1.1CONFERENCE COMMITTEE REPORT ON H. F. No. 26141.2A bill for an act1.3relating to state government; licensing; state health care programs; continuing 1.4care; children and family services; health reform; Department of Health; 1.5public health; health plans; assessing administrative penalties; modifying 1.6foreign operating corporation taxes; requiring reports; making supplemental 1.7and contingent appropriations and reductions for the Departments of Health 1.8and Human Services and other health-related boards and councils;amending 1.9Minnesota Statutes 2008, sections 62D.08, by adding a subdivision; 62J.07, 1.10subdivision 2, by adding a subdivision; 62J.38; 62J.692, subdivision 4; 62Q.19, 1.11subdivision 1; 62Q.76, subdivision 1; 62U.05; 119B.025, subdivision 1; 119B.09, 1.12subdivision 4; 119B.11, subdivision 1; 144.05, by adding a subdivision; 144.226, 1.13subdivision 3; 144.291, subdivision 2; 144.293, subdivision 4, by adding a 1.14subdivision; 144.651, subdivision 2; 144.9504, by adding a subdivision; 144A.51, 1.15subdivision 5; 144E.37; 214.40, subdivision 7; 245C.27, subdivision 2; 245C.28, 1.16subdivision 3; 246B.04, subdivision 2; 254B.01, subdivision 2; 254B.02, 1.17subdivisions 1, 5; 254B.03, subdivision 4, by adding a subdivision; 254B.05, 1.18subdivision 4; 254B.06, subdivision 2; 254B.09, subdivision 8; 256.01, by adding 1.19a subdivision; 256.9657, subdivision 3; 256B.04, subdivision 14; 256B.055, 1.20by adding a subdivision; 256B.056, subdivisions 3, 4; 256B.057, subdivision 1.219; 256B.0625, subdivisions 8, 8a, 8b, 18a, 22, 31, by adding subdivisions; 1.22256B.0631, subdivisions 1, 3; 256B.0644, as amended; 256B.0754, by adding a 1.23subdivision; 256B.0915, subdivision 3b; 256B.19, subdivision 1c; 256B.441, by 1.24adding a subdivision; 256B.5012, by adding a subdivision; 256B.69, subdivisions 1.2520, as amended, 27, by adding subdivisions; 256B.692, subdivision 1; 256B.75; 1.26256B.76, subdivisions 2, 4, by adding a subdivision; 256D.03, subdivision 3b; 1.27256D.0515; 256D.425, subdivision 2; 256I.05, by adding a subdivision; 256J.20, 1.28subdivision 3; 256J.24, subdivision 10; 256J.37, subdivision 3a; 256J.39, by 1.29adding subdivisions; 256L.02, subdivision 3; 256L.03, subdivision 3, by adding 1.30a subdivision; 256L.04, subdivision 7; 256L.05, by adding a subdivision; 1.31256L.07, subdivision 1, by adding a subdivision; 256L.12, subdivisions 5, 6, 1.329; 256L.15, subdivision 1; 290.01, subdivision 5, by adding a subdivision; 1.33290.17, subdivision 4; 326B.43, subdivision 2; 626.556, subdivision 10i; 1.34626.557, subdivision 9d; Minnesota Statutes 2009 Supplement, sections 1.3562J.495, subdivisions 1a, 3, by adding a subdivision; 157.16, subdivision 3; 1.36245A.11, subdivision 7b; 245C.27, subdivision 1; 246B.06, subdivision 6; 1.37252.025, subdivision 7; 252.27, subdivision 2a; 256.045, subdivision 3; 256.969, 1.38subdivision 3a; 256B.056, subdivision 3c; 256B.0625, subdivisions 9, 13e; 1.39256B.0653, subdivision 5; 256B.0911, subdivision 1a; 256B.0915, subdivision 1.403a; 256B.69, subdivisions 5a, 23; 256B.76, subdivision 1; 256B.766; 256D.03, 1.41subdivision 3, as amended; 256D.44, subdivision 5; 256J.425, subdivision 3; 1.42256L.03, subdivision 5; 256L.11, subdivision 1; 289A.08, subdivision 3; 290.01, 1.43subdivisions 19c, 19d; 327.15, subdivision 3; Laws 2005, First Special Session 2.1chapter 4, article 8, section 66, as amended; Laws 2009, chapter 79, article 3, 2.2section 18; article 5, sections 17; 18; 22; 75, subdivision 1; 78, subdivision 5; 2.3article 8, sections 2; 51; 81; article 13, sections 3, subdivisions 1, as amended, 2.43, as amended, 4, as amended, 8, as amended; 5, subdivision 8, as amended; 2.5Laws 2009, chapter 173, article 1, section 17; Laws 2010, chapter 200, article 1, 2.6sections 12, subdivisions 5, 6, 7, 8; 13, subdivision 1b; 16; 21; article 2, section 2, 2.7subdivisions 1, 8; proposing coding for new law in Minnesota Statutes, chapters 2.862A; 62D; 62E; 62J; 62Q; 144; 245; 254B; 256; 256B; proposing coding for new 2.9law as Minnesota Statutes, chapter 62V; repealing Minnesota Statutes 2008, 2.10sections 254B.02, subdivisions 2, 3, 4; 254B.09, subdivisions 4, 5, 7; 256D.03, 2.11subdivisions 3a, 3b, 5, 6, 7, 8; 290.01, subdivision 6b; 290.0921, subdivision 7; 2.12Minnesota Statutes 2009 Supplement, section 256D.03, subdivision 3; Laws 2.132009, chapter 79, article 7, section 26, subdivision 3; Laws 2010, chapter 200, 2.14article 1, sections 12, subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 9, 10; 18; 19.2.15May 12, 20102.16The Honorable Margaret Anderson Kelliher2.17Speaker of the House of Representatives2.18The Honorable James P. Metzen2.19President of the Senate2.20We, the undersigned conferees for H. F. No. 2614 report that we have agreed upon 2.21the items in dispute and recommend as follows:2.22That the House recede from its amendment and that H. F. No. 2614 be further 2.23amended as follows:2.24Delete everything after the enacting clause and insert:2.25"ARTICLE 12.26HEALTH CARE2.27    Section 1. Minnesota Statutes 2008, section 256.9657, subdivision 2, is amended to 2.28read:2.29    Subd. 2. Hospital surcharge. (a) Effective October 1, 1992, each Minnesota 2.30hospital except facilities of the federal Indian Health Service and regional treatment 2.31centers shall pay to the medical assistance account a surcharge equal to 1.4 percent of net 2.32patient revenues excluding net Medicare revenues reported by that provider to the health 2.33care cost information system according to the schedule in subdivision 4.2.34(b) Effective July 1, 1994, the surcharge under paragraph (a) is increased to 
         1.562.35percent. 2.36(c) Effective July 1, 2010, the surcharge under paragraph (b) is increased to 2.63 2.37percent. 2.38(d) Effective October 1, 2011, the surcharge under paragraph (c) is reduced to 2.392.30 percent.3.1(e) Notwithstanding the Medicare cost finding and allowable cost principles, the 3.2hospital surcharge is not an allowable cost for purposes of rate setting under sections 3.3256.9685
          to 
         256.9695. 3.4EFFECTIVE DATE.This section is effective July 1, 2010.3.5    Sec. 2. Minnesota Statutes 2008, section 256.9657, subdivision 3, is amended to read:3.6    Subd. 3. Surcharge on HMOs and community integrated service networks. (a) 3.7Effective October 1, 1992, each health maintenance organization with a certificate of 3.8authority issued by the commissioner of health under chapter 62D and each community 3.9integrated service network licensed by the commissioner under chapter 62N shall pay to 3.10the commissioner of human services a surcharge equal to six-tenths of one percent of the 3.11total premium revenues of the health maintenance organization or community integrated 3.12service network as reported to the commissioner of health according to the schedule in 3.13subdivision 4.3.14(b) Effective October 1, 2010, in addition to the surcharge under paragraph (a), each 3.15health maintenance organization shall pay to the commissioner a surcharge equal to 0.85 3.16percent of total premium revenues and each county-based purchasing plan authorized 3.17under section 256B.692 shall pay to the commissioner a surcharge equal to 1.45 percent 3.18of the total premium revenues of the plan, as reported to the commissioner of health, 3.19according to the payment schedule in subdivision 4. Notwithstanding section 256.9656, 3.20money collected under this paragraph shall be deposited in the health care access fund 3.21established in section 16A.724.3.22(c) For purposes of this subdivision, total premium revenue means:3.23(1) premium revenue recognized on a prepaid basis from individuals and groups 3.24for provision of a specified range of health services over a defined period of time which 3.25is normally one month, excluding premiums paid to a health maintenance organization 3.26or community integrated service network from the Federal Employees Health Benefit 3.27Program;3.28(2) premiums from Medicare wrap-around subscribers for health benefits which 3.29supplement Medicare coverage;3.30(3) Medicare revenue, as a result of an arrangement between a health maintenance 3.31organization or a community integrated service network and the Centers for Medicare 3.32and Medicaid Services of the federal Department of Health and Human Services, for 3.33services to a Medicare beneficiary, excluding Medicare revenue that states are prohibited 3.34from taxing under sections 1854, 1860D-12, and 1876 of title XVIII of the federal Social 4.1Security Act, codified as United States Code, title 42, sections 1395mm, 1395w-112, and 4.21395w-24, respectively, as they may be amended from time to time; and4.3(4) medical assistance revenue, as a result of an arrangement between a health 4.4maintenance organization or community integrated service network and a Medicaid state 4.5agency, for services to a medical assistance beneficiary.4.6If advance payments are made under clause (1) or (2) to the health maintenance 4.7organization or community integrated service network for more than one reporting period, 4.8the portion of the payment that has not yet been earned must be treated as a liability.4.9(c) (d) When a health maintenance organization or community integrated service 4.10network merges or consolidates with or is acquired by another health maintenance 4.11organization or community integrated service network, the surviving corporation or the 4.12new corporation shall be responsible for the annual surcharge originally imposed on 4.13each of the entities or corporations subject to the merger, consolidation, or acquisition, 4.14regardless of whether one of the entities or corporations does not retain a certificate of 4.15authority under chapter 62D or a license under chapter 62N.4.16(d) (e) Effective July 1 of each year, the surviving corporation's or the new 4.17corporation's surcharge shall be based on the revenues earned in the second previous 4.18calendar year by all of the entities or corporations subject to the merger, consolidation, 4.19or acquisition regardless of whether one of the entities or corporations does not retain a 4.20certificate of authority under chapter 62D or a license under chapter 62N until the total 4.21premium revenues of the surviving corporation include the total premium revenues of all 4.22the merged entities as reported to the commissioner of health.4.23(e) (f) When a health maintenance organization or community integrated service 4.24network, which is subject to liability for the surcharge under this chapter, transfers, 4.25assigns, sells, leases, or disposes of all or substantially all of its property or assets, liability 4.26for the surcharge imposed by this chapter is imposed on the transferee, assignee, or buyer 4.27of the health maintenance organization or community integrated service network.4.28(f) (g) In the event a health maintenance organization or community integrated 4.29service network converts its licensure to a different type of entity subject to liability 4.30for the surcharge under this chapter, but survives in the same or substantially similar 4.31form, the surviving entity remains liable for the surcharge regardless of whether one of 4.32the entities or corporations does not retain a certificate of authority under chapter 62D 4.33or a license under chapter 62N.4.34(g) (h) The surcharge assessed to a health maintenance organization or community 4.35integrated service network ends when the entity ceases providing services for premiums 4.36and the cessation is not connected with a merger, consolidation, acquisition, or conversion.5.1EFFECTIVE DATE.This section is effective July 1, 2010.5.2    Sec. 3. Minnesota Statutes 2009 Supplement, section 256.969, subdivision 2b, is 5.3amended to read:5.4    Subd. 2b. Operating payment rates. In determining operating payment rates for 5.5admissions occurring on or after the rate year beginning January 1, 1991, and every two 5.6years after, or more frequently as determined by the commissioner, the commissioner shall 5.7obtain operating data from an updated base year and establish operating payment rates 5.8per admission for each hospital based on the cost-finding methods and allowable costs of 5.9the Medicare program in effect during the base year. Rates under the general assistance 5.10medical care, medical assistance, and MinnesotaCare programs shall not be rebased to 5.11more current data on January 1, 1997, January 1, 2005, for the first 24 months of the 5.12rebased period beginning January 1, 2009. For the first three 24  months of the rebased 5.13period beginning January 1, 2011, rates shall  not be rebased at 74.25 percent of the full 5.14value of the rebasing percentage change. From April 1, 2011, to March 31, 2012, rates 5.15shall be rebased at 39.2 percent of the full value of the rebasing percentage change, except 5.16that a Minnesota long-term hospital shall be rebased effective January 1, 2011, based on 5.17its most recent Medicare cost report ending on or before September 1, 2008, with the 5.18provisions under subdivisions 9 and 23, based on the rates in effect on December 31, 2010. 5.19For subsequent rate setting periods in which the base years are updated, a Minnesota 5.20long-term hospital's base year shall remain within the same period as other hospitals. 5.21Effective April 1, 2012 January 1, 2013, rates shall be rebased at full value. The base year 5.22operating payment rate per admission is standardized by the case mix index and adjusted 5.23by the hospital cost index, relative values, and disproportionate population adjustment. 5.24The cost and charge data used to establish operating rates shall only reflect inpatient 5.25services covered by medical assistance and shall not include property cost information 5.26and costs recognized in outlier payments.5.27EFFECTIVE DATE.This section is effective July 1, 2010.5.28    Sec. 4. Minnesota Statutes 2009 Supplement, section 256.969, subdivision 3a, is 5.29amended to read:5.30    Subd. 3a. Payments. (a) Acute care hospital billings under the medical 5.31assistance program must not be submitted until the recipient is discharged. However, 5.32the commissioner shall establish monthly interim payments for inpatient hospitals that 5.33have individual patient lengths of stay over 30 days regardless of diagnostic category. 5.34Except as provided in section 
         256.9693, medical assistance reimbursement for treatment 6.1of mental illness shall be reimbursed based on diagnostic classifications. Individual 6.2hospital payments established under this section and sections 
         256.9685, 
         256.9686, and 6.3256.9695
         , in addition to third party and recipient liability, for discharges occurring during 6.4the rate year shall not exceed, in aggregate, the charges for the medical assistance covered 6.5inpatient services paid for the same period of time to the hospital. This payment limitation 6.6shall be calculated separately for medical assistance and general assistance medical 6.7care services. The limitation on general assistance medical care shall be effective for 6.8admissions occurring on or after July 1, 1991. Services that have rates established under 6.9subdivision 11 or 12, must be limited separately from other services. After consulting with 6.10the affected hospitals, the commissioner may consider related hospitals one entity and 6.11may merge the payment rates while maintaining separate provider numbers. The operating 6.12and property base rates per admission or per day shall be derived from the best Medicare 6.13and claims data available when rates are established. The commissioner shall determine 6.14the best Medicare and claims data, taking into consideration variables of recency of the 6.15data, audit disposition, settlement status, and the ability to set rates in a timely manner. 6.16The commissioner shall notify hospitals of payment rates by December 1 of the year 6.17preceding the rate year. The rate setting data must reflect the admissions data used to 6.18establish relative values. Base year changes from 1981 to the base year established for the 6.19rate year beginning January 1, 1991, and for subsequent rate years, shall not be limited 6.20to the limits ending June 30, 1987, on the maximum rate of increase under subdivision 6.211. The commissioner may adjust base year cost, relative value, and case mix index data 6.22to exclude the costs of services that have been discontinued by the October 1 of the year 6.23preceding the rate year or that are paid separately from inpatient services. Inpatient stays 6.24that encompass portions of two or more rate years shall have payments established based 6.25on payment rates in effect at the time of admission unless the date of admission preceded 6.26the rate year in effect by six months or more. In this case, operating payment rates for 6.27services rendered during the rate year in effect and established based on the date of 6.28admission shall be adjusted to the rate year in effect by the hospital cost index.6.29    (b) For fee-for-service admissions occurring on or after July 1, 2002, the total 6.30payment, before third-party liability and spenddown, made to hospitals for inpatient 6.31services is reduced by .5 percent from the current statutory rates.6.32    (c) In addition to the reduction in paragraph (b), the total payment for fee-for-service 6.33admissions occurring on or after July 1, 2003, made to hospitals for inpatient services 6.34before third-party liability and spenddown, is reduced five percent from the current 6.35statutory rates. Mental health services within diagnosis related groups 424 to 432, and 6.36facilities defined under subdivision 16 are excluded from this paragraph.7.1    (d) In addition to the reduction in paragraphs (b) and (c), the total payment for 7.2fee-for-service admissions occurring on or after August 1, 2005, made to hospitals for 7.3inpatient services before third-party liability and spenddown, is reduced 6.0 percent 7.4from the current statutory rates. Mental health services within diagnosis related groups 7.5424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph. 7.6Notwithstanding section 
         256.9686, subdivision 7, for purposes of this paragraph, medical 7.7assistance does not include general assistance medical care. Payments made to managed 7.8care plans shall be reduced for services provided on or after January 1, 2006, to reflect 7.9this reduction.7.10    (e) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for 7.11fee-for-service admissions occurring on or after July 1, 2008, through June 30, 2009, made 7.12to hospitals for inpatient services before third-party liability and spenddown, is reduced 7.133.46 percent from the current statutory rates. Mental health services with diagnosis related 7.14groups 424 to 432 and facilities defined under subdivision 16 are excluded from this 7.15paragraph. Payments made to managed care plans shall be reduced for services provided 7.16on or after January 1, 2009, through June 30, 2009, to reflect this reduction.7.17    (f) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for 7.18fee-for-service admissions occurring on or after July 1, 2009, through June 30, 2010, made 7.19to hospitals for inpatient services before third-party liability and spenddown, is reduced 7.201.9 percent from the current statutory rates. Mental health services with diagnosis related 7.21groups 424 to 432 and facilities defined under subdivision 16 are excluded from this 7.22paragraph. Payments made to managed care plans shall be reduced for services provided 7.23on or after July 1, 2009, through June 30, 2010, to reflect this reduction.7.24    (g) In addition to the reductions in paragraphs (b), (c), and (d), the total payment 7.25for fee-for-service admissions occurring on or after July 1, 2010, made to hospitals for 7.26inpatient services before third-party liability and spenddown, is reduced 1.79 percent 7.27from the current statutory rates. Mental health services with diagnosis related groups 7.28424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph. 7.29Payments made to managed care plans shall be reduced for services provided on or after 7.30July 1, 2010, to reflect this reduction.7.31(h) In addition to the reductions in paragraphs (b), (c), (d), (f), and (g), the total 7.32payment for fee-for-service admissions occurring on or after July 1, 2009, made to 7.33hospitals for inpatient services before third-party liability and spenddown, is reduced 7.34one percent from the current statutory rates. Facilities defined under subdivision 16 are 7.35excluded from this paragraph. Payments made to managed care plans shall be reduced for 7.36services provided on or after October 1, 2009, to reflect this reduction.8.1(i) In order to offset the ratable reductions provided for in this subdivision, the total 8.2payment rate for medical assistance fee-for-service admissions occurring on or after July 8.31, 2010, to June 30, 2011, made to Minnesota hospitals for inpatient services before 8.4third-party liability and spenddown, shall be increased by five percent from the current 8.5statutory rates. Effective July 1, 2011, the rate increase under this paragraph shall be 8.6reduced to 1.96 percent. For purposes of this paragraph, medical assistance does not 8.7include general assistance medical care. The commissioner shall not adjust rates paid to a 8.8prepaid health plan under contract with the commissioner to reflect payments provided 8.9in this paragraph. The commissioner may utilize a settlement process to adjust rates in 8.10excess of the Medicare upper limits on payments.8.11EFFECTIVE DATE.This section is effective July 1, 2010.8.12    Sec. 5. Minnesota Statutes 2008, section 256.969, subdivision 21, is amended to read:8.13    Subd. 21. Mental health or chemical dependency admissions; rates.(a) 8.14Admissions under the general assistance medical care program occurring on or after 8.15July 1, 1990, and admissions under medical assistance, excluding general assistance 8.16medical care, occurring on or after July 1, 1990, and on or before September 30, 1992, 8.17that are classified to a diagnostic category of mental health or chemical dependency 8.18shall have rates established according to the methods of subdivision 14, except the per 8.19day rate shall be multiplied by a factor of 2, provided that the total of the per day rates 8.20shall not exceed the per admission rate. This methodology shall also apply when a hold 8.21or commitment is ordered by the court for the days that inpatient hospital services are 8.22medically necessary. Stays which are medically necessary for inpatient hospital services 8.23and covered by medical assistance shall not be billable to any other governmental entity. 8.24Medical necessity shall be determined under criteria established to meet the requirements 8.25of section 
         256B.04, subdivision 15, or 
         256D.03, subdivision 7, paragraph (b). 8.26(b) In order to ensure adequate access for the provision of mental health services 8.27and to encourage broader delivery of these services outside the nonstate governmental 8.28hospital setting, payment rates for medical assistance admissions occurring on or after 8.29July 1, 2010, at a Minnesota private, not-for-profit hospital above the 75th percentile of all 8.30Minnesota private, nonprofit hospitals for diagnosis-related groups 424 to 432 and 521 8.31to 523 admissions paid by medical assistance for admissions occurring in calendar year 8.322007, shall be increased for these diagnosis-related groups at a percentage calculated to 8.33cost not more than $10,000,000 each fiscal year, including state and federal shares. For 8.34purposes of this paragraph, medical assistance does not include general assistance medical 8.35care. The commissioner shall not adjust rates paid to a prepaid health plan under contract 9.1with the commissioner to reflect payments provided in this paragraph. The commissioner 9.2may utilize a settlement process to adjust rates in excess of the Medicare upper limits 9.3on payments. 9.4EFFECTIVE DATE.This section is effective July 1, 2010.9.5    Sec. 6. Minnesota Statutes 2008, section 256.969, subdivision 26, is amended to read:9.6    Subd. 26. Greater Minnesota payment adjustment after June 30, 2001. (a) For 9.7admissions occurring after June 30, 2001, the commissioner shall pay fee-for-service 9.8inpatient admissions for the diagnosis-related groups specified in paragraph (b) at hospitals 9.9located outside of the seven-county metropolitan area at the higher of:9.10(1) the hospital's current payment rate for the diagnostic category to which the 9.11diagnosis-related group belongs, exclusive of disproportionate population adjustments 9.12received under subdivision 9 and hospital payment adjustments received under subdivision 9.1323; or9.14(2) 90 percent of the average payment rate for that diagnostic category for hospitals 9.15located within the seven-county metropolitan area, exclusive of disproportionate 9.16population adjustments received under subdivision 9 and hospital payment adjustments 9.17received under subdivisions 20 and 23.9.18(b) The payment increases provided in paragraph (a) apply to the following 9.19diagnosis-related groups, as they fall within the diagnostic categories:9.20(1) 370 cesarean section with complicating diagnosis;9.21(2) 371 cesarean section without complicating diagnosis;9.22(3) 372 vaginal delivery with complicating diagnosis;9.23(4) 373 vaginal delivery without complicating diagnosis;9.24(5) 386 extreme immaturity and respiratory distress syndrome, neonate;9.25(6) 388 full-term neonates with other problems;9.26(7) 390 prematurity without major problems;9.27(8) 391 normal newborn;9.28(9) 385 neonate, died or transferred to another acute care facility;9.29(10) 425 acute adjustment reaction and psychosocial dysfunction;9.30(11) 430 psychoses;9.31(12) 431 childhood mental disorders; and9.32(13) 164-167 appendectomy.9.33(c) For medical assistance admissions occurring on or after July 1, 2010, the 9.34payment rate under paragraph (a), clause (2), shall be increased to 100 percent from 90 9.35percent. For purposes of this paragraph, medical assistance does not include general 10.1assistance medical care. The commissioner shall not adjust rates paid to a prepaid 10.2health plan under contract with the commissioner to reflect payments provided in this 10.3paragraph. The commissioner may utilize a settlement process to adjust rates in excess of 10.4the Medicare upper limits on payments. 10.5EFFECTIVE DATE.This section is effective July 1, 2010.10.6    Sec. 7. Minnesota Statutes 2008, section 256.969, is amended by adding a subdivision 10.7to read:10.8    Subd. 31.Hospital payment adjustment after June 30, 2010.(a) For medical 10.9assistance admissions occurring on or after July 1, 2010, to March 31, 2011, the 10.10commissioner shall increase rates at Minnesota private, not-for-profit hospitals as follows:10.11(1) for a hospital with total admissions reimbursed by government payers equal to or 10.12greater than 50 percent, payment rates for inpatient hospital services shall be increased for 10.13each admission by $250 multiplied by 437 percent;10.14(2) for a hospital with total admissions reimbursed by government payers equal to 10.15or greater than 40 percent but less than 50 percent, payment rates for inpatient hospital 10.16services shall be increased for each admission by $250 multiplied by 349.6 percent; and10.17(3) for a hospital with total admissions reimbursed by government payers of less 10.18than 40 percent, payment rates for inpatient hospital services shall be increased for each 10.19admission by $250 multiplied by 262.2 percent.10.20(b) For medical assistance admissions occurring on or after April 1, 2011, the 10.21commissioner shall increase rates at Minnesota private, not-for-profit hospitals as follows:10.22(1) for a hospital with total admissions reimbursed by government payers equal to or 10.23greater than 50 percent, payment rates for inpatient hospital services shall be increased for 10.24each admission by $250 multiplied by 145 percent;10.25(2) for a hospital with total admissions reimbursed by government payers equal to 10.26or greater than 40 percent but less than 50 percent, payment rates for inpatient hospital 10.27services shall be increased for each admission by $250 multiplied by 116 percent; and10.28(3) for a hospital with total admissions reimbursed by government payers of less 10.29than 40 percent, payment rates for inpatient hospital services shall be increased for each 10.30admission by $250 multiplied by 87 percent.10.31(c) For purposes of paragraphs (a) and (b), "government payers" means Medicare, 10.32medical assistance, MinnesotaCare, and general assistance medical care.10.33(d) For medical assistance admissions occurring on or after July 1, 2010, to March 10.3431, 2011, the commissioner shall increase rates for inpatient hospital services at Minnesota 10.35hospitals by $850 for each admission. For medical assistance admissions occurring on 11.1or after April 1, 2011, the payment under this paragraph shall be reduced to $320 per 11.2admission.11.3(e) For purposes of this subdivision, medical assistance does not include general 11.4assistance medical care. The commissioner shall not adjust rates paid to a prepaid 11.5health plan under contract with the commissioner to reflect payments provided in this 11.6subdivision. The commissioner may utilize a settlement process to adjust rates in excess 11.7of the Medicare upper limits on payments.11.8EFFECTIVE DATE.This section is effective July 1, 2010.11.9    Sec. 8. Minnesota Statutes 2008, section 256B.055, is amended by adding a 11.10subdivision to read:11.11    Subd. 15.Adults without children.Medical assistance may be paid for a person 11.12who is:11.13(1) at least age 21 and under age 65;11.14(2) not pregnant;11.15(3) not entitled to Medicare Part A or enrolled in Medicare Part B under Title XVIII 11.16of the Social Security Act;11.17(4) not an adult in a family with children as defined in section 256L.01, subdivision 11.183a; and11.19(5) not described in another subdivision of this section.11.20EFFECTIVE DATE.This section is effective July 1, 2010.11.21    Sec. 9. Minnesota Statutes 2008, section 256B.056, subdivision 3, is amended to read:11.22    Subd. 3. Asset limitations for individuals and families.(a) To be eligible for 11.23medical assistance, a person must not individually own more than $3,000 in assets, or if a 11.24member of a household with two family members, husband and wife, or parent and child, 11.25the household must not own more than $6,000 in assets, plus $200 for each additional 11.26legal dependent. In addition to these maximum amounts, an eligible individual or family 11.27may accrue interest on these amounts, but they must be reduced to the maximum at the 11.28time of an eligibility redetermination. The accumulation of the clothing and personal 11.29needs allowance according to section 
         256B.35 must also be reduced to the maximum at 11.30the time of the eligibility redetermination. The value of assets that are not considered in 11.31determining eligibility for medical assistance is the value of those assets excluded under 11.32the supplemental security income program for aged, blind, and disabled persons, with 11.33the following exceptions: 12.1(1) household goods and personal effects are not considered;12.2(2) capital and operating assets of a trade or business that the local agency determines 12.3are necessary to the person's ability to earn an income are not considered;12.4(3) motor vehicles are excluded to the same extent excluded by the supplemental 12.5security income program;12.6(4) assets designated as burial expenses are excluded to the same extent excluded by 12.7the supplemental security income program. Burial expenses funded by annuity contracts 12.8or life insurance policies must irrevocably designate the individual's estate as contingent 12.9beneficiary to the extent proceeds are not used for payment of selected burial expenses; and12.10(5) effective upon federal approval, for a person who no longer qualifies as an 12.11employed person with a disability due to loss of earnings, assets allowed while eligible 12.12for medical assistance under section 
         256B.057, subdivision 9, are not considered for 12 12.13months, beginning with the first month of ineligibility as an employed person with a 12.14disability, to the extent that the person's total assets remain within the allowed limits of 12.15section 
         256B.057, subdivision 9, paragraph (c).12.16(b) No asset limit shall apply to persons eligible under section 256B.055, subdivision 12.1715.12.18EFFECTIVE DATE.This section is effective July 1, 2010.12.19    Sec. 10. Minnesota Statutes 2008, section 256B.056, subdivision 4, is amended to read:12.20    Subd. 4. Income. (a) To be eligible for medical assistance, a person eligible under 12.21section 
         256B.055, subdivisions 7, 7a, and 12, may have income up to 100 percent of 12.22the federal poverty guidelines. Effective January 1, 2000, and each successive January, 12.23recipients of supplemental security income may have an income up to the supplemental 12.24security income standard in effect on that date. 12.25(b) To be eligible for medical assistance, families and children may have an income 12.26up to 133-1/3 percent of the AFDC income standard in effect under the July 16, 1996, 12.27AFDC state plan. Effective July 1, 2000, the base AFDC standard in effect on July 16, 12.281996, shall be increased by three percent.12.29(c) Effective July 1, 2002, to be eligible for medical assistance, families and children 12.30may have an income up to 100 percent of the federal poverty guidelines for the family size.12.31(d) Effective June 1, 2010, to be eligible for medical assistance under section 12.32256B.055, subdivision 15, a person may have an income up to 75 percent of federal 12.33poverty guidelines for the family size.12.34(e) In computing income to determine eligibility of persons under paragraphs (a) to 12.35(c)(d) who are not residents of long-term care facilities, the commissioner shall disregard 13.1increases in income as required by Public Law Numbers 94-566, section 503; 99-272; 13.2and 99-509. Veterans aid and attendance benefits and Veterans Administration unusual 13.3medical expense payments are considered income to the recipient.13.4EFFECTIVE DATE.This section is effective July 1, 2010.13.5    Sec. 11. Minnesota Statutes 2008, section 256B.0625, subdivision 8, is amended to 13.6read:13.7    Subd. 8. Physical therapy. Medical assistance covers physical therapy and related 13.8services, including specialized maintenance therapy. Authorization by the commissioner 13.9is required to provide medically necessary services to a recipient beyond any of the 13.10following onetime service thresholds, or a lower threshold where one has been established 13.11by the commissioner for a specified service: (1) 80 units of any approved CPT code other 13.12than modalities; (2) 20 modality sessions; and (3) three evaluations or reevaluations. 13.13Services provided by a physical therapy assistant shall be reimbursed at the same rate as 13.14services performed by a physical therapist when the services of the physical therapy 13.15assistant are provided under the direction of a physical therapist who is on the premises. 13.16Services provided by a physical therapy assistant that are provided under the direction 13.17of a physical therapist who is not on the premises shall be reimbursed at 65 percent of 13.18the physical therapist rate.13.19EFFECTIVE DATE.This section is effective July 1, 2010, for services provided 13.20through fee-for-service, and January 1, 2011, for services provided through managed care.13.21    Sec. 12. Minnesota Statutes 2008, section 256B.0625, subdivision 8a, is amended to 13.22read:13.23    Subd. 8a. Occupational therapy. Medical assistance covers occupational therapy 13.24and related services, including specialized maintenance therapy. Authorization by the 13.25commissioner is required to provide medically necessary services to a recipient beyond 13.26any of the following onetime service thresholds, or a lower threshold where one has been 13.27established by the commissioner for a specified service: (1) 120 units of any combination 13.28of approved CPT codes; and (2) two evaluations or reevaluations. Services provided by an 13.29occupational therapy assistant shall be reimbursed at the same rate as services performed 13.30by an occupational therapist when the services of the occupational therapy assistant are 13.31provided under the direction of the occupational therapist who is on the premises. Services 13.32provided by an occupational therapy assistant that are provided under the direction of an 14.1occupational therapist who is not on the premises shall be reimbursed at 65 percent of 14.2the occupational therapist rate.14.3EFFECTIVE DATE.This section is effective July 1, 2010, for services provided 14.4through fee-for-service, and January 1, 2011, for services provided through managed care.14.5    Sec. 13. Minnesota Statutes 2008, section 256B.0625, subdivision 8b, is amended to 14.6read:14.7    Subd. 8b. Speech language pathology and audiology services. Medical assistance 14.8covers speech language pathology and related services, including specialized maintenance 14.9therapy. Authorization by the commissioner is required to provide medically necessary 14.10services to a recipient beyond any of the following onetime service thresholds, or a 14.11lower threshold where one has been established by the commissioner for a specified 14.12service: (1) 50 treatment sessions with any combination of approved CPT codes; and 14.13(2) one evaluation. Medical assistance covers audiology services and related services. 14.14Services provided by a person who has been issued a temporary registration under section 14.15148.5161
          shall be reimbursed at the same rate as services performed by a speech language 14.16pathologist or audiologist as long as the requirements of section 
         148.5161, subdivision 14.173
         , are met. 14.18EFFECTIVE DATE.This section is effective July 1, 2010, for services provided 14.19through fee-for-service, and January 1, 2011, for services provided through managed care.14.20    Sec. 14. Minnesota Statutes 2008, section 256B.0625, is amended by adding a 14.21subdivision to read:14.22    Subd. 8d.Chiropractic services.Payment for chiropractic services is limited to 14.23one annual evaluation and 12 visits per year unless prior authorization of a greater number 14.24of visits is obtained.14.25    Sec. 15. Minnesota Statutes 2009 Supplement, section 256B.0625, subdivision 13h, 14.26is amended to read:14.27    Subd. 13h. Medication therapy management services. (a) Medical assistance 14.28and general assistance medical care cover medication therapy management services for 14.29a recipient taking four or more prescriptions to treat or prevent two or more chronic 14.30medical conditions, or a recipient with a drug therapy problem that is identified or prior 14.31authorized by the commissioner that has resulted or is likely to result in significant 14.32nondrug program costs. The commissioner may cover medical therapy management 15.1services under MinnesotaCare if the commissioner determines this is cost-effective. For 15.2purposes of this subdivision, "medication therapy management" means the provision 15.3of the following pharmaceutical care services by a licensed pharmacist to optimize the 15.4therapeutic outcomes of the patient's medications:15.5    (1) performing or obtaining necessary assessments of the patient's health status;15.6    (2) formulating a medication treatment plan;15.7    (3) monitoring and evaluating the patient's response to therapy, including safety 15.8and effectiveness;15.9    (4) performing a comprehensive medication review to identify, resolve, and prevent 15.10medication-related problems, including adverse drug events;15.11    (5) documenting the care delivered and communicating essential information to 15.12the patient's other primary care providers;15.13    (6) providing verbal education and training designed to enhance patient 15.14understanding and appropriate use of the patient's medications;15.15    (7) providing information, support services, and resources designed to enhance 15.16patient adherence with the patient's therapeutic regimens; and15.17    (8) coordinating and integrating medication therapy management services within the 15.18broader health care management services being provided to the patient.15.19Nothing in this subdivision shall be construed to expand or modify the scope of practice of 15.20the pharmacist as defined in section 
         151.01, subdivision 27.15.21    (b) To be eligible for reimbursement for services under this subdivision, a pharmacist 15.22must meet the following requirements:15.23    (1) have a valid license issued under chapter 151;15.24    (2) have graduated from an accredited college of pharmacy on or after May 1996, or 15.25completed a structured and comprehensive education program approved by the Board of 15.26Pharmacy and the American Council of Pharmaceutical Education for the provision and 15.27documentation of pharmaceutical care management services that has both clinical and 15.28didactic elements;15.29    (3) be practicing in an ambulatory care setting as part of a multidisciplinary team or 15.30have developed a structured patient care process that is offered in a private or semiprivate 15.31patient care area that is separate from the commercial business that also occurs in the 15.32setting, or in home settings, excluding long-term care and group homes, if the service is 15.33ordered by the provider-directed care coordination team; and15.34    (4) make use of an electronic patient record system that meets state standards.15.35    (c) For purposes of reimbursement for medication therapy management services, 15.36the commissioner may enroll individual pharmacists as medical assistance and general 16.1assistance medical care providers. The commissioner may also establish contact 16.2requirements between the pharmacist and recipient, including limiting the number of 16.3reimbursable consultations per recipient.16.4(d) If there are no pharmacists who meet the requirements of paragraph (b) practicing 16.5within a reasonable geographic distance of the patient, a pharmacist who meets the 16.6requirements may provide the services via two-way interactive video. Reimbursement 16.7shall be at the same rates and under the same conditions that would otherwise apply to 16.8the services provided. To qualify for reimbursement under this paragraph, the pharmacist 16.9providing the services must meet the requirements of paragraph (b), and must be located 16.10within an ambulatory care setting approved by the commissioner. The patient must also 16.11be located within an ambulatory care setting approved by the commissioner. Services 16.12provided under this paragraph may not be transmitted into the patient's residence.16.13(e) The commissioner shall establish a pilot project for an intensive medication 16.14therapy management program for patients identified by the commissioner with multiple 16.15chronic conditions and a high number of medications who are at high risk of preventable 16.16hospitalizations, emergency room use, medication complications, and suboptimal 16.17treatment outcomes due to medication-related problems. For purposes of the pilot 16.18project, medication therapy management services may be provided in a patient's home 16.19or community setting, in addition to other authorized settings. The commissioner may 16.20waive existing payment policies and establish special payment rates for the pilot project. 16.21The pilot project must be designed to produce a net savings to the state compared to the 16.22estimated costs that would otherwise be incurred for similar patients without the program. 16.23The pilot project must begin by January 1, 2010, and end June 30, 2012.16.24EFFECTIVE DATE.This section is effective July 1, 2010.16.25    Sec. 16. Minnesota Statutes 2008, section 256B.0625, subdivision 18a, is amended to 16.26read:16.27    Subd. 18a. Access to medical services. (a) Medical assistance reimbursement for 16.28meals for persons traveling to receive medical care may not exceed $5.50 for breakfast, 16.29$6.50 for lunch, or $8 for dinner.16.30    (b) Medical assistance reimbursement for lodging for persons traveling to receive 16.31medical care may not exceed $50 per day unless prior authorized by the local agency.16.32    (c) Medical assistance direct mileage reimbursement to the eligible person or the 16.33eligible person's driver may not exceed 20 cents per mile.16.34    (d) Regardless of the number of employees that an enrolled health care provider 16.35may have, medical assistance covers sign and oral language interpreter services when 17.1provided by an enrolled health care provider during the course of providing a direct, 17.2person-to-person covered health care service to an enrolled recipient with limited English 17.3proficiency or who has a hearing loss and uses interpreting services. Coverage for 17.4face-to-face oral language interpreter services shall be provided only if the oral language 17.5interpreter used by the enrolled health care provider is listed in the registry or roster 17.6established under section 144.058.17.7EFFECTIVE DATE.This section is effective January 1, 2011.17.8    Sec. 17. Minnesota Statutes 2008, section 256B.0625, subdivision 31, is amended to 17.9read:17.10    Subd. 31. Medical supplies and equipment. Medical assistance covers medical 17.11supplies and equipment. Separate payment outside of the facility's payment rate shall 17.12be made for wheelchairs and wheelchair accessories for recipients who are residents 17.13of intermediate care facilities for the developmentally disabled. Reimbursement for 17.14wheelchairs and wheelchair accessories for ICF/MR recipients shall be subject to the same 17.15conditions and limitations as coverage for recipients who do not reside in institutions. A 17.16wheelchair purchased outside of the facility's payment rate is the property of the recipient.17.17The commissioner may set reimbursement rates for specified categories of medical 17.18supplies at levels below the Medicare payment rate.17.19    Sec. 18. Minnesota Statutes 2008, section 256B.0625, is amended by adding a 17.20subdivision to read:17.21    Subd. 54.Services provided in birth centers.(a) Medical assistance covers 17.22services provided in a licensed birth center by a licensed health professional if the service 17.23would otherwise be covered if provided in a hospital.17.24(b) Facility services provided by a birth center shall be paid at the lower of billed 17.25charges or 70 percent of the statewide average for a facility payment rate made to a 17.26hospital for an uncomplicated vaginal birth as determined using the most recent calendar 17.27year for which complete claims data is available. If a recipient is transported from a birth 17.28center to a hospital prior to the delivery, the payment for facility services to the birth center 17.29shall be the lower of billed charges or 15 percent of the average facility payment made to a 17.30hospital for the services provided for an uncomplicated vaginal delivery as determined 17.31using the most recent calendar year for which complete claims data is available.17.32(c) Nursery care services provided by a birth center shall be paid the lower of billed 17.33charges or 70 percent of the statewide average for a payment rate paid to a hospital for 18.1nursery care as determined by using the most recent calendar year for which complete 18.2claims data is available.18.3(d) Professional services provided by traditional midwives licensed under chapter 18.4147D shall be paid at the lower of billed charges or 100 percent of the rate paid to a 18.5physician performing the same services. If a recipient is transported from a birth center to 18.6a hospital prior to the delivery, a licensed traditional midwife who does not perform the 18.7delivery may not bill for any delivery services. Services are not covered if provided by an 18.8unlicensed traditional midwife.18.9(e) The commissioner shall apply for any necessary waivers from the Centers for 18.10Medicare and Medicaid Services to allow birth centers and birth center providers to be 18.11reimbursed.18.12EFFECTIVE DATE.This section is effective July 1, 2010.18.13    Sec. 19. Minnesota Statutes 2008, section 256B.0631, subdivision 1, is amended to 18.14read:18.15    Subdivision 1. Co-payments. (a) Except as provided in subdivision 2, the medical 18.16assistance benefit plan shall include the following co-payments for all recipients, effective 18.17for services provided on or after October 1, 2003, and before January 1, 2009:18.18    (1) $3 per nonpreventive visit. For purposes of this subdivision, a visit means an 18.19episode of service which is required because of a recipient's symptoms, diagnosis, or 18.20established illness, and which is delivered in an ambulatory setting by a physician or 18.21physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse, 18.22audiologist, optician, or optometrist;18.23    (2) $3 for eyeglasses;18.24    (3) $6 for nonemergency visits to a hospital-based emergency room; and18.25    (4) $3 per brand-name drug prescription and $1 per generic drug prescription, 18.26subject to a $12 per month maximum for prescription drug co-payments. No co-payments 18.27shall apply to antipsychotic drugs when used for the treatment of mental illness.18.28    (b) Except as provided in subdivision 2, the medical assistance benefit plan shall 18.29include the following co-payments for all recipients, effective for services provided on 18.30or after January 1, 2009:18.31    (1) $6 $3.50 for nonemergency visits to a hospital-based emergency room; 18.32    (2) $3 per brand-name drug prescription and $1 per generic drug prescription, 18.33subject to a $7 per month maximum for prescription drug co-payments. No co-payments 18.34shall apply to antipsychotic drugs when used for the treatment of mental illness; and19.1    (3) for individuals identified by the commissioner with income at or below 100 19.2percent of the federal poverty guidelines, total monthly co-payments must not exceed five 19.3percent of family income. For purposes of this paragraph, family income is the total 19.4earned and unearned income of the individual and the individual's spouse, if the spouse is 19.5enrolled in medical assistance and also subject to the five percent limit on co-payments.19.6    (c) Recipients of medical assistance are responsible for all co-payments in this 19.7subdivision.19.8EFFECTIVE DATE.This section is effective July 1, 2010.19.9    Sec. 20. Minnesota Statutes 2008, section 256B.0631, subdivision 3, is amended to 19.10read:19.11    Subd. 3. Collection. (a) The medical assistance reimbursement to the provider 19.12shall be reduced by the amount of the co-payment, except that reimbursements shall 19.13not be reduced:19.14    (1) once a recipient has reached the $12 per month maximum or the $7 per month 19.15maximum effective January 1, 2009, for prescription drug co-payments; or19.16    (2) for a recipient identified by the commissioner under 100 percent of the federal 19.17poverty guidelines who has met their monthly five percent co-payment limit.19.18    (b) The provider collects the co-payment from the recipient. Providers may not deny 19.19services to recipients who are unable to pay the co-payment.19.20    (c) Medical assistance reimbursement to fee-for-service providers and payments to 19.21managed care plans shall not be increased as a result of the removal of the co-payments 19.22effective on or after January 1, 2009.19.23    Sec. 21. Minnesota Statutes 2008, section 256B.0644, as amended by Laws 2010, 19.24chapter 200, article 1, section 6, is amended to read:19.25256B.0644 REIMBURSEMENT UNDER OTHER STATE HEALTH CARE 19.26PROGRAMS.19.27    (a) A vendor of medical care, as defined in section 
         256B.02, subdivision 7, and a 19.28health maintenance organization, as defined in chapter 62D, must participate as a provider 19.29or contractor in the medical assistance program, general assistance medical care program, 19.30and MinnesotaCare as a condition of participating as a provider in health insurance plans 19.31and programs or contractor for state employees established under section 
         43A.18, the 19.32public employees insurance program under section 
         43A.316, for health insurance plans 19.33offered to local statutory or home rule charter city, county, and school district employees, 20.1the workers' compensation system under section 
         176.135, and insurance plans provided 20.2through the Minnesota Comprehensive Health Association under sections 
         62E.01 to 20.362E.19
