1.1 	A bill for an act
1.2 	relating to state government; making technical health and human services 
1.3 	changes; making health care program policy changes; changing health care 
1.4 	eligibility provisions; authorizing rulemaking; requiring reports; changing 
1.5 	appropriations; appropriating money;amending Minnesota Statutes 2008, 
1.6 	sections 62J.2930, subdivision 3; 62J.497, subdivision 5, as added; 144.0724, 
1.7 	subdivision 11, as added; 245.494, subdivision 3; 245A.11, subdivision 7a, 
1.8 	as added; 245C.03, by adding a subdivision; 245C.04, subdivision 1, as 
1.9 	amended, by adding a subdivision; 245C.05, subdivision 2b, as added; 245C.10, 
1.10 	subdivision 5, as added, by adding a subdivision; 245C.21, subdivision 1a, as 
1.11 	amended; 246.50, subdivision 3; 256.01, subdivision 18b, as added; 256.015, 
1.12 	subdivision 7; 256.969, subdivisions 2b, as amended, 3a, 29, as added, by adding 
1.13 	a subdivision; 256.975, subdivision 7, as amended; 256B.037, subdivision 5; 
1.14 	256B.056, subdivisions 1c, 3b, 3c, 6; 256B.057, subdivision 11, as added; 
1.15 	256B.06, subdivision 4, as amended; 256B.0625, subdivisions 3c, as amended, 
1.16 	13h, as amended, by adding subdivisions; 256B.0655, subdivision 4, as amended; 
1.17 	256B.0659, subdivisions 9, as added, 10, as added, 13, as added, 21, as added, 
1.18 	29, as added; 256B.0911, subdivision 1a, as amended; 256B.094, subdivision 
1.19 	3; 256B.195, subdivisions 1, 2, 3; 256B.441, subdivision 55, as amended; 
1.20 	256B.49, subdivision 11a, as added; 256B.69, subdivision 5a; 256B.756, as 
1.21 	added; 256B.76, subdivision 1, as amended; 256B.77, subdivision 13; 256D.03, 
1.22 	subdivisions 3, 4, as amended; 256J.575, subdivision 3, as amended; 256L.01, 
1.23 	by adding a subdivision; 256L.03, subdivisions 3b, as added, 5; 256L.04, 
1.24 	subdivision 1, as amended; 256L.05, subdivision 1c, as added; 256L.11, 
1.25 	subdivision 1, as amended; 256L.15, subdivision 2; 402A.30, subdivision 4, as 
1.26 	added; 626.556, subdivision 3c, as amended; Laws 2005, First Special Session 
1.27 	chapter 4, article 8, sections 54; 61; 63; 66; 74; Laws 2009, chapter 79, article 
1.28 	2, section 36; article 5, sections 25; 52; article 8, sections 8; 13; 73; article 10, 
1.29 	section 46; article 13, sections 3; 4; 5; 6; repealing Minnesota Statutes 2008, 
1.30 	sections 256B.031; 256L.01, subdivision 4; Laws 2005, First Special Session 
1.31 	chapter 4, article 8, sections 21; 22; 23; 24; Laws 2009, chapter 79, article 7, 
1.32 	section 12; article 13, sections 7; 8.
1.33 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

2.1 	ARTICLE 1
2.2 	HEALTH AND HUMAN SERVICES TECHNICAL

2.3 	Section 1. Minnesota Statutes 2008, section 62J.497, subdivision 5, as added by Laws 
2.4 	2009, chapter 79, article 4, section 6, is amended to read:
2.5 		Subd. 5.Electronic drug prior authorization standardization and transmission.
 2.6 	(a) The commissioner of health, in consultation with the Minnesota e-Health Advisory 
2.7 	Committee and the Minnesota Administrative Uniformity Committee, shall, by February 
2.8 	15, 2010, identify an outline on how best to standardize drug prior authorization request 
2.9 	transactions between providers and group purchasers with the goal of maximizing 
2.10 	administrative simplification and efficiency in preparation for electronic transmissions.
2.11 	(b) No later than January 1, 2011, drug prior authorization requests must be 
2.12 	accessible and submitted by health care providers, and accepted and processed by group 
2.13 	purchasers, electronically through secure electronic transmissions. Facsimile shall not be 
2.14 	considered electronic transmission.

2.15 	Sec. 2. Minnesota Statutes 2008, section 144.0724, subdivision 11, as added by Laws 
2.16 	2009, chapter 79, article 8, section 4, is amended to read:
2.17 		Subd. 11.Nursing facility level of care. (a) For purposes of medical assistance 
2.18 	payment of long-term care services, a recipient must be determined, using assessments 
2.19 	defined in subdivision 4, to meet one of the following nursing facility level of care criteria:
2.20 	(1) the person needs the assistance of another person or constant supervision to begin 
2.21 	and complete at least four of the following activities of living: bathing, bed mobility, 
2.22 	dressing, eating, grooming, toileting, transferring, and walking; 
2.23 	(2) the person needs the assistance of another person or constant supervision to begin 
2.24 	and complete toileting, transferring, or positioning and the assistance cannot be scheduled;
2.25 	(3) the person has significant difficulty with memory, using information, daily 
2.26 	decision making, or behavioral needs that require intervention;
2.27 	(4) the person has had a qualifying nursing facility stay of at least 90 days; or
2.28 	(5) the person is determined to be at risk for nursing facility admission or 
2.29 	readmission through a face-to-face long-term care consultation assessment as specified 
2.30 	in section 256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or managed care 
2.31 	organization under contract with the Department of Human Services. The person is 
2.32 	considered at risk under this clause if the person currently lives alone or will live alone 
2.33 	upon discharge and also meets one of the following criteria:
2.34 	(i) the person has experienced a fall resulting in a fracture;
3.1 	(ii) the person has been determined to be at risk of maltreatment or neglect, 
3.2 	including self-neglect; or
3.3 	(iii) the person has a sensory impairment that substantially impacts functional ability 
3.4 	and maintenance of a community residence.
3.5 	(b) The assessment used to establish medical assistance payment for nursing facility 
3.6 	services must be the most recent assessment performed under subdivision 4, paragraph 
3.7 	(b), that occurred no more than 90 calendar days before the effective date of medical 
3.8 	assistance eligibility for payment of long-term care services. In no case shall medical 
3.9 	assistance payment for long-term care services occur prior to the date of the determination 
3.10 	of nursing facility level of care.
3.11 	(c) The assessment used to establish medical assistance payment for long-term care 
3.12 	services provided under sections 256B.0915 and 256B.49 and alternative care payment 
3.13 	for services provided under section 256B.0913 must be the most recent face-to-face 
3.14 	assessment performed under section 256B.0911, subdivision 3a, 3b, or 4d, that occurred 
3.15 	no more than 60 calendar days before the effective date of medical assistance eligibility 
3.16 	for payment of long-term care services.

3.17 	Sec. 3. Minnesota Statutes 2008, section 245A.11, subdivision 7a, as added by Laws 
3.18 	2009, chapter 79, article 1, section 4, is amended to read:
3.19 		Subd. 7a.Alternate overnight supervision technology; adult foster care license.
 3.20 	(a) The commissioner may grant an applicant or license holder an adult foster care license 
3.21 	for a residence that does not have a caregiver in the residence during normal sleeping 
3.22 	hours as required under Minnesota Rules, part 9555.5105, subpart 37, item B, but uses 
3.23 	monitoring technology to alert the license holder when an incident occurs that may 
3.24 	jeopardize the health, safety, or rights of a foster care recipient. The applicant or license 
3.25 	holder must comply with all other requirements under Minnesota Rules, parts 9555.5105 
3.26 	to 9555.6265, and the requirements under this subdivision. The license printed by the 
3.27 	commissioner must state in bold and large font:
3.28 	(1) that the facility is under electronic monitoring; and
3.29 	(2) the telephone number of the county's common entry point for making reports of 
3.30 	suspected maltreatment of vulnerable adults under section 626.557, subdivision 9.
3.31 	(b) Applications for a license under this section must be submitted directly to 
3.32 	the Department of Human Services licensing division. The licensing division must 
3.33 	immediately notify the host county and lead county contract agency and the host county 
3.34 	licensing agency. The licensing division must collaborate with the county licensing 
3.35 	agency in the review of the application and the licensing of the program.
4.1 	(c) Before a license is issued by the commissioner, and for the duration of the 
4.2 	license, the applicant or license holder must establish, maintain, and document the 
4.3 	implementation of written policies and procedures addressing the requirements in 
4.4 	paragraphs (d) through (f).
4.5 	(d) The applicant or license holder must have policies and procedures that:
4.6 	(1) establish characteristics of target populations that will be admitted into the home, 
4.7 	and characteristics of populations that will not be accepted into the home;
4.8 	(2) explain the discharge process when a foster care recipient requires overnight 
4.9 	supervision or other services that cannot be provided by the license holder due to the 
4.10 	limited hours that the license holder is on-site;
4.11 	(3) describe the types of events to which the program will respond with a physical 
4.12 	presence when those events occur in the home during time when staff are not on-site, and 
4.13 	how the license holder's response plan meets the requirements in paragraph (e), clause 
4.14 	(1) or (2);
4.15 	(4) establish a process for documenting a review of the implementation and 
4.16 	effectiveness of the response protocol for the response required under paragraph (e), 
4.17 	clause (1) or (2). The documentation must include:
4.18 	(i) a description of the triggering incident;
4.19 	(ii) the date and time of the triggering incident;
4.20 	(iii) the time of the response or responses under paragraph (e), clause (1) or (2);
4.21 	(iv) whether the response met the resident's needs;
4.22 	(v) whether the existing policies and response protocols were followed; and
4.23 	(vi) whether the existing policies and protocols are adequate or need modification.
4.24 	When no physical presence response is completed for a three-month period, the 
4.25 	license holder's written policies and procedures must require a physical presence response 
4.26 	drill be to conducted for which the effectiveness of the response protocol under paragraph 
4.27 	(e), clause (1) or (2), will be reviewed and documented as required under this clause; and
4.28 	(5) establish that emergency and nonemergency phone numbers are posted in a 
4.29 	prominent location in a common area of the home where they can be easily observed by a 
4.30 	person responding to an incident who is not otherwise affiliated with the home.
4.31 	(e) The license holder must document and include in the license application which 
4.32 	response alternative under clause (1) or (2) is in place for responding to situations that 
4.33 	present a serious risk to the health, safety, or rights of people receiving foster care services 
4.34 	in the home:
4.35 	(1) response alternative (1) requires only the technology to provide an electronic 
4.36 	notification or alert to the license holder that an event is underway that requires a response. 
5.1 	Under this alternative, no more than ten minutes will pass before the license holder will be 
5.2 	physically present on-site to respond to the situation; or
5.3 	(2) response alternative (2) requires the electronic notification and alert system 
5.4 	under alternative (1), but more than ten minutes may pass before the license holder is 
5.5 	present on-site to respond to the situation. Under alternative (2), all of the following 
5.6 	conditions are met:
5.7 	(i) the license holder has a written description of the interactive technological 
5.8 	applications that will assist the licenser license holder in communicating with and assessing 
5.9 	the needs related to care, health, and safety of the foster care recipients. This interactive 
5.10 	technology must permit the license holder to remotely assess the well being of the foster 
5.11 	care recipient without requiring the initiation of the foster care recipient. Requiring the 
5.12 	foster care recipient to initiate a telephone call does not meet this requirement;
5.13 	(ii) the license holder documents how the remote license holder is qualified and 
5.14 	capable of meeting the needs of the foster care recipients and assessing foster care 
5.15 	recipients' needs under item (i) during the absence of the license holder on-site;
5.16 	(iii) the license holder maintains written procedures to dispatch emergency response 
5.17 	personnel to the site in the event of an identified emergency; and
5.18 	(iv) each foster care recipient's individualized plan of care, individual service plan 
5.19 	under section 256B.092, subdivision 1b, if required, or individual resident placement 
5.20 	agreement under Minnesota Rules, part 9555.5105, subpart 19, if required, identifies the 
5.21 	maximum response time, which may be greater than ten minutes, for the license holder 
5.22 	to be on-site for that foster care recipient.
5.23 	(f) All placement agreements, individual service agreements, and plans applicable 
5.24 	to the foster care recipient must clearly state that the adult foster care license category is 
5.25 	a program without the presence of a caregiver in the residence during normal sleeping 
5.26 	hours; the protocols in place for responding to situations that present a serious risk 
5.27 	to health, safety, or rights of foster care recipients under paragraph (e), clause (1) or 
5.28 	(2); and a signed informed consent from each foster care recipient or the person's 
5.29 	legal representative documenting the person's or legal representative's agreement with 
5.30 	placement in the program. If electronic monitoring technology is used in the home, the 
5.31 	informed consent form must also explain the following:
5.32 	(1) how any electronic monitoring is incorporated into the alternative supervision 
5.33 	system;
5.34 	(2) the backup system for any electronic monitoring in times of electrical outages or 
5.35 	other equipment malfunctions;
5.36 	(3) how the license holder is trained on the use of the technology;
6.1 	(4) the event types and license holder response times established under paragraph (e);
6.2 	(5) how the license holder protects the foster care recipient's privacy related to 
6.3 	electronic monitoring and related to any electronically recorded data generated by the 
6.4 	monitoring system. A foster care recipient may not be removed from a program under 
6.5 	this subdivision for failure to consent to electronic monitoring. The consent form must 
6.6 	explain where and how the electronically recorded data is stored, with whom it will be 
6.7 	shared, and how long it is retained; and
6.8 	(6) the risks and benefits of the alternative overnight supervision system. 
6.9 	The written explanations under clauses (1) to (6) may be accomplished through 
6.10 	cross-references to other policies and procedures as long as they are explained to the 
6.11 	person giving consent, and the person giving consent is offered a copy.
6.12 	(g) Nothing in this section requires the applicant or license holder to develop or 
6.13 	maintain separate or duplicative polices, procedures, documentation, consent forms, or 
6.14 	individual plans that may be required for other licensing standards, if the requirements of 
6.15 	this section are incorporated into those documents.
6.16 	(h) The commissioner may grant variances to the requirements of this section 
6.17 	according to section 245A.04, subdivision 9.
6.18 	(i) For the purposes of paragraphs (d) through (h), license holder has the meaning 
6.19 	under section 245A.2, subdivision 9, and additionally includes all staff, volunteers, and 
6.20 	contractors affiliated with the license holder.
6.21 	(j) For the purposes of paragraph (e), the terms "assess" and "assessing" mean to 
6.22 	remotely determine what action the license holder needs to take to protect the well-being 
6.23 	of the foster care recipient.

6.24 	Sec. 4. Minnesota Statutes 2008, section 245C.03, is amended by adding a subdivision 
6.25 	to read:
6.26 		Subd. 6.Unlicensed home and community-based waiver providers of service to 
6.27 	seniors and individuals with disabilities. The commissioner shall conduct background 
6.28 	studies on any individual required under section 256B.4912 to have a background study 
6.29 	completed under this chapter.

6.30 	Sec. 5. Minnesota Statutes 2008, section 245C.04, subdivision 1, as amended by Laws 
6.31 	2009, chapter 79, article 1, section 8, is amended to read:
6.32 		Subdivision 1.Licensed programs. (a) The commissioner shall conduct a 
6.33 	background study of an individual required to be studied under section 245C.03, 
6.34 	subdivision 1, at least upon application for initial license for all license types. 
7.1 	(b) The commissioner shall conduct a background study of an individual required 
7.2 	to be studied under section 245C.03, subdivision 1, at reapplication for a license for 
7.3 	family child care. 
7.4 	(c) The commissioner is not required to conduct a study of an individual at the time 
7.5 	of reapplication for a license if the individual's background study was completed by the 
7.6 	commissioner of human services for an adult foster care license holder that is also:
7.7 	(1) registered under chapter 144D; or
7.8 	(2) licensed to provide home and community-based services to people with 
7.9 	disabilities at the foster care location and the license holder does not reside in the foster 
7.10 	care residence; and
7.11 	(3) the following conditions are met:
7.12 	(i) a study of the individual was conducted either at the time of initial licensure or 
7.13 	when the individual became affiliated with the license holder;
7.14 	(ii) the individual has been continuously affiliated with the license holder since 
7.15 	the last study was conducted; and
7.16 	(iii) the last study of the individual was conducted on or after October 1, 1995.
7.17 	(d) From July 1, 2007, to June 30, 2009, the commissioner of human services shall 
7.18 	conduct a study of an individual required to be studied under section 245C.03, at the 
7.19 	time of reapplication for a child foster care license. The county or private agency shall 
7.20 	collect and forward to the commissioner the information required under section 245C.05, 
7.21 	subdivisions 1, paragraphs (a) and (b), and 5, paragraphs (a) and (b). The background 
7.22 	study conducted by the commissioner of human services under this paragraph must 
7.23 	include a review of the information required under section 245C.08, subdivisions 1, 
7.24 	paragraph (a), clauses (1) to (5), 3, and 4.
7.25 	(e) The commissioner of human services shall conduct a background study of an 
7.26 	individual specified under section 245C.03, subdivision 1, paragraph (a), clauses (2) 
7.27 	to (6), who is newly affiliated with a child foster care license holder. The county or 
7.28 	private agency shall collect and forward to the commissioner the information required 
7.29 	under section 245C.05, subdivisions 1 and 5. The background study conducted by the 
7.30 	commissioner of human services under this paragraph must include a review of the 
7.31 	information required under section 245C.08, subdivisions 1, 3, and 4.
7.32 	(f) From January 1, 2010, to December 31, 2012, unless otherwise specified in 
7.33 	paragraph (c), the commissioner shall conduct a study of an individual required to be 
7.34 	studied under section 245C.03 at the time of reapplication for an adult foster care or family 
7.35 	adult day services license: (1) the county shall collect and forward to the commissioner 
7.36 	the information required under section 245C.05, subdivision 1, paragraphs (a) and (b), 
8.1 	and subdivision 5, paragraphs (a) and (b), for background studies conducted by the 
8.2 	commissioner for all family adult day services and for adult foster care and family adult 
8.3 	day services when the adult foster care license holder resides in the adult foster care 
8.4 	or family adult day services residence; (2) the license holder shall collect and forward 
8.5 	to the commissioner the information required under section 245C.05, subdivisions 1, 
8.6 	paragraphs (a) and (b); and 5, paragraphs (a) and (b), for background studies conducted by 
8.7 	the commissioner for adult foster care when the license holder does not reside in the adult 
8.8 	foster care residence; and (3) the background study conducted by the commissioner under 
8.9 	this paragraph must include a review of the information required under section 245C.08, 
8.10 	subdivision 1, paragraph (a), clauses (1) to (5), and subdivisions 3 and 4.
8.11 	(g) The commissioner shall conduct a background study of an individual specified 
8.12 	under section 245C.03, subdivision 1, paragraph (a), clauses (2) to (6), who is newly 
8.13 	affiliated with an adult foster care or family adult day services license holder: (1) the 
8.14 	county shall collect and forward to the commissioner the information required under 
8.15 	section 245C.05, subdivision 1, paragraphs (a) and (b), and subdivision 5, paragraphs (a) 
8.16 	and (b), for background studies conducted by the commissioner for all family adult day 
8.17 	services and for adult foster care and family adult day services when the adult foster care 
8.18 	license holder resides in the adult foster care or family adult day services residence; (2) 
8.19 	the license holder shall collect and forward to the commissioner the information required 
8.20 	under section 245C.05, subdivisions 1, paragraphs (a) and (b); and 5, paragraphs (a) 
8.21 	and (b), for background studies conducted by the commissioner for adult foster care 
8.22 	when the license holder does not reside in the adult foster care residence; and (3) the 
8.23 	background study conducted by the commissioner under this paragraph must include a 
8.24 	review of the information required under section 245C.08, subdivision 1, paragraph (a), 
8.25 	and subdivisions 3 and 4.
8.26 	(h) Applicants for licensure, license holders, and other entities as provided in this 
8.27 	chapter must submit completed background study forms to the commissioner before 
8.28 	individuals specified in section 245C.03, subdivision 1, begin positions allowing direct 
8.29 	contact in any licensed program. 
8.30 	(i) For purposes of this section, a physician licensed under chapter 147 is considered 
8.31 	to be continuously affiliated upon the license holder's receipt from the commissioner of 
8.32 	health or human services of the physician's background study results.

8.33 	Sec. 6. Minnesota Statutes 2008, section 245C.04, is amended by adding a subdivision 
8.34 	to read:
9.1 		Subd. 6.Unlicensed home and community-based waiver providers of service to 
9.2 	seniors and individuals with disabilities. (a) Providers required to initiate background 
9.3 	studies under section 256B.4912 must initiate a study before the individual begins in a 
9.4 	position allowing direct contact with persons served by the provider.
9.5 	(b) The commissioner shall conduct a background study annually of an individual 
9.6 	required to be studied under section 245C.03, subdivision 6.

9.7 	Sec. 7. Minnesota Statutes 2008, section 245C.05, subdivision 2b, as added by Laws 
9.8 	2009, chapter 79, article 1, section 9, is amended to read:
9.9 		Subd. 2b.County agency to collect and forward information to the 
9.10 	commissioner. For background studies related to all family adult day services and to adult 
9.11 	foster care and family adult day services when the adult foster care license holder resides 
9.12 	in the adult foster care or family adult day services residence, the county agency must 
9.13 	collect the information required under subdivision 1 and forward it to the commissioner.

9.14 	Sec. 8. Minnesota Statutes 2008, section 245C.10, subdivision 5, as added by Laws 
9.15 	2009, chapter 79, article 1, section 12, is amended to read:
9.16 		Subd. 5.Adult foster care and family adult day services. The commissioner shall 
9.17 	recover the cost of background studies required under section 245C.03, subdivision 1, 
9.18 	for the purposes of adult foster care and family adult day services licensing, through 
9.19 	a fee of no more than $20 per study charged to the license holder. The fees collected 
9.20 	under this subdivision are appropriated to the commissioner for the purpose of conducting 
9.21 	background studies.

9.22 	Sec. 9. Minnesota Statutes 2008, section 245C.10, is amended by adding a subdivision 
9.23 	to read:
9.24 		Subd. 6.Unlicensed home and community-based waiver providers of service to 
9.25 	seniors and individuals with disabilities. The commissioner shall recover the cost of 
9.26 	background studies initiated by unlicensed home and community-based waiver providers 
9.27 	of service to seniors and individuals with disabilities under section 256B.4912 through a 
9.28 	fee of no more than $20 per study.

9.29 	Sec. 10. Minnesota Statutes 2008, section 245C.21, subdivision 1a, as amended by 
9.30 	Laws 2009, chapter 79, article 1, section 16, is amended to read:
9.31 		Subd. 1a.Submission of reconsideration request. (a) For disqualifications related 
9.32 	to studies conducted by county agencies for family child care, and for disqualifications 
10.1 	related to studies conducted by the commissioner for child foster care, adult foster care, 
10.2 	and family adult day services, the individual shall submit the request for reconsideration 
10.3 	to the county agency that initiated the background study.
10.4 	(b) For disqualifications related to studies conducted by the commissioner for child 
10.5 	foster care providers monitored by private licensing agencies under section 245A.16, the 
10.6 	individual shall submit the request for reconsideration to the private agency that initiated 
10.7 	the background study.
10.8 	(c) A reconsideration request shall be submitted within 30 days of the individual's 
10.9 	receipt of the disqualification notice or the time frames specified in subdivision 2, 
10.10 	whichever time frame is shorter.
10.11 	(d) The county or private agency shall forward the individual's request for 
10.12 	reconsideration and provide the commissioner with a recommendation whether to set aside 
10.13 	the individual's disqualification.

10.14 	Sec. 11. Minnesota Statutes 2008, section 246.50, subdivision 3, is amended to read:
10.15 		Subd. 3.State facility. "State facility" means any state facility owned or operated 
10.16 	by the state of Minnesota and under the programmatic direction or fiscal control of the 
10.17 	commissioner, except the Minnesota sex offender program under chapter 246B. State 
10.18 	facility includes regional treatment centers; the state nursing homes; state-operated, 
10.19 	community-based programs; and other facilities owned or operated by the state and under 
10.20 	the commissioner's control.

10.21 	Sec. 12. Minnesota Statutes 2008, section 256.01, subdivision 18b, as added by Laws 
10.22 	2009, chapter 79, article 5, section 7, is amended to read:
10.23 		Subd. 18b.Protections for American Indians. Effective February 18 July 1, 
10.24 	2009, the commissioner shall comply with the federal requirements in the American 
10.25 	Recovery and Reinvestment Act of 2009, Public Law 111-5, section 5006, regarding 
10.26 	American Indians.

10.27 	Sec. 13. Minnesota Statutes 2008, section 256.969, subdivision 2b, as amended by 
10.28 	Laws 2009, chapter 79, article 5, section 11, is amended to read:
10.29 		Subd. 2b.Operating payment rates. In determining operating payment rates for 
10.30 	admissions occurring on or after the rate year beginning January 1, 1991, and every two 
10.31 	years after, or more frequently as determined by the commissioner, the commissioner 
10.32 	shall obtain operating data from an updated base year and establish operating payment 
10.33 	rates per admission for each hospital based on the cost-finding methods and allowable 
11.1 	costs of the Medicare program in effect during the base year. Rates under the general 
11.2 	assistance medical care, medical assistance, and MinnesotaCare programs shall not be 
11.3 	rebased to more current data on January 1, 1997, January 1, 2005, for the first 24 months 
11.4 	of the rebased period beginning January 1, 2009, and. For the first three months of the 
11.5 	rebased period beginning January 1, 2011, rates shall be rebased at 74.25 percent of the 
11.6 	full value of the rebasing percentage change. From April 1, 2011, to March 31, 2012, 
11.7 	rates shall be rebased at 39.2 percent of the full value of the rebasing percentage change. 
11.8 	Effective April 1, 2012, rates shall be rebased at full value. The base year operating 
11.9 	payment rate per admission is standardized by the case mix index and adjusted by the 
11.10 	hospital cost index, relative values, and disproportionate population adjustment. The 
11.11 	cost and charge data used to establish operating rates shall only reflect inpatient services 
11.12 	covered by medical assistance and shall not include property cost information and costs 
11.13 	recognized in outlier payments.

11.14 	Sec. 14. Minnesota Statutes 2008, section 256.969, is amended by adding a subdivision 
11.15 	to read:
11.16 		Subd. 28.Payment rates for births. (a) For admissions occurring on or after 
11.17 	October 1, 2009, the total operating and property payment rate, excluding disproportionate 
11.18 	population adjustment, for the following diagnosis-related groups, as they fall within 
11.19 	the diagnostic categories: (1) 371 cesarean section without complicating diagnosis; (2) 
11.20 	372 vaginal delivery with complicating diagnosis; and (3) 373 vaginal delivery without 
11.21 	complicating diagnosis, shall be no greater than $3,528.
11.22 	(b) The rates described in this subdivision do not include newborn care.
11.23 	(c) Payments to managed care and county-based purchasing plans under section 
11.24 	256B.69, 256B.692, or 256L.12 shall be reduced for services provided on or after October 
11.25 	1, 2009, to reflect the adjustments in paragraph (a).
11.26 	(d) Prior authorization shall not be required before reimbursement is paid for a 
11.27 	cesarean section delivery.

11.28 	Sec. 15. Minnesota Statutes 2008, section 256.969, subdivision 29, as added by Laws 
11.29 	2009, chapter 79, article 5, section 15, is amended to read:
11.30 		Subd. 29.Reimbursement for the fee increase for the early hearing detection 
11.31 	and intervention program. For services providedadmissions occurring on or after 
11.32 	July 1, 2010, in addition to any other payment under this section, the commissioner 
11.33 	shall reimburse hospitals for the increase in the fee for the early hearing detection and 
11.34 	intervention program described in section 144.125, subdivision 1, paid by the hospital 
12.1 	for public program recipients payment rates shall be adjusted to include the increase to 
12.2 	the fee that is effective on July 1, 2010, for the early hearing detection and intervention 
12.3 	program recipients under section 144.125, subdivision 1, that is paid by the hospital for 
12.4 	public program recipients. This payment increase shall be in effect until the increase 
12.5 	is fully recognized in the base year cost under subdivision 2b. This payment shall be 
12.6 	included in payments to contracted managed care organizations.

12.7 	Sec. 16. Minnesota Statutes 2008, section 256.975, subdivision 7, as amended by Laws 
12.8 	2009, chapter 79, article 8, section 16, is amended to read:
12.9 		Subd. 7.Consumer information and assistance and long-term care options 
12.10 	counseling; Senior LinkAge Line. (a) The Minnesota Board on Aging shall operate a 
12.11 	statewide service to aid older Minnesotans and their families in making informed choices 
12.12 	about long-term care options and health care benefits. Language services to persons with 
12.13 	limited English language skills may be made available. The service, known as Senior 
12.14 	LinkAge Line, must be available during business hours through a statewide toll-free 
12.15 	number and must also be available through the Internet.
12.16 	(b) The service must provide long-term care options counseling by assisting older 
12.17 	adults, caregivers, and providers in accessing information and options counseling about 
12.18 	choices in long-term care services that are purchased through private providers or available 
12.19 	through public options. The service must:
12.20 	(1) develop a comprehensive database that includes detailed listings in both 
12.21 	consumer- and provider-oriented formats;
12.22 	(2) make the database accessible on the Internet and through other telecommunication 
12.23 	and media-related tools;
12.24 	(3) link callers to interactive long-term care screening tools and make these tools 
12.25 	available through the Internet by integrating the tools with the database;
12.26 	(4) develop community education materials with a focus on planning for long-term 
12.27 	care and evaluating independent living, housing, and service options;
12.28 	(5) conduct an outreach campaign to assist older adults and their caregivers in 
12.29 	finding information on the Internet and through other means of communication;
12.30 	(6) implement a messaging system for overflow callers and respond to these callers 
12.31 	by the next business day;
12.32 	(7) link callers with county human services and other providers to receive more 
12.33 	in-depth assistance and consultation related to long-term care options;
12.34 	(8) link callers with quality profiles for nursing facilities and other providers 
12.35 	developed by the commissioner of health; 
13.1 	(9) incorporate information about housing with services and consumer rights 
13.2 	within the MinnesotaHelp.info network long-term care database to facilitate consumer 
13.3 	comparison of services and costs among housing with services establishments and with 
13.4 	other in-home services and to support financial self-sufficiency as long as possible. 
13.5 	Housing with services establishments and their arranged home care providers shall provide 
13.6 	information to the commissioner of human services that is consistent with information 
13.7 	required by the commissioner of health under section 144G.06, the Uniform Consumer 
13.8 	Information Guide. The commissioner of human services shall provide the data to the 
13.9 	Minnesota Board on Aging for inclusion in the MinnesotaHelp.info network long-term 
13.10 	care database;
13.11 	(10) provide long-term care options counseling. Long-term care options counselors 
13.12 	shall:
13.13 	(i) for individuals not eligible for case management under a public program or public 
13.14 	funding source, provide interactive decision support under which consumers, family 
13.15 	members, or other helpers are supported in their deliberations to determine appropriate 
13.16 	long-term care choices in the context of the consumer's needs, preferences, values, and 
13.17 	individual circumstances, including implementing a community support plan;
13.18 	(ii) provide Web-based educational information and collateral written materials to 
13.19 	familiarize consumers, family members, or other helpers with the long-term care basics, 
13.20 	issues to be considered, and the range of options available in the community;
13.21 	(iii) provide long-term care futures planning, which means providing assistance to 
13.22 	individuals who anticipate having long-term care needs to develop a plan for the more 
13.23 	distant future; and
13.24 	(iv) provide expertise in benefits and financing options for long-term care, including 
13.25 	Medicare, long-term care insurance, tax or employer-based incentives, reverse mortgages, 
13.26 	private pay options, and ways to access low or no-cost services or benefits through 
13.27 	volunteer-based or charitable programs; and
13.28 	(11) using risk management and support planning protocols, provide long-term care 
13.29 	options counseling to current residents of nursing homes deemed appropriate for discharge 
13.30 	by the commissioner. In order to meet this requirement, the commissioner shall provide 
13.31 	designated Senior LinkAge Line contact centers with a list of nursing home residents 
13.32 	appropriate for discharge planning via a secure Web portal. Senior LinkAge Line shall 
13.33 	provide these residents, if they indicate a preference to receive long-term care options 
13.34 	counseling, with initial assessment, review of risk factors, independent living support 
13.35 	consultation, or referral to:
13.36 	(i) long-term care consultation services under section 256B.0911, subdivision 3;
14.1 	(ii) designated care coordinators of contracted entities under section 256B.035 for 
14.2 	persons who are enrolled in a managed care plan; or
14.3 	(iii) the long-term care consultation team for those who are appropriate for relocation 
14.4 	service coordination due to high-risk factors or psychological or physical disability.

