1.1 	A bill for an act
1.2 	relating to state government; licensing; state health care programs; continuing 
1.3 	care; children and family services; health reform; Department of Health; 
1.4 	public health; assessing administrative penalties; requiring reports; making 
1.5 	supplemental and contingent appropriations and reductions for the Departments 
1.6 	of Health and Human Services and other health-related boards and councils;
1.7 	amending Minnesota Statutes 2008, sections 62D.08, by adding a subdivision; 
1.8 	62J.07, subdivision 2, by adding a subdivision; 62J.38; 62Q.19, subdivision 1; 
1.9 	62Q.76, subdivision 1; 62U.05; 119B.025, subdivision 1; 119B.09, subdivision 
1.10 	4; 119B.11, subdivision 1; 144.226, subdivision 3; 144.291, subdivision 2; 
1.11 	144.651, subdivision 2; 144.9504, by adding a subdivision; 144A.51, subdivision 
1.12 	5; 144E.37; 214.40, subdivision 7; 245C.27, subdivision 2; 245C.28, subdivision 
1.13 	3; 254B.01, subdivision 2; 254B.02, subdivisions 1, 5; 254B.03, subdivision 
1.14 	4, by adding a subdivision; 254B.05, subdivision 4; 254B.06, subdivision 2; 
1.15 	254B.09, subdivision 8; 256.01, by adding a subdivision; 256.9657, subdivision 
1.16 	3; 256B.04, subdivision 14; 256B.055, by adding a subdivision; 256B.056, 
1.17 	subdivision 4; 256B.057, subdivision 9; 256B.0625, subdivisions 8, 8a, 8b, 18a, 
1.18 	22, 31, by adding subdivisions; 256B.0631, subdivisions 1, 3; 256B.0644, as 
1.19 	amended; 256B.0754, by adding a subdivision; 256B.0915, subdivision 3b; 
1.20 	256B.19, subdivision 1c; 256B.69, subdivisions 20, as amended, 27, by adding 
1.21 	subdivisions; 256B.692, subdivision 1; 256B.75; 256B.76, subdivisions 2, 4, by 
1.22 	adding a subdivision; 256D.0515; 256J.20, subdivision 3; 256J.24, subdivision 
1.23 	10; 256J.37, subdivision 3a; 256L.02, subdivision 3; 256L.03, subdivision 
1.24 	3, by adding a subdivision; 256L.05, by adding a subdivision; 256L.07, by 
1.25 	adding a subdivision; 256L.12, subdivisions 5, 6, 9; 256L.15, subdivision 1; 
1.26 	626.556, subdivision 10i; 626.557, subdivision 9d; Minnesota Statutes 2009 
1.27 	Supplement, sections 62J.495, subdivisions 1a, 3, by adding a subdivision; 
1.28 	144.0724, subdivision 11; 157.16, subdivision 3; 245C.27, subdivision 1; 
1.29 	252.025, subdivision 7; 252.27, subdivision 2a; 256.045, subdivision 3; 256.969, 
1.30 	subdivision 3a; 256B.0625, subdivisions 9, 13e; 256B.0653, subdivision 5; 
1.31 	256B.0911, subdivision 1a; 256B.0915, subdivision 3a; 256B.69, subdivision 
1.32 	23; 256B.76, subdivision 1; 256B.766; 256D.03, subdivision 3, as amended; 
1.33 	256J.425, subdivision 3; 256L.03, subdivision 5; 256L.11, subdivision 1; 327.15, 
1.34 	subdivision 3; Laws 2005, First Special Session chapter 4, article 8, section 66, 
1.35 	as amended; Laws 2009, chapter 79, article 3, section 18; article 5, sections 17; 
1.36 	18; 22; 75, subdivision 1; 78, subdivision 5; article 13, sections 3, subdivisions 
1.37 	1, as amended, 3, as amended, 4, as amended, 8, as amended; 5, subdivision 
1.38 	8, as amended; Laws 2009, chapter 173, article 1, section 17; Laws 2010, 
1.39 	chapter 200, article 1, sections 12; 16; 21; article 2, section 2, subdivisions 1, 
2.1 	8; proposing coding for new law in Minnesota Statutes, chapters 62A; 62D; 
2.2 	62E; 62J; 62Q; 144; 245; 254B; 256; 256B; repealing Minnesota Statutes 2008, 
2.3 	sections 254B.02, subdivisions 2, 3, 4; 254B.09, subdivisions 4, 5, 7; 256D.03, 
2.4 	subdivisions 3a, 3b, 5, 6, 7, 8; Minnesota Statutes 2009 Supplement, section 
2.5 	256D.03, subdivision 3; Laws 2009, chapter 79, article 7, section 26, subdivision 
2.6 	3; Laws 2010, chapter 200, article 1, sections 12, subdivisions 1, 2, 3, 4, 5, 6, 7, 
2.7 	8, 9; 18; 19.
2.8 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

2.9 	ARTICLE 1
2.10 	DHS LICENSING

2.11 	Section 1. Minnesota Statutes 2009 Supplement, section 245C.27, subdivision 1, is 
2.12 	amended to read:
2.13 		Subdivision 1.Fair hearing when disqualification is not set aside rescinded. (a) 
2.14 	If the commissioner does not set aside rescind a disqualification of an individual under 
2.15 	section 245C.22 who is disqualified on the basis of a preponderance of evidence that the 
2.16 	individual committed an act or acts that meet the definition of any of the crimes listed in 
2.17 	section 245C.15; for a determination under section 626.556 or 626.557 of substantiated 
2.18 	maltreatment that was serious or recurring under section 245C.15; or for failure to make 
2.19 	required reports under section 626.556, subdivision 3; or 626.557, subdivision 3, pursuant 
2.20 	to section 245C.15, subdivision 4, paragraph (b), clause (1), the individual may request 
2.21 	a fair hearing under section 256.045, unless the disqualification is deemed conclusive 
2.22 	under section 245C.29.
2.23 	(b) The fair hearing is the only administrative appeal of the final agency 
2.24 	determination for purposes of appeal by the disqualified individual. The disqualified 
2.25 	individual does not have the right to challenge the accuracy and completeness of data 
2.26 	under section 13.04.
2.27 	(c) Except as provided under paragraph (e), if the individual was disqualified based 
2.28 	on a conviction of, admission to, or Alford Plea to any crimes listed in section 245C.15, 
2.29 	subdivisions 1 to 4, or for a disqualification under section 256.98, subdivision 8, the 
2.30 	reconsideration decision under section 245C.22 is the final agency determination for 
2.31 	purposes of appeal by the disqualified individual and is not subject to a hearing under 
2.32 	section 256.045. If the individual was disqualified based on a judicial determination, that 
2.33 	determination is treated the same as a conviction for purposes of appeal.
2.34 	(d) This subdivision does not apply to a public employee's appeal of a disqualification 
2.35 	under section 245C.28, subdivision 3.
2.36 	(e) Notwithstanding paragraph (c), if the commissioner does not set aside a 
2.37 	disqualification of an individual who was disqualified based on both a preponderance 
3.1 	of evidence and a conviction or admission, the individual may request a fair hearing 
3.2 	under section 256.045, unless the disqualifications are deemed conclusive under section 
3.3 	245C.29. The scope of the hearing conducted under section 256.045 with regard to the 
3.4 	disqualification based on a conviction or admission shall be limited solely to whether the 
3.5 	individual poses a risk of harm, according to section 256.045, subdivision 3b. In this case, 
3.6 	the reconsideration decision under section 245C.22 is not the final agency decision for 
3.7 	purposes of appeal by the disqualified individual.

3.8 	Sec. 2. Minnesota Statutes 2008, section 245C.27, subdivision 2, is amended to read:
3.9 		Subd. 2.Consolidated fair hearing. (a) If an individual who is disqualified on the 
3.10 	bases of serious or recurring maltreatment requests a fair hearing on the maltreatment 
3.11 	determination under section 626.556, subdivision 10i, or 626.557, subdivision 9d, and 
3.12 	requests a fair hearing under this section on the disqualification, which has not been 
3.13 	set aside rescinded, the scope of the fair hearing under section 256.045 shall include the 
3.14 	maltreatment determination and the disqualification. 
3.15 	(b) A fair hearing is the only administrative appeal of the final agency determination. 
3.16 	The disqualified individual does not have the right to challenge the accuracy and 
3.17 	completeness of data under section 13.04. 
3.18 	(c) This subdivision does not apply to a public employee's appeal of a disqualification 
3.19 	under section 245C.28, subdivision 3. 

3.20 	Sec. 3. Minnesota Statutes 2008, section 245C.28, subdivision 3, is amended to read:
3.21 		Subd. 3.Employees of public employer. (a) If the commissioner does not set 
3.22 	aside rescind the disqualification of an individual who is an employee of an employer, as 
3.23 	defined in section 179A.03, subdivision 15, the individual may request a contested case 
3.24 	hearing under chapter 14, unless the disqualification is deemed conclusive under section 
3.25 	245C.29. The request for a contested case hearing must be made in writing and must be 
3.26 	postmarked and sent within 30 calendar days after the employee receives notice that the 
3.27 	disqualification has not been set aside rescinded. If the individual was disqualified based 
3.28 	on a conviction or admission to any crimes listed in section 245C.15, the scope of the 
3.29 	contested case hearing shall be limited solely to whether the individual poses a risk of 
3.30 	harm pursuant to section 245C.22.
3.31 	(b) If the commissioner does not set aside rescind a disqualification that is based on 
3.32 	a maltreatment determination, the scope of the contested case hearing must include the 
3.33 	maltreatment determination and the disqualification. In such cases, a fair hearing must 
3.34 	not be conducted under section 256.045.
4.1 	(c) If the commissioner does not rescind a disqualification that is based on a 
4.2 	preponderance of evidence that the individual committed an act or acts that meet the 
4.3 	definition of any of the crimes listed in section 245C.15, the scope of the contested case 
4.4 	hearing must include the disqualification decision. In such cases, a fair hearing must 
4.5 	not be conducted under section 256.045.
4.6 	(c) (d) Rules adopted under this chapter may not preclude an employee in a contested 
4.7 	case hearing for a disqualification from submitting evidence concerning information 
4.8 	gathered under this chapter.
4.9 	(d) (e) When an individual has been disqualified from multiple licensed programs 
4.10 	and the disqualifications have not been set aside rescinded under section 245C.22, if at 
4.11 	least one of the disqualifications entitles the person to a contested case hearing under this 
4.12 	subdivision, the scope of the contested case hearing shall include all disqualifications from 
4.13 	licensed programs which were not set aside rescinded.
4.14 	(e) (f) In determining whether the disqualification should be set aside, the 
4.15 	administrative law judge shall consider all of the characteristics that cause the individual 
4.16 	to be disqualified in order to determine whether the individual poses a risk of harm. The 
4.17 	administrative law judge's recommendation and the commissioner's order to set aside 
4.18 	a disqualification that is the subject of the hearing constitutes a determination that the 
4.19 	individual does not pose a risk of harm and that the individual may provide direct contact 
4.20 	services in the individual program specified in the set aside.

4.21 	Sec. 4. Minnesota Statutes 2009 Supplement, section 256.045, subdivision 3, is 
4.22 	amended to read:
4.23 		Subd. 3.State agency hearings. (a) State agency hearings are available for the 
4.24 	following:
4.25 	(1) any person applying for, receiving or having received public assistance, medical 
4.26 	care, or a program of social services granted by the state agency or a county agency or 
4.27 	the federal Food Stamp Act whose application for assistance is denied, not acted upon 
4.28 	with reasonable promptness, or whose assistance is suspended, reduced, terminated, or 
4.29 	claimed to have been incorrectly paid;
4.30 	(2) any patient or relative aggrieved by an order of the commissioner under section 
4.31 	252.27;
4.32 	(3) a party aggrieved by a ruling of a prepaid health plan;
4.33 	(4) except as provided under chapter 245C, any individual or facility determined by 
4.34 	a lead agency to have maltreated a vulnerable adult under section 626.557 after they have 
4.35 	exercised their right to administrative reconsideration under section 626.557;
5.1 	(5) any person whose claim for foster care payment according to a placement of the 
5.2 	child resulting from a child protection assessment under section 626.556 is denied or not 
5.3 	acted upon with reasonable promptness, regardless of funding source;
5.4 	(6) any person to whom a right of appeal according to this section is given by other 
5.5 	provision of law;
5.6 	(7) an applicant aggrieved by an adverse decision to an application for a hardship 
5.7 	waiver under section 256B.15;
5.8 	(8) an applicant aggrieved by an adverse decision to an application or redetermination 
5.9 	for a Medicare Part D prescription drug subsidy under section 256B.04, subdivision 4a;
5.10 	(9) except as provided under chapter 245A, an individual or facility determined 
5.11 	to have maltreated a minor under section 626.556, after the individual or facility has 
5.12 	exercised the right to administrative reconsideration under section 626.556;
5.13 	(10) except as provided under chapter 245C, an individual disqualified under 
5.14 	sections 245C.14 and 245C.15, which has not been set aside rescinded under sections 
5.15 	245C.22 and 245C.23, on the basis of serious or recurring maltreatment; a preponderance 
5.16 	of the evidence that the individual has committed an act or acts that meet the definition 
5.17 	of any of the crimes listed in section 245C.15, subdivisions 1 to 4; or for failing to make 
5.18 	reports required under section 626.556, subdivision 3, or 626.557, subdivision 3. Hearings 
5.19 	regarding a maltreatment determination under clause (4) or (9) and a disqualification under 
5.20 	this clause in which the basis for a disqualification is serious or recurring maltreatment, 
5.21 	which has not been set aside rescinded under sections 245C.22 and 245C.23, shall be 
5.22 	consolidated into a single fair hearing. In such cases, the scope of review by the human 
5.23 	services referee shall include both the maltreatment determination and the disqualification. 
5.24 	The failure to exercise the right to an administrative reconsideration shall not be a bar to a 
5.25 	hearing under this section if federal law provides an individual the right to a hearing to 
5.26 	dispute a finding of maltreatment. Individuals and organizations specified in this section 
5.27 	may contest the specified action, decision, or final disposition before the state agency by 
5.28 	submitting a written request for a hearing to the state agency within 30 days after receiving 
5.29 	written notice of the action, decision, or final disposition, or within 90 days of such written 
5.30 	notice if the applicant, recipient, patient, or relative shows good cause why the request 
5.31 	was not submitted within the 30-day time limit; or
5.32 	(11) any person with an outstanding debt resulting from receipt of public assistance, 
5.33 	medical care, or the federal Food Stamp Act who is contesting a setoff claim by the 
5.34 	Department of Human Services or a county agency. The scope of the appeal is the validity 
5.35 	of the claimant agency's intention to request a setoff of a refund under chapter 270A 
5.36 	against the debt.
6.1 	(b) The hearing for an individual or facility under paragraph (a), clause (4), (9), or 
6.2 	(10), is the only administrative appeal to the final agency determination specifically, 
6.3 	including a challenge to the accuracy and completeness of data under section 13.04. 
6.4 	Hearings requested under paragraph (a), clause (4), apply only to incidents of maltreatment 
6.5 	that occur on or after October 1, 1995. Hearings requested by nursing assistants in nursing 
6.6 	homes alleged to have maltreated a resident prior to October 1, 1995, shall be held as a 
6.7 	contested case proceeding under the provisions of chapter 14. Hearings requested under 
6.8 	paragraph (a), clause (9), apply only to incidents of maltreatment that occur on or after 
6.9 	July 1, 1997. A hearing for an individual or facility under paragraph (a), clause (9), is 
6.10 	only available when there is no juvenile court or adult criminal action pending. If such 
6.11 	action is filed in either court while an administrative review is pending, the administrative 
6.12 	review must be suspended until the judicial actions are completed. If the juvenile court 
6.13 	action or criminal charge is dismissed or the criminal action overturned, the matter may be 
6.14 	considered in an administrative hearing.
6.15 	(c) For purposes of this section, bargaining unit grievance procedures are not an 
6.16 	administrative appeal.
6.17 	(d) The scope of hearings involving claims to foster care payments under paragraph 
6.18 	(a), clause (5), shall be limited to the issue of whether the county is legally responsible 
6.19 	for a child's placement under court order or voluntary placement agreement and, if so, 
6.20 	the correct amount of foster care payment to be made on the child's behalf and shall not 
6.21 	include review of the propriety of the county's child protection determination or child 
6.22 	placement decision.
6.23 	(e) A vendor of medical care as defined in section 256B.02, subdivision 7, or a 
6.24 	vendor under contract with a county agency to provide social services is not a party and 
6.25 	may not request a hearing under this section, except if assisting a recipient as provided in 
6.26 	subdivision 4.
6.27 	(f) An applicant or recipient is not entitled to receive social services beyond the 
6.28 	services prescribed under chapter 256M or other social services the person is eligible 
6.29 	for under state law.
6.30 	(g) The commissioner may summarily affirm the county or state agency's proposed 
6.31 	action without a hearing when the sole issue is an automatic change due to a change in 
6.32 	state or federal law.

6.33 	Sec. 5. Minnesota Statutes 2008, section 626.556, subdivision 10i, is amended to read:
6.34 		Subd. 10i.Administrative reconsideration; review panel. (a) Administrative 
6.35 	reconsideration is not applicable in family assessments since no determination concerning 
7.1 	maltreatment is made. For investigations, except as provided under paragraph (e), an 
7.2 	individual or facility that the commissioner of human services, a local social service 
7.3 	agency, or the commissioner of education determines has maltreated a child, an interested 
7.4 	person acting on behalf of the child, regardless of the determination, who contests 
7.5 	the investigating agency's final determination regarding maltreatment, may request the 
7.6 	investigating agency to reconsider its final determination regarding maltreatment. The 
7.7 	request for reconsideration must be submitted in writing to the investigating agency within 
7.8 	15 calendar days after receipt of notice of the final determination regarding maltreatment 
7.9 	or, if the request is made by an interested person who is not entitled to notice, within 
7.10 	15 days after receipt of the notice by the parent or guardian of the child. If mailed, the 
7.11 	request for reconsideration must be postmarked and sent to the investigating agency 
7.12 	within 15 calendar days of the individual's or facility's receipt of the final determination. If 
7.13 	the request for reconsideration is made by personal service, it must be received by the 
7.14 	investigating agency within 15 calendar days after the individual's or facility's receipt of the 
7.15 	final determination. Effective January 1, 2002, an individual who was determined to have 
7.16 	maltreated a child under this section and who was disqualified on the basis of serious or 
7.17 	recurring maltreatment under sections 245C.14 and 245C.15, may request reconsideration 
7.18 	of the maltreatment determination and the disqualification. The request for reconsideration 
7.19 	of the maltreatment determination and the disqualification must be submitted within 30 
7.20 	calendar days of the individual's receipt of the notice of disqualification under sections 
7.21 	245C.16 and 245C.17. If mailed, the request for reconsideration of the maltreatment 
7.22 	determination and the disqualification must be postmarked and sent to the investigating 
7.23 	agency within 30 calendar days of the individual's receipt of the maltreatment 
7.24 	determination and notice of disqualification. If the request for reconsideration is made by 
7.25 	personal service, it must be received by the investigating agency within 30 calendar days 
7.26 	after the individual's receipt of the notice of disqualification.
7.27 	(b) Except as provided under paragraphs (e) and (f), if the investigating agency 
7.28 	denies the request or fails to act upon the request within 15 working days after receiving 
7.29 	the request for reconsideration, the person or facility entitled to a fair hearing under section 
7.30 	256.045 may submit to the commissioner of human services or the commissioner of 
7.31 	education a written request for a hearing under that section. Section 256.045 also governs 
7.32 	hearings requested to contest a final determination of the commissioner of education. For 
7.33 	reports involving maltreatment of a child in a facility, an interested person acting on behalf 
7.34 	of the child may request a review by the Child Maltreatment Review Panel under section 
7.35 	256.022 if the investigating agency denies the request or fails to act upon the request or 
7.36 	if the interested person contests a reconsidered determination. The investigating agency 
8.1 	shall notify persons who request reconsideration of their rights under this paragraph. 
8.2 	The request must be submitted in writing to the review panel and a copy sent to the 
8.3 	investigating agency within 30 calendar days of receipt of notice of a denial of a request 
8.4 	for reconsideration or of a reconsidered determination. The request must specifically 
8.5 	identify the aspects of the agency determination with which the person is dissatisfied.
8.6 	(c) If, as a result of a reconsideration or review, the investigating agency changes 
8.7 	the final determination of maltreatment, that agency shall notify the parties specified in 
8.8 	subdivisions 10b, 10d, and 10f.
8.9 	(d) Except as provided under paragraph (f), if an individual or facility contests the 
8.10 	investigating agency's final determination regarding maltreatment by requesting a fair 
8.11 	hearing under section 256.045, the commissioner of human services shall assure that the 
8.12 	hearing is conducted and a decision is reached within 90 days of receipt of the request for 
8.13 	a hearing. The time for action on the decision may be extended for as many days as the 
8.14 	hearing is postponed or the record is held open for the benefit of either party.
8.15 	(e) Effective January 1, 2002, If an individual was disqualified under sections 
8.16 	245C.14 and 245C.15, on the basis of a determination of maltreatment, which was 
8.17 	serious or recurring, and the individual has requested reconsideration of the maltreatment 
8.18 	determination under paragraph (a) and requested reconsideration of the disqualification 
8.19 	under sections 245C.21 to 245C.27, reconsideration of the maltreatment determination and 
8.20 	reconsideration of the disqualification shall be consolidated into a single reconsideration. 
8.21 	If reconsideration of the maltreatment determination is denied or the disqualification is not 
8.22 	set aside rescinded under sections 245C.21 to 245C.27, the individual may request a fair 
8.23 	hearing under section 256.045. If an individual requests a fair hearing on the maltreatment 
8.24 	determination and the disqualification, the scope of the fair hearing shall include both the 
8.25 	maltreatment determination and the disqualification.
8.26 	(f) Effective January 1, 2002, If a maltreatment determination or a disqualification 
8.27 	based on serious or recurring maltreatment is the basis for a denial of a license under 
8.28 	section 245A.05 or a licensing sanction under section 245A.07, the license holder has the 
8.29 	right to a contested case hearing under chapter 14 and Minnesota Rules, parts 1400.8505 
8.30 	to 1400.8612. As provided for under section 245A.08, subdivision 2a, the scope of the 
8.31 	contested case hearing shall include the maltreatment determination, disqualification, 
8.32 	and licensing sanction or denial of a license. In such cases, a fair hearing regarding 
8.33 	the maltreatment determination and disqualification shall not be conducted under 
8.34 	section 256.045. Except for family child care and child foster care, reconsideration of a 
8.35 	maltreatment determination as provided under this subdivision, and reconsideration of a 
8.36 	disqualification as provided under section 245C.22, shall also not be conducted when:
9.1 	(1) a denial of a license under section 245A.05 or a licensing sanction under section 
9.2 	245A.07, is based on a determination that the license holder is responsible for maltreatment 
9.3 	or the disqualification of a license holder based on serious or recurring maltreatment;
9.4 	(2) the denial of a license or licensing sanction is issued at the same time as the 
9.5 	maltreatment determination or disqualification; and
9.6 	(3) the license holder appeals the maltreatment determination or disqualification, and 
9.7 	denial of a license or licensing sanction. 
9.8 	Notwithstanding clauses (1) to (3), if the license holder appeals the maltreatment 
9.9 	determination or disqualification, but does not appeal the denial of a license or a licensing 
9.10 	sanction, reconsideration of the maltreatment determination shall be conducted under 
9.11 	sections 626.556, subdivision 10i, and 626.557, subdivision 9d, and reconsideration of the 
9.12 	disqualification shall be conducted under section 245C.22. In such cases, a fair hearing 
9.13 	shall also be conducted as provided under sections 245C.27, 626.556, subdivision 10i, and 
9.14 	626.557, subdivision 9d.
9.15 	If the disqualified subject is an individual other than the license holder and upon 
9.16 	whom a background study must be conducted under chapter 245C, the hearings of all 
9.17 	parties may be consolidated into a single contested case hearing upon consent of all parties 
9.18 	and the administrative law judge.
9.19 	(g) For purposes of this subdivision, "interested person acting on behalf of the 
9.20 	child" means a parent or legal guardian; stepparent; grandparent; guardian ad litem; adult 
9.21 	stepbrother, stepsister, or sibling; or adult aunt or uncle; unless the person has been 
9.22 	determined to be the perpetrator of the maltreatment.

9.23 	Sec. 6. Minnesota Statutes 2008, section 626.557, subdivision 9d, is amended to read:
9.24 		Subd. 9d.Administrative reconsideration; review panel. (a) Except as provided 
9.25 	under paragraph (e), any individual or facility which a lead agency determines has 
9.26 	maltreated a vulnerable adult, or the vulnerable adult or an interested person acting on 
9.27 	behalf of the vulnerable adult, regardless of the lead agency's determination, who contests 
9.28 	the lead agency's final disposition of an allegation of maltreatment, may request the 
9.29 	lead agency to reconsider its final disposition. The request for reconsideration must be 
9.30 	submitted in writing to the lead agency within 15 calendar days after receipt of notice of 
9.31 	final disposition or, if the request is made by an interested person who is not entitled to 
9.32 	notice, within 15 days after receipt of the notice by the vulnerable adult or the vulnerable 
9.33 	adult's legal guardian. If mailed, the request for reconsideration must be postmarked and 
9.34 	sent to the lead agency within 15 calendar days of the individual's or facility's receipt of 
9.35 	the final disposition. If the request for reconsideration is made by personal service, it must 
10.1 	be received by the lead agency within 15 calendar days of the individual's or facility's 
10.2 	receipt of the final disposition. An individual who was determined to have maltreated a 
10.3 	vulnerable adult under this section and who was disqualified on the basis of serious or 
10.4 	recurring maltreatment under sections 245C.14 and 245C.15, may request reconsideration 
10.5 	of the maltreatment determination and the disqualification. The request for reconsideration 
10.6 	of the maltreatment determination and the disqualification must be submitted in writing 
10.7 	within 30 calendar days of the individual's receipt of the notice of disqualification 
10.8 	under sections 245C.16 and 245C.17. If mailed, the request for reconsideration of 
10.9 	the maltreatment determination and the disqualification must be postmarked and sent 
10.10 	to the lead agency within 30 calendar days of the individual's receipt of the notice of 
10.11 	disqualification. If the request for reconsideration is made by personal service, it must be 
10.12 	received by the lead agency within 30 calendar days after the individual's receipt of the 
10.13 	notice of disqualification.
10.14 	(b) Except as provided under paragraphs (e) and (f), if the lead agency denies the 
10.15 	request or fails to act upon the request within 15 working days after receiving the request 
10.16 	for reconsideration, the person or facility entitled to a fair hearing under section 256.045, 
10.17 	may submit to the commissioner of human services a written request for a hearing 
10.18 	under that statute. The vulnerable adult, or an interested person acting on behalf of the 
10.19 	vulnerable adult, may request a review by the Vulnerable Adult Maltreatment Review 
10.20 	Panel under section 256.021 if the lead agency denies the request or fails to act upon the 
10.21 	request, or if the vulnerable adult or interested person contests a reconsidered disposition. 
10.22 	The lead agency shall notify persons who request reconsideration of their rights under this 
10.23 	paragraph. The request must be submitted in writing to the review panel and a copy sent 
10.24 	to the lead agency within 30 calendar days of receipt of notice of a denial of a request for 
10.25 	reconsideration or of a reconsidered disposition. The request must specifically identify the 
10.26 	aspects of the agency determination with which the person is dissatisfied.
10.27 	(c) If, as a result of a reconsideration or review, the lead agency changes the final 
10.28 	disposition, it shall notify the parties specified in subdivision 9c, paragraph (d).
10.29 	(d) For purposes of this subdivision, "interested person acting on behalf of the 
10.30 	vulnerable adult" means a person designated in writing by the vulnerable adult to act 
10.31 	on behalf of the vulnerable adult, or a legal guardian or conservator or other legal 
10.32 	representative, a proxy or health care agent appointed under chapter 145B or 145C, 
10.33 	or an individual who is related to the vulnerable adult, as defined in section 245A.02, 
10.34 	subdivision 13.
10.35 	(e) If an individual was disqualified under sections 245C.14 and 245C.15, on 
10.36 	the basis of a determination of maltreatment, which was serious or recurring, and 
11.1 	the individual has requested reconsideration of the maltreatment determination under 
11.2 	paragraph (a) and reconsideration of the disqualification under sections 245C.21 to 
11.3 	245C.27, reconsideration of the maltreatment determination and requested reconsideration 
11.4 	of the disqualification shall be consolidated into a single reconsideration. If reconsideration 
11.5 	of the maltreatment determination is denied or if the disqualification is not set aside
11.6 	rescinded under sections 245C.21 to 245C.27, the individual may request a fair hearing 
11.7 	under section 256.045. If an individual requests a fair hearing on the maltreatment 
11.8 	determination and the disqualification, the scope of the fair hearing shall include both the 
11.9 	maltreatment determination and the disqualification.
11.10 	(f) If a maltreatment determination or a disqualification based on serious or recurring 
11.11 	maltreatment is the basis for a denial of a license under section 245A.05 or a licensing 
11.12 	sanction under section 245A.07, the license holder has the right to a contested case hearing 
11.13 	under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. As provided 
11.14 	for under section 245A.08, the scope of the contested case hearing must include the 
11.15 	maltreatment determination, disqualification, and licensing sanction or denial of a license. 
11.16 	In such cases, a fair hearing must not be conducted under section 256.045. Except for 
11.17 	family child care and child foster care, reconsideration of a maltreatment determination 
11.18 	under this subdivision, and reconsideration of a disqualification under section 245C.22, 
11.19 	must not be conducted when:
11.20 	(1) a denial of a license under section 245A.05, or a licensing sanction under section 
11.21 	245A.07, is based on a determination that the license holder is responsible for maltreatment 
11.22 	or the disqualification of a license holder based on serious or recurring maltreatment;
11.23 	(2) the denial of a license or licensing sanction is issued at the same time as the 
11.24 	maltreatment determination or disqualification; and
11.25 	(3) the license holder appeals the maltreatment determination or disqualification, and 
11.26 	denial of a license or licensing sanction.
11.27 	Notwithstanding clauses (1) to (3), if the license holder appeals the maltreatment 
11.28 	determination or disqualification, but does not appeal the denial of a license or a licensing 
11.29 	sanction, reconsideration of the maltreatment determination shall be conducted under 
11.30 	sections 626.556, subdivision 10i, and 626.557, subdivision 9d, and reconsideration of the 
11.31 	disqualification shall be conducted under section 245C.22. In such cases, a fair hearing 
11.32 	shall also be conducted as provided under sections 245C.27, 626.556, subdivision 10i, and 
11.33 	626.557, subdivision 9d.
11.34 	If the disqualified subject is an individual other than the license holder and upon 
11.35 	whom a background study must be conducted under chapter 245C, the hearings of all 
12.1 	parties may be consolidated into a single contested case hearing upon consent of all parties 
12.2 	and the administrative law judge.
12.3 	(g) Until August 1, 2002, an individual or facility that was determined by the 
12.4 	commissioner of human services or the commissioner of health to be responsible for 
12.5 	neglect under section 626.5572, subdivision 17, after October 1, 1995, and before August 
12.6 	1, 2001, that believes that the finding of neglect does not meet an amended definition of 
12.7 	neglect may request a reconsideration of the determination of neglect. The commissioner 
12.8 	of human services or the commissioner of health shall mail a notice to the last known 
12.9 	address of individuals who are eligible to seek this reconsideration. The request for 
12.10 	reconsideration must state how the established findings no longer meet the elements of 
12.11 	the definition of neglect. The commissioner shall review the request for reconsideration 
12.12 	and make a determination within 15 calendar days. The commissioner's decision on this 
12.13 	reconsideration is the final agency action.
12.14 	(1) For purposes of compliance with the data destruction schedule under subdivision 
12.15 	12b, paragraph (d), when a finding of substantiated maltreatment has been changed as 
12.16 	a result of a reconsideration under this paragraph, the date of the original finding of a 
12.17 	substantiated maltreatment must be used to calculate the destruction date.
12.18 	(2) For purposes of any background studies under chapter 245C, when a 
12.19 	determination of substantiated maltreatment has been changed as a result of a 
12.20 	reconsideration under this paragraph, any prior disqualification of the individual under 
12.21 	chapter 245C that was based on this determination of maltreatment shall be rescinded, 
12.22 	and for future background studies under chapter 245C the commissioner must not use the 
12.23 	previous determination of substantiated maltreatment as a basis for disqualification or as a 
12.24 	basis for referring the individual's maltreatment history to a health-related licensing board 
12.25 	under section 245C.31.

12.26 	ARTICLE 2
12.27 	HEALTH CARE

12.28 	Section 1. Minnesota Statutes 2008, section 144.291, subdivision 2, is amended to read:
12.29 		Subd. 2.Definitions. For the purposes of sections 144.291 to 144.298, the following 
12.30 	terms have the meanings given.
12.31 	(a) "Group purchaser" has the meaning given in section 62J.03, subdivision 6.
12.32 	(b) "Health information exchange" means a legal arrangement between health care 
12.33 	providers and group purchasers to enable and oversee the business and legal issues 
12.34 	involved in the electronic exchange of health records between the entities for the delivery 
12.35 	of patient care.
13.1 	(c) "Health record" means any information, whether oral or recorded in any form or 
13.2 	medium, that relates to the past, present, or future physical or mental health or condition of 
13.3 	a patient; the provision of health care to a patient; or the past, present, or future payment 
13.4 	for the provision of health care to a patient.
13.5 	(d) "Identifying information" means the patient's name, address, date of birth, 
13.6 	gender, parent's or guardian's name regardless of the age of the patient, and other 
13.7 	nonclinical data which can be used to uniquely identify a patient.
13.8 	(e) "Individually identifiable form" means a form in which the patient is or can be 
13.9 	identified as the subject of the health records.
13.10 	(f) "Medical emergency" means medically necessary care which is immediately 
13.11 	needed to preserve life, prevent serious impairment to bodily functions, organs, or parts, 
13.12 	or prevent placing the physical or mental health of the patient in serious jeopardy.
13.13 	(g) "Patient" means a natural person who has received health care services from a 
13.14 	provider for treatment or examination of a medical, psychiatric, or mental condition, the 
13.15 	surviving spouse and parents of a deceased patient, or a person the patient appoints in 
13.16 	writing as a representative, including a health care agent acting according to chapter 145C, 
13.17 	unless the authority of the agent has been limited by the principal in the principal's health 
13.18 	care directive. Except for minors who have received health care services under sections 
13.19 	144.341 to 144.347, in the case of a minor, patient includes a parent or guardian, or a 
13.20 	person acting as a parent or guardian in the absence of a parent or guardian.
13.21 	(h) "Provider" means: 
13.22 	(1) any person who furnishes health care services and is regulated to furnish the 
13.23 	services under chapter 147, 147A, 147B, 147C, 147D, 148, 148B, 148C, 148D, 150A, 
13.24 	151, 153, or 153A; 
13.25 	(2) a home care provider licensed under section 144A.46; 
13.26 	(3) a health care facility licensed under this chapter or chapter 144A; 
13.27 	(4) a physician assistant registered under chapter 147A; and 
13.28 	(5) an unlicensed mental health practitioner regulated under sections 148B.60 to 
13.29 	148B.71.
13.30 	(i) "Record locator service" means an electronic index of patient identifying 
13.31 	information that directs providers in a health information exchange to the location of 
13.32 	patient health records held by providers and group purchasers.
13.33 	(j) "Related health care entity" means an affiliate, as defined in section 144.6521, 
13.34 	subdivision 3, paragraph (b), of the provider releasing the health records, including, but 
13.35 	not limited to, affiliates of providers participating in a coordinated care delivery system 
13.36 	established under section 256D.031, subdivision 6.

14.1 	Sec. 2. Minnesota Statutes 2008, section 256.01, is amended by adding a subdivision 
14.2 	to read:
14.3 		Subd. 30.Review and evaluation of studies. The commissioner shall review 
14.4 	all published studies, reports, and program evaluations completed by the Department 
14.5 	of Human Services, and those requested by the legislature but not completed, for state 
14.6 	fiscal years 2000 through 2010. For each item, the commissioner shall report the 
14.7 	legislature's original appropriation for that work, if any, and the actual reported cost of the 
14.8 	completed work by the Department of Human Services. The commissioner shall make 
14.9 	recommendations to the legislature about which studies, reports, and program evaluations 
14.10 	required by law are duplicative, unnecessary, or obsolete. The commissioner shall repeat 
14.11 	this review every five fiscal years.

14.12 	Sec. 3. Minnesota Statutes 2008, section 256.9657, subdivision 3, is amended to read:
14.13 		Subd. 3.Surcharge on HMOs and community integrated service networks. (a) 
14.14 	Effective October 1, 1992, each health maintenance organization with a certificate of 
14.15 	authority issued by the commissioner of health under chapter 62D and each community 
14.16 	integrated service network licensed by the commissioner under chapter 62N shall pay to 
14.17 	the commissioner of human services a surcharge equal to six-tenths of one percent of the 
14.18 	total premium revenues of the health maintenance organization or community integrated 
14.19 	service network as reported to the commissioner of health according to the schedule in 
14.20 	subdivision 4.
14.21 	(b) Effective June 1, 2010: (1) the surcharge under paragraph (a) is increased to 2.5 
14.22 	percent; and (2) each county-based purchasing plan authorized under section 256B.692 
14.23 	shall pay to the commissioner a surcharge equal to 2.5 percent of the total premium 
14.24 	revenues of the plan, as reported to the commissioner of health, according to the payment 
14.25 	schedule in subdivision 4.
14.26 	(c) For purposes of this subdivision, total premium revenue means:
14.27 	(1) premium revenue recognized on a prepaid basis from individuals and groups 
14.28 	for provision of a specified range of health services over a defined period of time which 
14.29 	is normally one month, excluding premiums paid to a health maintenance organization 
14.30 	or community integrated service network from the Federal Employees Health Benefit 
14.31 	Program;
14.32 	(2) premiums from Medicare wrap-around subscribers for health benefits which 
14.33 	supplement Medicare coverage;
14.34 	(3) Medicare revenue, as a result of an arrangement between a health maintenance 
14.35 	organization or a community integrated service network and the Centers for Medicare 
15.1 	and Medicaid Services of the federal Department of Health and Human Services, for 
15.2 	services to a Medicare beneficiary, excluding Medicare revenue that states are prohibited 
15.3 	from taxing under sections 1854, 1860D-12, and 1876 of title XVIII of the federal Social 
15.4 	Security Act, codified as United States Code, title 42, sections 1395mm, 1395w-112, and 
15.5 	1395w-24, respectively, as they may be amended from time to time; and
15.6 	(4) medical assistance revenue, as a result of an arrangement between a health 
15.7 	maintenance organization or community integrated service network and a Medicaid state 
15.8 	agency, for services to a medical assistance beneficiary.
15.9 	If advance payments are made under clause (1) or (2) to the health maintenance 
15.10 	organization or community integrated service network for more than one reporting period, 
15.11 	the portion of the payment that has not yet been earned must be treated as a liability.
15.12 	(c) (d) When a health maintenance organization or community integrated service 
15.13 	network merges or consolidates with or is acquired by another health maintenance 
15.14 	organization or community integrated service network, the surviving corporation or the 
15.15 	new corporation shall be responsible for the annual surcharge originally imposed on 
15.16 	each of the entities or corporations subject to the merger, consolidation, or acquisition, 
15.17 	regardless of whether one of the entities or corporations does not retain a certificate of 
15.18 	authority under chapter 62D or a license under chapter 62N.
15.19 	(d) (e) Effective July 1 of each year, the surviving corporation's or the new 
15.20 	corporation's surcharge shall be based on the revenues earned in the second previous 
15.21 	calendar year by all of the entities or corporations subject to the merger, consolidation, 
15.22 	or acquisition regardless of whether one of the entities or corporations does not retain a 
15.23 	certificate of authority under chapter 62D or a license under chapter 62N until the total 
15.24 	premium revenues of the surviving corporation include the total premium revenues of all 
15.25 	the merged entities as reported to the commissioner of health.
15.26 	(e) (f) When a health maintenance organization or community integrated service 
15.27 	network, which is subject to liability for the surcharge under this chapter, transfers, 
15.28 	assigns, sells, leases, or disposes of all or substantially all of its property or assets, liability 
15.29 	for the surcharge imposed by this chapter is imposed on the transferee, assignee, or buyer 
15.30 	of the health maintenance organization or community integrated service network.
15.31 	(f) (g) In the event a health maintenance organization or community integrated 
15.32 	service network converts its licensure to a different type of entity subject to liability 
15.33 	for the surcharge under this chapter, but survives in the same or substantially similar 
15.34 	form, the surviving entity remains liable for the surcharge regardless of whether one of 
15.35 	the entities or corporations does not retain a certificate of authority under chapter 62D 
15.36 	or a license under chapter 62N.
16.1 	(g) (h) The surcharge assessed to a health maintenance organization or community 
16.2 	integrated service network ends when the entity ceases providing services for premiums 
16.3 	and the cessation is not connected with a merger, consolidation, acquisition, or conversion.

16.4 	EFFECTIVE DATE. This section is effective June 1, 2010.

16.5 	Sec. 4. Minnesota Statutes 2009 Supplement, section 256.969, subdivision 3a, is 
16.6 	amended to read:
16.7 		Subd. 3a.Payments. (a) Acute care hospital billings under the medical 
16.8 	assistance program must not be submitted until the recipient is discharged. However, 
16.9 	the commissioner shall establish monthly interim payments for inpatient hospitals that 
16.10 	have individual patient lengths of stay over 30 days regardless of diagnostic category. 
16.11 	Except as provided in section 256.9693, medical assistance reimbursement for treatment 
16.12 	of mental illness shall be reimbursed based on diagnostic classifications. Individual 
16.13 	hospital payments established under this section and sections 256.9685, 256.9686, and 
16.14 	256.9695, in addition to third party and recipient liability, for discharges occurring during 
16.15 	the rate year shall not exceed, in aggregate, the charges for the medical assistance covered 
16.16 	inpatient services paid for the same period of time to the hospital. This payment limitation 
16.17 	shall be calculated separately for medical assistance and general assistance medical 
16.18 	care services. The limitation on general assistance medical care shall be effective for 
16.19 	admissions occurring on or after July 1, 1991. Services that have rates established under 
16.20 	subdivision 11 or 12, must be limited separately from other services. After consulting with 
16.21 	the affected hospitals, the commissioner may consider related hospitals one entity and 
16.22 	may merge the payment rates while maintaining separate provider numbers. The operating 
16.23 	and property base rates per admission or per day shall be derived from the best Medicare 
16.24 	and claims data available when rates are established. The commissioner shall determine 
16.25 	the best Medicare and claims data, taking into consideration variables of recency of the 
16.26 	data, audit disposition, settlement status, and the ability to set rates in a timely manner. 
16.27 	The commissioner shall notify hospitals of payment rates by December 1 of the year 
16.28 	preceding the rate year. The rate setting data must reflect the admissions data used to 
16.29 	establish relative values. Base year changes from 1981 to the base year established for the 
16.30 	rate year beginning January 1, 1991, and for subsequent rate years, shall not be limited 
16.31 	to the limits ending June 30, 1987, on the maximum rate of increase under subdivision 
16.32 	1. The commissioner may adjust base year cost, relative value, and case mix index data 
16.33 	to exclude the costs of services that have been discontinued by the October 1 of the year 
16.34 	preceding the rate year or that are paid separately from inpatient services. Inpatient stays 
16.35 	that encompass portions of two or more rate years shall have payments established based 
17.1 	on payment rates in effect at the time of admission unless the date of admission preceded 
17.2 	the rate year in effect by six months or more. In this case, operating payment rates for 
17.3 	services rendered during the rate year in effect and established based on the date of 
17.4 	admission shall be adjusted to the rate year in effect by the hospital cost index.
17.5 	(b) For fee-for-service admissions occurring on or after July 1, 2002, the total 
17.6 	payment, before third-party liability and spenddown, made to hospitals for inpatient 
17.7 	services is reduced by .5 percent from the current statutory rates.
17.8 	(c) In addition to the reduction in paragraph (b), the total payment for fee-for-service 
17.9 	admissions occurring on or after July 1, 2003, made to hospitals for inpatient services 
17.10 	before third-party liability and spenddown, is reduced five percent from the current 
17.11 	statutory rates. Mental health services within diagnosis related groups 424 to 432, and 
17.12 	facilities defined under subdivision 16 are excluded from this paragraph.
17.13 	(d) In addition to the reduction in paragraphs (b) and (c), the total payment for 
17.14 	fee-for-service admissions occurring on or after August 1, 2005, made to hospitals for 
17.15 	inpatient services before third-party liability and spenddown, is reduced 6.0 percent 
17.16 	from the current statutory rates. Mental health services within diagnosis related groups 
17.17 	424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph. 
17.18 	Notwithstanding section 256.9686, subdivision 7, for purposes of this paragraph, medical 
17.19 	assistance does not include general assistance medical care. Payments made to managed 
17.20 	care plans shall be reduced for services provided on or after January 1, 2006, to reflect 
17.21 	this reduction.
17.22 	(e) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for 
17.23 	fee-for-service admissions occurring on or after July 1, 2008, through June 30, 2009, made 
17.24 	to hospitals for inpatient services before third-party liability and spenddown, is reduced 
17.25 	3.46 percent from the current statutory rates. Mental health services with diagnosis related 
17.26 	groups 424 to 432 and facilities defined under subdivision 16 are excluded from this 
17.27 	paragraph. Payments made to managed care plans shall be reduced for services provided 
17.28 	on or after January 1, 2009, through June 30, 2009, to reflect this reduction.
17.29 	(f) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for 
17.30 	fee-for-service admissions occurring on or after July 1, 2009, through June 30, 2010, made 
17.31 	to hospitals for inpatient services before third-party liability and spenddown, is reduced 
17.32 	1.9 percent from the current statutory rates. Mental health services with diagnosis related 
17.33 	groups 424 to 432 and facilities defined under subdivision 16 are excluded from this 
17.34 	paragraph. Payments made to managed care plans shall be reduced for services provided 
17.35 	on or after July 1, 2009, through June 30, 2010, to reflect this reduction.
18.1 	(g) In addition to the reductions in paragraphs (b), (c), and (d), the total payment 
18.2 	for fee-for-service admissions occurring on or after July 1, 2010, made to hospitals for 
18.3 	inpatient services before third-party liability and spenddown, is reduced 1.79 percent 
18.4 	from the current statutory rates. Mental health services with diagnosis related groups 
18.5 	424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph. 
18.6 	Payments made to managed care plans shall be reduced for services provided on or after 
18.7 	July 1, 2010, to reflect this reduction.
18.8 	(h) In addition to the reductions in paragraphs (b), (c), (d), (f), and (g), the total 
18.9 	payment for fee-for-service admissions occurring on or after July 1, 2009, made to 
18.10 	hospitals for inpatient services before third-party liability and spenddown, is reduced 
18.11 	one percent from the current statutory rates. Facilities defined under subdivision 16 are 
18.12 	excluded from this paragraph. Payments made to managed care plans shall be reduced for 
18.13 	services provided on or after October 1, 2009, to reflect this reduction.
18.14 	(i) In addition to the reductions in paragraphs (b), (c), (d), (g), and (h), the total 
18.15 	payment for fee-for-service admissions occurring on or after July 1, 2011, made to 
18.16 	hospitals for inpatient services before third-party liability and spenddown, is reduced 
18.17 	7.5 percent from the current statutory rates. Facilities defined under subdivision 16 are 
18.18 	excluded from this paragraph. Payments made to managed care plans shall be reduced 
18.19 	for services provided on or after January 1, 2012, to reflect this reduction. Hospitals that, 
18.20 	prior to December 31, 2007, received payment to support the training of residents from an 
18.21 	approved graduate medical residency training program pursuant to United States Code, 
18.22 	title 42, section 256e, are not subject to the provisions of this paragraph.

18.23 	Sec. 5. Minnesota Statutes 2008, section 256B.04, subdivision 14, is amended to read:
18.24 		Subd. 14.Competitive bidding. (a) When determined to be effective, economical, 
18.25 	and feasible, the commissioner may utilize volume purchase through competitive bidding 
18.26 	and negotiation under the provisions of chapter 16C, to provide items under the medical 
18.27 	assistance program including but not limited to the following:
18.28 	(1) eyeglasses;
18.29 	(2) oxygen. The commissioner shall provide for oxygen needed in an emergency 
18.30 	situation on a short-term basis, until the vendor can obtain the necessary supply from 
18.31 	the contract dealer;
18.32 	(3) hearing aids and supplies; and
18.33 	(4) durable medical equipment, including but not limited to:
18.34 	(i) hospital beds;
18.35 	(ii) commodes;
19.1 	(iii) glide-about chairs;
19.2 	(iv) patient lift apparatus;
19.3 	(v) wheelchairs and accessories;
19.4 	(vi) oxygen administration equipment;
19.5 	(vii) respiratory therapy equipment;
19.6 	(viii) electronic diagnostic, therapeutic and life-support systems;
19.7 	(5) nonemergency medical transportation level of need determinations, disbursement 
19.8 	of public transportation passes and tokens, and volunteer and recipient mileage and 
19.9 	parking reimbursements; and
19.10 	(6) drugs; and
19.11 	(7) medical supplies.
19.12 	(b) Rate changes under this chapter and chapters 256D and 256L do not affect 
19.13 	contract payments under this subdivision unless specifically identified.
19.14 	(c) The commissioner may not utilize volume purchase through competitive bidding 
19.15 	and negotiation for special transportation services under the provisions of chapter 16C.

19.16 	Sec. 6. Minnesota Statutes 2008, section 256B.055, is amended by adding a 
19.17 	subdivision to read:
19.18 		Subd. 15.Adults without children. Medical assistance may be paid for a person 
19.19 	who is over age 21 and under age 65, who is not pregnant, and who is not described in 
19.20 	subdivision 4, 7, or another subdivision of this section.

19.21 	EFFECTIVE DATE. This section is effective upon federal approval and is 
19.22 	retroactive from April 1, 2010.

19.23 	Sec. 7. Minnesota Statutes 2008, section 256B.056, subdivision 4, is amended to read:
19.24 		Subd. 4.Income. (a) To be eligible for medical assistance, a person eligible under 
19.25 	section 256B.055, subdivisions 7, 7a, and 12, may have income up to 100 percent of 
19.26 	the federal poverty guidelines. Effective January 1, 2000, and each successive January, 
19.27 	recipients of supplemental security income may have an income up to the supplemental 
19.28 	security income standard in effect on that date. 
19.29 	(b) To be eligible for medical assistance, families and children may have an income 
19.30 	up to 133-1/3 percent of the AFDC income standard in effect under the July 16, 1996, 
19.31 	AFDC state plan. Effective July 1, 2000, the base AFDC standard in effect on July 16, 
19.32 	1996, shall be increased by three percent.
19.33 	(c) Effective July 1, 2002, to be eligible for medical assistance, families and children 
19.34 	may have an income up to 100 percent of the federal poverty guidelines for the family size.
20.1 	(d) In computing income to determine eligibility of persons under paragraphs (a) 
20.2 	to (c) and (e) who are not residents of long-term care facilities, the commissioner shall 
20.3 	disregard increases in income as required by Public Law Numbers 94-566, section 503; 
20.4 	99-272; and 99-509. Veterans aid and attendance benefits and Veterans Administration 
20.5 	unusual medical expense payments are considered income to the recipient.
20.6 	(e) To be eligible for medical assistance, a person eligible under section 256B.055, 
20.7 	subdivision 15, may have income up to 75 percent of the federal poverty guidelines for 
20.8 	family size.

20.9 	EFFECTIVE DATE. This section is effective upon federal approval and is 
20.10 	retroactive from April 1, 2010.

20.11 	Sec. 8. Minnesota Statutes 2008, section 256B.0625, subdivision 8, is amended to read:
20.12 		Subd. 8.Physical therapy. Medical assistance covers physical therapy and related 
20.13 	services, including specialized maintenance therapy. Authorization by the commissioner 
20.14 	is required to provide services to a recipient beyond any of the following onetime service 
20.15 	thresholds: (1) 80 units of any approved CPT code other than modalities; (2) 20 modality 
20.16 	sessions; and (3) three evaluations or reevaluations. Services provided by a physical 
20.17 	therapy assistant shall be reimbursed at the same rate as services performed by a physical 
20.18 	therapist when the services of the physical therapy assistant are provided under the 
20.19 	direction of a physical therapist who is on the premises. Services provided by a physical 
20.20 	therapy assistant that are provided under the direction of a physical therapist who is not on 
20.21 	the premises shall be reimbursed at 65 percent of the physical therapist rate.

