl.375.19"></a><var>375.19</var>receiving home and community-based <br/>
<a id="pl.375.20"></a><var>375.20</var>waivered services under Minnesota <br/>
<a id="pl.375.21"></a><var>375.21</var>Disability Health Options shall not exceed <br/>
<a id="pl.375.22"></a><var>375.22</var>1,000. If the budget neutrality provision <br/>
<a id="pl.375.23"></a><var>375.23</var>in Minnesota Statutes, section 256B.69, <br/>
<a id="pl.375.24"></a><var>375.24</var>subdivision 23, paragraph (f), is reached <br/>
<a id="pl.375.25"></a><var>375.25</var>prior to June 30, 2013, the commissioner may <br/>
<a id="pl.375.26"></a><var>375.26</var>waive this monthly enrollment requirement.<br/>
<a id="pl.375.27"></a><var>375.27</var><b>Hospital Fee-for-Service Payment Delay.</b> <br/>
<a id="pl.375.28"></a><var>375.28</var>Payments from the Medicaid Management <br/>
<a id="pl.375.29"></a><var>375.29</var>Information System that would otherwise <br/>
<a id="pl.375.30"></a><var>375.30</var>have been made for inpatient hospital <br/>
<a id="pl.375.31"></a><var>375.31</var>services for Minnesota health care program <br/>
<a id="pl.375.32"></a><var>375.32</var>enrollees must be delayed as follows: for <br/>
<a id="pl.375.33"></a><var>375.33</var>fiscal year 2011, payments in the month of <br/>
<a id="pl.375.34"></a><var>375.34</var>June equal to $15,937,000 must be included <br/>
<a id="pl.376.1"></a><var>376.1</var>in the first payment of fiscal year 2012 and <br/>
<a id="pl.376.2"></a><var>376.2</var>for fiscal year 2013, payments in the month <br/>
<a id="pl.376.3"></a><var>376.3</var>of June equal to $6,666,000 must be included <br/>
<a id="pl.376.4"></a><var>376.4</var>in the first payment of fiscal year 2014. The <br/>
<a id="pl.376.5"></a><var>376.5</var>provisions of Minnesota Statutes, section <br/>
<a id="pl.376.6"></a><var>376.6</var>16A.124, do not apply to these delayed <br/>
<a id="pl.376.7"></a><var>376.7</var>payments. Notwithstanding any contrary <br/>
<a id="pl.376.8"></a><var>376.8</var>provision in this article, this paragraph <br/>
<a id="pl.376.9"></a><var>376.9</var>expires December 31, 2014.<br/>
<a id="pl.376.10"></a><var>376.10</var><b>Nonhospital Fee-for-Service Payment </b><br/>
<a id="pl.376.11"></a><var>376.11</var><b>Delay.</b> Payments from the Medicaid <br/>
<a id="pl.376.12"></a><var>376.12</var>Management Information System that would <br/>
<a id="pl.376.13"></a><var>376.13</var>otherwise have been made for nonhospital <br/>
<a id="pl.376.14"></a><var>376.14</var>acute care services for Minnesota health <br/>
<a id="pl.376.15"></a><var>376.15</var>care program enrollees must be delayed as <br/>
<a id="pl.376.16"></a><var>376.16</var>follows: payments in the month of June equal <br/>
<a id="pl.376.17"></a><var>376.17</var>to $23,438,000 for fiscal year 2011 must be <br/>
<a id="pl.376.18"></a><var>376.18</var>included in the first payment for fiscal year <br/>
<a id="pl.376.19"></a><var>376.19</var>2012, and payments in the month of June <br/>
<a id="pl.376.20"></a><var>376.20</var>equal to $27,156,000 for fiscal year 2013 <br/>
<a id="pl.376.21"></a><var>376.21</var>must be included in the first payment for <br/>
<a id="pl.376.22"></a><var>376.22</var>fiscal year 2014. This payment delay must <br/>
<a id="pl.376.23"></a><var>376.23</var>not include nursing facilities, intermediate <br/>
<a id="pl.376.24"></a><var>376.24</var>care facilities for persons with developmental <br/>
<a id="pl.376.25"></a><var>376.25</var>disabilities, home and community-based <br/>
<a id="pl.376.26"></a><var>376.26</var>services, prepaid health plans, personal care <br/>
<a id="pl.376.27"></a><var>376.27</var>provider organizations, and home health <br/>
<a id="pl.376.28"></a><var>376.28</var>agencies. The provisions of Minnesota <br/>
<a id="pl.376.29"></a><var>376.29</var>Statutes, section 16A.124, do not apply to <br/>
<a id="pl.376.30"></a><var>376.30</var>these delayed payments. Notwithstanding <br/>
<a id="pl.376.31"></a><var>376.31</var>any contrary provision in this article, this <br/>
<a id="pl.376.32"></a><var>376.32</var>paragraph expires December 31, 2014.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.4"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.376.33"></a><var>376.33</var><br/>
</td>
<td align="left" colspan="3"><b>(d) General Assistance Medical Care Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">345,223,000<br/>
</td>
<td align="center"></td>
<td align="right">381,081,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.376.34"></a><var>376.34</var><br/>
</td>
<td align="left" colspan="3"><b>(e) Other Health Care Grants</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.377.1"></a><var>377.1</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.377.2"></a><var>377.2</var><br/>
</td>
<td align="left">General<br/>
</td>
<td align="right">295,000<br/>
</td>
<td align="right">295,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.377.3"></a><var>377.3</var><br/>
</td>
<td align="left">Health Care Access<br/>
</td>
<td align="right">23,533,000<br/>
</td>
<td align="right">7,080,000<br/>
</td>
</tr>
</table><a id="pl.377.4"></a><var>377.4</var><b>Base Adjustment.</b> The health care access <br/>
<a id="pl.377.5"></a><var>377.5</var>fund base is reduced to $190,000 in each of <br/>
<a id="pl.377.6"></a><var>377.6</var>fiscal years 2012 and 2013.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.377.7"></a><var>377.7</var><br/>
</td>
<td align="left" colspan="3">Subd. 7.<b>Health Care Management</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table><a id="pl.377.8"></a><var>377.8</var>The amounts that may be spent from the <br/>
<a id="pl.377.9"></a><var>377.9</var>appropriation for each purpose are as follows:<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.377.10"></a><var>377.10</var><br/>
</td>
<td align="left" colspan="3"><b>(a) Health Care Administration</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.377.11"></a><var>377.11</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.377.12"></a><var>377.12</var><br/>
</td>
<td align="left">General<br/>
</td>
<td align="right">7,831,000<br/>
</td>
<td align="right">7,742,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.377.13"></a><var>377.13</var><br/>
</td>
<td align="left">Health Care Access<br/>
</td>
<td align="right">1,812,000<br/>
</td>
<td align="right">906,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.377.14"></a><var>377.14</var><br/>
</td>
<td align="left" colspan="3"><b>(b) Health Care Operations</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.377.15"></a><var>377.15</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.377.16"></a><var>377.16</var><br/>
</td>
<td align="left">General<br/>
</td>
<td align="right">19,914,000<br/>
</td>
<td align="right">18,949,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.377.17"></a><var>377.17</var><br/>
</td>
<td align="left">Health Care Access<br/>
</td>
<td align="right">25,099,000<br/>
</td>
<td align="right">25,875,000<br/>
</td>
</tr>
</table><a id="pl.377.18"></a><var>377.18</var><b>Base Adjustment.</b> The health care access <br/>
<a id="pl.377.19"></a><var>377.19</var>fund base is increased by $1,006,000 in <br/>
<a id="pl.377.20"></a><var>377.20</var>fiscal year 2012 and $1,781,000 in fiscal year <br/>
<a id="pl.377.21"></a><var>377.21</var>2013. The general fund base is decreased by <br/>
<a id="pl.377.22"></a><var>377.22</var>$237,000 in fiscal year 2012 and $237,000 in <br/>
<a id="pl.377.23"></a><var>377.23</var>fiscal year 2013.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.377.24"></a><var>377.24</var><br/>
</td>
<td align="left" colspan="3">Subd. 8.<b>Continuing Care Grants</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table><a id="pl.377.25"></a><var>377.25</var>The amounts that may be spent from the <br/>
<a id="pl.377.26"></a><var>377.26</var>appropriation for each purpose are as follows:<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.377.27"></a><var>377.27</var><br/>
</td>
<td align="left" colspan="3"><b>(a) Aging and Adult Services Grants</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.378.1"></a><var>378.1</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.378.2"></a><var>378.2</var><br/>
</td>
<td align="left">General<br/>
</td>
<td align="right">13,488,000<br/>
</td>
<td align="right">15,779,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.378.3"></a><var>378.3</var><br/>
</td>
<td align="left">Federal<br/>
</td>
<td align="right">500,000<br/>
</td>
<td align="right">0<br/>
</td>
</tr>
</table><a id="pl.378.4"></a><var>378.4</var><b>Base Adjustment.</b> The general fund base is <br/>
<a id="pl.378.5"></a><var>378.5</var>increased by $5,751,000 in fiscal year 2012 <br/>
<a id="pl.378.6"></a><var>378.6</var>and $6,705,000 in fiscal year 2013.<br/>
<a id="pl.378.7"></a><var>378.7</var><b>Information and Assistance </b><br/>
<a id="pl.378.8"></a><var>378.8</var><b>Reimbursement.</b> Federal administrative <br/>
<a id="pl.378.9"></a><var>378.9</var>reimbursement obtained from information <br/>
<a id="pl.378.10"></a><var>378.10</var>and assistance services provided by the <br/>
<a id="pl.378.11"></a><var>378.11</var>Senior LinkAge or Disability Linkage lines <br/>
<a id="pl.378.12"></a><var>378.12</var>to people who are identified as eligible for <br/>
<a id="pl.378.13"></a><var>378.13</var>medical assistance shall be appropriated to <br/>
<a id="pl.378.14"></a><var>378.14</var>the commissioner for this activity.<br/>
<a id="pl.378.15"></a><var>378.15</var><b>Community Service Development Grant </b><br/>
<a id="pl.378.16"></a><var>378.16</var><b>Reduction.</b> Funding for community service <br/>
<a id="pl.378.17"></a><var>378.17</var>development grants must be reduced by <br/>
<a id="pl.378.18"></a><var>378.18</var>$251,000 for fiscal year 2010; $266,000 in <br/>
<a id="pl.378.19"></a><var>378.19</var>fiscal year 2011; $25,000 in fiscal year 2012; <br/>
<a id="pl.378.20"></a><var>378.20</var>and $25,000 in fiscal year 2013. Base level <br/>
<a id="pl.378.21"></a><var>378.21</var>funding shall be restored in fiscal year 2014.<br/>
<a id="pl.378.22"></a><var>378.22</var><b>Senior Nutrition Use of Federal Funds.</b> <br/>
<a id="pl.378.23"></a><var>378.23</var>For fiscal year 2010, general fund grants <br/>
<a id="pl.378.24"></a><var>378.24</var>for home-delivered meals and congregate <br/>
<a id="pl.378.25"></a><var>378.25</var>dining shall be reduced by $500,000. The <br/>
<a id="pl.378.26"></a><var>378.26</var>commissioner must replace these general <br/>
<a id="pl.378.27"></a><var>378.27</var>fund reductions with equal amounts from <br/>
<a id="pl.378.28"></a><var>378.28</var>federal funding for senior nutrition from the <br/>
<a id="pl.378.29"></a><var>378.29</var>American Recovery and Reinvestment Act <br/>
<a id="pl.378.30"></a><var>378.30</var>of 2009.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.378.31"></a><var>378.31</var><br/>
</td>
<td align="left" colspan="3"><b>(b) Alternative Care Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">50,234,000<br/>
</td>
<td align="center"></td>
<td align="right">48,576,000<br/>
</td>
</tr>
</table><a id="pl.379.1"></a><var>379.1</var><b>Base Adjustment.</b> The general fund base is <br/>
<a id="pl.379.2"></a><var>379.2</var>decreased by $3,598,000 in fiscal year 2012 <br/>
<a id="pl.379.3"></a><var>379.3</var>and $3,470,000 in fiscal year 2013.<br/>
<a id="pl.379.4"></a><var>379.4</var><b>Alternative Care Transfer.</b> Any money <br/>
<a id="pl.379.5"></a><var>379.5</var>allocated to the alternative care program that <br/>
<a id="pl.379.6"></a><var>379.6</var>is not spent for the purposes indicated does <br/>
<a id="pl.379.7"></a><var>379.7</var>not cancel but must be transferred to the <br/>
<a id="pl.379.8"></a><var>379.8</var>medical assistance account.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.379.9"></a><var>379.9</var><br/>
<a id="pl.379.10"></a><var>379.10</var><br/>
</td>
<td align="left" colspan="3"><b>(c) Medical Assistance Grants; Long-Term </b><br/>
<b>Care Facilities.</b><br/>
</td>
<td align="center"></td>
<td align="right">367,444,000<br/>
</td>
<td align="center"></td>
<td align="right">419,749,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.379.11"></a><var>379.11</var><br/>
<a id="pl.379.12"></a><var>379.12</var><br/>
</td>
<td align="left" colspan="3"><b>(d) Medical Assistance Long-Term Care </b><br/>
<b>Waivers and Home Care Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">854,373,000<br/>
</td>
<td align="center"></td>
<td align="right">1,043,411,000<br/>
</td>
</tr>
</table><a id="pl.379.13"></a><var>379.13</var><b>Manage Growth in TBI and CADI </b><br/>
<a id="pl.379.14"></a><var>379.14</var><b>Waivers.</b> During the fiscal years beginning <br/>
<a id="pl.379.15"></a><var>379.15</var>on July 1, 2009, and July 1, 2010, the <br/>
<a id="pl.379.16"></a><var>379.16</var>commissioner shall allocate money for home <br/>
<a id="pl.379.17"></a><var>379.17</var>and community-based waiver programs <br/>
<a id="pl.379.18"></a><var>379.18</var>under Minnesota Statutes, section 256B.49, <br/>
<a id="pl.379.19"></a><var>379.19</var>to ensure a reduction in state spending that is <br/>
<a id="pl.379.20"></a><var>379.20</var>equivalent to limiting the caseload growth of <br/>
<a id="pl.379.21"></a><var>379.21</var>the TBI waiver to 12.5 allocations per month <br/>
<a id="pl.379.22"></a><var>379.22</var>each year of the biennium and the CADI <br/>
<a id="pl.379.23"></a><var>379.23</var>waiver to 95 allocations per month each year <br/>
<a id="pl.379.24"></a><var>379.24</var>of the biennium. Limits do not apply: (1) <br/>
<a id="pl.379.25"></a><var>379.25</var>when there is an approved plan for nursing <br/>
<a id="pl.379.26"></a><var>379.26</var>facility bed closures for individuals under <br/>
<a id="pl.379.27"></a><var>379.27</var>age 65 who require relocation due to the <br/>
<a id="pl.379.28"></a><var>379.28</var>bed closure; (2) to fiscal year 2009 waiver <br/>
<a id="pl.379.29"></a><var>379.29</var>allocations delayed due to unallotment; or (3) <br/>
<a id="pl.379.30"></a><var>379.30</var>to transfers authorized by the commissioner <br/>
<a id="pl.379.31"></a><var>379.31</var>from the personal care assistance program <br/>
<a id="pl.379.32"></a><var>379.32</var>of individuals having a home care rating <br/>
<a id="pl.379.33"></a><var>379.33</var>of "CS," "MT," or "HL." Priorities for the <br/>
<a id="pl.379.34"></a><var>379.34</var>allocation of funds must be for individuals <br/>
<a id="pl.380.1"></a><var>380.1</var>anticipated to be discharged from institutional <br/>
<a id="pl.380.2"></a><var>380.2</var>settings or who are at imminent risk of a <br/>
<a id="pl.380.3"></a><var>380.3</var>placement in an institutional setting.<br/>
<a id="pl.380.4"></a><var>380.4</var><b>Manage Growth in DD Waiver.</b> The <br/>
<a id="pl.380.5"></a><var>380.5</var>commissioner shall manage the growth in <br/>
<a id="pl.380.6"></a><var>380.6</var>the DD waiver by limiting the allocations <br/>
<a id="pl.380.7"></a><var>380.7</var>included in the February 2009 forecast to 15 <br/>
<a id="pl.380.8"></a><var>380.8</var>additional diversion allocations each month <br/>
<a id="pl.380.9"></a><var>380.9</var>for the calendar years that begin on January <br/>
<a id="pl.380.10"></a><var>380.10</var>1, 2010, and January 1, 2011. Additional <br/>
<a id="pl.380.11"></a><var>380.11</var>allocations must be made available for <br/>
<a id="pl.380.12"></a><var>380.12</var>transfers authorized by the commissioner <br/>
<a id="pl.380.13"></a><var>380.13</var>from the personal care program of individuals <br/>
<a id="pl.380.14"></a><var>380.14</var>having a home care rating of "CS," "MT," <br/>
<a id="pl.380.15"></a><var>380.15</var>or "HL."<br/>
<a id="pl.380.16"></a><var>380.16</var><b>Adjustment to Lead Agency Waiver </b><br/>
<a id="pl.380.17"></a><var>380.17</var><b>Allocations.</b> Prior to the availability of the <br/>
<a id="pl.380.18"></a><var>380.18</var>alternative license defined in Minnesota <br/>
<a id="pl.380.19"></a><var>380.19</var>Statutes, section 245A.11, subdivision 8, <br/>
<a id="pl.380.20"></a><var>380.20</var>the commissioner shall reduce lead agency <br/>
<a id="pl.380.21"></a><var>380.21</var>waiver allocations for the purposes of <br/>
<a id="pl.380.22"></a><var>380.22</var>implementing a moratorium on corporate <br/>
<a id="pl.380.23"></a><var>380.23</var>foster care.<br/>
<a id="pl.380.24"></a><var>380.24</var><b>Alternatives to Personal Care Assistance </b><br/>
<a id="pl.380.25"></a><var>380.25</var><b>Services.</b> Base level funding of $3,237,000 <br/>
<a id="pl.380.26"></a><var>380.26</var>in fiscal year 2012 and $4,856,000 in <br/>
<a id="pl.380.27"></a><var>380.27</var>fiscal year 2013 is to implement alternative <br/>