14.5 	Sec. 17. Minnesota Statutes 2008, section 256B.056, subdivision 3b, is amended to 
14.6 	read:
14.7 		Subd. 3b.Treatment of trusts. (a) A "medical assistance qualifying trust" is a 
14.8 	revocable or irrevocable trust, or similar legal device, established on or before August 
14.9 	10, 1993, by a person or the person's spouse under the terms of which the person 
14.10 	receives or could receive payments from the trust principal or income and the trustee 
14.11 	has discretion in making payments to the person from the trust principal or income. 
14.12 	Notwithstanding that definition, a medical assistance qualifying trust does not include: 
14.13 	(1) a trust set up by will; (2) a trust set up before April 7, 1986, solely to benefit a person 
14.14 	with a developmental disability living in an intermediate care facility for persons with 
14.15 	developmental disabilities; or (3) a trust set up by a person with payments made by the 
14.16 	Social Security Administration pursuant to the United States Supreme Court decision in 
14.17 	Sullivan v. Zebley, 110 S. Ct. 885 (1990). The maximum amount of payments that a 
14.18 	trustee of a medical assistance qualifying trust may make to a person under the terms of 
14.19 	the trust is considered to be available assets to the person, without regard to whether the 
14.20 	trustee actually makes the maximum payments to the person and without regard to the 
14.21 	purpose for which the medical assistance qualifying trust was established.
14.22 	(b) Except as provided in paragraphs (c) and (d),  trusts established after August 10, 
14.23 	1993, are treated according to section 13611(b) of the Omnibus Budget Reconciliation 
14.24 	Act of 1993 (OBRA), Public Law 103-66.
14.25 	(c) For purposes of paragraph (d), a pooled trust means a trust established under 
14.26 	United States Code, title 42, section 1396p(d)(4)(C).
14.27 	(d) A beneficiary's interest in a pooled trust is considered an available asset unless 
14.28 	the trust provides that upon the death of the beneficiary or termination of the trust during 
14.29 	the beneficiary's lifetime, whichever is sooner, the department receives any amount, up 
14.30 	to the amount of medical assistance benefits paid on behalf of the beneficiary, remaining 
14.31 	in the beneficiary's trust account after a deduction for reasonable administrative fees 
14.32 	and expenses, and an additional remainder amount. The retained remainder amount 
14.33 	of the subaccount must not exceed ten percent of the account value at the time of the 
14.34 	beneficiary's death or termination of the trust, and must only be used for the benefit of 
14.35 	disabled individuals who have a beneficiary interest in the pooled trust.

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

15.3 	Sec. 18. Minnesota Statutes 2008, section 256B.057, subdivision 11, as added by Laws 
15.4 	2009, chapter 79, article 5, section 19, is amended to read:
15.5 		Subd. 11.Treatment for colorectal cancer. (a) Medical assistance shall be paid for 
15.6 	an individual who:
15.7 	(1) has been screened for colorectal cancer by the colorectal cancer prevention 
15.8 	demonstration project;
15.9 	(2) according to the individual's treating health professional, needs treatment for 
15.10 	colorectal cancer;
15.11 	(3) meets income eligibility guidelines for the colorectal cancer prevention 
15.12 	demonstration project;
15.13 	(4) is under the age of 65; and
15.14 	(5) is not otherwise eligible for medical assistance or covered under creditable 
15.15 	coverage as defined under United States Code, title 42, section 300gg(a)(c), but without 
15.16 	regard to paragraph (1)(F) of such section.
15.17 	(b) Medical assistance provided under this subdivision shall be limited to services 
15.18 	provided during the period that the individual receives treatment for colorectal cancer.
15.19 	(c) An individual meeting the criteria in paragraph (a) is eligible for medical 
15.20 	assistance without meeting the eligibility criteria relating to income and assets in section 
15.21 	256B.056, subdivisions 1a to 5b.
15.22 	(d) This subdivision expires December 31, 2010.

15.23 	Sec. 19. Minnesota Statutes 2008, section 256B.06, subdivision 4, as amended by 
15.24 	Laws 2009, chapter 79, article 5, section 23, is amended to read:
15.25 		Subd. 4. Citizenship requirements. (a) Eligibility for medical assistance is limited 
15.26 	to citizens of the United States, qualified noncitizens as defined in this subdivision, and 
15.27 	other persons residing lawfully in the United States. Citizens or nationals of the United 
15.28 	States must cooperate in obtaining satisfactory documentary evidence of citizenship or 
15.29 	nationality according to the requirements of the federal Deficit Reduction Act of 2005, 
15.30 	Public Law 109-171. 
15.31 	(b) "Qualified noncitizen" means a person who meets one of the following 
15.32 	immigration criteria: 
15.33 	(1) admitted for lawful permanent residence according to United States Code, title 8; 
16.1 	(2) admitted to the United States as a refugee according to United States Code, 
16.2 	title 8, section 1157; 
16.3 	(3) granted asylum according to United States Code, title 8, section 1158; 
16.4 	(4) granted withholding of deportation according to United States Code, title 8, 
16.5 	section 1253(h); 
16.6 	(5) paroled for a period of at least one year according to United States Code, title 8, 
16.7 	section 1182(d)(5); 
16.8 	(6) granted conditional entrant status according to United States Code, title 8, 
16.9 	section 1153(a)(7); 
16.10 	(7) determined to be a battered noncitizen by the United States Attorney General 
16.11 	according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, 
16.12 	title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200; 
16.13 	(8) is a child of a noncitizen determined to be a battered noncitizen by the United 
16.14 	States Attorney General according to the Illegal Immigration Reform and Immigrant 
16.15 	Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill, 
16.16 	Public Law 104-200; or 
16.17 	(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public 
16.18 	Law 96-422, the Refugee Education Assistance Act of 1980. 
16.19 	(c) All qualified noncitizens who were residing in the United States before August 
16.20 	22, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for 
16.21 	medical assistance with federal financial participation. 
16.22 	(d) All qualified noncitizens who entered the United States on or after August 22, 
16.23 	1996, and who otherwise meet the eligibility requirements of this chapter, are eligible for 
16.24 	medical assistance with federal financial participation through November 30, 1996. 
16.25 	Beginning December 1, 1996, qualified noncitizens who entered the United States 
16.26 	on or after August 22, 1996, and who otherwise meet the eligibility requirements of this 
16.27 	chapter are eligible for medical assistance with federal participation for five years if they 
16.28 	meet one of the following criteria: 
16.29 	(i) refugees admitted to the United States according to United States Code, title 8, 
16.30 	section 1157; 
16.31 	(ii) persons granted asylum according to United States Code, title 8, section 1158; 
16.32 	(iii) persons granted withholding of deportation according to United States Code, 
16.33 	title 8, section 1253(h); 
16.34 	(iv) veterans of the United States armed forces with an honorable discharge for 
16.35 	a reason other than noncitizen status, their spouses and unmarried minor dependent 
16.36 	children; or 
17.1 	(v) persons on active duty in the United States armed forces, other than for training, 
17.2 	their spouses and unmarried minor dependent children. 
17.3 	Beginning December 1, 1996, qualified noncitizens who do not meet one of the 
17.4 	criteria in items (i) to (v) are eligible for medical assistance without federal financial 
17.5 	participation as described in paragraph (j). 
17.6 	Notwithstanding paragraph (j), beginning July 1, 2010, children and pregnant 
17.7 	women who are qualified noncitizens, as described in paragraph (b) or (e), are eligible 
17.8 	for medical assistance with federal financial participation as provided by the federal 
17.9 	Children's Health Insurance Program Reauthorization Act of 2009, Public Law 111-3.
17.10 	(e) Noncitizens who are not qualified noncitizens as defined in paragraph (b), who 
17.11 	are lawfully present in the United States, as defined in Code of Federal Regulations, title 
17.12 	8, section 103.12, and who otherwise meet the eligibility requirements of this chapter, are 
17.13 	eligible for medical assistance under clauses (1) to (3). These individuals must cooperate 
17.14 	with the United States Citizenship and Immigration Services to pursue any applicable 
17.15 	immigration status, including citizenship, that would qualify them for medical assistance 
17.16 	with federal financial participation. 
17.17 	(1) Persons who were medical assistance recipients on August 22, 1996, are eligible 
17.18 	for medical assistance with federal financial participation through December 31, 1996. 
17.19 	(2) Beginning January 1, 1997, persons described in clause (1) are eligible for 
17.20 	medical assistance without federal financial participation as described in paragraph (j). 
17.21 	(3) Beginning December 1, 1996, persons residing in the United States prior to 
17.22 	August 22, 1996, who were not receiving medical assistance and persons who arrived on 
17.23 	or after August 22, 1996, are eligible for medical assistance without federal financial 
17.24 	participation as described in paragraph (j). 
17.25 	(f) Nonimmigrants who otherwise meet the eligibility requirements of this chapter 
17.26 	are eligible for the benefits as provided in paragraphs (g) to (i). For purposes of this 
17.27 	subdivision, a "nonimmigrant" is a person in one of the classes listed in United States 
17.28 	Code, title 8, section 1101(a)(15). 
17.29 	(g) Payment shall also be made for care and services that are furnished to noncitizens, 
17.30 	regardless of immigration status, who otherwise meet the eligibility requirements of 
17.31 	this chapter, if such care and services are necessary for the treatment of an emergency 
17.32 	medical condition, except for organ transplants and related care and services and routine 
17.33 	prenatal care. 
17.34 	(h) For purposes of this subdivision, the term "emergency medical condition" means 
17.35 	a medical condition that meets the requirements of United States Code, title 42, section 
17.36 	1396b(v). 
18.1 	(i) Beginning July 1, 2009, pregnant noncitizens who are undocumented, 
18.2 	nonimmigrants, or lawfully present as designated in paragraph (e) and who are not 
18.3 	covered by a group health plan or health insurance coverage according to Code of 
18.4 	Federal Regulations, title 42, section 457.310, and who otherwise meet the eligibility 
18.5 	requirements of this chapter, are eligible for medical assistance through the period of 
18.6 	pregnancy, including labor and delivery, and 60 days postpartum, to the extent federal 
18.7 	funds are available under title XXI of the Social Security Act, and the state children's 
18.8 	health insurance program. 
18.9 	(j) Qualified noncitizens as described in paragraph (d), and all other noncitizens 
18.10 	lawfully residing in the United States as described in paragraph (e), who are ineligible 
18.11 	for medical assistance with federal financial participation and who otherwise meet the 
18.12 	eligibility requirements of chapter 256B and of this paragraph, are eligible for medical 
18.13 	assistance without federal financial participation. Qualified noncitizens as described 
18.14 	in paragraph (d) are only eligible for medical assistance without federal financial 
18.15 	participation for five years from their date of entry into the United States. 
18.16 	(k) Beginning October 1, 2003, persons who are receiving care and rehabilitation 
18.17 	services from a nonprofit center established to serve victims of torture and are otherwise 
18.18 	ineligible for medical assistance under this chapter are eligible for medical assistance 
18.19 	without federal financial participation. These individuals are eligible only for the period 
18.20 	during which they are receiving services from the center. Individuals eligible under this 
18.21 	paragraph shall not be required to participate in prepaid medical assistance. 

18.22 	Sec. 20. Minnesota Statutes 2008, section 256B.0625, subdivision 3c, as amended by 
18.23 	Laws 2009, chapter 79, article 5, section 26, is amended to read:
18.24 		Subd. 3c. Health Services Policy Committee. (a) The commissioner, after 
18.25 	receiving recommendations from professional physician associations, professional 
18.26 	associations representing licensed nonphysician health care professionals, and consumer 
18.27 	groups, shall establish a 13-member Health Services Policy Committee, which consists of 
18.28 	12 voting members and one nonvoting member. The Health Services Policy Committee 
18.29 	shall advise the commissioner regarding health services pertaining to the administration 
18.30 	of health care benefits covered under the medical assistance, general assistance medical 
18.31 	care, and MinnesotaCare programs. The Health Services Policy Committee shall meet at 
18.32 	least quarterly. The Health Services Policy Committee shall annually elect a physician 
18.33 	chair from among its members, who shall work directly with the commissioner's medical 
18.34 	director, to establish the agenda for each meeting. The Health Services Policy Committee 
18.35 	shall also recommend criteria for verifying centers of excellence for specific aspects of 
19.1 	medical care where a specific set of combined services, a volume of patients necessary to 
19.2 	maintain a high level of competency, or a specific level of technical capacity is associated 
19.3 	with improved health outcomes. 
19.4 	(b) The commissioner shall establish a dental subcommittee to operate under the 
19.5 	Health Services Policy Committee. The dental subcommittee consists of general dentists, 
19.6 	dental specialists, safety net providers, dental hygienists, health plan company and 
19.7 	county and public health representatives, health researchers, consumers, and a designee 
19.8 	of the commissioner of health. The dental subcommittee shall advise the commissioner 
19.9 	regarding:
19.10 	(1) the critical access dental program under section 256B.76, subdivision 4, including 
19.11 	but not limited to criteria for designating and terminating critical access dental providers;
19.12 	(2) any changes to the critical access dental provider program necessary to comply 
19.13 	with program expenditure limits;
19.14 	(3) dental coverage policy based on evidence, quality, continuity of care, and best 
19.15 	practices;
19.16 	(4) the development of dental delivery models; and
19.17 	(5) dental services to be added or eliminated from subdivision 9, paragraph (b).
19.18 	(c) The Health Services Policy Committee shall study approaches to making 
19.19 	provider reimbursement under the medical assistance, MinnesotaCare, and general 
19.20 	assistance medical care programs contingent on patient participation in a patient-centered 
19.21 	decision-making process, and shall evaluate the impact of these approaches on health 
19.22 	care quality, patient satisfaction, and health care costs. The committee shall present 
19.23 	findings and recommendations to the commissioner and the legislative committees with 
19.24 	jurisdiction over health care by January 15, 2010.
19.25 	(d) The Health Services Policy Committee shall monitor and track the practice 
19.26 	patterns of physicians providing services to medical assistance, MinnesotaCare, and 
19.27 	general assistance medical care enrollees under fee-for-service, managed care, and 
19.28 	county-based purchasing. The committee shall focus on services or specialties for which 
19.29 	there is a high variation in utilization across physicians, or which are associated with 
19.30 	high medical costs. The commissioner, based upon the findings of the committee, shall 
19.31 	regularly notify physicians whose practice patterns indicate higher than average utilization 
19.32 	or costs. Managed care and county-based purchasing plans shall provide the committee
19.33 	commissioner with utilization and cost data necessary to implement this paragraph, and 
19.34 	the commissioner shall make this data available to the committee.
19.35 	(e) The Health Services Policy Committee shall review caesarean section rates 
19.36 	for the fee-for-service medical assistance population. The committee may develop best 
20.1 	practices policies related to the minimization of caesarean sections, including but not 
20.2 	limited to standards and guidelines for health care providers and health care facilities.

20.3 	Sec. 21. Minnesota Statutes 2008, section 256B.0625, subdivision 13h, as amended by 
20.4 	Laws 2009, chapter 79, article 5, section 31, is amended to read:
20.5 		Subd. 13h. Medication therapy management services. (a) Medical assistance 
20.6 	and general assistance medical care cover medication therapy management services for 
20.7 	a recipient taking four or more prescriptions to treat or prevent two or more chronic 
20.8 	medical conditions, or a recipient with a drug therapy problem that is identified or prior 
20.9 	authorized by the commissioner that has resulted or is likely to result in significant 
20.10 	nondrug program costs. The commissioner may cover medical therapy management 
20.11 	services under MinnesotaCare if the commissioner determines this is cost-effective. For 
20.12 	purposes of this subdivision, "medication therapy management" means the provision 
20.13 	of the following pharmaceutical care services by a licensed pharmacist to optimize the 
20.14 	therapeutic outcomes of the patient's medications: 
20.15 	(1) performing or obtaining necessary assessments of the patient's health status; 
20.16 	(2) formulating a medication treatment plan; 
20.17 	(3) monitoring and evaluating the patient's response to therapy, including safety 
20.18 	and effectiveness; 
20.19 	(4) performing a comprehensive medication review to identify, resolve, and prevent 
20.20 	medication-related problems, including adverse drug events; 
20.21 	(5) documenting the care delivered and communicating essential information to 
20.22 	the patient's other primary care providers; 
20.23 	(6) providing verbal education and training designed to enhance patient 
20.24 	understanding and appropriate use of the patient's medications; 
20.25 	(7) providing information, support services, and resources designed to enhance 
20.26 	patient adherence with the patient's therapeutic regimens; and 
20.27 	(8) coordinating and integrating medication therapy management services within the 
20.28 	broader health care management services being provided to the patient. 
20.29 	Nothing in this subdivision shall be construed to expand or modify the scope of practice of 
20.30 	the pharmacist as defined in section 151.01, subdivision 27. 
20.31 	(b) To be eligible for reimbursement for services under this subdivision, a pharmacist 
20.32 	must meet the following requirements: 
20.33 	(1) have a valid license issued under chapter 151; 
20.34 	(2) have graduated from an accredited college of pharmacy on or after May 1996, or 
20.35 	completed a structured and comprehensive education program approved by the Board of 
21.1 	Pharmacy and the American Council of Pharmaceutical Education for the provision and 
21.2 	documentation of pharmaceutical care management services that has both clinical and 
21.3 	didactic elements; 
21.4 	(3) be practicing in an ambulatory care setting as part of a multidisciplinary team or 
21.5 	have developed a structured patient care process that is offered in a private or semiprivate 
21.6 	patient care area that is separate from the commercial business that also occurs in the 
21.7 	setting, or in home settings, excluding long-term care and group homes, if the service is 
21.8 	ordered by the provider-directed care coordination team; and 
21.9 	(4) make use of an electronic patient record system that meets state standards. 
21.10 	(c) For purposes of reimbursement for medication therapy management services, 
21.11 	the commissioner may enroll individual pharmacists as medical assistance and general 
21.12 	assistance medical care providers. The commissioner may also establish contact 
21.13 	requirements between the pharmacist and recipient, including limiting the number of 
21.14 	reimbursable consultations per recipient. 
21.15 	(d) The commissioner shall establish a pilot project for an intensive medication 
21.16 	therapy management program for patients identified by the commissioner with multiple 
21.17 	chronic conditions and a high number of medications who are at high risk of preventable 
21.18 	hospitalizations, emergency room use, medication complications, and suboptimal 
21.19 	treatment outcomes due to medication-related problems. For purposes of the pilot 
21.20 	project, medication therapy management services may be provided in a patient's home 
21.21 	or community setting, in addition to other authorized settings. The commissioner may 
21.22 	waive existing payment policies and establish special payment rates for the pilot project. 
21.23 	The pilot project must be designed to produce a net savings to the state compared to the 
21.24 	estimated costs that would otherwise be incurred for similar patients without the program.
21.25 	The pilot project must begin by January 1, 2010, and end June 30, 2012.

21.26 	Sec. 22. Minnesota Statutes 2008, section 256B.0655, subdivision 4, as amended by 
21.27 	Laws 2009, chapter 79, article 8, section 28, is amended to read:
21.28 		Subd. 4. Authorization; personal care assistance and qualified professional.
 21.29 	(a) All personal care assistance services, supervision by a qualified professional, and 
21.30 	additional services beyond the limits established in section 256B.0651, subdivision 11, 
21.31 	must be authorized by the commissioner or the commissioner's designee before services 
21.32 	begin except for the assessments established in sections 256B.0651, subdivision 11, and 
21.33 	256B.0911. The authorization for personal care assistance and qualified professional 
21.34 	services under section 256B.0659 must be completed within 30 days after receiving 
21.35 	a complete request.
22.1 	(b) The amount of personal care assistance services authorized must be based 
22.2 	on the recipient's home care rating. The home care rating shall be determined by the 
22.3 	commissioner or the commissioner's designee based on information submitted to the 
22.4 	commissioner identifying the following:
22.5 	(1) total number of dependencies of activities of daily living as defined in section 
22.6 	256B.0659;
22.7 	(2) number of complex health-related functions needs as defined in section 
22.8 	256B.0659; and
22.9 	(3) number of behavior descriptions as defined in section 256B.0659.
22.10 	(c) The methodology to determine total time for personal care assistance services for 
22.11 	each home care rating is based on the median paid units per day for each home care rating 
22.12 	from fiscal year 2007 data for the personal care assistance program. Each home care rating 
22.13 	has a base level of hours assigned. Additional time is added through the assessment and 
22.14 	identification of the following:
22.15 	(1) 30 additional minutes per day for a dependency in each critical activity of daily 
22.16 	living as defined in section 256B.0659;
22.17 	(2) 30 additional minutes per day for each complex health-related function as 
22.18 	defined in section 256B.0659; and
22.19 	(3) 30 additional minutes per day for each behavior issue as defined in section 
22.20 	256B.0659.
22.21 	(d) A limit of 96 units of qualified professional supervision may be authorized for 
22.22 	each recipient receiving personal care assistance services. A request to the commissioner 
22.23 	to exceed this total in a calendar year must be requested by the personal care provider 
22.24 	agency on a form approved by the commissioner.

22.25 	Sec. 23. Minnesota Statutes 2008, section 256B.0659, subdivision 9, as added by Laws 
22.26 	2009, chapter 79, article 8, section 31, is amended to read:
22.27 		Subd. 9.Responsible party; generally. (a) "Responsible party," effective January 
22.28 	1, 2010, means an individual who is capable of providing the support necessary to assist 
22.29 	the recipient to live in the community.
22.30 	(b) A responsible party must be 18 years of age, actively participate in planning and 
22.31 	directing of personal care assistance services, and attend all assessments for the recipient.
22.32 	(c) A responsible party must not be the:
22.33 	(1) personal care assistant;
22.34 	(2) home care provider agency owner or staff; or
22.35 	(3) county staff acting as part of employment.
23.1 	(d) A licensed family foster parent who lives with the recipient may be the 
23.2 	responsible party as long as the family foster parent meets the other responsible party 
23.3 	requirements.
23.4 	(e) A responsible party is required when:
23.5 	(1) the person is a minor according to section 524.5-102, subdivision 10;
23.6 	(2) the person is an incapacitated adult according to section 524.5-102, subdivision 
23.7 	6, resulting in a court-appointed guardian; or
23.8 	(3) the assessment according to section 256B.0655, subdivision 1b, determines that 
23.9 	the recipient is in need of a responsible party to direct the recipient's care.
23.10 	(f) There may be two persons designated as the responsible party for reasons such 
23.11 	as divided households and court-ordered custodies. Each person named as responsible 
23.12 	party must meet the program criteria and responsibilities.
23.13 	(g) The recipient or the recipient's legal representative shall appoint a responsible 
23.14 	party if necessary to direct and supervise the care provided to the recipient. The 
23.15 	responsible party must be identified at the time of assessment and listed on the recipient's 
23.16 	service agreement and personal care assistance care plan.

23.17 	Sec. 24. Minnesota Statutes 2008, section 256B.0659, subdivision 10, as added by 
23.18 	Laws 2009, chapter 79, article 8, section 31, is amended to read:
23.19 		Subd. 10.Responsible party; duties; delegation. (a) A responsible party shall 
23.20 	enter into a written agreement with a personal care assistance provider agency, on a form 
23.21 	determined by the commissioner, to perform the following duties:
23.22 	(1) be available while care is provided in a method agreed upon by the individual 
23.23 	or the individual's legal representative and documented in the recipient's personal care 
23.24 	assistance care plan;
23.25 	(2) monitor personal care assistance services to ensure the recipient's personal care 
23.26 	assistance care plan is being followed; and
23.27 	(3) review and sign personal care assistance time sheets after services are provided 
23.28 	to provide verification of the personal care assistance services.
23.29 	Failure to provide the support required by the recipient must result in a referral to the 
23.30 	county common entry point.
23.31 	(b) Responsible parties who are parents of minors or guardians of minors or 
23.32 	incapacitated persons may delegate the responsibility to another adult who is not the 
23.33 	personal care assistant during a temporary absence of at least 24 hours but not more 
23.34 	than six months. The person delegated as a responsible party must be able to meet the 
23.35 	definition of the responsible party, except that the delegated responsible party is required 
24.1 	to reside with the recipient only while serving as the responsible party. The responsible 
24.2 	party must ensure that the delegate performs the functions of the responsible party, is 
24.3 	identified at the time of the assessment, and is listed on the personal care assistance 
24.4 	care plan. The responsible party must communicate to the personal care assistance 
24.5 	provider agency about the need for a delegate responsible party, including the name of the 
24.6 	delegated responsible party, dates the delegated responsible party will be living with the 
24.7 	recipient, and contact numbers.

24.8 	Sec. 25. Minnesota Statutes 2008, section 256B.0659, subdivision 13, as added by 
24.9 	Laws 2009, chapter 79, article 8, section 31, is amended to read:
24.10 		Subd. 13.Qualified professional; qualifications. (a) The qualified professional 
24.11 	must be employed by a personal care assistance provider agency and meet the definition 
24.12 	under section 256B.0625, subdivision 19c. Before a qualified professional provides 
24.13 	services, the personal care assistance provider agency must initiate a background study on 
24.14 	the qualified professional under chapter 245C, and the personal care assistance provider 
24.15 	agency must have received a notice from the commissioner that the qualified professional:
24.16 	(1) is not disqualified under section 245C.14; or
24.17 	(2) is disqualified, but the qualified professional has received a set aside of the 
24.18 	disqualification under section 245C.22.
24.19 	(b) The qualified professional shall perform the duties of training, supervision, and 
24.20 	evaluation of the personal care assistance staff and evaluation of the effectiveness of 
24.21 	personal care assistance services. The qualified professional shall:
24.22 	(1) develop and monitor with the recipient a personal care assistance care plan based 
24.23 	on the service plan and individualized needs of the recipient;
24.24 	(2) develop and monitor with the recipient a monthly plan for the use of personal 
24.25 	care assistance services;
24.26 	(3) review documentation of personal care assistance services provided;
24.27 	(4) provide training and ensure competency for the personal care assistant in the 
24.28 	individual needs of the recipient; and
24.29 	(5) document all training, communication, evaluations, and needed actions to 
24.30 	improve performance of the personal care assistants.
24.31 	(c) Effective January 1, 2010, the qualified professional shall complete the provider 
24.32 	training with basic information about the personal care assistance program approved 
24.33 	by the commissioner within six months of the date hired by a personal care assistance 
24.34 	provider agency. Qualified professionals who have completed the required trainings as 
24.35 	an employee with a personal care assistance provider agency do not need to repeat the 
25.1 	required trainings if they are hired by another agency, if they have completed the training 
25.2 	within the last three years.

25.3 	Sec. 26. Minnesota Statutes 2008, section 256B.0659, subdivision 21, as added by 
25.4 	Laws 2009, chapter 79, article 8, section 31, is amended to read:
25.5 		Subd. 21.Requirements for initial enrollment of personal care assistance 
25.6 	provider agencies. (a) All personal care assistance provider agencies must provide, at the 
25.7 	time of enrollment as a personal care assistance provider agency in a format determined 
25.8 	by the commissioner, information and documentation that includes, but is not limited to, 
25.9 	the following:
25.10 	(1) the personal care assistance provider agency's current contact information 
25.11 	including address, telephone number, and e-mail address;
25.12 	(2) proof of surety bond coverage in the amount of $50,000 or ten percent of the 
25.13 	provider's payments from Medicaid in the previous year, whichever is less;
25.14 	(3) proof of fidelity bond coverage in the amount of $20,000;
25.15 	(4) proof of workers' compensation insurance coverage;
25.16 	(5) a description of the personal care assistance provider agency's organization 
25.17 	identifying the names of all owners, managing employees, staff, board of directors, and 
25.18 	the affiliations of the directors, owners, or staff to other service providers;
25.19 	(6) a copy of the personal care assistance provider agency's written policies and 
25.20 	procedures including: hiring of employees; training requirements; service delivery; 
25.21 	and employee and consumer safety including process for notification and resolution 
25.22 	of consumer grievances, identification and prevention of communicable diseases, and 
25.23 	employee misconduct;
25.24 	(7) copies of all other forms the personal care assistance provider agency uses in 
25.25 	the course of daily business including, but not limited to:
25.26 	(i) a copy of the personal care assistance provider agency's time sheet if the time 
25.27 	sheet varies from the standard time sheet for personal care assistance services approved 
25.28 	by the commissioner, and a letter requesting approval of the personal care assistance 
25.29 	provider agency's nonstandard time sheet;
25.30 	(ii) the personal care assistance provider agency's template for the personal care 
25.31 	assistance care plan; and
25.32 	(iii) the personal care assistance provider agency's template and for the written 
25.33 	agreement in subdivision 20 for recipients using the personal care assistance choice 
25.34 	option, if applicable;
26.1 	(8) a list of all trainings and classes that the personal care assistance provider agency 
26.2 	requires of its staff providing personal care assistance services;
26.3 	(9) documentation that the personal care assistance provider agency and staff have 
26.4 	successfully completed all the training required by this section; 
26.5 	(10) documentation of the agency's marketing practices;
26.6 	(11) disclosure of ownership, leasing, or management of all residential properties 
26.7 	that is used or could be used for providing home care services; and 
26.8 	(12) documentation that the agency will use the following percentages of revenue 
26.9 	generated from the medical assistance rate paid for personal care assistance services 
26.10 	for employee personal care assistant wages and benefits: 72.5 percent of revenue in the 
26.11 	personal care assistance choice option and 72.5 percent of revenue from other personal 
26.12 	care assistance providers.
26.13 	(b) Personal care assistance provider agencies shall provide the information specified 
26.14 	in paragraph (a) to the commissioner at the time the personal care assistance provider 
26.15 	agency enrolls as a vendor or upon request from the commissioner. The commissioner 
26.16 	shall collect the information specified in paragraph (a) from all personal care assistance 
26.17 	providers beginning upon enactment of this section.
26.18 	(c) All personal care assistance provider agencies shall complete mandatory training 
26.19 	as determined by the commissioner before enrollment as a provider. Personal care 
26.20 	assistance provider agencies are required to send all owners, qualified professionals 
26.21 	employed by the agency, and all other managing employees to the initial and subsequent 
26.22 	trainings. Personal care assistance provider agency billing staff shall complete training 
26.23 	about personal care assistance program financial management. This training is effective 
26.24 	upon enactment of this section. Any personal care assistance provider agency enrolled 
26.25 	before that date shall, if it has not already, complete the provider training within 18 months 
26.26 	of the effective date of this section. Any new owners, new qualified professionals, and new 
26.27 	managing employees are required to complete mandatory training as a requisite of hiring.