20.22 	Sec. 9. Minnesota Statutes 2008, section 256B.0625, subdivision 8a, is amended to 
20.23 	read:
20.24 		Subd. 8a.Occupational therapy. Medical assistance covers occupational therapy 
20.25 	and related services, including specialized maintenance therapy. Authorization by the 
20.26 	commissioner is required to provide services to a recipient beyond any of the following 
20.27 	onetime service thresholds: (1) 120 units of any combination of approved CPT codes; 
20.28 	and (2) two evaluations or reevaluations. Services provided by an occupational therapy 
20.29 	assistant shall be reimbursed at the same rate as services performed by an occupational 
20.30 	therapist when the services of the occupational therapy assistant are provided under the 
20.31 	direction of the occupational therapist who is on the premises. Services provided by an 
20.32 	occupational therapy assistant that are provided under the direction of an occupational 
20.33 	therapist who is not on the premises shall be reimbursed at 65 percent of the occupational 
20.34 	therapist rate.

21.1 	Sec. 10. Minnesota Statutes 2008, section 256B.0625, subdivision 8b, is amended to 
21.2 	read:
21.3 		Subd. 8b.Speech language pathology and audiology services. Medical assistance 
21.4 	covers speech language pathology and related services, including specialized maintenance 
21.5 	therapy. Authorization by the commissioner is required to provide services to a recipient 
21.6 	beyond any of the following onetime service thresholds: (1) 50 treatment sessions with 
21.7 	any combination of approved CPT codes; and (2) one evaluation. Medical assistance 
21.8 	covers audiology services and related services. Services provided by a person who has 
21.9 	been issued a temporary registration under section 148.5161 shall be reimbursed at the 
21.10 	same rate as services performed by a speech language pathologist or audiologist as long as 
21.11 	the requirements of section 148.5161, subdivision 3, are met. 

21.12 	Sec. 11. Minnesota Statutes 2008, section 256B.0625, is amended by adding a 
21.13 	subdivision to read:
21.14 		Subd. 8d.Chiropractic services. Payment for chiropractic services is limited to 
21.15 	one annual evaluation and 12 visits per year unless prior authorization of a greater number 
21.16 	of visits is obtained.

21.17 	Sec. 12. Minnesota Statutes 2009 Supplement, section 256B.0625, subdivision 9, 
21.18 	is amended to read:
21.19 		Subd. 9.Dental services. (a) Medical assistance covers dental services.
21.20 	(b) Medical assistance dental coverage for nonpregnant adults is limited to the 
21.21 	following services:
21.22 	(1) comprehensive exams, limited to once every five years;
21.23 	(2) periodic exams, limited to one per year;
21.24 	(3) limited exams;
21.25 	(4) bitewing x-rays, limited to one set per year;
21.26 	(5) periapical x-rays;
21.27 	(6) panoramic x-rays or full-mouth radiographs, limited to one every five years, 
21.28 	and only if provided in conjunction with a posterior extraction or scheduled outpatient 
21.29 	facility procedure, or as medically necessary for the diagnosis and follow-up of oral and 
21.30 	maxillofacial pathology and trauma. Panoramic x-rays may be taken once every two years 
21.31 	for patients who cannot cooperate for intraoral film due to a developmental disability or 
21.32 	medical condition that does not allow for intraoral film placement;
21.33 	(7) prophylaxis, limited to one per year;
21.34 	(8) application of fluoride varnish, limited to one per year;
22.1 	(9) posterior fillings, all at the amalgam rate;
22.2 	(10) anterior fillings;
22.3 	(11) endodontics, limited to root canals on the anterior and premolars only, and 
22.4 	molar root canal therapy as deemed medically necessary for patients that are at high risk 
22.5 	of osteonecrosis from molar extractions;
22.6 	(12) removable prostheses, each dental arch limited to one every six years; including:
22.7 	(i) relines of full dentures once every six years per dental arch;
22.8 	(ii) repair of acrylic bases of full dentures and acrylic partial dentures, limited to one 
22.9 	per year; and
22.10 	(iii) adding a maximum of two denture teeth and two wrought wire clasps per year to 
22.11 	partial dentures per dental arch;
22.12 	(13) oral surgery, limited to extractions, biopsies, and incision and drainage of 
22.13 	abscesses;
22.14 	(14) palliative treatment and sedative fillings for relief of pain; and
22.15 	(15) full-mouth debridement periodontal scaling and root planing, limited to one 
22.16 	every five years; and
22.17 	(16) moderate sedation, deep sedation, and general anesthesia, limited to when 
22.18 	provided by an oral maxillofacial surgeon who is board-certified, or actively participating 
22.19 	in the American Board of Oral and Maxillofacial Surgery certification process, when 
22.20 	medically necessary to allow the surgical management of acute oral and maxillofacial 
22.21 	pathology which cannot be accomplished safely with local anesthesia alone and would 
22.22 	otherwise require operating room services.
22.23 	(c) In addition to the services specified in paragraph (b), medical assistance 
22.24 	covers the following services for adults, if provided in an outpatient hospital setting or 
22.25 	freestanding ambulatory surgical center as part of outpatient dental surgery:
22.26 	(1) periodontics, limited to periodontal scaling and root planing once every two 
22.27 	years;
22.28 	(2) general anesthesia; and
22.29 	(3) full-mouth survey once every five two years.
22.30 	(d) Medical assistance covers dental services for children that are medically 
22.31 	necessary. The following guidelines apply:
22.32 	(1) posterior fillings are paid at the amalgam rate;
22.33 	(2) application of sealants once every five years per permanent molar; and
22.34 	(3) application of fluoride varnish once every six months.

23.1 	Sec. 13. Minnesota Statutes 2009 Supplement, section 256B.0625, subdivision 13e, 
23.2 	is amended to read:
23.3 		Subd. 13e.Payment rates. (a) The basis for determining the amount of payment 
23.4 	shall be the lower of the actual acquisition costs of the drugs plus a fixed dispensing fee; 
23.5 	the maximum allowable cost set by the federal government or by the commissioner plus 
23.6 	the fixed dispensing fee; or the usual and customary price charged to the public. The 
23.7 	amount of payment basis must be reduced to reflect all discount amounts applied to the 
23.8 	charge by any provider/insurer agreement or contract for submitted charges to medical 
23.9 	assistance programs. The net submitted charge may not be greater than the patient liability 
23.10 	for the service. The pharmacy dispensing fee shall be $3.65, except that the dispensing fee 
23.11 	for intravenous solutions which must be compounded by the pharmacist shall be $8 per 
23.12 	bag, $14 per bag for cancer chemotherapy products, and $30 per bag for total parenteral 
23.13 	nutritional products dispensed in one liter quantities, or $44 per bag for total parenteral 
23.14 	nutritional products dispensed in quantities greater than one liter. Actual acquisition cost 
23.15 	includes quantity and other special discounts except time and cash discounts. Effective 
23.16 	July 1, 2009 July 1, 2010, the actual acquisition cost of a drug shall be estimated by the 
23.17 	commissioner, at average wholesale price minus 15 12.5 percent or wholesale acquisition 
23.18 	cost plus 5.0 percent, whichever is lower. The actual acquisition cost of antihemophilic 
23.19 	factor drugs shall be estimated at the average wholesale price minus 30 28.12 percent or 
23.20 	wholesale acquisition cost minus 13.76 percent, whichever is lower. Average wholesale 
23.21 	price is defined as the price for a drug product listed as the average wholesale price in the 
23.22 	commissioner's primary reference source. Wholesale acquisition cost is defined as the 
23.23 	manufacturer's list price for a drug or biological to wholesalers or direct purchasers in the 
23.24 	United States, not including prompt pay or other discounts, rebates, or reductions in price, 
23.25 	for the most recent month for which information is available, as reported in wholesale price 
23.26 	guides or other publications of drug or biological pricing data. The maximum allowable 
23.27 	cost of a multisource drug may be set by the commissioner and it shall be comparable to, 
23.28 	but no higher than, the maximum amount paid by other third-party payors in this state who 
23.29 	have maximum allowable cost programs. Establishment of the amount of payment for 
23.30 	drugs shall not be subject to the requirements of the Administrative Procedure Act.
23.31 	(b) An additional dispensing fee of $.30 may be added to the dispensing fee paid 
23.32 	to pharmacists for legend drug prescriptions dispensed to residents of long-term care 
23.33 	facilities when a unit dose blister card system, approved by the department, is used. Under 
23.34 	this type of dispensing system, the pharmacist must dispense a 30-day supply of drug. 
23.35 	The National Drug Code (NDC) from the drug container used to fill the blister card must 
23.36 	be identified on the claim to the department. The unit dose blister card containing the 
24.1 	drug must meet the packaging standards set forth in Minnesota Rules, part 6800.2700, 
24.2 	that govern the return of unused drugs to the pharmacy for reuse. The pharmacy provider 
24.3 	will be required to credit the department for the actual acquisition cost of all unused 
24.4 	drugs that are eligible for reuse. Over-the-counter medications must be dispensed in the 
24.5 	manufacturer's unopened package. The commissioner may permit the drug clozapine to be 
24.6 	dispensed in a quantity that is less than a 30-day supply.
24.7 	(c) Whenever a generically equivalent product is available, payment shall be on the 
24.8 	basis of the actual acquisition cost of the generic drug, or on the maximum allowable cost 
24.9 	established by the commissioner.
24.10 	(d) The basis for determining the amount of payment for drugs administered in an 
24.11 	outpatient setting shall be the lower of the usual and customary cost submitted by the 
24.12 	provider or the amount established for Medicare by the United States Department of 
24.13 	Health and Human Services pursuant to title XVIII, section 1847a of the federal Social 
24.14 	Security Act.
24.15 	(e) The commissioner may negotiate lower reimbursement rates for specialty 
24.16 	pharmacy products than the rates specified in paragraph (a). The commissioner may 
24.17 	require individuals enrolled in the health care programs administered by the department 
24.18 	to obtain specialty pharmacy products from providers with whom the commissioner has 
24.19 	negotiated lower reimbursement rates. Specialty pharmacy products are defined as those 
24.20 	used by a small number of recipients or recipients with complex and chronic diseases 
24.21 	that require expensive and challenging drug regimens. Examples of these conditions 
24.22 	include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis 
24.23 	C, growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms 
24.24 	of cancer. Specialty pharmaceutical products include injectable and infusion therapies, 
24.25 	biotechnology drugs, high-cost therapies, and therapies that require complex care. The 
24.26 	commissioner shall consult with the formulary committee to develop a list of specialty 
24.27 	pharmacy products subject to this paragraph. In consulting with the formulary committee 
24.28 	in developing this list, the commissioner shall take into consideration the population 
24.29 	served by specialty pharmacy products, the current delivery system and standard of care in 
24.30 	the state, and access to care issues. The commissioner shall have the discretion to adjust 
24.31 	the reimbursement rate to prevent access to care issues.

24.32 	EFFECTIVE DATE. This section is effective July 1, 2010, or upon federal 
24.33 	approval, whichever is later.

24.34 	Sec. 14. Minnesota Statutes 2008, section 256B.0625, subdivision 18a, is amended to 
24.35 	read:
25.1 		Subd. 18a.Access to medical services. (a) Medical assistance reimbursement for 
25.2 	meals for persons traveling to receive medical care may not exceed $5.50 for breakfast, 
25.3 	$6.50 for lunch, or $8 for dinner.
25.4 	(b) Medical assistance reimbursement for lodging for persons traveling to receive 
25.5 	medical care may not exceed $50 per day unless prior authorized by the local agency.
25.6 	(c) Medical assistance direct mileage reimbursement to the eligible person or the 
25.7 	eligible person's driver may not exceed 20 cents per mile.
25.8 	(d) Regardless of the number of employees that an enrolled health care provider 
25.9 	may have, medical assistance covers sign and oral language interpreter services when 
25.10 	provided by an enrolled health care provider during the course of providing a direct, 
25.11 	person-to-person covered health care service to an enrolled recipient with limited English 
25.12 	proficiency or who has a hearing loss and uses interpreting services. Coverage for oral 
25.13 	language interpreter services shall be provided only if the oral language interpreter used 
25.14 	by the enrolled health care provider is listed in the registry or roster established under 
25.15 	section 144.058.

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

25.17 	Sec. 15. Minnesota Statutes 2008, section 256B.0625, subdivision 31, is amended to 
25.18 	read:
25.19 		Subd. 31.Medical supplies and equipment. Medical assistance covers medical 
25.20 	supplies and equipment. Separate payment outside of the facility's payment rate shall 
25.21 	be made for wheelchairs and wheelchair accessories for recipients who are residents 
25.22 	of intermediate care facilities for the developmentally disabled. Reimbursement for 
25.23 	wheelchairs and wheelchair accessories for ICF/MR recipients shall be subject to the same 
25.24 	conditions and limitations as coverage for recipients who do not reside in institutions. A 
25.25 	wheelchair purchased outside of the facility's payment rate is the property of the recipient.
25.26 	The commissioner may set reimbursement rates for specified categories of medical 
25.27 	supplies at levels below the Medicare payment rate.

25.28 	Sec. 16. Minnesota Statutes 2008, section 256B.0625, is amended by adding a 
25.29 	subdivision to read:
25.30 		Subd. 54.Services provided in birth centers. (a) Medical assistance covers 
25.31 	services provided in a birth center licensed under section 144.615 by a licensed health 
25.32 	professional if the service would otherwise be covered if provided in a hospital.
25.33 	(b) Facility services provided by a birth center shall be paid at the lower of billed 
25.34 	charges or 70 percent of the statewide average for a facility payment rate made to a 
26.1 	hospital for an uncomplicated vaginal birth as determined using the most recent calendar 
26.2 	year for which complete claims data is available. If a recipient is transported from a birth 
26.3 	center to a hospital prior to the delivery, the payment for facility services to the birth center 
26.4 	shall be the lower of billed charges or 15 percent of the average facility payment made to a 
26.5 	hospital for the services provided for an uncomplicated vaginal delivery as determined 
26.6 	using the most recent calendar year for which complete claims data is available.
26.7 	(c) Professional services provided by traditional midwives licensed under chapter 
26.8 	147D shall be paid at the lower of billed charges or 100 percent of the rate paid to a 
26.9 	physician performing the same services. If a recipient is transported from a birth center to 
26.10 	a hospital prior to the delivery, a licensed traditional midwife who does not perform the 
26.11 	delivery may not bill for any delivery services. Services are not covered if provided by an 
26.12 	unlicensed traditional midwife.
26.13 	(d) The commissioner shall apply for any necessary waivers from the Centers for 
26.14 	Medicare and Medicaid Services to allow birth centers and birth center providers to be 
26.15 	reimbursed.

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

26.18 	Sec. 17. Minnesota Statutes 2008, section 256B.0631, subdivision 1, is amended to 
26.19 	read:
26.20 		Subdivision 1.Co-payments. (a) Except as provided in subdivision 2, the medical 
26.21 	assistance benefit plan shall include the following co-payments for all recipients, effective 
26.22 	for services provided on or after October 1, 2003, and before January 1, 2009:
26.23 	(1) $3 per nonpreventive visit. For purposes of this subdivision, a visit means an 
26.24 	episode of service which is required because of a recipient's symptoms, diagnosis, or 
26.25 	established illness, and which is delivered in an ambulatory setting by a physician or 
26.26 	physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse, 
26.27 	audiologist, optician, or optometrist;
26.28 	(2) $3 for eyeglasses;
26.29 	(3) $6 for nonemergency visits to a hospital-based emergency room; and
26.30 	(4) $3 per brand-name drug prescription and $1 per generic drug prescription, 
26.31 	subject to a $12 per month maximum for prescription drug co-payments. No co-payments 
26.32 	shall apply to antipsychotic drugs when used for the treatment of mental illness.
26.33 	(b) Except as provided in subdivision 2, the medical assistance benefit plan shall 
26.34 	include the following co-payments for all recipients, effective for services provided on 
26.35 	or after January 1, 2009:
27.1 	(1) $6 $3.50 for nonemergency visits to a hospital-based emergency room; 
27.2 	(2) $3 per brand-name drug prescription and $1 per generic drug prescription, subject 
27.3 	to a $7 $12 per month maximum for prescription drug co-payments. No co-payments shall 
27.4 	apply to antipsychotic drugs when used for the treatment of mental illness; and
27.5 	(3) for individuals identified by the commissioner with income at or below 100 
27.6 	percent of the federal poverty guidelines, total monthly co-payments must not exceed five 
27.7 	percent of family income. For purposes of this paragraph, family income is the total 
27.8 	earned and unearned income of the individual and the individual's spouse, if the spouse is 
27.9 	enrolled in medical assistance and also subject to the five percent limit on co-payments.
27.10 	(c) Recipients of medical assistance are responsible for all co-payments in this 
27.11 	subdivision.

27.12 	EFFECTIVE DATE. The amendment to paragraph (b), clause (1), related to the 
27.13 	co-payment for nonemergency visits is effective January 1, 2011, and the amendment 
27.14 	to paragraph (b), clause (2), related to the per month maximum for prescription drug 
27.15 	co-payments is effective July 1, 2010.

27.16 	Sec. 18. Minnesota Statutes 2008, section 256B.0631, subdivision 3, is amended to 
27.17 	read:
27.18 		Subd. 3.Collection. (a) The medical assistance reimbursement to the provider 
27.19 	shall be reduced by the amount of the co-payment, except that reimbursements shall 
27.20 	not be reduced:
27.21 	(1) once a recipient has reached the $12 per month maximum or the $7 per month 
27.22 	maximum effective January 1, 2009, for prescription drug co-payments; or
27.23 	(2) for a recipient identified by the commissioner under 100 percent of the federal 
27.24 	poverty guidelines who has met their monthly five percent co-payment limit.
27.25 	(b) The provider collects the co-payment from the recipient. Providers may not deny 
27.26 	services to recipients who are unable to pay the co-payment.
27.27 	(c) Medical assistance reimbursement to fee-for-service providers and payments to 
27.28 	managed care plans shall not be increased as a result of the removal of the co-payments 
27.29 	effective on or after January 1, 2009.

27.30 	Sec. 19. Minnesota Statutes 2008, section 256B.0644, as amended by Laws 2010, 
27.31 	chapter 200, article 1, section 6, is amended to read:
27.32 	256B.0644 REIMBURSEMENT UNDER OTHER STATE HEALTH CARE 
27.33 	PROGRAMS.
28.1 	(a) A vendor of medical care, as defined in section 256B.02, subdivision 7, and a 
28.2 	health maintenance organization, as defined in chapter 62D, must participate as a provider 
28.3 	or contractor in the medical assistance program, general assistance medical care program, 
28.4 	and MinnesotaCare as a condition of participating as a provider in health insurance plans 
28.5 	and programs or contractor for state employees established under section 43A.18, the 
28.6 	public employees insurance program under section 43A.316, for health insurance plans 
28.7 	offered to local statutory or home rule charter city, county, and school district employees, 
28.8 	the workers' compensation system under section 176.135, and insurance plans provided 
28.9 	through the Minnesota Comprehensive Health Association under sections 62E.01 to 
28.10 	62E.19. The limitations on insurance plans offered to local government employees shall 
28.11 	not be applicable in geographic areas where provider participation is limited by managed 
28.12 	care contracts with the Department of Human Services.
28.13 	(b) For providers other than health maintenance organizations, participation in the 
28.14 	medical assistance program means that:
28.15 	 (1) the provider accepts new medical assistance, general assistance medical care, 
28.16 	and MinnesotaCare patients;
28.17 	(2) for providers other than dental service providers, at least 20 percent of the 
28.18 	provider's patients are covered by medical assistance, general assistance medical care, 
28.19 	and MinnesotaCare as their primary source of coverage; or
28.20 	(3) for dental service providers, at least ten percent of the provider's patients are 
28.21 	covered by medical assistance, general assistance medical care, and MinnesotaCare as 
28.22 	their primary source of coverage, or the provider accepts new medical assistance and 
28.23 	MinnesotaCare patients who are children with special health care needs. For purposes 
28.24 	of this section, "children with special health care needs" means children up to age 18 
28.25 	who: (i) require health and related services beyond that required by children generally; 
28.26 	and (ii) have or are at risk for a chronic physical, developmental, behavioral, or emotional 
28.27 	condition, including: bleeding and coagulation disorders; immunodeficiency disorders; 
28.28 	cancer; endocrinopathy; developmental disabilities; epilepsy, cerebral palsy, and other 
28.29 	neurological diseases; visual impairment or deafness; Down syndrome and other genetic 
28.30 	disorders; autism; fetal alcohol syndrome; and other conditions designated by the 
28.31 	commissioner after consultation with representatives of pediatric dental providers and 
28.32 	consumers.
28.33 	(c) Patients seen on a volunteer basis by the provider at a location other than 
28.34 	the provider's usual place of practice may be considered in meeting the participation 
28.35 	requirement in this section. The commissioner shall establish participation requirements 
28.36 	for health maintenance organizations. The commissioner shall provide lists of participating 
29.1 	medical assistance providers on a quarterly basis to the commissioner of management and 
29.2 	budget, the commissioner of labor and industry, and the commissioner of commerce. Each 
29.3 	of the commissioners shall develop and implement procedures to exclude as participating 
29.4 	providers in the program or programs under their jurisdiction those providers who do 
29.5 	not participate in the medical assistance program. The commissioner of management 
29.6 	and budget shall implement this section through contracts with participating health and 
29.7 	dental carriers.
29.8 	(d) Any hospital or other provider that is participating in a coordinated care 
29.9 	delivery system under section 256D.031, subdivision 6, or receives payments from the 
29.10 	uncompensated care pool under section 256D.031, subdivision 8, shall not refuse to 
29.11 	provide services to any patient enrolled in general assistance medical care regardless of 
29.12 	the availability or the amount of payment.
29.13 	(e) (d) For purposes of paragraphs (a) and (b), participation in the general assistance 
29.14 	medical care program applies only to pharmacy providers dispensing prescription drugs 
29.15 	according to section 256D.03, subdivision 3.

29.16 	EFFECTIVE DATE. The amendment striking the existing paragraph (d) is effective 
29.17 	30 days after federal approval of the amendments in this article to Minnesota Statutes, 
29.18 	sections 256B.055, subdivision 15, and 256B.056, subdivision 4, or January 1, 2011, 
29.19 	whichever is later. The amendment to the new paragraph (d) is effective June 1, 2010.

29.20 	Sec. 20. Minnesota Statutes 2009 Supplement, section 256B.0653, subdivision 5, 
29.21 	is amended to read:
29.22 		Subd. 5.Home care therapies. (a) Home care therapies include the following: 
29.23 	physical therapy, occupational therapy, respiratory therapy, and speech and language 
29.24 	pathology therapy services.
29.25 	(b) Home care therapies must be:
29.26 	(1) provided in the recipient's residence after it has been determined the recipient is 
29.27 	unable to access outpatient therapy;
29.28 	(2) prescribed, ordered, or referred by a physician and documented in a plan of care 
29.29 	and reviewed, according to Minnesota Rules, part 9505.0390;
29.30 	(3) assessed by an appropriate therapist; and
29.31 	(4) provided by a Medicare-certified home health agency enrolled as a Medicaid 
29.32 	provider agency.
29.33 	(c) Restorative and specialized maintenance therapies must be provided according to 
29.34 	Minnesota Rules, part 9505.0390. Physical and occupational therapy assistants may be 
29.35 	used as allowed under Minnesota Rules, part 9505.0390, subpart 1, item B.
30.1 	(d) For both physical and occupational therapies, the therapist and the therapist's 
30.2 	assistant may not both bill for services provided to a recipient on the same day.

30.3 	Sec. 21. [256B.0755] PAYMENT REFORM DEMONSTRATION PROJECT FOR 
30.4 	SPECIAL PATIENT POPULATIONS.
30.5 		Subdivision 1.Demonstration project. (a) The commissioner of human services, 
30.6 	in consultation with the commissioner of health, shall establish a payment reform 
30.7 	demonstration project implementing an alternative payment system for health care 
30.8 	providers serving an identified group of patients who are enrolled in a state health 
30.9 	care program, and are either high utilizers of high-cost health care services or have 
30.10 	characteristics that put them at high risk of becoming high utilizers.  The purpose of the 
30.11 	demonstration project is to implement and evaluate methods of reducing hospitalizations, 
30.12 	emergency room use, high-cost medications and specialty services, admissions to nursing 
30.13 	facilities, or use of long-term home and community-based services, in order to reduce the 
30.14 	total cost of care and services for the patients.   
30.15 	(b) The commissioner shall give the highest priority to projects that will serve 
30.16 	patients who have chronic medical conditions or complex medical needs that are 
30.17 	complicated by a physical disability, serious mental illness, or serious socioeconomic 
30.18 	factors such as poverty, homelessness, or language or cultural barriers.  The commissioner 
30.19 	shall also give the highest priority to providers or groups of providers who have the 
30.20 	highest concentrations of patients with these characteristics. 
30.21 	(c) The commissioner must implement this payment reform demonstration project 
30.22 	in a manner consistent with the payment reform initiative provided in sections 62U.02 
30.23 	to 62U.04.
30.24 	(d) For purposes of this section, "state health care program" means the medical 
30.25 	assistance, MinnesotaCare, and general assistance medical care programs.
30.26 		Subd. 2.Participation. (a) The commissioner shall request eligible providers or 
30.27 	groups of providers to submit a proposal to participate in the demonstration project by 
30.28 	September 1, 2010. The providers who are interested in participating shall negotiate with 
30.29 	the commissioner to determine: 
30.30 	(1) the identified group of patients who are to be enrolled in the program;
30.31 	(2) the services that are to be included in the total cost of care calculation;
30.32 	(3) the methodology for calculating the total cost of care, which may take into 
30.33 	consideration the impact on costs to other state or local government programs including, 
30.34 	but not limited to, social services and income maintenance programs;
30.35 	(4) the time period to be covered under the bid;
31.1 	(5) the implementation of a risk adjustment mechanism to adjust for factors that are 
31.2 	beyond the control of the provider including nonclinical factors that will affect the cost 
31.3 	or outcomes of treatment;
31.4 	(6) the payment reforms and payment methods to be used under the project, which 
31.5 	may include but are not limited to adjustments in fee-for-service payments, payment of 
31.6 	care coordination fees, payments for start-up and implementation costs to be recovered or 
31.7 	repaid later in the project, payments adjusted based on a provider's proportion of patients 
31.8 	who are enrolled in state health care programs; payments adjusted for the clinical or 
31.9 	socioeconomic complexity of the patients served, payment incentives tied to use of 
31.10 	inpatient and emergency room services, and periodic settle-up adjustments;
31.11 	(7) methods of sharing financial risk and benefit between the commissioner and 
31.12 	the provider or groups of providers, which may include but are not limited to stop-loss 
31.13 	arrangements to cover high-cost outlier cases or costs that are beyond the control of the 
31.14 	provider, and risk-sharing and benefit-sharing corridors; and
31.15 	(8) performance and outcome benchmarks to be used to measure performance, 
31.16 	achievement of cost-savings targets, and quality of care provided.
31.17 	(b) A provider or group of providers may submit a proposal for a demonstration 
31.18 	project in partnership with a health maintenance organization or county-based purchasing 
31.19 	plan for the purposes of sharing risk, claims processing, or administration of the project, 
31.20 	or to extend participation in the project to persons who are enrolled in prepaid health 
31.21 	care programs.
31.22 		Subd. 3.Total cost of care agreement. Based on negotiations, the commissioner 
31.23 	must enter into an agreement with interested and eligible providers or groups of providers 
31.24 	to implement projects that are designed to reduce the total cost of care for the identified 
31.25 	patients. To the extent possible, the projects shall begin implementation on January 1, 
31.26 	2011, or upon federal approval, whichever is later.
31.27 		Subd. 4.Eligibility. To be eligible to participate, providers or groups of providers 
31.28 	must meet certification standards for health care homes established by the Department of 
31.29 	Health and the Department of Human Services under section 256B.0751.
31.30 		Subd. 5.Alternative payments. The commissioner shall seek all federal waivers 
31.31 	and approvals necessary to implement this section and to obtain federal matching funds. To 
31.32 	the extent authorized by federal law, the commissioner may waive existing fee-for-service 
31.33 	payment rates, provider contract or performance requirements, consumer incentive 
31.34 	policies, or other requirements in statute or rule in order to allow the providers or groups 
31.35 	of providers to utilize alternative payment and financing methods that will appropriately 
31.36 	fund necessary and cost-effective primary care and care coordination services; establish 
32.1 	appropriate incentives for prevention, health promotion, and care coordination; and 
32.2 	mitigate financial harm to participating providers caused by the successful reduction in 
32.3 	preventable hospitalization, emergency room use, and other costly services.
32.4 		Subd. 6.Cost neutrality. The total cost, including administrative costs, of this 
32.5 	demonstration project must not exceed the costs that would otherwise be incurred by 
32.6 	the state had services to the state health care program enrollees participating in the 
32.7 	demonstration project been provided, as applicable for the enrollee, under fee-for-service 
32.8 	or through managed care or county-based purchasing plans.

32.9 	Sec. 22. [256B.0757] INTENSIVE CARE MANAGEMENT PROGRAM.
32.10 		Subdivision 1.Report. The commissioner shall review medical assistance 
32.11 	enrollment and by July 1, 2011, present a report to the legislature that describes the 
32.12 	common characteristics and costs of those enrollees age 18 and over whose annual medical 
32.13 	costs are greater than 95 percent of all other enrollees, using deidentified data.
32.14 		Subd. 2.Intensive care management system established. The commissioner shall 
32.15 	implement, by January 1, 2012, or upon federal approval, whichever is later, a program 
32.16 	to provide intensive care management to medical assistance enrollees age 18 and over 
32.17 	currently served under fee-for-service, managed care, or county-based purchasing, whose 
32.18 	annual medical care costs are in the top five percent of all medical assistance enrollees. 
32.19 	The intensive care management program must reduce these enrollees' medical assistance 
32.20 	costs by at least 20 percent on average, improve quality of care through care coordination, 
32.21 	and provide financial incentives for providers to deliver care efficiently. The commissioner 
32.22 	may require medical assistance enrollees meeting the criteria specified in this subdivision 
32.23 	to participate in the intensive care management program, and may reassign enrollees 
32.24 	from existing managed care and county-based purchasing plans to those plans that are 
32.25 	participating in the demonstration program. The commissioner shall seek all federal 
32.26 	approvals and waivers necessary to implement the intensive care management program.
32.27 		Subd. 3.Request for proposals. The commissioner of human services shall 
32.28 	request proposals by September 1, 2011, or upon federal approval, whichever is later, 
32.29 	from health care providers, managed care plans, and county-based purchasing plans to 
32.30 	provide  intensive care management services under the requirements of subdivision 1. 
32.31 	Proposals submitted must:
32.32 	(1) designate the medical assistance population and geographic area of the state 
32.33 	to be served;
32.34 	(2) describe in detail the proposed intensive care management program;
33.1 	(3) provide estimates of cost savings to the state and the evidence supporting these 
33.2 	estimates;
33.3 	(4) describe the extent to which the intensive care management program is consistent 
33.4 	with and builds upon current state health care home, care coordination, and payment 
33.5 	reform initiatives; and
33.6 	(5) meet quality assurance, data reporting, and other criteria specified by the 
33.7 	commissioner in the request for proposals.

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

33.9 	Sec. 23. Minnesota Statutes 2008, section 256B.69, is amended by adding a 
33.10 	subdivision to read:
33.11 		Subd. 5k.Payment rate modification. For services rendered on or after August 
33.12 	1, 2010, the total payment made to managed care and county-based purchasing plans 
33.13 	under the medical assistance program and under MinnesotaCare for families with children 
33.14 	shall be increased by 1.4 percent.

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

33.16 	Sec. 24. Minnesota Statutes 2008, section 256B.69, is amended by adding a 
33.17 	subdivision to read:
33.18 		Subd. 5l.Payment reduction. For services rendered on or after January 1, 2011, 
33.19 	the total payment made to managed care plans for providing covered services under 
33.20 	the medical assistance, general assistance medical care, and MinnesotaCare programs 
33.21 	is reduced by one percent from their current statutory rates. This provision excludes 
33.22 	payments for nursing home services, home and community-based waivers, home care 
33.23 	services covered under section 256B.0651, subdivision 2, payments to demonstration 
33.24 	projects for persons with disabilities, and mental health services added as covered benefits 
33.25 	after December 31, 2007.

33.26 	Sec. 25. Minnesota Statutes 2008, section 256B.69, subdivision 20, as amended by 
33.27 	Laws 2010, chapter 200, article 1, section 10, is amended to read:
33.28 		Subd. 20.Ombudsperson. (a) The commissioner shall designate an ombudsperson 
33.29 	to advocate for persons required to enroll in prepaid health plans under this section. The 
33.30 	ombudsperson shall advocate for recipients enrolled in prepaid health plans through 
33.31 	complaint and appeal procedures and ensure that necessary medical services are provided 
33.32 	either by the prepaid health plan directly or by referral to appropriate social services. At 
34.1 	the time of enrollment in a prepaid health plan, the local agency shall inform recipients 
34.2 	about the ombudsperson program and their right to a resolution of a complaint by the 
34.3 	prepaid health plan if they experience a problem with the plan or its providers.
34.4 	(b) The commissioner shall designate an ombudsperson to advocate for persons 
34.5 	enrolled in a care coordination delivery system under section 256D.031. The 
34.6 	ombudsperson shall advocate for recipients enrolled in a care coordination delivery 
34.7 	system through the state appeal process and assist enrollees in accessing necessary 
34.8 	medical services through the care coordination delivery systems directly or by referral to 
34.9 	appropriate services. At the time of enrollment in a care coordination delivery system, the 
34.10 	local agency shall inform recipients about the ombudsperson program.

34.11 	EFFECTIVE DATE. This section is effective 30 days after federal approval of the 
34.12 	amendments in this article to Minnesota Statutes, sections 256B.055, subdivision 15, and 
34.13 	256B.056, subdivision 4, or January 1, 2011, whichever is later.

34.14 	Sec. 26. Minnesota Statutes 2008, section 256B.69, subdivision 27, is amended to read:
34.15 		Subd. 27. Information for persons with limited English-language proficiency.
 34.16 	Managed care contracts entered into under this section and sections 256D.03, subdivision 
34.17 	4, paragraph (c), andsection 256L.12 must require demonstration providers to provide 
34.18 	language assistance to enrollees that ensures meaningful access to its programs and 
34.19 	services according to Title VI of the Civil Rights Act and federal regulations adopted 
34.20 	under that law or any guidance from the United States Department of Health and Human 
34.21 	Services. 

34.22 	EFFECTIVE DATE. This section is effective retroactively from April 1, 2010.

34.23 	Sec. 27. Minnesota Statutes 2008, section 256B.692, subdivision 1, is amended to read:
34.24 		Subdivision 1.In general. County boards or groups of county boards may elect 
34.25 	to purchase or provide health care services on behalf of persons eligible for medical 
34.26 	assistance and general assistance medical care who would otherwise be required to or may 
34.27 	elect to participate in the prepaid medical assistance or prepaid general assistance medical 
34.28 	care programs according to sectionssection 256B.69and 256D.03. Counties that elect to 
34.29 	purchase or provide health care under this section must provide all services included in 
34.30 	prepaid managed care programs according to sectionssection 256B.69, subdivisions 1 
34.31 	to 22, and 256D.03. County-based purchasing under this section is governed by section 
34.32 	256B.69, unless otherwise provided for under this section.  

34.33 	EFFECTIVE DATE. This section is effective retroactively from April 1, 2010.

35.1 	Sec. 28. Minnesota Statutes 2008, section 256B.75, is amended to read:
35.2 	256B.75 HOSPITAL OUTPATIENT REIMBURSEMENT.
35.3 	(a) For outpatient hospital facility fee payments for services rendered on or after 
35.4 	October 1, 1992, the commissioner of human services shall pay the lower of (1) submitted 
35.5 	charge, or (2) 32 percent above the rate in effect on June 30, 1992, except for those 
35.6 	services for which there is a federal maximum allowable payment. Effective for services 
35.7 	rendered on or after January 1, 2000, payment rates for nonsurgical outpatient hospital 
35.8 	facility fees and emergency room facility fees shall be increased by eight percent over the 
35.9 	rates in effect on December 31, 1999, except for those services for which there is a federal 
35.10 	maximum allowable payment. Services for which there is a federal maximum allowable 
35.11 	payment shall be paid at the lower of (1) submitted charge, or (2) the federal maximum 
35.12 	allowable payment. Total aggregate payment for outpatient hospital facility fee services 
35.13 	shall not exceed the Medicare upper limit. If it is determined that a provision of this 
35.14 	section conflicts with existing or future requirements of the United States government with 
35.15 	respect to federal financial participation in medical assistance, the federal requirements 
35.16 	prevail. The commissioner may, in the aggregate, prospectively reduce payment rates to 
35.17 	avoid reduced federal financial participation resulting from rates that are in excess of 
35.18 	the Medicare upper limitations.
35.19 	(b) Notwithstanding paragraph (a), payment for outpatient, emergency, and 
35.20 	ambulatory surgery hospital facility fee services for critical access hospitals designated 
35.21 	under section 144.1483, clause (10), shall be paid on a cost-based payment system that is 
35.22 	based on the cost-finding methods and allowable costs of the Medicare program.
35.23 	(c) Effective for services provided on or after July 1, 2003, rates that are based 
35.24 	on the Medicare outpatient prospective payment system shall be replaced by a budget 
35.25 	neutral prospective payment system that is derived using medical assistance data. The 
35.26 	commissioner shall provide a proposal to the 2003 legislature to define and implement 
35.27 	this provision.
35.28 	(d) For fee-for-service services provided on or after July 1, 2002, the total payment, 
35.29 	before third-party liability and spenddown, made to hospitals for outpatient hospital 
35.30 	facility services is reduced by .5 percent from the current statutory rate.
35.31 	(e) In addition to the reduction in paragraph (d), the total payment for fee-for-service 
35.32 	services provided on or after July 1, 2003, made to hospitals for outpatient hospital 
35.33 	facility services before third-party liability and spenddown, is reduced five percent from 
35.34 	the current statutory rates. Facilities defined under section 256.969, subdivision 16, are 
35.35 	excluded from this paragraph.
36.1 	(f) In addition to the reductions in paragraphs (d) and (e), the total payment for 
36.2 	fee-for-service services provided on or after July 1, 2008, made to hospitals for outpatient 
36.3 	hospital facility services before third-party liability and spenddown, is reduced three 
36.4 	percent from the current statutory rates. Mental health services and facilities defined under 
36.5 	section 256.969, subdivision 16, are excluded from this paragraph.
36.6 	(g) Notwithstanding any contrary provision in this section, payment for all outpatient 
36.7 	and emergency services provided by any hospital that, prior to December 31, 2007, has 
36.8 	received payment to support the training of residents from an approved graduate medical 
36.9 	residency training program under United States Code, title 42, section 256e, must be paid 
36.10 	for fiscal years 2012 and 2013 an additional $7,000,000. Payment rates for subsequent 
36.11 	fiscal years are as follows:
36.12 	(1) 2014: 50 percent of costs;
36.13 	(2) 2015: 60 percent of costs;
36.14 	(3) 2016: 70 percent of costs;
36.15 	(4) 2017: 80 percent of costs;
36.16 	(5) 2018: 90 percent of costs; and
36.17 	(6) 2019 and thereafter: 100 percent of costs.

36.18 	Sec. 29. Minnesota Statutes 2009 Supplement, section 256B.76, subdivision 1, is 
36.19 	amended to read:
36.20 		Subdivision 1.Physician reimbursement.  (a) Effective for services rendered on 
36.21 	or after October 1, 1992, the commissioner shall make payments for physician services 
36.22 	as follows:
36.23 	(1) payment for level one Centers for Medicare and Medicaid Services' common 
36.24 	procedural coding system codes titled "office and other outpatient services," "preventive 
36.25 	medicine new and established patient," "delivery, antepartum, and postpartum care," 
36.26 	"critical care," cesarean delivery and pharmacologic management provided to psychiatric 
36.27 	patients, and level three codes for enhanced services for prenatal high risk, shall be paid 
36.28 	at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June 
36.29 	30, 1992. If the rate on any procedure code within these categories is different than the 
36.30 	rate that would have been paid under the methodology in section 256B.74, subdivision 2, 
36.31 	then the larger rate shall be paid;
36.32 	(2) payments for all other services shall be paid at the lower of (i) submitted charges, 
36.33 	or (ii) 15.4 percent above the rate in effect on June 30, 1992; and
36.34 	(3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th 
36.35 	percentile of 1989, less the percent in aggregate necessary to equal the above increases 
37.1 	except that payment rates for home health agency services shall be the rates in effect 
37.2 	on September 30, 1992.
37.3 	(b) Effective for services rendered on or after January 1, 2000, payment rates for 
37.4 	physician and professional services shall be increased by three percent over the rates 
37.5 	in effect on December 31, 1999, except for home health agency and family planning 
37.6 	agency services. The increases in this paragraph shall be implemented January 1, 2000, 
37.7 	for managed care.
37.8 	(c) Effective for services rendered on or after July 1, 2009, payment rates for 
37.9 	physician and professional services shall be reduced by five percent over the rates in 
37.10 	effect on June 30, 2009. This reduction does not apply to office or other outpatient visits, 
37.11 	preventive medicine visits and family planning visits billed by physicians, advanced 
37.12 	practice nurses, or physician assistants in a family planning agency or in one of the 
37.13 	following primary care practices: general practice, general internal medicine, general 
37.14 	pediatrics, general geriatrics, and family medicine. This reduction does not apply to 
37.15 	federally qualified health centers, rural health centers, and Indian health services. This 
37.16 	reduction does not apply to physical therapy services, occupational therapy services, 
37.17 	and speech pathology and related services provided on or after July 1, 2010. Effective 
37.18 	October 1, 2009, payments made to managed care plans and county-based purchasing 
37.19 	plans under sections 256B.69, 256B.692, and 256L.12 shall reflect the payment reduction 
37.20 	described in this paragraph.
37.21 	(d) Effective for services rendered on or after July 1, 2010, payment rates for 
37.22 	physician and professional services shall be reduced by three percent over the rates in 
37.23 	effect on June 30, 2010. This reduction does not apply to those providers and entities 
37.24 	exempt from the reduction in paragraph (c). Effective October 1, 2010, payments made 
37.25 	to managed care plans and county-based purchasing plans under sections 256B.69, 
37.26 	256B.692, and 256L.12 shall reflect the payment reductions in this paragraph.
37.27 	(e) Effective for services rendered on or after June 1, 2010, payment rates for 
37.28 	physician and professional services billed by physicians employed by and clinics that are 
37.29 	owned by a nonprofit health maintenance organization shall be increased by 15 percent. 
37.30 	Effective October 1, 2010, payments to managed care and county-based purchasing 
37.31 	plans under sections 256B.69, 256B.692, and 256L.12 shall reflect the payment increase 
37.32 	described in this paragraph.

37.33 	Sec. 30. Minnesota Statutes 2008, section 256B.76, subdivision 2, is amended to read:
37.34 		Subd. 2.Dental reimbursement.  (a) Effective for services rendered on or after 
37.35 	October 1, 1992, the commissioner shall make payments for dental services as follows:
38.1 	(1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25 
38.2 	percent above the rate in effect on June 30, 1992; and
38.3 	(2) dental rates shall be converted from the 50th percentile of 1982 to the 50th 
38.4 	percentile of 1989, less the percent in aggregate necessary to equal the above increases.
38.5 	(b) Beginning October 1, 1999, the payment for tooth sealants and fluoride treatments 
38.6 	shall be the lower of (1) submitted charge, or (2) 80 percent of median 1997 charges.
38.7 	(c) Effective for services rendered on or after January 1, 2000, payment rates for 
38.8 	dental services shall be increased by three percent over the rates in effect on December 
38.9 	31, 1999.
38.10 	(d) Effective for services provided on or after January 1, 2002, payment for 
38.11 	diagnostic examinations and dental x-rays provided to children under age 21 shall be the 
38.12 	lower of (1) the submitted charge, or (2) 85 percent of median 1999 charges.
38.13 	(e) The increases listed in paragraphs (b) and (c) shall be implemented January 1, 
38.14 	2000, for managed care.
38.15 	(f) Effective for dental services rendered on or after October 1, 2010, by a 
38.16 	state-operated dental clinic, payment shall be paid on a cost-based payment system that 
38.17 	is based on the cost-finding methods and allowable costs of the Medicare program. For 
38.18 	services performed by a state-operated dental clinic pursuant to a contract between the 
38.19 	clinic and a managed care plan or a county-based purchasing plan, a supplemental payment 
38.20 	shall be made to the clinic by the commissioner that is equal to the amount by which the 
38.21 	amount determined under this paragraph exceeds the amount of the payments provided 
38.22 	under the contract. Managed care plans and county-based purchasing plans participating 
38.23 	in medical assistance must provide to the commissioner any expenditure, cost, and 
38.24 	revenue information deemed necessary by the commissioner for purposes of obtaining 
38.25 	federal Medicaid matching funds for cost-based reimbursement for state-operated dental 
38.26 	clinics. Cost-based reimbursement shall be implemented in managed care contracts 
38.27 	beginning January 1, 2011.
38.28 	(g) Beginning in fiscal year 2011, if the payments to state-operated dental clinics 
38.29 	in paragraph (f), including state and federal shares, are less than $1,850,000 per fiscal 
38.30 	year, a supplemental state payment equal to the difference between the total payments 
38.31 	in paragraph (f) and $1,850,000 shall be paid from the general fund to state-operated 
38.32 	services for the operation of the dental clinics.

38.33 	Sec. 31. Minnesota Statutes 2008, section 256B.76, subdivision 4, is amended to read:
38.34 		Subd. 4.Critical access dental providers.   Effective for dental services rendered 
38.35 	on or after January 1, 2002, the commissioner shall increase reimbursements to dentists 
39.1 	and dental clinics deemed by the commissioner to be critical access dental providers. 
39.2 	For dental services rendered on or after July 1, 2007, the commissioner shall increase 
39.3 	reimbursement by 30 percent above the reimbursement rate that would otherwise be paid to 
39.4 	the critical access dental provider. The commissioner shall pay the health plan companies 
39.5 	in amounts sufficient to reflect increased reimbursements to critical access dental providers 
39.6 	as approved by the commissioner. In determining which dentists and dental clinics shall 
39.7 	be deemed critical access dental providers, the commissioner shall review:
39.8 	(1) the utilization rate in the service area in which the dentist or dental clinic operates 
39.9 	for dental services to patients covered by medical assistance, general assistance medical 
39.10 	care, or MinnesotaCare as their primary source of coverage;
39.11 	(2) the level of services provided by the dentist or dental clinic to patients covered 
39.12 	by medical assistance, general assistance medical care, or MinnesotaCare as their primary 
39.13 	source of coverage; and. The commissioner shall pay critical access dental provider 
39.14 	payments to a dentist or dental clinic that meets any one of the following criteria:
39.15 	(i) at least 40 percent of patient encounters are with patients who are uninsured or 
39.16 	covered by medical assistance, general assistance medical care, or MinnesotaCare;
39.17 	(ii) the dental clinic or dental group is owned and operated by a nonprofit operation 
39.18 	under chapter 317A with more than 10,000 patient encounters per year with patients 
39.19 	who are uninsured or covered by medical assistance, general assistance medical care, 
39.20 	or MinnesotaCare; 
39.21 	(iii) the dental clinic is associated with an oral health or dental education program 
39.22 	operated by the University of Minnesota or an institution within the Minnesota State 
39.23 	Colleges and Universities system; or
39.24 	(iv) the dental clinic is a state-operated dental clinic;
39.25 	(3) whether the level of services provided by the dentist or dental clinic is critical to 
39.26 	maintaining adequate levels of patient access within the a geographic service area, and 
39.27 	to ensure that the maximum travel distance or travel time is the lesser of 60 miles or 60 
39.28 	minutes;
39.29 	(4) whether the provider has completed the application for critical access dental 
39.30 	provider designation by the due date, and has provided correct information;
39.31 	(5) whether the dentist or dental clinic meets the quality and continuity of care 
39.32 	criteria recommended by the dental services advisory committee and adopted by the 
39.33 	department; and
39.34 	(6) whether the dentist or dental clinic serves people in all Minnesota health care 
39.35 	programs. 
40.1 	In the absence of a critical access dental provider in a service area, the commissioner may 
40.2 	designate a dentist or dental clinic as a critical access dental provider if the dentist or 
40.3 	dental clinic is willing to provide care to patients covered by medical assistance, general 
40.4 	assistance medical care, or MinnesotaCare at a level which significantly increases access 
40.5 	to dental care in the service area.

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

40.7 	Sec. 32. Minnesota Statutes 2008, section 256B.76, is amended by adding a 
40.8 	subdivision to read:
40.9 		Subd. 4a.Designation and termination of critical access dental providers. (a) 
40.10 	Notwithstanding the provisions in subdivision 4, the commissioner may review and not 
40.11 	designate an individual dentist or dental clinic as a critical access dental provider under 
40.12 	subdivision 4 or section 256L.11, subdivision 7, when the dentist or clinic:
40.13 	(1) has been subject to a corrective or disciplinary action by the Board of Dentistry 
40.14 	related to fraud or direct patient care. Designation shall not be made until the provider is no 
40.15 	longer subject to a corrective or disciplinary action related to fraud or direct patient care; or
40.16 	(2) has been subject, within the past three years, to a postinvestigation action by the 
40.17 	commissioner of human services or issuance of a warning as specified in Minnesota Rules, 
40.18 	parts 9505.2160 to 9505.2245. The provider shall not be considered for critical access 
40.19 	dental designation until the January following the year in which the action has ended.
40.20 	(b) The commissioner may terminate a critical access designation of an individual 
40.21 	dentist or clinic if the dentist or clinic:
40.22 	(1) becomes subject to a disciplinary or corrective action by the Board of Dentistry 
40.23 	related to fraud or direct patient care. The provider shall not be considered for critical 
40.24 	access designation until the January following the year in which the action has ended;
40.25 	(2) becomes subject to a postinvestigation action by the commissioner of human 
40.26 	services or issuance of a warning as specified in Minnesota Rules, parts 9505.2160 
40.27 	to 9505.2245;
40.28 	(3) does not meet the quality and continuity of care criteria that have been 
40.29 	recommended by the Dental Services Advisory Committee and adopted by the department; 
40.30 	or
40.31 	(4) does not serve people in all Minnesota public health care programs.
40.32 	(c) Any termination is effective on the date of notification of the:
40.33 	(1) postinvestigative action;
40.34 	(2) disciplinary or corrective action by the Minnesota Board of Dentistry; or
40.35 	(3) determination of not meeting quality and continuity of care criteria.
41.1 	The commissioner may review postinvestigative actions taken by a health plan 
41.2 	under contract to provide dental services to Minnesota health care program enrollees. 
41.3 	After an investigation conducted by the Department of Human Services surveillance unit, 
41.4 	the findings of the health plan may be incorporated to determine if a provider will be 
41.5 	designated or terminated from the program.
41.6 	(d) A provider who has been terminated or not designated under this section may 
41.7 	appeal only through the contested hearing process as defined in section 14.02, subdivision 
41.8 	3, by filing with the commissioner a written request of appeal. The appeal request must 
41.9 	be received by the commissioner no later than 30 days after notification of termination 
41.10 	or nondesignation.
41.11 	(e) The commissioner may make an exception to paragraphs (a) and (b) if an action 
41.12 	taken by the Board of Dentistry or the commissioner is the result of events not directly 
41.13 	related to patient care or that will not affect direct patient care to Minnesota health care 
41.14 	program enrollees.

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

41.16 	Sec. 33. Minnesota Statutes 2009 Supplement, section 256B.766, is amended to read: 
41.17 	256B.766 REIMBURSEMENT FOR BASIC CARE SERVICES.
41.18 	(a) Effective for services provided on or after July 1, 2009, total payments for 
41.19 	basic care services, shall be reduced by three percent, prior to third-party liability and 
41.20 	spenddown calculation. This reduction applies to physical therapy services, occupational 
41.21 	therapy services, and speech language pathology and related services provided on or after 
41.22 	July 1, 2010. Effective July 1, 2010, the commissioner shall classify physical therapy 
41.23 	services, occupational therapy services, and speech language pathology and related 
41.24 	services as basic care services. Payments made to managed care plans and county-based 
41.25 	purchasing plans shall be reduced for services provided on or after October 1, 2009, 
41.26 	to reflect this reduction.
41.27 	(b) This section does not apply to physician and professional services, inpatient 
41.28 	hospital services, family planning services, mental health services, dental services, 
41.29 	prescription drugs, medical transportation, federally qualified health centers, rural health 
41.30 	centers, Indian health services, and Medicare cost-sharing.

