HF 2614

1st Committee Engrossment - 86th Legislature (2009 - 2010)

Posted on 03/19/2013 07:29 p.m.

1.1A bill for an act 1.2relating to human services; licensing; state health care programs; continuing 1.3care; children and family services; health reform; public health; assessing 1.4administrative penalties; requiring reports; making supplemental appropriations 1.5and reductions; amending Minnesota Statutes 2008, sections 3.971, subdivision 1.62; 3.98, by adding a subdivision; 62D.08, by adding a subdivision; 62J.07, 1.7subdivision 2, by adding a subdivision; 62J.38; 62Q.19, subdivision 1; 1.862Q.76, subdivision 1; 62U.05; 144.226, subdivision 3; 144.291, subdivision 1.92; 144.651, subdivision 2; 144.9504, by adding a subdivision; 144A.51, 1.10subdivision 5; 144E.37; 245C.27, subdivision 2; 245C.28, subdivision 3; 1.11254B.01, subdivision 2; 254B.02, subdivisions 1, 5; 254B.03, subdivision 4, 1.12by adding a subdivision; 254B.05, subdivision 4; 254B.06, subdivision 2; 1.13254B.09, subdivision 8; 256.01, by adding a subdivision; 256.9657, subdivision 1.143; 256B.04, subdivision 14; 256B.055, by adding a subdivision; 256B.056, 1.15subdivision 4; 256B.057, subdivision 9; 256B.0625, subdivisions 8, 8a, 8b, 1.1618a, 31, by adding subdivisions; 256B.0631, subdivisions 1, 3; 256B.0644, as 1.17amended; 256B.0754, by adding a subdivision; 256B.0915, subdivision 3b; 1.18256B.19, subdivision 1c; 256B.69, subdivisions 20, as amended, 27, by adding 1.19subdivisions; 256B.692, subdivision 1; 256B.75; 256B.76, subdivisions 2, 4, by 1.20adding a subdivision; 256D.0515; 256J.20, subdivision 3; 256J.24, subdivision 1.2110; 256J.37, subdivision 3a; 256L.02, subdivision 3; 256L.03, subdivision 1.223, by adding a subdivision; 256L.05, by adding a subdivision; 256L.07, by 1.23adding a subdivision; 256L.12, subdivisions 5, 6, 9; 626.556, subdivision 1.2410i; 626.557, subdivision 9d; Minnesota Statutes 2009 Supplement, sections 1.2562J.495, subdivisions 1a, 3, by adding a subdivision; 245C.27, subdivision 1; 1.26252.025, subdivision 7; 252.27, subdivision 2a; 256.045, subdivision 3; 256.969, 1.27subdivision 3a; 256B.0625, subdivisions 9, 13e; 256B.0653, subdivision 5; 1.28256B.0915, subdivision 3a; 256B.69, subdivision 23; 256B.76, subdivision 1.291; 256B.766; 256D.03, subdivision 3, as amended; 256J.425, subdivision 3; 1.30256L.03, subdivision 5; 256L.11, subdivision 1; Laws 2009, chapter 79, article 3, 1.31section 18; article 5, section 78, subdivision 5; article 13, section 3, subdivisions 1.321, as amended, 3, as amended, 4, as amended, 8, as amended; Laws 2010, chapter 1.33200, article 1, sections 12, subdivisions 6, 7, 8; 16; 21; article 2, section 2, 1.34subdivisions 1, 8; proposing coding for new law in Minnesota Statutes, chapters 1.3562A; 62D; 62E; 62J; 62Q; 144; 245; 254B; 256; 256B; repealing Minnesota 1.36Statutes 2008, sections 254B.02, subdivisions 2, 3, 4; 254B.09, subdivisions 4, 5, 1.377; 256D.03, subdivisions 3a, 3b, 5, 6, 7, 8; Minnesota Statutes 2009 Supplement, 1.38section 256D.03, subdivision 3; Laws 2009, chapter 79, article 7, section 26, 2.1subdivision 3; Laws 2010, chapter 200, article 1, sections 12, subdivisions 1, 2.22, 3, 4, 5, 6, 7, 8, 9; 18; 19. 2.3BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 2.4ARTICLE 1 2.5DHS LICENSING 2.6    Section 1. Minnesota Statutes 2009 Supplement, section 245C.27, subdivision 1, is 2.7amended to read: 2.8    Subdivision 1. Fair hearing when disqualification is not set aside new text begin rescinded new text end . (a) 2.9If the commissioner does not set aside new text begin rescind new text end a disqualification of an individual under 2.10section 245C.22 who is disqualified on the basis of a preponderance of evidence that the 2.11individual committed an act or acts that meet the definition of any of the crimes listed in 2.12section 245C.15; for a determination under section 626.556 or 626.557 of substantiated 2.13maltreatment that was serious or recurring under section 245C.15; or for failure to make 2.14required reports under section 626.556, subdivision 3; or 626.557, subdivision 3, pursuant 2.15to section 245C.15, subdivision 4, paragraph (b), clause (1), the individual may request 2.16a fair hearing under section 256.045, unless the disqualification is deemed conclusive 2.17under section 245C.29. 2.18    (b) The fair hearing is the only administrative appeal of the final agency 2.19determination for purposes of appeal by the disqualified individual. The disqualified 2.20individual does not have the right to challenge the accuracy and completeness of data 2.21under section 13.04. 2.22    (c) Except as provided under paragraph (e), if the individual was disqualified based 2.23on a conviction of, admission to, or Alford Plea to any crimes listed in section 245C.15, 2.24subdivisions 1 to 4 , or for a disqualification under section 256.98, subdivision 8, the 2.25reconsideration decision under section 245C.22 is the final agency determination for 2.26purposes of appeal by the disqualified individual and is not subject to a hearing under 2.27section 256.045. If the individual was disqualified based on a judicial determination, that 2.28determination is treated the same as a conviction for purposes of appeal. 