1.1 	A bill for an act
1.2 	relating to state government; state health care programs; continuing care; 
1.3 	children and family services; health care reform; Department of Health; 
1.4 	public health; health plans; increasing fees and surcharges; requiring reports; 
1.5 	making supplemental and contingent appropriations and reductions for the 
1.6 	Departments of Health and Human Services and other health-related boards 
1.7 	and councils;amending Minnesota Statutes 2008, sections 62D.08, by adding 
1.8 	a subdivision; 62J.692, subdivision 4; 62Q.19, subdivision 1; 144.05, by 
1.9 	adding a subdivision; 144.226, subdivision 3; 144.293, subdivision 4; 144.651, 
1.10 	subdivision 2; 144.9504, by adding a subdivision; 144A.51, subdivision 5; 
1.11 	144D.03, subdivision 2, by adding a subdivision; 144D.04, subdivision 2; 
1.12 	144E.37; 144G.06; 152.126, as amended; 214.40, subdivision 7; 246.18, by 
1.13 	adding a subdivision; 254B.01, subdivision 2; 254B.02, subdivisions 1, 5; 
1.14 	254B.03, subdivision 4; 254B.05, subdivision 4; 254B.06, subdivision 2; 
1.15 	254B.09, subdivision 8; 256.9657, subdivisions 2, 3, 3a; 256.969, subdivisions 
1.16 	21, 26, by adding a subdivision; 256B.055, by adding a subdivision; 256B.056, 
1.17 	subdivisions 3, 4; 256B.057, subdivision 9; 256B.0625, subdivisions 8, 8a, 8b, 
1.18 	18a, 22, 31, by adding subdivisions; 256B.0631, subdivisions 1, 3; 256B.0644, 
1.19 	as amended; 256B.0915, by adding a subdivision; 256B.19, subdivision 1c; 
1.20 	256B.5012, by adding a subdivision; 256B.69, subdivisions 20, as amended, 
1.21 	27, by adding a subdivision; 256B.692, subdivision 1; 256B.76, subdivisions 
1.22 	2, 4; 256D.03, subdivision 3b; 256D.0515; 256I.05, by adding a subdivision; 
1.23 	256J.24, subdivision 6; 256L.07, by adding a subdivision; 256L.11, subdivision 
1.24 	6; 256L.12, subdivisions 5, 9, by adding a subdivision; 256L.15, subdivision 
1.25 	1; 517.08, subdivision 1c, as amended; Minnesota Statutes 2009 Supplement, 
1.26 	sections 157.16, subdivision 3; 252.27, subdivision 2a; 256.969, subdivisions 2b, 
1.27 	3a; 256.975, subdivision 7; 256B.0625, subdivision 13h; 256B.0653, subdivision 
1.28 	5; 256B.0659, subdivision 11; 256B.0911, subdivisions 1a, 3c; 256B.441, 
1.29 	subdivision 55; 256B.69, subdivisions 5a, 23; 256B.76, subdivision 1; 256B.766; 
1.30 	256D.03, subdivision 3, as amended; 256J.425, subdivision 3; 256L.03, 
1.31 	subdivision 5; 327.15, subdivision 3; 517.08, subdivision 1b; Laws 2005, First 
1.32 	Special Session chapter 4, article 8, section 66, as amended; Laws 2009, chapter 
1.33 	79, article 3, section 18; article 5, sections 17; 18; 22; 75, subdivision 1; 78, 
1.34 	subdivision 5; article 8, sections 2; 51; 84; article 13, sections 3, subdivisions 
1.35 	1, as amended, 3, as amended, 4, as amended, 8, as amended; 5, subdivision 8, 
1.36 	as amended; Laws 2009, chapter 173, article 1, section 17; Laws 2010, chapter 
1.37 	200, article 1, sections 12; 16; 21; article 2, section 2, subdivisions 1, 5, 8; 
1.38 	proposing coding for new law in Minnesota Statutes, chapters 62D; 62E; 62Q; 
1.39 	137; 144; 144D; 246; 254B; 256; 256B; repealing Minnesota Statutes 2008, 
2.1 	sections 254B.02, subdivisions 2, 3, 4; 254B.09, subdivisions 4, 5, 7; 256D.03, 
2.2 	subdivisions 3, 3a, 5, 6, 7, 8; Minnesota Statutes 2009 Supplement, section 
2.3 	256J.621; Laws 2010, chapter 200, article 1, sections 12; 18; 19.
2.4 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

2.5 	ARTICLE 1
2.6 	HEALTH CARE

2.7 	Section 1. Minnesota Statutes 2008, section 256.9657, subdivision 2, is amended to 
2.8 	read:
2.9 		Subd. 2.Hospital surcharge. (a) Effective October 1, 1992, each Minnesota 
2.10 	hospital except facilities of the federal Indian Health Service and regional treatment 
2.11 	centers shall pay to the medical assistance account a surcharge equal to 1.4 percent of net 
2.12 	patient revenues excluding net Medicare revenues reported by that provider to the health 
2.13 	care cost information system according to the schedule in subdivision 4.
2.14 	(b) Effective July 1, 1994, the surcharge under paragraph (a) is increased to 1.56
2.15 	percent. 
2.16 	(c) Effective July 1, 2010, the surcharge under paragraph (b) is increased to 2.63 
2.17 	percent. 
2.18 	(d) Effective October 1, 2011, the surcharge under paragraph (c) is reduced to 
2.19 	2.30 percent.
2.20 	(e) Notwithstanding the Medicare cost finding and allowable cost principles, the 
2.21 	hospital surcharge is not an allowable cost for purposes of rate setting under sections 
2.22 	256.9685 to 256.9695. 

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

2.24 	Sec. 2. Minnesota Statutes 2008, section 256.9657, subdivision 3, is amended to read:
2.25 		Subd. 3.Surcharge on HMOs and community integrated service networks. (a) 
2.26 	Effective October 1, 1992, each health maintenance organization with a certificate of 
2.27 	authority issued by the commissioner of health under chapter 62D and each community 
2.28 	integrated service network licensed by the commissioner under chapter 62N shall pay to 
2.29 	the commissioner of human services a surcharge equal to six-tenths of one percent of the 
2.30 	total premium revenues of the health maintenance organization or community integrated 
2.31 	service network as reported to the commissioner of health according to the schedule in 
2.32 	subdivision 4.
2.33 	(b) Effective October 1, 2010, in addition to the surcharge under paragraph (a), each 
2.34 	health maintenance organization shall pay to the commissioner a surcharge equal to 0.85 
3.1 	percent of total premium revenues and each county-based purchasing plan authorized 
3.2 	under section 256B.692 shall pay to the commissioner a surcharge equal to 1.45 percent 
3.3 	of the total premium revenues of the plan, as reported to the commissioner of health, 
3.4 	according to the payment schedule in subdivision 4. Notwithstanding section 256.9656, 
3.5 	money collected under this paragraph shall be deposited in the health care access fund 
3.6 	established in section 16A.724.
3.7 	(c) For purposes of this subdivision, total premium revenue means:
3.8 	(1) premium revenue recognized on a prepaid basis from individuals and groups 
3.9 	for provision of a specified range of health services over a defined period of time which 
3.10 	is normally one month, excluding premiums paid to a health maintenance organization 
3.11 	or community integrated service network from the Federal Employees Health Benefit 
3.12 	Program;
3.13 	(2) premiums from Medicare wrap-around subscribers for health benefits which 
3.14 	supplement Medicare coverage;
3.15 	(3) Medicare revenue, as a result of an arrangement between a health maintenance 
3.16 	organization or a community integrated service network and the Centers for Medicare 
3.17 	and Medicaid Services of the federal Department of Health and Human Services, for 
3.18 	services to a Medicare beneficiary, excluding Medicare revenue that states are prohibited 
3.19 	from taxing under sections 1854, 1860D-12, and 1876 of title XVIII of the federal Social 
3.20 	Security Act, codified as United States Code, title 42, sections 1395mm, 1395w-112, and 
3.21 	1395w-24, respectively, as they may be amended from time to time; and
3.22 	(4) medical assistance revenue, as a result of an arrangement between a health 
3.23 	maintenance organization or community integrated service network and a Medicaid state 
3.24 	agency, for services to a medical assistance beneficiary.
3.25 	If advance payments are made under clause (1) or (2) to the health maintenance 
3.26 	organization or community integrated service network for more than one reporting period, 
3.27 	the portion of the payment that has not yet been earned must be treated as a liability.
3.28 	(c) (d) When a health maintenance organization or community integrated service 
3.29 	network merges or consolidates with or is acquired by another health maintenance 
3.30 	organization or community integrated service network, the surviving corporation or the 
3.31 	new corporation shall be responsible for the annual surcharge originally imposed on 
3.32 	each of the entities or corporations subject to the merger, consolidation, or acquisition, 
3.33 	regardless of whether one of the entities or corporations does not retain a certificate of 
3.34 	authority under chapter 62D or a license under chapter 62N.
3.35 	(d) (e) Effective July 1 of each year, the surviving corporation's or the new 
3.36 	corporation's surcharge shall be based on the revenues earned in the second previous 
4.1 	calendar year by all of the entities or corporations subject to the merger, consolidation, 
4.2 	or acquisition regardless of whether one of the entities or corporations does not retain a 
4.3 	certificate of authority under chapter 62D or a license under chapter 62N until the total 
4.4 	premium revenues of the surviving corporation include the total premium revenues of all 
4.5 	the merged entities as reported to the commissioner of health.
4.6 	(e) (f) When a health maintenance organization or community integrated service 
4.7 	network, which is subject to liability for the surcharge under this chapter, transfers, 
4.8 	assigns, sells, leases, or disposes of all or substantially all of its property or assets, liability 
4.9 	for the surcharge imposed by this chapter is imposed on the transferee, assignee, or buyer 
4.10 	of the health maintenance organization or community integrated service network.
4.11 	(f) (g) In the event a health maintenance organization or community integrated 
4.12 	service network converts its licensure to a different type of entity subject to liability 
4.13 	for the surcharge under this chapter, but survives in the same or substantially similar 
4.14 	form, the surviving entity remains liable for the surcharge regardless of whether one of 
4.15 	the entities or corporations does not retain a certificate of authority under chapter 62D 
4.16 	or a license under chapter 62N.
4.17 	(g) (h) The surcharge assessed to a health maintenance organization or community 
4.18 	integrated service network ends when the entity ceases providing services for premiums 
4.19 	and the cessation is not connected with a merger, consolidation, acquisition, or conversion.

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

4.21 	Sec. 3. Minnesota Statutes 2009 Supplement, section 256.969, subdivision 2b, is 
4.22 	amended to read:
4.23 		Subd. 2b.Operating payment rates. In determining operating payment rates for 
4.24 	admissions occurring on or after the rate year beginning January 1, 1991, and every two 
4.25 	years after, or more frequently as determined by the commissioner, the commissioner shall 
4.26 	obtain operating data from an updated base year and establish operating payment rates 
4.27 	per admission for each hospital based on the cost-finding methods and allowable costs of 
4.28 	the Medicare program in effect during the base year. Rates under the general assistance 
4.29 	medical care, medical assistance, and MinnesotaCare programs shall not be rebased to 
4.30 	more current data on January 1, 1997, January 1, 2005, for the first 24 months of the 
4.31 	rebased period beginning January 1, 2009. For the first three 24  months of the rebased 
4.32 	period beginning January 1, 2011, rates shall  not be rebased at 74.25 percent of the full 
4.33 	value of the rebasing percentage change. From April 1, 2011, to March 31, 2012, rates 
4.34 	shall be rebased at 39.2 percent of the full value of the rebasing percentage change, except 
4.35 	that a Minnesota long-term hospital shall be rebased effective January 1, 2011, based on 
5.1 	its most recent Medicare cost report ending on or before September 1, 2008, with the 
5.2 	provisions under subdivisions 9 and 23, based on the rates in effect on December 31, 2010. 
5.3 	For subsequent rate setting periods in which the base years are updated, a Minnesota 
5.4 	long-term hospital's base year shall remain within the same period as other hospitals. 
5.5 	Effective April 1, 2012 January 1, 2013, rates shall be rebased at full value. The base year 
5.6 	operating payment rate per admission is standardized by the case mix index and adjusted 
5.7 	by the hospital cost index, relative values, and disproportionate population adjustment. 
5.8 	The cost and charge data used to establish operating rates shall only reflect inpatient 
5.9 	services covered by medical assistance and shall not include property cost information 
5.10 	and costs recognized in outlier payments.

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

5.12 	Sec. 4. Minnesota Statutes 2009 Supplement, section 256.969, subdivision 3a, is 
5.13 	amended to read:
5.14 		Subd. 3a.Payments. (a) Acute care hospital billings under the medical 
5.15 	assistance program must not be submitted until the recipient is discharged. However, 
5.16 	the commissioner shall establish monthly interim payments for inpatient hospitals that 
5.17 	have individual patient lengths of stay over 30 days regardless of diagnostic category. 
5.18 	Except as provided in section 256.9693, medical assistance reimbursement for treatment 
5.19 	of mental illness shall be reimbursed based on diagnostic classifications. Individual 
5.20 	hospital payments established under this section and sections 256.9685, 256.9686, and 
5.21 	256.9695, in addition to third party and recipient liability, for discharges occurring during 
5.22 	the rate year shall not exceed, in aggregate, the charges for the medical assistance covered 
5.23 	inpatient services paid for the same period of time to the hospital. This payment limitation 
5.24 	shall be calculated separately for medical assistance and general assistance medical 
5.25 	care services. The limitation on general assistance medical care shall be effective for 
5.26 	admissions occurring on or after July 1, 1991. Services that have rates established under 
5.27 	subdivision 11 or 12, must be limited separately from other services. After consulting with 
5.28 	the affected hospitals, the commissioner may consider related hospitals one entity and 
5.29 	may merge the payment rates while maintaining separate provider numbers. The operating 
5.30 	and property base rates per admission or per day shall be derived from the best Medicare 
5.31 	and claims data available when rates are established. The commissioner shall determine 
5.32 	the best Medicare and claims data, taking into consideration variables of recency of the 
5.33 	data, audit disposition, settlement status, and the ability to set rates in a timely manner. 
5.34 	The commissioner shall notify hospitals of payment rates by December 1 of the year 
5.35 	preceding the rate year. The rate setting data must reflect the admissions data used to 
6.1 	establish relative values. Base year changes from 1981 to the base year established for the 
6.2 	rate year beginning January 1, 1991, and for subsequent rate years, shall not be limited 
6.3 	to the limits ending June 30, 1987, on the maximum rate of increase under subdivision 
6.4 	1. The commissioner may adjust base year cost, relative value, and case mix index data 
6.5 	to exclude the costs of services that have been discontinued by the October 1 of the year 
6.6 	preceding the rate year or that are paid separately from inpatient services. Inpatient stays 
6.7 	that encompass portions of two or more rate years shall have payments established based 
6.8 	on payment rates in effect at the time of admission unless the date of admission preceded 
6.9 	the rate year in effect by six months or more. In this case, operating payment rates for 
6.10 	services rendered during the rate year in effect and established based on the date of 
6.11 	admission shall be adjusted to the rate year in effect by the hospital cost index.
6.12 	(b) For fee-for-service admissions occurring on or after July 1, 2002, the total 
6.13 	payment, before third-party liability and spenddown, made to hospitals for inpatient 
6.14 	services is reduced by .5 percent from the current statutory rates.
6.15 	(c) In addition to the reduction in paragraph (b), the total payment for fee-for-service 
6.16 	admissions occurring on or after July 1, 2003, made to hospitals for inpatient services 
6.17 	before third-party liability and spenddown, is reduced five percent from the current 
6.18 	statutory rates. Mental health services within diagnosis related groups 424 to 432, and 
6.19 	facilities defined under subdivision 16 are excluded from this paragraph.
6.20 	(d) In addition to the reduction in paragraphs (b) and (c), the total payment for 
6.21 	fee-for-service admissions occurring on or after August 1, 2005, made to hospitals for 
6.22 	inpatient services before third-party liability and spenddown, is reduced 6.0 percent 
6.23 	from the current statutory rates. Mental health services within diagnosis related groups 
6.24 	424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph. 
6.25 	Notwithstanding section 256.9686, subdivision 7, for purposes of this paragraph, medical 
6.26 	assistance does not include general assistance medical care. Payments made to managed 
6.27 	care plans shall be reduced for services provided on or after January 1, 2006, to reflect 
6.28 	this reduction.
6.29 	(e) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for 
6.30 	fee-for-service admissions occurring on or after July 1, 2008, through June 30, 2009, made 
6.31 	to hospitals for inpatient services before third-party liability and spenddown, is reduced 
6.32 	3.46 percent from the current statutory rates. Mental health services with diagnosis related 
6.33 	groups 424 to 432 and facilities defined under subdivision 16 are excluded from this 
6.34 	paragraph. Payments made to managed care plans shall be reduced for services provided 
6.35 	on or after January 1, 2009, through June 30, 2009, to reflect this reduction.
7.1 	(f) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for 
7.2 	fee-for-service admissions occurring on or after July 1, 2009, through June 30, 2010, made 
7.3 	to hospitals for inpatient services before third-party liability and spenddown, is reduced 
7.4 	1.9 percent from the current statutory rates. Mental health services with diagnosis related 
7.5 	groups 424 to 432 and facilities defined under subdivision 16 are excluded from this 
7.6 	paragraph. Payments made to managed care plans shall be reduced for services provided 
7.7 	on or after July 1, 2009, through June 30, 2010, to reflect this reduction.
7.8 	(g) In addition to the reductions in paragraphs (b), (c), and (d), the total payment 
7.9 	for fee-for-service admissions occurring on or after July 1, 2010, made to hospitals for 
7.10 	inpatient services before third-party liability and spenddown, is reduced 1.79 percent 
7.11 	from the current statutory rates. Mental health services with diagnosis related groups 
7.12 	424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph. 
7.13 	Payments made to managed care plans shall be reduced for services provided on or after 
7.14 	July 1, 2010, to reflect this reduction.
7.15 	(h) In addition to the reductions in paragraphs (b), (c), (d), (f), and (g), the total 
7.16 	payment for fee-for-service admissions occurring on or after July 1, 2009, made to 
7.17 	hospitals for inpatient services before third-party liability and spenddown, is reduced 
7.18 	one percent from the current statutory rates. Facilities defined under subdivision 16 are 
7.19 	excluded from this paragraph. Payments made to managed care plans shall be reduced for 
7.20 	services provided on or after October 1, 2009, to reflect this reduction.
7.21 	(i) In order to offset the ratable reductions provided for in this subdivision, the total 
7.22 	payment rate for medical assistance fee-for-service admissions occurring on or after July 
7.23 	1, 2010, to June 30, 2011, made to Minnesota hospitals for inpatient services before 
7.24 	third-party liability and spenddown, shall be increased by five percent from the current 
7.25 	statutory rates. Effective July 1, 2011, the rate increase under this paragraph shall be 
7.26 	reduced to 1.96 percent. For purposes of this paragraph, medical assistance does not 
7.27 	include general assistance medical care. The commissioner shall not adjust rates paid to a 
7.28 	prepaid health plan under contract with the commissioner to reflect payments provided 
7.29 	in this paragraph. The commissioner may utilize a settlement process to adjust rates in 
7.30 	excess of the Medicare upper limits on payments.

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

7.32 	Sec. 5. Minnesota Statutes 2008, section 256.969, subdivision 21, is amended to read:
7.33 		Subd. 21.Mental health or chemical dependency admissions; rates. (a) 
7.34 	Admissions under the general assistance medical care program occurring on or after 
7.35 	July 1, 1990, and admissions under medical assistance, excluding general assistance 
8.1 	medical care, occurring on or after July 1, 1990, and on or before September 30, 1992, 
8.2 	that are classified to a diagnostic category of mental health or chemical dependency 
8.3 	shall have rates established according to the methods of subdivision 14, except the per 
8.4 	day rate shall be multiplied by a factor of 2, provided that the total of the per day rates 
8.5 	shall not exceed the per admission rate. This methodology shall also apply when a hold 
8.6 	or commitment is ordered by the court for the days that inpatient hospital services are 
8.7 	medically necessary. Stays which are medically necessary for inpatient hospital services 
8.8 	and covered by medical assistance shall not be billable to any other governmental entity. 
8.9 	Medical necessity shall be determined under criteria established to meet the requirements 
8.10 	of section 256B.04, subdivision 15, or 256D.03, subdivision 7, paragraph (b). 
8.11 	(b) In order to ensure adequate access for the provision of mental health services 
8.12 	and to encourage broader delivery of these services outside the nonstate governmental 
8.13 	hospital setting, payment rates for medical assistance admissions occurring on or after 
8.14 	July 1, 2010, at a Minnesota private, not-for-profit hospital above the 75th percentile of all 
8.15 	Minnesota private, nonprofit hospitals for diagnosis-related groups 424 to 432 and 521 
8.16 	to 523 admissions paid by medical assistance for admissions occurring in calendar year 
8.17 	2007, shall be increased for these diagnosis-related groups at a percentage calculated to 
8.18 	cost not more than $10,000,000 each fiscal year, including state and federal shares. For 
8.19 	purposes of this paragraph, medical assistance does not include general assistance medical 
8.20 	care. The commissioner shall not adjust rates paid to a prepaid health plan under contract 
8.21 	with the commissioner to reflect payments provided in this paragraph. The commissioner 
8.22 	may utilize a settlement process to adjust rates in excess of the Medicare upper limits 
8.23 	on payments. 

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

8.25 	Sec. 6. Minnesota Statutes 2008, section 256.969, subdivision 26, is amended to read:
8.26 		Subd. 26.Greater Minnesota payment adjustment after June 30, 2001. (a) For 
8.27 	admissions occurring after June 30, 2001, the commissioner shall pay fee-for-service 
8.28 	inpatient admissions for the diagnosis-related groups specified in paragraph (b) at hospitals 
8.29 	located outside of the seven-county metropolitan area at the higher of:
8.30 	(1) the hospital's current payment rate for the diagnostic category to which the 
8.31 	diagnosis-related group belongs, exclusive of disproportionate population adjustments 
8.32 	received under subdivision 9 and hospital payment adjustments received under subdivision 
8.33 	23; or
8.34 	(2) 90 percent of the average payment rate for that diagnostic category for hospitals 
8.35 	located within the seven-county metropolitan area, exclusive of disproportionate 
9.1 	population adjustments received under subdivision 9 and hospital payment adjustments 
9.2 	received under subdivisions 20 and 23.
9.3 	(b) The payment increases provided in paragraph (a) apply to the following 
9.4 	diagnosis-related groups, as they fall within the diagnostic categories:
9.5 	(1) 370 cesarean section with complicating diagnosis;
9.6 	(2) 371 cesarean section without complicating diagnosis;
9.7 	(3) 372 vaginal delivery with complicating diagnosis;
9.8 	(4) 373 vaginal delivery without complicating diagnosis;
9.9 	(5) 386 extreme immaturity and respiratory distress syndrome, neonate;
9.10 	(6) 388 full-term neonates with other problems;
9.11 	(7) 390 prematurity without major problems;
9.12 	(8) 391 normal newborn;
9.13 	(9) 385 neonate, died or transferred to another acute care facility;
9.14 	(10) 425 acute adjustment reaction and psychosocial dysfunction;
9.15 	(11) 430 psychoses;
9.16 	(12) 431 childhood mental disorders; and
9.17 	(13) 164-167 appendectomy.
9.18 	(c) For medical assistance admissions occurring on or after July 1, 2010, the 
9.19 	payment rate under paragraph (a), clause (2), shall be increased to 100 percent from 90 
9.20 	percent. For purposes of this paragraph, medical assistance does not include general 
9.21 	assistance medical care. The commissioner shall not adjust rates paid to a prepaid 
9.22 	health plan under contract with the commissioner to reflect payments provided in this 
9.23 	paragraph. The commissioner may utilize a settlement process to adjust rates in excess of 
9.24 	the Medicare upper limits on payments. 

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

9.26 	Sec. 7. Minnesota Statutes 2008, section 256.969, is amended by adding a subdivision 
9.27 	to read:
9.28 		Subd. 31.Hospital payment adjustment after June 30, 2010. (a) For medical 
9.29 	assistance admissions occurring on or after July 1, 2010, to March 31, 2011, the 
9.30 	commissioner shall increase rates at Minnesota private, not-for-profit hospitals as follows:
9.31 	(1) for a hospital with total admissions reimbursed by government payers equal to or 
9.32 	greater than 50 percent, payment rates for inpatient hospital services shall be increased for 
9.33 	each admission by $250 multiplied by 437 percent;
10.1 	(2) for a hospital with total admissions reimbursed by government payers equal to 
10.2 	or greater than 40 percent but less than 50 percent, payment rates for inpatient hospital 
10.3 	services shall be increased for each admission by $250 multiplied by 349.6 percent; and
10.4 	(3) for a hospital with total admissions reimbursed by government payers of less 
10.5 	than 40 percent, payment rates for inpatient hospital services shall be increased for each 
10.6 	admission by $250 multiplied by 262.2 percent.
10.7 	(b) For medical assistance admissions occurring on or after April 1, 2011, the 
10.8 	commissioner shall increase rates at Minnesota private, not-for-profit hospitals as follows:
10.9 	(1) for a hospital with total admissions reimbursed by government payers equal to or 
10.10 	greater than 50 percent, payment rates for inpatient hospital services shall be increased for 
10.11 	each admission by $250 multiplied by 145 percent;
10.12 	(2) for a hospital with total admissions reimbursed by government payers equal to 
10.13 	or greater than 40 percent but less than 50 percent, payment rates for inpatient hospital 
10.14 	services shall be increased for each admission by $250 multiplied by 116 percent; and
10.15 	(3) for a hospital with total admissions reimbursed by government payers of less 
10.16 	than 40 percent, payment rates for inpatient hospital services shall be increased for each 
10.17 	admission by $250 multiplied by 87 percent.
10.18 	(c) For purposes of paragraphs (a) and (b), "government payers" means Medicare, 
10.19 	medical assistance, MinnesotaCare, and general assistance medical care.
10.20 	(d) For medical assistance admissions occurring on or after July 1, 2010, to March 
10.21 	31, 2011, the commissioner shall increase rates for inpatient hospital services at Minnesota 
10.22 	hospitals by $850 for each admission. For medical assistance admissions occurring on 
10.23 	or after April 1, 2011, the payment under this paragraph shall be reduced to $320 per 
10.24 	admission.
10.25 	(e) For purposes of this subdivision, medical assistance does not include general 
10.26 	assistance medical care. The commissioner shall not adjust rates paid to a prepaid 
10.27 	health plan under contract with the commissioner to reflect payments provided in this 
10.28 	subdivision. The commissioner may utilize a settlement process to adjust rates in excess 
10.29 	of the Medicare upper limits on payments.

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

10.31 	Sec. 8. Minnesota Statutes 2008, section 256B.055, is amended by adding a 
10.32 	subdivision to read:
10.33 		Subd. 15.Adults without children. Medical assistance may be paid for a person 
10.34 	who is:
10.35 	(1) at least age 21 and under age 65;
11.1 	(2) not pregnant;
11.2 	(3) not entitled to Medicare Part A or enrolled in Medicare Part B under Title XVIII 
11.3 	of the Social Security Act;
11.4 	(4) not an adult in a family with children as defined in section 256L.01, subdivision 
11.5 	3a; and
11.6 	(5) not described in another subdivision of this section.

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

11.8 	Sec. 9. Minnesota Statutes 2008, section 256B.056, subdivision 3, is amended to read:
11.9 		Subd. 3.Asset limitations for individuals and families. (a) To be eligible for 
11.10 	medical assistance, a person must not individually own more than $3,000 in assets, or if a 
11.11 	member of a household with two family members, husband and wife, or parent and child, 
11.12 	the household must not own more than $6,000 in assets, plus $200 for each additional 
11.13 	legal dependent. In addition to these maximum amounts, an eligible individual or family 
11.14 	may accrue interest on these amounts, but they must be reduced to the maximum at the 
11.15 	time of an eligibility redetermination. The accumulation of the clothing and personal 
11.16 	needs allowance according to section 256B.35 must also be reduced to the maximum at 
11.17 	the time of the eligibility redetermination. The value of assets that are not considered in 
11.18 	determining eligibility for medical assistance is the value of those assets excluded under 
11.19 	the supplemental security income program for aged, blind, and disabled persons, with 
11.20 	the following exceptions: 
11.21 	(1) household goods and personal effects are not considered;
11.22 	(2) capital and operating assets of a trade or business that the local agency determines 
11.23 	are necessary to the person's ability to earn an income are not considered;
11.24 	(3) motor vehicles are excluded to the same extent excluded by the supplemental 
11.25 	security income program;
11.26 	(4) assets designated as burial expenses are excluded to the same extent excluded by 
11.27 	the supplemental security income program. Burial expenses funded by annuity contracts 
11.28 	or life insurance policies must irrevocably designate the individual's estate as contingent 
11.29 	beneficiary to the extent proceeds are not used for payment of selected burial expenses; and
11.30 	(5) effective upon federal approval, for a person who no longer qualifies as an 
11.31 	employed person with a disability due to loss of earnings, assets allowed while eligible 
11.32 	for medical assistance under section 256B.057, subdivision 9, are not considered for 12 
11.33 	months, beginning with the first month of ineligibility as an employed person with a 
11.34 	disability, to the extent that the person's total assets remain within the allowed limits of 
11.35 	section 256B.057, subdivision 9, paragraph (c).
12.1 	(b) No asset limit shall apply to persons eligible under section 256B.055, subdivision 
12.2 	15.

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

12.4 	Sec. 10. Minnesota Statutes 2008, section 256B.056, subdivision 4, is amended to read:
12.5 		Subd. 4.Income. (a) To be eligible for medical assistance, a person eligible under 
12.6 	section 256B.055, subdivisions 7, 7a, and 12, may have income up to 100 percent of 
12.7 	the federal poverty guidelines. Effective January 1, 2000, and each successive January, 
12.8 	recipients of supplemental security income may have an income up to the supplemental 
12.9 	security income standard in effect on that date. 
12.10 	(b) To be eligible for medical assistance, families and children may have an income 
12.11 	up to 133-1/3 percent of the AFDC income standard in effect under the July 16, 1996, 
12.12 	AFDC state plan. Effective July 1, 2000, the base AFDC standard in effect on July 16, 
12.13 	1996, shall be increased by three percent.
12.14 	(c) Effective July 1, 2002, to be eligible for medical assistance, families and children 
12.15 	may have an income up to 100 percent of the federal poverty guidelines for the family size.
12.16 	(d) Effective June 1, 2010, to be eligible for medical assistance under section 
12.17 	256B.055, subdivision 15, a person may have an income up to 75 percent of federal 
12.18 	poverty guidelines for the family size.
12.19 	(e) In computing income to determine eligibility of persons under paragraphs (a) to 
12.20 	(c)(d) who are not residents of long-term care facilities, the commissioner shall disregard 
12.21 	increases in income as required by Public Law Numbers 94-566, section 503; 99-272; 
12.22 	and 99-509. Veterans aid and attendance benefits and Veterans Administration unusual 
12.23 	medical expense payments are considered income to the recipient.

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

12.25 	Sec. 11. Minnesota Statutes 2008, section 256B.0625, subdivision 8, is amended to 
12.26 	read:
12.27 		Subd. 8.Physical therapy. Medical assistance covers physical therapy and related 
12.28 	services, including specialized maintenance therapy. Authorization by the commissioner 
12.29 	is required to provide medically necessary services to a recipient beyond any of the 
12.30 	following onetime service thresholds, or a lower threshold where one has been established 
12.31 	by the commissioner for a specified service: (1) 80 units of any approved CPT code other 
12.32 	than modalities; (2) 20 modality sessions; and (3) three evaluations or reevaluations. 
12.33 	Services provided by a physical therapy assistant shall be reimbursed at the same rate as 
13.1 	services performed by a physical therapist when the services of the physical therapy 
13.2 	assistant are provided under the direction of a physical therapist who is on the premises. 
13.3 	Services provided by a physical therapy assistant that are provided under the direction 
13.4 	of a physical therapist who is not on the premises shall be reimbursed at 65 percent of 
13.5 	the physical therapist rate.

13.6 	EFFECTIVE DATE. This section is effective July 1, 2010, for services provided 
13.7 	through fee-for-service, and January 1, 2011, for services provided through managed care.

13.8 	Sec. 12. Minnesota Statutes 2008, section 256B.0625, subdivision 8a, is amended to 
13.9 	read:
13.10 		Subd. 8a.Occupational therapy. Medical assistance covers occupational therapy 
13.11 	and related services, including specialized maintenance therapy. Authorization by the 
13.12 	commissioner is required to provide medically necessary services to a recipient beyond 
13.13 	any of the following onetime service thresholds, or a lower threshold where one has been 
13.14 	established by the commissioner for a specified service: (1) 120 units of any combination 
13.15 	of approved CPT codes; and (2) two evaluations or reevaluations. Services provided by an 
13.16 	occupational therapy assistant shall be reimbursed at the same rate as services performed 
13.17 	by an occupational therapist when the services of the occupational therapy assistant are 
13.18 	provided under the direction of the occupational therapist who is on the premises. Services 
13.19 	provided by an occupational therapy assistant that are provided under the direction of an 
13.20 	occupational therapist who is not on the premises shall be reimbursed at 65 percent of 
13.21 	the occupational therapist rate.

13.22 	EFFECTIVE DATE. This section is effective July 1, 2010, for services provided 
13.23 	through fee-for-service, and January 1, 2011, for services provided through managed care.

13.24 	Sec. 13. Minnesota Statutes 2008, section 256B.0625, subdivision 8b, is amended to 
13.25 	read:
13.26 		Subd. 8b.Speech language pathology and audiology services. Medical assistance 
13.27 	covers speech language pathology and related services, including specialized maintenance 
13.28 	therapy. Authorization by the commissioner is required to provide medically necessary 
13.29 	services to a recipient beyond any of the following onetime service thresholds, or a 
13.30 	lower threshold where one has been established by the commissioner for a specified 
13.31 	service: (1) 50 treatment sessions with any combination of approved CPT codes; and 
13.32 	(2) one evaluation. Medical assistance covers audiology services and related services. 
13.33 	Services provided by a person who has been issued a temporary registration under section 
14.1 	148.5161 shall be reimbursed at the same rate as services performed by a speech language 
14.2 	pathologist or audiologist as long as the requirements of section 148.5161, subdivision 
14.3 	3, are met. 

14.4 	EFFECTIVE DATE. This section is effective July 1, 2010, for services provided 
14.5 	through fee-for-service, and January 1, 2011, for services provided through managed care.

14.6 	Sec. 14. Minnesota Statutes 2008, section 256B.0625, is amended by adding a 
14.7 	subdivision to read:
14.8 		Subd. 8d.Chiropractic services. Payment for chiropractic services is limited to 
14.9 	one annual evaluation and 12 visits per year unless prior authorization of a greater number 
14.10 	of visits is obtained.

14.11 	Sec. 15. Minnesota Statutes 2009 Supplement, section 256B.0625, subdivision 13h, 
14.12 	is amended to read:
14.13 		Subd. 13h.Medication therapy management services. (a) Medical assistance 
14.14 	and general assistance medical care cover medication therapy management services for 
14.15 	a recipient taking four or more prescriptions to treat or prevent two or more chronic 
14.16 	medical conditions, or a recipient with a drug therapy problem that is identified or prior 
14.17 	authorized by the commissioner that has resulted or is likely to result in significant 
14.18 	nondrug program costs. The commissioner may cover medical therapy management 
14.19 	services under MinnesotaCare if the commissioner determines this is cost-effective. For 
14.20 	purposes of this subdivision, "medication therapy management" means the provision 
14.21 	of the following pharmaceutical care services by a licensed pharmacist to optimize the 
14.22 	therapeutic outcomes of the patient's medications:
14.23 	(1) performing or obtaining necessary assessments of the patient's health status;
14.24 	(2) formulating a medication treatment plan;
14.25 	(3) monitoring and evaluating the patient's response to therapy, including safety 
14.26 	and effectiveness;
14.27 	(4) performing a comprehensive medication review to identify, resolve, and prevent 
14.28 	medication-related problems, including adverse drug events;
14.29 	(5) documenting the care delivered and communicating essential information to 
14.30 	the patient's other primary care providers;
14.31 	(6) providing verbal education and training designed to enhance patient 
14.32 	understanding and appropriate use of the patient's medications;
14.33 	(7) providing information, support services, and resources designed to enhance 
14.34 	patient adherence with the patient's therapeutic regimens; and
15.1 	(8) coordinating and integrating medication therapy management services within the 
15.2 	broader health care management services being provided to the patient.
15.3 	Nothing in this subdivision shall be construed to expand or modify the scope of practice of 
15.4 	the pharmacist as defined in section 151.01, subdivision 27.
15.5 	(b) To be eligible for reimbursement for services under this subdivision, a pharmacist 
15.6 	must meet the following requirements:
15.7 	(1) have a valid license issued under chapter 151;
15.8 	(2) have graduated from an accredited college of pharmacy on or after May 1996, or 
15.9 	completed a structured and comprehensive education program approved by the Board of 
15.10 	Pharmacy and the American Council of Pharmaceutical Education for the provision and 
15.11 	documentation of pharmaceutical care management services that has both clinical and 
15.12 	didactic elements;
15.13 	(3) be practicing in an ambulatory care setting as part of a multidisciplinary team or 
15.14 	have developed a structured patient care process that is offered in a private or semiprivate 
15.15 	patient care area that is separate from the commercial business that also occurs in the 
15.16 	setting, or in home settings, excluding long-term care and group homes, if the service is 
15.17 	ordered by the provider-directed care coordination team; and
15.18 	(4) make use of an electronic patient record system that meets state standards.
15.19 	(c) For purposes of reimbursement for medication therapy management services, 
15.20 	the commissioner may enroll individual pharmacists as medical assistance and general 
15.21 	assistance medical care providers. The commissioner may also establish contact 
15.22 	requirements between the pharmacist and recipient, including limiting the number of 
15.23 	reimbursable consultations per recipient.
15.24 	(d) If there are no pharmacists who meet the requirements of paragraph (b) practicing 
15.25 	within a reasonable geographic distance of the patient, a pharmacist who meets the 
15.26 	requirements may provide the services via two-way interactive video. Reimbursement 
15.27 	shall be at the same rates and under the same conditions that would otherwise apply to 
15.28 	the services provided. To qualify for reimbursement under this paragraph, the pharmacist 
15.29 	providing the services must meet the requirements of paragraph (b), and must be located 
15.30 	within an ambulatory care setting approved by the commissioner. The patient must also 
15.31 	be located within an ambulatory care setting approved by the commissioner. Services 
15.32 	provided under this paragraph may not be transmitted into the patient's residence.
15.33 	(e) The commissioner shall establish a pilot project for an intensive medication 
15.34 	therapy management program for patients identified by the commissioner with multiple 
15.35 	chronic conditions and a high number of medications who are at high risk of preventable 
15.36 	hospitalizations, emergency room use, medication complications, and suboptimal 
16.1 	treatment outcomes due to medication-related problems. For purposes of the pilot 
16.2 	project, medication therapy management services may be provided in a patient's home 
16.3 	or community setting, in addition to other authorized settings. The commissioner may 
16.4 	waive existing payment policies and establish special payment rates for the pilot project. 
16.5 	The pilot project must be designed to produce a net savings to the state compared to the 
16.6 	estimated costs that would otherwise be incurred for similar patients without the program. 
16.7 	The pilot project must begin by January 1, 2010, and end June 30, 2012.

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

16.9 	Sec. 16. Minnesota Statutes 2008, section 256B.0625, subdivision 18a, is amended to 
16.10 	read:
16.11 		Subd. 18a.Access to medical services. (a) Medical assistance reimbursement for 
16.12 	meals for persons traveling to receive medical care may not exceed $5.50 for breakfast, 
16.13 	$6.50 for lunch, or $8 for dinner.
16.14 	(b) Medical assistance reimbursement for lodging for persons traveling to receive 
16.15 	medical care may not exceed $50 per day unless prior authorized by the local agency.
16.16 	(c) Medical assistance direct mileage reimbursement to the eligible person or the 
16.17 	eligible person's driver may not exceed 20 cents per mile.
16.18 	(d) Regardless of the number of employees that an enrolled health care provider 
16.19 	may have, medical assistance covers sign and oral language interpreter services when 
16.20 	provided by an enrolled health care provider during the course of providing a direct, 
16.21 	person-to-person covered health care service to an enrolled recipient with limited English 
16.22 	proficiency or who has a hearing loss and uses interpreting services. Coverage for 
16.23 	face-to-face oral language interpreter services shall be provided only if the oral language 
16.24 	interpreter used by the enrolled health care provider is listed in the registry or roster 
16.25 	established under section 144.058.

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

16.27 	Sec. 17. Minnesota Statutes 2008, section 256B.0625, subdivision 31, is amended to 
16.28 	read:
16.29 		Subd. 31.Medical supplies and equipment. Medical assistance covers medical 
16.30 	supplies and equipment. Separate payment outside of the facility's payment rate shall 
16.31 	be made for wheelchairs and wheelchair accessories for recipients who are residents 
16.32 	of intermediate care facilities for the developmentally disabled. Reimbursement for 
16.33 	wheelchairs and wheelchair accessories for ICF/MR recipients shall be subject to the same 
17.1 	conditions and limitations as coverage for recipients who do not reside in institutions. A 
17.2 	wheelchair purchased outside of the facility's payment rate is the property of the recipient.
17.3 	The commissioner may set reimbursement rates for specified categories of medical 
17.4 	supplies at levels below the Medicare payment rate.

17.5 	Sec. 18. Minnesota Statutes 2008, section 256B.0625, is amended by adding a 
17.6 	subdivision to read:
17.7 		Subd. 54.Services provided in birth centers. (a) Medical assistance covers 
17.8 	services provided in a licensed birth center by a licensed health professional if the service 
17.9 	would otherwise be covered if provided in a hospital.
17.10 	(b) Facility services provided by a birth center shall be paid at the lower of billed 
17.11 	charges or 70 percent of the statewide average for a facility payment rate made to a 
17.12 	hospital for an uncomplicated vaginal birth as determined using the most recent calendar 
17.13 	year for which complete claims data is available. If a recipient is transported from a birth 
17.14 	center to a hospital prior to the delivery, the payment for facility services to the birth center 
17.15 	shall be the lower of billed charges or 15 percent of the average facility payment made to a 
17.16 	hospital for the services provided for an uncomplicated vaginal delivery as determined 
17.17 	using the most recent calendar year for which complete claims data is available.
17.18 	(c) Nursery care services provided by a birth center shall be paid the lower of billed 
17.19 	charges or 70 percent of the statewide average for a payment rate paid to a hospital for 
17.20 	nursery care as determined by using the most recent calendar year for which complete 
17.21 	claims data is available.
17.22 	(d) Professional services provided by traditional midwives licensed under chapter 
17.23 	147D shall be paid at the lower of billed charges or 100 percent of the rate paid to a 
17.24 	physician performing the same services. If a recipient is transported from a birth center to 
17.25 	a hospital prior to the delivery, a licensed traditional midwife who does not perform the 
17.26 	delivery may not bill for any delivery services. Services are not covered if provided by an 
17.27 	unlicensed traditional midwife.
17.28 	(e) The commissioner shall apply for any necessary waivers from the Centers for 
17.29 	Medicare and Medicaid Services to allow birth centers and birth center providers to be 
17.30 	reimbursed.

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

17.32 	Sec. 19. Minnesota Statutes 2008, section 256B.0631, subdivision 1, is amended to 
17.33 	read:
18.1 		Subdivision 1.Co-payments. (a) Except as provided in subdivision 2, the medical 
18.2 	assistance benefit plan shall include the following co-payments for all recipients, effective 
18.3 	for services provided on or after October 1, 2003, and before January 1, 2009:
18.4 	(1) $3 per nonpreventive visit. For purposes of this subdivision, a visit means an 
18.5 	episode of service which is required because of a recipient's symptoms, diagnosis, or 
18.6 	established illness, and which is delivered in an ambulatory setting by a physician or 
18.7 	physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse, 
18.8 	audiologist, optician, or optometrist;
18.9 	(2) $3 for eyeglasses;
18.10 	(3) $6 for nonemergency visits to a hospital-based emergency room; and
18.11 	(4) $3 per brand-name drug prescription and $1 per generic drug prescription, 
18.12 	subject to a $12 per month maximum for prescription drug co-payments. No co-payments 
18.13 	shall apply to antipsychotic drugs when used for the treatment of mental illness.
18.14 	(b) Except as provided in subdivision 2, the medical assistance benefit plan shall 
18.15 	include the following co-payments for all recipients, effective for services provided on 
18.16 	or after January 1, 2009:
18.17 	(1) $6 $3.50 for nonemergency visits to a hospital-based emergency room; 
18.18 	(2) $3 per brand-name drug prescription and $1 per generic drug prescription, 
18.19 	subject to a $7 per month maximum for prescription drug co-payments. No co-payments 
18.20 	shall apply to antipsychotic drugs when used for the treatment of mental illness; and
18.21 	(3) for individuals identified by the commissioner with income at or below 100 
18.22 	percent of the federal poverty guidelines, total monthly co-payments must not exceed five 
18.23 	percent of family income. For purposes of this paragraph, family income is the total 
18.24 	earned and unearned income of the individual and the individual's spouse, if the spouse is 
18.25 	enrolled in medical assistance and also subject to the five percent limit on co-payments.
18.26 	(c) Recipients of medical assistance are responsible for all co-payments in this 
18.27 	subdivision.

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

18.29 	Sec. 20. Minnesota Statutes 2008, section 256B.0631, subdivision 3, is amended to 
18.30 	read:
18.31 		Subd. 3.Collection. (a) The medical assistance reimbursement to the provider 
18.32 	shall be reduced by the amount of the co-payment, except that reimbursements shall 
18.33 	not be reduced:
18.34 	(1) once a recipient has reached the $12 per month maximum or the $7 per month 
18.35 	maximum effective January 1, 2009, for prescription drug co-payments; or
19.1 	(2) for a recipient identified by the commissioner under 100 percent of the federal 
19.2 	poverty guidelines who has met their monthly five percent co-payment limit.
19.3 	(b) The provider collects the co-payment from the recipient. Providers may not deny 
19.4 	services to recipients who are unable to pay the co-payment.
19.5 	(c) Medical assistance reimbursement to fee-for-service providers and payments to 
19.6 	managed care plans shall not be increased as a result of the removal of the co-payments 
19.7 	effective on or after January 1, 2009.