26.28 	Sec. 27. Minnesota Statutes ..., section 256B.0659, subdivision 29, as added by Laws 
26.29 	2009, chapter 79, article 8, section 31, is amended to read:
26.30 		Subd. 29.Transitional assistance. The commissioner, counties, health plans, tribes, 
26.31 	and personal care assistance providers shall work together to provide transitional assistance 
26.32 	for recipients and families to come into compliance with the new requirements of this 
26.33 	section that may require a change in living arrangement no later than August 10, 2010 and 
26.34 	ensure the personal care assistance services are not provided by the housing provider.

27.1 	Sec. 28. Minnesota Statutes 2008, section 256B.0911, subdivision 1a, as amended by 
27.2 	Laws 2009, chapter 79, article 8, section 33, is amended to read:
27.3 		Subd. 1a.Definitions. For purposes of this section, the following definitions apply:
27.4 	(a) "Long-term care consultation services" means:
27.5 	(1) assistance in identifying services needed to maintain an individual in the most 
27.6 	inclusive environment;
27.7 	(2) providing recommendations on cost-effective community services that are 
27.8 	available to the individual;
27.9 	(3) development of an individual's person-centered community support plan;
27.10 	(4) providing information regarding eligibility for Minnesota health care programs;
27.11 	(5) face-to-face long-term care consultation assessments, which may be completed 
27.12 	in a hospital, nursing facility, intermediate care facility for persons with developmental 
27.13 	disabilities (ICF/DDs), regional treatment centers, or the person's current or planned 
27.14 	residence;
27.15 	(6) federally mandated screening to determine the need for a institutional level of 
27.16 	care under section 256B.0911, subdivision 4, paragraph (a);
27.17 	(7) determination of home and community-based waiver service eligibility including 
27.18 	level of care determination for individuals who need an institutional level of care as 
27.19 	defined under section 144.0724, subdivision 11, or 256B.092, service eligibility including 
27.20 	state plan home care services identified in section 256B.0625, subdivisions 6, 7, and 
27.21 	19, paragraphs (a) and (c), based on assessment and support plan development with 
27.22 	appropriate referrals;
27.23 	(8) providing recommendations for nursing facility placement when there are no 
27.24 	cost-effective community services available; and
27.25 	(9) assistance to transition people back to community settings after facility 
27.26 	admission.
27.27 	(b) "Long-term  care options counseling" means the services provided by the linkage 
27.28 	lines as mandated by sections 256.01 and 256.975, subdivision 7, and also includes 
27.29 	telephone assistance and follow up once a long-term care consultation assessment has 
27.30 	been completed. 
27.31 	(c) "Minnesota health care programs" means the medical assistance program under 
27.32 	chapter 256B and the alternative care program under section 256B.0913.
27.33 	(d) "Lead agencies" means counties or a collaboration of counties, tribes, and health 
27.34 	plans administering long-term care consultation assessment and support planning services.

28.1 	Sec. 29. Minnesota Statutes 2008, section 256B.441, subdivision 55, as amended by 
28.2 	Laws 2009, chapter 79, article 8, section 61, is amended to read:
28.3 		Subd. 55.Phase-in of rebased operating payment rates.  (a) For the rate years 
28.4 	beginning October 1, 2008, to October 1, 2015, the operating payment rate calculated 
28.5 	under this section shall be phased in by blending the operating rate with the operating 
28.6 	payment rate determined under section 256B.434. For purposes of this subdivision, the 
28.7 	rate to be used that is determined under section 256B.434 shall not include the portion of 
28.8 	the operating payment rate related to performance-based incentive payments under section 
28.9 	256B.434, subdivision 4, paragraph (d). For the rate year beginning October 1, 2008, the 
28.10 	operating payment rate for each facility shall be 13 percent of the operating payment rate 
28.11 	from this section, and 87 percent of the operating payment rate from section 256B.434. 
28.12 	For the rate period year  beginning October 1, 2009, through September 30, 2013, the 
28.13 	operating payment rate for each facility shall be 14 percent of the operating payment rate 
28.14 	from this section, and 86 percent of the operating payment rate from section 256B.434. 
28.15 	For rate years beginning October 1, 2010; October 1, 2011; and October 1, 2012, no 
28.16 	rate adjustments shall be implemented under this section, but shall be determined under 
28.17 	section 256B.434. For the rate year beginning October 1, 2013, the operating payment 
28.18 	rate for each facility shall be 65 percent of the operating payment rate from this section, 
28.19 	and 35 percent of the operating payment rate from section 256B.434. For the rate year 
28.20 	beginning October 1, 2014, the operating payment rate for each facility shall be 82 percent 
28.21 	of the operating payment rate from this section, and 18 percent of the operating payment 
28.22 	rate from section 256B.434. For the rate year beginning October 1, 2015, the operating 
28.23 	payment rate for each facility shall be the operating payment rate determined under this 
28.24 	section. The blending of operating payment rates under this section shall be performed 
28.25 	separately for each RUG's class.
28.26 	(b) For the rate year beginning October 1, 2008, the commissioner shall apply limits 
28.27 	to the operating payment rate increases under paragraph (a) by creating a minimum 
28.28 	percentage increase and a maximum percentage increase.
28.29 	(1) Each nursing facility that receives a blended October 1, 2008, operating payment 
28.30 	rate increase under paragraph (a) of less than one percent, when compared to its operating 
28.31 	payment rate on September 30, 2008, computed using rates with RUG's weight of 1.00, 
28.32 	shall receive a rate adjustment of one percent.
28.33 	(2) The commissioner shall determine a maximum percentage increase that will 
28.34 	result in savings equal to the cost of allowing the minimum increase in clause (1). Nursing 
28.35 	facilities with a blended October 1, 2008, operating payment rate increase under paragraph 
28.36 	(a) greater than the maximum percentage increase determined by the commissioner, when 
29.1 	compared to its operating payment rate on September 30, 2008, computed using rates with 
29.2 	a RUG's weight of 1.00, shall receive the maximum percentage increase.
29.3 	(3) Nursing facilities with a blended October 1, 2008, operating payment rate 
29.4 	increase under paragraph (a) greater than one percent and less than the maximum 
29.5 	percentage increase determined by the commissioner, when compared to its operating 
29.6 	payment rate on September 30, 2008, computed using rates with a RUG's weight of 1.00, 
29.7 	shall receive the blended October 1, 2008, operating payment rate increase determined 
29.8 	under paragraph (a).
29.9 	(4) The October 1, 2009, through October 1, 2015, operating payment rate for 
29.10 	facilities receiving the maximum percentage increase determined in clause (2) shall be 
29.11 	the amount determined under paragraph (a) less the difference between the amount 
29.12 	determined under paragraph (a) for October 1, 2008, and the amount allowed under clause 
29.13 	(2). This rate restriction does not apply to rate increases provided in any other section.
29.14 	(c) A portion of the funds received under this subdivision that are in excess of 
29.15 	operating payment rates that a facility would have received under section 256B.434, as 
29.16 	determined in accordance with clauses (1) to (3), shall be subject to the requirements in 
29.17 	section 256B.434, subdivision 19, paragraphs (b) to (h).
29.18 	(1) Determine the amount of additional funding available to a facility, which shall be 
29.19 	equal to total medical assistance resident days from the most recent reporting year times 
29.20 	the difference between the blended rate determined in paragraph (a) for the rate year being 
29.21 	computed and the blended rate for the prior year.
29.22 	(2) Determine the portion of all operating costs, for the most recent reporting year, 
29.23 	that are compensation related. If this value exceeds 75 percent, use 75 percent.
29.24 	(3) Subtract the amount determined in clause (2) from 75 percent.
29.25 	(4) The portion of the fund received under this subdivision that shall be subject to 
29.26 	the requirements in section 256B.434, subdivision 19, paragraphs (b) to (h), shall equal 
29.27 	the amount determined in clause (1) times the amount determined in clause (3).

29.28 	Sec. 30. Minnesota Statutes 2008, section 256B.49, subdivision 11a, as added by Laws 
29.29 	2009, chapter 79, article 8, section 64, is amended to read:
29.30 		Subd. 11a.Waivered services waiting list statewide priorities. (a) The 
29.31 	commissioner shall establish statewide priorities for individuals on the waiting list for 
29.32 	CAC, CADI, and TBI waiver services, as of January 1, 2010. The statewide priorities 
29.33 	must include, but are not limited to, individuals who continue to have a need for waiver 
29.34 	services after they have maximized the use of state plan services and other funding 
30.1 	resources, including natural supports, prior to accessing waiver services, and who meet at 
30.2 	least one of the following criteria:
30.3 	(1) have unstable living situations due to the age, incapacity, or sudden loss of 
30.4 	the primary caregivers;
30.5 	(2) are moving from an institution due to bed closures;
30.6 	(3) experience a sudden closure of their current living arrangement;
30.7 	(4) require protection from confirmed abuse, neglect, or exploitation;
30.8 	(5) experience a sudden change in need that can no longer be met through state plan 
30.9 	services or other funding resources alone; or
30.10 	(6) meet other priorities established by the department.
30.11 	(b) When allocating resources to lead agencies, the commissioner must take into 
30.12 	consideration the number of individuals waiting who meet statewide priorities and the 
30.13 	lead agencies' current use of waiver funds and existing service options.
30.14 	(c) The commissioner shall evaluate the impact of the use of statewide priorities and 
30.15 	provide recommendations to the legislature on whether to continue the use of statewide 
30.16 	priorities in the November 1, 2011, annual report required by the commissioner in sections 
30.17 	256B.0916, subdivision 7, and 256B.49, subdivision 21.

30.18 	Sec. 31. Minnesota Statutes 2008, section 256B.756, as added by Laws 2009, chapter 
30.19 	79, article 5, section 50, is amended to read:
30.20 	256B.756 REIMBURSEMENT RATES FOR BIRTHS.
30.21 		Subdivision 1.FacilityProvider rate. (a) Notwithstanding section 256.969
30.22 	256B.76, effective for services provided on or after October 1, 2009, the facility payment 
30.23 	rate for the following diagnosis-related groups, as they fall within the diagnostic 
30.24 	categories: (1) 371 cesarean section without complicating diagnosis; (2) 372 vaginal 
30.25 	delivery with complicating diagnosis; and (3) 373 vaginal delivery without complicating 
30.26 	diagnosis, shall be calculated as provided in professional services related to labor, 
30.27 	delivery, and antepartum and postpartum care when provided for any of the diagnostic 
30.28 	categories identified in paragraph (b) shall be calculated using the methodology specified 
30.29 	in paragraph (b).
30.30 	(b) The commissioner shall calculate a single rate for all of the diagnostic related 
30.31 	groups specified in paragraph (a)the following diagnosis-related groups, as they fall within 
30.32 	the diagnostic categories: (1) 371 cesarean sections without complicating diagnosis; (2) 
30.33 	372 vaginal delivery with complicating diagnosis; and (3) 373 vaginal delivery without 
30.34 	complicating diagnosis. The rate shall be consistent with an increase in the proportion of 
30.35 	births by vaginal delivery and a reduction in the percentage of births by cesarean section. 
31.1 	The calculated single rate must be based on an expected increase in the number of vaginal 
31.2 	births and expected reduction in the number of cesarean section such that the reduction 
31.3 	in cesarean sections is less than or equal to one standard deviation below the average in 
31.4 	the frequency of cesarean births for Minnesota health care program clients at hospitals 
31.5 	performing greater than 50 deliveries per year. not reflect a shift of greater than five 
31.6 	percent in the current proportion of all births delivered vaginally and by cesarean section.
31.7 	(c) The rates described in this subdivision do not include newborn care.
31.8 		Subd. 2.Provider rate. Notwithstanding section 256B.76, effective for services 
31.9 	provided on or after October 1, 2009, the payment rate for professional services related 
31.10 	to labor, delivery, and antepartum and postpartum care when provided for any of the 
31.11 	diagnostic categories identified in subdivision 1, paragraph (a), shall be calculated using 
31.12 	the methodology specified in subdivision 1, paragraph (b).
31.13 		Subd. 3.Health plans. Payments to managed care and county-based purchasing 
31.14 	plans under sections 256B.69, 256B.692, or 256L.12 shall be reduced for services provided 
31.15 	on or after October 1, 2009, to reflect the adjustments in subdivisions subdivision  1 and 2.
31.16 		Subd. 4.Prior authorization. Prior authorization shall not be required before 
31.17 	reimbursement is paid for a cesarean section delivery.

31.18 	Sec. 32. Minnesota Statutes 2008, section 256B.76, subdivision 1, as amended by 
31.19 	Laws 2009, chapter 79, article 5, section 51, is amended to read:
31.20 		Subdivision 1.Physician reimbursement.  (a) Effective for services rendered on 
31.21 	or after October 1, 1992, the commissioner shall make payments for physician services 
31.22 	as follows:
31.23 	(1) payment for level one Centers for Medicare and Medicaid Services' common 
31.24 	procedural coding system codes titled "office and other outpatient services," "preventive 
31.25 	medicine new and established patient," "delivery, antepartum, and postpartum care," 
31.26 	"critical care," cesarean delivery and pharmacologic management provided to psychiatric 
31.27 	patients, and level three codes for enhanced services for prenatal high risk, shall be paid 
31.28 	at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June 
31.29 	30, 1992. If the rate on any procedure code within these categories is different than the 
31.30 	rate that would have been paid under the methodology in section 256B.74, subdivision 2, 
31.31 	then the larger rate shall be paid; 
31.32 	(2) payments for all other services shall be paid at the lower of (i) submitted charges, 
31.33 	or (ii) 15.4 percent above the rate in effect on June 30, 1992; and
31.34 	(3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th 
31.35 	percentile of 1989, less the percent in aggregate necessary to equal the above increases 
32.1 	except that payment rates for home health agency services shall be the rates in effect 
32.2 	on September 30, 1992.
32.3 	(b) Effective for services rendered on or after January 1, 2000, payment rates for 
32.4 	physician and professional services shall be increased by three percent over the rates 
32.5 	in effect on December 31, 1999, except for home health agency and family planning 
32.6 	agency services. The increases in this paragraph shall be implemented January 1, 2000, 
32.7 	for managed care.
32.8 	(c) Effective for services rendered on or after July 1, 2009, payment rates for 
32.9 	physician and professional services shall be reduced by five percent over the rates in effect 
32.10 	on June 30, 2009. This reduction does not apply to office or other outpatient services 
32.11 	(procedure codes 99201 to 99215) visits, preventive medicine services (procedure codes 
32.12 	99381 to 99412) visits and family planning services visits billed by physicians, advanced 
32.13 	practice nurses, or physician assistants in a family planning agency or in one of  the 
32.14 	following primary care specialties practices: general practice, general internal medicine,
32.15 	general pediatrics, general geriatrics, and family practice, or by an advanced practice 
32.16 	registered nurse or physician assistant practicing in pediatrics, geriatrics, or family practice
32.17 	medicine. This reduction does not apply to federally qualified health centers, rural health 
32.18 	centers, and Indian health services. Effective October 1, 2009, payments made to managed 
32.19 	care plans and county-based purchasing plans under sections 256B.69, 256B.692, and 
32.20 	256L.12 shall reflect the payment reduction described in this paragraph.

32.21 	Sec. 33. Minnesota Statutes 2008, section 256D.03, subdivision 4, as amended by 
32.22 	Laws 2009, chapter 79, article 5, section 53, is amended to read:
32.23 		Subd. 4.General assistance medical care; services. (a)(i) For a person who is 
32.24 	eligible under subdivision 3, paragraph (a), clause (2), item (i), general assistance medical 
32.25 	care covers, except as provided in paragraph (c):
32.26 	(1) inpatient hospital services;
32.27 	(2) outpatient hospital services;
32.28 	(3) services provided by Medicare certified rehabilitation agencies;
32.29 	(4) prescription drugs and other products recommended through the process 
32.30 	established in section 256B.0625, subdivision 13;
32.31 	(5) equipment necessary to administer insulin and diagnostic supplies and equipment 
32.32 	for diabetics to monitor blood sugar level;
32.33 	(6) eyeglasses and eye examinations provided by a physician or optometrist;
32.34 	(7) hearing aids;
32.35 	(8) prosthetic devices;
33.1 	(9) laboratory and X-ray services;
33.2 	(10) physician's services;
33.3 	(11) medical transportation except special transportation;
33.4 	(12) chiropractic services as covered under the medical assistance program;
33.5 	(13) podiatric services;
33.6 	(14) dental services as covered under the medical assistance program;
33.7 	(15) mental health services covered under chapter 256B;
33.8 	(16) prescribed medications for persons who have been diagnosed as mentally ill as 
33.9 	necessary to prevent more restrictive institutionalization;
33.10 	(17) medical supplies and equipment, and Medicare premiums, coinsurance and 
33.11 	deductible payments;
33.12 	(18) medical equipment not specifically listed in this paragraph when the use of 
33.13 	the equipment will prevent the need for costlier services that are reimbursable under 
33.14 	this subdivision;
33.15 	(19) services performed by a certified pediatric nurse practitioner, a certified family 
33.16 	nurse practitioner, a certified adult nurse practitioner, a certified obstetric/gynecological 
33.17 	nurse practitioner, a certified neonatal nurse practitioner, or a certified geriatric nurse 
33.18 	practitioner in independent practice, if (1) the service is otherwise covered under this 
33.19 	chapter as a physician service, (2) the service provided on an inpatient basis is not included 
33.20 	as part of the cost for inpatient services included in the operating payment rate, and (3) the 
33.21 	service is within the scope of practice of the nurse practitioner's license as a registered 
33.22 	nurse, as defined in section 148.171;
33.23 	(20) services of a certified public health nurse or a registered nurse practicing in 
33.24 	a public health nursing clinic that is a department of, or that operates under the direct 
33.25 	authority of, a unit of government, if the service is within the scope of practice of the 
33.26 	public health nurse's license as a registered nurse, as defined in section 148.171;
33.27 	(21) telemedicine consultations, to the extent they are covered under section 
33.28 	256B.0625, subdivision 3b; 
33.29 	(22) care coordination and patient education services provided by a community 
33.30 	health worker according to section 256B.0625, subdivision 49; and
33.31 	(23) regardless of the number of employees that an enrolled health care provider 
33.32 	may have, sign language interpreter services when provided by an enrolled health care 
33.33 	provider during the course of providing a direct, person-to-person covered health care 
33.34 	service to an enrolled recipient who has a hearing loss and uses interpreting services.
33.35 	(ii) Effective October 1, 2003, for a person who is eligible under subdivision 3, 
33.36 	paragraph (a), clause (2), item (ii), general assistance medical care coverage is limited 
34.1 	to inpatient hospital services, including physician services provided during the inpatient 
34.2 	hospital stay. A $1,000 deductible is required for each inpatient hospitalization.
34.3 	(b) Effective August 1, 2005, sex reassignment surgery is not covered under this 
34.4 	subdivision.
34.5 	(c) In order to contain costs, the commissioner of human services shall select 
34.6 	vendors of medical care who can provide the most economical care consistent with high 
34.7 	medical standards and shall where possible contract with organizations on a prepaid 
34.8 	capitation basis to provide these services. The commissioner shall consider proposals by 
34.9 	counties and vendors for prepaid health plans, competitive bidding programs, block grants, 
34.10 	or other vendor payment mechanisms designed to provide services in an economical 
34.11 	manner or to control utilization, with safeguards to ensure that necessary services are 
34.12 	provided. Before implementing prepaid programs in counties with a county operated or 
34.13 	affiliated public teaching hospital or a hospital or clinic operated by the University of 
34.14 	Minnesota, the commissioner shall consider the risks the prepaid program creates for the 
34.15 	hospital and allow the county or hospital the opportunity to participate in the program in a 
34.16 	manner that reflects the risk of adverse selection and the nature of the patients served by 
34.17 	the hospital, provided the terms of participation in the program are competitive with the 
34.18 	terms of other participants considering the nature of the population served. Payment for 
34.19 	services provided pursuant to this subdivision shall be as provided to medical assistance 
34.20 	vendors of these services under sections 256B.02, subdivision 8, and 256B.0625. For 
34.21 	payments made during fiscal year 1990 and later years, the commissioner shall consult 
34.22 	with an independent actuary in establishing prepayment rates, but shall retain final control 
34.23 	over the rate methodology.
34.24 	(d) Effective January 1, 2008, drug coverage under general assistance medical 
34.25 	care is limited to prescription drugs that:
34.26 	(i) are covered under the medical assistance program as described in section 
34.27 	256B.0625, subdivisions 13 and 13d; and
34.28 	(ii) are provided by manufacturers that have fully executed general assistance 
34.29 	medical care rebate agreements with the commissioner and comply with the agreements. 
34.30 	Prescription drug coverage under general assistance medical care must conform to 
34.31 	coverage under the medical assistance program according to section 256B.0625, 
34.32 	subdivisions 13 to 13g.
34.33 	 (e) Recipients eligible under subdivision 3, paragraph (a), shall pay the following 
34.34 	co-payments for services provided on or after October 1, 2003, and before January 1, 2009:
34.35 	(1) $25 for eyeglasses;
34.36 	(2) $25 for nonemergency visits to a hospital-based emergency room;
35.1 	(3) $3 per brand-name drug prescription and $1 per generic drug prescription, 
35.2 	subject to a $12 per month maximum for prescription drug co-payments. No co-payments 
35.3 	shall apply to antipsychotic drugs when used for the treatment of mental illness; and
35.4 	(4) 50 percent coinsurance on restorative dental services.
35.5 	(f) Recipients eligible under subdivision 3, paragraph (a), shall include the following 
35.6 	co-payments for services provided on or after January 1, 2009: 
35.7 	(1) $25 for nonemergency visits to a hospital-based emergency room; and
35.8 	(2) $3 per brand-name drug prescription and $1 per generic drug prescription, 
35.9 	subject to a $7 per month maximum for prescription drug co-payments. No co-payments 
35.10 	shall apply to antipsychotic drugs when used for the treatment of mental illness.
35.11 	(g) MS 2007 Supp [Expired]
35.12 	(h) Effective January 1, 2009, co-payments shall be limited to one per day per 
35.13 	provider for nonemergency visits to a hospital-based emergency room. Recipients of 
35.14 	general assistance medical care are responsible for all co-payments in this subdivision. 
35.15 	The general assistance medical care reimbursement to the provider shall be reduced by the 
35.16 	amount of the co-payment, except that reimbursement for prescription drugs shall not be 
35.17 	reduced once a recipient has reached the $7 per month maximum for prescription drug 
35.18 	co-payments. The provider collects the co-payment from the recipient. Providers may not 
35.19 	deny services to recipients who are unable to pay the co-payment.
35.20 	(i) General assistance medical care reimbursement to fee-for-service providers 
35.21 	and payments to managed care plans shall not be increased as a result of the removal of 
35.22 	the co-payments effective January 1, 2009.
35.23 	(j) Any county may, from its own resources, provide medical payments for which 
35.24 	state payments are not made.
35.25 	(k) Chemical dependency services that are reimbursed under chapter 254B must not 
35.26 	be reimbursed under general assistance medical care.
35.27 	(l) The maximum payment for new vendors enrolled in the general assistance 
35.28 	medical care program after the base year shall be determined from the average usual and 
35.29 	customary charge of the same vendor type enrolled in the base year.
35.30 	(m) The conditions of payment for services under this subdivision are the same 
35.31 	as the conditions specified in rules adopted under chapter 256B governing the medical 
35.32 	assistance program, unless otherwise provided by statute or rule.
35.33 	 (n) Inpatient and outpatient payments shall be reduced by five percent, effective July 
35.34 	1, 2003. This reduction is in addition to the five percent reduction effective July 1, 2003, 
35.35 	and incorporated by reference in paragraph (l).
36.1 	(o) Payments for all other health services except inpatient, outpatient, and pharmacy 
36.2 	services shall be reduced by five percent, effective July 1, 2003.
36.3 	(p) Payments to managed care plans shall be reduced by five percent for services 
36.4 	provided on or after October 1, 2003.
36.5 	(q) A hospital receiving a reduced payment as a result of this section may apply the 
36.6 	unpaid balance toward satisfaction of the hospital's bad debts.
36.7 	(r) Fee-for-service payments for nonpreventive visits shall be reduced by $3 for 
36.8 	services provided on or after January 1, 2006. For purposes of this subdivision, a visit 
36.9 	means an episode of service which is required because of a recipient's symptoms, 
36.10 	diagnosis, or established illness, and which is delivered in an ambulatory setting by 
36.11 	a physician or physician ancillary, chiropractor, podiatrist, advance practice nurse, 
36.12 	audiologist, optician, or optometrist.
36.13 	(s) Payments to managed care plans shall not be increased as a result of the removal 
36.14 	of the $3 nonpreventive visit co-payment effective January 1, 2006.
36.15 	(t) Payments for mental health services added as covered benefits after December 
36.16 	31, 2007, are not subject to the reductions in paragraphs (l), (n), (o), and (p).
36.17 	(u) Effective for services provided on or after July 1, 2009, total payment rates for 
36.18 	basic care services shall be reduced by three percent, in accordance with section 256B.766. 
36.19 	Payments made to managed care plans shall be reduced for services provided on or after 
36.20 	October 1, 2009, to reflect this reduction.
36.21 	(v) Effective for services provided on or after July 1, 2009, payment rates for 
36.22 	physician and professional services shall be reduced as described under section 256B.76, 
36.23 	subdivision 1, paragraph (c). Payments made to managed care and county-based 
36.24 	purchasing plans shall be reduced for services provided on or after October 1, 2009, 
36.25 	to reflect this reduction.

36.26 	Sec. 34. Minnesota Statutes 2008, section 256J.575, subdivision 3, as amended by 
36.27 	Laws 2009, chapter 79, article 2, section 23, is amended to read:
36.28 		Subd. 3.Eligibility. (a) The following MFIP participants are eligible for the 
36.29 	services under this section:
36.30 	(1) a participant who meets the requirements for or has been granted a hardship 
36.31 	extension under section 256J.425, subdivision 2 or 3, except that it is not necessary for 
36.32 	the participant to have reached or be approaching 60 months of eligibility for this section 
36.33 	to apply;
36.34 	(2) a participant who is applying for Supplemental Security Income or Social 
36.35 	Security disability insurance; 
37.1 	(3) a participant who is a noncitizen who has been in the United States for 12 or 
37.2 	fewer months; and
37.3 	(4) a participant who is age 60 or older.
37.4 	(b) Families must meet all other eligibility requirements for MFIP established in 
37.5 	this chapter. Families are eligible for financial assistance to the same extent as if they 
37.6 	were participating in MFIP.
37.7 	(c) A participant under paragraph (a), clause (3), must be provided with English as a 
37.8 	second language opportunities and skills training for up to 12 months. After 12 months, 
37.9 	the case manager and participant must determine whether the participant should continue 
37.10 	with English as a second language classes or skills training, or both, and continue to 
37.11 	receive family stabilization services.
37.12 	(d) If a county agency or employment services provider has information that 
37.13 	an MFIP participant may meet the eligibility criteria set forth in this subdivision, the 
37.14 	county agency or employment services provider must assist the participant in obtaining 
37.15 	the documentation necessary to determine eligibility. Until necessary documentation is 
37.16 	obtained, the participant must be treated as an eligible participant under subdivisions 5 to 7.

37.17 	Sec. 35. Minnesota Statutes 2008, section 256L.03, subdivision 3b, as added by Laws 
37.18 	2009, chapter 79, article 5, section 54, is amended to read:
37.19 		Subd. 3b.Chiropractic services. MinnesotaCare covers the following chiropractic 
37.20 	services: medically necessary exams, manual manipulation of the spine, and x-rays.

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

37.23 	Sec. 36. Minnesota Statutes 2008, section 256L.04, subdivision 1, as amended by Laws 
37.24 	2009, chapter 79, article 5, section 55, is amended to read:
37.25 		Subdivision 1.Families with children. (a) Families with children with family 
37.26 	income equal to or less than 275 percent of the federal poverty guidelines for the 
37.27 	applicable family size shall be eligible for MinnesotaCare according to this section. All 
37.28 	other provisions of sections 256L.01 to 256L.18, including the insurance-related barriers 
37.29 	to enrollment under section 256L.07, shall apply unless otherwise specified. 
37.30 	(b) Parents who enroll in the MinnesotaCare program must also enroll their children, 
37.31 	if the children are eligible. Children may be enrolled separately without enrollment by 
37.32 	parents. However, if one parent in the household enrolls, both parents must enroll, unless 
37.33 	other insurance is available. If one child from a family is enrolled, all children must 
37.34 	be enrolled, unless other insurance is available. If one spouse in a household enrolls, 
38.1 	the other spouse in the household must also enroll, unless other insurance is available. 
38.2 	Families cannot choose to enroll only certain uninsured members.
38.3 	(c) Beginning October 1, 2003, the dependent sibling definition no longer applies 
38.4 	to the MinnesotaCare program. These persons are no longer counted in the parental 
38.5 	household and may apply as a separate household.
38.6 	(d) Beginning July 1, 2003, or upon federal approval, whichever is later, parents are 
38.7 	not eligible for MinnesotaCare if their gross income exceeds $57,500.
38.8 	(e) Children formerly enrolled in medical assistance and automatically deemed 
38.9 	eligible for MinnesotaCare according to section 256B.057, subdivision 2c, are exempt 
38.10 	from the requirements of this section until renewal.
38.11 	(f) Children deemed eligible for MinnesotaCare under section 256L.07, subdivision 
38.12 	8, are exempt from the eligibility requirements of this subdivision.

38.13 	EFFECTIVE DATE. Paragraph (f) is effective July 1, 2009, or upon federal 
38.14 	approval, whichever is later.

38.15 	Sec. 37. Minnesota Statutes 2008, section 256L.05, subdivision 1c, as added by Laws 
38.16 	2009, chapter 79, article 5, section 60, is amended to read:
38.17 		Subd. 1c.Open enrollment and streamlined application and enrollment 
38.18 	process. (a) The commissioner and local agencies working in partnership must develop a 
38.19 	streamlined and efficient application and enrollment process for medical assistance and 
38.20 	MinnesotaCare enrollees that meets the criteria specified in this subdivision.
38.21 	(b) The commissioners of human services and education shall provide 
38.22 	recommendations to the legislature by January 15, 2010, on the creation of an open 
38.23 	enrollment process for medical assistance and MinnesotaCare that is coordinated with 
38.24 	the public education system. The recommendations must:
38.25 	(1) be developed in consultation with medical assistance and MinnesotaCare 
38.26 	enrollees and representatives from organizations that advocate on behalf of children and 
38.27 	families, low-income persons and minority populations, counties, school administrators 
38.28 	and nurses, health plans, and health care providers;
38.29 	(2) be based on enrollment and renewal procedures best practices, including express 
38.30 	lane eligibility as required under subdivision 1d;
38.31 	(3) simplify the enrollment and renewal processes wherever possible; and
38.32 	(4) establish a process:
38.33 	(i) to disseminate information on medical assistance and MinnesotaCare to all 
38.34 	children in the public education system, including prekindergarten programs; and
39.1 	(ii) for the commissioner of human services to enroll children and other household 
39.2 	members who are eligible.
39.3 	The commissioner of human services in coordination with the commissioner of 
39.4 	education shall implement an open enrollment process by August 1, 2010, to be effective 
39.5 	beginning with the 2010-2011 school year.
39.6 	(c) The commissioner and local agencies shall develop an online application process 
39.7 	for medical assistance and MinnesotaCare.
39.8 	(d) The commissioner shall develop an application for children that is easily 
39.9 	understandable and does not exceed four pages in length.
39.10 	(e) The commissioner of human services shall present to the legislature, by January 
39.11 	15, 2010, an implementation plan for the open enrollment period and online application 
39.12 	process.