2.29    (d) This subdivision does not apply to a public employee's appeal of a disqualification 2.30under section 245C.28, subdivision 3. 2.31    (e) Notwithstanding paragraph (c), if the commissioner does not set aside a 2.32disqualification of an individual who was disqualified based on both a preponderance 2.33of evidence and a conviction or admission, the individual may request a fair hearing 2.34under section 256.045, unless the disqualifications are deemed conclusive under section 2.35245C.29 . The scope of the hearing conducted under section 256.045 with regard to the 3.1disqualification based on a conviction or admission shall be limited solely to whether the 3.2individual poses a risk of harm, according to section 256.045, subdivision 3b. In this case, 3.3the reconsideration decision under section 245C.22 is not the final agency decision for 3.4purposes of appeal by the disqualified individual. 3.5    Sec. 2. Minnesota Statutes 2008, section 245C.27, subdivision 2, is amended to read: 3.6    Subd. 2. Consolidated fair hearing. (a) If an individual who is disqualified on the 3.7bases of serious or recurring maltreatment requests a fair hearing on the maltreatment 3.8determination under section 626.556, subdivision 10i, or 626.557, subdivision 9d, and 3.9requests a fair hearing under this section on the disqualification, which has not been 3.10set aside new text begin rescinded new text end , the scope of the fair hearing under section 256.045 shall include the 3.11maltreatment determination and the disqualification. 3.12(b) A fair hearing is the only administrative appeal of the final agency determination. 3.13The disqualified individual does not have the right to challenge the accuracy and 3.14completeness of data under section 13.04. 3.15(c) This subdivision does not apply to a public employee's appeal of a disqualification 3.16under section 245C.28, subdivision 3. 3.17    Sec. 3. Minnesota Statutes 2008, section 245C.28, subdivision 3, is amended to read: 3.18    Subd. 3. Employees of public employer. (a) If the commissioner does not set 3.19aside new text begin rescind new text end the disqualification of an individual who is an employee of an employer, as 3.20defined in section 179A.03, subdivision 15, the individual may request a contested case 3.21hearing under chapter 14 new text begin , unless the disqualification is deemed conclusive under section new text end 3.22 new text begin 245C.29 new text end . The request for a contested case hearing must be made in writing and must be 3.23postmarked and sent within 30 calendar days after the employee receives notice that the 3.24disqualification has not been set aside new text begin rescinded new text end . If the individual was disqualified based 3.25on a conviction or admission to any crimes listed in section 245C.15, the scope of the 3.26contested case hearing shall be limited solely to whether the individual poses a risk of 3.27harm pursuant to section 245C.22. 3.28(b) If the commissioner does not set aside new text begin rescind new text end a disqualification that is based on 3.29a maltreatment determination, the scope of the contested case hearing must include the 3.30maltreatment determination and the disqualification. In such cases, a fair hearing must 3.31not be conducted under section 256.045. 3.32 new text begin (c) If the commissioner does not rescind a disqualification that is based on a new text end 3.33 new text begin preponderance of evidence that the individual committed an act or acts that meet the new text end 3.34 new text begin definition of any of the crimes listed in section 245C.15, the scope of the contested case new text end 4.1 new text begin hearing must include the disqualification decision. In such cases, a fair hearing must new text end 4.2 new text begin not be conducted under section 256.045. new text end 4.3(c) new text begin (d) new text end Rules adopted under this chapter may not preclude an employee in a contested 4.4case hearing for a disqualification from submitting evidence concerning information 4.5gathered under this chapter. 4.6(d) new text begin (e) new text end When an individual has been disqualified from multiple licensed programs 4.7and the disqualifications have not been set aside new text begin rescinded new text end under section 245C.22, if at 4.8least one of the disqualifications entitles the person to a contested case hearing under this 4.9subdivision, the scope of the contested case hearing shall include all disqualifications from 4.10licensed programs which were not set aside new text begin rescinded new text end . 