19.8 	Sec. 21. Minnesota Statutes 2008, section 256B.0644, as amended by Laws 2010, 
19.9 	chapter 200, article 1, section 6, is amended to read:
19.10 	256B.0644 REIMBURSEMENT UNDER OTHER STATE HEALTH CARE 
19.11 	PROGRAMS.
19.12 	(a) A vendor of medical care, as defined in section 256B.02, subdivision 7, and a 
19.13 	health maintenance organization, as defined in chapter 62D, must participate as a provider 
19.14 	or contractor in the medical assistance program, general assistance medical care program, 
19.15 	and MinnesotaCare as a condition of participating as a provider in health insurance plans 
19.16 	and programs or contractor for state employees established under section 43A.18, the 
19.17 	public employees insurance program under section 43A.316, for health insurance plans 
19.18 	offered to local statutory or home rule charter city, county, and school district employees, 
19.19 	the workers' compensation system under section 176.135, and insurance plans provided 
19.20 	through the Minnesota Comprehensive Health Association under sections 62E.01 to 
19.21 	62E.19. The limitations on insurance plans offered to local government employees shall 
19.22 	not be applicable in geographic areas where provider participation is limited by managed 
19.23 	care contracts with the Department of Human Services.
19.24 	(b) For providers other than health maintenance organizations, participation in the 
19.25 	medical assistance program means that:
19.26 	 (1) the provider accepts new medical assistance, general assistance medical care, 
19.27 	and MinnesotaCare patients;
19.28 	(2) for providers other than dental service providers, at least 20 percent of the 
19.29 	provider's patients are covered by medical assistance, general assistance medical care, 
19.30 	and MinnesotaCare as their primary source of coverage; or
19.31 	(3) for dental service providers, at least ten percent of the provider's patients are 
19.32 	covered by medical assistance, general assistance medical care, and MinnesotaCare as 
19.33 	their primary source of coverage, or the provider accepts new medical assistance and 
19.34 	MinnesotaCare patients who are children with special health care needs. For purposes 
19.35 	of this section, "children with special health care needs" means children up to age 18 
20.1 	who: (i) require health and related services beyond that required by children generally; 
20.2 	and (ii) have or are at risk for a chronic physical, developmental, behavioral, or emotional 
20.3 	condition, including: bleeding and coagulation disorders; immunodeficiency disorders; 
20.4 	cancer; endocrinopathy; developmental disabilities; epilepsy, cerebral palsy, and other 
20.5 	neurological diseases; visual impairment or deafness; Down syndrome and other genetic 
20.6 	disorders; autism; fetal alcohol syndrome; and other conditions designated by the 
20.7 	commissioner after consultation with representatives of pediatric dental providers and 
20.8 	consumers.
20.9 	(c) Patients seen on a volunteer basis by the provider at a location other than 
20.10 	the provider's usual place of practice may be considered in meeting the participation 
20.11 	requirement in this section. The commissioner shall establish participation requirements 
20.12 	for health maintenance organizations. The commissioner shall provide lists of participating 
20.13 	medical assistance providers on a quarterly basis to the commissioner of management and 
20.14 	budget, the commissioner of labor and industry, and the commissioner of commerce. Each 
20.15 	of the commissioners shall develop and implement procedures to exclude as participating 
20.16 	providers in the program or programs under their jurisdiction those providers who do 
20.17 	not participate in the medical assistance program. The commissioner of management 
20.18 	and budget shall implement this section through contracts with participating health and 
20.19 	dental carriers.
20.20 	(d) Any hospital or other provider that is participating in a coordinated care 
20.21 	delivery system under section 256D.031, subdivision 6, or receives payments from the 
20.22 	uncompensated care pool under section 256D.031, subdivision 8, shall not refuse to 
20.23 	provide services to any patient enrolled in general assistance medical care regardless of 
20.24 	the availability or the amount of payment.
20.25 	(e) For purposes of paragraphs (a) and (b), participation in the general assistance 
20.26 	medical care program applies only to pharmacy providers.

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

20.28 	Sec. 22. Minnesota Statutes 2009 Supplement, section 256B.0653, subdivision 5, 
20.29 	is amended to read:
20.30 		Subd. 5.Home care therapies. (a) Home care therapies include the following: 
20.31 	physical therapy, occupational therapy, respiratory therapy, and speech and language 
20.32 	pathology therapy services.
20.33 	(b) Home care therapies must be:
20.34 	(1) provided in the recipient's residence after it has been determined the recipient is 
20.35 	unable to access outpatient therapy;
21.1 	(2) prescribed, ordered, or referred by a physician and documented in a plan of care 
21.2 	and reviewed, according to Minnesota Rules, part 9505.0390;
21.3 	(3) assessed by an appropriate therapist; and
21.4 	(4) provided by a Medicare-certified home health agency enrolled as a Medicaid 
21.5 	provider agency.
21.6 	(c) Restorative and specialized maintenance therapies must be provided according to 
21.7 	Minnesota Rules, part 9505.0390. Physical and occupational therapy assistants may be 
21.8 	used as allowed under Minnesota Rules, part 9505.0390, subpart 1, item B.
21.9 	(d) For both physical and occupational therapies, the therapist and the therapist's 
21.10 	assistant may not both bill for services provided to a recipient on the same day.

21.11 	Sec. 23. [256B.0755] HEALTH CARE DELIVERY SYSTEMS 
21.12 	DEMONSTRATION PROJECT.
21.13 		Subdivision 1.Implementation. (a) The commissioner shall develop and 
21.14 	authorize a demonstration project to test alternative and innovative health care delivery 
21.15 	systems, including accountable care organizations that provide services to a specified 
21.16 	patient population for an agreed upon total cost of care or risk-gain sharing payment 
21.17 	arrangement. The commissioner shall develop a request for proposals for participation in 
21.18 	the demonstration project in consultation with hospitals, primary care providers, health 
21.19 	plans, and other key stakeholders.
21.20 	(b) In developing the request for proposals, the commissioner shall:
21.21 	(1) establish uniform statewide methods of forecasting utilization and cost of care 
21.22 	for the appropriate Minnesota public program populations, to be used by the commissioner 
21.23 	for the health care delivery system projects;
21.24 	(2) identify key indicators of quality, access, patient satisfaction, and other 
21.25 	performance indicators that will be measured, in addition to indicators for measuring 
21.26 	cost savings;
21.27 	(3) allow maximum flexibility to encourage innovation and variation so that a variety 
21.28 	of provider collaborations are able to become health care delivery systems;
21.29 	(4) encourage and authorize different levels and types of financial risk;
21.30 	(5) encourage and authorize projects representing a wide variety of geographic 
21.31 	locations, patient populations, provider relationships, and care coordination models;
21.32 	(6) encourage projects that involve close partnerships between the health care 
21.33 	delivery system and counties and nonprofit agencies that provide services to patients 
21.34 	enrolled with the health care delivery system, including social services, public health, 
21.35 	mental health, community-based services, and continuing care;
22.1 	(7) encourage projects established by community hospitals, clinics, and other 
22.2 	providers in rural communities;
22.3 	(8) identify required covered services for a total cost of care model or services 
22.4 	considered in whole or partially in an analysis of utilization for a risk/gain sharing model;
22.5 	(9) establish a mechanism to monitor enrollment;
22.6 	(10) establish quality standards for the delivery system demonstrations; and
22.7 	(11) encourage participation of privately insured population so as to create sufficient 
22.8 	alignment in demonstration systems.
22.9 	(c) To be eligible to participate in the demonstration project, a health care delivery 
22.10 	system must:
22.11 	(1) provide required covered services and care coordination to recipients enrolled in 
22.12 	the health care delivery system;
22.13 	(2) establish a process to monitor enrollment and ensure the quality of care provided;
22.14 	(3) in cooperation with counties and community social service agencies, coordinate 
22.15 	the delivery of health care services with existing social services programs;
22.16 	(4) provide a system for advocacy and consumer protection; and
22.17 	(5) adopt innovative and cost-effective methods of care delivery and coordination, 
22.18 	which may include the use of allied health professionals, telemedicine, patient educators, 
22.19 	care coordinators, and community health workers.
22.20 	(d) A health care delivery system demonstration may be formed by the following 
22.21 	groups of providers of services and suppliers if they have established a mechanism for 
22.22 	shared governance:
22.23 	(1) professionals in group practice arrangements;
22.24 	(2) networks of individual practices of professionals;
22.25 	(3) partnerships or joint venture arrangements between hospitals and ACO 
22.26 	professionals;
22.27 	(4) hospitals employing professionals; and
22.28 	(5) other groups of providers of services and suppliers as the commissioner 
22.29 	determines appropriate.
22.30 	A managed care plan or county-based purchasing plan may participate in this 
22.31 	demonstration in collaboration with one or more of the entities listed in clauses (1) to (5).
22.32 	A health care delivery system may contract with a managed care plan or a 
22.33 	county-based purchasing plan to provide administrative services, including the 
22.34 	administration of a payment system using the payment methods established by the 
22.35 	commissioner for health care delivery systems.
23.1 	(e) The commissioner may require a health care delivery system to enter into 
23.2 	additional third-party contractual relationships for the assessment of risk and purchase of 
23.3 	stop loss insurance or another form of insurance risk management related to the delivery 
23.4 	of care described in paragraph (c).
23.5 		Subd. 2.Enrollment. (a) Individuals eligible for medical assistance or 
23.6 	MinnesotaCare shall be eligible for enrollment in a health care delivery system.
23.7 	(b) Eligible applicants and recipients may enroll in a health care delivery system if 
23.8 	a system serves the county in which the applicant or recipient resides. If more than one 
23.9 	health care delivery system serves a county, the applicant or recipient shall be allowed 
23.10 	to choose among the delivery systems. The commissioner may assign an applicant or 
23.11 	recipient to a health care delivery system if a health care delivery system is available and 
23.12 	no choice has been made by the applicant or recipient.
23.13 		Subd. 3.Accountability. (a) Health care delivery systems must accept responsibility 
23.14 	for the quality of care based on standards established under subdivision 1, paragraph (b), 
23.15 	clause (10), and the cost of care or utilization of services provided to its enrollees under 
23.16 	subdivision 1, paragraph (b), clause (1).
23.17 	(b) A health care delivery system may contract and coordinate with providers and 
23.18 	clinics for the delivery of services and shall contract with community health clinics, 
23.19 	federally qualified health centers, and rural clinics to the extent practicable.
23.20 		Subd. 4.Payment system. (a) In developing a payment system for health care 
23.21 	delivery systems, the commissioner shall establish a total cost of care benchmark or a 
23.22 	risk/gain sharing payment model to be paid for services provided to the recipients enrolled 
23.23 	in a health care delivery system.
23.24 	(b) The payment system may include incentive payments to health care delivery 
23.25 	systems that meet or exceed annual quality and performance targets realized through 
23.26 	the coordination of care.
23.27 	(c) An amount equal to the savings realized to the general fund as a result of the 
23.28 	demonstration project shall be transferred each fiscal year to the health care access fund.
23.29 		Subd. 5.Outpatient prescription drug coverage. Outpatient prescription drug 
23.30 	coverage may be provided through accountable care organizations only if the delivery 
23.31 	method qualifies for federal prescription drug rebates.
23.32 		Subd. 6.Federal approval. The commissioner shall apply for any federal waivers 
23.33 	or other federal approval required to implement this section. The commissioner shall 
23.34 	also apply for any applicable grant or demonstration under the Patient Protection and 
23.35 	Affordable Health Care Act, Public Law 111-148, or the Health Care and Education 
24.1 	Reconciliation Act of 2010, Public Law 111-152, that would further the purposes of or 
24.2 	assist in the establishment of accountable care organizations.
24.3 		Subd. 7.Expansion. The commissioner shall explore the expansion of the 
24.4 	demonstration project to include additional medical assistance and MinnesotaCare 
24.5 	enrollees, and shall seek participation of Medicare in demonstration projects. The 
24.6 	commissioner shall seek to include participation of privately insured persons and Medicare 
24.7 	recipients in the health care delivery demonstration.

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

24.9 	Sec. 24. [256B.0756] HENNEPIN AND RAMSEY COUNTIES PILOT 
24.10 	PROGRAM.
24.11 	(a) The commissioner, upon federal approval of a new waiver request or amendment 
24.12 	of an existing demonstration, may establish a pilot program in Hennepin County or 
24.13 	Ramsey County, or both, to test alternative and innovative integrated health care delivery 
24.14 	networks.
24.15 	(b) Individuals eligible for the pilot program shall be individuals who are eligible for 
24.16 	medical assistance under Minnesota Statutes, section 256B.055, subdivision 15, and who 
24.17 	reside in Hennepin County or Ramsey County.
24.18 	(c) Individuals enrolled in the pilot shall be enrolled in an integrated health care 
24.19 	delivery network in their county of residence. The integrated health care delivery network 
24.20 	in Hennepin County shall be a network, such as an accountable care organization or a 
24.21 	community-based collaborative care network, created by or including Hennepin County 
24.22 	Medical Center. The integrated health care delivery network in Ramsey County shall be 
24.23 	a network, such as an accountable care organization or community-based collaborative 
24.24 	care network, created by or including Regions Hospital.
24.25 	(d) The commissioner shall cap pilot program enrollment at 7,000 enrollees for 
24.26 	Hennepin County and 3,500 enrollees for Ramsey County.
24.27 	(e) In developing a payment system for the pilot programs, the commissioner shall 
24.28 	establish a total cost of care for the recipients enrolled in the pilot programs that equals 
24.29 	the cost of care that would otherwise be spent for these enrollees in the prepaid medical 
24.30 	assistance program.
24.31 	(f) Counties may transfer funds necessary to support the nonfederal share of 
24.32 	payments for integrated health care delivery networks in their county. Such transfers per 
24.33 	county shall not exceed 15 percent of the expected expenses for county enrollees.
24.34 	(g) The commissioner shall apply to the federal government for, or as appropriate, 
24.35 	cooperate with counties, providers, or other entities that are applying for any applicable 
25.1 	grant or demonstration under the Patient Protection and Affordable Health Care Act, Public 
25.2 	Law 111-148, or the Health Care and Education Reconciliation Act of 2010, Public Law 
25.3 	111-152, that would further the purposes of or assist in the creation of an integrated health 
25.4 	care delivery network for the purposes of this subdivision, including, but not limited to, a 
25.5 	global payment demonstration or the community-based collaborative care network grants.

25.6 	Sec. 25. Minnesota Statutes 2009 Supplement, section 256B.69, subdivision 5a, 
25.7 	is amended to read:
25.8 		Subd. 5a.Managed care contracts. (a) Managed care contracts under this section 
25.9 	and sections 256L.12 and 256D.03, shall be entered into or renewed on a calendar year 
25.10 	basis beginning January 1, 1996. Managed care contracts which were in effect on June 
25.11 	30, 1995, and set to renew on July 1, 1995, shall be renewed for the period July 1, 1995 
25.12 	through December 31, 1995 at the same terms that were in effect on June 30, 1995. The 
25.13 	commissioner may issue separate contracts with requirements specific to services to 
25.14 	medical assistance recipients age 65 and older.
25.15 	(b) A prepaid health plan providing covered health services for eligible persons 
25.16 	pursuant to chapters 256B, 256D, and 256L, is responsible for complying with the terms 
25.17 	of its contract with the commissioner. Requirements applicable to managed care programs 
25.18 	under chapters 256B, 256D, and 256L, established after the effective date of a contract 
25.19 	with the commissioner take effect when the contract is next issued or renewed.
25.20 	(c) Effective for services rendered on or after January 1, 2003, the commissioner 
25.21 	shall withhold five percent of managed care plan payments under this section and 
25.22 	county-based purchasing plan's payment rate plan payments under section 256B.692 for 
25.23 	the prepaid medical assistance and general assistance medical care programs pending 
25.24 	completion of performance targets. Each performance target must be quantifiable, 
25.25 	objective, measurable, and reasonably attainable, except in the case of a performance target 
25.26 	based on a federal or state law or rule. Criteria for assessment of each performance target 
25.27 	must be outlined in writing prior to the contract effective date. The managed care plan 
25.28 	must demonstrate, to the commissioner's satisfaction, that the data submitted regarding 
25.29 	attainment of the performance target is accurate. The commissioner shall periodically 
25.30 	change the administrative measures used as performance targets in order to improve plan 
25.31 	performance across a broader range of administrative services. The performance targets 
25.32 	must include measurement of plan efforts to contain spending on health care services and 
25.33 	administrative activities. The commissioner may adopt plan-specific performance targets 
25.34 	that take into account factors affecting only one plan, including characteristics of the 
25.35 	plan's enrollee population. The withheld funds must be returned no sooner than July of the 
26.1 	following year if performance targets in the contract are achieved. The commissioner may 
26.2 	exclude special demonstration projects under subdivision 23.
26.3 	(d) Effective for services rendered on or after January 1, 2009, through December 31, 
26.4 	2009, the commissioner shall withhold three percent of managed care plan payments under 
26.5 	this section and county-based purchasing plan payments under section 256B.692 for the 
26.6 	prepaid medical assistance and general assistance medical care programs. The withheld 
26.7 	funds must be returned no sooner than July 1 and no later than July 31 of the following 
26.8 	year. The commissioner may exclude special demonstration projects under subdivision 23.
26.9 	The return of the withhold under this paragraph is not subject to the requirements of 
26.10 	paragraph (c).
26.11 	(e) Effective for services provided on or after January 1, 2010, the commissioner 
26.12 	shall require that managed care plans use the assessment and authorization processes, 
26.13 	forms, timelines, standards, documentation, and data reporting requirements, protocols, 
26.14 	billing processes, and policies consistent with medical assistance fee-for-service or the 
26.15 	Department of Human Services contract requirements consistent with medical assistance 
26.16 	fee-for-service or the Department of Human Services contract requirements for all 
26.17 	personal care assistance services under section 256B.0659.
26.18 	(f) Effective for services rendered on or after January 1, 2010, through December 
26.19 	31, 2010, the commissioner shall withhold 3.5 percent of managed care plan payments 
26.20 	under this section and county-based purchasing plan payments under section 256B.692 
26.21 	for the prepaid medical assistance program. The withheld funds must be returned no 
26.22 	sooner than July 1 and no later than July 31 of the following year. The commissioner may 
26.23 	exclude special demonstration projects under subdivision 23.
26.24 	(g) Effective for services rendered on or after January 1, 2011, the commissioner 
26.25 	shall include as part of the performance targets described in paragraph (c) a reduction in 
26.26 	the health plan's emergency room utilization rate for state health care program enrollees 
26.27 	by a measurable rate of five percent from the plan's utilization rate for state health care 
26.28 	program enrollees for the previous calendar year.
26.29 	The withheld funds must be returned no sooner than July 1 and no later than July 
26.30 	31 of the following calendar year if the managed care plan or county-based purchasing 
26.31 	plan demonstrates to the satisfaction of the commissioner that a reduction in the utilization 
26.32 	rate was achieved.
26.33 	The withhold described in this paragraph shall continue for each consecutive 
26.34 	contract period until the plan's emergency room utilization rate for state health care 
26.35 	program enrollees is reduced by 25 percent of the plan's emergency room utilization 
26.36 	rate for state health care program enrollees for calendar year 2009. Hospitals shall 
27.1 	cooperate with the health plans in meeting this performance target and shall accept 
27.2 	payment withholds that may be returned to the hospitals if the performance target is 
27.3 	achieved. The commissioner shall structure the withhold so that the commissioner returns 
27.4 	a portion of the withheld funds in amounts commensurate with achieved reductions in 
27.5 	utilization less than the targeted amount. The withhold in this paragraph does not apply to 
27.6 	county-based purchasing plans.
27.7 	(g) (h) Effective for services rendered on or after January 1, 2011, through December 
27.8 	31, 2011, the commissioner shall withhold four percent of managed care plan payments 
27.9 	under this section and county-based purchasing plan payments under section 256B.692
27.10 	for the prepaid medical assistance program. The withheld funds must be returned no 
27.11 	sooner than July 1 and no later than July 31 of the following year. The commissioner may 
27.12 	exclude special demonstration projects under subdivision 23.
27.13 	(h) (i) Effective for services rendered on or after January 1, 2012, through December 
27.14 	31, 2012, the commissioner shall withhold 4.5 percent of managed care plan payments 
27.15 	under this section and county-based purchasing plan payments under section 256B.692 
27.16 	for the prepaid medical assistance program. The withheld funds must be returned no 
27.17 	sooner than July 1 and no later than July 31 of the following year. The commissioner may 
27.18 	exclude special demonstration projects under subdivision 23.
27.19 	(i) (j) Effective for services rendered on or after January 1, 2013, through December 
27.20 	31, 2013, the commissioner shall withhold 4.5 percent of managed care plan payments 
27.21 	under this section and county-based purchasing plan payments under section 256B.692 
27.22 	for the prepaid medical assistance program. The withheld funds must be returned no 
27.23 	sooner than July 1 and no later than July 31 of the following year. The commissioner may 
27.24 	exclude special demonstration projects under subdivision 23.
27.25 	(j) (k) Effective for services rendered on or after January 1, 2014, the commissioner 
27.26 	shall withhold three percent of managed care plan payments under this section and 
27.27 	county-based purchasing plan payments under section 256B.692 for the prepaid medical 
27.28 	assistance and prepaid general assistance medical care programs. The withheld funds must 
27.29 	be returned no sooner than July 1 and no later than July 31 of the following year. The 
27.30 	commissioner may exclude special demonstration projects under subdivision 23.
27.31 	(k) (l) A managed care plan or a county-based purchasing plan under section 
27.32 	256B.692 may include as admitted assets under section 62D.044 any amount withheld 
27.33 	under this section that is reasonably expected to be returned.
27.34 	(l) (m) Contracts between the commissioner and a prepaid health plan are exempt 
27.35 	from the set-aside and preference provisions of section 16C.16, subdivisions 6, paragraph 
27.36 	(a), and 7.

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

28.2 	Sec. 26. Minnesota Statutes 2008, section 256B.69, is amended by adding a 
28.3 	subdivision to read:
28.4 		Subd. 5k.Rate modifications. For services rendered on or after October 1, 2010, 
28.5 	the total payment made to managed care plans and county-based purchasing plans under 
28.6 	the medical assistance program shall be increased by 1.28 percent.

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

28.8 	Sec. 27. Minnesota Statutes 2008, section 256B.69, subdivision 20, as amended by 
28.9 	Laws 2010, chapter 200, article 1, section 10, is amended to read:
28.10 		Subd. 20.Ombudsperson. (a) The commissioner shall designate an ombudsperson 
28.11 	to advocate for persons required to enroll in prepaid health plans under this section. The 
28.12 	ombudsperson shall advocate for recipients enrolled in prepaid health plans through 
28.13 	complaint and appeal procedures and ensure that necessary medical services are provided 
28.14 	either by the prepaid health plan directly or by referral to appropriate social services. At 
28.15 	the time of enrollment in a prepaid health plan, the local agency shall inform recipients 
28.16 	about the ombudsperson program and their right to a resolution of a complaint by the 
28.17 	prepaid health plan if they experience a problem with the plan or its providers.
28.18 	(b) The commissioner shall designate an ombudsperson to advocate for persons 
28.19 	enrolled in a care coordination delivery system under section 256D.031. The 
28.20 	ombudsperson shall advocate for recipients enrolled in a care coordination delivery 
28.21 	system through the state appeal process and assist enrollees in accessing necessary 
28.22 	medical services through the care coordination delivery systems directly or by referral to 
28.23 	appropriate services. At the time of enrollment in a care coordination delivery system, the 
28.24 	local agency shall inform recipients about the ombudsperson program.

28.25 	Sec. 28. Minnesota Statutes 2008, section 256B.69, subdivision 27, is amended to read:
28.26 		Subd. 27. Information for persons with limited English-language proficiency.
 28.27 	Managed care contracts entered into under this section and sections 256D.03, subdivision 
28.28 	4, paragraph (c), andsection 256L.12 must require demonstration providers to provide 
28.29 	language assistance to enrollees that ensures meaningful access to its programs and 
28.30 	services according to Title VI of the Civil Rights Act and federal regulations adopted 
28.31 	under that law or any guidance from the United States Department of Health and Human 
28.32 	Services. 

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

29.2 	Sec. 29. Minnesota Statutes 2008, section 256B.692, subdivision 1, is amended to read:
29.3 		Subdivision 1.In general. County boards or groups of county boards may elect 
29.4 	to purchase or provide health care services on behalf of persons eligible for medical 
29.5 	assistance and general assistance medical care who would otherwise be required to or may 
29.6 	elect to participate in the prepaid medical assistance or prepaid general assistance medical 
29.7 	care programs according to sectionssection 256B.69and 256D.03. Counties that elect to 
29.8 	purchase or provide health care under this section must provide all services included in 
29.9 	prepaid managed care programs according to sectionssection 256B.69, subdivisions 1 
29.10 	to 22, and 256D.03. County-based purchasing under this section is governed by section 
29.11 	256B.69, unless otherwise provided for under this section.  

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

29.13 	Sec. 30. Minnesota Statutes 2009 Supplement, section 256B.76, subdivision 1, is 
29.14 	amended to read:
29.15 		Subdivision 1.Physician reimbursement.  (a) Effective for services rendered on 
29.16 	or after October 1, 1992, the commissioner shall make payments for physician services 
29.17 	as follows:
29.18 	(1) payment for level one Centers for Medicare and Medicaid Services' common 
29.19 	procedural coding system codes titled "office and other outpatient services," "preventive 
29.20 	medicine new and established patient," "delivery, antepartum, and postpartum care," 
29.21 	"critical care," cesarean delivery and pharmacologic management provided to psychiatric 
29.22 	patients, and level three codes for enhanced services for prenatal high risk, shall be paid 
29.23 	at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June 
29.24 	30, 1992. If the rate on any procedure code within these categories is different than the 
29.25 	rate that would have been paid under the methodology in section 256B.74, subdivision 2, 
29.26 	then the larger rate shall be paid;
29.27 	(2) payments for all other services shall be paid at the lower of (i) submitted charges, 
29.28 	or (ii) 15.4 percent above the rate in effect on June 30, 1992; and
29.29 	(3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th 
29.30 	percentile of 1989, less the percent in aggregate necessary to equal the above increases 
29.31 	except that payment rates for home health agency services shall be the rates in effect 
29.32 	on September 30, 1992.
29.33 	(b) Effective for services rendered on or after January 1, 2000, payment rates for 
29.34 	physician and professional services shall be increased by three percent over the rates 
30.1 	in effect on December 31, 1999, except for home health agency and family planning 
30.2 	agency services. The increases in this paragraph shall be implemented January 1, 2000, 
30.3 	for managed care.
30.4 	(c) Effective for services rendered on or after July 1, 2009, payment rates for 
30.5 	physician and professional services shall be reduced by five percent over the rates in effect 
30.6 	on June 30, 2009. This reduction doesand the reductions in paragraph (d) do not apply 
30.7 	to office or other outpatient visits, preventive medicine visits and family planning visits 
30.8 	billed by physicians, advanced practice nurses, or physician assistants in a family planning 
30.9 	agency or in one of the following primary care practices: general practice, general internal 
30.10 	medicine, general pediatrics, general geriatrics, and family medicine. This reduction does
30.11 	and the reductions in paragraph (d) do not apply to federally qualified health centers, 
30.12 	rural health centers, and Indian health services. Effective October 1, 2009, payments 
30.13 	made to managed care plans and county-based purchasing plans under sections 256B.69, 
30.14 	256B.692, and 256L.12 shall reflect the payment reduction described in this paragraph.
30.15 	(d) Effective for services rendered on or after July 1, 2010, payment rates for 
30.16 	physician and professional services shall be reduced an additional seven percent over the 
30.17 	rates described in paragraph (c). This additional reduction does not apply to physical 
30.18 	therapy services, occupational therapy services, and speech pathology and related 
30.19 	services provided on or after July 1, 2010. This additional reduction does not apply to 
30.20 	physician services billed by a psychiatrist or advanced practice nurse with a specialty in 
30.21 	mental health. Effective October 1, 2010, payments made to managed care plans and 
30.22 	county-based purchasing plans under sections 256B.69, 256B.692, and 256L.12 shall 
30.23 	reflect the payment reduction described in this paragraph.
30.24 	(e) Effective for services rendered on or after October 1, 2010, payment rates for 
30.25 	physician and professional services billed by physicians employed by and clinics owned 
30.26 	by a nonprofit health maintenance organization shall be increased by 25 percent. Effective 
30.27 	October 1, 2010, payments made to managed care plans and county-based purchasing 
30.28 	plans under sections 256B.69, 256B.692, and 256L.12, shall reflect the payment increase 
30.29 	described in this paragraph.

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

30.31 	Sec. 31. Minnesota Statutes 2008, section 256B.76, subdivision 2, is amended to read:
30.32 		Subd. 2.Dental reimbursement.  (a) Effective for services rendered on or after 
30.33 	October 1, 1992, the commissioner shall make payments for dental services as follows:
30.34 	(1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25 
30.35 	percent above the rate in effect on June 30, 1992; and
31.1 	(2) dental rates shall be converted from the 50th percentile of 1982 to the 50th 
31.2 	percentile of 1989, less the percent in aggregate necessary to equal the above increases.
31.3 	(b) Beginning October 1, 1999, the payment for tooth sealants and fluoride treatments 
31.4 	shall be the lower of (1) submitted charge, or (2) 80 percent of median 1997 charges.
31.5 	(c) Effective for services rendered on or after January 1, 2000, payment rates for 
31.6 	dental services shall be increased by three percent over the rates in effect on December 
31.7 	31, 1999.
31.8 	(d) Effective for services provided on or after January 1, 2002, payment for 
31.9 	diagnostic examinations and dental x-rays provided to children under age 21 shall be the 
31.10 	lower of (1) the submitted charge, or (2) 85 percent of median 1999 charges.
31.11 	(e) The increases listed in paragraphs (b) and (c) shall be implemented January 1, 
31.12 	2000, for managed care.
31.13 	(f) Effective for dental services rendered on or after October 1, 2010, by a 
31.14 	state-operated dental clinic, payment shall be paid on a reasonable cost basis that is based 
31.15 	on the Medicare principles of reimbursement. This payment shall be effective for services 
31.16 	rendered on or after January 1, 2011, to recipients enrolled in managed care plans or 
31.17 	county-based purchasing plans.
31.18 	(g) Beginning in fiscal year 2011, if the payments to state-operated dental clinics 
31.19 	in paragraph (f), including state and federal shares, are less than $1,850,000 per fiscal 
31.20 	year, a supplemental state payment equal to the difference between the total payments 
31.21 	in paragraph (f) and $1,850,000 shall be paid from the general fund to state-operated 
31.22 	services for the operation of the dental clinics.
31.23 	(h) If the cost-based payment system for state-operated dental clinics described in 
31.24 	paragraph (f) does not receive federal approval, then state-operated dental clinics shall be 
31.25 	designated as critical access dental providers under subdivision 4, paragraph (b), and shall 
31.26 	receive the critical access dental reimbursement rate as described under subdivision 4, 
31.27 	paragraph (a).

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

31.29 	Sec. 32. Minnesota Statutes 2008, section 256B.76, subdivision 4, is amended to read:
31.30 		Subd. 4.Critical access dental providers.  (a) Effective for dental services 
31.31 	rendered on or after January 1, 2002, the commissioner shall increase reimbursements 
31.32 	to dentists and dental clinics deemed by the commissioner to be critical access dental 
31.33 	providers. For dental services rendered on or after July 1, 2007, the commissioner shall 
31.34 	increase reimbursement by 30 percent above the reimbursement rate that would otherwise 
31.35 	be paid to the critical access dental provider. The commissioner shall pay the health plan 
32.1 	companies managed care plans and county-based purchasing plans  in amounts sufficient 
32.2 	to reflect increased reimbursements to critical access dental providers as approved by the 
32.3 	commissioner. In determining which dentists and dental clinics shall be deemed critical 
32.4 	access dental providers, the commissioner shall review:
32.5 	(b) The commissioner shall designate the following dentists and dental clinics as 
32.6 	critical access dental providers:
32.7 	(1) the utilization rate in the service area in which the dentist or dental clinic operates 
32.8 	for dental services to patients covered by medical assistance, general assistance medical 
32.9 	care, or MinnesotaCare as their primary source of coverage nonprofit community clinics 
32.10 	that:
32.11 	(i) have nonprofit status in accordance with chapter 317A;
32.12 	(ii) have tax exempt status in accordance with the Internal Revenue Code, section 
32.13 	501(c)(3);
32.14 	(iii) are established to provide oral health services to patients who are low income, 
32.15 	uninsured, have special needs, and are underserved;
32.16 	(iv) have professional staff familiar with the cultural background of the clinic's 
32.17 	patients;
32.18 	(v) charge for services on a sliding fee scale designed to provide assistance to 
32.19 	low-income patients based on current poverty income guidelines and family size;
32.20 	(vi) do not restrict access or services because of a patient's financial limitations 
32.21 	or public assistance status; and
32.22 	(vii) have free care available as needed;
32.23 	(2) the level of services provided by the dentist or dental clinic to patients covered 
32.24 	by medical assistance, general assistance medical care, or MinnesotaCare as their primary 
32.25 	source of coverage federally qualified health centers, rural health clinics, and public 
32.26 	health clinics; and
32.27 	(3) whether the level of services provided by the dentist or dental clinic is critical 
32.28 	to maintaining adequate levels of patient access within the service area county owned 
32.29 	and operated hospital-based dental clinics;
32.30 	(4) a dental clinic or dental group owned and operated by a nonprofit corporation in 
32.31 	accordance with chapter 317A with more than 10,000 patient encounters per year with 
32.32 	patients who are uninsured or covered by medical assistance, general assistance medical 
32.33 	care, or MinnesotaCare; and
32.34 	(5) a dental clinic associated with an oral health or dental education program 
32.35 	operated by the University of Minnesota or an institution within the Minnesota State 
32.36 	Colleges and Universities system.
33.1 	In the absence of a critical access dental provider in a service area, (c) The 
33.2 	commissioner may designate a dentist or dental clinic as a critical access dental provider 
33.3 	if the dentist or dental clinic is willing to provide care to patients covered by medical 
33.4 	assistance, general assistance medical care, or MinnesotaCare at a level which significantly 
33.5 	increases access to dental care in the service area.

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

33.7 	Sec. 33. Minnesota Statutes 2009 Supplement, section 256B.766, is amended to read: 
33.8 	256B.766 REIMBURSEMENT FOR BASIC CARE SERVICES.
33.9 	(a) Effective for services provided on or after July 1, 2009, total payments for 
33.10 	basic care services, shall be reduced by three percent, prior to third-party liability and 
33.11 	spenddown calculation. This reduction applies to physical therapy services, occupational 
33.12 	therapy services, and speech language pathology and related services provided on or after 
33.13 	July 1, 2010. Effective July 1, 2010, the commissioner shall classify physical therapy 
33.14 	services, occupational therapy services, and speech language pathology and related 
33.15 	services as basic care services. Effective October 1, 2010, payments made to managed care 
33.16 	and county-based purchasing plans shall reflect the July 1, 2010, payment adjustments in 
33.17 	this paragraph. Payments made to managed care plans and county-based purchasing plans 
33.18 	shall be reduced for services provided on or after October 1, 2009, to reflect this reduction.
33.19 	(b) This section does not apply to physician and professional services, inpatient 
33.20 	hospital services, family planning services, mental health services, dental services, 
33.21 	prescription drugs, medical transportation, federally qualified health centers, rural health 
33.22 	centers, Indian health services, and Medicare cost-sharing.

33.23 	Sec. 34. [256B.767] MEDICARE PAYMENT LIMIT.
33.24 	Effective for services rendered on or after July 1, 2010, fee-for-service payment rates 
33.25 	for physician and professional services under section 256B.76, subdivision 1, and basic 
33.26 	care services subject to the rate reduction specified in section 256B.766, shall not exceed 
33.27 	the Medicare payment rate for the applicable service. The commissioner shall implement 
33.28 	this section after any other rate adjustment that is effective July 1, 2010, and shall reduce 
33.29 	rates under this section by first reducing or eliminating provider rate add-ons.

33.30 	Sec. 35. Minnesota Statutes 2009 Supplement, section 256D.03, subdivision 3, as 
33.31 	amended by Laws 2010, chapter 200, article 1, section 11, is amended to read:
34.1 		Subd. 3.General assistance medical care; eligibility. (a) Beginning April 1, 2010, 
34.2 	the general assistance medical care program shall be administered according to section 
34.3 	256D.031, unless otherwise stated, except for outpatient prescription drug coverage, 
34.4 	which shall continue to be administered under this section and funded under section 
34.5 	256D.031, subdivision 9, beginning June 1, 2010.
34.6 	(b) Outpatient prescription drug coverage under general assistance medical care is 
34.7 	limited to prescription drugs that:
34.8 	(1) are covered under the medical assistance program as described in section 
34.9 	256B.0625, subdivisions 13 and 13d; and
34.10 	(2) are provided by manufacturers that have fully executed general assistance 
34.11 	medical care rebate agreements with the commissioner and comply with the agreements. 
34.12 	Outpatient prescription drug coverage under general assistance medical care must conform 
34.13 	to coverage under the medical assistance program according to section 256B.0625, 
34.14 	subdivisions 13 to 13g 13h.
34.15 	(c) Outpatient prescription drug coverage does not include drugs administered in a 
34.16 	clinic or other outpatient setting.
34.17 	(d) For the period beginning April 1, 2010, to May 31, 2010, general assistance 
34.18 	medical care covers the services listed in subdivision 4.

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

34.20 	Sec. 36. Minnesota Statutes 2008, section 256D.03, subdivision 3b, is amended to read:
34.21 		Subd. 3b.Cooperation. (a) General assistance or general assistance medical care
34.22 	applicants and recipients must cooperate with the state and local agency to identify 
34.23 	potentially liable third-party payors and assist the state in obtaining third-party payments. 
34.24 	Cooperation includes identifying any third party who may be liable for care and services 
34.25 	provided under this chapter to the applicant, recipient, or any other family member for 
34.26 	whom application is made and providing relevant information to assist the state in pursuing 
34.27 	a potentially liable third party. General assistance medical care applicants and recipients 
34.28 	must cooperate by providing information about any group health plan in which they may 
34.29 	be eligible to enroll. They must cooperate with the state and local agency in determining 
34.30 	if the plan is cost-effective. For purposes of this subdivision, coverage provided by the 
34.31 	Minnesota Comprehensive Health Association under chapter 62E shall not be considered 
34.32 	group health plan coverage or cost-effective by the state and local agency. If the plan is 
34.33 	determined cost-effective and the premium will be paid by the state or local agency or is 
34.34 	available at no cost to the person, they must enroll or remain enrolled in the group health 
35.1 	plan. Cost-effective insurance premiums approved for payment by the state agency and 
35.2 	paid by the local agency are eligible for reimbursement according to subdivision 6.
35.3 	(b) Effective for all premiums due on or after June 30, 1997, general assistance 
35.4 	medical care does not cover premiums that a recipient is required to pay under a qualified 
35.5 	or Medicare supplement plan issued by the Minnesota Comprehensive Health Association. 
35.6 	General assistance medical care shall continue to cover premiums for recipients who are 
35.7 	covered under a plan issued by the Minnesota Comprehensive Health Association on June 
35.8 	30, 1997, for a period of six months following receipt of the notice of termination or 
35.9 	until December 31, 1997, whichever is later.

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

35.11 	Sec. 37. Minnesota Statutes 2008, section 256D.031, subdivision 5, as added by Laws 
35.12 	2010, chapter 200, article 1, section 12, subdivision 5, is amended to read:
35.13 		Subd. 5.Payment rates and contract modification; April 1, 2010, to May 31
35.14 	June 30, 2010. (a) For the period April 1, 2010, to May 31 June 30, 2010, general 
35.15 	assistance medical care shall be paid on a fee-for-service basis. Fee-for-service payment 
35.16 	rates for services other than outpatient prescription drugs shall be set at 37 percent of the 
35.17 	payment rate in effect on March 31, 2010, except that for the period June 1, 2010, to June 
35.18 	30, 2010, fee-for-service payment rates for services other than prescription drugs shall be 
35.19 	set at 27 percent of the payment rate in effect on March 31, 2010.
35.20 	(b) Outpatient prescription drugs covered under section 256D.03, subdivision 
35.21 	3, provided on or after April 1, 2010, to May 31 June 30, 2010, shall be paid on a 
35.22 	fee-for-service basis according to section 256B.0625, subdivisions 13 to 13g.

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

35.24 	Sec. 38. Minnesota Statutes 2009 Supplement, section 256L.03, subdivision 5, is 
35.25 	amended to read:
35.26 		Subd. 5.Co-payments and coinsurance. (a) Except as provided in paragraphs (b) 
35.27 	and (c), the MinnesotaCare benefit plan shall include the following co-payments and 
35.28 	coinsurance requirements for all enrollees:
35.29 	(1) ten percent of the paid charges for inpatient hospital services for adult enrollees, 
35.30 	subject to an annual inpatient out-of-pocket maximum of $1,000 per individual;
35.31 	(2) $3 per prescription for adult enrollees;
35.32 	(3) $25 for eyeglasses for adult enrollees;
36.1 	(4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an 
36.2 	episode of service which is required because of a recipient's symptoms, diagnosis, or 
36.3 	established illness, and which is delivered in an ambulatory setting by a physician or 
36.4 	physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse, 
36.5 	audiologist, optician, or optometrist; and
36.6 	(5) $6 for nonemergency visits to a hospital-based emergency room for services 
36.7 	provided through December 31, 2010, and $3.50 effective January 1, 2011.
36.8 	(b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of 
36.9 	children under the age of 21.
36.10 	(c) Paragraph (a) does not apply to pregnant women and children under the age of 21.
36.11 	(d) Paragraph (a), clause (4), does not apply to mental health services.
36.12 	(e) Adult enrollees with family gross income that exceeds 200 percent of the federal 
36.13 	poverty guidelines or 215 percent of the federal poverty guidelines on or after July 1, 2009, 
36.14 	and who are not pregnant shall be financially responsible for the coinsurance amount, if 
36.15 	applicable, and amounts which exceed the $10,000 inpatient hospital benefit limit.
36.16 	(f) When a MinnesotaCare enrollee becomes a member of a prepaid health plan, 
36.17 	or changes from one prepaid health plan to another during a calendar year, any charges 
36.18 	submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket 
36.19 	expenses incurred by the enrollee for inpatient services, that were submitted or incurred 
36.20 	prior to enrollment, or prior to the change in health plans, shall be disregarded.
36.21 	(g) MinnesotaCare reimbursements to fee-for-service providers and payments to 
36.22 	managed care plans or county-based purchasing plans shall not be increased as a result of 
36.23 	the reduction of the co-payments in paragraph (a), clause (5), effective January 1, 2011.

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

36.25 	Sec. 39. Minnesota Statutes 2008, section 256L.11, subdivision 6, is amended to read:
36.26 		Subd. 6.Enrollees 18 or older. Payment by the MinnesotaCare program for 
36.27 	inpatient hospital services provided to MinnesotaCare enrollees eligible under section 
36.28 	256L.04, subdivision 7, or who qualify under section 256L.04, subdivisions 1 and 2, 
36.29 	with family gross income that exceeds 175 percent of the federal poverty guidelines 
36.30 	and who are not pregnant, who are 18 years old or older on the date of admission to the 
36.31 	inpatient hospital must be in accordance with paragraphs (a) and (b). Payment for adults 
36.32 	who are not pregnant and are eligible under section 256L.04, subdivisions 1 and 2, and 
36.33 	whose incomes are equal to or less than 175 percent of the federal poverty guidelines, 
36.34 	shall be as provided for under paragraph (c). 
37.1 	(a) If the medical assistance rate minus any co-payment required under section 
37.2 	256L.03, subdivision 4, is less than or equal to the amount remaining in the enrollee's 
37.3 	benefit limit under section 256L.03, subdivision 3, payment must be the medical 
37.4 	assistance rate minus any co-payment required under section 256L.03, subdivision 4. The 
37.5 	hospital must not seek payment from the enrollee in addition to the co-payment. The 
37.6 	MinnesotaCare payment plus the co-payment must be treated as payment in full. 
37.7 	(b) If the medical assistance rate minus any co-payment required under section 
37.8 	256L.03, subdivision 4, is greater than the amount remaining in the enrollee's benefit limit 
37.9 	under section 256L.03, subdivision 3, payment must be the lesser of: 
37.10 	(1) the amount remaining in the enrollee's benefit limit; or
37.11 	(2) charges submitted for the inpatient hospital services less any co-payment 
37.12 	established under section 256L.03, subdivision 4. 
37.13 	The hospital may seek payment from the enrollee for the amount by which usual and 
37.14 	customary charges exceed the payment under this paragraph. If payment is reduced under 
37.15 	section 256L.03, subdivision 3, paragraph (b), the hospital may not seek payment from the 
37.16 	enrollee for the amount of the reduction. 
37.17 	(c) For admissions occurring during the period of July 1, 1997, through June 30, 
37.18 	1998, for adults who are not pregnant and are eligible under section 256L.04, subdivisions 
37.19 	1 and 2, and whose incomes are equal to or less than 175 percent of the federal poverty 
37.20 	guidelines, the commissioner shall pay hospitals directly, up to the medical assistance 
37.21 	payment rate, for inpatient hospital benefits in excess of the $10,000 annual inpatient 
37.22 	benefit limit. For admissions occurring on or after July 1, 2011, for single adults and 
37.23 	households without children who are eligible under section 256L.04, subdivision 7, the 
37.24 	commissioner shall pay hospitals directly, up to the medical assistance payment rate, for 
37.25 	inpatient hospital benefits up to the $10,000 annual inpatient benefit limit, minus any 
37.26 	co-payment required under section 256L.03, subdivision 5.

37.27 	Sec. 40. Minnesota Statutes 2008, section 256L.07, is amended by adding a subdivision 
37.28 	to read:
37.29 		Subd. 9.Firefighters; volunteer ambulance attendants. (a) For purposes of this 
37.30 	subdivision, "qualified individual" means:
37.31 	(1) a volunteer firefighter with a department as defined in section 299N.01, 
37.32 	subdivision 2, who has passed the probationary period; and
37.33 	(2) a volunteer ambulance attendant as defined in section 144E.001, subdivision 15.
37.34 	(b) A qualified individual who documents to the satisfaction of the commissioner 
37.35 	status as a qualified individual by completing and submitting a one-page form developed 
38.1 	by the commissioner is eligible for MinnesotaCare without meeting other eligibility 
38.2 	requirements of this chapter, but must pay premiums equal to the average expected 
38.3 	capitation rate for adults with no children paid under section 256L.12. Individuals eligible 
38.4 	under this subdivision shall receive coverage for the benefit set provided to adults with no 
38.5 	children.

38.6 	EFFECTIVE DATE. This section is effective April 1, 2011.

38.7 	Sec. 41. Minnesota Statutes 2008, section 256L.12, subdivision 5, is amended to read:
38.8 		Subd. 5.Eligibility for other state programs. MinnesotaCare enrollees who 
38.9 	become eligible for medical assistance or general assistance medical care will remain in 
38.10 	the same managed care plan if the managed care plan has a contract for that population. 
38.11 	Effective January 1, 1998, MinnesotaCare enrollees who were formerly eligible for 
38.12 	general assistance medical care pursuant to section 256D.03, subdivision 3, within six 
38.13 	months of MinnesotaCare enrollment and were enrolled in a prepaid health plan pursuant 
38.14 	to section 256D.03, subdivision 4, paragraph (c), must remain in the same managed care 
38.15 	plan if the managed care plan has a contract for that population. Managed care plans must 
38.16 	participate in the MinnesotaCare and general assistance medical care programsprogram 
38.17 	under a contract with the Department of Human Services in service areas where they 
38.18 	participate in the medical assistance program.  