39.13 	EFFECTIVE DATE. This section is effective July 1, 2010 2009, or upon federal 
39.14 	approval, which must be requested by the commissioner, whichever is later.

39.15 	Sec. 38. Minnesota Statutes 2008, section 256L.11, subdivision 1, as amended by Laws 
39.16 	2009, chapter 79, article 5, section 67, is amended to read:
39.17 		Subdivision 1.Medical assistance rate to be used. (a) Payment to providers under 
39.18 	sections 256L.01 to 256L.11 shall be at the same rates and conditions established for 
39.19 	medical assistance, except as provided in subdivisions 2 to 6. 
39.20 	(b) Effective for services provided on or after July 1, 2009, total payments for basic 
39.21 	care services shall be reduced by three percent, in accordance with section 256B.766. 
39.22 	Payments made to managed care and county-based purchasing plans shall be reduced for 
39.23 	services provided on or after October 1, 2009, to reflect this reduction.
39.24 	(c) Effective for services provided on or after July 1, 2009, payment rates for 
39.25 	physician and professional services shall be reduced as described under section 256B.76, 
39.26 	subdivision 1, paragraph (c). Payments made to managed care and county-based 
39.27 	purchasing plans shall be reduced for services provided on or after October 1, 2009, 
39.28 	to reflect this reduction.

39.29 	Sec. 39. Minnesota Statutes 2008, section 626.556, subdivision 3c, as amended by 
39.30 	Laws 2009, chapter 79, article 8, section 74, is amended to read:
39.31 		Subd. 3c.Local welfare agency, Department of Human Services or Department 
39.32 	of Health responsible for assessing or investigating reports of maltreatment. (a) 
39.33 	The county local welfare agency is the agency responsible for assessing or investigating 
39.34 	allegations of maltreatment in child foster care, family child care, legally unlicensed child 
40.1 	care, juvenile correctional facilities licensed under section 241.021 located in the local 
40.2 	welfare agency's county, and unlicensed personal care assistance provider organizations 
40.3 	providing services and receiving reimbursements under chapter 256Band reports involving 
40.4 	children served by an unlicensed personal care provider organization under section 
40.5 	256B.0659. Copies of findings related to personal care provider organizations under 
40.6 	section 256B.0659 must be forwarded to the Department of Human Services provider 
40.7 	enrollment. 
40.8 	(b) The Department of Human Services is the agency responsible for assessing or 
40.9 	investigating allegations of maltreatment in facilities licensed under chapters 245A and 
40.10 	245B, except for child foster care and family child care.
40.11 	(c) The Department of Health is the agency responsible for assessing or investigating 
40.12 	allegations of child maltreatment in facilities licensed under sections 144.50 to 144.58 
40.13 	and 144A.46. 
40.14 	(d) The commissioners of human services, public safety, and education must 
40.15 	jointly submit a written report by January 15, 2007, to the education policy and finance 
40.16 	committees of the legislature recommending the most efficient and effective allocation 
40.17 	of agency responsibility for assessing or investigating reports of maltreatment and must 
40.18 	specifically address allegations of maltreatment that currently are not the responsibility 
40.19 	of a designated agency. 

40.20 	Sec. 40. Laws 2009, chapter 79, article 2, section 36, is amended to read:
40.21 	Sec. 36. REPEALER.
 40.22 	Minnesota Statutes 2008, section 256I.06, subdivision 9, is repealed.

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

40.24 	Sec. 41. Laws 2009, chapter 79, article 5, section 25, is amended to read:
40.25 	Sec. 25. Minnesota Statutes 2008, section 256B.0625, subdivision 3, is amended to 
40.26 	read:
40.27 		Subd. 3.Physicians' services. (a) Medical assistance covers physicians' services.
40.28 	(b) Rates paid for anesthesiology services provided by physicians shall be according 
40.29 	to the formula utilized in the Medicare program and shall use a conversion factor "at 
40.30 	percentile of calendar year set by legislature, " except that rates paid to physicians for the 
40.31 	medical direction of a certified registered nurse anesthetist shall be the same as the rate 
40.32 	paid to the certified registered nurse anesthetist under medical direction.
41.1 	(c) Medical assistance does not cover physicians' services related to the provision of 
41.2 	care related to a treatment reportable under section 144.7065, subdivision 2, clauses (1), 
41.3 	(2), (3), and (5), and subdivision 7, clause (1). 
41.4 	(d) Medical assistance does not cover physicians' services related to the provision of 
41.5 	care (1) for which hospital reimbursement is prohibited under section 256.969, subdivision 
41.6 	3b, paragraph (c), or (2) reportable under section 144.7065, subdivisions 2 to 7, if the 
41.7 	physicians' services are billed by a physician who delivered care that contributed to or 
41.8 	caused the adverse health care event or hospital-acquired condition.
41.9 	(e) The payment limitations in this subdivision shall also apply to MinnesotaCare 
41.10 	and general assistance medical care.
41.11 	(f) A physician shall not bill a recipient of services for any payment disallowed 
41.12 	under this subdivision.

41.13 	Sec. 42. Laws 2009, chapter 79, article 5, section 52, is amended to read:
41.14 	Sec. 52. 256B.766 REIMBURSEMENT FOR BASIC CARE SERVICES.
41.15 	(a) Effective for services provided on or after July 1, 2009, total payments for basic 
41.16 	care services, shall be reduced by three percent, prior to third-party liability and spenddown 
41.17 	calculation. Payments made to managed care plans and county-based purchasing plans 
41.18 	shall be reduced for services provided on or after October 1, 2009, to reflect this reduction.
41.19 	(b) This section does not apply to physician and professional services, inpatient 
41.20 	hospital services, family planning services, mental health services, dental services, 
41.21 	prescription drugs, and medical transportation, federally qualified health centers, rural 
41.22 	health centers, Indian health services, and Medicare cost-sharing.

41.23 	Sec. 43. Laws 2009, chapter 79, article 8, section 8, the effective date, is amended to 
41.24 	read:

41.25 	EFFECTIVE DATE. This section is effective the day following final enactment
41.26 	July 1, 2009.

41.27 	Sec. 44. Laws 2009, chapter 79, article 8, section 13, is amended to read:
41.28 	Sec. 13. 256.0281 INTERAGENCY DATA EXCHANGE.
41.29 	The Department of Human Services, the Department of Health, and the Office of the 
41.30 	Ombudsman for Mental Health and Developmental Disabilities may establish interagency 
41.31 	agreements governing the electronic exchange of data on providers and individuals 
41.32 	collected, maintained, or used by each agency when such exchange is outlined by each 
41.33 	agency in an interagency agreement to accomplish the purposes in clauses (1) to (4):
42.1 	(1) to improve provider enrollment processes for home and community-based 
42.2 	services and state plan home care services;
42.3 	(2) to improve quality management of providers between state agencies;
42.4 	(3) to establish and maintain provider eligibility to participate as providers under 
42.5 	Minnesota health care programs; or
42.6 	(4) to meet the quality assurance reporting requirements under federal law under 
42.7 	section 1915(c) of the Social Security Act related to home and community-based waiver 
42.8 	programs.
42.9 	Each interagency agreement must include provisions to ensure anonymity of individuals, 
42.10 	including mandated reporters, and must outline the specific uses of and access to shared 
42.11 	data within each agency. Electronic interfaces between source data systems developed 
42.12 	under these interagency agreements must incorporate these provisions as well as other 
42.13 	HIPPA HIPAA provisions related to individual data.

42.14 	Sec. 45. Laws 2009, chapter 79, article 8, section 73, is amended to read:
42.15 	Sec. 73. Minnesota Statutes 2008, section 256D.44, subdivision 5, is amended to 
42.16 	read:
42.17 		Subd. 5.Special needs. In addition to the state standards of assistance established in 
42.18 	subdivisions 1 to 4, payments are allowed for the following special needs of recipients of 
42.19 	Minnesota supplemental aid who are not residents of a nursing home, a regional treatment 
42.20 	center, or a group residential housing facility.
42.21 	(a) The county agency shall pay a monthly allowance for medically prescribed 
42.22 	diets if the cost of those additional dietary needs cannot be met through some other 
42.23 	maintenance benefit. The need for special diets or dietary items must be prescribed by 
42.24 	a licensed physician. Costs for special diets shall be determined as percentages of the 
42.25 	allotment for a one-person household under the thrifty food plan as defined by the United 
42.26 	States Department of Agriculture. The types of diets and the percentages of the thrifty 
42.27 	food plan that are covered are as follows:
42.28 	(1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;
42.29 	(2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent 
42.30 	of thrifty food plan;
42.31 	(3) controlled protein diet, less than 40 grams and requires special products, 125 
42.32 	percent of thrifty food plan;
42.33 	(4) low cholesterol diet, 25 percent of thrifty food plan;
42.34 	(5) high residue diet, 20 percent of thrifty food plan;
42.35 	(6) pregnancy and lactation diet, 35 percent of thrifty food plan;
43.1 	(7) gluten-free diet, 25 percent of thrifty food plan;
43.2 	(8) lactose-free diet, 25 percent of thrifty food plan;
43.3 	(9) antidumping diet, 15 percent of thrifty food plan;
43.4 	(10) hypoglycemic diet, 15 percent of thrifty food plan; or
43.5 	(11) ketogenic diet, 25 percent of thrifty food plan.
43.6 	(b) Payment for nonrecurring special needs must be allowed for necessary home 
43.7 	repairs or necessary repairs or replacement of household furniture and appliances using 
43.8 	the payment standard of the AFDC program in effect on July 16, 1996, for these expenses, 
43.9 	as long as other funding sources are not available.
43.10 	(c) A fee for guardian or conservator service is allowed at a reasonable rate 
43.11 	negotiated by the county or approved by the court. This rate shall not exceed five percent 
43.12 	of the assistance unit's gross monthly income up to a maximum of $100 per month. If the 
43.13 	guardian or conservator is a member of the county agency staff, no fee is allowed.
43.14 	(d) The county agency shall continue to pay a monthly allowance of $68 for 
43.15 	restaurant meals for a person who was receiving a restaurant meal allowance on June 1, 
43.16 	1990, and who eats two or more meals in a restaurant daily. The allowance must continue 
43.17 	until the person has not received Minnesota supplemental aid for one full calendar month 
43.18 	or until the person's living arrangement changes and the person no longer meets the criteria 
43.19 	for the restaurant meal allowance, whichever occurs first.
43.20 	(e) A fee of ten percent of the recipient's gross income or $25, whichever is less, 
43.21 	is allowed for representative payee services provided by an agency that meets the 
43.22 	requirements under SSI regulations to charge a fee for representative payee services. This 
43.23 	special need is available to all recipients of Minnesota supplemental aid regardless of 
43.24 	their living arrangement.
43.25 	(f)(1) Notwithstanding the language in this subdivision, an amount equal to the 
43.26 	maximum allotment authorized by the federal Food Stamp Program for a single individual 
43.27 	which is in effect on the first day of July of each year will be added to the standards of 
43.28 	assistance established in subdivisions 1 to 4 for adults under the age of 65 who qualify 
43.29 	as shelter needy and are: (i) relocating from an institution, or an adult mental health 
43.30 	residential treatment program under section 256B.0622; (ii) eligible for the self-directed 
43.31 	supports option as defined under section 256B.0657, subdivision 2; or (iii) home and 
43.32 	community-based waiver recipients living in their own home or rented or leased apartment 
43.33 	which is not owned, operated, or controlled by a provider of service not related by blood 
43.34 	or marriage.
43.35 	(2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the 
43.36 	shelter needy benefit under this paragraph is considered a household of one. An eligible 
44.1 	individual who receives this benefit prior to age 65 may continue to receive the benefit 
44.2 	after the age of 65.
44.3 	(3) "Shelter needy" means that the assistance unit incurs monthly shelter costs that 
44.4 	exceed 40 percent of the assistance unit's gross income before the application of this 
44.5 	special needs standard. "Gross income" for the purposes of this section is the applicant's or 
44.6 	recipient's income as defined in section 256D.35, subdivision 10, or the standard specified 
44.7 	in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient of a federal or 
44.8 	state housing subsidy, that limits shelter costs to a percentage of gross income, shall not be 
44.9 	considered shelter needy for purposes of this paragraph.
44.10 	(g) Notwithstanding this subdivision, recipients of home and community-based 
44.11 	services may relocate to services without 24-hour supervision and receive the equivalent 
44.12 	of the recipient's group residential housing allocation in Minnesota supplemental 
44.13 	assistance shelter needy funding if the cost of the services and housing is equal to or less 
44.14 	than provided to the recipient in home and community-based services and the relocation is 
44.15 	the recipient's choice and is approved by the recipient or guardian.
44.16 	(h) To access housing and services as provided in paragraph (g), the recipient may 
44.17 	choose housing that may or may not be owned, operated, or controlled by the recipient's 
44.18 	service provider.
44.19 	(i) The provisions in paragraphs (g) and (h) are effective to June 30, 2011. The 
44.20 	commissioner shall assess the development of publicly owned housing, other housing 
44.21 	alternatives, and whether a public equity housing fund may be established that would 
44.22 	maintain the state's interest, to the extent paid from group residential housing and 
44.23 	Minnesota supplemental aid shelter needy funds in provider-owned housing so that when 
44.24 	sold, the state would recover its share for a public equity fund to be used for future public 
44.25 	needs under this chapter. The commissioner shall report findings and recommendations to 
44.26 	the legislative committees and budget divisions with jurisdiction over health and human 
44.27 	services policy and financing by January 15, 2012. 
44.28 	(j) In selecting prospective services needed by recipients for whom home and 
44.29 	community-based services have been authorized, the recipient and the recipient's guardian 
44.30 	shall first consider alternatives to home and community-based services. Minnesota 
44.31 	supplemental aid shelter needy funding for recipients who utilize Minnesota supplemental 
44.32 	aid shelter needy funding as provided in this section shall remain permanent unless the 
44.33 	recipient with the recipient's guardian later chooses to access home and community-based 
44.34 	services.
44.35 	(g) Notwithstanding this subdivision, to access housing and services as provided in 
44.36 	paragraph (f), the recipient may choose housing that may or may not be owned, operated, 
45.1 	or controlled by the recipient's service provider if the housing is located in a multifamily 
45.2 	building of six or more units. The maximum number of units that may be used by 
45.3 	recipients of this program shall be 50 percent of the units in a building. The department 
45.4 	shall develop an exception process to the 50 percent maximum. This paragraph expires 
45.5 	on June 30, 2011.

45.6 	Sec. 46. Minnesota Statutes 2008, section 402A.30, subdivision 4, as added by Laws 
45.7 	2009, chapter 79, article 9, section 6, is amended to read:
45.8 		Subd. 4.Process for establishing a service delivery authority. (a) The county or 
45.9 	consortium of counties proposing to form a service delivery authority shall, in conjunction 
45.10 	with the commissioner, prevent present a proposed memorandum of understanding to 
45.11 	the council accompanied by a resolution from the board of commissioners of each 
45.12 	participating county stating the county's intent to participate in a service delivery authority.
45.13 	(b) The council shall certify a county or consortium of counties as a service delivery 
45.14 	authority if:
45.15 	(1) the conditions in subdivision 2, paragraphs (a) and (b), are met; and
45.16 	(2) the county or consortium of counties are:
45.17 	(i) a single county with a population of 55,000 or more;
45.18 	(ii) a consortium of counties with a total combined population of 55,000 or more and 
45.19 	the counties comprising the consortium are in reasonable geographic proximity; or
45.20 	(iii) four or more counties in reasonable geographic proximity without regard 
45.21 	to population.
45.22 	The council may recommend that the commissioner of human services exempt a 
45.23 	single county or multicounty service delivery authority from the minimum population 
45.24 	standard if that service delivery authority can demonstrate that it can otherwise meet 
45.25 	the requirements of this chapter.
45.26 	(c) After the council has certified a county or consortium of counties as a service 
45.27 	delivery authority, the commissioner may enter into the memoranda of understanding with 
45.28 	the participating counties to form the service delivery authority.

45.29 	Sec. 47. Laws 2009, chapter 79, article 10, section 46, is amended to read:
45.30 	Sec. 46. FEASIBILITY PILOT PROJECT FOR CANCER SURVEILLANCE.
 45.31 	The commissioner of health must provide a grant to the Hennepin County Medical 
45.32 	Center for a one-year feasibility pilot project to collect occupational, residential, and 
45.33 	military service history data from newly diagnosed cancer patients at the Hennepin 
45.34 	County Medical Center's Cancer Center. Funding for this grant shall come from the 
46.1 	Department of Health's current resources for the Chronic Disease and Environmental 
46.2 	Epidemiology Section.
46.3 	Under this pilot project, Hennepin County Medical Center will design an expansion 
46.4 	of its existing cancer registry to include the collection of additional data, including the 
46.5 	cancer patient's occupational, residential, and military service history. Patient consent is 
46.6 	required for collection of these additional data. The consent must be in writing and must 
46.7 	contain notice informing the patient about private and confidential data concerning the 
46.8 	patient pursuant to Minnesota Statutes, section 13.04, subdivision 2. The patient is entitled 
46.9 	to opt out of the project at any time. The data collection expansion may also include the 
46.10 	cancer patient's possible toxic environmental exposure history, if known. The purpose of 
46.11 	this pilot project is to determine the following:
46.12 	(1) the feasibility of collecting these data on a statewide scale; 
46.13 	(2) the potential design of a self-administered patient questionnaire template; and 
46.14 	(3) necessary qualifications for staff who will collect these data. 
46.15 	Hennepin County Medical Center must report the results of this pilot project to the 
46.16 	legislature by October 1, 2010.

46.17 	Sec. 48. EXPOSURE LEVELS STUDY.
 46.18 	The commissioner of health shall work with appropriate local, state, and federal 
46.19 	agencies to determine whether the levels of exposure to pentachlorophenol (PCP) 
46.20 	in Minneapolis neighborhoods where utility poles treated with PCP, creosote, or 
46.21 	probable human carcinogens are installed, exceed human health risk limits or maximum 
46.22 	contaminant levels for residents, utility workers, and others who handle the treated poles.

46.23 	Sec. 49.  REPEALER.
 46.24 	Laws 2009, chapter 79, article 7, section 12, is repealed.

46.25 	ARTICLE 2
46.26 	TECHNICAL APPROPRIATION CHANGES

46.27 	Section 1. Laws 2009, chapter 79, article 13, section 3, is amended to read:

46.28	Sec. 3. HUMAN SERVICES

46.29
46.30	Subdivision 1.Total Appropriation
 	$
	5,230,100,000
 5,225,451,000
	$
	5,997,715,000
 6,002,864,000

46.31	Appropriations by Fund
	
46.32		2010
	2011
	
47.1
47.2	General
	4,376,839,000
 4,375,689,000
	5,211,018,000
 5,209,765,000
	
47.3
47.4	State Government 
Special Revenue
	1,315,000
 565,000
	565,000
	
47.5
47.6	Health Care Access
	450,792,000
 450,662,000
	527,489,000
 527,411,000
	
47.7
47.8	Federal TANF
	289,487,000
 286,770,000
	256,978,000
 263,458,000
	
47.9	Lottery Prize
	1,665,000
	1,665,000
	
47.10	Federal Fund
	110,000,000
	0
	
47.11 	Receipts for Systems Projects.
47.12 	Appropriations and federal receipts for 
47.13 	information systems projects for MAXIS, 
47.14 	PRISM, MMIS, and SSIS must be deposited 
47.15 	in the state system account authorized in 
47.16 	Minnesota Statutes, section 256.014. Money 
47.17 	appropriated for computer projects approved 
47.18 	by the Minnesota Office of Enterprise 
47.19 	Technology, funded by the legislature, and 
47.20 	approved by the commissioner of finance, 
47.21 	may be transferred from one project to 
47.22 	another and from development to operations 
47.23 	as the commissioner of human services 
47.24 	considers necessary, except that any transfers 
47.25 	to one project that exceed $1,000,000 or 
47.26 	multiple transfers to one project that exceed 
47.27 	$1,000,000 in total require the express 
47.28 	approval of the legislature. The preceding 
47.29 	requirement for legislative approval does not 
47.30 	apply to transfers made to establish a project's 
47.31 	initial operating budget each year; instead, 
47.32 	the requirements of section 11, subdivision 
47.33 	2, of this article apply to those transfers. Any 
47.34 	unexpended balance in the appropriation 
47.35 	for these projects does not cancel but is 
47.36 	available for ongoing development and 
47.37 	operations. Any computer project with a 
47.38 	total cost exceeding $1,000,000, including, 
48.1 	but not limited to, a replacement for the 
48.2 	proposed HealthMatch system, shall not be 
48.3 	commenced without the express approval of 
48.4 	the legislature.
48.5 	HealthMatch Systems Project. In fiscal 
48.6 	year 2010, $3,054,000 shall be transferred 
48.7 	from the HealthMatch account in the state 
48.8 	systems account in the special revenue fund 
48.9 	to the general fund.
48.10 	Nonfederal Share Transfers. The 
48.11 	nonfederal share of activities for which 
48.12 	federal administrative reimbursement is 
48.13 	appropriated to the commissioner may be 
48.14 	transferred to the special revenue fund.
48.15 	TANF Maintenance of Effort.
48.16 	(a) In order to meet the basic maintenance 
48.17 	of effort (MOE) requirements of the TANF 
48.18 	block grant specified under Code of Federal 
48.19 	Regulations, title 45, section 263.1, the 
48.20 	commissioner may only report nonfederal 
48.21 	money expended for allowable activities 
48.22 	listed in the following clauses as TANF/MOE 
48.23 	expenditures:
48.24 	(1) MFIP cash, diversionary work program, 
48.25 	and food assistance benefits under Minnesota 
48.26 	Statutes, chapter 256J;
48.27 	(2) the child care assistance programs 
48.28 	under Minnesota Statutes, sections 119B.03
48.29 	and 119B.05, and county child care 
48.30 	administrative costs under Minnesota 
48.31 	Statutes, section 119B.15;
48.32 	(3) state and county MFIP administrative 
48.33 	costs under Minnesota Statutes, chapters 
48.34 	256J and 256K;
49.1 	(4) state, county, and tribal MFIP 
49.2 	employment services under Minnesota 
49.3 	Statutes, chapters 256J and 256K;
49.4 	(5) expenditures made on behalf of 
49.5 	noncitizen MFIP recipients who qualify 
49.6 	for the medical assistance without federal 
49.7 	financial participation program under 
49.8 	Minnesota Statutes, section 256B.06, 
49.9 	subdivision 4, paragraphs (d), (e), and (j); 
49.10 	and
49.11 	(6) qualifying working family credit 
49.12 	expenditures under Minnesota Statutes, 
49.13 	section 290.0671.
49.14 	(b) The commissioner shall ensure that 
49.15 	sufficient qualified nonfederal expenditures 
49.16 	are made each year to meet the state's 
49.17 	TANF/MOE requirements. For the activities 
49.18 	listed in paragraph (a), clauses (2) to 
49.19 	(6), the commissioner may only report 
49.20 	expenditures that are excluded from the 
49.21 	definition of assistance under Code of 
49.22 	Federal Regulations, title 45, section 260.31.
49.23 	(c) For fiscal years beginning with state 
49.24 	fiscal year 2003, the commissioner shall 
49.25 	ensure that the maintenance of effort used 
49.26 	by the commissioner of finance for the 
49.27 	February and November forecasts required 
49.28 	under Minnesota Statutes, section 16A.103, 
49.29 	contains expenditures under paragraph (a), 
49.30 	clause (1), equal to at least 16 percent of 
49.31 	the total required under Code of Federal 
49.32 	Regulations, title 45, section 263.1.
49.33 	(d) For the federal fiscal years beginning on 
49.34 	or after October 1, 2007, the commissioner 
49.35 	may not claim an amount of TANF/MOE in 
50.1 	excess of the 75 percent standard in Code 
50.2 	of Federal Regulations, title 45, section 
50.3 	263.1(a)(2), except:
50.4 	(1) to the extent necessary to meet the 80 
50.5 	percent standard under Code of Federal 
50.6 	Regulations, title 45, section 263.1(a)(1), 
50.7 	if it is determined by the commissioner 
50.8 	that the state will not meet the TANF work 
50.9 	participation target rate for the current year;
50.10 	(2) to provide any additional amounts 
50.11 	under Code of Federal Regulations, title 45, 
50.12 	section 264.5, that relate to replacement of 
50.13 	TANF funds due to the operation of TANF 
50.14 	penalties; and
50.15 	(3) to provide any additional amounts that 
50.16 	may contribute to avoiding or reducing 
50.17 	TANF work participation penalties through 
50.18 	the operation of the excess MOE provisions 
50.19 	of Code of Federal Regulations, title 45, 
50.20 	section 261.43 (a)(2).
50.21 	For the purposes of clauses (1) to (3), 
50.22 	the commissioner may supplement the 
50.23 	MOE claim with working family credit 
50.24 	expenditures to the extent such expenditures 
50.25 	or other qualified expenditures are otherwise 
50.26 	available after considering the expenditures 
50.27 	allowed in this section.
50.28 	(e) Minnesota Statutes, section 256.011, 
50.29 	subdivision 3, which requires that federal 
50.30 	grants or aids secured or obtained under that 
50.31 	subdivision be used to reduce any direct 
50.32 	appropriations provided by law, do not apply 
50.33 	if the grants or aids are federal TANF funds.
51.1 	(f) Notwithstanding any contrary provision 
51.2 	in this article, this provision expires June 30, 
51.3 	2013.
51.4 	Working Family Credit Expenditures as 
51.5 	TANF/MOE. The commissioner may claim 
51.6 	as TANF/MOE up to $6,707,000 per year of 
51.7 	working family credit expenditures for fiscal 
51.8 	year 2010 through fiscal year 2011.
51.9 	Working Family Credit Expenditures 
51.10 	to be Claimed for TANF/MOE. The 
51.11 	commissioner may count the following 
51.12 	amounts of working family credit expenditure 
51.13 	as TANF/MOE:
51.14 	(1) fiscal year 2010, $30,217,000
51.15 	$50,973,000;
51.16 	(2) fiscal year 2011, $55,596,000
51.17 	$53,793,000;
51.18 	(3) fiscal year 2012, $28,519,000
51.19 	$23,516,000; and
51.20 	(4) fiscal year 2013, $22,138,000
51.21 	$16,808,000.
51.22 	Notwithstanding any contrary provision in 
51.23 	this article, this rider expires June 30, 2013.
51.24 	TANF Transfer to Federal Child Care 
51.25 	and Development Fund. The following 
51.26 	TANF fund amounts are appropriated to the 
51.27 	commissioner for the purposes of MFIP and 
51.28 	transition year child care under Minnesota 
51.29 	Statutes, section 119B.05:
51.30 	(1) fiscal year 2010, $5,909,000;
51.31 	(2) fiscal year 2011, $9,808,000;
51.32 	(3) fiscal year 2012, $10,826,000; and
51.33 	(4) fiscal year 2013, $4,026,000.
52.1 	The commissioner shall authorize the 
52.2 	transfer of sufficient TANF funds to the 
52.3 	federal child care and development fund to 
52.4 	meet this appropriation and shall ensure that 
52.5 	all transferred funds are expended according 
52.6 	to federal child care and development fund 
52.7 	regulations.
52.8 	Food Stamps Employment and Training.
52.9 	(a) The commissioner shall apply for and 
52.10 	claim the maximum allowable federal 
52.11 	matching funds under United States Code, 
52.12 	title 7, section 2025, paragraph (h), for 
52.13 	state expenditures made on behalf of family 
52.14 	stabilization services participants voluntarily 
52.15 	engaged in food stamp employment and 
52.16 	training activities, where appropriate.
52.17 	(b) Notwithstanding Minnesota Statutes, 
52.18 	sections 256D.051, subdivisions 1a, 6b, 
52.19 	and 6c, and 256J.626, federal food stamps 
52.20 	employment and training funds received 
52.21 	as reimbursement of MFIP consolidated 
52.22 	fund grant expenditures for diversionary 
52.23 	work program participants and child 
52.24 	care assistance program expenditures for 
52.25 	two-parent families must be deposited in the 
52.26 	general fund. The amount of funds must be 
52.27 	limited to $3,350,000 in fiscal year 2010 
52.28 	and $4,440,000 in fiscal years 2011 through 
52.29 	2013, contingent on approval by the federal 
52.30 	Food and Nutrition Service. 
52.31 	(c) Consistent with the receipt of these federal 
52.32 	funds, the commissioner may adjust the 
52.33 	level of working family credit expenditures 
52.34 	claimed as TANF maintenance of effort. 
53.1 	Notwithstanding any contrary provision in 
53.2 	this article, this rider expires June 30, 2013.
53.3 	ARRA Food Support Administration.
53.4 	The funds available for food support 
53.5 	administration under the American Recovery 
53.6 	and Reinvestment Act (ARRA) of 2009 
53.7 	are appropriated to the commissioner 
53.8 	to pay actual costs of implementing the 
53.9 	food support benefit increases, increased 
53.10 	eligibility determinations, and outreach. Of 
53.11 	these funds, 20 percent shall be allocated 
53.12 	to the commissioner and 80 percent shall 
53.13 	be allocated to counties. The commissioner 
53.14 	shall allocate the county portion based on 
53.15 	caseload. Reimbursement shall be based on 
53.16 	actual costs reported by counties through 
53.17 	existing processes. Tribal reimbursement 
53.18 	must be made from the state portion based 
53.19 	on a caseload factor equivalent to that of a 
53.20 	county.
53.21 	ARRA Food Support Benefit Increases.
53.22 	The funds provided for food support benefit 
53.23 	increases under the Supplemental Nutrition 
53.24 	Assistance Program provisions of the 
53.25 	American Recovery and Reinvestment Act 
53.26 	(ARRA) of 2009 must be used for benefit 
53.27 	increases beginning July 1, 2009.
53.28 	Emergency Fund for the TANF Program.
53.29 	TANF Emergency Contingency funds 
53.30 	available under the American Recovery 
53.31 	and Reinvestment Act of 2009 (Public Law 
53.32 	111-5) are appropriated to the commissioner. 
53.33 	The commissioner must request TANF 
53.34 	Emergency Contingency funds from the 
53.35 	Secretary of the Department of Health 
54.1 	and Human Services to the extent the 
54.2 	commissioner meets or expects to meet the 
54.3 	requirements of section 403(c) of the Social 
54.4 	Security Act. The commissioner must seek 
54.5 	to maximize such grants. The funds received 
54.6 	must be used as appropriated. Each county 
54.7 	must maintain the county's current level of 
54.8 	emergency assistance funding under the 
54.9 	MFIP consolidated fund and use the funds 
54.10 	under this paragraph to supplement existing 
54.11 	emergency assistance funding levels.

54.12	Subd. 2.Agency Management
 					
54.13 	The amounts that may be spent from the 
54.14 	appropriation for each purpose are as follows:

54.15	(a) Financial Operations

54.16	Appropriations by Fund
	
54.17	General
	3,380,000
	3,908,000
	
54.18	Health Care Access
	1,281,000
	1,016,000
	
54.19	Federal TANF
	122,000
	122,000

54.20	(b) Legal and Regulatory Operations

54.21	Appropriations by Fund
	
54.22	General
	13,749,000
	13,534,000
	
54.23
54.24	State Government 
Special Revenue
	440,000
	440,000
	
54.25	Health Care Access
	943,000
	943,000
	
54.26	Federal TANF
	100,000
	100,000
	
54.27 	Base Adjustment. The general fund base is 
54.28 	decreased by $180,000 in fiscal year 2012 
54.29 	and $180,000 in fiscal year 2013.