4.11(e) new text begin (f) new text end In determining whether the disqualification should be set aside, the 4.12administrative law judge shall consider all of the characteristics that cause the individual 4.13to be disqualified in order to determine whether the individual poses a risk of harm. The 4.14administrative law judge's recommendation and the commissioner's order to set aside 4.15a disqualification that is the subject of the hearing constitutes a determination that the 4.16individual does not pose a risk of harm and that the individual may provide direct contact 4.17services in the individual program specified in the set aside. 4.18    Sec. 4. Minnesota Statutes 2009 Supplement, section 256.045, subdivision 3, is 4.19amended to read: 4.20    Subd. 3. State agency hearings. (a) State agency hearings are available for the 4.21following: 4.22    (1) any person applying for, receiving or having received public assistance, medical 4.23care, or a program of social services granted by the state agency or a county agency or 4.24the federal Food Stamp Act whose application for assistance is denied, not acted upon 4.25with reasonable promptness, or whose assistance is suspended, reduced, terminated, or 4.26claimed to have been incorrectly paid; 4.27    (2) any patient or relative aggrieved by an order of the commissioner under section 4.28252.27 ; 4.29    (3) a party aggrieved by a ruling of a prepaid health plan; 4.30    (4) except as provided under chapter 245C, any individual or facility determined by 4.31a lead agency to have maltreated a vulnerable adult under section 626.557 after they have 4.32exercised their right to administrative reconsideration under section 626.557; 4.33    (5) any person whose claim for foster care payment according to a placement of the 4.34child resulting from a child protection assessment under section 626.556 is denied or not 4.35acted upon with reasonable promptness, regardless of funding source; 5.1    (6) any person to whom a right of appeal according to this section is given by other 5.2provision of law; 5.3    (7) an applicant aggrieved by an adverse decision to an application for a hardship 5.4waiver under section 256B.15; 5.5    (8) an applicant aggrieved by an adverse decision to an application or redetermination 5.6for a Medicare Part D prescription drug subsidy under section 256B.04, subdivision 4a; 5.7    (9) except as provided under chapter 245A, an individual or facility determined 5.8to have maltreated a minor under section 626.556, after the individual or facility has 5.9exercised the right to administrative reconsideration under section 626.556; 5.10    (10) except as provided under chapter 245C, an individual disqualified under 5.11sections 245C.14 and 245C.15, which has not been set aside new text begin rescinded new text end under sections 5.12245C.22 and 245C.23, on the basis of serious or recurring maltreatment; a preponderance 5.13of the evidence that the individual has committed an act or acts that meet the definition 5.14of any of the crimes listed in section 245C.15, subdivisions 1 to 4; or for failing to make 5.15reports required under section 626.556, subdivision 3, or 626.557, subdivision 3. Hearings 5.16regarding a maltreatment determination under clause (4) or (9) and a disqualification under 5.17this clause in which the basis for a disqualification is serious or recurring maltreatment, 5.18which has not been set aside new text begin rescinded new text end under sections 245C.22 and 245C.23, shall be 5.19consolidated into a single fair hearing. In such cases, the scope of review by the human 5.20services referee shall include both the maltreatment determination and the disqualification. 5.21The failure to exercise the right to an administrative reconsideration shall not be a bar to a 5.22hearing under this section if federal law provides an individual the right to a hearing to 5.23dispute a finding of maltreatment. Individuals and organizations specified in this section 5.24may contest the specified action, decision, or final disposition before the state agency by 5.25submitting a written request for a hearing to the state agency within 30 days after receiving 5.26written notice of the action, decision, or final disposition, or within 90 days of such written 5.27notice if the applicant, recipient, patient, or relative shows good cause why the request 5.28was not submitted within the 30-day time limit; or 5.29    (11) any person with an outstanding debt resulting from receipt of public assistance, 5.30medical care, or the federal Food Stamp Act who is contesting a setoff claim by the 5.31Department of Human Services or a county agency. The scope of the appeal is the validity 5.32of the claimant agency's intention to request a setoff of a refund under chapter 270A 5.33against the debt. 5.34    (b) The hearing for an individual or facility under paragraph (a), clause (4), (9), or 5.35(10), is the only administrative appeal to the final agency determination specifically, 5.36including a challenge to the accuracy and completeness of data under section 13.04. 