41.31 	Sec. 34. [256B.767] MEDICARE PAYMENT LIMIT.
41.32 	Effective for services rendered on or after July 1, 2010, fee-for-service payment 
41.33 	rates for physician and professional services under section 256B.76, subdivision 1, and 
42.1 	basic care services subject to the rate reduction specified in section 256B.766, shall not 
42.2 	exceed the Medicare payment rate for the applicable service.

42.3 	Sec. 35. [256B.768] FEE-FOR-SERVICE PAYMENT INCREASE.
42.4 	Effective for services rendered on or after January 1, 2011, the commissioner shall 
42.5 	increase fee-for-service payment rates by seven percent for physician and professional 
42.6 	services under section 256B.76, subdivision 1, and basic care services subject to the rate 
42.7 	reduction specified in section 256B.766.

42.8 	Sec. 36. Minnesota Statutes 2009 Supplement, section 256D.03, subdivision 3, as 
42.9 	amended by Laws 2010, chapter 200, article 1, section 11, is amended to read:
42.10 		Subd. 3.General assistance medical care; eligibility. (a) Beginning April 1, 2010, 
42.11 	the general assistance medical care program shall be administered according to section 
42.12 	256D.031, unless otherwise stated, except for outpatient prescription drug coverage, 
42.13 	which shall continue to be administered under this section and funded under section 
42.14 	256D.031, subdivision 9, beginning June 1, 2010.
42.15 	(b) Outpatient prescription drug coverage under general assistance medical care is 
42.16 	limited to prescription drugs that:
42.17 	(1) are covered under the medical assistance program as described in section 
42.18 	256B.0625, subdivisions 13 and 13d; and
42.19 	(2) are provided by manufacturers that have fully executed general assistance 
42.20 	medical care rebate agreements with the commissioner and comply with the agreements. 
42.21 	Outpatient prescription drug coverage under general assistance medical care must conform 
42.22 	to coverage under the medical assistance program according to section 256B.0625, 
42.23 	subdivisions 13 to 13g 13h.
42.24 	(c) Outpatient prescription drug coverage does not include drugs administered in a 
42.25 	clinic or other outpatient setting.
42.26 	(d) For the period beginning April 1, 2010, to May 31, 2010, general assistance 
42.27 	medical care covers the services listed in subdivision 4.

42.28 	EFFECTIVE DATE. This section is effective retroactively from April 1, 2010.

42.29 	Sec. 37. Minnesota Statutes 2008, section 256L.02, subdivision 3, is amended to read:
42.30 		Subd. 3.Financial management. (a) The commissioner shall manage spending for 
42.31 	the MinnesotaCare program in a manner that maintains a minimum reserve. As part of 
42.32 	each state revenue and expenditure forecast, the commissioner must make an assessment 
42.33 	of the expected expenditures for the covered services for the remainder of the current 
43.1 	biennium and for the following biennium. The estimated expenditure, including the 
43.2 	reserve, shall be compared to an estimate of the revenues that will be available in the health 
43.3 	care access fund. Based on this comparison, and after consulting with the chairs of the 
43.4 	house of representatives Ways and Means Committee and the senate Finance Committee, 
43.5 	and the Legislative Commission on Health Care Access, the commissioner shall, as 
43.6 	necessary, make the adjustments specified in paragraph (b) to ensure that expenditures 
43.7 	remain within the limits of available revenues for the remainder of the current biennium 
43.8 	and for the following biennium. The commissioner shall not hire additional staff using 
43.9 	appropriations from the health care access fund until the commissioner of management 
43.10 	and budget makes a determination that the adjustments implemented under paragraph (b) 
43.11 	are sufficient to allow MinnesotaCare expenditures to remain within the limits of available 
43.12 	revenues for the remainder of the current biennium and for the following biennium.
43.13 	(b) The adjustments the commissioner shall use must be implemented in this order, 
43.14 	but shall not be implemented before July 1, 2014: first, stop enrollment of single adults 
43.15 	and households without children; and second, upon 45 days' notice, stop coverage of 
43.16 	single adults and households without children already enrolled in the MinnesotaCare 
43.17 	program; third, upon 90 days' notice, decrease the premium subsidy amounts by ten 
43.18 	percent for families with gross annual income above 200 percent of the federal poverty 
43.19 	guidelines; fourth, upon 90 days' notice, decrease the premium subsidy amounts by ten 
43.20 	percent for families with gross annual income at or below 200 percent; and fifth, require 
43.21 	applicants to be uninsured for at least six months prior to eligibility in the MinnesotaCare 
43.22 	program. If these measures are insufficient to limit the expenditures to the estimated 
43.23 	amount of revenue, the commissioner shall further limit enrollment or decrease premium 
43.24 	subsidies notify the chairs of the house of representatives Ways and Means Committee and 
43.25 	the senate Finance Committee, and the Legislative Commission on Health Care Access, 
43.26 	and present recommendations to the chairs and commission for limiting expenditures to 
43.27 	the estimated amount of revenue.

43.28 	EFFECTIVE DATE. This section is effective upon federal approval of the 
43.29 	amendments in this article to Minnesota Statutes, sections 256B.055, subdivision 15, and 
43.30 	256B.056, subdivision 4.

43.31 	Sec. 38. Minnesota Statutes 2008, section 256L.03, subdivision 3, is amended to read:
43.32 		Subd. 3.Inpatient hospital services. (a) Covered health services shall include 
43.33 	inpatient hospital services, including inpatient hospital mental health services and inpatient 
43.34 	hospital and residential chemical dependency treatment, subject to those limitations 
43.35 	necessary to coordinate the provision of these services with eligibility under the medical 
44.1 	assistance spenddown. The inpatient hospital benefit for adult enrollees who qualify under 
44.2 	section 256L.04, subdivision 7, or who qualify under section 256L.04, subdivisions 1 and 
44.3 	2, with family gross income that exceeds 200 percent of the federal poverty guidelines or 
44.4 	215 percent of the federal poverty guidelines on or after July 1, 2009, and who are not 
44.5 	pregnant, is subject to an annual limit of $10,000, unless supplemental hospital coverage 
44.6 	has been purchased under subdivision 3c. 
44.7 	(b) Admissions for inpatient hospital services paid for under section 256L.11, 
44.8 	subdivision 3, must be certified as medically necessary in accordance with Minnesota 
44.9 	Rules, parts 9505.0500 to 9505.0540, except as provided in clauses (1) and (2): 
44.10 	(1) all admissions must be certified, except those authorized under rules established 
44.11 	under section 254A.03, subdivision 3, or approved under Medicare; and 
44.12 	(2) payment under section 256L.11, subdivision 3, shall be reduced by five percent 
44.13 	for admissions for which certification is requested more than 30 days after the day of 
44.14 	admission. The hospital may not seek payment from the enrollee for the amount of the 
44.15 	payment reduction under this clause. 

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

44.18 	Sec. 39. Minnesota Statutes 2008, section 256L.03, is amended by adding a subdivision 
44.19 	to read:
44.20 		Subd. 3c.Supplemental hospital coverage. (a) Effective January 1, 2011, or upon 
44.21 	federal approval, whichever is later, the commissioner shall offer all MinnesotaCare 
44.22 	applicants, and all enrollees during the open enrollment periods specified in paragraph 
44.23 	(b), the opportunity to purchase at full cost, supplemental hospital coverage to cover 
44.24 	inpatient hospital expenses in excess of the inpatient hospital annual limit established 
44.25 	under subdivision 3. Premiums for this coverage may vary only for age and shall be 
44.26 	collected by the commissioner using the procedures established for the sliding scale 
44.27 	premium determined under section 256L.15.
44.28 	(b) The commissioner shall notify all persons submitting applications of the option to 
44.29 	purchase this coverage at the time of application. The commissioner shall provide persons 
44.30 	enrolled in MinnesotaCare on the effective date of this subdivision with the opportunity to 
44.31 	purchase this supplemental coverage during an initial open enrollment period. Following 
44.32 	this initial open enrollment period, the commissioner shall provide all enrollees with the 
44.33 	opportunity to purchase this supplemental coverage during an annual open enrollment 
44.34 	period during the month of November with coverage to take effect the following January 1.

45.1 	Sec. 40. Minnesota Statutes 2009 Supplement, section 256L.03, subdivision 5, is 
45.2 	amended to read:
45.3 		Subd. 5.Co-payments and coinsurance. (a) Except as provided in paragraphs (b) 
45.4 	and (c), the MinnesotaCare benefit plan shall include the following co-payments and 
45.5 	coinsurance requirements for all enrollees:
45.6 	(1) ten percent of the paid charges for inpatient hospital services for adult enrollees, 
45.7 	subject to an annual inpatient out-of-pocket maximum of $1,000 per individual;
45.8 	(2) $3 per prescription for adult enrollees;
45.9 	(3) $25 for eyeglasses for adult enrollees;
45.10 	(4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an 
45.11 	episode of service which is required because of a recipient's symptoms, diagnosis, or 
45.12 	established illness, and which is delivered in an ambulatory setting by a physician or 
45.13 	physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse, 
45.14 	audiologist, optician, or optometrist; and
45.15 	(5) $6 for nonemergency visits to a hospital-based emergency room for services 
45.16 	provided through December 31, 2010, and $3.50 effective January 1, 2011.
45.17 	(b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of 
45.18 	children under the age of 21.
45.19 	(c) Paragraph (a) does not apply to pregnant women and children under the age of 21.
45.20 	(d) Paragraph (a), clause (4), does not apply to mental health services.
45.21 	(e) Adult enrollees with family gross income that exceeds 200 percent of the federal 
45.22 	poverty guidelines or 215 percent of the federal poverty guidelines on or after July 1, 2009, 
45.23 	and who are not pregnant shall be financially responsible for the coinsurance amount, if 
45.24 	applicable, and if supplemental coverage has not been purchased under subdivision 3c,
45.25 	amounts which exceed the $10,000 inpatient hospital benefit limit.
45.26 	(f) When a MinnesotaCare enrollee becomes a member of a prepaid health plan, 
45.27 	or changes from one prepaid health plan to another during a calendar year, any charges 
45.28 	submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket 
45.29 	expenses incurred by the enrollee for inpatient services, that were submitted or incurred 
45.30 	prior to enrollment, or prior to the change in health plans, shall be disregarded.
45.31 	(g) MinnesotaCare reimbursement to fee-for-service providers and payments to 
45.32 	managed care plans shall not be increased as a result of the reduction of the co-payments 
45.33 	in paragraph (a), clause (5), effective January 1, 2011.

45.34 	EFFECTIVE DATE. The amendment to paragraph (e) is effective January 1, 2011, 
45.35 	or upon federal approval, whichever is later.

46.1 	Sec. 41. Minnesota Statutes 2008, section 256L.05, is amended by adding a subdivision 
46.2 	to read:
46.3 		Subd. 6.Disclosure statement for inpatient hospital limit. The commissioner 
46.4 	shall develop, and include with MinnesotaCare application and renewal materials, a 
46.5 	disclosure statement that contains the following or similar language: "For adults without 
46.6 	children, and for parents and relative caretakers with family gross income that exceeds 
46.7 	215 percent of the federal poverty guidelines, who are not pregnant, coverage of inpatient 
46.8 	hospital services under MinnesotaCare is subject to an annual limit of $10,000. Enrollees 
46.9 	subject to the limit may be responsible for inpatient hospital costs that exceed the $10,000 
46.10 	annual limit."

46.11 	Sec. 42. Minnesota Statutes 2008, section 256L.07, is amended by adding a subdivision 
46.12 	to read:
46.13 		Subd. 9.Firefighters; volunteer ambulance attendants. (a) For purposes of this 
46.14 	subdivision, "qualified individual" means:
46.15 	(1) a volunteer firefighter with a department as defined in section 299N.01, 
46.16 	subdivision 2, who has passed the probationary period; and
46.17 	(2) a volunteer ambulance attendant as defined in section 144E.001, subdivision 15.
46.18 	(b) A qualified individual who documents to the satisfaction of the commissioner 
46.19 	status as a qualified individual by completing and submitting a one-page form developed 
46.20 	by the commissioner is eligible for MinnesotaCare without meeting other eligibility 
46.21 	requirements of this chapter, but must pay premiums equal to the average expected 
46.22 	capitation rate for adults with no children paid under section 256L.12. Individuals eligible 
46.23 	under this subdivision shall receive coverage for the benefit set provided to adults with no 
46.24 	children.

46.25 	Sec. 43. Minnesota Statutes 2009 Supplement, section 256L.11, subdivision 1, is 
46.26 	amended to read:
46.27 		Subdivision 1.Medical assistance rate to be used. (a) Payment to providers under 
46.28 	sections 256L.01 to 256L.11 shall be at the same rates and conditions established for 
46.29 	medical assistance, except as provided in subdivisions 2 to 6.
46.30 	(b) Effective for services provided on or after July 1, 2009, total payments for basic 
46.31 	care services shall be reduced by three percent, in accordance with section 256B.766. 
46.32 	Payments made to managed care and county-based purchasing plans shall be reduced for 
46.33 	services provided on or after October 1, 2009, to reflect this reduction.
47.1 	(c) Effective for services provided on or after July 1, 2009, payment rates for 
47.2 	physician and professional services shall be reduced as described under section 256B.76, 
47.3 	subdivision 1, paragraph (c). Payments made to managed care and county-based 
47.4 	purchasing plans shall be reduced for services provided on or after October 1, 2009, 
47.5 	to reflect this reduction.
47.6 	(d) Effective for services provided on or after July 1, 2010, payment rates for 
47.7 	physician and professional services shall be reduced as described under section 256B.76, 
47.8 	subdivision 1, paragraph (d). Payments made to managed care plans and county-based 
47.9 	purchasing plans shall be reduced for services provided on or after October 1, 2010, 
47.10 	to reflect this reduction.

47.11 	Sec. 44. Minnesota Statutes 2008, section 256L.12, subdivision 5, is amended to read:
47.12 		Subd. 5.Eligibility for other state programs. MinnesotaCare enrollees who 
47.13 	become eligible for medical assistance or general assistance medical care will remain in 
47.14 	the same managed care plan if the managed care plan has a contract for that population. 
47.15 	Effective January 1, 1998, MinnesotaCare enrollees who were formerly eligible for 
47.16 	general assistance medical care pursuant to section 256D.03, subdivision 3, within six 
47.17 	months of MinnesotaCare enrollment and were enrolled in a prepaid health plan pursuant 
47.18 	to section 256D.03, subdivision 4, paragraph (c), must remain in the same managed care 
47.19 	plan if the managed care plan has a contract for that population. Managed care plans must 
47.20 	participate in the MinnesotaCare and general assistance medical care programsprogram 
47.21 	under a contract with the Department of Human Services in service areas where they 
47.22 	participate in the medical assistance program.  

47.23 	EFFECTIVE DATE. This section is effective retroactively from April 1, 2010.

47.24 	Sec. 45. Minnesota Statutes 2008, section 256L.12, subdivision 6, is amended to read:
47.25 		Subd. 6.Co-payments and benefit limits. Enrollees are responsible for all 
47.26 	co-payments in sections 256L.03, subdivision 5, and 256L.035, and shall pay co-payments 
47.27 	to the managed care plan or to its participating providers. The enrollee is also responsible 
47.28 	for payment of inpatient hospital charges which exceed the MinnesotaCare benefit limit, 
47.29 	unless supplemental hospital coverage has been purchased under subdivision 3c.  

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

47.32 	Sec. 46. Minnesota Statutes 2008, section 256L.12, subdivision 9, is amended to read:
48.1 		Subd. 9.Rate setting; performance withholds. (a) Rates will be prospective, 
48.2 	per capita, where possible. The commissioner may allow health plans to arrange for 
48.3 	inpatient hospital services on a risk or nonrisk basis. The commissioner shall consult with 
48.4 	an independent actuary to determine appropriate rates.
48.5 	(b) For services rendered on or after January 1, 2003, to December 31, 2003, the 
48.6 	commissioner shall withhold .5 percent of managed care plan payments under this section 
48.7 	pending completion of performance targets. The withheld funds must be returned no 
48.8 	sooner than July 1 and no later than July 31 of the following year if performance targets 
48.9 	in the contract are achieved. A managed care plan may include as admitted assets under 
48.10 	section 62D.044 any amount withheld under this paragraph that is reasonably expected 
48.11 	to be returned. 
48.12 	(c) For services rendered on or after January 1, 2004, the commissioner shall 
48.13 	withhold five percent of managed care plan payments under this section pending 
48.14 	completion of performance targets. Each performance target must be quantifiable, 
48.15 	objective, measurable, and reasonably attainable, except in the case of a performance target 
48.16 	based on a federal or state law or rule. Criteria for assessment of each performance target 
48.17 	must be outlined in writing prior to the contract effective date. The managed care plan 
48.18 	must demonstrate, to the commissioner's satisfaction, that the data submitted regarding 
48.19 	attainment of the performance target is accurate. The commissioner shall periodically 
48.20 	change the administrative measures used as performance targets in order to improve plan 
48.21 	performance across a broader range of administrative services. The performance targets 
48.22 	must include measurement of plan efforts to contain spending on health care services and 
48.23 	administrative activities. The commissioner may adopt plan-specific performance targets 
48.24 	that take into account factors affecting only one plan, such as characteristics of the plan's 
48.25 	enrollee population. The withheld funds must be returned no sooner than July 1 and no 
48.26 	later than July 31 of the following calendar year if performance targets in the contract are 
48.27 	achieved. A managed care plan or a county-based purchasing plan under section 256B.692 
48.28 	may include as admitted assets under section 62D.044 any amount withheld under this 
48.29 	paragraph that is reasonably expected to be returned.
48.30 	(d) For services rendered on or after January 1, 2011, the commissioner shall 
48.31 	withhold an additional three percent of managed care plan payments under this section. 
48.32 	The withheld funds must be returned no sooner than July 1, and no later than July 31 of 
48.33 	the following calendar year. The return of the withhold under this paragraph is not subject 
48.34 	to the requirements of paragraph (b) or (c).
49.1 	(e) A managed care plan or a county-based purchasing plan under section 256B.692 
49.2 	may include as admitted assets under section 62D.044 any amount withheld under this 
49.3 	section.

49.4 	Sec. 47. Laws 2009, chapter 79, article 5, section 75, subdivision 1, is amended to read:
49.5 		Subdivision 1.Medical assistance coverage. The commissioner of human services 
49.6 	shall establish a demonstration project to provide additional medical assistance coverage 
49.7 	for a maximum of 200 American Indian children in Minneapolis, St. Paul, and Duluth 
49.8 	who are burdened by health disparities associated with the cumulative health impact 
49.9 	of toxic environmental exposures. Under this demonstration project, the additional 
49.10 	medical assistance coverage for this population must include, but is not limited to, home 
49.11 	environmental assessments for triggers of asthma, in-home asthma education on the proper 
49.12 	medical management of asthma by a certified asthma educator or public health nurse with 
49.13 	asthma management training limited to two visits per child. Coverage also includes the 
49.14 	following durable medical equipment: high efficiency particulate air (HEPA) cleaners, 
49.15 	HEPA vacuum cleaners, allergy bed and pillow encasements, high filtration filters for 
49.16 	forced air gas furnaces, and dehumidifiers with medical tubing to connect the appliance to 
49.17 	a floor drain, if the listed item is medically necessary useful to reduce asthma symptoms. 
49.18 	Provision of these items of durable medical equipment must be preceded by a home 
49.19 	environmental assessment for triggers of asthma and in-home asthma education on the 
49.20 	proper medical management of asthma by a Certified Asthma Educator or public health 
49.21 	nurse with asthma management training.

49.22 	Sec. 48. Laws 2009, chapter 79, article 5, section 78, subdivision 5, is amended to read:
49.23 		Subd. 5.Expiration. This section, with the exception of subdivision 4, expires 
49.24 	December 31, 2010 June 30, 2011. Subdivision 4 expires December 31, 2011.

49.25 	Sec. 49. Laws 2010, chapter 200, article 1, section 12, subdivision 6, is amended to 
49.26 	read:
49.27 		Subd. 6.Coordinated care delivery systems. (a) Effective June 1, 2010, the 
49.28 	commissioner shall contract with hospitals or groups of hospitals that qualify under 
49.29 	paragraph (b) and agree to deliver services according to this subdivision. Contracting 
49.30 	hospitals shall develop and implement a coordinated care delivery system to provide health 
49.31 	care services to individuals who are eligible for general assistance medical care under this 
49.32 	section and who either choose to receive services through the coordinated care delivery 
49.33 	system or who are enrolled by the commissioner under paragraph (c). A contracting 
50.1 	hospital may negotiate a limit to the number of general assistance medical care enrollees it 
50.2 	serves, but must comply with the emergency care requirements of United States Code, title 
50.3 	42, 1395dd (EMTALA). The health care services provided by the system must include: 
50.4 	(1) the services described in subdivision 4 with the exception of outpatient prescription 
50.5 	drug coverage but shall include drugs administered in a clinic or other outpatient setting; 
50.6 	or (2) a set of comprehensive and medically necessary health services that the recipients 
50.7 	might reasonably require to be maintained in good health and that has been approved by 
50.8 	the commissioner, including at a minimum, but not limited to, emergency care, medical 
50.9 	transportation services, inpatient hospital and physician care, outpatient health services, 
50.10 	preventive health services, mental health services, and prescription drugs administered 
50.11 	in a clinic or other outpatient setting. Outpatient prescription drug coverage is covered 
50.12 	on a fee-for-service basis in accordance with section 256D.03, subdivision 3, and funded 
50.13 	under subdivision 9. A hospital establishing a coordinated care delivery system under this 
50.14 	subdivision must ensure that the requirements of this subdivision are met.
50.15 	(b) A hospital or group of hospitals may contract with the commissioner to develop 
50.16 	and implement a coordinated care delivery system as follows:
50.17 	(1) effective June 1, 2010, a hospital qualifies under this subdivision if: (i) during 
50.18 	calendar year 2008, it received fee-for-service payments for services to general assistance 
50.19 	medical care recipients (A) equal to or greater than $1,500,000, or (B) equal to or greater 
50.20 	than 1.3 percent of net patient revenue; or (ii) a contract with the hospital is necessary to 
50.21 	provide geographic access or to ensure that at least 80 percent of enrollees have access to 
50.22 	a coordinated care delivery system; and
50.23 	(2) effective December 1, 2010, a Minnesota hospital not qualified under clause 
50.24 	(1) may contract with the commissioner under this subdivision if it agrees to satisfy the 
50.25 	requirements of this subdivision.
50.26 	Participation by hospitals shall become effective quarterly on June 1, September 1, 
50.27 	December 1, or March 1. Hospital participation is effective for a period of 12 months and 
50.28 	may be renewed for successive 12-month periods.
50.29 	Coordinated care delivery system contracts are in effect from June 1, 2010, to 
50.30 	December 31, 2010, or upon the effective date of the expansion of medical assistance 
50.31 	coverage to include adults without children, whichever is later.
50.32 	(c) Applicants and recipients may enroll in any available coordinated care delivery 
50.33 	system statewide. If more than one coordinated care delivery system is available, the 
50.34 	applicant or recipient shall be allowed to choose among the systems that provide services 
50.35 	within 25 miles of the individual's community of residence. The commissioner may assign 
50.36 	an applicant or recipient to a coordinated care delivery system that provides services 
51.1 	within 25 miles of the individual's community of residence, if no choice is made by the 
51.2 	applicant or recipient. The commissioner shall consider a recipient's zip code, city of 
51.3 	residence, county of residence, or distance from a participating coordinated care delivery 
51.4 	system when determining default assignment. An applicant or recipient may decline 
51.5 	enrollment in a coordinated care delivery system. Upon enrollment into a coordinated care 
51.6 	delivery system, the recipient must agree to receive all nonemergency services through the 
51.7 	coordinated care delivery system. Enrollment in a coordinated care delivery system is 
51.8 	for six months and may be renewed for additional six-month periods, except that initial 
51.9 	enrollment is for six months or until the end of a recipient's period of general assistance 
51.10 	medical care eligibility, whichever occurs first. A recipient who continues to meet the 
51.11 	eligibility requirements of this section is not eligible to enroll in MinnesotaCare during 
51.12 	a period of enrollment in a coordinated care delivery system. From June 1, 2010, to 
51.13 	November 30, 2010, applicants and recipients not enrolled in a coordinated care delivery 
51.14 	system may seek services from a hospital eligible for reimbursement under the temporary 
51.15 	uncompensated care pool established under subdivision 8. After November 30, 2010, 
51.16 	services are available only through a coordinated care delivery system.
51.17 	(d) A hospital must provide access to cost-effective outpatient services available 
51.18 	in its service area. The hospital may contract and coordinate with providers and clinics 
51.19 	for the delivery of services and shall contract with federally qualified health centers and
51.20 	essential community providers as defined under section 62Q.19, subdivision 1, paragraph 
51.21 	(a), clauses (1) and (2), to the extent practicable. If a provider or clinic contracts with a 
51.22 	hospital to provide services through the coordinated care delivery system, the provider 
51.23 	may not refuse to provide services to any recipient enrolled in the system, and payment for 
51.24 	services shall be negotiated with the hospital and paid by the hospital from the system's 
51.25 	allocation under subdivision 7.
51.26 	(e) A coordinated care delivery system must:
51.27 	(1) provide the covered services required under paragraph (a) to recipients enrolled 
51.28 	in the coordinated care delivery system, and comply with the requirements of subdivision 
51.29 	4, paragraphs (b) to (g);
51.30 	(2) establish a process to monitor enrollment and ensure the quality of care provided; 
51.31 	and
51.32 	(3) in cooperation with counties, coordinate the delivery of health care services with 
51.33 	existing homeless prevention, supportive housing, and rent subsidy programs and funding 
51.34 	administered by the Minnesota Housing Finance Agency under chapter 462A; and
52.1 	(4) adopt innovative and cost-effective methods of care delivery and coordination, 
52.2 	which may include the use of allied health professionals, telemedicine, patient educators, 
52.3 	care coordinators, and community health workers.
52.4 	(f) The hospital may require a recipient to designate a primary care provider or 
52.5 	a primary care clinic. The hospital may limit the delivery of services to a network of 
52.6 	providers who have contracted with the hospital to deliver services in accordance with 
52.7 	this subdivision, and require a recipient to seek services only within this network. The 
52.8 	hospital may also require a referral to a provider before the service is eligible for payment. 
52.9 	A coordinated care delivery system is not required to provide payment to a provider who 
52.10 	is not employed by or under contract with the system for services provided to a recipient 
52.11 	enrolled in the system, except in cases of an emergency. For purposes of this section, 
52.12 	emergency services are defined in accordance with Code of Federal Regulations, title 
52.13 	42, section 438.114 (a).
52.14 	(g) A recipient enrolled in a coordinated care delivery system has the right to appeal 
52.15 	to the commissioner according to section 256.045.
52.16 	(h) The state shall not be liable for the payment of any cost or obligation incurred 
52.17 	by the coordinated care delivery system.
52.18 	(i) The hospital must provide the commissioner with data necessary for assessing 
52.19 	enrollment, quality of care, cost, and utilization of services. Each hospital must provide, 
52.20 	on a quarterly basis on a form prescribed by the commissioner for each recipient served by 
52.21 	the coordinated care delivery system, the services provided, the cost of services provided, 
52.22 	and the actual payment amount for the services provided and any other information the 
52.23 	commissioner deems necessary to claim federal Medicaid match. The commissioner must 
52.24 	provide this data to the legislature on a quarterly basis.
52.25 	(j) Effective June 1, 2010, the provisions of section 256.9695, subdivision 2, 
52.26 	paragraph (b), do not apply to general assistance medical care provided under this section.
52.27 	(k) If a recipient is transferred from a hospital that is not participating in a 
52.28 	coordinated care delivery system to a hospital participating in a coordinated care delivery 
52.29 	system, in order to receive a higher level of care, the transferring hospital remains eligible 
52.30 	to receive any available funding through the temporary uncompensated care pool for the 
52.31 	care initially provided at that hospital. The hospital participating in the coordinated care 
52.32 	delivery system shall be responsible only for care provided at that hospital, and is not 
52.33 	financially liable for the initial care provided by the transferring hospital.

52.34 	Sec. 50. Laws 2010, chapter 200, article 1, section 12, subdivision 7, is amended to 
52.35 	read:
53.1 		Subd. 7.Payments; rate setting for the hospital coordinated care delivery 
53.2 	system. (a) Effective for general assistance medical care services, with the exception 
53.3 	of outpatient prescription drug coverage, provided on or after June 1, 2010, through a 
53.4 	coordinated care delivery system, the commissioner shall allocate the annual appropriation 
53.5 	for the coordinated care delivery system to hospitals participating under subdivision 
53.6 	6 in quarterly payments, beginning on the first scheduled warrant on or after June 1, 
53.7 	2010. The payment shall be allocated among all hospitals qualified to participate on the 
53.8 	allocation date. Each hospital or group of hospitals shall receive a pro rata share of the 
53.9 	allocation based on the hospital's or group of hospitals' calendar year 2008 payments for 
53.10 	general assistance medical care services, adjusted for any limits on the number of general 
53.11 	assistance medical care enrollees accepted by a hospital, provided that, for the purposes of 
53.12 	this allocation, payments to Hennepin County Medical Center, Regions Hospital, Saint 
53.13 	Mary's Medical Center, and University of Minnesota Medical Center, Fairview, shall be 
53.14 	weighted at 110 percent of the actual amount. The commissioner may prospectively 
53.15 	reallocate payments to participating hospitals on a biannual basis to ensure that final 
53.16 	allocations reflect actual coordinated care delivery system enrollment. The 2008 base year 
53.17 	shall be updated by one calendar year each June 1, beginning June 1, 2011.
53.18 	(b) Beginning June 1, 2010, and every quarter beginning in June thereafter, the 
53.19 	commissioner shall make one-third of the quarterly payment in June and the remaining 
53.20 	two-thirds of the quarterly payment in July to each participating hospital or group of 
53.21 	hospitals.
53.22 	(b) (c) In order to be reimbursed under this section, nonhospital providers of health 
53.23 	care services shall contract with one or more hospitals described in paragraph (a) to 
53.24 	provide services to general assistance medical care recipients through the coordinated care 
53.25 	delivery system established by the hospital. The hospital shall reimburse bills submitted 
53.26 	by nonhospital providers participating under this paragraph at a rate negotiated between 
53.27 	the hospital and the nonhospital provider.
53.28 	(c) (d) The commissioner shall apply for federal matching funds under section 
53.29 	256B.199, paragraphs (a) to (d), for expenditures under this subdivision.
53.30 	(d) (e) Outpatient prescription drug coverage is provided in accordance with section 
53.31 	256D.03, subdivision 3, and paid on a fee-for-service basis under subdivision 9.

53.32 	Sec. 51. Laws 2010, chapter 200, article 1, section 12, subdivision 8, is amended to 
53.33 	read:
53.34 		Subd. 8.Temporary uncompensated care pool. (a) The commissioner shall 
53.35 	establish a temporary uncompensated care pool, effective June 1, 2010. Payments from 
54.1 	the pool must be distributed, within the limits of the available appropriation, to hospitals 
54.2 	that are not part of a coordinated care delivery system established under subdivision 
54.3 	6. Payments from the pool must also be distributed, within the limits of the available 
54.4 	appropriation, to ambulance services licensed under chapter 144E that respond to a request 
54.5 	for an emergency ambulance call or interfacility transfer for a general assistance medical 
54.6 	care enrollee, if the call or transfer originates from a location more than 25 miles from the 
54.7 	health care facility that receives the enrollee.
54.8 	(b) Hospitals seeking reimbursement from this pool must submit an invoice to 
54.9 	the commissioner in a form prescribed by the commissioner for payment for services 
54.10 	provided to an applicant or recipient not enrolled in a coordinated care delivery system. A 
54.11 	payment amount, as calculated under current law, must be determined, but not paid, for 
54.12 	each admission of or service provided to a general assistance medical care recipient on 
54.13 	or after June 1, 2010, to November 30 December 31, 2010, or until medical assistance 
54.14 	coverage is expanded to include adults without children, whichever is later.
54.15 	(c) The aggregated payment amounts for each hospital must be calculated as a 
54.16 	percentage of the total calculated amount for all hospitals.
54.17 	(d) Distributions from the uncompensated care pool for each hospital must be 
54.18 	determined by multiplying the factor in paragraph (c) by the amount of money in the 
54.19 	uncompensated care pool that is available for the six-month period.
54.20 	(e) The commissioner shall apply for federal matching funds under section 
54.21 	256B.199, paragraphs (a) to (d), for expenditures under this subdivision.
54.22 	(f) Outpatient prescription drugs are not eligible for payment under this subdivision.

54.23 	Sec. 52. Laws 2010, chapter 200, article 1, section 12, the effective date, is amended to 
54.24 	read:

54.25 	EFFECTIVE DATE. This section is effective for services rendered on or after 
54.26 	April 1, 2010, except that subdivision 4 is effective June 1, 2010.

54.27 	EFFECTIVE DATE. This section is effective retroactively from April 1, 2010.

54.28 	Sec. 53. Laws 2010, chapter 200, article 1, section 16, is amended to read:
54.29 	Sec. 16. Minnesota Statutes 2008, section 256L.05, subdivision 3c, is amended to 
54.30 	read:
54.31 		Subd. 3c.Retroactive coverage. Notwithstanding subdivision 3, the effective 
54.32 	date of coverage shall be the first day of the month following termination from medical 
54.33 	assistance for families and individuals who are eligible for MinnesotaCare and who 
55.1 	submitted a written request for retroactive MinnesotaCare coverage with a completed 
55.2 	application within 30 days of the mailing of notification of termination from medical 
55.3 	assistance. The applicant must provide all required verifications within 30 days of the 
55.4 	written request for verification. For retroactive coverage, premiums must be paid in full 
55.5 	for any retroactive month, current month, and next month within 30 days of the premium 
55.6 	billing. General assistance medical care recipients may qualify for retroactive coverage 
55.7 	under this subdivision at six-month renewal.

55.8 	EFFECTIVE DATE. This section is effective June 1, 2010.

55.9 	Sec. 54. Laws 2010, chapter 200, article 1, section 21, is amended to read:
55.10 	Sec. 21. REPEALER.
 55.11 	(a) Minnesota Statutes 2008, sections 256.742; 256.979, subdivision 8; and 256D.03, 
55.12 	subdivision 9, are repealed effective April 1, 2010.
55.13 	(b) Minnesota Statutes 2009 Supplement, section 256D.03, subdivision 4, is repealed 
55.14 	effective AprilJune 1, 2010.
55.15 	(c) Minnesota Statutes 2008, section 256B.195, subdivisions 4 and 5, are repealed 
55.16 	effective for federal fiscal year 2010.
55.17 	(d) Minnesota Statutes 2009 Supplement, section 256B.195, subdivisions 1, 2, and 
55.18 	3, are repealed effective for federal fiscal year 2010.
55.19 	(e) Minnesota Statutes 2008, sections 256L.07, subdivision 6; 256L.15, subdivision 
55.20 	4; and 256L.17, subdivision 7, are repealed January 1, 2011.

55.21 	EFFECTIVE DATE. This section is effective retroactively from April 1, 2010.

55.22 	Sec. 55. Laws 2010, chapter 200, article 2, section 2, subdivision 1, is amended to read:

55.23	Subdivision 1.Total Appropriation
 	$
	(7,985,000)
	$
	(93,128,000)

55.24	Appropriations by Fund
	
55.25		2010
	2011
	
55.26	General
	34,807,000
	118,493,000
	
55.27	Health Care Access
	(42,792,000)
	(211,621,000)
	
55.28 	The amounts that may be spent for each 
55.29 	purpose are specified in the following 
55.30 	subdivisions.
55.31 	Special Revenue Fund Transfers.
56.1 	(1) The commissioner shall transfer the 
56.2 	following amounts from special revenue 
56.3 	fund balances to the general fund by June 
56.4 	30 of each respective fiscal year: $410,000 
56.5 	for fiscal year 2010, and $412,000 for fiscal 
56.6 	year 2011.
56.7 	(2) Actual transfers made under clause (1) 
56.8 	must be separately identified and reported as 
56.9 	part of the quarterly reporting of transfers 
56.10 	to the chairs of the relevant senate budget 
56.11 	division and house of representatives finance 
56.12 	division.

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

56.14 	Sec. 56. Laws 2010, chapter 200, article 2, section 2, subdivision 8, is amended to read:

56.15	Subd. 8.Transfers
 					
56.16 	The commissioner must transfer $29,538,000 
56.17 	in fiscal year 2010 and $18,462,000 in fiscal 
56.18 	year 2011 from the health care access fund to 
56.19 	the general fund. This is a onetime transfer.
56.20 	The commissioner must transfer $4,800,000 
56.21 	from the consolidated chemical dependency 
56.22 	treatment fund to the general fund by June 
56.23 	30, 2010.
56.24 	Compulsive Gambling Special Revenue
56.25 	Administration.The lottery prize fund 
56.26 	appropriation for compulsive gambling 
56.27 	administration is reduced by $6,000 for fiscal 
56.28 	year 2010 and $4,000 for fiscal year 2011
56.29 	must be transferred from the lottery prize 
56.30 	fund appropriation for compulsive gambling 
56.31 	administration to the general fund by June 
56.32 	30 of each respective fiscal year. These are 
56.33 	onetime reductions.

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

57.2 	Sec. 57. EARLY EXPANSION.
 57.3 	All costs related to implementation of Minnesota Statutes, sections 256B.055, 
57.4 	subdivision 15, and 256B.056, subdivision 4, paragraph (e), shall be paid from the health 
57.5 	care access fund.

57.6 	EFFECTIVE DATE. This section is effective upon federal approval and is 
57.7 	retroactive to April 1, 2010.

57.8 	Sec. 58. FISCAL AND ACTUARIAL ANALYSIS.
 57.9 	The commissioner of human services shall offer a request for proposal and accept 
57.10 	bids for the completion of a complete fiscal and actuarial analysis of 2010 House File 135 
57.11 	and 2010 Senate File 118. The commissioner shall report this analysis to the chairs of the 
57.12 	health and human services finance and policy divisions in the house of representatives and 
57.13 	senate no later than December 15, 2010.

57.14 	Sec. 59.  REPEALER; TRANSFER.
 57.15 	(a) Laws 2010, chapter 200, article 1, section 12, subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 
57.16 	and 9, are repealed.
57.17 	(b) Laws 2010, chapter 200, article 1, sections 18; and 19, are repealed.
57.18 	(c) Minnesota Statutes 2008, section 256D.03, subdivisions 3a, 3b, 5, 6, 7, and 8,
57.19 	and Minnesota Statutes 2009 Supplement, section 256D.03, subdivision 3, are repealed.

57.20 	EFFECTIVE DATE. Paragraphs (a) and (b) are effective 30 days after federal 
57.21 	approval of the amendments in this article to Minnesota Statutes, sections 256B.055, 
57.22 	subdivision 15, and 256B.056, subdivision 4, or January 1, 2011, whichever is later, 
57.23 	and all remaining unspent appropriations for the program established by Laws 2010, 
57.24 	chapter 200, are transferred to the health care access fund. Paragraph (c) is effective 
57.25 	30 days after federal approval of the amendments in this article to Minnesota Statutes, 
57.26 	sections 256B.055, subdivision 15, and 256B.056, subdivision 4, or January 1, 2011, 
57.27 	whichever is later.

57.28 	ARTICLE 3
57.29 	CONTINUING CARE

57.30 	Section 1. Minnesota Statutes 2009 Supplement, section 252.27, subdivision 2a, 
57.31 	is amended to read:
58.1 		Subd. 2a.Contribution amount. (a) The natural or adoptive parents of a minor 
58.2 	child, including a child determined eligible for medical assistance without consideration of 
58.3 	parental income, must contribute to the cost of services used by making monthly payments 
58.4 	on a sliding scale based on income, unless the child is married or has been married, 
58.5 	parental rights have been terminated, or the child's adoption is subsidized according to 
58.6 	section 259.67 or through title IV-E of the Social Security Act. The parental contribution 
58.7 	is a partial or full payment for medical services provided for diagnostic, therapeutic, 
58.8 	curing, treating, mitigating, rehabilitation, maintenance, and personal care services as 
58.9 	defined in United States Code, title 26, section 213, needed by the child with a chronic 
58.10 	illness or disability.
58.11 	(b) For households with adjusted gross income equal to or greater than 100 percent 
58.12 	of federal poverty guidelines, the parental contribution shall be computed by applying the 
58.13 	following schedule of rates to the adjusted gross income of the natural or adoptive parents:
58.14 	(1) if the adjusted gross income is equal to or greater than 100 percent of federal 
58.15 	poverty guidelines and less than 175 percent of federal poverty guidelines, the parental 
58.16 	contribution is $4 per month;
58.17 	(2) if the adjusted gross income is equal to or greater than 175 percent of federal 
58.18 	poverty guidelines and less than or equal to 545 percent of federal poverty guidelines, 
58.19 	the parental contribution shall be determined using a sliding fee scale established by the 
58.20 	commissioner of human services which begins at one percent of adjusted gross income 
58.21 	at 175 percent of federal poverty guidelines and increases to 7.5 percent of adjusted 
58.22 	gross income for those with adjusted gross income up to 545 percent of federal poverty 
58.23 	guidelines; and
58.24 	(3) if the adjusted gross income is greater than 545 percent of federal poverty 
58.25 	guidelines and less than 675 percent of federal poverty guidelines, the parental 
58.26 	contribution shall be 7.512.5 percent of adjusted gross income;.
58.27 	(4) if the adjusted gross income is equal to or greater than 675 percent of federal 
58.28 	poverty guidelines and less than 975 percent of federal poverty guidelines, the parental 
58.29 	contribution shall be determined using a sliding fee scale established by the commissioner 
58.30 	of human services which begins at 7.5 percent of adjusted gross income at 675 percent of 
58.31 	federal poverty guidelines and increases to ten percent of adjusted gross income for those 
58.32 	with adjusted gross income up to 975 percent of federal poverty guidelines; and
58.33 	(5) if the adjusted gross income is equal to or greater than 975 percent of federal 
58.34 	poverty guidelines, the parental contribution shall be 12.5 percent of adjusted gross 
58.35 	income.
59.1 	If the child lives with the parent, the annual adjusted gross income is reduced by 
59.2 	$2,400 prior to calculating the parental contribution. If the child resides in an institution 
59.3 	specified in section 256B.35, the parent is responsible for the personal needs allowance 
59.4 	specified under that section in addition to the parental contribution determined under this 
59.5 	section. The parental contribution is reduced by any amount required to be paid directly to 
59.6 	the child pursuant to a court order, but only if actually paid.
59.7 	(c) The household size to be used in determining the amount of contribution under 
59.8 	paragraph (b) includes natural and adoptive parents and their dependents, including the 
59.9 	child receiving services. Adjustments in the contribution amount due to annual changes 
59.10 	in the federal poverty guidelines shall be implemented on the first day of July following 
59.11 	publication of the changes.
59.12 	(d) For purposes of paragraph (b), "income" means the adjusted gross income of the 
59.13 	natural or adoptive parents determined according to the previous year's federal tax form, 
59.14 	except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds 
59.15 	have been used to purchase a home shall not be counted as income.
59.16 	(e) The contribution shall be explained in writing to the parents at the time eligibility 
59.17 	for services is being determined. The contribution shall be made on a monthly basis 
59.18 	effective with the first month in which the child receives services. Annually upon 
59.19 	redetermination or at termination of eligibility, if the contribution exceeded the cost of 
59.20 	services provided, the local agency or the state shall reimburse that excess amount to 
59.21 	the parents, either by direct reimbursement if the parent is no longer required to pay a 
59.22 	contribution, or by a reduction in or waiver of parental fees until the excess amount is 
59.23 	exhausted. All reimbursements must include a notice that the amount reimbursed may be 
59.24 	taxable income if the parent paid for the parent's fees through an employer's health care 
59.25 	flexible spending account under the Internal Revenue Code, section 125, and that the 
59.26 	parent is responsible for paying the taxes owed on the amount reimbursed.
59.27 	(f) The monthly contribution amount must be reviewed at least every 12 months; 
59.28 	when there is a change in household size; and when there is a loss of or gain in income 
59.29 	from one month to another in excess of ten percent. The local agency shall mail a written 
59.30 	notice 30 days in advance of the effective date of a change in the contribution amount. 
59.31 	A decrease in the contribution amount is effective in the month that the parent verifies a 
59.32 	reduction in income or change in household size.
59.33 	(g) Parents of a minor child who do not live with each other shall each pay the 
59.34 	contribution required under paragraph (a). An amount equal to the annual court-ordered 
59.35 	child support payment actually paid on behalf of the child receiving services shall be 
60.1 	deducted from the adjusted gross income of the parent making the payment prior to 
60.2 	calculating the parental contribution under paragraph (b).
60.3 	(h) The contribution under paragraph (b) shall be increased by an additional five 
60.4 	percent if the local agency determines that insurance coverage is available but not 
60.5 	obtained for the child. For purposes of this section, "available" means the insurance is a 
60.6 	benefit of employment for a family member at an annual cost of no more than five percent 
60.7 	of the family's annual income. For purposes of this section, "insurance" means health 
60.8 	and accident insurance coverage, enrollment in a nonprofit health service plan, health 
60.9 	maintenance organization, self-insured plan, or preferred provider organization.
60.10 	Parents who have more than one child receiving services shall not be required 
60.11 	to pay more than the amount for the child with the highest expenditures. There shall 
60.12 	be no resource contribution from the parents. The parent shall not be required to pay 
60.13 	a contribution in excess of the cost of the services provided to the child, not counting 
60.14 	payments made to school districts for education-related services. Notice of an increase in 
60.15 	fee payment must be given at least 30 days before the increased fee is due.
60.16 	(i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if, 
60.17 	in the 12 months prior to July 1:
60.18 	(1) the parent applied for insurance for the child;
60.19 	(2) the insurer denied insurance;
60.20 	(3) the parents submitted a complaint or appeal, in writing to the insurer, submitted 
60.21 	a complaint or appeal, in writing, to the commissioner of health or the commissioner of 
60.22 	commerce, or litigated the complaint or appeal; and
60.23 	(4) as a result of the dispute, the insurer reversed its decision and granted insurance.
60.24 	For purposes of this section, "insurance" has the meaning given in paragraph (h).
60.25 	A parent who has requested a reduction in the contribution amount under this 
60.26 	paragraph shall submit proof in the form and manner prescribed by the commissioner or 
60.27 	county agency, including, but not limited to, the insurer's denial of insurance, the written 
60.28 	letter or complaint of the parents, court documents, and the written response of the insurer 
60.29 	approving insurance. The determinations of the commissioner or county agency under this 
60.30 	paragraph are not rules subject to chapter 14.

60.31 	Sec. 2. Minnesota Statutes 2008, section 256B.057, subdivision 9, is amended to read:
60.32 		Subd. 9.Employed persons with disabilities. (a) Medical assistance may be paid 
60.33 	for a person who is employed and who:
60.34 	(1) but for excess earnings or assets, meets the definition of disabled under the 
60.35 	supplemental security income program;
61.1 	(2) is at least 16 but less than 65 years of age;
61.2 	(3) meets the asset limits in paragraph (c); and
61.3 	(4) effective November 1, 2003, pays a premium and other obligations under 
61.4 	paragraph (e).
61.5 	Any spousal income or assets shall be disregarded for purposes of eligibility and premium 
61.6 	determinations.
61.7 	(b) After the month of enrollment, a person enrolled in medical assistance under 
61.8 	this subdivision who:
61.9 	(1) is temporarily unable to work and without receipt of earned income due to a 
61.10 	medical condition, as verified by a physician, may retain eligibility for up to four calendar 
61.11 	months; or
61.12 	(2) effective January 1, 2004, loses employment for reasons not attributable to the 
61.13 	enrollee, may retain eligibility for up to four consecutive months after the month of job 
61.14 	loss. To receive a four-month extension, enrollees must verify the medical condition or 
61.15 	provide notification of job loss. All other eligibility requirements must be met and the 
61.16 	enrollee must pay all calculated premium costs for continued eligibility.
61.17 	(c) For purposes of determining eligibility under this subdivision, a person's assets 
61.18 	must not exceed $20,000, excluding:
61.19 	(1) all assets excluded under section 256B.056;
61.20 	(2) retirement accounts, including individual accounts, 401(k) plans, 403(b) plans, 
61.21 	Keogh plans, and pension plans; and
61.22 	(3) medical expense accounts set up through the person's employer.
61.23 	(d)(1) Effective January 1, 2004, for purposes of eligibility, there will be a $65 
61.24 	earned income disregard. To be eligible, a person applying for medical assistance under 
61.25 	this subdivision must have earned income above the disregard level.
61.26 	(2) Effective January 1, 2004, to be considered earned income, Medicare, Social 
61.27 	Security, and applicable state and federal income taxes must be withheld. To be eligible, 
61.28 	a person must document earned income tax withholding.
61.29 	(e)(1) A person whose earned and unearned income is equal to or greater than 100 
61.30 	percent of federal poverty guidelines for the applicable family size must pay a premium 
61.31 	to be eligible for medical assistance under this subdivision. The premium shall be based 
61.32 	on the person's gross earned and unearned income and the applicable family size using a 
61.33 	sliding fee scale established by the commissioner, which begins at one percent of income 
61.34 	at 100 percent of the federal poverty guidelines and increases to 7.5 percent of income 
61.35 	for those with incomes at or above 300 percent of the federal poverty guidelines. Annual 
62.1 	adjustments in the premium schedule based upon changes in the federal poverty guidelines 
62.2 	shall be effective for premiums due in July of each year.
62.3 	(2) Effective January 1, 2004, all enrollees must pay a premium to be eligible for 
62.4 	medical assistance under this subdivision. An enrollee shall pay the greater of a $35 $50
62.5 	premium or the premium calculated in clause (1).
62.6 	(3) Effective November 1, 2003, all enrollees who receive unearned income must 
62.7 	pay one-half of one 2.5 percent of unearned income in addition to the premium amount.
62.8 	(4) Effective November 1, 2003, for enrollees whose income does not exceed 200 
62.9 	percent of the federal poverty guidelines and who are also enrolled in Medicare, the 
62.10 	commissioner must reimburse the enrollee for Medicare Part B premiums under section 
62.11 	256B.0625, subdivision 15, paragraph (a).
62.12 	(5) Increases in benefits under title II of the Social Security Act shall not be counted 
62.13 	as income for purposes of this subdivision until July 1 of each year.
62.14 	(f) A person's eligibility and premium shall be determined by the local county 
62.15 	agency. Premiums must be paid to the commissioner. All premiums are dedicated to 
62.16 	the commissioner.
62.17 	(g) Any required premium shall be determined at application and redetermined at 
62.18 	the enrollee's six-month income review or when a change in income or household size is 
62.19 	reported. Enrollees must report any change in income or household size within ten days 
62.20 	of when the change occurs. A decreased premium resulting from a reported change in 
62.21 	income or household size shall be effective the first day of the next available billing month 
62.22 	after the change is reported. Except for changes occurring from annual cost-of-living 
62.23 	increases, a change resulting in an increased premium shall not affect the premium amount 
62.24 	until the next six-month review.
62.25 	(h) Premium payment is due upon notification from the commissioner of the 
62.26 	premium amount required. Premiums may be paid in installments at the discretion of 
62.27 	the commissioner.
62.28 	(i) Nonpayment of the premium shall result in denial or termination of medical 
62.29 	assistance unless the person demonstrates good cause for nonpayment. Good cause exists 
62.30 	if the requirements specified in Minnesota Rules, part 9506.0040, subpart 7, items B to 
62.31 	D, are met. Except when an installment agreement is accepted by the commissioner, 
62.32 	all persons disenrolled for nonpayment of a premium must pay any past due premiums 
62.33 	as well as current premiums due prior to being reenrolled. Nonpayment shall include 
62.34 	payment with a returned, refused, or dishonored instrument. The commissioner may 
62.35 	require a guaranteed form of payment as the only means to replace a returned, refused, 
62.36 	or dishonored instrument.
63.1 	(j) The commissioner shall notify enrollees annually beginning at least 24 months 
63.2 	before the person's 65th birthday of the medical assistance eligibility rules affecting 
63.3 	income, assets, and treatment of a spouse's income and assets that will be applied upon 
63.4 	reaching age 65.