         . The limitations on insurance plans offered to local government employees shall 20.4not be applicable in geographic areas where provider participation is limited by managed 20.5care contracts with the Department of Human Services.20.6    (b) For providers other than health maintenance organizations, participation in the 20.7medical assistance program means that:20.8     (1) the provider accepts new medical assistance, general assistance medical care, 20.9and MinnesotaCare patients;20.10    (2) for providers other than dental service providers, at least 20 percent of the 20.11provider's patients are covered by medical assistance, general assistance medical care, 20.12and MinnesotaCare as their primary source of coverage; or20.13    (3) for dental service providers, at least ten percent of the provider's patients are 20.14covered by medical assistance, general assistance medical care, and MinnesotaCare as 20.15their primary source of coverage, or the provider accepts new medical assistance and 20.16MinnesotaCare patients who are children with special health care needs. For purposes 20.17of this section, "children with special health care needs" means children up to age 18 20.18who: (i) require health and related services beyond that required by children generally; 20.19and (ii) have or are at risk for a chronic physical, developmental, behavioral, or emotional 20.20condition, including: bleeding and coagulation disorders; immunodeficiency disorders; 20.21cancer; endocrinopathy; developmental disabilities; epilepsy, cerebral palsy, and other 20.22neurological diseases; visual impairment or deafness; Down syndrome and other genetic 20.23disorders; autism; fetal alcohol syndrome; and other conditions designated by the 20.24commissioner after consultation with representatives of pediatric dental providers and 20.25consumers.20.26    (c) Patients seen on a volunteer basis by the provider at a location other than 20.27the provider's usual place of practice may be considered in meeting the participation 20.28requirement in this section. The commissioner shall establish participation requirements 20.29for health maintenance organizations. The commissioner shall provide lists of participating 20.30medical assistance providers on a quarterly basis to the commissioner of management and 20.31budget, the commissioner of labor and industry, and the commissioner of commerce. Each 20.32of the commissioners shall develop and implement procedures to exclude as participating 20.33providers in the program or programs under their jurisdiction those providers who do 20.34not participate in the medical assistance program. The commissioner of management 20.35and budget shall implement this section through contracts with participating health and 20.36dental carriers.21.1(d) Any hospital or other provider that is participating in a coordinated care 21.2delivery system under section 256D.031, subdivision 6, or receives payments from the 21.3uncompensated care pool under section 256D.031, subdivision 8, shall not refuse to 21.4provide services to any patient enrolled in general assistance medical care regardless of 21.5the availability or the amount of payment.21.6    (e) For purposes of paragraphs (a) and (b), participation in the general assistance 21.7medical care program applies only to pharmacy providers.21.8EFFECTIVE DATE.This section is effective July 1, 2010.21.9    Sec. 22. Minnesota Statutes 2009 Supplement, section 256B.0653, subdivision 5, 21.10is amended to read:21.11    Subd. 5. Home care therapies. (a) Home care therapies include the following: 21.12physical therapy, occupational therapy, respiratory therapy, and speech and language 21.13pathology therapy services.21.14(b) Home care therapies must be:21.15(1) provided in the recipient's residence after it has been determined the recipient is 21.16unable to access outpatient therapy;21.17(2) prescribed, ordered, or referred by a physician and documented in a plan of care 21.18and reviewed, according to Minnesota Rules, part 9505.0390;21.19(3) assessed by an appropriate therapist; and21.20(4) provided by a Medicare-certified home health agency enrolled as a Medicaid 21.21provider agency.21.22(c) Restorative and specialized maintenance therapies must be provided according to 21.23Minnesota Rules, part 9505.0390. Physical and occupational therapy assistants may be 21.24used as allowed under Minnesota Rules, part 9505.0390, subpart 1, item B.21.25(d) For both physical and occupational therapies, the therapist and the therapist's 21.26assistant may not both bill for services provided to a recipient on the same day.21.27    Sec. 23. [256B.0755] HEALTH CARE DELIVERY SYSTEMS 21.28DEMONSTRATION PROJECT.21.29    Subdivision 1.Implementation.(a) The commissioner shall develop and 21.30authorize a demonstration project to test alternative and innovative health care delivery 21.31systems, including accountable care organizations that provide services to a specified 21.32patient population for an agreed upon total cost of care or risk-gain sharing payment 21.33arrangement. The commissioner shall develop a request for proposals for participation in 22.1the demonstration project in consultation with hospitals, primary care providers, health 22.2plans, and other key stakeholders.22.3(b) In developing the request for proposals, the commissioner shall:22.4(1) establish uniform statewide methods of forecasting utilization and cost of care 22.5for the appropriate Minnesota public program populations, to be used by the commissioner 22.6for the health care delivery system projects;22.7(2) identify key indicators of quality, access, patient satisfaction, and other 22.8performance indicators that will be measured, in addition to indicators for measuring 22.9cost savings;22.10(3) allow maximum flexibility to encourage innovation and variation so that a variety 22.11of provider collaborations are able to become health care delivery systems;22.12(4) encourage and authorize different levels and types of financial risk;22.13(5) encourage and authorize projects representing a wide variety of geographic 22.14locations, patient populations, provider relationships, and care coordination models;22.15(6) encourage projects that involve close partnerships between the health care 22.16delivery system and counties and nonprofit agencies that provide services to patients 22.17enrolled with the health care delivery system, including social services, public health, 22.18mental health, community-based services, and continuing care;22.19(7) encourage projects established by community hospitals, clinics, and other 22.20providers in rural communities;22.21(8) identify required covered services for a total cost of care model or services 22.22considered in whole or partially in an analysis of utilization for a risk/gain sharing model;22.23(9) establish a mechanism to monitor enrollment;22.24(10) establish quality standards for the delivery system demonstrations; and22.25(11) encourage participation of privately insured population so as to create sufficient 22.26alignment in demonstration systems.22.27(c) To be eligible to participate in the demonstration project, a health care delivery 22.28system must:22.29(1) provide required covered services and care coordination to recipients enrolled in 22.30the health care delivery system;22.31(2) establish a process to monitor enrollment and ensure the quality of care provided;22.32(3) in cooperation with counties and community social service agencies, coordinate 22.33the delivery of health care services with existing social services programs;22.34(4) provide a system for advocacy and consumer protection; and23.1(5) adopt innovative and cost-effective methods of care delivery and coordination, 23.2which may include the use of allied health professionals, telemedicine, patient educators, 23.3care coordinators, and community health workers.23.4(d) A health care delivery system demonstration may be formed by the following 23.5groups of providers of services and suppliers if they have established a mechanism for 23.6shared governance:23.7(1) professionals in group practice arrangements;23.8(2) networks of individual practices of professionals;23.9(3) partnerships or joint venture arrangements between hospitals and ACO 23.10professionals;23.11(4) hospitals employing professionals; and23.12(5) other groups of providers of services and suppliers as the commissioner 23.13determines appropriate.23.14A managed care plan or county-based purchasing plan may participate in this 23.15demonstration in collaboration with one or more of the entities listed in clauses (1) to (5).23.16A health care delivery system may contract with a managed care plan or a 23.17county-based purchasing plan to provide administrative services, including the 23.18administration of a payment system using the payment methods established by the 23.19commissioner for health care delivery systems.23.20(e) The commissioner may require a health care delivery system to enter into 23.21additional third-party contractual relationships for the assessment of risk and purchase of 23.22stop loss insurance or another form of insurance risk management related to the delivery 23.23of care described in paragraph (c).23.24    Subd. 2.Enrollment.(a) Individuals eligible for medical assistance or 23.25MinnesotaCare shall be eligible for enrollment in a health care delivery system.23.26(b) Eligible applicants and recipients may enroll in a health care delivery system if 23.27a system serves the county in which the applicant or recipient resides. If more than one 23.28health care delivery system serves a county, the applicant or recipient shall be allowed 23.29to choose among the delivery systems. The commissioner may assign an applicant or 23.30recipient to a health care delivery system if a health care delivery system is available and 23.31no choice has been made by the applicant or recipient.23.32    Subd. 3.Accountability.(a) Health care delivery systems must accept responsibility 23.33for the quality of care based on standards established under subdivision 1, paragraph (b), 23.34clause (10), and the cost of care or utilization of services provided to its enrollees under 23.35subdivision 1, paragraph (b), clause (1).24.1(b) A health care delivery system may contract and coordinate with providers and 24.2clinics for the delivery of services and shall contract with community health clinics, 24.3federally qualified health centers, and rural clinics to the extent practicable.24.4    Subd. 4.Payment system.(a) In developing a payment system for health care 24.5delivery systems, the commissioner shall establish a total cost of care benchmark or a 24.6risk/gain sharing payment model to be paid for services provided to the recipients enrolled 24.7in a health care delivery system.24.8(b) The payment system may include incentive payments to health care delivery 24.9systems that meet or exceed annual quality and performance targets realized through 24.10the coordination of care.24.11(c) An amount equal to the savings realized to the general fund as a result of the 24.12demonstration project shall be transferred each fiscal year to the health care access fund.24.13    Subd. 5.Outpatient prescription drug coverage.Outpatient prescription drug 24.14coverage may be provided through accountable care organizations only if the delivery 24.15method qualifies for federal prescription drug rebates.24.16    Subd. 6.Federal approval.The commissioner shall apply for any federal waivers 24.17or other federal approval required to implement this section. The commissioner shall 24.18also apply for any applicable grant or demonstration under the Patient Protection and 24.19Affordable Health Care Act, Public Law 111-148, or the Health Care and Education 24.20Reconciliation Act of 2010, Public Law 111-152, that would further the purposes of or 24.21assist in the establishment of accountable care organizations.24.22    Subd. 7.Expansion.The commissioner shall explore the expansion of the 24.23demonstration project to include additional medical assistance and MinnesotaCare 24.24enrollees, and shall seek participation of Medicare in demonstration projects. The 24.25commissioner shall seek to include participation of privately insured persons and Medicare 24.26recipients in the health care delivery demonstration.24.27EFFECTIVE DATE.This section is effective July 1, 2011.24.28    Sec. 24. [256B.0756] HENNEPIN AND RAMSEY COUNTIES PILOT 24.29PROGRAM.24.30(a) The commissioner, upon federal approval of a new waiver request or amendment 24.31of an existing demonstration, may establish a pilot program in Hennepin County or 24.32Ramsey County, or both, to test alternative and innovative integrated health care delivery 24.33networks.25.1(b) Individuals eligible for the pilot program shall be individuals who are eligible for 25.2medical assistance under Minnesota Statutes, section 256B.055, subdivision 15, and who 25.3reside in Hennepin County or Ramsey County.25.4(c) Individuals enrolled in the pilot shall be enrolled in an integrated health care 25.5delivery network in their county of residence. The integrated health care delivery network 25.6in Hennepin County shall be a network, such as an accountable care organization or a 25.7community-based collaborative care network, created by or including Hennepin County 25.8Medical Center. The integrated health care delivery network in Ramsey County shall be 25.9a network, such as an accountable care organization or community-based collaborative 25.10care network, created by or including Regions Hospital.25.11(d) The commissioner shall cap pilot program enrollment at 7,000 enrollees for 25.12Hennepin County and 3,500 enrollees for Ramsey County.25.13(e) In developing a payment system for the pilot programs, the commissioner shall 25.14establish a total cost of care for the recipients enrolled in the pilot programs that equals 25.15the cost of care that would otherwise be spent for these enrollees in the prepaid medical 25.16assistance program.25.17(f) Counties may transfer funds necessary to support the nonfederal share of 25.18payments for integrated health care delivery networks in their county. Such transfers per 25.19county shall not exceed 15 percent of the expected expenses for county enrollees.25.20(g) The commissioner shall apply to the federal government for, or as appropriate, 25.21cooperate with counties, providers, or other entities that are applying for any applicable 25.22grant or demonstration under the Patient Protection and Affordable Health Care Act, Public 25.23Law 111-148, or the Health Care and Education Reconciliation Act of 2010, Public Law 25.24111-152, that would further the purposes of or assist in the creation of an integrated health 25.25care delivery network for the purposes of this subdivision, including, but not limited to, a 25.26global payment demonstration or the community-based collaborative care network grants.25.27    Sec. 25. Minnesota Statutes 2009 Supplement, section 256B.69, subdivision 5a, 25.28is amended to read:25.29    Subd. 5a. Managed care contracts. (a) Managed care contracts under this section 25.30and sections 
         256L.12 and 
         256D.03, shall be entered into or renewed on a calendar year 25.31basis beginning January 1, 1996. Managed care contracts which were in effect on June 25.3230, 1995, and set to renew on July 1, 1995, shall be renewed for the period July 1, 1995 25.33through December 31, 1995 at the same terms that were in effect on June 30, 1995. The 25.34commissioner may issue separate contracts with requirements specific to services to 25.35medical assistance recipients age 65 and older.26.1    (b) A prepaid health plan providing covered health services for eligible persons 26.2pursuant to chapters 256B, 256D, and 256L, is responsible for complying with the terms 26.3of its contract with the commissioner. Requirements applicable to managed care programs 26.4under chapters 256B, 256D, and 256L, established after the effective date of a contract 26.5with the commissioner take effect when the contract is next issued or renewed.26.6    (c) Effective for services rendered on or after January 1, 2003, the commissioner 26.7shall withhold five percent of managed care plan payments under this section and 26.8county-based purchasing plan's payment rate plan payments under section 
         256B.692 for 26.9the prepaid medical assistance and general assistance medical care programs pending 26.10completion of performance targets. Each performance target must be quantifiable, 26.11objective, measurable, and reasonably attainable, except in the case of a performance target 26.12based on a federal or state law or rule. Criteria for assessment of each performance target 26.13must be outlined in writing prior to the contract effective date. The managed care plan 26.14must demonstrate, to the commissioner's satisfaction, that the data submitted regarding 26.15attainment of the performance target is accurate. The commissioner shall periodically 26.16change the administrative measures used as performance targets in order to improve plan 26.17performance across a broader range of administrative services. The performance targets 26.18must include measurement of plan efforts to contain spending on health care services and 26.19administrative activities. The commissioner may adopt plan-specific performance targets 26.20that take into account factors affecting only one plan, including characteristics of the 26.21plan's enrollee population. The withheld funds must be returned no sooner than July of the 26.22following year if performance targets in the contract are achieved. The commissioner may 26.23exclude special demonstration projects under subdivision 23.26.24    (d) Effective for services rendered on or after January 1, 2009, through December 31, 26.252009, the commissioner shall withhold three percent of managed care plan payments under 26.26this section and county-based purchasing plan payments under section 
         256B.692 for the 26.27prepaid medical assistance and general assistance medical care programs. The withheld 26.28funds must be returned no sooner than July 1 and no later than July 31 of the following 26.29year. The commissioner may exclude special demonstration projects under subdivision 23.26.30    The return of the withhold under this paragraph is not subject to the requirements of 26.31paragraph (c).26.32(e) Effective for services provided on or after January 1, 2010, the commissioner 26.33shall require that managed care plans use the assessment and authorization processes, 26.34forms, timelines, standards, documentation, and data reporting requirements, protocols, 26.35billing processes, and policies consistent with medical assistance fee-for-service or the 26.36Department of Human Services contract requirements consistent with medical assistance 27.1fee-for-service or the Department of Human Services contract requirements for all 27.2personal care assistance services under section 
         256B.0659.27.3(f) Effective for services rendered on or after January 1, 2010, through December 27.431, 2010, the commissioner shall withhold 3.5 percent of managed care plan payments 27.5under this section and county-based purchasing plan payments under section 
         256B.692 27.6for the prepaid medical assistance program. The withheld funds must be returned no 27.7sooner than July 1 and no later than July 31 of the following year. The commissioner may 27.8exclude special demonstration projects under subdivision 23.27.9(g) Effective for services rendered on or after January 1, 2011, the commissioner 27.10shall include as part of the performance targets described in paragraph (c) a reduction in 27.11the health plan's emergency room utilization rate for state health care program enrollees 27.12by a measurable rate of five percent from the plan's utilization rate for state health care 27.13program enrollees for the previous calendar year.27.14The withheld funds must be returned no sooner than July 1 and no later than July 27.1531 of the following calendar year if the managed care plan or county-based purchasing 27.16plan demonstrates to the satisfaction of the commissioner that a reduction in the utilization 27.17rate was achieved.27.18The withhold described in this paragraph shall continue for each consecutive 27.19contract period until the plan's emergency room utilization rate for state health care 27.20program enrollees is reduced by 25 percent of the plan's emergency room utilization 27.21rate for state health care program enrollees for calendar year 2009. Hospitals shall 27.22cooperate with the health plans in meeting this performance target and shall accept 27.23payment withholds that may be returned to the hospitals if the performance target is 27.24achieved. The commissioner shall structure the withhold so that the commissioner returns 27.25a portion of the withheld funds in amounts commensurate with achieved reductions in 27.26utilization less than the targeted amount. The withhold in this paragraph does not apply to 27.27county-based purchasing plans.27.28(g) (h) Effective for services rendered on or after January 1, 2011, through December 27.2931, 2011, the commissioner shall withhold four percent of managed care plan payments 27.30under this section and county-based purchasing plan payments under section 
         256B.69227.31for the prepaid medical assistance program. The withheld funds must be returned no 27.32sooner than July 1 and no later than July 31 of the following year. The commissioner may 27.33exclude special demonstration projects under subdivision 23.27.34(h) (i) Effective for services rendered on or after January 1, 2012, through December 27.3531, 2012, the commissioner shall withhold 4.5 percent of managed care plan payments 27.36under this section and county-based purchasing plan payments under section 
         256B.692 28.1for the prepaid medical assistance program. The withheld funds must be returned no 28.2sooner than July 1 and no later than July 31 of the following year. The commissioner may 28.3exclude special demonstration projects under subdivision 23.28.4(i) (j) Effective for services rendered on or after January 1, 2013, through December 28.531, 2013, the commissioner shall withhold 4.5 percent of managed care plan payments 28.6under this section and county-based purchasing plan payments under section 
         256B.692 28.7for the prepaid medical assistance program. The withheld funds must be returned no 28.8sooner than July 1 and no later than July 31 of the following year. The commissioner may 28.9exclude special demonstration projects under subdivision 23.28.10(j) (k) Effective for services rendered on or after January 1, 2014, the commissioner 28.11shall withhold three percent of managed care plan payments under this section and 28.12county-based purchasing plan payments under section 
         256B.692 for the prepaid medical 28.13assistance and prepaid general assistance medical care programs. The withheld funds must 28.14be returned no sooner than July 1 and no later than July 31 of the following year. The 28.15commissioner may exclude special demonstration projects under subdivision 23.28.16(k) (l) A managed care plan or a county-based purchasing plan under section 28.17256B.692 
         may include as admitted assets under section 
         62D.044 any amount withheld 28.18under this section that is reasonably expected to be returned.28.19(l) (m) Contracts between the commissioner and a prepaid health plan are exempt 28.20from the set-aside and preference provisions of section 
         16C.16, subdivisions 6, paragraph 28.21(a), and 7.28.22EFFECTIVE DATE.This section is effective July 1, 2010.28.23    Sec. 26. Minnesota Statutes 2008, section 256B.69, is amended by adding a 28.24subdivision to read:28.25    Subd. 5k.Rate modifications.For services rendered on or after October 1, 2010, 28.26the total payment made to managed care plans and county-based purchasing plans under 28.27the medical assistance program shall be increased by 1.28 percent.28.28EFFECTIVE DATE.This section is effective October 1, 2010.28.29    Sec. 27. Minnesota Statutes 2008, section 256B.69, subdivision 20, as amended by 28.30Laws 2010, chapter 200, article 1, section 10, is amended to read:28.31    Subd. 20. Ombudsperson.(a) The commissioner shall designate an ombudsperson 28.32to advocate for persons required to enroll in prepaid health plans under this section. The 28.33ombudsperson shall advocate for recipients enrolled in prepaid health plans through 29.1complaint and appeal procedures and ensure that necessary medical services are provided 29.2either by the prepaid health plan directly or by referral to appropriate social services. At 29.3the time of enrollment in a prepaid health plan, the local agency shall inform recipients 29.4about the ombudsperson program and their right to a resolution of a complaint by the 29.5prepaid health plan if they experience a problem with the plan or its providers.29.6    (b) The commissioner shall designate an ombudsperson to advocate for persons 29.7enrolled in a care coordination delivery system under section 256D.031. The 29.8ombudsperson shall advocate for recipients enrolled in a care coordination delivery 29.9system through the state appeal process and assist enrollees in accessing necessary 29.10medical services through the care coordination delivery systems directly or by referral to 29.11appropriate services. At the time of enrollment in a care coordination delivery system, the 29.12local agency shall inform recipients about the ombudsperson program.29.13    Sec. 28. Minnesota Statutes 2008, section 256B.69, subdivision 27, is amended to read:29.14    Subd. 27.  Information for persons with limited English-language proficiency.29.15    Managed care contracts entered into under this section and sections 256D.03, subdivision 29.164, paragraph (c), andsection 256L.12 must require demonstration providers to provide 29.17language assistance to enrollees that ensures meaningful access to its programs and 29.18services according to Title VI of the Civil Rights Act and federal regulations adopted 29.19under that law or any guidance from the United States Department of Health and Human 29.20Services. 29.21EFFECTIVE DATE.This section is effective retroactively from April 1, 2010.29.22    Sec. 29. Minnesota Statutes 2008, section 256B.692, subdivision 1, is amended to read:29.23    Subdivision 1. In general. County boards or groups of county boards may elect 29.24to purchase or provide health care services on behalf of persons eligible for medical 29.25assistance and general assistance medical care who would otherwise be required to or may 29.26elect to participate in the prepaid medical assistance or prepaid general assistance medical 29.27care programs according to sectionssection 256B.69and 256D.03. Counties that elect to 29.28purchase or provide health care under this section must provide all services included in 29.29prepaid managed care programs according to sectionssection 256B.69, subdivisions 1 29.30to 22
         , and 256D.03. County-based purchasing under this section is governed by section 29.31256B.69
         , unless otherwise provided for under this section.  29.32EFFECTIVE DATE.This section is effective retroactively from April 1, 2010.30.1    Sec. 30. Minnesota Statutes 2009 Supplement, section 256B.76, subdivision 1, is 30.2amended to read:30.3    Subdivision 1. Physician reimbursement.  (a) Effective for services rendered on 30.4or after October 1, 1992, the commissioner shall make payments for physician services 30.5as follows:30.6    (1) payment for level one Centers for Medicare and Medicaid Services' common 30.7procedural coding system codes titled "office and other outpatient services," "preventive 30.8medicine new and established patient," "delivery, antepartum, and postpartum care," 30.9"critical care," cesarean delivery and pharmacologic management provided to psychiatric 30.10patients, and level three codes for enhanced services for prenatal high risk, shall be paid 30.11at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June 30.1230, 1992. If the rate on any procedure code within these categories is different than the 30.13rate that would have been paid under the methodology in section 
         256B.74, subdivision 2, 30.14then the larger rate shall be paid;30.15    (2) payments for all other services shall be paid at the lower of (i) submitted charges, 30.16or (ii) 15.4 percent above the rate in effect on June 30, 1992; and30.17    (3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th 30.18percentile of 1989, less the percent in aggregate necessary to equal the above increases 30.19except that payment rates for home health agency services shall be the rates in effect 30.20on September 30, 1992.30.21    (b) Effective for services rendered on or after January 1, 2000, payment rates for 30.22physician and professional services shall be increased by three percent over the rates 30.23in effect on December 31, 1999, except for home health agency and family planning 30.24agency services. The increases in this paragraph shall be implemented January 1, 2000, 30.25for managed care.30.26(c) Effective for services rendered on or after July 1, 2009, payment rates for 30.27physician and professional services shall be reduced by five percent over the rates in effect 30.28on June 30, 2009. This reduction doesand the reductions in paragraph (d) do not apply 30.29to office or other outpatient visits, preventive medicine visits and family planning visits 30.30billed by physicians, advanced practice nurses, or physician assistants in a family planning 30.31agency or in one of the following primary care practices: general practice, general internal 30.32medicine, general pediatrics, general geriatrics, and family medicine. This reduction does30.33and the reductions in paragraph (d) do not apply to federally qualified health centers, 30.34rural health centers, and Indian health services. Effective October 1, 2009, payments 30.35made to managed care plans and county-based purchasing plans under sections 
         256B.69, 30.36256B.692
         , and 
         256L.12 shall reflect the payment reduction described in this paragraph.31.1(d) Effective for services rendered on or after July 1, 2010, payment rates for 31.2physician and professional services shall be reduced an additional seven percent over the 31.3rates described in paragraph (c). This additional reduction does not apply to physical 31.4therapy services, occupational therapy services, and speech pathology and related 31.5services provided on or after July 1, 2010. This additional reduction does not apply to 31.6physician services billed by a psychiatrist or advanced practice nurse with a specialty in 31.7mental health. Effective October 1, 2010, payments made to managed care plans and 31.8county-based purchasing plans under sections 256B.69, 256B.692, and 256L.12 shall 31.9reflect the payment reduction described in this paragraph.31.10(e) Effective for services rendered on or after October 1, 2010, payment rates for 31.11physician and professional services billed by physicians employed by and clinics owned 31.12by a nonprofit health maintenance organization shall be increased by 25 percent. Effective 31.13October 1, 2010, payments made to managed care plans and county-based purchasing 31.14plans under sections 256B.69, 256B.692, and 256L.12, shall reflect the payment increase 31.15described in this paragraph.31.16EFFECTIVE DATE.This section is effective July 1, 2010.31.17    Sec. 31. Minnesota Statutes 2008, section 256B.76, subdivision 2, is amended to read:31.18    Subd. 2. Dental reimbursement.  (a) Effective for services rendered on or after 31.19October 1, 1992, the commissioner shall make payments for dental services as follows:31.20    (1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25 31.21percent above the rate in effect on June 30, 1992; and31.22    (2) dental rates shall be converted from the 50th percentile of 1982 to the 50th 31.23percentile of 1989, less the percent in aggregate necessary to equal the above increases.31.24    (b) Beginning October 1, 1999, the payment for tooth sealants and fluoride treatments 31.25shall be the lower of (1) submitted charge, or (2) 80 percent of median 1997 charges.31.26    (c) Effective for services rendered on or after January 1, 2000, payment rates for 31.27dental services shall be increased by three percent over the rates in effect on December 31.2831, 1999.31.29    (d) Effective for services provided on or after January 1, 2002, payment for 31.30diagnostic examinations and dental x-rays provided to children under age 21 shall be the 31.31lower of (1) the submitted charge, or (2) 85 percent of median 1999 charges.31.32    (e) The increases listed in paragraphs (b) and (c) shall be implemented January 1, 31.332000, for managed care.31.34(f) Effective for dental services rendered on or after October 1, 2010, by a 31.35state-operated dental clinic, payment shall be paid on a reasonable cost basis that is based 32.1on the Medicare principles of reimbursement. This payment shall be effective for services 32.2rendered on or after January 1, 2011, to recipients enrolled in managed care plans or 32.3county-based purchasing plans.32.4(g) Beginning in fiscal year 2011, if the payments to state-operated dental clinics 32.5in paragraph (f), including state and federal shares, are less than $1,850,000 per fiscal 32.6year, a supplemental state payment equal to the difference between the total payments 32.7in paragraph (f) and $1,850,000 shall be paid from the general fund to state-operated 32.8services for the operation of the dental clinics.32.9(h) If the cost-based payment system for state-operated dental clinics described in 32.10paragraph (f) does not receive federal approval, then state-operated dental clinics shall be 32.11designated as critical access dental providers under subdivision 4, paragraph (b), and shall 32.12receive the critical access dental reimbursement rate as described under subdivision 4, 32.13paragraph (a).32.14EFFECTIVE DATE.This section is effective July 1, 2010.32.15    Sec. 32. Minnesota Statutes 2008, section 256B.76, subdivision 4, is amended to read:32.16    Subd. 4. Critical access dental providers. (a) Effective for dental services 32.17rendered on or after January 1, 2002, the commissioner shall increase reimbursements 32.18to dentists and dental clinics deemed by the commissioner to be critical access dental 32.19providers. For dental services rendered on or after July 1, 2007, the commissioner shall 32.20increase reimbursement by 30 percent above the reimbursement rate that would otherwise 32.21be paid to the critical access dental provider. The commissioner shall pay the health plan 32.22companies managed care plans and county-based purchasing plans  in amounts sufficient 32.23to reflect increased reimbursements to critical access dental providers as approved by the 32.24commissioner. In determining which dentists and dental clinics shall be deemed critical 32.25access dental providers, the commissioner shall review:32.26(b) The commissioner shall designate the following dentists and dental clinics as 32.27critical access dental providers:32.28    (1) the utilization rate in the service area in which the dentist or dental clinic operates 32.29for dental services to patients covered by medical assistance, general assistance medical 32.30care, or MinnesotaCare as their primary source of coverage nonprofit community clinics 32.31that:32.32(i) have nonprofit status in accordance with chapter 317A;32.33(ii) have tax exempt status in accordance with the Internal Revenue Code, section 32.34501(c)(3);33.1(iii) are established to provide oral health services to patients who are low income, 33.2uninsured, have special needs, and are underserved;33.3(iv) have professional staff familiar with the cultural background of the clinic's 33.4patients;33.5(v) charge for services on a sliding fee scale designed to provide assistance to 33.6low-income patients based on current poverty income guidelines and family size;33.7(vi) do not restrict access or services because of a patient's financial limitations 33.8or public assistance status; and33.9(vii) have free care available as needed;33.10    (2) the level of services provided by the dentist or dental clinic to patients covered 33.11by medical assistance, general assistance medical care, or MinnesotaCare as their primary 33.12source of coverage federally qualified health centers, rural health clinics, and public 33.13health clinics; and33.14    (3) whether the level of services provided by the dentist or dental clinic is critical 33.15to maintaining adequate levels of patient access within the service area county owned 33.16and operated hospital-based dental clinics;33.17(4) a dental clinic or dental group owned and operated by a nonprofit corporation in 33.18accordance with chapter 317A with more than 10,000 patient encounters per year with 33.19patients who are uninsured or covered by medical assistance, general assistance medical 33.20care, or MinnesotaCare; and33.21(5) a dental clinic associated with an oral health or dental education program 33.22operated by the University of Minnesota or an institution within the Minnesota State 33.23Colleges and Universities system.33.24    In the absence of a critical access dental provider in a service area, (c) The 33.25commissioner may designate a dentist or dental clinic as a critical access dental provider 33.26if the dentist or dental clinic is willing to provide care to patients covered by medical 33.27assistance, general assistance medical care, or MinnesotaCare at a level which significantly 33.28increases access to dental care in the service area.33.29EFFECTIVE DATE.This section is effective July 1, 2010.33.30    Sec. 33. Minnesota Statutes 2009 Supplement, section 256B.766, is amended to read: 33.31256B.766 REIMBURSEMENT FOR BASIC CARE SERVICES.33.32(a) Effective for services provided on or after July 1, 2009, total payments for 33.33basic care services, shall be reduced by three percent, prior to third-party liability and 33.34spenddown calculation. This reduction applies to physical therapy services, occupational 34.1therapy services, and speech language pathology and related services provided on or after 34.2July 1, 2010. Effective July 1, 2010, the commissioner shall classify physical therapy 34.3services, occupational therapy services, and speech language pathology and related 34.4services as basic care services. Effective October 1, 2010, payments made to managed care 34.5and county-based purchasing plans shall reflect the July 1, 2010, payment adjustments in 34.6this paragraph. Payments made to managed care plans and county-based purchasing plans 34.7shall be reduced for services provided on or after October 1, 2009, to reflect this reduction.34.8(b) This section does not apply to physician and professional services, inpatient 34.9hospital services, family planning services, mental health services, dental services, 34.10prescription drugs, medical transportation, federally qualified health centers, rural health 34.11centers, Indian health services, and Medicare cost-sharing.34.12    Sec. 34. [256B.767] MEDICARE PAYMENT LIMIT.34.13Effective for services rendered on or after July 1, 2010, fee-for-service payment rates 34.14for physician and professional services under section 256B.76, subdivision 1, and basic 34.15care services subject to the rate reduction specified in section 256B.766, shall not exceed 34.16the Medicare payment rate for the applicable service. The commissioner shall implement 34.17this section after any other rate adjustment that is effective July 1, 2010, and shall reduce 34.18rates under this section by first reducing or eliminating provider rate add-ons.34.19    Sec. 35. Minnesota Statutes 2009 Supplement, section 256D.03, subdivision 3, as 34.20amended by Laws 2010, chapter 200, article 1, section 11, is amended to read:34.21    Subd. 3. General assistance medical care; eligibility. (a) Beginning April 1, 2010, 34.22the general assistance medical care program shall be administered according to section 34.23256D.031
         , unless otherwise stated, except for outpatient prescription drug coverage, 34.24which shall continue to be administered under this section and funded under section 34.25256D.031, subdivision 9
         , beginning June 1, 2010.34.26(b) Outpatient prescription drug coverage under general assistance medical care is 34.27limited to prescription drugs that:34.28(1) are covered under the medical assistance program as described in section 34.29256B.0625, subdivisions 13
          and 13d; and34.30(2) are provided by manufacturers that have fully executed general assistance 34.31medical care rebate agreements with the commissioner and comply with the agreements. 34.32Outpatient prescription drug coverage under general assistance medical care must conform 34.33to coverage under the medical assistance program according to section 
         256B.0625, 34.34subdivisions 13
          to 13g 13h.35.1    (c) Outpatient prescription drug coverage does not include drugs administered in a 35.2clinic or other outpatient setting.35.3(d) For the period beginning April 1, 2010, to May 31, 2010, general assistance 35.4medical care covers the services listed in subdivision 4.35.5EFFECTIVE DATE.This section is effective retroactively from April 1, 2010.35.6    Sec. 36. Minnesota Statutes 2008, section 256D.03, subdivision 3b, is amended to read:35.7    Subd. 3b. Cooperation.(a) General assistance or general assistance medical care35.8applicants and recipients must cooperate with the state and local agency to identify 35.9potentially liable third-party payors and assist the state in obtaining third-party payments. 35.10Cooperation includes identifying any third party who may be liable for care and services 35.11provided under this chapter to the applicant, recipient, or any other family member for 35.12whom application is made and providing relevant information to assist the state in pursuing 35.13a potentially liable third party. General assistance medical care applicants and recipients 35.14must cooperate by providing information about any group health plan in which they may 35.15be eligible to enroll. They must cooperate with the state and local agency in determining 35.16if the plan is cost-effective. For purposes of this subdivision, coverage provided by the 35.17Minnesota Comprehensive Health Association under chapter 62E shall not be considered 35.18group health plan coverage or cost-effective by the state and local agency. If the plan is 35.19determined cost-effective and the premium will be paid by the state or local agency or is 35.20available at no cost to the person, they must enroll or remain enrolled in the group health 35.21plan. Cost-effective insurance premiums approved for payment by the state agency and 35.22paid by the local agency are eligible for reimbursement according to subdivision 6.35.23    (b) Effective for all premiums due on or after June 30, 1997, general assistance 35.24medical care does not cover premiums that a recipient is required to pay under a qualified 35.25or Medicare supplement plan issued by the Minnesota Comprehensive Health Association. 35.26General assistance medical care shall continue to cover premiums for recipients who are 35.27covered under a plan issued by the Minnesota Comprehensive Health Association on June 35.2830, 1997, for a period of six months following receipt of the notice of termination or 35.29until December 31, 1997, whichever is later.35.30EFFECTIVE DATE.This section is effective July 1, 2010.35.31    Sec. 37. Minnesota Statutes 2008, section 256D.031, subdivision 5, as added by Laws 35.322010, chapter 200, article 1, section 12, subdivision 5, is amended to read:36.1    Subd. 5. Payment rates and contract modification; April 1, 2010, to May 3136.2June 30, 2010. (a) For the period April 1, 2010, to May 31 June 30, 2010, general 36.3assistance medical care shall be paid on a fee-for-service basis. Fee-for-service payment 36.4rates for services other than outpatient prescription drugs shall be set at 37 percent of the 36.5payment rate in effect on March 31, 2010, except that for the period June 1, 2010, to June 36.630, 2010, fee-for-service payment rates for services other than prescription drugs shall be 36.7set at 27 percent of the payment rate in effect on March 31, 2010.36.8(b) Outpatient prescription drugs covered under section 
         256D.03, subdivision 36.93
         , provided on or after April 1, 2010, to May 31 June 30, 2010, shall be paid on a 36.10fee-for-service basis according to section 
         256B.0625, subdivisions 13 to 13g.36.11EFFECTIVE DATE.This section is effective the day following final enactment.36.12    Sec. 38. Minnesota Statutes 2009 Supplement, section 256L.03, subdivision 5, is 36.13amended to read:36.14    Subd. 5. Co-payments and coinsurance. (a) Except as provided in paragraphs (b) 36.15and (c), the MinnesotaCare benefit plan shall include the following co-payments and 36.16coinsurance requirements for all enrollees:36.17    (1) ten percent of the paid charges for inpatient hospital services for adult enrollees, 36.18subject to an annual inpatient out-of-pocket maximum of $1,000 per individual;36.19    (2) $3 per prescription for adult enrollees;36.20    (3) $25 for eyeglasses for adult enrollees;36.21    (4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an 36.22episode of service which is required because of a recipient's symptoms, diagnosis, or 36.23established illness, and which is delivered in an ambulatory setting by a physician or 36.24physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse, 36.25audiologist, optician, or optometrist; and36.26    (5) $6 for nonemergency visits to a hospital-based emergency room for services 36.27provided through December 31, 2010, and $3.50 effective January 1, 2011.36.28    (b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of 36.29children under the age of 21.36.30    (c) Paragraph (a) does not apply to pregnant women and children under the age of 21.36.31    (d) Paragraph (a), clause (4), does not apply to mental health services.36.32    (e) Adult enrollees with family gross income that exceeds 200 percent of the federal 36.33poverty guidelines or 215 percent of the federal poverty guidelines on or after July 1, 2009, 36.34and who are not pregnant shall be financially responsible for the coinsurance amount, if 36.35applicable, and amounts which exceed the $10,000 inpatient hospital benefit limit.37.1    (f) When a MinnesotaCare enrollee becomes a member of a prepaid health plan, 37.2or changes from one prepaid health plan to another during a calendar year, any charges 37.3submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket 37.4expenses incurred by the enrollee for inpatient services, that were submitted or incurred 37.5prior to enrollment, or prior to the change in health plans, shall be disregarded.37.6(g) MinnesotaCare reimbursements to fee-for-service providers and payments to 37.7managed care plans or county-based purchasing plans shall not be increased as a result of 37.8the reduction of the co-payments in paragraph (a), clause (5), effective January 1, 2011.37.9EFFECTIVE DATE.This section is effective July 1, 2010.37.10    Sec. 39. Minnesota Statutes 2008, section 256L.11, subdivision 6, is amended to read:37.11    Subd. 6. Enrollees 18 or older. Payment by the MinnesotaCare program for 37.12inpatient hospital services provided to MinnesotaCare enrollees eligible under section 37.13256L.04, subdivision 7
         , or who qualify under section 
         256L.04, subdivisions 1 and 2, 37.14with family gross income that exceeds 175 percent of the federal poverty guidelines 37.15and who are not pregnant, who are 18 years old or older on the date of admission to the 37.16inpatient hospital must be in accordance with paragraphs (a) and (b). Payment for adults 37.17who are not pregnant and are eligible under section 
         256L.04, subdivisions 1 and 2, and 37.18whose incomes are equal to or less than 175 percent of the federal poverty guidelines, 37.19shall be as provided for under paragraph (c). 37.20(a) If the medical assistance rate minus any co-payment required under section 37.21256L.03, subdivision 4
         , is less than or equal to the amount remaining in the enrollee's 37.22benefit limit under section 
         256L.03, subdivision 3, payment must be the medical 37.23assistance rate minus any co-payment required under section 
         256L.03, subdivision 4. The 37.24hospital must not seek payment from the enrollee in addition to the co-payment. The 37.25MinnesotaCare payment plus the co-payment must be treated as payment in full. 37.26(b) If the medical assistance rate minus any co-payment required under section 37.27256L.03, subdivision 4
         , is greater than the amount remaining in the enrollee's benefit limit 37.28under section 
         256L.03, subdivision 3, payment must be the lesser of: 37.29(1) the amount remaining in the enrollee's benefit limit; or37.30(2) charges submitted for the inpatient hospital services less any co-payment 37.31established under section 
         256L.03, subdivision 4. 37.32The hospital may seek payment from the enrollee for the amount by which usual and 37.33customary charges exceed the payment under this paragraph. If payment is reduced under 37.34section 
         256L.03, subdivision 3, paragraph (b), the hospital may not seek payment from the 37.35enrollee for the amount of the reduction. 38.1(c) For admissions occurring during the period of July 1, 1997, through June 30, 38.21998, for adults who are not pregnant and are eligible under section 256L.04, subdivisions 38.31 and 2, and whose incomes are equal to or less than 175 percent of the federal poverty 38.4guidelines, the commissioner shall pay hospitals directly, up to the medical assistance 38.5payment rate, for inpatient hospital benefits in excess of the $10,000 annual inpatient 38.6benefit limit. For admissions occurring on or after July 1, 2011, for single adults and 38.7households without children who are eligible under section 256L.04, subdivision 7, the 38.8commissioner shall pay hospitals directly, up to the medical assistance payment rate, for 38.9inpatient hospital benefits up to the $10,000 annual inpatient benefit limit, minus any 38.10co-payment required under section 256L.03, subdivision 5.38.11    Sec. 40. Minnesota Statutes 2008, section 256L.07, is amended by adding a subdivision 38.12to read:38.13    Subd. 9.Firefighters; volunteer ambulance attendants.(a) For purposes of this 38.14subdivision, "qualified individual" means:38.15(1) a volunteer firefighter with a department as defined in section 299N.01, 38.16subdivision 2, who has passed the probationary period; and38.17(2) a volunteer ambulance attendant as defined in section 144E.001, subdivision 15.38.18(b) A qualified individual who documents to the satisfaction of the commissioner 38.19status as a qualified individual by completing and submitting a one-page form developed 38.20by the commissioner is eligible for MinnesotaCare without meeting other eligibility 38.21requirements of this chapter, but must pay premiums equal to the average expected 38.22capitation rate for adults with no children paid under section 256L.12. Individuals eligible 38.23under this subdivision shall receive coverage for the benefit set provided to adults with no 38.24children.38.25EFFECTIVE DATE.This section is effective April 1, 2011.38.26    Sec. 41. Minnesota Statutes 2008, section 256L.12, subdivision 5, is amended to read:38.27    Subd. 5. Eligibility for other state programs. MinnesotaCare enrollees who 38.28become eligible for medical assistance or general assistance medical care will remain in 38.29the same managed care plan if the managed care plan has a contract for that population. 38.30Effective January 1, 1998, MinnesotaCare enrollees who were formerly eligible for 38.31general assistance medical care pursuant to section 
         256D.03, subdivision 3, within six 38.32months of MinnesotaCare enrollment and were enrolled in a prepaid health plan pursuant 38.33to section 
         256D.03, subdivision 4, paragraph (c), must remain in the same managed care 38.34plan if the managed care plan has a contract for that population. Managed care plans must 39.1participate in the MinnesotaCare and general assistance medical care programsprogram 39.2under a contract with the Department of Human Services in service areas where they 39.3participate in the medical assistance program.  39.4EFFECTIVE DATE.This section is effective retroactively from April 1, 2010.39.5    Sec. 42. Minnesota Statutes 2008, section 256L.12, subdivision 9, is amended to read:39.6    Subd. 9. Rate setting; performance withholds. (a) Rates will be prospective, 39.7per capita, where possible. The commissioner may allow health plans to arrange for 39.8inpatient hospital services on a risk or nonrisk basis. The commissioner shall consult with 39.9an independent actuary to determine appropriate rates.39.10    (b) For services rendered on or after January 1, 2003, to December 31, 2003, the 39.11commissioner shall withhold .5 percent of managed care plan payments under this section 39.12pending completion of performance targets. The withheld funds must be returned no 39.13sooner than July 1 and no later than July 31 of the following year if performance targets 39.14in the contract are achieved. A managed care plan may include as admitted assets under 39.15section 62D.044 any amount withheld under this paragraph that is reasonably expected 39.16to be returned. 39.17    (c) For services rendered on or after January 1, 2004, the commissioner shall 39.18withhold five percent of managed care plan payments and county-based purchasing 39.19plan payments under this section pending completion of performance targets. Each 39.20performance target must be quantifiable, objective, measurable, and reasonably attainable, 39.21except in the case of a performance target based on a federal or state law or rule. Criteria 39.22for assessment of each performance target must be outlined in writing prior to the 39.23contract effective date. The managed care plan must demonstrate, to the commissioner's 39.24satisfaction, that the data submitted regarding attainment of the performance target is 39.25accurate. The commissioner shall periodically change the administrative measures used 39.26as performance targets in order to improve plan performance across a broader range of 39.27administrative services. The performance targets must include measurement of plan 39.28efforts to contain spending on health care services and administrative activities. The 39.29commissioner may adopt plan-specific performance targets that take into account factors 39.30affecting only one plan, such as characteristics of the plan's enrollee population. The 39.31withheld funds must be returned no sooner than July 1 and no later than July 31 of the 39.32following calendar year if performance targets in the contract are achieved. A managed 39.33care plan or a county-based purchasing plan under section 256B.692 may include as 39.34admitted assets under section 62D.044 any amount withheld under this paragraph that is 39.35reasonably expected to be returned.40.1(c) For services rendered on or after January 1, 2011, the commissioner shall 40.2withhold an additional three percent of managed care plan or county-based purchasing 40.3plan payments under this section. The withheld funds must be returned no sooner than 40.4July 1 and no later than July 31 of the following calendar year. The return of the withhold 40.5under this paragraph is not subject to the requirements of paragraph (b).40.6(d) Effective for services rendered on or after January 1, 2011, the commissioner 40.7shall include as part of the performance targets described in paragraph (b) a reduction in 40.8the plan's emergency room utilization rate for state health care program enrollees by a 40.9measurable rate of five percent from the plan's utilization rate for the previous calendar 40.10year.40.11The withheld funds must be returned no sooner than July 1 and no later than July 40.1231 of the following calendar year if the managed care plan or county-based purchasing 40.13plan demonstrates to the satisfaction of the commissioner that a reduction in the utilization 40.14rate was achieved.40.15The withhold described in this paragraph shall continue for each consecutive 40.16contract period until the plan's emergency room utilization rate for state health care 40.17program enrollees is reduced by 25 percent of the plan's emergency room utilization rate 40.18for state health care program enrollees for calendar year 2009. Hospitals shall cooperate 40.19with the health plans in meeting this performance target and shall accept payment 40.20withholds that may be returned to the hospitals if the performance target is achieved. The 40.21commissioner shall structure the withhold so that the commissioner returns a portion of 40.22the withheld funds in amounts commensurate with achieved reductions in utilization less 40.23than the targeted amount. The withhold described in this paragraph does not apply to 40.24county-based purchasing plans.40.25(e) A managed care plan or a county-based purchasing plan under section 256B.692 40.26may include as admitted assets under section 62D.044 any amount withheld under this 40.27section that is reasonably expected to be returned.40.28EFFECTIVE DATE.This section is effective July 1, 2010.40.29    Sec. 43. Minnesota Statutes 2008, section 256L.12, is amended by adding a subdivision 40.30to read:40.31    Subd. 9c.Rate setting; increase effective October 1, 2010.For services 40.32rendered on or after October 1, 2010, the total payment made to managed care plans and 40.33county-based purchasing plans under MinnesotaCare for families with children shall be 40.34increased by 1.28 percent.41.1EFFECTIVE DATE.This section is effective July 1, 2010.41.2    Sec. 44. Laws 2009, chapter 79, article 5, section 75, subdivision 1, is amended to read:41.3    Subdivision 1. Medical assistance coverage. The commissioner of human services 41.4shall establish a demonstration project to provide additional medical assistance coverage 41.5for a maximum of 200 American Indian children in Minneapolis, St. Paul, and Duluth 41.6who are burdened by health disparities associated with the cumulative health impact 41.7of toxic environmental exposures. Under this demonstration project, the additional 41.8medical assistance coverage for this population must include, but is not limited to, home 41.9environmental assessments for triggers of asthma, and in-home asthma education on the 41.10proper medical management of asthma by a certified asthma educator or public health 41.11nurse with asthma management training, and must be limited to two visits per child. The 41.12home visit payment rates must be based on a rate commensurate with a first-time visit rate 41.13and follow-up visit rate. Coverage also includes the following durable medical equipment: 41.14high efficiency particulate air (HEPA) cleaners, HEPA vacuum cleaners, allergy bed and 41.15pillow encasements, high filtration filters for forced air gas furnaces, and dehumidifiers 41.16with medical tubing to connect the appliance to a floor drain, if the listed item is medically 41.17necessaryuseful to reduce asthma symptoms. Provision of these items of durable medical 41.18equipment must be preceded by a home environmental assessment for triggers of asthma 41.19and in-home asthma education on the proper medical management of asthma by a Certified 41.20Asthma Educator or public health nurse with asthma management training.41.21    Sec. 45. Laws 2009, chapter 79, article 5, section 78, subdivision 5, is amended to read:41.22    Subd. 5. Expiration. This section, with the exception of subdivision 4, expires 41.23December 31, 2010 August 31, 2011. Subdivision 4 expires February 28, 2012.41.24    Sec. 46. Laws 2010, chapter 200, article 1, section 12, the effective date, is amended to 41.25read:41.26EFFECTIVE DATE.This section, except for subdivision 4,  is effective for services 41.27rendered on or after April 1, 2010. Subdivision 4 of this section is effective June 1, 2010.41.28EFFECTIVE DATE.This section is effective the day following final enactment.41.29    Sec. 47. Laws 2010, chapter 200, article 1, section 16, is amended by adding an 41.30effective date to read:41.31EFFECTIVE DATE.This section is effective June 1, 2010.42.1    Sec. 48. Laws 2010, chapter 200, article 1, section 21, is amended to read:42.2    Sec. 21. REPEALER.42.3(a) Minnesota Statutes 2008, sections 256.742; 256.979, subdivision 8; and 256D.03, 42.4subdivision 9, are repealed effective April 1, 2010.42.5(b) Minnesota Statutes 2009 Supplement, section 256D.03, subdivision 4, is repealed 42.6effective April June 1, 2010.42.7(c) Minnesota Statutes 2008, section 256B.195, subdivisions 4 and 5, are repealed 42.8effective for federal fiscal year 2010.42.9(d) Minnesota Statutes 2009 Supplement, section 256B.195, subdivisions 1, 2, and 42.103, are repealed effective for federal fiscal year 2010.42.11(e) Minnesota Statutes 2008, sections 256L.07, subdivision 6; 256L.15, subdivision 42.124; and 256L.17, subdivision 7, are repealed January 1, 2011 July 1, 2010.42.13EFFECTIVE DATE.This section is effective retroactively from April 1, 2010.42.14    Sec. 49. Laws 2010, chapter 200, article 2, section 2, subdivision 1, is amended to read:

42.15Subdivision 1.Total Appropriation$(7,985,000)$(93,128,000)

42.16Appropriations by Fund42.172010201142.18General34,807,000118,493,00042.19Health Care Access(42,792,000)(211,621,000)

42.20The amounts that may be spent for each 42.21purpose are specified in the following 42.22subdivisions.42.23Special Revenue Fund Transfers.42.24(a) The commissioner shall transfer the 42.25following amounts from special revenue 42.26fund balances to the general fund by June 42.2730 of each respective fiscal year: $410,000 42.28for fiscal year 2010, and $412,000 for fiscal 42.29year 2011.42.30(b) Actual transfers made under paragraph 42.31(a) must be separately identified and reported 42.32as part of the quarterly reporting of transfers 42.33to the chairs of the relevant senate budget 43.1division and house of representatives finance 43.2division.43.3EFFECTIVE DATE.This section is effective the day following final enactment.43.4    Sec. 50. Laws 2010, chapter 200, article 2, section 2, subdivision 5, is amended to read:

43.5Subd. 5.Health Care Management

43.6The amounts that may be spent from the 43.7appropriation for each purpose are as follows:

43.8Health Care Administration.(2,998,000)(5,270,000)

43.9Base Adjustment. The general fund base 43.10for health care administration is reduced by 43.11$182,000 $36,000  in fiscal year 2012 and 43.12$182,000 $36,000  in fiscal year 2013.43.13    Sec. 51. Laws 2010, chapter 200, article 2, section 2, subdivision 8, is amended to read:

43.14Subd. 8.Transfers

43.15The commissioner must transfer $29,538,000 43.16in fiscal year 2010 and $18,462,000 in fiscal 43.17year 2011 from the health care access fund to 43.18the general fund. This is a onetime transfer.43.19The commissioner must transfer $4,800,000 43.20from the consolidated chemical dependency 43.21treatment fund to the general fund by June 43.2230, 2010.43.23Compulsive Gambling Special Revenue43.24Administration.The lottery prize fund 43.25appropriation for compulsive gambling 43.26administration is reduced by $6,000 for fiscal 43.27year 2010 and $4,000 for fiscal year 201143.28must be transferred from the lottery prize 43.29fund appropriation for compulsive gambling 43.30administration to the general fund by June 44.130 of each respective fiscal year. These are 44.2onetime reductions.44.3EFFECTIVE DATE.This section is effective the day following final enactment.44.4    Sec. 52. PREPAID HEALTH PLAN RATES.44.5In negotiating the prepaid health plan contract rates for services rendered on or 44.6after January 1, 2011, the commissioner of human services shall take into consideration 44.7and the rates shall reflect the anticipated savings in the medical assistance program due 44.8to extending medical assistance coverage to services provided in licensed birth centers, 44.9the anticipated use of these services within the medical assistance population, and the 44.10reduced medical assistance costs associated with the use of birth centers for normal, 44.11low-risk deliveries.44.12EFFECTIVE DATE.This section is effective July 1, 2010.44.13    Sec. 53. STATE PLAN AMENDMENT; FEDERAL APPROVAL.44.14The commissioner of human services shall submit a Medicaid state plan amendment 44.15to receive federal fund participation for adults without children whose income is equal 44.16to or less than 75 percent of federal poverty guidelines in accordance with the Patient 44.17Protection and Affordable Care Act, Public Law 111-148, or the Health Care and 44.18Education Reconciliation Act of 2010, Public Law 111-152. The effective date of the 44.19state plan amendment shall be June 1, 2010.44.20EFFECTIVE DATE.This section is effective the day following final enactment.44.21    Sec. 54. UPPER PAYMENT LIMIT REPORT.44.22Each January 15, beginning in 2011, the commissioner of human services shall 44.23report the following information to the chairs of the house of representatives and senate 44.24finance committees and divisions with responsibility for human services appropriations:44.25(1) the estimated room within the Medicare hospital upper payment limit for the 44.26federal year beginning on October 1 of the year the report is made;44.27(2) the amount of a rate increase under Minnesota Statutes, section 256.969, 44.28subdivision 3a, paragraph (i), that would increase medical assistance hospital spending 44.29to the upper payment limit; and44.30(3) the amount of a surcharge increase under Minnesota Statutes, section 256.9657, 44.31subdivision 2, needed to generate the state share of the potential rate increase under 44.32clause (2).45.1EFFECTIVE DATE.This section is effective July 1, 2010.45.2    Sec. 55. REVISOR'S INSTRUCTION.45.3The revisor of statutes shall edit Minnesota Statutes and Minnesota Rules to remove 45.4references to the general assistance medical care program and references to Minnesota 45.5Statutes, section 256D.03, subdivision 3, or Minnesota Statutes, chapter 256D, as it 45.6pertains to general assistance medical care and make other changes as may be necessary 45.7to remove references to the general assistance medical care program. The revisor may 45.8consult with the Department of Human Services when making editing decisions on the 45.9removal of these references.45.10    Sec. 56.  REPEALER.45.11(a) Minnesota Statutes 2008, section 256D.03, subdivisions 3, 3a, 5, 6, 7, and 8,45.12are repealed July 1, 2010.45.13(b) Laws 2010, chapter 200, article 1, sections 12; 18; and 19, are repealed July 45.141, 2010.45.15EFFECTIVE DATE.This section is effective the day following final enactment.45.16ARTICLE 245.17CONTINUING CARE45.18    Section 1. Minnesota Statutes 2008, section 144D.03, subdivision 2, is amended to 45.19read:45.20    Subd. 2. Registration information. The establishment shall provide the following 45.21information to the commissioner in order to be registered:45.22(1) the business name, street address, and mailing address of the establishment;45.23(2) the name and mailing address of the owner or owners of the establishment and, if 45.24the owner or owners are not natural persons, identification of the type of business entity 45.25of the owner or owners, and the names and addresses of the officers and members of the 45.26governing body, or comparable persons for partnerships, limited liability corporations, or 45.27other types of business organizations of the owner or owners;45.28(3) the name and mailing address of the managing agent, whether through 45.29management agreement or lease agreement, of the establishment, if different from the 45.30owner or owners, and the name of the on-site manager, if any;45.31(4) verification that the establishment has entered into  a housing with services 45.32contract, as required in section  144D.04, with each resident or resident's representative; 46.1(5) verification that the establishment is complying with the requirements of section 46.2325F.72
         , if applicable; 46.3(6) the name and address of at least one natural person who shall be responsible 46.4for dealing with the commissioner on all matters provided for in sections  144D.01 to  46.5144D.06, and on whom personal service of all notices and orders shall be made, and who 46.6shall be authorized to accept service on behalf of the owner or owners and the managing 46.7agent, if any; and46.8(7) the signature of the authorized representative of the owner or owners or, if 46.9the owner or owners are not natural persons, signatures of at least two authorized 46.10representatives of each owner, one of which shall be an officer of the owner; and46.11(8) whether services are included in the base rate to be paid by the resident.46.12Personal service on the person identified under clause (6) by the owner or owners in 46.13the registration shall be considered service on the owner or owners, and it shall not be a 46.14defense to any action that personal service was not made on each individual or entity. The 46.15designation of one or more individuals under this subdivision shall not affect the legal 46.16responsibility of the owner or owners under sections  144D.01 to  144D.06. 46.17    Sec. 2. Minnesota Statutes 2008, section 144D.03, is amended by adding a subdivision 46.18to read:46.19    Subd. 3.Certificate of transitional consultation.(a) A housing with services 46.20establishment shall not execute a contract or allow a prospective resident to move in until 46.21the establishment has received certification from the Senior LinkAge Line that transition 46.22to housing with services consultation under section 256B.0911, subdivision 3c, has been 46.23completed. Prospective residents may be allowed to move in on an emergency basis prior 46.24to receiving a certificate, however, the certification must occur within 30 calendar days of 46.25admission. The housing with services establishment shall maintain copies of contracts and 46.26certificates for audit for a period of three years. The Senior LinkAge Line shall issue a 46.27certification within 24 hours of a contact by a prospective resident.46.28(b) This subdivision applies to housing with services establishments that are required 46.29to register under section 144D.02 and:46.30(1) include any service in the base rate as described in the contract established 46.31under section 144D.04; or46.32(2) require residents to purchase services as a condition of tenancy.46.33    Sec. 3. Minnesota Statutes 2008, section 144D.04, subdivision 2, is amended to read:47.1    Subd. 2. Contents of contract.  A housing with services contract, which need not be 47.2entitled as such to comply with this section, shall include at least the following elements 47.3in itself or through supporting documents or attachments:47.4(1) the name, street address, and mailing address of the establishment;47.5(2) the name and mailing address of the owner or owners of the establishment and, if 47.6the owner or owners is not a natural person, identification of the type of business entity 47.7of the owner or owners;47.8(3) the name and mailing address of the managing agent, through management 47.9agreement or lease agreement, of the establishment, if different from the owner or owners;47.10(4) the name and address of at least one natural person who is authorized to accept 47.11service of process on behalf of the owner or owners and managing agent;47.12(5) a statement describing the registration and licensure status of the establishment 47.13and any provider providing health-related or supportive services under an arrangement 47.14with the establishment;47.15(6) the term of the contract;47.16(7) a description of the services to be provided to the resident in the base rate to be 47.17paid by resident, including a delineation of the portion of the base rate that constitutes rent 47.18and a delineation of charges for each service included in the base rate;47.19(8) a description of any additional services, including home care services, available 47.20for an additional fee from the establishment directly or through arrangements with the 47.21establishment, and a schedule of fees charged for these services;47.22(9) a description of the process through which the contract may be modified, 47.23amended, or terminated;47.24(10) a description of the establishment's complaint resolution process available 47.25to residents including the toll-free complaint line for the Office of Ombudsman for 47.26Long-Term Care;47.27(11) the resident's designated representative, if any;47.28(12) the establishment's referral procedures if the contract is terminated;47.29(13) requirements of residency used by the establishment to determine who may 47.30reside or continue to reside in the  housing with services establishment;47.31(14) billing and payment procedures and requirements;47.32(15) a statement regarding the ability of residents to receive services from service 47.33providers with whom the establishment does not have an arrangement; 47.34(16) a statement regarding the availability of public funds for payment for residence 47.35or services in the establishment; and48.1(17) a statement regarding the availability of and contact information for 48.2long-term care consultation services under section 
         256B.0911 in the county in which the 48.3establishment is located.48.4    Sec. 4. [144D.08] UNIFORM CONSUMER INFORMATION GUIDE.48.5All housing with services establishments shall make available to all prospective 48.6and current residents information consistent with the uniform format and the required 48.7components adopted by the commissioner under section 144G.06.48.8    Sec. 5. [144D.09] TERMINATION OF LEASE.48.9The housing with services establishment shall include with notice of termination 48.10of lease information about how to contact the ombudsman for long-term care, including 48.11the address and phone number along with a statement of how to request problem-solving 48.12assistance.48.13    Sec. 6. Minnesota Statutes 2008, section 144G.06, is amended to read:48.14144G.06 UNIFORM CONSUMER INFORMATION GUIDE.48.15(a) The commissioner of health shall establish an advisory committee consisting 48.16of representatives of consumers, providers, county and state officials, and other 48.17groups the commissioner considers appropriate. The advisory committee shall present 48.18recommendations to the commissioner on:48.19(1) a format for a guide to be used by individual providers of assisted living, as 48.20defined in section 
         144G.01, that includes information about services offered by that 48.21provider, which services may be covered by Medicare, service costs, and other relevant 48.22provider-specific information, as well as a statement of philosophy and values associated 48.23with assisted living, presented in uniform categories that facilitate comparison with guides 48.24issued by other providers; and48.25(2) requirements for informing assisted living clients, as defined in section 
         144G.01, 48.26of their applicable legal rights.48.27(b) The commissioner, after reviewing the recommendations of the advisory 48.28committee, shall adopt a uniform format for the guide to be used by individual providers, 48.29and the required components of materials to be used by providers to inform assisted 48.30living clients of their legal rights, and shall make the uniform format and the required 48.31components available to assisted living providers.49.1    Sec. 7. Minnesota Statutes 2009 Supplement, section 252.27, subdivision 2a, is 49.2amended to read:49.3    Subd. 2a. Contribution amount. (a) The natural or adoptive parents of a minor 49.4child, including a child determined eligible for medical assistance without consideration of 49.5parental income, must contribute to the cost of services used by making monthly payments 49.6on a sliding scale based on income, unless the child is married or has been married, 49.7parental rights have been terminated, or the child's adoption is subsidized according to 49.8section 
         259.67 or through title IV-E of the Social Security Act. The parental contribution 49.9is a partial or full payment for medical services provided for diagnostic, therapeutic, 49.10curing, treating, mitigating, rehabilitation, maintenance, and personal care services as 49.11defined in United States Code, title 26, section 213, needed by the child with a chronic 49.12illness or disability.49.13    (b) For households with adjusted gross income equal to or greater than 100 percent 49.14of federal poverty guidelines, the parental contribution shall be computed by applying the 49.15following schedule of rates to the adjusted gross income of the natural or adoptive parents:49.16    (1) if the adjusted gross income is equal to or greater than 100 percent of federal 49.17poverty guidelines and less than 175 percent of federal poverty guidelines, the parental 49.18contribution is $4 per month;49.19    (2) if the adjusted gross income is equal to or greater than 175 percent of federal 49.20poverty guidelines and less than or equal to 545 percent of federal poverty guidelines, 49.21the parental contribution shall be determined using a sliding fee scale established by the 49.22commissioner of human services which begins at one percent of adjusted gross income 49.23at 175 percent of federal poverty guidelines and increases to 7.5 percent of adjusted 49.24gross income for those with adjusted gross income up to 545 percent of federal poverty 49.25guidelines;49.26    (3) if the adjusted gross income is greater than 545 percent of federal poverty 49.27guidelines and less than 675 percent of federal poverty guidelines, the parental 49.28contribution shall be 7.5 percent of adjusted gross income;49.29    (4) if the adjusted gross income is equal to or greater than 675 percent of federal 49.30poverty guidelines and less than 975 percent of federal poverty guidelines, the parental 49.31contribution shall be determined using a sliding fee scale established by the commissioner 49.32of human services which begins at 7.5 percent of adjusted gross income at 675 percent of 49.33federal poverty guidelines and increases to ten percent of adjusted gross income for those 49.34with adjusted gross income up to 975 percent of federal poverty guidelines; and50.1    (5) if the adjusted gross income is equal to or greater than 975 percent of federal 50.2poverty guidelines, the parental contribution shall be 12.5 percent of adjusted gross 50.3income.50.4    If the child lives with the parent, the annual adjusted gross income is reduced by 50.5$2,400 prior to calculating the parental contribution. If the child resides in an institution 50.6specified in section 
         256B.35, the parent is responsible for the personal needs allowance 50.7specified under that section in addition to the parental contribution determined under this 50.8section. The parental contribution is reduced by any amount required to be paid directly to 50.9the child pursuant to a court order, but only if actually paid.50.10    (c) The household size to be used in determining the amount of contribution under 50.11paragraph (b) includes natural and adoptive parents and their dependents, including the 50.12child receiving services. Adjustments in the contribution amount due to annual changes 50.13in the federal poverty guidelines shall be implemented on the first day of July following 50.14publication of the changes.50.15    (d) For purposes of paragraph (b), "income" means the adjusted gross income of the 50.16natural or adoptive parents determined according to the previous year's federal tax form, 50.17except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds 50.18have been used to purchase a home shall not be counted as income.50.19    (e) The contribution shall be explained in writing to the parents at the time eligibility 50.20for services is being determined. The contribution shall be made on a monthly basis 50.21effective with the first month in which the child receives services. Annually upon 50.22redetermination or at termination of eligibility, if the contribution exceeded the cost of 50.23services provided, the local agency or the state shall reimburse that excess amount to 50.24the parents, either by direct reimbursement if the parent is no longer required to pay a 50.25contribution, or by a reduction in or waiver of parental fees until the excess amount is 50.26exhausted. All reimbursements must include a notice that the amount reimbursed may be 50.27taxable income if the parent paid for the parent's fees through an employer's health care 50.28flexible spending account under the Internal Revenue Code, section 125, and that the 50.29parent is responsible for paying the taxes owed on the amount reimbursed.50.30    (f) The monthly contribution amount must be reviewed at least every 12 months; 50.31when there is a change in household size; and when there is a loss of or gain in income 50.32from one month to another in excess of ten percent. The local agency shall mail a written 50.33notice 30 days in advance of the effective date of a change in the contribution amount. 50.34A decrease in the contribution amount is effective in the month that the parent verifies a 50.35reduction in income or change in household size.51.1    (g) Parents of a minor child who do not live with each other shall each pay the 51.2contribution required under paragraph (a). An amount equal to the annual court-ordered 51.3child support payment actually paid on behalf of the child receiving services shall be 51.4deducted from the adjusted gross income of the parent making the payment prior to 51.5calculating the parental contribution under paragraph (b).51.6    (h) The contribution under paragraph (b) shall be increased by an additional five 51.7percent if the local agency determines that insurance coverage is available but not 51.8obtained for the child. For purposes of this section, "available" means the insurance is a 51.9benefit of employment for a family member at an annual cost of no more than five percent 51.10of the family's annual income. For purposes of this section, "insurance" means health 51.11and accident insurance coverage, enrollment in a nonprofit health service plan, health 51.12maintenance organization, self-insured plan, or preferred provider organization.51.13    Parents who have more than one child receiving services shall not be required 51.14to pay more than the amount for the child with the highest expenditures. There shall 51.15be no resource contribution from the parents. The parent shall not be required to pay 51.16a contribution in excess of the cost of the services provided to the child, not counting 51.17payments made to school districts for education-related services. Notice of an increase in 51.18fee payment must be given at least 30 days before the increased fee is due.51.19    (i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if, 51.20in the 12 months prior to July 1:51.21    (1) the parent applied for insurance for the child;51.22    (2) the insurer denied insurance;51.23    (3) the parents submitted a complaint or appeal, in writing to the insurer, submitted 51.24a complaint or appeal, in writing, to the commissioner of health or the commissioner of 51.25commerce, or litigated the complaint or appeal; and51.26    (4) as a result of the dispute, the insurer reversed its decision and granted insurance.51.27    For purposes of this section, "insurance" has the meaning given in paragraph (h).51.28    A parent who has requested a reduction in the contribution amount under this 51.29paragraph shall submit proof in the form and manner prescribed by the commissioner or 51.30county agency, including, but not limited to, the insurer's denial of insurance, the written 51.31letter or complaint of the parents, court documents, and the written response of the insurer 51.32approving insurance. The determinations of the commissioner or county agency under this 51.33paragraph are not rules subject to chapter 14.51.34(j) Notwithstanding paragraph (b), for the period from July 1, 2010, to June 30, 51.352013, the parental contribution shall be computed by applying the following contribution 51.36schedule to the adjusted gross income of the natural or adoptive parents:52.1(1) if the adjusted gross income is equal to or greater than 100 percent of federal 52.2poverty guidelines and less than 175 percent of federal poverty guidelines, the parental 52.3contribution is $4 per month;52.4(2) if the adjusted gross income is equal to or greater than 175 percent of federal 52.5poverty guidelines and less than or equal to 525 percent of federal poverty guidelines, 52.6the parental contribution shall be determined using a sliding fee scale established by the 52.7commissioner of human services which begins at one percent of adjusted gross income 52.8at 175 percent of federal poverty guidelines and increases to eight percent of adjusted 52.9gross income for those with adjusted gross income up to 525 percent of federal poverty 52.10guidelines;52.11(3) if the adjusted gross income is greater than 525 percent of federal poverty 52.12guidelines and less than 675 percent of federal poverty guidelines, the parental contribution 52.13shall be 9.5 percent of adjusted gross income;52.14(4) if the adjusted gross income is equal to or greater than 675 percent of federal 52.15poverty guidelines and less than 900 percent of federal poverty guidelines, the parental 52.16contribution shall be determined using a sliding fee scale established by the commissioner 52.17of human services which begins at 9.5 percent of adjusted gross income at 675 percent of 52.18federal poverty guidelines and increases to 12 percent of adjusted gross income for those 52.19with adjusted gross income up to 900 percent of federal poverty guidelines; and52.20(5) if the adjusted gross income is equal to or greater than 900 percent of federal 52.21poverty guidelines, the parental contribution shall be 13.5 percent of adjusted gross 52.22income. If the child lives with the parent, the annual adjusted gross income is reduced by 52.23$2,400 prior to calculating the parental contribution. If the child resides in an institution 52.24specified in section 256B.35, the parent is responsible for the personal needs allowance 52.25specified under that section in addition to the parental contribution determined under this 52.26section. The parental contribution is reduced by any amount required to be paid directly to 52.27the child pursuant to a court order, but only if actually paid.52.28    Sec. 8. [256.4825] REPORT REGARDING PROGRAMS AND SERVICES FOR 52.29PEOPLE WITH DISABILITIES.52.30The Minnesota State Council on Disability, the Minnesota Consortium for Citizens 52.31with Disabilities, and the Arc of Minnesota may submit an annual report by January 15 of 52.32each year, beginning in 2012, to the chairs and ranking minority members of the legislative 52.33committees with jurisdiction over programs serving people with disabilities as provided in 52.34this section. The report must describe the existing state policies and goals for programs 52.35serving people with disabilities including, but not limited to, programs for employment, 53.1transportation, housing, education, quality assurance, consumer direction, physical and 53.2programmatic access, and health. The report must provide data and measurements to 53.3assess the extent to which the policies and goals are being met. The commissioner of 53.4human services and the commissioners of other state agencies administering programs for 53.5people with disabilities shall cooperate with the Minnesota State Council on Disability, 53.6the Minnesota Consortium for Citizens with Disabilities, and the Arc of Minnesota and 53.7provide those organizations with existing published information and reports that will assist 53.8in the preparation of the report.53.9    Sec. 9. Minnesota Statutes 2008, section 256.9657, subdivision 3a, is amended to read:53.10    Subd. 3a. ICF/MR license surcharge.(a) Effective July 1, 2003, each 53.11non-state-operated facility as defined under section 
         256B.501, subdivision 1, shall pay 53.12to the commissioner an annual surcharge according to the schedule in subdivision 4, 53.13paragraph (d). The annual surcharge shall be $1,040 per licensed bed. If the number of 53.14licensed beds is reduced, the surcharge shall be based on the number of remaining licensed 53.15beds the second month following the receipt of timely notice by the commissioner of 53.16human services that beds have been delicensed. The facility must notify the commissioner 53.17of health in writing when beds are delicensed. The commissioner of health must notify 53.18the commissioner of human services within ten working days after receiving written 53.19notification. If the notification is received by the commissioner of human services by 53.20the 15th of the month, the invoice for the second following month must be reduced to 53.21recognize the delicensing of beds. The commissioner may reduce, and may subsequently 53.22restore, the surcharge under this subdivision based on the commissioner's determination of 53.23a permissible surcharge. 53.24(b) Effective July 1, 2010, the surcharge under paragraph (a) is increased to $4,037 53.25per licensed bed.53.26    Sec. 10. Minnesota Statutes 2009 Supplement, section 256.975, subdivision 7, is 53.27amended to read:53.28    Subd. 7. Consumer information and assistance and long-term care options 53.29counseling; Senior LinkAge Line. (a) The Minnesota Board on Aging shall operate a 53.30statewide service to aid older Minnesotans and their families in making informed choices 53.31about long-term care options and health care benefits. Language services to persons with 53.32limited English language skills may be made available. The service, known as Senior 53.33LinkAge Line, must be available during business hours through a statewide toll-free 53.34number and must also be available through the Internet.54.1    (b) The service must provide long-term care options counseling by assisting older 54.2adults, caregivers, and providers in accessing information and options counseling about 54.3choices in long-term care services that are purchased through private providers or available 54.4through public options. The service must:54.5    (1) develop a comprehensive database that includes detailed listings in both 54.6consumer- and provider-oriented formats;54.7    (2) make the database accessible on the Internet and through other telecommunication 54.8and media-related tools;54.9    (3) link callers to interactive long-term care screening tools and make these tools 54.10available through the Internet by integrating the tools with the database;54.11    (4) develop community education materials with a focus on planning for long-term 54.12care and evaluating independent living, housing, and service options;54.13    (5) conduct an outreach campaign to assist older adults and their caregivers in 54.14finding information on the Internet and through other means of communication;54.15    (6) implement a messaging system for overflow callers and respond to these callers 54.16by the next business day;54.17    (7) link callers with county human services and other providers to receive more 54.18in-depth assistance and consultation related to long-term care options;54.19    (8) link callers with quality profiles for nursing facilities and other providers 54.20developed by the commissioner of health;54.21    (9) incorporate information about the availability of housing options, as well as 54.22registered housing with services and consumer rights within the MinnesotaHelp.info 54.23network long-term care database to facilitate consumer comparison of services and costs 54.24among housing with services establishments and with other in-home services and to 54.25support financial self-sufficiency as long as possible. Housing with services establishments 54.26and their arranged home care providers shall provide information to the commissioner of 54.27human services that is consistent with information required by the commissioner of health 54.28under section 144G.06, the Uniform Consumer Information Guide that will facilitate price 54.29comparisons, including delineation of charges for rent and for services available. The 54.30commissioners of health and human services shall align the data elements required by 54.31section 144G.06, the Uniform Consumer Information Guide, and this section to provide 54.32consumers standardized information and ease of comparison of long-term care options. 54.33The commissioner of human services shall provide the data to the Minnesota Board on 54.34Aging for inclusion in the MinnesotaHelp.info network long-term care database;54.35(10) provide long-term care options counseling. Long-term care options counselors 54.36shall:55.1(i) for individuals not eligible for case management under a public program or public 55.2funding source, provide interactive decision support under which consumers, family 55.3members, or other helpers are supported in their deliberations to determine appropriate 55.4long-term care choices in the context of the consumer's needs, preferences, values, and 55.5individual circumstances, including implementing a community support plan;55.6(ii) provide Web-based educational information and collateral written materials to 55.7familiarize consumers, family members, or other helpers with the long-term care basics, 55.8issues to be considered, and the range of options available in the community;55.9(iii) provide long-term care futures planning, which means providing assistance to 55.10individuals who anticipate having long-term care needs to develop a plan for the more 55.11distant future; and55.12(iv) provide expertise in benefits and financing options for long-term care, including 55.13Medicare, long-term care insurance, tax or employer-based incentives, reverse mortgages, 55.14private pay options, and ways to access low or no-cost services or benefits through 55.15volunteer-based or charitable programs; and55.16(11) using risk management and support planning protocols, provide long-term care 55.17options counseling to current residents of nursing homes deemed appropriate for discharge 55.18by the commissioner. In order to meet this requirement, the commissioner shall provide 55.19designated Senior LinkAge Line contact centers with a list of nursing home residents 55.20appropriate for discharge planning via a secure Web portal. Senior LinkAge Line shall 55.21provide these residents, if they indicate a preference to receive long-term care options 55.22counseling, with initial assessment, review of risk factors, independent living support 55.23consultation, or referral to:55.24(i) long-term care consultation services under section 
         256B.0911;55.25(ii) designated care coordinators of contracted entities under section 
         256B.035 for 55.26persons who are enrolled in a managed care plan; or55.27(iii) the long-term care consultation team for those who are appropriate for relocation 55.28service coordination due to high-risk factors or psychological or physical disability.55.29    Sec. 11. Minnesota Statutes 2008, section 256B.057, subdivision 9, is amended to read:55.30    Subd. 9. Employed persons with disabilities. (a) Medical assistance may be paid 55.31for a person who is employed and who:55.32(1) but for excess earnings or assets, meets the definition of disabled under the 55.33supplemental security income program;55.34(2) is at least 16 but less than 65 years of age;55.35(3) meets the asset limits in paragraph (c); and56.1(4) effective November 1, 2003, pays a premium and other obligations under 56.2paragraph (e).56.3Any spousal income or assets shall be disregarded for purposes of eligibility and premium 56.4determinations.56.5(b) After the month of enrollment, a person enrolled in medical assistance under 56.6this subdivision who:56.7(1) is temporarily unable to work and without receipt of earned income due to a 56.8medical condition, as verified by a physician, may retain eligibility for up to four calendar 56.9months; or56.10(2) effective January 1, 2004, loses employment for reasons not attributable to the 56.11enrollee, may retain eligibility for up to four consecutive months after the month of job 56.12loss. To receive a four-month extension, enrollees must verify the medical condition or 56.13provide notification of job loss. All other eligibility requirements must be met and the 56.14enrollee must pay all calculated premium costs for continued eligibility.56.15(c) For purposes of determining eligibility under this subdivision, a person's assets 56.16must not exceed $20,000, excluding:56.17(1) all assets excluded under section 
         256B.056;56.18(2) retirement accounts, including individual accounts, 401(k) plans, 403(b) plans, 56.19Keogh plans, and pension plans; and56.20(3) medical expense accounts set up through the person's employer.56.21(d)(1) Effective January 1, 2004, for purposes of eligibility, there will be a $65 56.22earned income disregard. To be eligible, a person applying for medical assistance under 56.23this subdivision must have earned income above the disregard level.56.24(2) Effective January 1, 2004, to be considered earned income, Medicare, Social 56.25Security, and applicable state and federal income taxes must be withheld. To be eligible, 56.26a person must document earned income tax withholding.56.27(e)(1) A person whose earned and unearned income is equal to or greater than 100 56.28percent of federal poverty guidelines for the applicable family size must pay a premium 56.29to be eligible for medical assistance under this subdivision. The premium shall be based 56.30on the person's gross earned and unearned income and the applicable family size using a 56.31sliding fee scale established by the commissioner, which begins at one percent of income 56.32at 100 percent of the federal poverty guidelines and increases to 7.5 percent of income 56.33for those with incomes at or above 300 percent of the federal poverty guidelines. Annual 56.34adjustments in the premium schedule based upon changes in the federal poverty guidelines 56.35shall be effective for premiums due in July of each year.57.1(2) Effective January 1, 2004, all enrollees must pay a premium to be eligible for 57.2medical assistance under this subdivision. An enrollee shall pay the greater of a $35 57.3premium or the premium calculated in clause (1).57.4(3) Effective November 1, 2003, all enrollees who receive unearned income must 57.5pay one-half of one percent of unearned income in addition to the premium amount.57.6(4) Effective November 1, 2003, for enrollees whose income does not exceed 200 57.7percent of the federal poverty guidelines and who are also enrolled in Medicare, the 57.8commissioner must reimburse the enrollee for Medicare Part B premiums under section 57.9256B.0625, subdivision 15
         , paragraph (a).57.10(5) Increases in benefits under title II of the Social Security Act shall not be counted 57.11as income for purposes of this subdivision until July 1 of each year.57.12(f) A person's eligibility and premium shall be determined by the local county 57.13agency. Premiums must be paid to the commissioner. All premiums are dedicated to 57.14the commissioner.57.15(g) Any required premium shall be determined at application and redetermined at 57.16the enrollee's six-month income review or when a change in income or household size is 57.17reported. Enrollees must report any change in income or household size within ten days 57.18of when the change occurs. A decreased premium resulting from a reported change in 57.19income or household size shall be effective the first day of the next available billing month 57.20after the change is reported. Except for changes occurring from annual cost-of-living 57.21increases, a change resulting in an increased premium shall not affect the premium amount 57.22until the next six-month review.57.23(h) Premium payment is due upon notification from the commissioner of the 57.24premium amount required. Premiums may be paid in installments at the discretion of 57.25the commissioner.57.26(i) Nonpayment of the premium shall result in denial or termination of medical 57.27assistance unless the person demonstrates good cause for nonpayment. Good cause exists 57.28if the requirements specified in Minnesota Rules, part 9506.0040, subpart 7, items B to 57.29D, are met. Except when an installment agreement is accepted by the commissioner, 57.30all persons disenrolled for nonpayment of a premium must pay any past due premiums 57.31as well as current premiums due prior to being reenrolled. Nonpayment shall include 57.32payment with a returned, refused, or dishonored instrument. The commissioner may 57.33require a guaranteed form of payment as the only means to replace a returned, refused, 57.34or dishonored instrument.57.35(j) The commissioner shall notify enrollees annually beginning at least 24 months 57.36before the person's 65th birthday of the medical assistance eligibility rules affecting 58.1income, assets, and treatment of a spouse's income and assets that will be applied upon 58.2reaching age 65.58.3EFFECTIVE DATE.This section is effective January 1, 2011.58.4    Sec. 12. Minnesota Statutes 2009 Supplement, section 256B.0659, subdivision 11, 58.5is amended to read:58.6    Subd. 11. Personal care assistant; requirements. (a) A personal care assistant 58.7must meet the following requirements:58.8(1) be at least 18 years of age with the exception of persons who are 16 or 17 years 58.9of age with these additional requirements:58.10(i) supervision by a qualified professional every 60 days; and58.11(ii) employment by only one personal care assistance provider agency responsible 58.12for compliance with current labor laws;58.13(2) be employed by a personal care assistance provider agency;58.14(3) enroll with the department as a personal care assistant after clearing a background 58.15study. Before a personal care assistant provides services, the personal care assistance 58.16provider agency must initiate a background study on the personal care assistant under 58.17chapter 245C, and the personal care assistance provider agency must have received a 58.18notice from the commissioner that the personal care assistant is:58.19(i) not disqualified under section 
         245C.14; or58.20(ii) is disqualified, but the personal care assistant has received a set aside of the 58.21disqualification under section 
         245C.22;58.22(4) be able to effectively communicate with the recipient and personal care 58.23assistance provider agency;58.24(5) be able to provide covered personal care assistance services according to the 58.25recipient's personal care assistance care plan, respond appropriately to recipient needs, 58.26and report changes in the recipient's condition to the supervising qualified professional 58.27or physician;58.28(6) not be a consumer of personal care assistance services;58.29(7) maintain daily written records including, but not limited to, time sheets under 58.30subdivision 12;58.31(8) effective January 1, 2010, complete standardized training as determined by the 58.32commissioner before completing enrollment. Personal care assistant training must include 58.33successful completion of the following training components: basic first aid, vulnerable 58.34adult, child maltreatment, OSHA universal precautions, basic roles and responsibilities of 58.35personal care assistants including information about assistance with lifting and transfers 59.1for recipients, emergency preparedness, orientation to positive behavioral practices, fraud 59.2issues, and completion of time sheets. Upon completion of the training components, 59.3the personal care assistant must demonstrate the competency to provide assistance to 59.4recipients;59.5(9) complete training and orientation on the needs of the recipient within the first 59.6seven days after the services begin; and59.7(10) be limited to providing and being paid for up to 310 275  hours per month of 59.8personal care assistance services regardless of the number of recipients being served or the 59.9number of personal care assistance provider agencies enrolled with.59.10(b) A legal guardian may be a personal care assistant if the guardian is not being paid 59.11for the guardian services and meets the criteria for personal care assistants in paragraph (a).59.12(c) Effective January 1, 2010, persons who do not qualify as a personal care assistant 59.13include parents and stepparents of minors, spouses, paid legal guardians, family foster 59.14care providers, except as otherwise allowed in section 
         256B.0625, subdivision 19a, or 59.15staff of a residential setting.59.16EFFECTIVE DATE.This section is effective July 1, 2011.59.17    Sec. 13. Minnesota Statutes 2009 Supplement, section 256B.0911, subdivision 3c, 59.18is amended to read:59.19    Subd. 3c. Transition to housing with services. (a) Housing with services 59.20establishments offering or providing assisted living under chapter 144G shall inform 59.21all prospective residents of the availability of and contact information for transitional 59.22consultation services under this subdivision prior to executing a lease or contract with 59.23the prospective resident requirement to contact the Senior LinkAge Line for long-term 59.24care options counseling and transitional consultation. The Senior LinkAge Line shall 59.25provide a certificate to the prospective resident and also send a copy of the certificate to 59.26the housing with services establishment that the prospective resident chooses, verifying 59.27that consultation has been provided to the prospective resident or the prospective 59.28resident's legal representative. The housing with services establishment shall not execute a 59.29contract or allow a prospective resident to move in until the establishment has received 59.30certification from the Senior LinkAge Line. Prospective residents refusing to contact the 59.31Senior LinkAge Line are required to sign a waiver form supplied by the provider. The 59.32housing with services establishment shall maintain copies of contracts, waiver forms, and 59.33certificates for audit for a period of three years. The purpose of transitional long-term care 59.34consultation is to support persons with current or anticipated long-term care needs in 59.35making informed choices among options that include the most cost-effective and least 60.1restrictive settings, and to delay spenddown to eligibility for publicly funded programs by 60.2connecting people to alternative services in their homes before transition to housing with 60.3services. Regardless of the consultation, prospective residents maintain the right to choose 60.4housing with services or assisted living if that option is their preference.60.5    (b) Transitional consultation services are provided as determined by the 60.6commissioner of human services in partnership with county long-term care consultation 60.7units, and the Area Agencies on Aging under section 144D.03, subdivision 3, and 60.8are a combination of telephone-based and in-person assistance provided under models 60.9developed by the commissioner. The consultation shall be performed in a manner that 60.10provides objective and complete information. Transitional consultation must be provided 60.11within five working days of the request of the prospective resident as follows:60.12    (1) the consultation must be provided by a qualified professional as determined by 60.13the commissioner;60.14    (2) the consultation must include a review of the prospective resident's reasons for 60.15considering assisted living, the prospective resident's personal goals, a discussion of the 60.16prospective resident's immediate and projected long-term care needs, and alternative 60.17community services or assisted living settings that may meet the prospective resident's 60.18needs; and60.19    (3) the prospective resident shall be informed of the availability of long-term care 60.20consultation services described in subdivision 3a that are available at no charge to the 60.21prospective resident to assist the prospective resident in assessment and planning to meet 60.22the prospective resident's long-term care needs. The Senior LinkAge Line and long-term 60.23care consultation team shall give the highest priority to referrals who are at highest risk of 60.24nursing facility placement or as needed for determining eligibility.;60.25(4) a prospective resident does not include a person moving from the community, 60.26a hospital, or an institutional setting to housing with services during nonworking hours 60.27when:60.28(i) the move is based on a recent precipitating event that precludes the person from 60.29living safely in the community or institution, such as sustaining injury, unanticipated 60.30discharge from hospital or nursing facility, inability of caregivers to provide needed care, 60.31lack of access to needed care or services, or declining health status; and60.32(ii) the Senior LinkAge Line is contacted within ten working days following the 60.33move to the registered housing with services, or as soon as is reasonable considering 60.34the prospective resident's condition; and60.35(5) the Senior LinkAge Line may provide the long-term care options counseling and 60.36transitional consultation service.61.1    Sec. 14. Minnesota Statutes 2008, section 256B.0915, is amended by adding a 61.2subdivision to read:61.3    Subd. 3i.Rate reduction for customized living and 24-hour customized living 61.4services.(a) Effective July 1, 2010, the commissioner shall reduce service component 61.5rates and service rate limits for customized living services and 24-hour customized living 61.6services, from the rates in effect on June 30, 2010, by five percent.61.7(b) To implement the rate reductions in this subdivision, capitation rates paid by the 61.8commissioner to managed care organizations under section 256B.69 shall reflect a ten 61.9percent reduction for the specified services for the period January 1, 2011, to June 30, 61.102011, and a five percent reduction for those services on and after July 1, 2011.61.11    Sec. 15. Minnesota Statutes 2009 Supplement, section 256B.441, subdivision 55, 61.12is amended to read:61.13    Subd. 55. Phase-in of rebased operating payment rates.  (a) For the rate years 61.14beginning October 1, 2008, to October 1, 2015, the operating payment rate calculated 61.15under this section shall be phased in by blending the operating rate with the operating 61.16payment rate determined under section 
         256B.434. For purposes of this subdivision, the 61.17rate to be used that is determined under section 
         256B.434 shall not include the portion of 61.18the operating payment rate related to performance-based incentive payments under section 61.19256B.434, subdivision 4
         , paragraph (d). For the rate year beginning October 1, 2008, the 61.20operating payment rate for each facility shall be 13 percent of the operating payment rate 61.21from this section, and 87 percent of the operating payment rate from section 
         256B.434. 61.22For the rate year beginning October 1, 2009, the operating payment rate for each facility 61.23shall be 14 percent of the operating payment rate from this section, and 86 percent of 61.24the operating payment rate from section 256B.434. For rate years beginning October 1, 61.252010; October 1, 2011; and October 1, 2012, For the rate period from October 1, 2009, to 61.26September 30, 2013,  no rate adjustments shall be implemented under this section, but shall 61.27be determined under section 
         256B.434. For the rate year beginning October 1, 2013, the 61.28operating payment rate for each facility shall be 65 percent of the operating payment rate 61.29from this section, and 35 percent of the operating payment rate from section 
         256B.434. 61.30For the rate year beginning October 1, 2014, the operating payment rate for each facility 61.31shall be 82 percent of the operating payment rate from this section, and 18 percent of the 61.32operating payment rate from section 
         256B.434. For the rate year beginning October 1, 61.332015, the operating payment rate for each facility shall be the operating payment rate 61.34determined under this section. The blending of operating payment rates under this section 61.35shall be performed separately for each RUG's class.62.1    (b) For the rate year beginning October 1, 2008, the commissioner shall apply limits 62.2to the operating payment rate increases under paragraph (a) by creating a minimum 62.3percentage increase and a maximum percentage increase.62.4    (1) Each nursing facility that receives a blended October 1, 2008, operating payment 62.5rate increase under paragraph (a) of less than one percent, when compared to its operating 62.6payment rate on September 30, 2008, computed using rates with RUG's weight of 
         1.00, 62.7shall receive a rate adjustment of one percent.62.8    (2) The commissioner shall determine a maximum percentage increase that will 62.9result in savings equal to the cost of allowing the minimum increase in clause (1). Nursing 62.10facilities with a blended October 1, 2008, operating payment rate increase under paragraph 62.11(a) greater than the maximum percentage increase determined by the commissioner, when 62.12compared to its operating payment rate on September 30, 2008, computed using rates with 62.13a RUG's weight of 
         1.00, shall receive the maximum percentage increase.62.14    (3) Nursing facilities with a blended October 1, 2008, operating payment rate 62.15increase under paragraph (a) greater than one percent and less than the maximum 62.16percentage increase determined by the commissioner, when compared to its operating 62.17payment rate on September 30, 2008, computed using rates with a RUG's weight of 
         1.00, 62.18shall receive the blended October 1, 2008, operating payment rate increase determined 62.19under paragraph (a).62.20    (4) The October 1, 2009, through October 1, 2015, operating payment rate for 62.21facilities receiving the maximum percentage increase determined in clause (2) shall be 62.22the amount determined under paragraph (a) less the difference between the amount 62.23determined under paragraph (a) for October 1, 2008, and the amount allowed under clause 62.24(2). This rate restriction does not apply to rate increases provided in any other section.62.25    (c) A portion of the funds received under this subdivision that are in excess of 62.26operating payment rates that a facility would have received under section 
         256B.434, as 62.27determined in accordance with clauses (1) to (3), shall be subject to the requirements in 62.28section 
         256B.434, subdivision 19, paragraphs (b) to (h).62.29    (1) Determine the amount of additional funding available to a facility, which shall be 62.30equal to total medical assistance resident days from the most recent reporting year times 62.31the difference between the blended rate determined in paragraph (a) for the rate year being 62.32computed and the blended rate for the prior year.62.33    (2) Determine the portion of all operating costs, for the most recent reporting year, 62.34that are compensation related. If this value exceeds 75 percent, use 75 percent.62.35    (3) Subtract the amount determined in clause (2) from 75 percent.63.1    (4) The portion of the fund received under this subdivision that shall be subject to 63.2the requirements in section 
         256B.434, subdivision 19, paragraphs (b) to (h), shall equal 63.3the amount determined in clause (1) times the amount determined in clause (3).63.4EFFECTIVE DATE.This section is effective retroactive to October 1, 2009.63.5    Sec. 16. Minnesota Statutes 2008, section 256B.5012, is amended by adding a 63.6subdivision to read:63.7    Subd. 9.Rate increase effective June 1, 2010.For rate periods beginning on or 63.8after June 1, 2010, the commissioner shall increase the total operating payment rate for 63.9each facility reimbursed under this section by $8.74 per day. The increase shall not be 63.10subject to any annual percentage increase.63.11EFFECTIVE DATE.This section is effective June 1, 2010.63.12    Sec. 17. Minnesota Statutes 2009 Supplement, section 256B.69, subdivision 23, 63.13is amended to read:63.14    Subd. 23. Alternative services; elderly and disabled persons. (a) The 63.15commissioner may implement demonstration projects to create alternative integrated 63.16delivery systems for acute and long-term care services to elderly persons and persons 63.17with disabilities as defined in section 
         256B.77, subdivision 7a, that provide increased 63.18coordination, improve access to quality services, and mitigate future cost increases. 63.19The commissioner may seek federal authority to combine Medicare and Medicaid 63.20capitation payments for the purpose of such demonstrations and may contract with 63.21Medicare-approved special needs plans to provide Medicaid services. Medicare funds and 63.22services shall be administered according to the terms and conditions of the federal contract 63.23and demonstration provisions. For the purpose of administering medical assistance funds, 63.24demonstrations under this subdivision are subject to subdivisions 1 to 22. The provisions 63.25of Minnesota Rules, parts 
         9500.1450 to 
         9500.1464, apply to these demonstrations, 63.26with the exceptions of parts 
         9500.1452, subpart 2, item B; and 
         9500.1457, subpart 1, 63.27items B and C, which do not apply to persons enrolling in demonstrations under this 63.28section. An initial open enrollment period may be provided. Persons who disenroll from 63.29demonstrations under this subdivision remain subject to Minnesota Rules, parts 9500.1450 63.30to 9500.1464. When a person is enrolled in a health plan under these demonstrations and 63.31the health plan's participation is subsequently terminated for any reason, the person shall 63.32be provided an opportunity to select a new health plan and shall have the right to change 63.33health plans within the first 60 days of enrollment in the second health plan. Persons 64.1required to participate in health plans under this section who fail to make a choice of 64.2health plan shall not be randomly assigned to health plans under these demonstrations. 64.3Notwithstanding section 
         256L.12, subdivision 5, and Minnesota Rules, part 
         9505.5220, 64.4subpart 1, item A, if adopted, for the purpose of demonstrations under this subdivision, 64.5the commissioner may contract with managed care organizations, including counties, to 64.6serve only elderly persons eligible for medical assistance, elderly and disabled persons, or 64.7disabled persons only. For persons with a primary diagnosis of developmental disability, 64.8serious and persistent mental illness, or serious emotional disturbance, the commissioner 64.9must ensure that the county authority has approved the demonstration and contracting 64.10design. Enrollment in these projects for persons with disabilities shall be voluntary. The 64.11commissioner shall not implement any demonstration project under this subdivision for 64.12persons with a primary diagnosis of developmental disabilities, serious and persistent 64.13mental illness, or serious emotional disturbance, without approval of the county board of 64.14the county in which the demonstration is being implemented.64.15    (b) Notwithstanding chapter 245B, sections 
         252.40 to 
         252.46, 
         256B.092, 
         256B.501 64.16to 
         256B.5015, and Minnesota Rules, parts 9525.0004 to 9525.0036, 9525.1200 to 64.179525.1330, 9525.1580, and 9525.1800 to 9525.1930, the commissioner may implement 64.18under this section projects for persons with developmental disabilities. The commissioner 64.19may capitate payments for ICF/MR services, waivered services for developmental 64.20disabilities, including case management services, day training and habilitation and 64.21alternative active treatment services, and other services as approved by the state and by the 64.22federal government. Case management and active treatment must be individualized and 64.23developed in accordance with a person-centered plan. Costs under these projects may not 64.24exceed costs that would have been incurred under fee-for-service. Beginning July 1, 2003, 64.25and until four years after the pilot project implementation date, subcontractor participation 64.26in the long-term care developmental disability pilot is limited to a nonprofit long-term 64.27care system providing ICF/MR services, home and community-based waiver services, 64.28and in-home services to no more than 120 consumers with developmental disabilities in 64.29Carver, Hennepin, and Scott Counties. The commissioner shall report to the legislature 64.30prior to expansion of the developmental disability pilot project. This paragraph expires 64.31four years after the implementation date of the pilot project.64.32    (c) Before implementation of a demonstration project for disabled persons, the 64.33commissioner must provide information to appropriate committees of the house of 64.34representatives and senate and must involve representatives of affected disability groups 64.35in the design of the demonstration projects.65.1    (d) A nursing facility reimbursed under the alternative reimbursement methodology 65.2in section 
         256B.434 may, in collaboration with a hospital, clinic, or other health care entity 65.3provide services under paragraph (a). The commissioner shall amend the state plan and 65.4seek any federal waivers necessary to implement this paragraph.65.5    (e) The commissioner, in consultation with the commissioners of commerce and 65.6health, may approve and implement programs for all-inclusive care for the elderly (PACE) 65.7according to federal laws and regulations governing that program and state laws or rules 65.8applicable to participating providers. The process for approval of these programs shall 65.9begin only after the commissioner receives grant money in an amount sufficient to cover 65.10the state share of the administrative and actuarial costs to implement the programs during 65.11state fiscal years 2006 and 2007. Grant amounts for this purpose shall be deposited in an 65.12account in the special revenue fund and are appropriated to the commissioner to be used 65.13solely for the purpose of PACE administrative and actuarial costs. A PACE provider is 65.14not required to be licensed or certified as a health plan company as defined in section 65.1562Q.01, subdivision 4
         . Persons age 55 and older who have been screened by the county 65.16and found to be eligible for services under the elderly waiver or community alternatives 65.17for disabled individuals or who are already eligible for Medicaid but meet level of 65.18care criteria for receipt of waiver services may choose to enroll in the PACE program. 65.19Medicare and Medicaid services will be provided according to this subdivision and 65.20federal Medicare and Medicaid requirements governing PACE providers and programs. 65.21PACE enrollees will receive Medicaid home and community-based services through the 65.22PACE provider as an alternative to services for which they would otherwise be eligible 65.23through home and community-based waiver programs and Medicaid State Plan Services. 65.24The commissioner shall establish Medicaid rates for PACE providers that do not exceed 65.25costs that would have been incurred under fee-for-service or other relevant managed care 65.26programs operated by the state.65.27    (f) The commissioner shall seek federal approval to expand the Minnesota disability 65.28health options (MnDHO) program established under this subdivision in stages, first to 65.29regional population centers outside the seven-county metro area and then to all areas of 65.30the state. Until July 1, 2009, expansion for MnDHO projects that include home and 65.31community-based services is limited to the two projects and service areas in effect on 65.32March 1, 2006. Enrollment in integrated MnDHO programs that include home and 65.33community-based services shall remain voluntary. Costs for home and community-based 65.34services included under MnDHO must not exceed costs that would have been incurred 65.35under the fee-for-service program. Notwithstanding whether expansion occurs under 65.36this paragraph, in determining MnDHO payment rates and risk adjustment methods for 66.1contract years starting in 2012, the commissioner must consider the methods used to 66.2determine county allocations for home and community-based program participants. If 66.3necessary to reduce MnDHO rates to comply with the provision regarding MnDHO costs 66.4for home and community-based services, the commissioner shall achieve the reduction 66.5by maintaining the base rate for contract years year 2010 and 2011 for services provided 66.6under the community alternatives for disabled individuals waiver at the same level as for 66.7contract year 2009. The commissioner may apply other reductions to MnDHO rates to 66.8implement decreases in provider payment rates required by state law. Effective December 66.931, 2010, enrollment and operation of the MnDHO program in effect during 2010 shall 66.10cease. The commissioner may reopen the program provided all applicable conditions of 66.11this section are met. In developing program specifications for expansion of integrated 66.12programs, the commissioner shall involve and consult the state-level stakeholder group 66.13established in subdivision 28, paragraph (d), including consultation on whether and how 66.14to include home and community-based waiver programs. Plans for further expansion of to 66.15reopen MnDHO projects shall be presented to the chairs of the house of representatives 66.16and senate committees with jurisdiction over health and human services policy and finance 66.17by February 1, 2007 prior to implementation.66.18    (g) Notwithstanding section 
         256B.0261, health plans providing services under this 66.19section are responsible for home care targeted case management and relocation targeted 66.20case management. Services must be provided according to the terms of the waivers and 66.21contracts approved by the federal government.66.22    Sec. 18. Laws 2009, chapter 79, article 8, section 51, the effective date, is amended to 66.23read:66.24EFFECTIVE DATE.This section is effective January July 1, 2011.66.25    Sec. 19. Laws 2009, chapter 79, article 8, section 84, is amended to read:66.26    Sec. 84. HOUSING OPTIONS.66.27The commissioner of human services, in consultation with the commissioner of 66.28administration and the Minnesota Housing Finance Agency, and representatives of 66.29counties, residents' advocacy groups, consumers of housing services, and provider 66.30agencies shall explore ways to maximize the availability and affordability of housing 66.31choices available to persons with disabilities or who need care assistance due to other 66.32health challenges. A goal shall also be to minimize state physical plant costs in order to 66.33serve more persons with appropriate program and care support. Consideration shall be 66.34given to:67.1(1) improved access to rent subsidies;67.2(2) use of cooperatives, land trusts, and other limited equity ownership models;67.3(3) whether a public equity housing fund should be established that would maintain 67.4the state's interest, to the extent paid from state funds, including group residential housing 67.5and Minnesota supplemental aid shelter-needy funds in provider-owned housing, so that 67.6when sold, the state would recover its share for a public equity fund to be used for future 67.7public needs under this chapter;67.8(4) the desirability of the state acquiring an ownership interest or promoting the 67.9use of publicly owned housing;67.10(5) promoting more choices in the market for accessible housing that meets the 67.11needs of persons with physical challenges; and67.12(6) what consumer ownership models, if any, are appropriate; and67.13(7) a review of the definition of home and community services and appropriate 67.14settings where these services may be provided, including the number of people who 67.15may reside under one roof, through the home and community-based waivers for seniors 67.16and individuals with disabilities.67.17The commissioner shall provide a written report on the findings of the evaluation of 67.18housing options to the chairs and ranking minority members of the house of representatives 67.19and senate standing committees with jurisdiction over health and human services policy 67.20and funding by December 15, 2010. This report shall replace the November 1, 2010, 67.21annual report by the commissioner required in Minnesota Statutes, sections 
         256B.0916, 67.22subdivision 7
         , and 
         256B.49, subdivision 21.67.23    Sec. 20. CASE MANAGEMENT REFORM.67.24(a) By February 1, 2011, the commissioner of human services shall provide specific 67.25recommendations and language for proposed legislation to:67.26(1) define the administrative and the service functions of case management for 67.27persons with disabilities and make changes to improve the funding for administrative 67.28functions;67.29(2) standardize and simplify processes, standards, and timelines for case 67.30management within the Department of Human Services, Disability Services Division, 67.31including eligibility determinations, resource allocation, management of dollars, provision 67.32for assignment of one case manager at a time per person, waiting lists, quality assurance, 67.33host county concurrence requirements, county of financial responsibility provisions, and 67.34waiver compliance; and68.1(3) increase opportunities for consumer choice of case management functions 68.2involving service coordination.68.3(b) In developing these recommendations, the commissioner shall consider the 68.4recommendations of the 2007 Redesigning Case Management Services for Persons 68.5with Disabilities report and consult with existing stakeholder groups, which include 68.6representatives of counties, disability and senior advocacy groups, service providers, and 68.7representatives of agencies which provide contracted case management.68.8EFFECTIVE DATE.This section is effective the day following final enactment.68.9    Sec. 21. COMMISSIONER TO SEEK FEDERAL MATCH.68.10(a) The commissioner of human services shall seek federal financial participation 68.11for eligible activity related to fiscal years 2010 and 2011 grants to Advocating Change 68.12Together to establish a statewide self-advocacy network for persons with developmental 68.13disabilities and for eligible activities under any future grants to the organization.68.14(b) The commissioner shall report to the chairs and ranking minority members of 68.15the senate Health and Human Services Budget Division and the house of representatives 68.16Health Care and Human Services Finance Division by December 15, 2010, with the 68.17results of the application for federal matching funds.68.18    Sec. 22. ICF/MR RATE INCREASE.68.19    The daily rate at an intermediate care facility for the developmentally disabled 68.20located in Clearwater County and classified as a Class A facility with 15 beds shall be 68.21increased from $112.73 to $138.23 for the rate period July 1, 2010, to June 30, 2011.68.22ARTICLE 368.23CHILDREN AND FAMILY SERVICES68.24    Section 1. Minnesota Statutes 2008, section 256D.0515, is amended to read:68.25256D.0515 ASSET LIMITATIONS FOR FOOD STAMP HOUSEHOLDS.68.26All food stamp households must be determined eligible for the benefit discussed 68.27under section 
         256.029. Food stamp households must demonstrate that:68.28(1) their gross income meets the federal Food Stamp requirements under United 68.29States Code, title 7, section 2014(c); and68.30(2) they have financial resources, excluding vehicles, of less than $7,000is equal to 68.31or less than 165 percent of the federal poverty guidelines for the same family size.68.32EFFECTIVE DATE.This section is effective November 1, 2010.69.1    Sec. 2. Minnesota Statutes 2008, section 256I.05, is amended by adding a subdivision 69.2to read:69.3    Subd. 1n.Supplemental rate; Mahnomen County.Notwithstanding the 69.4provisions of this section, for the rate period July 1, 2010, to June 30, 2011, a county 69.5agency shall negotiate a supplemental service rate in addition to the rate specified in 69.6subdivision 1, not to exceed $753 per month or the existing rate, including any legislative 69.7authorized inflationary adjustments, for a group residential provider located in Mahnomen 69.8County that operates a 28-bed facility providing 24-hour care to individuals who are 69.9homeless, disabled, chemically dependent, mentally ill, or chronically homeless.69.10    Sec. 3. Minnesota Statutes 2008, section 256J.24, subdivision 6, is amended to read:69.11    Subd. 6. Family cap. (a) MFIP assistance units shall not receive an increase in the 69.12cash portion of the transitional standard as a result of the birth of a child, unless one of 69.13the conditions under paragraph (b) is met. The child shall be considered a member of the 69.14assistance unit according to subdivisions 1 to 3, but shall be excluded in determining 69.15family size for purposes of determining the amount of the cash portion of the transitional 69.16standard under subdivision 5. The child shall be included in determining family size for 69.17purposes of determining the food portion of the transitional standard. The transitional 69.18standard under this subdivision shall be the total of the cash and food portions as specified 69.19in this paragraph. The family wage level under this subdivision shall be based on the 69.20family size used to determine the food portion of the transitional standard.69.21(b) A child shall be included in determining family size for purposes of determining 69.22the amount of the cash portion of the MFIP transitional standard when at least one of 69.23the following conditions is met:69.24(1) for families receiving MFIP assistance on July 1, 2003, the child is born to the 69.25adult parent before May 1, 2004;69.26(2) for families who apply for the diversionary work program under section 
         256J.9569.27or MFIP assistance on or after July 1, 2003, the child is born to the adult parent within 69.28ten months of the date the family is eligible for assistance; 69.29(3) the child was conceived as a result of a sexual assault or incest, provided that the 69.30incident has been reported to a law enforcement agency;69.31(4) the child's mother is a minor caregiver as defined in section 
         256J.08, subdivision 69.3259
         , and the child, or multiple children, are the mother's first birth; or69.33(5) the child is the mother's first child subsequent to a pregnancy that did not result 69.34in a live birth; or70.1(6) any child previously excluded in determining family size under paragraph 70.2(a) shall be included if the adult parent or parents have not received benefits from the 70.3diversionary work program under section 
         256J.95 or MFIP assistance in the previous ten 70.4months. An adult parent or parents who reapply and have received benefits from the 70.5diversionary work program or MFIP assistance in the past ten months shall be under the 70.6ten-month grace period of their previous application under clause (2).70.7(c) Income and resources of a child excluded under this subdivision, except child 70.8support received or distributed on behalf of this child, must be considered using the same 70.9policies as for other children when determining the grant amount of the assistance unit.70.10(d) The caregiver must assign support and cooperate with the child support 70.11enforcement agency to establish paternity and collect child support on behalf of the 70.12excluded child. Failure to cooperate results in the sanction specified in section 
         256J.46, 70.13subdivisions 2 and 2a
         . Current support paid on behalf of the excluded child shall be 70.14distributed according to section 
         256.741, subdivision 15. 70.15(e) County agencies must inform applicants of the provisions under this subdivision 70.16at the time of each application and at recertification.70.17(f) Children excluded under this provision shall be deemed MFIP recipients for 70.18purposes of child care under chapter 119B.70.19EFFECTIVE DATE.This section is effective September 1, 2010.70.20    Sec. 4. Minnesota Statutes 2009 Supplement, section 256J.425, subdivision 3, is 70.21amended to read:70.22    Subd. 3. Hard-to-employ participants. (a) An assistance unit subject to the time 70.23limit in section 
         256J.42, subdivision 1, is eligible to receive months of assistance under 70.24a hardship extension if the participant who reached the time limit belongs to any of the 70.25following groups: 70.26    (1) a person who is diagnosed by a licensed physician, psychological practitioner, or 70.27other qualified professional, as developmentally disabled or mentally ill, and the condition 70.28severely limits the person's ability to obtain or maintain suitable employment;70.29    (2) a person who:70.30    (i) has been assessed by a vocational specialist or the county agency to be 70.31unemployable for purposes of this subdivision; or70.32    (ii) has an IQ below 80 who has been assessed by a vocational specialist or a county 70.33agency to be employable, but the condition severely limits the person's ability to obtain or 70.34maintain suitable employment. The determination of IQ level must be made by a qualified 70.35professional. In the case of a non-English-speaking person: (A) the determination must 71.1be made by a qualified professional with experience conducting culturally appropriate 71.2assessments, whenever possible; (B) the county may accept reports that identify an 71.3IQ range as opposed to a specific score; (C) these reports must include a statement of 71.4confidence in the results;71.5    (3) a person who is determined by a qualified professional to be learning disabled, 71.6and the condition severely limits the person's ability to obtain or maintain suitable 71.7employment. For purposes of the initial approval of a learning disability extension, the 71.8determination must have been made or confirmed within the previous 12 months. In the 71.9case of a non-English-speaking person: (i) the determination must be made by a qualified 71.10professional with experience conducting culturally appropriate assessments, whenever 71.11possible; and (ii) these reports must include a statement of confidence in the results. If a 71.12rehabilitation plan for a participant extended as learning disabled is developed or approved 71.13by the county agency, the plan must be incorporated into the employment plan. However, 71.14a rehabilitation plan does not replace the requirement to develop and comply with an 71.15employment plan under section 
         256J.521; or 71.16    (4) a person who has been granted a family violence waiver, and who is complying 71.17with an employment plan under section 
         256J.521, subdivision 3. 71.18    (b) For purposes of this section chapter, "severely limits the person's ability to obtain 71.19or maintain suitable employment" means: 71.20    (1) that a qualified professional has determined that the person's condition prevents 71.21the person from working 20 or more hours per week; or 71.22    (2) for a person who meets the requirements of paragraph (a), clause (2), item (ii), or 71.23clause (3), a qualified professional has determined the person's condition:71.24    (i) significantly restricts the range of employment that the person is able to perform; 71.25or 71.26    (ii) significantly interferes with the person's ability to obtain or maintain suitable 71.27employment for 20 or more hours per week.71.28    Sec. 5.  REPEALER.71.29Minnesota Statutes 2009 Supplement, section 256J.621, is repealed.71.30EFFECTIVE DATE.This section is effective December 1, 2010.71.31ARTICLE 471.32MISCELLANEOUS71.33    Section 1. [62Q.545] COVERAGE OF PRIVATE DUTY NURSING SERVICES.72.1(a) Private duty nursing services, as provided under section 256B.0625, subdivision 72.27, with the exception of section 256B.0654, subdivision 4, shall be covered under a health 72.3plan for persons who are concurrently covered by both the health plan  and enrolled in 72.4medical assistance under chapter 256B.72.5(b) For purposes of this section, a period of private duty nursing services may 72.6be subject to the co-payment, coinsurance, deductible, or other enrollee cost-sharing 72.7requirements that apply under the health plan. Cost-sharing requirements for private 72.8duty nursing services must not place a greater financial burden on the insured or enrollee 72.9than those requirements applied by the health plan to other similar services or benefits. 72.10Nothing in this section is intended to prevent a health plan company from requiring 72.11prior authorization by the health plan company for such services as required by section 72.12256B.0625, subdivision 7, or use of contracted providers under the applicable provisions 72.13of the health plan.72.14EFFECTIVE DATE.This section is effective July 1, 2010, and applies to health 72.15plans offered, sold, issued, or renewed on or after that date.72.16    Sec. 2. [137.32] MINNESOTA COUPLES ON THE BRINK PROJECT.72.17    Subdivision 1.Establishment.Within the limits of available appropriations, the 72.18Board of Regents of the University of Minnesota is requested to develop and implement 72.19a Minnesota couples on the brink project, as provided for in this section. The regents 72.20may administer the project with federal grants, state appropriations, and in-kind services 72.21received for this purpose.72.22    Subd. 2.Purpose.The purpose of the project is to develop, evaluate, and 72.23disseminate best practices for promoting successful reconciliation between married 72.24persons who are considering or have commenced a marriage dissolution proceeding and 72.25who choose to pursue reconciliation.72.26    Subd. 3.Implementation.The regents shall:72.27(1) enter into contracts or manage a grant process for implementation of the project; 72.28and72.29(2) develop and implement an evaluation component for the project.72.30    Sec. 3. Minnesota Statutes 2008, section 152.126, as amended by Laws 2009, chapter 72.3179, article 11, sections 9, 10, and 11, is amended to read:72.32152.126 SCHEDULE II AND III CONTROLLED SUBSTANCES 72.33PRESCRIPTION ELECTRONIC REPORTING SYSTEM.73.1    Subdivision 1. Definitions. For purposes of this section, the terms defined in this 73.2subdivision have the meanings given.73.3    (a) "Board" means the Minnesota State Board of Pharmacy established under 73.4chapter 151.73.5    (b) "Controlled substances" means those substances listed in section 
         152.02, 73.6subdivisions 3 to 5, and those substances defined by the board pursuant to section 
         152.02, 73.7subdivisions 7
         , 8, and 12.73.8    (c) "Dispense" or "dispensing" has the meaning given in section 
         151.01, subdivision 73.930. Dispensing does not include the direct administering of a controlled substance to a 73.10patient by a licensed health care professional.73.11    (d) "Dispenser" means a person authorized by law to dispense a controlled substance, 73.12pursuant to a valid prescription. For the purposes of this section, a dispenser does not 73.13include a licensed hospital pharmacy that distributes controlled substances for inpatient 73.14hospital care or a veterinarian who is dispensing prescriptions under section 
         156.18.73.15    (e) "Prescriber" means a licensed health care professional who is authorized to 73.16prescribe a controlled substance under section 
         152.12, subdivision 1.73.17    (f) "Prescription" has the meaning given in section 
         151.01, subdivision 16.73.18    Subd. 1a. Treatment of intractable pain. This section is not intended to limit or 73.19interfere with the legitimate prescribing of controlled substances for pain. No prescriber 73.20shall be subject to disciplinary action by a health-related licensing board for prescribing a 73.21controlled substance according to the provisions of section 