54.30	(c) Management Operations

54.31	Appropriations by Fund
	
54.32	General
	4,334,000
	4,562,000
	
54.33	Health Care Access
	242,000
	242,000
	
54.34 	Lease Cost Reduction. Base level funding 
54.35 	to the commissioner shall be reduced by 
55.1 	$381,000 in fiscal year 2010, and $153,000 
55.2 	in fiscal year 2011, to reflect a reduction in 
55.3 	lease costs related to the Minnehaha Avenue 
55.4 	building.
55.5 	Base Adjustment. The general fund base is 
55.6 	increased by $153,000 in each of fiscal years 
55.7 	2012 and 2013.

55.8	(d) Information Technology Operations

55.9	Appropriations by Fund
	
55.10	General
	28,077,000
	28,077,000
	
55.11	Health Care Access
	4,856,000
	4,868,000

55.12
55.13	Subd. 3.Revenue and Pass-Through Revenue 
Expenditures
 		65,746,000
 68,337,000
		67,068,000
 70,505,000
	
55.14 	This appropriation is from the federal TANF 
55.15 	fund.
55.16 	TANF Transfer to Federal Child Care 
55.17 	and Development Fund. The following 
55.18 	TANF fund amounts are appropriated to the 
55.19 	commissioner for the purposes of MFIP and 
55.20 	transition year child care under Minnesota 
55.21 	Statutes, section 119B.05: 
55.22 	(1) fiscal year 2010, $6,531,000;
55.23 	(2) fiscal year 2011, $10,241,000;
55.24 	(3) fiscal year 2012, $10,826,000; and
55.25 	(4) fiscal year 2013, $4,046,000.
55.26 	The commissioner shall authorize the 
55.27 	transfer of sufficient TANF funds to the 
55.28 	federal child care and development fund to 
55.29 	meet this appropriation and shall ensure that 
55.30 	all transferred funds are expended according 
55.31 	to federal child care and development fund 
55.32 	regulations.

55.33
55.34	Subd. 4.Children and Economic Assistance 
Grants
 					
56.1 	The amounts that may be spent from this 
56.2 	appropriation for each purpose are as follows:

56.3	(a) MFIP/DWP Grants

56.4	Appropriations by Fund
	
56.5	General
	63,205,000
	89,033,000
	
56.6
56.7	Federal TANF
	100,404,000
 100,818,000
	85,789,000
 84,538,000

56.8	(b) Support Services Grants

56.9	Appropriations by Fund
	
56.10	General
	8,715,000
	12,498,000
	
56.11
56.12	Federal TANF
	121,257,000
 116,557,000
	102,757,000
 107,457,000
	
56.13 	MFIP Consolidated Fund. The MFIP 
56.14 	consolidated fund TANF appropriation is 
56.15 	reduced by $1,854,000 in fiscal year 2011
56.16 	2010 and fiscal year 2012 2011.
56.17 	Notwithstanding Minnesota Statutes, section 
56.18 	256J.626, subdivision 8, paragraph (b), the 
56.19 	commissioner shall reduce proportionately 
56.20 	the reimbursement to counties for 
56.21 	administrative expenses.
56.22 	Subsidized Employment Funding Through 
56.23 	ARRA. The commissioner is authorized to 
56.24 	apply for TANF emergency fund grants for 
56.25 	subsidized employment activities. Growth 
56.26 	in expenditures for subsidized employment 
56.27 	within the supported work program and the 
56.28 	MFIP consolidated fund over the amount 
56.29 	expended in the calendar quarters in the 
56.30 	TANF emergency fund base year shall be 
56.31 	used to leverage the TANF emergency fund 
56.32 	grants for subsidized employment and to 
56.33 	fund supported work. The commissioner 
56.34 	shall develop procedures to maximize 
56.35 	reimbursement of these expenditures over the 
56.36 	TANF emergency fund base year quarters, 
57.1 	and may contract directly with employers 
57.2 	and providers to maximize these TANF 
57.3 	emergency fund grants.
57.4 	Supported Work. Of the TANF 
57.5 	appropriation, $6,400,000 $4,700,000 in 
57.6 	fiscal year 2011 is2010 and $4,700,000 in 
57.7 	fiscal year 2011 are to the commissioner for 
57.8 	supported work for MFIP recipients and is 
57.9 	available until expended. Supported work 
57.10 	includes paid transitional work experience 
57.11 	and a continuum of employment assistance, 
57.12 	including outreach and recruitment, 
57.13 	program orientation and intake, testing and 
57.14 	assessment, job development and marketing, 
57.15 	preworksite training, supported worksite 
57.16 	experience, job coaching, and postplacement 
57.17 	follow-up, in addition to extensive case 
57.18 	management and referral services. This is a 
57.19 	onetime appropriation.
57.20 	Base Adjustment. The general fund base 
57.21 	is reduced by $3,783,000 in each of fiscal 
57.22 	years 2012 and 2013. The TANF fund base is 
57.23 	increased by $9,704,000 $5,004,000 in each 
57.24 	of fiscal years 2012 and 2013.
57.25 	Integrated Services Program Funding.
57.26 	The TANF appropriation for integrated 
57.27 	services program funding is $1,250,000 in 
57.28 	fiscal year 2010 and $2,500,000 $0 in fiscal 
57.29 	year 2011 and the base for fiscal years 2012 
57.30 	and 2013 is $0.
57.31 	TANF Emergency Fund; Nonrecurrent 
57.32 	Short-Term Benefits. TANF emergency 
57.33 	contingency fund grants received due to 
57.34 	increases in expenditures for nonrecurrent 
57.35 	short-term benefits must be used to offset the 
58.1 	increase in these expenditures for counties 
58.2 	under the MFIP consolidated fund, under 
58.3 	Minnesota Statutes, section 256J.626, 
58.4 	and the diversionary work program. The 
58.5 	commissioner shall develop procedures 
58.6 	to maximize reimbursement of these 
58.7 	expenditures over the TANF emergency fund 
58.8 	base year quarters. Growth in expenditures 
58.9 	for the diversionary work program over the 
58.10 	amount expended in the calendar quarters in 
58.11 	the TANF emergency fund base year shall be 
58.12 	used to leverage these funds.

58.13	(c) MFIP Child Care Assistance Grants
		61,171,000
		65,214,000

58.14	Appropriations by Fund
	
58.15	General
	61,171,000
	65,214,000
	
58.16	Federal TANF
	1,022,000
	406,000
	
58.17 	ARRA Child Care Development Block 
58.18 	Grant Funds. The funds available from the 
58.19 	child care development block grant under 
58.20 	ARRA must be used for MFIP child care to 
58.21 	the extent that those funds are not earmarked 
58.22 	for quality expansion or to improve the 
58.23 	quality of infant and toddler care.
58.24 	Acceleration of ARRA Child Care and 
58.25 	Development Fund Expenditure. The 
58.26 	commissioner must liquidate all child care 
58.27 	and development money available under 
58.28 	the American Recovery and Reinvestment 
58.29 	Act (ARRA) of 2009, Public Law 111-5, 
58.30 	by September 30, 2010. In order to expend 
58.31 	those funds by September 30, 2010, the 
58.32 	commissioner may redesignate and expend 
58.33 	the ARRA child care and development funds 
58.34 	appropriated in fiscal year 2011 for purposes 
58.35 	under this section for related purposes that 
59.1 	will allow liquidation by September 30, 
59.2 	2010. Child care and development funds 
59.3 	otherwise available to the commissioner 
59.4 	for those related purposes shall be used to 
59.5 	fund the purposes from which the ARRA 
59.6 	child care and development funds had been 
59.7 	redesignated.
59.8 	School Readiness Service Agreements.
59.9 	$400,000 in fiscal year 2010 and $400,000 
59.10 	in fiscal year 2011 are from the federal 
59.11 	TANF fund to the commissioner of human 
59.12 	services consistent with federal regulations 
59.13 	for the purpose of school readiness service 
59.14 	agreements under Minnesota Statutes, section 
59.15 	119B.231. This is a onetime appropriation. 
59.16 	Any unexpended balance the first year is 
59.17 	available in the second year.

59.18
59.19	(d) Basic Sliding Fee Child Care Assistance 
Grants
		40,104,000
 40,100,000
		45,096,000
 45,092,000
	
59.20 	Base Adjustment. The general fund base is 
59.21 	decreased by $260,000 in each of fiscal years 
59.22 	2012 and 2013.
59.23 	School Readiness Service Agreements.
59.24 	$261,000 $257,000 in fiscal year 2010 and 
59.25 	$261,000 $257,000 in fiscal year 2011 are 
59.26 	from the federal child care development 
59.27 	funds received from the American Recovery 
59.28 	and Reinvestment Act of 2009, Public Law 
59.29 	111-5, to the commissioner of human services 
59.30 	consistent with federal regulations general 
59.31 	fund for the purpose of school readiness 
59.32 	service agreements under Minnesota 
59.33 	Statutes, section 119B.231. This is a onetime 
59.34 	appropriation. Any unexpended balance the 
59.35 	first year is available in the second year.
60.1 	Child Care Development Fund 
60.2 	Unexpended Balance. In addition to 
60.3 	the amount provided in this section, the 
60.4 	commissioner shall expend $5,244,000 in 
60.5 	fiscal year 2010 from the federal child care 
60.6 	development fund unexpended balance 
60.7 	for basic sliding fee child care under 
60.8 	Minnesota Statutes, section 119B.03. The 
60.9 	commissioner shall ensure that all child 
60.10 	care and development funds are expended 
60.11 	according to the federal child care and 
60.12 	development fund regulations.
60.13 	Basic Sliding Fee.$7,045,000 $4,000,000 in 
60.14 	fiscal year 2010 and $6,974,000 $4,000,000
60.15 	in fiscal year 2011 are from the federal child 
60.16 	care development funds received from the 
60.17 	American Recovery and Reinvestment Act of 
60.18 	2009, Public Law 111-5, to the commissioner 
60.19 	of human services consistent with federal 
60.20 	regulations for the purpose of basic sliding 
60.21 	fee child care assistance under Minnesota 
60.22 	Statutes, section 119B.03. This is a onetime 
60.23 	appropriation. Any unexpended balance the 
60.24 	first year is available in the second year.
60.25 	Basic Sliding Fee Allocation for Calendar 
60.26 	Year 2010. Notwithstanding Minnesota 
60.27 	Statutes, section 119B.03, subdivision 6, 
60.28 	in calendar year 2010, basic sliding fee 
60.29 	funds shall be distributed according to 
60.30 	this provision. Funds shall be allocated 
60.31 	first in amounts equal to each county's 
60.32 	guaranteed floor, according to Minnesota 
60.33 	Statutes, section 119B.03, subdivision 8, 
60.34 	with any remaining available funds allocated 
60.35 	according to the following formula:
61.1 	(a) Up to one-fourth of the funds shall be 
61.2 	allocated in proportion to the number of 
61.3 	families participating in the transition year 
61.4 	child care program as reported during and 
61.5 	averaged over the most recent six months 
61.6 	completed at the time of the notice of 
61.7 	allocation. Funds in excess of the amount 
61.8 	necessary to serve all families in this category 
61.9 	shall be allocated according to paragraph (d).
61.10 	(b) Up to three-fourths of the funds shall 
61.11 	be allocated in proportion to the average 
61.12 	of each county's most recent six months of 
61.13 	reported waiting list as defined in Minnesota 
61.14 	Statutes, section 119B.03, subdivision 2, and 
61.15 	the reinstatement list of those families whose 
61.16 	assistance was terminated with the approval 
61.17 	of the commissioner under Minnesota Rules, 
61.18 	part 3400.0183, subpart 1. Funds in excess 
61.19 	of the amount necessary to serve all families 
61.20 	in this category shall be allocated according 
61.21 	to paragraph (d).
61.22 	(c) The amount necessary to serve all families 
61.23 	in paragraphs (a) and (b) shall be calculated 
61.24 	based on the basic sliding fee average cost of 
61.25 	care per family in the county with the highest 
61.26 	cost in the most recently completed calendar 
61.27 	year.
61.28 	(d) Funds in excess of the amount necessary 
61.29 	to serve all families in paragraphs (a) and 
61.30 	(b) shall be allocated in proportion to each 
61.31 	county's total expenditures for the basic 
61.32 	sliding fee child care program reported 
61.33 	during the most recent fiscal year completed 
61.34 	at the time of the notice of allocation. To 
61.35 	the extent that funds are available, and 
62.1 	notwithstanding Minnesota Statutes, section 
62.2 	119B.03, subdivision 8, for the period 
62.3 	January 1, 2011, to December 31, 2011, each 
62.4 	county's guaranteed floor must be equal to its 
62.5 	original calendar year 2010 allocation.
62.6 	Base Adjustment. The general fund base is 
62.7 	decreased by $257,000 in each of fiscal years 
62.8 	2012 and 2013.

62.9	(e) Child Care Development Grants
		1,487,000
		1,487,000
	
62.10 	Family, friends, and neighbor grants.
62.11 	$375,000 in fiscal year 2010 and $375,000 
62.12 	in fiscal year 2011 are from the child 
62.13 	care development fund required targeted 
62.14 	quality funds for quality expansion and 
62.15 	infant/toddler from the American Recovery 
62.16 	and Reinvestment Act of 2009, Public 
62.17 	Law 111-5, to the commissioner of human 
62.18 	services for family, friends, and neighbor 
62.19 	grants under Minnesota Statutes, section 
62.20 	119B.232. This appropriation may be used 
62.21 	on programs receiving family, friends, and 
62.22 	neighbor grant funds as of June 30, 2009, 
62.23 	or on new programs or projects. This is a 
62.24 	onetime appropriation. Any unexpended 
62.25 	balance the first year is available in the 
62.26 	second year.
62.27 	Voluntary quality rating system training, 
62.28 	coaching, consultation, and supports.
62.29 	$633,000 in fiscal year 2010 and $633,000 
62.30 	in fiscal year 2011 are from the federal child 
62.31 	care development fund required targeted 
62.32 	quality funds for quality expansion and 
62.33 	infant/toddler from the American Recovery 
62.34 	and Reinvestment Act of 2009, Public 
62.35 	Law 111-5, to the commissioner of human 
63.1 	services consistent with federal regulations 
63.2 	for the purpose of providing grants to provide 
63.3 	statewide child-care provider training, 
63.4 	coaching, consultation, and supports to 
63.5 	prepare for the voluntary Minnesota quality 
63.6 	rating system rating tool. This is a onetime 
63.7 	appropriation. Any unexpended balance the 
63.8 	first year is available in the second year.
63.9 	Voluntary quality rating system. $184,000 
63.10 	in fiscal year 2010 and $1,200,000 in fiscal 
63.11 	year 2011 are from the federal child care 
63.12 	development fund required targeted funds for 
63.13 	quality expansion and infant/toddler from the 
63.14 	American Recovery and Reinvestment Act of 
63.15 	2009, Public Law 111-5, to the commissioner 
63.16 	of human services consistent with federal 
63.17 	regulations for the purpose of implementing 
63.18 	the voluntary Parent Aware quality star 
63.19 	rating system pilot in coordination with the 
63.20 	Minnesota Early Learning Foundation. The 
63.21 	appropriation for the first year is to complete 
63.22 	and promote the voluntary Parent Aware 
63.23 	quality rating system pilot program through 
63.24 	June 30, 2010, and the appropriation for 
63.25 	the second year is to continue the voluntary 
63.26 	Minnesota quality rating system pilot 
63.27 	through June 30, 2011. This is a onetime 
63.28 	appropriation. Any unexpended balance the 
63.29 	first year is available in the second year.

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

63.31	(g) Children's Services Grants

63.32	Appropriations by Fund
	
63.33	General
	48,333,000
	50,498,000
	
63.34	Federal TANF
	340,000
	240,000
	
64.1 	Base Adjustment. The general fund base 
64.2 	is decreased by $5,371,000 in fiscal year 
64.3 	2012 and increased $8,737,000 decreased 
64.4 	$5,371,000 in fiscal year 2013.
64.5 	Privatized Adoption Grants. Federal 
64.6 	reimbursement for privatized adoption grant 
64.7 	and foster care recruitment grant expenditures 
64.8 	is appropriated to the commissioner for 
64.9 	adoption grants and foster care and adoption 
64.10 	administrative purposes.
64.11 	Adoption Assistance Incentive Grants.
64.12 	Federal funds available during fiscal 
64.13 	year 2010 and fiscal year 2011 for the 
64.14 	adoption incentive grants are appropriated 
64.15 	to the commissioner for these purposes
64.16 	postadoption services including parent 
64.17 	support groups.
64.18 	Adoption Assistance and Relative Custody 
64.19 	Assistance. The commissioner may transfer 
64.20 	unencumbered appropriation balances for 
64.21 	adoption assistance and relative custody 
64.22 	assistance between fiscal years and between 
64.23 	programs.

64.24	(h) Children and Community Services Grants
		67,663,000
		67,542,000
	
64.25 	Targeted Case Management Temporary 
64.26 	Funding Adjustment. The commissioner 
64.27 	shall recover from each county and tribe 
64.28 	receiving a targeted case management 
64.29 	temporary funding payment in fiscal year 
64.30 	2008 an amount equal to that payment. The 
64.31 	commissioner shall recover one-half of the 
64.32 	funds by February 1, 2010, and the remainder 
64.33 	by February 1, 2011. At the commissioner's 
64.34 	discretion and at the request of a county 
64.35 	or tribe, the commissioner may revise 
65.1 	the payment schedule, but full payment 
65.2 	must not be delayed beyond May 1, 2011. 
65.3 	The commissioner may use the recovery 
65.4 	procedure under Minnesota Statutes, section 
65.5 	256.017, to recover the funds. Recovered 
65.6 	funds must be deposited into the general 
65.7 	fund.

65.8	(i) General Assistance Grants
		48,215,000
		48,608,000
	
65.9 	General Assistance Standard. The 
65.10 	commissioner shall set the monthly standard 
65.11 	of assistance for general assistance units 
65.12 	consisting of an adult recipient who is 
65.13 	childless and unmarried or living apart 
65.14 	from parents or a legal guardian at $203. 
65.15 	The commissioner may reduce this amount 
65.16 	according to Laws 1997, chapter 85, article 
65.17 	3, section 54.
65.18 	Emergency General Assistance. The 
65.19 	amount appropriated for emergency general 
65.20 	assistance funds is limited to no more 
65.21 	than $7,889,812 in fiscal year 2010 and 
65.22 	$7,889,812 in fiscal year 2011. Funds 
65.23 	to counties must be allocated by the 
65.24 	commissioner using the allocation method 
65.25 	specified in Minnesota Statutes, section 
65.26 	256D.06.

65.27	(j) Minnesota Supplemental Aid Grants
		33,930,000
		35,191,000
	
65.28 	Emergency Minnesota Supplemental 
65.29 	Aid Funds. The amount appropriated for 
65.30 	emergency Minnesota supplemental aid 
65.31 	funds is limited to no more than $1,100,000 
65.32 	in fiscal year 2010 and $1,100,000 in fiscal 
65.33 	year 2011. Funds to counties must be 
65.34 	allocated by the commissioner using the 
66.1 	allocation method specified in Minnesota 
66.2 	Statutes, section 256D.46.

66.3	(k) Group Residential Housing Grants
		111,778,000
		114,034,000
	
66.4 	Group Residential Housing Costs 
66.5 	Refinanced. (a) Effective July 1, 2011, the 
66.6 	commissioner shall increase the home and 
66.7 	community-based service rates and county 
66.8 	allocations provided to programs for persons 
66.9 	with disabilities established under section 
66.10 	1915(c) of the Social Security Act to the 
66.11 	extent that these programs will be paying 
66.12 	for the costs above the rate established 
66.13 	in Minnesota Statutes, section 256I.05, 
66.14 	subdivision 1.
66.15 	(b) For persons receiving services under 
66.16 	Minnesota Statutes, section 245A.02, who 
66.17 	reside in licensed adult foster care beds 
66.18 	for which a difficulty of care payment 
66.19 	was being made under Minnesota Statutes, 
66.20 	section 256I.05, subdivision 1c, paragraph 
66.21 	(b), counties may request an exception to 
66.22 	the individual's service authorization not to 
66.23 	exceed the difference between the client's 
66.24 	monthly service expenditures plus the 
66.25 	amount of the difficulty of care payment.

66.26	(l) Children's Mental Health Grants
		16,885,000
		16,882,000
	
66.27 	Funding Usage. Up to 75 percent of a fiscal 
66.28 	year's appropriation for children's mental 
66.29 	health grants may be used to fund allocations 
66.30 	in that portion of the fiscal year ending 
66.31 	December 31.

66.32
66.33	(m) Other Children and Economic Assistance 
Grants
		16,047,000
		15,339,000
	
66.34 	Fraud Prevention Grants. Of this 
66.35 	appropriation, $379,000 $228,000 in fiscal 
67.1 	year 2010 and $379,000 $228,000 in fiscal 
67.2 	year 2011 is to the commissioner for fraud 
67.3 	prevention grants to counties.
67.4 	Homeless and Runaway Youth. $218,000 
67.5 	in fiscal year 2010 is for the Runaway 
67.6 	and Homeless Youth Act under Minnesota 
67.7 	Statutes, section 256K.45. Funds shall be 
67.8 	spent in each area of the continuum of care 
67.9 	to ensure that programs are meeting the 
67.10 	greatest need. Any unexpended balance in 
67.11 	the first year is available in the second year. 
67.12 	Beginning July 1, 2011, the base is increased 
67.13 	by $119,000 each year.
67.14 	ARRA Homeless Youth Funds. To the 
67.15 	extent permitted under federal law, the 
67.16 	commissioner shall designate $2,500,000 
67.17 	of the Homeless Prevention and Rapid 
67.18 	Re-Housing Program funds provided under 
67.19 	the American Recovery and Reinvestment 
67.20 	Act of 2009, Public Law 111-5, for agencies 
67.21 	providing homelessness prevention and rapid 
67.22 	rehousing services to youth.
67.23 	Supportive Housing Services. $1,500,000 
67.24 	each year is for supportive services under 
67.25 	Minnesota Statutes, section 256K.26. This is 
67.26 	a onetime appropriation. Beginning in fiscal 
67.27 	year 2012, the base is increased by $68,000 
67.28 	per year.
67.29 	Community Action Grants. Community 
67.30 	action grants are reduced one time by 
67.31 	$1,764,000 $1,794,000 each year. This 
67.32 	reduction is due to the availability of federal 
67.33 	funds under the American Recovery and 
67.34 	Reinvestment Act.
68.1 	Base Adjustment. The general fund base 
68.2 	is increased by $773,000 in fiscal year 2012 
68.3 	and $773,000 in fiscal year 2013.
68.4 	Federal ARRA Funds for Existing 
68.5 	Programs. (a) Federal funds received by the 
68.6 	commissioner for the emergency food and 
68.7 	shelter program from the American Recovery 
68.8 	and Reinvestment Act of 2009, Public 
68.9 	Law 111-5, but not previously approved 
68.10 	by the legislature are appropriated to the 
68.11 	commissioner for the purposes of the grant 
68.12 	program.
68.13 	(b) Federal funds received by the 
68.14 	commissioner for the emergency shelter 
68.15 	grant program including the Homelessness 
68.16 	Prevention and Rapid Re-Housing 
68.17 	Program from the American Recovery and 
68.18 	Reinvestment Act of 2009, Public Law 
68.19 	111-5, are appropriated to the commissioner 
68.20 	for the purposes of the grant programs.
68.21 	(c) Federal funds received by the 
68.22 	commissioner for the emergency food 
68.23 	assistance program from the American 
68.24 	Recovery and Reinvestment Act of 2009, 
68.25 	Public Law 111-5, are appropriated to the 
68.26 	commissioner for the purposes of the grant 
68.27 	program.
68.28 	(d) Federal funds received by the 
68.29 	commissioner for senior congregate meals 
68.30 	and senior home-delivered meals from the 
68.31 	American Recovery and Reinvestment Act 
68.32 	of 2009, Public Law 111-5, are appropriated 
68.33 	to the commissioner for the Minnesota Board 
68.34 	on Aging, for purposes of the grant programs.
69.1 	(e) Federal funds received by the 
69.2 	commissioner for the community services 
69.3 	block grant program from the American 
69.4 	Recovery and Reinvestment Act of 2009, 
69.5 	Public Law 111-5, are appropriated to the 
69.6 	commissioner for the purposes of the grant 
69.7 	program.
69.8 	Long-Term Homeless Supportive 
69.9 	Service Fund Appropriation. To the 
69.10 	extent permitted under federal law, the 
69.11 	commissioner shall designate $3,000,000 
69.12 	of the Homelessness Prevention and Rapid 
69.13 	Re-Housing Program funds provided under 
69.14 	the American Recovery and Reinvestment 
69.15 	Act of 2009, Public Law, 111-5, to the 
69.16 	long-term homeless service fund under 
69.17 	Minnesota Statutes, section 256K.26. This 
69.18 	appropriation shall become available by July 
69.19 	1, 2009. This paragraph is effective the day 
69.20 	following final enactment.

69.21
69.22	Subd. 5.Children and Economic Assistance 
Management
 					
69.23 	The amounts that may be spent from the 
69.24 	appropriation for each purpose are as follows:

69.25
69.26	(a) Children and Economic Assistance 
Administration

69.27	Appropriations by Fund
	
69.28	General
	10,318,000
	10,308,000
	
69.29	Federal TANF
	496,000
	496,000
	
69.30 	Base Adjustment. The federal TANF base 
69.31 	is increased by $700,000 in each of fiscal 
69.32 	years 2012 and 2013.
69.33 	School Readiness Service Agreements.
69.34 	$406,000$106,000 in fiscal year 2010 and 
69.35 	$406,000 $241,000 in fiscal year 2011 are 
70.1 	from the federal child care development 
70.2 	funds received from the American Recovery 
70.3 	and Reinvestment Act of 2009, Public 
70.4 	Law 111-5, to the commissioner of human 
70.5 	services consistent with federal regulations 
70.6 	for the purpose of school readiness service 
70.7 	agreements under Minnesota Statutes, 
70.8 	section 119B.231, and the voluntary quality 
70.9 	rating system in Minnesota Statutes, section 
70.10 	119B.231, subdivision 3e. This is a onetime 
70.11 	appropriation. Any unexpended balance the 
70.12 	first year is available in the second year.

70.13
70.14	(b) Children and Economic Assistance 
Operations

70.15	Appropriations by Fund
	
70.16	General
	33,590,000
	33,423,000
	
70.17	Health Care Access
	361,000
	361,000
	
70.18 	Financial Institution Data Match and 
70.19 	Payment of Fees. The commissioner is 
70.20 	authorized to allocate up to $310,000 each 
70.21 	year in fiscal years 2010 and 2011 from the 
70.22 	PRISM special revenue account to make 
70.23 	payments to financial institutions in exchange 
70.24 	for performing data matches between account 
70.25 	information held by financial institutions 
70.26 	and the public authority's database of child 
70.27 	support obligors as authorized by Minnesota 
70.28 	Statutes, section 13B.06, subdivision 7.
70.29 	School Readiness Service Agreements.
70.30 	$106,000 in fiscal year 2010 and $241,000 
70.31 	in fiscal year 2011 are from the federal 
70.32 	child care development funds received from 
70.33 	the American Recovery and Reinvestment 
70.34 	Act of 2009, Public Law 111-5, to the 
70.35 	commissioner of human services consistent 
70.36 	with federal regulations for the purpose of 
71.1 	school readiness service agreements under 
71.2 	Minnesota Statutes, section 119B.231. This 
71.3 	is a onetime appropriation.
71.4 	Use of Federal Stabilization Funds.
71.5 	$33,000,000 in fiscal year 2010 is 
71.6 	appropriated from the fiscal stabilization 
71.7 	account in the federal fund to the 
71.8 	commissioner. This appropriation must not 
71.9 	be used for any activity or service for which 
71.10 	federal reimbursement is claimed. This is a 
71.11 	onetime appropriation.

71.12	Subd. 6.Basic Health Care Grants
 					
71.13 	The amounts that may be spent from this 
71.14 	appropriation for each purpose are as follows:

71.15
71.16	(a) MinnesotaCare Grants
		391,915,000
 391,785,000
		485,448,000
 485,370,000
	
71.17 	This appropriation is from the health care 
71.18 	access fund.

71.19
71.20	(b) MA Basic Health Care Grants - Families 
and Children
		751,988,000
 751,166,000
		973,088,000
 972,901,000
	
71.21 	Medical Education Research Costs 
71.22 	(MERC). Of these funds, the commissioner 
71.23 	of human services shall transfer $38,000,000 
71.24 	in fiscal year 2010 to the medical education 
71.25 	research fund. These funds must restore the 
71.26 	fiscal year 2009 unallotment of the transfers 
71.27 	under Minnesota Statutes, section 256B.69, 
71.28 	subdivision 5c, paragraph (a), for the July 1, 
71.29 	2008, through June 30, 2009, period.
71.30 	Newborn Screening Fee. Of the general 
71.31 	fund appropriation, $34,000 in fiscal year 
71.32 	2011 is to the commissioner for the hospital 
71.33 	reimbursement increase described under 
71.34 	Minnesota Statutes, section 256.969, 
71.35 	subdivision 2829.
72.1 	Local Share Payment Modification 
72.2 	Required for ARRA Compliance.
72.3 	Effective retroactively from July 1, 2009
72.4 	October 1, 2008, to December 31, 2010, 
72.5 	Hennepin County's monthly contribution to 
72.6 	the nonfederal share of medical assistance 
72.7 	costs must be reduced to the percentage 
72.8 	required on September 1, 2008, to meet 
72.9 	federal requirements for enhanced federal 
72.10 	match under the American Reinvestment 
72.11 	and Recovery Act (ARRA) of 2009. 
72.12 	Notwithstanding the requirements of 
72.13 	Minnesota Statutes, section 256B.19, 
72.14 	subdivision 1c, paragraph (d), for the period 
72.15 	beginning July 1, 2009 October 1, 2008, 
72.16 	to December 31, 2010, Hennepin County's 
72.17 	monthly payment under that provision is 
72.18 	reduced to $434,688. This provision is 
72.19 	effective the day following final enactment.
72.20 	Capitation Payments. Effective 
72.21 	retroactively from July 1, 2009 October 1, 
72.22 	2008, to December 31, 2010, notwithstanding 
72.23 	the provisions of Minnesota Statutes 2008, 
72.24 	section 256B.19, subdivision 1c, paragraph 
72.25 	(c), the commissioner shall increase 
72.26 	capitation payments made to the Metropolitan 
72.27 	Health Plan under Minnesota Statutes 2008, 
72.28 	section 256B.69, by $6,800,000 to recognize 
72.29 	higher than average medical education 
72.30 	costs. The increased amount includes federal 
72.31 	matching funds. This provision is effective 
72.32 	the day following final enactment.
72.33 	Use of Savings. Any savings derived 
72.34 	from implementation of the prohibition in 
72.35 	Minnesota Statutes, section 256B.032, on the 
72.36 	enrollment of low-quality, high-cost health 
73.1 	care providers as vendors of state health care 
73.2 	program services shall be used to offset on a 
73.3 	pro rata basis the reimbursement reductions 
73.4 	for basic care services in Minnesota Statutes, 
73.5 	section 256B.766.