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

63.6 	Sec. 3. Minnesota Statutes 2009 Supplement, section 256B.0915, subdivision 3a, 
63.7 	is amended to read:
63.8 		Subd. 3a.Elderly waiver cost limits. (a) The monthly limit for the cost of 
63.9 	waivered services to an individual elderly waiver client except for individuals described 
63.10 	in paragraph (b) shall be the weighted average monthly nursing facility rate of the case 
63.11 	mix resident class to which the elderly waiver client would be assigned under Minnesota 
63.12 	Rules, parts 9549.0050 to 9549.0059, less the recipient's maintenance needs allowance 
63.13 	as described in subdivision 1d, paragraph (a), until the first day of the state fiscal year in 
63.14 	which the resident assessment system as described in section 256B.438 for nursing home 
63.15 	rate determination is implemented. Effective on the first day of the state fiscal year in 
63.16 	which the resident assessment system as described in section 256B.438 for nursing home 
63.17 	rate determination is implemented and the first day of each subsequent state fiscal year, the 
63.18 	monthly limit for the cost of waivered services to an individual elderly waiver client shall 
63.19 	be the rate of the case mix resident class to which the waiver client would be assigned 
63.20 	under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect on the last day of the 
63.21 	previous state fiscal year, adjusted by the greater of any legislatively adopted home and 
63.22 	community-based services percentage rate increase or the average statewide percentage 
63.23 	increase in nursing facility payment rates adjustment.
63.24 	(b) The monthly limit for the cost of waivered services to an individual elderly 
63.25 	waiver client assigned to a case mix classification A under paragraph (a) with (1) no 
63.26 	dependencies in activities of daily living, (2) only one dependency in bathing, dressing, 
63.27 	grooming, or walking, or (3) a dependency score of less than three if eating is the only 
63.28 	dependency, shall be the lower of the case mix classification amount for case mix A as 
63.29 	determined under paragraph (a) or the case mix classification amount for case mix A 
63.30 	effective on October 1, 2008, per month for all new participants enrolled in the program 
63.31 	on or after July 1, 2009. This monthly limit shall be applied to all other participants who 
63.32 	meet this criteria at reassessment.
63.33 	(c) If extended medical supplies and equipment or environmental modifications are 
63.34 	or will be purchased for an elderly waiver client, the costs may be prorated for up to 
63.35 	12 consecutive months beginning with the month of purchase. If the monthly cost of a 
64.1 	recipient's waivered services exceeds the monthly limit established in paragraph (a) or 
64.2 	(b), the annual cost of all waivered services shall be determined. In this event, the annual 
64.3 	cost of all waivered services shall not exceed 12 times the monthly limit of waivered 
64.4 	services as described in paragraph (a) or (b).

64.5 	Sec. 4. Minnesota Statutes 2008, section 256B.0915, subdivision 3b, is amended to 
64.6 	read:
64.7 		Subd. 3b.Cost limits for elderly waiver applicants who reside in a nursing 
64.8 	facility. (a) For a person who is a nursing facility resident at the time of requesting a 
64.9 	determination of eligibility for elderly waivered services, a monthly conversion limit for 
64.10 	the cost of elderly waivered services may be requested. The monthly conversion limit for 
64.11 	the cost of elderly waiver services shall be the resident class assigned under Minnesota 
64.12 	Rules, parts 9549.0050 to 9549.0059, for that resident in the nursing facility where 
64.13 	the resident currently resides until July 1 of the state fiscal year in which the resident 
64.14 	assessment system as described in section 256B.438 for nursing home rate determination 
64.15 	is implemented. Effective on July 1 of the state fiscal year in which the resident 
64.16 	assessment system as described in section 256B.438 for nursing home rate determination 
64.17 	is implemented, the monthly conversion limit for the cost of elderly waiver services shall 
64.18 	be the per diem nursing facility rate as determined by the resident assessment system as 
64.19 	described in section 256B.438 for that residentresidents in the nursing facility where the 
64.20 	resident currently resides, but in effect on June 30, 2010, and adjusted annually by any 
64.21 	legislatively adopted percentage change in the elderly waiver services rates. That per 
64.22 	diem shall be multiplied by 365 and, divided by 12, lessand reduced by the recipient's 
64.23 	maintenance needs allowance as described in subdivision 1d. The initially approved 
64.24 	conversion rate maymust be adjusted by the greater of any subsequent legislatively 
64.25 	adopted home and community-based services percentage rate increase or the average 
64.26 	statewide percentage increase in nursing facility payment rates adjustment. The limit 
64.27 	under this subdivision only applies to persons discharged from a nursing facility after a 
64.28 	minimum 30-day stay and found eligible for waivered services on or after July 1, 1997. 
64.29 	For conversions from the nursing home to the elderly waiver with consumer directed 
64.30 	community support services, the conversion rate limit is equal to the nursing facility rate 
64.31 	reduced by a percentage equal to the percentage difference between the consumer directed 
64.32 	services budget limit that would be assigned according to the federally approved waiver 
64.33 	plan and the corresponding community case mix cap, but not to exceed 50 percent.
64.34 	(b) The following costs must be included in determining the total monthly costs 
64.35 	for the waiver client:
65.1 	(1) cost of all waivered services, including extended medicalspecialized supplies 
65.2 	and equipment and environmental modifications andaccessibility adaptations; and
65.3 	(2) cost of skilled nursing, home health aide, and personal care services reimbursable 
65.4 	by medical assistance.

65.5 	Sec. 5. Minnesota Statutes 2009 Supplement, section 256B.69, subdivision 23, is 
65.6 	amended to read:
65.7 		Subd. 23.Alternative services; elderly and disabled persons. (a) The 
65.8 	commissioner may implement demonstration projects to create alternative integrated 
65.9 	delivery systems for acute and long-term care services to elderly persons and persons 
65.10 	with disabilities as defined in section 256B.77, subdivision 7a, that provide increased 
65.11 	coordination, improve access to quality services, and mitigate future cost increases. 
65.12 	The commissioner may seek federal authority to combine Medicare and Medicaid 
65.13 	capitation payments for the purpose of such demonstrations and may contract with 
65.14 	Medicare-approved special needs plans to provide Medicaid services. Medicare funds and 
65.15 	services shall be administered according to the terms and conditions of the federal contract 
65.16 	and demonstration provisions. For the purpose of administering medical assistance funds, 
65.17 	demonstrations under this subdivision are subject to subdivisions 1 to 22. The provisions 
65.18 	of Minnesota Rules, parts 9500.1450 to 9500.1464, apply to these demonstrations, 
65.19 	with the exceptions of parts 9500.1452, subpart 2, item B; and 9500.1457, subpart 1, 
65.20 	items B and C, which do not apply to persons enrolling in demonstrations under this 
65.21 	section. An initial open enrollment period may be provided. Persons who disenroll from 
65.22 	demonstrations under this subdivision remain subject to Minnesota Rules, parts 9500.1450 
65.23 	to 9500.1464. When a person is enrolled in a health plan under these demonstrations and 
65.24 	the health plan's participation is subsequently terminated for any reason, the person shall 
65.25 	be provided an opportunity to select a new health plan and shall have the right to change 
65.26 	health plans within the first 60 days of enrollment in the second health plan. Persons 
65.27 	required to participate in health plans under this section who fail to make a choice of 
65.28 	health plan shall not be randomly assigned to health plans under these demonstrations. 
65.29 	Notwithstanding section 256L.12, subdivision 5, and Minnesota Rules, part 9505.5220, 
65.30 	subpart 1, item A, if adopted, for the purpose of demonstrations under this subdivision, 
65.31 	the commissioner may contract with managed care organizations, including counties, to 
65.32 	serve only elderly persons eligible for medical assistance, elderly and disabled persons, or 
65.33 	disabled persons only. For persons with a primary diagnosis of developmental disability, 
65.34 	serious and persistent mental illness, or serious emotional disturbance, the commissioner 
65.35 	must ensure that the county authority has approved the demonstration and contracting 
66.1 	design. Enrollment in these projects for persons with disabilities shall be voluntary. The 
66.2 	commissioner shall not implement any demonstration project under this subdivision for 
66.3 	persons with a primary diagnosis of developmental disabilities, serious and persistent 
66.4 	mental illness, or serious emotional disturbance, without approval of the county board of 
66.5 	the county in which the demonstration is being implemented.
66.6 	(b) Notwithstanding chapter 245B, sections 252.40 to 252.46, 256B.092, 256B.501 
66.7 	to 256B.5015, and Minnesota Rules, parts 9525.0004 to 9525.0036, 9525.1200 to 
66.8 	9525.1330, 9525.1580, and 9525.1800 to 9525.1930, the commissioner may implement 
66.9 	under this section projects for persons with developmental disabilities. The commissioner 
66.10 	may capitate payments for ICF/MR services, waivered services for developmental 
66.11 	disabilities, including case management services, day training and habilitation and 
66.12 	alternative active treatment services, and other services as approved by the state and by the 
66.13 	federal government. Case management and active treatment must be individualized and 
66.14 	developed in accordance with a person-centered plan. Costs under these projects may not 
66.15 	exceed costs that would have been incurred under fee-for-service. Beginning July 1, 2003, 
66.16 	and until four years after the pilot project implementation date, subcontractor participation 
66.17 	in the long-term care developmental disability pilot is limited to a nonprofit long-term 
66.18 	care system providing ICF/MR services, home and community-based waiver services, 
66.19 	and in-home services to no more than 120 consumers with developmental disabilities in 
66.20 	Carver, Hennepin, and Scott Counties. The commissioner shall report to the legislature 
66.21 	prior to expansion of the developmental disability pilot project. This paragraph expires 
66.22 	four years after the implementation date of the pilot project.
66.23 	(c) Before implementation of a demonstration project for disabled persons, the 
66.24 	commissioner must provide information to appropriate committees of the house of 
66.25 	representatives and senate and must involve representatives of affected disability groups 
66.26 	in the design of the demonstration projects.
66.27 	(d) A nursing facility reimbursed under the alternative reimbursement methodology 
66.28 	in section 256B.434 may, in collaboration with a hospital, clinic, or other health care entity 
66.29 	provide services under paragraph (a). The commissioner shall amend the state plan and 
66.30 	seek any federal waivers necessary to implement this paragraph.
66.31 	(e) The commissioner, in consultation with the commissioners of commerce and 
66.32 	health, may approve and implement programs for all-inclusive care for the elderly (PACE) 
66.33 	according to federal laws and regulations governing that program and state laws or rules 
66.34 	applicable to participating providers. The process for approval of these programs shall 
66.35 	begin only after the commissioner receives grant money in an amount sufficient to cover 
66.36 	the state share of the administrative and actuarial costs to implement the programs during 
67.1 	state fiscal years 2006 and 2007. Grant amounts for this purpose shall be deposited in an 
67.2 	account in the special revenue fund and are appropriated to the commissioner to be used 
67.3 	solely for the purpose of PACE administrative and actuarial costs. A PACE provider is 
67.4 	not required to be licensed or certified as a health plan company as defined in section 
67.5 	62Q.01, subdivision 4. Persons age 55 and older who have been screened by the county 
67.6 	and found to be eligible for services under the elderly waiver or community alternatives 
67.7 	for disabled individuals or who are already eligible for Medicaid but meet level of 
67.8 	care criteria for receipt of waiver services may choose to enroll in the PACE program. 
67.9 	Medicare and Medicaid services will be provided according to this subdivision and 
67.10 	federal Medicare and Medicaid requirements governing PACE providers and programs. 
67.11 	PACE enrollees will receive Medicaid home and community-based services through the 
67.12 	PACE provider as an alternative to services for which they would otherwise be eligible 
67.13 	through home and community-based waiver programs and Medicaid State Plan Services. 
67.14 	The commissioner shall establish Medicaid rates for PACE providers that do not exceed 
67.15 	costs that would have been incurred under fee-for-service or other relevant managed care 
67.16 	programs operated by the state.
67.17 	(f) The commissioner shall seek federal approval to expand the Minnesota disability 
67.18 	health options (MnDHO) program established under this subdivision in stages, first to 
67.19 	regional population centers outside the seven-county metro area and then to all areas of 
67.20 	the state. Until July 1, 2009, expansion for MnDHO projects that include home and 
67.21 	community-based services is limited to the two projects and service areas in effect on 
67.22 	March 1, 2006. Enrollment in integrated MnDHO programs that include home and 
67.23 	community-based services shall remain voluntary. Costs for home and community-based 
67.24 	services included under MnDHO must not exceed costs that would have been incurred 
67.25 	under the fee-for-service program. Notwithstanding whether expansion occurs under 
67.26 	this paragraph, in determining MnDHO payment rates and risk adjustment methods for 
67.27 	contract years starting in 2012, the commissioner must consider the methods used to 
67.28 	determine county allocations for home and community-based program participants. If 
67.29 	necessary to reduce MnDHO rates to comply with the provision regarding MnDHO costs 
67.30 	for home and community-based services, the commissioner shall achieve the reduction by 
67.31 	maintaining the base rate for contract years 2010 and 2011 for services provided under the 
67.32 	community alternatives for disabled individuals waiver at the same level as for contract 
67.33 	year 2009. The commissioner may apply other reductions to MnDHO rates to implement 
67.34 	decreases in provider payment rates required by state law. In developing program 
67.35 	specifications for expansion of integrated programs, the commissioner shall involve and 
67.36 	consult the state-level stakeholder group established in subdivision 28, paragraph (d), 
68.1 	including consultation on whether and how to include home and community-based waiver 
68.2 	programs. Plans for further expansion of MnDHO projects shall be presented to the chairs 
68.3 	of the house of representatives and senate committees with jurisdiction over health and 
68.4 	human services policy and finance by February 1, 2007.
68.5 	(g) Notwithstanding section 256B.0261, health plans providing services under this 
68.6 	section are responsible for home care targeted case management and relocation targeted 
68.7 	case management. Services must be provided according to the terms of the waivers and 
68.8 	contracts approved by the federal government.

68.9 	Sec. 6. [256.4825] REPORT REGARDING PROGRAMS AND SERVICES FOR 
68.10 	PEOPLE WITH DISABILITIES.
68.11 	The Minnesota State Council on Disability, the Minnesota Consortium for Citizens 
68.12 	with Disabilities, and the Arc of Minnesota may submit an annual report by January 15 of 
68.13 	each year, beginning in 2012, to the chairs and ranking minority members of the legislative 
68.14 	committees with jurisdiction over programs serving people with disabilities as provided in 
68.15 	this section. The report must describe the existing state policies and goals for programs 
68.16 	serving people with disabilities including, but not limited to, programs for employment, 
68.17 	transportation, housing, education, quality assurance, consumer direction, physical and 
68.18 	programmatic access, and health. The report must provide data and measurements to 
68.19 	assess the extent to which the policies and goals are being met. The commissioner of 
68.20 	human services and the commissioners of other state agencies administering programs for 
68.21 	people with disabilities shall cooperate with the Minnesota State Council on Disability, 
68.22 	the Minnesota Consortium for Citizens with Disabilities, and the Arc of Minnesota and 
68.23 	provide those organizations with existing published information and reports that will assist 
68.24 	in the preparation of the report.

68.25 	Sec. 7. CASE MANAGEMENT REFORM.
 68.26 	(a) By February 1, 2011, the commissioner of human services shall provide specific 
68.27 	recommendations and language for proposed legislation to:
68.28 	(1) define the administrative and the service functions of case management and make 
68.29 	changes to improve the funding for administrative functions;
68.30 	(2) standardize and simplify processes, standards, and timelines for administrative 
68.31 	functions of case management within the Department of Human Services, Disability 
68.32 	Services Division, including eligibility determinations, resource allocation, management 
68.33 	of dollars, provision for assignment of one case manager at a time per person, waiting lists, 
69.1 	quality assurance, host county concurrence requirements, county of financial responsibility 
69.2 	provisions, and waiver compliance; and
69.3 	(3) increase opportunities for consumer choice of case management functions 
69.4 	involving service coordination.
69.5 	(b) In developing these recommendations, the commissioner shall consider the 
69.6 	recommendations of the 2007 Redesigning Case Management Services for Persons 
69.7 	with Disabilities report and consult with existing stakeholder groups, which include 
69.8 	representatives of counties, disability and senior advocacy groups, service providers, and 
69.9 	representatives of agencies which provide contracted case management.

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

69.11 	Sec. 8. COMMISSIONER TO SEEK FEDERAL MATCH.
 69.12 	(a) The commissioner of human services shall seek federal financial participation 
69.13 	for eligible activity related to fiscal years 2010 and 2011 grants to Advocating Change 
69.14 	Together to establish a statewide self-advocacy network for persons with developmental 
69.15 	disabilities and for eligible activities under any future grants to the organization.
69.16 	(b) The commissioner shall report to the chairs of the senate Health and Human 
69.17 	Services Budget Division and the house of representatives Health Care and Human 
69.18 	Services Finance Division by December 15, 2010, with the results of the application for 
69.19 	federal matching funds.

69.20 	ARTICLE 4
69.21 	CHILDREN AND FAMILY SERVICES

69.22 	Section 1. Minnesota Statutes 2008, section 119B.025, subdivision 1, is amended to 
69.23 	read:
69.24 		Subdivision 1.Factors which must be verified. (a) The county shall verify the 
69.25 	following at all initial child care applications using the universal application:
69.26 	(1) identity of adults;
69.27 	(2) presence of the minor child in the home, if questionable;
69.28 	(3) relationship of minor child to the parent, stepparent, legal guardian, eligible 
69.29 	relative caretaker, or the spouses of any of the foregoing;
69.30 	(4) age;
69.31 	(5) immigration status, if related to eligibility;
69.32 	(6) Social Security number, if given;
69.33 	(7) income;
70.1 	(8) spousal support and child support payments made to persons outside the 
70.2 	household;
70.3 	(9) residence; and
70.4 	(10) inconsistent information, if related to eligibility.
70.5 	(b) If a family did not use the universal application or child care addendum to apply 
70.6 	for child care assistance, the family must complete the universal application or child care 
70.7 	addendum at its next eligibility redetermination and the county must verify the factors 
70.8 	listed in paragraph (a) as part of that redetermination. Once a family has completed a 
70.9 	universal application or child care addendum, the county shall use the redetermination 
70.10 	form described in paragraph (c) for that family's subsequent redeterminations. Eligibility 
70.11 	must be redetermined at least every six months. For a family where at least one parent is 
70.12 	under the age of 21, does not have a high school or general equivalency diploma, and is a 
70.13 	student in a school district or another similar program that provides or arranges for child 
70.14 	care, as well as parenting, social services, career and employment supports, and academic 
70.15 	support to achieve high school graduation, the redetermination of eligibility shall be 
70.16 	deferred beyond six months, but not to exceed 12 months, to the end of the student's 
70.17 	school year. If a family reports a change in an eligibility factor before the family's next 
70.18 	regularly scheduled redetermination, the county must recalculate eligibility without 
70.19 	requiring verification of any eligibility factor that did not change.
70.20 	(c) The commissioner shall develop a redetermination form to redetermine eligibility 
70.21 	and a change report form to report changes that minimize paperwork for the county and 
70.22 	the participant.
70.23 	(d) Families have the primary responsibility to verify information. A county must 
70.24 	consider the family's circumstances and ability to produce verification when initiating a 
70.25 	request for verification. If a family is unable to verify an eligibility factor, the county 
70.26 	must request written consent from the family to obtain verification from other sources. A 
70.27 	county may not request a specific form of verification if another is more readily available. 
70.28 	When verification of an eligibility factor other than income is not available despite the 
70.29 	efforts of the county and the family, the county must accept a signed statement from the 
70.30 	family attesting to the correctness of the information if one is provided. The county must 
70.31 	deny or end assistance to families who refuse or deliberately fail to verify information.

70.32 	EFFECTIVE DATE. This section is effective October 15, 2010.

70.33 	Sec. 2. Minnesota Statutes 2008, section 119B.09, subdivision 4, is amended to read:
70.34 		Subd. 4.Eligibility; annual income; calculation. Annual income of the applicant 
70.35 	family is the current monthly income of the family multiplied by 12 or the income for 
71.1 	the 12-month period immediately preceding the date of application, or income calculated 
71.2 	by the method which provides the most accurate assessment of income available to the 
71.3 	family. Self-employment income must be calculated based on gross receipts less operating 
71.4 	expenses. Income must be recalculated when the family's income changes, but no less 
71.5 	often than every six months. For a family where at least one parent is under the age 
71.6 	of 21, does not have a high school or general equivalency diploma, and is a student in 
71.7 	a school district or another similar program that provides or arranges for child care, 
71.8 	as well as parenting, social services, career and employment supports, and academic 
71.9 	support to achieve high school graduation, income must be recalculated when the family's 
71.10 	income changes, but otherwise shall be deferred beyond six months, but not to exceed 12 
71.11 	months, to the end of the student's school year. Income must be verified with documentary 
71.12 	evidence. If the applicant does not have sufficient evidence of income, verification must 
71.13 	be obtained from the source of the income.

71.14 	EFFECTIVE DATE. This section is effective October 15, 2010.

71.15 	Sec. 3. Minnesota Statutes 2008, section 119B.11, subdivision 1, is amended to read:
71.16 		Subdivision 1.County contributions required. (a) In addition to payments from 
71.17 	basic sliding fee child care program participants, each county shall contribute from county 
71.18 	tax or other sources a fixed local match maintenance of effort equal to its calendar year 
71.19 	1996 required county contribution reduced by the administrative funding loss that would 
71.20 	have occurred in state fiscal year 1996 under section 119B.15, except the maintenance of 
71.21 	effort for a county must be equal to at least 1.1 percent of the county's basic sliding fee 
71.22 	direct services allocation for the previous calendar year and no greater than six percent 
71.23 	of the county's basic sliding fee direct services allocation for the previous calendar year. 
71.24 	The commissioner shall recover funds from the county as necessary to bring county 
71.25 	expenditures into compliance with this subdivision. The commissioner may accept county 
71.26 	contributions, including contributions above the fixed local match county maintenance of 
71.27 	effort, in order to make state payments.
71.28 	(b) The commissioner may accept payments from counties to:
71.29 	(1) fulfill the county contribution as required under subdivision 1;
71.30 	(2) pay for services authorized under this chapter beyond those paid for with federal 
71.31 	or state funds or with the required county contributions; or
71.32 	(3) pay for child care services in addition to those authorized under this chapter, as 
71.33 	authorized under other federal, state, or local statutes or regulations.
71.34 	(c) The county payments must be deposited in an account in the special revenue 
71.35 	fund. Money in this account is appropriated to the commissioner for child care assistance 
72.1 	under this chapter and other applicable statutes and regulations and is in addition to other 
72.2 	state and federal appropriations.

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

72.4 	Sec. 4. Minnesota Statutes 2008, section 256D.0515, is amended to read:
72.5 	256D.0515 ASSET LIMITATIONS FOR FOOD STAMP HOUSEHOLDS.
72.6 	All food stamp households must be determined eligible for the benefit discussed 
72.7 	under section 256.029. Food stamp households must demonstrate that:
72.8 	(1) their gross income meets the federal Food Stamp requirements under United 
72.9 	States Code, title 7, section 2014(c); and is equal to or less than 165 percent of the federal 
72.10 	poverty guidelines for the same family size.
72.11 	(2) they have financial resources, excluding vehicles, of less than $7,000.

72.12 	Sec. 5. Minnesota Statutes 2008, section 256J.20, subdivision 3, is amended to read:
72.13 		Subd. 3.Other property limitations. To be eligible for MFIP, the equity value of 
72.14 	all nonexcluded real and personal property of the assistance unit must not exceed $2,000 
72.15 	for applicants and $5,000 for ongoing participants. The value of assets in clauses (1) to 
72.16 	(19) must be excluded when determining the equity value of real and personal property:
72.17 	(1) a licensed vehicle up to a loan value of less than or equal to $15,000 $7,500. If the 
72.18 	assistance unit owns more than one licensed vehicle, the county agency shall determine the 
72.19 	loan value of all additional vehicles and exclude the combined loan value of less than or 
72.20 	equal to $7,500. The county agency shall apply any excess loan value as if it were equity 
72.21 	value to the asset limit described in this section,. If the assistance unit owns more than 
72.22 	one licensed vehicle, the county agency shall determine the vehicle with the highest loan 
72.23 	value and count only the loan value over $7,500, excluding: (i) the value of one vehicle 
72.24 	per physically disabled person when the vehicle is needed to transport the disabled unit 
72.25 	member; this exclusion does not apply to mentally disabled people; (ii) the value of special 
72.26 	equipment for a disabled member of the assistance unit; and (iii) any vehicle used for 
72.27 	long-distance travel, other than daily commuting, for the employment of a unit member.
72.28 	The county agency shall count the loan value of all other vehicles and apply this 
72.29 	amount as if it were equity value to the asset limit described in this section. To establish the 
72.30 	loan value of vehicles, a county agency must use the N.A.D.A. Official Used Car Guide, 
72.31 	Midwest Edition, for newer model cars. When a vehicle is not listed in the guidebook, 
72.32 	or when the applicant or participant disputes the loan value listed in the guidebook as 
72.33 	unreasonable given the condition of the particular vehicle, the county agency may require 
73.1 	the applicant or participant document the loan value by securing a written statement from 
73.2 	a motor vehicle dealer licensed under section 168.27, stating the amount that the dealer 
73.3 	would pay to purchase the vehicle. The county agency shall reimburse the applicant or 
73.4 	participant for the cost of a written statement that documents a lower loan value; 
73.5 	(2) the value of life insurance policies for members of the assistance unit;
73.6 	(3) one burial plot per member of an assistance unit;
73.7 	(4) the value of personal property needed to produce earned income, including 
73.8 	tools, implements, farm animals, inventory, business loans, business checking and 
73.9 	savings accounts used at least annually and used exclusively for the operation of a 
73.10 	self-employment business, and any motor vehicles if at least 50 percent of the vehicle's use 
73.11 	is to produce income and if the vehicles are essential for the self-employment business;
73.12 	(5) the value of personal property not otherwise specified which is commonly 
73.13 	used by household members in day-to-day living such as clothing, necessary household 
73.14 	furniture, equipment, and other basic maintenance items essential for daily living;
73.15 	(6) the value of real and personal property owned by a recipient of Supplemental 
73.16 	Security Income or Minnesota supplemental aid;
73.17 	(7) the value of corrective payments, but only for the month in which the payment 
73.18 	is received and for the following month;
73.19 	(8) a mobile home or other vehicle used by an applicant or participant as the 
73.20 	applicant's or participant's home;
73.21 	(9) money in a separate escrow account that is needed to pay real estate taxes or 
73.22 	insurance and that is used for this purpose;
73.23 	(10) money held in escrow to cover employee FICA, employee tax withholding, 
73.24 	sales tax withholding, employee worker compensation, business insurance, property rental, 
73.25 	property taxes, and other costs that are paid at least annually, but less often than monthly;
73.26 	(11) monthly assistance payments for the current month's or short-term emergency 
73.27 	needs under section 256J.626, subdivision 2; 
73.28 	(12) the value of school loans, grants, or scholarships for the period they are 
73.29 	intended to cover;
73.30 	(13) payments listed in section 256J.21, subdivision 2, clause (9), which are held 
73.31 	in escrow for a period not to exceed three months to replace or repair personal or real 
73.32 	property; 
73.33 	(14) income received in a budget month through the end of the payment month;
73.34 	(15) savings from earned income of a minor child or a minor parent that are set aside 
73.35 	in a separate account designated specifically for future education or employment costs;
74.1 	(16) the federal earned income credit, Minnesota working family credit, state and 
74.2 	federal income tax refunds, state homeowners and renters credits under chapter 290A, 
74.3 	property tax rebates and other federal or state tax rebates in the month received and the 
74.4 	following month;
74.5 	(17) payments excluded under federal law as long as those payments are held in a 
74.6 	separate account from any nonexcluded funds;
74.7 	(18) the assets of children ineligible to receive MFIP benefits because foster care or 
74.8 	adoption assistance payments are made on their behalf; and
74.9 	(19) the assets of persons whose income is excluded under section 256J.21, 
74.10 	subdivision 2, clause (43). 

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

74.12 	Sec. 6. Minnesota Statutes 2008, section 256J.24, subdivision 10, is amended to read:
74.13 		Subd. 10.MFIP exit level. The commissioner shall adjust the MFIP earned income 
74.14 	disregard to ensure that most participants do not lose eligibility for MFIP until their 
74.15 	income reaches at least 115 110 percent of the federal poverty guidelines in effect in 
74.16 	October of each fiscal year at the time of the adjustment. The adjustment to the disregard 
74.17 	shall be based on a household size of three, and the resulting earned income disregard 
74.18 	percentage must be applied to all household sizes. The adjustment under this subdivision 
74.19 	must be implemented at the same time as the October food stamp or whenever there is a
74.20 	food support cost-of-living adjustment is reflected in the food portion of MFIP transitional 
74.21 	standard as required under subdivision 5a.

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

74.23 	Sec. 7. Minnesota Statutes 2008, section 256J.37, subdivision 3a, is amended to read:
74.24 		Subd. 3a.Rental subsidies; unearned income. (a) Effective July 1, 2003, The 
74.25 	county agency shall count $50$100 of the value of public and assisted rental subsidies 
74.26 	provided through the Department of Housing and Urban Development (HUD) as unearned 
74.27 	income to the cash portion of the MFIP grant. The full amount of the subsidy must be 
74.28 	counted as unearned income when the subsidy is less than $50 $100. The income from 
74.29 	this subsidy shall be budgeted according to section 256J.34. 
74.30 	(b) The provisions of this subdivision shall not apply to an MFIP assistance unit 
74.31 	which includes a participant who is:
74.32 	(1) age 60 or older;
75.1 	(2) a caregiver who is suffering from an illness, injury, or incapacity that has been 
75.2 	certified by a qualified professional when the illness, injury, or incapacity is expected 
75.3 	to continue for more than 30 days and prevents the person from obtaining or retaining 
75.4 	employment; or
75.5 	(3) a caregiver whose presence in the home is required due to the illness or 
75.6 	incapacity of another member in the assistance unit, a relative in the household, or a foster 
75.7 	child in the household when the illness or incapacity and the need for the participant's 
75.8 	presence in the home has been certified by a qualified professional and is expected to 
75.9 	continue for more than 30 days.
75.10 	(c) The provisions of this subdivision shall not apply to an MFIP assistance unit 
75.11 	where the parental caregiver is an SSI recipient.
75.12 	(d) Prior to implementing this provision, the commissioner must identify the MFIP 
75.13 	participants subject to this provision and provide written notice to these participants at 
75.14 	least 30 days before the first grant reduction. The notice must inform the participant of the 
75.15 	basis for the potential grant reduction, the exceptions to the provision, if any, and inform 
75.16 	the participant of the steps necessary to claim an exception. A person who is found not to 
75.17 	meet one of the exceptions to the provision must be notified and informed of the right to a 
75.18 	fair hearing under section 256J.40. The notice must also inform the participant that the 
75.19 	participant may be eligible for a rent reduction resulting from a reduction in the MFIP 
75.20 	grant and encourage the participant to contact the local housing authority. 

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

75.22 	Sec. 8. Minnesota Statutes 2009 Supplement, section 256J.425, subdivision 3, is 
75.23 	amended to read:
75.24 		Subd. 3.Hard-to-employ participants. (a) An assistance unit subject to the time 
75.25 	limit in section 256J.42, subdivision 1, is eligible to receive months of assistance under 
75.26 	a hardship extension if the participant who reached the time limit belongs to any of the 
75.27 	following groups: 
75.28 	(1) a person who is diagnosed by a licensed physician, psychological practitioner, or 
75.29 	other qualified professional, as developmentally disabled or mentally ill, and the condition 
75.30 	severely limits the person's ability to obtain or maintain suitable employment;
75.31 	(2) a person who:
75.32 	(i) has been assessed by a vocational specialist or the county agency to be 
75.33 	unemployable for purposes of this subdivision; or
75.34 	(ii) has an IQ below 80 who has been assessed by a vocational specialist or a county 
75.35 	agency to be employable, but the condition severely limits the person's ability to obtain or 
76.1 	maintain suitable employment. The determination of IQ level must be made by a qualified 
76.2 	professional. In the case of a non-English-speaking person: (A) the determination must 
76.3 	be made by a qualified professional with experience conducting culturally appropriate 
76.4 	assessments, whenever possible; (B) the county may accept reports that identify an 
76.5 	IQ range as opposed to a specific score; (C) these reports must include a statement of 
76.6 	confidence in the results;
76.7 	(3) a person who is determined by a qualified professional to be learning disabled, 
76.8 	and the condition severely limits the person's ability to obtain or maintain suitable 
76.9 	employment. For purposes of the initial approval of a learning disability extension, the 
76.10 	determination must have been made or confirmed within the previous 12 months. In the 
76.11 	case of a non-English-speaking person: (i) the determination must be made by a qualified 
76.12 	professional with experience conducting culturally appropriate assessments, whenever 
76.13 	possible; and (ii) these reports must include a statement of confidence in the results. If a 
76.14 	rehabilitation plan for a participant extended as learning disabled is developed or approved 
76.15 	by the county agency, the plan must be incorporated into the employment plan. However, 
76.16 	a rehabilitation plan does not replace the requirement to develop and comply with an 
76.17 	employment plan under section 256J.521; or 
76.18 	(4) a person who has been granted a family violence waiver, and who is complying 
76.19 	with an employment plan under section 256J.521, subdivision 3. 
76.20 	(b) For purposes of this section chapter, "severely limits the person's ability to obtain 
76.21 	or maintain suitable employment" means: 
76.22 	(1) that a qualified professional has determined that the person's condition prevents 
76.23 	the person from working 20 or more hours per week; or 
76.24 	(2) for a person who meets the requirements of paragraph (a), clause (2), item (ii), or 
76.25 	clause (3), a qualified professional has determined the person's condition:
76.26 	(i) significantly restricts the range of employment that the person is able to perform; 
76.27 	or 
76.28 	(ii) significantly interferes with the person's ability to obtain or maintain suitable 
76.29 	employment for 20 or more hours per week.

76.30 	Sec. 9. QUALITY RATING SYSTEM TRAINING, COACHING, 
76.31 	CONSULTATION, AND SUPPORTS.
 76.32 	The commissioner of human services shall direct $500,000 in federal child care 
76.33 	development funds used for grants under Minnesota Statutes, section 119B.21, in fiscal 
76.34 	year 2011 for the purpose of providing statewide child care provider training, coaching, 
76.35 	consultation, and supports to prepare for the voluntary Minnesota quality rating system. 
77.1 	This is a onetime appropriation. In addition, to the extent that private funds are made 
77.2 	available, the commissioner shall designate those funds for this purpose.

77.3 	Sec. 10. CHILD CARE ASSISTANCE REDETERMINATION OF ELIGIBILITY 
77.4 	AND INFORMATION VERIFICATION.
 77.5 	The commissioner of human services shall use existing resources to implement 
77.6 	the changes in this act related to child care assistance redetermination of eligibility and 
77.7 	information verification under Minnesota Statutes, sections 119B.025, subdivision 1, and 
77.8 	119B.09, subdivision 4.

77.9 	ARTICLE 5
77.10 	MISCELLANEOUS

77.11 	Section 1. [62A.3075] CANCER CHEMOTHERAPY TREATMENT 
77.12 	COVERAGE.
77.13 	(a) A health plan company that provides coverage under a health plan for cancer 
77.14 	chemotherapy treatment shall not require a higher co-payment, deductible, or coinsurance 
77.15 	amount for a prescribed, orally administered anticancer medication that is used to kill or 
77.16 	slow the growth of cancerous cells than what the health plan requires for an intravenously 
77.17 	administered or injected cancer medication that is provided, regardless of formulation or 
77.18 	benefit category determination by the health plan company.
77.19 	(b) A health plan company must not achieve compliance with this section 
77.20 	by imposing an increase in co-payment, deductible, or coinsurance amount for an 
77.21 	intravenously administered or injected cancer chemotherapy agent covered under the 
77.22 	health plan.
77.23 	(c) Nothing in this section shall be interpreted to prohibit a health plan company 
77.24 	from requiring prior authorization or imposing other appropriate utilization controls in 
77.25 	approving coverage for any chemotherapy.
77.26 	(d) A plan offered by the commissioner of management and budget under section 
77.27 	43A.23 is deemed to be at parity and in compliance with this section.

77.28 	EFFECTIVE DATE. Paragraphs (a) and (c) are effective August 1, 2010, and apply 
77.29 	to health plans providing coverage to a Minnesota resident offered, issued, sold, renewed, 
77.30 	or continued as defined in Minnesota Statutes, section 60A.02, subdivision 2a, on or after 
77.31 	that date. Paragraph (b) is effective the day following final enactment.

77.32 	Sec. 2. [62A.3094] COVERAGE FOR AUTISM SPECTRUM DISORDERS.
78.1 		Subdivision 1.Definitions. (a) For purposes of this section, the terms defined in 
78.2 	paragraphs (b) to (e) have the meanings given.
78.3 	(b) "Autism spectrum disorder" means the following conditions as determined by 
78.4 	criteria set forth in the most recent edition of the Diagnostic and Statistical Manual of 
78.5 	Mental Disorders of the American Psychiatric Association:
78.6 	(1) autism or autistic disorder;
78.7 	(2) Asperger's syndrome; or
78.8 	(3) pervasive developmental disorder - not otherwise specified.
78.9 	(c) "Board-certified behavior analyst" means an individual certified by the Behavior 
78.10 	Analyst Certification Board as a board-certified behavior analyst.
78.11 	(d) "Evidence-based," for purposes of this section only, is as described in subdivision 
78.12 	2, paragraph (c), clause (2).
78.13 	(e) "Health plan" has the meaning given in section 62Q.01, subdivision 3.
78.14 	(f) "Manualized approach" means a self-contained volume, text, or set of 
78.15 	instructional media, which may include videos or compact discs, that codifies in 
78.16 	reasonable detail the procedures for implementing treatment.
78.17 	(g) "Medical necessity" or "medically necessary care" has the meaning given in 
78.18 	section 62Q.53, subdivision 2.
78.19 	(h) "Mental health professional" has the meaning given in section 245.4871, 
78.20 	subdivision 27, clauses (1) to (6).
78.21 	(i) "Qualified mental health behavioral aide" means a mental health behavioral aide 
78.22 	as defined in section 256B.0943, subdivision 7.
78.23 	(j) "Qualified mental health practitioner" means a mental health practitioner as 
78.24 	defined in section 245.4871, subdivision 26.
78.25 	(k) "Statistically superior outcomes" means a research study in which the probability 
78.26 	that the results would be obtained under the null hypothesis is less than five percent.
78.27 		Subd. 2.Coverage required. (a) For coverage requirements to apply, an individual 
78.28 	must have a diagnosis of autism spectrum disorder made through an evaluation of the 
78.29 	patient, completed within the six months prior to the start of treatment, which includes 
78.30 	all of the following:
78.31 	(1) a complete medical and psychological evaluation performed by a licensed 
78.32 	physician and psychologist using empirically validated tools or tests that incorporate 
78.33 	measures for intellectual functioning, language development, adaptive skills, and 
78.34 	behavioral problems, which must include:
78.35 	(i) a developmental history of the child, focusing on developmental milestones 
78.36 	and delays;
79.1 	(ii) a family history, including whether there are other family members with an 
79.2 	autism spectrum disorder, developmental disability, fragile X syndrome, or tuberous 
79.3 	sclerosis;
79.4 	(iii) a medical history, including signs of deterioration, seizure activity, brain injury, 
79.5 	and head circumference;
79.6 	(iv) a physical examination completed within the past 12 months;
79.7 	(v) an evaluation for intellectual functioning;
79.8 	(vi) a lead screening for those children with a developmental disability; and
79.9 	(vii) other evaluations and testing as indicated by the medical evaluation, which 
79.10 	may include neuropsychological testing, occupational therapy, physical therapy, family 
79.11 	functioning, genetic testing, imaging laboratory tests, and electrophysiological testing;
79.12 	(2) a communication assessment conducted by a speech pathologist; and
79.13 	(3) a comprehensive hearing test conducted by an audiologist with experience in 
79.14 	testing very young children.
79.15 	(b) A health plan must provide coverage for the diagnosis, evaluation, assessment, 
79.16 	and medically necessary care of autism spectrum disorders that is evidence-based, 
79.17 	including but not limited to:
79.18 	(1) neurodevelopmental and behavioral health treatments, instruction, and 
79.19 	management;
79.20 	(2) applied behavior analysis and intensive early intervention services, including 
79.21 	service package models such as intensive early intervention behavior therapy services 
79.22 	and Lovaas therapy;
79.23 	(3) speech therapy;
79.24 	(4) occupational therapy;
79.25 	(5) physical therapy; and
79.26 	(6) prescription medications.
79.27 	(c) Coverage required under this section shall include treatment that is in accordance 
79.28 	with:
79.29 	(1) an individualized treatment plan prescribed by the insured's treating physician or 
79.30 	mental health professional as defined in this section; and
79.31 	(2) medically and scientifically accepted evidence that meets the criteria of a 
79.32 	peer-reviewed, published study that is one of the following:
79.33 	(i) a randomized study with adequate statistical power, including a sample size of 
79.34 	30 or more for each group, that shows statistically superior outcomes to a pill placebo 
79.35 	group, psychological placebo group, another treatment group, or a wait list control group, 
80.1 	or that is equivalent to another evidence-based treatment that meets the above standard 
80.2 	for the specified problem area; or
80.3 	(ii) a series of at least three single-case design experiments with clear specification 
80.4 	of the subjects and with clear specification of the treatment approach that:
80.5 	(A) use robust experimental designs;
80.6 	(B) show statistically superior outcomes to pill placebo, psychological placebo, 
80.7 	or another treatment group; and 
80.8 	(C) either use a manualized approach or are conducted by at least two independent 
80.9 	investigators or teams; or
80.10 	(3) where evidence meeting the standards of this subdivision does not exist for 
80.11 	the treatment of a diagnosed condition or for an individual matching the demographic 
80.12 	characteristics for which the evidence is valid, practice guidelines based on consensus 
80.13 	of Minnesota health care professionals knowledgeable in the treatment of individuals 
80.14 	with autism spectrum disorders. 
80.15 	(d) Early intensive behavior therapies that meet the criteria set forth in paragraphs 
80.16 	(b) and (c) must also meet the following best practices standards:
80.17 	(1) the services must be prescribed by a mental health professional as an appropriate 
80.18 	treatment option for the individual child;
80.19 	(2) regular reporting of services provided and the child's progress must be submitted 
80.20 	to the prescribing mental health professional;
80.21 	(3) care must include appropriate parent or legal guardian education and 
80.22 	involvement;
80.23 	(4) the medically prescribed treatment and frequency of services should be 
80.24 	coordinated between the school and provider for all children up to age 21; and
80.25 	(5) services must be provided by a mental health professional or, as appropriate, a 
80.26 	board-certified behavior analyst, a qualified mental health practitioner, or a qualified 
80.27 	mental health behavioral aide.
80.28 	(e) Providers under this section must work with the commissioner in implementing 
80.29 	evidence-based practices and, specifically for children under age 21, the Minnesota 
80.30 	Evidence-Based Practice Database of research-informed practice elements and specific 
80.31 	constituent practices.
80.32 	(f) A health plan company may not refuse to renew or reissue, or otherwise terminate 
80.33 	or restrict coverage of an individual solely because the individual is diagnosed with an 
80.34 	autism spectrum disorder.
81.1 	(g) A health plan company may request an updated treatment plan only once every 
81.2 	six months, unless the health plan company and the treating physician or mental health 
81.3 	professional agree that a more frequent review is necessary due to emerging circumstances.
81.4 		Subd. 3.Supervision, delegation of duties, and observation of qualified mental 
81.5 	health practitioner, board-certified behavior analyst, or mental health behavioral 
81.6 	aide.  A mental health professional who uses the services of a qualified mental health 
81.7 	practitioner, board-certified behavior analyst, or qualified mental health behavioral aide for 
81.8 	the purpose of assisting in the provision of services to patients who have autism spectrum 
81.9 	disorder is responsible for functions performed by these service providers. The qualified 
81.10 	mental health professional must maintain clinical supervision of services they provide 
81.11 	and accept full responsibility for their actions. The services provided must be medically 
81.12 	necessary and identified in the child's individual treatment plan. Service providers must 
81.13 	document their activities in written progress notes that reflect implementation of the 
81.14 	individual treatment plan.
81.15 		Subd. 4.State health care programs. This section does not affect benefits 
81.16 	available under the medical assistance, MinnesotaCare, and general assistance medical 
81.17 	care programs, and the state employee group insurance plan offered under sections 
81.18 	43A.22 to 43A.30. These programs and the state employee group insurance plan must 
81.19 	maintain current levels of coverage, and section 256B.0644 shall continue to apply. 
81.20 	The commissioner shall monitor these services and report to the chairs of the house 
81.21 	of representatives and senate standing committees that have jurisdiction over health 
81.22 	and human services by February 1, 2011, whether there are gaps in the level of service 
81.23 	provided by these programs and the state employee group insurance plan, and the level of 
81.24 	service provided by private health plans following enactment of this section.
81.25 		Subd. 5.No effect on other law. Nothing in this section limits in any way the 
81.26 	coverage required under sections 62Q.47 and 62Q.53.

81.27 	EFFECTIVE DATE. This section is effective August 1, 2010, and applies to 
81.28 	coverage offered, issued, sold, renewed, or continued as defined in Minnesota Statutes, 
81.29 	section 60A.02, subdivision 2a, on or after that date.

81.30 	Sec. 3. Minnesota Statutes 2008, section 62J.38, is amended to read:
81.31 	62J.38 COST CONTAINMENT DATA FROM GROUP PURCHASERS.
81.32 	(a) The commissioner shall require group purchasers to submit detailed data on total 
81.33 	health care spending for each calendar year. Group purchasers shall submit data for the 
82.1 	1993 calendar year by April 1, 1994, and each April 1 thereafter shall submit data for the 
82.2 	preceding calendar year.
82.3 	(b) The commissioner shall require each group purchaser to submit data on revenue, 
82.4 	expenses, and member months, as applicable. Revenue data must distinguish between 
82.5 	premium revenue and revenue from other sources and must also include information 
82.6 	on the amount of revenue in reserves and changes in reserves. Expenditure data must 
82.7 	distinguish between costs incurred for patient care and administrative costs, including 
82.8 	amounts paid to contractors, subcontractors, and other entities for the purpose of managing 
82.9 	provider utilization or distributing provider payments. Patient care and administrative 
82.10 	costs must include only expenses incurred on behalf of health plan members and must 
82.11 	not include the cost of providing health care services for nonmembers at facilities owned 
82.12 	by the group purchaser or affiliate. Expenditure data must be provided separately 
82.13 	for the following categories and for other categories required by the commissioner: 
82.14 	physician services, dental services, other professional services, inpatient hospital services, 
82.15 	outpatient hospital services, emergency, pharmacy services and other nondurable medical 
82.16 	goods, mental health, and chemical dependency services, other expenditures, subscriber 
82.17 	liability, and administrative costs. Administrative costs must include costs for marketing; 
82.18 	advertising; overhead; salaries and benefits of central office staff who do not provide 
82.19 	direct patient care; underwriting; lobbying; claims processing; provider contracting and 
82.20 	credentialing; detection and prevention of payment for fraudulent or unjustified requests 
82.21 	for reimbursement or services; clinical quality assurance and other types of medical care 
82.22 	quality improvement efforts; concurrent or prospective utilization review as defined in 
82.23 	section 62M.02; costs incurred to acquire a hospital, clinic, or health care facility, or the 
82.24 	assets thereof; capital costs incurred on behalf of a hospital or clinic; lease payments; or 
82.25 	any other costs incurred pursuant to a partnership, joint venture, integration, or affiliation 
82.26 	agreement with a hospital, clinic, or other health care provider. Capital costs and costs 
82.27 	incurred must be recorded according to standard accounting principles. The reports of 
82.28 	this data must also separately identify expenses for local, state, and federal taxes, fees, 
82.29 	and assessments. The commissioner may require each group purchaser to submit any 
82.30 	other data, including data in unaggregated form, for the purposes of developing spending 
82.31 	estimates, setting spending limits, and monitoring actual spending and costs. In addition to 
82.32 	reporting administrative costs incurred to acquire a hospital, clinic, or health care facility, 
82.33 	or the assets thereof; or any other costs incurred pursuant to a partnership, joint venture, 
82.34 	integration, or affiliation agreement with a hospital, clinic, or other health care provider; 
82.35 	reports submitted under this section also must include the payments made during the 
82.36 	calendar year for these purposes. The commissioner shall make public, by group purchaser 
83.1 	data collected under this paragraph in accordance with section 62J.321, subdivision 5. 
83.2 	Workers' compensation insurance plans and automobile insurance plans are exempt from 
83.3 	complying with this paragraph as it relates to the submission of administrative costs.  
83.4 	(c) The commissioner may collect information on:
83.5 	(1) premiums, benefit levels, managed care procedures, and other features of health 
83.6 	plan companies;
83.7 	(2) prices, provider experience, and other information for services less commonly 
83.8 	covered by insurance or for which patients commonly face significant out-of-pocket 
83.9 	expenses; and
83.10 	(3) information on health care services not provided through health plan companies, 
83.11 	including information on prices, costs, expenditures, and utilization.
83.12 	(d) All group purchasers shall provide the required data using a uniform format and 
83.13 	uniform definitions, as prescribed by the commissioner.

83.14 	Sec. 4. [62Q.545] COVERAGE OF PRIVATE DUTY NURSING SERVICES.
83.15 	(a) A health plan must cover private duty nursing services as provided under section 
83.16 	256B.0625, subdivision 7, for persons who are covered under the health plan and require 
83.17 	private duty nursing services.
83.18 	(b) For purposes of this section, a period of private duty nursing services may 
83.19 	be subject to the co-payment, coinsurance, deductible, or other enrollee cost-sharing 
83.20 	requirements that apply under the health plan. Cost-sharing requirements for private duty 
83.21 	nursing services must not place a greater financial burden on the insured or enrollee than 
83.22 	those requirements applied by the health plan to other similar services or benefits.

83.23 	EFFECTIVE DATE. This section is effective July 1, 2010, and applies to health 
83.24 	plans offered, sold, issued, or renewed on or after that date.

83.25 	Sec. 5. Minnesota Statutes 2008, section 62Q.76, subdivision 1, is amended to read:
83.26 		Subdivision 1.Applicability. For purposes of sections 62Q.76 to 62Q.79 62Q.791, 
83.27 	the terms defined in this section contract, health care provider, dental plan, dental 
83.28 	organization, dentist, and enrollee have the meanings given them in sections 62Q.733 
83.29 	and 62Q.76.  

83.30 	Sec. 6. [62Q.791] CONTRACTS WITH DENTAL CARE PROVIDERS.
83.31 	(a) Notwithstanding any other provision of law, no contract of any dental 
83.32 	organization licensed under chapter 62C for provision of dental care services may:
84.1 	(1) require, directly or indirectly, that a dentist or health care provider provide dental 
84.2 	care services to its enrollees at a fee set by the dental organization, unless the services 
84.3 	provided are covered dental care services for enrollees under the dental plan or contract; or
84.4 	(2) prohibit, directly or indirectly, the dentist or health care provider from offering or 
84.5 	providing dental care services that are not covered dental care services under the dental 
84.6 	plan or contract, on terms and conditions acceptable to the enrollee and the dentist or 
84.7 	health care provider. For purposes of this section, "covered dental care services" means 
84.8 	dental care services that are expressly covered under the dental plan or contract, including 
84.9 	dental care services that are subject to contractual limitations such as deductibles, 
84.10 	co-payments, annual maximums, and waiting periods.
84.11 	(b) When making payment or otherwise adjudicating any claim for dental care 
84.12 	services provided to an enrollee, a dental organization or dental plan must clearly identify 
84.13 	on an explanation of benefits form or other form of claim resolution the amount, if any, 
84.14 	that is the enrollee's responsibility to pay to the enrollee's dentist or health care provider.
84.15 	(c) This section does not apply to any contract for the provision of dental care 
84.16 	services under any public program sponsored or funded by the state or federal government.