         152.125.73.22    Subd. 2. Prescription electronic reporting system. (a) The board shall establish 73.23by January 1, 2010, an electronic system for reporting the information required under 73.24subdivision 4 for all controlled substances dispensed within the state. 73.25    (b) The board may contract with a vendor for the purpose of obtaining technical 73.26assistance in the design, implementation, operation, and maintenance of the electronic 73.27reporting system. 73.28    Subd. 3. Prescription Electronic Reporting Advisory Committee. (a) The 73.29board shall convene an advisory committee. The committee must include at least one 73.30representative of:73.31    (1) the Department of Health;73.32    (2) the Department of Human Services;73.33    (3) each health-related licensing board that licenses prescribers;73.34    (4) a professional medical association, which may include an association of pain 73.35management and chemical dependency specialists;73.36    (5) a professional pharmacy association;74.1    (6) a professional nursing association;74.2    (7) a professional dental association;74.3    (8) a consumer privacy or security advocate; and74.4    (9) a consumer or patient rights organization.74.5    (b) The advisory committee shall advise the board on the development and operation 74.6of the electronic reporting system, including, but not limited to:74.7    (1) technical standards for electronic prescription drug reporting;74.8    (2) proper analysis and interpretation of prescription monitoring data; and74.9    (3) an evaluation process for the program.74.10    (c) The Board of Pharmacy, after consultation with the advisory committee, shall 74.11present recommendations and draft legislation on the issues addressed by the advisory 74.12committee under paragraph (b), to the legislature by December 15, 2007.74.13    Subd. 4. Reporting requirements; notice. (a) Each dispenser must submit the 74.14following data to the board or its designated vendor, subject to the notice required under 74.15paragraph (d):74.16    (1) name of the prescriber;74.17    (2) national provider identifier of the prescriber;74.18    (3) name of the dispenser;74.19    (4) national provider identifier of the dispenser;74.20    (5) prescription number;74.21    (6) name of the patient for whom the prescription was written;74.22    (7) address of the patient for whom the prescription was written;74.23    (8) date of birth of the patient for whom the prescription was written;74.24    (9) date the prescription was written;74.25    (10) date the prescription was filled;74.26    (11) name and strength of the controlled substance;74.27    (12) quantity of controlled substance prescribed;74.28    (13) quantity of controlled substance dispensed; and74.29    (14) number of days supply.74.30    (b) The dispenser must submit the required information by a procedure and in a 74.31format established by the board. The board may allow dispensers to omit data listed in this 74.32subdivision or may require the submission of data not listed in this subdivision provided 74.33the omission or submission is necessary for the purpose of complying with the electronic 74.34reporting or data transmission standards of the American Society for Automation in 74.35Pharmacy, the National Council on Prescription Drug Programs, or other relevant national 74.36standard-setting body.75.1    (c) A dispenser is not required to submit this data for those controlled substance 75.2prescriptions dispensed for:75.3    (1) individuals residing in licensed skilled nursing or intermediate care facilities;75.4    (2) individuals receiving assisted living services under chapter 144G or through a 75.5medical assistance home and community-based waiver;75.6    (3) individuals receiving medication intravenously;75.7    (4) individuals receiving hospice and other palliative or end-of-life care; and75.8    (5) individuals receiving services from a home care provider regulated under chapter 75.9144A.75.10    (d) A dispenser must not submit data under this subdivision unless a conspicuous 75.11notice of the reporting requirements of this section is given to the patient for whom the 75.12prescription was written.75.13    Subd. 5. Use of data by board. (a) The board shall develop and maintain a database 75.14of the data reported under subdivision 4. The board shall maintain data that could identify 75.15an individual prescriber or dispenser in encrypted form. The database may be used by 75.16permissible users identified under subdivision 6 for the identification of:75.17    (1) individuals receiving prescriptions for controlled substances from prescribers 75.18who subsequently obtain controlled substances from dispensers in quantities or with a 75.19frequency inconsistent with generally recognized standards of use for those controlled 75.20substances, including standards accepted by national and international pain management 75.21associations; and75.22    (2) individuals presenting forged or otherwise false or altered prescriptions for 75.23controlled substances to dispensers.75.24    (b) No permissible user identified under subdivision 6 may access the database 75.25for the sole purpose of identifying prescribers of controlled substances for unusual or 75.26excessive prescribing patterns without a valid search warrant or court order.75.27    (c) No personnel of a state or federal occupational licensing board or agency may 75.28access the database for the purpose of obtaining information to be used to initiate or 75.29substantiate a disciplinary action against a prescriber.75.30    (d) Data reported under subdivision 4 shall be retained by the board in the database 75.31for a 12-month period, and shall be removed from the database no later than 12 months 75.32from the datethe last day of the month during which the data was received.75.33    Subd. 6. Access to reporting system data. (a) Except as indicated in this 75.34subdivision, the data submitted to the board under subdivision 4 is private data on 75.35individuals as defined in section 
         13.02, subdivision 12, and not subject to public disclosure.76.1    (b) Except as specified in subdivision 5, the following persons shall be considered 76.2permissible users and may access the data submitted under subdivision 4 in the same or 76.3similar manner, and for the same or similar purposes, as those persons who are authorized 76.4to access similar private data on individuals under federal and state law:76.5    (1) a prescriber or an agent or employee of the prescriber to whom the prescriber has 76.6delegated the task of accessing the data, to the extent the information relates specifically to 76.7a current patient, to whom the prescriber is prescribing or considering prescribing any 76.8controlled substance and with the provision that the prescriber remains responsible for the 76.9use or misuse of data accessed by a delegated agent or employee;76.10    (2) a dispenser or an agent or employee of the dispenser to whom the dispenser has 76.11delegated the task of accessing the data, to the extent the information relates specifically 76.12to a current patient to whom that dispenser is dispensing or considering dispensing any 76.13controlled substance and with the provision that the dispenser remains responsible for the 76.14use or misuse of data accessed by a delegated agent or employee;76.15    (3) an individual who is the recipient of a controlled substance prescription for 76.16which data was submitted under subdivision 4, or a guardian of the individual, parent or 76.17guardian of a minor, or health care agent of the individual acting under a health care 76.18directive under chapter 145C;76.19    (4) personnel of the board specifically assigned to conduct a bona fide investigation 76.20of a specific licensee;76.21    (5) personnel of the board engaged in the collection of controlled substance 76.22prescription information as part of the assigned duties and responsibilities under this 76.23section;76.24    (6) authorized personnel of a vendor under contract with the board who are engaged 76.25in the design, implementation, operation, and maintenance of the electronic reporting 76.26system as part of the assigned duties and responsibilities of their employment, provided 76.27that access to data is limited to the minimum amount necessary to carry out such duties 76.28and responsibilities;76.29    (7) federal, state, and local law enforcement authorities acting pursuant to a valid 76.30search warrant; and76.31    (8) personnel of the medical assistance program assigned to use the data collected 76.32under this section to identify recipients whose usage of controlled substances may warrant 76.33restriction to a single primary care physician, a single outpatient pharmacy, or a single 76.34hospital.76.35    For purposes of clause (3), access by an individual includes persons in the definition 76.36of an individual under section 
         13.02.77.1    (c) Any permissible user identified in paragraph (b), who directly accesses 77.2the data electronically, shall implement and maintain a comprehensive information 77.3security program that contains administrative, technical, and physical safeguards that 77.4are appropriate to the user's size and complexity, and the sensitivity of the personal 77.5information obtained. The permissible user shall identify reasonably foreseeable internal 77.6and external risks to the security, confidentiality, and integrity of personal information 77.7that could result in the unauthorized disclosure, misuse, or other compromise of the 77.8information and assess the sufficiency of any safeguards in place to control the risks.77.9    (d) The board shall not release data submitted under this section unless it is provided 77.10with evidence, satisfactory to the board, that the person requesting the information is 77.11entitled to receive the data.77.12    (e) The board shall not release the name of a prescriber without the written consent 77.13of the prescriber or a valid search warrant or court order. The board shall provide a 77.14mechanism for a prescriber to submit to the board a signed consent authorizing the release 77.15of the prescriber's name when data containing the prescriber's name is requested.77.16    (f) The board shall maintain a log of all persons who access the data and shall ensure 77.17that any permissible user complies with paragraph (c) prior to attaining direct access to 77.18the data.77.19(g) Section 
         13.05, subdivision 6, shall apply to any contract the board enters into 77.20pursuant to subdivision 2. A vendor shall not use data collected under this section for 77.21any purpose not specified in this section.77.22    Subd. 7. Disciplinary action. (a) A dispenser who knowingly fails to submit data to 77.23the board as required under this section is subject to disciplinary action by the appropriate 77.24health-related licensing board.77.25    (b) A prescriber or dispenser authorized to access the data who knowingly discloses 77.26the data in violation of state or federal laws relating to the privacy of health care data 77.27shall be subject to disciplinary action by the appropriate health-related licensing board, 77.28and appropriate civil penalties.77.29    Subd. 8. Evaluation and reporting. (a) The board shall evaluate the prescription 77.30electronic reporting system to determine if the system is negatively impacting appropriate 77.31prescribing practices of controlled substances. The board may contract with a vendor to 77.32design and conduct the evaluation.77.33    (b) The board shall submit the evaluation of the system to the legislature by January77.34July 15, 2011.77.35    Subd. 9. Immunity from liability; no requirement to obtain information. (a) A 77.36pharmacist, prescriber, or other dispenser making a report to the program in good faith 78.1under this section is immune from any civil, criminal, or administrative liability, which 78.2might otherwise be incurred or imposed as a result of the report, or on the basis that the 78.3pharmacist or prescriber did or did not seek or obtain or use information from the program.78.4    (b) Nothing in this section shall require a pharmacist, prescriber, or other dispenser 78.5to obtain information about a patient from the program, and the pharmacist, prescriber, 78.6or other dispenser, if acting in good faith, is immune from any civil, criminal, or 78.7administrative liability that might otherwise be incurred or imposed for requesting, 78.8receiving, or using information from the program.78.9    Subd. 10.Funding.(a) The board may seek grants and private funds from nonprofit 78.10charitable foundations, the federal government, and other sources to fund the enhancement 78.11and ongoing operations of the prescription electronic reporting system established under 78.12this section. Any funds received shall be appropriated to the board for this purpose. The 78.13board may not expend funds to enhance the program in a way that conflicts with this 78.14section without seeking approval from the legislature.78.15(b) The administrative services unit for the health-related licensing boards shall 78.16apportion between the Board of Medical Practice, the Board of Nursing, the Board of 78.17Dentistry, the Board of Podiatric Medicine, the Board of Optometry, and the Board 78.18of Pharmacy an amount to be paid through fees by each respective board. The amount 78.19apportioned to each board shall equal each board's share of the annual appropriation to 78.20the Board of Pharmacy from the state government special revenue fund for operating the 78.21prescription electronic reporting system under this section. Each board's apportioned 78.22share shall be based on the number of prescribers or dispensers that each board identified 78.23in this paragraph licenses as a percentage of the total number of prescribers and dispensers 78.24licensed collectively by these boards. Each respective board may adjust the fees that the 78.25boards are required to collect to compensate for the amount apportioned to each board by 78.26the administrative services unit.78.27    Sec. 4. [246.125] CHEMICAL AND MENTAL HEALTH SERVICES 78.28TRANSFORMATION ADVISORY TASK FORCE.78.29    Subdivision 1.Establishment.The Chemical and Mental Health Services 78.30Transformation Advisory Task Force is established to make recommendations to the 78.31commissioner of human services and the legislature on the continuum of services needed 78.32to provide individuals with complex conditions including mental illness, chemical 78.33dependency, traumatic brain injury, and developmental disabilities access to quality care 78.34and the appropriate level of care across the state to promote wellness, reduce cost, and 78.35improve efficiency.79.1    Subd. 2.Duties.The Chemical and Mental Health Services Transformation 79.2Advisory Task Force shall make recommendations to the commissioner and the legislature 79.3no later than December 15, 2010, on the following:79.4(1) transformation needed to improve service delivery and provide a continuum of 79.5care, such as transition of current facilities, closure of current facilities, or the development 79.6of new models of care, including the redesign of the Anoka-Metro Regional Treatment 79.7Center;79.8(2) gaps and barriers to accessing quality care, system inefficiencies, and cost 79.9pressures;79.10(3) services that are best provided by the state and those that are best provided 79.11in the community;79.12(4) an implementation plan to achieve integrated service delivery across the public, 79.13private, and nonprofit sectors;79.14(5) an implementation plan to ensure that individuals with complex chemical and 79.15mental health needs receive the appropriate level of care to achieve recovery and wellness; 79.16and79.17(6) financing mechanisms that include all possible revenue sources to maximize 79.18federal funding and promote cost efficiencies and sustainability.79.19    Subd. 3.Membership.The advisory task force shall be composed of the following, 79.20who will serve at the pleasure of their appointing authority:79.21(1) the commissioner of human services or the commissioner's designee, and two 79.22additional representatives from the department;79.23(2) two legislators appointed by the speaker of the house, one from the minority 79.24and one from the majority;79.25(3) two legislators appointed by the senate rules committee, one from the minority 79.26and one from the majority;79.27(4) one representative appointed by AFSCME Council 5;79.28(5) one representative appointed by the ombudsman for mental health and 79.29developmental disabilities;79.30(6) one representative appointed by the Minnesota Association of Professional 79.31Employees;79.32(7) one representative appointed by the Minnesota Hospital Association;79.33(8) one representative appointed by the Minnesota Nurses Association;79.34(9) one representative appointed by NAMI-MN;79.35(10) one representative appointed by the Mental Health Association of Minnesota;80.1(11) one representative appointed by the Minnesota Association Of Community 80.2Mental Health Programs;80.3(12) one representative appointed by the Minnesota Dental Association;80.4(13) three clients or client family members representing different populations 80.5receiving services from state-operated services, who are appointed by the commissioner;80.6(14) one representative appointed by the chair of the state-operated services 80.7governing board;80.8(15) one representative appointed by the Minnesota Disability Law Center;80.9(16) one representative appointed by the Consumer Survivor Network;80.10(17) one representative appointed by the Association of Residential Resources 80.11in Minnesota;80.12(18) one representative appointed by the Minnesota Council of Child Caring 80.13Agencies;80.14(19) one representative appointed by the Association of Minnesota Counties; and80.15(20) one representative appointed by the Minnesota Pharmacists Association.80.16The commissioner may appoint additional members to reflect stakeholders who 80.17are not represented above.80.18    Subd. 4.Administration.The commissioner shall convene the first meeting of the 80.19advisory task force and shall provide administrative support and staff.80.20    Subd. 5.Recommendations.The advisory task force must report its 80.21recommendations to the commissioner and to the legislature no later than December 80.2215, 2010.80.23    Subd. 6.Member requirement.The commissioner shall provide per diem and 80.24travel expenses pursuant to section 256.01, subdivision 6, for task force members who 80.25are consumers or family members and whose participation on the task force is not as a 80.26paid representative of any agency, organization, or association. Notwithstanding section 80.2715.059, other task members are not eligible for per diem or travel reimbursement.80.28    Sec. 5. [246.128] NOTIFICATION TO LEGISLATURE REQUIRED.80.29The commissioner shall notify the chairs and ranking minority members of 80.30the relevant legislative committees regarding the redesign, closure, or relocation of 80.31state-operated services programs. The notification must include the advice of the Chemical 80.32and Mental Health Services Transformation Advisory Task Force under section 246.125.80.33    Sec. 6. [246.129] LEGISLATIVE APPROVAL REQUIRED.81.1If the closure of a state-operated facility is proposed, and the department and 81.2respective bargaining units fail to arrive at a mutually agreed upon solution to transfer 81.3affected state employees to other state jobs, the closure of the facility requires legislative 81.4approval. This does not apply to state-operated enterprise services.81.5    Sec. 7. Minnesota Statutes 2008, section 246.18, is amended by adding a subdivision 81.6to read:81.7    Subd. 8.State-operated services account.The state-operated services account is 81.8established in the special revenue fund. Revenue generated by new state-operated services 81.9listed under this section established after July 1, 2010, that are not enterprise activities must 81.10be deposited into the state-operated services account, unless otherwise specified in law:81.11(1) intensive residential treatment services;81.12(2) foster care services; and81.13(3) psychiatric extensive recovery treatment services.81.14    Sec. 8. Minnesota Statutes 2008, section 254B.01, subdivision 2, is amended to read:81.15    Subd. 2. American Indian. For purposes of services provided under section 81.16254B.09, subdivision 7 8, "American Indian" means a person who is a member of an 81.17Indian tribe, and the commissioner shall use the definitions of "Indian" and "Indian tribe" 81.18and "Indian organization" provided in Public Law 93-638. For purposes of services 81.19provided under section 
         254B.09, subdivision 4 6, "American Indian" means a resident of 81.20federally recognized tribal lands who is recognized as an Indian person by the federally 81.21recognized tribal governing body.  81.22    Sec. 9. Minnesota Statutes 2008, section 254B.02, subdivision 1, is amended to read:81.23    Subdivision 1. Chemical dependency treatment allocation. The chemical 81.24dependency funds appropriated for allocation treatment appropriation  shall be placed in 81.25a special revenue account. The commissioner shall annually transfer funds from the 81.26chemical dependency fund to pay for operation of the drug and alcohol abuse normative 81.27evaluation system and to pay for all costs incurred by adding two positions for licensing 81.28of chemical dependency treatment and rehabilitation programs located in hospitals for 81.29which funds are not otherwise appropriated. Six percent of the remaining money must 81.30be reserved for tribal allocation under section 254B.09, subdivisions 4 and 5. The 81.31commissioner shall annually divide the money available in the chemical dependency 81.32fund that is not held in reserve by counties from a previous allocation, or allocated to the 81.33American Indian chemical dependency tribal account. Six percent of the remaining money 82.1must be reserved for the nonreservation American Indian chemical dependency allocation 82.2for treatment of American Indians by eligible vendors under section 254B.05, subdivision 82.31. The remainder of the money must be allocated among the counties according to the 82.4following formula, using state demographer data and other data sources determined by 82.5the commissioner: 82.6    (a) For purposes of this formula, American Indians and children under age 14 are 82.7subtracted from the population of each county to determine the restricted population.82.8    (b) The amount of chemical dependency fund expenditures for entitled persons for 82.9services not covered by prepaid plans governed by section 256B.69 in the previous year is 82.10divided by the amount of chemical dependency fund expenditures for entitled persons for 82.11all services to determine the proportion of exempt service expenditures for each county. 82.12    (c) The prepaid plan months of eligibility is multiplied by the proportion of exempt 82.13service expenditures to determine the adjusted prepaid plan months of eligibility for 82.14each county.82.15    (d) The adjusted prepaid plan months of eligibility is added to the number of 82.16restricted population fee for service months of eligibility for the Minnesota family 82.17investment program, general assistance, and medical assistance and divided by the county 82.18restricted population to determine county per capita months of covered service eligibility.82.19    (e) The number of adjusted prepaid plan months of eligibility for the state is added 82.20to the number of fee for service months of eligibility for the Minnesota family investment 82.21program, general assistance, and medical assistance for the state restricted population and 82.22divided by the state restricted population to determine state per capita months of covered 82.23service eligibility.82.24    (f) The county per capita months of covered service eligibility is divided by the 82.25state per capita months of covered service eligibility to determine the county welfare 82.26caseload factor.82.27    (g) The median married couple income for the most recent three-year period 82.28available for the state is divided by the median married couple income for the same period 82.29for each county to determine the income factor for each county.82.30    (h) The county restricted population is multiplied by the sum of the county welfare 82.31caseload factor and the county income factor to determine the adjusted population.82.32    (i) $15,000 shall be allocated to each county.82.33    (j) The remaining funds shall be allocated proportional to the county adjusted 82.34population  in the special revenue account must be used according to the requirements 82.35in this chapter.83.1    Sec. 10. Minnesota Statutes 2008, section 254B.02, subdivision 5, is amended to read:83.2    Subd. 5. Administrative adjustment. The commissioner may make payments to 83.3local agencies from money allocated under this section to support administrative activities 83.4under sections 
         254B.03 and 
         254B.04. The administrative payment must not exceed 83.5the lesser of: (1) five percent of the first $50,000, four percent of the next $50,000, and 83.6three percent of the remaining payments for services from the allocation special revenue 83.7account according to subdivision 1; or (2) the local agency administrative payment for 83.8the fiscal year ending June 30, 2009, adjusted in proportion to the statewide change in 83.9the appropriation for this chapter. 83.10    Sec. 11. Minnesota Statutes 2008, section 254B.03, subdivision 4, is amended to read:83.11    Subd. 4. Division of costs. Except for services provided by a county under 83.12section 
         254B.09, subdivision 1, or services provided under section 
         256B.69 or 
         256D.03, 83.13subdivision 4
         , paragraph (b), the county shall, out of local money, pay the state for 83.1415 16.14 percent of the cost of chemical dependency services, including those services 83.15provided to persons eligible for medical assistance under chapter 256B and general 83.16assistance medical care under chapter 256D. Counties may use the indigent hospitalization 83.17levy for treatment and hospital payments made under this section. Fifteen 16.14 percent 83.18of any state collections from private or third-party pay, less 15 percent of for the cost 83.19of payment and collections, must be distributed to the county that paid for a portion of 83.20the treatment under this section. If all funds allocated according to section 254B.02 are 83.21exhausted by a county and the county has met or exceeded the base level of expenditures 83.22under section 254B.02, subdivision 3, the county shall pay the state for 15 percent of the 83.23costs paid by the state under this section. The commissioner may refuse to pay state funds 83.24for services to persons not eligible under section 254B.04, subdivision 1, if the county 83.25financially responsible for the persons has exhausted its allocation. 83.26    Sec. 12. Minnesota Statutes 2008, section 254B.05, subdivision 4, is amended to read:83.27    Subd. 4. Regional treatment centers. Regional treatment center chemical 83.28dependency treatment units are eligible vendors. The commissioner may expand the 83.29capacity of chemical dependency treatment units beyond the capacity funded by direct 83.30legislative appropriation to serve individuals who are referred for treatment by counties 83.31and whose treatment will be paid for with a county's allocation under section 254B.02 by 83.32funding under this chapter or other funding sources. Notwithstanding the provisions of 83.33sections 
         254B.03 to 
         254B.041, payment for any person committed at county request to 83.34a regional treatment center under chapter 253B for chemical dependency treatment and 84.1determined to be ineligible under the chemical dependency consolidated treatment fund, 84.2shall become the responsibility of the county.  84.3    Sec. 13. Minnesota Statutes 2008, section 254B.06, subdivision 2, is amended to read:84.4    Subd. 2. Allocation of collections. The commissioner shall allocate all federal 84.5financial participation collections to the reserve fund under section 254B.02, subdivision 384.6a special revenue account. The commissioner shall retain 85 allocate 83.86 percent of 84.7patient payments and third-party payments to the special revenue account and allocate 84.8the collections to the treatment allocation for the county that is financially responsible 84.9for the person. Fifteen 16.14 percent of patient and third-party payments must be paid84.10to the county financially responsible for the patient. Collections for patient payment and 84.11third-party payment for services provided under section 254B.09 shall be allocated to the 84.12allocation of the tribal unit which placed the person. Collections of federal financial 84.13participation for services provided under section 254B.09 shall be allocated to the tribal 84.14reserve account under section 254B.09, subdivision 5.84.15    Sec. 14. Minnesota Statutes 2008, section 254B.09, subdivision 8, is amended to read:84.16    Subd. 8. Payments to improve services to American Indians. The commissioner 84.17may set rates for chemical dependency services to American Indians according to the 84.18American Indian Health Improvement Act, Public Law 94-437, for eligible vendors. 84.19These rates shall supersede rates set in county purchase of service agreements when 84.20payments are made on behalf of clients eligible according to Public Law 94-437.84.21    Sec. 15. [254B.13] PILOT PROJECTS; CHEMICAL HEALTH CARE.84.22    Subdivision 1.Authorization for pilot projects.The commissioner may approve 84.23and implement pilot projects developed under the planning process required under Laws 84.242009, chapter 79, article 7, section 26, to provide alternatives to and enhance coordination 84.25of the delivery of chemical health services required under section 254B.03.84.26    Subd. 2.Program design and implementation.(a) The commissioner and counties 84.27participating in the pilot projects shall continue to work in partnership to refine and 84.28implement the pilot projects initiated under Laws 2009, chapter 79, article 7, section 26.84.29(b) The commissioner and counties participating in the pilot projects shall 84.30complete the planning phase by June 30, 2010, and, if approved by the commissioner for 84.31implementation, enter into agreements governing the operation of the pilot projects with 84.32implementation scheduled no earlier than July 1, 2010.85.1    Subd. 3.Program evaluation. The commissioner shall evaluate pilot projects under 85.2this section and report the results of the evaluation to the chairs and ranking minority 85.3members of the legislative committees with jurisdiction over chemical health issues by 85.4January 15, 2013. Evaluation of the pilot projects must be based on outcome evaluation 85.5criteria negotiated with the pilot projects prior to implementation.85.6    Subd. 4.Notice of project discontinuation.Each county's participation in the 85.7pilot project may be discontinued for any reason by the county or the commissioner of 85.8human services after 30 days' written notice to the other party. Any unspent funds held 85.9for the exiting county's pro rata share in the special revenue fund under the authority in 85.10subdivision 5, paragraph (d), shall be transferred to the consolidated chemical dependency 85.11treatment fund following discontinuation of the pilot project.85.12    Subd. 5.Duties of commissioner.(a) Notwithstanding any other provisions in 85.13this chapter, the commissioner may authorize pilot projects to use chemical dependency 85.14treatment funds to pay for nontreatment pilot services:85.15(1) in addition to those authorized under section 254B.03, subdivision 2, paragraph 85.16(a); and85.17(2) by vendors in addition to those authorized under section 254B.05 when not 85.18providing chemical dependency treatment services.85.19(b) For purposes of this section, "nontreatment pilot services" include navigator 85.20services, peer support, family engagement and support, housing support, rent subsidies, 85.21supported employment, and independent living skills.85.22(c) State expenditures for chemical dependency services and nontreatment pilot 85.23services provided by or through the pilot projects must not be greater than the chemical 85.24dependency treatment fund expected share of forecasted expenditures in the absence of 85.25the pilot projects. The commissioner may restructure the schedule of payments between 85.26the state and participating counties under the local agency share and division of cost 85.27provisions under section 254B.03, subdivisions 3 and 4, as necessary to facilitate the 85.28operation of the pilot projects.85.29(d) To the extent that state fiscal year expenditures within a pilot project are less 85.30than the expected share of forecasted expenditures in the absence of the pilot projects, 85.31the commissioner shall deposit the unexpended funds in a separate account within the 85.32consolidated chemical dependency treatment fund, and make these funds available for 85.33expenditure by the pilot projects the following year. To the extent that treatment and 85.34nontreatment pilot services expenditures within the pilot project exceed the amount 85.35expected in the absence of the pilot projects, the pilot project county or counties are 86.1responsible for the portion of nontreatment pilot services expenditures in excess of the 86.2otherwise expected share of forecasted expenditures.86.3(e) The commissioner may waive administrative rule requirements that are 86.4incompatible with the implementation of the pilot project, except that any chemical 86.5dependency treatment funded under this section must continue to be provided by a 86.6licensed treatment provider.86.7(f) The commissioner shall not approve or enter into any agreement related to pilot 86.8projects authorized under this section that puts current or future federal funding at risk.86.9    Subd. 6.Duties of county board.The county board, or other county entity that is 86.10approved to administer a pilot project, shall:86.11(1) administer the pilot project in a manner consistent with the objectives described 86.12in subdivision 2 and the planning process in subdivision 5;86.13(2) ensure that no one is denied chemical dependency treatment services for which 86.14they would otherwise be eligible under section 254A.03, subdivision 3; and86.15(3) provide the commissioner with timely and pertinent information as negotiated 86.16in agreements governing operation of the pilot projects.86.17    Sec. 16. Minnesota Statutes 2009 Supplement, section 517.08, subdivision 1b, is 86.18amended to read:86.19    Subd. 1b. Term of license; fee; premarital education. (a) The local registrar 86.20shall examine upon oath the parties applying for a license relative to the legality of the 86.21contemplated marriage. If one party is unable to appear in person, the party appearing 86.22may complete the absent applicant's information. The local registrar shall provide a copy 86.23of the marriage application to the party who is unable to appear, who must verify the 86.24accuracy of the party's information in a notarized statement. The marriage license must 86.25not be released until the verification statement has been received by the local registrar. If 86.26at the expiration of a five-day period, on being satisfied that there is no legal impediment 86.27to it, including the restriction contained in section 
         259.13, the local registrar shall issue 86.28the license, containing the full names of the parties before and after marriage, and county 86.29and state of residence, with the county seal attached, and make a record of the date of 86.30issuance. The license shall be valid for a period of six months. Except as provided in 86.31paragraph (c), the local registrar shall collect from the applicant a fee of $110 $115 for 86.32administering the oath, issuing, recording, and filing all papers required, and preparing 86.33and transmitting to the state registrar of vital statistics the reports of marriage required 86.34by this section. If the license should not be used within the period of six months due to 86.35illness or other extenuating circumstances, it may be surrendered to the local registrar for 87.1cancellation, and in that case a new license shall issue upon request of the parties of the 87.2original license without fee. A local registrar who knowingly issues or signs a marriage 87.3license in any manner other than as provided in this section shall pay to the parties 87.4aggrieved an amount not to exceed $1,000.87.5(b) In case of emergency or extraordinary circumstances, a judge of the district court 87.6of the county in which the application is made may authorize the license to be issued at 87.7any time before expiration of the five-day period required under paragraph (a). A waiver 87.8of the five-day waiting period must be in the following form:87.9STATE OF MINNESOTA, COUNTY OF .................... (insert county name)87.10APPLICATION FOR WAIVER OF MARRIAGE LICENSE WAITING PERIOD:87.11................................................................................. (legal names of the applicants)87.12Represent and state as follows:87.13That on ......................... (date of application) the applicants applied to the local 87.14registrar of the above-named county for a license to marry.87.15That it is necessary that the license be issued before the expiration of five days 87.16from the date of the application by reason of the following: (insert reason for requesting 87.17waiver of waiting period)87.18.............................................................................................................87.19.............................................................................................................87.20.............................................................................................................87.21WHEREAS, the applicants request that the judge waive the required five-day 87.22waiting period and the local registrar be authorized and directed to issue the marriage 87.23license immediately.87.24Date: .............................87.25.......................................................................................87.26.......................................................................................87.27(Signatures of applicants)87.28Acknowledged before me on this ....... day of .................... .87.29..........................................87.30NOTARY PUBLIC87.31COURT ORDER AND AUTHORIZATION:87.32STATE OF MINNESOTA, COUNTY OF .................... (insert county name)87.33After reviewing the above application, I am satisfied that an emergency or 87.34extraordinary circumstance exists that justifies the issuance of the marriage license before 87.35the expiration of five days from the date of the application. IT IS HEREBY ORDERED 87.36that the local registrar is authorized and directed to issue the license forthwith.88.1.....................................................88.2................................ (judge of district court)88.3................................ (date).88.4(c) The marriage license fee for parties who have completed at least 12 hours of 88.5premarital education is $40. In order to qualify for the reduced license fee, the parties 88.6must submit at the time of applying for the marriage license a signed, dated, and notarized 88.7statement from the person who provided the premarital education on their letterhead 88.8confirming that it was received. The premarital education must be provided by a licensed 88.9or ordained minister or the minister's designee, a person authorized to solemnize marriages 88.10under section 
         517.18, or a person authorized to practice marriage and family therapy under 88.11section 
         148B.33. The education must include the use of a premarital inventory and the 88.12teaching of communication and conflict management skills.88.13    (d) The statement from the person who provided the premarital education under 88.14paragraph (b) must be in the following form:88.15    "I, .......................... (name of educator), confirm that .......................... (names of 88.16both parties) received at least 12 hours of premarital education that included the use of a 88.17premarital inventory and the teaching of communication and conflict management skills. 88.18I am a licensed or ordained minister, a person authorized to solemnize marriages under 88.19Minnesota Statutes, section 
         517.18, or a person licensed to practice marriage and family 88.20therapy under Minnesota Statutes, section 
         148B.33."88.21    The names of the parties in the educator's statement must be identical to the legal 88.22names of the parties as they appear in the marriage license application. Notwithstanding 88.23section 
         138.17, the educator's statement must be retained for seven years, after which 88.24time it may be destroyed.88.25    (e) If section 
         259.13 applies to the request for a marriage license, the local registrar 88.26shall grant the marriage license without the requested name change. Alternatively, the local 88.27registrar may delay the granting of the marriage license until the party with the conviction:88.28    (1) certifies under oath that 30 days have passed since service of the notice for a 88.29name change upon the prosecuting authority and, if applicable, the attorney general and no 88.30objection has been filed under section 
         259.13; or88.31    (2) provides a certified copy of the court order granting it. The parties seeking the 88.32marriage license shall have the right to choose to have the license granted without the 88.33name change or to delay its granting pending further action on the name change request.88.34    Sec. 17. Minnesota Statutes 2008, section 517.08, subdivision 1c, as amended by Laws 88.352010, chapter 200, article 1, section 17, is amended to read:89.1    Subd. 1c. Disposition of license fee. (a) Of the marriage license fee collected 89.2pursuant to subdivision 1b, paragraph (a), $25 must be retained by the county. The 89.3local registrar must pay $85 $90 to the commissioner of management and budget to be 89.4deposited as follows:89.5    (1) $55 in the general fund;89.6    (2) $3 in the state government special revenue fund to be appropriated to the 89.7commissioner of public safety for parenting time centers under section 
         119A.37;89.8    (3) $2 in the special revenue fund to be appropriated to the commissioner of health 89.9for developing and implementing the MN ENABL program under section 
         145.9255; and89.10    (4) $25 in the special revenue fund is appropriated to the commissioner of 89.11employment and economic development for the displaced homemaker program under 89.12section 
         116L.96; and89.13    (5) $5 in the special revenue fund, which is appropriated to the Board of Regents 89.14of the University of Minnesota for the Minnesota couples on the brink project under 89.15section 137.32.89.16    (b) Of the $40 fee under subdivision 1b, paragraph (b), $25 must be retained by the 89.17county. The local registrar must pay $15 to the commissioner of management and budget 89.18to be deposited as follows:89.19    (1) $5 as provided in paragraph (a), clauses (2) and (3); and89.20    (2) $10 in the special revenue fund is appropriated to the commissioner of 89.21employment and economic development for the displaced homemaker program under 89.22section 
         116L.96.89.23    Sec. 18. Laws 2009, chapter 79, article 3, section 18, is amended to read:89.24    Sec. 18. REQUIRING THE DEVELOPMENT OF COMMUNITY-BASED 89.25MENTAL HEALTH SERVICES FOR PATIENTS COMMITTED TO THE 89.26ANOKA-METRO REGIONAL TREATMENT CENTER.89.27In consultation with community partners, the commissioner of human services89.28The Chemical and Mental Health Services Transformation Advisory Task Force shall 89.29develop recommend an array of community-based services in the metro area to transform 89.30the current services now provided to patients at the Anoka-Metro Regional Treatment 89.31Center. The community-based services may be provided in facilities with 16 or fewer 89.32beds, and must provide the appropriate level of care for the patients being admitted to 89.33the facilities established in partnership with private and public hospital organizations, 89.34community mental health centers and other mental health community services providers, 89.35and community partnerships, and must be staffed by state employees. The planning 90.1for this transition must be completed by October 1, 2009 2010, with an initial a  report 90.2detailing the transition plan, services that will be provided, including incorporating peer 90.3specialists where appropriate, the location of the services, and the number of patients 90.4that will be served, to the committee chairs of health and human services by November 90.530, 2009, and a semiannual report on progress until the transition is completed. The 90.6commissioner of human services shall solicit interest from stakeholders and potential 90.7community partners 2010. The individuals working inemployed by the community-based 90.8services facilities under this section are state employees supervised by the commissioner 90.9of human services. No layoffs shall occur as a result of restructuring under this section.90.10Savings generated as a result of transitioning patients from the Anoka-Metro Regional 90.11Treatment Center to community-based services may be used to fund supportive housing 90.12staffed by state employees.90.13    Sec. 19. REPORT ON HUMAN SERVICES FISCAL NOTES.90.14The commissioner of management and budget shall issue a report to the legislature 90.15no later than November 15, 2010, making recommendations for improving the preparation 90.16and delivery of fiscal notes under Minnesota Statutes, section 3.98, relating to human 90.17services. The report shall consider: (1) the establishment of an independent fiscal 90.18note office in the human services department and (2) transferring the responsibility for 90.19preparing human services fiscal notes to the legislature. The report must include detailed 90.20information regarding the financial costs, staff resources, training, access to information, 90.21and data protection issues relative to the preparation of human services fiscal notes. The 90.22report shall describe methods and procedures used by other states to insure independence 90.23and accuracy of fiscal estimates on legislative proposals for changes in human services.90.24    Sec. 20. PRESCRIPTION DRUG WASTE REDUCTION.90.25The Minnesota Board of Pharmacy, in cooperation with the commissioners of 90.26human services, pollution control, health, veterans affairs, and corrections, shall study 90.27prescription drug waste reduction techniques and technologies applicable to long-term 90.28care facilities, veterans nursing homes, and correctional facilities. In conducting the 90.29study, the commissioners shall consult with the Minnesota Pharmacists Association, the 90.30University of Minnesota College of Pharmacy, University of Minnesota's Minnesota 90.31Technical Assistance Project, consumers, long-term care providers, and other interested 90.32parties. The board shall evaluate the extent to which new prescription drug waste reduction 90.33techniques and technologies can reduce the amount of prescription drugs that enter the 90.34waste stream and reduce state prescription drug costs. The techniques and technologies 91.1studied must include, but are not limited to, daily, weekly, and automated dose dispensing. 91.2The study must provide an estimate of the cost of adopting these and other techniques 91.3and technologies, and an estimate of waste reduction and state prescription drug savings 91.4that would result from adoption. The study must also evaluate methods of encouraging 91.5the adoption of effective drug waste reduction techniques and technologies. The board 91.6shall present recommendations on the adoption of new prescription drug waste reduction 91.7techniques and technologies to the legislature by December 15, 2011.91.8    Sec. 21. VETERINARY PRACTICE AND CONTROLLED SUBSTANCE 91.9ABUSE STUDY.91.10The Board of Pharmacy, in consultation with the Prescription Electronic Reporting 91.11Advisory Committee and the Board of Veterinary Medical Practice, shall study the issue 91.12of the diversion of controlled substances from veterinary practice and report to the chairs 91.13and ranking minority members of the senate health and human services policy and finance 91.14division and the house of representatives health care and human services policy and 91.15finance division by December 15, 2011, on recommendations to include veterinarians in 91.16the prescription electronic reporting system in Minnesota Statutes, section 152.126.91.17    Sec. 22.  REPEALER.91.18Minnesota Statutes 2008, sections 254B.02, subdivisions 2, 3, and 4; and 254B.09, 91.19subdivisions 4, 5, and 7, are repealed.91.20    Sec. 23. EFFECTIVE DATE.91.21Sections 8 to 14 and 22 are effective for claims paid on or after July 1, 2010.91.22ARTICLE 591.23DEPARTMENT OF HEALTH91.24    Section 1. Minnesota Statutes 2008, section 62D.08, is amended by adding a 91.25subdivision to read:91.26    Subd. 7.Consistent administrative expenses and investment income reporting.91.27(a) Every health maintenance organization must directly allocate administrative expenses 91.28to specific lines of business or products when such information is available. Remaining 91.29expenses that cannot be directly allocated must be allocated based on other methods, as 91.30recommended by the Advisory Group on Administrative Expenses. Health maintenance 91.31organizations must submit this information, including administrative expenses for dental 91.32services, using the reporting template provided by the commissioner of health.92.1(b) Every health maintenance organization must allocate investment income based 92.2on cumulative net income over time by business line or product and must submit this 92.3information, including investment income for dental services, using the reporting template 92.4provided by the commissioner of health.92.5EFFECTIVE DATE.This section is effective January 1, 2013.92.6    Sec. 2. [62D.31] ADVISORY GROUP ON ADMINISTRATIVE EXPENSES.92.7    Subdivision 1.Establishment.The Advisory Group on Administrative Expenses 92.8is established to make recommendations on the development of consistent guidelines 92.9and reporting requirements, including development of a reporting template, for health 92.10maintenance organizations and county-based purchasing plans that participate in publicly 92.11funded programs. 92.12    Subd. 2.Membership.The membership of the advisory group shall be comprised 92.13of the following, who serve at the pleasure of their appointing authority:92.14(1) the commissioner of health or the commissioner's designee;92.15(2) the commissioner of human services or the commissioner's designee;92.16(3) the commissioner of commerce or the commissioner's designee; and92.17(4) representatives of health maintenance organizations and county-based purchasers 92.18appointed by the commissioner of health.92.19    Subd. 3.Administration.The commissioner of health shall convene the first 92.20meeting of the advisory group by December 1, 2010, and shall provide administrative 92.21support and staff. The commissioner of health may contract with a consultant to provide 92.22professional assistance and expertise to the advisory group.92.23    Subd. 4.Recommendations.The Advisory Group on Administrative Expenses 92.24must report its recommendations, including any proposed legislation necessary to 92.25implement the recommendations, to the commissioner of health and to the chairs and 92.26ranking minority members of the legislative committees and divisions with jurisdiction 92.27over health policy and finance by February 15, 2012.92.28    Subd. 5.Expiration.This section expires after submission of the report required 92.29under subdivision 4 or June 30, 2012, whichever is sooner.92.30    Sec. 3. Minnesota Statutes 2008, section 62Q.19, subdivision 1, is amended to read:92.31    Subdivision 1. Designation. (a) The commissioner shall designate essential 92.32community providers. The criteria for essential community provider designation shall be 92.33the following:93.1(1) a demonstrated ability to integrate applicable supportive and stabilizing services 93.2with medical care for uninsured persons and high-risk and special needs populations, 93.3underserved, and other special needs populations; and93.4(2) a commitment to serve low-income and underserved populations by meeting the 93.5following requirements:93.6(i) has nonprofit status in accordance with chapter 317A;93.7(ii) has tax exempt status in accordance with the Internal Revenue Service Code, 93.8section 501(c)(3);93.9(iii) charges for services on a sliding fee schedule based on current poverty income 93.10guidelines; and93.11(iv) does not restrict access or services because of a client's financial limitation;93.12(3) status as a local government unit as defined in section 
         62D.02, subdivision 11, a 93.13hospital district created or reorganized under sections 
         447.31 to 
         447.37, an Indian tribal 93.14government, an Indian health service unit, or a community health board as defined in 93.15chapter 145A;  93.16(4) a former state hospital that specializes in the treatment of cerebral palsy, spina 93.17bifida, epilepsy, closed head injuries, specialized orthopedic problems, and other disabling 93.18conditions; or93.19(5) a sole community hospital. For these rural hospitals, the essential community 93.20provider designation applies to all health services provided, including both inpatient and 93.21outpatient services. For purposes of this section, "sole community hospital" means a 93.22rural hospital that:93.23(i) is eligible to be classified as a sole community hospital according to Code 93.24of Federal Regulations, title 42, section 
         412.92, or is located in a community with a 93.25population of less than 5,000 and located more than 25 miles from a like hospital currently 93.26providing acute short-term services;  93.27(ii) has experienced net operating income losses in two of the previous three 93.28most recent consecutive hospital fiscal years for which audited financial information is 93.29available; and93.30(iii) consists of 40 or fewer licensed beds; or93.31(6) a birth center licensed under section 144.615.93.32(b) Prior to designation, the commissioner shall publish the names of all applicants 93.33in the State Register. The public shall have 30 days from the date of publication to submit 93.34written comments to the commissioner on the application. No designation shall be made 93.35by the commissioner until the 30-day period has expired.94.1(c) The commissioner may designate an eligible provider as an essential community 94.2provider for all the services offered by that provider or for specific services designated by 94.3the commissioner.94.4(d) For the purpose of this subdivision, supportive and stabilizing services include at 94.5a minimum, transportation, child care, cultural, and linguistic services where appropriate.94.6    Sec. 4. Minnesota Statutes 2008, section 144.05, is amended by adding a subdivision 94.7to read:94.8    Subd. 5.Firearms data.Notwithstanding any law to the contrary, the commissioner 94.9of health is prohibited from collecting data on individuals regarding lawful firearm 94.10ownership in the state or data related to an individual's right to carry a weapon under 94.11section 624.714.94.12    Sec. 5. Minnesota Statutes 2008, section 144.226, subdivision 3, is amended to read:94.13    Subd. 3. Birth record surcharge.(a) In addition to any fee prescribed under 94.14subdivision 1, there shall be a nonrefundable surcharge of $3 for each certified birth or 94.15stillbirth record and for a certification that the vital record cannot be found. The local or 94.16state registrar shall forward this amount to the commissioner of management and budget 94.17for deposit into the account for the children's trust fund for the prevention of child abuse 94.18established under section 
         256E.22. This surcharge shall not be charged under those 94.19circumstances in which no fee for a certified birth or stillbirth record is permitted under 94.20subdivision 1, paragraph (a). Upon certification by the commissioner of management and 94.21budget that the assets in that fund exceed $20,000,000, this surcharge shall be discontinued.94.22(b) In addition to any fee prescribed under subdivision 1, there shall be a 94.23nonrefundable surcharge of $10 for each certified birth record. The local or state registrar 94.24shall forward this amount to the commissioner of management and budget for deposit in 94.25the general fund. This surcharge shall not be charged under those circumstances in which 94.26no fee for a certified birth record is permitted under subdivision 1, paragraph (a).94.27EFFECTIVE DATE.This section is effective July 1, 2010.94.28    Sec. 6. Minnesota Statutes 2008, section 144.293, subdivision 4, is amended to read:94.29    Subd. 4. Duration of consent. Except as provided in this section, a consent is 94.30valid for one year or for a lesser period specified in the consent or for a different period 94.31provided by law.94.32    Sec. 7. [144.615] BIRTH CENTERS.95.1    Subdivision 1.Definitions.(a) For purposes of this section, the following definitions 95.2have the meanings given them.95.3(b) "Birth center" means a facility licensed for the primary purpose of performing 95.4low-risk deliveries that is not a hospital or licensed as part of a hospital and where births are 95.5planned to occur away from the mother's usual residence following a low-risk pregnancy.95.6(c) "CABC" means the Commission for the Accreditation of Birth Centers.95.7(d) "Low-risk pregnancy" means a normal, uncomplicated prenatal course as 95.8determined by documentation of adequate prenatal care and the anticipation of a normal 95.9uncomplicated labor and birth, as defined by reasonable and generally accepted criteria 95.10adopted by professional groups for maternal, fetal, and neonatal health care.95.11    Subd. 2.License required.(a) Beginning January 1, 2011, no birth center shall be 95.12established, operated, or maintained in the state without first obtaining a license from the 95.13commissioner of health according to this section.95.14(b) A license issued under this section is not transferable or assignable and is subject 95.15to suspension or revocation at any time for failure to comply with this section.95.16(c) A birth center licensed under this section shall not assert, represent, offer, 95.17provide, or imply that the center is or may render care or services other than the services it 95.18is permitted to render within the scope of the license or the accreditation issued.95.19(d) The license must be conspicuously posted in an area where patients are admitted.95.20    Subd. 3.Temporary license.For new birth centers planning to begin operations 95.21after January 1, 2011, the commissioner may issue a temporary license to the birth center 95.22that is valid for a period of six months from the date of issuance. The birth center must 95.23submit to the commissioner an application and applicable fee for licensure as required 95.24under subdivision 4. The application must include the information required in subdivision 95.254, clauses (1) to (3) and (5) to (7), and documentation that the birth center has submitted 95.26an application for accreditation to the CABC. Upon receipt of accreditation from the 95.27CABC, the birth center must submit to the commissioner the information required in 95.28subdivision 4, clause (4), and the applicable fee under subdivision 8. The commissioner 95.29shall issue a new license.95.30    Subd. 4.Application.An application for a license to operate a birth center and the 95.31applicable fee under subdivision 8 must be submitted to the commissioner on a form 95.32provided by the commissioner and must contain:95.33(1) the name of the applicant;95.34(2) the site location of the birth center;95.35(3) the name of the person in charge of the center;96.1(4) documentation that the accreditation described under subdivision 6 has been 96.2issued, including the effective date and the expiration date of the accreditation, and the 96.3date of the last site visit by the CABC;96.4(5) the number of patients the birth center is capable of serving at a given time;96.5(6) the names and license numbers, if applicable, of the health care professionals 96.6on staff at the birth center; and96.7(7) any other information the commissioner deems necessary.96.8    Subd. 5.Suspension, revocation, and refusal to renew.The commissioner may 96.9refuse to grant or renew, or may suspend or revoke, a license on any of the grounds 96.10described under section 144.55, subdivision 6, paragraph (a), clause (2), (3), or (4), or 96.11upon the loss of accreditation by the CABC. The applicant or licensee is entitled to notice 96.12and a hearing as described under section 144.55, subdivision 7, and a new license may be 96.13issued after proper inspection of the birth center has been conducted.96.14    Subd. 6.Standards for licensure.(a) To be eligible for licensure under this 96.15section, a birth center must be accredited by the CABC or must obtain accreditation 96.16within six months of the date of the application for licensure. If the birth center loses its 96.17accreditation, the birth center must immediately notify the commissioner.96.18(b) The center must have procedures in place specifying criteria by which risk status 96.19will be established and applied to each woman at admission and during labor.96.20(c) Upon request, the birth center shall provide the commissioner of health with any 96.21material submitted by the birth center to the CABC as part of the accreditation process, 96.22including the accreditation application, the self-evaluation report, the accreditation 96.23decision letter from the CABC, and any reports from the CABC following a site visit.96.24    Subd. 7.Limitations of services.(a) The following limitations apply to the services 96.25performed at a birth center:96.26(1) surgical procedures must be limited to those normally accomplished during an 96.27uncomplicated birth, including episiotomy and repair;96.28(2) no abortions may be administered; and96.29(3) no general or regional anesthesia may be administered.96.30(b) Notwithstanding paragraph (a), local anesthesia may be administered at a birth 96.31center if the administration of the anesthetic is performed within the scope of practice of a 96.32health care professional.96.33    Subd. 8.Fees.(a) The biennial license fee for a birth center is $365.96.34(b) The temporary license fee is $365.96.35(c) Fees shall be collected and deposited according to section 144.122.97.1    Subd. 9.Renewal.(a) Except as provided in paragraph (b), a license issued under 97.2this section expires two years from the date of issue.97.3(b) A temporary license issued under subdivision 3 expires six months from the date 97.4of issue, and may be renewed for one additional six-month period.97.5(c) An application for renewal shall be submitted at least 60 days prior to expiration 97.6of the license on forms prescribed by the commissioner of health.97.7    Subd. 10.Records.All health records maintained on each client by a birth center 97.8are subject to sections 144.292 to 144.298.97.9    Subd. 11.Report.(a) The commissioner of health, in consultation with the 97.10commissioner of human services and representatives of the licensed birth centers, 97.11the American College of Obstetricians and Gynecologists, the American Academy 97.12of Pediatrics, the Minnesota Hospital Association, and the Minnesota Ambulance 97.13Association, shall evaluate the quality of care and outcomes for services provided in 97.14licensed birth centers, including, but not limited to, the utilization of services provided at a 97.15birth center, the outcomes of care provided to both mothers and newborns, and the numbers 97.16of transfers to other health care facilities that are required and the reasons for the transfers. 97.17The commissioner shall work with the birth centers to establish a process to gather and 97.18analyze the data within protocols that protect the confidentiality of patient identification.97.19(b) The commissioner of health shall report the findings of the evaluation to the 97.20legislature by January 15, 2014.97.21    Sec. 8. Minnesota Statutes 2008, section 144.651, subdivision 2, is amended to read:97.22    Subd. 2. Definitions. For the purposes of this section, "patient" means a person 97.23who is admitted to an acute care inpatient facility for a continuous period longer than 97.2424 hours, for the purpose of diagnosis or treatment bearing on the physical or mental 97.25health of that person. For purposes of subdivisions 4 to 9, 12, 13, 15, 16, and 18 to 20, 97.26"patient" also means a person who receives health care services at an outpatient surgical 97.27center or at a birth center licensed under section 144.615. "Patient" also means a minor 97.28who is admitted to a residential program as defined in section 
         253C.01. For purposes of 97.29subdivisions 1, 3 to 16, 18, 20 and 30, "patient" also means any person who is receiving 97.30mental health treatment on an outpatient basis or in a community support program or other 97.31community-based program. "Resident" means a person who is admitted to a nonacute care 97.32facility including extended care facilities, nursing homes, and boarding care homes for 97.33care required because of prolonged mental or physical illness or disability, recovery from 97.34injury or disease, or advancing age. For purposes of all subdivisions except subdivisions 97.3528 and 29, "resident" also means a person who is admitted to a facility licensed as a board 98.1and lodging facility under Minnesota Rules, parts 4625.0100 to 4625.2355, or a supervised 98.2living facility under Minnesota Rules, parts 4665.0100 to 4665.9900, and which operates 98.3a rehabilitation program licensed under Minnesota Rules, parts 9530.4100 to 9530.4450. 98.4    Sec. 9. Minnesota Statutes 2008, section 144.9504, is amended by adding a subdivision 98.5to read:98.6    Subd. 12.Blood lead level guidelines.(a) By January 1, 2011, the commissioner 98.7must revise clinical and case management guidelines to include recommendations 98.8for protective health actions and follow-up services when a child's blood lead level 98.9exceeds five micrograms of lead per deciliter of blood. The revised guidelines must be 98.10implemented to the extent possible using available resources.98.11(b) In revising the clinical and case management guidelines for blood lead levels 98.12greater than five micrograms of lead per deciliter of blood under this subdivision, 98.13the commissioner of health must consult with a statewide organization representing 98.14physicians, the public health department of Minneapolis and other public health 98.15departments, one representative of the residential construction industry, and a nonprofit 98.16organization with expertise in lead abatement.98.17    Sec. 10. Minnesota Statutes 2008, section 144A.51, subdivision 5, is amended to read:98.18    Subd. 5. Health facility. "Health facility" means a facility or that part of a facility 98.19which is required to be licensed pursuant to sections 
         144.50 to 
         144.58, 144.615, and a 98.20facility or that part of a facility which is required to be licensed under any law of this state 98.21which provides for the licensure of nursing homes. 98.22    Sec. 11. Minnesota Statutes 2008, section 144E.37, is amended to read:98.23144E.37 COMPREHENSIVE ADVANCED LIFE SUPPORT.98.24The board commissioner of health shall establish a comprehensive advanced 98.25life-support educational program to train rural medical personnel, including physicians, 98.26physician assistants, nurses, and allied health care providers, in a team approach to 98.27anticipate, recognize, and treat life-threatening emergencies before serious injury or 98.28cardiac arrest occurs.98.29EFFECTIVE DATE.This section is effective July 1, 2010.98.30    Sec. 12. HEALTH PLAN AND COUNTY ADMINISTRATIVE COST 98.31REDUCTION; REPORTING REQUIREMENTS.99.1(a) Minnesota health plans and county-based purchasing plans may complete an 99.2inventory of existing data collection and reporting requirements for health plans and 99.3county-based purchasing plans and submit to the commissioners of health and human 99.4services a list of data, documentation, and reports that:99.5(1) are collected from the same health plan or county-based purchasing plan more 99.6than once;99.7(2) are collected directly from the health plan or county-based purchasing plan but 99.8are available to the state agencies from other sources;99.9(3) are not currently being used by state agencies; or99.10(4) collect similar information more than once in different formats, at different 99.11times, or by more than one state agency.99.12(b) The report to the commissioners may also identify the percentage of health 99.13plan and county-based purchasing plan administrative time and expense attributed to 99.14fulfilling reporting requirements and include recommendations regarding ways to reduce 99.15duplicative reporting requirements.99.16(c) Upon receipt, the commissioners shall submit the inventory and recommendations 99.17to the chairs of the appropriate legislative committees, along with their comments 99.18and recommendations as to whether any action should be taken by the legislature to 99.19establish a consolidated and streamlined reporting system under which data, reports, and 99.20documentation are collected only once and only when needed for the state agencies to 99.21fulfill their duties under law and applicable regulations.99.22    Sec. 13. VENDOR ACCREDITATION SIMPLIFICATION.99.23The Minnesota Hospital Association must coordinate with the Minnesota 99.24Credentialing Collaborative to make recommendations by January 1, 2012, on the 99.25development of standard accreditation methods for vendor services provided within 99.26hospitals and clinics. The recommendations must be consistent with requirements of 99.27hospital credentialing organizations and applicable federal requirements.99.28    Sec. 14. APPLICATION PROCESS FOR HEALTH INFORMATION 99.29EXCHANGE.99.30To the extent that the commissioner of health applies for additional federal funding 99.31to support the commissioner's responsibilities of developing and maintaining state level 99.32health information exchange under section 3013 of the HITECH Act, the commissioner of 99.33health shall ensure that applications are made through an open process that provides health 99.34information exchange service providers equal opportunity to receive funding.100.1    Sec. 15. TRANSFER.100.2The powers and duties of the Emergency Medical Services Regulatory Board with 100.3respect to the comprehensive advanced life-support educational program under Minnesota 100.4Statutes, section 144E.37, are transferred to the commissioner of health under Minnesota 100.5Statutes, section 15.039.100.6EFFECTIVE DATE.This section is effective July 1, 2010.100.7    Sec. 16. REVISOR'S INSTRUCTION.100.8The revisor of statutes shall renumber Minnesota Statutes, section 144E.37, as 100.9Minnesota Statutes, section 144.6062, and make all necessary changes in statutory 100.10cross-references in Minnesota Statutes and Minnesota Rules.100.11EFFECTIVE DATE.This section is effective July 1, 2010.100.12ARTICLE 6100.13PUBLIC HEALTH100.14    Section 1. Minnesota Statutes 2008, section 62J.692, subdivision 4, is amended to read:100.15    Subd. 4. Distribution of funds. (a) Following the distribution described under 100.16paragraph (b), the commissioner shall annually distribute the available medical education 100.17funds to all qualifying applicants based on a distribution formula that reflects a summation 100.18of two factors:100.19    (1) a public program volume factor, which is determined by the total volume of 100.20public program revenue received by each training site as a percentage of all public 100.21program revenue received by all training sites in the fund pool; and100.22    (2) a supplemental public program volume factor, which is determined by providing 100.23a supplemental payment of 20 percent of each training site's grant to training sites whose 100.24public program revenue accounted for at least 0.98 percent of the total public program 100.25revenue received by all eligible training sites. Grants to training sites whose public 100.26program revenue accounted for less than 0.98 percent of the total public program revenue 100.27received by all eligible training sites shall be reduced by an amount equal to the total 100.28value of the supplemental payment.100.29    Public program revenue for the distribution formula includes revenue from medical 100.30assistance, prepaid medical assistance, general assistance medical care, and prepaid 100.31general assistance medical care. Training sites that receive no public program revenue 100.32are ineligible for funds available under this subdivision. For purposes of determining 100.33training-site level grants to be distributed under paragraph (a), total statewide average 101.1costs per trainee for medical residents is based on audited clinical training costs per trainee 101.2in primary care clinical medical education programs for medical residents. Total statewide 101.3average costs per trainee for dental residents is based on audited clinical training costs 101.4per trainee in clinical medical education programs for dental students. Total statewide 101.5average costs per trainee for pharmacy residents is based on audited clinical training costs 101.6per trainee in clinical medical education programs for pharmacy students.101.7    (b) $5,350,000 of the available medical education funds shall be distributed as 101.8follows:101.9    (1) $1,475,000 to the University of Minnesota Medical Center-Fairview;101.10    (2) $2,075,000 to the University of Minnesota School of Dentistry; and101.11    (3) $1,800,000 to the Academic Health Center. $150,000 of the funds distributed to 101.12the Academic Health Center under this paragraph shall be used for a program to assist 101.13internationally trained physicians who are legal residents and who commit to serving 101.14underserved Minnesota communities in a health professional shortage area to successfully 101.15compete for family medicine residency programs at the University of Minnesota.101.16    (c) Funds distributed shall not be used to displace current funding appropriations 101.17from federal or state sources.101.18    (d) Funds shall be distributed to the sponsoring institutions indicating the amount 101.19to be distributed to each of the sponsor's clinical medical education programs based on 101.20the criteria in this subdivision and in accordance with the commissioner's approval letter. 101.21Each clinical medical education program must distribute funds allocated under paragraph 101.22(a) to the training sites as specified in the commissioner's approval letter. Sponsoring 101.23institutions, which are accredited through an organization recognized by the Department 101.24of Education or the Centers for Medicare and Medicaid Services, may contract directly 101.25with training sites to provide clinical training. To ensure the quality of clinical training, 101.26those accredited sponsoring institutions must:101.27    (1) develop contracts specifying the terms, expectations, and outcomes of the clinical 101.28training conducted at sites; and101.29    (2) take necessary action if the contract requirements are not met. Action may 101.30include the withholding of payments under this section or the removal of students from 101.31the site.101.32    (e) Any funds not distributed in accordance with the commissioner's approval letter 101.33must be returned to the medical education and research fund within 30 days of receiving 101.34notice from the commissioner. The commissioner shall distribute returned funds to the 101.35appropriate training sites in accordance with the commissioner's approval letter.102.1    (f) A maximum of $150,000 of the funds dedicated to the commissioner under 102.2section 
         297F.10, subdivision 1, clause (2), may be used by the commissioner for 102.3administrative expenses associated with implementing this section.102.4    Sec. 2. Minnesota Statutes 2009 Supplement, section 157.16, subdivision 3, is 102.5amended to read:102.6    Subd. 3.  Establishment fees; definitions. (a) The following fees are required 102.7for food and beverage service establishments, youth camps, hotels, motels, lodging 102.8establishments, public pools, and resorts licensed under this chapter. Food and beverage 102.9service establishments must pay the highest applicable fee under paragraph (d), clause 102.10(1), (2), (3), or (4), and establishments serving alcohol must pay the highest applicable 102.11fee under paragraph (d), clause (6) or (7). The license fee for new operators previously 102.12licensed under this chapter for the same calendar year is one-half of the appropriate annual 102.13license fee, plus any penalty that may be required. The license fee for operators opening 102.14on or after October 1 is one-half of the appropriate annual license fee, plus any penalty 102.15that may be required. 102.16    (b) All food and beverage service establishments, except special event food stands, 102.17and all hotels, motels, lodging establishments, public pools, and resorts shall pay an 102.18annual base fee of $150. 102.19    (c) A special event food stand shall pay a flat fee of $50 annually. "Special event 102.20food stand" means a fee category where food is prepared or served in conjunction with 102.21celebrations, county fairs, or special events from a special event food stand as defined 102.22in section 
         157.15. 102.23    (d) In addition to the base fee in paragraph (b), each food and beverage service 102.24establishment, other than a special event food stand, and each hotel, motel, lodging 102.25establishment, public pool, and resort shall pay an additional annual fee for each fee 102.26category, additional food service, or required additional inspection specified in this 102.27paragraph: 102.28    (1) Limited food menu selection, $60. "Limited food menu selection" means a fee 102.29category that provides one or more of the following: 102.30    (i) prepackaged food that receives heat treatment and is served in the package; 102.31    (ii) frozen pizza that is heated and served; 102.32    (iii) a continental breakfast such as rolls, coffee, juice, milk, and cold cereal; 102.33    (iv) soft drinks, coffee, or nonalcoholic beverages; or 102.34    (v) cleaning for eating, drinking, or cooking utensils, when the only food served 102.35is prepared off site. 103.1    (2) Small establishment, including boarding establishments, $120. "Small 103.2establishment" means a fee category that has no salad bar and meets one or more of 103.3the following: 103.4    (i) possesses food service equipment that consists of no more than a deep fat fryer, a 103.5grill, two hot holding containers, and one or more microwave ovens; 103.6    (ii) serves dipped ice cream or soft serve frozen desserts; 103.7    (iii) serves breakfast in an owner-occupied bed and breakfast establishment; 103.8    (iv) is a boarding establishment; or 103.9    (v) meets the equipment criteria in clause (3), item (i) or (ii), and has a maximum 103.10patron seating capacity of not more than 50. 103.11    (3) Medium establishment, $310. "Medium establishment" means a fee category 103.12that meets one or more of the following: 103.13    (i) possesses food service equipment that includes a range, oven, steam table, salad 103.14bar, or salad preparation area; 103.15    (ii) possesses food service equipment that includes more than one deep fat fryer, 103.16one grill, or two hot holding containers; or 103.17    (iii) is an establishment where food is prepared at one location and served at one or 103.18more separate locations. 103.19    Establishments meeting criteria in clause (2), item (v), are not included in this fee 103.20category. 103.21    (4) Large establishment, $540. "Large establishment" means either: 103.22    (i) a fee category that (A) meets the criteria in clause (3), items (i) or (ii), for a 103.23medium establishment, (B) seats more than 175 people, and (C) offers the full menu 103.24selection an average of five or more days a week during the weeks of operation; or 103.25    (ii) a fee category that (A) meets the criteria in clause (3), item (iii), for a medium 103.26establishment, and (B) prepares and serves 500 or more meals per day. 103.27    (5) Other food and beverage service, including food carts, mobile food units, 103.28seasonal temporary food stands, and seasonal permanent food stands, $60. 103.29    (6) Beer or wine table service, $60. "Beer or wine table service" means a fee 103.30category where the only alcoholic beverage service is beer or wine, served to customers 103.31seated at tables. 103.32    (7) Alcoholic beverage service, other than beer or wine table service, $165. 103.33    "Alcohol beverage service, other than beer or wine table service" means a fee 103.34category where alcoholic mixed drinks are served or where beer or wine are served from 103.35a bar. 104.1    (8) Lodging per sleeping accommodation unit, $10, including hotels, motels, 104.2lodging establishments, and resorts, up to a maximum of $1,000. "Lodging per sleeping 104.3accommodation unit" means a fee category including the number of guest rooms, cottages, 104.4or other rental units of a hotel, motel, lodging establishment, or resort; or the number of 104.5beds in a dormitory. 104.6    (9) First public pool, $325; each additional public pool, $175. "Public pool" means a 104.7fee category that has the meaning given in section 
         144.1222, subdivision 4. 104.8    (10) First spa, $175; each additional spa, $100. "Spa pool" means a fee category that 104.9has the meaning given in Minnesota Rules, part 4717.0250, subpart 9. 104.10    (11) Private sewer or water, $60. "Individual private water" means a fee category 104.11with a water supply other than a community public water supply as defined in Minnesota 104.12Rules, chapter 4720. "Individual private sewer" means a fee category with an individual 104.13sewage treatment system which uses subsurface treatment and disposal. 104.14    (12) Additional food service, $150. "Additional food service" means a location at 104.15a food service establishment, other than the primary food preparation and service area, 104.16used to prepare or serve food to the public. 104.17    (13) Additional inspection fee, $360. "Additional inspection fee" means a fee to 104.18conduct the second inspection each year for elementary and secondary education facility 104.19school lunch programs when required by the Richard B. Russell National School Lunch 104.20Act. 104.21    (e) A fee for review of construction plans must accompany the initial license 104.22application for restaurants, hotels, motels, lodging establishments, resorts, seasonal food 104.23stands, and mobile food units. The fee for this construction plan review is as follows:

104.24Service AreaTypeFee104.25Foodlimited food menu$275104.26small establishment$400104.27medium establishment$450104.28large food establishment$500104.29additional food service$150104.30Transient food servicefood cart$250104.31seasonal permanent food stand$250104.32seasonal temporary food stand$250104.33mobile food unit$350104.34Alcoholbeer or wine table service$150104.35alcohol service from bar$250104.36Lodgingless than 25 rooms$375104.3725 to less than 100 rooms$400104.38100 rooms or more$500104.39less than five cabins$350105.1five to less than ten cabins$400105.2ten cabins or more$450

105.3    (f) When existing food and beverage service establishments, hotels, motels, lodging 105.4establishments, resorts, seasonal food stands, and mobile food units are extensively 105.5remodeled, a fee must be submitted with the remodeling plans. The fee for this 105.6construction plan review is as follows:

105.7Service AreaTypeFee105.8Foodlimited food menu$250105.9small establishment$300105.10medium establishment$350105.11large food establishment$400105.12additional food service$150105.13Transient food servicefood cart$250105.14seasonal permanent food stand$250105.15seasonal temporary food stand$250105.16mobile food unit$250105.17Alcoholbeer or wine table service$150105.18alcohol service from bar$250105.19Lodgingless than 25 rooms$250105.2025 to less than 100 rooms$300105.21100 rooms or more$450105.22less than five cabins$250105.23five to less than ten cabins$350105.24ten cabins or more$400

105.25    (g) Special event food stands are not required to submit construction or remodeling 105.26plans for review. 105.27(h) Youth camps shall pay an annual single fee for food and lodging as follows:105.28(1) camps with up to 99 campers, $325;105.29(2) camps with 100 to 199 campers, $550; and105.30(3) camps with 200 or more campers, $750.105.31(i) A youth camp which pays fees under paragraph (d) is not required to pay fees 105.32under paragraph (h).105.33    Sec. 3. Minnesota Statutes 2009 Supplement, section 327.15, subdivision 3, is 105.34amended to read:105.35    Subd. 3. Fees, manufactured home parks and recreational camping areas. (a) 105.36The following fees are required for manufactured home parks and recreational camping 105.37areas licensed under this chapter. Recreational camping areas and manufactured home 105.38parks shall pay the highest applicable base fee under paragraph (c) (b). The license fee 106.1for new operators of a manufactured home park or recreational camping area previously 106.2licensed under this chapter for the same calendar year is one-half of the appropriate annual 106.3license fee, plus any penalty that may be required. The license fee for operators opening 106.4on or after October 1 is one-half of the appropriate annual license fee, plus any penalty 106.5that may be required.106.6(b) All manufactured home parks and recreational camping areas shall pay the 106.7following annual base fee:106.8(1) a manufactured home park, $150; and106.9(2) a recreational camping area with:106.10(i) 24 or less sites, $50;106.11(ii) 25 to 99 sites, $212; and106.12(iii) 100 or more sites, $300.106.13In addition to the base fee, manufactured home parks and recreational camping areas shall 106.14pay $4 for each licensed site. This paragraph does not apply to special event recreational 106.15camping areas or to. Operators of a manufactured home park or a recreational camping 106.16area also licensed under section 
         157.16 for the same location shall pay only one base fee, 106.17whichever is the highest of the base fees found in this section or section 157.16.106.18(c) In addition to the fee in paragraph (b), each manufactured home park or 106.19recreational camping area shall pay an additional annual fee for each fee category 106.20specified in this paragraph:106.21(1) Manufactured home parks and recreational camping areas with public swimming 106.22pools and spas shall pay the appropriate fees specified in section 
         157.16.106.23(2) Individual private sewer or water, $60. "Individual private water" means a fee 106.24category with a water supply other than a community public water supply as defined in 106.25Minnesota Rules, chapter 4720. "Individual private sewer" means a fee category with a 106.26subsurface sewage treatment system which uses subsurface treatment and disposal.106.27(d) The following fees must accompany a plan review application for initial 106.28construction of a manufactured home park or recreational camping area:106.29(1) for initial construction of less than 25 sites, $375;106.30(2) for initial construction of 25 to 99 sites, $400; and106.31(3) for initial construction of 100 or more sites, $500.106.32(e) The following fees must accompany a plan review application when an existing 106.33manufactured home park or recreational camping area is expanded:106.34(1) for expansion of less than 25 sites, $250;106.35(2) for expansion of 25 to 99 sites, $300; and106.36(3) for expansion of 100 or more sites, $450.107.1    Sec. 4. FOOD SUPPORT FOR CHILDREN WITH SEVERE ALLERGIES.107.2The commissioner of human services must seek a federal waiver from the federal 107.3Department of Agriculture, Food and Nutrition Service, for the supplemental nutrition 107.4assistance program, to increase the income eligibility requirements to 375 percent of the 107.5federal poverty guidelines, in order to cover nutritional food products required to treat 107.6or manage severe food allergies, including allergies to wheat and gluten, for infants and 107.7children who have been diagnosed with life-threatening severe food allergies.107.8ARTICLE 7107.9HEALTH CARE REFORM107.10    Section 1. [62E.20] RELATIONSHIP TO TEMPORARY FEDERAL HIGH-RISK 107.11POOL.107.12    Subdivision 1.Definitions.(a) For purposes of this section, the terms defined in 107.13this subdivision have the meanings given.107.14(b) "Association" means the Minnesota Comprehensive Health Association.107.15(c) "Federal law" means Title I, subtitle B, section 1101, of the federal Patient 107.16Protection and Affordable Care Act, Public Law 111-148, including any federal 107.17regulations adopted under it.107.18(d) "Federal qualified high-risk pool" means an arrangement established by the 107.19federal secretary of health and human services that meets the requirements of the federal 107.20law.107.21    Subd. 2.Timing of this section.This section applies beginning the date the 107.22temporary federal qualified high-risk health pool created under the federal law begins 107.23to provide coverage in this state.107.24    Subd. 3.Maintenance of effort.The assessments made by the comprehensive 107.25health association on its member insurers must comply with the maintenance of effort 107.26requirement contained in paragraph (b), clause (3), of the federal law, to the extent that the 107.27requirement applies to assessments made by the association.107.28    Subd. 4.Coordination with state health care programs.The commissioner 107.29of commerce and the Minnesota Comprehensive Health Association shall ensure that 107.30applicants for coverage through the federal qualified high-risk pool, or through the 107.31Minnesota Comprehensive Health Association, are referred to the medical assistance or 107.32MinnesotaCare programs if they are determined to be potentially eligible for coverage 107.33through those programs. The commissioner of human services shall ensure that applicants 107.34for coverage under medical assistance or MinnesotaCare who are determined not to be 108.1eligible for those programs are provided information about coverage through the federal 108.2qualified high-risk pool and the Minnesota Comprehensive Health Association.108.3    Subd. 5.Federal funding.Minnesota shall coordinate its efforts with the United 108.4States Department of Health and Human Services (HHS) to obtain the federal funds to 108.5implement in Minnesota the federal qualified high-risk pool.108.6    Sec. 2. [256B.0756] COORDINATED CARE THROUGH A HEALTH HOME.108.7    Subdivision 1.Provision of coverage.(a) The commissioner shall provide 108.8medical assistance coverage of health home services for eligible individuals with chronic 108.9conditions who select a designated provider, a team of health care professionals, or a 108.10health team as the individual's health home.108.11(b) The commissioner shall implement this section in compliance with the 108.12requirements of the state option to provide health homes for enrollees with chronic 108.13conditions, as provided under the Patient Protection and Affordable Care Act, Public 108.14Law 111-148, sections 2703 and 3502. Terms used in this section have the meaning 108.15provided in that act.108.16    Subd. 2.Eligible individual.An individual is eligible for health home services 108.17under this section if the individual is eligible for medical assistance under this chapter 108.18and has at least:108.19(1) two chronic conditions;108.20(2) one chronic condition and is at risk of having a second chronic condition; or108.21(3) one serious and persistent mental health condition.108.22    Subd. 3.Health home services.(a) Health home services means comprehensive and 108.23timely high-quality services that are provided by a health home. These services include:108.24(1) comprehensive care management;108.25(2) care coordination and health promotion;108.26(3) comprehensive transitional care, including appropriate follow-up, from inpatient 108.27to other settings;108.28(4) patient and family support, including authorized representatives;108.29(5) referral to community and social support services, if relevant; and108.30(6) use of health information technology to link services, as feasible and appropriate.108.31(b) The commissioner shall maximize the number and type of services 108.32included in this subdivision to the extent permissible under federal law, including 108.33physician, outpatient, mental health treatment, and rehabilitation services necessary for 108.34comprehensive transitional care following hospitalization.109.1    Subd. 4.Health teams.The commissioner shall establish health teams to support 109.2the patient-centered health home and provide the services described in subdivision 3 to 109.3individuals eligible under subdivision 2. The commissioner shall apply for grants or 109.4contracts as provided under section 3502 of the Patient Protection and Affordable Care 109.5Act to establish health teams and provide capitated payments to primary care providers. 109.6For purposes of this section, "health teams" means community-based, interdisciplinary, 109.7inter-professional teams of health care providers that support primary care practices. 109.8These providers may include medical specialists, nurses, advanced practice registered 109.9nurses, pharmacists, nutritionists, social workers, behavioral and mental health providers, 109.10doctors of chiropractic, licensed complementary and alternative medicine practitioners, 109.11and physician assistants.109.12    Subd. 5.Payments.The commissioner shall make payments to each health home 109.13and each health team for the provision of health home services to each eligible individual 109.14with chronic conditions that selects the health home as a provider.109.15    Subd. 6.Coordination.The commissioner, to the extent feasible, shall ensure that 109.16the requirements and payment methods for health homes and health teams developed 109.17under this section are consistent with the requirements and payment methods for health 109.18care homes established under sections 256B.0751 and 256B.0753. The commissioner may 109.19modify requirements and payment methods under sections 256B.0751 and 256B.0753 in 109.20order to be consistent with federal health home requirements and payment methods.109.21    Subd. 7.State plan amendment.The commissioner shall submit a state plan 109.22amendment to implement this section to the federal Centers for Medicare and Medicaid 109.23Services by January 1, 2011.109.24EFFECTIVE DATE.This section is effective January 1, 2011, or upon federal 109.25approval, whichever is later.109.26    Sec. 3. FEDERAL HEALTH CARE REFORM DEMONSTRATION PROJECTS 109.27AND GRANTS.109.28(a) The commissioner of human services shall seek to participate in the following 109.29demonstration projects, or apply for the following grants, as described in the federal 109.30Patient Protection and Affordable Care Act, Public Law 111-148:109.31(1) the demonstration project to evaluate integrated care around a hospitalization, 109.32Public Law 111-148, section 2704;109.33(2) the Medicaid global payment system demonstration project, Public Law 111-148, 109.34section 2705, including a demonstration project for the specific population of childless 110.1adults under 75 percent of federal poverty guidelines that were to be served by the general 110.2assistance medical care program;110.3(3) the pediatric accountable care organization demonstration project, Public Law 110.4111-148, section 2706;110.5(4) the Medicaid emergency psychiatric demonstration project, Public Law 111-148, 110.6section 2707; and110.7(5) grants to provide incentives for prevention of chronic diseases in Medicaid, 110.8Public Law 111-148, section 4108.110.9(b) The commissioner of human services shall report to the chairs and ranking 110.10minority members of the house of representatives and senate committees or divisions with 110.11jurisdiction over health care policy and finance on the status of the demonstration project 110.12and grant applications. If the state is accepted as a demonstration project participant, or is 110.13awarded a grant, the commissioner shall notify the chairs and ranking minority members 110.14of those committees or divisions of any legislative changes necessary to implement the 110.15demonstration projects or grants.110.16(c) The commissioner of health shall apply for federal grants available under the 110.17federal Patient Protection and Affordable Care Act, Public Law 111-148, for purposes 110.18of funding wellness and prevention, and health improvement programs. To the extent 110.19possible under federal law, the commissioner of health must utilize the state health 110.20improvement program, established under Minnesota Statutes, section 145.986, to 110.21implement grant programs related to wellness and prevention, and health improvement, 110.22for which the state receives funding under the federal Patient Protection and Affordable 110.23Care Act, Public Law 111-148.110.24    Sec. 4. HEALTH CARE REFORM TASK FORCE.110.25    Subdivision 1.Task force.(a) The governor shall convene a Health Care 110.26Reform Task Force to advise and assist the governor and the legislature regarding state 110.27implementation of federal health care reform legislation. For purposes of this section, 110.28"federal health care reform legislation" means the Patient Protection and Affordable Care 110.29Act, Public Law 111-148, and the health care reform provisions in the Health Care and 110.30Education Reconciliation Act of 2010, Public Law 111-152. The task force shall consist of:110.31(1) two legislators from the house of representatives appointed by the speaker and 110.32two legislators from the senate appointed by the Subcommittee on Committees of the 110.33Committee on Rules and Administration;110.34    (2) two representatives appointed by the governor to represent the governor and 110.35state agencies;111.1    (3) three persons appointed by the governor who have demonstrated leadership in 111.2health care organizations, health plan companies, or health care trade or professional 111.3associations;111.4    (4) three persons appointed by the governor who have demonstrated leadership in 111.5employer and group purchaser activities related to health system improvement of whom 111.6two must be from a labor organization and one from the business community; and111.7    (5) five persons appointed by the governor who have demonstrated expertise in the 111.8areas of health care financing, access, and quality.111.9    The governor is exempt from the requirements of the open appointments process 111.10for purposes of appointing task force members. Members shall be appointed for one-year 111.11terms and may be reappointed.111.12    (b) The Department of Health, Department of Human Services, and Department of 111.13Commerce shall provide staff support to the task force. The task force may accept outside 111.14resources to help support its efforts.111.15    (c) Task force members must be appointed by July 1, 2010.  The task force must hold 111.16its first meeting by July 15, 2010.111.17    Subd. 2.Duties.(a) By December 15, 2010, the task force shall develop and 111.18present to the legislature and the governor a preliminary report and recommendations on 111.19state implementation of federal health care reform legislation. The report must include 111.20recommendations for state law and program changes necessary to comply with the federal 111.21health care reform legislation, and also recommendations for implementing provisions of 111.22the federal legislation that are optional for states. In developing recommendations, the task 111.23force shall consider the extent to which an approach maximizes federal funding to the state.111.24(b) The task force, in consultation with the governor and the legislature, shall also 111.25establish timelines and criteria for future reports on state implementation of the federal 111.26health care reform legislation.111.27    Sec. 5. AMERICAN HEALTH BENEFIT EXCHANGE; PLANNING 111.28PROVISIONS.111.29    Subdivision 1.Federal planning grants.The commissioners of commerce, health, 111.30and human services shall jointly or separately apply to the federal secretary of health and 111.31human services for one or more planning grants, including renewal grants, authorized 111.32under section 1311 of the Patient Protection and Affordable Care Act, Public Law 111.33111-148, including any future amendments of that provision, relating to state creation 111.34of American Health Benefit Exchanges.112.1    Subd. 2.Consideration of early creation and operation of exchange.(a) The 112.2commissioners referenced in subdivision 1 shall analyze the advantages and disadvantages 112.3to the state of planning to have a state health insurance exchange, similar to an American 112.4Health Benefit Exchange referenced in subdivision 1, begin prior to the federal deadline 112.5of January 1, 2014.112.6(b) The commissioners shall provide a written report to the legislature on the results 112.7of the analysis required under paragraph (a) no later than December 15, 2010. The written 112.8report must comply with Minnesota Statutes, sections 3.195 and 3.197.112.9ARTICLE 8112.10HUMAN SERVICES FORECAST ADJUSTMENTS

112.11Section 1.  SUMMARY OF APPROPRIATIONS.

112.12The amounts shown in this section summarize direct appropriations, by fund, made 112.13in this article.

112.1420102011Total112.15General$(109,876,000)$(28,344,000)$(138,220,000)112.16Health Care Access$99,654,000$276,500,000$376,154,000112.17Federal TANF$(9,830,000)$15,133,000$5,303,000112.18Total$(20,052,000)$263,289,000$243,237,000

112.19Sec. 2. DEPARTMENT OF HUMAN SERVICES APPROPRIATION.

112.20    The sums shown in the columns marked "Appropriations" are added to or, if shown 112.21in parentheses, subtracted from the appropriations in Laws 2009, chapter 79, article 13, 112.22as amended by Laws 2009, chapter 173, article 2, to the agencies and for the purposes 112.23specified in this article. The appropriations are from the general fund, or another named 112.24fund, and are available for the fiscal years indicated for each purpose. The figures "2010" 112.25and "2011" used in this article mean that the addition to or subtraction from appropriations 112.26listed under them is available for the fiscal year ending June 30, 2010, or June 30, 2011, 112.27respectively. "The first year" is fiscal year 2010. "The second year" is fiscal year 2011. 112.28"The biennium" is fiscal years 2010 and 2011. Supplemental appropriations and reductions 112.29for the fiscal year ending June 30, 2010, are effective the day following final enactment 112.30unless a different effective date is explicit.

112.31APPROPRIATIONS112.32Available for the Year112.33Ending June 30112.3420102011

113.1113.2Sec. 3. DEPARTMENT OF HUMAN SERVICES

113.3Subdivision 1.Total Appropriation$(20,052,000)$263,289,000

113.4Appropriations by Fund113.520102011113.6General(109,876,000)(28,344,000)113.7Health Care Access99,654,000276,500,000113.8Federal TANF(9,830,000)15,133,000

113.9The amounts that may be spent for each 113.10purpose are specified in the following 113.11subdivisions.

113.12Subd. 2.Revenue and Pass-through

113.13Appropriations by Fund113.14Federal TANF390,000(251,000)

113.15113.16Subd. 3.Children and Economic Assistance Grants

113.17Appropriations by Fund113.18General4,489,000(4,140,000)113.19Federal TANF(10,220,000)15,384,000

113.20The amounts that may be spent from this 113.21appropriation are as follows:

113.22(a) MFIP Grants

113.23General7,916,000(14,481,000)113.24Federal TANF(10,220,000)15,384,000

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

113.26(c) General Assistance Grants875,0001,339,000

113.27(d)Minnesota Supplemental Aid Grants2,454,0003,843,000

113.28(e)Group Residential Housing Grants1,076,0002,580,000

113.29Subd. 4.Basic Health Care Grants

113.30Appropriations by Fund113.31General (62,770,000)29,192,000113.32Health Care Access99,654,000276,500,000

114.1The amounts that may be spent from the 114.2appropriation for each purpose are as follows:

114.3(a)MinnesotaCare Grants

114.4Health Care Access99,654,000276,500,000

114.5114.6(b)Medical Assistance Basic Health Care - Families and Children1,165,00024,146,000

114.7114.8(c)Medical Assistance Basic Health Care - Elderly and Disabled(63,935,000)5,046,000

114.9Subd. 5.Continuing Care Grants(51,595,000)(53,396,000)

114.10The amounts that may be spent from the 114.11appropriation for each purpose are as follows:

114.12114.13(a)Medical Assistance Long-Term Care Facilities(3,774,000)(8,275,000)

114.14114.15(b)Medical Assistance Long-Term Care Waivers(27,710,000)(22,452,000)

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

114.17    Sec. 4. EFFECTIVE DATE.114.18This article is effective the day following final enactment.114.19ARTICLE 9114.20HUMAN SERVICES CONTINGENT APPROPRIATIONS

114.21Section 1.  SUMMARY OF HUMAN SERVICES APPROPRIATIONS.

114.22The amounts shown in this section summarize direct appropriations, by fund, made 114.23in this bill.

114.2420102011Total114.25General$-0-$13,383,000$13,383,000114.26Health Care Access-0-686,000686,000114.27Total$-0-$14,069,000$14,069,000

114.28Sec. 2. HEALTH AND HUMAN SERVICES CONTINGENT APPROPRIATIONS.

114.29(a) The sums shown in the columns marked "Appropriations" are added to the 114.30appropriations in Laws 2009, chapter 79, article 13, as amended by Laws 2009, chapter 114.31173, article 2, to the agency and for the purposes specified in this bill. The appropriations 114.32are from the general fund, or another named fund, and are available for the fiscal years 115.1indicated for each purpose. The figures "2010" and "2011" used in this bill mean that the 115.2addition to or subtraction from the appropriation listed under them is available for the 115.3fiscal year ending June 30, 2010, or June 30, 2011, respectively.115.4(b) Upon enactment of the extension of the enhanced federal medical assistance 115.5percentage (FMAP) under Public Law 111-5 to June 30, 2011, that is contained in the 115.6president's budget for federal fiscal year 2011 or contained in House Resolution 2847, 115.7the federal "Jobs for Main Street Act, 2010," or contained in House Resolution 4213, 115.8"American Workers, State, and Business Relief Act of 2010," or subsequent federal 115.9legislation, the appropriations identified in section 3 shall be made for fiscal year 2011.

115.10APPROPRIATIONS115.11Available for the Year115.12Ending June 30115.1320102011

115.14115.15Sec. 3. COMMISSIONER OF HUMAN SERVICES

115.16Subdivision 1.Total Appropriation$-0-$14,069,000

115.17Appropriations by Fund115.1820102011115.19General-0-13,383,000115.20Health Care Access-0-686,000

115.21The appropriations for each purpose are 115.22shown in the following subdivisions.

115.23Subd. 2.Basic Health Care Grants

115.24(a) MinnesotaCare Grants-0-686,000

115.25This appropriation is from the health care 115.26access fund.

115.27115.28(b) Medical Assistance Basic Health Care Grants - Families and Children-0-6,297,000

115.29115.30(c) Medical Assistance Basic Health Care Grants - Elderly and Disabled-0-3,697,000

115.31Subd. 3.Continuing Care Grants

115.32115.33(a) Medical Assistance - Long-Term Care Facilities Grants-0-2,486,000

115.34115.35(b) Medical Assistance Grants - Long-Term Care Waivers and Home Care Grants-0-547,000

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

116.2    Sec. 4. Minnesota Statutes 2008, section 256B.0625, subdivision 22, is amended to 116.3read:116.4    Subd. 22. Hospice care. Medical assistance covers hospice care services under 116.5Public Law 99-272, section 9505, to the extent authorized by rule, except that a recipient 116.6age 21 or under who elects to receive hospice services does not waive coverage for 116.7services that are related to the treatment of the condition for which a diagnosis of terminal 116.8illness has been made.116.9EFFECTIVE DATE.This section is effective retroactive from March 23, 2010.116.10    Sec. 5. Minnesota Statutes 2009 Supplement, section 256B.0911, subdivision 1a, 116.11is amended to read:116.12    Subd. 1a. Definitions. For purposes of this section, the following definitions apply:116.13(a) "Long-term care consultation services" means:116.14(1) assistance in identifying services needed to maintain an individual in the most 116.15inclusive environment;116.16(2) providing recommendations on cost-effective community services that are 116.17available to the individual;116.18(3) development of an individual's person-centered community support plan;116.19(4) providing information regarding eligibility for Minnesota health care programs;116.20(5) face-to-face long-term care consultation assessments, which may be completed 116.21in a hospital, nursing facility, intermediate care facility for persons with developmental 116.22disabilities (ICF/DDs), regional treatment centers, or the person's current or planned 116.23residence;116.24(6) federally mandated screening to determine the need for a institutional level of 116.25care under section 
         256B.0911, subdivision 4, paragraph (a) subdivision 4a;116.26(7) determination of home and community-based waiver service eligibility including 116.27level of care determination for individuals who need an institutional level of care as 116.28defined under section 
         144.0724, subdivision 11, or 
         256B.092, service eligibility including 116.29state plan home care services identified in section 
         256B.0625, subdivisions 6, 7, and 116.3019, paragraphs (a) and (c), based on assessment and support plan development with 116.31appropriate referrals;116.32(8) providing recommendations for nursing facility placement when there are no 116.33cost-effective community services available; and117.1(9) assistance to transition people back to community settings after facility 117.2admission.117.3(b) "Long-term care options counseling" means the services provided by the linkage 117.4lines as mandated by sections 
         256.01 and 
         256.975, subdivision 7, and also includes 117.5telephone assistance and follow up once a long-term care consultation assessment has 117.6been completed.117.7(c) "Minnesota health care programs" means the medical assistance program under 117.8chapter 256B and the alternative care program under section 
         256B.0913.117.9(d) "Lead agencies" means counties or a collaboration of counties, tribes, and health 117.10plans administering long-term care consultation assessment and support planning services.117.11    Sec. 6. Minnesota Statutes 2008, section 256B.19, subdivision 1c, is amended to read:117.12    Subd. 1c. Additional portion of nonfederal share. (a) Hennepin County shall 117.13be responsible for a monthly transfer payment of $1,500,000, due before noon on the 117.1415th of each month and the University of Minnesota shall be responsible for a monthly 117.15transfer payment of $500,000 due before noon on the 15th of each month, beginning July 117.1615, 1995. These sums shall be part of the designated governmental unit's portion of the 117.17nonfederal share of medical assistance costs.117.18(b) Beginning July 1, 2001, Hennepin County's payment under paragraph (a) shall 117.19be $2,066,000 each month.117.20(c) Beginning July 1, 2001, the commissioner shall increase annual capitation 117.21payments to the metropolitan health plan under section 
         256B.69 for the prepaid medical 117.22assistance program by approximately $3,400,000, plus any available federal matching 117.23funds, $6,800,000 to recognize higher than average medical education costs.117.24(d) Effective August 1, 2005, Hennepin County's payment under paragraphs (a) 117.25and (b) shall be reduced to $566,000, and the University of Minnesota's payment under 117.26paragraph (a) shall be reduced to zero. Effective October 1, 2008, to December 31, 2010, 117.27Hennepin County's payment under paragraphs (a) and (b) shall be $434,688. Effective 117.28January 1, 2011, Hennepin County's payment under paragraphs (a) and (b) shall be 117.29$566,000.117.30(e) Notwithstanding paragraph (d), upon federal enactment of an extension to June 117.3130, 2011, of the enhanced federal medical assistance percentage (FMAP) originally 117.32provided under Public Law 111-5, for the six-month period from January 1, 2011, to June 117.3330, 2011, Hennepin County's payment under paragraphs (a) and (b) shall be $434,688.117.34    Sec. 7. Minnesota Statutes 2008, section 256L.15, subdivision 1, is amended to read:118.1    Subdivision 1. Premium determination. (a) Families with children and individuals 118.2shall pay a premium determined according to subdivision 2.118.3    (b) Pregnant women and children under age two are exempt from the provisions 118.4of section 
         256L.06, subdivision 3, paragraph (b), clause (3), requiring disenrollment 118.5for failure to pay premiums. For pregnant women, this exemption continues until the 118.6first day of the month following the 60th day postpartum. Women who remain enrolled 118.7during pregnancy or the postpartum period, despite nonpayment of premiums, shall be 118.8disenrolled on the first of the month following the 60th day postpartum for the penalty 118.9period that otherwise applies under section 
         256L.06, unless they begin paying premiums. 118.10    (c) Members of the military and their families who meet the eligibility criteria 118.11for MinnesotaCare upon eligibility approval made within 24 months following the end 118.12of the member's tour of active duty shall have their premiums paid by the commissioner. 118.13The effective date of coverage for an individual or family who meets the criteria of this 118.14paragraph shall be the first day of the month following the month in which eligibility is 118.15approved. This exemption applies for 12 months. This paragraph expires June 30, 2010. 118.16If the expiration of this provision is in violation of section 5001 of Public Law 111-5, this 118.17provision will expire on the date when it is no longer subject to section 5001 of Public Law 118.18111-5. The commissioner of human services shall notify the revisor of statutes of that date.118.19    Sec. 8. Laws 2005, First Special Session chapter 4, article 8, section 66, as amended by 118.20Laws 2009, chapter 173, article 3, section 24, the effective date, is amended to read:118.21EFFECTIVE DATE.Paragraph (a) is effective August 1, 2009, and upon federal 118.22approval and on the date when it is no longer subject to the maintenance of effort 118.23requirements of section 5001 of Public Law 111-5. The commissioner of human services 118.24shall notify the revisor of statutes of that date. Paragraph (e) is effective September 1, 118.252006.118.26    Sec. 9. Laws 2009, chapter 79, article 5, section 17, the effective date, is amended to 118.27read:118.28EFFECTIVE DATE.This section is effective January 1, 2011, or upon federal 118.29approval, whichever is later and on the date when it is no longer subject to the maintenance 118.30of effort requirements of section 5001 of Public Law 111-5. The commissioner of human 118.31services shall notify the revisor of statutes of that date.119.1    Sec. 10. Laws 2009, chapter 79, article 5, section 18, the effective date, is amended to 119.2read:119.3EFFECTIVE DATE.This section is effective January 1, 2011 upon federal 119.4approval and on the date when it is no longer subject to the maintenance of effort 119.5requirements of section 5001 of Public Law 111-5. The commissioner of human services 119.6shall notify the revisor of statutes when federal approval is obtained.119.7    Sec. 11. Laws 2009, chapter 79, article 5, section 22, the effective date, is amended to 119.8read:119.9EFFECTIVE DATE.This section is effective for periods of ineligibility established 119.10on or after January 1, 2011, unless it is in violation of section 5001 of Public Law 111-5. 119.11If it is in violation of that section, then it shall be effective on the date when it is no longer 119.12subject to maintenance of effort requirements of section 5001 of Public Law 111-5. The 119.13commissioner of human services shall notify the revisor of statutes of that date.119.14    Sec. 12. Laws 2009, chapter 79, article 8, section 4, the effective date, is amended to 119.15read:119.16EFFECTIVE DATE.The section is effective January July 1, 2011.119.17    Sec. 13. Laws 2009, chapter 173, article 1, section 17, the effective date, is amended to 119.18read:119.19EFFECTIVE DATE.This section is effective for pooled trust accounts established 119.20on or after January 1, 2011, unless it is in violation of section 5001 of Public Law 111-5. 119.21If it is in violation of that section, then it shall be effective on the date when it is no longer 119.22subject to maintenance of effort requirements of section 5001 of Public Law 111-5. The 119.23commissioner of human services shall notify the revisor of statutes of that date.119.24ARTICLE 10119.25HEALTH AND HUMAN SERVICES APPROPRIATIONS

119.26Section 1. SUMMARY OF APPROPRIATIONS.