<a id="pl.380.28"></a><var>380.28</var>services to personal care assistance services <br/>
<a id="pl.380.29"></a><var>380.29</var>for persons with mental health and other <br/>
<a id="pl.380.30"></a><var>380.30</var>behavioral challenges who can benefit <br/>
<a id="pl.380.31"></a><var>380.31</var>from other services that more appropriately <br/>
<a id="pl.380.32"></a><var>380.32</var>meet their needs and assist them in living <br/>
<a id="pl.380.33"></a><var>380.33</var>independently in the community. These <br/>
<a id="pl.380.34"></a><var>380.34</var>services may include, but not be limited to, a <br/>
<a id="pl.380.35"></a><var>380.35</var>1915(i) state plan option.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.381.1"></a><var>381.1</var><br/>
</td>
<td align="left" colspan="3"><b>(e) Mental Health Grants</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.381.2"></a><var>381.2</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.381.3"></a><var>381.3</var><br/>
</td>
<td align="left">General<br/>
</td>
<td align="right">77,739,000<br/>
</td>
<td align="right">77,739,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.381.4"></a><var>381.4</var><br/>
</td>
<td align="left">Health Care Access<br/>
</td>
<td align="right">750,000<br/>
</td>
<td align="right">750,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.381.5"></a><var>381.5</var><br/>
</td>
<td align="left">Lottery Prize<br/>
</td>
<td align="right">1,508,000<br/>
</td>
<td align="right">1,508,000<br/>
</td>
</tr>
</table><a id="pl.381.6"></a><var>381.6</var><b>Funding Usage.</b> Up to 75 percent of a fiscal <br/>
<a id="pl.381.7"></a><var>381.7</var>year's appropriation for adult mental health <br/>
<a id="pl.381.8"></a><var>381.8</var>grants may be used to fund allocations in that <br/>
<a id="pl.381.9"></a><var>381.9</var>portion of the fiscal year ending December <br/>
<a id="pl.381.10"></a><var>381.10</var>31.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.381.11"></a><var>381.11</var><br/>
</td>
<td align="left" colspan="3"><b>(f) Deaf and Hard-of-Hearing Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">1,930,000<br/>
</td>
<td align="center"></td>
<td align="right">1,917,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.381.12"></a><var>381.12</var><br/>
</td>
<td align="left" colspan="3"><b>(g) Chemical Dependency Entitlement Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">111,303,000<br/>
</td>
<td align="center"></td>
<td align="right">122,822,000<br/>
</td>
</tr>
</table><a id="pl.381.13"></a><var>381.13</var><b>Payments for Substance Abuse Treatment.</b> <br/>
<a id="pl.381.14"></a><var>381.14</var>For services provided during fiscal years <br/>
<a id="pl.381.15"></a><var>381.15</var>2010 and 2011, county-negotiated rates and <br/>
<a id="pl.381.16"></a><var>381.16</var>provider claims to the consolidated chemical <br/>
<a id="pl.381.17"></a><var>381.17</var>dependency fund must not exceed rates <br/>
<a id="pl.381.18"></a><var>381.18</var>charged for these services on January 1, 2009. <br/>
<a id="pl.381.19"></a><var>381.19</var>For services provided in fiscal years 2012 <br/>
<a id="pl.381.20"></a><var>381.20</var>and 2013, statewide average rates under the <br/>
<a id="pl.381.21"></a><var>381.21</var>new rate methodology to be developed under <br/>
<a id="pl.381.22"></a><var>381.22</var>Minnesota Statutes, section 254B.12, must <br/>
<a id="pl.381.23"></a><var>381.23</var>not exceed the average rates charged for these <br/>
<a id="pl.381.24"></a><var>381.24</var>services on January 1, 2009, plus $3,787,000 <br/>
<a id="pl.381.25"></a><var>381.25</var>for fiscal year 2012 and $5,023,000 for fiscal <br/>
<a id="pl.381.26"></a><var>381.26</var>year 2013. Notwithstanding any provision <br/>
<a id="pl.381.27"></a><var>381.27</var>to the contrary in this article, this provision <br/>
<a id="pl.381.28"></a><var>381.28</var>expires on June 30, 2013.<br/>
<a id="pl.381.29"></a><var>381.29</var><b>Chemical Dependency Special Revenue </b><br/>
<a id="pl.381.30"></a><var>381.30</var><b>Account.</b> For fiscal year 2010, $750,000 <br/>
<a id="pl.381.31"></a><var>381.31</var>must be transferred from the consolidated <br/>
<a id="pl.382.1"></a><var>382.1</var>chemical dependency treatment fund <br/>
<a id="pl.382.2"></a><var>382.2</var>administrative account and deposited into the <br/>
<a id="pl.382.3"></a><var>382.3</var>general fund.<br/>
<a id="pl.382.4"></a><var>382.4</var><b>County CD Share of MA Costs for </b><br/>
<a id="pl.382.5"></a><var>382.5</var><b>ARRA Compliance.</b> Notwithstanding the <br/>
<a id="pl.382.6"></a><var>382.6</var>provisions of Minnesota Statutes, chapter <br/>
<a id="pl.382.7"></a><var>382.7</var>254B, for chemical dependency services <br/>
<a id="pl.382.8"></a><var>382.8</var>provided during the period July 1, 2009, <br/>
<a id="pl.382.9"></a><var>382.9</var>to December 31, 2010, and reimbursed by <br/>
<a id="pl.382.10"></a><var>382.10</var>medical assistance at the enhanced federal <br/>
<a id="pl.382.11"></a><var>382.11</var>matching rate provided under the American <br/>
<a id="pl.382.12"></a><var>382.12</var>Recovery and Reinvestment Act of 2009, the <br/>
<a id="pl.382.13"></a><var>382.13</var>county share is 30 percent of the nonfederal <br/>
<a id="pl.382.14"></a><var>382.14</var>share.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.382.15"></a><var>382.15</var><br/>
<a id="pl.382.16"></a><var>382.16</var><br/>
</td>
<td align="left" colspan="3"><b>(h) Chemical Dependency Nonentitlement </b><br/>
<b>Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">1,729,000<br/>
</td>
<td align="center"></td>
<td align="right">1,729,000<br/>
</td>
</tr>
</table><a id="pl.382.17"></a><var>382.17</var><b>Base Adjustment.</b> The general fund base is <br/>
<a id="pl.382.18"></a><var>382.18</var>decreased by $3,000 in each of fiscal years <br/>
<a id="pl.382.19"></a><var>382.19</var>2012 and 2013.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.382.20"></a><var>382.20</var><br/>
</td>
<td align="left" colspan="3"><b>(i) Other Continuing Care Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">18,272,000<br/>
</td>
<td align="center"></td>
<td align="right">13,139,000<br/>
</td>
</tr>
</table><a id="pl.382.21"></a><var>382.21</var><b>Base Adjustment.</b> The general fund base is <br/>
<a id="pl.382.22"></a><var>382.22</var>increased by $7,028,000 in fiscal year 2012 <br/>
<a id="pl.382.23"></a><var>382.23</var>and increased by $8,243,000 in fiscal year <br/>
<a id="pl.382.24"></a><var>382.24</var>2013.<br/>
<a id="pl.382.25"></a><var>382.25</var><b>Technology Grants.</b> $650,000 in fiscal <br/>
<a id="pl.382.26"></a><var>382.26</var>year 2010 and $1,000,000 in fiscal year <br/>
<a id="pl.382.27"></a><var>382.27</var>2011 are for technology grants, case <br/>
<a id="pl.382.28"></a><var>382.28</var>consultation, evaluation, and consumer <br/>
<a id="pl.382.29"></a><var>382.29</var>information grants related to developing and <br/>
<a id="pl.382.30"></a><var>382.30</var>supporting alternatives to shift-staff foster <br/>
<a id="pl.382.31"></a><var>382.31</var>care residential service models.<br/>
<a id="pl.382.32"></a><var>382.32</var><b>Other Continuing Care Grants; HIV </b><br/>
<a id="pl.382.33"></a><var>382.33</var><b>Grants.</b> Money appropriated for the HIV <br/>
<a id="pl.383.1"></a><var>383.1</var>drug and insurance grant program in fiscal <br/>
<a id="pl.383.2"></a><var>383.2</var>year 2010 may be used in either year of the <br/>
<a id="pl.383.3"></a><var>383.3</var>biennium.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.383.4"></a><var>383.4</var><br/>
</td>
<td align="left" colspan="3">Subd. 9.<b>Continuing Care Management</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.383.5"></a><var>383.5</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.383.6"></a><var>383.6</var><br/>
</td>
<td align="left">General<br/>
</td>
<td align="right">24,927,000<br/>
</td>
<td align="right">25,314,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.383.7"></a><var>383.7</var><br/>
<a id="pl.383.8"></a><var>383.8</var><br/>
</td>
<td align="left">State Government <br/>
Special Revenue<br/>
</td>
<td align="right">875,000<br/>
</td>
<td align="right">125,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.383.9"></a><var>383.9</var><br/>
</td>
<td align="left">Lottery Prize<br/>
</td>
<td align="right">157,000<br/>
</td>
<td align="right">157,000<br/>
</td>
</tr>
</table><a id="pl.383.10"></a><var>383.10</var><b>Quality Assurance Commission.</b> Effective <br/>
<a id="pl.383.11"></a><var>383.11</var>July 1, 2009, state funding for the quality <br/>
<a id="pl.383.12"></a><var>383.12</var>assurance commission under Minnesota <br/>
<a id="pl.383.13"></a><var>383.13</var>Statutes, section 256B.0951, is canceled.<br/>
<a id="pl.383.14"></a><var>383.14</var><b>County Maintenance of Effort.</b> $350,000 in <br/>
<a id="pl.383.15"></a><var>383.15</var>fiscal year 2010 is from the general fund for <br/>
<a id="pl.383.16"></a><var>383.16</var>the State-County Results Accountability and <br/>
<a id="pl.383.17"></a><var>383.17</var>Service Delivery Reform under Minnesota <br/>
<a id="pl.383.18"></a><var>383.18</var>Statutes, chapter 402A.<br/>
<a id="pl.383.19"></a><var>383.19</var><b>Base Adjustment. </b> The general fund base is <br/>
<a id="pl.383.20"></a><var>383.20</var>decreased $2,697,000 in fiscal year 2012 and <br/>
<a id="pl.383.21"></a><var>383.21</var>$2,791,000 in fiscal year 2013.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.383.22"></a><var>383.22</var><br/>
</td>
<td align="left" colspan="3">Subd. 10.<b>State-Operated Services</b><br/>
</td>
<td align="center"></td>
<td align="right">258,794,000<br/>
</td>
<td align="center"></td>
<td align="right">266,191,000<br/>
</td>
</tr>
</table><a id="pl.383.23"></a><var>383.23</var>The amounts that may be spent from the <br/>
<a id="pl.383.24"></a><var>383.24</var>appropriation for each purpose are as follows:<br/>
<a id="pl.383.25"></a><var>383.25</var><b>Transfer Authority Related to </b><br/>
<a id="pl.383.26"></a><var>383.26</var><b>State-Operated Services.</b> Money <br/>
<a id="pl.383.27"></a><var>383.27</var>appropriated to finance state-operated <br/>
<a id="pl.383.28"></a><var>383.28</var>services may be transferred between the <br/>
<a id="pl.383.29"></a><var>383.29</var>fiscal years of the biennium with the approval <br/>
<a id="pl.383.30"></a><var>383.30</var>of the commissioner of finance.<br/>
<a id="pl.383.31"></a><var>383.31</var><b>County Past Due Receivables.</b> The <br/>
<a id="pl.383.32"></a><var>383.32</var>commissioner is authorized to withhold <br/>
<a id="pl.384.1"></a><var>384.1</var>county federal administrative reimbursement <br/>
<a id="pl.384.2"></a><var>384.2</var>when the county of financial responsibility <br/>
<a id="pl.384.3"></a><var>384.3</var>for cost-of-care payments due the state <br/>
<a id="pl.384.4"></a><var>384.4</var>under Minnesota Statutes, section 246.54 <br/>
<a id="pl.384.5"></a><var>384.5</var>or 253B.045, is 90 days past due. The <br/>
<a id="pl.384.6"></a><var>384.6</var>commissioner shall deposit the withheld <br/>
<a id="pl.384.7"></a><var>384.7</var>federal administrative earnings for the county <br/>
<a id="pl.384.8"></a><var>384.8</var>into the general fund to settle the claims with <br/>
<a id="pl.384.9"></a><var>384.9</var>the county of financial responsibility. The <br/>
<a id="pl.384.10"></a><var>384.10</var>process for withholding funds is governed by <br/>
<a id="pl.384.11"></a><var>384.11</var>Minnesota Statutes, section 256.017.<br/>
<a id="pl.384.12"></a><var>384.12</var><b>Forecast and Census Data.</b> The <br/>
<a id="pl.384.13"></a><var>384.13</var>commissioner shall include census data and <br/>
<a id="pl.384.14"></a><var>384.14</var>fiscal projections for state-operated services <br/>
<a id="pl.384.15"></a><var>384.15</var>and Minnesota sex offender services with the <br/>
<a id="pl.384.16"></a><var>384.16</var>November and February budget forecasts. <br/>
<a id="pl.384.17"></a><var>384.17</var>Notwithstanding any contrary provision in <br/>
<a id="pl.384.18"></a><var>384.18</var>this article, this paragraph shall not expire.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.384.19"></a><var>384.19</var><br/>
</td>
<td align="left" colspan="3"><b>(a) Adult Mental Health Services</b><br/>
</td>
<td align="center"></td>
<td align="right">107,702,000<br/>
</td>
<td align="center"></td>
<td align="right">107,201,000<br/>
</td>
</tr>
</table><a id="pl.384.20"></a><var>384.20</var><b>Appropriation Limitation.</b> No part of <br/>
<a id="pl.384.21"></a><var>384.21</var>the appropriation in this article to the <br/>
<a id="pl.384.22"></a><var>384.22</var>commissioner for mental health treatment <br/>
<a id="pl.384.23"></a><var>384.23</var>services provided by state-operated services <br/>
<a id="pl.384.24"></a><var>384.24</var>shall be used for the Minnesota sex offender <br/>
<a id="pl.384.25"></a><var>384.25</var>program.<br/>
<a id="pl.384.26"></a><var>384.26</var><b>Community Behavioral Health Hospitals.</b> <br/>
<a id="pl.384.27"></a><var>384.27</var>Under Minnesota Statutes, section 246.51, <br/>
<a id="pl.384.28"></a><var>384.28</var>subdivision 1, a determination order for the <br/>
<a id="pl.384.29"></a><var>384.29</var>clients served in a community behavioral <br/>
<a id="pl.384.30"></a><var>384.30</var>health hospital operated by the commissioner <br/>
<a id="pl.384.31"></a><var>384.31</var>of human services is only required when <br/>
<a id="pl.384.32"></a><var>384.32</var>a client's third-party coverage has been <br/>
<a id="pl.384.33"></a><var>384.33</var>exhausted.<br/>
<a id="pl.385.1"></a><var>385.1</var><b>Base Adjustment.</b> The general fund base is <br/>
<a id="pl.385.2"></a><var>385.2</var>decreased by $500,000 for fiscal year 2012 <br/>
<a id="pl.385.3"></a><var>385.3</var>and by $500,000 for fiscal year 2013.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.385.4"></a><var>385.4</var><br/>
</td>
<td align="left" colspan="3"><b>(b) Minnesota Sex Offender Services</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.385.5"></a><var>385.5</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.385.6"></a><var>385.6</var><br/>
</td>
<td align="left">General <br/>
</td>
<td align="right">38,348,000<br/>
</td>
<td align="right">67,503,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.385.7"></a><var>385.7</var><br/>
</td>
<td align="left">Federal Fund<br/>
</td>
<td align="right">26,495,000<br/>
</td>
<td align="right">0<br/>
</td>
</tr>
</table><a id="pl.385.8"></a><var>385.8</var><b>Use of Federal Stabilization Funds.</b> Of <br/>
<a id="pl.385.9"></a><var>385.9</var>this appropriation, $26,495,000 in fiscal year <br/>
<a id="pl.385.10"></a><var>385.10</var>2010 is from the fiscal stabilization account <br/>
<a id="pl.385.11"></a><var>385.11</var>in the federal fund to the commissioner. <br/>
<a id="pl.385.12"></a><var>385.12</var>This appropriation must not be used for <br/>
<a id="pl.385.13"></a><var>385.13</var>any activity or service for which federal <br/>
<a id="pl.385.14"></a><var>385.14</var>reimbursement is claimed. This is a onetime <br/>
<a id="pl.385.15"></a><var>385.15</var>appropriation.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.385.16"></a><var>385.16</var><br/>
<a id="pl.385.17"></a><var>385.17</var><br/>
</td>
<td align="left" colspan="3"><b>(c) Minnesota Security Hospital and METO </b><br/>
<b>Services</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.385.18"></a><var>385.18</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.385.19"></a><var>385.19</var><br/>
</td>
<td align="left">General <br/>
</td>
<td align="right">230,000,000<br/>
</td>
<td align="right">83,735,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.385.20"></a><var>385.20</var><br/>
</td>
<td align="left">Federal Fund<br/>
</td>
<td align="right">83,504,000<br/>
</td>
<td align="right">0<br/>
</td>
</tr>
</table><a id="pl.385.21"></a><var>385.21</var><b>Minnesota Security Hospital. </b> For the <br/>
<a id="pl.385.22"></a><var>385.22</var>purposes of enhancing the safety of <br/>
<a id="pl.385.23"></a><var>385.23</var>the public, improving supervision, and <br/>
<a id="pl.385.24"></a><var>385.24</var>enhancing community-based mental health <br/>
<a id="pl.385.25"></a><var>385.25</var>treatment, state-operated services may <br/>
<a id="pl.385.26"></a><var>385.26</var>establish additional community capacity <br/>
<a id="pl.385.27"></a><var>385.27</var>for providing treatment and supervision <br/>
<a id="pl.385.28"></a><var>385.28</var>of clients who have been ordered into a <br/>
<a id="pl.385.29"></a><var>385.29</var>less restrictive alternative of care from the <br/>
<a id="pl.385.30"></a><var>385.30</var>state-operated services transitional services <br/>