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

38.20 	Sec. 42. Minnesota Statutes 2008, section 256L.12, subdivision 9, is amended to read:
38.21 		Subd. 9.Rate setting; performance withholds. (a) Rates will be prospective, 
38.22 	per capita, where possible. The commissioner may allow health plans to arrange for 
38.23 	inpatient hospital services on a risk or nonrisk basis. The commissioner shall consult with 
38.24 	an independent actuary to determine appropriate rates.
38.25 	(b) For services rendered on or after January 1, 2003, to December 31, 2003, the 
38.26 	commissioner shall withhold .5 percent of managed care plan payments under this section 
38.27 	pending completion of performance targets. The withheld funds must be returned no 
38.28 	sooner than July 1 and no later than July 31 of the following year if performance targets 
38.29 	in the contract are achieved. A managed care plan may include as admitted assets under 
38.30 	section 62D.044 any amount withheld under this paragraph that is reasonably expected 
38.31 	to be returned. 
38.32 	(c) For services rendered on or after January 1, 2004, the commissioner shall 
38.33 	withhold five percent of managed care plan payments and county-based purchasing 
39.1 	plan payments under this section pending completion of performance targets. Each 
39.2 	performance target must be quantifiable, objective, measurable, and reasonably attainable, 
39.3 	except in the case of a performance target based on a federal or state law or rule. Criteria 
39.4 	for assessment of each performance target must be outlined in writing prior to the 
39.5 	contract effective date. The managed care plan must demonstrate, to the commissioner's 
39.6 	satisfaction, that the data submitted regarding attainment of the performance target is 
39.7 	accurate. The commissioner shall periodically change the administrative measures used 
39.8 	as performance targets in order to improve plan performance across a broader range of 
39.9 	administrative services. The performance targets must include measurement of plan 
39.10 	efforts to contain spending on health care services and administrative activities. The 
39.11 	commissioner may adopt plan-specific performance targets that take into account factors 
39.12 	affecting only one plan, such as characteristics of the plan's enrollee population. The 
39.13 	withheld funds must be returned no sooner than July 1 and no later than July 31 of the 
39.14 	following calendar year if performance targets in the contract are achieved. A managed 
39.15 	care plan or a county-based purchasing plan under section 256B.692 may include as 
39.16 	admitted assets under section 62D.044 any amount withheld under this paragraph that is 
39.17 	reasonably expected to be returned.
39.18 	(c) For services rendered on or after January 1, 2011, the commissioner shall 
39.19 	withhold an additional three percent of managed care plan or county-based purchasing 
39.20 	plan payments under this section. The withheld funds must be returned no sooner than 
39.21 	July 1 and no later than July 31 of the following calendar year. The return of the withhold 
39.22 	under this paragraph is not subject to the requirements of paragraph (b).
39.23 	(d) Effective for services rendered on or after January 1, 2011, the commissioner 
39.24 	shall include as part of the performance targets described in paragraph (b) a reduction in 
39.25 	the plan's emergency room utilization rate for state health care program enrollees by a 
39.26 	measurable rate of five percent from the plan's utilization rate for the previous calendar 
39.27 	year.
39.28 	The withheld funds must be returned no sooner than July 1 and no later than July 
39.29 	31 of the following calendar year if the managed care plan or county-based purchasing 
39.30 	plan demonstrates to the satisfaction of the commissioner that a reduction in the utilization 
39.31 	rate was achieved.
39.32 	The withhold described in this paragraph shall continue for each consecutive 
39.33 	contract period until the plan's emergency room utilization rate for state health care 
39.34 	program enrollees is reduced by 25 percent of the plan's emergency room utilization rate 
39.35 	for state health care program enrollees for calendar year 2009. Hospitals shall cooperate 
39.36 	with the health plans in meeting this performance target and shall accept payment 
40.1 	withholds that may be returned to the hospitals if the performance target is achieved. The 
40.2 	commissioner shall structure the withhold so that the commissioner returns a portion of 
40.3 	the withheld funds in amounts commensurate with achieved reductions in utilization less 
40.4 	than the targeted amount. The withhold described in this paragraph does not apply to 
40.5 	county-based purchasing plans.
40.6 	(e) A managed care plan or a county-based purchasing plan under section 256B.692 
40.7 	may include as admitted assets under section 62D.044 any amount withheld under this 
40.8 	section that is reasonably expected to be returned.

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

40.10 	Sec. 43. Minnesota Statutes 2008, section 256L.12, is amended by adding a subdivision 
40.11 	to read:
40.12 		Subd. 9c.Rate setting; increase effective October 1, 2010. For services 
40.13 	rendered on or after October 1, 2010, the total payment made to managed care plans and 
40.14 	county-based purchasing plans under MinnesotaCare for families with children shall be 
40.15 	increased by 1.28 percent.

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

40.17 	Sec. 44. Laws 2009, chapter 79, article 5, section 75, subdivision 1, is amended to read:
40.18 		Subdivision 1.Medical assistance coverage. The commissioner of human services 
40.19 	shall establish a demonstration project to provide additional medical assistance coverage 
40.20 	for a maximum of 200 American Indian children in Minneapolis, St. Paul, and Duluth 
40.21 	who are burdened by health disparities associated with the cumulative health impact 
40.22 	of toxic environmental exposures. Under this demonstration project, the additional 
40.23 	medical assistance coverage for this population must include, but is not limited to, home 
40.24 	environmental assessments for triggers of asthma, and in-home asthma education on the 
40.25 	proper medical management of asthma by a certified asthma educator or public health 
40.26 	nurse with asthma management training, and must be limited to two visits per child. The 
40.27 	home visit payment rates must be based on a rate commensurate with a first-time visit rate 
40.28 	and follow-up visit rate. Coverage also includes the following durable medical equipment: 
40.29 	high efficiency particulate air (HEPA) cleaners, HEPA vacuum cleaners, allergy bed and 
40.30 	pillow encasements, high filtration filters for forced air gas furnaces, and dehumidifiers 
40.31 	with medical tubing to connect the appliance to a floor drain, if the listed item is medically 
40.32 	necessaryuseful to reduce asthma symptoms. Provision of these items of durable medical 
40.33 	equipment must be preceded by a home environmental assessment for triggers of asthma 
41.1 	and in-home asthma education on the proper medical management of asthma by a Certified 
41.2 	Asthma Educator or public health nurse with asthma management training.

41.3 	Sec. 45. Laws 2009, chapter 79, article 5, section 78, subdivision 5, is amended to read:
41.4 		Subd. 5.Expiration. This section, with the exception of subdivision 4, expires 
41.5 	December 31, 2010 August 31, 2011. Subdivision 4 expires February 28, 2012.

41.6 	Sec. 46. Laws 2010, chapter 200, article 1, section 12, the effective date, is amended to 
41.7 	read:

41.8 	EFFECTIVE DATE. This section, except for subdivision 4,  is effective for services 
41.9 	rendered on or after April 1, 2010. Subdivision 4 of this section is effective June 1, 2010.

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

41.11 	Sec. 47. Laws 2010, chapter 200, article 1, section 16, is amended by adding an 
41.12 	effective date to read:

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

41.14 	Sec. 48. Laws 2010, chapter 200, article 1, section 21, is amended to read:
41.15 	Sec. 21. REPEALER.
 41.16 	(a) Minnesota Statutes 2008, sections 256.742; 256.979, subdivision 8; and 256D.03, 
41.17 	subdivision 9, are repealed effective April 1, 2010.
41.18 	(b) Minnesota Statutes 2009 Supplement, section 256D.03, subdivision 4, is repealed 
41.19 	effective April June 1, 2010.
41.20 	(c) Minnesota Statutes 2008, section 256B.195, subdivisions 4 and 5, are repealed 
41.21 	effective for federal fiscal year 2010.
41.22 	(d) Minnesota Statutes 2009 Supplement, section 256B.195, subdivisions 1, 2, and 
41.23 	3, are repealed effective for federal fiscal year 2010.
41.24 	(e) Minnesota Statutes 2008, sections 256L.07, subdivision 6; 256L.15, subdivision 
41.25 	4; and 256L.17, subdivision 7, are repealed January 1, 2011 July 1, 2010.

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

41.27 	Sec. 49. Laws 2010, chapter 200, article 2, section 2, subdivision 1, is amended to read:

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

42.1	Appropriations by Fund
	
42.2		2010
	2011
	
42.3	General
	34,807,000
	118,493,000
	
42.4	Health Care Access
	(42,792,000)
	(211,621,000)
	
42.5 	The amounts that may be spent for each 
42.6 	purpose are specified in the following 
42.7 	subdivisions.
42.8 	Special Revenue Fund Transfers.
42.9 	(a) The commissioner shall transfer the 
42.10 	following amounts from special revenue 
42.11 	fund balances to the general fund by June 
42.12 	30 of each respective fiscal year: $410,000 
42.13 	for fiscal year 2010, and $412,000 for fiscal 
42.14 	year 2011.
42.15 	(b) Actual transfers made under paragraph 
42.16 	(a) must be separately identified and reported 
42.17 	as part of the quarterly reporting of transfers 
42.18 	to the chairs of the relevant senate budget 
42.19 	division and house of representatives finance 
42.20 	division.

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

42.22 	Sec. 50. Laws 2010, chapter 200, article 2, section 2, subdivision 5, is amended to read:

42.23	Subd. 5.Health Care Management
 					
42.24 	The amounts that may be spent from the 
42.25 	appropriation for each purpose are as follows:

42.26	Health Care Administration.
		(2,998,000)
		(5,270,000)
	
42.27 	Base Adjustment. The general fund base 
42.28 	for health care administration is reduced by 
42.29 	$182,000 $36,000  in fiscal year 2012 and 
42.30 	$182,000 $36,000  in fiscal year 2013.

42.31 	Sec. 51. Laws 2010, chapter 200, article 2, section 2, subdivision 8, is amended to read:

43.1	Subd. 8.Transfers
 					
43.2 	The commissioner must transfer $29,538,000 
43.3 	in fiscal year 2010 and $18,462,000 in fiscal 
43.4 	year 2011 from the health care access fund to 
43.5 	the general fund. This is a onetime transfer.
43.6 	The commissioner must transfer $4,800,000 
43.7 	from the consolidated chemical dependency 
43.8 	treatment fund to the general fund by June 
43.9 	30, 2010.
43.10 	Compulsive Gambling Special Revenue
43.11 	Administration.The lottery prize fund 
43.12 	appropriation for compulsive gambling 
43.13 	administration is reduced by $6,000 for fiscal 
43.14 	year 2010 and $4,000 for fiscal year 2011
43.15 	must be transferred from the lottery prize 
43.16 	fund appropriation for compulsive gambling 
43.17 	administration to the general fund by June 
43.18 	30 of each respective fiscal year. These are 
43.19 	onetime reductions.

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

43.21 	Sec. 52. PREPAID HEALTH PLAN RATES.
 43.22 	In negotiating the prepaid health plan contract rates for services rendered on or 
43.23 	after January 1, 2011, the commissioner of human services shall take into consideration 
43.24 	and the rates shall reflect the anticipated savings in the medical assistance program due 
43.25 	to extending medical assistance coverage to services provided in licensed birth centers, 
43.26 	the anticipated use of these services within the medical assistance population, and the 
43.27 	reduced medical assistance costs associated with the use of birth centers for normal, 
43.28 	low-risk deliveries.

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

43.30 	Sec. 53. STATE PLAN AMENDMENT; FEDERAL APPROVAL.
 43.31 	The commissioner of human services shall submit a Medicaid state plan amendment 
43.32 	to receive federal fund participation for adults without children whose income is equal 
44.1 	to or less than 75 percent of federal poverty guidelines in accordance with the Patient 
44.2 	Protection and Affordable Care Act, Public Law 111-148, or the Health Care and 
44.3 	Education Reconciliation Act of 2010, Public Law 111-152. The effective date of the 
44.4 	state plan amendment shall be June 1, 2010.

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

44.6 	Sec. 54. UPPER PAYMENT LIMIT REPORT.
 44.7 	Each January 15, beginning in 2011, the commissioner of human services shall 
44.8 	report the following information to the chairs of the house of representatives and senate 
44.9 	finance committees and divisions with responsibility for human services appropriations:
44.10 	(1) the estimated room within the Medicare hospital upper payment limit for the 
44.11 	federal year beginning on October 1 of the year the report is made;
44.12 	(2) the amount of a rate increase under Minnesota Statutes, section 256.969, 
44.13 	subdivision 3a, paragraph (i), that would increase medical assistance hospital spending 
44.14 	to the upper payment limit; and
44.15 	(3) the amount of a surcharge increase under Minnesota Statutes, section 256.9657, 
44.16 	subdivision 2, needed to generate the state share of the potential rate increase under 
44.17 	clause (2).

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

44.19 	Sec. 55. REVISOR'S INSTRUCTION.
 44.20 	The revisor of statutes shall edit Minnesota Statutes and Minnesota Rules to remove 
44.21 	references to the general assistance medical care program and references to Minnesota 
44.22 	Statutes, section 256D.03, subdivision 3, or Minnesota Statutes, chapter 256D, as it 
44.23 	pertains to general assistance medical care and make other changes as may be necessary 
44.24 	to remove references to the general assistance medical care program. The revisor may 
44.25 	consult with the Department of Human Services when making editing decisions on the 
44.26 	removal of these references.

44.27 	Sec. 56.  REPEALER.
 44.28 	(a) Minnesota Statutes 2008, section 256D.03, subdivisions 3, 3a, 5, 6, 7, and 8,
44.29 	are repealed July 1, 2010.
44.30 	(b) Laws 2010, chapter 200, article 1, sections 12; 18; and 19, are repealed July 
44.31 	1, 2010.

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

45.1 	ARTICLE 2
45.2 	CONTINUING CARE

45.3 	Section 1. Minnesota Statutes 2008, section 144D.03, subdivision 2, is amended to 
45.4 	read:
45.5 		Subd. 2.Registration information. The establishment shall provide the following 
45.6 	information to the commissioner in order to be registered:
45.7 	(1) the business name, street address, and mailing address of the establishment;
45.8 	(2) the name and mailing address of the owner or owners of the establishment and, if 
45.9 	the owner or owners are not natural persons, identification of the type of business entity 
45.10 	of the owner or owners, and the names and addresses of the officers and members of the 
45.11 	governing body, or comparable persons for partnerships, limited liability corporations, or 
45.12 	other types of business organizations of the owner or owners;
45.13 	(3) the name and mailing address of the managing agent, whether through 
45.14 	management agreement or lease agreement, of the establishment, if different from the 
45.15 	owner or owners, and the name of the on-site manager, if any;
45.16 	(4) verification that the establishment has entered into  a housing with services 
45.17 	contract, as required in section  144D.04, with each resident or resident's representative; 
45.18 	(5) verification that the establishment is complying with the requirements of section 
45.19 	325F.72, if applicable; 
45.20 	(6) the name and address of at least one natural person who shall be responsible 
45.21 	for dealing with the commissioner on all matters provided for in sections  144D.01 to  
45.22 	144D.06, and on whom personal service of all notices and orders shall be made, and who 
45.23 	shall be authorized to accept service on behalf of the owner or owners and the managing 
45.24 	agent, if any; and
45.25 	(7) the signature of the authorized representative of the owner or owners or, if 
45.26 	the owner or owners are not natural persons, signatures of at least two authorized 
45.27 	representatives of each owner, one of which shall be an officer of the owner; and
45.28 	(8) whether services are included in the base rate to be paid by the resident.
45.29 	Personal service on the person identified under clause (6) by the owner or owners in 
45.30 	the registration shall be considered service on the owner or owners, and it shall not be a 
45.31 	defense to any action that personal service was not made on each individual or entity. The 
45.32 	designation of one or more individuals under this subdivision shall not affect the legal 
45.33 	responsibility of the owner or owners under sections  144D.01 to  144D.06. 

46.1 	Sec. 2. Minnesota Statutes 2008, section 144D.03, is amended by adding a subdivision 
46.2 	to read:
46.3 		Subd. 3.Certificate of transitional consultation. (a) A housing with services 
46.4 	establishment shall not execute a contract or allow a prospective resident to move in until 
46.5 	the establishment has received certification from the Senior LinkAge Line that transition 
46.6 	to housing with services consultation under section 256B.0911, subdivision 3c, has been 
46.7 	completed. Prospective residents may be allowed to move in on an emergency basis prior 
46.8 	to receiving a certificate, however, the certification must occur within 30 calendar days of 
46.9 	admission. The housing with services establishment shall maintain copies of contracts and 
46.10 	certificates for audit for a period of three years. The Senior LinkAge Line shall issue a 
46.11 	certification within 24 hours of a contact by a prospective resident.
46.12 	(b) This subdivision applies to housing with services establishments that are required 
46.13 	to register under section 144D.02 and:
46.14 	(1) include any service in the base rate as described in the contract established 
46.15 	under section 144D.04; or
46.16 	(2) require residents to purchase services as a condition of tenancy.

46.17 	Sec. 3. Minnesota Statutes 2008, section 144D.04, subdivision 2, is amended to read:
46.18 		Subd. 2.Contents of contract.  A housing with services contract, which need not be 
46.19 	entitled as such to comply with this section, shall include at least the following elements 
46.20 	in itself or through supporting documents or attachments:
46.21 	(1) the name, street address, and mailing address of the establishment;
46.22 	(2) the name and mailing address of the owner or owners of the establishment and, if 
46.23 	the owner or owners is not a natural person, identification of the type of business entity 
46.24 	of the owner or owners;
46.25 	(3) the name and mailing address of the managing agent, through management 
46.26 	agreement or lease agreement, of the establishment, if different from the owner or owners;
46.27 	(4) the name and address of at least one natural person who is authorized to accept 
46.28 	service of process on behalf of the owner or owners and managing agent;
46.29 	(5) a statement describing the registration and licensure status of the establishment 
46.30 	and any provider providing health-related or supportive services under an arrangement 
46.31 	with the establishment;
46.32 	(6) the term of the contract;
46.33 	(7) a description of the services to be provided to the resident in the base rate to be 
46.34 	paid by resident, including a delineation of the portion of the base rate that constitutes rent 
46.35 	and a delineation of charges for each service included in the base rate;
47.1 	(8) a description of any additional services, including home care services, available 
47.2 	for an additional fee from the establishment directly or through arrangements with the 
47.3 	establishment, and a schedule of fees charged for these services;
47.4 	(9) a description of the process through which the contract may be modified, 
47.5 	amended, or terminated;
47.6 	(10) a description of the establishment's complaint resolution process available 
47.7 	to residents including the toll-free complaint line for the Office of Ombudsman for 
47.8 	Long-Term Care;
47.9 	(11) the resident's designated representative, if any;
47.10 	(12) the establishment's referral procedures if the contract is terminated;
47.11 	(13) requirements of residency used by the establishment to determine who may 
47.12 	reside or continue to reside in the  housing with services establishment;
47.13 	(14) billing and payment procedures and requirements;
47.14 	(15) a statement regarding the ability of residents to receive services from service 
47.15 	providers with whom the establishment does not have an arrangement; 
47.16 	(16) a statement regarding the availability of public funds for payment for residence 
47.17 	or services in the establishment; and
47.18 	(17) a statement regarding the availability of and contact information for 
47.19 	long-term care consultation services under section 256B.0911 in the county in which the 
47.20 	establishment is located.

47.21 	Sec. 4. [144D.08] UNIFORM CONSUMER INFORMATION GUIDE.
47.22 	All housing with services establishments shall make available to all prospective 
47.23 	and current residents information consistent with the uniform format and the required 
47.24 	components adopted by the commissioner under section 144G.06.

47.25 	Sec. 5. [144D.09] TERMINATION OF LEASE.
47.26 	The housing with services establishment shall include with notice of termination 
47.27 	of lease information about how to contact the ombudsman for long-term care, including 
47.28 	the address and phone number along with a statement of how to request problem-solving 
47.29 	assistance.

47.30 	Sec. 6. Minnesota Statutes 2008, section 144G.06, is amended to read:
47.31 	144G.06 UNIFORM CONSUMER INFORMATION GUIDE.
47.32 	(a) The commissioner of health shall establish an advisory committee consisting 
47.33 	of representatives of consumers, providers, county and state officials, and other 
48.1 	groups the commissioner considers appropriate. The advisory committee shall present 
48.2 	recommendations to the commissioner on:
48.3 	(1) a format for a guide to be used by individual providers of assisted living, as 
48.4 	defined in section 144G.01, that includes information about services offered by that 
48.5 	provider, which services may be covered by Medicare, service costs, and other relevant 
48.6 	provider-specific information, as well as a statement of philosophy and values associated 
48.7 	with assisted living, presented in uniform categories that facilitate comparison with guides 
48.8 	issued by other providers; and
48.9 	(2) requirements for informing assisted living clients, as defined in section 144G.01, 
48.10 	of their applicable legal rights.
48.11 	(b) The commissioner, after reviewing the recommendations of the advisory 
48.12 	committee, shall adopt a uniform format for the guide to be used by individual providers, 
48.13 	and the required components of materials to be used by providers to inform assisted 
48.14 	living clients of their legal rights, and shall make the uniform format and the required 
48.15 	components available to assisted living providers.

48.16 	Sec. 7. Minnesota Statutes 2009 Supplement, section 252.27, subdivision 2a, is 
48.17 	amended to read:
48.18 		Subd. 2a.Contribution amount. (a) The natural or adoptive parents of a minor 
48.19 	child, including a child determined eligible for medical assistance without consideration of 
48.20 	parental income, must contribute to the cost of services used by making monthly payments 
48.21 	on a sliding scale based on income, unless the child is married or has been married, 
48.22 	parental rights have been terminated, or the child's adoption is subsidized according to 
48.23 	section 259.67 or through title IV-E of the Social Security Act. The parental contribution 
48.24 	is a partial or full payment for medical services provided for diagnostic, therapeutic, 
48.25 	curing, treating, mitigating, rehabilitation, maintenance, and personal care services as 
48.26 	defined in United States Code, title 26, section 213, needed by the child with a chronic 
48.27 	illness or disability.
48.28 	(b) For households with adjusted gross income equal to or greater than 100 percent 
48.29 	of federal poverty guidelines, the parental contribution shall be computed by applying the 
48.30 	following schedule of rates to the adjusted gross income of the natural or adoptive parents:
48.31 	(1) if the adjusted gross income is equal to or greater than 100 percent of federal 
48.32 	poverty guidelines and less than 175 percent of federal poverty guidelines, the parental 
48.33 	contribution is $4 per month;
48.34 	(2) if the adjusted gross income is equal to or greater than 175 percent of federal 
48.35 	poverty guidelines and less than or equal to 545 percent of federal poverty guidelines, 
49.1 	the parental contribution shall be determined using a sliding fee scale established by the 
49.2 	commissioner of human services which begins at one percent of adjusted gross income 
49.3 	at 175 percent of federal poverty guidelines and increases to 7.5 percent of adjusted 
49.4 	gross income for those with adjusted gross income up to 545 percent of federal poverty 
49.5 	guidelines;
49.6 	(3) if the adjusted gross income is greater than 545 percent of federal poverty 
49.7 	guidelines and less than 675 percent of federal poverty guidelines, the parental 
49.8 	contribution shall be 7.5 percent of adjusted gross income;
49.9 	(4) if the adjusted gross income is equal to or greater than 675 percent of federal 
49.10 	poverty guidelines and less than 975 percent of federal poverty guidelines, the parental 
49.11 	contribution shall be determined using a sliding fee scale established by the commissioner 
49.12 	of human services which begins at 7.5 percent of adjusted gross income at 675 percent of 
49.13 	federal poverty guidelines and increases to ten percent of adjusted gross income for those 
49.14 	with adjusted gross income up to 975 percent of federal poverty guidelines; and
49.15 	(5) if the adjusted gross income is equal to or greater than 975 percent of federal 
49.16 	poverty guidelines, the parental contribution shall be 12.5 percent of adjusted gross 
49.17 	income.
49.18 	If the child lives with the parent, the annual adjusted gross income is reduced by 
49.19 	$2,400 prior to calculating the parental contribution. If the child resides in an institution 
49.20 	specified in section 256B.35, the parent is responsible for the personal needs allowance 
49.21 	specified under that section in addition to the parental contribution determined under this 
49.22 	section. The parental contribution is reduced by any amount required to be paid directly to 
49.23 	the child pursuant to a court order, but only if actually paid.
49.24 	(c) The household size to be used in determining the amount of contribution under 
49.25 	paragraph (b) includes natural and adoptive parents and their dependents, including the 
49.26 	child receiving services. Adjustments in the contribution amount due to annual changes 
49.27 	in the federal poverty guidelines shall be implemented on the first day of July following 
49.28 	publication of the changes.
49.29 	(d) For purposes of paragraph (b), "income" means the adjusted gross income of the 
49.30 	natural or adoptive parents determined according to the previous year's federal tax form, 
49.31 	except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds 
49.32 	have been used to purchase a home shall not be counted as income.
49.33 	(e) The contribution shall be explained in writing to the parents at the time eligibility 
49.34 	for services is being determined. The contribution shall be made on a monthly basis 
49.35 	effective with the first month in which the child receives services. Annually upon 
49.36 	redetermination or at termination of eligibility, if the contribution exceeded the cost of 
50.1 	services provided, the local agency or the state shall reimburse that excess amount to 
50.2 	the parents, either by direct reimbursement if the parent is no longer required to pay a 
50.3 	contribution, or by a reduction in or waiver of parental fees until the excess amount is 
50.4 	exhausted. All reimbursements must include a notice that the amount reimbursed may be 
50.5 	taxable income if the parent paid for the parent's fees through an employer's health care 
50.6 	flexible spending account under the Internal Revenue Code, section 125, and that the 
50.7 	parent is responsible for paying the taxes owed on the amount reimbursed.
50.8 	(f) The monthly contribution amount must be reviewed at least every 12 months; 
50.9 	when there is a change in household size; and when there is a loss of or gain in income 
50.10 	from one month to another in excess of ten percent. The local agency shall mail a written 
50.11 	notice 30 days in advance of the effective date of a change in the contribution amount. 
50.12 	A decrease in the contribution amount is effective in the month that the parent verifies a 
50.13 	reduction in income or change in household size.
50.14 	(g) Parents of a minor child who do not live with each other shall each pay the 
50.15 	contribution required under paragraph (a). An amount equal to the annual court-ordered 
50.16 	child support payment actually paid on behalf of the child receiving services shall be 
50.17 	deducted from the adjusted gross income of the parent making the payment prior to 
50.18 	calculating the parental contribution under paragraph (b).
50.19 	(h) The contribution under paragraph (b) shall be increased by an additional five 
50.20 	percent if the local agency determines that insurance coverage is available but not 
50.21 	obtained for the child. For purposes of this section, "available" means the insurance is a 
50.22 	benefit of employment for a family member at an annual cost of no more than five percent 
50.23 	of the family's annual income. For purposes of this section, "insurance" means health 
50.24 	and accident insurance coverage, enrollment in a nonprofit health service plan, health 
50.25 	maintenance organization, self-insured plan, or preferred provider organization.
50.26 	Parents who have more than one child receiving services shall not be required 
50.27 	to pay more than the amount for the child with the highest expenditures. There shall 
50.28 	be no resource contribution from the parents. The parent shall not be required to pay 
50.29 	a contribution in excess of the cost of the services provided to the child, not counting 
50.30 	payments made to school districts for education-related services. Notice of an increase in 
50.31 	fee payment must be given at least 30 days before the increased fee is due.
50.32 	(i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if, 
50.33 	in the 12 months prior to July 1:
50.34 	(1) the parent applied for insurance for the child;
50.35 	(2) the insurer denied insurance;
51.1 	(3) the parents submitted a complaint or appeal, in writing to the insurer, submitted 
51.2 	a complaint or appeal, in writing, to the commissioner of health or the commissioner of 
51.3 	commerce, or litigated the complaint or appeal; and
51.4 	(4) as a result of the dispute, the insurer reversed its decision and granted insurance.
51.5 	For purposes of this section, "insurance" has the meaning given in paragraph (h).
51.6 	A parent who has requested a reduction in the contribution amount under this 
51.7 	paragraph shall submit proof in the form and manner prescribed by the commissioner or 
51.8 	county agency, including, but not limited to, the insurer's denial of insurance, the written 
51.9 	letter or complaint of the parents, court documents, and the written response of the insurer 
51.10 	approving insurance. The determinations of the commissioner or county agency under this 
51.11 	paragraph are not rules subject to chapter 14.
51.12 	(j) Notwithstanding paragraph (b), for the period from July 1, 2010, to June 30, 
51.13 	2013, the parental contribution shall be computed by applying the following contribution 
51.14 	schedule to the adjusted gross income of the natural or adoptive parents:
51.15 	(1) if the adjusted gross income is equal to or greater than 100 percent of federal 
51.16 	poverty guidelines and less than 175 percent of federal poverty guidelines, the parental 
51.17 	contribution is $4 per month;
51.18 	(2) if the adjusted gross income is equal to or greater than 175 percent of federal 
51.19 	poverty guidelines and less than or equal to 525 percent of federal poverty guidelines, 
51.20 	the parental contribution shall be determined using a sliding fee scale established by the 
51.21 	commissioner of human services which begins at one percent of adjusted gross income 
51.22 	at 175 percent of federal poverty guidelines and increases to eight percent of adjusted 
51.23 	gross income for those with adjusted gross income up to 525 percent of federal poverty 
51.24 	guidelines;
51.25 	(3) if the adjusted gross income is greater than 525 percent of federal poverty 
51.26 	guidelines and less than 675 percent of federal poverty guidelines, the parental contribution 
51.27 	shall be 9.5 percent of adjusted gross income;
51.28 	(4) if the adjusted gross income is equal to or greater than 675 percent of federal 
51.29 	poverty guidelines and less than 900 percent of federal poverty guidelines, the parental 
51.30 	contribution shall be determined using a sliding fee scale established by the commissioner 
51.31 	of human services which begins at 9.5 percent of adjusted gross income at 675 percent of 
51.32 	federal poverty guidelines and increases to 12 percent of adjusted gross income for those 
51.33 	with adjusted gross income up to 900 percent of federal poverty guidelines; and
51.34 	(5) if the adjusted gross income is equal to or greater than 900 percent of federal 
51.35 	poverty guidelines, the parental contribution shall be 13.5 percent of adjusted gross 
51.36 	income. If the child lives with the parent, the annual adjusted gross income is reduced by 
52.1 	$2,400 prior to calculating the parental contribution. If the child resides in an institution 
52.2 	specified in section 256B.35, the parent is responsible for the personal needs allowance 
52.3 	specified under that section in addition to the parental contribution determined under this 
52.4 	section. The parental contribution is reduced by any amount required to be paid directly to 
52.5 	the child pursuant to a court order, but only if actually paid.

52.6 	Sec. 8. [256.4825] REPORT REGARDING PROGRAMS AND SERVICES FOR 
52.7 	PEOPLE WITH DISABILITIES.
52.8 	The Minnesota State Council on Disability, the Minnesota Consortium for Citizens 
52.9 	with Disabilities, and the Arc of Minnesota may submit an annual report by January 15 of 
52.10 	each year, beginning in 2012, to the chairs and ranking minority members of the legislative 
52.11 	committees with jurisdiction over programs serving people with disabilities as provided in 
52.12 	this section. The report must describe the existing state policies and goals for programs 
52.13 	serving people with disabilities including, but not limited to, programs for employment, 
52.14 	transportation, housing, education, quality assurance, consumer direction, physical and 
52.15 	programmatic access, and health. The report must provide data and measurements to 
52.16 	assess the extent to which the policies and goals are being met. The commissioner of 
52.17 	human services and the commissioners of other state agencies administering programs for 
52.18 	people with disabilities shall cooperate with the Minnesota State Council on Disability, 
52.19 	the Minnesota Consortium for Citizens with Disabilities, and the Arc of Minnesota and 
52.20 	provide those organizations with existing published information and reports that will assist 
52.21 	in the preparation of the report.

52.22 	Sec. 9. Minnesota Statutes 2008, section 256.9657, subdivision 3a, is amended to read:
52.23 		Subd. 3a.ICF/MR license surcharge. (a) Effective July 1, 2003, each 
52.24 	non-state-operated facility as defined under section 256B.501, subdivision 1, shall pay 
52.25 	to the commissioner an annual surcharge according to the schedule in subdivision 4, 
52.26 	paragraph (d). The annual surcharge shall be $1,040 per licensed bed. If the number of 
52.27 	licensed beds is reduced, the surcharge shall be based on the number of remaining licensed 
52.28 	beds the second month following the receipt of timely notice by the commissioner of 
52.29 	human services that beds have been delicensed. The facility must notify the commissioner 
52.30 	of health in writing when beds are delicensed. The commissioner of health must notify 
52.31 	the commissioner of human services within ten working days after receiving written 
52.32 	notification. If the notification is received by the commissioner of human services by 
52.33 	the 15th of the month, the invoice for the second following month must be reduced to 
52.34 	recognize the delicensing of beds. The commissioner may reduce, and may subsequently 
53.1 	restore, the surcharge under this subdivision based on the commissioner's determination of 
53.2 	a permissible surcharge. 
53.3 	(b) Effective July 1, 2010, the surcharge under paragraph (a) is increased to $4,037 
53.4 	per licensed bed.

53.5 	Sec. 10. Minnesota Statutes 2009 Supplement, section 256.975, subdivision 7, is 
53.6 	amended to read:
53.7 		Subd. 7.Consumer information and assistance and long-term care options 
53.8 	counseling; Senior LinkAge Line. (a) The Minnesota Board on Aging shall operate a 
53.9 	statewide service to aid older Minnesotans and their families in making informed choices 
53.10 	about long-term care options and health care benefits. Language services to persons with 
53.11 	limited English language skills may be made available. The service, known as Senior 
53.12 	LinkAge Line, must be available during business hours through a statewide toll-free 
53.13 	number and must also be available through the Internet.
53.14 	(b) The service must provide long-term care options counseling by assisting older 
53.15 	adults, caregivers, and providers in accessing information and options counseling about 
53.16 	choices in long-term care services that are purchased through private providers or available 
53.17 	through public options. The service must:
53.18 	(1) develop a comprehensive database that includes detailed listings in both 
53.19 	consumer- and provider-oriented formats;
53.20 	(2) make the database accessible on the Internet and through other telecommunication 
53.21 	and media-related tools;
53.22 	(3) link callers to interactive long-term care screening tools and make these tools 
53.23 	available through the Internet by integrating the tools with the database;
53.24 	(4) develop community education materials with a focus on planning for long-term 
53.25 	care and evaluating independent living, housing, and service options;
53.26 	(5) conduct an outreach campaign to assist older adults and their caregivers in 
53.27 	finding information on the Internet and through other means of communication;
53.28 	(6) implement a messaging system for overflow callers and respond to these callers 
53.29 	by the next business day;
53.30 	(7) link callers with county human services and other providers to receive more 
53.31 	in-depth assistance and consultation related to long-term care options;
53.32 	(8) link callers with quality profiles for nursing facilities and other providers 
53.33 	developed by the commissioner of health;
53.34 	(9) incorporate information about the availability of housing options, as well as 
53.35 	registered housing with services and consumer rights within the MinnesotaHelp.info 
54.1 	network long-term care database to facilitate consumer comparison of services and costs 
54.2 	among housing with services establishments and with other in-home services and to 
54.3 	support financial self-sufficiency as long as possible. Housing with services establishments 
54.4 	and their arranged home care providers shall provide information to the commissioner of 
54.5 	human services that is consistent with information required by the commissioner of health 
54.6 	under section 144G.06, the Uniform Consumer Information Guide that will facilitate price 
54.7 	comparisons, including delineation of charges for rent and for services available. The 
54.8 	commissioners of health and human services shall align the data elements required by 
54.9 	section 144G.06, the Uniform Consumer Information Guide, and this section to provide 
54.10 	consumers standardized information and ease of comparison of long-term care options. 
54.11 	The commissioner of human services shall provide the data to the Minnesota Board on 
54.12 	Aging for inclusion in the MinnesotaHelp.info network long-term care database;
54.13 	(10) provide long-term care options counseling. Long-term care options counselors 
54.14 	shall:
54.15 	(i) for individuals not eligible for case management under a public program or public 
54.16 	funding source, provide interactive decision support under which consumers, family 
54.17 	members, or other helpers are supported in their deliberations to determine appropriate 
54.18 	long-term care choices in the context of the consumer's needs, preferences, values, and 
54.19 	individual circumstances, including implementing a community support plan;
54.20 	(ii) provide Web-based educational information and collateral written materials to 
54.21 	familiarize consumers, family members, or other helpers with the long-term care basics, 
54.22 	issues to be considered, and the range of options available in the community;
54.23 	(iii) provide long-term care futures planning, which means providing assistance to 
54.24 	individuals who anticipate having long-term care needs to develop a plan for the more 
54.25 	distant future; and
54.26 	(iv) provide expertise in benefits and financing options for long-term care, including 
54.27 	Medicare, long-term care insurance, tax or employer-based incentives, reverse mortgages, 
54.28 	private pay options, and ways to access low or no-cost services or benefits through 
54.29 	volunteer-based or charitable programs; and
54.30 	(11) using risk management and support planning protocols, provide long-term care 
54.31 	options counseling to current residents of nursing homes deemed appropriate for discharge 
54.32 	by the commissioner. In order to meet this requirement, the commissioner shall provide 
54.33 	designated Senior LinkAge Line contact centers with a list of nursing home residents 
54.34 	appropriate for discharge planning via a secure Web portal. Senior LinkAge Line shall 
54.35 	provide these residents, if they indicate a preference to receive long-term care options 
55.1 	counseling, with initial assessment, review of risk factors, independent living support 
55.2 	consultation, or referral to:
55.3 	(i) long-term care consultation services under section 256B.0911;
55.4 	(ii) designated care coordinators of contracted entities under section 256B.035 for 
55.5 	persons who are enrolled in a managed care plan; or
55.6 	(iii) the long-term care consultation team for those who are appropriate for relocation 
55.7 	service coordination due to high-risk factors or psychological or physical disability.

55.8 	Sec. 11. Minnesota Statutes 2008, section 256B.057, subdivision 9, is amended to read:
55.9 		Subd. 9.Employed persons with disabilities. (a) Medical assistance may be paid 
55.10 	for a person who is employed and who:
55.11 	(1) but for excess earnings or assets, meets the definition of disabled under the 
55.12 	supplemental security income program;
55.13 	(2) is at least 16 but less than 65 years of age;
55.14 	(3) meets the asset limits in paragraph (c); and
55.15 	(4) effective November 1, 2003, pays a premium and other obligations under 
55.16 	paragraph (e).
55.17 	Any spousal income or assets shall be disregarded for purposes of eligibility and premium 
55.18 	determinations.
55.19 	(b) After the month of enrollment, a person enrolled in medical assistance under 
55.20 	this subdivision who:
55.21 	(1) is temporarily unable to work and without receipt of earned income due to a 
55.22 	medical condition, as verified by a physician, may retain eligibility for up to four calendar 
55.23 	months; or
55.24 	(2) effective January 1, 2004, loses employment for reasons not attributable to the 
55.25 	enrollee, may retain eligibility for up to four consecutive months after the month of job 
55.26 	loss. To receive a four-month extension, enrollees must verify the medical condition or 
55.27 	provide notification of job loss. All other eligibility requirements must be met and the 
55.28 	enrollee must pay all calculated premium costs for continued eligibility.
55.29 	(c) For purposes of determining eligibility under this subdivision, a person's assets 
55.30 	must not exceed $20,000, excluding:
55.31 	(1) all assets excluded under section 256B.056;
55.32 	(2) retirement accounts, including individual accounts, 401(k) plans, 403(b) plans, 
55.33 	Keogh plans, and pension plans; and
55.34 	(3) medical expense accounts set up through the person's employer.
56.1 	(d)(1) Effective January 1, 2004, for purposes of eligibility, there will be a $65 
56.2 	earned income disregard. To be eligible, a person applying for medical assistance under 
56.3 	this subdivision must have earned income above the disregard level.
56.4 	(2) Effective January 1, 2004, to be considered earned income, Medicare, Social 
56.5 	Security, and applicable state and federal income taxes must be withheld. To be eligible, 
56.6 	a person must document earned income tax withholding.
56.7 	(e)(1) A person whose earned and unearned income is equal to or greater than 100 
56.8 	percent of federal poverty guidelines for the applicable family size must pay a premium 
56.9 	to be eligible for medical assistance under this subdivision. The premium shall be based 
56.10 	on the person's gross earned and unearned income and the applicable family size using a 
56.11 	sliding fee scale established by the commissioner, which begins at one percent of income 
56.12 	at 100 percent of the federal poverty guidelines and increases to 7.5 percent of income 
56.13 	for those with incomes at or above 300 percent of the federal poverty guidelines. Annual 
56.14 	adjustments in the premium schedule based upon changes in the federal poverty guidelines 
56.15 	shall be effective for premiums due in July of each year.
56.16 	(2) Effective January 1, 2004, all enrollees must pay a premium to be eligible for 
56.17 	medical assistance under this subdivision. An enrollee shall pay the greater of a $35 
56.18 	premium or the premium calculated in clause (1).
56.19 	(3) Effective November 1, 2003, all enrollees who receive unearned income must 
56.20 	pay one-half of one percent of unearned income in addition to the premium amount.
56.21 	(4) Effective November 1, 2003, for enrollees whose income does not exceed 200 
56.22 	percent of the federal poverty guidelines and who are also enrolled in Medicare, the 
56.23 	commissioner must reimburse the enrollee for Medicare Part B premiums under section 
56.24 	256B.0625, subdivision 15, paragraph (a).
56.25 	(5) Increases in benefits under title II of the Social Security Act shall not be counted 
56.26 	as income for purposes of this subdivision until July 1 of each year.
56.27 	(f) A person's eligibility and premium shall be determined by the local county 
56.28 	agency. Premiums must be paid to the commissioner. All premiums are dedicated to 
56.29 	the commissioner.
56.30 	(g) Any required premium shall be determined at application and redetermined at 
56.31 	the enrollee's six-month income review or when a change in income or household size is 
56.32 	reported. Enrollees must report any change in income or household size within ten days 
56.33 	of when the change occurs. A decreased premium resulting from a reported change in 
56.34 	income or household size shall be effective the first day of the next available billing month 
56.35 	after the change is reported. Except for changes occurring from annual cost-of-living 
57.1 	increases, a change resulting in an increased premium shall not affect the premium amount 
57.2 	until the next six-month review.
57.3 	(h) Premium payment is due upon notification from the commissioner of the 
57.4 	premium amount required. Premiums may be paid in installments at the discretion of 
57.5 	the commissioner.
57.6 	(i) Nonpayment of the premium shall result in denial or termination of medical 
57.7 	assistance unless the person demonstrates good cause for nonpayment. Good cause exists 
57.8 	if the requirements specified in Minnesota Rules, part 9506.0040, subpart 7, items B to 
57.9 	D, are met. Except when an installment agreement is accepted by the commissioner, 
57.10 	all persons disenrolled for nonpayment of a premium must pay any past due premiums 
57.11 	as well as current premiums due prior to being reenrolled. Nonpayment shall include 
57.12 	payment with a returned, refused, or dishonored instrument. The commissioner may 
57.13 	require a guaranteed form of payment as the only means to replace a returned, refused, 
57.14 	or dishonored instrument.
57.15 	(j) The commissioner shall notify enrollees annually beginning at least 24 months 
57.16 	before the person's 65th birthday of the medical assistance eligibility rules affecting 
57.17 	income, assets, and treatment of a spouse's income and assets that will be applied upon 
57.18 	reaching age 65.

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

57.20 	Sec. 12. Minnesota Statutes 2009 Supplement, section 256B.0659, subdivision 11, 
57.21 	is amended to read:
57.22 		Subd. 11.Personal care assistant; requirements. (a) A personal care assistant 
57.23 	must meet the following requirements:
57.24 	(1) be at least 18 years of age with the exception of persons who are 16 or 17 years 
57.25 	of age with these additional requirements:
57.26 	(i) supervision by a qualified professional every 60 days; and
57.27 	(ii) employment by only one personal care assistance provider agency responsible 
57.28 	for compliance with current labor laws;
57.29 	(2) be employed by a personal care assistance provider agency;
57.30 	(3) enroll with the department as a personal care assistant after clearing a background 
57.31 	study. Before a personal care assistant provides services, the personal care assistance 
57.32 	provider agency must initiate a background study on the personal care assistant under 
57.33 	chapter 245C, and the personal care assistance provider agency must have received a 
57.34 	notice from the commissioner that the personal care assistant is:
57.35 	(i) not disqualified under section 245C.14; or
58.1 	(ii) is disqualified, but the personal care assistant has received a set aside of the 
58.2 	disqualification under section 245C.22;
58.3 	(4) be able to effectively communicate with the recipient and personal care 
58.4 	assistance provider agency;
58.5 	(5) be able to provide covered personal care assistance services according to the 
58.6 	recipient's personal care assistance care plan, respond appropriately to recipient needs, 
58.7 	and report changes in the recipient's condition to the supervising qualified professional 
58.8 	or physician;
58.9 	(6) not be a consumer of personal care assistance services;
58.10 	(7) maintain daily written records including, but not limited to, time sheets under 
58.11 	subdivision 12;
58.12 	(8) effective January 1, 2010, complete standardized training as determined by the 
58.13 	commissioner before completing enrollment. Personal care assistant training must include 
58.14 	successful completion of the following training components: basic first aid, vulnerable 
58.15 	adult, child maltreatment, OSHA universal precautions, basic roles and responsibilities of 
58.16 	personal care assistants including information about assistance with lifting and transfers 
58.17 	for recipients, emergency preparedness, orientation to positive behavioral practices, fraud 
58.18 	issues, and completion of time sheets. Upon completion of the training components, 
58.19 	the personal care assistant must demonstrate the competency to provide assistance to 
58.20 	recipients;
58.21 	(9) complete training and orientation on the needs of the recipient within the first 
58.22 	seven days after the services begin; and
58.23 	(10) be limited to providing and being paid for up to 310 275  hours per month of 
58.24 	personal care assistance services regardless of the number of recipients being served or the 
58.25 	number of personal care assistance provider agencies enrolled with.
58.26 	(b) A legal guardian may be a personal care assistant if the guardian is not being paid 
58.27 	for the guardian services and meets the criteria for personal care assistants in paragraph (a).
58.28 	(c) Effective January 1, 2010, persons who do not qualify as a personal care assistant 
58.29 	include parents and stepparents of minors, spouses, paid legal guardians, family foster 
58.30 	care providers, except as otherwise allowed in section 256B.0625, subdivision 19a, or 
58.31 	staff of a residential setting.