119.27    The amounts shown in this section summarize direct appropriations by fund made 119.28in this article.

119.2920102011Total119.30General$(6,784,000)$215,726,000$208,942,000120.1120.2State Government Special Revenue113,000624,000737,000120.3Health Care Access998,00011,579,00012,577,000120.4Federal TANF8,000,00020,000,00028,000,000120.5Special Revenue-0-93,00093,000120.6Total$2,327,000$248,021,000$250,348,000

120.7Sec. 2. HEALTH AND HUMAN SERVICES APPROPRIATIONS.

120.8    The sums shown in the columns marked "Appropriations" are added to or, if shown 120.9in parentheses, subtracted from the appropriations in Laws 2009, chapter 79, article 13, 120.10as amended by Laws 2009, chapter 173, article 2, to the agencies and for the purposes 120.11specified in this article. The appropriations are from the general fund, or another named 120.12fund, and are available for the fiscal years indicated for each purpose. The figures "2010" 120.13and "2011" used in this article mean that the addition to or subtraction from appropriations 120.14listed under them is available for the fiscal year ending June 30, 2010, or June 30, 2011, 120.15respectively. "The first year" is fiscal year 2010. "The second year" is fiscal year 2011. 120.16"The biennium" is fiscal years 2010 and 2011. Supplemental appropriations and reductions 120.17for the fiscal year ending June 30, 2010, are effective the day following final enactment 120.18unless a different effective date is explicit.

120.19APPROPRIATIONS120.20Available for the Year120.21Ending June 30120.2220102011

120.23120.24Sec. 3. COMMISSIONER OF HUMAN SERVICES

120.25Subdivision 1.Total Appropriation$4,409,000$246,347,000

120.26Appropriations by Fund120.2720102011120.28General(4,589,000)215,006,000120.29Health Care Access998,00011,342,000120.30Federal TANF8,000,00020,000,000

120.31The appropriation modifications for 120.32each purpose are shown in the following 120.33subdivisions.120.34TANF Financing and Maintenance of 120.35Effort. The commissioner, with the approval 120.36of the commissioner of management and 121.1budget, and after notification of the chairs 121.2of the relevant senate budget division and 121.3house of representatives finance division, 121.4may adjust the amount of TANF transfers 121.5between the MFIP transition year child care 121.6assistance program and MFIP grant programs 121.7within the fiscal year and within the current 121.8biennium and the biennium ending June 30, 121.92013, to ensure that state and federal match 121.10and maintenance of effort requirements are 121.11met. These transfers and amounts shall be 121.12reported to the chairs of the senate and house 121.13of representatives Finance Committees, the 121.14senate Health and Human Services Budget 121.15Division, and the house of representatives 121.16Health Care and Human Services Finance 121.17Division and Early Childhood Finance and 121.18Policy Division by December 1 of each 121.19fiscal year. Notwithstanding any contrary 121.20provision in this article, this paragraph 121.21expires June 30, 2013.121.22SNAP Enhanced Administrative Funding.121.23The funds available for administration 121.24of the Supplemental Nutrition Assistance 121.25Program under the Department of Defense 121.26Appropriations Act of 2010, Public 121.27Law 111-118, are appropriated to the 121.28commissioner to pay the actual costs 121.29of providing for increased eligibility 121.30determinations, caseload-related costs, 121.31timely application processing, and quality 121.32control. Of these funds, 20 percent shall 121.33be allocated to the commissioner and 80 121.34percent shall be allocated to counties. 121.35The commissioner shall allocate the 121.36county portion based on recent caseload. 122.1Reimbursement shall be based on actual 122.2costs reported by counties through existing 122.3processes. Tribal reimbursement must be 122.4made from the state portion, based on a 122.5caseload factor equivalent to that of a county.122.6TANF Summer Food Programs - 122.7TANF Emergency Fund Non-Recurrent 122.8Short-Term Benefits. In addition to the 122.9TANF emergency fund (TEF) non-recurrent 122.10short-term benefits provided in this 122.11subdivision, the commissioner may 122.12supplement funds available under Minnesota 122.13Statutes, section 256E.34 to provide for 122.14summer food programs to the extent such 122.15funds are available and eligible to leverage 122.16TANF emergency funds non-recurrent 122.17benefits. The commissioner may contract 122.18directly with providers or third-party funders 122.19to maximize these TANF emergency fund 122.20grants. Up to $800,000 of TEF non-recurrent 122.21short-term benefit earnings may be used in 122.22this program. This paragraph is effective the 122.23day following final enactment.122.24TANF Transfer to Federal Child 122.25Care and Development Fund. Of the 122.26TANF appropriation in fiscal year 2011, 122.27$12,500,000 is to the commissioner for 122.28the purposes of MFIP and transition year 122.29child care under Minnesota Statutes, section 122.30119B.05. The commissioner shall authorize 122.31the transfer of sufficient TANF funds to the 122.32federal child care and development fund to 122.33meet this appropriation and shall ensure that 122.34all transferred funds are expended according 122.35to federal child care and development fund 122.36regulations.123.1Special Revenue Fund Transfers. (a) The 123.2commissioner shall transfer the following 123.3amounts from special revenue fund balances 123.4to the general fund by June 30 of each 123.5respective fiscal year: $613,000 in fiscal year 123.62010, and $493,000 in fiscal year 2011. This 123.7provision is effective the day following final 123.8enactment.123.9(b) The actual transfers made under 123.10paragraph (a) must be separately identified 123.11and reported as part of the quarterly reporting 123.12of transfers to the chairs of the relevant senate 123.13budget division and house of representatives 123.14finance division.

123.15Subd. 2.Agency Management 

123.16(a)  Financial Operations-0-103,000

123.17Base Adjustment.  The general fund base is 123.18decreased by $3,292,000 in fiscal year 2012 123.19and $3,292,000 in fiscal year 2013.

123.20(b)  Legal and Regulatory Operations-0-114,000

123.21Base Adjustment.  The general fund base is 123.22decreased by $18,000 in fiscal year 2012 and 123.23$18,000 in fiscal year 2013.

123.24(c) Management Operations-0-(114,000)

123.25Base Adjustment.  The general fund base is 123.26increased by $18,000 in fiscal year 2012 and 123.27$18,000 in fiscal year 2013.

123.28123.29Subd. 3.Revenue and Pass-Through Revenue Expenditures8,000,00020,000,000

123.30These appropriations are from the federal 123.31TANF fund.123.32TANF Funding for the Working Family 123.33Tax Credit. In addition to the amounts 124.1specified in Minnesota Statutes, section 124.2290.0671, subdivision 6, $15,500,000 124.3of TANF funds in fiscal year 2010 are 124.4appropriated to the commissioner to 124.5reimburse the general fund for the cost of 124.6the working family tax credit for eligible 124.7families. With respect to the amounts 124.8appropriated for fiscal year 2010, the 124.9commissioner shall reimburse the general 124.10fund by June 30, 2010. This paragraph is 124.11effective the day following final enactment.124.12Child Care Development Fund 124.13Unexpended Balance. In addition to 124.14the amount provided in this section, the 124.15commissioner shall carry over and expend 124.16in fiscal year 2011 $7,500,000 of the TANF 124.17funds transferred in fiscal year 2010 that 124.18reflect the child care and development fund 124.19unexpended balance for the basic sliding 124.20fee child care assistance program under 124.21Minnesota Statutes, section 119B.03. The 124.22commissioner shall ensure that all funds are 124.23expended according to the federal child care 124.24and development fund regulations relating to 124.25the TANF transfers.124.26Base Adjustment. The general fund base is 124.27increased by $7,500,000 in fiscal year 2012 124.28and $7,500,000 in fiscal year 2013.

124.29Subd. 4.Economic Support Grants

124.30(a) Support Services Grants-0--0-

124.31Base Adjustment. The federal TANF fund 124.32base is decreased by $5,004,000 in fiscal year 124.332012 and $5,004,000 in fiscal year 2013.

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

125.1125.2(c) Basic Sliding Fee Child Care Assistance Grants-0-(7,500,000)

125.3(d) Children's Services Grants(900,000)-0-

125.4Adoption Assistance. Of the appropriation 125.5reduction in fiscal year 2010, $900,000 is 125.6from the adoption assistance program. This 125.7reduction is onetime.

125.8(e) Child and Community Services Grants-0-(16,750,000)

125.9Base adjustment. The general fund is 125.10increased by $13,509,000 in fiscal year 2012 125.11and $13,509,000 in fiscal year 2013.

125.12(f) Group Residential Housing Grants-0-84,000

125.13Reduction of Supplemental Service Rate.125.14Effective July 1, 2011, to June 30, 2013, 125.15the commissioner shall decrease the group 125.16residential housing supplementary service 125.17rate under Minnesota Statutes, section 125.18256I.05, subdivision 1a, by five percent 125.19for services rendered on or after that date, 125.20except that reimbursement rates for a group 125.21residential housing facility reimbursed as a 125.22nursing facility shall not be reduced. The 125.23reduction in this paragraph is in addition to 125.24the reduction under Laws 2009, chapter 79, 125.25article 8, section 79, paragraph (b), clause 125.26(11).125.27Base Adjustment. The general fund base is 125.28decreased by $784,000 in fiscal year 2012 125.29and $784,000 in fiscal year 2013.

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

125.31125.32(h) Other Children's and Economic Assistance Grants400,000213,000

126.1Minnesota Food Assistance Program.  Of 126.2the 2011 appropriation, $150,000 is for the 126.3Minnesota Food Assistance Program. This 126.4appropriation is onetime.126.5Of this appropriation, $400,000 in fiscal 126.6year 2010 and $63,000 in fiscal year 2011 126.7is for food shelf programs under Minnesota 126.8Statutes, section 256E.34. This appropriation 126.9is available until spent.126.10Base Adjustment. The general fund base is 126.11decreased by $20,000 in fiscal year 2012 and 126.12decreased by $510,000 in fiscal year 2013.

126.13126.14Subd. 5.Children and Economic Assistance Management

126.15126.16(a) Children and Economic Assistance Administration-0--0-

126.17Base Adjustment. The federal TANF fund 126.18base is decreased by $700,000 in fiscal year 126.192012 and $700,000 in fiscal year 2013.

126.20126.21(b) Children and Economic Assistance Operations-0-195,000

126.22Base Adjustment. The general fund base is 126.23decreased by $12,000 in fiscal year 2012 and 126.24$12,000 in fiscal year 2013.

126.25Subd. 6.Health Care Grants

126.26(a) MinnesotaCare Grants998,00018,124,000

126.27This appropriation is from the health care 126.28access fund.126.29Health Care Access Fund Transfer to 126.30General Fund. The commissioner of 126.31management and budget shall transfer 126.32$998,000 in fiscal year 2010 and 126.33$199,337,000 in fiscal year 2011 from the 126.34health care access fund to the general fund. 127.1This paragraph is effective the day following 127.2final enactment.127.3The amount of this transfer is $178,682,000 127.4in fiscal year 2012 and $297,135,000 in fiscal 127.5year 2013.127.6MinnesotaCare Ratable Reduction.127.7Effective for services rendered on or 127.8after July 1, 2010, to December 31, 2013, 127.9MinnesotaCare payments to managed care 127.10plans under Minnesota Statutes, section 127.11256L.12, for single adults and households 127.12without children whose income is greater 127.13than 75 percent of federal poverty guidelines 127.14shall be reduced by ten percent. Effective 127.15for services provided from July 1, 2010, to 127.16June 30, 2011, this reduction shall apply to 127.17all services. Effective for services provided 127.18from July 1, 2011, to December 31, 2013, this 127.19reduction shall apply to all services except 127.20inpatient hospital services. Notwithstanding 127.21any contrary provision of this article, this 127.22paragraph shall expire on December 31, 127.232013.

127.24127.25(b) Medical Assistance Basic Health Care Grants - Families and Children-0-318,106,000

127.26Critical Access Dental. Of the general 127.27fund appropriation, $731,000 in fiscal year 127.282011 is to the commissioner for critical 127.29access dental provider reimbursement 127.30payments under Minnesota Statutes, section 127.31256B.76 subdivision 4. This is a onetime 127.32appropriation.127.33Nonadministrative Rate Reduction. For 127.34services rendered on or after July 1, 2010, 127.35to December 31, 2013, the commissioner 128.1shall reduce contract rates paid to managed 128.2care plans under Minnesota Statutes, 128.3sections 256B.69 and 256L.12, and to 128.4county-based purchasing plans under 128.5Minnesota Statutes, section 256B.692, by 128.6three percent of the contract rate attributable 128.7to nonadministrative services in effect on 128.8June 30, 2010. Notwithstanding any contrary 128.9provision in this article, this rider expires on 128.10December 31, 2013.

128.11128.12(c) Medical Assistance Basic Health Care Grants - Elderly and Disabled-0-(3,659,000)

128.13MnDHO Transition. Of the general fund 128.14appropriation for fiscal year 2011, $250,000 128.15is to the commissioner to be made available 128.16to county agencies to assist in the transition 128.17of the approximately 1,290 current MnDHO 128.18members to the fee-for-service Medicaid 128.19program or another managed care option by 128.20January 1, 2011.128.21County agencies shall work with the 128.22commissioner, health plans, and MnDHO 128.23members and their legal representatives to 128.24develop and implement transition plans that 128.25include:128.26(1) identification of service needs of MnDHO 128.27members based on the current assessment or 128.28through the completion of a new assessment;128.29(2) identification of services currently 128.30provided to MnDHO members and which 128.31of those services will continue to be 128.32reimbursable through fee-for-service 128.33or another managed care option under 128.34the Medicaid state plan or a home and 128.35community-based waiver program;129.1(3) identification of service providers who do 129.2not have a contract with the county or who 129.3are currently reimbursed at a different rate 129.4than the county contracted rate; and129.5(4) development of an individual service 129.6plan that is within allowable waiver funding 129.7limits.

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

129.9(e)  Other Health Care Grants-0-700,000,000

129.10Cobra Carryforward. Unexpended funds 129.11appropriated in fiscal year 2010 for COBRA 129.12grants under Laws 2009, chapter 79, article 129.135, section 78, do not cancel and are available 129.14to the commissioner for fiscal year 2011 129.15COBRA grant expenditures. Up to $111,000 129.16of the fiscal year 2011 appropriation for 129.17COBRA grants provided in Laws 2009, 129.18chapter 79, article 13, section 3, subdivision 129.196, may be used by the commissioner for costs 129.20related to administration of the COBRA 129.21grants.

129.22Subd. 7.Health Care Management

129.23(a) Health Care Administration-0-442,000

129.24Fiscal Note Report. Of this appropriation, 129.25$50,000 in fiscal year 2011 is for a transfer to 129.26the commissioner of Minnesota Management 129.27and Budget for the completion of the human 129.28services fiscal note report in article 5.129.29PACE Implementation Funding. For fiscal 129.30year 2011, $145,000 is appropriated from 129.31the general fund to the commissioner of 129.32human services to complete the actuarial and 129.33administrative work necessary to begin the 129.34operation of PACE under Minnesota Statutes, 130.1section 256B.69, subdivision 23, paragraph 130.2(e). Base level funding for this activity shall 130.3be $130,000 in fiscal year 2012 and $0 in 130.4fiscal year 2013.130.5Minnesota Senior Health Options 130.6Reimbursement. Effective July 1, 2011, 130.7federal administrative reimbursement 130.8resulting from the Minnesota senior 130.9health options project is appropriated 130.10to the commissioner for this activity. 130.11Notwithstanding any contrary provision, this 130.12provision expires June 30, 2013.130.13Utilization Review. Effective July 1, 130.142011, federal administrative reimbursement 130.15resulting from prior authorization and 130.16inpatient admission certification by a 130.17professional review organization shall be 130.18dedicated to, and is appropriated to, the 130.19commissioner for these activities. A portion 130.20of these funds must be used for activities 130.21to decrease unnecessary pharmaceutical 130.22costs in medical assistance. Notwithstanding 130.23any contrary provision of this article, this 130.24paragraph expires June 30, 2013.130.25Certified Public Expenditures. (1) The 130.26entities named in Minnesota Statutes, section 130.27256B.199, paragraph (b), clause (1), shall 130.28comply with the requirements of that statute 130.29by promptly reporting on a quarterly basis 130.30certified public expenditures that may qualify 130.31for federal matching funds. Reporting under 130.32this paragraph shall be voluntary from July 1, 130.332010, to December 31, 2010. Upon federal 130.34enactment of an extension to June 30, 2011, 130.35of the enhanced federal medical assistance 131.1percentage (FMAP) originally provided 131.2under Public Law 111-5, reporting under 131.3this paragraph shall also be voluntary from 131.4January 1, 2011, to June 30, 2011.131.5(2) To the extent that certified public 131.6expenditures reported in compliance 131.7with paragraph (1) earn federal matching 131.8payments that exceed $8,079,000 in fiscal 131.9year 2012 and $18,316,000 in fiscal year 131.102013, the excess amount shall be deposited 131.11in the health care access fund. For each fiscal 131.12year after fiscal year 2013, the commissioner 131.13shall forecast in November the amount 131.14of federal payments anticipated to match 131.15certified public expenditures reported in 131.16compliance with paragraph (a). Any federal 131.17match earned in a fiscal year in excess of 131.18the amount forecasted in November shall be 131.19deposited to the health care access fund.131.20(3) Notwithstanding any contrary provision 131.21of this article, this rider shall not expire.131.22Poverty Guidelines. Notwithstanding 131.23Minnesota Statutes, sections 256B.56, 131.24subdivision 1c; 256D.03, subdivision 3; 131.25or 256L.04, subdivision 7b, the poverty 131.26guidelines for medical assistance, general 131.27assistance medical care, and MinnesotaCare 131.28from July 1, 2010, through June 30, 2011, 131.29shall not be lower than the poverty guidelines 131.30issued by the Secretary of Health and Human 131.31Services on January 23, 2009. This section 131.32shall have no effect on the revision of poverty 131.33guidelines for the Minnesota health care 131.34programs that would be in effect starting on 132.1July 1, 2011. This paragraph is effective the 132.2day following final enactment.132.3Base Adjustment. The general fund base is 132.4decreased by $227,000 in fiscal year 2012 132.5and $357,000 in fiscal year 2013.

132.6(b) Health Care Operations

132.7Appropriations by Fund132.8General-0-186,000132.9Health Care Access-0-218,000

132.10The general fund appropriation is a onetime 132.11appropriation in fiscal year 2011.132.12Base Adjustment. The health care access 132.13fund base for health care operations is 132.14decreased by $812,000 in fiscal year 2012 132.15and $944,000 in fiscal year 2013.

132.16Subd. 8.Continuing Care Grants

132.17(a) Aging and Adult Services Grants-0-(1,091,000)

132.18Base Adjustment. The general fund base for 132.19aging and adult services grants is increased 132.20by $1,139,000 in fiscal year 2012 and 132.21$1,280,000 in fiscal year 2013.132.22Community Service Development 132.23Reduction. The appropriation in Laws 132.242009, chapter 79, article 13, section 3, 132.25subdivision 8, paragraph (a), for community 132.26service development grants, as amended by 132.27Laws 2009, chapter 173, article 2, section 132.281, subdivision 8, paragraph (a), is reduced 132.29by $154,000 in fiscal year 2011. The 132.30appropriation base is reduced by $139,000 132.31for fiscal year 2012 and $0 for fiscal year 132.322013. Notwithstanding any law or rule to 132.33the contrary, this provision expires June 30, 132.342012.

133.1133.2(b) Medical Assistance Long-Term Care Facilities Grants-0-4,143,000

133.3ICF/MR Occupancy Rate Adjustment 133.4Suspension. Effective for fiscal years 2012 133.5and 2013, approval of new applications for 133.6occupancy rate adjustments for unoccupied 133.7short-term beds under Minnesota Statutes, 133.8section 256B.5013, subdivision 7, is 133.9suspended.133.10Kandiyohi County; ICF/MR Payment 133.11Rate. $36,000 is appropriated from the 133.12general fund in fiscal year 2011 and $4,000 133.13in fiscal year 2012 to increase payment rates 133.14for an ICF/MR licensed for six beds and 133.15located in Kandiyohi County to serve persons 133.16with high behavioral needs. The payment 133.17rate increase shall be effective for services 133.18provided from July 1, 2010, through June 30, 133.192011. These appropriations are onetime.

133.20133.21(c) Medical Assistance Long-Term Care Waivers and Home Care Grants-0-(4,631,000)

133.22Manage Growth in Traumatic Brain 133.23Injury and Community Alternatives for 133.24Disabled Individuals Waivers. During 133.25the fiscal year beginning July 1, 2010, the 133.26commissioner shall allocate money for home 133.27and community-based waiver programs 133.28under Minnesota Statutes, section 256B.49, 133.29to ensure a reduction in state spending that is 133.30equivalent to limiting the caseload growth 133.31of the traumatic brain injury waiver to six 133.32allocations per month and the community 133.33alternatives for disabled individuals waiver 133.34to 60 allocations per month. The limits do not 133.35apply: (1) when there is an approved plan for 134.1nursing facility bed closures for individuals 134.2under age 65 who require relocation due to 134.3the bed closure; (2) to fiscal year 2009 waiver 134.4allocations delayed due to unallotment; or (3) 134.5to transfers authorized by the commissioner 134.6from the personal care assistance program 134.7of individuals having a home care rating of 134.8CS, MT, or HL. Priorities for the allocation 134.9of funds must be for individuals anticipated 134.10to be discharged from institutional settings or 134.11who are at imminent risk of a placement in 134.12an institutional setting.134.13Manage Growth in the Developmental 134.14Disability (DD) Waiver. The commissioner 134.15shall manage the growth in the developmental 134.16disability waiver by limiting the allocations 134.17included in the November 2010 forecast to 134.18six additional diversion allocations each 134.19month for the calendar year that begins on 134.20January 1, 2011. Additional allocations must 134.21be made available for transfers authorized 134.22by the commissioner from the personal care 134.23assistance program of individuals having a 134.24home care rating of CS, MT, or HL. This 134.25provision is effective through December 31, 134.262011.

134.27(d) Adult Mental Health Grants(3,500,000)(300,000)

134.28Compulsive Gambling Special Revenue 134.29Account. $149,000 for fiscal year 2010 134.30and $27,000 for fiscal year 2011 from 134.31the compulsive gambling special revenue 134.32account established under Minnesota 134.33Statutes, section 245.982, shall be transferred 134.34and deposited into the general fund by 134.35June 30 of each respective fiscal year. This 135.1paragraph is effective the day following final 135.2enactment.135.3Compulsive Gambling Lottery Prize 135.4Fund. The lottery prize fund appropriation 135.5for compulsive gambling is reduced by 135.6$80,000 in fiscal year 2010 and $79,000 in 135.7fiscal year 2011. This is a onetime reduction.135.8Culturally Specific Treatment. The 135.9appropriation for culturally specific treatment 135.10is reduced by $300,000 in fiscal year 2011. 135.11This is a onetime reduction.135.12(1) Of the fiscal year 2010 general fund 135.13appropriation for grants to counties for 135.14housing with support services for adults 135.15with serious and persistent mental illness, 135.16$3,300,000 is canceled and returned to the 135.17general fund.135.18(2) Of the fiscal year 2010 general 135.19fund appropriation for additional crisis 135.20intervention team training for law 135.21enforcement, $200,000 is canceled and 135.22returned to the general fund.

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

135.24135.25(f) Chemical Dependency Nonentitlement Grants(389,000)-0-

135.26Base adjustment. The general fund base is 135.27reduced by $393,000 in fiscal year 2012 and 135.28fiscal year 2013.135.29Chemical Health. Of the fiscal year 2010 135.30general fund appropriation to Mother's First 135.31and the Native American Program, $389,000 135.32is canceled and returned to the general fund.

135.33(g) Other Continuing Care Grants-0-350,000

136.1 This is a onetime appropriation in fiscal year 136.22011.136.3Region 10 Quality Assurance Commission.136.4$100,000 is appropriated from the general 136.5fund in fiscal year 2011 to the commissioner 136.6of human services for the purposes 136.7of the Region 10 Quality Assurance 136.8Commission under Minnesota Statutes, 136.9section 256B.0951. This appropriation is 136.10onetime.

136.11Subd. 9.Continuing Care Management-0-414,000

136.12PACE Implementation Funding. For fiscal 136.13year 2011, $111,000 is appropriated from 136.14the general fund to the commissioner of 136.15human services to complete the actuarial 136.16and administrative work necessary to begin 136.17the operation of PACE under Minnesota 136.18Statutes, section 256B.69, subdivision 23, 136.19paragraph (e). Base level funding for this 136.20activity shall be $101,000 in fiscal year 2012 136.21and $0 in fiscal year 2013. For fiscal year 136.222013 and beyond, the commissioner must 136.23work with stakeholders to develop financing 136.24mechanisms to complete the actuarial 136.25and administrative costs of PACE. The 136.26commissioner shall inform the chairs and 136.27ranking minority members of the legislative 136.28committee with jurisdiction over health care 136.29funding by January 15, 2011, on progress to 136.30develop financing mechanisms.136.31Base Adjustment. The general fund base for 136.32continuing care management is increased by 136.33$97,000 in fiscal year 2012 and decreased by 136.34$12,000 in fiscal year 2013.

136.35Subd. 10.State-Operated Services

137.1Obsolete Laundry Depreciation Account.137.2$669,000, or the balance, whichever is 137.3greater, must be transferred from the 137.4state-operated services laundry depreciation 137.5account in the special revenue fund and 137.6deposited into the general fund by June 30, 137.72010. This paragraph is effective the day 137.8following final enactment.137.9Operating Budget Reductions. No 137.10operating budget reductions enacted in Laws 137.112010, chapter 200, or in this act shall be 137.12allocated to state-operated services.137.13Prohibition on Transferring Funds. The 137.14commissioner shall not transfer mental 137.15health grants to state-operated services 137.16without specific legislative approval. 137.17Notwithstanding any contrary provision in 137.18this article, this paragraph shall not expire.

137.19(a) Adult Mental Health Services-0-6,888,000

137.20Base Adjustment. The general fund base is 137.21decreased by $12,286,000 in fiscal year 2012 137.22and $12,394,000 in fiscal year 2013.137.23Appropriation Requirements.  (a) 137.24The general fund appropriation to the 137.25commissioner includes funding for the 137.26following:137.27(1) to a community collaborative to begin 137.28providing crisis center services in the 137.29Mankato area that are comparable to 137.30the crisis services provided prior to the 137.31closure of the Mankato Crisis Center. The 137.32commissioner shall recruit former employees 137.33of the Mankato Crisis Center who were 137.34recently laid off to staff the new crisis 138.1services. The commissioner shall obtain 138.2legislative approval prior to discontinuing 138.3this funding;138.4(2) to maintain the building in Eveleth 138.5that currently houses community transition 138.6services and to establish a psychiatric 138.7intensive therapeutic foster home as an 138.8enterprise activity. The commissioner shall 138.9request a waiver amendment to allow CADI 138.10funding for psychiatric intensive therapeutic 138.11foster care services provided in the same 138.12location and building as the community 138.13transition services. If the federal government 138.14does not approve the waiver amendment, the 138.15commissioner shall continue to pay the lease 138.16for the building out of the state-operated 138.17services budget until the commissioner of 138.18administration subleases the space or until 138.19the lease expires, and shall establish the 138.20psychiatric intensive therapeutic foster home 138.21at a different site. The commissioner shall 138.22make diligent efforts to sublease the space;138.23(3) to convert the community behavioral 138.24health hospitals in Wadena and Willmar to 138.25facilities that provide more suitable services 138.26based on the needs of the community, 138.27which may include, but are not limited to, 138.28psychiatric extensive recovery treatment 138.29services. The commissioner may also 138.30establish other community-based services in 138.31the Willmar and Wadena areas that deliver 138.32the appropriate level of care in response to 138.33the express needs of the communities. The 138.34services established under this provision 138.35must be staffed by state employees.139.1(4) to continue the operation of the dental 139.2clinics in Brainerd, Cambridge, Faribault, 139.3Fergus Falls, and Willmar at the same level of 139.4care and staffing that was in effect on March 139.51, 2010. The commissioner shall not proceed 139.6with the planned closure of the dental 139.7clinics, and shall not discontinue services or 139.8downsize any of the state-operated dental 139.9clinics without specific legislative approval. 139.10The commissioner shall continue to bill 139.11for services provided to obtain medical 139.12assistance critical access dental payments 139.13and cost-based payment rates as provided 139.14in Minnesota Statutes, section 256B.76, 139.15subdivision 2, and shall bill for services 139.16provided three months retroactively from 139.17the date of this act. This appropriation is 139.18onetime;139.19(5) to convert the Minnesota 139.20Neurorehabilitation Hospital in Brainerd 139.21to a neurocognitive psychiatric extensive 139.22recovery treatment service; and139.23(6) to convert the Minnesota extended 139.24treatment options (METO) program to 139.25the following community-based services 139.26provided by state employees: (i) psychiatric 139.27extensive recovery treatment services; 139.28(ii) intensive transitional foster homes 139.29as enterprise activities; and (iii) other 139.30community-based support services. The 139.31provisions under Minnesota Statutes, section 139.32252.025, subdivision 7, are applicable to 139.33the METO services established under this 139.34clause. Notwithstanding Minnesota Statutes, 139.35section 246.18, subdivision 8, any revenue 139.36lost to the general fund by the conversion 140.1of METO to new services must be replaced 140.2by revenue from the new services to offset 140.3the lost revenue to the general fund until 140.4June 30, 2013. Any revenue generated in 140.5excess of this amount shall be deposited into 140.6the special revenue fund under Minnesota 140.7Statutes, section 246.18, subdivision 8.140.8(b) The commissioner shall not move beds 140.9from the Anoka-Metro Regional Treatment 140.10Center to the psychiatric nursing facility 140.11at St. Peter without specific legislative 140.12approval.140.13(c) The commissioner shall implement 140.14changes, including the following, to save a 140.15minimum of $6,006,000 beginning in fiscal 140.16year 2011, and report to the legislature the 140.17specific initiatives implemented and the 140.18savings allocated to each one, including:140.19(1) maximizing budget savings through 140.20strategic employee staffing; and140.21(2) identifying and implementing cost 140.22reductions in cooperation with state-operated 140.23services employees.140.24Base level funding is reduced by $6,006,000 140.25effective fiscal year 2011.140.26(d) The commissioner shall seek certification 140.27or approval from the federal government for 140.28the new services under paragraph (a) that are 140.29eligible for federal financial participation 140.30and deposit the revenue associated with 140.31these new services in the account established 140.32under Minnesota Statutes, section 246.18, 140.33subdivision 8, unless otherwise specified.141.1(e) Notwithstanding any contrary provision 141.2in this article, this rider shall not expire.

141.3(b) Minnesota Sex Offender Services-0-(145,000)

141.4Sex Offender Services. Base level funding 141.5for Minnesota sex offender services is 141.6reduced by $418,000 in fiscal year 2012 and 141.7$419,000 in fiscal year 2013 for the 50-bed 141.8sex offender treatment program within the 141.9Moose Lake correctional facility in which 141.10Department of Human Services staff from 141.11Minnesota sex offender services provide 141.12clinical treatment to incarcerated offenders. 141.13This reduction shall become part of the base 141.14for the Department of Human Services.141.15Interagency Agreements. The 141.16commissioner of human services may 141.17enter into interagency agreements with the 141.18commissioner of corrections to continue sex 141.19offender treatment and chemical dependency 141.20treatment on a cost-sharing basis, in which 141.21each department pays 50 percent of the costs 141.22of these services.

141.23Sec. 4. COMMISSIONER OF HEALTH

141.24Subdivision 1.Total Appropriation$(2,392,000)$(1,310,000)

141.25Appropriations by Fund141.2620102011141.27General(2,392,000)(1,064,000)141.28141.29State Government Special Revenue-0-9,000141.30Health Care Access-0-237,000

141.31Subd. 2.Community and Family Health(221,000)(47,000)

141.32Base Level Adjustment. The general fund 141.33base is decreased by $388,000 in fiscal years 141.342012 and 2013.

142.1Subd. 3.Policy, Quality, and Compliance

142.2Appropriations by Fund142.320102011142.4General(1,797,000)497,000142.5142.6State Government Special Revenue-0-9,000142.7Health Care Access-0-237,000

142.8Health Care Reform. Funds appropriated 142.9in Laws 2008, chapter 358, article 5, section 142.104, subdivision 3, for health reform activities 142.11to implement Laws 2008, chapter 358, 142.12article 4, are available until expended. 142.13Notwithstanding any contrary provision in 142.14this article, this provision shall not expire.142.15Health Care Reform Task Force. $198,000 142.16from the general fund is for expenses related 142.17to the Health Care Reform Task Force 142.18established under article 7.142.19Rural Hospital Capital Improvement 142.20Grants. Of the general fund reductions in 142.21fiscal year 2010, $1,755,000 is for the rural 142.22hospital capital improvement grant program.142.23Section 125 Plans. The remaining balance 142.24from the Laws 2008, chapter 358, article 5, 142.25section 4, subdivision 3, appropriation for 142.26Section 125 Plan Employer Incentives is 142.27canceled.142.28Birth Centers. Of the appropriation in fiscal 142.29year 2011 from the state government special 142.30revenue fund, $9,000 is to the commissioner 142.31to license birth centers. Base level funding 142.32for this activity shall be $7,000 in fiscal year 142.332012 and $7,000 in fiscal year 2013.142.34Comprehensive Advanced Life Support 142.35Program. Of the general fund appropriation, 143.1$377,000 in fiscal year 2011 is to the 143.2commissioner for the comprehensive 143.3advanced life support educational program. 143.4For fiscal year 2012, base level funding for 143.5this program shall be $377,000.143.6Advisory Group on Administrative 143.7Expenses. Of the health care access fund 143.8appropriation for fiscal year 2011, $39,000 is 143.9to the commissioner for the advisory group 143.10established under Minnesota Statutes, section 143.1162D.31. This is a onetime appropriation.143.12Base Level Adjustment. The general fund 143.13base is decreased by $253,000 in fiscal year 143.142012 and $253,000 in fiscal year 2013. The 143.15state government special revenue fund base 143.16is decreased by $2,000 in fiscal year 2012 143.17and $2,000 in fiscal year 2013.143.18Office of Unlicensed Health Care Practice.143.19Of the general fund appropriation, $74,000 143.20in fiscal year 2011 is for the Office of 143.21Unlicensed Complementary and Alternative 143.22Health Care Practice. This is a onetime 143.23appropriation.

143.24Subd. 4.Health Protection(374,000)714,000

143.25Lead Base Grant Program. Of the general 143.26fund reduction, $25,000 in fiscal year 2010 143.27and fiscal year 2011 is for the elimination 143.28of state funding for the temporary lead-safe 143.29housing base grant program.143.30Birth Defects Information System. Of the 143.31general fund appropriation for fiscal year 143.322011, $919,000 is for the Minnesota Birth 143.33Defects Information System established 143.34under Minnesota Statutes, section 144.2215.144.1Base Adjustment. The general fund base 144.2is increased by $440,000 in fiscal year 2012 144.3and $984,000 in fiscal year 2013. 

144.4Subd. 5.Administrative Support Services-0-(100,000)

144.5The general fund base is decreased by 144.6$22,000 in fiscal year 2012 and $22,000 in 144.7fiscal year 2013.

144.8144.9Sec. 5. DEPARTMENT OF VETERANS AFFAIRS$(50,000)$-0-

144.10Cancellation of Prior Appropriation.144.11By June 30, 2010, the commissioner of 144.12management and budget shall cancel the 144.13$50,000 appropriation for fiscal year 2008 to 144.14the board in Laws 2007, chapter 147, article 144.1519, section 5, in the paragraph titled "Pay for 144.16Performance."

144.17Sec. 6. HEALTH-RELATED BOARDS

144.18Subdivision 1.Total Appropriation$113,000$615,000

144.19The appropriations in this section are from 144.20the state government special revenue fund.144.21In fiscal year 2010, $591,000 shall be 144.22transferred from the state government special 144.23revenue fund to the general fund. In fiscal 144.24year 2011, $3,052,000 shall be transferred 144.25from the state government special revenue 144.26fund to the general fund. These transfers 144.27are in addition to those made in Laws 2009, 144.28chapter 79, article 13, section 5, as amended 144.29by Laws 2009, chapter 173, article 2, section 144.303.144.31The transfers in this section are onetime in 144.32the fiscal year 2010-2011 biennium.145.1The appropriations for each purpose are 145.2shown in the following subdivisions.

145.3145.4Subd. 2.Board of Marriage and Family Therapy47,00022,000

145.5Operating Costs and Rulemaking. Of 145.6this appropriation, $22,000 in fiscal year 145.72010 and $22,000 in fiscal year 2011 are 145.8for operating costs. This is an ongoing 145.9appropriation. Of this appropriation, $25,000 145.10in fiscal year 2010 is for rulemaking. This is 145.11a onetime appropriation.

145.12145.13Subd. 3.Board of Nursing Home Administrators51,00061,000

145.14Subd. 4.Board of Pharmacy-0-517,000

145.15Prescription Electronic Reporting. Of 145.16the state government special revenue fund 145.17appropriation, $517,000 in fiscal year 2011 145.18is to the board to operate the prescription 145.19electronic reporting system in Minnesota 145.20Statutes, section 152.126. Base level funding 145.21for this activity in fiscal year 2012 shall be 145.22$356,000.

145.23Subd. 5.Board of Podiatry15,00015,000

145.24Purpose. This appropriation is to pay health 145.25insurance coverage costs and to cover the 145.26cost of expert witnesses in disciplinary cases.

145.27145.28Sec. 7. EMERGENCY MEDICAL SERVICES BOARD$247,000$(382,000)

145.29Sec. 8. UNIVERSITY OF MINNESOTA$-0-$93,000

145.30This appropriation is from the special 145.31revenue fund for the couples on the brink 145.32program.

146.1Sec. 9. DEPARTMENT OF CORRECTIONS$-0-$-0-

146.2Sex Offender Services. From the general 146.3fund appropriations to the commissioner of 146.4corrections, the commissioner shall transfer 146.5$418,000 in fiscal year 2012 and $419,000 146.6in fiscal year 2013 to the commissioner of 146.7human services to provide clinical treatment 146.8to incarcerated offenders. This transfer shall 146.9become part of the base for the Department 146.10of Corrections.