<a id="pl.386.1"></a><var>386.1</var>program consistent with Minnesota Statutes, <br/>
<a id="pl.386.2"></a><var>386.2</var>section 246.014.<br/>
<a id="pl.386.3"></a><var>386.3</var><b>Use of Federal Stabilization Funds.</b> <br/>
<a id="pl.386.4"></a><var>386.4</var>$83,505,000 in fiscal year 2010 is <br/>
<a id="pl.386.5"></a><var>386.5</var>appropriated from the fiscal stabilization <br/>
<a id="pl.386.6"></a><var>386.6</var>account in the federal fund to the <br/>
<a id="pl.386.7"></a><var>386.7</var>commissioner. This appropriation must not <br/>
<a id="pl.386.8"></a><var>386.8</var>be used for any activity or service for which <br/>
<a id="pl.386.9"></a><var>386.9</var>federal reimbursement is claimed. This is a <br/>
<a id="pl.386.10"></a><var>386.10</var>onetime appropriation.<br/>
<br/>
<a id="bill.13.4.0"></a><table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.386.11"></a><var>386.11</var><br/>
</td>
<td align="left" colspan="3">Sec. 4. <b>COMMISSIONER OF HEALTH</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.386.12"></a><var>386.12</var><br/>
</td>
<td align="left" colspan="3">Subdivision 1.<b>Total Appropriation</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>165,717,000</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>161,841,000</b><br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="95px"/>
<col width="96px"/>
<tr>
<td><a id="pl.386.13"></a><var>386.13</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.386.14"></a><var>386.14</var><br/>
</td>
<td align="left"></td>
<td align="center">2010<br/>
</td>
<td align="center">2011<br/>
</td>
</tr>
<tr>
<td><a id="pl.386.15"></a><var>386.15</var><br/>
</td>
<td align="left">General<br/>
</td>
<td align="right">69,366,000<br/>
</td>
<td align="right">63,884,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.386.16"></a><var>386.16</var><br/>
<a id="pl.386.17"></a><var>386.17</var><br/>
</td>
<td align="left">State Government <br/>
Special Revenue<br/>
</td>
<td align="right">45,415,000<br/>
</td>
<td align="right">45,415,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.386.18"></a><var>386.18</var><br/>
</td>
<td align="left">Health Care Access<br/>
</td>
<td align="right">39,203,000<br/>
</td>
<td align="right">40,809,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.386.19"></a><var>386.19</var><br/>
</td>
<td align="left">Federal TANF<br/>
</td>
<td align="right">11,733,000<br/>
</td>
<td align="right">11,733,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.386.20"></a><var>386.20</var><br/>
<a id="pl.386.21"></a><var>386.21</var><br/>
</td>
<td align="left" colspan="3">Subd. 2.<b>Community and Family Health </b><br/>
<b>Promotion</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="95px"/>
<col width="96px"/>
<tr>
<td><a id="pl.386.22"></a><var>386.22</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.386.23"></a><var>386.23</var><br/>
</td>
<td align="left">General<br/>
</td>
<td align="right">44,814,000<br/>
</td>
<td align="right">39,671,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.386.24"></a><var>386.24</var><br/>
<a id="pl.386.25"></a><var>386.25</var><br/>
</td>
<td align="left">State Government <br/>
Special Revenue<br/>
</td>
<td align="right">1,033,000<br/>
</td>
<td align="right"> 1,304,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.386.26"></a><var>386.26</var><br/>
</td>
<td align="left">Federal TANF<br/>
</td>
<td align="right">11,733,000<br/>
</td>
<td align="right">11,733,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.386.27"></a><var>386.27</var><br/>
</td>
<td align="left">Health Care Access<br/>
</td>
<td align="right">21,642,000<br/>
</td>
<td align="right">28,719,000<br/>
</td>
</tr>
</table><a id="pl.386.28"></a><var>386.28</var><b>Newborn Screening Fee.</b> Of the general <br/>
<a id="pl.386.29"></a><var>386.29</var>fund appropriation, $300,000 in fiscal year <br/>
<a id="pl.386.30"></a><var>386.30</var>2011 is to the commissioner for the purpose <br/>
<a id="pl.387.1"></a><var>387.1</var>of providing support services to families as <br/>
<a id="pl.387.2"></a><var>387.2</var>required under Minnesota Statutes, section <br/>
<a id="pl.387.3"></a><var>387.3</var>144.966, subdivision 3a. $74,000 of this <br/>
<a id="pl.387.4"></a><var>387.4</var>appropriation in fiscal year 2011 and $51,000 <br/>
<a id="pl.387.5"></a><var>387.5</var>of this appropriation in subsequent fiscal <br/>
<a id="pl.387.6"></a><var>387.6</var>years may be used by the commissioner <br/>
<a id="pl.387.7"></a><var>387.7</var>for administrative costs associated with <br/>
<a id="pl.387.8"></a><var>387.8</var>increasing the fee, contract administration, <br/>
<a id="pl.387.9"></a><var>387.9</var>program oversight, and provide follow-up to <br/>
<a id="pl.387.10"></a><var>387.10</var>families who need assistance beyond those <br/>
<a id="pl.387.11"></a><var>387.11</var>available through the contractor.<br/>
<a id="pl.387.12"></a><var>387.12</var><b>Support Services for Families With </b><br/>
<a id="pl.387.13"></a><var>387.13</var><b>Children Who are Deaf or Have Hearing </b><br/>
<a id="pl.387.14"></a><var>387.14</var><b>Loss.</b> Of the general fund amount, $16,000 <br/>
<a id="pl.387.15"></a><var>387.15</var>in fiscal year 2010 and $284,000 in fiscal <br/>
<a id="pl.387.16"></a><var>387.16</var>year 2011 is for support services to families <br/>
<a id="pl.387.17"></a><var>387.17</var>with children who are deaf or have hearing <br/>
<a id="pl.387.18"></a><var>387.18</var>loss. Of this amount, in fiscal year 2011, <br/>
<a id="pl.387.19"></a><var>387.19</var>$223,000 is for grants and the balance is for <br/>
<a id="pl.387.20"></a><var>387.20</var>administrative costs. Base funding in fiscal <br/>
<a id="pl.387.21"></a><var>387.21</var>years 2012 and 2013 is $300,000 each year. <br/>
<a id="pl.387.22"></a><var>387.22</var>Of this amount, $241,000 each year is for <br/>
<a id="pl.387.23"></a><var>387.23</var>grants and the balance is for administrative <br/>
<a id="pl.387.24"></a><var>387.24</var>costs.<br/>
<a id="pl.387.25"></a><var>387.25</var><b>Funding Usage.</b> Up to 75 percent of the <br/>
<a id="pl.387.26"></a><var>387.26</var>fiscal year 2012 appropriation for local public <br/>
<a id="pl.387.27"></a><var>387.27</var>health grants may be used to fund calendar <br/>
<a id="pl.387.28"></a><var>387.28</var>year 2011 allocations for this program. The <br/>
<a id="pl.387.29"></a><var>387.29</var>general fund reduction of $5,193,000 in <br/>
<a id="pl.387.30"></a><var>387.30</var>fiscal year 2011 for local public health grants <br/>
<a id="pl.387.31"></a><var>387.31</var>is onetime and the base funding for local <br/>
<a id="pl.387.32"></a><var>387.32</var>public health grants for fiscal year 2012 is <br/>
<a id="pl.387.33"></a><var>387.33</var>increased by $5,193,000.<br/>
<a id="pl.387.34"></a><var>387.34</var><b>Colorectal Screening.</b> $88,000 in fiscal year <br/>
<a id="pl.387.35"></a><var>387.35</var>2010 and $62,000 in fiscal year 2011 are <br/>
<a id="pl.388.1"></a><var>388.1</var>for grants to the Hennepin County Medical <br/>
<a id="pl.388.2"></a><var>388.2</var>Center and MeritCare Bemidji for colorectal <br/>
<a id="pl.388.3"></a><var>388.3</var>screening demonstration projects.<br/>
<a id="pl.388.4"></a><var>388.4</var><b>Feasibility Pilot Project for Cancer </b><br/>
<a id="pl.388.5"></a><var>388.5</var><b>Surveillance.</b> Of the general fund <br/>
<a id="pl.388.6"></a><var>388.6</var>appropriation for fiscal year 2010, $100,000 <br/>
<a id="pl.388.7"></a><var>388.7</var>is to the commissioner to provide grant <br/>
<a id="pl.388.8"></a><var>388.8</var>funding to cover the cost of one full-time <br/>
<a id="pl.388.9"></a><var>388.9</var>equivalent position at the Hennepin County <br/>
<a id="pl.388.10"></a><var>388.10</var>Medical Center to carry out the feasibility <br/>
<a id="pl.388.11"></a><var>388.11</var>pilot project.<br/>
<a id="pl.388.12"></a><var>388.12</var><b>American Recovery and Reinvestment </b><br/>
<a id="pl.388.13"></a><var>388.13</var><b>Act Funds.</b> Federal funds received by the <br/>
<a id="pl.388.14"></a><var>388.14</var>commissioner for WIC program management <br/>
<a id="pl.388.15"></a><var>388.15</var>information systems from the American <br/>
<a id="pl.388.16"></a><var>388.16</var>Recovery and Reinvestment Act of 2009, <br/>
<a id="pl.388.17"></a><var>388.17</var>Public Law 111-5, are appropriated to the <br/>
<a id="pl.388.18"></a><var>388.18</var>commissioner for the purpose of the grant.<br/>
<a id="pl.388.19"></a><var>388.19</var><b>TANF Appropriations.</b> (1) $1,156,000 of <br/>
<a id="pl.388.20"></a><var>388.20</var>the TANF funds are appropriated each year to <br/>
<a id="pl.388.21"></a><var>388.21</var>the commissioner for family planning grants <br/>
<a id="pl.388.22"></a><var>388.22</var>under Minnesota Statutes, section 145.925.<br/>
<a id="pl.388.23"></a><var>388.23</var>(2) $3,579,000 of the TANF funds are <br/>
<a id="pl.388.24"></a><var>388.24</var>appropriated each year to the commissioner <br/>
<a id="pl.388.25"></a><var>388.25</var>for home visiting and nutritional services <br/>
<a id="pl.388.26"></a><var>388.26</var>listed under Minnesota Statutes, section <br/>
<a id="pl.388.27"></a><var>388.27</var>145.882, subdivision 7, clauses (6) and (7). <br/>
<a id="pl.388.28"></a><var>388.28</var>Funds must be distributed to community <br/>
<a id="pl.388.29"></a><var>388.29</var>health boards according to Minnesota <br/>
<a id="pl.388.30"></a><var>388.30</var>Statutes, section 145A.131, subdivision 1.<br/>
<a id="pl.388.31"></a><var>388.31</var>(3) $2,000,000 of the TANF funds are <br/>
<a id="pl.388.32"></a><var>388.32</var>appropriated each year to the commissioner <br/>
<a id="pl.388.33"></a><var>388.33</var>for decreasing racial and ethnic disparities <br/>
<a id="pl.388.34"></a><var>388.34</var>in infant mortality rates under Minnesota <br/>
<a id="pl.388.35"></a><var>388.35</var>Statutes, section 145.928, subdivision 7.<br/>
<a id="pl.389.1"></a><var>389.1</var>(4) $4,998,000 of the TANF funds are <br/>
<a id="pl.389.2"></a><var>389.2</var>appropriated each year to the commissioner <br/>
<a id="pl.389.3"></a><var>389.3</var>for the family home visiting grant program <br/>
<a id="pl.389.4"></a><var>389.4</var>according to Minnesota Statutes, section <br/>
<a id="pl.389.5"></a><var>389.5</var>145A.17. $4,000,000 of the funding must <br/>
<a id="pl.389.6"></a><var>389.6</var>be distributed to community health boards <br/>
<a id="pl.389.7"></a><var>389.7</var>according to Minnesota Statutes, section <br/>
<a id="pl.389.8"></a><var>389.8</var>145A.131, subdivision 1. $998,000 of <br/>
<a id="pl.389.9"></a><var>389.9</var>the funding must be distributed to tribal <br/>
<a id="pl.389.10"></a><var>389.10</var>governments based on Minnesota Statutes, <br/>
<a id="pl.389.11"></a><var>389.11</var>section 145A.14, subdivision 2a. The <br/>
<a id="pl.389.12"></a><var>389.12</var>commissioner may use five percent of <br/>
<a id="pl.389.13"></a><var>389.13</var>the funds appropriated each fiscal year to <br/>
<a id="pl.389.14"></a><var>389.14</var>conduct the ongoing evaluations required <br/>
<a id="pl.389.15"></a><var>389.15</var>under Minnesota Statutes, section 145A.17, <br/>
<a id="pl.389.16"></a><var>389.16</var>subdivision 7, and may use ten percent of <br/>
<a id="pl.389.17"></a><var>389.17</var>the funds appropriated each fiscal year to <br/>
<a id="pl.389.18"></a><var>389.18</var>provide training and technical assistance as <br/>
<a id="pl.389.19"></a><var>389.19</var>required under Minnesota Statutes, section <br/>
<a id="pl.389.20"></a><var>389.20</var>145A.17, subdivisions 4 and 5.<br/>
<a id="pl.389.21"></a><var>389.21</var><b>Base Adjustment.</b> The general fund base <br/>
<a id="pl.389.22"></a><var>389.22</var>is increased by $10,302,000 for fiscal year <br/>
<a id="pl.389.23"></a><var>389.23</var>2012 and increased by $5,109,000 for fiscal <br/>
<a id="pl.389.24"></a><var>389.24</var>year 2013. The health care access fund base <br/>
<a id="pl.389.25"></a><var>389.25</var>is reduced to $1,719,000 for both fiscal years <br/>
<a id="pl.389.26"></a><var>389.26</var>2012 and 2013.<br/>
<a id="pl.389.27"></a><var>389.27</var><b>TANF Carryforward.</b> Any unexpended <br/>
<a id="pl.389.28"></a><var>389.28</var>balance of the TANF appropriation in the <br/>
<a id="pl.389.29"></a><var>389.29</var>first year of the biennium does not cancel but <br/>
<a id="pl.389.30"></a><var>389.30</var>is available for the second year.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.389.31"></a><var>389.31</var><br/>
</td>
<td align="left" colspan="3">Subd. 3.<b>Policy Quality and Compliance</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.389.32"></a><var>389.32</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.389.33"></a><var>389.33</var><br/>
</td>
<td align="left">General<br/>
</td>
<td align="right">7,491,000<br/>
</td>
<td align="right">7,242,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.390.1"></a><var>390.1</var><br/>
<a id="pl.390.2"></a><var>390.2</var><br/>
</td>
<td align="left">State Government <br/>
Special Revenue<br/>
</td>
<td align="right">14,173,000<br/>
</td>
<td align="right">14,173,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.390.3"></a><var>390.3</var><br/>
</td>
<td align="left">Health Care Access<br/>
</td>
<td align="right">17,561,000<br/>
</td>
<td align="right">12,090,000<br/>
</td>
</tr>
</table><a id="pl.390.4"></a><var>390.4</var><b>Community-Based Health Care </b><br/>
<a id="pl.390.5"></a><var>390.5</var><b>Demonstration Project.</b> Notwithstanding <br/>
<a id="pl.390.6"></a><var>390.6</var>the provisions of Laws 2007, chapter 147, <br/>
<a id="pl.390.7"></a><var>390.7</var>article 19, section 3, subdivision 6, paragraph <br/>
<a id="pl.390.8"></a><var>390.8</var>(e), base level funding to the commissioner <br/>
<a id="pl.390.9"></a><var>390.9</var>for the demonstration project grant described <br/>
<a id="pl.390.10"></a><var>390.10</var>in Minnesota Statutes, section 62Q.80, <br/>
<a id="pl.390.11"></a><var>390.11</var>subdivision 1a, shall be zero for fiscal years <br/>
<a id="pl.390.12"></a><var>390.12</var>2011 and 2012.<br/>
<a id="pl.390.13"></a><var>390.13</var><b>Medical Education and Research Cost </b><br/>
<a id="pl.390.14"></a><var>390.14</var><b>Federal Compliance.</b> Notwithstanding <br/>
<a id="pl.390.15"></a><var>390.15</var>Laws 2008, chapter 363, article 18, section <br/>
<a id="pl.390.16"></a><var>390.16</var>4, subdivision 3, the base level funding <br/>
<a id="pl.390.17"></a><var>390.17</var>for the commissioner to distribute to the <br/>
<a id="pl.390.18"></a><var>390.18</var>Mayo Clinic for transitional funding while <br/>
<a id="pl.390.19"></a><var>390.19</var>federal compliance changes are made to the <br/>
<a id="pl.390.20"></a><var>390.20</var>medical education and research cost funding <br/>
<a id="pl.390.21"></a><var>390.21</var>distribution formula shall be $0 for fiscal <br/>
<a id="pl.390.22"></a><var>390.22</var>years 2010 and 2011.<br/>
<a id="pl.390.23"></a><var>390.23</var><b>Autism Clinical Research.</b> The <br/>
<a id="pl.390.24"></a><var>390.24</var>commissioner, in partnership with a <br/>
<a id="pl.390.25"></a><var>390.25</var>Minnesota research institution, shall apply <br/>
<a id="pl.390.26"></a><var>390.26</var>for funds available for research grants under <br/>
<a id="pl.390.27"></a><var>390.27</var>the American Recovery and Reinvestment <br/>
<a id="pl.390.28"></a><var>390.28</var>Act (ARRA) of 2009 in order to expand <br/>
<a id="pl.390.29"></a><var>390.29</var>research and treatment of autism spectrum <br/>
<a id="pl.390.30"></a><var>390.30</var>disorders.<br/>
<a id="pl.390.31"></a><var>390.31</var><b>Health Information Technology.</b> (a) Of <br/>
<a id="pl.390.32"></a><var>390.32</var>the health care access fund appropriation, <br/>
<a id="pl.390.33"></a><var>390.33</var>$4,000,000 is to fund the revolving loan <br/>
<a id="pl.390.34"></a><var>390.34</var>account under Minnesota Statutes, section <br/>
<a id="pl.391.1"></a><var>391.1</var>62J.496. This appropriation must not be <br/>
<a id="pl.391.2"></a><var>391.2</var>expended unless it is matched with federal <br/>
<a id="pl.391.3"></a><var>391.3</var>funding under the federal Health Information <br/>
<a id="pl.391.4"></a><var>391.4</var>Technology for Economic and Clinical <br/>
<a id="pl.391.5"></a><var>391.5</var>Health (HITECH) Act. This appropriation <br/>
<a id="pl.391.6"></a><var>391.6</var>must not be included in the agency's base <br/>
<a id="pl.391.7"></a><var>391.7</var>budget for the fiscal year beginning July 1, <br/>
<a id="pl.391.8"></a><var>391.8</var>2012.<br/>
<a id="pl.391.9"></a><var>391.9</var>(b) On or before June 30, 2013, $1,200,000 <br/>