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

84.18 	Sec. 7. [245.6971] ADVISORY GROUP ON STATE-OPERATED SERVICES 
84.19 	REDESIGN.
84.20 		Subdivision 1.Establishment. The Advisory Group on State-Operated Services 
84.21 	Redesign is established to make recommendations to the commissioner of human services 
84.22 	and the legislature on the continuum of services needed to provide individuals with 
84.23 	complex conditions including mental illness and developmental disabilities access to 
84.24 	quality care and the appropriate level of care across the state to promote wellness, reduce 
84.25 	cost, and improve efficiency.
84.26 		Subd. 2.Duties. The Advisory Group on State-Operated Services Redesign shall 
84.27 	make recommendations to the commissioner and the legislature no later than December 
84.28 	15, 2010, on the following:
84.29 	(1) transformation needed to improve service delivery and provide a continuum of 
84.30 	care, such as transition of current facilities, closure of current facilities, or the development 
84.31 	of new models of care;
84.32 	(2) gaps and barriers to accessing quality care, system inefficiencies, and cost 
84.33 	pressures;
84.34 	(3) services that are best provided by the state and those that are best provided 
84.35 	in the community;
85.1 	(4) an implementation plan to achieve integrated service delivery across the public, 
85.2 	private, and nonprofit sectors;
85.3 	(5) an implementation plan to ensure that individuals with complex chemical and 
85.4 	mental health needs receive the appropriate level of care to achieve recovery and wellness; 
85.5 	and
85.6 	(6) financing mechanisms that include all possible revenue sources to maximize 
85.7 	federal funding and promote cost efficiencies and sustainability.
85.8 		Subd. 3.Membership. The advisory group shall be composed of the following, 
85.9 	who will serve at the pleasure of their appointing authority:
85.10 	(1) the commissioner of human services or the commissioner's designee, and two 
85.11 	additional representatives from the department;
85.12 	(2) two legislators appointed by the speaker of the house, one from the minority 
85.13 	and one from the majority;
85.14 	(3) two legislators appointed by the senate rules committee, one from the minority 
85.15 	and one from the majority;
85.16 	(4) one representative appointed by AFSCME Council 5;
85.17 	(5) one representative appointed by the ombudsman for mental health and 
85.18 	developmental disabilities;
85.19 	(6) one representative appointed by the Minnesota Association of Professional 
85.20 	Employees;
85.21 	(7) one representative appointed by the Minnesota Hospital Association;
85.22 	(8) one representative appointed by the Minnesota Nurses Association;
85.23 	(9) one representative appointed by NAMI-MN;
85.24 	(10) one representative appointed by the Mental Health Association of Minnesota;
85.25 	(11) one representative appointed by the Minnesota Association Of Community 
85.26 	Mental Health Programs;
85.27 	(12) one representative appointed by the Minnesota Dental Association;
85.28 	(13) three clients or client family members representing different populations 
85.29 	receiving services from state-operated services, who are appointed by the commissioner;
85.30 	(14) one representative appointed by the chair of the state-operated services 
85.31 	governing board; and
85.32 	(15) one representative appointed by the Minnesota Disability Law Center.
85.33 		Subd. 4.Administration. The commissioner shall convene the first meeting of the 
85.34 	advisory group and shall provide administrative support and staff.
85.35 		Subd. 5.Recommendations. The advisory group must report its recommendations 
85.36 	to the commissioner and to the legislature no later than December 15, 2010.
86.1 		Subd. 6.Expiration. This section expires January 31, 2011.

86.2 	Sec. 8. [245.6972] LEGISLATIVE APPROVAL REQUIRED.
86.3 	The commissioner of human services shall not redesign or move state-operated 
86.4 	services programs without specific legislative approval. The commissioner may proceed 
86.5 	with redesign at the Mankato Crisis Center and the closure of the Community Behavioral 
86.6 	Health Hospital in Cold Spring.

86.7 	Sec. 9. Minnesota Statutes 2009 Supplement, section 252.025, subdivision 7, is 
86.8 	amended to read:
86.9 		Subd. 7.Minnesota extended treatment options. The commissioner shall develop 
86.10 	by July 1, 1997, the Minnesota extended treatment options to serve Minnesotans who have 
86.11 	developmental disabilities and exhibit severe behaviors which present a risk to public 
86.12 	safety. This program is statewide and must provide specialized residential services in 
86.13 	Cambridge and an array of community-based services with sufficient levels of care and a 
86.14 	sufficient number of specialists to ensure that individuals referred to the program receive 
86.15 	the appropriate care. The number of beds at the Cambridge facility may be reorganized 
86.16 	into two 16-bed facilities, one for individuals with developmental disabilities and one 
86.17 	for individuals with developmental disabilities and a co-occurring mental illness, with 
86.18 	the remaining beds converted into transitional intensive treatment foster homes.The 
86.19 	individuals working in the community-based services under this section are state 
86.20 	employees supervised by the commissioner of human services. No layoffs shall occur as a 
86.21 	result of restructuring under this section.

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

86.23 	Sec. 10. Minnesota Statutes 2008, section 254B.01, subdivision 2, is amended to read:
86.24 		Subd. 2.American Indian. For purposes of services provided under section 
86.25 	254B.09, subdivision 7 254B.09, subdivision 8, "American Indian" means a person who is 
86.26 	a member of an Indian tribe, and the commissioner shall use the definitions of "Indian" 
86.27 	and "Indian tribe" and "Indian organization" provided in Public Law 93-638. For purposes 
86.28 	of services provided under section 254B.09, subdivision 4 254B.09, subdivision 6, 
86.29 	"American Indian" means a resident of federally recognized tribal lands who is recognized 
86.30 	as an Indian person by the federally recognized tribal governing body.  

86.31 	Sec. 11. Minnesota Statutes 2008, section 254B.02, subdivision 1, is amended to read:
87.1 		Subdivision 1.Chemical dependency treatment allocation. The chemical 
87.2 	dependency funds appropriated for allocation treatment appropriation shall be placed in 
87.3 	a special revenue account. The commissioner shall annually transfer funds from the 
87.4 	chemical dependency fund to pay for operation of the drug and alcohol abuse normative 
87.5 	evaluation system and to pay for all costs incurred by adding two positions for licensing 
87.6 	of chemical dependency treatment and rehabilitation programs located in hospitals for 
87.7 	which funds are not otherwise appropriated. Six percent of the remaining money must 
87.8 	be reserved for tribal allocation under section 254B.09, subdivisions 4 and 5. The 
87.9 	commissioner shall annually divide the money available in the chemical dependency 
87.10 	fund that is not held in reserve by counties from a previous allocation, or allocated to 
87.11 	the American Indian chemical dependency tribal account. Six percent of the remaining 
87.12 	money must be reserved for the nonreservation American Indian chemical dependency 
87.13 	allocation for treatment of American Indians by eligible vendors under section 254B.05, 
87.14 	subdivision 1. The remainder of the money must be allocated among the counties 
87.15 	according to the following formula, using state demographer data and other data sources 
87.16 	determined by the commissioner: in the special revenue account must be used according 
87.17 	to the requirements in this chapter.
87.18 	(a) For purposes of this formula, American Indians and children under age 14 are 
87.19 	subtracted from the population of each county to determine the restricted population.
87.20 	(b) The amount of chemical dependency fund expenditures for entitled persons for 
87.21 	services not covered by prepaid plans governed by section 256B.69 in the previous year is 
87.22 	divided by the amount of chemical dependency fund expenditures for entitled persons for 
87.23 	all services to determine the proportion of exempt service expenditures for each county. 
87.24 	(c) The prepaid plan months of eligibility is multiplied by the proportion of exempt 
87.25 	service expenditures to determine the adjusted prepaid plan months of eligibility for 
87.26 	each county.
87.27 	(d) The adjusted prepaid plan months of eligibility is added to the number of 
87.28 	restricted population fee for service months of eligibility for the Minnesota family 
87.29 	investment program, general assistance, and medical assistance and divided by the county 
87.30 	restricted population to determine county per capita months of covered service eligibility.
87.31 	(e) The number of adjusted prepaid plan months of eligibility for the state is added 
87.32 	to the number of fee for service months of eligibility for the Minnesota family investment 
87.33 	program, general assistance, and medical assistance for the state restricted population and 
87.34 	divided by the state restricted population to determine state per capita months of covered 
87.35 	service eligibility.
88.1 	(f) The county per capita months of covered service eligibility is divided by the 
88.2 	state per capita months of covered service eligibility to determine the county welfare 
88.3 	caseload factor.
88.4 	(g) The median married couple income for the most recent three-year period 
88.5 	available for the state is divided by the median married couple income for the same period 
88.6 	for each county to determine the income factor for each county.
88.7 	(h) The county restricted population is multiplied by the sum of the county welfare 
88.8 	caseload factor and the county income factor to determine the adjusted population.
88.9 	(i) $15,000 shall be allocated to each county.
88.10 	(j) The remaining funds shall be allocated proportional to the county adjusted 
88.11 	population.

88.12 	Sec. 12. Minnesota Statutes 2008, section 254B.02, subdivision 5, is amended to read:
88.13 		Subd. 5.Administrative adjustment. The commissioner may make payments to 
88.14 	local agencies from money allocated under this section to support administrative activities 
88.15 	under sections 254B.03 and 254B.04. The administrative payment must not exceed 
88.16 	the lesser of (1) five percent of the first $50,000, four percent of the next $50,000, and 
88.17 	three percent of the remaining payments for services from the allocation special revenue 
88.18 	account according to subdivision 1; or (2) the local agency administrative payment for 
88.19 	the fiscal year ending June 30, 2009, adjusted in proportion to the statewide change in 
88.20 	the appropriation for this chapter. 

88.21 	Sec. 13. Minnesota Statutes 2008, section 254B.03, subdivision 4, is amended to read:
88.22 		Subd. 4.Division of costs. Except for services provided by a county under 
88.23 	section 254B.09, subdivision 1, or services provided under section 256B.69 or 256D.03, 
88.24 	subdivision 4, paragraph (b), the county shall, out of local money, pay the state for 
88.25 	15 16.14 percent of the cost of chemical dependency services, including those services 
88.26 	provided to persons eligible for medical assistance under chapter 256B and general 
88.27 	assistance medical care under chapter 256D. Counties may use the indigent hospitalization 
88.28 	levy for treatment and hospital payments made under this section. Fifteen 16.14 percent 
88.29 	of any state collections from private or third-party pay, less 15 percent of for the cost 
88.30 	of payment and collections, must be distributed to the county that paid for a portion of 
88.31 	the treatment under this section. If all funds allocated according to section 254B.02 are 
88.32 	exhausted by a county and the county has met or exceeded the base level of expenditures 
88.33 	under section 254B.02, subdivision 3, the county shall pay the state for 15 percent of the 
88.34 	costs paid by the state under this section. The commissioner may refuse to pay state funds 
89.1 	for services to persons not eligible under section 254B.04, subdivision 1, if the county 
89.2 	financially responsible for the persons has exhausted its allocation. 

89.3 	Sec. 14. Minnesota Statutes 2008, section 254B.05, subdivision 4, is amended to read:
89.4 		Subd. 4.Regional treatment centers. Regional treatment center chemical 
89.5 	dependency treatment units are eligible vendors. The commissioner may expand the 
89.6 	capacity of chemical dependency treatment units beyond the capacity funded by direct 
89.7 	legislative appropriation to serve individuals who are referred for treatment by counties 
89.8 	and whose treatment will be paid for with a county's allocation under section 254B.02 by 
89.9 	funding under this chapter or other funding sources. Notwithstanding the provisions of 
89.10 	sections 254B.03 to 254B.041, payment for any person committed at county request to 
89.11 	a regional treatment center under chapter 253B for chemical dependency treatment and 
89.12 	determined to be ineligible under the chemical dependency consolidated treatment fund, 
89.13 	shall become the responsibility of the county.  

89.14 	Sec. 15. Minnesota Statutes 2008, section 254B.06, subdivision 2, is amended to read:
89.15 		Subd. 2.Allocation of collections. The commissioner shall allocate all federal 
89.16 	financial participation collections to the reserve fund under section 254B.02, subdivision 3
89.17 	a special revenue account. The commissioner shall retain 85 allocate 83.86 percent of 
89.18 	patient payments and third-party payments to the special revenue account and allocate 
89.19 	the collections to the treatment allocation for the county that is financially responsible 
89.20 	for the person. Fifteen 16.14 percent of patient and third-party payments must be paid
89.21 	to the county financially responsible for the patient. Collections for patient payment and 
89.22 	third-party payment for services provided under section 254B.09 shall be allocated to the 
89.23 	allocation of the tribal unit which placed the person. Collections of federal financial 
89.24 	participation for services provided under section 254B.09 shall be allocated to the tribal 
89.25 	reserve account under section 254B.09, subdivision 5.

89.26 	Sec. 16. Minnesota Statutes 2008, section 254B.09, subdivision 8, is amended to read:
89.27 		Subd. 8.Payments to improve services to American Indians. The commissioner 
89.28 	may set rates for chemical dependency services to American Indians according to the 
89.29 	American Indian Health Improvement Act, Public Law 94-437, for eligible vendors. 
89.30 	These rates shall supersede rates set in county purchase of service agreements when 
89.31 	payments are made on behalf of clients eligible according to Public Law 94-437.

89.32 	Sec. 17. [254B.13] PILOT PROJECTS; CHEMICAL HEALTH CARE.
90.1 		Subdivision 1.Authorization for pilot projects. The commissioner of human 
90.2 	services may approve and implement pilot projects developed under the planning process 
90.3 	required under Laws 2009, chapter 79, article 7, section 26, to provide alternatives to and 
90.4 	enhance coordination of the delivery of chemical health services required under section 
90.5 	254B.03.
90.6 		Subd. 2.Program design and implementation. (a) The commissioner of 
90.7 	human services and counties participating in the pilot projects shall continue to work in 
90.8 	partnership to refine and implement the pilot projects initiated under Laws 2009, chapter 
90.9 	79, article 7, section 26.
90.10 	(b) The commissioner and counties participating in the pilot projects shall 
90.11 	complete the planning phase by June 30, 2010, and, if approved by the commissioner for 
90.12 	implementation, enter into agreements governing the operation of the pilot projects with 
90.13 	implementation scheduled no earlier than July 1, 2010.
90.14 		Subd. 3.Program evaluation.  The commissioner of human services shall evaluate 
90.15 	pilot projects under this section and report the results of the evaluation to the legislative 
90.16 	committees with jurisdiction over chemical health by June 30, 2013. Evaluation of the 
90.17 	pilot projects must be based on outcome evaluation criteria negotiated with the projects 
90.18 	prior to implementation.
90.19 		Subd. 4.Notice of project discontinuation. Each county's participation in the 
90.20 	pilot project may be discontinued for any reason by the county or the commissioner of 
90.21 	human services after 30 days' written notice to the other party. Any unspent funds held 
90.22 	for the exiting county's pro rata share in the special revenue fund under the authority 
90.23 	in subdivision 5, paragraph (c), shall be transferred to the general fund following 
90.24 	discontinuation of the pilot project.
90.25 		Subd. 5.Duties of commissioner. (a) Notwithstanding any other provisions in 
90.26 	this chapter, the commissioner may authorize pilot projects to use chemical dependency 
90.27 	treatment funds to pay for services:
90.28 	(1) in addition to those authorized under section 254B.03, subdivision 2, paragraph 
90.29 	(a); and
90.30 	(2) by vendors in addition to those authorized under section 254B.05 when not 
90.31 	providing chemical dependency treatment services.
90.32 	(b) State expenditures for chemical dependency services and any other services 
90.33 	provided by or through the pilot projects must not be greater than chemical dependency 
90.34 	treatment fund expenditures expected in the absence of the pilot projects. The 
90.35 	commissioner may restructure the schedule of payments between the state and participating 
91.1 	counties under the local agency share and division of cost provisions under section 
91.2 	254B.03, subdivisions 3 and 4, as necessary to facilitate the operation of the pilot projects.
91.3 	(c) To the extent that state fiscal year expenditures within a pilot project region are 
91.4 	less than expected in the absence of the pilot projects, the commissioner may deposit 
91.5 	these unexpended funds in the special revenue fund and make these funds available for 
91.6 	expenditure by the pilot counties the following year. To the extent that treatment and pilot 
91.7 	project ancillary services expenditures within the pilot project exceed the amount expected 
91.8 	in the absence of the pilot projects, the pilot counties are responsible for the portion of 
91.9 	nontreatment expenditures in excess of otherwise expected expenditures.
91.10 	(d) The commissioner may waive administrative rule requirements which are 
91.11 	incompatible with the implementation of the pilot project.
91.12 	(e) The commissioner shall not approve or enter into any agreement related to pilot 
91.13 	projects authorized under this section which puts current or future federal funding at risk.
91.14 		Subd. 6.Duties of county board. The county board, or other county entity that is 
91.15 	approved to administer a pilot project, shall:
91.16 	(1) administer the pilot project in a manner consistent with the objectives described 
91.17 	in subdivision 2 and the planning process in subdivision 5;
91.18 	(2) ensure that no one is denied chemical dependency treatment services for which 
91.19 	they would otherwise be eligible under section 254A.03, subdivision 3; and
91.20 	(3) provide the commissioner of human services with timely and pertinent 
91.21 	information as negotiated in agreements governing operation of the pilot projects.

91.22 	Sec. 18. Minnesota Statutes 2008, section 256.01, is amended by adding a subdivision 
91.23 	to read:
91.24 		Subd. 30.Office of Health Care Inspector General. (a) The commissioner shall 
91.25 	create within the Department of Human Services an Office of Health Care Inspector 
91.26 	General to enhance antifraud activities and to protect the integrity of the state health care 
91.27 	programs, as well as the health and welfare of the beneficiaries of those programs. The 
91.28 	Office of Health Care Inspector General must periodically report to the commissioner and 
91.29 	to the legislature program and management problems and recommendations to correct 
91.30 	them.
91.31 	(b) The duties of the Office of Health Care Inspector General include, but are not 
91.32 	limited to:
91.33 	(1) promoting economy, efficiency, and effectiveness through the elimination of 
91.34 	waste, fraud, and abuse;
92.1 	(2) conducting and supervising audits, investigations, inspections, and evaluations 
92.2 	relating to the state health care programs under chapters 256B, 256D, and 256L;
92.3 	(3) identifying weaknesses giving rise to opportunities for fraud and abuse in the 
92.4 	state health care programs and operations and making recommendations to prevent their 
92.5 	recurrence;
92.6 	(4) leading and coordinating activities to prevent and detect fraud and abuse in the 
92.7 	state health care programs and operations;
92.8 	(5) detecting wrongdoers and abusers of the state health care programs and 
92.9 	beneficiaries so appropriate remedies may be brought;
92.10 	(6) keeping the commissioner and the legislature fully and currently informed about 
92.11 	problems and deficiencies in the administration of the state health care programs and 
92.12 	operations and about the need for and progress of corrective action;
92.13 	(7) operating a toll-free hotline to permit individuals to call in suspected fraud, 
92.14 	waste, or abuse, referring the calls for appropriate action by the agency, and analyzing the 
92.15 	calls to identify trends and patterns of fraud and abuse needing attention;
92.16 	(8) developing and reviewing legislative, regulatory, and program proposals to 
92.17 	reduce vulnerabilities to fraud, waste, and mismanagement; and
92.18 	(9) recommending changes in program policies, regulations, and laws to improve 
92.19 	efficiency and effectiveness, and to prevent fraud, waste, abuse, and mismanagement.
92.20 	(c) Beginning July 1, 2011, the commissioner, in consultation with the Office of 
92.21 	Health Care Inspector General, shall annually report to the legislature and the governor 
92.22 	new results from the two ongoing federal Medicaid audits. The commissioner shall report 
92.23 	(1) the most recent Medicaid Integrity Program (MIP) audit results, with any corrective 
92.24 	actions needed, and (2) certify the rate of errors determined for the state health care 
92.25 	programs under chapters 256B, 256D, and 256L, as determined from the most recent 
92.26 	Payment Error Rate Measurement (PERM) audit results for Minnesota. When the PERM 
92.27 	audit rate for Minnesota is greater than the national rate for the year or the MIP audit 
92.28 	determines the need for corrective action, the commissioner shall present a plan to the 
92.29 	legislature and the governor for the corrective actions and reduction of the error rate 
92.30 	in the next calendar year.

92.31 	Sec. 19. Laws 2009, chapter 79, article 3, section 18, is amended to read:
92.32 	Sec. 18. REQUIRING THE DEVELOPMENT OF COMMUNITY-BASED 
92.33 	MENTAL HEALTH SERVICES FOR PATIENTS COMMITTED TO THE 
92.34 	ANOKA-METRO REGIONAL TREATMENT CENTER.
 93.1 	In consultation with community partners, the commissioner of human services The 
93.2 	Advisory Group on State-Operated Services Redesign shall develop recommend an array 
93.3 	of community-based services to transform the current services now provided to patients 
93.4 	at the Anoka-Metro Regional Treatment Center. The community-based services may 
93.5 	be provided in facilities with 16 or fewer beds, and must provide the appropriate level 
93.6 	of care for the patients being admitted to the facilities. The planning for this transition 
93.7 	must be completed by October 1, 2009 2010, with an initial report to the committee chairs 
93.8 	of health and human services by November 30, 2009 2010, and a semiannual report on 
93.9 	progress until the transition is completed. The commissioner of human services shall 
93.10 	solicit interest from stakeholders and potential community partners. The individuals 
93.11 	working in the community-based services facilities under this section are state employees 
93.12 	supervised by the commissioner of human services. No layoffs shall occur as a result of 
93.13 	restructuring under this section.

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

93.15 	Sec. 20. NONSUBMISSION OF HEALTH CARE CLAIM BY 
93.16 	CLEARINGHOUSE; SIGNIFICANT DISRUPTION.
 93.17 	(a) A situation shall be considered a significant disruption to normal operations that 
93.18 	materially affects the provider's or facility's ability to conduct business in a normal manner 
93.19 	and to submit claims on a timely basis under Minnesota Statutes, section 62Q.75, if: 
93.20 	(1) a clearinghouse loses, or otherwise does not submit, a health care claim as 
93.21 	required by Minnesota Statutes, section 62J.536; and
93.22 	(2) the provider or facility can substantiate that it submitted a complete claim to the 
93.23 	clearinghouse within provisions stated in contract or six months of the date of service, 
93.24 	whichever is less.
93.25 	(b) This section expires January 1, 2012.

93.26 	Sec. 21. REPORT ON HUMAN SERVICES FISCAL NOTES.
 93.27 	The commissioner of human services shall issue a report to the legislature no later 
93.28 	than November 15, 2010, making recommendations for the establishment of a legislative 
93.29 	budget office division for the preparation and completion of fiscal notes as required by 
93.30 	Minnesota Statutes, section 3.98. The report must include detailed information regarding 
93.31 	the necessary financial costs, staff resources, and data protection requirements for a 
93.32 	legislative budget office to complete fiscal notes for the Department of Human Services. 
93.33 	The report must describe the methods and procedures used by legislatures in other states 
93.34 	that ensure the independence and accuracy of fiscal estimates on legislative proposals. The 
94.1 	report must include proposed bill language for transferring all fiscal note responsibilities 
94.2 	to an appropriate nonpartisan office within the legislative branch.

94.3 	Sec. 22.  REPEALER.
 94.4 	Minnesota Statutes 2008, sections 254B.02, subdivisions 2, 3, and 4; and 254B.09, 
94.5 	subdivisions 4, 5, and 7, and Laws 2009, chapter 79, article 7, section 26, subdivision 
94.6 	3,  are repealed.

94.7 	Sec. 23. EFFECTIVE DATE.
 94.8 	Sections 10 to 14 and 22 are effective for claims paid on or after July 1, 2010.

94.9 	ARTICLE 6
94.10 	DEPARTMENT OF HEALTH

94.11 	Section 1. Minnesota Statutes 2008, section 62D.08, is amended by adding a 
94.12 	subdivision to read:
94.13 		Subd. 7.Consistent administrative expenses and investment income reporting.
 94.14 	(a) Every health maintenance organization must directly allocate administrative expenses 
94.15 	to specific lines of business or products when such information is available. Remaining 
94.16 	expenses that cannot be directly allocated must be allocated based on other methods, as 
94.17 	recommended by the Advisory Group on Administrative Expenses. Health maintenance 
94.18 	organizations must submit this information, including administrative expenses for dental 
94.19 	services, using the reporting template provided by the commissioner of health.
94.20 	(b) Every health maintenance organization must allocate investment income based 
94.21 	on cumulative net income over time by business line or product and must submit this 
94.22 	information, including investment income for dental services, using the reporting template 
94.23 	provided by the commissioner of health.

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

94.25 	Sec. 2. [62D.31] ADVISORY GROUP ON ADMINISTRATIVE EXPENSES.
94.26 		Subdivision 1.Establishment. The Advisory Group on Administrative Expenses 
94.27 	is established to make recommendations on the development of consistent guidelines 
94.28 	and reporting requirements, including development of a reporting template, for health 
94.29 	maintenance organizations and county-based purchasers that participate in publicly 
94.30 	funded programs. 
95.1 		Subd. 2.Membership. The membership of the advisory group shall be comprised 
95.2 	of the following, who serve at the pleasure of their appointing authority:
95.3 	(1) the commissioner of health or the commissioner's designee;
95.4 	(2) the commissioner of human services or the commissioner's designee;
95.5 	(3) the commissioner of commerce or the commissioner's designee; and
95.6 	(4) representatives of health maintenance organizations and county-based purchasers 
95.7 	appointed by the commissioner of health.
95.8 		Subd. 3.Administration. The commissioner of health shall convene the first 
95.9 	meeting of the advisory group by September 1, 2010, and shall provide administrative 
95.10 	support and staff. The commissioner of health may contract with a consultant to provide 
95.11 	professional assistance and expertise to the advisory group.
95.12 		Subd. 4.Recommendations. The Advisory Group on Administrative Expenses 
95.13 	must report its recommendations, including any proposed legislation necessary to 
95.14 	implement the recommendations, to the commissioner of health and to the chairs and 
95.15 	ranking minority members of the legislative committees and divisions with jurisdiction 
95.16 	over health policy and finance by July 1, 2011.
95.17 		Subd. 5.Expiration. This section expires after submission of the report required 
95.18 	under subdivision 4 or June 30, 2012, whichever is sooner.

95.19 	Sec. 3. Minnesota Statutes 2009 Supplement, section 62J.495, subdivision 1a, is 
95.20 	amended to read:
95.21 		Subd. 1a.Definitions. (a) "Certified electronic health record technology" means an 
95.22 	electronic health record that is certified pursuant to section 3001(c)(5) of the HITECH 
95.23 	Act to meet the standards and implementation specifications adopted under section 3004 
95.24 	as applicable.
95.25 	(b) "Commissioner" means the commissioner of health.
95.26 	(c) "Pharmaceutical electronic data intermediary" means any entity that provides 
95.27 	the infrastructure to connect computer systems or other electronic devices utilized 
95.28 	by prescribing practitioners with those used by pharmacies, health plans, third-party 
95.29 	administrators, and pharmacy benefit managers in order to facilitate the secure 
95.30 	transmission of electronic prescriptions, refill authorization requests, communications, 
95.31 	and other prescription-related information between such entities.
95.32 	(d) "HITECH Act" means the Health Information Technology for Economic and 
95.33 	Clinical Health Act in division A, title XIII and division B, title IV of the American 
95.34 	Recovery and Reinvestment Act of 2009, including federal regulations adopted under 
95.35 	that act.
96.1 	(e) "Interoperable electronic health record" means an electronic health record that 
96.2 	securely exchanges health information with another electronic health record system that 
96.3 	meets requirements specified in subdivision 3, and national requirements for certification 
96.4 	under the HITECH Act.
96.5 	(f) "Qualified electronic health record" means an electronic record of health-related 
96.6 	information on an individual that includes patient demographic and clinical health 
96.7 	information and has the capacity to:
96.8 	(1) provide clinical decision support;
96.9 	(2) support physician order entry;
96.10 	(3) capture and query information relevant to health care quality; and
96.11 	(4) exchange electronic health information with, and integrate such information 
96.12 	from, other sources.

96.13 	Sec. 4. Minnesota Statutes 2009 Supplement, section 62J.495, subdivision 3, is 
96.14 	amended to read:
96.15 		Subd. 3.Interoperable electronic health record requirements.  To meet the 
96.16 	requirements of subdivision 1, hospitals and health care providers must meet the following 
96.17 	criteria when implementing an interoperable electronic health records system within their 
96.18 	hospital system or clinical practice setting.
96.19 	(a) The electronic health record must be a qualified electronic health record.
96.20 	(b) The electronic health record must be certified by the Office of the National 
96.21 	Coordinator pursuant to the HITECH Act. This criterion only applies to hospitals and 
96.22 	health care providers only if a certified electronic health record product for the provider's 
96.23 	particular practice setting is available. This criterion shall be considered met if a hospital 
96.24 	or health care provider is using an electronic health records system that has been certified 
96.25 	within the last three years, even if a more current version of the system has been certified 
96.26 	within the three-year period.
96.27 	(c) The electronic health record must meet the standards established according to 
96.28 	section 3004 of the HITECH Act as applicable.
96.29 	(d) The electronic health record must have the ability to generate information on 
96.30 	clinical quality measures and other measures reported under sections 4101, 4102, and 
96.31 	4201 of the HITECH Act.
96.32 	(e) The electronic health record system must be connected to a state-certified 
96.33 	health information organization either directly or through a connection facilitated by a 
96.34 	state-certified health data intermediary as defined in section 62J.498.
97.1 	(e) (f) A health care provider who is a prescriber or dispenser of legend drugs must 
97.2 	have an electronic health record system that meets the requirements of section 62J.497.

97.3 	Sec. 5. Minnesota Statutes 2009 Supplement, section 62J.495, is amended by adding a 
97.4 	subdivision to read:
97.5 		Subd. 6.State agency information system. Development of a state agency 
97.6 	information system necessary to implement this section is subject to the authority of the 
97.7 	Office of Enterprise Technology in chapter 16E, including, but not limited to:
97.8 	(1) evaluation and approval of the system as specified in section 16E.03, subdivisions 
97.9 	3 and 4;
97.10 	(2) review of the system to ensure compliance with security policies, guidelines, and 
97.11 	standards as specified in section 16E.03, subdivision 7; and
97.12 	(3) assurance that the system complies with accessibility standards developed under 
97.13 	section 16E.03, subdivision 9.

97.14 	Sec. 6. [62J.498] HEALTH INFORMATION EXCHANGE.
97.15 		Subdivision 1. Definitions.  The following definitions apply to sections 62J.498 to 
97.16 	62J.4982:
97.17 	(a) "Clinical transaction" means any meaningful use transaction that is not covered 
97.18 	by section 62J.536.
97.19 	(b) "Commissioner" means the commissioner of health.
97.20 	(c) "Direct health information exchange" means the electronic transmission of 
97.21 	health-related information through a direct connection between the electronic health 
97.22 	record systems of health care providers without the use of a health data intermediary.
97.23 	(d) "Health care provider" or "provider" means a health care provider or provider as 
97.24 	defined in section 62J.03, subdivision 8.
97.25 	(e) "Health data intermediary" means an entity that provides the infrastructure to 
97.26 	connect computer systems or other electronic devices used by health care providers, 
97.27 	laboratories, pharmacies, health plans, third-party administrators, or pharmacy benefit 
97.28 	managers to facilitate the secure transmission of health information, including 
97.29 	pharmaceutical electronic data intermediaries as defined in section 62J.495.  This does not 
97.30 	include health care providers engaged in a direct health information exchange.
97.31 	(f) "Health information exchange" means the electronic transmission of 
97.32 	health-related information between organizations according to nationally recognized 
97.33 	standards.
98.1 	(g) "Health information exchange service provider" means a health data intermediary 
98.2 	or health information organization that has been issued a certificate of authority by the 
98.3 	commissioner under section 62J.4981.
98.4 	(h) "Health information organization" means an organization that oversees, governs, 
98.5 	and facilitates the exchange of health-related information among organizations according 
98.6 	to nationally recognized standards.
98.7 	(i) "HITECH Act" means the Health Information Technology for Economic and 
98.8 	Clinical Health Act as defined in section 62J.495.
98.9 	(j) "Major participating entity" means:
98.10 	(1) a participating entity that receives compensation for services that is greater 
98.11 	than 30 percent of the health information organization's gross annual revenues from the 
98.12 	health information exchange service provider;
98.13 	(2) a participating entity providing administrative, financial, or management services 
98.14 	to the health information organization, if the total payment for all services provided by the 
98.15 	participating entity exceeds three percent of the gross revenue of the health information 
98.16 	organization; and
98.17 	(3) a participating entity that nominates or appoints 30 percent or more of the board 
98.18 	of directors of the health information organization.
98.19 	(k) "Meaningful use" means use of certified electronic health record technology that 
98.20 	includes e-prescribing, and is connected in a manner that provides for the electronic 
98.21 	exchange of health information and used for the submission of clinical quality measures 
98.22 	as established by the Center for Medicare and Medicaid Services and the Minnesota 
98.23 	Department of Human Services pursuant to sections 4101, 4102, and 4201 of the HITECH 
98.24 	Act.
98.25 	(l) "Meaningful use transaction" means an electronic transaction that a health care 
98.26 	provider must exchange to receive Medicare or Medicaid incentives or avoid Medicare 
98.27 	penalties pursuant to sections 4101, 4102, and 4201 of the HITECH Act.
98.28 	(m) "Participating entity" means any of the following persons, health care providers, 
98.29 	companies, or other organizations with which a health information organization or health 
98.30 	data intermediary has contracts or other agreements for the provision of health information 
98.31 	exchange service providers: 
98.32 	(1) a health care facility licensed under sections 144.50 to 144.56, a nursing home 
98.33 	licensed under sections 144A.02 to 144A.10, and any other health care facility otherwise 
98.34 	licensed under the laws of this state or registered with the commissioner;
98.35 	(2) a health care provider, and any other health care professional otherwise licensed 
98.36 	under the laws of this state or registered with the commissioner;
99.1 	(3) a group, professional corporation, or other organization that provides the 
99.2 	services of individuals or entities identified in clause (2), including but not limited to a 
99.3 	medical clinic, a medical group, a home health care agency, an urgent care center, and 
99.4 	an emergent care center;
99.5 	(4) a health plan as defined in section 62A.011, subdivision 3; and
99.6 	(5) a state agency as defined in section 13.02, subdivision 17.
99.7 	(n) "Reciprocal agreement" means an arrangement in which two or more health 
99.8 	information exchange service providers agree to share in-kind services and resources to 
99.9 	allow for the pass-through of meaningful use transactions.
99.10 	(o) "State-certified health data intermediary" means a health data intermediary that:
99.11 	(1) provides a subset of the meaningful use transaction capabilities necessary for 
99.12 	hospitals and providers to achieve meaningful use of electronic health records;
99.13 	(2) is not exclusively engaged in the exchange of meaningful use transactions 
99.14 	covered by section 62J.536; and
99.15 	(3) has been issued a certificate of authority to operate in Minnesota.
99.16 	(p) "State-certified health information organization" means a nonprofit health 
99.17 	information organization that provides transaction capabilities necessary to fully support 
99.18 	clinical transactions required for meaningful use of electronic health records that has been 
99.19 	issued a certificate of authority to operate in Minnesota.
99.20 		Subd. 2. Health information exchange oversight.  (a) The commissioner shall 
99.21 	protect the public interest on matters pertaining to health information exchange. The 
99.22 	commissioner shall:
99.23 	(1) review and act on applications from health data intermediaries and health 
99.24 	information organizations for certificates of authority to operate in Minnesota;
99.25 	(2) provide ongoing monitoring to ensure compliance with criteria established under 
99.26 	sections 62J.498 to 62J.4982;
99.27 	(3) respond to public complaints related to health information exchange services;
99.28 	(4) take enforcement actions as necessary, including the imposition of fines, 
99.29 	suspension, or revocation of certificates of authority as outlined in section 62J.4982;
99.30 	(5) provide a biannual report on the status of health information exchange services 
99.31 	that includes but is not limited to:
99.32 	(i) recommendations on actions necessary to ensure that health information exchange 
99.33 	services are adequate to meet the needs of Minnesota citizens and providers statewide;
99.34 	(ii) recommendations on enforcement actions to ensure that health information 
99.35 	exchange service providers act in the public interest without causing disruption in health 
99.36 	information exchange services;
100.1 	(iii) recommendations on updates to criteria for obtaining certificates of authority 
100.2 	under this section; and
100.3 	(iv) recommendations on standard operating procedures for health information 
100.4 	exchange, including but not limited to the management of consumer preferences; and
100.5 	(6) other duties necessary to protect the public interest.
100.6 	(b) As part of the application review process for certification under paragraph (a), 
100.7 	prior to issuing a certificate of authority, the commissioner shall:
100.8 	(1) hold public hearings that provide an adequate opportunity for participating 
100.9 	entities and consumers to provide feedback and recommendations on the application under 
100.10 	consideration. The commissioner shall make all portions of the application classified 
100.11 	as public data available to the public at least ten days in advance of the hearing. The 
100.12 	applicant shall participate in the hearing by presenting an application overview and 
100.13 	responding to questions from interested parties;
100.14 	(2) make available all feedback and recommendations from the hearing available to 
100.15 	the public prior to issuing a certificate of authority; and
100.16 	(3) consult with hospitals, physicians, and other professionals eligible to receive 
100.17 	meaningful use incentive payments or are subject to penalties as established in the 
100.18 	HITECH Act, and their respective statewide associations, prior to issuing a certificate of 
100.19 	authority.
100.20 	(c)(1) When the commissioner is actively considering a suspension or revocation of 
100.21 	a certificate of authority as described in section 62J.4982, subdivision 3, all investigatory 
100.22 	data that are collected, created, or maintained related to the suspension or revocation 
100.23 	are classified as confidential data on individuals and as protected nonpublic data in the 
100.24 	case of data not on individuals.
100.25 	(2) The commissioner may disclose data classified as protected nonpublic or 
100.26 	confidential under this paragraph if disclosing the data will protect the health or safety of 
100.27 	patients.
100.28 	(d) After the commissioner makes a final determination regarding a suspension or 
100.29 	revocation of a certificate of authority, all minutes, orders for hearing, findings of fact, 
100.30 	conclusions of law, and the specification of the final disciplinary action, are classified 
100.31 	as public data.

100.32 	Sec. 7. [62J.4981] CERTIFICATE OF AUTHORITY TO PROVIDE HEALTH 
100.33 	INFORMATION EXCHANGE SERVICES.
100.34 		Subdivision 1. Authority to require organizations to apply.  The commissioner 
100.35 	shall require an entity providing health information exchange services to apply for a 
101.1 	certificate of authority under this section. An applicant may continue to operate until 
101.2 	the commissioner acts on the application. If the application is denied, the applicant is 
101.3 	considered a health information organization whose certificate of authority has been 
101.4 	revoked under section 62J.4982, subdivision 2, paragraph (d).
101.5 		Subd. 2. Certificate of authority for health data intermediaries.  (a) A health 
101.6 	data intermediary that provides health information exchange services for the transmission 
101.7 	of one or more clinical transactions necessary for hospitals, providers, or eligible 
101.8 	professionals to achieve meaningful use must be registered with the state and comply with 
101.9 	requirements established in this section.
101.10 	(b) Notwithstanding any law to the contrary, any corporation organized to do so 
101.11 	may apply to the commissioner for a certificate of authority to establish and operate as 
101.12 	a health data intermediary in compliance with this section. No person shall establish or 
101.13 	operate a health data intermediary in this state, nor sell or offer to sell, or solicit offers 
101.14 	to purchase or receive advance or periodic consideration in conjunction with a health 
101.15 	data intermediary contract unless the organization has a certificate of authority or has an 
101.16 	application under active consideration under  this section.
101.17 	(c) In issuing the certificate of authority, the commissioner shall determine whether 
101.18 	the applicant for the certificate of authority has demonstrated that the applicant meets 
101.19 	the following minimum criteria:
101.20 	(1) can interoperate with at least one state-certified health information organization;
101.21 	(2) can provide an option for Minnesota entities to connect to their services through 
101.22 	at least one state-certified health information organization;
101.23 	(3) has a record locator service as defined in section 144.291, subdivision 2, 
101.24 	paragraph (i), that is compliant with the requirements of section 144.293, subdivision 8, 
101.25 	when conducting meaningful use transactions; and
101.26 	(4) holds reciprocal agreements with at least one state-certified health information 
101.27 	organization to enable access to record locator services to find patient data, and for the 
101.28 	transmission and receipt of meaningful use transactions consistent with the format and 
101.29 	content required by national standards established by Centers for Medicare and Medicaid 
101.30 	Services. Reciprocal agreements must meet the requirements established in subdivision 5.
101.31 		Subd. 3. Certificate of authority for health information organizations.
 101.32 	(a) A health information organization that provides all electronic capabilities for the 
101.33 	transmission of clinical transactions necessary for meaningful use of electronic health 
101.34 	records must obtain a certificate of authority from the commissioner and demonstrate 
101.35 	compliance with the criteria in paragraph (c).
102.1 	(b) Notwithstanding any law to the contrary, a nonprofit corporation organized to do 
102.2 	so may apply for a certificate of authority to establish and operate a health information 
102.3 	organization under this section. No person shall establish or operate a health information 
102.4 	organization in this state, or sell or offer to sell, or solicit offers to purchase or receive 
102.5 	advance or periodic consideration in conjunction with a health information organization 
102.6 	or health information contract unless the organization has a certificate of authority under 
102.7 	this section.
102.8 	(c) In issuing the certificate of authority, the commissioner shall determine whether 
102.9 	the applicant for the certificate of authority has demonstrated that the applicant meets 
102.10 	the following minimum criteria:
102.11 	(1) the entity is a legally established, nonprofit organization;
102.12 	(2) has appropriate insurance, including liability insurance, for the operation of the 
102.13 	health information organization is in place and sufficient to protect the interest of the 
102.14 	public and participating entities;
102.15 	(3) has strategic and operational plans that clearly address how the organization will 
102.16 	expand technical capacity of the health information organization to support providers in 
102.17 	achieving meaningful use of electronic health records over time;
102.18 	(4) the entity addresses the parameters to be used with participating entities and 
102.19 	other health information organizations for meaningful use transactions, compliance with 
102.20 	Minnesota law, and interstate health information exchange in trust agreements;
102.21 	(5) the entity's board of directors is comprised of members that broadly represent the 
102.22 	health information organization's participating entities and consumers;
102.23 	(6) the entity maintains a professional staff responsible to the board of directors with 
102.24 	the capacity to ensure accountability to the organization's mission;
102.25 	(7) the entity is compliant with criteria established under the Health Information 
102.26 	Exchange Accreditation Program of the Electronic Healthcare Network Accreditation 
102.27 	Commission (EHNAC) or equivalent criteria established by the commissioner;
102.28 	(8) the entity maintains a record locator service as defined in section 144.291, 
102.29 	subdivision 2, paragraph (i), that is compliant with the requirements of section 144.293, 
102.30 	subdivision 8, when conducting meaningful use transactions;
102.31 	(9) the organization demonstrates interoperability with all other state-certified health 
102.32 	information organizations using nationally recognized standards;
102.33 	(10) the organization demonstrates compliance with all privacy and security 
102.34 	requirements required by state and federal law; and
103.1 	(11) the organization uses financial policies and procedures consistent with generally 
103.2 	accepted accounting principles and has an independent audit of the organization's 
103.3 	financials on an annual basis.
103.4 	(d) Health information organizations that have obtained a certificate of authority 
103.5 	must:
103.6 	(1) meet the requirements established for connecting to the Nationwide Health 
103.7 	Information Network (NHIN) within the federally mandated timeline or within a time 
103.8 	frame established by the commissioner and published in the State Register. If the state 
103.9 	timeline for implementation varies from the federal timeline, the State Register notice 
103.10 	shall include an explanation for the variation;
103.11 	(2) annually submit strategic and operational plans for review by the commissioner 
103.12 	that address:
103.13 	(i) increasing adoption rates to include a sufficient number of participating entities to 
103.14 	achieve financial sustainability; and
103.15 	(ii) progress in achieving objectives included in previously submitted strategic 
103.16 	and operational plans across the following domains:  business and technical operations, 
103.17 	technical infrastructure, legal and policy issues, finance, and organizational governance;
103.18 	(3) develop and maintain a business plan that addresses:
103.19 	(i) plans for ensuring the necessary capacity to support meaningful use transactions;
103.20 	(ii) approach for attaining financial sustainability, including public and private 
103.21 	financing strategies, and rate structures;
103.22 	(iii) rates of adoption, utilization, and transaction volume, and mechanisms to 
103.23 	support health information exchange; and
103.24 	(iv) an explanation of methods employed to address the needs of community clinics, 
103.25 	critical access hospitals, and free clinics in accessing health information exchange services;
103.26 	(4) annually submit a rate plan outlining fee structures for health information 
103.27 	exchange services for approval by the commissioner. The commissioner shall approve the 
103.28 	rate plan if it:
103.29 	(i) distributes costs equitably among users of health information services;
103.30 	(ii) provides predictable costs for participating entities;
103.31 	(iii) covers all costs associated with conducting the full range of meaningful use 
103.32 	clinical transactions, including access to health information retrieved through other 
103.33 	state-certified health information exchange service providers; and
103.34 	(iv) provides for a predictable revenue stream for the health information organization 
103.35 	and generates sufficient resources to maintain operating costs and develop technical 
103.36 	infrastructure necessary to serve the public interest;
104.1 	(5) enter into reciprocal agreements with all other state-certified health information 
104.2 	organizations to enable access to record locator services to find patient data, and 
104.3 	transmission and receipt of meaningful use transactions consistent with the format and 
104.4 	content required by national standards established by Centers for Medicare and Medicaid 
104.5 	Services. Reciprocal agreements must meet the requirements in subdivision 5; and
104.6 	(6) comply with additional requirements for the certification or recertification of 
104.7 	health information organizations that may be established by the commissioner.
104.8 		Subd. 4. Application for certificate of authority for health information exchange 
104.9 	service providers. (a)  Each application for a certificate of authority shall be in a form 
104.10 	prescribed by the commissioner and verified by an officer or authorized representative of 
104.11 	the applicant. Each application shall include the following:
104.12 	(1) a copy of the basic organizational document, if any, of the applicant and of 
104.13 	each major participating entity, such as the articles of incorporation, or other applicable 
104.14 	documents, and all amendments to it;
104.15 	(2) a list of the names, addresses, and official positions of the following:
104.16 	(i) all members of the board of directors and the principal officers and, if applicable, 
104.17 	shareholders of the applicant organization; and
104.18 	(ii) all members of the board of directors and the principal officers of each major 
104.19 	participating entity and, if applicable, each shareholder beneficially owning more than ten 
104.20 	percent of any voting stock of the major participating entity;
104.21 	(3) the name and address of each participating entity and the agreed-upon duration 
104.22 	of each contract or agreement if applicable;
104.23 	(4) a copy of each standard agreement or contract intended to bind the participating 
104.24 	entities and the health information organization. Contractual provisions shall be consistent 
104.25 	with the purposes of this section in regard to the services to be performed under the 
104.26 	standard agreement or contract, the manner in which payment for services is determined, 
104.27 	the nature and extent of responsibilities to be retained by the health information 
104.28 	organization, and contractual termination provisions;
104.29 	(5) a copy of each contract intended to bind major participating entities and the 
104.30 	health information organization. Contract information filed with the commissioner under 
104.31 	this section shall be nonpublic as defined in section 13.02, subdivision 9;
104.32 	(6) a statement generally describing the health information organization, its health 
104.33 	information exchange contracts, facilities, and personnel, including a statement describing 
104.34 	the manner in which the applicant proposes to provide participants with comprehensive 
104.35 	health information exchange services;
105.1 	(7) financial statements showing the applicant's assets, liabilities, and sources 
105.2 	of financial support, including a copy of the applicant's most recent certified financial 
105.3 	statement;
105.4 	(8) strategic and operational plans that specifically address how the organization 
105.5 	will expand technical capacity of the health information organization to support providers 
105.6 	in achieving meaningful use of electronic health records over time, a description of 
105.7 	the proposed method of marketing the services, a schedule of proposed charges, and a 
105.8 	financial plan that includes a three-year projection of the expenses and income and other 
105.9 	sources of future capital;
105.10 	(9) a statement reasonably describing the geographic area or areas to be served and 
105.11 	the type or types of participants to be served;
105.12 	(10) a description of the complaint procedures to be used as required under this 
105.13 	section;
105.14 	(11) a description of the mechanism by which participating entities will have an 
105.15 	opportunity to participate in matters of policy and operation;
105.16 	(12) a copy of any pertinent agreements between the health information organization 
105.17 	and insurers, including liability insurers, demonstrating coverage is in place;
105.18 	(13) a copy of the conflict of interest policy that applies to all members of the board 
105.19 	of directors and the principal officers of the health information organization; and
105.20 	(14) other information as the commissioner may reasonably require to be provided.
105.21 	(b) Thirty days after the receipt of the application for a certificate of authority, 
105.22 	the commissioner shall determine whether or not the application submitted meets the 
105.23 	requirements for completion in paragraph (a), and notify the applicant of any further 
105.24 	information required for the application to be processed.
105.25 	(c) Ninety days after the receipt of a complete application for a certificate of 
105.26 	authority, the commissioner shall issue a certificate of authority to the applicant if the 
105.27 	commissioner determines that the applicant meets the minimum criteria requirements 
105.28 	of subdivision 2 for health data intermediaries or subdivision 3 for health information 
105.29 	organizations. If the commissioner determines that the applicant is not qualified, the 
105.30 	commissioner shall notify the applicant and specify the reasons for disqualification.
105.31 	(d) Upon being granted a certificate of authority to operate as a health information 
105.32 	organization, the organization must operate in compliance with the provisions of this 
105.33 	section. Noncompliance may result in the imposition of a fine or the suspension or 
105.34 	revocation of the certificate of authority according to section 62J.4982.
105.35 		Subd. 5. Reciprocal agreements between health information exchange entities.
 105.36 	(a) Reciprocal agreements between two health information organizations or between a 
106.1 	health information organization and a health data intermediary must include a fair and 
106.2 	equitable model for charges between the entities that:
106.3 	(1) does not impede the secure transmission of transactions necessary to achieve 
106.4 	meaningful use;
106.5 	(2) does not charge a fee for the exchange of meaningful use transactions transmitted 
106.6 	according to nationally recognized standards where no additional value-added service 
106.7 	is rendered to the sending or receiving health information organization or health data 
106.8 	intermediary either directly or on behalf of the client;
106.9 	(3) is consistent with fair market value and proportionately reflects the value-added 
106.10 	services accessed as a result of the agreement; and
106.11 	(4) prevents health care stakeholders from being charged multiple times for the 
106.12 	same service.
106.13 	(b) Reciprocal agreements must include comparable quality of service standards that 
106.14 	ensure equitable levels of services.
106.15 	(c) Reciprocal agreements are subject to review and approval by the commissioner.
106.16 	(d) Nothing in this section precludes a state-certified health information organization 
106.17 	or state-certified health data intermediary from entering into contractual agreements for 
106.18 	the provision of value-added services beyond meaningful use. 
106.19 	(e) The commissioner of human services or health, when providing access to data or 
106.20 	services through a certified health information organization, must offer the same data or 
106.21 	services directly through any certified health information organization at the same pricing, 
106.22 	if the health information organization pays for all connection costs to the state data or 
106.23 	service. For all external connectivity to the respective agencies through existing or future 
106.24 	information exchange implementations, the respective agency shall establish the required 
106.25 	connectivity methods as well as protocol standards to be utilized.
106.26 		Subd. 6.State participation in health information exchange. A state agency 
106.27 	that connects to a health information exchange service provider for the purpose of 
106.28 	exchanging meaningful use transactions must ensure that the contracted health information 
106.29 	exchange service provider has reciprocal agreements in place as required by this section. 
106.30 	The reciprocal agreements must provide equal access to information supplied by the 
106.31 	agency and necessary for meaningful use by the participating entities of the other health 
106.32 	information service providers.