146.11Sec. 10. DEPARTMENT OF COMMERCE$-0-$38,000

146.12Health Plan Filings. Of this appropriation:146.13(1) $19,000 is for the review and approval 146.14of new health plan filings due to Minnesota 146.15Statutes, section 62Q.545. This is a onetime 146.16appropriation in fiscal year 2011; and146.17(2) $19,000 is for regulation of Minnesota 146.18Statutes, section 62A.3075.146.19    Sec. 11. Minnesota Statutes 2008, section 214.40, subdivision 7, is amended to read:146.20    Subd. 7. Medical professional liability insurance. (a) Within the limit of funds 146.21appropriated for this program, the administrative services unit must purchase medical 146.22professional liability insurance, if available, for a health care provider who is registered in 146.23accordance with subdivision 4 and who is not otherwise covered by a medical professional 146.24liability insurance policy or self-insured plan either personally or through another facility 146.25or employer. The administrative services unit is authorized to prorate payments or 146.26otherwise limit the number of participants in the program if the costs of the insurance for 146.27eligible providers exceed the funds appropriated for the program.146.28(b) Coverage purchased under this subdivision must be limited to the provision of 146.29health care services performed by the provider for which the provider does not receive 146.30direct monetary compensation.146.31EFFECTIVE DATE.This section is effective the day following final enactment.147.1    Sec. 12. Laws 2009, chapter 79, article 13, section 3, subdivision 1, as amended by 147.2Laws 2009, chapter 173, article 2, section 1, subdivision 1, is amended to read:

147.3Subdivision 1.Total Appropriation$5,225,451,000$6,002,864,000

147.4Appropriations by Fund147.520102011147.6General4,375,689,0005,209,765,000147.7147.8State Government 
                  		Special Revenue565,000565,000147.9Health Care Access450,662,000527,411,000147.10Federal TANF286,770,000263,458,000147.11Lottery Prize1,665,0001,665,000147.12Federal Fund110,000,0000

147.13Receipts for Systems Projects.147.14Appropriations and federal receipts for 147.15information systems projects for MAXIS, 147.16PRISM, MMIS, and SSIS must be deposited 147.17in the state system account authorized in 147.18Minnesota Statutes, section 
         256.014. Money 147.19appropriated for computer projects approved 147.20by the Minnesota Office of Enterprise 147.21Technology, funded by the legislature, and 147.22approved by the commissioner of finance, 147.23may be transferred from one project to 147.24another and from development to operations 147.25as the commissioner of human services 147.26considers necessary, except that any transfers 147.27to one project that exceed $1,000,000 or 147.28multiple transfers to one project that exceed 147.29$1,000,000 in total require the express 147.30approval of the legislature. The preceding 147.31requirement for legislative approval does not 147.32apply to transfers made to establish a project's 147.33initial operating budget each year; instead, 147.34the requirements of section 11, subdivision 147.352, of this article apply to those transfers. Any 147.36unexpended balance in the appropriation 147.37for these projects does not cancel but is 148.1available for ongoing development and 148.2operations. Any computer project with a 148.3total cost exceeding $1,000,000, including, 148.4but not limited to, a replacement for the 148.5proposed HealthMatch system, shall not be 148.6commenced without the express approval of 148.7the legislature.148.8HealthMatch Systems Project. In fiscal 148.9year 2010, $3,054,000 shall be transferred 148.10from the HealthMatch account in the state 148.11systems account in the special revenue fund 148.12to the general fund.148.13Nonfederal Share Transfers. The 148.14nonfederal share of activities for which 148.15federal administrative reimbursement is 148.16appropriated to the commissioner may be 148.17transferred to the special revenue fund.148.18TANF Maintenance of Effort.148.19(a) In order to meet the basic maintenance 148.20of effort (MOE) requirements of the TANF 148.21block grant specified under Code of Federal 148.22Regulations, title 45, section 263.1, the 148.23commissioner may only report nonfederal 148.24money expended for allowable activities 148.25listed in the following clauses as TANF/MOE 148.26expenditures:148.27(1) MFIP cash, diversionary work program, 148.28and food assistance benefits under Minnesota 148.29Statutes, chapter 256J;148.30(2) the child care assistance programs 148.31under Minnesota Statutes, sections 
         119B.03148.32and 
         119B.05, and county child care 148.33administrative costs under Minnesota 148.34Statutes, section 
         119B.15;149.1(3) state and county MFIP administrative 149.2costs under Minnesota Statutes, chapters 149.3256J and 256K;149.4(4) state, county, and tribal MFIP 149.5employment services under Minnesota 149.6Statutes, chapters 256J and 256K;149.7(5) expenditures made on behalf of 149.8noncitizen MFIP recipients who qualify 149.9for the medical assistance without federal 149.10financial participation program under 149.11Minnesota Statutes, section 
         256B.06, 149.12subdivision 4
         , paragraphs (d), (e), and (j); 149.13and149.14(6) qualifying working family credit 149.15expenditures under Minnesota Statutes, 149.16section 
         290.0671.; and149.17(7) qualifying Minnesota education credit 149.18expenditures under Minnesota Statutes, 149.19section 290.0674.149.20(b) The commissioner shall ensure that 149.21sufficient qualified nonfederal expenditures 149.22are made each year to meet the state's 149.23TANF/MOE requirements. For the activities 149.24listed in paragraph (a), clauses (2) to 149.25(6), the commissioner may only report 149.26expenditures that are excluded from the 149.27definition of assistance under Code of 149.28Federal Regulations, title 45, section 
         260.31.149.29(c) For fiscal years beginning with state 149.30fiscal year 2003, the commissioner shall 149.31ensure that the maintenance of effort used 149.32by the commissioner of finance for the 149.33February and November forecasts required 149.34under Minnesota Statutes, section 
         16A.103, 150.1contains expenditures under paragraph (a), 150.2clause (1), equal to at least 16 percent of 150.3the total required under Code of Federal 150.4Regulations, title 45, section 263.1.150.5(d) For the federal fiscal years beginning on 150.6or after October 1, 2007, the commissioner 150.7may not claim an amount of TANF/MOE in 150.8excess of the 75 percent standard in Code 150.9of Federal Regulations, title 45, section 150.10263.1(a)(2), except:150.11(1) to the extent necessary to meet the 80 150.12percent standard under Code of Federal 150.13Regulations, title 45, section 263.1(a)(1), 150.14if it is determined by the commissioner 150.15that the state will not meet the TANF work 150.16participation target rate for the current year;150.17(2) to provide any additional amounts 150.18under Code of Federal Regulations, title 45, 150.19section 264.5, that relate to replacement of 150.20TANF funds due to the operation of TANF 150.21penalties; and150.22(3) to provide any additional amounts that 150.23may contribute to avoiding or reducing 150.24TANF work participation penalties through 150.25the operation of the excess MOE provisions 150.26of Code of Federal Regulations, title 45, 150.27section 
         261.43 (a)(2).150.28For the purposes of clauses (1) to (3), 150.29the commissioner may supplement the 150.30MOE claim with working family credit 150.31expenditures to the extent such expenditures 150.32or other qualified expenditures are otherwise 150.33available after considering the expenditures 150.34allowed in this section.151.1(e) Minnesota Statutes, section 
         256.011, 151.2subdivision 3
         , which requires that federal 151.3grants or aids secured or obtained under that 151.4subdivision be used to reduce any direct 151.5appropriations provided by law, do not apply 151.6if the grants or aids are federal TANF funds.151.7(f) Notwithstanding any contrary provision 151.8in this article, this provision expires June 30, 151.92013.151.10Working Family Credit Expenditures as 151.11TANF/MOE. The commissioner may claim 151.12as TANF/MOE up to $6,707,000 per year of 151.13working family credit expenditures for fiscal 151.14year 2010 through fiscal year 2011.151.15Working Family Credit Expenditures 151.16to be Claimed for TANF/MOE. The 151.17commissioner may count the following 151.18amounts of working family credit expenditure 151.19as TANF/MOE:151.20(1) fiscal year 2010, $50,973,000151.21$50,897,000;151.22(2) fiscal year 2011, $53,793,000151.23$54,243,000;151.24(3) fiscal year 2012, $23,516,000151.25$23,345,000; and151.26(4) fiscal year 2013, $16,808,000151.27$16,585,000.151.28Notwithstanding any contrary provision in 151.29this article, this rider expires June 30, 2013.151.30Food Stamps Employment and Training.151.31(a) The commissioner shall apply for and 151.32claim the maximum allowable federal 151.33matching funds under United States Code, 152.1title 7, section 2025, paragraph (h), for 152.2state expenditures made on behalf of family 152.3stabilization services participants voluntarily 152.4engaged in food stamp employment and 152.5training activities, where appropriate.152.6(b) Notwithstanding Minnesota Statutes, 152.7sections 
         256D.051, subdivisions 1a, 6b, 152.8and 6c, and 
         256J.626, federal food stamps 152.9employment and training funds received 152.10as reimbursement of MFIP consolidated 152.11fund grant expenditures for diversionary 152.12work program participants and child 152.13care assistance program expenditures for 152.14two-parent families must be deposited in the 152.15general fund. The amount of funds must be 152.16limited to $3,350,000 in fiscal year 2010 152.17and $4,440,000 in fiscal years 2011 through 152.182013, contingent on approval by the federal 152.19Food and Nutrition Service. 152.20(c) Consistent with the receipt of these federal 152.21funds, the commissioner may adjust the 152.22level of working family credit expenditures 152.23claimed as TANF maintenance of effort. 152.24Notwithstanding any contrary provision in 152.25this article, this rider expires June 30, 2013.152.26ARRA Food Support Administration.152.27The funds available for food support 152.28administration under the American Recovery 152.29and Reinvestment Act (ARRA) of 2009 152.30are appropriated to the commissioner 152.31to pay actual costs of implementing the 152.32food support benefit increases, increased 152.33eligibility determinations, and outreach. Of 152.34these funds, 20 percent shall be allocated 152.35to the commissioner and 80 percent shall 153.1be allocated to counties. The commissioner 153.2shall allocate the county portion based on 153.3caseload. Reimbursement shall be based on 153.4actual costs reported by counties through 153.5existing processes. Tribal reimbursement 153.6must be made from the state portion based 153.7on a caseload factor equivalent to that of a 153.8county.153.9ARRA Food Support Benefit Increases.153.10The funds provided for food support benefit 153.11increases under the Supplemental Nutrition 153.12Assistance Program provisions of the 153.13American Recovery and Reinvestment Act 153.14(ARRA) of 2009 must be used for benefit 153.15increases beginning July 1, 2009.153.16Emergency Fund for the TANF Program.153.17TANF Emergency Contingency funds 153.18available under the American Recovery 153.19and Reinvestment Act of 2009 (Public Law 153.20111-5) are appropriated to the commissioner. 153.21The commissioner must request TANF 153.22Emergency Contingency funds from the 153.23Secretary of the Department of Health 153.24and Human Services to the extent the 153.25commissioner meets or expects to meet the 153.26requirements of section 403(c) of the Social 153.27Security Act. The commissioner must seek 153.28to maximize such grants. The funds received 153.29must be used as appropriated. Each county 153.30must maintain the county's current level of 153.31emergency assistance funding under the 153.32MFIP consolidated fund and use the funds 153.33under this paragraph to supplement existing 153.34emergency assistance funding levels.154.1    Sec. 13. Laws 2009, chapter 79, article 13, section 3, subdivision 3, as amended by 154.2Laws 2009, chapter 173, article 2, section 1, subdivision 3, is amended to read:

154.3154.4Subd. 3.Revenue and Pass-Through Revenue Expenditures68,337,00070,505,000

154.5This appropriation is from the federal TANF 154.6fund.154.7TANF Transfer to Federal Child Care 154.8and Development Fund. The following 154.9TANF fund amounts are appropriated to the 154.10commissioner for the purposes of MFIP and 154.11transition year child care under Minnesota 154.12Statutes, section 
         119B.05: 154.13(1) fiscal year 2010, $6,531,000 $862,000;154.14(2) fiscal year 2011, $10,241,000 $978,000;154.15(3) fiscal year 2012, $10,826,000 $0; and154.16(4) fiscal year 2013, $4,046,000 $0.154.17The commissioner shall authorize the 154.18transfer of sufficient TANF funds to the 154.19federal child care and development fund to 154.20meet this appropriation and shall ensure that 154.21all transferred funds are expended according 154.22to federal child care and development fund 154.23regulations.154.24    Sec. 14. Laws 2009, chapter 79, article 13, section 3, subdivision 4, as amended by 154.25Laws 2009, chapter 173, article 2, section 1, subdivision 4, is amended to read:

154.26154.27Subd. 4.Children and Economic Assistance Grants

154.28The amounts that may be spent from this 154.29appropriation for each purpose are as follows:

154.30(a) MFIP/DWP Grants

155.1Appropriations by Fund155.2General63,205,00089,033,000155.3Federal TANF100,818,00084,538,000

155.4(b) Support Services Grants

155.5Appropriations by Fund155.6General8,715,00012,498,000155.7Federal TANF116,557,000107,457,000

155.8MFIP Consolidated Fund. The MFIP 155.9consolidated fund TANF appropriation is 155.10reduced by $1,854,000 in fiscal year 2010 155.11and fiscal year 2011.155.12Notwithstanding Minnesota Statutes, section 155.13256J.626, subdivision 8
         , paragraph (b), the 155.14commissioner shall reduce proportionately 155.15the reimbursement to counties for 155.16administrative expenses.155.17Subsidized Employment Funding Through 155.18ARRA. The commissioner is authorized to 155.19apply for TANF emergency fund grants for 155.20subsidized employment activities. Growth 155.21in expenditures for subsidized employment 155.22within the supported work program and the 155.23MFIP consolidated fund over the amount 155.24expended in the calendar quarters in the 155.25TANF emergency fund base year shall be 155.26used to leverage the TANF emergency fund 155.27grants for subsidized employment and to 155.28fund supported work. The commissioner 155.29shall develop procedures to maximize 155.30reimbursement of these expenditures over the 155.31TANF emergency fund base year quarters, 155.32and may contract directly with employers 155.33and providers to maximize these TANF 155.34emergency fund grants, including provisions 155.35of TANF summer youth program wage 156.1subsidies for MFIP youth and caregivers. 156.2MFIP youth are individuals up to age 25 who 156.3are part of an eligible household as defined 156.4under rules governing TANF maintenance 156.5of effort with incomes less than 200 percent 156.6of federal poverty guidelines. Expenditures 156.7may only be used for subsidized wages and 156.8benefits and eligible training and supervision 156.9expenditures. The commissioner shall 156.10contract with the Minnesota Department of 156.11Employment and Economic Development 156.12for the summer youth program. The 156.13commissioner shall develop procedures 156.14to maximize reimbursement of these 156.15expenditures over the TANF emergency fund 156.16year quarters. No more than $6,000,000 shall 156.17be reimbursed. This provision is effective 156.18upon enactment.156.19Supported Work. Of the TANF 156.20appropriation, $4,700,000 in fiscal year 2010 156.21and $4,700,000 in fiscal year 2011 are to the 156.22commissioner for supported work for MFIP 156.23recipients and is available until expended. 156.24Supported work includes paid transitional 156.25work experience and a continuum of 156.26employment assistance, including outreach 156.27and recruitment, program orientation 156.28and intake, testing and assessment, job 156.29development and marketing, preworksite 156.30training, supported worksite experience, 156.31job coaching, and postplacement follow-up, 156.32in addition to extensive case management 156.33and referral services. This is a onetime 156.34appropriation.156.35Base Adjustment. The general fund base 156.36is reduced by $3,783,000 in each of fiscal 157.1years 2012 and 2013. The TANF fund base 157.2is increased by $5,004,000 in each of fiscal 157.3years 2012 and 2013.157.4Integrated Services Program Funding.157.5The TANF appropriation for integrated 157.6services program funding is $1,250,000 in 157.7fiscal year 2010 and $0 in fiscal year 2011 157.8and the base for fiscal years 2012 and 2013 157.9is $0.157.10TANF Emergency Fund; Nonrecurrent 157.11Short-Term Benefits.(a) TANF emergency 157.12contingency fund grants received due to 157.13increases in expenditures for nonrecurrent 157.14short-term benefits must be used to offset the 157.15increase in these expenditures for counties 157.16under the MFIP consolidated fund, under 157.17Minnesota Statutes, section 
         256J.626, 157.18and the diversionary work program. The 157.19commissioner shall develop procedures 157.20to maximize reimbursement of these 157.21expenditures over the TANF emergency fund 157.22base year quarters. Growth in expenditures 157.23for the diversionary work program over the 157.24amount expended in the calendar quarters in 157.25the TANF emergency fund base year shall be 157.26used to leverage these funds.157.27(b) To the extent that the commissioner 157.28can claim eligible tax credit growth as 157.29nonrecurrent short-term benefits, the 157.30commissioner shall use those funds to 157.31leverage the increased expenditures in 157.32paragraph (a).157.33(c) TANF emergency funds for nonrecurrent 157.34short-term benefits received in excess of the 157.35amounts necessary for paragraphs (a) and (b) 158.1shall be used to reimburse the general fund 158.2for the costs of eligible tax credits in fiscal 158.3year 2011. The amount of such funds shall 158.4not exceed $15,500,000 in fiscal year 2010. 158.5(d) This rider is effective the day following 158.6final enactment.

158.7(c) MFIP Child Care Assistance Grants61,171,00065,214,000

158.8Acceleration of ARRA Child Care and 158.9Development Fund Expenditure. The 158.10commissioner must liquidate all child care 158.11and development money available under 158.12the American Recovery and Reinvestment 158.13Act (ARRA) of 2009, Public Law 111-5, 158.14by September 30, 2010. In order to expend 158.15those funds by September 30, 2010, the 158.16commissioner may redesignate and expend 158.17the ARRA child care and development funds 158.18appropriated in fiscal year 2011 for purposes 158.19under this section for related purposes that 158.20will allow liquidation by September 30, 158.212010. Child care and development funds 158.22otherwise available to the commissioner 158.23for those related purposes shall be used to 158.24fund the purposes from which the ARRA 158.25child care and development funds had been 158.26redesignated.158.27School Readiness Service Agreements.158.28$400,000 in fiscal year 2010 and $400,000 158.29in fiscal year 2011 are from the federal 158.30TANF fund to the commissioner of human 158.31services consistent with federal regulations 158.32for the purpose of school readiness service 158.33agreements under Minnesota Statutes, 158.34section 
         119B.231. This is a onetime 159.1appropriation. Any unexpended balance the 159.2first year is available in the second year.

159.3159.4(d) Basic Sliding Fee Child Care Assistance Grants40,100,00045,092,000

159.5School Readiness Service Agreements.159.6$257,000 in fiscal year 2010 and $257,000 159.7in fiscal year 2011 are from the general 159.8fund for the purpose of school readiness 159.9service agreements under Minnesota 159.10Statutes, section 
         119B.231. This is a onetime 159.11appropriation. Any unexpended balance the 159.12first year is available in the second year.159.13Child Care Development Fund 159.14Unexpended Balance. In addition to 159.15the amount provided in this section, the 159.16commissioner shall expend $5,244,000 in 159.17fiscal year 2010 from the federal child care 159.18development fund unexpended balance 159.19for basic sliding fee child care under 159.20Minnesota Statutes, section 
         119B.03. The 159.21commissioner shall ensure that all child 159.22care and development funds are expended 159.23according to the federal child care and 159.24development fund regulations.159.25Basic Sliding Fee. $4,000,000 in fiscal year 159.262010 and $4,000,000 in fiscal year 2011 are 159.27from the federal child care development 159.28funds received from the American Recovery 159.29and Reinvestment Act of 2009, Public 159.30Law 111-5, to the commissioner of human 159.31services consistent with federal regulations 159.32for the purpose of basic sliding fee child care 159.33assistance under Minnesota Statutes, section 159.34119B.03
         . This is a onetime appropriation. 160.1Any unexpended balance the first year is 160.2available in the second year.160.3Basic Sliding Fee Allocation for Calendar 160.4Year 2010. Notwithstanding Minnesota 160.5Statutes, section 
         119B.03, subdivision 6, 160.6in calendar year 2010, basic sliding fee 160.7funds shall be distributed according to 160.8this provision. Funds shall be allocated 160.9first in amounts equal to each county's 160.10guaranteed floor, according to Minnesota 160.11Statutes, section 
         119B.03, subdivision 8, 160.12with any remaining available funds allocated 160.13according to the following formula:160.14(a) Up to one-fourth of the funds shall be 160.15allocated in proportion to the number of 160.16families participating in the transition year 160.17child care program as reported during and 160.18averaged over the most recent six months 160.19completed at the time of the notice of 160.20allocation. Funds in excess of the amount 160.21necessary to serve all families in this category 160.22shall be allocated according to paragraph (d).160.23(b) Up to three-fourths of the funds shall 160.24be allocated in proportion to the average 160.25of each county's most recent six months of 160.26reported waiting list as defined in Minnesota 160.27Statutes, section 
         119B.03, subdivision 2, and 160.28the reinstatement list of those families whose 160.29assistance was terminated with the approval 160.30of the commissioner under Minnesota Rules, 160.31part 3400.0183, subpart 1. Funds in excess 160.32of the amount necessary to serve all families 160.33in this category shall be allocated according 160.34to paragraph (d).161.1(c) The amount necessary to serve all families 161.2in paragraphs (a) and (b) shall be calculated 161.3based on the basic sliding fee average cost of 161.4care per family in the county with the highest 161.5cost in the most recently completed calendar 161.6year.161.7(d) Funds in excess of the amount necessary 161.8to serve all families in paragraphs (a) and 161.9(b) shall be allocated in proportion to each 161.10county's total expenditures for the basic 161.11sliding fee child care program reported 161.12during the most recent fiscal year completed 161.13at the time of the notice of allocation. To 161.14the extent that funds are available, and 161.15notwithstanding Minnesota Statutes, section 161.16119B.03, subdivision 8
         , for the period 161.17January 1, 2011, to December 31, 2011, each 161.18county's guaranteed floor must be equal to its 161.19original calendar year 2010 allocation.161.20Base Adjustment. The general fund base is 161.21decreased by $257,000 in each of fiscal years 161.222012 and 2013.

161.23(e) Child Care Development Grants1,487,0001,487,000

161.24Family, friends, and neighbor grants.161.25$375,000 in fiscal year 2010 and $375,000 161.26in fiscal year 2011 are from the child 161.27care development fund required targeted 161.28quality funds for quality expansion and 161.29infant/toddler from the American Recovery 161.30and Reinvestment Act of 2009, Public 161.31Law 111-5, to the commissioner of human 161.32services for family, friends, and neighbor 161.33grants under Minnesota Statutes, section 161.34119B.232
         . This appropriation may be used 161.35on programs receiving family, friends, and 162.1neighbor grant funds as of June 30, 2009, 162.2or on new programs or projects. This is a 162.3onetime appropriation. Any unexpended 162.4balance the first year is available in the 162.5second year.162.6Voluntary quality rating system training, 162.7coaching, consultation, and supports.162.8$633,000 in fiscal year 2010 and $633,000 162.9in fiscal year 2011 are from the federal child 162.10care development fund required targeted 162.11quality funds for quality expansion and 162.12infant/toddler from the American Recovery 162.13and Reinvestment Act of 2009, Public 162.14Law 111-5, to the commissioner of human 162.15services consistent with federal regulations 162.16for the purpose of providing grants to provide 162.17statewide child-care provider training, 162.18coaching, consultation, and supports to 162.19prepare for the voluntary Minnesota quality 162.20rating system rating tool. This is a onetime 162.21appropriation. Any unexpended balance the 162.22first year is available in the second year.162.23Voluntary quality rating system. $184,000 162.24in fiscal year 2010 and $1,200,000 in fiscal 162.25year 2011 are from the federal child care 162.26development fund required targeted funds for 162.27quality expansion and infant/toddler from the 162.28American Recovery and Reinvestment Act of 162.292009, Public Law 111-5, to the commissioner 162.30of human services consistent with federal 162.31regulations for the purpose of implementing 162.32the voluntary Parent Aware quality star 162.33rating system pilot in coordination with the 162.34Minnesota Early Learning Foundation. The 162.35appropriation for the first year is to complete 162.36and promote the voluntary Parent Aware 163.1quality rating system pilot program through 163.2June 30, 2010, and the appropriation for 163.3the second year is to continue the voluntary 163.4Minnesota quality rating system pilot 163.5through June 30, 2011. This is a onetime 163.6appropriation. Any unexpended balance the 163.7first year is available in the second year.

163.8(f) Child Support Enforcement Grants3,705,0003,705,000

163.9(g) Children's Services Grants

163.10Appropriations by Fund163.11General48,333,00050,498,000163.12Federal TANF340,000240,000

163.13Base Adjustment. The general fund base is 163.14decreased by $5,371,000 in fiscal year 2012 163.15and decreased $5,371,000 in fiscal year 2013.163.16Privatized Adoption Grants. Federal 163.17reimbursement for privatized adoption grant 163.18and foster care recruitment grant expenditures 163.19is appropriated to the commissioner for 163.20adoption grants and foster care and adoption 163.21administrative purposes.163.22Adoption Assistance Incentive Grants.163.23Federal funds available during fiscal year 163.242010 and fiscal year 2011 for the adoption 163.25incentive grants are appropriated to the 163.26commissioner for postadoption services 163.27including parent support groups.163.28Adoption Assistance and Relative Custody 163.29Assistance. The commissioner may transfer 163.30unencumbered appropriation balances for 163.31adoption assistance and relative custody 163.32assistance between fiscal years and between 163.33programs.

163.34(h) Children and Community Services Grants67,663,00067,542,000

164.1Targeted Case Management Temporary 164.2Funding Adjustment. The commissioner 164.3shall recover from each county and tribe 164.4receiving a targeted case management 164.5temporary funding payment in fiscal year 164.62008 an amount equal to that payment. The 164.7commissioner shall recover one-half of the 164.8funds by February 1, 2010, and the remainder 164.9by February 1, 2011. At the commissioner's 164.10discretion and at the request of a county 164.11or tribe, the commissioner may revise 164.12the payment schedule, but full payment 164.13must not be delayed beyond May 1, 2011. 164.14The commissioner may use the recovery 164.15procedure under Minnesota Statutes, section 164.16256.017
         , to recover the funds. Recovered 164.17funds must be deposited into the general 164.18fund.

164.19(i) General Assistance Grants48,215,00048,608,000

164.20General Assistance Standard. The 164.21commissioner shall set the monthly standard 164.22of assistance for general assistance units 164.23consisting of an adult recipient who is 164.24childless and unmarried or living apart 164.25from parents or a legal guardian at $203. 164.26The commissioner may reduce this amount 164.27according to Laws 1997, chapter 85, article 164.283, section 54.164.29Emergency General Assistance. The 164.30amount appropriated for emergency general 164.31assistance funds is limited to no more 164.32than $7,889,812 in fiscal year 2010 and 164.33$7,889,812 in fiscal year 2011. Funds 164.34to counties must be allocated by the 164.35commissioner using the allocation method 165.1specified in Minnesota Statutes, section 165.2256D.06
         .

165.3(j) Minnesota Supplemental Aid Grants33,930,00035,191,000

165.4Emergency Minnesota Supplemental 165.5Aid Funds. The amount appropriated for 165.6emergency Minnesota supplemental aid 165.7funds is limited to no more than $1,100,000 165.8in fiscal year 2010 and $1,100,000 in fiscal 165.9year 2011. Funds to counties must be 165.10allocated by the commissioner using the 165.11allocation method specified in Minnesota 165.12Statutes, section 
         256D.46.

165.13(k) Group Residential Housing Grants111,778,000114,034,000

165.14Group Residential Housing Costs 165.15Refinanced. (a) Effective July 1, 2011, the 165.16commissioner shall increase the home and 165.17community-based service rates and county 165.18allocations provided to programs for persons 165.19with disabilities established under section 165.201915(c) of the Social Security Act to the 165.21extent that these programs will be paying 165.22for the costs above the rate established 165.23in Minnesota Statutes, section 
         256I.05, 165.24subdivision 1
         .165.25(b) For persons receiving services under 165.26Minnesota Statutes, section 
         245A.02, who 165.27reside in licensed adult foster care beds 165.28for which a difficulty of care payment 165.29was being made under Minnesota Statutes, 165.30section 
         256I.05, subdivision 1c, paragraph 165.31(b), counties may request an exception to 165.32the individual's service authorization not to 165.33exceed the difference between the client's 165.34monthly service expenditures plus the 165.35amount of the difficulty of care payment.

166.1(l) Children's Mental Health Grants16,885,00016,882,000

166.2Funding Usage. Up to 75 percent of a fiscal 166.3year's appropriation for children's mental 166.4health grants may be used to fund allocations 166.5in that portion of the fiscal year ending 166.6December 31.

166.7166.8(m) Other Children and Economic Assistance Grants16,047,00015,339,000

166.9Fraud Prevention Grants. Of this 166.10appropriation, $228,000 in fiscal year 2010 166.11and $228,000 $379,000 in fiscal year 2011 166.12is to the commissioner for fraud prevention 166.13grants to counties.166.14Homeless and Runaway Youth. $218,000 166.15in fiscal year 2010 is for the Runaway 166.16and Homeless Youth Act under Minnesota 166.17Statutes, section 
         256K.45. Funds shall be 166.18spent in each area of the continuum of care 166.19to ensure that programs are meeting the 166.20greatest need. Any unexpended balance in 166.21the first year is available in the second year. 166.22Beginning July 1, 2011, the base is increased 166.23by $119,000 each year.166.24ARRA Homeless Youth Funds. To the 166.25extent permitted under federal law, the 166.26commissioner shall designate $2,500,000 166.27of the Homeless Prevention and Rapid 166.28Re-Housing Program funds provided under 166.29the American Recovery and Reinvestment 166.30Act of 2009, Public Law 111-5, for agencies 166.31providing homelessness prevention and rapid 166.32rehousing services to youth.166.33Supportive Housing Services. $1,500,000 166.34each year is for supportive services under 167.1Minnesota Statutes, section 
         256K.26. This is 167.2a onetime appropriation. 167.3Community Action Grants. Community 167.4action grants are reduced one time by 167.5$1,794,000 each year. This reduction is due 167.6to the availability of federal funds under the 167.7American Recovery and Reinvestment Act.167.8Base Adjustment. The general fund base 167.9is increased by $773,000 $903,000 in fiscal 167.10year 2012 and $773,000 $413,000 in fiscal 167.11year 2013.167.12Federal ARRA Funds for Existing 167.13Programs. (a) Federal funds received by the 167.14commissioner for the emergency food and 167.15shelter program from the American Recovery 167.16and Reinvestment Act of 2009, Public 167.17Law 111-5, but not previously approved 167.18by the legislature are appropriated to the 167.19commissioner for the purposes of the grant 167.20program.167.21(b) Federal funds received by the 167.22commissioner for the emergency shelter 167.23grant program including the Homelessness 167.24Prevention and Rapid Re-Housing 167.25Program from the American Recovery and 167.26Reinvestment Act of 2009, Public Law 167.27111-5, are appropriated to the commissioner 167.28for the purposes of the grant programs.167.29(c) Federal funds received by the 167.30commissioner for the emergency food 167.31assistance program from the American 167.32Recovery and Reinvestment Act of 2009, 167.33Public Law 111-5, are appropriated to the 167.34commissioner for the purposes of the grant 167.35program.168.1(d) Federal funds received by the 168.2commissioner for senior congregate meals 168.3and senior home-delivered meals from the 168.4American Recovery and Reinvestment Act 168.5of 2009, Public Law 111-5, are appropriated 168.6to the commissioner for the Minnesota Board 168.7on Aging, for purposes of the grant programs.168.8(e) Federal funds received by the 168.9commissioner for the community services 168.10block grant program from the American 168.11Recovery and Reinvestment Act of 2009, 168.12Public Law 111-5, are appropriated to the 168.13commissioner for the purposes of the grant 168.14program.168.15Long-Term Homeless Supportive 168.16Service Fund Appropriation. To the 168.17extent permitted under federal law, the 168.18commissioner shall designate $3,000,000 168.19of the Homelessness Prevention and Rapid 168.20Re-Housing Program funds provided under 168.21the American Recovery and Reinvestment 168.22Act of 2009, Public Law, 111-5, to the 168.23long-term homeless service fund under 168.24Minnesota Statutes, section 
         256K.26. This 168.25appropriation shall become available by July 168.261, 2009. This paragraph is effective the day 168.27following final enactment.168.28    Sec. 15. Laws 2009, chapter 79, article 13, section 3, subdivision 8, as amended by 168.29Laws 2009, chapter 173, article 2, section 1, subdivision 8, is amended to read:

168.30Subd. 8.Continuing Care Grants

168.31The amounts that may be spent from the 168.32appropriation for each purpose are as follows:

168.33(a) Aging and Adult Services Grants13,499,00015,805,000

169.1Base Adjustment. The general fund base is 169.2increased by $5,751,000 in fiscal year 2012 169.3and $6,705,000 in fiscal year 2013.169.4Information and Assistance 169.5Reimbursement. Federal administrative 169.6reimbursement obtained from information 169.7and assistance services provided by the 169.8Senior LinkAge or Disability Linkage lines 169.9to people who are identified as eligible for 169.10medical assistance shall be appropriated to 169.11the commissioner for this activity.169.12Community Service Development Grant 169.13Reduction. Funding for community service 169.14development grants must be reduced by 169.15$260,000 for fiscal year 2010; $284,000 in 169.16fiscal year 2011; $43,000 in fiscal year 2012; 169.17and $43,000 in fiscal year 2013. Base level 169.18funding shall be restored in fiscal year 2014.169.19Community Service Development Grant 169.20Community Initiative. Funding for 169.21community service development grants shall 169.22be used to offset the cost of aging support 169.23grants. Base level funding shall be restored 169.24in fiscal year 2014.169.25Senior Nutrition Use of Federal Funds.169.26For fiscal year 2010, general fund grants 169.27for home-delivered meals and congregate 169.28dining shall be reduced by $500,000. The 169.29commissioner must replace these general 169.30fund reductions with equal amounts from 169.31federal funding for senior nutrition from the 169.32American Recovery and Reinvestment Act 169.33of 2009.

169.34(b) Alternative Care Grants50,234,00048,576,000

170.1Base Adjustment. The general fund base is 170.2decreased by $3,598,000 in fiscal year 2012 170.3and $3,470,000 in fiscal year 2013.170.4Alternative Care Transfer. Any money 170.5allocated to the alternative care program that 170.6is not spent for the purposes indicated does 170.7not cancel but must be transferred to the 170.8medical assistance account.

170.9170.10(c) Medical Assistance Grants; Long-Term Care Facilities.367,444,000419,749,000

170.11170.12(d) Medical Assistance Long-Term Care Waivers and Home Care Grants853,567,0001,039,517,000

170.13Manage Growth in TBI and CADI 170.14Waivers. During the fiscal years beginning 170.15on July 1, 2009, and July 1, 2010, the 170.16commissioner shall allocate money for home 170.17and community-based waiver programs 170.18under Minnesota Statutes, section 
         256B.49, 170.19to ensure a reduction in state spending that is 170.20equivalent to limiting the caseload growth of 170.21the TBI waiver to 12.5 allocations per month 170.22each year of the biennium and the CADI 170.23waiver to 95 allocations per month each year 170.24of the biennium. Limits do not apply: (1) 170.25when there is an approved plan for nursing 170.26facility bed closures for individuals under 170.27age 65 who require relocation due to the 170.28bed closure; (2) to fiscal year 2009 waiver 170.29allocations delayed due to unallotment; or (3) 170.30to transfers authorized by the commissioner 170.31from the personal care assistance program 170.32of individuals having a home care rating 170.33of "CS," "MT," or "HL." Priorities for the 170.34allocation of funds must be for individuals 170.35anticipated to be discharged from institutional 171.1settings or who are at imminent risk of a 171.2placement in an institutional setting.171.3Manage Growth in DD Waiver. The 171.4commissioner shall manage the growth in 171.5the DD waiver by limiting the allocations 171.6included in the February 2009 forecast to 15 171.7additional diversion allocations each month 171.8for the calendar years that begin on January 171.91, 2010, and January 1, 2011. Additional 171.10allocations must be made available for 171.11transfers authorized by the commissioner 171.12from the personal care program of individuals 171.13having a home care rating of "CS," "MT," 171.14or "HL."171.15Adjustment to Lead Agency Waiver 171.16Allocations. Prior to the availability of the 171.17alternative license defined in Minnesota 171.18Statutes, section 
         245A.11, subdivision 8, 171.19the commissioner shall reduce lead agency 171.20waiver allocations for the purposes of 171.21implementing a moratorium on corporate 171.22foster care.171.23Alternatives to Personal Care Assistance 171.24Services. Base level funding of $3,237,000 171.25in fiscal year 2012 and $4,856,000 in 171.26fiscal year 2013 is to implement alternative 171.27services to personal care assistance services 171.28for persons with mental health and other 171.29behavioral challenges who can benefit 171.30from other services that more appropriately 171.31meet their needs and assist them in living 171.32independently in the community. These 171.33services may include, but not be limited to, a 171.341915(i) state plan option.

171.35(e) Mental Health Grants

172.1Appropriations by Fund172.2General77,739,00077,739,000172.3Health Care Access750,000750,000172.4Lottery Prize1,508,0001,508,000

172.5Funding Usage. Up to 75 percent of a fiscal 172.6year's appropriation for adult mental health 172.7grants may be used to fund allocations in that 172.8portion of the fiscal year ending December 172.931.

172.10(f) Deaf and Hard-of-Hearing Grants1,930,0001,917,000

172.11(g) Chemical Dependency Entitlement Grants111,303,000122,822,000

172.12Payments for Substance Abuse Treatment.172.13For services providedplacements beginning 172.14during fiscal years 2010 and 2011, 172.15county-negotiated rates and provider claims 172.16to the consolidated chemical dependency 172.17fund must not exceed the lesser of:172.18(1)  rates charged for these services on 172.19January 1, 2009; or172.20(2) 160 percent of the average rate on January 172.211, 2009, for each group of vendors with 172.22similar attributes.172.23Effective July 1, 2010, rates that were above 172.24the average rate on January 1, 2009, are 172.25reduced by five percent from the rates in 172.26effect on June 1, 2010. Rates below the 172.27average rate on January 1, 2009, are reduced 172.28by 1.8 percent from the rates in effect on June 172.291, 2010. Services provided under this section 172.30by state-operated services are exempt from 172.31the rate reduction. For services provided in 172.32fiscal years 2012 and 2013, statewide average 172.33rates the statewide aggregate payment  under 172.34the new rate methodology to be developed 173.1under Minnesota Statutes, section 
         254B.12, 173.2must not exceed the average rates charged 173.3for these services on January 1, 2009173.4projected aggregate payment under the rates 173.5in effect for fiscal year 2011 excluding the 173.6rate reduction for rates that were below 173.7the average on January 1, 2009, plus a 173.8state share increase of $3,787,000 for fiscal 173.9year 2012 and $5,023,000 for fiscal year 173.102013. Notwithstanding any provision to the 173.11contrary in this article, this provision expires 173.12on June 30, 2013.173.13Chemical Dependency Special Revenue 173.14Account. For fiscal year 2010, $750,000 173.15must be transferred from the consolidated 173.16chemical dependency treatment fund 173.17administrative account and deposited into the 173.18general fund.173.19County CD Share of MA Costs for 173.20ARRA Compliance. Notwithstanding the 173.21provisions of Minnesota Statutes, chapter 173.22254B, for chemical dependency services 173.23provided during the period October 1, 2008, 173.24to December 31, 2010, and reimbursed by 173.25medical assistance at the enhanced federal 173.26matching rate provided under the American 173.27Recovery and Reinvestment Act of 2009, the 173.28county share is 30 percent of the nonfederal 173.29share. This provision is effective the day 173.30following final enactment.

173.31173.32(h) Chemical Dependency Nonentitlement Grants1,729,0001,729,000

173.33(i) Other Continuing Care Grants19,201,00017,528,000

173.34Base Adjustment. The general fund base is 173.35increased by $2,639,000 in fiscal year 2012 174.1and increased by $3,854,000 in fiscal year 174.22013.174.3Technology Grants. $650,000 in fiscal 174.4year 2010 and $1,000,000 in fiscal year 174.52011 are for technology grants, case 174.6consultation, evaluation, and consumer 174.7information grants related to developing and 174.8supporting alternatives to shift-staff foster 174.9care residential service models.174.10Other Continuing Care Grants; HIV 174.11Grants. Money appropriated for the HIV 174.12drug and insurance grant program in fiscal 174.13year 2010 may be used in either year of the 174.14biennium.174.15Quality Assurance Commission. Effective 174.16July 1, 2009, state funding for the quality 174.17assurance commission under Minnesota 174.18Statutes, section 
         256B.0951, is canceled.174.19    Sec. 16. Laws 2009, chapter 79, article 13, section 5, subdivision 8, as amended by 174.20Laws 2009, chapter 173, article 2, section 3, subdivision 8, is amended to read:

174.21174.22Subd. 8.Board of Nursing Home Administrators1,211,0001,023,000

174.23Administrative Services Unit - Operating 174.24Costs. Of this appropriation, $524,000 174.25in fiscal year 2010 and $526,000 in 174.26fiscal year 2011 are for operating costs 174.27of the administrative services unit. The 174.28administrative services unit may receive 174.29and expend reimbursements for services 174.30performed by other agencies.174.31Administrative Services Unit - Retirement 174.32Costs. Of this appropriation in fiscal year 174.332010, $201,000 is for onetime retirement 174.34costs in the health-related boards. This 175.1funding may be transferred to the health 175.2boards incurring those costs for their 175.3payment. These funds are available either 175.4year of the biennium.175.5Administrative Services Unit - Volunteer 175.6Health Care Provider Program. Of this 175.7appropriation, $79,000 $130,000  in fiscal 175.8year 2010 and $89,000 $150,000  in fiscal 175.9year 2011 are to pay for medical professional 175.10liability coverage required under Minnesota 175.11Statutes, section 
         214.40.175.12Administrative Services Unit - Contested 175.13Cases and Other Legal Proceedings. Of 175.14this appropriation, $200,000 in fiscal year 175.152010 and $200,000 in fiscal year 2011 are 175.16for costs of contested case hearings and other 175.17unanticipated costs of legal proceedings 175.18involving health-related boards funded 175.19under this section and for unforeseen 175.20expenditures of an urgent nature. Upon 175.21certification of a health-related board to the 175.22administrative services unit that the costs 175.23will be incurred and that there is insufficient 175.24money available to pay for the costs out of 175.25money currently available to that board, the 175.26administrative services unit is authorized 175.27to transfer money from this appropriation 175.28to the board for payment of those costs 175.29with the approval of the commissioner of 175.30finance. This appropriation does not cancel. 175.31Any unencumbered and unspent balances 175.32remain available for these expenditures in 175.33subsequent fiscal years. The boards receiving 175.34funds under this section shall include these 175.35amounts when setting fees to cover their 175.36costs.176.1    Sec. 17. EXPIRATION OF UNCODIFIED LANGUAGE.176.2All uncodified language contained in this article expires on June 30, 2011, unless a 176.3different expiration date is explicit.176.4    Sec. 18. EFFECTIVE DATE.176.5The provisions in this article are effective July 1, 2010, unless a different effective 176.6date is explicit."176.7Delete the title and insert:176.8"A bill for an act176.9relating to state government; state health care programs; continuing care; 176.10children and family services; health care reform; Department of Health; 176.11public health; health plans; increasing fees and surcharges; requiring reports; 176.12making supplemental and contingent appropriations and reductions for the 176.13Departments of Health and Human Services and other health-related boards 176.14and councils;amending Minnesota Statutes 2008, sections 62D.08, by adding 176.15a subdivision; 62J.692, subdivision 4; 62Q.19, subdivision 1; 144.05, by 176.16adding a subdivision; 144.226, subdivision 3; 144.293, subdivision 4; 144.651, 176.17subdivision 2; 144.9504, by adding a subdivision; 144A.51, subdivision 5; 176.18144D.03, subdivision 2, by adding a subdivision; 144D.04, subdivision 2; 176.19144E.37; 144G.06; 152.126, as amended; 214.40, subdivision 7; 246.18, by 176.20adding a subdivision; 254B.01, subdivision 2; 254B.02, subdivisions 1, 5; 176.21254B.03, subdivision 4; 254B.05, subdivision 4; 254B.06, subdivision 2; 176.22254B.09, subdivision 8; 256.9657, subdivisions 2, 3, 3a; 256.969, subdivisions 176.2321, 26, by adding a subdivision; 256B.055, by adding a subdivision; 256B.056, 176.24subdivisions 3, 4; 256B.057, subdivision 9; 256B.0625, subdivisions 8, 8a, 8b, 176.2518a, 22, 31, by adding subdivisions; 256B.0631, subdivisions 1, 3; 256B.0644, 176.26as amended; 256B.0915, by adding a subdivision; 256B.19, subdivision 1c; 176.27256B.5012, by adding a subdivision; 256B.69, subdivisions 20, as amended, 176.2827, by adding a subdivision; 256B.692, subdivision 1; 256B.76, subdivisions 176.292, 4; 256D.03, subdivision 3b; 256D.0515; 256I.05, by adding a subdivision; 176.30256J.24, subdivision 6; 256L.07, by adding a subdivision; 256L.11, subdivision 176.316; 256L.12, subdivisions 5, 9, by adding a subdivision; 256L.15, subdivision 176.321; 517.08, subdivision 1c, as amended; Minnesota Statutes 2009 Supplement, 176.33sections 157.16, subdivision 3; 252.27, subdivision 2a; 256.969, subdivisions 2b, 176.343a; 256.975, subdivision 7; 256B.0625, subdivision 13h; 256B.0653, subdivision 176.355; 256B.0659, subdivision 11; 256B.0911, subdivisions 1a, 3c; 256B.441, 176.36subdivision 55; 256B.69, subdivisions 5a, 23; 256B.76, subdivision 1; 256B.766; 176.37256D.03, subdivision 3, as amended; 256J.425, subdivision 3; 256L.03, 176.38subdivision 5; 327.15, subdivision 3; 517.08, subdivision 1b; Laws 2005, First 176.39Special Session chapter 4, article 8, section 66, as amended; Laws 2009, chapter 176.4079, article 3, section 18; article 5, sections 17; 18; 22; 75, subdivision 1; 78, 176.41subdivision 5; article 8, sections 2; 51; 84; article 13, sections 3, subdivisions 176.421, as amended, 3, as amended, 4, as amended, 8, as amended; 5, subdivision 8, 176.43as amended; Laws 2009, chapter 173, article 1, section 17; Laws 2010, chapter 176.44200, article 1, sections 12; 16; 21; article 2, section 2, subdivisions 1, 5, 8; 176.45proposing coding for new law in Minnesota Statutes, chapters 62D; 62E; 62Q; 176.46137; 144; 144D; 246; 254B; 256; 256B; repealing Minnesota Statutes 2008, 176.47sections 254B.02, subdivisions 2, 3, 4; 254B.09, subdivisions 4, 5, 7; 256D.03, 176.48subdivisions 3, 3a, 5, 6, 7, 8; Minnesota Statutes 2009 Supplement, section 176.49256J.621; Laws 2010, chapter 200, article 1, sections 12; 18; 19."

177.1We request the adoption of this report and repassage of the bill.177.2House Conferees:177.3
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                     						177.4Thomas HuntleyKaren Clark177.5
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                     						177.6Paul ThissenLarry Hosch177.7
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                     						177.8Jim Abeler177.9Senate Conferees:177.10
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                     						177.11Linda BerglinYvonne Prettner Solon177.12
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                     						177.13Kathy SheranTony Lourey177.14
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                     						177.15Steve Dille