<a id="pl.391.10"></a><var>391.10</var>shall be transferred from the revolving loan <br/>
<a id="pl.391.11"></a><var>391.11</var>account under Minnesota Statutes, section <br/>
<a id="pl.391.12"></a><var>391.12</var>62J.496, to the health care access fund. <br/>
<a id="pl.391.13"></a><var>391.13</var>This is a onetime transfer and must not be <br/>
<a id="pl.391.14"></a><var>391.14</var>included in the agency's base budget for the <br/>
<a id="pl.391.15"></a><var>391.15</var>fiscal year beginning July 1, 2014.<br/>
<a id="pl.391.16"></a><var>391.16</var><b>Base Adjustment.</b> The general fund <br/>
<a id="pl.391.17"></a><var>391.17</var>base is $8,243,000 in fiscal year 2012 and <br/>
<a id="pl.391.18"></a><var>391.18</var>$8,243,000 in fiscal year 2013. The health <br/>
<a id="pl.391.19"></a><var>391.19</var>care access fund base is $10,950,000 in fiscal <br/>
<a id="pl.391.20"></a><var>391.20</var>year 2012 and $6,816,000 in fiscal year 2013.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.391.21"></a><var>391.21</var><br/>
</td>
<td align="left" colspan="3">Subd. 4.<b>Health Protection</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.391.22"></a><var>391.22</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.391.23"></a><var>391.23</var><br/>
</td>
<td align="left">General<br/>
</td>
<td align="right">9,871,000<br/>
</td>
<td align="right">9,780,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.391.24"></a><var>391.24</var><br/>
<a id="pl.391.25"></a><var>391.25</var><br/>
</td>
<td align="left">State Government <br/>
Special Revenue<br/>
</td>
<td align="right">30,209,000<br/>
</td>
<td align="right">30,209,000<br/>
</td>
</tr>
</table><a id="pl.391.26"></a><var>391.26</var><b>Base Adjustment.</b> The general fund base is <br/>
<a id="pl.391.27"></a><var>391.27</var>reduced by $50,000 in each of fiscal years <br/>
<a id="pl.391.28"></a><var>391.28</var>2012 and 2013.<br/>
<a id="pl.391.29"></a><var>391.29</var><b>Health Protection Appropriations.</b> (a) <br/>
<a id="pl.391.30"></a><var>391.30</var>$163,000 each year is for the lead abatement <br/>
<a id="pl.391.31"></a><var>391.31</var>grant program. <br/>
<a id="pl.391.32"></a><var>391.32</var>(b) $100,000 each year is for emergency <br/>
<a id="pl.391.33"></a><var>391.33</var>preparedness and response activities. <br/>
<a id="pl.392.1"></a><var>392.1</var>(c) $50,000 each year is for tuberculosis <br/>
<a id="pl.392.2"></a><var>392.2</var>prevention and control. This is a onetime <br/>
<a id="pl.392.3"></a><var>392.3</var>appropriation.<br/>
<a id="pl.392.4"></a><var>392.4</var><b>American Recovery and Reinvestment </b><br/>
<a id="pl.392.5"></a><var>392.5</var><b>Act Funds.</b> Federal funds received <br/>
<a id="pl.392.6"></a><var>392.6</var>by the commissioner for immunization <br/>
<a id="pl.392.7"></a><var>392.7</var>operations from the American Recovery <br/>
<a id="pl.392.8"></a><var>392.8</var>and Reinvestment Act of 2009, Public Law <br/>
<a id="pl.392.9"></a><var>392.9</var>111-5, are appropriated to the commissioner <br/>
<a id="pl.392.10"></a><var>392.10</var>for the purposes of the grant.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.392.11"></a><var>392.11</var><br/>
</td>
<td align="left" colspan="3">Subd. 5.<b>Administrative Support Services</b><br/>
</td>
<td align="center"></td>
<td align="right">7,190,000<br/>
</td>
<td align="center"></td>
<td align="right">7,190,000<br/>
</td>
</tr>
</table><br/>
<a id="bill.13.5.0"></a><table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.392.12"></a><var>392.12</var><br/>
</td>
<td align="left" colspan="3">Sec. 5. <b>HEALTH-RELATED BOARDS</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.392.13"></a><var>392.13</var><br/>
</td>
<td align="left" colspan="3">Subdivision 1.<b>Total Appropriation </b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>15,017,000</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>14,831,000</b><br/>
</td>
</tr>
</table><a id="pl.392.14"></a><var>392.14</var>This appropriation is from the state <br/>
<a id="pl.392.15"></a><var>392.15</var>government special revenue fund.<br/>
<a id="pl.392.16"></a><var>392.16</var><b>Transfer.</b> In fiscal year 2010, $6,000,000 <br/>
<a id="pl.392.17"></a><var>392.17</var>shall be transferred from the state government <br/>
<a id="pl.392.18"></a><var>392.18</var>special revenue fund to the general fund. <br/>
<a id="pl.392.19"></a><var>392.19</var>The amounts that may be spent for each <br/>
<a id="pl.392.20"></a><var>392.20</var>purpose are specified in the following <br/>
<a id="pl.392.21"></a><var>392.21</var>subdivisions.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.392.22"></a><var>392.22</var><br/>
</td>
<td align="left" colspan="3" valign="bottom">Subd. 2.<b>Board of Chiropractic Examiners</b><br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom">447,000<br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom">447,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.392.23"></a><var>392.23</var><br/>
</td>
<td align="left" colspan="3" valign="bottom">Subd. 3.<b>Board of Dentistry</b><br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom">1,009,000<br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom">1,009,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.392.24"></a><var>392.24</var><br/>
<a id="pl.392.25"></a><var>392.25</var><br/>
</td>
<td align="left" colspan="3" valign="bottom">Subd. 4.<b>Board of Dietetic and Nutrition </b><br/>
<b>Practice</b><br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom">105,000<br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom">105,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.392.26"></a><var>392.26</var><br/>
<a id="pl.392.27"></a><var>392.27</var><br/>
</td>
<td align="left" colspan="3" valign="bottom">Subd. 5.<b>Board of Marriage and Family </b><br/>
<b>Therapy</b><br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom">137,000<br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom">137,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.392.28"></a><var>392.28</var><br/>
</td>
<td align="left" colspan="3" valign="bottom">Subd. 6.<b>Board of Medical Practice</b><br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom">3,674,000<br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom">3,674,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.392.29"></a><var>392.29</var><br/>
</td>
<td align="left" colspan="3" valign="bottom">Subd. 7.<b>Board of Nursing</b><br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom">4,217,000<br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom">4,219,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.393.1"></a><var>393.1</var><br/>
<a id="pl.393.2"></a><var>393.2</var><br/>
</td>
<td align="left" colspan="3" valign="bottom">Subd. 8.<b>Board of Nursing Home </b><br/>
<b>Administrators</b><br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom">1,146,000<br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom">958,000<br/>
</td>
</tr>
</table><a id="pl.393.3"></a><var>393.3</var><b>Administrative Services Unit - Operating </b><br/>
<a id="pl.393.4"></a><var>393.4</var><b>Costs.</b> Of this appropriation, $524,000 <br/>
<a id="pl.393.5"></a><var>393.5</var>in fiscal year 2010 and $526,000 in <br/>
<a id="pl.393.6"></a><var>393.6</var>fiscal year 2011 are for operating costs <br/>
<a id="pl.393.7"></a><var>393.7</var>of the administrative services unit. The <br/>
<a id="pl.393.8"></a><var>393.8</var>administrative services unit may receive <br/>
<a id="pl.393.9"></a><var>393.9</var>and expend reimbursements for services <br/>
<a id="pl.393.10"></a><var>393.10</var>performed by other agencies.<br/>
<a id="pl.393.11"></a><var>393.11</var><b>Administrative Services Unit - Retirement </b><br/>
<a id="pl.393.12"></a><var>393.12</var><b>Costs.</b> Of this appropriation in fiscal year <br/>
<a id="pl.393.13"></a><var>393.13</var>2010, $201,000 is for onetime retirement <br/>
<a id="pl.393.14"></a><var>393.14</var>costs in the health-related boards. This <br/>
<a id="pl.393.15"></a><var>393.15</var>funding may be transferred to the health <br/>
<a id="pl.393.16"></a><var>393.16</var>boards incurring those costs for their <br/>
<a id="pl.393.17"></a><var>393.17</var>payment. These funds are available either <br/>
<a id="pl.393.18"></a><var>393.18</var>year of the biennium.<br/>
<a id="pl.393.19"></a><var>393.19</var><b>Administrative Services Unit - Volunteer </b><br/>
<a id="pl.393.20"></a><var>393.20</var><b>Health Care Provider Program.</b> Of this <br/>
<a id="pl.393.21"></a><var>393.21</var>appropriation, $79,000 in fiscal year 2010 <br/>
<a id="pl.393.22"></a><var>393.22</var>and $89,000 in fiscal year 2011 are to pay <br/>
<a id="pl.393.23"></a><var>393.23</var>for medical professional liability coverage <br/>
<a id="pl.393.24"></a><var>393.24</var>required under Minnesota Statutes, section <br/>
<a id="pl.393.25"></a><var>393.25</var>214.40.<br/>
<a id="pl.393.26"></a><var>393.26</var><b>Administrative Services Unit - Contested </b><br/>
<a id="pl.393.27"></a><var>393.27</var><b>Cases and Other Legal Proceedings.</b> Of <br/>
<a id="pl.393.28"></a><var>393.28</var>this appropriation, $200,000 in fiscal year <br/>
<a id="pl.393.29"></a><var>393.29</var>2010 and $200,000 in fiscal year 2011 <br/>
<a id="pl.393.30"></a><var>393.30</var>are for costs of contested case hearings <br/>
<a id="pl.393.31"></a><var>393.31</var>and other unanticipated costs of legal <br/>
<a id="pl.393.32"></a><var>393.32</var>proceedings involving health-related <br/>
<a id="pl.393.33"></a><var>393.33</var>boards funded under this section. Upon <br/>
<a id="pl.393.34"></a><var>393.34</var>certification of a health-related board to the <br/>
<a id="pl.394.1"></a><var>394.1</var>administrative services unit that the costs <br/>
<a id="pl.394.2"></a><var>394.2</var>will be incurred and that there is insufficient <br/>
<a id="pl.394.3"></a><var>394.3</var>money available to pay for the costs out of <br/>
<a id="pl.394.4"></a><var>394.4</var>money currently available to that board, the <br/>
<a id="pl.394.5"></a><var>394.5</var>administrative services unit is authorized <br/>
<a id="pl.394.6"></a><var>394.6</var>to transfer money from this appropriation <br/>
<a id="pl.394.7"></a><var>394.7</var>to the board for payment of those costs <br/>
<a id="pl.394.8"></a><var>394.8</var>with the approval of the commissioner of <br/>
<a id="pl.394.9"></a><var>394.9</var>finance. This appropriation does not cancel. <br/>
<a id="pl.394.10"></a><var>394.10</var>Any unencumbered and unspent balances <br/>
<a id="pl.394.11"></a><var>394.11</var>remain available for these expenditures in <br/>
<a id="pl.394.12"></a><var>394.12</var>subsequent fiscal years.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.394.13"></a><var>394.13</var><br/>
</td>
<td align="left" colspan="3" valign="bottom">Subd. 9.<b>Board of Optometry</b><br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom">101,000<br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom">101,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.394.14"></a><var>394.14</var><br/>
</td>
<td align="left" colspan="3" valign="bottom">Subd. 10.<b>Board of Pharmacy</b><br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom">1,413,000<br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom">1,413,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.394.15"></a><var>394.15</var><br/>
</td>
<td align="left" colspan="3" valign="bottom">Subd. 11.<b>Board of Physical Therapy</b><br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom">295,000<br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom">295,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.394.16"></a><var>394.16</var><br/>
</td>
<td align="left" colspan="3" valign="bottom">Subd. 12.<b>Board of Podiatry</b><br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom">56,000<br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom">56,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.394.17"></a><var>394.17</var><br/>
</td>
<td align="left" colspan="3" valign="bottom">Subd. 13.<b>Board of Psychology</b><br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom">806,000<br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom">806,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.394.18"></a><var>394.18</var><br/>
</td>
<td align="left" colspan="3" valign="bottom">Subd. 14.<b>Board of Social Work</b><br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom">1,022,000<br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom">1,022,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.394.19"></a><var>394.19</var><br/>
</td>
<td align="left" colspan="3" valign="bottom">Subd. 15.<b>Board of Veterinary Medicine</b><br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom">195,000<br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom">195,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.394.20"></a><var>394.20</var><br/>
<a id="pl.394.21"></a><var>394.21</var><br/>
</td>
<td align="left" colspan="3" valign="bottom">Subd. 16.<b>Board of Behavioral Health and </b><br/>
<b>Therapy</b><br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom">394,000<br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom">394,000<br/>
</td>
</tr>
</table><br/>
<a id="bill.13.6.0"></a><table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.394.22"></a><var>394.22</var><br/>
<a id="pl.394.23"></a><var>394.23</var><br/>
</td>
<td align="left" colspan="3">Sec. 6. <b>EMERGENCY MEDICAL SERVICES </b><br/>
<b>BOARD</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b> 4,378,000</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>3,828,000</b><br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="93px"/>
<col width="96px"/>
<tr>
<td><a id="pl.394.24"></a><var>394.24</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.394.25"></a><var>394.25</var><br/>
</td>
<td align="left"></td>
<td align="right">2010<br/>
</td>
<td align="right">2011<br/>
</td>
</tr>
<tr>
<td><a id="pl.394.26"></a><var>394.26</var><br/>
</td>
<td align="left">General<br/>
</td>
<td align="right"> 3,674,000<br/>
</td>
<td align="right">3,124,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.394.27"></a><var>394.27</var><br/>
<a id="pl.394.28"></a><var>394.28</var><br/>
</td>
<td align="left">State Government <br/>
Special Revenue<br/>
</td>
<td align="right">704,000<br/>
</td>
<td align="right">704 ,000<br/>
</td>
</tr>
</table><a id="pl.394.29"></a><var>394.29</var><b>Longevity Award and Incentive Program.</b> <br/>
<a id="pl.394.30"></a><var>394.30</var>Of the general fund appropriation, $700,000 <br/>
<a id="pl.395.1"></a><var>395.1</var>in fiscal year 2010 and $700,000 in fiscal year <br/>
<a id="pl.395.2"></a><var>395.2</var>2011 are to the board for the Cooper/Sams <br/>
<a id="pl.395.3"></a><var>395.3</var>volunteer ambulance program, under <br/>
<a id="pl.395.4"></a><var>395.4</var>Minnesota Statutes, section 144E.40.<br/>
<a id="pl.395.5"></a><var>395.5</var><b>Transfer.</b> In fiscal year 2010, $6,182,000 <br/>
<a id="pl.395.6"></a><var>395.6</var>is transferred from the Cooper/Sams <br/>
<a id="pl.395.7"></a><var>395.7</var>volunteer ambulance trust, established under <br/>
<a id="pl.395.8"></a><var>395.8</var>Minnesota Statutes, section 144E.42, to the <br/>
<a id="pl.395.9"></a><var>395.9</var>general fund.<br/>
<a id="pl.395.10"></a><var>395.10</var><b>Health Professional Services Program.</b> <br/>
<a id="pl.395.11"></a><var>395.11</var>$704,000 in fiscal year 2010 and $704,000 in <br/>
<a id="pl.395.12"></a><var>395.12</var>fiscal year 2011 from the state government <br/>
<a id="pl.395.13"></a><var>395.13</var>special revenue fund are for the health <br/>
<a id="pl.395.14"></a><var>395.14</var>professional services program.<br/>
<a id="pl.395.15"></a><var>395.15</var><b>Comprehensive Advanced Life-Support </b><br/>
<a id="pl.395.16"></a><var>395.16</var><b>Educational (CALS) Program.</b> $100,000 in <br/>
<a id="pl.395.17"></a><var>395.17</var>the first year from the Cooper/Sams volunteer <br/>
<a id="pl.395.18"></a><var>395.18</var>ambulance trust is for the comprehensive <br/>
<a id="pl.395.19"></a><var>395.19</var>advanced life-support educational (CALS) <br/>
<a id="pl.395.20"></a><var>395.20</var>program established under Minnesota <br/>
<a id="pl.395.21"></a><var>395.21</var>Statutes, section 144E.37. This appropriation <br/>
<a id="pl.395.22"></a><var>395.22</var>is to extend availability and affordability <br/>
<a id="pl.395.23"></a><var>395.23</var>of the CALS program for rural emergency <br/>
<a id="pl.395.24"></a><var>395.24</var>medical personnel and to assist hospital staff <br/>
<a id="pl.395.25"></a><var>395.25</var>in attaining the credentialing levels necessary <br/>