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

58.33 	Sec. 13. Minnesota Statutes 2009 Supplement, section 256B.0911, subdivision 3c, 
58.34 	is amended to read:
59.1 		Subd. 3c.Transition to housing with services. (a) Housing with services 
59.2 	establishments offering or providing assisted living under chapter 144G shall inform 
59.3 	all prospective residents of the availability of and contact information for transitional 
59.4 	consultation services under this subdivision prior to executing a lease or contract with 
59.5 	the prospective resident requirement to contact the Senior LinkAge Line for long-term 
59.6 	care options counseling and transitional consultation. The Senior LinkAge Line shall 
59.7 	provide a certificate to the prospective resident and also send a copy of the certificate to 
59.8 	the housing with services establishment that the prospective resident chooses, verifying 
59.9 	that consultation has been provided to the prospective resident or the prospective 
59.10 	resident's legal representative. The housing with services establishment shall not execute a 
59.11 	contract or allow a prospective resident to move in until the establishment has received 
59.12 	certification from the Senior LinkAge Line. Prospective residents refusing to contact the 
59.13 	Senior LinkAge Line are required to sign a waiver form supplied by the provider. The 
59.14 	housing with services establishment shall maintain copies of contracts, waiver forms, and 
59.15 	certificates for audit for a period of three years. The purpose of transitional long-term care 
59.16 	consultation is to support persons with current or anticipated long-term care needs in 
59.17 	making informed choices among options that include the most cost-effective and least 
59.18 	restrictive settings, and to delay spenddown to eligibility for publicly funded programs by 
59.19 	connecting people to alternative services in their homes before transition to housing with 
59.20 	services. Regardless of the consultation, prospective residents maintain the right to choose 
59.21 	housing with services or assisted living if that option is their preference.
59.22 	(b) Transitional consultation services are provided as determined by the 
59.23 	commissioner of human services in partnership with county long-term care consultation 
59.24 	units, and the Area Agencies on Aging under section 144D.03, subdivision 3, and 
59.25 	are a combination of telephone-based and in-person assistance provided under models 
59.26 	developed by the commissioner. The consultation shall be performed in a manner that 
59.27 	provides objective and complete information. Transitional consultation must be provided 
59.28 	within five working days of the request of the prospective resident as follows:
59.29 	(1) the consultation must be provided by a qualified professional as determined by 
59.30 	the commissioner;
59.31 	(2) the consultation must include a review of the prospective resident's reasons for 
59.32 	considering assisted living, the prospective resident's personal goals, a discussion of the 
59.33 	prospective resident's immediate and projected long-term care needs, and alternative 
59.34 	community services or assisted living settings that may meet the prospective resident's 
59.35 	needs; and
60.1 	(3) the prospective resident shall be informed of the availability of long-term care 
60.2 	consultation services described in subdivision 3a that are available at no charge to the 
60.3 	prospective resident to assist the prospective resident in assessment and planning to meet 
60.4 	the prospective resident's long-term care needs. The Senior LinkAge Line and long-term 
60.5 	care consultation team shall give the highest priority to referrals who are at highest risk of 
60.6 	nursing facility placement or as needed for determining eligibility.;
60.7 	(4) a prospective resident does not include a person moving from the community, 
60.8 	a hospital, or an institutional setting to housing with services during nonworking hours 
60.9 	when:
60.10 	(i) the move is based on a recent precipitating event that precludes the person from 
60.11 	living safely in the community or institution, such as sustaining injury, unanticipated 
60.12 	discharge from hospital or nursing facility, inability of caregivers to provide needed care, 
60.13 	lack of access to needed care or services, or declining health status; and
60.14 	(ii) the Senior LinkAge Line is contacted within ten working days following the 
60.15 	move to the registered housing with services, or as soon as is reasonable considering 
60.16 	the prospective resident's condition; and
60.17 	(5) the Senior LinkAge Line may provide the long-term care options counseling and 
60.18 	transitional consultation service.

60.19 	Sec. 14. Minnesota Statutes 2008, section 256B.0915, is amended by adding a 
60.20 	subdivision to read:
60.21 		Subd. 3i.Rate reduction for customized living and 24-hour customized living 
60.22 	services. (a) Effective July 1, 2010, the commissioner shall reduce service component 
60.23 	rates and service rate limits for customized living services and 24-hour customized living 
60.24 	services, from the rates in effect on June 30, 2010, by five percent.
60.25 	(b) To implement the rate reductions in this subdivision, capitation rates paid by the 
60.26 	commissioner to managed care organizations under section 256B.69 shall reflect a ten 
60.27 	percent reduction for the specified services for the period January 1, 2011, to June 30, 
60.28 	2011, and a five percent reduction for those services on and after July 1, 2011.

60.29 	Sec. 15. Minnesota Statutes 2009 Supplement, section 256B.441, subdivision 55, 
60.30 	is amended to read:
60.31 		Subd. 55.Phase-in of rebased operating payment rates.  (a) For the rate years 
60.32 	beginning October 1, 2008, to October 1, 2015, the operating payment rate calculated 
60.33 	under this section shall be phased in by blending the operating rate with the operating 
60.34 	payment rate determined under section 256B.434. For purposes of this subdivision, the 
61.1 	rate to be used that is determined under section 256B.434 shall not include the portion of 
61.2 	the operating payment rate related to performance-based incentive payments under section 
61.3 	256B.434, subdivision 4, paragraph (d). For the rate year beginning October 1, 2008, the 
61.4 	operating payment rate for each facility shall be 13 percent of the operating payment rate 
61.5 	from this section, and 87 percent of the operating payment rate from section 256B.434. 
61.6 	For the rate year beginning October 1, 2009, the operating payment rate for each facility 
61.7 	shall be 14 percent of the operating payment rate from this section, and 86 percent of 
61.8 	the operating payment rate from section 256B.434. For rate years beginning October 1, 
61.9 	2010; October 1, 2011; and October 1, 2012, For the rate period from October 1, 2009, to 
61.10 	September 30, 2013,  no rate adjustments shall be implemented under this section, but shall 
61.11 	be determined under section 256B.434. For the rate year beginning October 1, 2013, the 
61.12 	operating payment rate for each facility shall be 65 percent of the operating payment rate 
61.13 	from this section, and 35 percent of the operating payment rate from section 256B.434. 
61.14 	For the rate year beginning October 1, 2014, the operating payment rate for each facility 
61.15 	shall be 82 percent of the operating payment rate from this section, and 18 percent of the 
61.16 	operating payment rate from section 256B.434. For the rate year beginning October 1, 
61.17 	2015, the operating payment rate for each facility shall be the operating payment rate 
61.18 	determined under this section. The blending of operating payment rates under this section 
61.19 	shall be performed separately for each RUG's class.
61.20 	(b) For the rate year beginning October 1, 2008, the commissioner shall apply limits 
61.21 	to the operating payment rate increases under paragraph (a) by creating a minimum 
61.22 	percentage increase and a maximum percentage increase.
61.23 	(1) Each nursing facility that receives a blended October 1, 2008, operating payment 
61.24 	rate increase under paragraph (a) of less than one percent, when compared to its operating 
61.25 	payment rate on September 30, 2008, computed using rates with RUG's weight of 1.00, 
61.26 	shall receive a rate adjustment of one percent.
61.27 	(2) The commissioner shall determine a maximum percentage increase that will 
61.28 	result in savings equal to the cost of allowing the minimum increase in clause (1). Nursing 
61.29 	facilities with a blended October 1, 2008, operating payment rate increase under paragraph 
61.30 	(a) greater than the maximum percentage increase determined by the commissioner, when 
61.31 	compared to its operating payment rate on September 30, 2008, computed using rates with 
61.32 	a RUG's weight of 1.00, shall receive the maximum percentage increase.
61.33 	(3) Nursing facilities with a blended October 1, 2008, operating payment rate 
61.34 	increase under paragraph (a) greater than one percent and less than the maximum 
61.35 	percentage increase determined by the commissioner, when compared to its operating 
61.36 	payment rate on September 30, 2008, computed using rates with a RUG's weight of 1.00, 
62.1 	shall receive the blended October 1, 2008, operating payment rate increase determined 
62.2 	under paragraph (a).
62.3 	(4) The October 1, 2009, through October 1, 2015, operating payment rate for 
62.4 	facilities receiving the maximum percentage increase determined in clause (2) shall be 
62.5 	the amount determined under paragraph (a) less the difference between the amount 
62.6 	determined under paragraph (a) for October 1, 2008, and the amount allowed under clause 
62.7 	(2). This rate restriction does not apply to rate increases provided in any other section.
62.8 	(c) A portion of the funds received under this subdivision that are in excess of 
62.9 	operating payment rates that a facility would have received under section 256B.434, as 
62.10 	determined in accordance with clauses (1) to (3), shall be subject to the requirements in 
62.11 	section 256B.434, subdivision 19, paragraphs (b) to (h).
62.12 	(1) Determine the amount of additional funding available to a facility, which shall be 
62.13 	equal to total medical assistance resident days from the most recent reporting year times 
62.14 	the difference between the blended rate determined in paragraph (a) for the rate year being 
62.15 	computed and the blended rate for the prior year.
62.16 	(2) Determine the portion of all operating costs, for the most recent reporting year, 
62.17 	that are compensation related. If this value exceeds 75 percent, use 75 percent.
62.18 	(3) Subtract the amount determined in clause (2) from 75 percent.
62.19 	(4) The portion of the fund received under this subdivision that shall be subject to 
62.20 	the requirements in section 256B.434, subdivision 19, paragraphs (b) to (h), shall equal 
62.21 	the amount determined in clause (1) times the amount determined in clause (3).

62.22 	EFFECTIVE DATE. This section is effective retroactive to October 1, 2009.

62.23 	Sec. 16. Minnesota Statutes 2008, section 256B.5012, is amended by adding a 
62.24 	subdivision to read:
62.25 		Subd. 9.Rate increase effective June 1, 2010. For rate periods beginning on or 
62.26 	after June 1, 2010, the commissioner shall increase the total operating payment rate for 
62.27 	each facility reimbursed under this section by $8.74 per day. The increase shall not be 
62.28 	subject to any annual percentage increase.

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

62.30 	Sec. 17. Minnesota Statutes 2009 Supplement, section 256B.69, subdivision 23, 
62.31 	is amended to read:
62.32 		Subd. 23.Alternative services; elderly and disabled persons. (a) The 
62.33 	commissioner may implement demonstration projects to create alternative integrated 
63.1 	delivery systems for acute and long-term care services to elderly persons and persons 
63.2 	with disabilities as defined in section 256B.77, subdivision 7a, that provide increased 
63.3 	coordination, improve access to quality services, and mitigate future cost increases. 
63.4 	The commissioner may seek federal authority to combine Medicare and Medicaid 
63.5 	capitation payments for the purpose of such demonstrations and may contract with 
63.6 	Medicare-approved special needs plans to provide Medicaid services. Medicare funds and 
63.7 	services shall be administered according to the terms and conditions of the federal contract 
63.8 	and demonstration provisions. For the purpose of administering medical assistance funds, 
63.9 	demonstrations under this subdivision are subject to subdivisions 1 to 22. The provisions 
63.10 	of Minnesota Rules, parts 9500.1450 to 9500.1464, apply to these demonstrations, 
63.11 	with the exceptions of parts 9500.1452, subpart 2, item B; and 9500.1457, subpart 1, 
63.12 	items B and C, which do not apply to persons enrolling in demonstrations under this 
63.13 	section. An initial open enrollment period may be provided. Persons who disenroll from 
63.14 	demonstrations under this subdivision remain subject to Minnesota Rules, parts 9500.1450 
63.15 	to 9500.1464. When a person is enrolled in a health plan under these demonstrations and 
63.16 	the health plan's participation is subsequently terminated for any reason, the person shall 
63.17 	be provided an opportunity to select a new health plan and shall have the right to change 
63.18 	health plans within the first 60 days of enrollment in the second health plan. Persons 
63.19 	required to participate in health plans under this section who fail to make a choice of 
63.20 	health plan shall not be randomly assigned to health plans under these demonstrations. 
63.21 	Notwithstanding section 256L.12, subdivision 5, and Minnesota Rules, part 9505.5220, 
63.22 	subpart 1, item A, if adopted, for the purpose of demonstrations under this subdivision, 
63.23 	the commissioner may contract with managed care organizations, including counties, to 
63.24 	serve only elderly persons eligible for medical assistance, elderly and disabled persons, or 
63.25 	disabled persons only. For persons with a primary diagnosis of developmental disability, 
63.26 	serious and persistent mental illness, or serious emotional disturbance, the commissioner 
63.27 	must ensure that the county authority has approved the demonstration and contracting 
63.28 	design. Enrollment in these projects for persons with disabilities shall be voluntary. The 
63.29 	commissioner shall not implement any demonstration project under this subdivision for 
63.30 	persons with a primary diagnosis of developmental disabilities, serious and persistent 
63.31 	mental illness, or serious emotional disturbance, without approval of the county board of 
63.32 	the county in which the demonstration is being implemented.
63.33 	(b) Notwithstanding chapter 245B, sections 252.40 to 252.46, 256B.092, 256B.501 
63.34 	to 256B.5015, and Minnesota Rules, parts 9525.0004 to 9525.0036, 9525.1200 to 
63.35 	9525.1330, 9525.1580, and 9525.1800 to 9525.1930, the commissioner may implement 
63.36 	under this section projects for persons with developmental disabilities. The commissioner 
64.1 	may capitate payments for ICF/MR services, waivered services for developmental 
64.2 	disabilities, including case management services, day training and habilitation and 
64.3 	alternative active treatment services, and other services as approved by the state and by the 
64.4 	federal government. Case management and active treatment must be individualized and 
64.5 	developed in accordance with a person-centered plan. Costs under these projects may not 
64.6 	exceed costs that would have been incurred under fee-for-service. Beginning July 1, 2003, 
64.7 	and until four years after the pilot project implementation date, subcontractor participation 
64.8 	in the long-term care developmental disability pilot is limited to a nonprofit long-term 
64.9 	care system providing ICF/MR services, home and community-based waiver services, 
64.10 	and in-home services to no more than 120 consumers with developmental disabilities in 
64.11 	Carver, Hennepin, and Scott Counties. The commissioner shall report to the legislature 
64.12 	prior to expansion of the developmental disability pilot project. This paragraph expires 
64.13 	four years after the implementation date of the pilot project.
64.14 	(c) Before implementation of a demonstration project for disabled persons, the 
64.15 	commissioner must provide information to appropriate committees of the house of 
64.16 	representatives and senate and must involve representatives of affected disability groups 
64.17 	in the design of the demonstration projects.
64.18 	(d) A nursing facility reimbursed under the alternative reimbursement methodology 
64.19 	in section 256B.434 may, in collaboration with a hospital, clinic, or other health care entity 
64.20 	provide services under paragraph (a). The commissioner shall amend the state plan and 
64.21 	seek any federal waivers necessary to implement this paragraph.
64.22 	(e) The commissioner, in consultation with the commissioners of commerce and 
64.23 	health, may approve and implement programs for all-inclusive care for the elderly (PACE) 
64.24 	according to federal laws and regulations governing that program and state laws or rules 
64.25 	applicable to participating providers. The process for approval of these programs shall 
64.26 	begin only after the commissioner receives grant money in an amount sufficient to cover 
64.27 	the state share of the administrative and actuarial costs to implement the programs during 
64.28 	state fiscal years 2006 and 2007. Grant amounts for this purpose shall be deposited in an 
64.29 	account in the special revenue fund and are appropriated to the commissioner to be used 
64.30 	solely for the purpose of PACE administrative and actuarial costs. A PACE provider is 
64.31 	not required to be licensed or certified as a health plan company as defined in section 
64.32 	62Q.01, subdivision 4. Persons age 55 and older who have been screened by the county 
64.33 	and found to be eligible for services under the elderly waiver or community alternatives 
64.34 	for disabled individuals or who are already eligible for Medicaid but meet level of 
64.35 	care criteria for receipt of waiver services may choose to enroll in the PACE program. 
64.36 	Medicare and Medicaid services will be provided according to this subdivision and 
65.1 	federal Medicare and Medicaid requirements governing PACE providers and programs. 
65.2 	PACE enrollees will receive Medicaid home and community-based services through the 
65.3 	PACE provider as an alternative to services for which they would otherwise be eligible 
65.4 	through home and community-based waiver programs and Medicaid State Plan Services. 
65.5 	The commissioner shall establish Medicaid rates for PACE providers that do not exceed 
65.6 	costs that would have been incurred under fee-for-service or other relevant managed care 
65.7 	programs operated by the state.
65.8 	(f) The commissioner shall seek federal approval to expand the Minnesota disability 
65.9 	health options (MnDHO) program established under this subdivision in stages, first to 
65.10 	regional population centers outside the seven-county metro area and then to all areas of 
65.11 	the state. Until July 1, 2009, expansion for MnDHO projects that include home and 
65.12 	community-based services is limited to the two projects and service areas in effect on 
65.13 	March 1, 2006. Enrollment in integrated MnDHO programs that include home and 
65.14 	community-based services shall remain voluntary. Costs for home and community-based 
65.15 	services included under MnDHO must not exceed costs that would have been incurred 
65.16 	under the fee-for-service program. Notwithstanding whether expansion occurs under 
65.17 	this paragraph, in determining MnDHO payment rates and risk adjustment methods for 
65.18 	contract years starting in 2012, the commissioner must consider the methods used to 
65.19 	determine county allocations for home and community-based program participants. If 
65.20 	necessary to reduce MnDHO rates to comply with the provision regarding MnDHO costs 
65.21 	for home and community-based services, the commissioner shall achieve the reduction 
65.22 	by maintaining the base rate for contract years year 2010 and 2011 for services provided 
65.23 	under the community alternatives for disabled individuals waiver at the same level as for 
65.24 	contract year 2009. The commissioner may apply other reductions to MnDHO rates to 
65.25 	implement decreases in provider payment rates required by state law. Effective December 
65.26 	31, 2010, enrollment and operation of the MnDHO program in effect during 2010 shall 
65.27 	cease. The commissioner may reopen the program provided all applicable conditions of 
65.28 	this section are met. In developing program specifications for expansion of integrated 
65.29 	programs, the commissioner shall involve and consult the state-level stakeholder group 
65.30 	established in subdivision 28, paragraph (d), including consultation on whether and how 
65.31 	to include home and community-based waiver programs. Plans for further expansion of to 
65.32 	reopen MnDHO projects shall be presented to the chairs of the house of representatives 
65.33 	and senate committees with jurisdiction over health and human services policy and finance 
65.34 	by February 1, 2007 prior to implementation.
65.35 	(g) Notwithstanding section 256B.0261, health plans providing services under this 
65.36 	section are responsible for home care targeted case management and relocation targeted 
66.1 	case management. Services must be provided according to the terms of the waivers and 
66.2 	contracts approved by the federal government.

66.3 	Sec. 18. Laws 2009, chapter 79, article 8, section 51, the effective date, is amended to 
66.4 	read:

66.5 	EFFECTIVE DATE. This section is effective January July 1, 2011.

66.6 	Sec. 19. Laws 2009, chapter 79, article 8, section 84, is amended to read:
66.7 	Sec. 84. HOUSING OPTIONS.
 66.8 	The commissioner of human services, in consultation with the commissioner of 
66.9 	administration and the Minnesota Housing Finance Agency, and representatives of 
66.10 	counties, residents' advocacy groups, consumers of housing services, and provider 
66.11 	agencies shall explore ways to maximize the availability and affordability of housing 
66.12 	choices available to persons with disabilities or who need care assistance due to other 
66.13 	health challenges. A goal shall also be to minimize state physical plant costs in order to 
66.14 	serve more persons with appropriate program and care support. Consideration shall be 
66.15 	given to:
66.16 	(1) improved access to rent subsidies;
66.17 	(2) use of cooperatives, land trusts, and other limited equity ownership models;
66.18 	(3) whether a public equity housing fund should be established that would maintain 
66.19 	the state's interest, to the extent paid from state funds, including group residential housing 
66.20 	and Minnesota supplemental aid shelter-needy funds in provider-owned housing, so that 
66.21 	when sold, the state would recover its share for a public equity fund to be used for future 
66.22 	public needs under this chapter;
66.23 	(4) the desirability of the state acquiring an ownership interest or promoting the 
66.24 	use of publicly owned housing;
66.25 	(5) promoting more choices in the market for accessible housing that meets the 
66.26 	needs of persons with physical challenges; and
66.27 	(6) what consumer ownership models, if any, are appropriate; and
66.28 	(7) a review of the definition of home and community services and appropriate 
66.29 	settings where these services may be provided, including the number of people who 
66.30 	may reside under one roof, through the home and community-based waivers for seniors 
66.31 	and individuals with disabilities.
66.32 	The commissioner shall provide a written report on the findings of the evaluation of 
66.33 	housing options to the chairs and ranking minority members of the house of representatives 
66.34 	and senate standing committees with jurisdiction over health and human services policy 
67.1 	and funding by December 15, 2010. This report shall replace the November 1, 2010, 
67.2 	annual report by the commissioner required in Minnesota Statutes, sections 256B.0916, 
67.3 	subdivision 7, and 256B.49, subdivision 21.

67.4 	Sec. 20. CASE MANAGEMENT REFORM.
 67.5 	(a) By February 1, 2011, the commissioner of human services shall provide specific 
67.6 	recommendations and language for proposed legislation to:
67.7 	(1) define the administrative and the service functions of case management for 
67.8 	persons with disabilities and make changes to improve the funding for administrative 
67.9 	functions;
67.10 	(2) standardize and simplify processes, standards, and timelines for case 
67.11 	management within the Department of Human Services, Disability Services Division, 
67.12 	including eligibility determinations, resource allocation, management of dollars, provision 
67.13 	for assignment of one case manager at a time per person, waiting lists, quality assurance, 
67.14 	host county concurrence requirements, county of financial responsibility provisions, and 
67.15 	waiver compliance; and
67.16 	(3) increase opportunities for consumer choice of case management functions 
67.17 	involving service coordination.
67.18 	(b) In developing these recommendations, the commissioner shall consider the 
67.19 	recommendations of the 2007 Redesigning Case Management Services for Persons 
67.20 	with Disabilities report and consult with existing stakeholder groups, which include 
67.21 	representatives of counties, disability and senior advocacy groups, service providers, and 
67.22 	representatives of agencies which provide contracted case management.

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

67.24 	Sec. 21. COMMISSIONER TO SEEK FEDERAL MATCH.
 67.25 	(a) The commissioner of human services shall seek federal financial participation 
67.26 	for eligible activity related to fiscal years 2010 and 2011 grants to Advocating Change 
67.27 	Together to establish a statewide self-advocacy network for persons with developmental 
67.28 	disabilities and for eligible activities under any future grants to the organization.
67.29 	(b) The commissioner shall report to the chairs and ranking minority members of 
67.30 	the senate Health and Human Services Budget Division and the house of representatives 
67.31 	Health Care and Human Services Finance Division by December 15, 2010, with the 
67.32 	results of the application for federal matching funds.

67.33 	Sec. 22. ICF/MR RATE INCREASE.
 68.1 	The daily rate at an intermediate care facility for the developmentally disabled 
68.2 	located in Clearwater County and classified as a Class A facility with 15 beds shall be 
68.3 	increased from $112.73 to $138.23 for the rate period July 1, 2010, to June 30, 2011.

68.4 	ARTICLE 3
68.5 	CHILDREN AND FAMILY SERVICES

68.6 	Section 1. Minnesota Statutes 2008, section 256D.0515, is amended to read:
68.7 	256D.0515 ASSET LIMITATIONS FOR FOOD STAMP HOUSEHOLDS.
68.8 	All food stamp households must be determined eligible for the benefit discussed 
68.9 	under section 256.029. Food stamp households must demonstrate that:
68.10 	(1) their gross income meets the federal Food Stamp requirements under United 
68.11 	States Code, title 7, section 2014(c); and
68.12 	(2) they have financial resources, excluding vehicles, of less than $7,000is equal to 
68.13 	or less than 165 percent of the federal poverty guidelines for the same family size.

68.14 	EFFECTIVE DATE. This section is effective November 1, 2010.

68.15 	Sec. 2. Minnesota Statutes 2008, section 256I.05, is amended by adding a subdivision 
68.16 	to read:
68.17 		Subd. 1n.Supplemental rate; Mahnomen County. Notwithstanding the 
68.18 	provisions of this section, for the rate period July 1, 2010, to June 30, 2011, a county 
68.19 	agency shall negotiate a supplemental service rate in addition to the rate specified in 
68.20 	subdivision 1, not to exceed $753 per month or the existing rate, including any legislative 
68.21 	authorized inflationary adjustments, for a group residential provider located in Mahnomen 
68.22 	County that operates a 28-bed facility providing 24-hour care to individuals who are 
68.23 	homeless, disabled, chemically dependent, mentally ill, or chronically homeless.

68.24 	Sec. 3. Minnesota Statutes 2008, section 256J.24, subdivision 6, is amended to read:
68.25 		Subd. 6.Family cap. (a) MFIP assistance units shall not receive an increase in the 
68.26 	cash portion of the transitional standard as a result of the birth of a child, unless one of 
68.27 	the conditions under paragraph (b) is met. The child shall be considered a member of the 
68.28 	assistance unit according to subdivisions 1 to 3, but shall be excluded in determining 
68.29 	family size for purposes of determining the amount of the cash portion of the transitional 
68.30 	standard under subdivision 5. The child shall be included in determining family size for 
68.31 	purposes of determining the food portion of the transitional standard. The transitional 
68.32 	standard under this subdivision shall be the total of the cash and food portions as specified 
69.1 	in this paragraph. The family wage level under this subdivision shall be based on the 
69.2 	family size used to determine the food portion of the transitional standard.
69.3 	(b) A child shall be included in determining family size for purposes of determining 
69.4 	the amount of the cash portion of the MFIP transitional standard when at least one of 
69.5 	the following conditions is met:
69.6 	(1) for families receiving MFIP assistance on July 1, 2003, the child is born to the 
69.7 	adult parent before May 1, 2004;
69.8 	(2) for families who apply for the diversionary work program under section 256J.95
69.9 	or MFIP assistance on or after July 1, 2003, the child is born to the adult parent within 
69.10 	ten months of the date the family is eligible for assistance; 
69.11 	(3) the child was conceived as a result of a sexual assault or incest, provided that the 
69.12 	incident has been reported to a law enforcement agency;
69.13 	(4) the child's mother is a minor caregiver as defined in section 256J.08, subdivision 
69.14 	59, and the child, or multiple children, are the mother's first birth; or
69.15 	(5) the child is the mother's first child subsequent to a pregnancy that did not result 
69.16 	in a live birth; or
69.17 	(6) any child previously excluded in determining family size under paragraph 
69.18 	(a) shall be included if the adult parent or parents have not received benefits from the 
69.19 	diversionary work program under section 256J.95 or MFIP assistance in the previous ten 
69.20 	months. An adult parent or parents who reapply and have received benefits from the 
69.21 	diversionary work program or MFIP assistance in the past ten months shall be under the 
69.22 	ten-month grace period of their previous application under clause (2).
69.23 	(c) Income and resources of a child excluded under this subdivision, except child 
69.24 	support received or distributed on behalf of this child, must be considered using the same 
69.25 	policies as for other children when determining the grant amount of the assistance unit.
69.26 	(d) The caregiver must assign support and cooperate with the child support 
69.27 	enforcement agency to establish paternity and collect child support on behalf of the 
69.28 	excluded child. Failure to cooperate results in the sanction specified in section 256J.46, 
69.29 	subdivisions 2 and 2a. Current support paid on behalf of the excluded child shall be 
69.30 	distributed according to section 256.741, subdivision 15. 
69.31 	(e) County agencies must inform applicants of the provisions under this subdivision 
69.32 	at the time of each application and at recertification.
69.33 	(f) Children excluded under this provision shall be deemed MFIP recipients for 
69.34 	purposes of child care under chapter 119B.

69.35 	EFFECTIVE DATE. This section is effective September 1, 2010.

70.1 	Sec. 4. Minnesota Statutes 2009 Supplement, section 256J.425, subdivision 3, is 
70.2 	amended to read:
70.3 		Subd. 3.Hard-to-employ participants. (a) An assistance unit subject to the time 
70.4 	limit in section 256J.42, subdivision 1, is eligible to receive months of assistance under 
70.5 	a hardship extension if the participant who reached the time limit belongs to any of the 
70.6 	following groups: 
70.7 	(1) a person who is diagnosed by a licensed physician, psychological practitioner, or 
70.8 	other qualified professional, as developmentally disabled or mentally ill, and the condition 
70.9 	severely limits the person's ability to obtain or maintain suitable employment;
70.10 	(2) a person who:
70.11 	(i) has been assessed by a vocational specialist or the county agency to be 
70.12 	unemployable for purposes of this subdivision; or
70.13 	(ii) has an IQ below 80 who has been assessed by a vocational specialist or a county 
70.14 	agency to be employable, but the condition severely limits the person's ability to obtain or 
70.15 	maintain suitable employment. The determination of IQ level must be made by a qualified 
70.16 	professional. In the case of a non-English-speaking person: (A) the determination must 
70.17 	be made by a qualified professional with experience conducting culturally appropriate 
70.18 	assessments, whenever possible; (B) the county may accept reports that identify an 
70.19 	IQ range as opposed to a specific score; (C) these reports must include a statement of 
70.20 	confidence in the results;
70.21 	(3) a person who is determined by a qualified professional to be learning disabled, 
70.22 	and the condition severely limits the person's ability to obtain or maintain suitable 
70.23 	employment. For purposes of the initial approval of a learning disability extension, the 
70.24 	determination must have been made or confirmed within the previous 12 months. In the 
70.25 	case of a non-English-speaking person: (i) the determination must be made by a qualified 
70.26 	professional with experience conducting culturally appropriate assessments, whenever 
70.27 	possible; and (ii) these reports must include a statement of confidence in the results. If a 
70.28 	rehabilitation plan for a participant extended as learning disabled is developed or approved 
70.29 	by the county agency, the plan must be incorporated into the employment plan. However, 
70.30 	a rehabilitation plan does not replace the requirement to develop and comply with an 
70.31 	employment plan under section 256J.521; or 
70.32 	(4) a person who has been granted a family violence waiver, and who is complying 
70.33 	with an employment plan under section 256J.521, subdivision 3. 
70.34 	(b) For purposes of this section chapter, "severely limits the person's ability to obtain 
70.35 	or maintain suitable employment" means: 
71.1 	(1) that a qualified professional has determined that the person's condition prevents 
71.2 	the person from working 20 or more hours per week; or 
71.3 	(2) for a person who meets the requirements of paragraph (a), clause (2), item (ii), or 
71.4 	clause (3), a qualified professional has determined the person's condition:
71.5 	(i) significantly restricts the range of employment that the person is able to perform; 
71.6 	or 
71.7 	(ii) significantly interferes with the person's ability to obtain or maintain suitable 
71.8 	employment for 20 or more hours per week.

71.9 	Sec. 5.  REPEALER.
 71.10 	Minnesota Statutes 2009 Supplement, section 256J.621, is repealed.

71.11 	EFFECTIVE DATE. This section is effective December 1, 2010.

71.12 	ARTICLE 4
71.13 	MISCELLANEOUS

71.14 	Section 1. [62Q.545] COVERAGE OF PRIVATE DUTY NURSING SERVICES.
71.15 	(a) Private duty nursing services, as provided under section 256B.0625, subdivision 
71.16 	7, with the exception of section 256B.0654, subdivision 4, shall be covered under a health 
71.17 	plan for persons who are concurrently covered by both the health plan  and enrolled in 
71.18 	medical assistance under chapter 256B.
71.19 	(b) For purposes of this section, a period of private duty nursing services may 
71.20 	be subject to the co-payment, coinsurance, deductible, or other enrollee cost-sharing 
71.21 	requirements that apply under the health plan. Cost-sharing requirements for private 
71.22 	duty nursing services must not place a greater financial burden on the insured or enrollee 
71.23 	than those requirements applied by the health plan to other similar services or benefits. 
71.24 	Nothing in this section is intended to prevent a health plan company from requiring 
71.25 	prior authorization by the health plan company for such services as required by section 
71.26 	256B.0625, subdivision 7, or use of contracted providers under the applicable provisions 
71.27 	of the health plan.

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

71.30 	Sec. 2. [137.32] MINNESOTA COUPLES ON THE BRINK PROJECT.
71.31 		Subdivision 1.Establishment. Within the limits of available appropriations, the 
71.32 	Board of Regents of the University of Minnesota is requested to develop and implement 
72.1 	a Minnesota couples on the brink project, as provided for in this section. The regents 
72.2 	may administer the project with federal grants, state appropriations, and in-kind services 
72.3 	received for this purpose.
72.4 		Subd. 2.Purpose. The purpose of the project is to develop, evaluate, and 
72.5 	disseminate best practices for promoting successful reconciliation between married 
72.6 	persons who are considering or have commenced a marriage dissolution proceeding and 
72.7 	who choose to pursue reconciliation.
72.8 		Subd. 3.Implementation. The regents shall:
72.9 	(1) enter into contracts or manage a grant process for implementation of the project; 
72.10 	and
72.11 	(2) develop and implement an evaluation component for the project.

72.12 	Sec. 3. Minnesota Statutes 2008, section 152.126, as amended by Laws 2009, chapter 
72.13 	79, article 11, sections 9, 10, and 11, is amended to read:
72.14 	152.126 SCHEDULE II AND III CONTROLLED SUBSTANCES 
72.15 	PRESCRIPTION ELECTRONIC REPORTING SYSTEM.
72.16 		Subdivision 1.Definitions. For purposes of this section, the terms defined in this 
72.17 	subdivision have the meanings given.
72.18 	(a) "Board" means the Minnesota State Board of Pharmacy established under 
72.19 	chapter 151.
72.20 	(b) "Controlled substances" means those substances listed in section 152.02, 
72.21 	subdivisions 3 to 5, and those substances defined by the board pursuant to section 152.02, 
72.22 	subdivisions 7, 8, and 12.
72.23 	(c) "Dispense" or "dispensing" has the meaning given in section 151.01, subdivision 
72.24 	30. Dispensing does not include the direct administering of a controlled substance to a 
72.25 	patient by a licensed health care professional.
72.26 	(d) "Dispenser" means a person authorized by law to dispense a controlled substance, 
72.27 	pursuant to a valid prescription. For the purposes of this section, a dispenser does not 
72.28 	include a licensed hospital pharmacy that distributes controlled substances for inpatient 
72.29 	hospital care or a veterinarian who is dispensing prescriptions under section 156.18.
72.30 	(e) "Prescriber" means a licensed health care professional who is authorized to 
72.31 	prescribe a controlled substance under section 152.12, subdivision 1.
72.32 	(f) "Prescription" has the meaning given in section 151.01, subdivision 16.
72.33 		Subd. 1a.Treatment of intractable pain. This section is not intended to limit or 
72.34 	interfere with the legitimate prescribing of controlled substances for pain. No prescriber 
73.1 	shall be subject to disciplinary action by a health-related licensing board for prescribing a 
73.2 	controlled substance according to the provisions of section 152.125.
73.3 		Subd. 2.Prescription electronic reporting system. (a) The board shall establish 
73.4 	by January 1, 2010, an electronic system for reporting the information required under 
73.5 	subdivision 4 for all controlled substances dispensed within the state. 
73.6 	(b) The board may contract with a vendor for the purpose of obtaining technical 
73.7 	assistance in the design, implementation, operation, and maintenance of the electronic 
73.8 	reporting system. 
73.9 		Subd. 3.Prescription Electronic Reporting Advisory Committee. (a) The 
73.10 	board shall convene an advisory committee. The committee must include at least one 
73.11 	representative of:
73.12 	(1) the Department of Health;
73.13 	(2) the Department of Human Services;
73.14 	(3) each health-related licensing board that licenses prescribers;
73.15 	(4) a professional medical association, which may include an association of pain 
73.16 	management and chemical dependency specialists;
73.17 	(5) a professional pharmacy association;
73.18 	(6) a professional nursing association;
73.19 	(7) a professional dental association;
73.20 	(8) a consumer privacy or security advocate; and
73.21 	(9) a consumer or patient rights organization.
73.22 	(b) The advisory committee shall advise the board on the development and operation 
73.23 	of the electronic reporting system, including, but not limited to:
73.24 	(1) technical standards for electronic prescription drug reporting;
73.25 	(2) proper analysis and interpretation of prescription monitoring data; and
73.26 	(3) an evaluation process for the program.
73.27 	(c) The Board of Pharmacy, after consultation with the advisory committee, shall 
73.28 	present recommendations and draft legislation on the issues addressed by the advisory 
73.29 	committee under paragraph (b), to the legislature by December 15, 2007.
73.30 		Subd. 4.Reporting requirements; notice. (a) Each dispenser must submit the 
73.31 	following data to the board or its designated vendor, subject to the notice required under 
73.32 	paragraph (d):
73.33 	(1) name of the prescriber;
73.34 	(2) national provider identifier of the prescriber;
73.35 	(3) name of the dispenser;
73.36 	(4) national provider identifier of the dispenser;
74.1 	(5) prescription number;
74.2 	(6) name of the patient for whom the prescription was written;
74.3 	(7) address of the patient for whom the prescription was written;
74.4 	(8) date of birth of the patient for whom the prescription was written;
74.5 	(9) date the prescription was written;
74.6 	(10) date the prescription was filled;
74.7 	(11) name and strength of the controlled substance;
74.8 	(12) quantity of controlled substance prescribed;
74.9 	(13) quantity of controlled substance dispensed; and
74.10 	(14) number of days supply.
74.11 	(b) The dispenser must submit the required information by a procedure and in a 
74.12 	format established by the board. The board may allow dispensers to omit data listed in this 
74.13 	subdivision or may require the submission of data not listed in this subdivision provided 
74.14 	the omission or submission is necessary for the purpose of complying with the electronic 
74.15 	reporting or data transmission standards of the American Society for Automation in 
74.16 	Pharmacy, the National Council on Prescription Drug Programs, or other relevant national 
74.17 	standard-setting body.
74.18 	(c) A dispenser is not required to submit this data for those controlled substance 
74.19 	prescriptions dispensed for:
74.20 	(1) individuals residing in licensed skilled nursing or intermediate care facilities;
74.21 	(2) individuals receiving assisted living services under chapter 144G or through a 
74.22 	medical assistance home and community-based waiver;
74.23 	(3) individuals receiving medication intravenously;
74.24 	(4) individuals receiving hospice and other palliative or end-of-life care; and
74.25 	(5) individuals receiving services from a home care provider regulated under chapter 
74.26 	144A.
74.27 	(d) A dispenser must not submit data under this subdivision unless a conspicuous 
74.28 	notice of the reporting requirements of this section is given to the patient for whom the 
74.29 	prescription was written.
74.30 		Subd. 5.Use of data by board. (a) The board shall develop and maintain a database 
74.31 	of the data reported under subdivision 4. The board shall maintain data that could identify 
74.32 	an individual prescriber or dispenser in encrypted form. The database may be used by 
74.33 	permissible users identified under subdivision 6 for the identification of:
74.34 	(1) individuals receiving prescriptions for controlled substances from prescribers 
74.35 	who subsequently obtain controlled substances from dispensers in quantities or with a 
74.36 	frequency inconsistent with generally recognized standards of use for those controlled 
75.1 	substances, including standards accepted by national and international pain management 
75.2 	associations; and
75.3 	(2) individuals presenting forged or otherwise false or altered prescriptions for 
75.4 	controlled substances to dispensers.
75.5 	(b) No permissible user identified under subdivision 6 may access the database 
75.6 	for the sole purpose of identifying prescribers of controlled substances for unusual or 
75.7 	excessive prescribing patterns without a valid search warrant or court order.
75.8 	(c) No personnel of a state or federal occupational licensing board or agency may 
75.9 	access the database for the purpose of obtaining information to be used to initiate or 
75.10 	substantiate a disciplinary action against a prescriber.
75.11 	(d) Data reported under subdivision 4 shall be retained by the board in the database 
75.12 	for a 12-month period, and shall be removed from the database no later than 12 months 
75.13 	from the datethe last day of the month during which the data was received.
75.14 		Subd. 6.Access to reporting system data. (a) Except as indicated in this 
75.15 	subdivision, the data submitted to the board under subdivision 4 is private data on 
75.16 	individuals as defined in section 13.02, subdivision 12, and not subject to public disclosure.
75.17 	(b) Except as specified in subdivision 5, the following persons shall be considered 
75.18 	permissible users and may access the data submitted under subdivision 4 in the same or 
75.19 	similar manner, and for the same or similar purposes, as those persons who are authorized 
75.20 	to access similar private data on individuals under federal and state law:
75.21 	(1) a prescriber or an agent or employee of the prescriber to whom the prescriber has 
75.22 	delegated the task of accessing the data, to the extent the information relates specifically to 
75.23 	a current patient, to whom the prescriber is prescribing or considering prescribing any 
75.24 	controlled substance and with the provision that the prescriber remains responsible for the 
75.25 	use or misuse of data accessed by a delegated agent or employee;
75.26 	(2) a dispenser or an agent or employee of the dispenser to whom the dispenser has 
75.27 	delegated the task of accessing the data, to the extent the information relates specifically 
75.28 	to a current patient to whom that dispenser is dispensing or considering dispensing any 
75.29 	controlled substance and with the provision that the dispenser remains responsible for the 
75.30 	use or misuse of data accessed by a delegated agent or employee;
75.31 	(3) an individual who is the recipient of a controlled substance prescription for 
75.32 	which data was submitted under subdivision 4, or a guardian of the individual, parent or 
75.33 	guardian of a minor, or health care agent of the individual acting under a health care 
75.34 	directive under chapter 145C;
75.35 	(4) personnel of the board specifically assigned to conduct a bona fide investigation 
75.36 	of a specific licensee;
76.1 	(5) personnel of the board engaged in the collection of controlled substance 
76.2 	prescription information as part of the assigned duties and responsibilities under this 
76.3 	section;
76.4 	(6) authorized personnel of a vendor under contract with the board who are engaged 
76.5 	in the design, implementation, operation, and maintenance of the electronic reporting 
76.6 	system as part of the assigned duties and responsibilities of their employment, provided 
76.7 	that access to data is limited to the minimum amount necessary to carry out such duties 
76.8 	and responsibilities;
76.9 	(7) federal, state, and local law enforcement authorities acting pursuant to a valid 
76.10 	search warrant; and
76.11 	(8) personnel of the medical assistance program assigned to use the data collected 
76.12 	under this section to identify recipients whose usage of controlled substances may warrant 
76.13 	restriction to a single primary care physician, a single outpatient pharmacy, or a single 
76.14 	hospital.
76.15 	For purposes of clause (3), access by an individual includes persons in the definition 
76.16 	of an individual under section 13.02.
76.17 	(c) Any permissible user identified in paragraph (b), who directly accesses 
76.18 	the data electronically, shall implement and maintain a comprehensive information 
76.19 	security program that contains administrative, technical, and physical safeguards that 
76.20 	are appropriate to the user's size and complexity, and the sensitivity of the personal 
76.21 	information obtained. The permissible user shall identify reasonably foreseeable internal 
76.22 	and external risks to the security, confidentiality, and integrity of personal information 
76.23 	that could result in the unauthorized disclosure, misuse, or other compromise of the 
76.24 	information and assess the sufficiency of any safeguards in place to control the risks.
76.25 	(d) The board shall not release data submitted under this section unless it is provided 
76.26 	with evidence, satisfactory to the board, that the person requesting the information is 
76.27 	entitled to receive the data.
76.28 	(e) The board shall not release the name of a prescriber without the written consent 
76.29 	of the prescriber or a valid search warrant or court order. The board shall provide a 
76.30 	mechanism for a prescriber to submit to the board a signed consent authorizing the release 
76.31 	of the prescriber's name when data containing the prescriber's name is requested.
76.32 	(f) The board shall maintain a log of all persons who access the data and shall ensure 
76.33 	that any permissible user complies with paragraph (c) prior to attaining direct access to 
76.34 	the data.
77.1 	(g) Section 13.05, subdivision 6, shall apply to any contract the board enters into 
77.2 	pursuant to subdivision 2. A vendor shall not use data collected under this section for 
77.3 	any purpose not specified in this section.
77.4 		Subd. 7.Disciplinary action. (a) A dispenser who knowingly fails to submit data to 
77.5 	the board as required under this section is subject to disciplinary action by the appropriate 
77.6 	health-related licensing board.
77.7 	(b) A prescriber or dispenser authorized to access the data who knowingly discloses 
77.8 	the data in violation of state or federal laws relating to the privacy of health care data 
77.9 	shall be subject to disciplinary action by the appropriate health-related licensing board, 
77.10 	and appropriate civil penalties.
77.11 		Subd. 8.Evaluation and reporting. (a) The board shall evaluate the prescription 
77.12 	electronic reporting system to determine if the system is negatively impacting appropriate 
77.13 	prescribing practices of controlled substances. The board may contract with a vendor to 
77.14 	design and conduct the evaluation.
77.15 	(b) The board shall submit the evaluation of the system to the legislature by January
77.16 	July 15, 2011.
77.17 		Subd. 9.Immunity from liability; no requirement to obtain information. (a) A 
77.18 	pharmacist, prescriber, or other dispenser making a report to the program in good faith 
77.19 	under this section is immune from any civil, criminal, or administrative liability, which 
77.20 	might otherwise be incurred or imposed as a result of the report, or on the basis that the 
77.21 	pharmacist or prescriber did or did not seek or obtain or use information from the program.
77.22 	(b) Nothing in this section shall require a pharmacist, prescriber, or other dispenser 
77.23 	to obtain information about a patient from the program, and the pharmacist, prescriber, 
77.24 	or other dispenser, if acting in good faith, is immune from any civil, criminal, or 
77.25 	administrative liability that might otherwise be incurred or imposed for requesting, 
77.26 	receiving, or using information from the program.
77.27 		Subd. 10.Funding. (a) The board may seek grants and private funds from nonprofit 
77.28 	charitable foundations, the federal government, and other sources to fund the enhancement 
77.29 	and ongoing operations of the prescription electronic reporting system established under 
77.30 	this section. Any funds received shall be appropriated to the board for this purpose. The 
77.31 	board may not expend funds to enhance the program in a way that conflicts with this 
77.32 	section without seeking approval from the legislature.
77.33 	(b) The administrative services unit for the health-related licensing boards shall 
77.34 	apportion between the Board of Medical Practice, the Board of Nursing, the Board of 
77.35 	Dentistry, the Board of Podiatric Medicine, the Board of Optometry, and the Board 
77.36 	of Pharmacy an amount to be paid through fees by each respective board. The amount 
78.1 	apportioned to each board shall equal each board's share of the annual appropriation to 
78.2 	the Board of Pharmacy from the state government special revenue fund for operating the 
78.3 	prescription electronic reporting system under this section. Each board's apportioned 
78.4 	share shall be based on the number of prescribers or dispensers that each board identified 
78.5 	in this paragraph licenses as a percentage of the total number of prescribers and dispensers 
78.6 	licensed collectively by these boards. Each respective board may adjust the fees that the 
78.7 	boards are required to collect to compensate for the amount apportioned to each board by 
78.8 	the administrative services unit.