73.6
73.7	(c) MA Basic Health Care Grants - Elderly and 
Disabled
		970,183,000
 969,992,000
		1,142,310,000
 1,141,575,000
	
73.8 	Minnesota Disability Health Options. 
73.9 	Notwithstanding Minnesota Statutes, section 
73.10 	256B.69, subdivision 5a, paragraph (b), for 
73.11 	the period beginning July 1, 2009, to June 
73.12 	30, 2011, the monthly enrollment of persons 
73.13 	receiving home and community-based 
73.14 	waivered services under Minnesota 
73.15 	Disability Health Options shall not exceed 
73.16 	1,000. If the budget neutrality provision 
73.17 	in Minnesota Statutes, section 256B.69, 
73.18 	subdivision 23, paragraph (f), is reached 
73.19 	prior to June 30, 2013, the commissioner may 
73.20 	waive this monthly enrollment requirement.
73.21 	Hospital Fee-for-Service Payment Delay.
73.22 	Payments from the Medicaid Management 
73.23 	Information System that would otherwise 
73.24 	have been made for inpatient hospital 
73.25 	services for Minnesota health care program 
73.26 	enrollees must be delayed as follows: for 
73.27 	fiscal year 2011, payments in the month of 
73.28 	June equal to $15,937,000 must be included 
73.29 	in the first payment of fiscal year 2012 and 
73.30 	for fiscal year 2013, payments in the month 
73.31 	of June equal to $6,666,000 must be included 
73.32 	in the first payment of fiscal year 2014. The 
73.33 	provisions of Minnesota Statutes, section 
73.34 	16A.124, do not apply to these delayed 
73.35 	payments. Notwithstanding any contrary 
74.1 	provision in this article, this paragraph 
74.2 	expires December 31, 2014.
74.3 	Nonhospital Fee-for-Service Payment 
74.4 	Delay. Payments from the Medicaid 
74.5 	Management Information System that would 
74.6 	otherwise have been made for nonhospital 
74.7 	acute care services for Minnesota health 
74.8 	care program enrollees must be delayed as 
74.9 	follows: payments in the month of June equal 
74.10 	to $23,438,000 for fiscal year 2011 must be 
74.11 	included in the first payment for fiscal year 
74.12 	2012, and payments in the month of June 
74.13 	equal to $27,156,000 for fiscal year 2013 
74.14 	must be included in the first payment for 
74.15 	fiscal year 2014. This payment delay must 
74.16 	not include nursing facilities, intermediate 
74.17 	care facilities for persons with developmental 
74.18 	disabilities, home and community-based 
74.19 	services, prepaid health plans, personal care 
74.20 	provider organizations, and home health 
74.21 	agencies. The provisions of Minnesota 
74.22 	Statutes, section 16A.124, do not apply to 
74.23 	these delayed payments. Notwithstanding 
74.24 	any contrary provision in this article, this 
74.25 	paragraph expires December 31, 2014.

74.26
74.27	(d) General Assistance Medical Care Grants
		345,223,000
 344,907,000
		381,081,000
	
74.28 	* (The preceding text "381,081,000" was indicated as vetoed by the Governor.)

74.29	(e) Other Health Care Grants

74.30	Appropriations by Fund
	
74.31	General
	295,000
	295,000
	
74.32	Health Care Access
	23,533,000
	7,080,000
	
74.33 	Base Adjustment. The health care access 
74.34 	fund base is reduced to $190,000 in each of 
74.35 	fiscal years 2012 and 2013 by $6,890,000 
75.1 	in fiscal year 2012 and $6,890,000 in fiscal 
75.2 	year 2013.

75.3	Subd. 7.Health Care Management
 					
75.4 	The amounts that may be spent from the 
75.5 	appropriation for each purpose are as follows:

75.6	(a) Health Care Administration

75.7	Appropriations by Fund
	
75.8
75.9	General
	7,831,000
 7,880,000
	7,742,000
 7,786,000
	
75.10	Health Care Access
	1,812,000
	906,000
	
75.11 	Base Adjustment. The general fund base is 
75.12 	increased by $44,000 in fiscal year 2012 and 
75.13 	increased by $44,000 in fiscal year 2013.

75.14	(b) Health Care Operations

75.15	Appropriations by Fund
	
75.16	General
	19,914,000
	18,949,000
	
75.17	Health Care Access
	25,099,000
	25,875,000
	
75.18 	Base Adjustment. The health care access 
75.19 	fund base is increased by $1,006,000 in 
75.20 	fiscal year 2012 and $1,781,000 in fiscal year 
75.21 	2013. The general fund base is decreased by 
75.22 	$237,000 in fiscal year 2012 and $237,000 in 
75.23 	fiscal year 2013.

75.24	Subd. 8.Continuing Care Grants
 					
75.25 	The amounts that may be spent from the 
75.26 	appropriation for each purpose are as follows:

75.27	(a) Aging and Adult Services Grants

75.28	Appropriations by Fund
	
75.29	General
	13,488,000
	15,779,000
	
75.30	Federal
	500,000
	0

75.31	(a) Aging and Adult Services Grants
		13,499,000
		15,805,000
	
75.32 	Base Adjustment. The general fund base is 
75.33 	increased by $5,751,000 in fiscal year 2012 
75.34 	and $6,705,000 in fiscal year 2013.
76.1 	Information and Assistance 
76.2 	Reimbursement. Federal administrative 
76.3 	reimbursement obtained from information 
76.4 	and assistance services provided by the 
76.5 	Senior LinkAge or Disability Linkage lines 
76.6 	to people who are identified as eligible for 
76.7 	medical assistance shall be appropriated to 
76.8 	the commissioner for this activity.
76.9 	Community Service Development Grant 
76.10 	Reduction. Funding for community service 
76.11 	development grants must be reduced by 
76.12 	$251,000 $260,000 for fiscal year 2010; 
76.13 	$266,000 $284,000 in fiscal year 2011; 
76.14 	$25,000 $43,000 in fiscal year 2012; and 
76.15 	$25,000 $43,000 in fiscal year 2013. Base 
76.16 	level funding shall be restored in fiscal year 
76.17 	2014.
76.18 	Community Service Development Grant 
76.19 	Community Initiative. Funding for 
76.20 	community service development grants shall 
76.21 	be used to offset the cost of aging support 
76.22 	grants. Base level funding shall be restored 
76.23 	in fiscal year 2014.
76.24 	Senior Nutrition Use of Federal Funds.
76.25 	For fiscal year 2010, general fund grants 
76.26 	for home-delivered meals and congregate 
76.27 	dining shall be reduced by $500,000. The 
76.28 	commissioner must replace these general 
76.29 	fund reductions with equal amounts from 
76.30 	federal funding for senior nutrition from the 
76.31 	American Recovery and Reinvestment Act 
76.32 	of 2009.

76.33	(b) Alternative Care Grants
		50,234,000
		48,576,000
	
77.1 	Base Adjustment. The general fund base is 
77.2 	decreased by $3,598,000 in fiscal year 2012 
77.3 	and $3,470,000 in fiscal year 2013.
77.4 	Alternative Care Transfer. Any money 
77.5 	allocated to the alternative care program that 
77.6 	is not spent for the purposes indicated does 
77.7 	not cancel but must be transferred to the 
77.8 	medical assistance account.

77.977.10
	(c) Medical Assistance Grants; Long-Term 
Care Facilities.
		367,444,000
		419,749,000

77.11
77.12	(d) Medical Assistance Long-Term Care 
Waivers and Home Care Grants
		854,373,000
 853,567,000
		1,043,411,000
 1,039,517,000
	
77.13 	Manage Growth in TBI and CADI 
77.14 	Waivers. During the fiscal years beginning 
77.15 	on July 1, 2009, and July 1, 2010, the 
77.16 	commissioner shall allocate money for home 
77.17 	and community-based waiver programs 
77.18 	under Minnesota Statutes, section 256B.49, 
77.19 	to ensure a reduction in state spending that is 
77.20 	equivalent to limiting the caseload growth of 
77.21 	the TBI waiver to 12.5 allocations per month 
77.22 	each year of the biennium and the CADI 
77.23 	waiver to 95 allocations per month each year 
77.24 	of the biennium. Limits do not apply: (1) 
77.25 	when there is an approved plan for nursing 
77.26 	facility bed closures for individuals under 
77.27 	age 65 who require relocation due to the 
77.28 	bed closure; (2) to fiscal year 2009 waiver 
77.29 	allocations delayed due to unallotment; or (3) 
77.30 	to transfers authorized by the commissioner 
77.31 	from the personal care assistance program 
77.32 	of individuals having a home care rating 
77.33 	of "CS," "MT," or "HL." Priorities for the 
77.34 	allocation of funds must be for individuals 
77.35 	anticipated to be discharged from institutional 
78.1 	settings or who are at imminent risk of a 
78.2 	placement in an institutional setting.
78.3 	Manage Growth in DD Waiver. The 
78.4 	commissioner shall manage the growth in 
78.5 	the DD waiver by limiting the allocations 
78.6 	included in the February 2009 forecast to 15 
78.7 	additional diversion allocations each month 
78.8 	for the calendar years that begin on January 
78.9 	1, 2010, and January 1, 2011. Additional 
78.10 	allocations must be made available for 
78.11 	transfers authorized by the commissioner 
78.12 	from the personal care program of individuals 
78.13 	having a home care rating of "CS," "MT," 
78.14 	or "HL."
78.15 	Adjustment to Lead Agency Waiver 
78.16 	Allocations. Prior to the availability of the 
78.17 	alternative license defined in Minnesota 
78.18 	Statutes, section 245A.11, subdivision 8, 
78.19 	the commissioner shall reduce lead agency 
78.20 	waiver allocations for the purposes of 
78.21 	implementing a moratorium on corporate 
78.22 	foster care.
78.23 	Alternatives to Personal Care Assistance 
78.24 	Services. Base level funding of $3,237,000 
78.25 	in fiscal year 2012 and $4,856,000 in 
78.26 	fiscal year 2013 is to implement alternative 
78.27 	services to personal care assistance services 
78.28 	for persons with mental health and other 
78.29 	behavioral challenges who can benefit 
78.30 	from other services that more appropriately 
78.31 	meet their needs and assist them in living 
78.32 	independently in the community. These 
78.33 	services may include, but not be limited to, a 
78.34 	1915(i) state plan option.

78.35	(e) Mental Health Grants

79.1	Appropriations by Fund
	
79.2	General
	77,739,000
	77,739,000
	
79.3	Health Care Access
	750,000
	750,000
	
79.4	Lottery Prize
	1,508,000
	1,508,000
	
79.5 	Funding Usage. Up to 75 percent of a fiscal 
79.6 	year's appropriation for adult mental health 
79.7 	grants may be used to fund allocations in that 
79.8 	portion of the fiscal year ending December 
79.9 	31.

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

79.11	(g) Chemical Dependency Entitlement Grants
		111,303,000
		122,822,000
	
79.12 	Payments for Substance Abuse Treatment.
79.13 	For services provided during fiscal years 
79.14 	2010 and 2011, county-negotiated rates and 
79.15 	provider claims to the consolidated chemical 
79.16 	dependency fund must not exceed rates 
79.17 	charged for these services on January 1, 
79.18 	2009. For services provided in fiscal years 
79.19 	2012 and 2013, statewide average rates under 
79.20 	the new rate methodology to be developed 
79.21 	under Minnesota Statutes, section 254B.12, 
79.22 	must not exceed the average rates charged 
79.23 	for these services on January 1, 2009, plus a 
79.24 	state share increase of $3,787,000 for fiscal 
79.25 	year 2012 and $5,023,000 for fiscal year 
79.26 	2013. Notwithstanding any provision to the 
79.27 	contrary in this article, this provision expires 
79.28 	on June 30, 2013.
79.29 	Chemical Dependency Special Revenue 
79.30 	Account. For fiscal year 2010, $750,000 
79.31 	must be transferred from the consolidated 
79.32 	chemical dependency treatment fund 
79.33 	administrative account and deposited into the 
79.34 	general fund.
80.1 	County CD Share of MA Costs for 
80.2 	ARRA Compliance. Notwithstanding the 
80.3 	provisions of Minnesota Statutes, chapter 
80.4 	254B, for chemical dependency services 
80.5 	provided during the period July 1, 2009
80.6 	October 1, 2008, to December 31, 2010, 
80.7 	and reimbursed by medical assistance 
80.8 	at the enhanced federal matching rate 
80.9 	provided under the American Recovery and 
80.10 	Reinvestment Act of 2009, the county share 
80.11 	is 30 percent of the nonfederal share. This 
80.12 	provision is effective the day following final 
80.13 	enactment.

80.14
80.15	(h) Chemical Dependency Nonentitlement 
Grants
		1,729,000
		1,729,000
	
80.16 	Base Adjustment. The general fund base is 
80.17 	decreased by $3,000 in each of fiscal years 
80.18 	2012 and 2013.

80.19
80.20	(i) Other Continuing Care Grants
		18,272,000
 19,201,000
		13,139,000
 17,528,000
	
80.21 	Base Adjustment. The general fund base 
80.22 	is increased by $7,028,000 $2,639,000 in 
80.23 	fiscal year 2012 and increased by $8,243,000
80.24 	$3,854,000 in fiscal year 2013.
80.25 	Technology Grants. $650,000 in fiscal 
80.26 	year 2010 and $1,000,000 in fiscal year 
80.27 	2011 are for technology grants, case 
80.28 	consultation, evaluation, and consumer 
80.29 	information grants related to developing and 
80.30 	supporting alternatives to shift-staff foster 
80.31 	care residential service models.
80.32 	Other Continuing Care Grants; HIV 
80.33 	Grants. Money appropriated for the HIV 
80.34 	drug and insurance grant program in fiscal 
81.1 	year 2010 may be used in either year of the 
81.2 	biennium.
81.3 	Quality Assurance Commission. Effective 
81.4 	July 1, 2009, state funding for the quality 
81.5 	assurance commission under Minnesota 
81.6 	Statutes, section 256B.0951, is canceled.

81.7	Subd. 9.Continuing Care Management

81.8	Appropriations by Fund
	
81.9	General
	24,927,000
	25,314,000
	
81.10
81.11	State Government 
Special Revenue
	875,000
 125,000
	125,000
	
81.12	Lottery Prize
	157,000
	157,000
	
81.13 	Quality Assurance Commission. Effective 
81.14 	July 1, 2009, state funding for the quality 
81.15 	assurance commission under Minnesota 
81.16 	Statutes, section 256B.0951, is canceled.
81.17 	County Maintenance of Effort. $350,000 in 
81.18 	fiscal year 2010 is from the general fund for 
81.19 	the State-County Results Accountability and 
81.20 	Service Delivery Reform under Minnesota 
81.21 	Statutes, chapter 402A.
81.22 	Base Adjustment. The general fund base is 
81.23 	decreased $2,697,000 in fiscal year 2012 and 
81.24 	$2,791,000 in fiscal year 2013.

81.25	Subd. 10.State-Operated Services
 		258,794,000
		266,191,000
	
81.26 	The amounts that may be spent from the 
81.27 	appropriation for each purpose are as follows:
81.28 	Transfer Authority Related to 
81.29 	State-Operated Services. Money 
81.30 	appropriated to finance state-operated 
81.31 	services may be transferred between the 
81.32 	fiscal years of the biennium with the approval 
81.33 	of the commissioner of finance.
82.1 	County Past Due Receivables. The 
82.2 	commissioner is authorized to withhold 
82.3 	county federal administrative reimbursement 
82.4 	when the county of financial responsibility 
82.5 	for cost-of-care payments due the state 
82.6 	under Minnesota Statutes, section 246.54
82.7 	or 253B.045, is 90 days past due. The 
82.8 	commissioner shall deposit the withheld 
82.9 	federal administrative earnings for the county 
82.10 	into the general fund to settle the claims with 
82.11 	the county of financial responsibility. The 
82.12 	process for withholding funds is governed by 
82.13 	Minnesota Statutes, section 256.017.
82.14 	Forecast and Census Data. The 
82.15 	commissioner shall include census data and 
82.16 	fiscal projections for state-operated services 
82.17 	and Minnesota sex offender services with the 
82.18 	November and February budget forecasts. 
82.19 	Notwithstanding any contrary provision in 
82.20 	this article, this paragraph shall not expire.

82.21
82.22	(a) Adult Mental Health Services
		107,702,000
 106,702,000
		107,201,000
	
82.23 	Appropriation Limitation. No part of 
82.24 	the appropriation in this article to the 
82.25 	commissioner for mental health treatment 
82.26 	services provided by state-operated services 
82.27 	shall be used for the Minnesota sex offender 
82.28 	program.
82.29 	Community Behavioral Health Hospitals.
82.30 	Under Minnesota Statutes, section 246.51, 
82.31 	subdivision 1, a determination order for the 
82.32 	clients served in a community behavioral 
82.33 	health hospital operated by the commissioner 
82.34 	of human services is only required when 
82.35 	a client's third-party coverage has been 
82.36 	exhausted.
83.1 	Base Adjustment. The general fund base is 
83.2 	decreased by $500,000 for fiscal year 2012 
83.3 	and by $500,000 for fiscal year 2013.

83.4	(b) Minnesota Sex Offender Services

83.5	Appropriations by Fund
	
83.6	General 
	38,348,000
	67,503,000
	
83.7	Federal Fund
	26,495,000
	0
	
83.8 	Use of Federal Stabilization Funds. Of 
83.9 	this appropriation, $26,495,000 in fiscal year 
83.10 	2010 is from the fiscal stabilization account 
83.11 	in the federal fund to the commissioner. 
83.12 	This appropriation must not be used for 
83.13 	any activity or service for which federal 
83.14 	reimbursement is claimed. This is a onetime 
83.15 	appropriation.

83.16
83.17	(c) Minnesota Security Hospital and METO 
Services

83.18	Appropriations by Fund
	
83.19
83.20	General 
	230,000,000
230,000
	83,735,000
	
83.21
83.22	Federal Fund
	83,504,000
 83,505,000
	0
	
83.23 	Minnesota Security Hospital. For the 
83.24 	purposes of enhancing the safety of 
83.25 	the public, improving supervision, and 
83.26 	enhancing community-based mental health 
83.27 	treatment, state-operated services may 
83.28 	establish additional community capacity 
83.29 	for providing treatment and supervision 
83.30 	of clients who have been ordered into a 
83.31 	less restrictive alternative of care from the 
83.32 	state-operated services transitional services 
83.33 	program consistent with Minnesota Statutes, 
83.34 	section 246.014.
83.35 	Use of Federal Stabilization Funds.
83.36 	$83,505,000 in fiscal year 2010 is 
84.1 	appropriated from the fiscal stabilization 
84.2 	account in the federal fund to the 
84.3 	commissioner. This appropriation must not 
84.4 	be used for any activity or service for which 
84.5 	federal reimbursement is claimed. This is a 
84.6 	onetime appropriation.

84.7 	Sec. 2. Laws 2009, chapter 79, article 13, section 4, is amended to read:

84.8	Sec. 4. COMMISSIONER OF HEALTH

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

84.10	Appropriations by Fund
	
84.11		2010
	2011
	
84.12	General
	69,366,000
	63,884,000
	
84.13
84.14	State Government 
Special Revenue
	45,415,000
	45,415,000
	
84.15	Health Care Access
	39,203,000
	40,809,000
	
84.16	Federal TANF
	11,733,000
	11,733,000

84.17
84.18	Subd. 2.Community and Family Health 
Promotion

84.19	Appropriations by Fund
	
84.20	General
	44,814,000
	39,671,000
	
84.21
84.22	State Government 
Special Revenue
	1,033,000
	1,304,000
 1,033,000
	
84.23	Federal TANF
	11,733,000
	11,733,000
	
84.24	Health Care Access
	21,642,000
	28,719,000
	
84.25 	Newborn Screening Fee. Of the general 
84.26 	fund appropriation, $300,000 in fiscal year 
84.27 	2011 is to the commissioner for the purpose 
84.28 	of providing support services to families as 
84.29 	required under Minnesota Statutes, section 
84.30 	144.966, subdivision 3a. $74,000 of this 
84.31 	appropriation in fiscal year 2011 and $51,000 
84.32 	of this appropriation in subsequent fiscal 
84.33 	years may be used by the commissioner 
84.34 	for administrative costs associated with 
84.35 	increasing the fee, contract administration, 
84.36 	program oversight, and provide follow-up to 
85.1 	families who need assistance beyond those 
85.2 	available through the contractor.
85.3 	Support Services for Families With 
85.4 	Children Who are Deaf or Have Hearing 
85.5 	Loss. Of the general fund amount, $16,000 
85.6 	in fiscal year 2010 and $284,000 in fiscal 
85.7 	year 2011 is for support services to families 
85.8 	with children who are deaf or have hearing 
85.9 	loss. Of this amount, in fiscal year 2011, 
85.10 	$223,000 is for grants and the balance is for 
85.11 	administrative costs. Base funding in fiscal 
85.12 	years 2012 and 2013 is $300,000 each year. 
85.13 	Of this amount, $241,000 each year is for 
85.14 	grants and the balance is for administrative 
85.15 	costs.
85.16 	Funding Usage. Up to 75 percent of the 
85.17 	fiscal year 2012 appropriation for local public 
85.18 	health grants may be used to fund calendar 
85.19 	year 2011 allocations for this program. The 
85.20 	general fund reduction of $5,193,000 in 
85.21 	fiscal year 2011 for local public health grants 
85.22 	is onetime and the base funding for local 
85.23 	public health grants for fiscal year 2012 is 
85.24 	increased by $5,193,000.
85.25 	Colorectal Screening.$88,000 $188,000 in 
85.26 	fiscal year 2010 and $62,000 in fiscal year 
85.27 	2011 are for grants to the Hennepin County 
85.28 	Medical Center and MeritCare Bemidji for 
85.29 	colorectal screening demonstration projects.
85.30 	Feasibility Pilot Project for Cancer 
85.31 	Surveillance. Of the general fund 
85.32 	appropriation for fiscal year 2010, $100,000 
85.33 	is to the commissioner to provide grant 
85.34 	funding to cover the cost of one full-time 
85.35 	equivalent position at the Hennepin County 
86.1 	Medical Center to carry out the feasibility 
86.2 	pilot project.
86.3 	American Recovery and Reinvestment 
86.4 	Act Funds. Federal funds received by the 
86.5 	commissioner for WIC program management 
86.6 	information systems from the American 
86.7 	Recovery and Reinvestment Act of 2009, 
86.8 	Public Law 111-5, are appropriated to the 
86.9 	commissioner for the purpose of the grant.
86.10 	TANF Appropriations. (1) $1,156,000 of 
86.11 	the TANF funds are appropriated each year to 
86.12 	the commissioner for family planning grants 
86.13 	under Minnesota Statutes, section 145.925.
86.14 	(2) $3,579,000 of the TANF funds are 
86.15 	appropriated each year to the commissioner 
86.16 	for home visiting and nutritional services 
86.17 	listed under Minnesota Statutes, section 
86.18 	145.882, subdivision 7, clauses (6) and (7). 
86.19 	Funds must be distributed to community 
86.20 	health boards according to Minnesota 
86.21 	Statutes, section 145A.131, subdivision 1.
86.22 	(3) $2,000,000 of the TANF funds are 
86.23 	appropriated each year to the commissioner 
86.24 	for decreasing racial and ethnic disparities 
86.25 	in infant mortality rates under Minnesota 
86.26 	Statutes, section 145.928, subdivision 7.
86.27 	(4) $4,998,000 of the TANF funds are 
86.28 	appropriated each year to the commissioner 
86.29 	for the family home visiting grant program 
86.30 	according to Minnesota Statutes, section 
86.31 	145A.17. $4,000,000 of the funding must 
86.32 	be distributed to community health boards 
86.33 	according to Minnesota Statutes, section 
86.34 	145A.131, subdivision 1. $998,000 of 
86.35 	the funding must be distributed to tribal 
87.1 	governments based on Minnesota Statutes, 
87.2 	section 145A.14, subdivision 2a. The 
87.3 	commissioner may use five percent of 
87.4 	the funds appropriated each fiscal year to 
87.5 	conduct the ongoing evaluations required 
87.6 	under Minnesota Statutes, section 145A.17, 
87.7 	subdivision 7, and may use ten percent of 
87.8 	the funds appropriated each fiscal year to 
87.9 	provide training and technical assistance as 
87.10 	required under Minnesota Statutes, section 
87.11 	145A.17, subdivisions 4 and 5.
87.12 	Base Adjustment. The general fund base 
87.13 	is increased by $10,302,000 for fiscal year 
87.14 	2012 and increased by $5,109,000 for fiscal 
87.15 	year 2013. The health care access fund base 
87.16 	is reduced to $1,719,000 for both fiscal years 
87.17 	2012 and 2013.
87.18 	TANF Carryforward. Any unexpended 
87.19 	balance of the TANF appropriation in the 
87.20 	first year of the biennium does not cancel but 
87.21 	is available for the second year.

87.22	Subd. 3.Policy Quality and Compliance

87.23	Appropriations by Fund
	
87.24
87.25	General
	7,491,000
	7,242,000
 7,243,000
	
87.26
87.27	State Government 
Special Revenue
	14,173,000
	14,173,000
	
87.28	Health Care Access
	17,561,000
	12,090,000
	
87.29 	Community-Based Health Care 
87.30 	Demonstration Project. Notwithstanding 
87.31 	the provisions of Laws 2007, chapter 147, 
87.32 	article 19, section 3, subdivision 6, paragraph 
87.33 	(e), base level funding to the commissioner 
87.34 	for the demonstration project grant described 
87.35 	in Minnesota Statutes, section 62Q.80, 
88.1 	subdivision 1a, shall be zero for fiscal years 
88.2 	2011 and 2012.
88.3 	Medical Education and Research Cost 
88.4 	Federal Compliance. Notwithstanding 
88.5 	Laws 2008, chapter 363, article 18, section 
88.6 	4, subdivision 3, the base level funding 
88.7 	for the commissioner to distribute to the 
88.8 	Mayo Clinic for transitional funding while 
88.9 	federal compliance changes are made to the 
88.10 	medical education and research cost funding 
88.11 	distribution formula shall be $0 for fiscal 
88.12 	years 2010 and 2011.
88.13 	Autism Clinical Research. The 
88.14 	commissioner, in partnership with a 
88.15 	Minnesota research institution, shall apply 
88.16 	for funds available for research grants under 
88.17 	the American Recovery and Reinvestment 
88.18 	Act (ARRA) of 2009 in order to expand 
88.19 	research and treatment of autism spectrum 
88.20 	disorders.
88.21 	Health Information Technology. (a) Of 
88.22 	the health care access fund appropriation, 
88.23 	$4,000,000 is to fund the revolving loan 
88.24 	account under Minnesota Statutes, section 
88.25 	62J.496. This appropriation must not be 
88.26 	expended unless it is matched with federal 
88.27 	funding under the federal Health Information 
88.28 	Technology for Economic and Clinical 
88.29 	Health (HITECH) Act. This appropriation 
88.30 	must not be included in the agency's base 
88.31 	budget for the fiscal year beginning July 1, 
88.32 	2012.
88.33 	(b) On or before June 30, 2013, $1,200,000 
88.34 	shall be transferred from the revolving loan 
88.35 	account under Minnesota Statutes, section 
89.1 	62J.496, to the health care access fund. 
89.2 	This is a onetime transfer and must not be 
89.3 	included in the agency's base budget for the 
89.4 	fiscal year beginning July 1, 2014.
89.5 	Base Adjustment. The general fund 
89.6 	base is $8,243,000 in fiscal year 2012 and 
89.7 	$8,243,000 in fiscal year 2013. The health 
89.8 	care access fund base is $10,950,000 in fiscal 
89.9 	year 2012 and $6,816,000 in fiscal year 2013.

89.10	Subd. 4.Health Protection

89.11	Appropriations by Fund
	
89.12	General
	9,871,000
	9,780,000
	
89.13
89.14	State Government 
Special Revenue
	30,209,000
	30,209,000
	
89.15 	Base Adjustment. The general fund base is 
89.16 	reduced by $50,000 in each of fiscal years 
89.17 	2012 and 2013.
89.18 	Health Protection Appropriations. (a) 
89.19 	$163,000 each year is for the lead abatement 
89.20 	grant program. 
89.21 	(b) $100,000 each year is for emergency 
89.22 	preparedness and response activities. 
89.23 	(c) $50,000 each year is for tuberculosis 
89.24 	prevention and control. This is a onetime 
89.25 	appropriation.
89.26 	(d) $55,000 in fiscal year 2010 is for 
89.27 	pentachlorophenol.
89.28 	(e) $20,000 in fiscal year 2010 is for a PFC 
89.29 	Citizens Advisory Group.
89.30 	American Recovery and Reinvestment 
89.31 	Act Funds. Federal funds received 
89.32 	by the commissioner for immunization 
89.33 	operations from the American Recovery 
89.34 	and Reinvestment Act of 2009, Public Law 
90.1 	111-5, are appropriated to the commissioner 
90.2 	for the purposes of the grant.

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

90.4 	Sec. 3. Laws 2009, chapter 79, article 13, section 5, is amended to read:

90.5	Sec. 5. HEALTH-RELATED BOARDS

90.6
90.7	Subdivision 1.Total Appropriation 
 	$
	15,017,000
 14,034,000
	$
	14,831,000
 13,848,000
	
90.8 	This appropriation is from the state 
90.9 	government special revenue fund.
90.10 	Transfer. In fiscal year 2010 2011, 
90.11 	$6,000,000 shall be transferred from the 
90.12 	state government special revenue fund to 
90.13 	the general fund. The boards must allocate 
90.14 	this reduction to boards carrying a positive 
90.15 	balance as of July 1, 2009.
90.16 	The amounts that may be spent for each 
90.17 	purpose are specified in the following 
90.18 	subdivisions.

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

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

90.21
90.22	Subd. 4.Board of Dietetic and Nutrition 
Practice
 		105,000
		105,000

90.23
90.24	Subd. 5.Board of Marriage and Family 
Therapy
 		137,000
		137,000

90.25
90.26	Subd. 6.Board of Medical Practice
 		3,674,000
 3,682,000
		3,674,000
 3,682,000

90.27
90.28	Subd. 7.Board of Nursing
 		4,217,000
 3,287,000
		4,219,000
 3,289,000

90.29
90.30	Subd. 8.Board of Nursing Home 
Administrators
 		1,146,000
 1,211,000
		958,000
 1,023,000
	
90.31 	Administrative Services Unit - Operating 
90.32 	Costs. Of this appropriation, $524,000 
90.33 	in fiscal year 2010 and $526,000 in 
91.1 	fiscal year 2011 are for operating costs 
91.2 	of the administrative services unit. The 
91.3 	administrative services unit may receive 
91.4 	and expend reimbursements for services 
91.5 	performed by other agencies.
91.6 	Administrative Services Unit - Retirement 
91.7 	Costs. Of this appropriation in fiscal year 
91.8 	2010, $201,000 is for onetime retirement 
91.9 	costs in the health-related boards. This 
91.10 	funding may be transferred to the health 
91.11 	boards incurring those costs for their 
91.12 	payment. These funds are available either 
91.13 	year of the biennium.
91.14 	Administrative Services Unit - Volunteer 
91.15 	Health Care Provider Program. Of this 
91.16 	appropriation, $79,000 in fiscal year 2010 
91.17 	and $89,000 in fiscal year 2011 are to pay 
91.18 	for medical professional liability coverage 
91.19 	required under Minnesota Statutes, section 
91.20 	214.40.
91.21 	Administrative Services Unit - Contested 
91.22 	Cases and Other Legal Proceedings. Of 
91.23 	this appropriation, $200,000 in fiscal year 
91.24 	2010 and $200,000 in fiscal year 2011 
91.25 	are for costs of contested case hearings 
91.26 	and other unanticipated costs of legal 
91.27 	proceedings involving health-related 
91.28 	boards funded under this section. Upon 
91.29 	certification of a health-related board to the 
91.30 	administrative services unit that the costs 
91.31 	will be incurred and that there is insufficient 
91.32 	money available to pay for the costs out of 
91.33 	money currently available to that board, the 
91.34 	administrative services unit is authorized 
91.35 	to transfer money from this appropriation 
92.1 	to the board for payment of those costs 
92.2 	with the approval of the commissioner of 
92.3 	finance. This appropriation does not cancel. 
92.4 	Any unencumbered and unspent balances 
92.5 	remain available for these expenditures in 
92.6 	subsequent fiscal years.