106.33 	Sec. 8. [62J.4982] ENFORCEMENT AUTHORITY; COMPLIANCE.
106.34 		Subdivision 1. Penalties and enforcement.  (a) The commissioner may, for any 
106.35 	violation of statute or rule applicable to a health information exchange service provider, 
107.1 	levy an administrative penalty in an amount up to $25,000 for each violation. In 
107.2 	determining the level of an administrative penalty, the commissioner shall consider the 
107.3 	following factors:
107.4 	(1) the number of participating entities affected by the violation;
107.5 	(2) the effect of the violation on participating entities' access to health information 
107.6 	exchange services;
107.7 	(3) if only one participating entity is affected, the effect of the violation on the 
107.8 	patients of that entity;
107.9 	(4) whether the violation is an isolated incident or part of a pattern of violations;
107.10 	(5) the economic benefits derived by the health information organization or a health 
107.11 	data intermediary by virtue of the violation;
107.12 	(6) whether the violation hindered or facilitated an individual's ability to obtain 
107.13 	health care;
107.14 	(7) whether the violation was intentional;
107.15 	(8) whether the violation was beyond the direct control of the health information 
107.16 	exchange service provider;
107.17 	(9) any history of prior compliance with the provisions of this section, including 
107.18 	violations;
107.19 	(10) whether and to what extent the health information exchange service provider 
107.20 	attempted to correct previous violations;
107.21 	(11) how the health information exchange service provider responded to technical 
107.22 	assistance from the commissioner provided in the context of a compliance effort; and
107.23 	(12) the financial condition of the health information exchange service provider 
107.24 	including, but not limited to, whether the health information exchange service provider 
107.25 	had financial difficulties that affected its ability to comply or whether the imposition of an 
107.26 	administrative monetary penalty would jeopardize the ability of the health information 
107.27 	exchange service provider to continue to deliver health information exchange services.
107.28 	Reasonable notice in writing shall be given to the health information exchange 
107.29 	service provider of the intent to levy the penalty and the reasons for them. A health 
107.30 	information exchange service provider may have 15 days within which to contest whether 
107.31 	the finding of facts constitute a violation of this section and section 62J.4981, according to 
107.32 	the contested case and judicial review provisions of sections 14.57 to 14.69.
107.33 	(b) If the commissioner has reason to believe that a violation of this section or 
107.34 	section 62J.4981 has occurred or is likely, the commissioner may confer with the persons 
107.35 	involved before commencing action under subdivision 2. The commissioner may notify 
107.36 	the health information exchange service provider and the representatives, or other persons 
108.1 	who appear to be involved in the suspected violation, to arrange a voluntary conference 
108.2 	with the alleged violators or their authorized representatives. The purpose of the 
108.3 	conference is to attempt to learn the facts about the suspected violation and if it appears 
108.4 	that a violation has occurred or is threatened, to find a way to correct or prevent it. The 
108.5 	conference is not governed by any formal procedural requirements and may be conducted 
108.6 	as the commissioner considers appropriate.
108.7 	(c) The commissioner may issue an order directing a health information exchange 
108.8 	service provider or a representative of a health information exchange service provider to 
108.9 	cease and desist from engaging in any act or practice in violation of this section and 
108.10 	section 62J.4981.
108.11 	(d) Within 20 days after service of the order to cease and desist, a health information 
108.12 	exchange service provider may contest whether the finding of facts constitutes a violation 
108.13 	of this section and section 62J.4981 according to the contested case and judicial review 
108.14 	provisions of sections 14.57 to 14.69.
108.15 	(e) In the event of noncompliance with a cease and desist order issued under this 
108.16 	subdivision, the commissioner may institute a proceeding to obtain injunctive relief or 
108.17 	other appropriate relief in Ramsey County District Court.
108.18 		Subd. 2. Suspension or revocation of certificates of authority. (a) The 
108.19 	commissioner may suspend or revoke a certificate of authority issued to a health 
108.20 	data intermediary or health information organization under section 62J.4981 if the 
108.21 	commissioner finds that:
108.22 	(1) the health information exchange service provider is operating significantly 
108.23 	in contravention of its basic organizational document, or in a manner contrary to that 
108.24 	described in and reasonably inferred from any other information submitted under section 
108.25 	62J.4981, unless amendments to the submissions have been filed with and approved by 
108.26 	the commissioner;
108.27 	(2) the health information exchange service provider is unable to fulfill its 
108.28 	obligations to furnish comprehensive health information exchange services as required 
108.29 	under its health information exchange contract;
108.30 	(3) the health information exchange service provider is no longer financially solvent 
108.31 	or may not reasonably be expected to meet its obligations to participating entities;
108.32 	(4) the health information exchange service provider has failed to implement the 
108.33 	complaint system in a manner designed to reasonably resolve valid complaints;
108.34 	(5) the health information exchange service provider, or any person acting with its 
108.35 	sanction, has advertised or merchandised its services in an untrue, misleading, deceptive, 
108.36 	or unfair manner;
109.1 	(6) the continued operation of the health information exchange service provider 
109.2 	would be hazardous to its participating entities or the patients served by the participating 
109.3 	entities; or
109.4 	(7) the health information exchange service provider has otherwise failed to 
109.5 	substantially comply with section 62J.4981 or with any other statute or administrative 
109.6 	rule applicable to health information exchange service providers, or has submitted false 
109.7 	information in any report required under sections 62J.498 to 62J.4982.
109.8 	(b) A certificate of authority shall be suspended or revoked only after meeting the 
109.9 	requirements of subdivision 3.
109.10 	(c) If the certificate of authority of a health information exchange service provider is 
109.11 	suspended, the health information exchange service provider shall not, during the period 
109.12 	of suspension, enroll any additional participating entities, and shall not engage in any 
109.13 	advertising or solicitation.
109.14 	(d) If the certificate of authority of a health information exchange service provider is 
109.15 	revoked, the organization shall proceed, immediately following the effective date of the 
109.16 	order of revocation, to wind up its affairs and shall conduct no further business except as 
109.17 	necessary to the orderly conclusion of the affairs of the organization. The organization 
109.18 	shall engage in no further advertising or solicitation. The commissioner may, by written 
109.19 	order, permit further operation of the organization as the commissioner finds to be in the 
109.20 	best interest of participating entities, to the end that participating entities will be given the 
109.21 	greatest practical opportunity to access continuing health information exchange services.
109.22 		Subd. 3. Denial, suspension, and revocation; administrative procedures.  (a) 
109.23 	When the commissioner has cause to believe that grounds for the denial, suspension, 
109.24 	or revocation of a certificate of authority exists, the commissioner shall notify the 
109.25 	health information exchange service provider in writing stating the grounds for denial, 
109.26 	suspension, or revocation and setting a time within 20 days for a hearing on the matter.
109.27 	(b) After a hearing before the commissioner at which the health information 
109.28 	exchange service provider may respond to the grounds for denial, suspension, or 
109.29 	revocation, or upon the failure of the health information exchange service provider to 
109.30 	appear at the hearing, the commissioner shall take action as deemed necessary and shall 
109.31 	issue written findings that shall be mailed to the health information exchange service 
109.32 	provider.
109.33 	(c) If suspension, revocation, or an administrative penalty is proposed according 
109.34 	to this section, the commissioner must deliver, or send by certified mail with return 
109.35 	receipt requested, to the health information exchange service provider written notice of 
110.1 	the commissioner's intent to impose a penalty. This notice of proposed determination 
110.2 	must include:
110.3 	(1) a reference to the statutory basis for the penalty;
110.4 	(2) a description of the findings of fact regarding the violations with respect to 
110.5 	which the penalty is proposed;
110.6 	(3) the nature and amount of the proposed penalty;
110.7 	(4) any circumstances described in subdivision 1, paragraph (a), that were considered 
110.8 	in determining the amount of the proposed penalty;
110.9 	(5) instructions for responding to the notice, including a statement of the health 
110.10 	information exchange service provider's right to a contested case proceeding and a 
110.11 	statement that failure to request a contested case proceeding within 30 calendar days 
110.12 	permits the imposition of the proposed penalty; and
110.13 	(6) the address to which the contested case proceeding request must be sent.
110.14 		Subd. 4. Coordination. (a) To the extent possible when implementing sections 
110.15 	62J.498 to 62J.4982, the commissioner shall seek the advice of the Minnesota e-Health 
110.16 	Advisory Committee, in the review and update of criteria for the certification and 
110.17 	recertification of health information exchange service providers.
110.18 	(b) By January 1, 2011, the commissioner shall report to the governor and the 
110.19 	chairs of the senate and house of representatives committees having jurisdiction over 
110.20 	health information policy issues on the status of the health information exchange in 
110.21 	Minnesota and provide recommendations on further action necessary to facilitate the 
110.22 	secure electronic movement of health information among health providers that will enable 
110.23 	Minnesota providers and hospitals to meet meaningful use exchange requirements.
110.24 		Subd. 5. Fees and monetary penalties.  (a) Every health information exchange 
110.25 	service provider subject to this section and section 62J.4981 shall be assessed fees as 
110.26 	follows:
110.27 	(1) filing an application for certificate of authority to operate as a health information 
110.28 	organization, $10,500;
110.29 	(2) filing an application for certificate of authority to operate as a health data 
110.30 	intermediary, $7,000;
110.31 	(3) annual health information organization certificate fee, $14,000;
110.32 	(4) annual health data intermediary certificate fee, $7,000; and
110.33 	(5) fees for other filings, as specified by rule.
110.34 	(b) Administrative monetary penalties imposed under this subdivision shall be 
110.35 	deposited into a revolving fund and are appropriated to the commissioner for the purposes 
110.36 	of sections 62J.498 to 62J.4982.

111.1 	Sec. 9. Minnesota Statutes 2008, section 62Q.19, subdivision 1, is amended to read:
111.2 		Subdivision 1.Designation. (a) The commissioner shall designate essential 
111.3 	community providers. The criteria for essential community provider designation shall be 
111.4 	the following:
111.5 	(1) a demonstrated ability to integrate applicable supportive and stabilizing services 
111.6 	with medical care for uninsured persons and high-risk and special needs populations, 
111.7 	underserved, and other special needs populations; and
111.8 	(2) a commitment to serve low-income and underserved populations by meeting the 
111.9 	following requirements:
111.10 	(i) has nonprofit status in accordance with chapter 317A;
111.11 	(ii) has tax exempt status in accordance with the Internal Revenue Service Code, 
111.12 	section 501(c)(3);
111.13 	(iii) charges for services on a sliding fee schedule based on current poverty income 
111.14 	guidelines; and
111.15 	(iv) does not restrict access or services because of a client's financial limitation;
111.16 	(3) status as a local government unit as defined in section 62D.02, subdivision 11, a 
111.17 	hospital district created or reorganized under sections 447.31 to 447.37, an Indian tribal 
111.18 	government, an Indian health service unit, or a community health board as defined in 
111.19 	chapter 145A;  
111.20 	(4) a former state hospital that specializes in the treatment of cerebral palsy, spina 
111.21 	bifida, epilepsy, closed head injuries, specialized orthopedic problems, and other disabling 
111.22 	conditions; or
111.23 	(5) a sole community hospital. For these rural hospitals, the essential community 
111.24 	provider designation applies to all health services provided, including both inpatient and 
111.25 	outpatient services. For purposes of this section, "sole community hospital" means a 
111.26 	rural hospital that:
111.27 	(i) is eligible to be classified as a sole community hospital according to Code 
111.28 	of Federal Regulations, title 42, section 412.92, or is located in a community with a 
111.29 	population of less than 5,000 and located more than 25 miles from a like hospital currently 
111.30 	providing acute short-term services;  
111.31 	(ii) has experienced net operating income losses in two of the previous three 
111.32 	most recent consecutive hospital fiscal years for which audited financial information is 
111.33 	available; and
111.34 	(iii) consists of 40 or fewer licensed beds; or
111.35 	(6) a birth center licensed under section 144.615.
112.1 	(b) Prior to designation, the commissioner shall publish the names of all applicants 
112.2 	in the State Register. The public shall have 30 days from the date of publication to submit 
112.3 	written comments to the commissioner on the application. No designation shall be made 
112.4 	by the commissioner until the 30-day period has expired.
112.5 	(c) The commissioner may designate an eligible provider as an essential community 
112.6 	provider for all the services offered by that provider or for specific services designated by 
112.7 	the commissioner.
112.8 	(d) For the purpose of this subdivision, supportive and stabilizing services include at 
112.9 	a minimum, transportation, child care, cultural, and linguistic services where appropriate.

112.10 	Sec. 10. Minnesota Statutes 2008, section 144.226, subdivision 3, is amended to read:
112.11 		Subd. 3.Birth record surcharge. (a) In addition to any fee prescribed under 
112.12 	subdivision 1, there shall be a nonrefundable surcharge of $3 for each certified birth or 
112.13 	stillbirth record and for a certification that the vital record cannot be found. The local or 
112.14 	state registrar shall forward this amount to the commissioner of management and budget 
112.15 	for deposit into the account for the children's trust fund for the prevention of child abuse 
112.16 	established under section 256E.22. This surcharge shall not be charged under those 
112.17 	circumstances in which no fee for a certified birth or stillbirth record is permitted under 
112.18 	subdivision 1, paragraph (a). Upon certification by the commissioner of management and 
112.19 	budget that the assets in that fund exceed $20,000,000, this surcharge shall be discontinued.
112.20 	(b) In addition to any fee prescribed under subdivision 1, there shall be a 
112.21 	nonrefundable surcharge of $10 for each certified birth record. The local or state registrar 
112.22 	shall forward this amount to the commissioner of finance for deposit in the general fund 
112.23 	for the Minnesota Birth Defects Information System established under section 144.2215. 
112.24 	This surcharge shall not be charged under those circumstances in which no fee for a 
112.25 	certified birth record is permitted under subdivision 1, paragraph (a).

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

112.27 	Sec. 11. [144.615] BIRTH CENTERS.
112.28 		Subdivision 1.Definitions. (a) For purposes of this section, the following definitions 
112.29 	have the meanings given them.
112.30 	(b) "Birth center" means a facility licensed for the primary purpose of performing 
112.31 	low-risk deliveries that is not a hospital or licensed as part of a hospital and where births are 
112.32 	planned to occur away from the mother's usual residence following a low-risk pregnancy.
112.33 	(c) "CABC" means the Commission for the Accreditation of Birth Centers.
113.1 	(d) "Low-risk pregnancy" means a normal, uncomplicated prenatal course as 
113.2 	determined by documentation of adequate prenatal care and the anticipation of a normal 
113.3 	uncomplicated labor and birth, as defined by reasonable and generally accepted criteria 
113.4 	adopted by professional groups for maternal, fetal, and neonatal health care.
113.5 		Subd. 2.License required. (a) Beginning January 1, 2011, no birth center shall be 
113.6 	established, operated, or maintained in the state without first obtaining a license from the 
113.7 	commissioner of health according to this section.
113.8 	(b) A license issued under this section is not transferable or assignable and is subject 
113.9 	to suspension or revocation at any time for failure to comply with this section.
113.10 	(c) A birth center licensed under this section shall not assert, represent, offer, 
113.11 	provide, or imply that the center is or may render care or services other than the services it 
113.12 	is permitted to render within the scope of the license or the accreditation issued.
113.13 	(d) The license must be conspicuously posted in an area where patients are admitted.
113.14 		Subd. 3.Temporary license. For new birth centers planning to begin operations 
113.15 	after January 1, 2011, the commissioner may issue a temporary license to the birth center 
113.16 	that is valid for a period of six months from the date of issuance. The birth center must 
113.17 	submit to the commissioner an application and applicable fee for licensure as required 
113.18 	under subdivision 4. The application must include the information required in subdivision 
113.19 	4, clauses (1) to (3) and (5) to (7), and documentation that the birth center has submitted 
113.20 	an application for accreditation to the CABC. Upon receipt of accreditation from the 
113.21 	CABC, the birth center must submit to the commissioner the information required in 
113.22 	subdivision 4, clause (4), and the applicable fee under subdivision 8. The commissioner 
113.23 	shall issue a new license.
113.24 		Subd. 4.Application. An application for a license to operate a birth center and the 
113.25 	applicable fee under subdivision 8 must be submitted to the commissioner on a form 
113.26 	provided by the commissioner and must contain:
113.27 	(1) the name of the applicant;
113.28 	(2) the site location of the birth center;
113.29 	(3) the name of the person in charge of the center;
113.30 	(4) documentation that the accreditation described under subdivision 6 has been 
113.31 	issued, including the effective date and the expiration date of the accreditation, and the 
113.32 	date of the last site visit by the CABC;
113.33 	(5) the number of patients the birth center is capable of serving at a given time;
113.34 	(6) the names and license numbers, if applicable, of the health care professionals 
113.35 	on staff at the birth center; and
113.36 	(7) any other information the commissioner deems necessary.
114.1 		Subd. 5.Suspension, revocation, and refusal to renew. The commissioner may 
114.2 	refuse to grant or renew, or may suspend or revoke, a license on any of the grounds 
114.3 	described under section 144.55, subdivision 6, paragraph (a), clause (2), (3), or (4), or 
114.4 	upon the loss of accreditation by the CABC. The applicant or licensee is entitled to notice 
114.5 	and a hearing as described under section 144.55, subdivision 7, and a new license may be 
114.6 	issued after proper inspection of the birth center has been conducted.
114.7 		Subd. 6.Standards for licensure. (a) To be eligible for licensure under this 
114.8 	section, a birth center must be accredited by the CABC or must obtain accreditation 
114.9 	within six months of the date of the application for licensure. If the birth center loses its 
114.10 	accreditation, the birth center must immediately notify the commissioner.
114.11 	(b) The center must have procedures in place specifying criteria by which risk status 
114.12 	will be established and applied to each woman at admission and during labor.
114.13 	(c) Upon request, the birth center shall provide the commissioner of health with any 
114.14 	material submitted by the birth center to the CABC as part of the accreditation process, 
114.15 	including the accreditation application, the self-evaluation report, the accreditation 
114.16 	decision letter from the CABC, and any reports from the CABC following a site visit.
114.17 		Subd. 7.Limitations of services. (a) The following limitations apply to the services 
114.18 	performed at a birth center:
114.19 	(1) surgical procedures must be limited to those normally accomplished during an 
114.20 	uncomplicated birth, including episiotomy and repair;
114.21 	(2) no abortions may be administered; and
114.22 	(3) no general or regional anesthesia may be administered.
114.23 	(b) Notwithstanding paragraph (a), local anesthesia may be administered at a birth 
114.24 	center if the administration of the anesthetic is performed within the scope of practice of a 
114.25 	health care professional.
114.26 		Subd. 8.Fees. (a) The biennial license fee for a birth center is $365.
114.27 	(b) The temporary license fee is $365.
114.28 	(c) Fees shall be collected and deposited according to section 144.122.
114.29 		Subd. 9.Renewal. (a) Except as provided in paragraph (b), a license issued under 
114.30 	this section expires two years from the date of issue.
114.31 	(b) A temporary license issued under subdivision 3 expires six months from the date 
114.32 	of issue, and may be renewed for one additional six-month period.
114.33 	(c) An application for renewal shall be submitted at least 60 days prior to expiration 
114.34 	of the license on forms prescribed by the commissioner of health.
114.35 		Subd. 10.Records. All health records maintained on each client by a birth center 
114.36 	are subject to sections 144.292 to 144.298.
115.1 		Subd. 11.Report. (a) The commissioner of health, in consultation with the 
115.2 	commissioner of human services and representatives of the licensed birth centers, 
115.3 	the American College of Obstetricians and Gynecologists, the American Academy 
115.4 	of Pediatrics, the Minnesota Hospital Association, and the Minnesota Ambulance 
115.5 	Association, shall evaluate the quality of care and outcomes for services provided in 
115.6 	licensed birth centers, including, but not limited to, the utilization of services provided at a 
115.7 	birth center, the outcomes of care provided to both mothers and newborns, and the numbers 
115.8 	of transfers to other health care facilities that are required and the reasons for the transfers. 
115.9 	The commissioner shall work with the birth centers to establish a process to gather and 
115.10 	analyze the data within protocols that protect the confidentiality of patient identification.
115.11 	(b) The commissioner of health shall report the findings of the evaluation to the 
115.12 	legislature by January 15, 2014.

115.13 	Sec. 12. Minnesota Statutes 2008, section 144.651, subdivision 2, is amended to read:
115.14 		Subd. 2.Definitions. For the purposes of this section, "patient" means a person 
115.15 	who is admitted to an acute care inpatient facility for a continuous period longer than 
115.16 	24 hours, for the purpose of diagnosis or treatment bearing on the physical or mental 
115.17 	health of that person. For purposes of subdivisions 4 to 9, 12, 13, 15, 16, and 18 to 20, 
115.18 	"patient" also means a person who receives health care services at an outpatient surgical 
115.19 	center or at a birth center licensed under section 144.615. "Patient" also means a minor 
115.20 	who is admitted to a residential program as defined in section 253C.01. For purposes of 
115.21 	subdivisions 1, 3 to 16, 18, 20 and 30, "patient" also means any person who is receiving 
115.22 	mental health treatment on an outpatient basis or in a community support program or other 
115.23 	community-based program. "Resident" means a person who is admitted to a nonacute care 
115.24 	facility including extended care facilities, nursing homes, and boarding care homes for 
115.25 	care required because of prolonged mental or physical illness or disability, recovery from 
115.26 	injury or disease, or advancing age. For purposes of all subdivisions except subdivisions 
115.27 	28 and 29, "resident" also means a person who is admitted to a facility licensed as a board 
115.28 	and lodging facility under Minnesota Rules, parts 4625.0100 to 4625.2355, or a supervised 
115.29 	living facility under Minnesota Rules, parts 4665.0100 to 4665.9900, and which operates 
115.30 	a rehabilitation program licensed under Minnesota Rules, parts 9530.4100 to 9530.4450. 

115.31 	Sec. 13. Minnesota Statutes 2008, section 144.9504, is amended by adding a 
115.32 	subdivision to read:
115.33 		Subd. 12.Blood lead level guidelines. (a) By January 1, 2011, the commissioner 
115.34 	must revise clinical and case management guidelines to include recommendations 
116.1 	for protective health actions and follow-up services when a child's blood lead level 
116.2 	exceeds five micrograms of lead per deciliter of blood. The revised guidelines must be 
116.3 	implemented to the extent possible using available resources.
116.4 	(b) In revising the clinical and case management guidelines for blood lead levels 
116.5 	greater than five micrograms of lead per deciliter of blood under this subdivision, 
116.6 	the commissioner of health must consult with a statewide organization representing 
116.7 	physicians, the public health department of Minneapolis and other public health 
116.8 	departments, and a nonprofit organization with expertise in lead abatement.

116.9 	Sec. 14. Minnesota Statutes 2008, section 144A.51, subdivision 5, is amended to read:
116.10 		Subd. 5.Health facility. "Health facility" means a facility or that part of a facility 
116.11 	which is required to be licensed pursuant to sections 144.50 to 144.58, 144.615, and a 
116.12 	facility or that part of a facility which is required to be licensed under any law of this state 
116.13 	which provides for the licensure of nursing homes. 

116.14 	Sec. 15. Minnesota Statutes 2008, section 144E.37, is amended to read:
116.15 	144E.37 COMPREHENSIVE ADVANCED LIFE SUPPORT.
116.16 	The board commissioner of health shall establish a comprehensive advanced 
116.17 	life-support educational program to train rural medical personnel, including physicians, 
116.18 	physician assistants, nurses, and allied health care providers, in a team approach to 
116.19 	anticipate, recognize, and treat life-threatening emergencies before serious injury or 
116.20 	cardiac arrest occurs.

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

116.22 	Sec. 16. HEALTH PLAN AND COUNTY ADMINISTRATIVE COST 
116.23 	REDUCTION; REPORTING REQUIREMENTS.
 116.24 	(a) Minnesota health plans and county-based purchasing plans may complete an 
116.25 	inventory of existing data collection and reporting requirements for health plans and 
116.26 	county-based purchasing plans and submit to the commissioners of health and human 
116.27 	services a list of data, documentation, and reports that:
116.28 	(1) are collected from the same health plan or county-based purchasing plan more 
116.29 	than once;
116.30 	(2) are collected directly from the health plan or county-based purchasing plan but 
116.31 	are available to the state agencies from other sources;
116.32 	(3) are not currently being used by state agencies; or
117.1 	(4) collect similar information more than once in different formats, at different 
117.2 	times, or by more than one state agency.
117.3 	(b) The report to the commissioners may also identify the percentage of health 
117.4 	plan and county-based purchasing plan administrative time and expense attributed to 
117.5 	fulfilling reporting requirements and include recommendations regarding ways to reduce 
117.6 	duplicative reporting requirements.
117.7 	(c) Upon receipt, the commissioners shall submit the inventory and recommendations 
117.8 	to the chairs of the appropriate legislative committees, along with their comments 
117.9 	and recommendations as to whether any action should be taken by the legislature to 
117.10 	establish a consolidated and streamlined reporting system under which data, reports, and 
117.11 	documentation are collected only once and only when needed for the state agencies to 
117.12 	fulfill their duties under law and applicable regulations.

117.13 	Sec. 17. APPLICATION PROCESS FOR HEALTH INFORMATION 
117.14 	EXCHANGE.
 117.15 	To the extent that the commissioner of health applies for additional federal funding 
117.16 	to support the commissioner's responsibilities of developing and maintaining state level 
117.17 	health information exchange under section 3013 of the HITECH Act, the commissioner of 
117.18 	health shall ensure that applications are made through an open process that provides health 
117.19 	information exchange service providers equal opportunity to receive funding.

117.20 	Sec. 18. TRANSFER.
 117.21 	The powers and duties of the Emergency Medical Services Regulatory Board with 
117.22 	respect to the comprehensive advanced life-support educational program under Minnesota 
117.23 	Statutes, section 144E.37, are transferred to the commissioner of health under Minnesota 
117.24 	Statutes, section 15.039.

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

117.26 	Sec. 19. REVISOR'S INSTRUCTION.
 117.27 	The revisor of statutes shall renumber Minnesota Statutes, section 144E.37, as 
117.28 	Minnesota Statutes, section 144.6062, and make all necessary changes in statutory 
117.29 	cross-references in Minnesota Statutes and Minnesota Rules.

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

118.1 	ARTICLE 7
118.2 	HEALTH CARE REFORM

118.3 	Section 1. [62E.20] RELATIONSHIP TO TEMPORARY FEDERAL HIGH-RISK 
118.4 	POOL.
118.5 		Subdivision 1.Definitions. (a) For purposes of this section, the terms defined in 
118.6 	this subdivision have the meanings given.
118.7 	(b) "Association" means the Minnesota Comprehensive Health Association.
118.8 	(c) "Federal law" means Title I, subtitle B, section 1101, of the federal Patient 
118.9 	Protection and Affordable Care Act, Public Law 111-148, including any federal 
118.10 	regulations adopted under it.
118.11 	(d) "Federal qualified high-risk pool" means an arrangement established by the 
118.12 	federal secretary of health and human services that meets the requirements of the federal 
118.13 	law.
118.14 		Subd. 2.Timing of this section. This section applies beginning as of the date the 
118.15 	temporary federal qualified high risk health pool created under the federal law begins 
118.16 	to provide coverage in this state.
118.17 		Subd. 3.Maintenance of effort. The assessments made by the comprehensive 
118.18 	health association on its member insurers must comply with the maintenance of effort 
118.19 	requirement contained in paragraph (b), clause (3), of the federal law, to the extent that 
118.20 	requirement applies to assessments made by the association.
118.21 		Subd. 4.Coordination with federal law. Upon the date a federal qualified high-risk 
118.22 	pool begins to provide coverage in this state, the comprehensive health association must 
118.23 	not enroll new enrollees, notwithstanding section 62E.14 or other law to the contrary. If 
118.24 	the lack of new enrollees would otherwise lead to noncompliance with subdivision 3, the 
118.25 	association shall reduce the premiums to levels below those otherwise required under 
118.26 	section 62E.08, to the extent necessary to comply with subdivision 3.
118.27 		Subd. 5.Coordination with state health care programs. The commissioner of 
118.28 	human services, in consultation with the commissioner of commerce and the Minnesota 
118.29 	Comprehensive Health Association, shall coordinate enrollment between medical 
118.30 	assistance, MinnesotaCare, the federal qualified high-risk pool, and the Minnesota 
118.31 	Comprehensive Health Association, to ensure that:
118.32 	(1) applicants for coverage through the federal qualified high-risk pool, or through 
118.33 	the Minnesota Comprehensive Health Association to the extent the association is enrolling 
118.34 	new members, are referred to the medical assistance or MinnesotaCare programs if they 
118.35 	are determined to be potentially eligible for coverage through those programs; and
119.1 	(2) applicants for coverage under medical assistance or MinnesotaCare who are 
119.2 	determined not to be eligible for those programs are provided information about coverage 
119.3 	through the federal qualified high-risk pool and the Minnesota Comprehensive Health 
119.4 	Association.

119.5 	Sec. 2. Minnesota Statutes 2008, section 62J.07, subdivision 2, is amended to read:
119.6 		Subd. 2.Membership. The Legislative Commission on Health Care Access 
119.7 	consists of five seven members of the senate appointed under the rules of the senate and 
119.8 	five seven members of the house of representatives appointed under the rules of the house 
119.9 	of representatives. The Legislative Commission on Health Care Access must include three
119.10 	five members of the majority party and two members of the minority party in each house.

119.11 	Sec. 3. Minnesota Statutes 2008, section 62J.07, is amended by adding a subdivision to 
119.12 	read:
119.13 		Subd. 5.Federal health care reform. (a) The Legislative Commission on 
119.14 	Health Care Access shall analyze  options  and make recommendations regarding the 
119.15 	implementation of provisions of the Patient Protection and Affordable Health Care Act, 
119.16 	Public Law 111-148, and the health care reform provisions in the Health Care and 
119.17 	Education Reconciliation Act of 2010, Public Law 111-152, including:
119.18 	(1) development of accountable care organizations;
119.19 	(2) health insurance reform, including options related to coverage, purchasing, 
119.20 	exchange development, and coverage for high-risk individuals; and
119.21 	(3) other provisions that will require changes in state law.
119.22 	(b) Before finalizing and submitting federal applications for pilot projects authorized 
119.23 	under federal health care reform, the governor and state agencies shall seek review and 
119.24 	advice from the commission.
119.25 	(c) The commission may create and make appointments to work groups to assist the 
119.26 	commission in its work. Work group members may include legislators, representatives 
119.27 	of businesses and nonprofit agencies impacted by federal health care reform, academic 
119.28 	experts, and consumer representatives.

119.29 	Sec. 4. Minnesota Statutes 2008, section 62U.05, is amended to read:
119.30 	62U.05 PROVIDER PRICING FOR BASKETS OF CARE; ACCOUNTABLE 
119.31 	CARE ORGANIZATIONS.
119.32 		Subdivision 1.Establishment of definitions. (a) By July 1, 2009, the commissioner 
119.33 	of health shall establish uniform definitions for baskets of care beginning with a minimum 
120.1 	of seven baskets of care. In selecting health conditions for which baskets of care should 
120.2 	be defined, the commissioner shall consider coronary artery and heart disease, diabetes, 
120.3 	asthma, and depression. In selecting health conditions, the commissioner shall also 
120.4 	consider the prevalence of the health conditions, the cost of treating the health conditions, 
120.5 	and the potential for innovations to reduce cost and improve quality.
120.6 	(b) The commissioner shall convene one or more work groups to assist in 
120.7 	establishing these definitions. Each work group shall include members appointed by 
120.8 	statewide associations representing relevant health care providers and health plan 
120.9 	companies, and organizations that work to improve health care quality in Minnesota.
120.10 	(c) To the extent possible, the baskets of care must incorporate a patient-directed, 
120.11 	decision-making support model.
120.12 	(d) By January 1, 2012, the commissioner shall establish uniform definitions for the 
120.13 	total cost of providing all necessary services to a patient through an accountable care 
120.14 	organization meeting the standards specified in section 3022 of the Patient Protection 
120.15 	and Affordable Care Act, Public Law 111-148, and shall develop a standard method 
120.16 	and format for accountable care organizations to use for submitting package prices for 
120.17 	the total cost of care. This method must be published in the State Register and must be 
120.18 	made available to all providers.
120.19 		Subd. 2.Package prices. (a) Beginning January 1, 2010, health care providers may 
120.20 	establish package prices for the baskets of care defined under subdivision 1. Beginning 
120.21 	July 1, 2012, accountable care organizations may establish package prices for the total 
120.22 	cost of care defined under subdivision 1.
120.23 	(b) Beginning January 1, 2010, no health care provider or group of providers that 
120.24 	has established a package price for a basket of care under this section, and beginning 
120.25 	July 1, 2012, no accountable care organization that has established a package price for 
120.26 	the total cost of care under this section, shall vary the payment amount that the provider 
120.27 	or organization accepts as full payment for a health care service based upon the identity of 
120.28 	the payer, upon a contractual relationship with a payer, upon the identity of the patient, 
120.29 	or upon whether the patient has coverage through a group purchaser. This paragraph 
120.30 	applies only to health care services provided to Minnesota residents or to non-Minnesota 
120.31 	residents who obtain health insurance through a Minnesota employer. This paragraph does 
120.32 	not apply to services paid for by Medicare, state public health care programs through 
120.33 	fee-for-service or prepaid arrangements, workers' compensation, or no-fault automobile 
120.34 	insurance. This paragraph does not affect the right of a provider to provide charity care 
120.35 	or care for a reduced price due to financial hardship of the patient or due to the patient 
120.36 	being a relative or friend of the provider. 
121.1 		Subd. 3.Quality measurements for baskets of care. (a) The commissioner shall 
121.2 	establish quality measurements for the defined baskets of care by December 31, 2009.
121.3 	The commissioner shall establish quality measures for the total cost of care for services 
121.4 	delivered through an accountable care organization by June 30, 2012. The commissioner 
121.5 	may contract with an organization that works to improve health care quality to make 
121.6 	recommendations about the use of existing measures or establishing new measures where 
121.7 	no measures currently exist.
121.8 	(b) Beginning July 1, 2010, the commissioner or the commissioner's designee shall 
121.9 	publish comparative price and quality information on the baskets of care in a manner 
121.10 	that is easily accessible and understandable to the public, as this information becomes 
121.11 	available. Beginning January 1, 2013, the commissioner or the commissioner's designee 
121.12 	shall publish comparative price and quality information on the total cost of care for 
121.13 	services delivered through an accountable care organization in a manner that is easily 
121.14 	accessible and understandable to the public, as this information becomes available.

121.15 	Sec. 5. Minnesota Statutes 2008, section 256B.0754, is amended by adding a 
121.16 	subdivision to read:
121.17 		Subd. 3.Accountable care organizations. By July 1, 2012, the commissioner of 
121.18 	human services shall deliver services to enrollees in state health care programs through 
121.19 	accountable care organizations, and shall provide incentive payments to accountable care 
121.20 	organizations that meet or exceed annual quality and performance targets. Accountable 
121.21 	care organizations and incentive payments must meet the standards specified in the Patient 
121.22 	Protection and Affordable Care Act, Public Law 111-148.

121.23 	Sec. 6. [256B.0756] COORDINATED CARE THROUGH A HEALTH HOME.
121.24 		Subdivision 1.Provision of coverage. (a) The commissioner shall provide 
121.25 	medical assistance coverage of health home services for eligible individuals with chronic 
121.26 	conditions who select a designated provider, a team of health care professionals, or a 
121.27 	health team as the individual's health home.
121.28 	(b) The commissioner shall implement this section in compliance with the 
121.29 	requirements of the state option to provide health homes for enrollees with chronic 
121.30 	conditions, as provided under the Patient Protection and Affordable Care Act, Public 
121.31 	Law 111-148, sections 2703 and 3502. Terms used in this section have the meaning 
121.32 	provided in that act.
122.1 		Subd. 2.Eligible individual. An individual is eligible for health home services 
122.2 	under this section if the individual is eligible for medical assistance under this chapter 
122.3 	and has at least:
122.4 	(1) two chronic conditions;
122.5 	(2) one chronic condition and is at risk of having a second chronic condition; or
122.6 	(3) one serious and persistent mental health condition.
122.7 		Subd. 3.Health home services. (a) Health home services means comprehensive and 
122.8 	timely high-quality services that are provided by a health home. These services include:
122.9 	(1) comprehensive care management;
122.10 	(2) care coordination and health promotion;
122.11 	(3) comprehensive transitional care, including appropriate follow-up, from inpatient 
122.12 	to other settings;
122.13 	(4) patient and family support, including authorized representatives;
122.14 	(5) referral to community and social support services, if relevant; and
122.15 	(6) use of health information technology to link services, as feasible and appropriate.
122.16 	(b) The commissioner shall maximize the number and type of services 
122.17 	included in this subdivision to the extent permissible under federal law, including 
122.18 	physician, outpatient, mental health treatment, and rehabilitation services necessary for 
122.19 	comprehensive transitional care following hospitalization.
122.20 		Subd. 4.Health teams. The commissioner shall establish health teams to support 
122.21 	the patient-centered health home and provide the services described in subdivision 3 to 
122.22 	individuals eligible under subdivision 2. The commissioner shall apply for grants or 
122.23 	contracts as provided under section 3502 of the Patient Protection and Affordable Care 
122.24 	Act to establish health teams and provide capitated payments to primary care providers. 
122.25 	For purposes of this section, "health teams" means community-based, interdisciplinary, 
122.26 	inter-professional teams of health care providers that support primary care practices. 
122.27 	These providers may include medical specialists, nurses, advanced practice registered 
122.28 	nurses, pharmacists, nutritionists, social workers, behavioral and mental health providers, 
122.29 	doctors of chiropractic, licensed complementary and alternative medicine practitioners, 
122.30 	and physician's assistants.
122.31 		Subd. 5.Payments. The commissioner shall make payments to each health home 
122.32 	and each health team for the provision of health home services to each eligible individual 
122.33 	with chronic conditions that selects the health home as a provider.
122.34 		Subd. 6.Coordination. The commissioner, to the extent feasible, shall ensure that 
122.35 	the requirements and payment methods for health homes and health teams developed 
122.36 	under this section are consistent with the requirements and payment methods for health 
123.1 	care homes established under sections 256B.0751 and 256B.0753. The commissioner may 
123.2 	modify requirements and payment methods under sections 256B.0751 and 256B.0753 in 
123.3 	order to be consistent with federal health home requirements and payment methods.
123.4 		Subd. 7.State plan amendment. The commissioner shall submit a state plan 
123.5 	amendment to implement this section to the federal Centers for Medicare and Medicaid 
123.6 	Services by January 1, 2011.

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

123.9 	Sec. 7. FEDERAL HEALTH CARE REFORM DEMONSTRATION PROJECTS 
123.10 	AND GRANTS.
 123.11 	(a) The commissioner of human services shall seek to participate in the following 
123.12 	demonstration projects, or apply for the following grants, as described in the federal 
123.13 	Patient Protection and Affordable Care Act, Public Law 111-148:
123.14 	(1) the demonstration project to evaluate integrated care around a hospitalization, 
123.15 	Public Law 111-148, section 2704;
123.16 	(2) the Medicaid global payment system demonstration project, Public Law 111-148, 
123.17 	section 2705;
123.18 	(3) the pediatric accountable care organization demonstration project, Public Law 
123.19 	111-148, section 2706;
123.20 	(4) the Medicaid emergency psychiatric demonstration project, Public Law 111-148, 
123.21 	section 2707; and
123.22 	(5) grants to provide incentives for prevention of chronic diseases in Medicaid, 
123.23 	Public Law 111-148, section 4108.
123.24 	(b) The commissioner of human services shall report to the chairs and ranking 
123.25 	minority members of the house of representatives and senate committees or divisions with 
123.26 	jurisdiction over health care policy and finance on the status of the demonstration project 
123.27 	and grant applications. If the state is accepted as a demonstration project participant, or is 
123.28 	awarded a grant, the commissioner shall notify the chairs and ranking minority members 
123.29 	of those committees or divisions of any legislative changes necessary to implement the 
123.30 	demonstration projects or grants.

123.31 	Sec. 8. HEALTH CARE REFORM TASK FORCE.
 123.32 		Subdivision 1.Task force. (a) The governor shall convene a Health Care 
123.33 	Reform Task Force to advise and assist the governor and the legislature regarding state 
123.34 	implementation of federal health care reform legislation. For purposes of this section, 
124.1 	"federal health care reform legislation" means the Patient Protection and Affordable Care 
124.2 	Act, Public Law 111-148, and the health care reform provisions in the Health Care and 
124.3 	Education Reconciliation Act of 2010, Public Law 111-152. The task force shall consist of:
124.4 	(1) two legislators from the house of representatives appointed by the speaker and 
124.5 	two legislators from the senate appointed by the Subcommittee on Committees of the 
124.6 	Committee on Rules and Administration;
124.7 	(2) two representatives appointed by the governor to represent the governor and 
124.8 	state agencies;
124.9 	(3) three persons appointed by the governor who have demonstrated leadership in 
124.10 	health care organizations, health plan companies, or health care trade or professional 
124.11 	associations;
124.12 	(4) three persons appointed by the governor who have demonstrated leadership in 
124.13 	employer and group purchaser activities related to health system improvement of whom at 
124.14 	least two must be from a labor organization; and
124.15 	(5) five persons appointed by the governor who have demonstrated expertise in the 
124.16 	areas of health care financing, access, and quality.
124.17 	The governor is exempt from the requirements of the open appointments process 
124.18 	for purposes of appointing task force members. Members shall be appointed for one-year 
124.19 	terms and may be reappointed.
124.20 	(b) The Department of Health, Department of Human Services, and Department of 
124.21 	Commerce shall provide staff support to the task force. The task force may accept outside 
124.22 	resources to help support its efforts.
124.23 	(c) Task force members must be appointed by July 1, 2010.  The task force must hold 
124.24 	its first meeting by July 15, 2010.
124.25 		Subd. 2.Duties. (a) By December 15, 2010, the task force shall develop and 
124.26 	present to the legislature and the governor a preliminary report and recommendations on 
124.27 	state implementation of federal health care reform legislation. The report must include 
124.28 	recommendations for state law and program changes necessary to comply with the federal 
124.29 	health care reform legislation, and also recommendations for implementing provisions of 
124.30 	the federal legislation that are optional for states. In developing recommendations, the task 
124.31 	force shall consider the extent to which an approach maximizes federal funding to the state.
124.32 	(b) The task force, in consultation with the governor and the legislature, shall also 
124.33 	establish timelines and criteria for future reports on state implementation of the federal 
124.34 	health care reform legislation.

125.1 	Sec. 9. AMERICAN HEALTH BENEFIT EXCHANGE; PLANNING 
125.2 	PROVISIONS.
 125.3 		Subdivision 1.Federal planning grants. The commissioners of commerce, health, 
125.4 	and human services shall jointly or separately apply to the federal secretary of health and 
125.5 	human services for one or more planning and establishment grants, including renewal 
125.6 	grants, authorized under section 1311 of the Patient Protection and Affordable Care Act, 
125.7 	Public Law 111-148, including any future amendments of that provision, relating to state 
125.8 	creation of American Health Benefit Exchanges.
125.9 		Subd. 2.Consideration of early creation and operation of exchange. (a) The 
125.10 	commissioners referenced in subdivision 1 shall analyze the advantages and disadvantages 
125.11 	to the state of planning to have a state health insurance exchange, similar to an American 
125.12 	Health Benefit Exchange referenced in subdivision 1, begin prior to the federal deadline 
125.13 	of January 1, 2014.
125.14 	(b) The commissioners shall provide a written report to the legislature on the results 
125.15 	of the analysis required under paragraph (a) no later than December 15, 2010. The written 
125.16 	report must comply with Minnesota Statutes, sections 3.195 and 3.197.

125.17 	Sec. 10. STATE FISCAL IMPACT OF FEDERAL REFORM.
 125.18 	The commissioner of human services, in consultation with the commissioners of 
125.19 	health and commerce, must report to the legislature by January 1, 2011, the additional costs 
125.20 	and savings to the state in fiscal years 2011 through 2015 imposed under implementation 
125.21 	of the Federal Patient Protection and Affordable Care Act.

125.22 	ARTICLE 8
125.23 	PUBLIC HEALTH

125.24 	Section 1. Minnesota Statutes 2009 Supplement, section 157.16, subdivision 3, is 
125.25 	amended to read:
125.26 		Subd. 3. Establishment fees; definitions. (a) The following fees are required 
125.27 	for food and beverage service establishments, youth camps, hotels, motels, lodging 
125.28 	establishments, public pools, and resorts licensed under this chapter. Food and beverage 
125.29 	service establishments must pay the highest applicable fee under paragraph (d), clause 
125.30 	(1), (2), (3), or (4), and establishments serving alcohol must pay the highest applicable 
125.31 	fee under paragraph (d), clause (6) or (7). The license fee for new operators previously 
125.32 	licensed under this chapter for the same calendar year is one-half of the appropriate annual 
125.33 	license fee, plus any penalty that may be required. The license fee for operators opening 
126.1 	on or after October 1 is one-half of the appropriate annual license fee, plus any penalty 
126.2 	that may be required. 
126.3 	(b) All food and beverage service establishments, except special event food stands, 
126.4 	and all hotels, motels, lodging establishments, public pools, and resorts shall pay an 
126.5 	annual base fee of $150. 
126.6 	(c) A special event food stand shall pay a flat fee of $50 annually. "Special event 
126.7 	food stand" means a fee category where food is prepared or served in conjunction with 
126.8 	celebrations, county fairs, or special events from a special event food stand as defined 
126.9 	in section 157.15. 
126.10 	(d) In addition to the base fee in paragraph (b), each food and beverage service 
126.11 	establishment, other than a special event food stand, and each hotel, motel, lodging 
126.12 	establishment, public pool, and resort shall pay an additional annual fee for each fee 
126.13 	category, additional food service, or required additional inspection specified in this 
126.14 	paragraph: 
126.15 	(1) Limited food menu selection, $60. "Limited food menu selection" means a fee 
126.16 	category that provides one or more of the following: 
126.17 	(i) prepackaged food that receives heat treatment and is served in the package; 
126.18 	(ii) frozen pizza that is heated and served; 
126.19 	(iii) a continental breakfast such as rolls, coffee, juice, milk, and cold cereal; 
126.20 	(iv) soft drinks, coffee, or nonalcoholic beverages; or 
126.21 	(v) cleaning for eating, drinking, or cooking utensils, when the only food served 
126.22 	is prepared off site. 
126.23 	(2) Small establishment, including boarding establishments, $120. "Small 
126.24 	establishment" means a fee category that has no salad bar and meets one or more of 
126.25 	the following: 
126.26 	(i) possesses food service equipment that consists of no more than a deep fat fryer, a 
126.27 	grill, two hot holding containers, and one or more microwave ovens; 
126.28 	(ii) serves dipped ice cream or soft serve frozen desserts; 
126.29 	(iii) serves breakfast in an owner-occupied bed and breakfast establishment; 
126.30 	(iv) is a boarding establishment; or 
126.31 	(v) meets the equipment criteria in clause (3), item (i) or (ii), and has a maximum 
126.32 	patron seating capacity of not more than 50. 
126.33 	(3) Medium establishment, $310. "Medium establishment" means a fee category 
126.34 	that meets one or more of the following: 
126.35 	(i) possesses food service equipment that includes a range, oven, steam table, salad 
126.36 	bar, or salad preparation area; 
127.1 	(ii) possesses food service equipment that includes more than one deep fat fryer, 
127.2 	one grill, or two hot holding containers; or 
127.3 	(iii) is an establishment where food is prepared at one location and served at one or 
127.4 	more separate locations. 
127.5 	Establishments meeting criteria in clause (2), item (v), are not included in this fee 
127.6 	category. 
127.7 	(4) Large establishment, $540. "Large establishment" means either: 
127.8 	(i) a fee category that (A) meets the criteria in clause (3), items (i) or (ii), for a 
127.9 	medium establishment, (B) seats more than 175 people, and (C) offers the full menu 
127.10 	selection an average of five or more days a week during the weeks of operation; or 
127.11 	(ii) a fee category that (A) meets the criteria in clause (3), item (iii), for a medium 
127.12 	establishment, and (B) prepares and serves 500 or more meals per day. 
127.13 	(5) Other food and beverage service, including food carts, mobile food units, 
127.14 	seasonal temporary food stands, and seasonal permanent food stands, $60. 
127.15 	(6) Beer or wine table service, $60. "Beer or wine table service" means a fee 
127.16 	category where the only alcoholic beverage service is beer or wine, served to customers 
127.17 	seated at tables. 
127.18 	(7) Alcoholic beverage service, other than beer or wine table service, $165. 
127.19 	"Alcohol beverage service, other than beer or wine table service" means a fee 
127.20 	category where alcoholic mixed drinks are served or where beer or wine are served from 
127.21 	a bar. 
127.22 	(8) Lodging per sleeping accommodation unit, $10, including hotels, motels, 
127.23 	lodging establishments, and resorts, up to a maximum of $1,000. "Lodging per sleeping 
127.24 	accommodation unit" means a fee category including the number of guest rooms, cottages, 
127.25 	or other rental units of a hotel, motel, lodging establishment, or resort; or the number of 
127.26 	beds in a dormitory. 
127.27 	(9) First public pool, $325; each additional public pool, $175. "Public pool" means a 
127.28 	fee category that has the meaning given in section 144.1222, subdivision 4. 
127.29 	(10) First spa, $175; each additional spa, $100. "Spa pool" means a fee category that 
127.30 	has the meaning given in Minnesota Rules, part 4717.0250, subpart 9. 
127.31 	(11) Private sewer or water, $60. "Individual private water" means a fee category 
127.32 	with a water supply other than a community public water supply as defined in Minnesota 
127.33 	Rules, chapter 4720. "Individual private sewer" means a fee category with an individual 
127.34 	sewage treatment system which uses subsurface treatment and disposal. 
128.1 	(12) Additional food service, $150. "Additional food service" means a location at 
128.2 	a food service establishment, other than the primary food preparation and service area, 
128.3 	used to prepare or serve food to the public. 
128.4 	(13) Additional inspection fee, $360. "Additional inspection fee" means a fee to 
128.5 	conduct the second inspection each year for elementary and secondary education facility 
128.6 	school lunch programs when required by the Richard B. Russell National School Lunch 
128.7 	Act. 
128.8 	(e) A fee for review of construction plans must accompany the initial license 
128.9 	application for restaurants, hotels, motels, lodging establishments, resorts, seasonal food 
128.10 	stands, and mobile food units. The fee for this construction plan review is as follows:

128.11	Service Area
	Type
	Fee
	
128.12	Food
	limited food menu
	$275
	
128.13		small establishment
	$400
	
128.14		medium establishment
	$450
	
128.15		large food establishment
	$500
	
128.16		additional food service
	$150
	
128.17	Transient food service
	food cart
	$250
	
128.18		seasonal permanent food stand
	$250
	
128.19		seasonal temporary food stand
	$250
	
128.20		mobile food unit
	$350
	
128.21	Alcohol
	beer or wine table service
	$150
	
128.22		alcohol service from bar
	$250
	
128.23	Lodging
	less than 25 rooms
	$375
	
128.24		25 to less than 100 rooms
	$400
	
128.25		100 rooms or more
	$500
	
128.26		less than five cabins
	$350
	
128.27		five to less than ten cabins
	$400
	
128.28		ten cabins or more
	$450
	
128.29 	(f) When existing food and beverage service establishments, hotels, motels, lodging 
128.30 	establishments, resorts, seasonal food stands, and mobile food units are extensively 
128.31 	remodeled, a fee must be submitted with the remodeling plans. The fee for this 
128.32 	construction plan review is as follows:

128.33	Service Area
	Type
	Fee
	
128.34	Food
	limited food menu
	$250
	
128.35		small establishment
	$300
	
128.36		medium establishment
	$350
	
128.37		large food establishment
	$400
	
128.38		additional food service
	$150
	
128.39	Transient food service
	food cart
	$250
	
128.40		seasonal permanent food stand
	$250
	
129.1		seasonal temporary food stand
	$250
	
129.2		mobile food unit
	$250
	
129.3	Alcohol
	beer or wine table service
	$150
	
129.4		alcohol service from bar
	$250
	
129.5	Lodging
	less than 25 rooms
	$250
	
129.6		25 to less than 100 rooms
	$300
	
129.7		100 rooms or more
	$450
	
129.8		less than five cabins
	$250
	
129.9		five to less than ten cabins
	$350
	
129.10		ten cabins or more
	$400
	
129.11 	(g) Special event food stands are not required to submit construction or remodeling 
129.12 	plans for review. 
129.13 	(h) Youth camps shall pay an annual single fee for food and lodging as follows:
129.14 	(1) camps with up to 99 campers, $325;
129.15 	(2) camps with 100 to 199 campers, $550; and
129.16 	(3) camps with 200 or more campers, $750.
129.17 	(i) A youth camp which pays fees under paragraph (d) is not required to pay fees 
129.18 	under paragraph (h).

129.19 	Sec. 2. Minnesota Statutes 2009 Supplement, section 327.15, subdivision 3, is 
129.20 	amended to read:
129.21 		Subd. 3.Fees, manufactured home parks and recreational camping areas. (a) 
129.22 	The following fees are required for manufactured home parks and recreational camping 
129.23 	areas licensed under this chapter. Recreational camping areas and manufactured home 
129.24 	parks shall pay the highest applicable base fee under paragraph (c) (b). The license fee 
129.25 	for new operators of a manufactured home park or recreational camping area previously 
129.26 	licensed under this chapter for the same calendar year is one-half of the appropriate annual 
129.27 	license fee, plus any penalty that may be required. The license fee for operators opening 
129.28 	on or after October 1 is one-half of the appropriate annual license fee, plus any penalty 
129.29 	that may be required.
129.30 	(b) All manufactured home parks and recreational camping areas shall pay the 
129.31 	following annual base fee:
129.32 	(1) a manufactured home park, $150; and
129.33 	(2) a recreational camping area with:
129.34 	(i) 24 or less sites, $50;
129.35 	(ii) 25 to 99 sites, $212; and
129.36 	(iii) 100 or more sites, $300.
130.1 	In addition to the base fee, manufactured home parks and recreational camping areas shall 
130.2 	pay $4 for each licensed site. This paragraph does not apply to special event recreational 
130.3 	camping areas or to. Operators of a manufactured home park or a recreational camping 
130.4 	area also licensed under section 157.16 for the same location shall pay only one base fee, 
130.5 	whichever is the highest of the base fees found in this section or section 157.16.
130.6 	(c) In addition to the fee in paragraph (b), each manufactured home park or 
130.7 	recreational camping area shall pay an additional annual fee for each fee category 
130.8 	specified in this paragraph:
130.9 	(1) Manufactured home parks and recreational camping areas with public swimming 
130.10 	pools and spas shall pay the appropriate fees specified in section 157.16.
130.11 	(2) Individual private sewer or water, $60. "Individual private water" means a fee 
130.12 	category with a water supply other than a community public water supply as defined in 
130.13 	Minnesota Rules, chapter 4720. "Individual private sewer" means a fee category with a 
130.14 	subsurface sewage treatment system which uses subsurface treatment and disposal.
130.15 	(d) The following fees must accompany a plan review application for initial 
130.16 	construction of a manufactured home park or recreational camping area:
130.17 	(1) for initial construction of less than 25 sites, $375;
130.18 	(2) for initial construction of 25 to 99 sites, $400; and
130.19 	(3) for initial construction of 100 or more sites, $500.
130.20 	(e) The following fees must accompany a plan review application when an existing 
130.21 	manufactured home park or recreational camping area is expanded:
130.22 	(1) for expansion of less than 25 sites, $250;
130.23 	(2) for expansion of 25 to 99 sites, $300; and
130.24 	(3) for expansion of 100 or more sites, $450.