78.9 	Sec. 4. [246.125] CHEMICAL AND MENTAL HEALTH SERVICES 
78.10 	TRANSFORMATION ADVISORY TASK FORCE.
78.11 		Subdivision 1.Establishment. The Chemical and Mental Health Services 
78.12 	Transformation Advisory Task Force is established to make recommendations to the 
78.13 	commissioner of human services and the legislature on the continuum of services needed 
78.14 	to provide individuals with complex conditions including mental illness, chemical 
78.15 	dependency, traumatic brain injury, and developmental disabilities access to quality care 
78.16 	and the appropriate level of care across the state to promote wellness, reduce cost, and 
78.17 	improve efficiency.
78.18 		Subd. 2.Duties. The Chemical and Mental Health Services Transformation 
78.19 	Advisory Task Force shall make recommendations to the commissioner and the legislature 
78.20 	no later than December 15, 2010, on the following:
78.21 	(1) transformation needed to improve service delivery and provide a continuum of 
78.22 	care, such as transition of current facilities, closure of current facilities, or the development 
78.23 	of new models of care, including the redesign of the Anoka-Metro Regional Treatment 
78.24 	Center;
78.25 	(2) gaps and barriers to accessing quality care, system inefficiencies, and cost 
78.26 	pressures;
78.27 	(3) services that are best provided by the state and those that are best provided 
78.28 	in the community;
78.29 	(4) an implementation plan to achieve integrated service delivery across the public, 
78.30 	private, and nonprofit sectors;
78.31 	(5) an implementation plan to ensure that individuals with complex chemical and 
78.32 	mental health needs receive the appropriate level of care to achieve recovery and wellness; 
78.33 	and
78.34 	(6) financing mechanisms that include all possible revenue sources to maximize 
78.35 	federal funding and promote cost efficiencies and sustainability.
79.1 		Subd. 3.Membership. The advisory task force shall be composed of the following, 
79.2 	who will serve at the pleasure of their appointing authority:
79.3 	(1) the commissioner of human services or the commissioner's designee, and two 
79.4 	additional representatives from the department;
79.5 	(2) two legislators appointed by the speaker of the house, one from the minority 
79.6 	and one from the majority;
79.7 	(3) two legislators appointed by the senate rules committee, one from the minority 
79.8 	and one from the majority;
79.9 	(4) one representative appointed by AFSCME Council 5;
79.10 	(5) one representative appointed by the ombudsman for mental health and 
79.11 	developmental disabilities;
79.12 	(6) one representative appointed by the Minnesota Association of Professional 
79.13 	Employees;
79.14 	(7) one representative appointed by the Minnesota Hospital Association;
79.15 	(8) one representative appointed by the Minnesota Nurses Association;
79.16 	(9) one representative appointed by NAMI-MN;
79.17 	(10) one representative appointed by the Mental Health Association of Minnesota;
79.18 	(11) one representative appointed by the Minnesota Association Of Community 
79.19 	Mental Health Programs;
79.20 	(12) one representative appointed by the Minnesota Dental Association;
79.21 	(13) three clients or client family members representing different populations 
79.22 	receiving services from state-operated services, who are appointed by the commissioner;
79.23 	(14) one representative appointed by the chair of the state-operated services 
79.24 	governing board;
79.25 	(15) one representative appointed by the Minnesota Disability Law Center;
79.26 	(16) one representative appointed by the Consumer Survivor Network;
79.27 	(17) one representative appointed by the Association of Residential Resources 
79.28 	in Minnesota;
79.29 	(18) one representative appointed by the Minnesota Council of Child Caring 
79.30 	Agencies;
79.31 	(19) one representative appointed by the Association of Minnesota Counties; and
79.32 	(20) one representative appointed by the Minnesota Pharmacists Association.
79.33 	The commissioner may appoint additional members to reflect stakeholders who 
79.34 	are not represented above.
79.35 		Subd. 4.Administration. The commissioner shall convene the first meeting of the 
79.36 	advisory task force and shall provide administrative support and staff.
80.1 		Subd. 5.Recommendations. The advisory task force must report its 
80.2 	recommendations to the commissioner and to the legislature no later than December 
80.3 	15, 2010.
80.4 		Subd. 6.Member requirement. The commissioner shall provide per diem and 
80.5 	travel expenses pursuant to section 256.01, subdivision 6, for task force members who 
80.6 	are consumers or family members and whose participation on the task force is not as a 
80.7 	paid representative of any agency, organization, or association. Notwithstanding section 
80.8 	15.059, other task members are not eligible for per diem or travel reimbursement.

80.9 	Sec. 5. [246.128] NOTIFICATION TO LEGISLATURE REQUIRED.
80.10 	The commissioner shall notify the chairs and ranking minority members of 
80.11 	the relevant legislative committees regarding the redesign, closure, or relocation of 
80.12 	state-operated services programs. The notification must include the advice of the Chemical 
80.13 	and Mental Health Services Transformation Advisory Task Force under section 246.125.

80.14 	Sec. 6. [246.129] LEGISLATIVE APPROVAL REQUIRED.
80.15 	If the closure of a state-operated facility is proposed, and the department and 
80.16 	respective bargaining units fail to arrive at a mutually agreed upon solution to transfer 
80.17 	affected state employees to other state jobs, the closure of the facility requires legislative 
80.18 	approval. This does not apply to state-operated enterprise services.

80.19 	Sec. 7. Minnesota Statutes 2008, section 246.18, is amended by adding a subdivision 
80.20 	to read:
80.21 		Subd. 8.State-operated services account. The state-operated services account is 
80.22 	established in the special revenue fund. Revenue generated by new state-operated services 
80.23 	listed under this section established after July 1, 2010, that are not enterprise activities must 
80.24 	be deposited into the state-operated services account, unless otherwise specified in law:
80.25 	(1) intensive residential treatment services;
80.26 	(2) foster care services; and
80.27 	(3) psychiatric extensive recovery treatment services.

80.28 	Sec. 8. Minnesota Statutes 2008, section 254B.01, subdivision 2, is amended to read:
80.29 		Subd. 2.American Indian. For purposes of services provided under section 
80.30 	254B.09, subdivision 7 8, "American Indian" means a person who is a member of an 
80.31 	Indian tribe, and the commissioner shall use the definitions of "Indian" and "Indian tribe" 
80.32 	and "Indian organization" provided in Public Law 93-638. For purposes of services 
81.1 	provided under section 254B.09, subdivision 4 6, "American Indian" means a resident of 
81.2 	federally recognized tribal lands who is recognized as an Indian person by the federally 
81.3 	recognized tribal governing body.  

81.4 	Sec. 9. Minnesota Statutes 2008, section 254B.02, subdivision 1, is amended to read:
81.5 		Subdivision 1.Chemical dependency treatment allocation. The chemical 
81.6 	dependency funds appropriated for allocation treatment appropriation  shall be placed in 
81.7 	a special revenue account. The commissioner shall annually transfer funds from the 
81.8 	chemical dependency fund to pay for operation of the drug and alcohol abuse normative 
81.9 	evaluation system and to pay for all costs incurred by adding two positions for licensing 
81.10 	of chemical dependency treatment and rehabilitation programs located in hospitals for 
81.11 	which funds are not otherwise appropriated. Six percent of the remaining money must 
81.12 	be reserved for tribal allocation under section 254B.09, subdivisions 4 and 5. The 
81.13 	commissioner shall annually divide the money available in the chemical dependency 
81.14 	fund that is not held in reserve by counties from a previous allocation, or allocated to the 
81.15 	American Indian chemical dependency tribal account. Six percent of the remaining money 
81.16 	must be reserved for the nonreservation American Indian chemical dependency allocation 
81.17 	for treatment of American Indians by eligible vendors under section 254B.05, subdivision 
81.18 	1. The remainder of the money must be allocated among the counties according to the 
81.19 	following formula, using state demographer data and other data sources determined by 
81.20 	the commissioner: 
81.21 	(a) For purposes of this formula, American Indians and children under age 14 are 
81.22 	subtracted from the population of each county to determine the restricted population.
81.23 	(b) The amount of chemical dependency fund expenditures for entitled persons for 
81.24 	services not covered by prepaid plans governed by section 256B.69 in the previous year is 
81.25 	divided by the amount of chemical dependency fund expenditures for entitled persons for 
81.26 	all services to determine the proportion of exempt service expenditures for each county. 
81.27 	(c) The prepaid plan months of eligibility is multiplied by the proportion of exempt 
81.28 	service expenditures to determine the adjusted prepaid plan months of eligibility for 
81.29 	each county.
81.30 	(d) The adjusted prepaid plan months of eligibility is added to the number of 
81.31 	restricted population fee for service months of eligibility for the Minnesota family 
81.32 	investment program, general assistance, and medical assistance and divided by the county 
81.33 	restricted population to determine county per capita months of covered service eligibility.
81.34 	(e) The number of adjusted prepaid plan months of eligibility for the state is added 
81.35 	to the number of fee for service months of eligibility for the Minnesota family investment 
82.1 	program, general assistance, and medical assistance for the state restricted population and 
82.2 	divided by the state restricted population to determine state per capita months of covered 
82.3 	service eligibility.
82.4 	(f) The county per capita months of covered service eligibility is divided by the 
82.5 	state per capita months of covered service eligibility to determine the county welfare 
82.6 	caseload factor.
82.7 	(g) The median married couple income for the most recent three-year period 
82.8 	available for the state is divided by the median married couple income for the same period 
82.9 	for each county to determine the income factor for each county.
82.10 	(h) The county restricted population is multiplied by the sum of the county welfare 
82.11 	caseload factor and the county income factor to determine the adjusted population.
82.12 	(i) $15,000 shall be allocated to each county.
82.13 	(j) The remaining funds shall be allocated proportional to the county adjusted 
82.14 	population  in the special revenue account must be used according to the requirements 
82.15 	in this chapter.

82.16 	Sec. 10. Minnesota Statutes 2008, section 254B.02, subdivision 5, is amended to read:
82.17 		Subd. 5.Administrative adjustment. The commissioner may make payments to 
82.18 	local agencies from money allocated under this section to support administrative activities 
82.19 	under sections 254B.03 and 254B.04. The administrative payment must not exceed 
82.20 	the lesser of: (1) five percent of the first $50,000, four percent of the next $50,000, and 
82.21 	three percent of the remaining payments for services from the allocation special revenue 
82.22 	account according to subdivision 1; or (2) the local agency administrative payment for 
82.23 	the fiscal year ending June 30, 2009, adjusted in proportion to the statewide change in 
82.24 	the appropriation for this chapter. 

82.25 	Sec. 11. Minnesota Statutes 2008, section 254B.03, subdivision 4, is amended to read:
82.26 		Subd. 4.Division of costs. Except for services provided by a county under 
82.27 	section 254B.09, subdivision 1, or services provided under section 256B.69 or 256D.03, 
82.28 	subdivision 4, paragraph (b), the county shall, out of local money, pay the state for 
82.29 	15 16.14 percent of the cost of chemical dependency services, including those services 
82.30 	provided to persons eligible for medical assistance under chapter 256B and general 
82.31 	assistance medical care under chapter 256D. Counties may use the indigent hospitalization 
82.32 	levy for treatment and hospital payments made under this section. Fifteen 16.14 percent 
82.33 	of any state collections from private or third-party pay, less 15 percent of for the cost 
82.34 	of payment and collections, must be distributed to the county that paid for a portion of 
83.1 	the treatment under this section. If all funds allocated according to section 254B.02 are 
83.2 	exhausted by a county and the county has met or exceeded the base level of expenditures 
83.3 	under section 254B.02, subdivision 3, the county shall pay the state for 15 percent of the 
83.4 	costs paid by the state under this section. The commissioner may refuse to pay state funds 
83.5 	for services to persons not eligible under section 254B.04, subdivision 1, if the county 
83.6 	financially responsible for the persons has exhausted its allocation. 

83.7 	Sec. 12. Minnesota Statutes 2008, section 254B.05, subdivision 4, is amended to read:
83.8 		Subd. 4.Regional treatment centers. Regional treatment center chemical 
83.9 	dependency treatment units are eligible vendors. The commissioner may expand the 
83.10 	capacity of chemical dependency treatment units beyond the capacity funded by direct 
83.11 	legislative appropriation to serve individuals who are referred for treatment by counties 
83.12 	and whose treatment will be paid for with a county's allocation under section 254B.02 by 
83.13 	funding under this chapter or other funding sources. Notwithstanding the provisions of 
83.14 	sections 254B.03 to 254B.041, payment for any person committed at county request to 
83.15 	a regional treatment center under chapter 253B for chemical dependency treatment and 
83.16 	determined to be ineligible under the chemical dependency consolidated treatment fund, 
83.17 	shall become the responsibility of the county.  

83.18 	Sec. 13. Minnesota Statutes 2008, section 254B.06, subdivision 2, is amended to read:
83.19 		Subd. 2.Allocation of collections. The commissioner shall allocate all federal 
83.20 	financial participation collections to the reserve fund under section 254B.02, subdivision 3
83.21 	a special revenue account. The commissioner shall retain 85 allocate 83.86 percent of 
83.22 	patient payments and third-party payments to the special revenue account and allocate 
83.23 	the collections to the treatment allocation for the county that is financially responsible 
83.24 	for the person. Fifteen 16.14 percent of patient and third-party payments must be paid
83.25 	to the county financially responsible for the patient. Collections for patient payment and 
83.26 	third-party payment for services provided under section 254B.09 shall be allocated to the 
83.27 	allocation of the tribal unit which placed the person. Collections of federal financial 
83.28 	participation for services provided under section 254B.09 shall be allocated to the tribal 
83.29 	reserve account under section 254B.09, subdivision 5.

83.30 	Sec. 14. Minnesota Statutes 2008, section 254B.09, subdivision 8, is amended to read:
83.31 		Subd. 8.Payments to improve services to American Indians. The commissioner 
83.32 	may set rates for chemical dependency services to American Indians according to the 
83.33 	American Indian Health Improvement Act, Public Law 94-437, for eligible vendors. 
84.1 	These rates shall supersede rates set in county purchase of service agreements when 
84.2 	payments are made on behalf of clients eligible according to Public Law 94-437.

84.3 	Sec. 15. [254B.13] PILOT PROJECTS; CHEMICAL HEALTH CARE.
84.4 		Subdivision 1.Authorization for pilot projects. The commissioner may approve 
84.5 	and implement pilot projects developed under the planning process required under Laws 
84.6 	2009, chapter 79, article 7, section 26, to provide alternatives to and enhance coordination 
84.7 	of the delivery of chemical health services required under section 254B.03.
84.8 		Subd. 2.Program design and implementation. (a) The commissioner and counties 
84.9 	participating in the pilot projects shall continue to work in partnership to refine and 
84.10 	implement the pilot projects initiated under Laws 2009, chapter 79, article 7, section 26.
84.11 	(b) The commissioner and counties participating in the pilot projects shall 
84.12 	complete the planning phase by June 30, 2010, and, if approved by the commissioner for 
84.13 	implementation, enter into agreements governing the operation of the pilot projects with 
84.14 	implementation scheduled no earlier than July 1, 2010.
84.15 		Subd. 3.Program evaluation.  The commissioner shall evaluate pilot projects under 
84.16 	this section and report the results of the evaluation to the chairs and ranking minority 
84.17 	members of the legislative committees with jurisdiction over chemical health issues by 
84.18 	January 15, 2013. Evaluation of the pilot projects must be based on outcome evaluation 
84.19 	criteria negotiated with the pilot projects prior to implementation.
84.20 		Subd. 4.Notice of project discontinuation. Each county's participation in the 
84.21 	pilot project may be discontinued for any reason by the county or the commissioner of 
84.22 	human services after 30 days' written notice to the other party. Any unspent funds held 
84.23 	for the exiting county's pro rata share in the special revenue fund under the authority in 
84.24 	subdivision 5, paragraph (d), shall be transferred to the consolidated chemical dependency 
84.25 	treatment fund following discontinuation of the pilot project.
84.26 		Subd. 5.Duties of commissioner. (a) Notwithstanding any other provisions in 
84.27 	this chapter, the commissioner may authorize pilot projects to use chemical dependency 
84.28 	treatment funds to pay for nontreatment pilot services:
84.29 	(1) in addition to those authorized under section 254B.03, subdivision 2, paragraph 
84.30 	(a); and
84.31 	(2) by vendors in addition to those authorized under section 254B.05 when not 
84.32 	providing chemical dependency treatment services.
84.33 	(b) For purposes of this section, "nontreatment pilot services" include navigator 
84.34 	services, peer support, family engagement and support, housing support, rent subsidies, 
84.35 	supported employment, and independent living skills.
85.1 	(c) State expenditures for chemical dependency services and nontreatment pilot 
85.2 	services provided by or through the pilot projects must not be greater than the chemical 
85.3 	dependency treatment fund expected share of forecasted expenditures in the absence of 
85.4 	the pilot projects. The commissioner may restructure the schedule of payments between 
85.5 	the state and participating counties under the local agency share and division of cost 
85.6 	provisions under section 254B.03, subdivisions 3 and 4, as necessary to facilitate the 
85.7 	operation of the pilot projects.
85.8 	(d) To the extent that state fiscal year expenditures within a pilot project are less 
85.9 	than the expected share of forecasted expenditures in the absence of the pilot projects, 
85.10 	the commissioner shall deposit the unexpended funds in a separate account within the 
85.11 	consolidated chemical dependency treatment fund, and make these funds available for 
85.12 	expenditure by the pilot projects the following year. To the extent that treatment and 
85.13 	nontreatment pilot services expenditures within the pilot project exceed the amount 
85.14 	expected in the absence of the pilot projects, the pilot project county or counties are 
85.15 	responsible for the portion of nontreatment pilot services expenditures in excess of the 
85.16 	otherwise expected share of forecasted expenditures.
85.17 	(e) The commissioner may waive administrative rule requirements that are 
85.18 	incompatible with the implementation of the pilot project, except that any chemical 
85.19 	dependency treatment funded under this section must continue to be provided by a 
85.20 	licensed treatment provider.
85.21 	(f) The commissioner shall not approve or enter into any agreement related to pilot 
85.22 	projects authorized under this section that puts current or future federal funding at risk.
85.23 		Subd. 6.Duties of county board. The county board, or other county entity that is 
85.24 	approved to administer a pilot project, shall:
85.25 	(1) administer the pilot project in a manner consistent with the objectives described 
85.26 	in subdivision 2 and the planning process in subdivision 5;
85.27 	(2) ensure that no one is denied chemical dependency treatment services for which 
85.28 	they would otherwise be eligible under section 254A.03, subdivision 3; and
85.29 	(3) provide the commissioner with timely and pertinent information as negotiated 
85.30 	in agreements governing operation of the pilot projects.

85.31 	Sec. 16. Minnesota Statutes 2009 Supplement, section 517.08, subdivision 1b, is 
85.32 	amended to read:
85.33 		Subd. 1b.Term of license; fee; premarital education. (a) The local registrar 
85.34 	shall examine upon oath the parties applying for a license relative to the legality of the 
85.35 	contemplated marriage. If one party is unable to appear in person, the party appearing 
86.1 	may complete the absent applicant's information. The local registrar shall provide a copy 
86.2 	of the marriage application to the party who is unable to appear, who must verify the 
86.3 	accuracy of the party's information in a notarized statement. The marriage license must 
86.4 	not be released until the verification statement has been received by the local registrar. If 
86.5 	at the expiration of a five-day period, on being satisfied that there is no legal impediment 
86.6 	to it, including the restriction contained in section 259.13, the local registrar shall issue 
86.7 	the license, containing the full names of the parties before and after marriage, and county 
86.8 	and state of residence, with the county seal attached, and make a record of the date of 
86.9 	issuance. The license shall be valid for a period of six months. Except as provided in 
86.10 	paragraph (c), the local registrar shall collect from the applicant a fee of $110 $115 for 
86.11 	administering the oath, issuing, recording, and filing all papers required, and preparing 
86.12 	and transmitting to the state registrar of vital statistics the reports of marriage required 
86.13 	by this section. If the license should not be used within the period of six months due to 
86.14 	illness or other extenuating circumstances, it may be surrendered to the local registrar for 
86.15 	cancellation, and in that case a new license shall issue upon request of the parties of the 
86.16 	original license without fee. A local registrar who knowingly issues or signs a marriage 
86.17 	license in any manner other than as provided in this section shall pay to the parties 
86.18 	aggrieved an amount not to exceed $1,000.
86.19 	(b) In case of emergency or extraordinary circumstances, a judge of the district court 
86.20 	of the county in which the application is made may authorize the license to be issued at 
86.21 	any time before expiration of the five-day period required under paragraph (a). A waiver 
86.22 	of the five-day waiting period must be in the following form:
86.23 	STATE OF MINNESOTA, COUNTY OF .................... (insert county name)
86.24 	APPLICATION FOR WAIVER OF MARRIAGE LICENSE WAITING PERIOD:
86.25 	................................................................................. (legal names of the applicants)
86.26 	Represent and state as follows:
86.27 	That on ......................... (date of application) the applicants applied to the local 
86.28 	registrar of the above-named county for a license to marry.
86.29 	That it is necessary that the license be issued before the expiration of five days 
86.30 	from the date of the application by reason of the following: (insert reason for requesting 
86.31 	waiver of waiting period)
86.32 	.............................................................................................................
86.33 	.............................................................................................................
86.34 	.............................................................................................................
87.1 	WHEREAS, the applicants request that the judge waive the required five-day 
87.2 	waiting period and the local registrar be authorized and directed to issue the marriage 
87.3 	license immediately.
87.4 	Date: .............................
87.5 	.......................................................................................
87.6 	.......................................................................................
87.7 	(Signatures of applicants)
87.8 	Acknowledged before me on this ....... day of .................... .
87.9 	..........................................
87.10 	NOTARY PUBLIC
87.11 	COURT ORDER AND AUTHORIZATION:
87.12 	STATE OF MINNESOTA, COUNTY OF .................... (insert county name)
87.13 	After reviewing the above application, I am satisfied that an emergency or 
87.14 	extraordinary circumstance exists that justifies the issuance of the marriage license before 
87.15 	the expiration of five days from the date of the application. IT IS HEREBY ORDERED 
87.16 	that the local registrar is authorized and directed to issue the license forthwith.
87.17 	.....................................................
87.18 	................................ (judge of district court)
87.19 	................................ (date).
87.20 	(c) The marriage license fee for parties who have completed at least 12 hours of 
87.21 	premarital education is $40. In order to qualify for the reduced license fee, the parties 
87.22 	must submit at the time of applying for the marriage license a signed, dated, and notarized 
87.23 	statement from the person who provided the premarital education on their letterhead 
87.24 	confirming that it was received. The premarital education must be provided by a licensed 
87.25 	or ordained minister or the minister's designee, a person authorized to solemnize marriages 
87.26 	under section 517.18, or a person authorized to practice marriage and family therapy under 
87.27 	section 148B.33. The education must include the use of a premarital inventory and the 
87.28 	teaching of communication and conflict management skills.
87.29 	(d) The statement from the person who provided the premarital education under 
87.30 	paragraph (b) must be in the following form:
87.31 	"I, .......................... (name of educator), confirm that .......................... (names of 
87.32 	both parties) received at least 12 hours of premarital education that included the use of a 
87.33 	premarital inventory and the teaching of communication and conflict management skills. 
87.34 	I am a licensed or ordained minister, a person authorized to solemnize marriages under 
87.35 	Minnesota Statutes, section 517.18, or a person licensed to practice marriage and family 
87.36 	therapy under Minnesota Statutes, section 148B.33."
88.1 	The names of the parties in the educator's statement must be identical to the legal 
88.2 	names of the parties as they appear in the marriage license application. Notwithstanding 
88.3 	section 138.17, the educator's statement must be retained for seven years, after which 
88.4 	time it may be destroyed.
88.5 	(e) If section 259.13 applies to the request for a marriage license, the local registrar 
88.6 	shall grant the marriage license without the requested name change. Alternatively, the local 
88.7 	registrar may delay the granting of the marriage license until the party with the conviction:
88.8 	(1) certifies under oath that 30 days have passed since service of the notice for a 
88.9 	name change upon the prosecuting authority and, if applicable, the attorney general and no 
88.10 	objection has been filed under section 259.13; or
88.11 	(2) provides a certified copy of the court order granting it. The parties seeking the 
88.12 	marriage license shall have the right to choose to have the license granted without the 
88.13 	name change or to delay its granting pending further action on the name change request.

88.14 	Sec. 17. Minnesota Statutes 2008, section 517.08, subdivision 1c, as amended by Laws 
88.15 	2010, chapter 200, article 1, section 17, is amended to read:
88.16 		Subd. 1c.Disposition of license fee. (a) Of the marriage license fee collected 
88.17 	pursuant to subdivision 1b, paragraph (a), $25 must be retained by the county. The 
88.18 	local registrar must pay $85 $90 to the commissioner of management and budget to be 
88.19 	deposited as follows:
88.20 	(1) $55 in the general fund;
88.21 	(2) $3 in the state government special revenue fund to be appropriated to the 
88.22 	commissioner of public safety for parenting time centers under section 119A.37;
88.23 	(3) $2 in the special revenue fund to be appropriated to the commissioner of health 
88.24 	for developing and implementing the MN ENABL program under section 145.9255; and
88.25 	(4) $25 in the special revenue fund is appropriated to the commissioner of 
88.26 	employment and economic development for the displaced homemaker program under 
88.27 	section 116L.96; and
88.28 	(5) $5 in the special revenue fund, which is appropriated to the Board of Regents 
88.29 	of the University of Minnesota for the Minnesota couples on the brink project under 
88.30 	section 137.32.
88.31 	(b) Of the $40 fee under subdivision 1b, paragraph (b), $25 must be retained by the 
88.32 	county. The local registrar must pay $15 to the commissioner of management and budget 
88.33 	to be deposited as follows:
88.34 	(1) $5 as provided in paragraph (a), clauses (2) and (3); and
89.1 	(2) $10 in the special revenue fund is appropriated to the commissioner of 
89.2 	employment and economic development for the displaced homemaker program under 
89.3 	section 116L.96.

89.4 	Sec. 18. Laws 2009, chapter 79, article 3, section 18, is amended to read:
89.5 	Sec. 18. REQUIRING THE DEVELOPMENT OF COMMUNITY-BASED 
89.6 	MENTAL HEALTH SERVICES FOR PATIENTS COMMITTED TO THE 
89.7 	ANOKA-METRO REGIONAL TREATMENT CENTER.
 89.8 	In consultation with community partners, the commissioner of human services
89.9 	The Chemical and Mental Health Services Transformation Advisory Task Force shall 
89.10 	develop recommend an array of community-based services in the metro area to transform 
89.11 	the current services now provided to patients at the Anoka-Metro Regional Treatment 
89.12 	Center. The community-based services may be provided in facilities with 16 or fewer 
89.13 	beds, and must provide the appropriate level of care for the patients being admitted to 
89.14 	the facilities established in partnership with private and public hospital organizations, 
89.15 	community mental health centers and other mental health community services providers, 
89.16 	and community partnerships, and must be staffed by state employees. The planning 
89.17 	for this transition must be completed by October 1, 2009 2010, with an initial a  report 
89.18 	detailing the transition plan, services that will be provided, including incorporating peer 
89.19 	specialists where appropriate, the location of the services, and the number of patients 
89.20 	that will be served, to the committee chairs of health and human services by November 
89.21 	30, 2009, and a semiannual report on progress until the transition is completed. The 
89.22 	commissioner of human services shall solicit interest from stakeholders and potential 
89.23 	community partners 2010. The individuals working inemployed by the community-based 
89.24 	services facilities under this section are state employees supervised by the commissioner 
89.25 	of human services. No layoffs shall occur as a result of restructuring under this section.
89.26 	Savings generated as a result of transitioning patients from the Anoka-Metro Regional 
89.27 	Treatment Center to community-based services may be used to fund supportive housing 
89.28 	staffed by state employees.

89.29 	Sec. 19. REPORT ON HUMAN SERVICES FISCAL NOTES.
 89.30 	The commissioner of management and budget shall issue a report to the legislature 
89.31 	no later than November 15, 2010, making recommendations for improving the preparation 
89.32 	and delivery of fiscal notes under Minnesota Statutes, section 3.98, relating to human 
89.33 	services. The report shall consider: (1) the establishment of an independent fiscal 
89.34 	note office in the human services department and (2) transferring the responsibility for 
90.1 	preparing human services fiscal notes to the legislature. The report must include detailed 
90.2 	information regarding the financial costs, staff resources, training, access to information, 
90.3 	and data protection issues relative to the preparation of human services fiscal notes. The 
90.4 	report shall describe methods and procedures used by other states to insure independence 
90.5 	and accuracy of fiscal estimates on legislative proposals for changes in human services.

90.6 	Sec. 20. PRESCRIPTION DRUG WASTE REDUCTION.
 90.7 	The Minnesota Board of Pharmacy, in cooperation with the commissioners of 
90.8 	human services, pollution control, health, veterans affairs, and corrections, shall study 
90.9 	prescription drug waste reduction techniques and technologies applicable to long-term 
90.10 	care facilities, veterans nursing homes, and correctional facilities. In conducting the 
90.11 	study, the commissioners shall consult with the Minnesota Pharmacists Association, the 
90.12 	University of Minnesota College of Pharmacy, University of Minnesota's Minnesota 
90.13 	Technical Assistance Project, consumers, long-term care providers, and other interested 
90.14 	parties. The board shall evaluate the extent to which new prescription drug waste reduction 
90.15 	techniques and technologies can reduce the amount of prescription drugs that enter the 
90.16 	waste stream and reduce state prescription drug costs. The techniques and technologies 
90.17 	studied must include, but are not limited to, daily, weekly, and automated dose dispensing. 
90.18 	The study must provide an estimate of the cost of adopting these and other techniques 
90.19 	and technologies, and an estimate of waste reduction and state prescription drug savings 
90.20 	that would result from adoption. The study must also evaluate methods of encouraging 
90.21 	the adoption of effective drug waste reduction techniques and technologies. The board 
90.22 	shall present recommendations on the adoption of new prescription drug waste reduction 
90.23 	techniques and technologies to the legislature by December 15, 2011.

90.24 	Sec. 21. VETERINARY PRACTICE AND CONTROLLED SUBSTANCE 
90.25 	ABUSE STUDY.
 90.26 	The Board of Pharmacy, in consultation with the Prescription Electronic Reporting 
90.27 	Advisory Committee and the Board of Veterinary Medical Practice, shall study the issue 
90.28 	of the diversion of controlled substances from veterinary practice and report to the chairs 
90.29 	and ranking minority members of the senate health and human services policy and finance 
90.30 	division and the house of representatives health care and human services policy and 
90.31 	finance division by December 15, 2011, on recommendations to include veterinarians in 
90.32 	the prescription electronic reporting system in Minnesota Statutes, section 152.126.

90.33 	Sec. 22.  REPEALER.
 91.1 	Minnesota Statutes 2008, sections 254B.02, subdivisions 2, 3, and 4; and 254B.09, 
91.2 	subdivisions 4, 5, and 7, are repealed.

91.3 	Sec. 23. EFFECTIVE DATE.
 91.4 	Sections 8 to 14 and 22 are effective for claims paid on or after July 1, 2010.

91.5 	ARTICLE 5
91.6 	DEPARTMENT OF HEALTH

91.7 	Section 1. Minnesota Statutes 2008, section 62D.08, is amended by adding a 
91.8 	subdivision to read:
91.9 		Subd. 7.Consistent administrative expenses and investment income reporting.
 91.10 	(a) Every health maintenance organization must directly allocate administrative expenses 
91.11 	to specific lines of business or products when such information is available. Remaining 
91.12 	expenses that cannot be directly allocated must be allocated based on other methods, as 
91.13 	recommended by the Advisory Group on Administrative Expenses. Health maintenance 
91.14 	organizations must submit this information, including administrative expenses for dental 
91.15 	services, using the reporting template provided by the commissioner of health.
91.16 	(b) Every health maintenance organization must allocate investment income based 
91.17 	on cumulative net income over time by business line or product and must submit this 
91.18 	information, including investment income for dental services, using the reporting template 
91.19 	provided by the commissioner of health.

91.20 	EFFECTIVE DATE. This section is effective January 1, 2013.

91.21 	Sec. 2. [62D.31] ADVISORY GROUP ON ADMINISTRATIVE EXPENSES.
91.22 		Subdivision 1.Establishment. The Advisory Group on Administrative Expenses 
91.23 	is established to make recommendations on the development of consistent guidelines 
91.24 	and reporting requirements, including development of a reporting template, for health 
91.25 	maintenance organizations and county-based purchasing plans that participate in publicly 
91.26 	funded programs. 
91.27 		Subd. 2.Membership. The membership of the advisory group shall be comprised 
91.28 	of the following, who serve at the pleasure of their appointing authority:
91.29 	(1) the commissioner of health or the commissioner's designee;
91.30 	(2) the commissioner of human services or the commissioner's designee;
91.31 	(3) the commissioner of commerce or the commissioner's designee; and
92.1 	(4) representatives of health maintenance organizations and county-based purchasers 
92.2 	appointed by the commissioner of health.
92.3 		Subd. 3.Administration. The commissioner of health shall convene the first 
92.4 	meeting of the advisory group by December 1, 2010, and shall provide administrative 
92.5 	support and staff. The commissioner of health may contract with a consultant to provide 
92.6 	professional assistance and expertise to the advisory group.
92.7 		Subd. 4.Recommendations. The Advisory Group on Administrative Expenses 
92.8 	must report its recommendations, including any proposed legislation necessary to 
92.9 	implement the recommendations, to the commissioner of health and to the chairs and 
92.10 	ranking minority members of the legislative committees and divisions with jurisdiction 
92.11 	over health policy and finance by February 15, 2012.
92.12 		Subd. 5.Expiration. This section expires after submission of the report required 
92.13 	under subdivision 4 or June 30, 2012, whichever is sooner.

92.14 	Sec. 3. Minnesota Statutes 2008, section 62Q.19, subdivision 1, is amended to read:
92.15 		Subdivision 1.Designation. (a) The commissioner shall designate essential 
92.16 	community providers. The criteria for essential community provider designation shall be 
92.17 	the following:
92.18 	(1) a demonstrated ability to integrate applicable supportive and stabilizing services 
92.19 	with medical care for uninsured persons and high-risk and special needs populations, 
92.20 	underserved, and other special needs populations; and
92.21 	(2) a commitment to serve low-income and underserved populations by meeting the 
92.22 	following requirements:
92.23 	(i) has nonprofit status in accordance with chapter 317A;
92.24 	(ii) has tax exempt status in accordance with the Internal Revenue Service Code, 
92.25 	section 501(c)(3);
92.26 	(iii) charges for services on a sliding fee schedule based on current poverty income 
92.27 	guidelines; and
92.28 	(iv) does not restrict access or services because of a client's financial limitation;
92.29 	(3) status as a local government unit as defined in section 62D.02, subdivision 11, a 
92.30 	hospital district created or reorganized under sections 447.31 to 447.37, an Indian tribal 
92.31 	government, an Indian health service unit, or a community health board as defined in 
92.32 	chapter 145A;  
92.33 	(4) a former state hospital that specializes in the treatment of cerebral palsy, spina 
92.34 	bifida, epilepsy, closed head injuries, specialized orthopedic problems, and other disabling 
92.35 	conditions; or
93.1 	(5) a sole community hospital. For these rural hospitals, the essential community 
93.2 	provider designation applies to all health services provided, including both inpatient and 
93.3 	outpatient services. For purposes of this section, "sole community hospital" means a 
93.4 	rural hospital that:
93.5 	(i) is eligible to be classified as a sole community hospital according to Code 
93.6 	of Federal Regulations, title 42, section 412.92, or is located in a community with a 
93.7 	population of less than 5,000 and located more than 25 miles from a like hospital currently 
93.8 	providing acute short-term services;  
93.9 	(ii) has experienced net operating income losses in two of the previous three 
93.10 	most recent consecutive hospital fiscal years for which audited financial information is 
93.11 	available; and
93.12 	(iii) consists of 40 or fewer licensed beds; or
93.13 	(6) a birth center licensed under section 144.615.
93.14 	(b) Prior to designation, the commissioner shall publish the names of all applicants 
93.15 	in the State Register. The public shall have 30 days from the date of publication to submit 
93.16 	written comments to the commissioner on the application. No designation shall be made 
93.17 	by the commissioner until the 30-day period has expired.
93.18 	(c) The commissioner may designate an eligible provider as an essential community 
93.19 	provider for all the services offered by that provider or for specific services designated by 
93.20 	the commissioner.
93.21 	(d) For the purpose of this subdivision, supportive and stabilizing services include at 
93.22 	a minimum, transportation, child care, cultural, and linguistic services where appropriate.

93.23 	Sec. 4. Minnesota Statutes 2008, section 144.05, is amended by adding a subdivision 
93.24 	to read:
93.25 		Subd. 5.Firearms data. Notwithstanding any law to the contrary, the commissioner 
93.26 	of health is prohibited from collecting data on individuals regarding lawful firearm 
93.27 	ownership in the state or data related to an individual's right to carry a weapon under 
93.28 	section 624.714.

93.29 	Sec. 5. Minnesota Statutes 2008, section 144.226, subdivision 3, is amended to read:
93.30 		Subd. 3.Birth record surcharge. (a) In addition to any fee prescribed under 
93.31 	subdivision 1, there shall be a nonrefundable surcharge of $3 for each certified birth or 
93.32 	stillbirth record and for a certification that the vital record cannot be found. The local or 
93.33 	state registrar shall forward this amount to the commissioner of management and budget 
93.34 	for deposit into the account for the children's trust fund for the prevention of child abuse 
94.1 	established under section 256E.22. This surcharge shall not be charged under those 
94.2 	circumstances in which no fee for a certified birth or stillbirth record is permitted under 
94.3 	subdivision 1, paragraph (a). Upon certification by the commissioner of management and 
94.4 	budget that the assets in that fund exceed $20,000,000, this surcharge shall be discontinued.
94.5 	(b) In addition to any fee prescribed under subdivision 1, there shall be a 
94.6 	nonrefundable surcharge of $10 for each certified birth record. The local or state registrar 
94.7 	shall forward this amount to the commissioner of management and budget for deposit in 
94.8 	the general fund. This surcharge shall not be charged under those circumstances in which 
94.9 	no fee for a certified birth record is permitted under subdivision 1, paragraph (a).

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

94.11 	Sec. 6. Minnesota Statutes 2008, section 144.293, subdivision 4, is amended to read:
94.12 		Subd. 4.Duration of consent. Except as provided in this section, a consent is 
94.13 	valid for one year or for a lesser period specified in the consent or for a different period 
94.14 	provided by law.

94.15 	Sec. 7. [144.615] BIRTH CENTERS.
94.16 		Subdivision 1.Definitions. (a) For purposes of this section, the following definitions 
94.17 	have the meanings given them.
94.18 	(b) "Birth center" means a facility licensed for the primary purpose of performing 
94.19 	low-risk deliveries that is not a hospital or licensed as part of a hospital and where births are 
94.20 	planned to occur away from the mother's usual residence following a low-risk pregnancy.
94.21 	(c) "CABC" means the Commission for the Accreditation of Birth Centers.
94.22 	(d) "Low-risk pregnancy" means a normal, uncomplicated prenatal course as 
94.23 	determined by documentation of adequate prenatal care and the anticipation of a normal 
94.24 	uncomplicated labor and birth, as defined by reasonable and generally accepted criteria 
94.25 	adopted by professional groups for maternal, fetal, and neonatal health care.
94.26 		Subd. 2.License required. (a) Beginning January 1, 2011, no birth center shall be 
94.27 	established, operated, or maintained in the state without first obtaining a license from the 
94.28 	commissioner of health according to this section.
94.29 	(b) A license issued under this section is not transferable or assignable and is subject 
94.30 	to suspension or revocation at any time for failure to comply with this section.
94.31 	(c) A birth center licensed under this section shall not assert, represent, offer, 
94.32 	provide, or imply that the center is or may render care or services other than the services it 
94.33 	is permitted to render within the scope of the license or the accreditation issued.
94.34 	(d) The license must be conspicuously posted in an area where patients are admitted.
95.1 		Subd. 3.Temporary license. For new birth centers planning to begin operations 
95.2 	after January 1, 2011, the commissioner may issue a temporary license to the birth center 
95.3 	that is valid for a period of six months from the date of issuance. The birth center must 
95.4 	submit to the commissioner an application and applicable fee for licensure as required 
95.5 	under subdivision 4. The application must include the information required in subdivision 
95.6 	4, clauses (1) to (3) and (5) to (7), and documentation that the birth center has submitted 
95.7 	an application for accreditation to the CABC. Upon receipt of accreditation from the 
95.8 	CABC, the birth center must submit to the commissioner the information required in 
95.9 	subdivision 4, clause (4), and the applicable fee under subdivision 8. The commissioner 
95.10 	shall issue a new license.
95.11 		Subd. 4.Application. An application for a license to operate a birth center and the 
95.12 	applicable fee under subdivision 8 must be submitted to the commissioner on a form 
95.13 	provided by the commissioner and must contain:
95.14 	(1) the name of the applicant;
95.15 	(2) the site location of the birth center;
95.16 	(3) the name of the person in charge of the center;
95.17 	(4) documentation that the accreditation described under subdivision 6 has been 
95.18 	issued, including the effective date and the expiration date of the accreditation, and the 
95.19 	date of the last site visit by the CABC;
95.20 	(5) the number of patients the birth center is capable of serving at a given time;
95.21 	(6) the names and license numbers, if applicable, of the health care professionals 
95.22 	on staff at the birth center; and
95.23 	(7) any other information the commissioner deems necessary.
95.24 		Subd. 5.Suspension, revocation, and refusal to renew. The commissioner may 
95.25 	refuse to grant or renew, or may suspend or revoke, a license on any of the grounds 
95.26 	described under section 144.55, subdivision 6, paragraph (a), clause (2), (3), or (4), or 
95.27 	upon the loss of accreditation by the CABC. The applicant or licensee is entitled to notice 
95.28 	and a hearing as described under section 144.55, subdivision 7, and a new license may be 
95.29 	issued after proper inspection of the birth center has been conducted.
95.30 		Subd. 6.Standards for licensure. (a) To be eligible for licensure under this 
95.31 	section, a birth center must be accredited by the CABC or must obtain accreditation 
95.32 	within six months of the date of the application for licensure. If the birth center loses its 
95.33 	accreditation, the birth center must immediately notify the commissioner.
95.34 	(b) The center must have procedures in place specifying criteria by which risk status 
95.35 	will be established and applied to each woman at admission and during labor.
96.1 	(c) Upon request, the birth center shall provide the commissioner of health with any 
96.2 	material submitted by the birth center to the CABC as part of the accreditation process, 
96.3 	including the accreditation application, the self-evaluation report, the accreditation 
96.4 	decision letter from the CABC, and any reports from the CABC following a site visit.
96.5 		Subd. 7.Limitations of services. (a) The following limitations apply to the services 
96.6 	performed at a birth center:
96.7 	(1) surgical procedures must be limited to those normally accomplished during an 
96.8 	uncomplicated birth, including episiotomy and repair;
96.9 	(2) no abortions may be administered; and
96.10 	(3) no general or regional anesthesia may be administered.
96.11 	(b) Notwithstanding paragraph (a), local anesthesia may be administered at a birth 
96.12 	center if the administration of the anesthetic is performed within the scope of practice of a 
96.13 	health care professional.
96.14 		Subd. 8.Fees. (a) The biennial license fee for a birth center is $365.
96.15 	(b) The temporary license fee is $365.
96.16 	(c) Fees shall be collected and deposited according to section 144.122.
96.17 		Subd. 9.Renewal. (a) Except as provided in paragraph (b), a license issued under 
96.18 	this section expires two years from the date of issue.
96.19 	(b) A temporary license issued under subdivision 3 expires six months from the date 
96.20 	of issue, and may be renewed for one additional six-month period.
96.21 	(c) An application for renewal shall be submitted at least 60 days prior to expiration 
96.22 	of the license on forms prescribed by the commissioner of health.
96.23 		Subd. 10.Records. All health records maintained on each client by a birth center 
96.24 	are subject to sections 144.292 to 144.298.
96.25 		Subd. 11.Report. (a) The commissioner of health, in consultation with the 
96.26 	commissioner of human services and representatives of the licensed birth centers, 
96.27 	the American College of Obstetricians and Gynecologists, the American Academy 
96.28 	of Pediatrics, the Minnesota Hospital Association, and the Minnesota Ambulance 
96.29 	Association, shall evaluate the quality of care and outcomes for services provided in 
96.30 	licensed birth centers, including, but not limited to, the utilization of services provided at a 
96.31 	birth center, the outcomes of care provided to both mothers and newborns, and the numbers 
96.32 	of transfers to other health care facilities that are required and the reasons for the transfers. 
96.33 	The commissioner shall work with the birth centers to establish a process to gather and 
96.34 	analyze the data within protocols that protect the confidentiality of patient identification.
96.35 	(b) The commissioner of health shall report the findings of the evaluation to the 
96.36 	legislature by January 15, 2014.

97.1 	Sec. 8. Minnesota Statutes 2008, section 144.651, subdivision 2, is amended to read:
97.2 		Subd. 2.Definitions. For the purposes of this section, "patient" means a person 
97.3 	who is admitted to an acute care inpatient facility for a continuous period longer than 
97.4 	24 hours, for the purpose of diagnosis or treatment bearing on the physical or mental 
97.5 	health of that person. For purposes of subdivisions 4 to 9, 12, 13, 15, 16, and 18 to 20, 
97.6 	"patient" also means a person who receives health care services at an outpatient surgical 
97.7 	center or at a birth center licensed under section 144.615. "Patient" also means a minor 
97.8 	who is admitted to a residential program as defined in section 253C.01. For purposes of 
97.9 	subdivisions 1, 3 to 16, 18, 20 and 30, "patient" also means any person who is receiving 
97.10 	mental health treatment on an outpatient basis or in a community support program or other 
97.11 	community-based program. "Resident" means a person who is admitted to a nonacute care 
97.12 	facility including extended care facilities, nursing homes, and boarding care homes for 
97.13 	care required because of prolonged mental or physical illness or disability, recovery from 
97.14 	injury or disease, or advancing age. For purposes of all subdivisions except subdivisions 
97.15 	28 and 29, "resident" also means a person who is admitted to a facility licensed as a board 
97.16 	and lodging facility under Minnesota Rules, parts 4625.0100 to 4625.2355, or a supervised 
97.17 	living facility under Minnesota Rules, parts 4665.0100 to 4665.9900, and which operates 
97.18 	a rehabilitation program licensed under Minnesota Rules, parts 9530.4100 to 9530.4450. 

97.19 	Sec. 9. Minnesota Statutes 2008, section 144.9504, is amended by adding a subdivision 
97.20 	to read:
97.21 		Subd. 12.Blood lead level guidelines. (a) By January 1, 2011, the commissioner 
97.22 	must revise clinical and case management guidelines to include recommendations 
97.23 	for protective health actions and follow-up services when a child's blood lead level 
97.24 	exceeds five micrograms of lead per deciliter of blood. The revised guidelines must be 
97.25 	implemented to the extent possible using available resources.
97.26 	(b) In revising the clinical and case management guidelines for blood lead levels 
97.27 	greater than five micrograms of lead per deciliter of blood under this subdivision, 
97.28 	the commissioner of health must consult with a statewide organization representing 
97.29 	physicians, the public health department of Minneapolis and other public health 
97.30 	departments, one representative of the residential construction industry, and a nonprofit 
97.31 	organization with expertise in lead abatement.

97.32 	Sec. 10. Minnesota Statutes 2008, section 144A.51, subdivision 5, is amended to read:
97.33 		Subd. 5.Health facility. "Health facility" means a facility or that part of a facility 
97.34 	which is required to be licensed pursuant to sections 144.50 to 144.58, 144.615, and a 
98.1 	facility or that part of a facility which is required to be licensed under any law of this state 
98.2 	which provides for the licensure of nursing homes. 