<a id="pl.395.26"></a><var>395.26</var>for implementation of the statewide trauma <br/>
<a id="pl.395.27"></a><var>395.27</var>system.<br/>
<br/>
<a id="bill.13.7.0"></a><table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.395.28"></a><var>395.28</var><br/>
<a id="pl.395.29"></a><var>395.29</var><br/>
</td>
<td align="left" colspan="3">Sec. 7. <b>DEPARTMENT OF VETERANS </b><br/>
<b>AFFAIRS</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>200,000</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>0</b><br/>
</td>
</tr>
</table><a id="pl.395.30"></a><var>395.30</var><b>Veterans Paramedic Apprenticeship </b><br/>
<a id="pl.395.31"></a><var>395.31</var><b>Program.</b> Of this appropriation, $200,000 <br/>
<a id="pl.395.32"></a><var>395.32</var>in the first year is from the Cooper/Sams <br/>
<a id="pl.395.33"></a><var>395.33</var>volunteer ambulance trust for transfer <br/>
<a id="pl.395.34"></a><var>395.34</var>to the commissioner of veterans affairs <br/>
<a id="pl.396.1"></a><var>396.1</var>for a grant to the Minnesota Ambulance <br/>
<a id="pl.396.2"></a><var>396.2</var>Association to implement a veterans <br/>
<a id="pl.396.3"></a><var>396.3</var>paramedic apprenticeship program to <br/>
<a id="pl.396.4"></a><var>396.4</var>reintegrate returning military medics into <br/>
<a id="pl.396.5"></a><var>396.5</var>Minnesota's workforce in the field of <br/>
<a id="pl.396.6"></a><var>396.6</var>paramedic and emergency services, thereby <br/>
<a id="pl.396.7"></a><var>396.7</var>guaranteeing returning military medics <br/>
<a id="pl.396.8"></a><var>396.8</var>gainful employment with livable wages and <br/>
<a id="pl.396.9"></a><var>396.9</var>benefits. This appropriation is available until <br/>
<a id="pl.396.10"></a><var>396.10</var>expended.<br/>
<br/>
<a id="bill.13.8.0"></a><table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.396.11"></a><var>396.11</var><br/>
</td>
<td align="left" colspan="3">Sec. 8. <b>DEPARTMENT OF PUBLIC SAFETY</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>250,000</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>0</b><br/>
</td>
</tr>
</table><a id="pl.396.12"></a><var>396.12</var><b>Medical Response Unit Reimbursement </b><br/>
<a id="pl.396.13"></a><var>396.13</var><b>Pilot Program.</b> (a) $250,000 in the first <br/>
<a id="pl.396.14"></a><var>396.14</var>year is from the Cooper/Sams volunteer <br/>
<a id="pl.396.15"></a><var>396.15</var>ambulance trust for a transfer to the <br/>
<a id="pl.396.16"></a><var>396.16</var>Department of Public Safety for a medical <br/>
<a id="pl.396.17"></a><var>396.17</var>response unit reimbursement pilot program. <br/>
<a id="pl.396.18"></a><var>396.18</var>Of this appropriation, $75,000 is for <br/>
<a id="pl.396.19"></a><var>396.19</var>administrative costs to the Department of <br/>
<a id="pl.396.20"></a><var>396.20</var>Public Safety, including providing contract <br/>
<a id="pl.396.21"></a><var>396.21</var>staff support and technical assistance to the <br/>
<a id="pl.396.22"></a><var>396.22</var>pilot program partners if necessary.<br/>
<a id="pl.396.23"></a><var>396.23</var>(b) Of the amount in paragraph (a), $175,000 <br/>
<a id="pl.396.24"></a><var>396.24</var>is to be used to provide a predetermined <br/>
<a id="pl.396.25"></a><var>396.25</var>reimbursement amount to the participating <br/>
<a id="pl.396.26"></a><var>396.26</var>medical response units. The Department <br/>
<a id="pl.396.27"></a><var>396.27</var>of Public Safety or its contract designee <br/>
<a id="pl.396.28"></a><var>396.28</var>will develop an agreement with the medical <br/>
<a id="pl.396.29"></a><var>396.29</var>response units outlining reimbursement and <br/>
<a id="pl.396.30"></a><var>396.30</var>program requirements to include HIPAA <br/>
<a id="pl.396.31"></a><var>396.31</var>compliance while participating in the pilot <br/>
<a id="pl.396.32"></a><var>396.32</var>program.<br/>
<br/>
<a id="bill.13.9.0"></a><table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.396.33"></a><var>396.33</var><br/>
</td>
<td align="left" colspan="3">Sec. 9. <b>COUNCIL ON DISABILITY</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>524,000</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>524,000</b><br/>
</td>
</tr>
</table><br/>
<a id="bill.13.10.0"></a><table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.397.1"></a><var>397.1</var><br/>
<a id="pl.397.2"></a><var>397.2</var><br/>
<a id="pl.397.3"></a><var>397.3</var><br/>
</td>
<td align="left" colspan="3">Sec. 10. <b>OMBUDSMAN FOR MENTAL </b><br/>
<b>HEALTH AND DEVELOPMENTAL </b><br/>
<b>DISABILITIES</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>1,655,000</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>1,655,000</b><br/>
</td>
</tr>
</table><br/>
<a id="bill.13.11.0"></a><table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.397.4"></a><var>397.4</var><br/>
</td>
<td align="left" colspan="3">Sec. 11. <b>OMBUDSPERSON FOR FAMILIES</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>265,000</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>265,000</b><br/>
</td>
</tr>
</table><br/>
<a id="bill.13.12.0"></a><a id="pl.397.5"></a><var>397.5</var>    Sec. 12. Laws 2007, chapter 147, article 19, section 3, subdivision 4, as amended <br/>
<a id="pl.397.6"></a><var>397.6</var>by Laws 2008, chapter 277, article 5, section 1; and Laws 2008, chapter 363, article <br/>
<a id="pl.397.7"></a><var>397.7</var>18, section 7, is amended to read:<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.397.8"></a><var>397.8</var><br/>
<a id="pl.397.9"></a><var>397.9</var><br/>
</td>
<td align="left" colspan="3" valign="bottom">Subd. 4. <b>Children and Economic Assistance </b><br/>
<b>Grants</b><br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
</tr>
</table><a id="pl.397.10"></a><var>397.10</var>The amounts that may be spent from this <br/>
<a id="pl.397.11"></a><var>397.11</var>appropriation for each purpose are as follows: <br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.397.12"></a><var>397.12</var><br/>
</td>
<td align="left" colspan="3" valign="bottom">(a) <b>MFIP/DWP Grants </b><br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.397.13"></a><var>397.13</var><br/>
</td>
<td align="center" colspan="3" valign="bottom">Appropriations by Fund <br/>
</td>
</tr>
<tr>
<td><a id="pl.397.14"></a><var>397.14</var><br/>
</td>
<td align="left" valign="bottom">General <br/>
</td>
<td align="right" valign="bottom">62,069,000 <br/>
</td>
<td align="right" valign="bottom">62,405,000 <br/>
</td>
</tr>
<tr>
<td><a id="pl.397.15"></a><var>397.15</var><br/>
</td>
<td align="left" valign="bottom">Federal TANF <br/>
</td>
<td align="right" valign="bottom">75,904,000 <br/>
</td>
<td align="right" valign="bottom">80,841,000 <br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.397.16"></a><var>397.16</var><br/>
</td>
<td align="left" colspan="3" valign="bottom">(b) <b>Support Services Grants </b><br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.397.17"></a><var>397.17</var><br/>
</td>
<td align="center" colspan="3" valign="bottom">Appropriations by Fund <br/>
</td>
</tr>
<tr>
<td><a id="pl.397.18"></a><var>397.18</var><br/>
</td>
<td align="left" valign="bottom">General <br/>
</td>
<td align="right" valign="bottom">8,715,000 <br/>
</td>
<td align="right" valign="bottom">8,715,000 <br/>
</td>
</tr>
<tr>
<td><a id="pl.397.19"></a><var>397.19</var><br/>
</td>
<td align="left" valign="bottom">Federal TANF <br/>
</td>
<td align="right" valign="bottom">113,429,000 <br/>
</td>
<td align="right" valign="bottom">115,902,000 <br/>
</td>
</tr>
</table><a id="pl.397.20"></a><var>397.20</var><b>TANF Prior Appropriation Cancellation.</b> <br/>
<a id="pl.397.21"></a><var>397.21</var>Notwithstanding Laws 2001, First Special <br/>
<a id="pl.397.22"></a><var>397.22</var>Session chapter 9, article 17, section <br/>
<a id="pl.397.23"></a><var>397.23</var>2, subdivision 11, paragraph (b), any <br/>
<a id="pl.397.24"></a><var>397.24</var>unexpended TANF funds appropriated to the <br/>
<a id="pl.397.25"></a><var>397.25</var>commissioner to contract with the Board of <br/>
<a id="pl.397.26"></a><var>397.26</var>Trustees of Minnesota State Colleges and <br/>
<a id="pl.397.27"></a><var>397.27</var>Universities, to provide tuition waivers to <br/>
<a id="pl.397.28"></a><var>397.28</var>employees of health care and human service <br/>
<a id="pl.398.1"></a><var>398.1</var>providers that are members of qualifying <br/>
<a id="pl.398.2"></a><var>398.2</var>consortia operating under Minnesota <br/>
<a id="pl.398.3"></a><var>398.3</var>Statutes, sections 
         <statute_ref>116L.10</statute_ref> to 
         <statute_ref>116L.15</statute_ref>, must <br/>
<a id="pl.398.4"></a><var>398.4</var>cancel at the end of fiscal year 2007. <br/>
<a id="pl.398.5"></a><var>398.5</var><b>MFIP Pilot Program.</b> Of the TANF <br/>
<a id="pl.398.6"></a><var>398.6</var>appropriation, $100,000 in fiscal year 2008 <br/>
<a id="pl.398.7"></a><var>398.7</var>and $750,000 in fiscal year 2009 are for a <br/>
<a id="pl.398.8"></a><var>398.8</var>grant to the Stearns-Benton Employment and <br/>
<a id="pl.398.9"></a><var>398.9</var>Training Council for the Workforce U pilot <br/>
<a id="pl.398.10"></a><var>398.10</var>program. Base level funding for this program <br/>
<a id="pl.398.11"></a><var>398.11</var>shall be $750,000 in 2010 and $0 in 2011. <br/>
<a id="pl.398.12"></a><var>398.12</var><b>Supported Work. </b>(1) Of the TANF <br/>
<a id="pl.398.13"></a><var>398.13</var>appropriation, $5,468,000 in fiscal year 2008 <br/>
<a id="pl.398.14"></a><var>398.14</var>is for supported work for MFIP participants, <br/>
<a id="pl.398.15"></a><var>398.15</var>to be allocated to counties and tribes based <br/>
<a id="pl.398.16"></a><var>398.16</var>on the criteria under clauses (2) and (3), and <br/>
<a id="pl.398.17"></a><var>398.17</var>is available until expended. Paid transitional <br/>
<a id="pl.398.18"></a><var>398.18</var>work experience and other supported <br/>
<a id="pl.398.19"></a><var>398.19</var>employment under this rider provides <br/>
<a id="pl.398.20"></a><var>398.20</var>a continuum of employment assistance, <br/>
<a id="pl.398.21"></a><var>398.21</var>including outreach and recruitment, <br/>
<a id="pl.398.22"></a><var>398.22</var>program orientation and intake, testing and <br/>
<a id="pl.398.23"></a><var>398.23</var>assessment, job development and marketing, <br/>
<a id="pl.398.24"></a><var>398.24</var>preworksite training, supported worksite <br/>
<a id="pl.398.25"></a><var>398.25</var>experience, job coaching, and postplacement <br/>
<a id="pl.398.26"></a><var>398.26</var>follow-up, in addition to extensive case <br/>
<a id="pl.398.27"></a><var>398.27</var>management and referral services. * (The <br/>
<a id="pl.398.28"></a><var>398.28</var>preceding text "and $7,291,000 in fiscal <br/>
<a id="pl.398.29"></a><var>398.29</var>year 2009" was indicated as vetoed by the <br/>
<a id="pl.398.30"></a><var>398.30</var>governor.) <br/>
<a id="pl.398.31"></a><var>398.31</var>(2) A county or tribe is eligible to receive an <br/>
<a id="pl.398.32"></a><var>398.32</var>allocation under this rider if: <br/>
<a id="pl.398.33"></a><var>398.33</var>(i) the county or tribe is not meeting the <br/>
<a id="pl.398.34"></a><var>398.34</var>federal work participation rate; <br/>
<a id="pl.399.1"></a><var>399.1</var>(ii) the county or tribe has participants who <br/>
<a id="pl.399.2"></a><var>399.2</var>are required to perform work activities under <br/>
<a id="pl.399.3"></a><var>399.3</var>Minnesota Statutes, chapter 256J, but are not <br/>
<a id="pl.399.4"></a><var>399.4</var>meeting hourly work requirements; and <br/>
<a id="pl.399.5"></a><var>399.5</var>(iii) the county or tribe has assessed <br/>
<a id="pl.399.6"></a><var>399.6</var>participants who have completed six weeks <br/>
<a id="pl.399.7"></a><var>399.7</var>of job search or are required to perform <br/>
<a id="pl.399.8"></a><var>399.8</var>work activities and are not meeting the <br/>
<a id="pl.399.9"></a><var>399.9</var>hourly requirements, and the county or tribe <br/>
<a id="pl.399.10"></a><var>399.10</var>has determined that the participant would <br/>
<a id="pl.399.11"></a><var>399.11</var>benefit from working in a supported work <br/>
<a id="pl.399.12"></a><var>399.12</var>environment. <br/>
<a id="pl.399.13"></a><var>399.13</var>(3) A county or tribe may also be eligible for <br/>
<a id="pl.399.14"></a><var>399.14</var>funds in order to contract for supplemental <br/>
<a id="pl.399.15"></a><var>399.15</var>hours of paid work at the participant's child's <br/>
<a id="pl.399.16"></a><var>399.16</var>place of education, child care location, or the <br/>
<a id="pl.399.17"></a><var>399.17</var>child's physical or mental health treatment <br/>
<a id="pl.399.18"></a><var>399.18</var>facility or office. This grant to counties and <br/>
<a id="pl.399.19"></a><var>399.19</var>tribes is specifically for MFIP participants <br/>
<a id="pl.399.20"></a><var>399.20</var>who need to work up to five hours more <br/>
<a id="pl.399.21"></a><var>399.21</var>per week in order to meet the hourly work <br/>
<a id="pl.399.22"></a><var>399.22</var>requirement, and the participant's employer <br/>
<a id="pl.399.23"></a><var>399.23</var>cannot or will not offer more hours to the <br/>
<a id="pl.399.24"></a><var>399.24</var>participant. <br/>
<a id="pl.399.25"></a><var>399.25</var><b>Work Study.</b> Of the TANF appropriation, <br/>
<a id="pl.399.26"></a><var>399.26</var>$750,000 each year are to the commissioner <br/>
<a id="pl.399.27"></a><var>399.27</var>to contract with the Minnesota Office of <br/>
<a id="pl.399.28"></a><var>399.28</var>Higher Education for the biennium beginning <br/>
<a id="pl.399.29"></a><var>399.29</var>July 1, 2007, for work study grants under <br/>
<a id="pl.399.30"></a><var>399.30</var>Minnesota Statutes, section 
         <statute_ref>136A.233</statute_ref>, <br/>
<a id="pl.399.31"></a><var>399.31</var>specifically for low-income individuals who <br/>
<a id="pl.399.32"></a><var>399.32</var>receive assistance under Minnesota Statutes, <br/>
<a id="pl.399.33"></a><var>399.33</var>chapter 256J, and for grants to opportunities <br/>
<a id="pl.399.34"></a><var>399.34</var>industrialization centers. * (The preceding <br/>
<a id="pl.399.35"></a><var>399.35</var>text beginning "Work Study. Of the TANF <br/>
<a id="pl.400.1"></a><var>400.1</var>appropriation," was indicated as vetoed <br/>
<a id="pl.400.2"></a><var>400.2</var>by the governor.) <br/>
<a id="pl.400.3"></a><var>400.3</var><b>Integrated Service Projects.</b> $2,500,000 <br/>
<a id="pl.400.4"></a><var>400.4</var>in fiscal year 2008 and $2,500,000 in fiscal <br/>
<a id="pl.400.5"></a><var>400.5</var>year 2009 are appropriated from the TANF <br/>
<a id="pl.400.6"></a><var>400.6</var>fund to the commissioner to continue to <br/>
<a id="pl.400.7"></a><var>400.7</var>fund the existing integrated services projects <br/>
<a id="pl.400.8"></a><var>400.8</var>for MFIP families, and if funding allows, <br/>
<a id="pl.400.9"></a><var>400.9</var>additional similar projects. <br/>
<a id="pl.400.10"></a><var>400.10</var><b>Base Adjustment.</b> The TANF base for fiscal <br/>
<a id="pl.400.11"></a><var>400.11</var>year 2010 is $115,902,000 and for fiscal year <br/>
<a id="pl.400.12"></a><var>400.12</var>2011 is $115,152,000. <br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.400.13"></a><var>400.13</var><br/>
</td>
<td align="left" colspan="3" valign="bottom">(c) <b>MFIP Child Care Assistance Grants </b><br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.400.14"></a><var>400.14</var><br/>
</td>
<td align="left" valign="bottom">General <br/>
</td>
<td align="right" valign="bottom">74,654,000 <br/>
</td>
<td align="right" valign="bottom">71,951,000 <br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.400.15"></a><var>400.15</var><br/>
<a id="pl.400.16"></a><var>400.16</var><br/>
</td>
<td align="left" colspan="3" valign="bottom">(d) <b>Basic Sliding Fee Child Care Assistance </b><br/>
<b>Grants </b><br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.400.17"></a><var>400.17</var><br/>
</td>
<td align="left" valign="bottom">General <br/>
</td>
<td align="right" valign="bottom">42,995,000 <br/>
</td>
<td align="right" valign="bottom">45,008,000 <br/>
</td>
</tr>
</table><a id="pl.400.18"></a><var>400.18</var><b>Base Adjustment.</b> The general fund base <br/>
<a id="pl.400.19"></a><var>400.19</var>is $44,881,000 for fiscal year 2010 and <br/>
<a id="pl.400.20"></a><var>400.20</var>$44,852,000 for fiscal year 2011. <br/>
<a id="pl.400.21"></a><var>400.21</var><b>At-Home Infant Care Program.</b> No <br/>
<a id="pl.400.22"></a><var>400.22</var>funding shall be allocated to or spent on <br/>