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

92.8
92.9	Subd. 10.Board of Pharmacy
 		1,413,000
 1,388,000 
		1,413,000
 1,388,000

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

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

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

92.13
92.14	Subd. 14.Board of Social Work
 		1,022,000
 921,000
		1,022,000
 921,000

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

92.16
92.17	Subd. 16.Board of Behavioral Health and 
Therapy
 		394,000
		394,000

92.18 	Sec. 4. Laws 2009, chapter 79, article 13, section 6, is amended to read:

92.19
92.20	Sec. 6. EMERGENCY MEDICAL SERVICES 
BOARD
 	$
	4,378,000
 3,928,000
	$
	3,828,000
 3,828,000

92.21	Appropriations by Fund
	
92.22		2010
	2011
	
92.23
92.24	General
	3,674,000
 3,224,000
	3,124,000
	
92.25
92.26	State Government 
Special Revenue
	704,000
	704 ,000
	
92.27 	Longevity Award and Incentive Program.
92.28 	Of the general fund appropriation, $700,000 
92.29 	in fiscal year 2010 and $700,000 in fiscal year 
92.30 	2011 are to the board for the Cooper/Sams 
92.31 	volunteer ambulance program, under 
92.32 	Minnesota Statutes, section 144E.40.
92.33 	Transfer. In fiscal year 2010, $6,182,000 
92.34 	is transferred from the Cooper/Sams 
93.1 	volunteer ambulance trust, established under 
93.2 	Minnesota Statutes, section 144E.42, to the 
93.3 	general fund.
93.4 	Health Professional Services Program.
93.5 	$704,000 in fiscal year 2010 and $704,000 in 
93.6 	fiscal year 2011 from the state government 
93.7 	special revenue fund are for the health 
93.8 	professional services program.
93.9 	Comprehensive Advanced Life-Support 
93.10 	Educational (CALS) Program. $100,000 
93.11 	in the first year from the Cooper/Sams 
93.12 	volunteer ambulance trust general fund is 
93.13 	for the comprehensive advanced life-support 
93.14 	educational (CALS) program established 
93.15 	under Minnesota Statutes, section 144E.37. 
93.16 	This appropriation is to extend availability 
93.17 	and affordability of the CALS program 
93.18 	for rural emergency medical personnel 
93.19 	and to assist hospital staff in attaining 
93.20 	the credentialing levels necessary for 
93.21 	implementation of the statewide trauma 
93.22 	system.
93.23 	Veterans Paramedic Apprenticeship 
93.24 	Program. Of this appropriation, $200,000 
93.25 	in the first year is from the general fund for 
93.26 	transfer to the commissioner of veterans 
93.27 	affairs for a grant to the Minnesota 
93.28 	Ambulance Association to implement a 
93.29 	veterans paramedic apprenticeship program 
93.30 	to reintegrate returning military medics 
93.31 	into Minnesota's workforce in the field of 
93.32 	paramedic and emergency services, thereby 
93.33 	guaranteeing returning military medics 
93.34 	gainful employment with livable wages and 
94.1 	benefits. This appropriation is available until 
94.2 	expended.
94.3 	Medical Response Unit Reimbursement 
94.4 	Pilot Program. (a) $250,000 in the first 
94.5 	year is from the general fund for a transfer 
94.6 	to the Department of Public Safety for a 
94.7 	medical response unit reimbursement pilot 
94.8 	program. Of this appropriation, $75,000 is 
94.9 	for administrative costs to the Department of 
94.10 	Public Safety, including providing contract 
94.11 	staff support and technical assistance to the 
94.12 	pilot program partners if necessary.
94.13 	(b) Of the amount in paragraph (a), $175,000 
94.14 	is to be used to provide a predetermined 
94.15 	reimbursement amount to the participating 
94.16 	medical response units. The Department 
94.17 	of Public Safety or its contract designee 
94.18 	will develop an agreement with the medical 
94.19 	response units outlining reimbursement and 
94.20 	program requirements to include HIPAA 
94.21 	compliance while participating in the pilot 
94.22 	program.

94.23 	Sec. 5.  REPEALER.
 94.24 	Laws 2009, chapter 79, article 13, sections 7; and 8, are repealed.

94.25 	ARTICLE 3
94.26 	HEALTH CARE ELIGIBILITY

94.27 	Section 1. Minnesota Statutes 2008, section 62J.2930, subdivision 3, is amended to 
94.28 	read:
94.29 		Subd. 3.Consumer information. (a) The information clearinghouse or another 
94.30 	entity designated by the commissioner shall provide consumer information to health 
94.31 	plan company enrollees to:
94.32 	(1) assist enrollees in understanding their rights;
95.1 	(2) explain and assist in the use of all available complaint systems, including internal 
95.2 	complaint systems within health carriers, community integrated service networks, and 
95.3 	the Departments of Health and Commerce;
95.4 	(3) provide information on coverage options in each region of the state;
95.5 	(4) provide information on the availability of purchasing pools and enrollee 
95.6 	subsidies; and
95.7 	(5) help consumers use the health care system to obtain coverage.
95.8 	(b) The information clearinghouse or other entity designated by the commissioner 
95.9 	for the purposes of this subdivision shall not:
95.10 	(1) provide legal services to consumers;
95.11 	(2) represent a consumer or enrollee; or
95.12 	(3) serve as an advocate for consumers in disputes with health plan companies.
95.13 	(c) Nothing in this subdivision shall interfere with the ombudsman program 
95.14 	established under section 256B.031, subdivision 6 256B.69, subdivision 20, or other 
95.15 	existing ombudsman programs.  

95.16 	Sec. 2. Minnesota Statutes 2008, section 245.494, subdivision 3, is amended to read:
95.17 		Subd. 3.Duties of the commissioner of human services. The commissioner of 
95.18 	human services, in consultation with the Integrated Fund Task Force, shall:
95.19 	(1) in the first quarter of 1994, in areas where a local children's mental health 
95.20 	collaborative has been established, based on an independent actuarial analysis, identify all 
95.21 	medical assistance and MinnesotaCare resources devoted to mental health services for 
95.22 	children in the target population including inpatient, outpatient, medication management, 
95.23 	services under the rehabilitation option, and related physician services in the total health 
95.24 	capitation of prepaid plans under contract with the commissioner to provide medical 
95.25 	assistance services under section 256B.69; 
95.26 	(2) assist each children's mental health collaborative to determine an actuarially 
95.27 	feasible operational target population;
95.28 	(3) ensure that a prepaid health plan that contracts with the commissioner to provide 
95.29 	medical assistance or MinnesotaCare services shall pass through the identified resources 
95.30 	to a collaborative or collaboratives upon the collaboratives meeting the requirements 
95.31 	of section 245.4933 to serve the collaborative's operational target population. The 
95.32 	commissioner shall, through an independent actuarial analysis, specify differential rates 
95.33 	the prepaid health plan must pay the collaborative based upon severity, functioning, and 
95.34 	other risk factors, taking into consideration the fee-for-service experience of children 
95.35 	excluded from prepaid medical assistance participation; 
96.1 	(4) ensure that a children's mental health collaborative that enters into an agreement 
96.2 	with a prepaid health plan under contract with the commissioner shall accept medical 
96.3 	assistance recipients in the operational target population on a first-come, first-served basis 
96.4 	up to the collaborative's operating capacity or as determined in the agreement between 
96.5 	the collaborative and the commissioner;
96.6 	(5) ensure that a children's mental health collaborative that receives resources passed 
96.7 	through a prepaid health plan under contract with the commissioner shall be subject to 
96.8 	the quality assurance standards, reporting of utilization information, standards set out in 
96.9 	sections 245.487 to 245.4889, and other requirements established in Minnesota Rules, 
96.10 	part 9500.1460; 
96.11 	(6) ensure that any prepaid health plan that contracts with the commissioner, 
96.12 	including a plan that contracts under section 256B.69, must enter into an agreement with 
96.13 	any collaborative operating in the same service delivery area that: 
96.14 	(i) meets the requirements of section 245.4933; 
96.15 	(ii) is willing to accept the rate determined by the commissioner to provide medical 
96.16 	assistance services; and
96.17 	(iii) requests to contract with the prepaid health plan;
96.18 	(7) ensure that no agreement between a health plan and a collaborative shall 
96.19 	terminate the legal responsibility of the health plan to assure that all activities under the 
96.20 	contract are carried out. The agreement may require the collaborative to indemnify the 
96.21 	health plan for activities that are not carried out;
96.22 	(8) ensure that where a collaborative enters into an agreement with the commissioner 
96.23 	to provide medical assistance and MinnesotaCare services a separate capitation rate will 
96.24 	be determined through an independent actuarial analysis which is based upon the factors 
96.25 	set forth in clause (3) to be paid to a collaborative for children in the operational target 
96.26 	population who are eligible for medical assistance but not included in the prepaid health 
96.27 	plan contract with the commissioner;
96.28 	(9) ensure that in counties where no prepaid health plan contract to provide medical 
96.29 	assistance or MinnesotaCare services exists, a children's mental health collaborative that 
96.30 	meets the requirements of section 245.4933 shall: 
96.31 	(i) be paid a capitated rate, actuarially determined, that is based upon the 
96.32 	collaborative's operational target population;
96.33 	(ii) accept medical assistance or MinnesotaCare recipients in the operational target 
96.34 	population on a first-come, first-served basis up to the collaborative's operating capacity or 
96.35 	as determined in the contract between the collaborative and the commissioner; and
97.1 	(iii) comply with quality assurance standards, reporting of utilization information, 
97.2 	standards set out in sections 245.487 to 245.4889, and other requirements established in 
97.3 	Minnesota Rules, part 9500.1460; 
97.4 	(10) subject to federal approval, in the development of rates for local children's 
97.5 	mental health collaboratives, the commissioner shall consider, and may adjust, trend and 
97.6 	utilization factors, to reflect changes in mental health service utilization and access;
97.7 	(11) consider changes in mental health service utilization, access, and price, and 
97.8 	determine the actuarial value of the services in the maintenance of rates for local children's 
97.9 	mental health collaborative provided services, subject to federal approval;
97.10 	(12) provide written notice to any prepaid health plan operating within the service 
97.11 	delivery area of a children's mental health collaborative of the collaborative's existence 
97.12 	within 30 days of the commissioner's receipt of notice of the collaborative's formation;
97.13 	(13) ensure that in a geographic area where both a prepaid health plan including 
97.14 	those established under either section 256B.69 or 256L.12 and a local children's mental 
97.15 	health collaborative exist, medical assistance and MinnesotaCare recipients in the 
97.16 	operational target population who are enrolled in prepaid health plans will have the choice 
97.17 	to receive mental health services through either the prepaid health plan or the collaborative 
97.18 	that has a contract with the prepaid health plan, according to the terms of the contract; 
97.19 	(14) develop a mechanism for integrating medical assistance resources for mental 
97.20 	health service with MinnesotaCare and any other state and local resources available for 
97.21 	services for children in the operational target population, and develop a procedure for 
97.22 	making these resources available for use by a local children's mental health collaborative;
97.23 	(15) gather data needed to manage mental health care including evaluation data and 
97.24 	data necessary to establish a separate capitation rate for children's mental health services 
97.25 	if that option is selected;
97.26 	(16) by January 1, 1994, develop a model contract for providers of mental health 
97.27 	managed care that meets the requirements set out in sections 245.491 to 245.495 and 
97.28 	256B.69, and utilize this contract for all subsequent awards, and before January 1, 1995, 
97.29 	the commissioner of human services shall not enter into or extend any contract for any 
97.30 	prepaid plan that would impede the implementation of sections 245.491 to 245.495; 
97.31 	(17) develop revenue enhancement or rebate mechanisms and procedures to 
97.32 	certify expenditures made through local children's mental health collaboratives for 
97.33 	services including administration and outreach that may be eligible for federal financial 
97.34 	participation under medical assistance and other federal programs;
97.35 	(18) ensure that new contracts and extensions or modifications to existing contracts 
97.36 	under section 256B.69 do not impede implementation of sections 245.491 to 245.495; 
98.1 	(19) provide technical assistance to help local children's mental health collaboratives 
98.2 	certify local expenditures for federal financial participation, using due diligence in order to 
98.3 	meet implementation timelines for sections 245.491 to 245.495 and recommend necessary 
98.4 	legislation to enhance federal revenue, provide clinical and management flexibility, and 
98.5 	otherwise meet the goals of local children's mental health collaboratives and request 
98.6 	necessary state plan amendments to maximize the availability of medical assistance for 
98.7 	activities undertaken by the local children's mental health collaborative; 
98.8 	(20) take all steps necessary to secure medical assistance reimbursement under the 
98.9 	rehabilitation option for family community support services and therapeutic support of 
98.10 	foster care and for individualized rehabilitation services;
98.11 	(21) provide a mechanism to identify separately the reimbursement to a county 
98.12 	for child welfare targeted case management provided to children served by the local 
98.13 	collaborative for purposes of subsequent transfer by the county to the integrated fund;
98.14 	(22) ensure that family members who are enrolled in a prepaid health plan and 
98.15 	whose children are receiving mental health services through a local children's mental 
98.16 	health collaborative file complaints about mental health services needed by the family 
98.17 	members, the commissioner shall comply with section 256B.031, subdivision 6 256B.69, 
98.18 	subdivision 20. A collaborative may assist a family to make a complaint; and 
98.19 	(23) facilitate a smooth transition for children receiving prepaid medical assistance 
98.20 	or MinnesotaCare services through a children's mental health collaborative who become 
98.21 	enrolled in a prepaid health plan.

98.22 	Sec. 3. Minnesota Statutes 2008, section 256.015, subdivision 7, is amended to read:
98.23 		Subd. 7.Cooperation with information requests required. (a) Upon the request 
98.24 	of the Department commissioner of human services,:
98.25 	(1) any state agency or third party payer shall cooperate with the department in by
98.26 	furnishing information to help establish a third party liability. Upon the request of the 
98.27 	Department of Human Services or county child support or human service agencies, as 
98.28 	required by the federal Deficit Reduction Act of 2005, Public Law 109-171;
98.29 	(2) any employer or third party payer shall cooperate in by furnishing a data file 
98.30 	containing information about group health insurance plans plan or medical benefit plans 
98.31 	available to plan coverage of its employees or insureds within 60 days of the request.
98.32 	(b) For purposes of section 176.191, subdivision 4, the Department commissioner
98.33 	of labor and industry may allow the Department commissioner of human services and 
98.34 	county agencies direct access and data matching on information relating to workers' 
98.35 	compensation claims in order to determine whether the claimant has reported the fact of 
99.1 	a pending claim and the amount paid to or on behalf of the claimant to the Department
99.2 	commissioner of human services.
99.3 	(c) For the purpose of compliance with section 169.09, subdivision 13, and 
99.4 	federal requirements under Code of Federal Regulations, title 42, section 433.138(d)(4), 
99.5 	the commissioner of public safety shall provide accident data as requested by the 
99.6 	commissioner of human services. The disclosure shall not violate section 169.09, 
99.7 	subdivision 13, paragraph (d).
99.8 	(d) The Department commissioner of human services and county agencies shall 
99.9 	limit its use of information gained from agencies, third party payers, and employers to 
99.10 	purposes directly connected with the administration of its public assistance and child 
99.11 	support programs. The provision of information by agencies, third party payers, and 
99.12 	employers to the department under this subdivision is not a violation of any right of 
99.13 	confidentiality or data privacy.

99.14 	Sec. 4. Minnesota Statutes 2008, section 256.969, subdivision 3a, is amended to read:
99.15 		Subd. 3a.Payments. (a) Acute care hospital billings under the medical 
99.16 	assistance program must not be submitted until the recipient is discharged. However, 
99.17 	the commissioner shall establish monthly interim payments for inpatient hospitals that 
99.18 	have individual patient lengths of stay over 30 days regardless of diagnostic category. 
99.19 	Except as provided in section 256.9693, medical assistance reimbursement for treatment 
99.20 	of mental illness shall be reimbursed based on diagnostic classifications. Individual 
99.21 	hospital payments established under this section and sections 256.9685, 256.9686, and 
99.22 	256.9695, in addition to third party and recipient liability, for discharges occurring during 
99.23 	the rate year shall not exceed, in aggregate, the charges for the medical assistance covered 
99.24 	inpatient services paid for the same period of time to the hospital. This payment limitation 
99.25 	shall be calculated separately for medical assistance and general assistance medical 
99.26 	care services. The limitation on general assistance medical care shall be effective for 
99.27 	admissions occurring on or after July 1, 1991. Services that have rates established under 
99.28 	subdivision 11 or 12, must be limited separately from other services. After consulting with 
99.29 	the affected hospitals, the commissioner may consider related hospitals one entity and 
99.30 	may merge the payment rates while maintaining separate provider numbers. The operating 
99.31 	and property base rates per admission or per day shall be derived from the best Medicare 
99.32 	and claims data available when rates are established. The commissioner shall determine 
99.33 	the best Medicare and claims data, taking into consideration variables of recency of the 
99.34 	data, audit disposition, settlement status, and the ability to set rates in a timely manner. 
99.35 	The commissioner shall notify hospitals of payment rates by December 1 of the year 
100.1 	preceding the rate year. The rate setting data must reflect the admissions data used to 
100.2 	establish relative values. Base year changes from 1981 to the base year established for the 
100.3 	rate year beginning January 1, 1991, and for subsequent rate years, shall not be limited 
100.4 	to the limits ending June 30, 1987, on the maximum rate of increase under subdivision 
100.5 	1. The commissioner may adjust base year cost, relative value, and case mix index data 
100.6 	to exclude the costs of services that have been discontinued by the October 1 of the year 
100.7 	preceding the rate year or that are paid separately from inpatient services. Inpatient stays 
100.8 	that encompass portions of two or more rate years shall have payments established based 
100.9 	on payment rates in effect at the time of admission unless the date of admission preceded 
100.10 	the rate year in effect by six months or more. In this case, operating payment rates for 
100.11 	services rendered during the rate year in effect and established based on the date of 
100.12 	admission shall be adjusted to the rate year in effect by the hospital cost index.
100.13 	(b) For fee-for-service admissions occurring on or after July 1, 2002, the total 
100.14 	payment, before third-party liability and spenddown, made to hospitals for inpatient 
100.15 	services is reduced by .5 percent from the current statutory rates.
100.16 	(c) In addition to the reduction in paragraph (b), the total payment for fee-for-service 
100.17 	admissions occurring on or after July 1, 2003, made to hospitals for inpatient services 
100.18 	before third-party liability and spenddown, is reduced five percent from the current 
100.19 	statutory rates. Mental health services within diagnosis related groups 424 to 432, and 
100.20 	facilities defined under subdivision 16 are excluded from this paragraph.
100.21 	(d) In addition to the reduction in paragraphs (b) and (c), the total payment for 
100.22 	fee-for-service admissions occurring on or after July August 1, 2005, made to hospitals 
100.23 	for inpatient services before third-party liability and spenddown, is reduced 6.0 percent 
100.24 	from the current statutory rates. Mental health services within diagnosis related groups 
100.25 	424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph. 
100.26 	Notwithstanding section 256.9686, subdivision 7, for purposes of this paragraph, medical 
100.27 	assistance does not include general assistance medical care. Payments made to managed 
100.28 	care plans shall be reduced for services provided on or after January 1, 2006, to reflect 
100.29 	this reduction.
100.30 	(e) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for 
100.31 	fee-for-service admissions occurring on or after July 1, 2008, through June 30, 2009, made 
100.32 	to hospitals for inpatient services before third-party liability and spenddown, is reduced 
100.33 	3.46 percent from the current statutory rates. Mental health services with diagnosis related 
100.34 	groups 424 to 432 and facilities defined under subdivision 16 are excluded from this 
100.35 	paragraph. Payments made to managed care plans shall be reduced for services provided 
100.36 	on or after January 1, 2009, through June 30, 2009, to reflect this reduction.
101.1 	(f) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for 
101.2 	fee-for-service admissions occurring on or after July 1, 2009, through June 30, 2010, made 
101.3 	to hospitals for inpatient services before third-party liability and spenddown, is reduced 
101.4 	1.9 percent from the current statutory rates. Mental health services with diagnosis related 
101.5 	groups 424 to 432 and facilities defined under subdivision 16 are excluded from this 
101.6 	paragraph. Payments made to managed care plans shall be reduced for services provided 
101.7 	on or after July 1, 2009, through June 30, 2010, to reflect this reduction.
101.8 	(g) In addition to the reductions in paragraphs (b), (c), and (d), the total payment 
101.9 	for fee-for-service admissions occurring on or after July 1, 2010, made to hospitals for 
101.10 	inpatient services before third-party liability and spenddown, is reduced 1.79 percent 
101.11 	from the current statutory rates. Mental health services with diagnosis related groups 
101.12 	424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph. 
101.13 	Payments made to managed care plans shall be reduced for services provided on or after 
101.14 	July 1, 2010, to reflect this reduction.

101.15 	Sec. 5. Minnesota Statutes 2008, section 256B.037, subdivision 5, is amended to read:
101.16 		Subd. 5.Other contracts permitted. Nothing in this section prohibits the 
101.17 	commissioner from contracting with an organization for comprehensive health services, 
101.18 	including dental services, under section 256B.031, sections256B.035, 256B.69, or 
101.19 	256D.03, subdivision 4, paragraph (c).  

101.20 	Sec. 6. Minnesota Statutes 2008, section 256B.056, subdivision 1c, is amended to read:
101.21 		Subd. 1c.Families with children income methodology. (a)(1) [Expired, 1Sp2003 
101.22 	c 14 art 12 s 17]
101.23 	(2) For applications processed within one calendar month prior to July 1, 2003, 
101.24 	eligibility shall be determined by applying the income standards and methodologies in 
101.25 	effect prior to July 1, 2003, for any months in the six-month budget period before July 
101.26 	1, 2003, and the income standards and methodologies in effect on July 1, 2003, for any 
101.27 	months in the six-month budget period on or after that date. The income standards for 
101.28 	each month shall be added together and compared to the applicant's total countable income 
101.29 	for the six-month budget period to determine eligibility.
101.30 	(3) For children ages one through 18 whose eligibility is determined under section 
101.31 	256B.057, subdivision 2, the following deductions shall be applied to income counted 
101.32 	toward the child's eligibility as allowed under the state's AFDC plan in effect as of July 
101.33 	16, 1996: $90 work expense, dependent care, and child support paid under court order. 
101.34 	This clause is effective October 1, 2003.
102.1 	(b) For families with children whose eligibility is determined using the standard 
102.2 	specified in section 256B.056, subdivision 4, paragraph (c), 17 percent of countable 
102.3 	earned income shall be disregarded for up to four months and the following deductions 
102.4 	shall be applied to each individual's income counted toward eligibility as allowed under 
102.5 	the state's AFDC plan in effect as of July 16, 1996: dependent care and child support paid 
102.6 	under court order.
102.7 	(c) If the four-month disregard in paragraph (b) has been applied to the wage 
102.8 	earner's income for four months, the disregard shall not be applied again until the wage 
102.9 	earner's income has not been considered in determining medical assistance eligibility for 
102.10 	12 consecutive months.
102.11 	(d) The commissioner shall adjust the income standards under this section each July 
102.12 	1 by the annual update of the federal poverty guidelines following publication by the 
102.13 	United States Department of Health and Human Services.
102.14 	(e) For children age 18 or under, annual gifts of $2,000 or less by a tax-exempt 
102.15 	organization to or for the benefit of the child with a life-threatening illness must be 
102.16 	disregarded from income.

102.17 	Sec. 7. Minnesota Statutes 2008, section 256B.056, subdivision 3c, is amended to read:
102.18 		Subd. 3c.Asset limitations for families and children. A household of two or more 
102.19 	persons must not own more than $20,000 in total net assets, and a household of one 
102.20 	person must not own more than $10,000 in total net assets. In addition to these maximum 
102.21 	amounts, an eligible individual or family may accrue interest on these amounts, but they 
102.22 	must be reduced to the maximum at the time of an eligibility redetermination. The value of 
102.23 	assets that are not considered in determining eligibility for medical assistance for families 
102.24 	and children is the value of those assets excluded under the AFDC state plan as of July 16, 
102.25 	1996, as required by the Personal Responsibility and Work Opportunity Reconciliation 
102.26 	Act of 1996 (PRWORA), Public Law 104-193, with the following exceptions:
102.27 	(1) household goods and personal effects are not considered;
102.28 	(2) capital and operating assets of a trade or business up to $200,000 are not 
102.29 	considered;
102.30 	(3) one motor vehicle is excluded for each person of legal driving age who is 
102.31 	employed or seeking employment;
102.32 	(4) one burial plot and all other burial expenses equal to the supplemental security 
102.33 	income program asset limit are not considered for each individual assets designated as 
102.34 	burial expenses are excluded to the same extent they are excluded by the Supplemental 
102.35 	Security Income program;
103.1 	(5) court-ordered settlements up to $10,000 are not considered;
103.2 	(6) individual retirement accounts and funds are not considered; and
103.3 	(7) assets owned by children are not considered.

103.4 	Sec. 8. Minnesota Statutes 2008, section 256B.056, subdivision 6, is amended to read:
103.5 		Subd. 6.Assignment of benefits. To be eligible for medical assistance a person 
103.6 	must have applied or must agree to apply all proceeds received or receivable by the person 
103.7 	or the person's legal representative from any third party liable for the costs of medical 
103.8 	care. By accepting or receiving assistance, the person is deemed to have assigned the 
103.9 	person's rights to medical support and third party payments as required by title 19 of 
103.10 	the Social Security Act. Persons must cooperate with the state in establishing paternity 
103.11 	and obtaining third party payments. By accepting medical assistance, a person assigns 
103.12 	to the Department of Human Services all rights the person may have to medical support 
103.13 	or payments for medical expenses from any other person or entity on their own or their 
103.14 	dependent's behalf and agrees to cooperate with the state in establishing paternity and 
103.15 	obtaining third party payments. Any rights or amounts so assigned shall be applied against 
103.16 	the cost of medical care paid for under this chapter. Any assignment takes effect upon 
103.17 	the determination that the applicant is eligible for medical assistance and up to three 
103.18 	months prior to the date of application if the applicant is determined eligible for and 
103.19 	receives medical assistance benefits. The application must contain a statement explaining 
103.20 	this assignment. For the purposes of this section, "the Department of Human Services or 
103.21 	the state" includes prepaid health plans under contract with the commissioner according 
103.22 	to sections 256B.031,256B.69, 256D.03, subdivision 4, paragraph (c), and 256L.12; 
103.23 	children's mental health collaboratives under section 245.493; demonstration projects for 
103.24 	persons with disabilities under section 256B.77; nursing facilities under the alternative 
103.25 	payment demonstration project under section 256B.434; and the county-based purchasing 
103.26 	entities under section 256B.692. 

103.27 	Sec. 9. Minnesota Statutes 2008, section 256B.0625, is amended by adding a 
103.28 	subdivision to read:
103.29 		Subd. 13i.Drug Utilization Review Board; report. (a) A nine-member Drug 
103.30 	Utilization Review Board is established. The board must be comprised of at least three 
103.31 	but no more than four licensed physicians actively engaged in the practice of medicine 
103.32 	in Minnesota; at least three licensed pharmacists actively engaged in the practice of 
103.33 	pharmacy in Minnesota; and one consumer representative. The remainder must be made 
103.34 	up of health care professionals who are licensed in their field and have recognized 
104.1 	knowledge in the clinically appropriate prescribing, dispensing, and monitoring of covered 
104.2 	outpatient drugs. Members of the board must be appointed by the commissioner, shall 
104.3 	serve three-year terms, and may be reappointed by the commissioner. The board shall 
104.4 	annually elect a chair from among its members.
104.5 	(b) The board must be staffed by an employee of the department who shall serve as 
104.6 	an ex officio nonvoting member of the board.
104.7 	(c) The commissioner shall, with the advice of the board:
104.8 	(1) implement a medical assistance retrospective and prospective drug utilization 
104.9 	review program as required by United States Code, title 42, section 1396r-8(g)(3);
104.10 	(2) develop and implement the predetermined criteria and practice parameters for 
104.11 	appropriate prescribing to be used in retrospective and prospective drug utilization review;
104.12 	(3) develop, select, implement, and assess interventions for physicians, pharmacists, 
104.13 	and patients that are educational and not punitive in nature;
104.14 	(4) establish a grievance and appeals process for physicians and pharmacists under 
104.15 	this section;
104.16 	(5) publish and disseminate educational information to physicians and pharmacists 
104.17 	regarding the board and the review program;
104.18 	(6) adopt and implement procedures designed to ensure the confidentiality of any 
104.19 	information collected, stored, retrieved, assessed, or analyzed by the board, staff to 
104.20 	the board, or contractors to the review program that identifies individual physicians, 
104.21 	pharmacists, or recipients;
104.22 	(7) establish and implement an ongoing process to:
104.23 	(i) receive public comment regarding drug utilization review criteria and standards; 
104.24 	and
104.25 	(ii) consider the comments along with other scientific and clinical information in 
104.26 	order to revise criteria and standards on a timely basis; and
104.27 	(8) adopt any rules necessary to carry out this section.
104.28 	(d) The board may establish advisory committees. The commissioner may contract 
104.29 	with appropriate organizations to assist the board in carrying out the board's duties. 
104.30 	The commissioner may enter into contracts for services to develop and implement a 
104.31 	retrospective and prospective review program.
104.32 	(e) The board shall report to the commissioner annually on the date the drug 
104.33 	utilization review annual report is due to the Centers for Medicare and Medicaid Services. 
104.34 	This report must cover the preceding federal fiscal year. The commissioner shall make the 
104.35 	report available to the public upon request. The report must include information on the 
104.36 	activities of the board and the program; the effectiveness of implemented interventions; 
105.1 	administrative costs; and any fiscal impact resulting from the program. An honorarium 
105.2 	of $100 per meeting and reimbursement for mileage must be paid to each board member 
105.3 	in attendance.
105.4 	(f) This subdivision is exempt from the provisions of section 15.059. 
105.5 	Notwithstanding section 15.059, subdivision 5, the board is permanent and does not expire.

105.6 	Sec. 10. Minnesota Statutes 2008, section 256B.0625, is amended by adding a 
105.7 	subdivision to read:
105.8 		Subd. 53.Centers of excellence. For complex medical procedures with a high 
105.9 	degree of variation in outcomes, for which the Medicare program requires facilities 
105.10 	providing the services to meet certain criteria as a condition of coverage, the commissioner 
105.11 	may develop centers of excellence facility criteria in consultation with the Health Services 
105.12 	Policy Committee, section 256B.0625, subdivision 3c. The criteria must reflect facility 
105.13 	traits that have been linked to superior patient safety and outcomes for the procedures 
105.14 	in question, and must be based on the best available empirical evidence. For medical 
105.15 	assistance recipients enrolled on a fee-for-service basis, the commissioner may make 
105.16 	coverage for these procedures conditional upon the facility providing the services meeting 
105.17 	the specified criteria. Only facilities meeting the criteria may be reimbursed for the 
105.18 	procedures in question.