98.3 	Sec. 11. Minnesota Statutes 2008, section 144E.37, is amended to read:
98.4 	144E.37 COMPREHENSIVE ADVANCED LIFE SUPPORT.
98.5 	The board commissioner of health shall establish a comprehensive advanced 
98.6 	life-support educational program to train rural medical personnel, including physicians, 
98.7 	physician assistants, nurses, and allied health care providers, in a team approach to 
98.8 	anticipate, recognize, and treat life-threatening emergencies before serious injury or 
98.9 	cardiac arrest occurs.

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

98.11 	Sec. 12. HEALTH PLAN AND COUNTY ADMINISTRATIVE COST 
98.12 	REDUCTION; REPORTING REQUIREMENTS.
 98.13 	(a) Minnesota health plans and county-based purchasing plans may complete an 
98.14 	inventory of existing data collection and reporting requirements for health plans and 
98.15 	county-based purchasing plans and submit to the commissioners of health and human 
98.16 	services a list of data, documentation, and reports that:
98.17 	(1) are collected from the same health plan or county-based purchasing plan more 
98.18 	than once;
98.19 	(2) are collected directly from the health plan or county-based purchasing plan but 
98.20 	are available to the state agencies from other sources;
98.21 	(3) are not currently being used by state agencies; or
98.22 	(4) collect similar information more than once in different formats, at different 
98.23 	times, or by more than one state agency.
98.24 	(b) The report to the commissioners may also identify the percentage of health 
98.25 	plan and county-based purchasing plan administrative time and expense attributed to 
98.26 	fulfilling reporting requirements and include recommendations regarding ways to reduce 
98.27 	duplicative reporting requirements.
98.28 	(c) Upon receipt, the commissioners shall submit the inventory and recommendations 
98.29 	to the chairs of the appropriate legislative committees, along with their comments 
98.30 	and recommendations as to whether any action should be taken by the legislature to 
98.31 	establish a consolidated and streamlined reporting system under which data, reports, and 
98.32 	documentation are collected only once and only when needed for the state agencies to 
98.33 	fulfill their duties under law and applicable regulations.

99.1 	Sec. 13. VENDOR ACCREDITATION SIMPLIFICATION.
 99.2 	The Minnesota Hospital Association must coordinate with the Minnesota 
99.3 	Credentialing Collaborative to make recommendations by January 1, 2012, on the 
99.4 	development of standard accreditation methods for vendor services provided within 
99.5 	hospitals and clinics. The recommendations must be consistent with requirements of 
99.6 	hospital credentialing organizations and applicable federal requirements.

99.7 	Sec. 14. APPLICATION PROCESS FOR HEALTH INFORMATION 
99.8 	EXCHANGE.
 99.9 	To the extent that the commissioner of health applies for additional federal funding 
99.10 	to support the commissioner's responsibilities of developing and maintaining state level 
99.11 	health information exchange under section 3013 of the HITECH Act, the commissioner of 
99.12 	health shall ensure that applications are made through an open process that provides health 
99.13 	information exchange service providers equal opportunity to receive funding.

99.14 	Sec. 15. TRANSFER.
 99.15 	The powers and duties of the Emergency Medical Services Regulatory Board with 
99.16 	respect to the comprehensive advanced life-support educational program under Minnesota 
99.17 	Statutes, section 144E.37, are transferred to the commissioner of health under Minnesota 
99.18 	Statutes, section 15.039.

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

99.20 	Sec. 16. REVISOR'S INSTRUCTION.
 99.21 	The revisor of statutes shall renumber Minnesota Statutes, section 144E.37, as 
99.22 	Minnesota Statutes, section 144.6062, and make all necessary changes in statutory 
99.23 	cross-references in Minnesota Statutes and Minnesota Rules.

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

99.25 	ARTICLE 6
99.26 	PUBLIC HEALTH

99.27 	Section 1. Minnesota Statutes 2008, section 62J.692, subdivision 4, is amended to read:
99.28 		Subd. 4.Distribution of funds. (a) Following the distribution described under 
99.29 	paragraph (b), the commissioner shall annually distribute the available medical education 
99.30 	funds to all qualifying applicants based on a distribution formula that reflects a summation 
99.31 	of two factors:
100.1 	(1) a public program volume factor, which is determined by the total volume of 
100.2 	public program revenue received by each training site as a percentage of all public 
100.3 	program revenue received by all training sites in the fund pool; and
100.4 	(2) a supplemental public program volume factor, which is determined by providing 
100.5 	a supplemental payment of 20 percent of each training site's grant to training sites whose 
100.6 	public program revenue accounted for at least 0.98 percent of the total public program 
100.7 	revenue received by all eligible training sites. Grants to training sites whose public 
100.8 	program revenue accounted for less than 0.98 percent of the total public program revenue 
100.9 	received by all eligible training sites shall be reduced by an amount equal to the total 
100.10 	value of the supplemental payment.
100.11 	Public program revenue for the distribution formula includes revenue from medical 
100.12 	assistance, prepaid medical assistance, general assistance medical care, and prepaid 
100.13 	general assistance medical care. Training sites that receive no public program revenue 
100.14 	are ineligible for funds available under this subdivision. For purposes of determining 
100.15 	training-site level grants to be distributed under paragraph (a), total statewide average 
100.16 	costs per trainee for medical residents is based on audited clinical training costs per trainee 
100.17 	in primary care clinical medical education programs for medical residents. Total statewide 
100.18 	average costs per trainee for dental residents is based on audited clinical training costs 
100.19 	per trainee in clinical medical education programs for dental students. Total statewide 
100.20 	average costs per trainee for pharmacy residents is based on audited clinical training costs 
100.21 	per trainee in clinical medical education programs for pharmacy students.
100.22 	(b) $5,350,000 of the available medical education funds shall be distributed as 
100.23 	follows:
100.24 	(1) $1,475,000 to the University of Minnesota Medical Center-Fairview;
100.25 	(2) $2,075,000 to the University of Minnesota School of Dentistry; and
100.26 	(3) $1,800,000 to the Academic Health Center. $150,000 of the funds distributed to 
100.27 	the Academic Health Center under this paragraph shall be used for a program to assist 
100.28 	internationally trained physicians who are legal residents and who commit to serving 
100.29 	underserved Minnesota communities in a health professional shortage area to successfully 
100.30 	compete for family medicine residency programs at the University of Minnesota.
100.31 	(c) Funds distributed shall not be used to displace current funding appropriations 
100.32 	from federal or state sources.
100.33 	(d) Funds shall be distributed to the sponsoring institutions indicating the amount 
100.34 	to be distributed to each of the sponsor's clinical medical education programs based on 
100.35 	the criteria in this subdivision and in accordance with the commissioner's approval letter. 
100.36 	Each clinical medical education program must distribute funds allocated under paragraph 
101.1 	(a) to the training sites as specified in the commissioner's approval letter. Sponsoring 
101.2 	institutions, which are accredited through an organization recognized by the Department 
101.3 	of Education or the Centers for Medicare and Medicaid Services, may contract directly 
101.4 	with training sites to provide clinical training. To ensure the quality of clinical training, 
101.5 	those accredited sponsoring institutions must:
101.6 	(1) develop contracts specifying the terms, expectations, and outcomes of the clinical 
101.7 	training conducted at sites; and
101.8 	(2) take necessary action if the contract requirements are not met. Action may 
101.9 	include the withholding of payments under this section or the removal of students from 
101.10 	the site.
101.11 	(e) Any funds not distributed in accordance with the commissioner's approval letter 
101.12 	must be returned to the medical education and research fund within 30 days of receiving 
101.13 	notice from the commissioner. The commissioner shall distribute returned funds to the 
101.14 	appropriate training sites in accordance with the commissioner's approval letter.
101.15 	(f) A maximum of $150,000 of the funds dedicated to the commissioner under 
101.16 	section 297F.10, subdivision 1, clause (2), may be used by the commissioner for 
101.17 	administrative expenses associated with implementing this section.

101.18 	Sec. 2. Minnesota Statutes 2009 Supplement, section 157.16, subdivision 3, is 
101.19 	amended to read:
101.20 		Subd. 3. Establishment fees; definitions. (a) The following fees are required 
101.21 	for food and beverage service establishments, youth camps, hotels, motels, lodging 
101.22 	establishments, public pools, and resorts licensed under this chapter. Food and beverage 
101.23 	service establishments must pay the highest applicable fee under paragraph (d), clause 
101.24 	(1), (2), (3), or (4), and establishments serving alcohol must pay the highest applicable 
101.25 	fee under paragraph (d), clause (6) or (7). The license fee for new operators previously 
101.26 	licensed under this chapter for the same calendar year is one-half of the appropriate annual 
101.27 	license fee, plus any penalty that may be required. The license fee for operators opening 
101.28 	on or after October 1 is one-half of the appropriate annual license fee, plus any penalty 
101.29 	that may be required. 
101.30 	(b) All food and beverage service establishments, except special event food stands, 
101.31 	and all hotels, motels, lodging establishments, public pools, and resorts shall pay an 
101.32 	annual base fee of $150. 
101.33 	(c) A special event food stand shall pay a flat fee of $50 annually. "Special event 
101.34 	food stand" means a fee category where food is prepared or served in conjunction with 
102.1 	celebrations, county fairs, or special events from a special event food stand as defined 
102.2 	in section 157.15. 
102.3 	(d) In addition to the base fee in paragraph (b), each food and beverage service 
102.4 	establishment, other than a special event food stand, and each hotel, motel, lodging 
102.5 	establishment, public pool, and resort shall pay an additional annual fee for each fee 
102.6 	category, additional food service, or required additional inspection specified in this 
102.7 	paragraph: 
102.8 	(1) Limited food menu selection, $60. "Limited food menu selection" means a fee 
102.9 	category that provides one or more of the following: 
102.10 	(i) prepackaged food that receives heat treatment and is served in the package; 
102.11 	(ii) frozen pizza that is heated and served; 
102.12 	(iii) a continental breakfast such as rolls, coffee, juice, milk, and cold cereal; 
102.13 	(iv) soft drinks, coffee, or nonalcoholic beverages; or 
102.14 	(v) cleaning for eating, drinking, or cooking utensils, when the only food served 
102.15 	is prepared off site. 
102.16 	(2) Small establishment, including boarding establishments, $120. "Small 
102.17 	establishment" means a fee category that has no salad bar and meets one or more of 
102.18 	the following: 
102.19 	(i) possesses food service equipment that consists of no more than a deep fat fryer, a 
102.20 	grill, two hot holding containers, and one or more microwave ovens; 
102.21 	(ii) serves dipped ice cream or soft serve frozen desserts; 
102.22 	(iii) serves breakfast in an owner-occupied bed and breakfast establishment; 
102.23 	(iv) is a boarding establishment; or 
102.24 	(v) meets the equipment criteria in clause (3), item (i) or (ii), and has a maximum 
102.25 	patron seating capacity of not more than 50. 
102.26 	(3) Medium establishment, $310. "Medium establishment" means a fee category 
102.27 	that meets one or more of the following: 
102.28 	(i) possesses food service equipment that includes a range, oven, steam table, salad 
102.29 	bar, or salad preparation area; 
102.30 	(ii) possesses food service equipment that includes more than one deep fat fryer, 
102.31 	one grill, or two hot holding containers; or 
102.32 	(iii) is an establishment where food is prepared at one location and served at one or 
102.33 	more separate locations. 
102.34 	Establishments meeting criteria in clause (2), item (v), are not included in this fee 
102.35 	category. 
102.36 	(4) Large establishment, $540. "Large establishment" means either: 
103.1 	(i) a fee category that (A) meets the criteria in clause (3), items (i) or (ii), for a 
103.2 	medium establishment, (B) seats more than 175 people, and (C) offers the full menu 
103.3 	selection an average of five or more days a week during the weeks of operation; or 
103.4 	(ii) a fee category that (A) meets the criteria in clause (3), item (iii), for a medium 
103.5 	establishment, and (B) prepares and serves 500 or more meals per day. 
103.6 	(5) Other food and beverage service, including food carts, mobile food units, 
103.7 	seasonal temporary food stands, and seasonal permanent food stands, $60. 
103.8 	(6) Beer or wine table service, $60. "Beer or wine table service" means a fee 
103.9 	category where the only alcoholic beverage service is beer or wine, served to customers 
103.10 	seated at tables. 
103.11 	(7) Alcoholic beverage service, other than beer or wine table service, $165. 
103.12 	"Alcohol beverage service, other than beer or wine table service" means a fee 
103.13 	category where alcoholic mixed drinks are served or where beer or wine are served from 
103.14 	a bar. 
103.15 	(8) Lodging per sleeping accommodation unit, $10, including hotels, motels, 
103.16 	lodging establishments, and resorts, up to a maximum of $1,000. "Lodging per sleeping 
103.17 	accommodation unit" means a fee category including the number of guest rooms, cottages, 
103.18 	or other rental units of a hotel, motel, lodging establishment, or resort; or the number of 
103.19 	beds in a dormitory. 
103.20 	(9) First public pool, $325; each additional public pool, $175. "Public pool" means a 
103.21 	fee category that has the meaning given in section 144.1222, subdivision 4. 
103.22 	(10) First spa, $175; each additional spa, $100. "Spa pool" means a fee category that 
103.23 	has the meaning given in Minnesota Rules, part 4717.0250, subpart 9. 
103.24 	(11) Private sewer or water, $60. "Individual private water" means a fee category 
103.25 	with a water supply other than a community public water supply as defined in Minnesota 
103.26 	Rules, chapter 4720. "Individual private sewer" means a fee category with an individual 
103.27 	sewage treatment system which uses subsurface treatment and disposal. 
103.28 	(12) Additional food service, $150. "Additional food service" means a location at 
103.29 	a food service establishment, other than the primary food preparation and service area, 
103.30 	used to prepare or serve food to the public. 
103.31 	(13) Additional inspection fee, $360. "Additional inspection fee" means a fee to 
103.32 	conduct the second inspection each year for elementary and secondary education facility 
103.33 	school lunch programs when required by the Richard B. Russell National School Lunch 
103.34 	Act. 
104.1 	(e) A fee for review of construction plans must accompany the initial license 
104.2 	application for restaurants, hotels, motels, lodging establishments, resorts, seasonal food 
104.3 	stands, and mobile food units. The fee for this construction plan review is as follows:

104.4	Service Area
	Type
	Fee
	
104.5	Food
	limited food menu
	$275
	
104.6		small establishment
	$400
	
104.7		medium establishment
	$450
	
104.8		large food establishment
	$500
	
104.9		additional food service
	$150
	
104.10	Transient food service
	food cart
	$250
	
104.11		seasonal permanent food stand
	$250
	
104.12		seasonal temporary food stand
	$250
	
104.13		mobile food unit
	$350
	
104.14	Alcohol
	beer or wine table service
	$150
	
104.15		alcohol service from bar
	$250
	
104.16	Lodging
	less than 25 rooms
	$375
	
104.17		25 to less than 100 rooms
	$400
	
104.18		100 rooms or more
	$500
	
104.19		less than five cabins
	$350
	
104.20		five to less than ten cabins
	$400
	
104.21		ten cabins or more
	$450
	
104.22 	(f) When existing food and beverage service establishments, hotels, motels, lodging 
104.23 	establishments, resorts, seasonal food stands, and mobile food units are extensively 
104.24 	remodeled, a fee must be submitted with the remodeling plans. The fee for this 
104.25 	construction plan review is as follows:

104.26	Service Area
	Type
	Fee
	
104.27	Food
	limited food menu
	$250
	
104.28		small establishment
	$300
	
104.29		medium establishment
	$350
	
104.30		large food establishment
	$400
	
104.31		additional food service
	$150
	
104.32	Transient food service
	food cart
	$250
	
104.33		seasonal permanent food stand
	$250
	
104.34		seasonal temporary food stand
	$250
	
104.35		mobile food unit
	$250
	
104.36	Alcohol
	beer or wine table service
	$150
	
104.37		alcohol service from bar
	$250
	
104.38	Lodging
	less than 25 rooms
	$250
	
104.39		25 to less than 100 rooms
	$300
	
104.40		100 rooms or more
	$450
	
104.41		less than five cabins
	$250
	
105.1		five to less than ten cabins
	$350
	
105.2		ten cabins or more
	$400
	
105.3 	(g) Special event food stands are not required to submit construction or remodeling 
105.4 	plans for review. 
105.5 	(h) Youth camps shall pay an annual single fee for food and lodging as follows:
105.6 	(1) camps with up to 99 campers, $325;
105.7 	(2) camps with 100 to 199 campers, $550; and
105.8 	(3) camps with 200 or more campers, $750.
105.9 	(i) A youth camp which pays fees under paragraph (d) is not required to pay fees 
105.10 	under paragraph (h).

105.11 	Sec. 3. Minnesota Statutes 2009 Supplement, section 327.15, subdivision 3, is 
105.12 	amended to read:
105.13 		Subd. 3.Fees, manufactured home parks and recreational camping areas. (a) 
105.14 	The following fees are required for manufactured home parks and recreational camping 
105.15 	areas licensed under this chapter. Recreational camping areas and manufactured home 
105.16 	parks shall pay the highest applicable base fee under paragraph (c) (b). The license fee 
105.17 	for new operators of a manufactured home park or recreational camping area previously 
105.18 	licensed under this chapter for the same calendar year is one-half of the appropriate annual 
105.19 	license fee, plus any penalty that may be required. The license fee for operators opening 
105.20 	on or after October 1 is one-half of the appropriate annual license fee, plus any penalty 
105.21 	that may be required.
105.22 	(b) All manufactured home parks and recreational camping areas shall pay the 
105.23 	following annual base fee:
105.24 	(1) a manufactured home park, $150; and
105.25 	(2) a recreational camping area with:
105.26 	(i) 24 or less sites, $50;
105.27 	(ii) 25 to 99 sites, $212; and
105.28 	(iii) 100 or more sites, $300.
105.29 	In addition to the base fee, manufactured home parks and recreational camping areas shall 
105.30 	pay $4 for each licensed site. This paragraph does not apply to special event recreational 
105.31 	camping areas or to. Operators of a manufactured home park or a recreational camping 
105.32 	area also licensed under section 157.16 for the same location shall pay only one base fee, 
105.33 	whichever is the highest of the base fees found in this section or section 157.16.
106.1 	(c) In addition to the fee in paragraph (b), each manufactured home park or 
106.2 	recreational camping area shall pay an additional annual fee for each fee category 
106.3 	specified in this paragraph:
106.4 	(1) Manufactured home parks and recreational camping areas with public swimming 
106.5 	pools and spas shall pay the appropriate fees specified in section 157.16.
106.6 	(2) Individual private sewer or water, $60. "Individual private water" means a fee 
106.7 	category with a water supply other than a community public water supply as defined in 
106.8 	Minnesota Rules, chapter 4720. "Individual private sewer" means a fee category with a 
106.9 	subsurface sewage treatment system which uses subsurface treatment and disposal.
106.10 	(d) The following fees must accompany a plan review application for initial 
106.11 	construction of a manufactured home park or recreational camping area:
106.12 	(1) for initial construction of less than 25 sites, $375;
106.13 	(2) for initial construction of 25 to 99 sites, $400; and
106.14 	(3) for initial construction of 100 or more sites, $500.
106.15 	(e) The following fees must accompany a plan review application when an existing 
106.16 	manufactured home park or recreational camping area is expanded:
106.17 	(1) for expansion of less than 25 sites, $250;
106.18 	(2) for expansion of 25 to 99 sites, $300; and
106.19 	(3) for expansion of 100 or more sites, $450.

106.20 	Sec. 4. FOOD SUPPORT FOR CHILDREN WITH SEVERE ALLERGIES.
 106.21 	The commissioner of human services must seek a federal waiver from the federal 
106.22 	Department of Agriculture, Food and Nutrition Service, for the supplemental nutrition 
106.23 	assistance program, to increase the income eligibility requirements to 375 percent of the 
106.24 	federal poverty guidelines, in order to cover nutritional food products required to treat 
106.25 	or manage severe food allergies, including allergies to wheat and gluten, for infants and 
106.26 	children who have been diagnosed with life-threatening severe food allergies.

106.27 	ARTICLE 7
106.28 	HEALTH CARE REFORM

106.29 	Section 1. [62E.20] RELATIONSHIP TO TEMPORARY FEDERAL HIGH-RISK 
106.30 	POOL.
106.31 		Subdivision 1.Definitions. (a) For purposes of this section, the terms defined in 
106.32 	this subdivision have the meanings given.
106.33 	(b) "Association" means the Minnesota Comprehensive Health Association.
107.1 	(c) "Federal law" means Title I, subtitle B, section 1101, of the federal Patient 
107.2 	Protection and Affordable Care Act, Public Law 111-148, including any federal 
107.3 	regulations adopted under it.
107.4 	(d) "Federal qualified high-risk pool" means an arrangement established by the 
107.5 	federal secretary of health and human services that meets the requirements of the federal 
107.6 	law.
107.7 		Subd. 2.Timing of this section. This section applies beginning the date the 
107.8 	temporary federal qualified high-risk health pool created under the federal law begins 
107.9 	to provide coverage in this state.
107.10 		Subd. 3.Maintenance of effort. The assessments made by the comprehensive 
107.11 	health association on its member insurers must comply with the maintenance of effort 
107.12 	requirement contained in paragraph (b), clause (3), of the federal law, to the extent that the 
107.13 	requirement applies to assessments made by the association.
107.14 		Subd. 4.Coordination with state health care programs. The commissioner 
107.15 	of commerce and the Minnesota Comprehensive Health Association shall ensure that 
107.16 	applicants for coverage through the federal qualified high-risk pool, or through the 
107.17 	Minnesota Comprehensive Health Association, are referred to the medical assistance or 
107.18 	MinnesotaCare programs if they are determined to be potentially eligible for coverage 
107.19 	through those programs. The commissioner of human services shall ensure that applicants 
107.20 	for coverage under medical assistance or MinnesotaCare who are determined not to be 
107.21 	eligible for those programs are provided information about coverage through the federal 
107.22 	qualified high-risk pool and the Minnesota Comprehensive Health Association.
107.23 		Subd. 5.Federal funding. Minnesota shall coordinate its efforts with the United 
107.24 	States Department of Health and Human Services (HHS) to obtain the federal funds to 
107.25 	implement in Minnesota the federal qualified high-risk pool.

107.26 	Sec. 2. [256B.0756] COORDINATED CARE THROUGH A HEALTH HOME.
107.27 		Subdivision 1.Provision of coverage. (a) The commissioner shall provide 
107.28 	medical assistance coverage of health home services for eligible individuals with chronic 
107.29 	conditions who select a designated provider, a team of health care professionals, or a 
107.30 	health team as the individual's health home.
107.31 	(b) The commissioner shall implement this section in compliance with the 
107.32 	requirements of the state option to provide health homes for enrollees with chronic 
107.33 	conditions, as provided under the Patient Protection and Affordable Care Act, Public 
107.34 	Law 111-148, sections 2703 and 3502. Terms used in this section have the meaning 
107.35 	provided in that act.
108.1 		Subd. 2.Eligible individual. An individual is eligible for health home services 
108.2 	under this section if the individual is eligible for medical assistance under this chapter 
108.3 	and has at least:
108.4 	(1) two chronic conditions;
108.5 	(2) one chronic condition and is at risk of having a second chronic condition; or
108.6 	(3) one serious and persistent mental health condition.
108.7 		Subd. 3.Health home services. (a) Health home services means comprehensive and 
108.8 	timely high-quality services that are provided by a health home. These services include:
108.9 	(1) comprehensive care management;
108.10 	(2) care coordination and health promotion;
108.11 	(3) comprehensive transitional care, including appropriate follow-up, from inpatient 
108.12 	to other settings;
108.13 	(4) patient and family support, including authorized representatives;
108.14 	(5) referral to community and social support services, if relevant; and
108.15 	(6) use of health information technology to link services, as feasible and appropriate.
108.16 	(b) The commissioner shall maximize the number and type of services 
108.17 	included in this subdivision to the extent permissible under federal law, including 
108.18 	physician, outpatient, mental health treatment, and rehabilitation services necessary for 
108.19 	comprehensive transitional care following hospitalization.
108.20 		Subd. 4.Health teams. The commissioner shall establish health teams to support 
108.21 	the patient-centered health home and provide the services described in subdivision 3 to 
108.22 	individuals eligible under subdivision 2. The commissioner shall apply for grants or 
108.23 	contracts as provided under section 3502 of the Patient Protection and Affordable Care 
108.24 	Act to establish health teams and provide capitated payments to primary care providers. 
108.25 	For purposes of this section, "health teams" means community-based, interdisciplinary, 
108.26 	inter-professional teams of health care providers that support primary care practices. 
108.27 	These providers may include medical specialists, nurses, advanced practice registered 
108.28 	nurses, pharmacists, nutritionists, social workers, behavioral and mental health providers, 
108.29 	doctors of chiropractic, licensed complementary and alternative medicine practitioners, 
108.30 	and physician assistants.
108.31 		Subd. 5.Payments. The commissioner shall make payments to each health home 
108.32 	and each health team for the provision of health home services to each eligible individual 
108.33 	with chronic conditions that selects the health home as a provider.
108.34 		Subd. 6.Coordination. The commissioner, to the extent feasible, shall ensure that 
108.35 	the requirements and payment methods for health homes and health teams developed 
108.36 	under this section are consistent with the requirements and payment methods for health 
109.1 	care homes established under sections 256B.0751 and 256B.0753. The commissioner may 
109.2 	modify requirements and payment methods under sections 256B.0751 and 256B.0753 in 
109.3 	order to be consistent with federal health home requirements and payment methods.
109.4 		Subd. 7.State plan amendment. The commissioner shall submit a state plan 
109.5 	amendment to implement this section to the federal Centers for Medicare and Medicaid 
109.6 	Services by January 1, 2011.

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

109.9 	Sec. 3. FEDERAL HEALTH CARE REFORM DEMONSTRATION PROJECTS 
109.10 	AND GRANTS.
 109.11 	(a) The commissioner of human services shall seek to participate in the following 
109.12 	demonstration projects, or apply for the following grants, as described in the federal 
109.13 	Patient Protection and Affordable Care Act, Public Law 111-148:
109.14 	(1) the demonstration project to evaluate integrated care around a hospitalization, 
109.15 	Public Law 111-148, section 2704;
109.16 	(2) the Medicaid global payment system demonstration project, Public Law 111-148, 
109.17 	section 2705, including a demonstration project for the specific population of childless 
109.18 	adults under 75 percent of federal poverty guidelines that were to be served by the general 
109.19 	assistance medical care program;
109.20 	(3) the pediatric accountable care organization demonstration project, Public Law 
109.21 	111-148, section 2706;
109.22 	(4) the Medicaid emergency psychiatric demonstration project, Public Law 111-148, 
109.23 	section 2707; and
109.24 	(5) grants to provide incentives for prevention of chronic diseases in Medicaid, 
109.25 	Public Law 111-148, section 4108.
109.26 	(b) The commissioner of human services shall report to the chairs and ranking 
109.27 	minority members of the house of representatives and senate committees or divisions with 
109.28 	jurisdiction over health care policy and finance on the status of the demonstration project 
109.29 	and grant applications. If the state is accepted as a demonstration project participant, or is 
109.30 	awarded a grant, the commissioner shall notify the chairs and ranking minority members 
109.31 	of those committees or divisions of any legislative changes necessary to implement the 
109.32 	demonstration projects or grants.
109.33 	(c) The commissioner of health shall apply for federal grants available under the 
109.34 	federal Patient Protection and Affordable Care Act, Public Law 111-148, for purposes 
109.35 	of funding wellness and prevention, and health improvement programs. To the extent 
110.1 	possible under federal law, the commissioner of health must utilize the state health 
110.2 	improvement program, established under Minnesota Statutes, section 145.986, to 
110.3 	implement grant programs related to wellness and prevention, and health improvement, 
110.4 	for which the state receives funding under the federal Patient Protection and Affordable 
110.5 	Care Act, Public Law 111-148.

110.6 	Sec. 4. HEALTH CARE REFORM TASK FORCE.
 110.7 		Subdivision 1.Task force. (a) The governor shall convene a Health Care 
110.8 	Reform Task Force to advise and assist the governor and the legislature regarding state 
110.9 	implementation of federal health care reform legislation. For purposes of this section, 
110.10 	"federal health care reform legislation" means the Patient Protection and Affordable Care 
110.11 	Act, Public Law 111-148, and the health care reform provisions in the Health Care and 
110.12 	Education Reconciliation Act of 2010, Public Law 111-152. The task force shall consist of:
110.13 	(1) two legislators from the house of representatives appointed by the speaker and 
110.14 	two legislators from the senate appointed by the Subcommittee on Committees of the 
110.15 	Committee on Rules and Administration;
110.16 	(2) two representatives appointed by the governor to represent the governor and 
110.17 	state agencies;
110.18 	(3) three persons appointed by the governor who have demonstrated leadership in 
110.19 	health care organizations, health plan companies, or health care trade or professional 
110.20 	associations;
110.21 	(4) three persons appointed by the governor who have demonstrated leadership in 
110.22 	employer and group purchaser activities related to health system improvement of whom 
110.23 	two must be from a labor organization and one from the business community; and
110.24 	(5) five persons appointed by the governor who have demonstrated expertise in the 
110.25 	areas of health care financing, access, and quality.
110.26 	The governor is exempt from the requirements of the open appointments process 
110.27 	for purposes of appointing task force members. Members shall be appointed for one-year 
110.28 	terms and may be reappointed.
110.29 	(b) The Department of Health, Department of Human Services, and Department of 
110.30 	Commerce shall provide staff support to the task force. The task force may accept outside 
110.31 	resources to help support its efforts.
110.32 	(c) Task force members must be appointed by July 1, 2010.  The task force must hold 
110.33 	its first meeting by July 15, 2010.
110.34 		Subd. 2.Duties. (a) By December 15, 2010, the task force shall develop and 
110.35 	present to the legislature and the governor a preliminary report and recommendations on 
111.1 	state implementation of federal health care reform legislation. The report must include 
111.2 	recommendations for state law and program changes necessary to comply with the federal 
111.3 	health care reform legislation, and also recommendations for implementing provisions of 
111.4 	the federal legislation that are optional for states. In developing recommendations, the task 
111.5 	force shall consider the extent to which an approach maximizes federal funding to the state.
111.6 	(b) The task force, in consultation with the governor and the legislature, shall also 
111.7 	establish timelines and criteria for future reports on state implementation of the federal 
111.8 	health care reform legislation.

111.9 	Sec. 5. AMERICAN HEALTH BENEFIT EXCHANGE; PLANNING 
111.10 	PROVISIONS.
 111.11 		Subdivision 1.Federal planning grants. The commissioners of commerce, health, 
111.12 	and human services shall jointly or separately apply to the federal secretary of health and 
111.13 	human services for one or more planning grants, including renewal grants, authorized 
111.14 	under section 1311 of the Patient Protection and Affordable Care Act, Public Law 
111.15 	111-148, including any future amendments of that provision, relating to state creation 
111.16 	of American Health Benefit Exchanges.
111.17 		Subd. 2.Consideration of early creation and operation of exchange. (a) The 
111.18 	commissioners referenced in subdivision 1 shall analyze the advantages and disadvantages 
111.19 	to the state of planning to have a state health insurance exchange, similar to an American 
111.20 	Health Benefit Exchange referenced in subdivision 1, begin prior to the federal deadline 
111.21 	of January 1, 2014.
111.22 	(b) The commissioners shall provide a written report to the legislature on the results 
111.23 	of the analysis required under paragraph (a) no later than December 15, 2010. The written 
111.24 	report must comply with Minnesota Statutes, sections 3.195 and 3.197.

111.25 	ARTICLE 8
111.26 	HUMAN SERVICES FORECAST ADJUSTMENTS

111.27	Section 1.  SUMMARY OF APPROPRIATIONS.
 	
111.28 	The amounts shown in this section summarize direct appropriations, by fund, made 
111.29 	in this article.

111.30			2010
		2011
		Total
	
111.31	General
	$
	(109,876,000)
	$
	(28,344,000)
	$
	(138,220,000)
	
111.32	Health Care Access
	$
	99,654,000
	$
	276,500,000
	$
	376,154,000
	
111.33	Federal TANF
	$
	(9,830,000)
	$
	15,133,000
	$
	5,303,000
	
111.34	Total
	$
	(20,052,000)
	$
	263,289,000
	$
	243,237,000

112.1	Sec. 2. DEPARTMENT OF HUMAN SERVICES APPROPRIATION.
 	
112.2 	The sums shown in the columns marked "Appropriations" are added to or, if shown 
112.3 	in parentheses, subtracted from the appropriations in Laws 2009, chapter 79, article 13, 
112.4 	as amended by Laws 2009, chapter 173, article 2, to the agencies and for the purposes 
112.5 	specified in this article. The appropriations are from the general fund, or another named 
112.6 	fund, and are available for the fiscal years indicated for each purpose. The figures "2010" 
112.7 	and "2011" used in this article mean that the addition to or subtraction from appropriations 
112.8 	listed under them is available for the fiscal year ending June 30, 2010, or June 30, 2011, 
112.9 	respectively. "The first year" is fiscal year 2010. "The second year" is fiscal year 2011. 
112.10 	"The biennium" is fiscal years 2010 and 2011. Supplemental appropriations and reductions 
112.11 	for the fiscal year ending June 30, 2010, are effective the day following final enactment 
112.12 	unless a different effective date is explicit.

112.13				APPROPRIATIONS
	
112.14				Available for the Year
	
112.15				Ending June 30
	
112.16					2010
		2011

112.17
112.18	Sec. 3. DEPARTMENT OF HUMAN 
SERVICES

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

112.20	Appropriations by Fund
	
112.21		2010
	2011
	
112.22	General
	(109,876,000)
	(28,344,000)
	
112.23	Health Care Access
	99,654,000
	276,500,000
	
112.24	Federal TANF
	(9,830,000)
	15,133,000
	
112.25 	The amounts that may be spent for each 
112.26 	purpose are specified in the following 
112.27 	subdivisions.

112.28	Subd. 2.Revenue and Pass-through

112.29	Appropriations by Fund
	
112.30	Federal TANF
	390,000
	(251,000)

112.31
112.32	Subd. 3.Children and Economic Assistance 
Grants

112.33	Appropriations by Fund
	
112.34	General
	4,489,000
	(4,140,000)
	
112.35	Federal TANF
	(10,220,000)
	15,384,000
	
113.1 	The amounts that may be spent from this 
113.2 	appropriation are as follows:

113.3	(a) MFIP Grants

113.4	General
	7,916,000
	(14,481,000)
	
113.5	Federal TANF
	(10,220,000)
	15,384,000

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

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

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

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

113.10	Subd. 4.Basic Health Care Grants

113.11	Appropriations by Fund
	
113.12	General 
	(62,770,000)
	29,192,000
	
113.13	Health Care Access
	99,654,000
	276,500,000
	
113.14 	The amounts that may be spent from the 
113.15 	appropriation for each purpose are as follows:

113.16	(a)MinnesotaCare Grants

113.17	Health Care Access
	99,654,000
	276,500,000

113.18
113.19	(b)Medical Assistance Basic Health Care - 
Families and Children
		1,165,000
		24,146,000

113.20
113.21	(c)Medical Assistance Basic Health Care - 
Elderly and Disabled
		(63,935,000)
		5,046,000

113.22	Subd. 5.Continuing Care Grants
 		(51,595,000)
		(53,396,000)
	
113.23 	The amounts that may be spent from the 
113.24 	appropriation for each purpose are as follows:

113.25
113.26	(a)Medical Assistance Long-Term Care 
Facilities
		(3,774,000)
		(8,275,000)

113.27
113.28	(b)Medical Assistance Long-Term Care 
Waivers
		(27,710,000)
		(22,452,000)

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

113.30 	Sec. 4. EFFECTIVE DATE.
 113.31 	This article is effective the day following final enactment.

114.1 	ARTICLE 9
114.2 	HUMAN SERVICES CONTINGENT APPROPRIATIONS

114.3	Section 1.  SUMMARY OF HUMAN SERVICES APPROPRIATIONS.
 	
114.4 	The amounts shown in this section summarize direct appropriations, by fund, made 
114.5 	in this bill.

114.6			2010
		2011
		Total
	
114.7	General
	$
	-0-
	$
	13,383,000
	$
	13,383,000
	
114.8	Health Care Access
		-0-
		686,000
		686,000
	
114.9	Total
	$
	-0-
	$
	14,069,000
	$
	14,069,000

114.10	Sec. 2. HEALTH AND HUMAN SERVICES CONTINGENT APPROPRIATIONS.
 	
114.11 	(a) The sums shown in the columns marked "Appropriations" are added to the 
114.12 	appropriations in Laws 2009, chapter 79, article 13, as amended by Laws 2009, chapter 
114.13 	173, article 2, to the agency and for the purposes specified in this bill. The appropriations 
114.14 	are from the general fund, or another named fund, and are available for the fiscal years 
114.15 	indicated for each purpose. The figures "2010" and "2011" used in this bill mean that the 
114.16 	addition to or subtraction from the appropriation listed under them is available for the 
114.17 	fiscal year ending June 30, 2010, or June 30, 2011, respectively.
114.18 	(b) Upon enactment of the extension of the enhanced federal medical assistance 
114.19 	percentage (FMAP) under Public Law 111-5 to June 30, 2011, that is contained in the 
114.20 	president's budget for federal fiscal year 2011 or contained in House Resolution 2847, 
114.21 	the federal "Jobs for Main Street Act, 2010," or contained in House Resolution 4213, 
114.22 	"American Workers, State, and Business Relief Act of 2010," or subsequent federal 
114.23 	legislation, the appropriations identified in section 3 shall be made for fiscal year 2011.

114.24				APPROPRIATIONS
	
114.25				Available for the Year
	
114.26				Ending June 30
	
114.27					2010
		2011

114.28
114.29	Sec. 3. COMMISSIONER OF HUMAN 
SERVICES

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

114.31	Appropriations by Fund
	
114.32		2010
	2011
	
114.33	General
	-0-
	13,383,000
	
114.34	Health Care Access
	-0-
	686,000
	
115.1 	The appropriations for each purpose are 
115.2 	shown in the following subdivisions.

115.3	Subd. 2.Basic Health Care Grants

115.4	(a) MinnesotaCare Grants
		-0-
		686,000
	
115.5 	This appropriation is from the health care 
115.6 	access fund.

115.7
115.8	(b) Medical Assistance Basic Health Care 
Grants - Families and Children
		-0-
		6,297,000

115.9115.10
	(c) Medical Assistance Basic Health Care 
Grants - Elderly and Disabled
		-0-
		3,697,000

115.11	Subd. 3.Continuing Care Grants

115.12
115.13	(a) Medical Assistance - Long-Term Care 
Facilities Grants
		-0-
		2,486,000

115.14
115.15	(b) Medical Assistance Grants - Long-Term 
Care Waivers and Home Care Grants
		-0-
		547,000

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

115.17 	Sec. 4. Minnesota Statutes 2008, section 256B.0625, subdivision 22, is amended to 
115.18 	read:
115.19 		Subd. 22.Hospice care. Medical assistance covers hospice care services under 
115.20 	Public Law 99-272, section 9505, to the extent authorized by rule, except that a recipient 
115.21 	age 21 or under who elects to receive hospice services does not waive coverage for 
115.22 	services that are related to the treatment of the condition for which a diagnosis of terminal 
115.23 	illness has been made.

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

115.25 	Sec. 5. Minnesota Statutes 2009 Supplement, section 256B.0911, subdivision 1a, 
115.26 	is amended to read:
115.27 		Subd. 1a.Definitions. For purposes of this section, the following definitions apply:
115.28 	(a) "Long-term care consultation services" means:
115.29 	(1) assistance in identifying services needed to maintain an individual in the most 
115.30 	inclusive environment;
115.31 	(2) providing recommendations on cost-effective community services that are 
115.32 	available to the individual;
116.1 	(3) development of an individual's person-centered community support plan;
116.2 	(4) providing information regarding eligibility for Minnesota health care programs;
116.3 	(5) face-to-face long-term care consultation assessments, which may be completed 
116.4 	in a hospital, nursing facility, intermediate care facility for persons with developmental 
116.5 	disabilities (ICF/DDs), regional treatment centers, or the person's current or planned 
116.6 	residence;
116.7 	(6) federally mandated screening to determine the need for a institutional level of 
116.8 	care under section 256B.0911, subdivision 4, paragraph (a) subdivision 4a;
116.9 	(7) determination of home and community-based waiver service eligibility including 
116.10 	level of care determination for individuals who need an institutional level of care as 
116.11 	defined under section 144.0724, subdivision 11, or 256B.092, service eligibility including 
116.12 	state plan home care services identified in section 256B.0625, subdivisions 6, 7, and 
116.13 	19, paragraphs (a) and (c), based on assessment and support plan development with 
116.14 	appropriate referrals;
116.15 	(8) providing recommendations for nursing facility placement when there are no 
116.16 	cost-effective community services available; and
116.17 	(9) assistance to transition people back to community settings after facility 
116.18 	admission.
116.19 	(b) "Long-term care options counseling" means the services provided by the linkage 
116.20 	lines as mandated by sections 256.01 and 256.975, subdivision 7, and also includes 
116.21 	telephone assistance and follow up once a long-term care consultation assessment has 
116.22 	been completed.
116.23 	(c) "Minnesota health care programs" means the medical assistance program under 
116.24 	chapter 256B and the alternative care program under section 256B.0913.
116.25 	(d) "Lead agencies" means counties or a collaboration of counties, tribes, and health 
116.26 	plans administering long-term care consultation assessment and support planning services.

116.27 	Sec. 6. Minnesota Statutes 2008, section 256B.19, subdivision 1c, is amended to read:
116.28 		Subd. 1c.Additional portion of nonfederal share. (a) Hennepin County shall 
116.29 	be responsible for a monthly transfer payment of $1,500,000, due before noon on the 
116.30 	15th of each month and the University of Minnesota shall be responsible for a monthly 
116.31 	transfer payment of $500,000 due before noon on the 15th of each month, beginning July 
116.32 	15, 1995. These sums shall be part of the designated governmental unit's portion of the 
116.33 	nonfederal share of medical assistance costs.
116.34 	(b) Beginning July 1, 2001, Hennepin County's payment under paragraph (a) shall 
116.35 	be $2,066,000 each month.
117.1 	(c) Beginning July 1, 2001, the commissioner shall increase annual capitation 
117.2 	payments to the metropolitan health plan under section 256B.69 for the prepaid medical 
117.3 	assistance program by approximately $3,400,000, plus any available federal matching 
117.4 	funds, $6,800,000 to recognize higher than average medical education costs.
117.5 	(d) Effective August 1, 2005, Hennepin County's payment under paragraphs (a) 
117.6 	and (b) shall be reduced to $566,000, and the University of Minnesota's payment under 
117.7 	paragraph (a) shall be reduced to zero. Effective October 1, 2008, to December 31, 2010, 
117.8 	Hennepin County's payment under paragraphs (a) and (b) shall be $434,688. Effective 
117.9 	January 1, 2011, Hennepin County's payment under paragraphs (a) and (b) shall be 
117.10 	$566,000.
117.11 	(e) Notwithstanding paragraph (d), upon federal enactment of an extension to June 
117.12 	30, 2011, of the enhanced federal medical assistance percentage (FMAP) originally 
117.13 	provided under Public Law 111-5, for the six-month period from January 1, 2011, to June 
117.14 	30, 2011, Hennepin County's payment under paragraphs (a) and (b) shall be $434,688.

117.15 	Sec. 7. Minnesota Statutes 2008, section 256L.15, subdivision 1, is amended to read:
117.16 		Subdivision 1.Premium determination. (a) Families with children and individuals 
117.17 	shall pay a premium determined according to subdivision 2.
117.18 	(b) Pregnant women and children under age two are exempt from the provisions 
117.19 	of section 256L.06, subdivision 3, paragraph (b), clause (3), requiring disenrollment 
117.20 	for failure to pay premiums. For pregnant women, this exemption continues until the 
117.21 	first day of the month following the 60th day postpartum. Women who remain enrolled 
117.22 	during pregnancy or the postpartum period, despite nonpayment of premiums, shall be 
117.23 	disenrolled on the first of the month following the 60th day postpartum for the penalty 
117.24 	period that otherwise applies under section 256L.06, unless they begin paying premiums. 
117.25 	(c) Members of the military and their families who meet the eligibility criteria 
117.26 	for MinnesotaCare upon eligibility approval made within 24 months following the end 
117.27 	of the member's tour of active duty shall have their premiums paid by the commissioner. 
117.28 	The effective date of coverage for an individual or family who meets the criteria of this 
117.29 	paragraph shall be the first day of the month following the month in which eligibility is 
117.30 	approved. This exemption applies for 12 months. This paragraph expires June 30, 2010. 
117.31 	If the expiration of this provision is in violation of section 5001 of Public Law 111-5, this 
117.32 	provision will expire on the date when it is no longer subject to section 5001 of Public Law 
117.33 	111-5. The commissioner of human services shall notify the revisor of statutes of that date.

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

118.3 	EFFECTIVE DATE. Paragraph (a) is effective August 1, 2009, and upon federal 
118.4 	approval and on the date when it is no longer subject to the maintenance of effort 
118.5 	requirements of section 5001 of Public Law 111-5. The commissioner of human services 
118.6 	shall notify the revisor of statutes of that date. Paragraph (e) is effective September 1, 
118.7 	2006.

118.8 	Sec. 9. Laws 2009, chapter 79, article 5, section 17, the effective date, is amended to 
118.9 	read:

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

118.14 	Sec. 10. Laws 2009, chapter 79, article 5, section 18, the effective date, is amended to 
118.15 	read:

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

118.20 	Sec. 11. Laws 2009, chapter 79, article 5, section 22, the effective date, is amended to 
118.21 	read:

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

118.27 	Sec. 12. Laws 2009, chapter 79, article 8, section 4, the effective date, is amended to 
118.28 	read:

118.29 	EFFECTIVE DATE. The section is effective January July 1, 2011.

119.1 	Sec. 13. Laws 2009, chapter 173, article 1, section 17, the effective date, is amended to 
119.2 	read:

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

119.8 	ARTICLE 10
119.9 	HEALTH AND HUMAN SERVICES APPROPRIATIONS

119.10	Section 1. SUMMARY OF APPROPRIATIONS.
 	
119.11 	The amounts shown in this section summarize direct appropriations by fund made 
119.12 	in this article.

119.13			2010
		2011
		Total
	
119.14	General
	$
	(6,784,000)
	$
	215,726,000
	$
	208,942,000
	
119.15
119.16	State Government Special 
Revenue
		113,000
		624,000
		737,000
	
119.17	Health Care Access
		998,000
		11,579,000
		12,577,000
	
119.18	Federal TANF
		8,000,000
		20,000,000
		28,000,000
	
119.19	Special Revenue
		-0-
		93,000
		93,000
	
119.20	Total
	$
	2,327,000
	$
	248,021,000
	$
	250,348,000

119.21	Sec. 2. HEALTH AND HUMAN SERVICES APPROPRIATIONS.
 	
119.22 	The sums shown in the columns marked "Appropriations" are added to or, if shown 
119.23 	in parentheses, subtracted from the appropriations in Laws 2009, chapter 79, article 13, 
119.24 	as amended by Laws 2009, chapter 173, article 2, to the agencies and for the purposes 
119.25 	specified in this article. The appropriations are from the general fund, or another named 
119.26 	fund, and are available for the fiscal years indicated for each purpose. The figures "2010" 
119.27 	and "2011" used in this article mean that the addition to or subtraction from appropriations 
119.28 	listed under them is available for the fiscal year ending June 30, 2010, or June 30, 2011, 
119.29 	respectively. "The first year" is fiscal year 2010. "The second year" is fiscal year 2011. 
119.30 	"The biennium" is fiscal years 2010 and 2011. Supplemental appropriations and reductions 
119.31 	for the fiscal year ending June 30, 2010, are effective the day following final enactment 
119.32 	unless a different effective date is explicit.