<a id="pl.400.23"></a><var>400.23</var>the at-home infant care program under <br/>
<a id="pl.400.24"></a><var>400.24</var>Minnesota Statutes, section 
         <statute_ref>119B.035</statute_ref>. <br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.400.25"></a><var>400.25</var><br/>
</td>
<td align="left" colspan="3" valign="bottom">(e) <b>Child Care Development Grants </b><br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.400.26"></a><var>400.26</var><br/>
</td>
<td align="left" valign="bottom">General <br/>
</td>
<td align="right" valign="bottom">4,390,000 <br/>
</td>
<td align="right" valign="bottom">6,390,000 <br/>
</td>
</tr>
</table><a id="pl.400.27"></a><var>400.27</var><b>Prekindergarten Exploratory Projects.</b> Of <br/>
<a id="pl.400.28"></a><var>400.28</var>the general fund appropriation, $2,000,000 <br/>
<a id="pl.400.29"></a><var>400.29</var>the first year and $4,000,000 the second <br/>
<a id="pl.401.1"></a><var>401.1</var>year are for grants to the city of St. Paul, <br/>
<a id="pl.401.2"></a><var>401.2</var>Hennepin County, and Blue Earth County to <br/>
<a id="pl.401.3"></a><var>401.3</var>establish scholarship demonstration projects <br/>
<a id="pl.401.4"></a><var>401.4</var>to be conducted in partnership with the <br/>
<a id="pl.401.5"></a><var>401.5</var>Minnesota Early Learning Foundation to <br/>
<a id="pl.401.6"></a><var>401.6</var>promote children's school readiness. This <br/>
<a id="pl.401.7"></a><var>401.7</var>appropriation is available until June 30, 2009. <br/>
<a id="pl.401.8"></a><var>401.8</var><b>Child Care Services Grants.</b> Of this <br/>
<a id="pl.401.9"></a><var>401.9</var>appropriation, $250,000 each year are for <br/>
<a id="pl.401.10"></a><var>401.10</var>the purpose of providing child care services <br/>
<a id="pl.401.11"></a><var>401.11</var>grants under Minnesota Statutes, section <br/>
<statute_ref><a id="pl.401.12"></a><var>401.12</var>119B.21, subdivision 5
         </statute_ref>. This appropriation <br/>
<a id="pl.401.13"></a><var>401.13</var>is for the 2008-2009 biennium only, and does <br/>
<a id="pl.401.14"></a><var>401.14</var>not increase the base funding. <br/>
<a id="pl.401.15"></a><var>401.15</var><b>Early Childhood Professional </b><br/>
<a id="pl.401.16"></a><var>401.16</var><b>Development System.</b> Of this appropriation, <br/>
<a id="pl.401.17"></a><var>401.17</var>$250,000 each year are for purposes of the <br/>
<a id="pl.401.18"></a><var>401.18</var>early childhood professional development <br/>
<a id="pl.401.19"></a><var>401.19</var>system, which increases the quality and <br/>
<a id="pl.401.20"></a><var>401.20</var>continuum of professional development <br/>
<a id="pl.401.21"></a><var>401.21</var>opportunities for child care practitioners. <br/>
<a id="pl.401.22"></a><var>401.22</var>This appropriation is for the 2008-2009 <br/>
<a id="pl.401.23"></a><var>401.23</var>biennium only, and does not increase the <br/>
<a id="pl.401.24"></a><var>401.24</var>base funding. <br/>
<a id="pl.401.25"></a><var>401.25</var><b>Base Adjustment.</b> The general fund base <br/>
<a id="pl.401.26"></a><var>401.26</var>is $1,515,000 for each of fiscal years 2010 <br/>
<a id="pl.401.27"></a><var>401.27</var>and 2011. <br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.401.28"></a><var>401.28</var><br/>
</td>
<td align="left" colspan="3" valign="bottom">(f) <b>Child Support Enforcement Grants </b><br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.401.29"></a><var>401.29</var><br/>
</td>
<td align="left" valign="bottom">General <br/>
</td>
<td align="right" valign="bottom">11,038,000 <br/>
</td>
<td align="right" valign="bottom">3,705,000 <br/>
</td>
</tr>
</table><a id="pl.401.30"></a><var>401.30</var><b>Child Support Enforcement.</b> $7,333,000 <br/>
<a id="pl.401.31"></a><var>401.31</var>for fiscal year 2008 is to make grants to <br/>
<a id="pl.401.32"></a><var>401.32</var>counties for child support enforcement <br/>
<a id="pl.401.33"></a><var>401.33</var>programs to make up for the loss under the <br/>
<a id="pl.402.1"></a><var>402.1</var>2005 federal Deficit Reduction Act of federal <br/>
<a id="pl.402.2"></a><var>402.2</var>matching funds for federal incentive funds <br/>
<a id="pl.402.3"></a><var>402.3</var>passed on to the counties by the state. <br/>
<a id="pl.402.4"></a><var>402.4</var>This appropriation is available until June 30, <br/>
<a id="pl.402.5"></a><var>402.5</var>2009. <br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.402.6"></a><var>402.6</var><br/>
</td>
<td align="left" colspan="3" valign="bottom">(g) <b>Children's Services Grants </b><br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.402.7"></a><var>402.7</var><br/>
</td>
<td align="center" colspan="3" valign="bottom">Appropriations by Fund <br/>
</td>
</tr>
<tr>
<td><a id="pl.402.8"></a><var>402.8</var><br/>
</td>
<td align="left" valign="bottom">General <br/>
</td>
<td align="right" valign="bottom">63,647,000 <br/>
</td>
<td align="right" valign="bottom">71,147,000 <br/>
</td>
</tr>
<tr>
<td><a id="pl.402.9"></a><var>402.9</var><br/>
</td>
<td align="left" valign="bottom">Health Care Access <br/>
</td>
<td align="right" valign="bottom">250,000 <br/>
</td>
<td align="right" valign="bottom">-0- <br/>
</td>
</tr>
<tr>
<td><a id="pl.402.10"></a><var>402.10</var><br/>
</td>
<td align="left" valign="bottom">TANF <br/>
</td>
<td align="right" valign="bottom">240,000 <br/>
</td>
<td align="right" valign="bottom">340,000 <br/>
</td>
</tr>
</table><a id="pl.402.11"></a><var>402.11</var><b>Grants for Programs Serving Young </b><br/>
<a id="pl.402.12"></a><var>402.12</var><b>Parents.</b> Of the TANF fund appropriation, <br/>
<a id="pl.402.13"></a><var>402.13</var>$140,000 each year is for a grant to a program <br/>
<a id="pl.402.14"></a><var>402.14</var>or programs that provide comprehensive <br/>
<a id="pl.402.15"></a><var>402.15</var>services through a private, nonprofit agency <br/>
<a id="pl.402.16"></a><var>402.16</var>to young parents in Hennepin County who <br/>
<a id="pl.402.17"></a><var>402.17</var>have dropped out of school and are receiving <br/>
<a id="pl.402.18"></a><var>402.18</var>public assistance. The program administrator <br/>
<a id="pl.402.19"></a><var>402.19</var>shall report annually to the commissioner on <br/>
<a id="pl.402.20"></a><var>402.20</var>skills development, education, job training, <br/>
<a id="pl.402.21"></a><var>402.21</var>and job placement outcomes for program <br/>
<a id="pl.402.22"></a><var>402.22</var>participants. <br/>
<a id="pl.402.23"></a><var>402.23</var><b>County Allocations for Rate Increases.</b> <br/>
<a id="pl.402.24"></a><var>402.24</var>County Children and Community Services <br/>
<a id="pl.402.25"></a><var>402.25</var>Act allocations shall be increased by <br/>
<a id="pl.402.26"></a><var>402.26</var>$197,000 effective October 1, 2007, and <br/>
<a id="pl.402.27"></a><var>402.27</var>$696,000 effective October 1, 2008, to help <br/>
<a id="pl.402.28"></a><var>402.28</var>counties pay for the rate adjustments to <br/>
<a id="pl.402.29"></a><var>402.29</var>day training and habilitation providers for <br/>
<a id="pl.402.30"></a><var>402.30</var>participants paid by county social service <br/>
<a id="pl.402.31"></a><var>402.31</var>funds. Notwithstanding the provisions of <br/>
<a id="pl.402.32"></a><var>402.32</var>Minnesota Statutes, section 
         <statute_ref>256M.40</statute_ref>, the <br/>
<a id="pl.402.33"></a><var>402.33</var>allocation to a county shall be based on <br/>
<a id="pl.403.1"></a><var>403.1</var>the county's proportion of social services <br/>
<a id="pl.403.2"></a><var>403.2</var>spending for day training and habilitation <br/>
<a id="pl.403.3"></a><var>403.3</var>services as determined in the most recent <br/>
<a id="pl.403.4"></a><var>403.4</var>social services expenditure and grant <br/>
<a id="pl.403.5"></a><var>403.5</var>reconciliation report. <br/>
<a id="pl.403.6"></a><var>403.6</var><b>Privatized Adoption Grants.</b> Federal <br/>
<a id="pl.403.7"></a><var>403.7</var>reimbursement for privatized adoption grant <br/>
<a id="pl.403.8"></a><var>403.8</var>and foster care recruitment grant expenditures <br/>
<a id="pl.403.9"></a><var>403.9</var>is appropriated to the commissioner for <br/>
<a id="pl.403.10"></a><var>403.10</var>adoption grants and foster care and adoption <br/>
<a id="pl.403.11"></a><var>403.11</var>administrative purposes. <br/>
<a id="pl.403.12"></a><var>403.12</var><b>Adoption Assistance Incentive Grants.</b> <br/>
<a id="pl.403.13"></a><var>403.13</var>Federal funds available during fiscal year <br/>
<a id="pl.403.14"></a><var>403.14</var>2008 and fiscal year 2009 for the adoption <br/>
<a id="pl.403.15"></a><var>403.15</var>incentive grants are appropriated to the <br/>
<a id="pl.403.16"></a><var>403.16</var>commissioner for these purposes. <br/>
<a id="pl.403.17"></a><var>403.17</var><b>Adoption Assistance and Relative Custody </b><br/>
<a id="pl.403.18"></a><var>403.18</var><b>Assistance.</b> The commissioner may transfer <br/>
<a id="pl.403.19"></a><var>403.19</var>unencumbered appropriation balances for <br/>
<a id="pl.403.20"></a><var>403.20</var>adoption assistance and relative custody <br/>
<a id="pl.403.21"></a><var>403.21</var>assistance between fiscal years and between <br/>
<a id="pl.403.22"></a><var>403.22</var>programs. <br/>
<a id="pl.403.23"></a><var>403.23</var><b>Children's Mental Health Grants.</b> Of the <br/>
<a id="pl.403.24"></a><var>403.24</var>general fund appropriation, $5,913,000 in <br/>
<a id="pl.403.25"></a><var>403.25</var>fiscal year 2008 and $6,825,000 in fiscal year <br/>
<a id="pl.403.26"></a><var>403.26</var>2009 are for children's mental health grants. <br/>
<a id="pl.403.27"></a><var>403.27</var>The purpose of these grants is to increase and <br/>
<a id="pl.403.28"></a><var>403.28</var>maintain the state's children's mental health <br/>
<a id="pl.403.29"></a><var>403.29</var>service capacity, especially for school-based <br/>
<a id="pl.403.30"></a><var>403.30</var>mental health services. The commissioner <br/>
<a id="pl.403.31"></a><var>403.31</var>shall require grantees to utilize all available <br/>
<a id="pl.403.32"></a><var>403.32</var>third party reimbursement sources as a <br/>
<a id="pl.403.33"></a><var>403.33</var>condition of using state grant funds. At <br/>
<a id="pl.403.34"></a><var>403.34</var>least 15 percent of these funds shall be <br/>
<a id="pl.403.35"></a><var>403.35</var>used to encourage efficiencies through early <br/>
<a id="pl.404.1"></a><var>404.1</var>intervention services. At least another 15 <br/>
<a id="pl.404.2"></a><var>404.2</var>percent shall be used to provide respite care <br/>
<a id="pl.404.3"></a><var>404.3</var>services for children with severe emotional <br/>
<a id="pl.404.4"></a><var>404.4</var>disturbance at risk of out-of-home placement. <br/>
<a id="pl.404.5"></a><var>404.5</var><b>Mental Health Crisis Services.</b> Of the <br/>
<a id="pl.404.6"></a><var>404.6</var>general fund appropriation, $2,528,000 in <br/>
<a id="pl.404.7"></a><var>404.7</var>fiscal year 2008 and $2,850,000 in fiscal year <br/>
<a id="pl.404.8"></a><var>404.8</var>2009 are for statewide funding of children's <br/>
<a id="pl.404.9"></a><var>404.9</var>mental health crisis services. Providers must <br/>
<a id="pl.404.10"></a><var>404.10</var>utilize all available funding streams. <br/>
<a id="pl.404.11"></a><var>404.11</var><b>Children's Mental Health Evidence-Based </b><br/>
<a id="pl.404.12"></a><var>404.12</var><b>and Best Practices.</b> Of the general fund <br/>
<a id="pl.404.13"></a><var>404.13</var>appropriation, $375,000 in fiscal year 2008 <br/>
<a id="pl.404.14"></a><var>404.14</var>and $750,000 in fiscal year 2009 are for <br/>
<a id="pl.404.15"></a><var>404.15</var>children's mental health evidence-based and <br/>
<a id="pl.404.16"></a><var>404.16</var>best practices including, but not limited <br/>
<a id="pl.404.17"></a><var>404.17</var>to: Adolescent Integrated Dual Diagnosis <br/>
<a id="pl.404.18"></a><var>404.18</var>Treatment services; school-based mental <br/>
<a id="pl.404.19"></a><var>404.19</var>health services; co-location of mental <br/>
<a id="pl.404.20"></a><var>404.20</var>health and physical health care, and; the <br/>
<a id="pl.404.21"></a><var>404.21</var>use of technological resources to better <br/>
<a id="pl.404.22"></a><var>404.22</var>inform diagnosis and development of <br/>
<a id="pl.404.23"></a><var>404.23</var>treatment plan development by mental <br/>
<a id="pl.404.24"></a><var>404.24</var>health professionals. The commissioner <br/>
<a id="pl.404.25"></a><var>404.25</var>shall require grantees to utilize all available <br/>
<a id="pl.404.26"></a><var>404.26</var>third-party reimbursement sources as a <br/>
<a id="pl.404.27"></a><var>404.27</var>condition of using state grant funds. <br/>
<a id="pl.404.28"></a><var>404.28</var><b>Culturally Specific Mental Health </b><br/>
<a id="pl.404.29"></a><var>404.29</var><b>Treatment Grants.</b> Of the general fund <br/>
<a id="pl.404.30"></a><var>404.30</var>appropriation, $75,000 in fiscal year 2008 <br/>
<a id="pl.404.31"></a><var>404.31</var>and $300,000 in fiscal year 2009 are for <br/>
<a id="pl.404.32"></a><var>404.32</var>children's mental health grants to support <br/>
<a id="pl.404.33"></a><var>404.33</var>increased availability of mental health <br/>
<a id="pl.404.34"></a><var>404.34</var>services for persons from cultural and <br/>
<a id="pl.404.35"></a><var>404.35</var>ethnic minorities within the state. The <br/>
<a id="pl.405.1"></a><var>405.1</var>commissioner shall use at least 20 percent <br/>
<a id="pl.405.2"></a><var>405.2</var>of these funds to help members of cultural <br/>
<a id="pl.405.3"></a><var>405.3</var>and ethnic minority communities to become <br/>
<a id="pl.405.4"></a><var>405.4</var>qualified mental health professionals and <br/>
<a id="pl.405.5"></a><var>405.5</var>practitioners. The commissioner shall assist <br/>
<a id="pl.405.6"></a><var>405.6</var>grantees to meet third-party credentialing <br/>
<a id="pl.405.7"></a><var>405.7</var>requirements and require them to utilize all <br/>
<a id="pl.405.8"></a><var>405.8</var>available third-party reimbursement sources <br/>
<a id="pl.405.9"></a><var>405.9</var>as a condition of using state grant funds. <br/>
<a id="pl.405.10"></a><var>405.10</var><b>Mental Health Services for Children with </b><br/>
<a id="pl.405.11"></a><var>405.11</var><b>Special Treatment Needs.</b> Of the general <br/>
<a id="pl.405.12"></a><var>405.12</var>fund appropriation, $50,000 in fiscal year <br/>
<a id="pl.405.13"></a><var>405.13</var>2008 and $200,000 in fiscal year 2009 are <br/>
<a id="pl.405.14"></a><var>405.14</var>for children's mental health grants to support <br/>
<a id="pl.405.15"></a><var>405.15</var>increased availability of mental health <br/>
<a id="pl.405.16"></a><var>405.16</var>services for children with special treatment <br/>
<a id="pl.405.17"></a><var>405.17</var>needs. These shall include, but not be limited <br/>
<a id="pl.405.18"></a><var>405.18</var>to: victims of trauma, including children <br/>
<a id="pl.405.19"></a><var>405.19</var>subjected to abuse or neglect, veterans and <br/>
<a id="pl.405.20"></a><var>405.20</var>their families, and refugee populations; <br/>
<a id="pl.405.21"></a><var>405.21</var>persons with complex treatment needs, such <br/>
<a id="pl.405.22"></a><var>405.22</var>as eating disorders; and those with low <br/>
<a id="pl.405.23"></a><var>405.23</var>incidence disorders. <br/>
<a id="pl.405.24"></a><var>405.24</var><b>MFIP and Children's Mental Health </b><br/>
<a id="pl.405.25"></a><var>405.25</var><b>Pilot Project.</b> Of the TANF appropriation, <br/>
<a id="pl.405.26"></a><var>405.26</var>$100,000 in fiscal year 2008 and $200,000 <br/>
<a id="pl.405.27"></a><var>405.27</var>in fiscal year 2009 are to fund the MFIP <br/>
<a id="pl.405.28"></a><var>405.28</var>and children's mental health pilot project. <br/>
<a id="pl.405.29"></a><var>405.29</var>Of these amounts, up to $100,000 may be <br/>
<a id="pl.405.30"></a><var>405.30</var>expended on evaluation of this pilot. <br/>
<a id="pl.405.31"></a><var>405.31</var><b>Prenatal Alcohol or Drug Use.</b> Of the <br/>
<a id="pl.405.32"></a><var>405.32</var>general fund appropriation, $75,000 each <br/>
<a id="pl.405.33"></a><var>405.33</var>year is to award grants beginning July 1, <br/>
<a id="pl.405.34"></a><var>405.34</var>2007, to programs that provide services <br/>
<a id="pl.405.35"></a><var>405.35</var>under Minnesota Statutes, section 
<statute_ref>254A.171</statute_ref>, <br/>
<a id="pl.406.1"></a><var>406.1</var>in Pine, Kanabec, and Carlton Counties. <br/>
<a id="pl.406.2"></a><var>406.2</var>the second year is for a grant to A Circle <br/>
<a id="pl.406.3"></a><var>406.3</var>of Women for program services. This <br/>