130.25 	Sec. 3. FOOD SUPPORT FOR CHILDREN WITH SEVERE ALLERGIES.
 130.26 	The commissioner of human services must seek a federal waiver from the federal 
130.27 	Department of Agriculture, Food and Nutrition Service, for the supplemental nutrition 
130.28 	assistance program, to increase the income eligibility requirements to 375 percent of the 
130.29 	federal poverty guidelines, in order to cover nutritional food products required to treat 
130.30 	or manage severe food allergies, including allergies to wheat and gluten, for infants and 
130.31 	children who have been diagnosed with life-threatening severe food allergies.

131.1 	ARTICLE 9
131.2 	HUMAN SERVICES FORECAST ADJUSTMENTS

131.3
131.4	Section 1. SUMMARY OF APPROPRIATIONS; DEPARTMENT OF HUMAN 
SERVICES FORECAST ADJUSTMENT.
 	
131.5 	The dollar amounts shown are added to or if shown in parentheses, are subtracted 
131.6 	from the appropriations in Laws 2009, chapter 79, article 13, as amended by Laws 2009, 
131.7 	chapter 173, article 2, from the general fund or any fund named to the Department of 
131.8 	Human Services for the purposes specified in this article, to be available for the fiscal 
131.9 	year indicated for each purpose. The figure "2010" used in this article means that the 
131.10 	appropriation or appropriations listed are available for the fiscal year ending June 30, 
131.11 	2010. The figure "2011" used in this article means that the appropriation or appropriations 
131.12 	listed are available for the fiscal year ending June 30, 2011.

131.13					2010
		2011
	
131.14	General
			$
	(109,876,000)
	$
	(28,344,000)
	
131.15	Health Care Access
				99,654,000
		276,500,000
	
131.16	Federal TANF
				 (9,830,000)
		15,133,000
	
131.17	Total
			$
	(20,052,000)
	$
	263,289,000

131.18
131.19	Sec. 2. COMMISSIONER OF HUMAN 
SERVICES

131.20	Subdivision 1.Total Appropriation
 	$
	(20,052,000)
	$
	263,289,000

131.21	Appropriations by Fund
	
131.22		2010
	2011
	
131.23	General
	(109,876,000)
	(28,344,000)
	
131.24	Health Care Access
	99,654,000
	276,500,000
	
131.25	Federal TANF
	 (9,830,000)
	15,133,000

131.26	Subd. 2. Revenue and Pass-Through

131.27	Federal TANF
	390,000
	(251,000)

131.28
131.29	Subd. 3.Children and Economic Assistance 
Grants

131.30	General Fund
	4,489,000
	(4,140,000)
	
131.31	Federal TANF
	(10,220,000)
	15,384,000
	
131.32 	The amounts that may be spent from this 
131.33 	appropriation are as follows:

131.34	(a) MFIP Grants

132.1	General Fund
	7,916,000
	(14,481,000)
	
132.2	TANF Fund
	(10,220,000)
	15,384,000

132.3	(b) MFIP Child Care Assistance Grants
		(7,832,000)
		2,579,000

132.4	(c) General Assistance Grants
		875,000
		1,339,000

132.5	(d) Minnesota Supplemental Aid Grants
		2,454,000
		3,843,000

132.6	(e) Group Residential Housing Grants
		1,076,000
		2,580,000

132.7	Subd. 4.Basic Health Care Grants

132.8	General Fund
	(62,770,000)
	29,192,000
	
132.9	TANF Fund
	99,654,000
	276,500,000
	
132.10 	The amounts that may be spent from this 
132.11 	appropriation are as follows:

132.12	(a) MinnesotaCare Grants

132.13
132.14	Health Care Access 
Fund
	99,654,000
	276,500,000

132.15
132.16	(b) Medical Assistance Basic Health Care â€“ 
Families and Children
		1,165,000
		24,146,000

132.17
132.18	(c) Medical Assistance Basic Health Care â€“ 
Elderly and Disabled
		(63,935,000)
		5,046,000

132.19	Subd. 5.Continuing Care Grants
 		(51,595,000)
		(53,396,000)
	
132.20 	The amounts that may be spent from this 
132.21 	appropriation are as follows:

132.22
132.23	(a) Medical Assistance Long-Term Care 
Facilities
		(3,774,000)
		(8,275,000)

132.24
132.25	(b) Medical Assistance Long-Term Care 
Waivers
		(27,710,000)
		(22,452,000)

132.26	(c) Chemical Dependency Entitlement Grants
		(20,111,000)
		(22,669,000)

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

132.29 	ARTICLE 10
132.30 	HUMAN SERVICES CONTINGENT APPROPRIATIONS

132.31	Section 1.  SUMMARY OF HUMAN SERVICES APPROPRIATIONS.
 	
133.1 	The amounts shown in this section summarize direct appropriations, by fund, made 
133.2 	in this bill.

133.3			2010
		2011
		Total
	
133.4	General
	$
	-0-
	$
	13,383,000
	$
	13,383,000
	
133.5	Health Care Access
		-0-
		686,000
		686,000
	
133.6	Total
	$
	-0-
	$
	14,069,000
	$
	14,069,000

133.7	Sec. 2. HEALTH AND HUMAN SERVICES CONTINGENT APPROPRIATIONS.
 	
133.8 	(a) The sums shown in the columns marked "Appropriations" are added to the 
133.9 	appropriations in Laws 2009, chapter 79, article 13, as amended by Laws 2009, chapter 
133.10 	173, article 2, to the agency and for the purposes specified in this bill. The appropriations 
133.11 	are from the general fund, or another named fund, and are available for the fiscal years 
133.12 	indicated for each purpose. The figures "2010" and "2011" used in this bill mean that the 
133.13 	addition to or subtraction from the appropriation listed under them is available for the 
133.14 	fiscal year ending June 30, 2010, or June 30, 2011, respectively.
133.15 	(b) Upon enactment of the extension of the enhanced federal medical assistance 
133.16 	percentage (FMAP) under Public Law 111-5 to June 30, 2011, that is contained in the 
133.17 	president's budget for federal fiscal year 2011 or contained in House Resolution 2847, 
133.18 	the federal "Jobs for Main Street Act, 2010," or contained in House Resolution 4213, 
133.19 	"American Workers, State, and Business Relief Act of 2010," or subsequent federal 
133.20 	legislation, the appropriations identified in section 3 shall be made for fiscal year 2011.

133.21				APPROPRIATIONS
	
133.22				Available for the Year
	
133.23				Ending June 30
	
133.24					2010
		2011

133.25
133.26	Sec. 3. COMMISSIONER OF HUMAN 
SERVICES

133.27	Subdivision 1.Total Appropriation
 	$
	-0-
	$
	14,069,000

133.28	Appropriations by Fund
	
133.29		2010
	2011
	
133.30	General
	-0-
	13,383,000
	
133.31	Health Care Access
	-0-
	686,000
	
133.32 	The appropriations for each purpose are 
133.33 	shown in the following subdivisions.

133.34	Subd. 2.Basic Health Care Grants

134.1	(a) MinnesotaCare Grants
		-0-
		686,000
	
134.2 	This appropriation is from the health care 
134.3 	access fund.

134.4
134.5	(b) Medical Assistance Basic Health Care 
Grants - Families and Children
		-0-
		6,297,000

134.6
134.7	(c) Medical Assistance Basic Health Care 
Grants - Elderly and Disabled
		-0-
		3,697,000

134.8	Subd. 3.Continuing Care Grants

134.9134.10
	(a) Medical Assistance - Long-Term Care 
Facilities Grants
		-0-
		2,486,000

134.11
134.12	(b) Medical Assistance Grants - Long-Term 
Care Waivers and Home Care Grants
		-0-
		547,000

134.13	(c) Chemical Dependency Entitlement Grants
		-0-
		356,000

134.14 	Sec. 4. Minnesota Statutes 2009 Supplement, section 144.0724, subdivision 11, 
134.15 	is amended to read:
134.16 		Subd. 11.Nursing facility level of care. (a) For purposes of medical assistance 
134.17 	payment of long-term care services, a recipient must be determined, using assessments 
134.18 	defined in subdivision 4, to meet one of the following nursing facility level of care criteria:
134.19 	(1) the person needs the assistance of another person or constant supervision to begin 
134.20 	and complete at least four of the following activities of living: bathing, bed mobility, 
134.21 	dressing, eating, grooming, toileting, transferring, and walking; 
134.22 	(2) the person needs the assistance of another person or constant supervision to begin 
134.23 	and complete toileting, transferring, or positioning and the assistance cannot be scheduled;
134.24 	(3) the person has significant difficulty with memory, using information, daily 
134.25 	decision making, or behavioral needs that require intervention;
134.26 	(4) the person has had a qualifying nursing facility stay of at least 90 days; or
134.27 	(5) the person is determined to be at risk for nursing facility admission or 
134.28 	readmission through a face-to-face long-term care consultation assessment as specified 
134.29 	in section 256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or managed care 
134.30 	organization under contract with the Department of Human Services. The person is 
134.31 	considered at risk under this clause if the person currently lives alone or will live alone 
134.32 	upon discharge and also meets one of the following criteria:
134.33 	(i) the person has experienced a fall resulting in a fracture;
135.1 	(ii) the person has been determined to be at risk of maltreatment or neglect, 
135.2 	including self-neglect; or
135.3 	(iii) the person has a sensory impairment that substantially impacts functional ability 
135.4 	and maintenance of a community residence.
135.5 	(b) The assessment used to establish medical assistance payment for nursing facility 
135.6 	services must be the most recent assessment performed under subdivision 4, paragraph 
135.7 	(b), that occurred no more than 90 calendar days before the effective date of medical 
135.8 	assistance eligibility for payment of long-term care services. In no case shall medical 
135.9 	assistance payment for long-term care services occur prior to the date of the determination 
135.10 	of nursing facility level of care.
135.11 	(c) The assessment used to establish medical assistance payment for long-term care 
135.12 	services provided under sections 256B.0915 and 256B.49 and alternative care payment 
135.13 	for services provided under section 256B.0913 must be the most recent face-to-face 
135.14 	assessment performed under section 256B.0911, subdivision 3a, 3b, or 4d, that occurred 
135.15 	no more than 60 calendar days before the effective date of medical assistance eligibility 
135.16 	for payment of long-term care services.

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

135.18 	Sec. 5. Minnesota Statutes 2008, section 254B.03, is amended by adding a subdivision 
135.19 	to read:
135.20 		Subd. 4a.Division of costs for medical assistance services. Notwithstanding 
135.21 	subdivision 4, for chemical dependency services provided on or after October 1, 2008, and 
135.22 	reimbursed by medical assistance, the county share is 30 percent of the nonfederal share.

135.23 	Sec. 6. Minnesota Statutes 2008, section 256B.0625, subdivision 22, is amended to 
135.24 	read:
135.25 		Subd. 22.Hospice care. Medical assistance covers hospice care services under 
135.26 	Public Law 99-272, section 9505, to the extent authorized by rule, except that a recipient 
135.27 	age 21 or under who elects to receive hospice services does not waive coverage for 
135.28 	services that are related to the treatment of the condition for which a diagnosis of terminal 
135.29 	illness has been made.

135.30 	EFFECTIVE DATE. This section is effective retroactive from March 23, 2010.

135.31 	Sec. 7. Minnesota Statutes 2009 Supplement, section 256B.0911, subdivision 1a, 
135.32 	is amended to read:
136.1 		Subd. 1a.Definitions. For purposes of this section, the following definitions apply:
136.2 	(a) "Long-term care consultation services" means:
136.3 	(1) assistance in identifying services needed to maintain an individual in the most 
136.4 	inclusive environment;
136.5 	(2) providing recommendations on cost-effective community services that are 
136.6 	available to the individual;
136.7 	(3) development of an individual's person-centered community support plan;
136.8 	(4) providing information regarding eligibility for Minnesota health care programs;
136.9 	(5) face-to-face long-term care consultation assessments, which may be completed 
136.10 	in a hospital, nursing facility, intermediate care facility for persons with developmental 
136.11 	disabilities (ICF/DDs), regional treatment centers, or the person's current or planned 
136.12 	residence;
136.13 	(6) federally mandated screening to determine the need for a institutional level of 
136.14 	care under section 256B.0911, subdivision 4, paragraph (a) subdivision 4a;
136.15 	(7) determination of home and community-based waiver service eligibility including 
136.16 	level of care determination for individuals who need an institutional level of care as 
136.17 	defined under section 144.0724, subdivision 11, or 256B.092, service eligibility including 
136.18 	state plan home care services identified in section 256B.0625, subdivisions 6, 7, and 
136.19 	19, paragraphs (a) and (c), based on assessment and support plan development with 
136.20 	appropriate referrals;
136.21 	(8) providing recommendations for nursing facility placement when there are no 
136.22 	cost-effective community services available; and
136.23 	(9) assistance to transition people back to community settings after facility 
136.24 	admission.
136.25 	(b) "Long-term care options counseling" means the services provided by the linkage 
136.26 	lines as mandated by sections 256.01 and 256.975, subdivision 7, and also includes 
136.27 	telephone assistance and follow up once a long-term care consultation assessment has 
136.28 	been completed.
136.29 	(c) "Minnesota health care programs" means the medical assistance program under 
136.30 	chapter 256B and the alternative care program under section 256B.0913.
136.31 	(d) "Lead agencies" means counties or a collaboration of counties, tribes, and health 
136.32 	plans administering long-term care consultation assessment and support planning services.

136.33 	Sec. 8. Minnesota Statutes 2008, section 256B.19, subdivision 1c, is amended to read:
136.34 		Subd. 1c.Additional portion of nonfederal share. (a) Hennepin County shall 
136.35 	be responsible for a monthly transfer payment of $1,500,000, due before noon on the 
137.1 	15th of each month and the University of Minnesota shall be responsible for a monthly 
137.2 	transfer payment of $500,000 due before noon on the 15th of each month, beginning July 
137.3 	15, 1995. These sums shall be part of the designated governmental unit's portion of the 
137.4 	nonfederal share of medical assistance costs.
137.5 	(b) Beginning July 1, 2001, Hennepin County's payment under paragraph (a) shall 
137.6 	be $2,066,000 each month.
137.7 	(c) Beginning July 1, 2001, the commissioner shall increase annual capitation 
137.8 	payments to the metropolitan health plan under section 256B.69 for the prepaid medical 
137.9 	assistance program by approximately $3,400,000, plus any available federal matching 
137.10 	funds, $6,800,000 to recognize higher than average medical education costs.
137.11 	(d) Effective August 1, 2005, Hennepin County's payment under paragraphs (a) 
137.12 	and (b) shall be reduced to $566,000, and the University of Minnesota's payment under 
137.13 	paragraph (a) shall be reduced to zero. Effective October 1, 2008, to December 31, 2010, 
137.14 	Hennepin County's payment under paragraphs (a) and (b) shall be $434,688. Effective 
137.15 	January 1, 2011, Hennepin County's payment under paragraphs (a) and (b) shall be 
137.16 	$566,000.
137.17 	(e) Notwithstanding paragraph (d), upon federal enactment of an extension to June 
137.18 	30, 2011, of the enhanced federal medical assistance percentage (FMAP) originally 
137.19 	provided under Public Law 111-5, for the six-month period from January 1, 2011, to June 
137.20 	30, 2011, Hennepin County's payment under paragraphs (a) and (b) shall be $434,688.

137.21 	Sec. 9. Minnesota Statutes 2008, section 256L.15, subdivision 1, is amended to read:
137.22 		Subdivision 1.Premium determination. (a) Families with children and individuals 
137.23 	shall pay a premium determined according to subdivision 2.
137.24 	(b) Pregnant women and children under age two are exempt from the provisions 
137.25 	of section 256L.06, subdivision 3, paragraph (b), clause (3), requiring disenrollment 
137.26 	for failure to pay premiums. For pregnant women, this exemption continues until the 
137.27 	first day of the month following the 60th day postpartum. Women who remain enrolled 
137.28 	during pregnancy or the postpartum period, despite nonpayment of premiums, shall be 
137.29 	disenrolled on the first of the month following the 60th day postpartum for the penalty 
137.30 	period that otherwise applies under section 256L.06, unless they begin paying premiums. 
137.31 	(c) Members of the military and their families who meet the eligibility criteria 
137.32 	for MinnesotaCare upon eligibility approval made within 24 months following the end 
137.33 	of the member's tour of active duty shall have their premiums paid by the commissioner. 
137.34 	The effective date of coverage for an individual or family who meets the criteria of this 
137.35 	paragraph shall be the first day of the month following the month in which eligibility is 
138.1 	approved. This exemption applies for 12 months. This paragraph expires June 30, 2010. 
138.2 	If the expiration of this provision is in violation of section 5001 of Public Law 111-5, this 
138.3 	provision will expire on the date when it is no longer subject to section 5001 of Public Law 
138.4 	111-5. The commissioner of human services shall notify the revisor of statutes of that date.

138.5 	Sec. 10. Laws 2005, First Special Session chapter 4, article 8, section 66, as amended 
138.6 	by Laws 2009, chapter 173, article 3, section 24, the effective date, is amended to read:

138.7 	EFFECTIVE DATE. Paragraph (a) is effective August 1, 2009, and upon federal 
138.8 	approval and on the date when it is no longer subject to the maintenance of effort 
138.9 	requirements of section 5001 of Public Law 111-5. The commissioner of human services 
138.10 	shall notify the revisor of statutes of that date. Paragraph (e) is effective September 1, 
138.11 	2006.

138.12 	Sec. 11. Laws 2009, chapter 79, article 5, section 17, the effective date, is amended to 
138.13 	read:

138.14 	EFFECTIVE DATE. This section is effective January 1, 2011, or upon federal 
138.15 	approval, whichever is later and on the date when it is no longer subject to the maintenance 
138.16 	of effort requirements of section 5001 of Public Law 111-5. The commissioner of human 
138.17 	services shall notify the revisor of statutes of that date.

138.18 	Sec. 12. Laws 2009, chapter 79, article 5, section 18, the effective date, is amended to 
138.19 	read:

138.20 	EFFECTIVE DATE. This section is effective January 1, 2011 upon federal 
138.21 	approval and on the date when it is no longer subject to the maintenance of effort 
138.22 	requirements of section 5001 of Public Law 111-5. The commissioner of human services 
138.23 	shall notify the revisor of statutes when federal approval is obtained.

138.24 	Sec. 13. Laws 2009, chapter 79, article 5, section 22, the effective date, is amended to 
138.25 	read:

138.26 	EFFECTIVE DATE. This section is effective for periods of ineligibility established 
138.27 	on or after January 1, 2011, unless it is in violation of section 5001 of Public Law 111-5. 
138.28 	If it is in violation of that section, then it shall be effective on the date when it is no longer 
138.29 	subject to maintenance of effort requirements of section 5001 of Public Law 111-5. The 
138.30 	commissioner of human services shall notify the revisor of statutes of that date.

139.1 	Sec. 14. Laws 2009, chapter 173, article 1, section 17, the effective date, is amended to 
139.2 	read:

139.3 	EFFECTIVE DATE. This section is effective for pooled trust accounts established 
139.4 	on or after January 1, 2011, unless it is in violation of section 5001 of Public Law 111-5. 
139.5 	If it is in violation of that section, then it shall be effective on the date when it is no longer 
139.6 	subject to maintenance of effort requirements of section 5001 of Public Law 111-5. The 
139.7 	commissioner of human services shall notify the revisor of statutes of that date.

139.8 	ARTICLE 11
139.9 	HEALTH AND HUMAN SERVICES APPROPRIATIONS

139.10	Section 1.  SUMMARY OF APPROPRIATIONS.
 	
139.11 	The amounts shown in this section summarize direct appropriations, by fund, made 
139.12 	in this article.

139.13			2010
		2011
		Total
	
139.14	General
	$
	(10,141,000)
	$
	(107,438,000)
	$
	(117,579,000)
	
139.15
139.16	State Government Special 
Revenue
		2,002,000
		(275,000)
		1,727,000
	
139.17	Health Care Access
		(1,094,000)
		72,459,000
		71,365,000
	
139.18	Federal TANF
		(7,500,000)
		35,418,000
		27,918,000
	
139.19	Total
	$
	(16,733,000)
	$
	163,000
	$
	(16,570,000)

139.20	Sec. 2. HEALTH AND HUMAN SERVICES APPROPRIATIONS.
 	
139.21 	The sums shown in the columns marked "Appropriations" are added to or, if shown 
139.22 	in parentheses, subtracted from the appropriations in Laws 2009, chapter 79, article 13, 
139.23 	as amended by Laws 2009, chapter 173, article 2, to the agencies and for the purposes 
139.24 	specified in this article. The appropriations are from the general fund and are available 
139.25 	for the fiscal years indicated for each purpose. The figures "2010" and "2011" used in 
139.26 	this article mean that the addition to or subtraction from the appropriation listed under 
139.27 	them is available for the fiscal year ending June 30, 2010, or June 30, 2011, respectively. 
139.28 	Supplemental appropriations and reductions to appropriations for the fiscal year ending 
139.29 	June 30, 2010, are effective the day following final enactment unless a different effective 
139.30 	date is explicit.

139.31				APPROPRIATIONS
	
139.32				Available for the Year
	
139.33				Ending June 30
	
139.34					2010
		2011

140.1
140.2	Sec. 3. COMMISSIONER OF HUMAN 
SERVICES

140.3	Subdivision 1.Total Appropriation
 	$
	(16,667,000)
	$
	(4,971,000)

140.4	Appropriations by Fund
	
140.5		2010
	2011
	
140.6	General
	(8,075,000)
	(112,631,000)
	
140.7
140.8	State Government 
Special Revenue
	(8,000)
	(16,000)
	
140.9	Health Care Access
	(1,094,000)
	72,259,000
	
140.10	Federal TANF
	(7,500,000)
	35,418,000
	
140.11 	Working Family Credit Expenditures to 
140.12 	be Claimed for TANF/MOE. For fiscal year 
140.13 	2011, the commissioner may count $38,000 
140.14 	of working family credit expenditures as 
140.15 	TANF/MOE. Notwithstanding any provision 
140.16 	to the contrary, this rider expires June 30, 
140.17 	2013.
140.18 	TANF Financing and Maintenance of 
140.19 	Effort. The commissioner of human 
140.20 	services, with the approval of the 
140.21 	commissioner of management and budget, 
140.22 	and after notification of the chairs of the 
140.23 	relevant senate budget division and house of 
140.24 	representatives finance division, may adjust 
140.25 	the amount of TANF transfers between the 
140.26 	MFIP transition year child care assistance 
140.27 	program and MFIP grant programs within the 
140.28 	fiscal year, and within the current biennium 
140.29 	and the biennium ending June 30, 2013, 
140.30 	to ensure that state and federal match and 
140.31 	maintenance of effort requirements are 
140.32 	met. These transfers and amounts must be 
140.33 	reported to the chairs of the senate and house 
140.34 	of representatives Finance Committees, the 
140.35 	senate Health and Human Services Budget 
140.36 	Division, the house of representatives Health 
140.37 	Care and Human Services Finance Division, 
141.1 	and Early Childhood Finance and Policy 
141.2 	Division by December 1 of each fiscal 
141.3 	year. Notwithstanding any provision to the 
141.4 	contrary, this rider expires June 30, 2013.
141.5 	The appropriation reductions for each 
141.6 	purpose are shown in the following 
141.7 	subdivisions.

141.8
141.9	Subd. 2.Agency Management; Financial 
Operations
 		(8,000)
		(16,000)
	
141.10 	This appropriation reduction is from the state 
141.11 	government special revenue fund.

141.12
141.13	Subd. 3.Revenue and Pass-Through Revenue 
Expenditures
 		(7,500,000)
		35,500,000
	
141.14 	TANF Funding for the Working Family 
141.15 	Tax Credit. In addition to the amounts 
141.16 	specified in Minnesota Statutes, section 
141.17 	290.0671, subdivision 6, $18,722,000 
141.18 	of TANF funds in fiscal year 2010 and 
141.19 	$18,689,000 of TANF funds in fiscal year 
141.20 	2011 are appropriated to the commissioner 
141.21 	of human services to reimburse the cost of 
141.22 	the working family tax credit for eligible 
141.23 	families. Beginning January 1, 2011, the 
141.24 	commissioner shall reimburse the general 
141.25 	fund on a monthly basis according to a 
141.26 	schedule based on the pattern of working 
141.27 	family credit expenditures through June 20, 
141.28 	2011. This rider is effective upon enactment.

141.29
141.30	Subd. 4.Children and Economic Assistance 
Grants

141.31
141.32	(a) MFIP and Diversionary Work Program 
Grants
		-0-
		(2,033,000)
	
141.33 	This appropriation reduces the general 
141.34 	fund appropriation by $5,691,000 and 
142.1 	increases the federal TANF appropriation by 
142.2 	$3,658,000.

142.3	(b) Support Services Grants
		-0-
		(7,646,000)
	
142.4 	Supported Work. The fiscal year 2011 
142.5 	TANF appropriation to the commissioner of 
142.6 	human services for supported work for MFIP 
142.7 	recipients is reduced by $4,000,000. This 
142.8 	reduction is onetime.
142.9 	Base Adjustment. The federal TANF base 
142.10 	shall be increased by $2,642,000 for fiscal 
142.11 	years 2012 and 2013.

142.12	(c) MFIP Child Care Assistance Grants
		-0-
		(38,000)
	
142.13 	This appropriation reduces the general 
142.14 	fund appropriation by $4,000,000 and 
142.15 	increases the federal TANF appropriation by 
142.16 	$3,962,000.

142.17
142.18	(d) Basic Sliding Fee Child Care Assistance 
Grants
		-0-
		(7,500,000)
	
142.19 	This appropriation reduces the fiscal 
142.20 	year 2011 general fund appropriation by 
142.21 	$7,500,000 and carries over and expends, in 
142.22 	fiscal year 2011, $7,500,000 of the TANF 
142.23 	funds transferred in fiscal year 2010, which 
142.24 	reflect the child care and development 
142.25 	fund unexpended balance for the basic 
142.26 	sliding fee child care assistance program 
142.27 	under Minnesota Statutes, section 119B.03. 
142.28 	The commissioner shall ensure that all 
142.29 	the funds are expended according to the 
142.30 	federal child care and development fund 
142.31 	regulations relating to TANF transfers. This 
142.32 	appropriation is onetime.

142.33	(e) Children and Community Services Grants
		-0-
		(9,900,000)
	
143.1 	Children and Community Services Grant 
143.2 	Reduction. The fiscal year 2011 general 
143.3 	fund appropriation to the commissioner 
143.4 	of human services for the children and 
143.5 	community services grants under Minnesota 
143.6 	Statutes, section 256M.40, is reduced by 
143.7 	$9,900,000. This reduction is ongoing and is 
143.8 	subtracted from the base.

143.9	(f) Children's Mental Health Grants
		-0-
		(8,028,000)
	
143.10 	(1) The general fund appropriation for 
143.11 	respite care services for children with 
143.12 	severe emotional disturbance who are at 
143.13 	risk of out-of-home placement is reduced 
143.14 	by $1,024,000 for fiscal year 2011. This 
143.15 	reduction is onetime.
143.16 	(2) The general fund appropriation for 
143.17 	children's early intervention services is 
143.18 	reduced by $1,024,000 for fiscal year 2011. 
143.19 	This reduction is onetime.
143.20 	(3) The general fund appropriation for 
143.21 	children's capacity school-based services is 
143.22 	reduced by $4,777,000 for fiscal year 2011.
143.23 	(4) The general fund appropriation for 
143.24 	children's mental health targeted case 
143.25 	management grants is reduced by $1,210,000 
143.26 	for fiscal year 2011.
143.27 	Base adjustment. The general fund base 
143.28 	is increased by $2,048,000 in each of fiscal 
143.29 	years 2012 and 2013.

143.30
143.31	(g) Other Children and Economic Assistance 
Grants
		290,000
		63,000

143.32
143.33	Subd. 5.Children and Economic Assistance 
Management

143.34
143.35	(a) Children and Economic Assistance 
Administration
		-0-
		-0-
	
144.1 	The general fund appropriation is reduced by 
144.2 	$172,000 in fiscal year 2010 and by $176,000 
144.3 	in fiscal year 2011.
144.4 	The federal TANF appropriation is increased 
144.5 	by $172,000 in fiscal year 2010 and by 
144.6 	$176,000 in fiscal year 2011. The TANF 
144.7 	fund base shall be reduced by $700,000 in 
144.8 	fiscal years 2012 and 2013.

144.9144.10
	(b) Children and Economic Assistance 
Operations
		(1,580,000)
		(1,692,000)
	
144.11 	The general fund appropriation is reduced 
144.12 	by $1,408,000 in fiscal year 2010 and by 
144.13 	$1,534,000 in fiscal year 2011. The general 
144.14 	fund base is reduced by $26,000 in each of 
144.15 	fiscal years 2012 and 2013.
144.16 	$74,000 in fiscal year 2011 is appropriated 
144.17 	from the health care access fund. This 
144.18 	appropriation is onetime.
144.19 	The federal TANF appropriation is reduced 
144.20 	by $172,000 in fiscal year 2010 and by 
144.21 	$232,000 in fiscal year 2011.

144.22	Subd. 6.Basic Health Care Grants

144.23	(a) MinnesotaCare Grants
		-0-
		(67,549,000)
	
144.24 	This appropriation reduction is from the 
144.25 	health care access fund.

144.26
144.27	(b) Medical Assistance Basic Health Care 
Grants - Families and Children
		-0-
		(1,108,000)

144.28
144.29	(c) Medical Assistance Basic Health Care 
Grants - Elderly and Disabled
		-0-
		(2,817,000)

144.30	(d) General Assistance Medical Care Grants
		-0-
		(52,614,000)
	
144.31 	Funding Reduction; Coordinated Care 
144.32 	Delivery Systems. The appropriation for 
144.33 	payments to coordinated care delivery 
144.34 	systems in Laws 2010, chapter 200, article 
145.1 	2, section 2, subdivision 4, paragraph (d), is 
145.2 	reduced by $20,000,000 in fiscal year 2011.

145.3
145.4	(e) Medical Assistance; Adults Without 
Children
		-0-
		144,114,000
	
145.5 	Of this appropriation, $142,768,000 is from 
145.6 	the health care access fund.

145.7	(f) Other Health Care Grants
		-0-
		(1,831,000)
	
145.8 	Of this appropriation, the general fund is 
145.9 	increased by $19,000 and the health care 
145.10 	access fund appropriation is reduced by 
145.11 	$1,850,000. This appropriation is onetime.
145.12 	COBRA Carryforward. Unexpended 
145.13 	funds appropriated in fiscal year 2010 for 
145.14 	COBRA grants under Laws 2009, chapter 
145.15 	79, article 5, section 78, do not cancel and 
145.16 	are available to the commissioner of human 
145.17 	services for fiscal year 2011 COBRA grant 
145.18 	expenditures. Up to $110,000 of the fiscal 
145.19 	year 2011 appropriation for COBRA grants 
145.20 	provided in Laws 2009, chapter 79, article 
145.21 	13, section 3, subdivision 6, may be used 
145.22 	by the commissioner of human services for 
145.23 	costs related to administration of the COBRA 
145.24 	grants.
145.25 	Transfer. The commissioner shall transfer 
145.26 	$19,000 to the commissioner of commerce 
145.27 	for regulation of Minnesota Statutes, section 
145.28 	62A.3075.

145.29	Subd. 7.Health Care Management

145.30	(a) Health Care Administration
		(2,853,000)
		(4,683,000)
	
145.31 	For fiscal year 2011 the health care access 
145.32 	fund appropriation is increased by $250,000 
145.33 	and the general fund appropriation is reduced 
145.34 	by $4,633,000.
146.1 	Fiscal Note Report. $50,000 in fiscal 
146.2 	year 2011 is from the general fund for the 
146.3 	completion of the human services fiscal note 
146.4 	report in article 5.
146.5 	Reduction in Appropriation. The base 
146.6 	funding under the current law forecast used 
146.7 	to calculate the state appropriation for the 
146.8 	medical assistance program is reduced by 
146.9 	one percent for the 2012-2013 biennium. 
146.10 	This reduction is subject to federal approval 
146.11 	of the intensive care management program 
146.12 	authorized under Minnesota Statutes, section 
146.13 	256B.0755, and is ongoing and shall apply 
146.14 	to future bienniums, or for as long as the 
146.15 	intensive care management program is 
146.16 	determined to be cost-effective by the 
146.17 	commissioner of human services.
146.18 	PACE Implementation Funding. For fiscal 
146.19 	year 2011, $145,000 is appropriated from 
146.20 	the general fund to the commissioner of 
146.21 	human services to complete the actuarial and 
146.22 	administrative work necessary to begin the 
146.23 	operation of PACE under Minnesota Statutes, 
146.24 	section 256B.69, subdivision 23, paragraph 
146.25 	(e). Base level funding for this activity shall 
146.26 	be $130,000 in fiscal year 2012 and $0 in 
146.27 	fiscal year 2013.
146.28 	Minnesota Senior Health Options 
146.29 	Reimbursement. Effective July 1, 2011, 
146.30 	federal administrative reimbursement 
146.31 	resulting from the Minnesota senior 
146.32 	health options project is appropriated 
146.33 	to the commissioner for this activity. 
146.34 	Notwithstanding any contrary provision, this 
146.35 	provision expires June 30, 2013.
147.1 	Health Care Inspector General. $120,000 
147.2 	from the general fund in fiscal year 2011 
147.3 	is for the Office of Health Care Inspector 
147.4 	General, established under Minnesota 
147.5 	Statutes, section 256.01, subdivision 30.
147.6 	Fiscal and Actuarial Analysis. $250,000 
147.7 	from the general fund is for the fiscal and 
147.8 	actuarial analysis of 2010 House File No. 
147.9 	135 and 2010 Senate File No. 118. This 
147.10 	appropriation is onetime.
147.11 	Utilization Review. Effective July 1, 
147.12 	2011, federal administrative reimbursement 
147.13 	resulting from prior authorization and 
147.14 	inpatient admission certification by a 
147.15 	professional review organization shall be 
147.16 	dedicated to, and is appropriated to, the 
147.17 	commissioner for these activities. A portion 
147.18 	of these funds must be used for activities to 
147.19 	decrease unnecessary pharmaceutical costs 
147.20 	in medical assistance. Notwithstanding any 
147.21 	contrary provision, this provision expires 
147.22 	June 30, 2013.
147.23 	Base Adjustment. The health care access 
147.24 	fund base is reduced by $50,000 in each of 
147.25 	fiscal years 2012 and 2013.
147.26 	The general fund base is reduced by $516,000 
147.27 	in each of fiscal years 2012 and 2013.

147.28	(b) Health Care Operations

147.29	Appropriations by Fund
	
147.30	General
	-0-
	64,000
	
147.31	Health Care Access
	(1,094,000)
	(1,234,000)
	
147.32 	Base Adjustment. The health care access 
147.33 	fund base for health care operations is 
147.34 	reduced by $1,272,000 in fiscal year 2012 
148.1 	and $1,337,000 in fiscal year 2013. The 
148.2 	general fund appropriation is onetime.

148.3	Subd. 8.Continuing Care Grants

148.4	(a) Aging and Adult Services Grants
		(154,000)
		(139,000)
	
148.5 	This reduction is onetime and must not be 
148.6 	applied to the base.
148.7 	Community Service Development 
148.8 	Reduction. The appropriation in Laws 
148.9 	2009, chapter 79, article 13, section 3, 
148.10 	subdivision 8, paragraph (a), for community 
148.11 	service development grants, as amended by 
148.12 	Laws 2009, chapter 173, article 2, section 
148.13 	1, subdivision 8, paragraph (a), is reduced 
148.14 	by $154,000 in fiscal year 2011. The 
148.15 	appropriation base is reduced by $139,000 
148.16 	for fiscal year 2012 and $0 for fiscal year 
148.17 	2013. Notwithstanding any law or rule to 
148.18 	the contrary, this provision expires June 30, 
148.19 	2012.

148.20
148.21	(b) Medical Assistance Long-Term Care 
Facilities Grants
		-0-
		551,000

148.22
148.23	(c) Medical Assistance Long-Term Care 
Waivers and Home Care Grants
		-0-
		(2,747,000)
	
148.24 	Manage Growth in Traumatic Brain 
148.25 	Injury and Community Alternatives for 
148.26 	Disabled Individuals' Waivers. During 
148.27 	the fiscal year beginning July 1, 2010, the 
148.28 	commissioner shall allocate money for home 
148.29 	and community-based waiver programs 
148.30 	under Minnesota Statutes, section 256B.49, 
148.31 	to ensure a reduction in state spending that is 
148.32 	equivalent to limiting the caseload growth 
148.33 	of the traumatic brain injury waiver to six 
148.34 	allocations per month and the community 
148.35 	alternatives for disabled individuals waiver 
149.1 	to 60 allocations per month. The limits do not 
149.2 	apply: (1) when there is an approved plan for 
149.3 	nursing facility bed closures for individuals 
149.4 	under age 65 who require relocation due to 
149.5 	the bed closure; (2) to fiscal year 2009 waiver 
149.6 	allocations delayed due to unallotment; or (3) 
149.7 	to transfers authorized by the commissioner 
149.8 	from the personal care assistance program 
149.9 	of individuals having a home care rating of 
149.10 	CS, MT, or HL. Priorities for the allocation 
149.11 	of funds must be for individuals anticipated 
149.12 	to be discharged from institutional settings or 
149.13 	who are at imminent risk of a placement in 
149.14 	an institutional setting.
149.15 	Manage Growth in the Developmental 
149.16 	Disability (DD) Waiver. The commissioner 
149.17 	shall manage the growth in the developmental 
149.18 	disability waiver by limiting the allocations 
149.19 	included in the November 2010 forecast to 
149.20 	six additional diversion allocations each 
149.21 	month for the calendar year that begins on 
149.22 	January 1, 2011. Additional allocations must 
149.23 	be made available for transfers authorized 
149.24 	by the commissioner from the personal care 
149.25 	assistance program of individuals having a 
149.26 	home care rating of CS, MT, or HL. This 
149.27 	provision is effective through December 31, 
149.28 	2011.

149.29	(d) Adult Mental Health Grants
		(3,500,000)
		(9,903,000)
	
149.30 	Compulsive Gambling Special Revenue 
149.31 	Account. $149,000 for fiscal year 2010 
149.32 	and $27,000 for fiscal year 2011 from 
149.33 	the compulsive gambling special revenue 
149.34 	account established under Minnesota 
149.35 	Statutes, section 245.982, must be transferred 
150.1 	and deposited into the general fund by June 
150.2 	30 of each respective fiscal year.
150.3 	Compulsive Gambling Lottery Prize Fund 
150.4 	Appropriation. The lottery prize fund 
150.5 	appropriation for compulsive gambling, is 
150.6 	reduced by $80,000 in fiscal year 2010 and 
150.7 	$79,000 in fiscal year 2011. This is a onetime 
150.8 	reduction.
150.9 	Adult Mental Health. (1) The general 
150.10 	fund appropriation for adult mental health 
150.11 	evidence-based practices, including but not 
150.12 	limited to, assertive community treatment 
150.13 	and integrated dual diagnosis treatment 
150.14 	services, is reduced by $750,000 for fiscal 
150.15 	year 2011. This reduction is onetime.
150.16 	(2) The general fund appropriation for 
150.17 	mental health grants to increase availability 
150.18 	of culturally specific adult mental health 
150.19 	services is reduced by $300,000 for fiscal 
150.20 	year 2011. This reduction is onetime.
150.21 	(3) The general fund appropriation for 
150.22 	grants to community hospitals to provide 
150.23 	alternatives to residential treatment center 
150.24 	mental health programs is reduced by 
150.25 	$2,653,000 for fiscal year 2011. This 
150.26 	reduction is onetime.
150.27 	(4) The general fund appropriation for grants 
150.28 	to counties for adult mental health services is 
150.29 	reduced by $6,200,000 for fiscal year 2011, 
150.30 	and $6,000,000 in each of fiscal years 2012 
150.31 	and 2013.
150.32 	(5) Of the fiscal year 2010 general fund 
150.33 	appropriation for grants to counties for 
150.34 	housing with support services for adults 
150.35 	with serious and persistent mental illness, 
151.1 	$3,300,000 is canceled and returned to the 
151.2 	general fund.
151.3 	(6) Of the fiscal year 2010 general 
151.4 	fund appropriation for additional crisis 
151.5 	intervention team training for law 
151.6 	enforcement, $200,000 is canceled and 
151.7 	returned to the general fund.
151.8 	Base adjustment. The general fund base 
151.9 	is increased by $3,903,000 in each of fiscal 
151.10 	years 2012 and 2013.

151.11	(e) Chemical Dependency Entitlement Grants
		-0-
		(3,986,000)

151.12
151.13	(f) Chemical Dependency Nonentitlement 
Grants
		(389,000)
		-0-
	
151.14 	Chemical Health. Of the fiscal year 2010 
151.15 	general fund appropriation to Mother's First 
151.16 	and the Native American Program, $389,000 
151.17 	is canceled and returned to the general fund.

151.18	(g) Other Continuing Care Grants
		-0-
		100,000
	
151.19 	Intermediate Care Facilities for the 
151.20 	Developmentally Disabled Payment Rates.
151.21 	$36,000 is appropriated from the general 
151.22 	fund in fiscal year 2011 and $4,000 in fiscal 
151.23 	year 2012 to increase payment rates for an 
151.24 	ICF/MR licensed for six beds and located in 
151.25 	Kandiyohi County to serve persons with high 
151.26 	behavioral needs. The payment rate increase 
151.27 	shall be effective for services provided from 
151.28 	July 1, 2010, through June 30, 2011. These 
151.29 	appropriations are onetime.
151.30 	Region 10 Quality Assurance Commission.
151.31 	$100,000 is appropriated from the general 
151.32 	fund in fiscal year 2011 to the commissioner 
151.33 	of human services for the purposes 
151.34 	of the Region 10 Quality Assurance 
152.1 	Commission under Minnesota Statutes, 
152.2 	section 256B.0951. This appropriation is 
152.3 	onetime.

152.4	Subd. 9.Continuing Care Management
 		111,000
		101,000
	
152.5 	PACE Implementation Funding. For fiscal 
152.6 	year 2011, $111,000 is appropriated from 
152.7 	the general fund to the commissioner of 
152.8 	human services to complete the actuarial 
152.9 	and administrative work necessary to begin 
152.10 	the operation of PACE under Minnesota 
152.11 	Statutes, section 256B.69, subdivision 23, 
152.12 	paragraph (e). Base level funding for this 
152.13 	activity shall be $101,000 in fiscal year 2012 
152.14 	and $0 in fiscal year 2013. For fiscal year 
152.15 	2013 and beyond, the commissioner must 
152.16 	work with stakeholders to develop financing 
152.17 	mechanisms to complete the actuarial 
152.18 	and administrative costs of PACE. The 
152.19 	commissioner shall inform the chairs and 
152.20 	ranking minority members of the legislative 
152.21 	committee with jurisdiction over health care 
152.22 	funding by January 15, 2011, on progress to 
152.23 	develop financing mechanisms.

152.24	Subd. 10.State-Operated Services
 					
152.25 	Obsolete Laundry Depreciation Account.
152.26 	$669,000, or the balance, whichever is 
152.27 	greater, must be transferred from the 
152.28 	state-operated services laundry depreciation 
152.29 	account in the special revenue fund and 
152.30 	deposited into the general fund by June 30, 
152.31 	2010.
152.32 	State-operated Services Programs. Of 
152.33 	the fiscal year 2011 appropriation for 
152.34 	the Minnesota sex offender program, 
152.35 	$12,600,000 is transferred to state-operated 
153.1 	services to maintain the METO program and 
153.2 	other residential adult mental health services.

153.3	Subd. 11.Adult Mental Health Services
 		-0-
		12,600,000
	
153.4 	This appropriation is onetime and does not 
153.5 	affect the agency's base.

153.6	Subd. 12.Minnesota Sex Offender Services
 		-0-
		(12,600,000)
	
153.7 	This appropriation is onetime and does not 
153.8 	affect the agency's base.

153.9153.10
	Subd. 13.Contingent Appropriations 
Reductions
 					
153.11 	Upon enactment of the extension of 
153.12 	the enhanced federal medical assistance 
153.13 	percentage (FMAP) under Public Law 111-5 
153.14 	to June 30, 2011, that is contained in the 
153.15 	president's budget for federal fiscal year 2011 
153.16 	or contained in House Resolution 2847, the 
153.17 	federal "Jobs for Main Street Act of 2010," or 
153.18 	subsequent federal legislation, the reductions 
153.19 	identified in each clause shall be made to 
153.20 	the specified general fund appropriations 
153.21 	for fiscal year 2011. These contingent 
153.22 	reductions, if implemented, are in addition 
153.23 	to the reductions specified in subdivision 6, 
153.24 	paragraphs (a), (b), and (c), and subdivision 
153.25 	8, paragraphs (c) and (d), respectively.

153.26	(1) MinnesotaCare Grants
		-0-
		(9,200,000)

153.27
153.28	(2) Medical Assistance Basic Health Care Grants 
- Families and Children
		-0-
		(109,662,500)

153.29
153.30	(3) Medical Assistance Basic Health Care Grants 
- Elderly and Disabled
		-0-
		(110,437,500)

153.31
153.32	(4) Medical Assistance Long-Term Care Facilities 
Grants
		-0-
		(51,925,000)

153.33
153.34	(5) Medical Assistance Long-Term Care Waivers 
and Home Care Grants
		-0-
		(115,475,000)

154.1	Sec. 4. COMMISSIONER OF HEALTH

154.2				APPROPRIATIONS
	
154.3				Available for the Year
	
154.4				Ending June 30
	
154.5					2010
		2011

154.6	Subdivision 1.Total Appropriation
 	$
	(2,992,000)
	$
	5,325,000

154.7	Appropriations by Fund
	
154.8		2010
	2011
	
154.9	General
	(2,392,000)
	5,384,000
	
154.10
154.11	State Government 
Special Revenue
	(600,000)
	(259,000)
	
154.12
154.13	Health Care Access 
Fund
	-0-
	200,000

154.14	Subd. 2.Community and Family Health
 		(221,000)
		(21,000)
	
154.15 	Grant for Memory Care Clinic. $100,000 
154.16 	from the general fund in fiscal year 2011 
154.17 	is for a grant to a nonprofit, multispecialty 
154.18 	clinic located in the city of St. Cloud that 
154.19 	provides early identification, diagnosis, and 
154.20 	treatment of memory loss, and information 
154.21 	and support for family members who care for 
154.22 	persons with memory impairment. In order 
154.23 	to receive the grant, the clinic must certify to 
154.24 	the commissioner that it has a commitment 
154.25 	from a private foundation to provide a 50 
154.26 	percent match of the grant amount. This 
154.27 	appropriation is onetime.
154.28 	Statewide Health Improvement Program.
154.29 	$8,500,000 from the health care access 
154.30 	fund in fiscal year 2012 and $8,500,000 in 
154.31 	fiscal year 2013 is for the statewide health 
154.32 	improvement program under Minnesota 
154.33 	Statutes, section 145.986. These additions 
154.34 	are onetime.
155.1 	Base adjustment. The general fund base is 
155.2 	reduced by $132,000 in each of fiscal years 
155.3 	2012 and 2013.

155.4	Subd. 3.Policy, Quality, and Compliance

155.5	Appropriations by Fund
	
155.6		2010
	2011
	
155.7	General
	(1,797,000)
	5,210,000
	
155.8
155.9	State Government 
Special Revenue
	(600,000)
	(268,000)
	
155.10
155.11	Health Care Access 
Fund
	-0-
	200,000
	
155.12 	Of this appropriation, $74,000 in fiscal 
155.13 	year 2011 is to restore unallotments for the 
155.14 	Office of Unlicensed Complementary and 
155.15 	Alternative Health Care Practice.
155.16 	Health Care Reform. Funds appropriated 
155.17 	in Laws 2008, chapter 358, article 5, section 
155.18 	4, subdivision 3, for health reform activities 
155.19 	to implement Laws 2008, chapter 358, 
155.20 	article 4, are available until expended. 
155.21 	Notwithstanding any contrary provision in 
155.22 	this article, this provision shall not expire.
155.23 	Health Care Reform Task Force. $200,000 
155.24 	from the general fund is for expenses related 
155.25 	to the Health Care Reform Task Force 
155.26 	established under article 7, section 8.
155.27 	Autism Coverage Study. $50,000 in 
155.28 	fiscal year 2011 is appropriated to the 
155.29 	commissioner of health to monitor the gaps 
155.30 	in the level of service provided by state 
155.31 	health programs, the state employee group 
155.32 	insurance plan, and private health plans for 
155.33 	autism spectrum disorder. This appropriation 
155.34 	is onetime.
155.35 	Rural Hospital Capital Improvement 
155.36 	Grants. Of the general fund reductions in 
156.1 	fiscal year 2010, $1,755,000 is for the rural 
156.2 	hospital capital improvement grant program.
156.3 	Health Information Exchange Oversight.
156.4 	Of the state government special revenue fund 
156.5 	appropriations, $104,000 in fiscal year 2011 
156.6 	is for the duties required under Minnesota 
156.7 	Statutes, sections 62J.498 to 62J.4982.
156.8 	Birth Centers. Of the state government 
156.9 	special revenue fund appropriations, $9,000 
156.10 	is for licensing birth centers under Minnesota 
156.11 	Statutes, section 144.651. Base funding shall 
156.12 	be $7,000 in fiscal year 2012 and $7,000 in 
156.13 	fiscal year 2013.
156.14 	Advisory Group on Administrative 
156.15 	Expenses. Of the general fund appropriation, 
156.16 	$40,000 in fiscal year 2011 is for the advisory 
156.17 	group established under Minnesota Statutes, 
156.18 	section 62D.31.
156.19 	Community Clinic Grants. Of this 
156.20 	appropriation, $2,500,000 in fiscal 
156.21 	year 2011 is for the commissioner to 
156.22 	provide community clinic grants under 
156.23 	Minnesota Statutes, section 145.9268. This 
156.24 	appropriation is onetime. In awarding grants 
156.25 	using this funding, the commissioner shall 
156.26 	give priority to proposals that seek to serve 
156.27 	medically underserved areas of the state that 
156.28 	are not served by a coordinated care delivery 
156.29 	system established under Minnesota Statutes, 
156.30 	section 256D.031, subdivision 6.
156.31 	Federally Qualified Health Center 
156.32 	Subsidies. Of this appropriation, $2,500,000 
156.33 	in fiscal year 2011 is for the commissioner to 
156.34 	increase subsidies to federally qualified health 
156.35 	centers provided under Minnesota Statutes, 
157.1 	section 145.9269. This appropriation is 
157.2 	onetime. In awarding subsidies using this 
157.3 	funding, the commissioner shall give priority 
157.4 	to federally qualified health centers that serve 
157.5 	medically underserved areas of the state that 
157.6 	are not served by a coordinated care delivery 
157.7 	system established under Minnesota Statutes, 
157.8 	section 256D.031, subdivision 6.
157.9 	Base Level Adjustment. The general 
157.10 	fund base is reduced by $5,134,000 in each 
157.11 	of fiscal years 2012 and 2013. The state 
157.12 	government special revenue fund base is 
157.13 	increased by $365,000 in each of fiscal years 
157.14 	2012 and 2013.