119.33				APPROPRIATIONS
	
119.34				Available for the Year
	
120.1				Ending June 30
	
120.2					2010
		2011

120.3
120.4	Sec. 3. COMMISSIONER OF HUMAN 
SERVICES

120.5	Subdivision 1.Total Appropriation
 	$
	4,409,000
	$
	246,347,000

120.6	Appropriations by Fund
	
120.7		2010
	2011
	
120.8	General
	(4,589,000)
	215,006,000
	
120.9	Health Care Access
	998,000
	11,342,000
	
120.10	Federal TANF
	8,000,000
	20,000,000
	
120.11 	The appropriation modifications for 
120.12 	each purpose are shown in the following 
120.13 	subdivisions.
120.14 	TANF Financing and Maintenance of 
120.15 	Effort. The commissioner, with the approval 
120.16 	of the commissioner of management and 
120.17 	budget, and after notification of the chairs 
120.18 	of the relevant senate budget division and 
120.19 	house of representatives finance division, 
120.20 	may adjust the amount of TANF transfers 
120.21 	between the MFIP transition year child care 
120.22 	assistance program and MFIP grant programs 
120.23 	within the fiscal year and within the current 
120.24 	biennium and the biennium ending June 30, 
120.25 	2013, to ensure that state and federal match 
120.26 	and maintenance of effort requirements are 
120.27 	met. These transfers and amounts shall be 
120.28 	reported to the chairs of the senate and house 
120.29 	of representatives Finance Committees, the 
120.30 	senate Health and Human Services Budget 
120.31 	Division, and the house of representatives 
120.32 	Health Care and Human Services Finance 
120.33 	Division and Early Childhood Finance and 
120.34 	Policy Division by December 1 of each 
120.35 	fiscal year. Notwithstanding any contrary 
121.1 	provision in this article, this paragraph 
121.2 	expires June 30, 2013.
121.3 	SNAP Enhanced Administrative Funding.
121.4 	The funds available for administration 
121.5 	of the Supplemental Nutrition Assistance 
121.6 	Program under the Department of Defense 
121.7 	Appropriations Act of 2010, Public 
121.8 	Law 111-118, are appropriated to the 
121.9 	commissioner to pay the actual costs 
121.10 	of providing for increased eligibility 
121.11 	determinations, caseload-related costs, 
121.12 	timely application processing, and quality 
121.13 	control. Of these funds, 20 percent shall 
121.14 	be allocated to the commissioner and 80 
121.15 	percent shall be allocated to counties. 
121.16 	The commissioner shall allocate the 
121.17 	county portion based on recent caseload. 
121.18 	Reimbursement shall be based on actual 
121.19 	costs reported by counties through existing 
121.20 	processes. Tribal reimbursement must be 
121.21 	made from the state portion, based on a 
121.22 	caseload factor equivalent to that of a county.
121.23 	TANF Summer Food Programs - 
121.24 	TANF Emergency Fund Non-Recurrent 
121.25 	Short-Term Benefits. In addition to the 
121.26 	TANF emergency fund (TEF) non-recurrent 
121.27 	short-term benefits provided in this 
121.28 	subdivision, the commissioner may 
121.29 	supplement funds available under Minnesota 
121.30 	Statutes, section 256E.34 to provide for 
121.31 	summer food programs to the extent such 
121.32 	funds are available and eligible to leverage 
121.33 	TANF emergency funds non-recurrent 
121.34 	benefits. The commissioner may contract 
121.35 	directly with providers or third-party funders 
121.36 	to maximize these TANF emergency fund 
122.1 	grants. Up to $800,000 of TEF non-recurrent 
122.2 	short-term benefit earnings may be used in 
122.3 	this program. This paragraph is effective the 
122.4 	day following final enactment.
122.5 	TANF Transfer to Federal Child 
122.6 	Care and Development Fund. Of the 
122.7 	TANF appropriation in fiscal year 2011, 
122.8 	$12,500,000 is to the commissioner for 
122.9 	the purposes of MFIP and transition year 
122.10 	child care under Minnesota Statutes, section 
122.11 	119B.05. The commissioner shall authorize 
122.12 	the transfer of sufficient TANF funds to the 
122.13 	federal child care and development fund to 
122.14 	meet this appropriation and shall ensure that 
122.15 	all transferred funds are expended according 
122.16 	to federal child care and development fund 
122.17 	regulations.
122.18 	Special Revenue Fund Transfers. (a) The 
122.19 	commissioner shall transfer the following 
122.20 	amounts from special revenue fund balances 
122.21 	to the general fund by June 30 of each 
122.22 	respective fiscal year: $613,000 in fiscal year 
122.23 	2010, and $493,000 in fiscal year 2011. This 
122.24 	provision is effective the day following final 
122.25 	enactment.
122.26 	(b) The actual transfers made under 
122.27 	paragraph (a) must be separately identified 
122.28 	and reported as part of the quarterly reporting 
122.29 	of transfers to the chairs of the relevant senate 
122.30 	budget division and house of representatives 
122.31 	finance division.

122.32	Subd. 2.Agency Management 

122.33	(a)  Financial Operations
		-0-
		103,000
	
123.1 	Base Adjustment.  The general fund base is 
123.2 	decreased by $3,292,000 in fiscal year 2012 
123.3 	and $3,292,000 in fiscal year 2013.

123.4	(b)  Legal and Regulatory Operations
		-0-
		114,000
	
123.5 	Base Adjustment.  The general fund base is 
123.6 	decreased by $18,000 in fiscal year 2012 and 
123.7 	$18,000 in fiscal year 2013.

123.8	(c) Management Operations
		-0-
		(114,000)
	
123.9 	Base Adjustment.  The general fund base is 
123.10 	increased by $18,000 in fiscal year 2012 and 
123.11 	$18,000 in fiscal year 2013.

123.12
123.13	Subd. 3.Revenue and Pass-Through Revenue 
Expenditures
 		8,000,000
		20,000,000
	
123.14 	These appropriations are from the federal 
123.15 	TANF fund.
123.16 	TANF Funding for the Working Family 
123.17 	Tax Credit. In addition to the amounts 
123.18 	specified in Minnesota Statutes, section 
123.19 	290.0671, subdivision 6, $15,500,000 
123.20 	of TANF funds in fiscal year 2010 are 
123.21 	appropriated to the commissioner to 
123.22 	reimburse the general fund for the cost of 
123.23 	the working family tax credit for eligible 
123.24 	families. With respect to the amounts 
123.25 	appropriated for fiscal year 2010, the 
123.26 	commissioner shall reimburse the general 
123.27 	fund by June 30, 2010. This paragraph is 
123.28 	effective the day following final enactment.
123.29 	Child Care Development Fund 
123.30 	Unexpended Balance. In addition to 
123.31 	the amount provided in this section, the 
123.32 	commissioner shall carry over and expend 
123.33 	in fiscal year 2011 $7,500,000 of the TANF 
123.34 	funds transferred in fiscal year 2010 that 
124.1 	reflect the child care and development fund 
124.2 	unexpended balance for the basic sliding 
124.3 	fee child care assistance program under 
124.4 	Minnesota Statutes, section 119B.03. The 
124.5 	commissioner shall ensure that all funds are 
124.6 	expended according to the federal child care 
124.7 	and development fund regulations relating to 
124.8 	the TANF transfers.
124.9 	Base Adjustment. The general fund base is 
124.10 	increased by $7,500,000 in fiscal year 2012 
124.11 	and $7,500,000 in fiscal year 2013.

124.12	Subd. 4.Economic Support Grants

124.13	(a) Support Services Grants
		-0-
		-0-
	
124.14 	Base Adjustment. The federal TANF fund 
124.15 	base is decreased by $5,004,000 in fiscal year 
124.16 	2012 and $5,004,000 in fiscal year 2013.

124.17	(b) MFIP/DWP Grants
		-0-
		(1,520,000)

124.18
124.19	(c) Basic Sliding Fee Child Care Assistance 
Grants
		-0-
		(7,500,000)

124.20	(d) Children's Services Grants
		(900,000)
		-0-
	
124.21 	Adoption Assistance. Of the appropriation 
124.22 	reduction in fiscal year 2010, $900,000 is 
124.23 	from the adoption assistance program. This 
124.24 	reduction is onetime.

124.25	(e) Child and Community Services Grants
		-0-
		(16,750,000)
	
124.26 	Base adjustment. The general fund is 
124.27 	increased by $13,509,000 in fiscal year 2012 
124.28 	and $13,509,000 in fiscal year 2013.

124.29	(f) Group Residential Housing Grants
		-0-
		84,000
	
124.30 	Reduction of Supplemental Service Rate.
124.31 	Effective July 1, 2011, to June 30, 2013, 
124.32 	the commissioner shall decrease the group 
124.33 	residential housing supplementary service 
125.1 	rate under Minnesota Statutes, section 
125.2 	256I.05, subdivision 1a, by five percent 
125.3 	for services rendered on or after that date, 
125.4 	except that reimbursement rates for a group 
125.5 	residential housing facility reimbursed as a 
125.6 	nursing facility shall not be reduced. The 
125.7 	reduction in this paragraph is in addition to 
125.8 	the reduction under Laws 2009, chapter 79, 
125.9 	article 8, section 79, paragraph (b), clause 
125.10 	(11).
125.11 	Base Adjustment. The general fund base is 
125.12 	decreased by $784,000 in fiscal year 2012 
125.13 	and $784,000 in fiscal year 2013.

125.14	(g) Children's Mental Health Grants
		(200,000)
		(200,000)

125.15
125.16	(h) Other Children's and Economic Assistance 
Grants
		400,000
		213,000
	
125.17 	Minnesota Food Assistance Program.  Of 
125.18 	the 2011 appropriation, $150,000 is for the 
125.19 	Minnesota Food Assistance Program. This 
125.20 	appropriation is onetime.
125.21 	Of this appropriation, $400,000 in fiscal 
125.22 	year 2010 and $63,000 in fiscal year 2011 
125.23 	is for food shelf programs under Minnesota 
125.24 	Statutes, section 256E.34. This appropriation 
125.25 	is available until spent.
125.26 	Base Adjustment. The general fund base is 
125.27 	decreased by $20,000 in fiscal year 2012 and 
125.28 	decreased by $510,000 in fiscal year 2013.

125.29
125.30	Subd. 5.Children and Economic Assistance 
Management

125.31
125.32	(a) Children and Economic Assistance 
Administration
		-0-
		-0-
	
125.33 	Base Adjustment. The federal TANF fund 
125.34 	base is decreased by $700,000 in fiscal year 
125.35 	2012 and $700,000 in fiscal year 2013.

126.1
126.2	(b) Children and Economic Assistance 
Operations
		-0-
		195,000
	
126.3 	Base Adjustment. The general fund base is 
126.4 	decreased by $12,000 in fiscal year 2012 and 
126.5 	$12,000 in fiscal year 2013.

126.6	Subd. 6.Health Care Grants

126.7	(a) MinnesotaCare Grants
		998,000
		18,124,000
	
126.8 	This appropriation is from the health care 
126.9 	access fund.
126.10 	Health Care Access Fund Transfer to 
126.11 	General Fund. The commissioner of 
126.12 	management and budget shall transfer 
126.13 	$998,000 in fiscal year 2010 and 
126.14 	$199,337,000 in fiscal year 2011 from the 
126.15 	health care access fund to the general fund. 
126.16 	This paragraph is effective the day following 
126.17 	final enactment.
126.18 	The amount of this transfer is $178,682,000 
126.19 	in fiscal year 2012 and $297,135,000 in fiscal 
126.20 	year 2013.
126.21 	MinnesotaCare Ratable Reduction.
126.22 	Effective for services rendered on or 
126.23 	after July 1, 2010, to December 31, 2013, 
126.24 	MinnesotaCare payments to managed care 
126.25 	plans under Minnesota Statutes, section 
126.26 	256L.12, for single adults and households 
126.27 	without children whose income is greater 
126.28 	than 75 percent of federal poverty guidelines 
126.29 	shall be reduced by ten percent. Effective 
126.30 	for services provided from July 1, 2010, to 
126.31 	June 30, 2011, this reduction shall apply to 
126.32 	all services. Effective for services provided 
126.33 	from July 1, 2011, to December 31, 2013, this 
126.34 	reduction shall apply to all services except 
127.1 	inpatient hospital services. Notwithstanding 
127.2 	any contrary provision of this article, this 
127.3 	paragraph shall expire on December 31, 
127.4 	2013.

127.5
127.6	(b) Medical Assistance Basic Health Care 
Grants - Families and Children
		-0-
		318,106,000
	
127.7 	Critical Access Dental. Of the general 
127.8 	fund appropriation, $731,000 in fiscal year 
127.9 	2011 is to the commissioner for critical 
127.10 	access dental provider reimbursement 
127.11 	payments under Minnesota Statutes, section 
127.12 	256B.76 subdivision 4. This is a onetime 
127.13 	appropriation.
127.14 	Nonadministrative Rate Reduction. For 
127.15 	services rendered on or after July 1, 2010, 
127.16 	to December 31, 2013, the commissioner 
127.17 	shall reduce contract rates paid to managed 
127.18 	care plans under Minnesota Statutes, 
127.19 	sections 256B.69 and 256L.12, and to 
127.20 	county-based purchasing plans under 
127.21 	Minnesota Statutes, section 256B.692, by 
127.22 	three percent of the contract rate attributable 
127.23 	to nonadministrative services in effect on 
127.24 	June 30, 2010. Notwithstanding any contrary 
127.25 	provision in this article, this rider expires on 
127.26 	December 31, 2013.

127.27
127.28	(c) Medical Assistance Basic Health Care 
Grants - Elderly and Disabled
		-0-
		(3,659,000)
	
127.29 	MnDHO Transition. Of the general fund 
127.30 	appropriation for fiscal year 2011, $250,000 
127.31 	is to the commissioner to be made available 
127.32 	to county agencies to assist in the transition 
127.33 	of the approximately 1,290 current MnDHO 
127.34 	members to the fee-for-service Medicaid 
127.35 	program or another managed care option by 
127.36 	January 1, 2011.
128.1 	County agencies shall work with the 
128.2 	commissioner, health plans, and MnDHO 
128.3 	members and their legal representatives to 
128.4 	develop and implement transition plans that 
128.5 	include:
128.6 	(1) identification of service needs of MnDHO 
128.7 	members based on the current assessment or 
128.8 	through the completion of a new assessment;
128.9 	(2) identification of services currently 
128.10 	provided to MnDHO members and which 
128.11 	of those services will continue to be 
128.12 	reimbursable through fee-for-service 
128.13 	or another managed care option under 
128.14 	the Medicaid state plan or a home and 
128.15 	community-based waiver program;
128.16 	(3) identification of service providers who do 
128.17 	not have a contract with the county or who 
128.18 	are currently reimbursed at a different rate 
128.19 	than the county contracted rate; and
128.20 	(4) development of an individual service 
128.21 	plan that is within allowable waiver funding 
128.22 	limits.

128.23	(d) General Assistance Medical Care Grants
		-0-
		(75,389,000)

128.24	(e)  Other Health Care Grants
		-0-
		700,000,000
	
128.25 	Cobra Carryforward. Unexpended funds 
128.26 	appropriated in fiscal year 2010 for COBRA 
128.27 	grants under Laws 2009, chapter 79, article 
128.28 	5, section 78, do not cancel and are available 
128.29 	to the commissioner for fiscal year 2011 
128.30 	COBRA grant expenditures. Up to $111,000 
128.31 	of the fiscal year 2011 appropriation for 
128.32 	COBRA grants provided in Laws 2009, 
128.33 	chapter 79, article 13, section 3, subdivision 
128.34 	6, may be used by the commissioner for costs 
129.1 	related to administration of the COBRA 
129.2 	grants.

129.3	Subd. 7.Health Care Management

129.4	(a) Health Care Administration
		-0-
		442,000
	
129.5 	Fiscal Note Report. Of this appropriation, 
129.6 	$50,000 in fiscal year 2011 is for a transfer to 
129.7 	the commissioner of Minnesota Management 
129.8 	and Budget for the completion of the human 
129.9 	services fiscal note report in article 5.
129.10 	PACE Implementation Funding. For fiscal 
129.11 	year 2011, $145,000 is appropriated from 
129.12 	the general fund to the commissioner of 
129.13 	human services to complete the actuarial and 
129.14 	administrative work necessary to begin the 
129.15 	operation of PACE under Minnesota Statutes, 
129.16 	section 256B.69, subdivision 23, paragraph 
129.17 	(e). Base level funding for this activity shall 
129.18 	be $130,000 in fiscal year 2012 and $0 in 
129.19 	fiscal year 2013.
129.20 	Minnesota Senior Health Options 
129.21 	Reimbursement. Effective July 1, 2011, 
129.22 	federal administrative reimbursement 
129.23 	resulting from the Minnesota senior 
129.24 	health options project is appropriated 
129.25 	to the commissioner for this activity. 
129.26 	Notwithstanding any contrary provision, this 
129.27 	provision expires June 30, 2013.
129.28 	Utilization Review. Effective July 1, 
129.29 	2011, federal administrative reimbursement 
129.30 	resulting from prior authorization and 
129.31 	inpatient admission certification by a 
129.32 	professional review organization shall be 
129.33 	dedicated to, and is appropriated to, the 
129.34 	commissioner for these activities. A portion 
129.35 	of these funds must be used for activities 
130.1 	to decrease unnecessary pharmaceutical 
130.2 	costs in medical assistance. Notwithstanding 
130.3 	any contrary provision of this article, this 
130.4 	paragraph expires June 30, 2013.
130.5 	Certified Public Expenditures. (1) The 
130.6 	entities named in Minnesota Statutes, section 
130.7 	256B.199, paragraph (b), clause (1), shall 
130.8 	comply with the requirements of that statute 
130.9 	by promptly reporting on a quarterly basis 
130.10 	certified public expenditures that may qualify 
130.11 	for federal matching funds. Reporting under 
130.12 	this paragraph shall be voluntary from July 1, 
130.13 	2010, to December 31, 2010. Upon federal 
130.14 	enactment of an extension to June 30, 2011, 
130.15 	of the enhanced federal medical assistance 
130.16 	percentage (FMAP) originally provided 
130.17 	under Public Law 111-5, reporting under 
130.18 	this paragraph shall also be voluntary from 
130.19 	January 1, 2011, to June 30, 2011.
130.20 	(2) To the extent that certified public 
130.21 	expenditures reported in compliance 
130.22 	with paragraph (1) earn federal matching 
130.23 	payments that exceed $8,079,000 in fiscal 
130.24 	year 2012 and $18,316,000 in fiscal year 
130.25 	2013, the excess amount shall be deposited 
130.26 	in the health care access fund. For each fiscal 
130.27 	year after fiscal year 2013, the commissioner 
130.28 	shall forecast in November the amount 
130.29 	of federal payments anticipated to match 
130.30 	certified public expenditures reported in 
130.31 	compliance with paragraph (a). Any federal 
130.32 	match earned in a fiscal year in excess of 
130.33 	the amount forecasted in November shall be 
130.34 	deposited to the health care access fund.
131.1 	(3) Notwithstanding any contrary provision 
131.2 	of this article, this rider shall not expire.
131.3 	Poverty Guidelines. Notwithstanding 
131.4 	Minnesota Statutes, sections 256B.56, 
131.5 	subdivision 1c; 256D.03, subdivision 3; 
131.6 	or 256L.04, subdivision 7b, the poverty 
131.7 	guidelines for medical assistance, general 
131.8 	assistance medical care, and MinnesotaCare 
131.9 	from July 1, 2010, through June 30, 2011, 
131.10 	shall not be lower than the poverty guidelines 
131.11 	issued by the Secretary of Health and Human 
131.12 	Services on January 23, 2009. This section 
131.13 	shall have no effect on the revision of poverty 
131.14 	guidelines for the Minnesota health care 
131.15 	programs that would be in effect starting on 
131.16 	July 1, 2011. This paragraph is effective the 
131.17 	day following final enactment.
131.18 	Base Adjustment. The general fund base is 
131.19 	decreased by $227,000 in fiscal year 2012 
131.20 	and $357,000 in fiscal year 2013.

131.21	(b) Health Care Operations

131.22	Appropriations by Fund
	
131.23	General
	-0-
	186,000
	
131.24	Health Care Access
	-0-
	218,000
	
131.25 	The general fund appropriation is a onetime 
131.26 	appropriation in fiscal year 2011.
131.27 	Base Adjustment. The health care access 
131.28 	fund base for health care operations is 
131.29 	decreased by $812,000 in fiscal year 2012 
131.30 	and $944,000 in fiscal year 2013.

131.31	Subd. 8.Continuing Care Grants

131.32	(a) Aging and Adult Services Grants
		-0-
		(1,091,000)
	
131.33 	Base Adjustment. The general fund base for 
131.34 	aging and adult services grants is increased 
132.1 	by $1,139,000 in fiscal year 2012 and 
132.2 	$1,280,000 in fiscal year 2013.
132.3 	Community Service Development 
132.4 	Reduction. The appropriation in Laws 
132.5 	2009, chapter 79, article 13, section 3, 
132.6 	subdivision 8, paragraph (a), for community 
132.7 	service development grants, as amended by 
132.8 	Laws 2009, chapter 173, article 2, section 
132.9 	1, subdivision 8, paragraph (a), is reduced 
132.10 	by $154,000 in fiscal year 2011. The 
132.11 	appropriation base is reduced by $139,000 
132.12 	for fiscal year 2012 and $0 for fiscal year 
132.13 	2013. Notwithstanding any law or rule to 
132.14 	the contrary, this provision expires June 30, 
132.15 	2012.

132.16
132.17	(b) Medical Assistance Long-Term Care 
Facilities Grants
		-0-
		4,143,000
	
132.18 	ICF/MR Occupancy Rate Adjustment 
132.19 	Suspension. Effective for fiscal years 2012 
132.20 	and 2013, approval of new applications for 
132.21 	occupancy rate adjustments for unoccupied 
132.22 	short-term beds under Minnesota Statutes, 
132.23 	section 256B.5013, subdivision 7, is 
132.24 	suspended.
132.25 	Kandiyohi County; ICF/MR Payment 
132.26 	Rate. $36,000 is appropriated from the 
132.27 	general fund in fiscal year 2011 and $4,000 
132.28 	in fiscal year 2012 to increase payment rates 
132.29 	for an ICF/MR licensed for six beds and 
132.30 	located in Kandiyohi County to serve persons 
132.31 	with high behavioral needs. The payment 
132.32 	rate increase shall be effective for services 
132.33 	provided from July 1, 2010, through June 30, 
132.34 	2011. These appropriations are onetime.

132.35
132.36	(c) Medical Assistance Long-Term Care 
Waivers and Home Care Grants
		-0-
		(4,631,000)
	
133.1 	Manage Growth in Traumatic Brain 
133.2 	Injury and Community Alternatives for 
133.3 	Disabled Individuals Waivers. During 
133.4 	the fiscal year beginning July 1, 2010, the 
133.5 	commissioner shall allocate money for home 
133.6 	and community-based waiver programs 
133.7 	under Minnesota Statutes, section 256B.49, 
133.8 	to ensure a reduction in state spending that is 
133.9 	equivalent to limiting the caseload growth 
133.10 	of the traumatic brain injury waiver to six 
133.11 	allocations per month and the community 
133.12 	alternatives for disabled individuals waiver 
133.13 	to 60 allocations per month. The limits do not 
133.14 	apply: (1) when there is an approved plan for 
133.15 	nursing facility bed closures for individuals 
133.16 	under age 65 who require relocation due to 
133.17 	the bed closure; (2) to fiscal year 2009 waiver 
133.18 	allocations delayed due to unallotment; or (3) 
133.19 	to transfers authorized by the commissioner 
133.20 	from the personal care assistance program 
133.21 	of individuals having a home care rating of 
133.22 	CS, MT, or HL. Priorities for the allocation 
133.23 	of funds must be for individuals anticipated 
133.24 	to be discharged from institutional settings or 
133.25 	who are at imminent risk of a placement in 
133.26 	an institutional setting.
133.27 	Manage Growth in the Developmental 
133.28 	Disability (DD) Waiver. The commissioner 
133.29 	shall manage the growth in the developmental 
133.30 	disability waiver by limiting the allocations 
133.31 	included in the November 2010 forecast to 
133.32 	six additional diversion allocations each 
133.33 	month for the calendar year that begins on 
133.34 	January 1, 2011. Additional allocations must 
133.35 	be made available for transfers authorized 
133.36 	by the commissioner from the personal care 
134.1 	assistance program of individuals having a 
134.2 	home care rating of CS, MT, or HL. This 
134.3 	provision is effective through December 31, 
134.4 	2011.

134.5	(d) Adult Mental Health Grants
		(3,500,000)
		(300,000)
	
134.6 	Compulsive Gambling Special Revenue 
134.7 	Account. $149,000 for fiscal year 2010 
134.8 	and $27,000 for fiscal year 2011 from 
134.9 	the compulsive gambling special revenue 
134.10 	account established under Minnesota 
134.11 	Statutes, section 245.982, shall be transferred 
134.12 	and deposited into the general fund by 
134.13 	June 30 of each respective fiscal year. This 
134.14 	paragraph is effective the day following final 
134.15 	enactment.
134.16 	Compulsive Gambling Lottery Prize 
134.17 	Fund. The lottery prize fund appropriation 
134.18 	for compulsive gambling is reduced by 
134.19 	$80,000 in fiscal year 2010 and $79,000 in 
134.20 	fiscal year 2011. This is a onetime reduction.
134.21 	Culturally Specific Treatment. The 
134.22 	appropriation for culturally specific treatment 
134.23 	is reduced by $300,000 in fiscal year 2011. 
134.24 	This is a onetime reduction.
134.25 	(1) Of the fiscal year 2010 general fund 
134.26 	appropriation for grants to counties for 
134.27 	housing with support services for adults 
134.28 	with serious and persistent mental illness, 
134.29 	$3,300,000 is canceled and returned to the 
134.30 	general fund.
134.31 	(2) Of the fiscal year 2010 general 
134.32 	fund appropriation for additional crisis 
134.33 	intervention team training for law 
134.34 	enforcement, $200,000 is canceled and 
134.35 	returned to the general fund.

135.1	(e) Chemical Dependency Entitlement Grants
		-0-
		(2,433,000)

135.2
135.3	(f) Chemical Dependency Nonentitlement 
Grants
		(389,000)
		-0-
	
135.4 	Base adjustment. The general fund base is 
135.5 	reduced by $393,000 in fiscal year 2012 and 
135.6 	fiscal year 2013.
135.7 	Chemical Health. Of the fiscal year 2010 
135.8 	general fund appropriation to Mother's First 
135.9 	and the Native American Program, $389,000 
135.10 	is canceled and returned to the general fund.

135.11	(g) Other Continuing Care Grants
		-0-
		350,000
	
135.12 	 This is a onetime appropriation in fiscal year 
135.13 	2011.
135.14 	Region 10 Quality Assurance Commission.
135.15 	$100,000 is appropriated from the general 
135.16 	fund in fiscal year 2011 to the commissioner 
135.17 	of human services for the purposes 
135.18 	of the Region 10 Quality Assurance 
135.19 	Commission under Minnesota Statutes, 
135.20 	section 256B.0951. This appropriation is 
135.21 	onetime.

135.22	Subd. 9.Continuing Care Management
 		-0-
		414,000
	
135.23 	PACE Implementation Funding. For fiscal 
135.24 	year 2011, $111,000 is appropriated from 
135.25 	the general fund to the commissioner of 
135.26 	human services to complete the actuarial 
135.27 	and administrative work necessary to begin 
135.28 	the operation of PACE under Minnesota 
135.29 	Statutes, section 256B.69, subdivision 23, 
135.30 	paragraph (e). Base level funding for this 
135.31 	activity shall be $101,000 in fiscal year 2012 
135.32 	and $0 in fiscal year 2013. For fiscal year 
135.33 	2013 and beyond, the commissioner must 
135.34 	work with stakeholders to develop financing 
136.1 	mechanisms to complete the actuarial 
136.2 	and administrative costs of PACE. The 
136.3 	commissioner shall inform the chairs and 
136.4 	ranking minority members of the legislative 
136.5 	committee with jurisdiction over health care 
136.6 	funding by January 15, 2011, on progress to 
136.7 	develop financing mechanisms.
136.8 	Base Adjustment. The general fund base for 
136.9 	continuing care management is increased by 
136.10 	$97,000 in fiscal year 2012 and decreased by 
136.11 	$12,000 in fiscal year 2013.

136.12	Subd. 10.State-Operated Services
 					
136.13 	Obsolete Laundry Depreciation Account.
136.14 	$669,000, or the balance, whichever is 
136.15 	greater, must be transferred from the 
136.16 	state-operated services laundry depreciation 
136.17 	account in the special revenue fund and 
136.18 	deposited into the general fund by June 30, 
136.19 	2010. This paragraph is effective the day 
136.20 	following final enactment.
136.21 	Operating Budget Reductions. No 
136.22 	operating budget reductions enacted in Laws 
136.23 	2010, chapter 200, or in this act shall be 
136.24 	allocated to state-operated services.
136.25 	Prohibition on Transferring Funds. The 
136.26 	commissioner shall not transfer mental 
136.27 	health grants to state-operated services 
136.28 	without specific legislative approval. 
136.29 	Notwithstanding any contrary provision in 
136.30 	this article, this paragraph shall not expire.

136.31	(a) Adult Mental Health Services
		-0-
		6,888,000
	
136.32 	Base Adjustment. The general fund base is 
136.33 	decreased by $12,286,000 in fiscal year 2012 
136.34 	and $12,394,000 in fiscal year 2013.
137.1 	Appropriation Requirements.  (a) 
137.2 	The general fund appropriation to the 
137.3 	commissioner includes funding for the 
137.4 	following:
137.5 	(1) to a community collaborative to begin 
137.6 	providing crisis center services in the 
137.7 	Mankato area that are comparable to 
137.8 	the crisis services provided prior to the 
137.9 	closure of the Mankato Crisis Center. The 
137.10 	commissioner shall recruit former employees 
137.11 	of the Mankato Crisis Center who were 
137.12 	recently laid off to staff the new crisis 
137.13 	services. The commissioner shall obtain 
137.14 	legislative approval prior to discontinuing 
137.15 	this funding;
137.16 	(2) to maintain the building in Eveleth 
137.17 	that currently houses community transition 
137.18 	services and to establish a psychiatric 
137.19 	intensive therapeutic foster home as an 
137.20 	enterprise activity. The commissioner shall 
137.21 	request a waiver amendment to allow CADI 
137.22 	funding for psychiatric intensive therapeutic 
137.23 	foster care services provided in the same 
137.24 	location and building as the community 
137.25 	transition services. If the federal government 
137.26 	does not approve the waiver amendment, the 
137.27 	commissioner shall continue to pay the lease 
137.28 	for the building out of the state-operated 
137.29 	services budget until the commissioner of 
137.30 	administration subleases the space or until 
137.31 	the lease expires, and shall establish the 
137.32 	psychiatric intensive therapeutic foster home 
137.33 	at a different site. The commissioner shall 
137.34 	make diligent efforts to sublease the space;
138.1 	(3) to convert the community behavioral 
138.2 	health hospitals in Wadena and Willmar to 
138.3 	facilities that provide more suitable services 
138.4 	based on the needs of the community, 
138.5 	which may include, but are not limited to, 
138.6 	psychiatric extensive recovery treatment 
138.7 	services. The commissioner may also 
138.8 	establish other community-based services in 
138.9 	the Willmar and Wadena areas that deliver 
138.10 	the appropriate level of care in response to 
138.11 	the express needs of the communities. The 
138.12 	services established under this provision 
138.13 	must be staffed by state employees.
138.14 	(4) to continue the operation of the dental 
138.15 	clinics in Brainerd, Cambridge, Faribault, 
138.16 	Fergus Falls, and Willmar at the same level of 
138.17 	care and staffing that was in effect on March 
138.18 	1, 2010. The commissioner shall not proceed 
138.19 	with the planned closure of the dental 
138.20 	clinics, and shall not discontinue services or 
138.21 	downsize any of the state-operated dental 
138.22 	clinics without specific legislative approval. 
138.23 	The commissioner shall continue to bill 
138.24 	for services provided to obtain medical 
138.25 	assistance critical access dental payments 
138.26 	and cost-based payment rates as provided 
138.27 	in Minnesota Statutes, section 256B.76, 
138.28 	subdivision 2, and shall bill for services 
138.29 	provided three months retroactively from 
138.30 	the date of this act. This appropriation is 
138.31 	onetime;
138.32 	(5) to convert the Minnesota 
138.33 	Neurorehabilitation Hospital in Brainerd 
138.34 	to a neurocognitive psychiatric extensive 
138.35 	recovery treatment service; and
139.1 	(6) to convert the Minnesota extended 
139.2 	treatment options (METO) program to 
139.3 	the following community-based services 
139.4 	provided by state employees: (i) psychiatric 
139.5 	extensive recovery treatment services; 
139.6 	(ii) intensive transitional foster homes 
139.7 	as enterprise activities; and (iii) other 
139.8 	community-based support services. The 
139.9 	provisions under Minnesota Statutes, section 
139.10 	252.025, subdivision 7, are applicable to 
139.11 	the METO services established under this 
139.12 	clause. Notwithstanding Minnesota Statutes, 
139.13 	section 246.18, subdivision 8, any revenue 
139.14 	lost to the general fund by the conversion 
139.15 	of METO to new services must be replaced 
139.16 	by revenue from the new services to offset 
139.17 	the lost revenue to the general fund until 
139.18 	June 30, 2013. Any revenue generated in 
139.19 	excess of this amount shall be deposited into 
139.20 	the special revenue fund under Minnesota 
139.21 	Statutes, section 246.18, subdivision 8.
139.22 	(b) The commissioner shall not move beds 
139.23 	from the Anoka-Metro Regional Treatment 
139.24 	Center to the psychiatric nursing facility 
139.25 	at St. Peter without specific legislative 
139.26 	approval.
139.27 	(c) The commissioner shall implement 
139.28 	changes, including the following, to save a 
139.29 	minimum of $6,006,000 beginning in fiscal 
139.30 	year 2011, and report to the legislature the 
139.31 	specific initiatives implemented and the 
139.32 	savings allocated to each one, including:
139.33 	(1) maximizing budget savings through 
139.34 	strategic employee staffing; and
140.1 	(2) identifying and implementing cost 
140.2 	reductions in cooperation with state-operated 
140.3 	services employees.
140.4 	Base level funding is reduced by $6,006,000 
140.5 	effective fiscal year 2011.
140.6 	(d) The commissioner shall seek certification 
140.7 	or approval from the federal government for 
140.8 	the new services under paragraph (a) that are 
140.9 	eligible for federal financial participation 
140.10 	and deposit the revenue associated with 
140.11 	these new services in the account established 
140.12 	under Minnesota Statutes, section 246.18, 
140.13 	subdivision 8, unless otherwise specified.
140.14 	(e) Notwithstanding any contrary provision 
140.15 	in this article, this rider shall not expire.

140.16	(b) Minnesota Sex Offender Services
		-0-
		(145,000)
	
140.17 	Sex Offender Services. Base level funding 
140.18 	for Minnesota sex offender services is 
140.19 	reduced by $418,000 in fiscal year 2012 and 
140.20 	$419,000 in fiscal year 2013 for the 50-bed 
140.21 	sex offender treatment program within the 
140.22 	Moose Lake correctional facility in which 
140.23 	Department of Human Services staff from 
140.24 	Minnesota sex offender services provide 
140.25 	clinical treatment to incarcerated offenders. 
140.26 	This reduction shall become part of the base 
140.27 	for the Department of Human Services.
140.28 	Interagency Agreements. The 
140.29 	commissioner of human services may 
140.30 	enter into interagency agreements with the 
140.31 	commissioner of corrections to continue sex 
140.32 	offender treatment and chemical dependency 
140.33 	treatment on a cost-sharing basis, in which 
140.34 	each department pays 50 percent of the costs 
140.35 	of these services.

141.1	Sec. 4. COMMISSIONER OF HEALTH

141.2	Subdivision 1.Total Appropriation
 	$
	(2,392,000)
	$
	(1,310,000)

141.3	Appropriations by Fund
	
141.4		2010
	2011
	
141.5	General
	(2,392,000)
	(1,064,000)
	
141.6
141.7	State Government 
Special Revenue
	-0-
	9,000
	
141.8	Health Care Access
	-0-
	237,000

141.9	Subd. 2.Community and Family Health
 		(221,000)
		(47,000)
	
141.10 	Base Level Adjustment. The general fund 
141.11 	base is decreased by $388,000 in fiscal years 
141.12 	2012 and 2013.

141.13	Subd. 3.Policy, Quality, and Compliance

141.14	Appropriations by Fund
	
141.15		2010
	2011
	
141.16	General
	(1,797,000)
	497,000
	
141.17
141.18	State Government 
Special Revenue
	-0-
	9,000
	
141.19	Health Care Access
	-0-
	237,000
	
141.20 	Health Care Reform. Funds appropriated 
141.21 	in Laws 2008, chapter 358, article 5, section 
141.22 	4, subdivision 3, for health reform activities 
141.23 	to implement Laws 2008, chapter 358, 
141.24 	article 4, are available until expended. 
141.25 	Notwithstanding any contrary provision in 
141.26 	this article, this provision shall not expire.
141.27 	Health Care Reform Task Force. $198,000 
141.28 	from the general fund is for expenses related 
141.29 	to the Health Care Reform Task Force 
141.30 	established under article 7.
141.31 	Rural Hospital Capital Improvement 
141.32 	Grants. Of the general fund reductions in 
141.33 	fiscal year 2010, $1,755,000 is for the rural 
141.34 	hospital capital improvement grant program.
142.1 	Section 125 Plans. The remaining balance 
142.2 	from the Laws 2008, chapter 358, article 5, 
142.3 	section 4, subdivision 3, appropriation for 
142.4 	Section 125 Plan Employer Incentives is 
142.5 	canceled.
142.6 	Birth Centers. Of the appropriation in fiscal 
142.7 	year 2011 from the state government special 
142.8 	revenue fund, $9,000 is to the commissioner 
142.9 	to license birth centers. Base level funding 
142.10 	for this activity shall be $7,000 in fiscal year 
142.11 	2012 and $7,000 in fiscal year 2013.
142.12 	Comprehensive Advanced Life Support 
142.13 	Program. Of the general fund appropriation, 
142.14 	$377,000 in fiscal year 2011 is to the 
142.15 	commissioner for the comprehensive 
142.16 	advanced life support educational program. 
142.17 	For fiscal year 2012, base level funding for 
142.18 	this program shall be $377,000.
142.19 	Advisory Group on Administrative 
142.20 	Expenses. Of the health care access fund 
142.21 	appropriation for fiscal year 2011, $39,000 is 
142.22 	to the commissioner for the advisory group 
142.23 	established under Minnesota Statutes, section 
142.24 	62D.31. This is a onetime appropriation.
142.25 	Base Level Adjustment. The general fund 
142.26 	base is decreased by $253,000 in fiscal year 
142.27 	2012 and $253,000 in fiscal year 2013. The 
142.28 	state government special revenue fund base 
142.29 	is decreased by $2,000 in fiscal year 2012 
142.30 	and $2,000 in fiscal year 2013.
142.31 	Office of Unlicensed Health Care Practice.
142.32 	Of the general fund appropriation, $74,000 
142.33 	in fiscal year 2011 is for the Office of 
142.34 	Unlicensed Complementary and Alternative 
143.1 	Health Care Practice. This is a onetime 
143.2 	appropriation.

143.3	Subd. 4.Health Protection
 		(374,000)
		714,000
	
143.4 	Lead Base Grant Program. Of the general 
143.5 	fund reduction, $25,000 in fiscal year 2010 
143.6 	and fiscal year 2011 is for the elimination 
143.7 	of state funding for the temporary lead-safe 
143.8 	housing base grant program.
143.9 	Birth Defects Information System. Of the 
143.10 	general fund appropriation for fiscal year 
143.11 	2011, $919,000 is for the Minnesota Birth 
143.12 	Defects Information System established 
143.13 	under Minnesota Statutes, section 144.2215.
143.14 	Base Adjustment. The general fund base 
143.15 	is increased by $440,000 in fiscal year 2012 
143.16 	and $984,000 in fiscal year 2013. 

143.17	Subd. 5.Administrative Support Services
 		-0-
		(100,000)
	
143.18 	The general fund base is decreased by 
143.19 	$22,000 in fiscal year 2012 and $22,000 in 
143.20 	fiscal year 2013.

143.21
143.22	Sec. 5. DEPARTMENT OF VETERANS 
AFFAIRS
 	$
	(50,000)
	$
	-0-
	
143.23 	Cancellation of Prior Appropriation.
143.24 	By June 30, 2010, the commissioner of 
143.25 	management and budget shall cancel the 
143.26 	$50,000 appropriation for fiscal year 2008 to 
143.27 	the board in Laws 2007, chapter 147, article 
143.28 	19, section 5, in the paragraph titled "Pay for 
143.29 	Performance."

143.30	Sec. 6. HEALTH-RELATED BOARDS

143.31	Subdivision 1.Total Appropriation
 	$
	113,000
	$
	615,000
	
143.32 	The appropriations in this section are from 
143.33 	the state government special revenue fund.
144.1 	In fiscal year 2010, $591,000 shall be 
144.2 	transferred from the state government special 
144.3 	revenue fund to the general fund. In fiscal 
144.4 	year 2011, $3,052,000 shall be transferred 
144.5 	from the state government special revenue 
144.6 	fund to the general fund. These transfers 
144.7 	are in addition to those made in Laws 2009, 
144.8 	chapter 79, article 13, section 5, as amended 
144.9 	by Laws 2009, chapter 173, article 2, section 
144.10 	3.
144.11 	The transfers in this section are onetime in 
144.12 	the fiscal year 2010-2011 biennium.
144.13 	The appropriations for each purpose are 
144.14 	shown in the following subdivisions.

144.15
144.16	Subd. 2.Board of Marriage and Family 
Therapy
 		47,000
		22,000
	
144.17 	Operating Costs and Rulemaking. Of 
144.18 	this appropriation, $22,000 in fiscal year 
144.19 	2010 and $22,000 in fiscal year 2011 are 
144.20 	for operating costs. This is an ongoing 
144.21 	appropriation. Of this appropriation, $25,000 
144.22 	in fiscal year 2010 is for rulemaking. This is 
144.23 	a onetime appropriation.

144.24
144.25	Subd. 3.Board of Nursing Home 
Administrators
 		51,000
		61,000

144.26	Subd. 4.Board of Pharmacy
 		-0-
		517,000
	
144.27 	Prescription Electronic Reporting. Of 
144.28 	the state government special revenue fund 
144.29 	appropriation, $517,000 in fiscal year 2011 
144.30 	is to the board to operate the prescription 
144.31 	electronic reporting system in Minnesota 
144.32 	Statutes, section 152.126. Base level funding 
144.33 	for this activity in fiscal year 2012 shall be 
144.34 	$356,000.

144.35	Subd. 5.Board of Podiatry
 		15,000
		15,000
	
145.1 	Purpose. This appropriation is to pay health 
145.2 	insurance coverage costs and to cover the 
145.3 	cost of expert witnesses in disciplinary cases.

145.4
145.5	Sec. 7. EMERGENCY MEDICAL SERVICES 
BOARD
 	$
	247,000
	$
	(382,000)

145.6	Sec. 8. UNIVERSITY OF MINNESOTA
 	$
	-0-
	$
	93,000
	
145.7 	This appropriation is from the special 
145.8 	revenue fund for the couples on the brink 
145.9 	program.

145.10	Sec. 9. DEPARTMENT OF CORRECTIONS
 	$
	-0-
	$
	-0-
	
145.11 	Sex Offender Services. From the general 
145.12 	fund appropriations to the commissioner of 
145.13 	corrections, the commissioner shall transfer 
145.14 	$418,000 in fiscal year 2012 and $419,000 
145.15 	in fiscal year 2013 to the commissioner of 
145.16 	human services to provide clinical treatment 
145.17 	to incarcerated offenders. This transfer shall 
145.18 	become part of the base for the Department 
145.19 	of Corrections.

145.20	Sec. 10. DEPARTMENT OF COMMERCE
 	$
	-0-
	$
	38,000
	
145.21 	Health Plan Filings. Of this appropriation:
145.22 	(1) $19,000 is for the review and approval 
145.23 	of new health plan filings due to Minnesota 
145.24 	Statutes, section 62Q.545. This is a onetime 
145.25 	appropriation in fiscal year 2011; and
145.26 	(2) $19,000 is for regulation of Minnesota 
145.27 	Statutes, section 62A.3075.

145.28 	Sec. 11. Minnesota Statutes 2008, section 214.40, subdivision 7, is amended to read:
145.29 		Subd. 7.Medical professional liability insurance. (a) Within the limit of funds 
145.30 	appropriated for this program, the administrative services unit must purchase medical 
145.31 	professional liability insurance, if available, for a health care provider who is registered in 
146.1 	accordance with subdivision 4 and who is not otherwise covered by a medical professional 
146.2 	liability insurance policy or self-insured plan either personally or through another facility 
146.3 	or employer. The administrative services unit is authorized to prorate payments or 
146.4 	otherwise limit the number of participants in the program if the costs of the insurance for 
146.5 	eligible providers exceed the funds appropriated for the program.
146.6 	(b) Coverage purchased under this subdivision must be limited to the provision of 
146.7 	health care services performed by the provider for which the provider does not receive 
146.8 	direct monetary compensation.