<a id="pl.406.4"></a><var>406.4</var>appropriation shall become part of the base <br/>
<a id="pl.406.5"></a><var>406.5</var>appropriation.<br/>
<a id="pl.406.6"></a><var>406.6</var><b>Base Adjustment.</b> The general fund base <br/>
<a id="pl.406.7"></a><var>406.7</var>is $62,572,000 in fiscal year 2010 and <br/>
<a id="pl.406.8"></a><var>406.8</var>$62,575,000 in fiscal year 2011.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.406.9"></a><var>406.9</var><br/>
</td>
<td align="left" colspan="3" valign="bottom">(h) <b>Children and Community Services Grants</b><br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.406.10"></a><var>406.10</var><br/>
</td>
<td align="left" valign="bottom">General<br/>
</td>
<td align="right" valign="bottom">101,369,000 <br/>
</td>
<td align="right" valign="bottom">69,208,000 <br/>
</td>
</tr>
</table><a id="pl.406.11"></a><var>406.11</var><b>Base Adjustment.</b> The general fund base <br/>
<a id="pl.406.12"></a><var>406.12</var>is $69,274,000 in each of fiscal years 2010 <br/>
<a id="pl.406.13"></a><var>406.13</var>and 2011.<br/>
<a id="pl.406.14"></a><var>406.14</var><b>Targeted Case Management Temporary </b><br/>
<a id="pl.406.15"></a><var>406.15</var><b>Funding.</b> (a) Of the general fund <br/>
<a id="pl.406.16"></a><var>406.16</var>appropriation, $32,667,000 in fiscal year <br/>
<a id="pl.406.17"></a><var>406.17</var>2008 is transferred to the targeted case <br/>
<a id="pl.406.18"></a><var>406.18</var>management contingency reserve account in <br/>
<a id="pl.406.19"></a><var>406.19</var>the general fund to be allocated to counties <br/>
<a id="pl.406.20"></a><var>406.20</var>and tribes affected by reductions in targeted <br/>
<a id="pl.406.21"></a><var>406.21</var>case management federal Medicaid revenue <br/>
<a id="pl.406.22"></a><var>406.22</var>as a result of the provisions in the federal <br/>
<a id="pl.406.23"></a><var>406.23</var>Deficit Reduction Act of 2005, Public Law <br/>
<a id="pl.406.24"></a><var>406.24</var>109-171. <br/>
<a id="pl.406.25"></a><var>406.25</var>(b) Contingent upon (1) publication by the <br/>
<a id="pl.406.26"></a><var>406.26</var>federal Centers for Medicare and Medicaid <br/>
<a id="pl.406.27"></a><var>406.27</var>Services of final regulations implementing <br/>
<a id="pl.406.28"></a><var>406.28</var>the targeted case management provisions <br/>
<a id="pl.406.29"></a><var>406.29</var>of the federal Deficit Reduction Act of <br/>
<a id="pl.406.30"></a><var>406.30</var>2005, Public Law 109-171, or (2) the <br/>
<a id="pl.406.31"></a><var>406.31</var>issuance of a finding by the Centers for <br/>
<a id="pl.406.32"></a><var>406.32</var>Medicare and Medicaid Services of federal <br/>
<a id="pl.406.33"></a><var>406.33</var>Medicaid overpayments for targeted case <br/>
<a id="pl.407.1"></a><var>407.1</var>management expenditures, up to $32,667,000 <br/>
<a id="pl.407.2"></a><var>407.2</var>is appropriated to the commissioner of human <br/>
<a id="pl.407.3"></a><var>407.3</var>services. Prior to distribution of funds, the <br/>
<a id="pl.407.4"></a><var>407.4</var>commissioner shall estimate and certify the <br/>
<a id="pl.407.5"></a><var>407.5</var>amount by which the federal regulations or <br/>
<a id="pl.407.6"></a><var>407.6</var>federal disallowance will reduce targeted <br/>
<a id="pl.407.7"></a><var>407.7</var>case management Medicaid revenue over the <br/>
<a id="pl.407.8"></a><var>407.8</var>2008-2009 biennium. <br/>
<a id="pl.407.9"></a><var>407.9</var>(c) Within 60 days of a contingency described <br/>
<a id="pl.407.10"></a><var>407.10</var>in paragraph (b), the commissioner shall <br/>
<a id="pl.407.11"></a><var>407.11</var>distribute the grants proportionate to each <br/>
<a id="pl.407.12"></a><var>407.12</var>affected county or tribe's targeted case <br/>
<a id="pl.407.13"></a><var>407.13</var>management federal earnings for calendar <br/>
<a id="pl.407.14"></a><var>407.14</var>year 2005, not to exceed the lower of (1) the <br/>
<a id="pl.407.15"></a><var>407.15</var>amount of the estimated reduction in federal <br/>
<a id="pl.407.16"></a><var>407.16</var>revenue or (2) $32,667,000. <br/>
<a id="pl.407.17"></a><var>407.17</var>(d) These funds are available in either year of <br/>
<a id="pl.407.18"></a><var>407.18</var>the biennium. Counties and tribes shall use <br/>
<a id="pl.407.19"></a><var>407.19</var>these funds to pay for social service-related <br/>
<a id="pl.407.20"></a><var>407.20</var>costs, but the funds are not subject to <br/>
<a id="pl.407.21"></a><var>407.21</var>provisions of the Children and Community <br/>
<a id="pl.407.22"></a><var>407.22</var>Services Act grant under Minnesota Statutes, <br/>
<a id="pl.407.23"></a><var>407.23</var>chapter 256M. <br/>
<a id="pl.407.24"></a><var>407.24</var>(e) This appropriation shall be available to <br/>
<a id="pl.407.25"></a><var>407.25</var>pay counties and tribes for expenses incurred <br/>
<a id="pl.407.26"></a><var>407.26</var>on or after July 1, 2007. The appropriation <br/>
<a id="pl.407.27"></a><var>407.27</var>shall be available until expended. <br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.407.28"></a><var>407.28</var><br/>
</td>
<td align="left" colspan="3" valign="bottom">(i) <b>General Assistance Grants </b><br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.407.29"></a><var>407.29</var><br/>
</td>
<td align="left" valign="bottom">General <br/>
</td>
<td align="right" valign="bottom">37,876,000 <br/>
</td>
<td align="right" valign="bottom">38,253,000 <br/>
</td>
</tr>
</table><a id="pl.407.30"></a><var>407.30</var><b>General Assistance Standard.</b> The <br/>
<a id="pl.407.31"></a><var>407.31</var>commissioner shall set the monthly standard <br/>
<a id="pl.407.32"></a><var>407.32</var>of assistance for general assistance units <br/>
<a id="pl.407.33"></a><var>407.33</var>consisting of an adult recipient who is <br/>
<a id="pl.408.1"></a><var>408.1</var>childless and unmarried or living apart <br/>
<a id="pl.408.2"></a><var>408.2</var>from parents or a legal guardian at $203. <br/>
<a id="pl.408.3"></a><var>408.3</var>The commissioner may reduce this amount <br/>
<a id="pl.408.4"></a><var>408.4</var>according to Laws 1997, chapter 85, article <br/>
<a id="pl.408.5"></a><var>408.5</var>3, section 54. <br/>
<a id="pl.408.6"></a><var>408.6</var><b>Emergency General Assistance.</b> The <br/>
<a id="pl.408.7"></a><var>408.7</var>amount appropriated for emergency general <br/>
<a id="pl.408.8"></a><var>408.8</var>assistance funds is limited to no more <br/>
<a id="pl.408.9"></a><var>408.9</var>than $7,889,812 in fiscal year 2008 and <br/>
<a id="pl.408.10"></a><var>408.10</var>$7,889,812 in fiscal year 2009. Funds <br/>
<a id="pl.408.11"></a><var>408.11</var>to counties must be allocated by the <br/>
<a id="pl.408.12"></a><var>408.12</var>commissioner using the allocation method <br/>
<a id="pl.408.13"></a><var>408.13</var>specified in Minnesota Statutes, section <br/>
<statute_ref><a id="pl.408.14"></a><var>408.14</var>256D.06
         </statute_ref>. <br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.408.15"></a><var>408.15</var><br/>
</td>
<td align="left" colspan="3" valign="bottom">(j) <b>Minnesota Supplemental Aid Grants </b><br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.408.16"></a><var>408.16</var><br/>
</td>
<td align="left" valign="bottom">General <br/>
</td>
<td align="right" valign="bottom">30,505,000 <br/>
</td>
<td align="right" valign="bottom">30,812,000 <br/>
</td>
</tr>
</table><a id="pl.408.17"></a><var>408.17</var><b>Emergency Minnesota Supplemental </b><br/>
<a id="pl.408.18"></a><var>408.18</var><b>Aid Funds.</b> The amount appropriated for <br/>
<a id="pl.408.19"></a><var>408.19</var>emergency Minnesota supplemental aid <br/>
<a id="pl.408.20"></a><var>408.20</var>funds is limited to no more than $1,100,000 <br/>
<a id="pl.408.21"></a><var>408.21</var>in fiscal year 2008 and $1,100,000 in fiscal <br/>
<a id="pl.408.22"></a><var>408.22</var>year 2009. Funds to counties must be <br/>
<a id="pl.408.23"></a><var>408.23</var>allocated by the commissioner using the <br/>
<a id="pl.408.24"></a><var>408.24</var>allocation method specified in Minnesota <br/>
<a id="pl.408.25"></a><var>408.25</var>Statutes, section 
         <statute_ref>256D.46</statute_ref>. <br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.408.26"></a><var>408.26</var><br/>
</td>
<td align="left" colspan="3" valign="bottom">(k) <b>Group Residential Housing Grants </b><br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.408.27"></a><var>408.27</var><br/>
</td>
<td align="left" valign="bottom">General <br/>
</td>
<td align="right" valign="bottom">91,069,000 <br/>
</td>
<td align="right" valign="bottom">98,671,000 <br/>
</td>
</tr>
</table><a id="pl.408.28"></a><var>408.28</var><b>People Incorporated.</b> Of the general fund <br/>
<a id="pl.408.29"></a><var>408.29</var>appropriation, $460,000 each year is to <br/>
<a id="pl.408.30"></a><var>408.30</var>augment community support and mental <br/>
<a id="pl.408.31"></a><var>408.31</var>health services provided to individuals <br/>
<a id="pl.409.1"></a><var>409.1</var>residing in facilities under Minnesota <br/>
<a id="pl.409.2"></a><var>409.2</var>Statutes, section 
         <statute_ref>256I.05, subdivision 1m</statute_ref>. <br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.409.3"></a><var>409.3</var><br/>
<a id="pl.409.4"></a><var>409.4</var><br/>
</td>
<td align="left" colspan="3" valign="bottom">(l) <b>Other Children and Economic Assistance </b><br/>
<b>Grants </b><br/>
</td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
<td align="center" valign="bottom"></td>
<td align="right" valign="bottom"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.409.5"></a><var>409.5</var><br/>
</td>
<td align="left" valign="bottom">General <br/>
</td>
<td align="right" valign="bottom">20,183,000 <br/>
</td>
<td align="right" valign="bottom">16,333,000 <br/>
</td>
</tr>
<tr>
<td><a id="pl.409.6"></a><var>409.6</var><br/>
</td>
<td align="left" valign="bottom">Federal TANF <br/>
</td>
<td align="right" valign="bottom">1,500,000 <br/>
</td>
<td align="right" valign="bottom">1,500,000 <br/>
</td>
</tr>
</table><a id="pl.409.7"></a><var>409.7</var><b>Base Adjustment.</b> The general fund base <br/>
<a id="pl.409.8"></a><var>409.8</var>shall be $16,033,000 in fiscal year 2010 and <br/>
<a id="pl.409.9"></a><var>409.9</var>$15,533,000 in fiscal year 2011. The TANF <br/>
<a id="pl.409.10"></a><var>409.10</var>base shall be $1,500,000 in fiscal year 2010 <br/>
<a id="pl.409.11"></a><var>409.11</var>and $1,181,000 in fiscal year 2011. <br/>
<a id="pl.409.12"></a><var>409.12</var><b>Homeless and Runaway Youth.</b> Of the <br/>
<a id="pl.409.13"></a><var>409.13</var>general fund appropriation, $500,000 each <br/>
<a id="pl.409.14"></a><var>409.14</var>year are for the Runaway and Homeless <br/>
<a id="pl.409.15"></a><var>409.15</var>Youth Act under Minnesota Statutes, section <br/>
<statute_ref><a id="pl.409.16"></a><var>409.16</var>256K.45
         </statute_ref>. Funds shall be spent in each area <br/>
<a id="pl.409.17"></a><var>409.17</var>of the continuum of care to ensure that <br/>
<a id="pl.409.18"></a><var>409.18</var>programs are meeting the greatest need. This <br/>
<a id="pl.409.19"></a><var>409.19</var>is a onetime appropriation. <br/>
<a id="pl.409.20"></a><var>409.20</var><b>Long-Term Homelessness.</b> Of the general <br/>
<a id="pl.409.21"></a><var>409.21</var>fund appropriation, $2,000,000 in fiscal year <br/>
<a id="pl.409.22"></a><var>409.22</var>2008 is for implementation of programs <br/>
<a id="pl.409.23"></a><var>409.23</var>to address long-term homelessness and is <br/>
<a id="pl.409.24"></a><var>409.24</var>available in either year of the biennium. This <br/>
<a id="pl.409.25"></a><var>409.25</var>is a onetime appropriation. <br/>
<a id="pl.409.26"></a><var>409.26</var><b>Minnesota Community Action Grants.</b> (a) <br/>
<a id="pl.409.27"></a><var>409.27</var>Of the general fund appropriation, $250,000 <br/>
<a id="pl.409.28"></a><var>409.28</var>each year is for the purposes of Minnesota <br/>
<a id="pl.409.29"></a><var>409.29</var>community action grants under Minnesota <br/>
<a id="pl.409.30"></a><var>409.30</var>Statutes, sections 
         <statute_ref>256E.30</statute_ref> to 
         <statute_ref>256E.32</statute_ref>. This <br/>
<a id="pl.409.31"></a><var>409.31</var>is a onetime appropriation. <br/>
<a id="pl.409.32"></a><var>409.32</var>(b) Of the TANF appropriation, $1,500,000 <br/>
<a id="pl.409.33"></a><var>409.33</var>each year is for community action agencies <br/>
<a id="pl.410.1"></a><var>410.1</var>for auto repairs, auto loans, and auto <br/>
<a id="pl.410.2"></a><var>410.2</var>purchase grants to individuals who are <br/>
<a id="pl.410.3"></a><var>410.3</var>eligible to receive benefits under Minnesota <br/>
<a id="pl.410.4"></a><var>410.4</var>Statutes, chapter 256J, or who have lost <br/>
<a id="pl.410.5"></a><var>410.5</var>eligibility for benefits under Minnesota <br/>
<a id="pl.410.6"></a><var>410.6</var>Statutes, chapter 256J, due to earnings in the <br/>
<a id="pl.410.7"></a><var>410.7</var>prior 12 months. Base level funding for this <br/>
<a id="pl.410.8"></a><var>410.8</var>activity shall be $1,500,000 in fiscal year <br/>
<a id="pl.410.9"></a><var>410.9</var>2010 and $1,181,000 in fiscal year 2011. * <br/>
<a id="pl.410.10"></a><var>410.10</var>(The preceding text beginning "(b) Of the <br/>
<a id="pl.410.11"></a><var>410.11</var>TANF appropriation," was indicated as <br/>
<a id="pl.410.12"></a><var>410.12</var>vetoed by the governor.) <br/>
<a id="pl.410.13"></a><var>410.13</var>(c) Money appropriated under paragraphs (a) <br/>
<a id="pl.410.14"></a><var>410.14</var>and (b) that is not spent in the first year does <br/>
<a id="pl.410.15"></a><var>410.15</var>not cancel but is available for the second <br/>
<a id="pl.410.16"></a><var>410.16</var>year.<br/>
<a id="pl.410.17"></a><var>410.17</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br/>
<br/>
<a id="bill.13.13.0"></a><a id="pl.410.18"></a><var>410.18</var>    Sec. 13. <b>EMERGENCY SERVICES SHELTER GRANTS FROM AMERICAN </b><br/>
<a id="pl.410.19"></a><var>410.19</var><b>RECOVERY AND REINVESTMENT ACT.</b><br/>
<a id="pl.410.20"></a><var>410.20</var>    (a) To the extent permitted under federal law, the commissioner of human services, <br/>
<a id="pl.410.21"></a><var>410.21</var>when determining the uses of the emergency services shelter grants provided under the <br/>
<a id="pl.410.22"></a><var>410.22</var>American Recovery and Reinvestment Act, shall give priority to programs that serve <br/>
<a id="pl.410.23"></a><var>410.23</var>the following:<br/>
<a id="pl.410.24"></a><var>410.24</var>    (1) homeless youth;<br/>
<a id="pl.410.25"></a><var>410.25</var>    (2) American Indian women who are victims of trafficking; <br/>
<a id="pl.410.26"></a><var>410.26</var>    (3) high-risk adult males considered to be very likely to enter or reenter state or <br/>
<a id="pl.410.27"></a><var>410.27</var>county correctional programs, or chemical and mental health programs;<br/>
<a id="pl.410.28"></a><var>410.28</var>    (4) battered women; and<br/>
<a id="pl.410.29"></a><var>410.29</var>    (5) families affected by foreclosure.<br/>
<a id="pl.410.30"></a><var>410.30</var>(b) Paragraph (a) does not supersede use of ARRA funds as otherwise provided <br/>
<a id="pl.410.31"></a><var>410.31</var>in this act.<br/>
<br/>
<a id="bill.13.14.0"></a><a id="pl.410.32"></a><var>410.32</var>    Sec. 14. <b>TRANSFERS.</b><br/>
<a id="pl.410.33"></a><var>410.33</var>    Subdivision 1. <b>Grants.</b> The commissioner of human services, with the approval <br/>
<a id="pl.410.34"></a><var>410.34</var>of the commissioner of finance, and after notification of the chairs of the relevant senate <br/>
<a id="pl.411.1"></a><var>411.1</var>budget division and house of representatives finance division committee, may transfer <br/>
<a id="pl.411.2"></a><var>411.2</var>unencumbered appropriation balances for the biennium ending June 30, 2011, within <br/>
<a id="pl.411.3"></a><var>411.3</var>fiscal years among the MFIP, general assistance, general assistance medical care, medical <br/>
<a id="pl.411.4"></a><var>411.4</var>assistance, MinnesotaCare, MFIP child care assistance under Minnesota Statutes, section <br/>
<a id="pl.411.5"></a><var>411.5</var>119B.05, Minnesota supplemental aid, and group residential housing programs, and the <br/>
<a id="pl.411.6"></a><var>411.6</var>entitlement portion of the chemical dependency consolidated treatment fund, and between <br/>
<a id="pl.411.7"></a><var>411.7</var>fiscal years of the biennium.<br/>
<a id="pl.411.8"></a><var>411.8</var>    Subd. 2. <b>Administration.</b> Positions, salary money, and nonsalary administrative <br/>