157.15	Subd. 4.Health Protection
 		(374,000)
		295,000
	
157.16 	Lead Base Grant Program. Of the general 
157.17 	fund reduction, $25,000 in fiscal year 2010 
157.18 	and fiscal year 2011 is for the elimination 
157.19 	of state funding for the temporary lead-safe 
157.20 	housing base grant program.
157.21 	Birth Defects Information System. Of 
157.22 	the general fund appropriation, $500,000 in 
157.23 	fiscal year 2011 is for the Minnesota Birth 
157.24 	Defects Information System established 
157.25 	under Minnesota Statutes, section 144.2215.
157.26 	Base Adjustment. The general fund base is 
157.27 	reduced by $99,000 in each of fiscal years 
157.28 	2012 and 2013.

157.29	Subd. 5.Administrative Support Services
 		-0-
		(100,000)

157.30	Sec. 5. HEALTH-RELATED BOARDS

157.31	Subdivision 1.Total Appropriation
 	$
	2,900,000
	$
	-0-
	
157.32 	In fiscal year 2010, $591,000 shall be 
157.33 	transferred from the state government special 
158.1 	revenue fund to the general fund. In fiscal 
158.2 	year 2011, $442,000 shall be transferred from 
158.3 	the state government special revenue fund 
158.4 	to the general fund. These transfers are in 
158.5 	addition to those made in Laws 2009, chapter 
158.6 	79, article 13, section 5, as amended by Laws 
158.7 	2009, chapter 173, article 2, section 3.
158.8 	The transfers in this section are onetime in 
158.9 	the fiscal year 2010-2011 biennium.

158.10
158.11	Subd. 2.Board of Nursing Home 
Administrators
 		2,610,000
		-0-
	
158.12 	Administrative Services Unit; Transfer.
158.13 	This appropriation is from the state 
158.14 	government special revenue fund in fiscal 
158.15 	year 2010 to the administrative services 
158.16 	unit. Upon request for a transfer from a 
158.17 	health-related board, the administrative 
158.18 	services unit is authorized to transfer 
158.19 	money from this appropriation to the board 
158.20 	with the approval of the commissioner of 
158.21 	management and budget. This appropriation 
158.22 	does not cancel. Any unencumbered and 
158.23 	unspent balances remain available for these 
158.24 	expenditures in subsequent fiscal years. The 
158.25 	administrative services unit must report to 
158.26 	the legislature a detailed spending report 
158.27 	by September 1, 2011, on the uses of these 
158.28 	appropriated funds.

158.29
158.30	Sec. 6. EMERGENCY MEDICAL SERVICES 
BOARD
 		361,000
		(133,000)
	
158.31 	This appropriation must be applied to 
158.32 	emergency medical services grant programs. 
158.33 	Reductions from the general fund must be 
158.34 	applied to the board's operating budget and 
158.35 	must not be applied to grant programs.

159.1	Longevity Award and Incentive Program
		(19,000)
		(19,000)
	
159.2 	Emergency Medical Services Relief 
159.3 	Transfer. $10,000 in fiscal year 2010 
159.4 	and $24,000 in fiscal year 2011 shall be 
159.5 	transferred to the general fund from the 
159.6 	portion of the emergency medical services 
159.7 	relief account in the special revenue fund 
159.8 	otherwise designated for distribution by 
159.9 	the Emergency Medical Services Board 
159.10 	under Minnesota Statutes, section 169.686, 
159.11 	subdivision 3. These transfers are onetime in 
159.12 	the 2010-2011 biennium.

159.13
159.14
159.15	Sec. 7. OMBUDSMAN FOR MENTAL 
HEALTH AND DEVELOPMENTAL 
DISABILITIES
 	$
	(31,000)
	$
	(50,000)

159.16	Sec. 8. OMBUDSPERSON FOR FAMILIES
 	$
	(4,000)
	$
	(8,000)

159.17 	Sec. 9. Minnesota Statutes 2008, section 214.40, subdivision 7, is amended to read:
159.18 		Subd. 7.Medical professional liability insurance. (a) Within the limit of funds 
159.19 	appropriated for this program, the administrative services unit must purchase medical 
159.20 	professional liability insurance, if available, for a health care provider who is registered in 
159.21 	accordance with subdivision 4 and who is not otherwise covered by a medical professional 
159.22 	liability insurance policy or self-insured plan either personally or through another facility 
159.23 	or employer. The administrative services unit is authorized to prorate payments or 
159.24 	otherwise limit the number of participants in the program if the costs of the insurance for 
159.25 	eligible providers exceed the funds appropriated for the program.
159.26 	(b) Coverage purchased under this subdivision must be limited to the provision of 
159.27 	health care services performed by the provider for which the provider does not receive 
159.28 	direct monetary compensation.

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

159.30 	Sec. 10. Laws 2009, chapter 79, article 13, section 3, subdivision 1, as amended by 
159.31 	Laws 2009, chapter 173, article 2, section 1, subdivision 1, is amended to read:

159.32	Subdivision 1.Total Appropriation
 	$
	5,225,451,000
	$
	6,002,864,000

160.1	Appropriations by Fund
	
160.2		2010
	2011
	
160.3	General
	4,375,689,000
	5,209,765,000
	
160.4
160.5	State Government 
Special Revenue
	565,000
	565,000
	
160.6	Health Care Access
	450,662,000
	527,411,000
	
160.7	Federal TANF
	286,770,000
	263,458,000
	
160.8	Lottery Prize
	1,665,000
	1,665,000
	
160.9	Federal Fund
	110,000,000
	0
	
160.10 	Receipts for Systems Projects.
160.11 	Appropriations and federal receipts for 
160.12 	information systems projects for MAXIS, 
160.13 	PRISM, MMIS, and SSIS must be deposited 
160.14 	in the state system account authorized in 
160.15 	Minnesota Statutes, section 256.014. Money 
160.16 	appropriated for computer projects approved 
160.17 	by the Minnesota Office of Enterprise 
160.18 	Technology, funded by the legislature, and 
160.19 	approved by the commissioner of finance, 
160.20 	may be transferred from one project to 
160.21 	another and from development to operations 
160.22 	as the commissioner of human services 
160.23 	considers necessary, except that any transfers 
160.24 	to one project that exceed $1,000,000 or 
160.25 	multiple transfers to one project that exceed 
160.26 	$1,000,000 in total require the express 
160.27 	approval of the legislature. The preceding 
160.28 	requirement for legislative approval does not 
160.29 	apply to transfers made to establish a project's 
160.30 	initial operating budget each year; instead, 
160.31 	the requirements of section 11, subdivision 
160.32 	2, of this article apply to those transfers. Any 
160.33 	unexpended balance in the appropriation 
160.34 	for these projects does not cancel but is 
160.35 	available for ongoing development and 
160.36 	operations. Any computer project with a 
160.37 	total cost exceeding $1,000,000, including, 
161.1 	but not limited to, a replacement for the 
161.2 	proposed HealthMatch system, shall not be 
161.3 	commenced without the express approval of 
161.4 	the legislature.
161.5 	HealthMatch Systems Project. In fiscal 
161.6 	year 2010, $3,054,000 shall be transferred 
161.7 	from the HealthMatch account in the state 
161.8 	systems account in the special revenue fund 
161.9 	to the general fund.
161.10 	Nonfederal Share Transfers. The 
161.11 	nonfederal share of activities for which 
161.12 	federal administrative reimbursement is 
161.13 	appropriated to the commissioner may be 
161.14 	transferred to the special revenue fund.
161.15 	TANF Maintenance of Effort.
161.16 	(a) In order to meet the basic maintenance 
161.17 	of effort (MOE) requirements of the TANF 
161.18 	block grant specified under Code of Federal 
161.19 	Regulations, title 45, section 263.1, the 
161.20 	commissioner may only report nonfederal 
161.21 	money expended for allowable activities 
161.22 	listed in the following clauses as TANF/MOE 
161.23 	expenditures:
161.24 	(1) MFIP cash, diversionary work program, 
161.25 	and food assistance benefits under Minnesota 
161.26 	Statutes, chapter 256J;
161.27 	(2) the child care assistance programs 
161.28 	under Minnesota Statutes, sections 119B.03
161.29 	and 119B.05, and county child care 
161.30 	administrative costs under Minnesota 
161.31 	Statutes, section 119B.15;
161.32 	(3) state and county MFIP administrative 
161.33 	costs under Minnesota Statutes, chapters 
161.34 	256J and 256K;
162.1 	(4) state, county, and tribal MFIP 
162.2 	employment services under Minnesota 
162.3 	Statutes, chapters 256J and 256K;
162.4 	(5) expenditures made on behalf of 
162.5 	noncitizen MFIP recipients who qualify 
162.6 	for the medical assistance without federal 
162.7 	financial participation program under 
162.8 	Minnesota Statutes, section 256B.06, 
162.9 	subdivision 4, paragraphs (d), (e), and (j); 
162.10 	and
162.11 	(6) qualifying working family credit 
162.12 	expenditures under Minnesota Statutes, 
162.13 	section 290.0671.; and
162.14 	(7) qualifying Minnesota education credit 
162.15 	expenditures under Minnesota Statutes, 
162.16 	section 290.0674.
162.17 	(b) The commissioner shall ensure that 
162.18 	sufficient qualified nonfederal expenditures 
162.19 	are made each year to meet the state's 
162.20 	TANF/MOE requirements. For the activities 
162.21 	listed in paragraph (a), clauses (2) to 
162.22 	(6), the commissioner may only report 
162.23 	expenditures that are excluded from the 
162.24 	definition of assistance under Code of 
162.25 	Federal Regulations, title 45, section 260.31.
162.26 	(c) For fiscal years beginning with state 
162.27 	fiscal year 2003, the commissioner shall 
162.28 	ensure that the maintenance of effort used 
162.29 	by the commissioner of finance for the 
162.30 	February and November forecasts required 
162.31 	under Minnesota Statutes, section 16A.103, 
162.32 	contains expenditures under paragraph (a), 
162.33 	clause (1), equal to at least 16 percent of 
162.34 	the total required under Code of Federal 
162.35 	Regulations, title 45, section 263.1.
163.1 	(d) For the federal fiscal years beginning on 
163.2 	or after October 1, 2007, the commissioner 
163.3 	may not claim an amount of TANF/MOE in 
163.4 	excess of the 75 percent standard in Code 
163.5 	of Federal Regulations, title 45, section 
163.6 	263.1(a)(2), except:
163.7 	(1) to the extent necessary to meet the 80 
163.8 	percent standard under Code of Federal 
163.9 	Regulations, title 45, section 263.1(a)(1), 
163.10 	if it is determined by the commissioner 
163.11 	that the state will not meet the TANF work 
163.12 	participation target rate for the current year;
163.13 	(2) to provide any additional amounts 
163.14 	under Code of Federal Regulations, title 45, 
163.15 	section 264.5, that relate to replacement of 
163.16 	TANF funds due to the operation of TANF 
163.17 	penalties; and
163.18 	(3) to provide any additional amounts that 
163.19 	may contribute to avoiding or reducing 
163.20 	TANF work participation penalties through 
163.21 	the operation of the excess MOE provisions 
163.22 	of Code of Federal Regulations, title 45, 
163.23 	section 261.43 (a)(2).
163.24 	For the purposes of clauses (1) to (3), 
163.25 	the commissioner may supplement the 
163.26 	MOE claim with working family credit 
163.27 	expenditures to the extent such expenditures 
163.28 	or other qualified expenditures are otherwise 
163.29 	available after considering the expenditures 
163.30 	allowed in this section.
163.31 	(e) Minnesota Statutes, section 256.011, 
163.32 	subdivision 3, which requires that federal 
163.33 	grants or aids secured or obtained under that 
163.34 	subdivision be used to reduce any direct 
164.1 	appropriations provided by law, do not apply 
164.2 	if the grants or aids are federal TANF funds.
164.3 	(f) Notwithstanding any contrary provision 
164.4 	in this article, this provision expires June 30, 
164.5 	2013.
164.6 	Working Family Credit Expenditures as 
164.7 	TANF/MOE. The commissioner may claim 
164.8 	as TANF/MOE up to $6,707,000 per year of 
164.9 	working family credit expenditures for fiscal 
164.10 	year 2010 through fiscal year 2011.
164.11 	Working Family Credit Expenditures 
164.12 	to be Claimed for TANF/MOE. The 
164.13 	commissioner may count the following 
164.14 	amounts of working family credit expenditure 
164.15 	as TANF/MOE:
164.16 	(1) fiscal year 2010, $50,973,000
164.17 	$50,897,000;
164.18 	(2) fiscal year 2011, $53,793,000
164.19 	$54,243,000;
164.20 	(3) fiscal year 2012, $23,516,000
164.21 	$23,345,000; and
164.22 	(4) fiscal year 2013, $16,808,000
164.23 	$16,585,000.
164.24 	Notwithstanding any contrary provision in 
164.25 	this article, this rider expires June 30, 2013.
164.26 	Food Stamps Employment and Training.
164.27 	(a) The commissioner shall apply for and 
164.28 	claim the maximum allowable federal 
164.29 	matching funds under United States Code, 
164.30 	title 7, section 2025, paragraph (h), for 
164.31 	state expenditures made on behalf of family 
164.32 	stabilization services participants voluntarily 
164.33 	engaged in food stamp employment and 
164.34 	training activities, where appropriate.
165.1 	(b) Notwithstanding Minnesota Statutes, 
165.2 	sections 256D.051, subdivisions 1a, 6b, 
165.3 	and 6c, and 256J.626, federal food stamps 
165.4 	employment and training funds received 
165.5 	as reimbursement of MFIP consolidated 
165.6 	fund grant expenditures for diversionary 
165.7 	work program participants and child 
165.8 	care assistance program expenditures for 
165.9 	two-parent families must be deposited in the 
165.10 	general fund. The amount of funds must be 
165.11 	limited to $3,350,000 in fiscal year 2010 
165.12 	and $4,440,000 in fiscal years 2011 through 
165.13 	2013, contingent on approval by the federal 
165.14 	Food and Nutrition Service. 
165.15 	(c) Consistent with the receipt of these federal 
165.16 	funds, the commissioner may adjust the 
165.17 	level of working family credit expenditures 
165.18 	claimed as TANF maintenance of effort. 
165.19 	Notwithstanding any contrary provision in 
165.20 	this article, this rider expires June 30, 2013.
165.21 	ARRA Food Support Administration.
165.22 	The funds available for food support 
165.23 	administration under the American Recovery 
165.24 	and Reinvestment Act (ARRA) of 2009 
165.25 	are appropriated to the commissioner 
165.26 	to pay actual costs of implementing the 
165.27 	food support benefit increases, increased 
165.28 	eligibility determinations, and outreach. Of 
165.29 	these funds, 20 percent shall be allocated 
165.30 	to the commissioner and 80 percent shall 
165.31 	be allocated to counties. The commissioner 
165.32 	shall allocate the county portion based on 
165.33 	caseload. Reimbursement shall be based on 
165.34 	actual costs reported by counties through 
165.35 	existing processes. Tribal reimbursement 
165.36 	must be made from the state portion based 
166.1 	on a caseload factor equivalent to that of a 
166.2 	county.
166.3 	ARRA Food Support Benefit Increases.
166.4 	The funds provided for food support benefit 
166.5 	increases under the Supplemental Nutrition 
166.6 	Assistance Program provisions of the 
166.7 	American Recovery and Reinvestment Act 
166.8 	(ARRA) of 2009 must be used for benefit 
166.9 	increases beginning July 1, 2009.
166.10 	Emergency Fund for the TANF Program.
166.11 	TANF Emergency Contingency funds 
166.12 	available under the American Recovery 
166.13 	and Reinvestment Act of 2009 (Public Law 
166.14 	111-5) are appropriated to the commissioner. 
166.15 	The commissioner must request TANF 
166.16 	Emergency Contingency funds from the 
166.17 	Secretary of the Department of Health 
166.18 	and Human Services to the extent the 
166.19 	commissioner meets or expects to meet the 
166.20 	requirements of section 403(c) of the Social 
166.21 	Security Act. The commissioner must seek 
166.22 	to maximize such grants. The funds received 
166.23 	must be used as appropriated. Each county 
166.24 	must maintain the county's current level of 
166.25 	emergency assistance funding under the 
166.26 	MFIP consolidated fund and use the funds 
166.27 	under this paragraph to supplement existing 
166.28 	emergency assistance funding levels.

166.29 	Sec. 11. Laws 2009, chapter 79, article 13, section 3, subdivision 3, as amended by 
166.30 	Laws 2009, chapter 173, article 2, section 1, subdivision 3, is amended to read:

166.31
166.32	Subd. 3.Revenue and Pass-Through Revenue 
Expenditures
 		68,337,000
		70,505,000
	
166.33 	This appropriation is from the federal TANF 
166.34 	fund.
167.1 	TANF Transfer to Federal Child Care 
167.2 	and Development Fund. The following 
167.3 	TANF fund amounts are appropriated to the 
167.4 	commissioner for the purposes of MFIP and 
167.5 	transition year child care under Minnesota 
167.6 	Statutes, section 119B.05: 
167.7 	(1) fiscal year 2010, $6,531,000 $862,000;
167.8 	(2) fiscal year 2011, $10,241,000 $978,000;
167.9 	(3) fiscal year 2012, $10,826,000 $0; and
167.10 	(4) fiscal year 2013, $4,046,000 $0.
167.11 	The commissioner shall authorize the 
167.12 	transfer of sufficient TANF funds to the 
167.13 	federal child care and development fund to 
167.14 	meet this appropriation and shall ensure that 
167.15 	all transferred funds are expended according 
167.16 	to federal child care and development fund 
167.17 	regulations.

167.18 	Sec. 12. Laws 2009, chapter 79, article 13, section 3, subdivision 4, as amended by 
167.19 	Laws 2009, chapter 173, article 2, section 1, subdivision 4, is amended to read:

167.20
167.21	Subd. 4.Children and Economic Assistance 
Grants
 					
167.22 	The amounts that may be spent from this 
167.23 	appropriation for each purpose are as follows:

167.24	(a) MFIP/DWP Grants

167.25	Appropriations by Fund
	
167.26	General
	63,205,000
	89,033,000
	
167.27	Federal TANF
	100,818,000
	84,538,000

167.28	(b) Support Services Grants

167.29	Appropriations by Fund
	
167.30	General
	8,715,000
	12,498,000
	
167.31	Federal TANF
	116,557,000
	107,457,000
	
167.32 	MFIP Consolidated Fund. The MFIP 
167.33 	consolidated fund TANF appropriation is 
168.1 	reduced by $1,854,000 in fiscal year 2010 
168.2 	and fiscal year 2011.
168.3 	Notwithstanding Minnesota Statutes, section 
168.4 	256J.626, subdivision 8, paragraph (b), the 
168.5 	commissioner shall reduce proportionately 
168.6 	the reimbursement to counties for 
168.7 	administrative expenses.
168.8 	Subsidized Employment Funding Through 
168.9 	ARRA. The commissioner is authorized to 
168.10 	apply for TANF emergency fund grants for 
168.11 	subsidized employment activities. Growth 
168.12 	in expenditures for subsidized employment 
168.13 	within the supported work program and the 
168.14 	MFIP consolidated fund over the amount 
168.15 	expended in the calendar quarters in the 
168.16 	TANF emergency fund base year shall be 
168.17 	used to leverage the TANF emergency fund 
168.18 	grants for subsidized employment and to 
168.19 	fund supported work. The commissioner 
168.20 	shall develop procedures to maximize 
168.21 	reimbursement of these expenditures over the 
168.22 	TANF emergency fund base year quarters, 
168.23 	and may contract directly with employers 
168.24 	and providers to maximize these TANF 
168.25 	emergency fund grants.
168.26 	Supported Work. Of the TANF 
168.27 	appropriation, $4,700,000 in fiscal year 2010 
168.28 	and $4,700,000 in fiscal year 2011 are to the 
168.29 	commissioner for supported work for MFIP 
168.30 	recipients and is available until expended. 
168.31 	Supported work includes paid transitional 
168.32 	work experience and a continuum of 
168.33 	employment assistance, including outreach 
168.34 	and recruitment, program orientation 
168.35 	and intake, testing and assessment, job 
169.1 	development and marketing, preworksite 
169.2 	training, supported worksite experience, 
169.3 	job coaching, and postplacement follow-up, 
169.4 	in addition to extensive case management 
169.5 	and referral services. This is a onetime 
169.6 	appropriation.
169.7 	Base Adjustment. The general fund base 
169.8 	is reduced by $3,783,000 in each of fiscal 
169.9 	years 2012 and 2013. The TANF fund base 
169.10 	is increased by $5,004,000 in each of fiscal 
169.11 	years 2012 and 2013.
169.12 	Integrated Services Program Funding.
169.13 	The TANF appropriation for integrated 
169.14 	services program funding is $1,250,000 in 
169.15 	fiscal year 2010 and $0 in fiscal year 2011 
169.16 	and the base for fiscal years 2012 and 2013 
169.17 	is $0.
169.18 	TANF Emergency Fund; Nonrecurrent 
169.19 	Short-Term Benefits.(1) TANF emergency 
169.20 	contingency fund grants received due to 
169.21 	increases in expenditures for nonrecurrent 
169.22 	short-term benefits must be used to offset the 
169.23 	increase in these expenditures for counties 
169.24 	under the MFIP consolidated fund, under 
169.25 	Minnesota Statutes, section 256J.626, 
169.26 	and the diversionary work program. The 
169.27 	commissioner shall develop procedures 
169.28 	to maximize reimbursement of these 
169.29 	expenditures over the TANF emergency fund 
169.30 	base year quarters. Growth in expenditures 
169.31 	for the diversionary work program over the 
169.32 	amount expended in the calendar quarters in 
169.33 	the TANF emergency fund base year shall be 
169.34 	used to leverage these funds.
170.1 	(2) To the extent that the commissioner 
170.2 	can claim eligible tax credit growth as 
170.3 	nonrecurrent short-term benefits, the 
170.4 	commissioner shall use those funds to 
170.5 	leverage the increased expenditures in clause 
170.6 	(1).
170.7 	(3) TANF emergency funds for nonrecurrent 
170.8 	short-term benefits received in excess of the 
170.9 	amounts necessary for clauses (1) and (2) 
170.10 	shall be used to reimburse the general fund 
170.11 	for the costs of eligible tax credits in fiscal 
170.12 	year 2011. The amount of such funds shall 
170.13 	not exceed $28,000,000.

170.14	(c) MFIP Child Care Assistance Grants
		61,171,000
		65,214,000
	
170.15 	Acceleration of ARRA Child Care and 
170.16 	Development Fund Expenditure. The 
170.17 	commissioner must liquidate all child care 
170.18 	and development money available under 
170.19 	the American Recovery and Reinvestment 
170.20 	Act (ARRA) of 2009, Public Law 111-5, 
170.21 	by September 30, 2010. In order to expend 
170.22 	those funds by September 30, 2010, the 
170.23 	commissioner may redesignate and expend 
170.24 	the ARRA child care and development funds 
170.25 	appropriated in fiscal year 2011 for purposes 
170.26 	under this section for related purposes that 
170.27 	will allow liquidation by September 30, 
170.28 	2010. Child care and development funds 
170.29 	otherwise available to the commissioner 
170.30 	for those related purposes shall be used to 
170.31 	fund the purposes from which the ARRA 
170.32 	child care and development funds had been 
170.33 	redesignated.
170.34 	School Readiness Service Agreements.
170.35 	$400,000 in fiscal year 2010 and $400,000 
171.1 	in fiscal year 2011 are from the federal 
171.2 	TANF fund to the commissioner of human 
171.3 	services consistent with federal regulations 
171.4 	for the purpose of school readiness service 
171.5 	agreements under Minnesota Statutes, 
171.6 	section 119B.231. This is a onetime 
171.7 	appropriation. Any unexpended balance the 
171.8 	first year is available in the second year.

171.9171.10
	(d) Basic Sliding Fee Child Care Assistance 
Grants
		40,100,000
		45,092,000
	
171.11 	School Readiness Service Agreements.
171.12 	$257,000 in fiscal year 2010 and $257,000 
171.13 	in fiscal year 2011 are from the general 
171.14 	fund for the purpose of school readiness 
171.15 	service agreements under Minnesota 
171.16 	Statutes, section 119B.231. This is a onetime 
171.17 	appropriation. Any unexpended balance the 
171.18 	first year is available in the second year.
171.19 	Child Care Development Fund 
171.20 	Unexpended Balance. In addition to 
171.21 	the amount provided in this section, the 
171.22 	commissioner shall expend $5,244,000 in 
171.23 	fiscal year 2010 from the federal child care 
171.24 	development fund unexpended balance 
171.25 	for basic sliding fee child care under 
171.26 	Minnesota Statutes, section 119B.03. The 
171.27 	commissioner shall ensure that all child 
171.28 	care and development funds are expended 
171.29 	according to the federal child care and 
171.30 	development fund regulations.
171.31 	Basic Sliding Fee. $4,000,000 in fiscal year 
171.32 	2010 and $4,000,000 in fiscal year 2011 are 
171.33 	from the federal child care development 
171.34 	funds received from the American Recovery 
171.35 	and Reinvestment Act of 2009, Public 
171.36 	Law 111-5, to the commissioner of human 
172.1 	services consistent with federal regulations 
172.2 	for the purpose of basic sliding fee child care 
172.3 	assistance under Minnesota Statutes, section 
172.4 	119B.03. This is a onetime appropriation. 
172.5 	Any unexpended balance the first year is 
172.6 	available in the second year.
172.7 	Basic Sliding Fee Allocation for Calendar 
172.8 	Year 2010. Notwithstanding Minnesota 
172.9 	Statutes, section 119B.03, subdivision 6, 
172.10 	in calendar year 2010, basic sliding fee 
172.11 	funds shall be distributed according to 
172.12 	this provision. Funds shall be allocated 
172.13 	first in amounts equal to each county's 
172.14 	guaranteed floor, according to Minnesota 
172.15 	Statutes, section 119B.03, subdivision 8, 
172.16 	with any remaining available funds allocated 
172.17 	according to the following formula:
172.18 	(a) Up to one-fourth of the funds shall be 
172.19 	allocated in proportion to the number of 
172.20 	families participating in the transition year 
172.21 	child care program as reported during and 
172.22 	averaged over the most recent six months 
172.23 	completed at the time of the notice of 
172.24 	allocation. Funds in excess of the amount 
172.25 	necessary to serve all families in this category 
172.26 	shall be allocated according to paragraph (d).
172.27 	(b) Up to three-fourths of the funds shall 
172.28 	be allocated in proportion to the average 
172.29 	of each county's most recent six months of 
172.30 	reported waiting list as defined in Minnesota 
172.31 	Statutes, section 119B.03, subdivision 2, and 
172.32 	the reinstatement list of those families whose 
172.33 	assistance was terminated with the approval 
172.34 	of the commissioner under Minnesota Rules, 
172.35 	part 3400.0183, subpart 1. Funds in excess 
173.1 	of the amount necessary to serve all families 
173.2 	in this category shall be allocated according 
173.3 	to paragraph (d).
173.4 	(c) The amount necessary to serve all families 
173.5 	in paragraphs (a) and (b) shall be calculated 
173.6 	based on the basic sliding fee average cost of 
173.7 	care per family in the county with the highest 
173.8 	cost in the most recently completed calendar 
173.9 	year.
173.10 	(d) Funds in excess of the amount necessary 
173.11 	to serve all families in paragraphs (a) and 
173.12 	(b) shall be allocated in proportion to each 
173.13 	county's total expenditures for the basic 
173.14 	sliding fee child care program reported 
173.15 	during the most recent fiscal year completed 
173.16 	at the time of the notice of allocation. To 
173.17 	the extent that funds are available, and 
173.18 	notwithstanding Minnesota Statutes, section 
173.19 	119B.03, subdivision 8, for the period 
173.20 	January 1, 2011, to December 31, 2011, each 
173.21 	county's guaranteed floor must be equal to its 
173.22 	original calendar year 2010 allocation.
173.23 	Base Adjustment. The general fund base is 
173.24 	decreased by $257,000 in each of fiscal years 
173.25 	2012 and 2013.

173.26	(e) Child Care Development Grants
		1,487,000
		1,487,000
	
173.27 	Family, friends, and neighbor grants.
173.28 	$375,000 in fiscal year 2010 and $375,000 
173.29 	in fiscal year 2011 are from the child 
173.30 	care development fund required targeted 
173.31 	quality funds for quality expansion and 
173.32 	infant/toddler from the American Recovery 
173.33 	and Reinvestment Act of 2009, Public 
173.34 	Law 111-5, to the commissioner of human 
173.35 	services for family, friends, and neighbor 
174.1 	grants under Minnesota Statutes, section 
174.2 	119B.232. This appropriation may be used 
174.3 	on programs receiving family, friends, and 
174.4 	neighbor grant funds as of June 30, 2009, 
174.5 	or on new programs or projects. This is a 
174.6 	onetime appropriation. Any unexpended 
174.7 	balance the first year is available in the 
174.8 	second year.
174.9 	Voluntary quality rating system training, 
174.10 	coaching, consultation, and supports.
174.11 	$633,000 in fiscal year 2010 and $633,000 
174.12 	in fiscal year 2011 are from the federal child 
174.13 	care development fund required targeted 
174.14 	quality funds for quality expansion and 
174.15 	infant/toddler from the American Recovery 
174.16 	and Reinvestment Act of 2009, Public 
174.17 	Law 111-5, to the commissioner of human 
174.18 	services consistent with federal regulations 
174.19 	for the purpose of providing grants to provide 
174.20 	statewide child-care provider training, 
174.21 	coaching, consultation, and supports to 
174.22 	prepare for the voluntary Minnesota quality 
174.23 	rating system rating tool. This is a onetime 
174.24 	appropriation. Any unexpended balance the 
174.25 	first year is available in the second year.
174.26 	Voluntary quality rating system. $184,000 
174.27 	in fiscal year 2010 and $1,200,000 in fiscal 
174.28 	year 2011 are from the federal child care 
174.29 	development fund required targeted funds for 
174.30 	quality expansion and infant/toddler from the 
174.31 	American Recovery and Reinvestment Act of 
174.32 	2009, Public Law 111-5, to the commissioner 
174.33 	of human services consistent with federal 
174.34 	regulations for the purpose of implementing 
174.35 	the voluntary Parent Aware quality star 
174.36 	rating system pilot in coordination with the 
175.1 	Minnesota Early Learning Foundation. The 
175.2 	appropriation for the first year is to complete 
175.3 	and promote the voluntary Parent Aware 
175.4 	quality rating system pilot program through 
175.5 	June 30, 2010, and the appropriation for 
175.6 	the second year is to continue the voluntary 
175.7 	Minnesota quality rating system pilot 
175.8 	through June 30, 2011. This is a onetime 
175.9 	appropriation. Any unexpended balance the 
175.10 	first year is available in the second year.

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

175.12	(g) Children's Services Grants

175.13	Appropriations by Fund
	
175.14	General
	48,333,000
	50,498,000
	
175.15	Federal TANF
	340,000
	240,000
	
175.16 	Base Adjustment. The general fund base is 
175.17 	decreased by $5,371,000 in fiscal year 2012 
175.18 	and decreased $5,371,000 in fiscal year 2013.
175.19 	Privatized Adoption Grants. Federal 
175.20 	reimbursement for privatized adoption grant 
175.21 	and foster care recruitment grant expenditures 
175.22 	is appropriated to the commissioner for 
175.23 	adoption grants and foster care and adoption 
175.24 	administrative purposes.
175.25 	Adoption Assistance Incentive Grants.
175.26 	Federal funds available during fiscal year 
175.27 	2010 and fiscal year 2011 for the adoption 
175.28 	incentive grants are appropriated to the 
175.29 	commissioner for postadoption services 
175.30 	including parent support groups.
175.31 	Adoption Assistance and Relative Custody 
175.32 	Assistance. The commissioner may transfer 
175.33 	unencumbered appropriation balances for 
175.34 	adoption assistance and relative custody 
176.1 	assistance between fiscal years and between 
176.2 	programs.

176.3	(h) Children and Community Services Grants
		67,663,000
		67,542,000
	
176.4 	Targeted Case Management Temporary 
176.5 	Funding Adjustment. The commissioner 
176.6 	shall recover from each county and tribe 
176.7 	receiving a targeted case management 
176.8 	temporary funding payment in fiscal year 
176.9 	2008 an amount equal to that payment. The 
176.10 	commissioner shall recover one-half of the 
176.11 	funds by February 1, 2010, and the remainder 
176.12 	by February 1, 2011. At the commissioner's 
176.13 	discretion and at the request of a county 
176.14 	or tribe, the commissioner may revise 
176.15 	the payment schedule, but full payment 
176.16 	must not be delayed beyond May 1, 2011. 
176.17 	The commissioner may use the recovery 
176.18 	procedure under Minnesota Statutes, section 
176.19 	256.017, to recover the funds. Recovered 
176.20 	funds must be deposited into the general 
176.21 	fund.

176.22	(i) General Assistance Grants
		48,215,000
		48,608,000
	
176.23 	General Assistance Standard. The 
176.24 	commissioner shall set the monthly standard 
176.25 	of assistance for general assistance units 
176.26 	consisting of an adult recipient who is 
176.27 	childless and unmarried or living apart 
176.28 	from parents or a legal guardian at $203. 
176.29 	The commissioner may reduce this amount 
176.30 	according to Laws 1997, chapter 85, article 
176.31 	3, section 54.
176.32 	Emergency General Assistance. The 
176.33 	amount appropriated for emergency general 
176.34 	assistance funds is limited to no more 
176.35 	than $7,889,812 in fiscal year 2010 and 
177.1 	$7,889,812 in fiscal year 2011. Funds 
177.2 	to counties must be allocated by the 
177.3 	commissioner using the allocation method 
177.4 	specified in Minnesota Statutes, section 
177.5 	256D.06.

177.6	(j) Minnesota Supplemental Aid Grants
		33,930,000
		35,191,000
	
177.7 	Emergency Minnesota Supplemental 
177.8 	Aid Funds. The amount appropriated for 
177.9 	emergency Minnesota supplemental aid 
177.10 	funds is limited to no more than $1,100,000 
177.11 	in fiscal year 2010 and $1,100,000 in fiscal 
177.12 	year 2011. Funds to counties must be 
177.13 	allocated by the commissioner using the 
177.14 	allocation method specified in Minnesota 
177.15 	Statutes, section 256D.46.

177.16	(k) Group Residential Housing Grants
		111,778,000
		114,034,000
	
177.17 	Group Residential Housing Costs 
177.18 	Refinanced. (a) Effective July 1, 2011, the 
177.19 	commissioner shall increase the home and 
177.20 	community-based service rates and county 
177.21 	allocations provided to programs for persons 
177.22 	with disabilities established under section 
177.23 	1915(c) of the Social Security Act to the 
177.24 	extent that these programs will be paying 
177.25 	for the costs above the rate established 
177.26 	in Minnesota Statutes, section 256I.05, 
177.27 	subdivision 1.
177.28 	(b) For persons receiving services under 
177.29 	Minnesota Statutes, section 245A.02, who 
177.30 	reside in licensed adult foster care beds 
177.31 	for which a difficulty of care payment 
177.32 	was being made under Minnesota Statutes, 
177.33 	section 256I.05, subdivision 1c, paragraph 
177.34 	(b), counties may request an exception to 
177.35 	the individual's service authorization not to 
178.1 	exceed the difference between the client's 
178.2 	monthly service expenditures plus the 
178.3 	amount of the difficulty of care payment.

178.4	(l) Children's Mental Health Grants
		16,885,000
		16,882,000
	
178.5 	Funding Usage. Up to 75 percent of a fiscal 
178.6 	year's appropriation for children's mental 
178.7 	health grants may be used to fund allocations 
178.8 	in that portion of the fiscal year ending 
178.9 	December 31.

178.10
178.11	(m) Other Children and Economic Assistance 
Grants
		16,047,000
		15,339,000
	
178.12 	Fraud Prevention Grants. Of this 
178.13 	appropriation, $228,000 in fiscal year 2010 
178.14 	and $228,000 $379,000 in fiscal year 2011 
178.15 	is to the commissioner for fraud prevention 
178.16 	grants to counties.
178.17 	Homeless and Runaway Youth. $218,000 
178.18 	in fiscal year 2010 is for the Runaway 
178.19 	and Homeless Youth Act under Minnesota 
178.20 	Statutes, section 256K.45. Funds shall be 
178.21 	spent in each area of the continuum of care 
178.22 	to ensure that programs are meeting the 
178.23 	greatest need. Any unexpended balance in 
178.24 	the first year is available in the second year. 
178.25 	Beginning July 1, 2011, the base is increased 
178.26 	by $119,000 each year.
178.27 	ARRA Homeless Youth Funds. To the 
178.28 	extent permitted under federal law, the 
178.29 	commissioner shall designate $2,500,000 
178.30 	of the Homeless Prevention and Rapid 
178.31 	Re-Housing Program funds provided under 
178.32 	the American Recovery and Reinvestment 
178.33 	Act of 2009, Public Law 111-5, for agencies 
178.34 	providing homelessness prevention and rapid 
178.35 	rehousing services to youth.
179.1 	Supportive Housing Services. $1,500,000 
179.2 	each year is for supportive services under 
179.3 	Minnesota Statutes, section 256K.26. This is 
179.4 	a onetime appropriation. 
179.5 	Community Action Grants. Community 
179.6 	action grants are reduced one time by 
179.7 	$1,794,000 each year. This reduction is due 
179.8 	to the availability of federal funds under the 
179.9 	American Recovery and Reinvestment Act.
179.10 	Base Adjustment. The general fund base 
179.11 	is increased by $773,000 $903,000 in fiscal 
179.12 	year 2012 and $773,000 $413,000 in fiscal 
179.13 	year 2013.
179.14 	Federal ARRA Funds for Existing 
179.15 	Programs.(a) (1) Federal funds received by 
179.16 	the commissioner for the emergency food 
179.17 	and shelter program from the American 
179.18 	Recovery and Reinvestment Act of 2009, 
179.19 	Public Law 111-5, but not previously 
179.20 	approved by the legislature are appropriated 
179.21 	to the commissioner for the purposes of the 
179.22 	grant program.
179.23 	(b) (2) Federal funds received by the 
179.24 	commissioner for the emergency shelter 
179.25 	grant program including the Homelessness 
179.26 	Prevention and Rapid Re-Housing 
179.27 	Program from the American Recovery and 
179.28 	Reinvestment Act of 2009, Public Law 
179.29 	111-5, are appropriated to the commissioner 
179.30 	for the purposes of the grant programs.
179.31 	(c) (3) Federal funds received by the 
179.32 	commissioner for the emergency food 
179.33 	assistance program from the American 
179.34 	Recovery and Reinvestment Act of 2009, 
179.35 	Public Law 111-5, are appropriated to the 
180.1 	commissioner for the purposes of the grant 
180.2 	program.
180.3 	(d) (4) Federal funds received by the 
180.4 	commissioner for senior congregate meals 
180.5 	and senior home-delivered meals from the 
180.6 	American Recovery and Reinvestment Act 
180.7 	of 2009, Public Law 111-5, are appropriated 
180.8 	to the commissioner for the Minnesota Board 
180.9 	on Aging, for purposes of the grant programs.
180.10 	(e) (5) Federal funds received by the 
180.11 	commissioner for the community services 
180.12 	block grant program from the American 
180.13 	Recovery and Reinvestment Act of 2009, 
180.14 	Public Law 111-5, are appropriated to the 
180.15 	commissioner for the purposes of the grant 
180.16 	program.
180.17 	Long-Term Homeless Supportive 
180.18 	Service Fund Appropriation. To the 
180.19 	extent permitted under federal law, the 
180.20 	commissioner shall designate $3,000,000 
180.21 	of the Homelessness Prevention and Rapid 
180.22 	Re-Housing Program funds provided under 
180.23 	the American Recovery and Reinvestment 
180.24 	Act of 2009, Public Law, 111-5, to the 
180.25 	long-term homeless service fund under 
180.26 	Minnesota Statutes, section 256K.26. This 
180.27 	appropriation shall become available by July 
180.28 	1, 2009. This paragraph is effective the day 
180.29 	following final enactment.

180.30 	Sec. 13. Laws 2009, chapter 79, article 13, section 3, subdivision 8, as amended by 
180.31 	Laws 2009, chapter 173, article 2, section 1, subdivision 8, is amended to read:

180.32	Subd. 8.Continuing Care Grants
 					
180.33 	The amounts that may be spent from the 
180.34 	appropriation for each purpose are as follows:

181.1	(a) Aging and Adult Services Grants
		13,499,000
		15,805,000
	
181.2 	Base Adjustment. The general fund base is 
181.3 	increased by $5,751,000 in fiscal year 2012 
181.4 	and $6,705,000 in fiscal year 2013.
181.5 	Information and Assistance 
181.6 	Reimbursement. Federal administrative 
181.7 	reimbursement obtained from information 
181.8 	and assistance services provided by the 
181.9 	Senior LinkAge or Disability Linkage lines 
181.10 	to people who are identified as eligible for 
181.11 	medical assistance shall be appropriated to 
181.12 	the commissioner for this activity.
181.13 	Community Service Development Grant 
181.14 	Reduction. Funding for community service 
181.15 	development grants must be reduced by 
181.16 	$260,000 for fiscal year 2010; $284,000 in 
181.17 	fiscal year 2011; $43,000 in fiscal year 2012; 
181.18 	and $43,000 in fiscal year 2013. Base level 
181.19 	funding shall be restored in fiscal year 2014.
181.20 	Community Service Development Grant 
181.21 	Community Initiative. Funding for 
181.22 	community service development grants shall 
181.23 	be used to offset the cost of aging support 
181.24 	grants. Base level funding shall be restored 
181.25 	in fiscal year 2014.
181.26 	Senior Nutrition Use of Federal Funds.
181.27 	For fiscal year 2010, general fund grants 
181.28 	for home-delivered meals and congregate 
181.29 	dining shall be reduced by $500,000. The 
181.30 	commissioner must replace these general 
181.31 	fund reductions with equal amounts from 
181.32 	federal funding for senior nutrition from the 
181.33 	American Recovery and Reinvestment Act 
181.34 	of 2009.

182.1	(b) Alternative Care Grants
		50,234,000
		48,576,000
	
182.2 	Base Adjustment. The general fund base is 
182.3 	decreased by $3,598,000 in fiscal year 2012 
182.4 	and $3,470,000 in fiscal year 2013.
182.5 	Alternative Care Transfer. Any money 
182.6 	allocated to the alternative care program that 
182.7 	is not spent for the purposes indicated does 
182.8 	not cancel but must be transferred to the 
182.9 	medical assistance account.

182.10
182.11	(c) Medical Assistance Grants; Long-Term 
Care Facilities.
		367,444,000
		419,749,000

182.12
182.13	(d) Medical Assistance Long-Term Care 
Waivers and Home Care Grants
		853,567,000
		1,039,517,000
	
182.14 	Manage Growth in TBI and CADI 
182.15 	Waivers. During the fiscal years beginning 
182.16 	on July 1, 2009, and July 1, 2010, the 
182.17 	commissioner shall allocate money for home 
182.18 	and community-based waiver programs 
182.19 	under Minnesota Statutes, section 256B.49, 
182.20 	to ensure a reduction in state spending that is 
182.21 	equivalent to limiting the caseload growth of 
182.22 	the TBI waiver to 12.5 allocations per month 
182.23 	each year of the biennium and the CADI 
182.24 	waiver to 95 allocations per month each year 
182.25 	of the biennium. Limits do not apply: (1) 
182.26 	when there is an approved plan for nursing 
182.27 	facility bed closures for individuals under 
182.28 	age 65 who require relocation due to the 
182.29 	bed closure; (2) to fiscal year 2009 waiver 
182.30 	allocations delayed due to unallotment; or (3) 
182.31 	to transfers authorized by the commissioner 
182.32 	from the personal care assistance program 
182.33 	of individuals having a home care rating 
182.34 	of "CS," "MT," or "HL." Priorities for the 
182.35 	allocation of funds must be for individuals 
183.1 	anticipated to be discharged from institutional 
183.2 	settings or who are at imminent risk of a 
183.3 	placement in an institutional setting.
183.4 	Manage Growth in DD Developmental 
183.5 	Disability Waiver. The commissioner 
183.6 	shall manage the growth in the DD waiver 
183.7 	by limiting the allocations included in the 
183.8 	February 2009 forecast to 15 additional 
183.9 	diversion allocations each month for the 
183.10 	calendar years that begin on January 1, 2010, 
183.11 	and January 1, 2011. Additional allocations 
183.12 	must be made available for transfers 
183.13 	authorized by the commissioner from the 
183.14 	personal care program of individuals having 
183.15 	a home care rating of "CS," "MT," or "HL."
183.16 	Adjustment to Lead Agency Waiver 
183.17 	Allocations. Prior to the availability of the 
183.18 	alternative license defined in Minnesota 
183.19 	Statutes, section 245A.11, subdivision 8, 
183.20 	the commissioner shall reduce lead agency 
183.21 	waiver allocations for the purposes of 
183.22 	implementing a moratorium on corporate 
183.23 	foster care.
183.24 	Alternatives to Personal Care Assistance 
183.25 	Services. Base level funding of $3,237,000 
183.26 	in fiscal year 2012 and $4,856,000 in 
183.27 	fiscal year 2013 is to implement alternative 
183.28 	services to personal care assistance services 
183.29 	for persons with mental health and other 
183.30 	behavioral challenges who can benefit 
183.31 	from other services that more appropriately 
183.32 	meet their needs and assist them in living 
183.33 	independently in the community. These 
183.34 	services may include, but not be limited to, a 
183.35 	1915(i) state plan option.

184.1	(e) Mental Health Grants

184.2	Appropriations by Fund
	
184.3	General
	77,739,000
	77,739,000
	
184.4	Health Care Access
	750,000
	750,000
	
184.5	Lottery Prize
	1,508,000
	1,508,000
	
184.6 	Funding Usage. Up to 75 percent of a fiscal 
184.7 	year's appropriation for adult mental health 
184.8 	grants may be used to fund allocations in that 
184.9 	portion of the fiscal year ending December 
184.10 	31.

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

184.12	(g) Chemical Dependency Entitlement Grants
		111,303,000
		122,822,000
	
184.13 	Payments for Substance Abuse Treatment.
184.14 	For services provided during fiscal years 
184.15 	2010 and 2011, county-negotiated rates 
184.16 	and provider claims to the consolidated 
184.17 	chemical dependency fund must not exceed
184.18 	the lesser of: (1) rates charged for these 
184.19 	services on January 1, 2009; or (2) 160 
184.20 	percent of the average rate on January 1, 
184.21 	2009, for each group of vendors with similar 
184.22 	attributes. For services provided in fiscal 
184.23 	years 2012 and 2013, the statewide average 
184.24 	rates aggregate payment under the new 
184.25 	rate methodology to be developed under 
184.26 	Minnesota Statutes, section 254B.12, must 
184.27 	not exceed the average rates charged for 
184.28 	these services on January 1, 2009, plus a 
184.29 	state share increase of $3,787,000 for fiscal 
184.30 	year 2012 and $5,023,000 for fiscal year 
184.31 	2013 projected aggregate payment under 
184.32 	the rates in effect for fiscal year 2010 minus 
184.33 	1.25 percent. Notwithstanding any provision 
184.34 	to the contrary in this article, this provision 
184.35 	expires on June 30, 2013.
185.1 	Chemical Dependency Special Revenue 
185.2 	Account. For fiscal year 2010, $750,000 
185.3 	must be transferred from the consolidated 
185.4 	chemical dependency treatment fund 
185.5 	administrative account and deposited into the 
185.6 	general fund.
185.7 	County CD Share of MA Costs for 
185.8 	ARRA Compliance. Notwithstanding the 
185.9 	provisions of Minnesota Statutes, chapter 
185.10 	254B, for chemical dependency services 
185.11 	provided during the period October 1, 2008, 
185.12 	to December 31, 2010, and reimbursed by 
185.13 	medical assistance at the enhanced federal 
185.14 	matching rate provided under the American 
185.15 	Recovery and Reinvestment Act of 2009, the 
185.16 	county share is 30 percent of the nonfederal 
185.17 	share. This provision is effective the day 
185.18 	following final enactment.

185.19
185.20	(h) Chemical Dependency Nonentitlement 
Grants
		1,729,000
		1,729,000

185.21	(i) Other Continuing Care Grants
		19,201,000
		17,528,000
	
185.22 	Base Adjustment. The general fund base is 
185.23 	increased by $2,639,000 in fiscal year 2012 
185.24 	and increased by $3,854,000 in fiscal year 
185.25 	2013.
185.26 	Technology Grants. $650,000 in fiscal 
185.27 	year 2010 and $1,000,000 in fiscal year 
185.28 	2011 are for technology grants, case 
185.29 	consultation, evaluation, and consumer 
185.30 	information grants related to developing and 
185.31 	supporting alternatives to shift-staff foster 
185.32 	care residential service models.
185.33 	Other Continuing Care Grants; HIV 
185.34 	Grants. Money appropriated for the HIV 
185.35 	drug and insurance grant program in fiscal 
186.1 	year 2010 may be used in either year of the 
186.2 	biennium.
186.3 	Quality Assurance Commission. Effective 
186.4 	July 1, 2009, state funding for the quality 
186.5 	assurance commission under Minnesota 
186.6 	Statutes, section 256B.0951, is canceled.

186.7 	Sec. 14. Laws 2009, chapter 79, article 13, section 5, subdivision 8, as amended by 
186.8 	Laws 2009, chapter 173, article 2, section 3, subdivision 8, is amended to read:

186.9186.10
	Subd. 8.Board of Nursing Home 
Administrators
 		1,211,000
		1,023,000
	
186.11 	Administrative Services Unit - Operating 
186.12 	Costs. Of this appropriation, $524,000 
186.13 	in fiscal year 2010 and $526,000 in 
186.14 	fiscal year 2011 are for operating costs 
186.15 	of the administrative services unit. The 
186.16 	administrative services unit may receive 
186.17 	and expend reimbursements for services 
186.18 	performed by other agencies.
186.19 	Administrative Services Unit - Retirement 
186.20 	Costs. Of this appropriation in fiscal year 
186.21 	2010, $201,000 is for onetime retirement 
186.22 	costs in the health-related boards. This 
186.23 	funding may be transferred to the health 
186.24 	boards incurring those costs for their 
186.25 	payment. These funds are available either 
186.26 	year of the biennium.
186.27 	Administrative Services Unit - Volunteer 
186.28 	Health Care Provider Program. Of this 
186.29 	appropriation, $79,000 in fiscal year 2010 
186.30 	and $89,000 in fiscal year 2011 are to pay 
186.31 	for medical professional liability coverage 
186.32 	required under Minnesota Statutes, section 
186.33 	214.40.
187.1 	Administrative Services Unit - Contested 
187.2 	Cases and Other Legal Proceedings. Of 
187.3 	this appropriation, $200,000 in fiscal year 
187.4 	2010 and $200,000 in fiscal year 2011 are 
187.5 	for costs of contested case hearings and other 
187.6 	unanticipated costs of legal proceedings 
187.7 	involving health-related boards funded 
187.8 	under this section and for unforeseen 
187.9 	expenditures of an urgent nature. Upon 
187.10 	certification of a health-related board to the 
187.11 	administrative services unit that the costs 
187.12 	will be incurred and that there is insufficient 
187.13 	money available to pay for the costs out of 
187.14 	money currently available to that board, the 
187.15 	administrative services unit is authorized 
187.16 	to transfer money from this appropriation 
187.17 	to the board for payment of those costs 
187.18 	with the approval of the commissioner of 
187.19 	finance. This appropriation does not cancel. 
187.20 	Any unencumbered and unspent balances 
187.21 	remain available for these expenditures in 
187.22 	subsequent fiscal years. The boards receiving 
187.23 	funds under this section shall include these 
187.24 	amounts when setting fees to cover their 
187.25 	costs.

187.26 	Sec. 15. CANCELLATIONS.
 187.27 	The remaining balance from Laws 2008, chapter 358, article 5, section 4, subdivision 
187.28 	3, appropriation for Section 125 employer incentives, is canceled.

187.29 	Sec. 16. TRANSFERS.
 187.30 	The commissioner of management and budget shall transfer from the general fund to 
187.31 	the health care access fund $38,475,000 in fiscal year 2011, $14,758,000 in fiscal year 
187.32 	2012, and $35,058,000 in fiscal year 2013.

188.1 	EFFECTIVE DATE. This section is effective upon federal approval of the 
188.2 	amendments to Minnesota Statutes, sections 256B.055, subdivision 15, and 256B.056, 
188.3 	subdivision 4.

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

188.7 	Sec. 18. EFFECTIVE DATE.
 188.8 	The provisions in this article are effective July 1, 2010, unless a different effective 
188.9 	date is explicit.