105.19 	EFFECTIVE DATE. This section is effective August 1, 2009, or upon federal 
105.20 	approval, whichever is later.

105.21 	Sec. 11. Minnesota Statutes 2008, section 256B.094, subdivision 3, is amended to read:
105.22 		Subd. 3.Coordination and provision of services. (a) In a county or reservation 
105.23 	where a prepaid medical assistance provider has contracted under section 256B.031 or
105.24 	256B.69 to provide mental health services, the case management provider shall coordinate 
105.25 	with the prepaid provider to ensure that all necessary mental health services required 
105.26 	under the contract are provided to recipients of case management services. 
105.27 	(b) When the case management provider determines that a prepaid provider is not 
105.28 	providing mental health services as required under the contract, the case management 
105.29 	provider shall assist the recipient to appeal the prepaid provider's denial pursuant to 
105.30 	section 256.045, and may make other arrangements for provision of the covered services. 
105.31 	(c) The case management provider may bill the provider of prepaid health care 
105.32 	services for any mental health services provided to a recipient of case management 
105.33 	services which the county or tribal social services arranges for or provides and which are 
105.34 	included in the prepaid provider's contract, and which were determined to be medically 
106.1 	necessary as a result of an appeal pursuant to section 256.045. The prepaid provider 
106.2 	must reimburse the mental health provider, at the prepaid provider's standard rate for that 
106.3 	service, for any services delivered under this subdivision. 
106.4 	(d) If the county or tribal social services has not obtained prior authorization for 
106.5 	this service, or an appeal results in a determination that the services were not medically 
106.6 	necessary, the county or tribal social services may not seek reimbursement from the 
106.7 	prepaid provider.

106.8 	Sec. 12. Minnesota Statutes 2008, section 256B.195, subdivision 1, is amended to read:
106.9 		Subdivision 1.Federal approval required. Sections Section145.9268, 256.969, 
106.10 	subdivision 26, and this section are contingent on federal approval of the intergovernmental 
106.11 	transfers and payments to safety net hospitals and community clinics authorized under 
106.12 	this section. These sections are also contingent on current payment, by the government 
106.13 	entities, of intergovernmental transfers under section 256B.19 and this section.  

106.14 	Sec. 13. Minnesota Statutes 2008, section 256B.195, subdivision 2, is amended to read:
106.15 		Subd. 2.Payments from governmental entities. (a) In addition to any payment 
106.16 	required under section 256B.19, effective July 15, 2001, the following government entities 
106.17 	shall make the payments indicated before noon on the 15th of each month annually:  
106.18 	(1) Hennepin County, $2,000,000 $24,000,000; and
106.19 	(2) Ramsey County, $1,000,000 $12,000,000.
106.20 	(b) These sums shall be part of the designated governmental unit's portion of the 
106.21 	nonfederal share of medical assistance costs. Of these payments, Hennepin County shall 
106.22 	pay 71 percent directly to Hennepin County Medical Center, and Ramsey County shall 
106.23 	pay 71 percent directly to Regions Hospital. The counties must provide certification to the 
106.24 	commissioner of payments to hospitals under this subdivision.

106.25 	Sec. 14. Minnesota Statutes 2008, section 256B.195, subdivision 3, is amended to read:
106.26 		Subd. 3.Payments to certain safety net providers. (a) Effective July 15, 2001, 
106.27 	the commissioner shall make the following payments to the hospitals indicated after 
106.28 	noon on the 15th of each month annually:
106.29 	(1) to Hennepin County Medical Center, any federal matching funds available to 
106.30 	match the payments received by the medical center under subdivision 2, to increase 
106.31 	payments for medical assistance admissions and to recognize higher medical assistance 
106.32 	costs in institutions that provide high levels of charity care; and
107.1 	(2) to Regions Hospital, any federal matching funds available to match the payments 
107.2 	received by the hospital under subdivision 2, to increase payments for medical assistance 
107.3 	admissions and to recognize higher medical assistance costs in institutions that provide 
107.4 	high levels of charity care.
107.5 	(b) Effective July 15, 2001, the following percentages of the transfers under 
107.6 	subdivision 2 shall be retained by the commissioner for deposit each month into the 
107.7 	general fund:
107.8 	(1) 18 percent, plus any federal matching funds, shall be allocated for the following 
107.9 	purposes:
107.10 	(i) during the fiscal year beginning July 1, 2001, of the amount available under 
107.11 	this clause, 39.7 percent shall be allocated to make increased hospital payments under 
107.12 	section 256.969, subdivision 26; 34.2 percent shall be allocated to fund the amounts 
107.13 	due from small rural hospitals, as defined in section 144.148, for overpayments under 
107.14 	section 256.969, subdivision 5a, resulting from a determination that medical assistance 
107.15 	and general assistance payments exceeded the charge limit during the period from 1994 to 
107.16 	1997; and 26.1 percent shall be allocated to the commissioner of health for rural hospital 
107.17 	capital improvement grants under section 144.148; and
107.18 	(ii) during fiscal years beginning on or after July 1, 2002, of the amount available 
107.19 	under this clause, 55 percent shall be allocated to make increased hospital payments under 
107.20 	section 256.969, subdivision 26, and 45 percent shall be allocated to the commissioner of 
107.21 	health for rural hospital capital improvement grants under section 144.148; and
107.22 	(2) 11 percent shall be allocated to the commissioner of health to fund community 
107.23 	clinic grants under section 145.9268.
107.24 	(c) This subdivision shall apply to fee-for-service payments only and shall not 
107.25 	increase capitation payments or payments made based on average rates. The allocation in 
107.26 	paragraph (b), clause (1), item (ii), to increase hospital payments under section 256.969, 
107.27 	subdivision 26, shall not limit payments under that section.
107.28 	(d) Medical assistance rate or payment changes, including those required to obtain 
107.29 	federal financial participation under section 62J.692, subdivision 8, shall precede the 
107.30 	determination of intergovernmental transfer amounts determined in this subdivision. 
107.31 	Participation in the intergovernmental transfer program shall not result in the offset of 
107.32 	any health care provider's receipt of medical assistance payment increases other than 
107.33 	limits resulting from hospital-specific charge limits and limits on disproportionate share 
107.34 	hospital payments.
107.35 	(e) Effective July 1, 2003, if the amount available for allocation under paragraph 
107.36 	(b) is greater than the amounts available during March 2003, after any increase in 
108.1 	intergovernmental transfers and payments that result from section 256.969, subdivision 
108.2 	3a, paragraph (c), are paid to the general fund, any additional amounts available under this 
108.3 	subdivision after reimbursement of the transfers under subdivision 2 shall be allocated to 
108.4 	increase medical assistance payments, subject to hospital-specific charge limits and limits 
108.5 	on disproportionate share hospital payments, as follows:
108.6 	(1) if the payments under subdivision 5 are approved, the amount shall be paid to 
108.7 	the largest ten percent of hospitals as measured by 2001 payments for medical assistance, 
108.8 	general assistance medical care, and MinnesotaCare in the nonstate government hospital 
108.9 	category. Payments shall be allocated according to each hospital's proportionate share 
108.10 	of the 2001 payments; or
108.11 	(2) if the payments under subdivision 5 are not approved, the amount shall be paid to 
108.12 	the largest ten percent of hospitals as measured by 2001 payments for medical assistance, 
108.13 	general assistance medical care, and MinnesotaCare in the nonstate government category 
108.14 	and to the largest ten percent of hospitals as measured by payments for medical assistance, 
108.15 	general assistance medical care, and MinnesotaCare in the nongovernment hospital 
108.16 	category. Payments shall be allocated according to each hospital's proportionate 
108.17 	share of the 2001 payments in their respective category of nonstate government and 
108.18 	nongovernment. The commissioner shall determine which hospitals are in the nonstate 
108.19 	government and nongovernment hospital categories.

108.20 	Sec. 15. Minnesota Statutes 2008, section 256B.69, subdivision 5a, is amended to read:
108.21 		Subd. 5a.Managed care contracts. (a) Managed care contracts under this section 
108.22 	and sections 256L.12 and 256D.03, shall be entered into or renewed on a calendar year 
108.23 	basis beginning January 1, 1996. Managed care contracts which were in effect on June 
108.24 	30, 1995, and set to renew on July 1, 1995, shall be renewed for the period July 1, 1995 
108.25 	through December 31, 1995 at the same terms that were in effect on June 30, 1995. The 
108.26 	commissioner may issue separate contracts with requirements specific to services to 
108.27 	medical assistance recipients age 65 and older.
108.28 	(b) A prepaid health plan providing covered health services for eligible persons 
108.29 	pursuant to chapters 256B, 256D, and 256L, is responsible for complying with the terms 
108.30 	of its contract with the commissioner. Requirements applicable to managed care programs 
108.31 	under chapters 256B, 256D, and 256L, established after the effective date of a contract 
108.32 	with the commissioner take effect when the contract is next issued or renewed.
108.33 	(c) Effective for services rendered on or after January 1, 2003, the commissioner 
108.34 	shall withhold five percent of managed care plan payments under this section for the 
108.35 	prepaid medical assistance and general assistance medical care programs pending 
109.1 	completion of performance targets. Each performance target must be quantifiable, 
109.2 	objective, measurable, and reasonably attainable, except in the case of a performance 
109.3 	target based on a federal or state law or rule. Criteria for assessment of each performance 
109.4 	target must be outlined in writing prior to the contract effective date. The managed 
109.5 	care plan must demonstrate, to the commissioner's satisfaction, that the data submitted 
109.6 	regarding attainment of the performance target is accurate. The commissioner shall 
109.7 	periodically change the administrative measures used as performance targets in order 
109.8 	to improve plan performance across a broader range of administrative services. The 
109.9 	performance targets must include measurement of plan efforts to contain spending 
109.10 	on health care services and administrative activities. The commissioner may adopt 
109.11 	plan-specific performance targets that take into account factors affecting only one plan, 
109.12 	including characteristics of the plan's enrollee population. The withheld funds must be 
109.13 	returned no sooner than July of the following year if performance targets in the contract 
109.14 	are achieved. The commissioner may exclude special demonstration projects under 
109.15 	subdivision 23. A managed care plan or a county-based purchasing plan under section 
109.16 	256B.692 may include as admitted assets under section 62D.044 any amount withheld 
109.17 	under this paragraph that is reasonably expected to be returned.
109.18 	(d)(1) Effective for services rendered on or after January 1, 2009, the commissioner 
109.19 	shall withhold three percent of managed care plan payments under this section for the 
109.20 	prepaid medical assistance and general assistance medical care programs. The withheld 
109.21 	funds must be returned no sooner than July 1 and no later than July 31 of the following 
109.22 	year. The commissioner may exclude special demonstration projects under subdivision 23.
109.23 	(2) A managed care plan or a county-based purchasing plan under section 256B.692 
109.24 	may include as admitted assets under section 62D.044 any amount withheld under 
109.25 	this paragraph. The return of the withhold under this paragraph is not subject to the 
109.26 	requirements of paragraph (c).
109.27 	(e) Contracts between the commissioner and a prepaid health plan are exempt from 
109.28 	the set-aside and preference provisions of section 16C.16, subdivisions 6, paragraph 
109.29 	(a), and 7.

109.30 	Sec. 16. Minnesota Statutes 2008, section 256B.77, subdivision 13, is amended to read:
109.31 		Subd. 13.Ombudsman. Enrollees shall have access to ombudsman services 
109.32 	established in section 256B.031, subdivision 6 256B.69, subdivision 20, and advocacy 
109.33 	services provided by the ombudsman for mental health and developmental disabilities 
109.34 	established in sections 245.91 to 245.97. The managed care ombudsman and the 
109.35 	ombudsman for mental health and developmental disabilities shall coordinate services 
110.1 	provided to avoid duplication of services. For purposes of the demonstration project, 
110.2 	the powers and responsibilities of the Office of Ombudsman for Mental Health and 
110.3 	Developmental Disabilities, as provided in sections 245.91 to 245.97 are expanded 
110.4 	to include all eligible individuals, health plan companies, agencies, and providers 
110.5 	participating in the demonstration project. 

110.6 	Sec. 17. Minnesota Statutes 2008, section 256D.03, subdivision 3, is amended to read:
110.7 		Subd. 3. General assistance medical care; eligibility. (a) General assistance 
110.8 	medical care may be paid for any person who is not eligible for medical assistance under 
110.9 	chapter 256B, including eligibility for medical assistance based on a spenddown of excess 
110.10 	income according to section 256B.056, subdivision 5, or MinnesotaCare as for applicants 
110.11 	and recipients defined in paragraph (b) (c), except as provided in paragraph (c) (d), and: 
110.12 	(1) who is receiving assistance under section 256D.05, except for families with 
110.13 	children who are eligible under Minnesota family investment program (MFIP), or who is 
110.14 	having a payment made on the person's behalf under sections 256I.01 to 256I.06; or 
110.15 	(2) who is a resident of Minnesota; and 
110.16 	(i) who has gross countable income not in excess of 75 percent of the federal poverty 
110.17 	guidelines for the family size, using a six-month budget period and whose equity in assets 
110.18 	is not in excess of $1,000 per assistance unit. General assistance medical care is not 
110.19 	available for applicants or enrollees who are otherwise eligible for medical assistance but 
110.20 	fail to verify their assets. Enrollees who become eligible for medical assistance shall be 
110.21 	terminated and transferred to medical assistance. Exempt assets, the reduction of excess 
110.22 	assets, and the waiver of excess assets must conform to the medical assistance program in 
110.23 	section 256B.056, subdivisions 3 and 3d, with the following exception: the maximum 
110.24 	amount of undistributed funds in a trust that could be distributed to or on behalf of the 
110.25 	beneficiary by the trustee, assuming the full exercise of the trustee's discretion under the 
110.26 	terms of the trust, must be applied toward the asset maximum; or
110.27 	(ii) who has gross countable income above 75 percent of the federal poverty 
110.28 	guidelines but not in excess of 175 percent of the federal poverty guidelines for the 
110.29 	family size, using a six-month budget period, whose equity in assets is not in excess 
110.30 	of the limits in section 256B.056, subdivision 3c, and who applies during an inpatient 
110.31 	hospitalization; or.
110.32 	(iii) (b) the commissioner shall adjust the income standards under this section each 
110.33 	July 1 by the annual update of the federal poverty guidelines following publication by the 
110.34 	United States Department of Health and Human Services. 
111.1 	(b) (c) Effective for applications and renewals processed on or after September 1, 
111.2 	2006, general assistance medical care may not be paid for applicants or recipients who are 
111.3 	adults with dependent children under 21 whose gross family income is equal to or less than 
111.4 	275 percent of the federal poverty guidelines who are not described in paragraph (e) (f). 
111.5 	(c) (d) Effective for applications and renewals processed on or after September 1, 
111.6 	2006, general assistance medical care may be paid for applicants and recipients who meet 
111.7 	all eligibility requirements of paragraph (a), clause (2), item (i), for a temporary period 
111.8 	beginning the date of application. Immediately following approval of general assistance 
111.9 	medical care, enrollees shall be enrolled in MinnesotaCare under section 256L.04, 
111.10 	subdivision 7, with covered services as provided in section 256L.03 for the rest of the 
111.11 	six-month general assistance medical care eligibility period, until their six-month renewal. 
111.12 	(d) (e) To be eligible for general assistance medical care following enrollment in 
111.13 	MinnesotaCare as required by paragraph (c) (d), an individual must complete a new 
111.14 	application. 
111.15 	(e) (f) Applicants and recipients eligible under paragraph (a), clause (1) (2), item (i), 
111.16 	are exempt from the MinnesotaCare enrollment requirements in this subdivision if they: 
111.17 	(1) have applied for and are awaiting a determination of blindness or disability by 
111.18 	the state medical review team or a determination of eligibility for Supplemental Security 
111.19 	Income or Social Security Disability Insurance by the Social Security Administration; 
111.20 	(2) fail to meet the requirements of section 256L.09, subdivision 2; 
111.21 	(3) are homeless as defined by United States Code, title 42, section 11301, et seq.; 
111.22 	(4) are classified as end-stage renal disease beneficiaries in the Medicare program; 
111.23 	(5) are enrolled in private health care coverage as defined in section 256B.02, 
111.24 	subdivision 9; 
111.25 	(6) are eligible under paragraph (j) (k); 
111.26 	(7) receive treatment funded pursuant to section 254B.02; or 
111.27 	(8) reside in the Minnesota sex offender program defined in chapter 246B. 
111.28 	(f) (g) For applications received on or after October 1, 2003, eligibility may begin no 
111.29 	earlier than the date of application. For individuals eligible under paragraph (a), clause 
111.30 	(2), item (i), a redetermination of eligibility must occur every 12 months. Individuals are 
111.31 	eligible under paragraph (a), clause (2), item (ii), only during inpatient hospitalization but 
111.32 	may reapply if there is a subsequent period of inpatient hospitalization. 
111.33 	(g) (h) Beginning September 1, 2006, Minnesota health care program applications 
111.34 	and renewals completed by recipients and applicants who are persons described 
111.35 	in paragraph (c) (d) and submitted to the county agency shall be determined for 
111.36 	MinnesotaCare eligibility by the county agency. If all other eligibility requirements of 
112.1 	this subdivision are met, eligibility for general assistance medical care shall be available 
112.2 	in any month during which MinnesotaCare enrollment is pending. Upon notification of 
112.3 	eligibility for MinnesotaCare, notice of termination for eligibility for general assistance 
112.4 	medical care shall be sent to an applicant or recipient. If all other eligibility requirements 
112.5 	of this subdivision are met, eligibility for general assistance medical care shall be available 
112.6 	until enrollment in MinnesotaCare subject to the provisions of paragraphs (c) (d), (e) (f), 
112.7 	and (f) (g). 
112.8 	(h) (i) The date of an initial Minnesota health care program application necessary 
112.9 	to begin a determination of eligibility shall be the date the applicant has provided a 
112.10 	name, address, and Social Security number, signed and dated, to the county agency 
112.11 	or the Department of Human Services. If the applicant is unable to provide a name, 
112.12 	address, Social Security number, and signature when health care is delivered due to a 
112.13 	medical condition or disability, a health care provider may act on an applicant's behalf to 
112.14 	establish the date of an initial Minnesota health care program application by providing 
112.15 	the county agency or Department of Human Services with provider identification and a 
112.16 	temporary unique identifier for the applicant. The applicant must complete the remainder 
112.17 	of the application and provide necessary verification before eligibility can be determined.
112.18 	The applicant must complete the application within the time periods required under the 
112.19 	medical assistance program as specified in Minnesota Rules, parts 9505.0015, subpart 
112.20 	5, and 9505.0090, subpart 2. The county agency must assist the applicant in obtaining 
112.21 	verification if necessary. 
112.22 	(i) (j) County agencies are authorized to use all automated databases containing 
112.23 	information regarding recipients' or applicants' income in order to determine eligibility for 
112.24 	general assistance medical care or MinnesotaCare. Such use shall be considered sufficient 
112.25 	in order to determine eligibility and premium payments by the county agency. 
112.26 	(j) (k) General assistance medical care is not available for a person in a correctional 
112.27 	facility unless the person is detained by law for less than one year in a county correctional 
112.28 	or detention facility as a person accused or convicted of a crime, or admitted as an 
112.29 	inpatient to a hospital on a criminal hold order, and the person is a recipient of general 
112.30 	assistance medical care at the time the person is detained by law or admitted on a criminal 
112.31 	hold order and as long as the person continues to meet other eligibility requirements 
112.32 	of this subdivision. 
112.33 	(k) (l) General assistance medical care is not available for applicants or recipients 
112.34 	who do not cooperate with the county agency to meet the requirements of medical 
112.35 	assistance. 
113.1 	(l) (m) In determining the amount of assets of an individual eligible under paragraph 
113.2 	(a), clause (2), item (i), there shall be included any asset or interest in an asset, including 
113.3 	an asset excluded under paragraph (a), that was given away, sold, or disposed of for 
113.4 	less than fair market value within the 60 months preceding application for general 
113.5 	assistance medical care or during the period of eligibility. Any transfer described in this 
113.6 	paragraph shall be presumed to have been for the purpose of establishing eligibility for 
113.7 	general assistance medical care, unless the individual furnishes convincing evidence to 
113.8 	establish that the transaction was exclusively for another purpose. For purposes of this 
113.9 	paragraph, the value of the asset or interest shall be the fair market value at the time it 
113.10 	was given away, sold, or disposed of, less the amount of compensation received. For any 
113.11 	uncompensated transfer, the number of months of ineligibility, including partial months, 
113.12 	shall be calculated by dividing the uncompensated transfer amount by the average monthly 
113.13 	per person payment made by the medical assistance program to skilled nursing facilities 
113.14 	for the previous calendar year. The individual shall remain ineligible until this fixed period 
113.15 	has expired. The period of ineligibility may exceed 30 months, and a reapplication for 
113.16 	benefits after 30 months from the date of the transfer shall not result in eligibility unless 
113.17 	and until the period of ineligibility has expired. The period of ineligibility begins in the 
113.18 	month the transfer was reported to the county agency, or if the transfer was not reported, 
113.19 	the month in which the county agency discovered the transfer, whichever comes first. For 
113.20 	applicants, the period of ineligibility begins on the date of the first approved application. 
113.21 	(m) (n) When determining eligibility for any state benefits under this subdivision, 
113.22 	the income and resources of all noncitizens shall be deemed to include their sponsor's 
113.23 	income and resources as defined in the Personal Responsibility and Work Opportunity 
113.24 	Reconciliation Act of 1996, title IV, Public Law 104-193, sections 421 and 422, and 
113.25 	subsequently set out in federal rules. 
113.26 	(n) (o) Undocumented noncitizens and nonimmigrants are ineligible for general 
113.27 	assistance medical care. For purposes of this subdivision, a nonimmigrant is an individual 
113.28 	in one or more of the classes listed in United States Code, title 8, section 1101(a)(15), and 
113.29 	an undocumented noncitizen is an individual who resides in the United States without the 
113.30 	approval or acquiescence of the United States Citizenship and Immigration Services. 
113.31 	(o) (p) Notwithstanding any other provision of law, a noncitizen who is ineligible for 
113.32 	medical assistance due to the deeming of a sponsor's income and resources, is ineligible 
113.33 	for general assistance medical care. 
113.34 	(p) (q) Effective July 1, 2003, general assistance medical care emergency services 
113.35 	end. 

114.1 	Sec. 18. Minnesota Statutes 2008, section 256L.01, is amended by adding a subdivision 
114.2 	to read:
114.3 		Subd. 4a.Gross individual or gross family income. (a) "Gross individual or gross 
114.4 	family income" for nonfarm self-employed means income calculated for the 12-month 
114.5 	period of eligibility using as a baseline the adjusted gross income reported on the 
114.6 	applicant's federal income tax form for the previous year and adding back in depreciation, 
114.7 	and carryover net operating loss amounts that apply to the business in which the family is 
114.8 	currently engaged.
114.9 	(b) "Gross individual or gross family income" for farm self-employed means income 
114.10 	calculated for the 12-month period of eligibility using as the baseline the adjusted gross 
114.11 	income reported on the applicant's federal income tax form for the previous year.
114.12 	(c) "Gross individual or gross family income" means the total income for all family 
114.13 	members, calculated for the 12-month period of eligibility.

114.14 	EFFECTIVE DATE. This section is effective August 1, 2009, except that the 
114.15 	amendment made to the "gross individual or gross family income" for farm self-employed 
114.16 	is effective July 1, 2009, or upon federal approval, whichever is later.

114.17 	Sec. 19. Minnesota Statutes 2008, section 256L.03, subdivision 5, is amended to read:
114.18 		Subd. 5.Co-payments and coinsurance. (a) Except as provided in paragraphs (b) 
114.19 	and (c), the MinnesotaCare benefit plan shall include the following co-payments and 
114.20 	coinsurance requirements for all enrollees:
114.21 	(1) ten percent of the paid charges for inpatient hospital services for adult enrollees, 
114.22 	subject to an annual inpatient out-of-pocket maximum of $1,000 per individual and 
114.23 	$3,000 per family;
114.24 	(2) $3 per prescription for adult enrollees;
114.25 	(3) $25 for eyeglasses for adult enrollees;
114.26 	(4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an 
114.27 	episode of service which is required because of a recipient's symptoms, diagnosis, or 
114.28 	established illness, and which is delivered in an ambulatory setting by a physician or 
114.29 	physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse, 
114.30 	audiologist, optician, or optometrist; and
114.31 	(5) $6 for nonemergency visits to a hospital-based emergency room.
114.32 	(b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of 
114.33 	children under the age of 21.
114.34 	(c) Paragraph (a) does not apply to pregnant women and children under the age of 21.
114.35 	(d) Paragraph (a), clause (4), does not apply to mental health services.
115.1 	(e) Adult enrollees with family gross income that exceeds 200 percent of the federal 
115.2 	poverty guidelines or 215 percent of the federal poverty guidelines on or after July 1, 2009, 
115.3 	and who are not pregnant shall be financially responsible for the coinsurance amount, if 
115.4 	applicable, and amounts which exceed the $10,000 inpatient hospital benefit limit.
115.5 	(f) When a MinnesotaCare enrollee becomes a member of a prepaid health plan, 
115.6 	or changes from one prepaid health plan to another during a calendar year, any charges 
115.7 	submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket 
115.8 	expenses incurred by the enrollee for inpatient services, that were submitted or incurred 
115.9 	prior to enrollment, or prior to the change in health plans, shall be disregarded.

115.10 	Sec. 20. Minnesota Statutes 2008, section 256L.15, subdivision 2, is amended to read:
115.11 		Subd. 2.Sliding fee scale; monthly gross individual or family income. (a) The 
115.12 	commissioner shall establish a sliding fee scale to determine the percentage of monthly 
115.13 	gross individual or family income that households at different income levels must pay to 
115.14 	obtain coverage through the MinnesotaCare program. The sliding fee scale must be based 
115.15 	on the enrollee's monthly gross individual or family income. The sliding fee scale must 
115.16 	contain separate tables based on enrollment of one, two, or three or more persons. Until 
115.17 	June 30, 2009, the sliding fee scale begins with a premium of 1.5 percent of monthly gross 
115.18 	individual or family income for individuals or families with incomes below the limits for 
115.19 	the medical assistance program for families and children in effect on January 1, 1999, and 
115.20 	proceeds through the following evenly spaced steps: 1.8, 2.3, 3.1, 3.8, 4.8, 5.9, 7.4, and 
115.21 	8.8 percent. These percentages are matched to evenly spaced income steps ranging from 
115.22 	the medical assistance income limit for families and children in effect on January 1, 1999, 
115.23 	to 275 percent of the federal poverty guidelines for the applicable family size, up to a 
115.24 	family size of five. The sliding fee scale for a family of five must be used for families of 
115.25 	more than five. The sliding fee scale and percentages are not subject to the provisions of 
115.26 	chapter 14. If a family or individual reports increased income after enrollment, premiums 
115.27 	shall be adjusted at the time the change in income is reported.
115.28 	(b) Children in families whose gross income is above 275 percent of the federal 
115.29 	poverty guidelines shall pay the maximum premium. The maximum premium is defined 
115.30 	as a base charge for one, two, or three or more enrollees so that if all MinnesotaCare 
115.31 	cases paid the maximum premium, the total revenue would equal the total cost of 
115.32 	MinnesotaCare medical coverage and administration. In this calculation, administrative 
115.33 	costs shall be assumed to equal ten percent of the total. The costs of medical coverage 
115.34 	for pregnant women and children under age two and the enrollees in these groups shall 
115.35 	be excluded from the total. The maximum premium for two enrollees shall be twice the 
116.1 	maximum premium for one, and the maximum premium for three or more enrollees shall 
116.2 	be three times the maximum premium for one.
116.3 	(c) Beginning July 1, 2009, MinnesotaCare enrollees shall pay premiums according 
116.4 	to the premium scale specified in paragraph (d) with the exception that children in families 
116.5 	with income at or below 150 percent of the federal poverty guidelines shall pay a monthly 
116.6 	premium of $4. For purposes of paragraph (d), "minimum" means a monthly premium 
116.7 	of $4.
116.8 	(d) The following premium scale is established for individuals and families with 
116.9 	gross family incomes of 300 275 percent of the federal poverty guidelines or less:

116.10
116.11	Federal Poverty Guideline Range
	Percent of Average Gross Monthly 
Income
	
116.12	0-45%
	minimum
	
116.13
116.14	46-54%
	$4 or 1.1% of family income, whichever is 
greater
	
116.15	55-81%
	1.6%
	
116.16	82-109%
	2.2%
	
116.17	110-136%
	2.9%
	
116.18	137-164%
	3.6%
	
116.19	165-191%
	4.6%
	
116.20	192-219%
	5.6%
	
116.21	220-248%
	6.5%
	
116.22	249-274%249-275%
	7.2%
	
116.23	275-300%
	8.0%

116.24 	EFFECTIVE DATE. This section is effective January 1, 2009, or upon federal 
116.25 	approval, whichever is later. The commissioner of human services shall notify the revisor 
116.26 	of statutes when federal approval is obtained.

116.27 	Sec. 21. Laws 2005, First Special Session chapter 4, article 8, section 54, the effective 
116.28 	date, is amended to read:

116.29 	EFFECTIVE DATE. This section is effective August 1, 2007, or upon HealthMatch 
116.30 	implementation, whichever is later 2009.

116.31 	Sec. 22. Laws 2005, First Special Session chapter 4, article 8, section 61, the effective 
116.32 	date, is amended to read:

116.33 	EFFECTIVE DATE. This section is effective August 1, 2007, or upon HealthMatch 
116.34 	implementation, whichever is later 2009.

117.1 	Sec. 23. Laws 2005, First Special Session chapter 4, article 8, section 63, the effective 
117.2 	date, is amended to read:

117.3 	EFFECTIVE DATE. This section is effective August 1, 2007, or upon HealthMatch 
117.4 	implementation, whichever is later 2009.

117.5 	Sec. 24. Laws 2005, First Special Session chapter 4, article 8, section 66, the effective 
117.6 	date, is amended to read:

117.7 	EFFECTIVE DATE. Paragraph (a) is effective August 1, 2007, or upon 
117.8 	HealthMatch implementation, whichever is later 2009, and paragraph (e) is effective 
117.9 	September 1, 2006.

117.10 	Sec. 25. Laws 2005, First Special Session chapter 4, article 8, section 74, the effective 
117.11 	date, is amended to read:

117.12 	EFFECTIVE DATE. The amendment to paragraph (a) changing gross family or 
117.13 	individual income to monthly gross family or individual income is effective August 1, 
117.14 	2007, or upon implementation of HealthMatch, whichever is later 2009. The amendment 
117.15 	to paragraph (a) related to premium adjustments and changes of income and the 
117.16 	amendment to paragraph (c) are effective September 1, 2005, or upon federal approval, 
117.17 	whichever is later. Prior to the implementation of HealthMatch, The commissioner 
117.18 	shall implement this section to the fullest extent possible, including the use of manual 
117.19 	processing. Upon implementation of HealthMatch, the commissioner shall implement this 
117.20 	section in a manner consistent with the procedures and requirements of HealthMatch.

117.21 	Sec. 26.  REPEALER.
 117.22 	(a) Minnesota Statutes 2008, sections 256B.031; and 256L.01, subdivision 4, are 
117.23 	repealed.
117.24 	(b) Laws 2005, First Special Session chapter 4, article 8, sections 21; 22; 23; and 
117.25 	24, are repealed.

117.26 	EFFECTIVE DATE. This section is effective August 1, 2009.