<a id="pl.411.9"></a><var>411.9</var>money may be transferred within the Departments of Human Services and Health as the <br/>
<a id="pl.411.10"></a><var>411.10</var>commissioners consider necessary, with the advance approval of the commissioner of <br/>
<a id="pl.411.11"></a><var>411.11</var>finance. The commissioner shall inform the chairs of the relevant house and senate health <br/>
<a id="pl.411.12"></a><var>411.12</var>committees quarterly about transfers made under this provision.<br/>
<br/>
<a id="bill.13.15.0"></a><a id="pl.411.13"></a><var>411.13</var>    Sec. 15. <b>2007 AND 2008 APPROPRIATION AMENDMENTS.</b><br/>
<a id="pl.411.14"></a><var>411.14</var>(a) Notwithstanding Laws 2007, chapter 147, article 19, section 3, subdivision 4, <br/>
<a id="pl.411.15"></a><var>411.15</var>paragraph (g), as amended by Laws 2008, chapter 363, article 18, section 7, the TANF <br/>
<a id="pl.411.16"></a><var>411.16</var>fund base for the Children's Mental Health Pilots is $0 in fiscal year 2011. This paragraph <br/>
<a id="pl.411.17"></a><var>411.17</var>is effective retroactively from July 1, 2008.<br/>
<a id="pl.411.18"></a><var>411.18</var>(b) The appropriation for patient incentive programs under Laws 2007, chapter 147, <br/>
<a id="pl.411.19"></a><var>411.19</var>article 19, section 3, subdivision 6, paragraph (e), is canceled. This paragraph is effective <br/>
<a id="pl.411.20"></a><var>411.20</var>retroactively from July 1, 2007.<br/>
<a id="pl.411.21"></a><var>411.21</var>(c) The onetime general fund base reduction for Child Care Development Grants <br/>
<a id="pl.411.22"></a><var>411.22</var>under Laws 2008, chapter 363, article 18, section 3, subdivision 4, paragraph (d), is <br/>
<a id="pl.411.23"></a><var>411.23</var>increased by $4,000. This paragraph is effective retroactively from July 1, 2008.<br/>
<a id="pl.411.24"></a><var>411.24</var>(d) The base for Children Services Grants under Laws 2008, chapter 363, article 18, <br/>
<a id="pl.411.25"></a><var>411.25</var>section 3, subdivision 4, paragraph (e), is decreased $1,000 in each year of the fiscal year <br/>
<a id="pl.411.26"></a><var>411.26</var>2010 and 2011 biennium. This paragraph is effective retroactively from July 1, 2008.<br/>
<a id="pl.411.27"></a><var>411.27</var>(e) Notwithstanding Laws 2008, chapter 363, article 18, section 3, subdivision 4, the <br/>
<a id="pl.411.28"></a><var>411.28</var>general fund base adjustment for Children and Community Services Grants under Laws <br/>
<a id="pl.411.29"></a><var>411.29</var>2008, chapter 363, article 18, section 3, subdivision 4, paragraph (f), is increased by <br/>
<a id="pl.411.30"></a><var>411.30</var>$98,000 each year of fiscal years 2010 and 2011. This paragraph is effective retroactively <br/>
<a id="pl.411.31"></a><var>411.31</var>from July 1, 2008.<br/>
<a id="pl.411.32"></a><var>411.32</var>(f) The base for Other Continuing Care Grants under Laws 2008, chapter 363, article <br/>
<a id="pl.411.33"></a><var>411.33</var>18, section 3, subdivision 6, paragraph (h), is decreased by $10,000 in fiscal year 2010. <br/>
<a id="pl.411.34"></a><var>411.34</var>This paragraph is effective retroactively from July 1, 2008.<br/>
<br/>
<a id="bill.13.16.0"></a><a id="pl.412.1"></a><var>412.1</var>    Sec. 16. <b>INDIRECT COSTS NOT TO FUND PROGRAMS.</b><br/>
<a id="pl.412.2"></a><var>412.2</var>The commissioners of health and human services shall not use indirect cost <br/>
<a id="pl.412.3"></a><var>412.3</var>allocations to pay for the operational costs of any program for which they are responsible.<br/>
<br/>
<a id="bill.13.17.0"></a><a id="pl.412.4"></a><var>412.4</var>    Sec. 17. <b>EXPIRATION OF UNCODIFIED LANGUAGE.</b><br/>
<a id="pl.412.5"></a><var>412.5</var>    All uncodified language contained in this article expires on June 30, 2011, unless a <br/>
<a id="pl.412.6"></a><var>412.6</var>different expiration date is explicit.<br/>
<br/>
<a id="bill.13.18.0"></a><a id="pl.412.7"></a><var>412.7</var>    Sec. 18. <b>EFFECTIVE DATE.</b><br/>
<a id="pl.412.8"></a><var>412.8</var>    The provisions in this article are effective July 1, 2009, unless a different effective <br/>
<a id="pl.412.9"></a><var>412.9</var>date is specified."<br/>
<a id="pl.412.10"></a><var>412.10</var>Delete the title and insert:<br/>

<a id="pl.412.13"></a><var>412.13</var>amending provisions related to licensing, the Minnesota family investment <br/>
<a id="pl.412.14"></a><var>412.14</var>program, child care, adult supports; fraud prevention, state-operated services, <br/>
<a id="pl.412.15"></a><var>412.15</var>the Minnesota sex offender program, the Department of Health, health care <br/>
<a id="pl.412.16"></a><var>412.16</var>programs, chemical and mental health; continuing care programs, and public <br/>
<a id="pl.412.17"></a><var>412.17</var>health; establishing the State-County Results, Accountability, and Service <br/>
<a id="pl.412.18"></a><var>412.18</var>Delivery Redesign; making technical changes; making forecast adjustments; <br/>
<a id="pl.412.19"></a><var>412.19</var>requiring reports; establishing and increasing fees; appropriating money;<br/>
<a id="pl.412.20"></a><var>412.20</var>amending Minnesota Statutes 2008, sections 60A.092, subdivision 2; 62D.03, <br/>
<a id="pl.412.21"></a><var>412.21</var>subdivision 4; 62D.05, subdivision 3; 62J.495; 62J.496; 62J.497, subdivisions <br/>
<a id="pl.412.22"></a><var>412.22</var>1, 2, by adding subdivisions; 62J.692, subdivision 7; 103I.208, subdivision <br/>
<a id="pl.412.23"></a><var>412.23</var>2; 119B.09, subdivision 7; 119B.13, subdivision 6; 119B.21, subdivisions 5, <br/>
<a id="pl.412.24"></a><var>412.24</var>10; 119B.231, subdivisions 2, 3, 4; 144.0724, subdivisions 2, 4, 8, by adding <br/>
<a id="pl.412.25"></a><var>412.25</var>subdivisions; 144.121, subdivisions 1a, 1b; 144.122; 144.1222, subdivision <br/>
<a id="pl.412.26"></a><var>412.26</var>1a; 144.125, subdivision 1; 144.226, subdivision 4; 144.72, subdivisions 1, 3; <br/>
<a id="pl.412.27"></a><var>412.27</var>144.9501, subdivisions 22b, 26a, by adding subdivisions; 144.9505, subdivisions <br/>
<a id="pl.412.28"></a><var>412.28</var>1g, 4; 144.9508, subdivisions 2, 3, 4; 144.9512, subdivision 2; 144.966, by <br/>
<a id="pl.412.29"></a><var>412.29</var>adding a subdivision; 144.97, subdivisions 2, 4, 6, by adding subdivisions; <br/>
<a id="pl.412.30"></a><var>412.30</var>144.98, subdivisions 1, 2, 3, by adding subdivisions; 144.99, subdivision <br/>
<a id="pl.412.31"></a><var>412.31</var>1; 144A.073, by adding a subdivision; 144A.44, subdivision 2; 144A.46, <br/>
<a id="pl.412.32"></a><var>412.32</var>subdivision 1; 145A.17, by adding a subdivision; 148.6445, by adding a <br/>
<a id="pl.412.33"></a><var>412.33</var>subdivision; 148D.180, subdivisions 1, 2, 3, 5; 148E.180, subdivisions 1, 2, 3, 5; <br/>
<a id="pl.412.34"></a><var>412.34</var>152.126, subdivisions 1, 2, 6; 153A.17; 157.15, by adding a subdivision; 157.16; <br/>
<a id="pl.412.35"></a><var>412.35</var>157.22; 176.011, subdivision 9; 245.462, subdivision 18; 245.470, subdivision <br/>
<a id="pl.412.36"></a><var>412.36</var>1; 245.4871, subdivision 27; 245.488, subdivision 1; 245A.03, by adding a <br/>
<a id="pl.412.37"></a><var>412.37</var>subdivision; 245A.10, subdivisions 2, 3; 245A.11, subdivision 2a, by adding <br/>
<a id="pl.412.38"></a><var>412.38</var>subdivisions; 245A.16, subdivisions 1, 3; 245C.03, subdivision 2; 245C.04, <br/>
<a id="pl.412.39"></a><var>412.39</var>subdivisions 1, 3; 245C.05, subdivision 4, by adding a subdivision; 245C.08, <br/>
<a id="pl.412.40"></a><var>412.40</var>subdivision 2; 245C.10, subdivision 3, by adding subdivisions; 245C.17, by <br/>
<a id="pl.412.41"></a><var>412.41</var>adding a subdivision; 245C.20; 245C.21, subdivision 1a; 245C.23, subdivision 2; <br/>
<a id="pl.412.42"></a><var>412.42</var>246.50, subdivision 5, by adding subdivisions; 246.51, by adding subdivisions; <br/>
<a id="pl.412.43"></a><var>412.43</var>246.511; 246.52; 246.54, subdivision 2; 246B.01, by adding subdivisions; <br/>
<a id="pl.412.44"></a><var>412.44</var>252.025, subdivision 7; 252.46, by adding a subdivision; 252.50, subdivision 1; <br/>
<a id="pl.412.45"></a><var>412.45</var>254A.02, by adding a subdivision; 254A.16, by adding a subdivision; 254B.03, <br/>
<a id="pl.412.46"></a><var>412.46</var>subdivisions 1, 3, by adding a subdivision; 254B.05, subdivision 1; 254B.09, <br/>
<a id="pl.412.47"></a><var>412.47</var>subdivision 2; 256.01, subdivision 2b, by adding subdivisions; 256.045, <br/>
<a id="pl.412.48"></a><var>412.48</var>subdivision 3; 256.476, subdivisions 5, 11; 256.962, subdivisions 2, 6; 256.969, <br/>
<a id="pl.412.49"></a><var>412.49</var>subdivisions 2b, 3a, by adding subdivisions; 256.975, subdivision 7; 256.983, <br/>
<a id="pl.413.1"></a><var>413.1</var>subdivision 1; 256B.04, subdivision 16; 256B.055, subdivisions 7, 12; 256B.056, <br/>
<a id="pl.413.2"></a><var>413.2</var>subdivisions 3c, 3d; 256B.057, by adding a subdivision; 256B.0575; 256B.0595, <br/>
<a id="pl.413.3"></a><var>413.3</var>subdivisions 1, 2; 256B.06, subdivisions 4, 5; 256B.0621, subdivision 2; <br/>
<a id="pl.413.4"></a><var>413.4</var>256B.0622, subdivision 2; 256B.0623, subdivision 5; 256B.0624, subdivisions <br/>
<a id="pl.413.5"></a><var>413.5</var>5, 8; 256B.0625, subdivisions 3, 3c, 6a, 7, 9, 11, 13, 13e, 13h, 17, 17a, 19a, <br/>
<a id="pl.413.6"></a><var>413.6</var>19c, 26, 42, 47, by adding subdivisions; 256B.0641, subdivision 3; 256B.0651; <br/>
<a id="pl.413.7"></a><var>413.7</var>256B.0652; 256B.0653; 256B.0654; 256B.0655, subdivisions 1b, 4; 256B.0657, <br/>
<a id="pl.413.8"></a><var>413.8</var>subdivisions 2, 6, 8, by adding a subdivision; 256B.08, by adding a subdivision; <br/>
<a id="pl.413.9"></a><var>413.9</var>256B.0911, subdivisions 1, 1a, 3, 3a, 3b, 3c, 4a, 5, 6, 7, by adding subdivisions; <br/>
<a id="pl.413.10"></a><var>413.10</var>256B.0913, subdivision 4; 256B.0915, subdivisions 3a, 3e, 3h, 5, by adding a <br/>
<a id="pl.413.11"></a><var>413.11</var>subdivision; 256B.0916, subdivision 2; 256B.0917, by adding a subdivision; <br/>
<a id="pl.413.12"></a><var>413.12</var>256B.092, subdivision 8a, by adding subdivisions; 256B.0943, subdivisions 1, <br/>
<a id="pl.413.13"></a><var>413.13</var>12; 256B.0944, by adding a subdivision; 256B.0947, subdivision 1; 256B.15, <br/>
<a id="pl.413.14"></a><var>413.14</var>subdivisions 1, 1a, 1h, 2, by adding subdivisions; 256B.199; 256B.37, <br/>
<a id="pl.413.15"></a><var>413.15</var>subdivisions 1, 5; 256B.434, subdivision 4, by adding a subdivision; 256B.437, <br/>
<a id="pl.413.16"></a><var>413.16</var>subdivision 6; 256B.441, subdivisions 55, 58, by adding a subdivision; 256B.49, <br/>
<a id="pl.413.17"></a><var>413.17</var>subdivisions 12, 13, 14, 17, by adding subdivisions; 256B.501, subdivision <br/>
<a id="pl.413.18"></a><var>413.18</var>4a; 256B.5011, subdivision 2; 256B.5012, by adding a subdivision; 256B.69, <br/>
<a id="pl.413.19"></a><var>413.19</var>subdivisions 5a, 5c, 5f, 23; 256B.76, subdivision 1; 256D.03, subdivision 4; <br/>
<a id="pl.413.20"></a><var>413.20</var>256D.44, subdivision 5; 256G.02, subdivision 6; 256I.03, subdivision 7; 256I.05, <br/>
<a id="pl.413.21"></a><var>413.21</var>subdivisions 1a, 7c; 256J.08, subdivision 73a; 256J.24, subdivision 5; 256J.425, <br/>
<a id="pl.413.22"></a><var>413.22</var>subdivisions 2, 3; 256J.45, subdivision 3; 256J.49, subdivisions 1, 4; 256J.521, <br/>
<a id="pl.413.23"></a><var>413.23</var>subdivision 2; 256J.545; 256J.561, subdivisions 2, 3; 256J.57, subdivision <br/>
<a id="pl.413.24"></a><var>413.24</var>1; 256J.575, subdivisions 3, 4, 6, 7; 256J.621; 256J.626, subdivision 7; <br/>
<a id="pl.413.25"></a><var>413.25</var>256J.95, subdivisions 3, 11, 12, 13; 256L.03, by adding a subdivision; 256L.04, <br/>
<a id="pl.413.26"></a><var>413.26</var>subdivisions 1, 7a, 10a, by adding a subdivision; 256L.05, subdivisions 1, 3, 3a, <br/>
<a id="pl.413.27"></a><var>413.27</var>by adding a subdivision; 256L.07, subdivisions 1, 2, 3, by adding a subdivision; <br/>
<a id="pl.413.28"></a><var>413.28</var>256L.11, subdivision 1; 256L.15, subdivisions 2, 3; 256L.17, subdivisions 3, 5; <br/>
<a id="pl.413.29"></a><var>413.29</var>259.67, by adding a subdivision; 270A.09, by adding a subdivision; 327.14, <br/>
<a id="pl.413.30"></a><var>413.30</var>by adding a subdivision; 327.15; 327.16; 327.20, subdivision 1, by adding a <br/>
<a id="pl.413.31"></a><var>413.31</var>subdivision; 501B.89, by adding a subdivision; 519.05; 604A.33, subdivision <br/>
<a id="pl.413.32"></a><var>413.32</var>1; 609.232, subdivision 11; 626.556, subdivision 3c; 626.5572, subdivisions <br/>
<a id="pl.413.33"></a><var>413.33</var>6, 13, 21; Laws 2003, First Special Session chapter 14, article 13C, section <br/>
<a id="pl.413.34"></a><var>413.34</var>2, subdivision 1, as amended; Laws 2007, chapter 147, article 19, section 3, <br/>
<a id="pl.413.35"></a><var>413.35</var>subdivision 4, as amended; proposing coding for new law in Minnesota Statutes, <br/>
<a id="pl.413.36"></a><var>413.36</var>chapters 62Q; 246B; 254B; 256; 256B; proposing coding for new law as <br/>
<a id="pl.413.37"></a><var>413.37</var>Minnesota Statutes, chapter 402A; repealing Minnesota Statutes 2008, sections <br/>
<a id="pl.413.38"></a><var>413.38</var>103I.112; 144.9501, subdivision 17b; 148D.180, subdivision 8; 245C.11, <br/>
<a id="pl.413.39"></a><var>413.39</var>subdivisions 1, 2; 246.51, subdivision 1; 246.53, subdivision 3; 256.962, <br/>
<a id="pl.413.40"></a><var>413.40</var>subdivision 7; 256B.0655, subdivisions 1, 1a, 1c, 1d, 1e, 1f, 1g, 1h, 1i, 2, 3, 5, 6, <br/>
<a id="pl.413.41"></a><var>413.41</var>7, 8, 9, 10, 11, 12, 13; 256B.071, subdivisions 1, 2, 3, 4; 256B.092, subdivision <br/>
<a id="pl.413.42"></a><var>413.42</var>5a; 256B.19, subdivision 1d; 256B.431, subdivision 23; 256I.06, subdivision <br/>
<a id="pl.413.43"></a><var>413.43</var>9; 256L.17, subdivision 6; 327.14, subdivisions 5, 6; Minnesota Rules, parts <br/>
<a id="pl.413.44"></a><var>413.44</var>4626.2015, subpart 9; 9555.6125, subpart 4, item B."<br/>
         		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
         <table>
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<tr>
<td><a id="pl.414.1"></a><var>414.1</var><br/>
</td>
<td colspan="3">We request the adoption of this report and repassage of the bill.<br/>
</td>
</tr>
<tr>
<td><a id="pl.414.2"></a><var>414.2</var><br/>
</td>
<td>House Conferees:<span width="2em"></span>(Signed)<br/>
</td>
<td></td>
<td></td>
</tr>
<tr>
<td><a id="pl.414.3"></a><var>414.3</var><br/>
</td>
<td><span>
                     							.....
                     						</span><br/>
</td>
<td></td>
<td><span>
                     							.....
                     						</span><br/>
</td>
</tr>
<tr>
<td><a id="pl.414.4"></a><var>414.4</var><br/>
</td>
<td>Thomas Huntley<br/>
</td>
<td></td>
<td>Paul Thissen<br/>
</td>
</tr>
<tr>
<td><a id="pl.414.5"></a><var>414.5</var><br/>
</td>
<td><span>
                     							.....
                     						</span><br/>
</td>
<td></td>
<td><span>
                     							.....
                     						</span><br/>
</td>
</tr>
<tr>
<td><a id="pl.414.6"></a><var>414.6</var><br/>
</td>
<td>Larry Hosch<br/>
</td>
<td></td>
<td>Karen Clark<br/>
</td>
</tr>
<tr>
<td><a id="pl.414.7"></a><var>414.7</var><br/>
</td>
<td><span>
                     							.....
                     						</span><br/>
</td>
<td></td>
<td></td>
</tr>
<tr>
<td><a id="pl.414.8"></a><var>414.8</var><br/>
</td>
<td>Jim Abeler<br/>
</td>
<td></td>
<td></td>
</tr>
<tr>
<td><a id="pl.414.9"></a><var>414.9</var><br/>
</td>
<td>Senate Conferees:<span width="2em"></span>(Signed)<br/>
</td>
<td></td>
<td></td>
</tr>
<tr>
<td><a id="pl.414.10"></a><var>414.10</var><br/>
</td>
<td><span>
                     							.....
                     						</span><br/>
</td>
<td></td>
<td><span>
                     							.....
                     						</span><br/>
</td>
</tr>
<tr>
<td><a id="pl.414.11"></a><var>414.11</var><br/>
</td>
<td>Linda Berglin<br/>
</td>
<td></td>
<td>Tony Lourey<br/>
</td>
</tr>
<tr>
<td><a id="pl.414.12"></a><var>414.12</var><br/>
</td>
<td><span>
                     							.....
                     						</span><br/>
</td>
<td></td>
<td><span>
                     							.....
                     						</span><br/>
</td>
</tr>
<tr>
<td><a id="pl.414.13"></a><var>414.13</var><br/>
</td>
<td>Kathy Sheran<br/>
</td>
<td></td>
<td>Julie Rosen<br/>
</td>
</tr>
<tr>
<td><a id="pl.414.14"></a><var>414.14</var><br/>
</td>
<td><span>
                     							.....
                     						</span><br/>
</td>
<td></td>
<td></td>
</tr>
<tr>
<td><a id="pl.414.15"></a><var>414.15</var><br/>
</td>
<td>Yvonne Prettner Solon<br/>
</td>
<td></td>
<td></td>
</tr>
</table>