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

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

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

146.13	Appropriations by Fund
	
146.14		2010
	2011
	
146.15	General
	4,375,689,000
	5,209,765,000
	
146.16
146.17	State Government 
Special Revenue
	565,000
	565,000
	
146.18	Health Care Access
	450,662,000
	527,411,000
	
146.19	Federal TANF
	286,770,000
	263,458,000
	
146.20	Lottery Prize
	1,665,000
	1,665,000
	
146.21	Federal Fund
	110,000,000
	0
	
146.22 	Receipts for Systems Projects.
146.23 	Appropriations and federal receipts for 
146.24 	information systems projects for MAXIS, 
146.25 	PRISM, MMIS, and SSIS must be deposited 
146.26 	in the state system account authorized in 
146.27 	Minnesota Statutes, section 256.014. Money 
146.28 	appropriated for computer projects approved 
146.29 	by the Minnesota Office of Enterprise 
146.30 	Technology, funded by the legislature, and 
146.31 	approved by the commissioner of finance, 
146.32 	may be transferred from one project to 
146.33 	another and from development to operations 
146.34 	as the commissioner of human services 
146.35 	considers necessary, except that any transfers 
147.1 	to one project that exceed $1,000,000 or 
147.2 	multiple transfers to one project that exceed 
147.3 	$1,000,000 in total require the express 
147.4 	approval of the legislature. The preceding 
147.5 	requirement for legislative approval does not 
147.6 	apply to transfers made to establish a project's 
147.7 	initial operating budget each year; instead, 
147.8 	the requirements of section 11, subdivision 
147.9 	2, of this article apply to those transfers. Any 
147.10 	unexpended balance in the appropriation 
147.11 	for these projects does not cancel but is 
147.12 	available for ongoing development and 
147.13 	operations. Any computer project with a 
147.14 	total cost exceeding $1,000,000, including, 
147.15 	but not limited to, a replacement for the 
147.16 	proposed HealthMatch system, shall not be 
147.17 	commenced without the express approval of 
147.18 	the legislature.
147.19 	HealthMatch Systems Project. In fiscal 
147.20 	year 2010, $3,054,000 shall be transferred 
147.21 	from the HealthMatch account in the state 
147.22 	systems account in the special revenue fund 
147.23 	to the general fund.
147.24 	Nonfederal Share Transfers. The 
147.25 	nonfederal share of activities for which 
147.26 	federal administrative reimbursement is 
147.27 	appropriated to the commissioner may be 
147.28 	transferred to the special revenue fund.
147.29 	TANF Maintenance of Effort.
147.30 	(a) In order to meet the basic maintenance 
147.31 	of effort (MOE) requirements of the TANF 
147.32 	block grant specified under Code of Federal 
147.33 	Regulations, title 45, section 263.1, the 
147.34 	commissioner may only report nonfederal 
147.35 	money expended for allowable activities 
148.1 	listed in the following clauses as TANF/MOE 
148.2 	expenditures:
148.3 	(1) MFIP cash, diversionary work program, 
148.4 	and food assistance benefits under Minnesota 
148.5 	Statutes, chapter 256J;
148.6 	(2) the child care assistance programs 
148.7 	under Minnesota Statutes, sections 119B.03
148.8 	and 119B.05, and county child care 
148.9 	administrative costs under Minnesota 
148.10 	Statutes, section 119B.15;
148.11 	(3) state and county MFIP administrative 
148.12 	costs under Minnesota Statutes, chapters 
148.13 	256J and 256K;
148.14 	(4) state, county, and tribal MFIP 
148.15 	employment services under Minnesota 
148.16 	Statutes, chapters 256J and 256K;
148.17 	(5) expenditures made on behalf of 
148.18 	noncitizen MFIP recipients who qualify 
148.19 	for the medical assistance without federal 
148.20 	financial participation program under 
148.21 	Minnesota Statutes, section 256B.06, 
148.22 	subdivision 4, paragraphs (d), (e), and (j); 
148.23 	and
148.24 	(6) qualifying working family credit 
148.25 	expenditures under Minnesota Statutes, 
148.26 	section 290.0671.; and
148.27 	(7) qualifying Minnesota education credit 
148.28 	expenditures under Minnesota Statutes, 
148.29 	section 290.0674.
148.30 	(b) The commissioner shall ensure that 
148.31 	sufficient qualified nonfederal expenditures 
148.32 	are made each year to meet the state's 
148.33 	TANF/MOE requirements. For the activities 
148.34 	listed in paragraph (a), clauses (2) to 
149.1 	(6), the commissioner may only report 
149.2 	expenditures that are excluded from the 
149.3 	definition of assistance under Code of 
149.4 	Federal Regulations, title 45, section 260.31.
149.5 	(c) For fiscal years beginning with state 
149.6 	fiscal year 2003, the commissioner shall 
149.7 	ensure that the maintenance of effort used 
149.8 	by the commissioner of finance for the 
149.9 	February and November forecasts required 
149.10 	under Minnesota Statutes, section 16A.103, 
149.11 	contains expenditures under paragraph (a), 
149.12 	clause (1), equal to at least 16 percent of 
149.13 	the total required under Code of Federal 
149.14 	Regulations, title 45, section 263.1.
149.15 	(d) For the federal fiscal years beginning on 
149.16 	or after October 1, 2007, the commissioner 
149.17 	may not claim an amount of TANF/MOE in 
149.18 	excess of the 75 percent standard in Code 
149.19 	of Federal Regulations, title 45, section 
149.20 	263.1(a)(2), except:
149.21 	(1) to the extent necessary to meet the 80 
149.22 	percent standard under Code of Federal 
149.23 	Regulations, title 45, section 263.1(a)(1), 
149.24 	if it is determined by the commissioner 
149.25 	that the state will not meet the TANF work 
149.26 	participation target rate for the current year;
149.27 	(2) to provide any additional amounts 
149.28 	under Code of Federal Regulations, title 45, 
149.29 	section 264.5, that relate to replacement of 
149.30 	TANF funds due to the operation of TANF 
149.31 	penalties; and
149.32 	(3) to provide any additional amounts that 
149.33 	may contribute to avoiding or reducing 
149.34 	TANF work participation penalties through 
149.35 	the operation of the excess MOE provisions 
150.1 	of Code of Federal Regulations, title 45, 
150.2 	section 261.43 (a)(2).
150.3 	For the purposes of clauses (1) to (3), 
150.4 	the commissioner may supplement the 
150.5 	MOE claim with working family credit 
150.6 	expenditures to the extent such expenditures 
150.7 	or other qualified expenditures are otherwise 
150.8 	available after considering the expenditures 
150.9 	allowed in this section.
150.10 	(e) Minnesota Statutes, section 256.011, 
150.11 	subdivision 3, which requires that federal 
150.12 	grants or aids secured or obtained under that 
150.13 	subdivision be used to reduce any direct 
150.14 	appropriations provided by law, do not apply 
150.15 	if the grants or aids are federal TANF funds.
150.16 	(f) Notwithstanding any contrary provision 
150.17 	in this article, this provision expires June 30, 
150.18 	2013.
150.19 	Working Family Credit Expenditures as 
150.20 	TANF/MOE. The commissioner may claim 
150.21 	as TANF/MOE up to $6,707,000 per year of 
150.22 	working family credit expenditures for fiscal 
150.23 	year 2010 through fiscal year 2011.
150.24 	Working Family Credit Expenditures 
150.25 	to be Claimed for TANF/MOE. The 
150.26 	commissioner may count the following 
150.27 	amounts of working family credit expenditure 
150.28 	as TANF/MOE:
150.29 	(1) fiscal year 2010, $50,973,000
150.30 	$50,897,000;
150.31 	(2) fiscal year 2011, $53,793,000
150.32 	$54,243,000;
150.33 	(3) fiscal year 2012, $23,516,000
150.34 	$23,345,000; and
151.1 	(4) fiscal year 2013, $16,808,000
151.2 	$16,585,000.
151.3 	Notwithstanding any contrary provision in 
151.4 	this article, this rider expires June 30, 2013.
151.5 	Food Stamps Employment and Training.
151.6 	(a) The commissioner shall apply for and 
151.7 	claim the maximum allowable federal 
151.8 	matching funds under United States Code, 
151.9 	title 7, section 2025, paragraph (h), for 
151.10 	state expenditures made on behalf of family 
151.11 	stabilization services participants voluntarily 
151.12 	engaged in food stamp employment and 
151.13 	training activities, where appropriate.
151.14 	(b) Notwithstanding Minnesota Statutes, 
151.15 	sections 256D.051, subdivisions 1a, 6b, 
151.16 	and 6c, and 256J.626, federal food stamps 
151.17 	employment and training funds received 
151.18 	as reimbursement of MFIP consolidated 
151.19 	fund grant expenditures for diversionary 
151.20 	work program participants and child 
151.21 	care assistance program expenditures for 
151.22 	two-parent families must be deposited in the 
151.23 	general fund. The amount of funds must be 
151.24 	limited to $3,350,000 in fiscal year 2010 
151.25 	and $4,440,000 in fiscal years 2011 through 
151.26 	2013, contingent on approval by the federal 
151.27 	Food and Nutrition Service. 
151.28 	(c) Consistent with the receipt of these federal 
151.29 	funds, the commissioner may adjust the 
151.30 	level of working family credit expenditures 
151.31 	claimed as TANF maintenance of effort. 
151.32 	Notwithstanding any contrary provision in 
151.33 	this article, this rider expires June 30, 2013.
151.34 	ARRA Food Support Administration.
151.35 	The funds available for food support 
152.1 	administration under the American Recovery 
152.2 	and Reinvestment Act (ARRA) of 2009 
152.3 	are appropriated to the commissioner 
152.4 	to pay actual costs of implementing the 
152.5 	food support benefit increases, increased 
152.6 	eligibility determinations, and outreach. Of 
152.7 	these funds, 20 percent shall be allocated 
152.8 	to the commissioner and 80 percent shall 
152.9 	be allocated to counties. The commissioner 
152.10 	shall allocate the county portion based on 
152.11 	caseload. Reimbursement shall be based on 
152.12 	actual costs reported by counties through 
152.13 	existing processes. Tribal reimbursement 
152.14 	must be made from the state portion based 
152.15 	on a caseload factor equivalent to that of a 
152.16 	county.
152.17 	ARRA Food Support Benefit Increases.
152.18 	The funds provided for food support benefit 
152.19 	increases under the Supplemental Nutrition 
152.20 	Assistance Program provisions of the 
152.21 	American Recovery and Reinvestment Act 
152.22 	(ARRA) of 2009 must be used for benefit 
152.23 	increases beginning July 1, 2009.
152.24 	Emergency Fund for the TANF Program.
152.25 	TANF Emergency Contingency funds 
152.26 	available under the American Recovery 
152.27 	and Reinvestment Act of 2009 (Public Law 
152.28 	111-5) are appropriated to the commissioner. 
152.29 	The commissioner must request TANF 
152.30 	Emergency Contingency funds from the 
152.31 	Secretary of the Department of Health 
152.32 	and Human Services to the extent the 
152.33 	commissioner meets or expects to meet the 
152.34 	requirements of section 403(c) of the Social 
152.35 	Security Act. The commissioner must seek 
152.36 	to maximize such grants. The funds received 
153.1 	must be used as appropriated. Each county 
153.2 	must maintain the county's current level of 
153.3 	emergency assistance funding under the 
153.4 	MFIP consolidated fund and use the funds 
153.5 	under this paragraph to supplement existing 
153.6 	emergency assistance funding levels.

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

153.9153.10
	Subd. 3.Revenue and Pass-Through Revenue 
Expenditures
 		68,337,000
		70,505,000
	
153.11 	This appropriation is from the federal TANF 
153.12 	fund.
153.13 	TANF Transfer to Federal Child Care 
153.14 	and Development Fund. The following 
153.15 	TANF fund amounts are appropriated to the 
153.16 	commissioner for the purposes of MFIP and 
153.17 	transition year child care under Minnesota 
153.18 	Statutes, section 119B.05: 
153.19 	(1) fiscal year 2010, $6,531,000 $862,000;
153.20 	(2) fiscal year 2011, $10,241,000 $978,000;
153.21 	(3) fiscal year 2012, $10,826,000 $0; and
153.22 	(4) fiscal year 2013, $4,046,000 $0.
153.23 	The commissioner shall authorize the 
153.24 	transfer of sufficient TANF funds to the 
153.25 	federal child care and development fund to 
153.26 	meet this appropriation and shall ensure that 
153.27 	all transferred funds are expended according 
153.28 	to federal child care and development fund 
153.29 	regulations.

153.30 	Sec. 14. Laws 2009, chapter 79, article 13, section 3, subdivision 4, as amended by 
153.31 	Laws 2009, chapter 173, article 2, section 1, subdivision 4, is amended to read:

153.32
153.33	Subd. 4.Children and Economic Assistance 
Grants
 					
154.1 	The amounts that may be spent from this 
154.2 	appropriation for each purpose are as follows:

154.3	(a) MFIP/DWP Grants

154.4	Appropriations by Fund
	
154.5	General
	63,205,000
	89,033,000
	
154.6	Federal TANF
	100,818,000
	84,538,000

154.7	(b) Support Services Grants

154.8	Appropriations by Fund
	
154.9	General
	8,715,000
	12,498,000
	
154.10	Federal TANF
	116,557,000
	107,457,000
	
154.11 	MFIP Consolidated Fund. The MFIP 
154.12 	consolidated fund TANF appropriation is 
154.13 	reduced by $1,854,000 in fiscal year 2010 
154.14 	and fiscal year 2011.
154.15 	Notwithstanding Minnesota Statutes, section 
154.16 	256J.626, subdivision 8, paragraph (b), the 
154.17 	commissioner shall reduce proportionately 
154.18 	the reimbursement to counties for 
154.19 	administrative expenses.
154.20 	Subsidized Employment Funding Through 
154.21 	ARRA. The commissioner is authorized to 
154.22 	apply for TANF emergency fund grants for 
154.23 	subsidized employment activities. Growth 
154.24 	in expenditures for subsidized employment 
154.25 	within the supported work program and the 
154.26 	MFIP consolidated fund over the amount 
154.27 	expended in the calendar quarters in the 
154.28 	TANF emergency fund base year shall be 
154.29 	used to leverage the TANF emergency fund 
154.30 	grants for subsidized employment and to 
154.31 	fund supported work. The commissioner 
154.32 	shall develop procedures to maximize 
154.33 	reimbursement of these expenditures over the 
154.34 	TANF emergency fund base year quarters, 
154.35 	and may contract directly with employers 
155.1 	and providers to maximize these TANF 
155.2 	emergency fund grants, including provisions 
155.3 	of TANF summer youth program wage 
155.4 	subsidies for MFIP youth and caregivers. 
155.5 	MFIP youth are individuals up to age 25 who 
155.6 	are part of an eligible household as defined 
155.7 	under rules governing TANF maintenance 
155.8 	of effort with incomes less than 200 percent 
155.9 	of federal poverty guidelines. Expenditures 
155.10 	may only be used for subsidized wages and 
155.11 	benefits and eligible training and supervision 
155.12 	expenditures. The commissioner shall 
155.13 	contract with the Minnesota Department of 
155.14 	Employment and Economic Development 
155.15 	for the summer youth program. The 
155.16 	commissioner shall develop procedures 
155.17 	to maximize reimbursement of these 
155.18 	expenditures over the TANF emergency fund 
155.19 	year quarters. No more than $6,000,000 shall 
155.20 	be reimbursed. This provision is effective 
155.21 	upon enactment.
155.22 	Supported Work. Of the TANF 
155.23 	appropriation, $4,700,000 in fiscal year 2010 
155.24 	and $4,700,000 in fiscal year 2011 are to the 
155.25 	commissioner for supported work for MFIP 
155.26 	recipients and is available until expended. 
155.27 	Supported work includes paid transitional 
155.28 	work experience and a continuum of 
155.29 	employment assistance, including outreach 
155.30 	and recruitment, program orientation 
155.31 	and intake, testing and assessment, job 
155.32 	development and marketing, preworksite 
155.33 	training, supported worksite experience, 
155.34 	job coaching, and postplacement follow-up, 
155.35 	in addition to extensive case management 
156.1 	and referral services. This is a onetime 
156.2 	appropriation.
156.3 	Base Adjustment. The general fund base 
156.4 	is reduced by $3,783,000 in each of fiscal 
156.5 	years 2012 and 2013. The TANF fund base 
156.6 	is increased by $5,004,000 in each of fiscal 
156.7 	years 2012 and 2013.
156.8 	Integrated Services Program Funding.
156.9 	The TANF appropriation for integrated 
156.10 	services program funding is $1,250,000 in 
156.11 	fiscal year 2010 and $0 in fiscal year 2011 
156.12 	and the base for fiscal years 2012 and 2013 
156.13 	is $0.
156.14 	TANF Emergency Fund; Nonrecurrent 
156.15 	Short-Term Benefits.(a) TANF emergency 
156.16 	contingency fund grants received due to 
156.17 	increases in expenditures for nonrecurrent 
156.18 	short-term benefits must be used to offset the 
156.19 	increase in these expenditures for counties 
156.20 	under the MFIP consolidated fund, under 
156.21 	Minnesota Statutes, section 256J.626, 
156.22 	and the diversionary work program. The 
156.23 	commissioner shall develop procedures 
156.24 	to maximize reimbursement of these 
156.25 	expenditures over the TANF emergency fund 
156.26 	base year quarters. Growth in expenditures 
156.27 	for the diversionary work program over the 
156.28 	amount expended in the calendar quarters in 
156.29 	the TANF emergency fund base year shall be 
156.30 	used to leverage these funds.
156.31 	(b) To the extent that the commissioner 
156.32 	can claim eligible tax credit growth as 
156.33 	nonrecurrent short-term benefits, the 
156.34 	commissioner shall use those funds to 
157.1 	leverage the increased expenditures in 
157.2 	paragraph (a).
157.3 	(c) TANF emergency funds for nonrecurrent 
157.4 	short-term benefits received in excess of the 
157.5 	amounts necessary for paragraphs (a) and (b) 
157.6 	shall be used to reimburse the general fund 
157.7 	for the costs of eligible tax credits in fiscal 
157.8 	year 2011. The amount of such funds shall 
157.9 	not exceed $15,500,000 in fiscal year 2010. 
157.10 	(d) This rider is effective the day following 
157.11 	final enactment.

157.12	(c) MFIP Child Care Assistance Grants
		61,171,000
		65,214,000
	
157.13 	Acceleration of ARRA Child Care and 
157.14 	Development Fund Expenditure. The 
157.15 	commissioner must liquidate all child care 
157.16 	and development money available under 
157.17 	the American Recovery and Reinvestment 
157.18 	Act (ARRA) of 2009, Public Law 111-5, 
157.19 	by September 30, 2010. In order to expend 
157.20 	those funds by September 30, 2010, the 
157.21 	commissioner may redesignate and expend 
157.22 	the ARRA child care and development funds 
157.23 	appropriated in fiscal year 2011 for purposes 
157.24 	under this section for related purposes that 
157.25 	will allow liquidation by September 30, 
157.26 	2010. Child care and development funds 
157.27 	otherwise available to the commissioner 
157.28 	for those related purposes shall be used to 
157.29 	fund the purposes from which the ARRA 
157.30 	child care and development funds had been 
157.31 	redesignated.
157.32 	School Readiness Service Agreements.
157.33 	$400,000 in fiscal year 2010 and $400,000 
157.34 	in fiscal year 2011 are from the federal 
157.35 	TANF fund to the commissioner of human 
158.1 	services consistent with federal regulations 
158.2 	for the purpose of school readiness service 
158.3 	agreements under Minnesota Statutes, 
158.4 	section 119B.231. This is a onetime 
158.5 	appropriation. Any unexpended balance the 
158.6 	first year is available in the second year.

158.7
158.8	(d) Basic Sliding Fee Child Care Assistance 
Grants
		40,100,000
		45,092,000
	
158.9 	School Readiness Service Agreements.
158.10 	$257,000 in fiscal year 2010 and $257,000 
158.11 	in fiscal year 2011 are from the general 
158.12 	fund for the purpose of school readiness 
158.13 	service agreements under Minnesota 
158.14 	Statutes, section 119B.231. This is a onetime 
158.15 	appropriation. Any unexpended balance the 
158.16 	first year is available in the second year.
158.17 	Child Care Development Fund 
158.18 	Unexpended Balance. In addition to 
158.19 	the amount provided in this section, the 
158.20 	commissioner shall expend $5,244,000 in 
158.21 	fiscal year 2010 from the federal child care 
158.22 	development fund unexpended balance 
158.23 	for basic sliding fee child care under 
158.24 	Minnesota Statutes, section 119B.03. The 
158.25 	commissioner shall ensure that all child 
158.26 	care and development funds are expended 
158.27 	according to the federal child care and 
158.28 	development fund regulations.
158.29 	Basic Sliding Fee. $4,000,000 in fiscal year 
158.30 	2010 and $4,000,000 in fiscal year 2011 are 
158.31 	from the federal child care development 
158.32 	funds received from the American Recovery 
158.33 	and Reinvestment Act of 2009, Public 
158.34 	Law 111-5, to the commissioner of human 
158.35 	services consistent with federal regulations 
158.36 	for the purpose of basic sliding fee child care 
159.1 	assistance under Minnesota Statutes, section 
159.2 	119B.03. This is a onetime appropriation. 
159.3 	Any unexpended balance the first year is 
159.4 	available in the second year.
159.5 	Basic Sliding Fee Allocation for Calendar 
159.6 	Year 2010. Notwithstanding Minnesota 
159.7 	Statutes, section 119B.03, subdivision 6, 
159.8 	in calendar year 2010, basic sliding fee 
159.9 	funds shall be distributed according to 
159.10 	this provision. Funds shall be allocated 
159.11 	first in amounts equal to each county's 
159.12 	guaranteed floor, according to Minnesota 
159.13 	Statutes, section 119B.03, subdivision 8, 
159.14 	with any remaining available funds allocated 
159.15 	according to the following formula:
159.16 	(a) Up to one-fourth of the funds shall be 
159.17 	allocated in proportion to the number of 
159.18 	families participating in the transition year 
159.19 	child care program as reported during and 
159.20 	averaged over the most recent six months 
159.21 	completed at the time of the notice of 
159.22 	allocation. Funds in excess of the amount 
159.23 	necessary to serve all families in this category 
159.24 	shall be allocated according to paragraph (d).
159.25 	(b) Up to three-fourths of the funds shall 
159.26 	be allocated in proportion to the average 
159.27 	of each county's most recent six months of 
159.28 	reported waiting list as defined in Minnesota 
159.29 	Statutes, section 119B.03, subdivision 2, and 
159.30 	the reinstatement list of those families whose 
159.31 	assistance was terminated with the approval 
159.32 	of the commissioner under Minnesota Rules, 
159.33 	part 3400.0183, subpart 1. Funds in excess 
159.34 	of the amount necessary to serve all families 
160.1 	in this category shall be allocated according 
160.2 	to paragraph (d).
160.3 	(c) The amount necessary to serve all families 
160.4 	in paragraphs (a) and (b) shall be calculated 
160.5 	based on the basic sliding fee average cost of 
160.6 	care per family in the county with the highest 
160.7 	cost in the most recently completed calendar 
160.8 	year.
160.9 	(d) Funds in excess of the amount necessary 
160.10 	to serve all families in paragraphs (a) and 
160.11 	(b) shall be allocated in proportion to each 
160.12 	county's total expenditures for the basic 
160.13 	sliding fee child care program reported 
160.14 	during the most recent fiscal year completed 
160.15 	at the time of the notice of allocation. To 
160.16 	the extent that funds are available, and 
160.17 	notwithstanding Minnesota Statutes, section 
160.18 	119B.03, subdivision 8, for the period 
160.19 	January 1, 2011, to December 31, 2011, each 
160.20 	county's guaranteed floor must be equal to its 
160.21 	original calendar year 2010 allocation.
160.22 	Base Adjustment. The general fund base is 
160.23 	decreased by $257,000 in each of fiscal years 
160.24 	2012 and 2013.

160.25	(e) Child Care Development Grants
		1,487,000
		1,487,000
	
160.26 	Family, friends, and neighbor grants.
160.27 	$375,000 in fiscal year 2010 and $375,000 
160.28 	in fiscal year 2011 are from the child 
160.29 	care development fund required targeted 
160.30 	quality funds for quality expansion and 
160.31 	infant/toddler from the American Recovery 
160.32 	and Reinvestment Act of 2009, Public 
160.33 	Law 111-5, to the commissioner of human 
160.34 	services for family, friends, and neighbor 
160.35 	grants under Minnesota Statutes, section 
161.1 	119B.232. This appropriation may be used 
161.2 	on programs receiving family, friends, and 
161.3 	neighbor grant funds as of June 30, 2009, 
161.4 	or on new programs or projects. This is a 
161.5 	onetime appropriation. Any unexpended 
161.6 	balance the first year is available in the 
161.7 	second year.
161.8 	Voluntary quality rating system training, 
161.9 	coaching, consultation, and supports.
161.10 	$633,000 in fiscal year 2010 and $633,000 
161.11 	in fiscal year 2011 are from the federal child 
161.12 	care development fund required targeted 
161.13 	quality funds for quality expansion and 
161.14 	infant/toddler from the American Recovery 
161.15 	and Reinvestment Act of 2009, Public 
161.16 	Law 111-5, to the commissioner of human 
161.17 	services consistent with federal regulations 
161.18 	for the purpose of providing grants to provide 
161.19 	statewide child-care provider training, 
161.20 	coaching, consultation, and supports to 
161.21 	prepare for the voluntary Minnesota quality 
161.22 	rating system rating tool. This is a onetime 
161.23 	appropriation. Any unexpended balance the 
161.24 	first year is available in the second year.
161.25 	Voluntary quality rating system. $184,000 
161.26 	in fiscal year 2010 and $1,200,000 in fiscal 
161.27 	year 2011 are from the federal child care 
161.28 	development fund required targeted funds for 
161.29 	quality expansion and infant/toddler from the 
161.30 	American Recovery and Reinvestment Act of 
161.31 	2009, Public Law 111-5, to the commissioner 
161.32 	of human services consistent with federal 
161.33 	regulations for the purpose of implementing 
161.34 	the voluntary Parent Aware quality star 
161.35 	rating system pilot in coordination with the 
161.36 	Minnesota Early Learning Foundation. The 
162.1 	appropriation for the first year is to complete 
162.2 	and promote the voluntary Parent Aware 
162.3 	quality rating system pilot program through 
162.4 	June 30, 2010, and the appropriation for 
162.5 	the second year is to continue the voluntary 
162.6 	Minnesota quality rating system pilot 
162.7 	through June 30, 2011. This is a onetime 
162.8 	appropriation. Any unexpended balance the 
162.9 	first year is available in the second year.

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

162.11	(g) Children's Services Grants

162.12	Appropriations by Fund
	
162.13	General
	48,333,000
	50,498,000
	
162.14	Federal TANF
	340,000
	240,000
	
162.15 	Base Adjustment. The general fund base is 
162.16 	decreased by $5,371,000 in fiscal year 2012 
162.17 	and decreased $5,371,000 in fiscal year 2013.
162.18 	Privatized Adoption Grants. Federal 
162.19 	reimbursement for privatized adoption grant 
162.20 	and foster care recruitment grant expenditures 
162.21 	is appropriated to the commissioner for 
162.22 	adoption grants and foster care and adoption 
162.23 	administrative purposes.
162.24 	Adoption Assistance Incentive Grants.
162.25 	Federal funds available during fiscal year 
162.26 	2010 and fiscal year 2011 for the adoption 
162.27 	incentive grants are appropriated to the 
162.28 	commissioner for postadoption services 
162.29 	including parent support groups.
162.30 	Adoption Assistance and Relative Custody 
162.31 	Assistance. The commissioner may transfer 
162.32 	unencumbered appropriation balances for 
162.33 	adoption assistance and relative custody 
162.34 	assistance between fiscal years and between 
162.35 	programs.

163.1	(h) Children and Community Services Grants
		67,663,000
		67,542,000
	
163.2 	Targeted Case Management Temporary 
163.3 	Funding Adjustment. The commissioner 
163.4 	shall recover from each county and tribe 
163.5 	receiving a targeted case management 
163.6 	temporary funding payment in fiscal year 
163.7 	2008 an amount equal to that payment. The 
163.8 	commissioner shall recover one-half of the 
163.9 	funds by February 1, 2010, and the remainder 
163.10 	by February 1, 2011. At the commissioner's 
163.11 	discretion and at the request of a county 
163.12 	or tribe, the commissioner may revise 
163.13 	the payment schedule, but full payment 
163.14 	must not be delayed beyond May 1, 2011. 
163.15 	The commissioner may use the recovery 
163.16 	procedure under Minnesota Statutes, section 
163.17 	256.017, to recover the funds. Recovered 
163.18 	funds must be deposited into the general 
163.19 	fund.

163.20	(i) General Assistance Grants
		48,215,000
		48,608,000
	
163.21 	General Assistance Standard. The 
163.22 	commissioner shall set the monthly standard 
163.23 	of assistance for general assistance units 
163.24 	consisting of an adult recipient who is 
163.25 	childless and unmarried or living apart 
163.26 	from parents or a legal guardian at $203. 
163.27 	The commissioner may reduce this amount 
163.28 	according to Laws 1997, chapter 85, article 
163.29 	3, section 54.
163.30 	Emergency General Assistance. The 
163.31 	amount appropriated for emergency general 
163.32 	assistance funds is limited to no more 
163.33 	than $7,889,812 in fiscal year 2010 and 
163.34 	$7,889,812 in fiscal year 2011. Funds 
163.35 	to counties must be allocated by the 
164.1 	commissioner using the allocation method 
164.2 	specified in Minnesota Statutes, section 
164.3 	256D.06.

164.4	(j) Minnesota Supplemental Aid Grants
		33,930,000
		35,191,000
	
164.5 	Emergency Minnesota Supplemental 
164.6 	Aid Funds. The amount appropriated for 
164.7 	emergency Minnesota supplemental aid 
164.8 	funds is limited to no more than $1,100,000 
164.9 	in fiscal year 2010 and $1,100,000 in fiscal 
164.10 	year 2011. Funds to counties must be 
164.11 	allocated by the commissioner using the 
164.12 	allocation method specified in Minnesota 
164.13 	Statutes, section 256D.46.

164.14	(k) Group Residential Housing Grants
		111,778,000
		114,034,000
	
164.15 	Group Residential Housing Costs 
164.16 	Refinanced. (a) Effective July 1, 2011, the 
164.17 	commissioner shall increase the home and 
164.18 	community-based service rates and county 
164.19 	allocations provided to programs for persons 
164.20 	with disabilities established under section 
164.21 	1915(c) of the Social Security Act to the 
164.22 	extent that these programs will be paying 
164.23 	for the costs above the rate established 
164.24 	in Minnesota Statutes, section 256I.05, 
164.25 	subdivision 1.
164.26 	(b) For persons receiving services under 
164.27 	Minnesota Statutes, section 245A.02, who 
164.28 	reside in licensed adult foster care beds 
164.29 	for which a difficulty of care payment 
164.30 	was being made under Minnesota Statutes, 
164.31 	section 256I.05, subdivision 1c, paragraph 
164.32 	(b), counties may request an exception to 
164.33 	the individual's service authorization not to 
164.34 	exceed the difference between the client's 
165.1 	monthly service expenditures plus the 
165.2 	amount of the difficulty of care payment.

165.3	(l) Children's Mental Health Grants
		16,885,000
		16,882,000
	
165.4 	Funding Usage. Up to 75 percent of a fiscal 
165.5 	year's appropriation for children's mental 
165.6 	health grants may be used to fund allocations 
165.7 	in that portion of the fiscal year ending 
165.8 	December 31.

165.9165.10
	(m) Other Children and Economic Assistance 
Grants
		16,047,000
		15,339,000
	
165.11 	Fraud Prevention Grants. Of this 
165.12 	appropriation, $228,000 in fiscal year 2010 
165.13 	and $228,000 $379,000 in fiscal year 2011 
165.14 	is to the commissioner for fraud prevention 
165.15 	grants to counties.
165.16 	Homeless and Runaway Youth. $218,000 
165.17 	in fiscal year 2010 is for the Runaway 
165.18 	and Homeless Youth Act under Minnesota 
165.19 	Statutes, section 256K.45. Funds shall be 
165.20 	spent in each area of the continuum of care 
165.21 	to ensure that programs are meeting the 
165.22 	greatest need. Any unexpended balance in 
165.23 	the first year is available in the second year. 
165.24 	Beginning July 1, 2011, the base is increased 
165.25 	by $119,000 each year.
165.26 	ARRA Homeless Youth Funds. To the 
165.27 	extent permitted under federal law, the 
165.28 	commissioner shall designate $2,500,000 
165.29 	of the Homeless Prevention and Rapid 
165.30 	Re-Housing Program funds provided under 
165.31 	the American Recovery and Reinvestment 
165.32 	Act of 2009, Public Law 111-5, for agencies 
165.33 	providing homelessness prevention and rapid 
165.34 	rehousing services to youth.
166.1 	Supportive Housing Services. $1,500,000 
166.2 	each year is for supportive services under 
166.3 	Minnesota Statutes, section 256K.26. This is 
166.4 	a onetime appropriation. 
166.5 	Community Action Grants. Community 
166.6 	action grants are reduced one time by 
166.7 	$1,794,000 each year. This reduction is due 
166.8 	to the availability of federal funds under the 
166.9 	American Recovery and Reinvestment Act.
166.10 	Base Adjustment. The general fund base 
166.11 	is increased by $773,000 $903,000 in fiscal 
166.12 	year 2012 and $773,000 $413,000 in fiscal 
166.13 	year 2013.
166.14 	Federal ARRA Funds for Existing 
166.15 	Programs. (a) Federal funds received by the 
166.16 	commissioner for the emergency food and 
166.17 	shelter program from the American Recovery 
166.18 	and Reinvestment Act of 2009, Public 
166.19 	Law 111-5, but not previously approved 
166.20 	by the legislature are appropriated to the 
166.21 	commissioner for the purposes of the grant 
166.22 	program.
166.23 	(b) Federal funds received by the 
166.24 	commissioner for the emergency shelter 
166.25 	grant program including the Homelessness 
166.26 	Prevention and Rapid Re-Housing 
166.27 	Program from the American Recovery and 
166.28 	Reinvestment Act of 2009, Public Law 
166.29 	111-5, are appropriated to the commissioner 
166.30 	for the purposes of the grant programs.
166.31 	(c) Federal funds received by the 
166.32 	commissioner for the emergency food 
166.33 	assistance program from the American 
166.34 	Recovery and Reinvestment Act of 2009, 
166.35 	Public Law 111-5, are appropriated to the 
167.1 	commissioner for the purposes of the grant 
167.2 	program.
167.3 	(d) Federal funds received by the 
167.4 	commissioner for senior congregate meals 
167.5 	and senior home-delivered meals from the 
167.6 	American Recovery and Reinvestment Act 
167.7 	of 2009, Public Law 111-5, are appropriated 
167.8 	to the commissioner for the Minnesota Board 
167.9 	on Aging, for purposes of the grant programs.
167.10 	(e) Federal funds received by the 
167.11 	commissioner for the community services 
167.12 	block grant program from the American 
167.13 	Recovery and Reinvestment Act of 2009, 
167.14 	Public Law 111-5, are appropriated to the 
167.15 	commissioner for the purposes of the grant 
167.16 	program.
167.17 	Long-Term Homeless Supportive 
167.18 	Service Fund Appropriation. To the 
167.19 	extent permitted under federal law, the 
167.20 	commissioner shall designate $3,000,000 
167.21 	of the Homelessness Prevention and Rapid 
167.22 	Re-Housing Program funds provided under 
167.23 	the American Recovery and Reinvestment 
167.24 	Act of 2009, Public Law, 111-5, to the 
167.25 	long-term homeless service fund under 
167.26 	Minnesota Statutes, section 256K.26. This 
167.27 	appropriation shall become available by July 
167.28 	1, 2009. This paragraph is effective the day 
167.29 	following final enactment.

167.30 	Sec. 15. Laws 2009, chapter 79, article 13, section 3, subdivision 8, as amended by 
167.31 	Laws 2009, chapter 173, article 2, section 1, subdivision 8, is amended to read:

167.32	Subd. 8.Continuing Care Grants
 					
167.33 	The amounts that may be spent from the 
167.34 	appropriation for each purpose are as follows:

168.1	(a) Aging and Adult Services Grants
		13,499,000
		15,805,000
	
168.2 	Base Adjustment. The general fund base is 
168.3 	increased by $5,751,000 in fiscal year 2012 
168.4 	and $6,705,000 in fiscal year 2013.
168.5 	Information and Assistance 
168.6 	Reimbursement. Federal administrative 
168.7 	reimbursement obtained from information 
168.8 	and assistance services provided by the 
168.9 	Senior LinkAge or Disability Linkage lines 
168.10 	to people who are identified as eligible for 
168.11 	medical assistance shall be appropriated to 
168.12 	the commissioner for this activity.
168.13 	Community Service Development Grant 
168.14 	Reduction. Funding for community service 
168.15 	development grants must be reduced by 
168.16 	$260,000 for fiscal year 2010; $284,000 in 
168.17 	fiscal year 2011; $43,000 in fiscal year 2012; 
168.18 	and $43,000 in fiscal year 2013. Base level 
168.19 	funding shall be restored in fiscal year 2014.
168.20 	Community Service Development Grant 
168.21 	Community Initiative. Funding for 
168.22 	community service development grants shall 
168.23 	be used to offset the cost of aging support 
168.24 	grants. Base level funding shall be restored 
168.25 	in fiscal year 2014.
168.26 	Senior Nutrition Use of Federal Funds.
168.27 	For fiscal year 2010, general fund grants 
168.28 	for home-delivered meals and congregate 
168.29 	dining shall be reduced by $500,000. The 
168.30 	commissioner must replace these general 
168.31 	fund reductions with equal amounts from 
168.32 	federal funding for senior nutrition from the 
168.33 	American Recovery and Reinvestment Act 
168.34 	of 2009.

169.1	(b) Alternative Care Grants
		50,234,000
		48,576,000
	
169.2 	Base Adjustment. The general fund base is 
169.3 	decreased by $3,598,000 in fiscal year 2012 
169.4 	and $3,470,000 in fiscal year 2013.
169.5 	Alternative Care Transfer. Any money 
169.6 	allocated to the alternative care program that 
169.7 	is not spent for the purposes indicated does 
169.8 	not cancel but must be transferred to the 
169.9 	medical assistance account.

169.10
169.11	(c) Medical Assistance Grants; Long-Term 
Care Facilities.
		367,444,000
		419,749,000

169.12
169.13	(d) Medical Assistance Long-Term Care 
Waivers and Home Care Grants
		853,567,000
		1,039,517,000
	
169.14 	Manage Growth in TBI and CADI 
169.15 	Waivers. During the fiscal years beginning 
169.16 	on July 1, 2009, and July 1, 2010, the 
169.17 	commissioner shall allocate money for home 
169.18 	and community-based waiver programs 
169.19 	under Minnesota Statutes, section 256B.49, 
169.20 	to ensure a reduction in state spending that is 
169.21 	equivalent to limiting the caseload growth of 
169.22 	the TBI waiver to 12.5 allocations per month 
169.23 	each year of the biennium and the CADI 
169.24 	waiver to 95 allocations per month each year 
169.25 	of the biennium. Limits do not apply: (1) 
169.26 	when there is an approved plan for nursing 
169.27 	facility bed closures for individuals under 
169.28 	age 65 who require relocation due to the 
169.29 	bed closure; (2) to fiscal year 2009 waiver 
169.30 	allocations delayed due to unallotment; or (3) 
169.31 	to transfers authorized by the commissioner 
169.32 	from the personal care assistance program 
169.33 	of individuals having a home care rating 
169.34 	of "CS," "MT," or "HL." Priorities for the 
169.35 	allocation of funds must be for individuals 
170.1 	anticipated to be discharged from institutional 
170.2 	settings or who are at imminent risk of a 
170.3 	placement in an institutional setting.
170.4 	Manage Growth in DD Waiver. The 
170.5 	commissioner shall manage the growth in 
170.6 	the DD waiver by limiting the allocations 
170.7 	included in the February 2009 forecast to 15 
170.8 	additional diversion allocations each month 
170.9 	for the calendar years that begin on January 
170.10 	1, 2010, and January 1, 2011. Additional 
170.11 	allocations must be made available for 
170.12 	transfers authorized by the commissioner 
170.13 	from the personal care program of individuals 
170.14 	having a home care rating of "CS," "MT," 
170.15 	or "HL."
170.16 	Adjustment to Lead Agency Waiver 
170.17 	Allocations. Prior to the availability of the 
170.18 	alternative license defined in Minnesota 
170.19 	Statutes, section 245A.11, subdivision 8, 
170.20 	the commissioner shall reduce lead agency 
170.21 	waiver allocations for the purposes of 
170.22 	implementing a moratorium on corporate 
170.23 	foster care.
170.24 	Alternatives to Personal Care Assistance 
170.25 	Services. Base level funding of $3,237,000 
170.26 	in fiscal year 2012 and $4,856,000 in 
170.27 	fiscal year 2013 is to implement alternative 
170.28 	services to personal care assistance services 
170.29 	for persons with mental health and other 
170.30 	behavioral challenges who can benefit 
170.31 	from other services that more appropriately 
170.32 	meet their needs and assist them in living 
170.33 	independently in the community. These 
170.34 	services may include, but not be limited to, a 
170.35 	1915(i) state plan option.

171.1	(e) Mental Health Grants

171.2	Appropriations by Fund
	
171.3	General
	77,739,000
	77,739,000
	
171.4	Health Care Access
	750,000
	750,000
	
171.5	Lottery Prize
	1,508,000
	1,508,000
	
171.6 	Funding Usage. Up to 75 percent of a fiscal 
171.7 	year's appropriation for adult mental health 
171.8 	grants may be used to fund allocations in that 
171.9 	portion of the fiscal year ending December 
171.10 	31.

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

171.12	(g) Chemical Dependency Entitlement Grants
		111,303,000
		122,822,000
	
171.13 	Payments for Substance Abuse Treatment.
171.14 	For services providedplacements beginning 
171.15 	during fiscal years 2010 and 2011, 
171.16 	county-negotiated rates and provider claims 
171.17 	to the consolidated chemical dependency 
171.18 	fund must not exceed the lesser of:
171.19 	(1)  rates charged for these services on 
171.20 	January 1, 2009; or
171.21 	(2) 160 percent of the average rate on January 
171.22 	1, 2009, for each group of vendors with 
171.23 	similar attributes.
171.24 	Effective July 1, 2010, rates that were above 
171.25 	the average rate on January 1, 2009, are 
171.26 	reduced by five percent from the rates in 
171.27 	effect on June 1, 2010. Rates below the 
171.28 	average rate on January 1, 2009, are reduced 
171.29 	by 1.8 percent from the rates in effect on June 
171.30 	1, 2010. Services provided under this section 
171.31 	by state-operated services are exempt from 
171.32 	the rate reduction. For services provided in 
171.33 	fiscal years 2012 and 2013, statewide average 
171.34 	rates the statewide aggregate payment  under 
172.1 	the new rate methodology to be developed 
172.2 	under Minnesota Statutes, section 254B.12, 
172.3 	must not exceed the average rates charged 
172.4 	for these services on January 1, 2009
172.5 	projected aggregate payment under the rates 
172.6 	in effect for fiscal year 2011 excluding the 
172.7 	rate reduction for rates that were below 
172.8 	the average on January 1, 2009, plus a 
172.9 	state share increase of $3,787,000 for fiscal 
172.10 	year 2012 and $5,023,000 for fiscal year 
172.11 	2013. Notwithstanding any provision to the 
172.12 	contrary in this article, this provision expires 
172.13 	on June 30, 2013.
172.14 	Chemical Dependency Special Revenue 
172.15 	Account. For fiscal year 2010, $750,000 
172.16 	must be transferred from the consolidated 
172.17 	chemical dependency treatment fund 
172.18 	administrative account and deposited into the 
172.19 	general fund.
172.20 	County CD Share of MA Costs for 
172.21 	ARRA Compliance. Notwithstanding the 
172.22 	provisions of Minnesota Statutes, chapter 
172.23 	254B, for chemical dependency services 
172.24 	provided during the period October 1, 2008, 
172.25 	to December 31, 2010, and reimbursed by 
172.26 	medical assistance at the enhanced federal 
172.27 	matching rate provided under the American 
172.28 	Recovery and Reinvestment Act of 2009, the 
172.29 	county share is 30 percent of the nonfederal 
172.30 	share. This provision is effective the day 
172.31 	following final enactment.

172.32
172.33	(h) Chemical Dependency Nonentitlement 
Grants
		1,729,000
		1,729,000

172.34	(i) Other Continuing Care Grants
		19,201,000
		17,528,000
	
173.1 	Base Adjustment. The general fund base is 
173.2 	increased by $2,639,000 in fiscal year 2012 
173.3 	and increased by $3,854,000 in fiscal year 
173.4 	2013.
173.5 	Technology Grants. $650,000 in fiscal 
173.6 	year 2010 and $1,000,000 in fiscal year 
173.7 	2011 are for technology grants, case 
173.8 	consultation, evaluation, and consumer 
173.9 	information grants related to developing and 
173.10 	supporting alternatives to shift-staff foster 
173.11 	care residential service models.
173.12 	Other Continuing Care Grants; HIV 
173.13 	Grants. Money appropriated for the HIV 
173.14 	drug and insurance grant program in fiscal 
173.15 	year 2010 may be used in either year of the 
173.16 	biennium.
173.17 	Quality Assurance Commission. Effective 
173.18 	July 1, 2009, state funding for the quality 
173.19 	assurance commission under Minnesota 
173.20 	Statutes, section 256B.0951, is canceled.

173.21 	Sec. 16. Laws 2009, chapter 79, article 13, section 5, subdivision 8, as amended by 
173.22 	Laws 2009, chapter 173, article 2, section 3, subdivision 8, is amended to read:

173.23
173.24	Subd. 8.Board of Nursing Home 
Administrators
 		1,211,000
		1,023,000
	
173.25 	Administrative Services Unit - Operating 
173.26 	Costs. Of this appropriation, $524,000 
173.27 	in fiscal year 2010 and $526,000 in 
173.28 	fiscal year 2011 are for operating costs 
173.29 	of the administrative services unit. The 
173.30 	administrative services unit may receive 
173.31 	and expend reimbursements for services 
173.32 	performed by other agencies.
173.33 	Administrative Services Unit - Retirement 
173.34 	Costs. Of this appropriation in fiscal year 
174.1 	2010, $201,000 is for onetime retirement 
174.2 	costs in the health-related boards. This 
174.3 	funding may be transferred to the health 
174.4 	boards incurring those costs for their 
174.5 	payment. These funds are available either 
174.6 	year of the biennium.
174.7 	Administrative Services Unit - Volunteer 
174.8 	Health Care Provider Program. Of this 
174.9 	appropriation, $79,000 $130,000  in fiscal 
174.10 	year 2010 and $89,000 $150,000  in fiscal 
174.11 	year 2011 are to pay for medical professional 
174.12 	liability coverage required under Minnesota 
174.13 	Statutes, section 214.40.
174.14 	Administrative Services Unit - Contested 
174.15 	Cases and Other Legal Proceedings. Of 
174.16 	this appropriation, $200,000 in fiscal year 
174.17 	2010 and $200,000 in fiscal year 2011 are 
174.18 	for costs of contested case hearings and other 
174.19 	unanticipated costs of legal proceedings 
174.20 	involving health-related boards funded 
174.21 	under this section and for unforeseen 
174.22 	expenditures of an urgent nature. Upon 
174.23 	certification of a health-related board to the 
174.24 	administrative services unit that the costs 
174.25 	will be incurred and that there is insufficient 
174.26 	money available to pay for the costs out of 
174.27 	money currently available to that board, the 
174.28 	administrative services unit is authorized 
174.29 	to transfer money from this appropriation 
174.30 	to the board for payment of those costs 
174.31 	with the approval of the commissioner of 
174.32 	finance. This appropriation does not cancel. 
174.33 	Any unencumbered and unspent balances 
174.34 	remain available for these expenditures in 
174.35 	subsequent fiscal years. The boards receiving 
174.36 	funds under this section shall include these 
175.1 	amounts when setting fees to cover their 
175.2 	costs.

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

175.6 	Sec. 18. EFFECTIVE DATE.
 175.7 	The provisions in this article are effective July 1, 2010, unless a different effective 
175.8 	date is explicit.