6.1Hearings requested under paragraph (a), clause (4), apply only to incidents of maltreatment 6.2that occur on or after October 1, 1995. Hearings requested by nursing assistants in nursing 6.3homes alleged to have maltreated a resident prior to October 1, 1995, shall be held as a 6.4contested case proceeding under the provisions of chapter 14. Hearings requested under 6.5paragraph (a), clause (9), apply only to incidents of maltreatment that occur on or after 6.6July 1, 1997. A hearing for an individual or facility under paragraph (a), clause (9), is 6.7only available when there is no juvenile court or adult criminal action pending. If such 6.8action is filed in either court while an administrative review is pending, the administrative 6.9review must be suspended until the judicial actions are completed. If the juvenile court 6.10action or criminal charge is dismissed or the criminal action overturned, the matter may be 6.11considered in an administrative hearing. 6.12    (c) For purposes of this section, bargaining unit grievance procedures are not an 6.13administrative appeal. 6.14    (d) The scope of hearings involving claims to foster care payments under paragraph 6.15(a), clause (5), shall be limited to the issue of whether the county is legally responsible 6.16for a child's placement under court order or voluntary placement agreement and, if so, 6.17the correct amount of foster care payment to be made on the child's behalf and shall not 6.18include review of the propriety of the county's child protection determination or child 6.19placement decision. 6.20    (e) A vendor of medical care as defined in section 256B.02, subdivision 7, or a 6.21vendor under contract with a county agency to provide social services is not a party and 6.22may not request a hearing under this section, except if assisting a recipient as provided in 6.23subdivision 4. 6.24    (f) An applicant or recipient is not entitled to receive social services beyond the 6.25services prescribed under chapter 256M or other social services the person is eligible 6.26for under state law. 6.27    (g) The commissioner may summarily affirm the county or state agency's proposed 6.28action without a hearing when the sole issue is an automatic change due to a change in 6.29state or federal law. 6.30    Sec. 5. Minnesota Statutes 2008, section 626.556, subdivision 10i, is amended to read: 6.31    Subd. 10i. Administrative reconsideration; review panel. (a) Administrative 6.32reconsideration is not applicable in family assessments since no determination concerning 6.33maltreatment is made. For investigations, except as provided under paragraph (e), an 6.34individual or facility that the commissioner of human services, a local social service 6.35agency, or the commissioner of education determines has maltreated a child, an interested 7.1person acting on behalf of the child, regardless of the determination, who contests 7.2the investigating agency's final determination regarding maltreatment, may request the 7.3investigating agency to reconsider its final determination regarding maltreatment. The 7.4request for reconsideration must be submitted in writing to the investigating agency within 7.515 calendar days after receipt of notice of the final determination regarding maltreatment 7.6or, if the request is made by an interested person who is not entitled to notice, within 7.715 days after receipt of the notice by the parent or guardian of the child. If mailed, the 7.8request for reconsideration must be postmarked and sent to the investigating agency 7.9within 15 calendar days of the individual's or facility's receipt of the final determination. If 7.10the request for reconsideration is made by personal service, it must be received by the 7.11investigating agency within 15 calendar days after the individual's or facility's receipt of the 7.12final determination. Effective January 1, 2002, an individual who was determined to have 7.13maltreated a child under this section and who was disqualified on the basis of serious or 7.14recurring maltreatment under sections 245C.14 and 245C.15, may request reconsideration 7.15of the maltreatment determination and the disqualification. The request for reconsideration 7.16of the maltreatment determination and the disqualification must be submitted within 30 7.17calendar days of the individual's receipt of the notice of disqualification under sections 7.18245C.16 and 245C.17. If mailed, the request for reconsideration of the maltreatment 7.19determination and the disqualification must be postmarked and sent to the investigating 7.20agency within 30 calendar days of the individual's receipt of the maltreatment 7.21determination and notice of disqualification. If the request for reconsideration is made by 7.22personal service, it must be received by the investigating agency within 30 calendar days 7.23after the individual's receipt of the notice of disqualification. 7.24    (b) Except as provided under paragraphs (e) and (f), if the investigating agency 7.25denies the request or fails to act upon the request within 15 working days after receiving 7.26the request for reconsideration, the person or facility entitled to a fair hearing under section 7.27256.045 may submit to the commissioner of human services or the commissioner of 7.28education a written request for a hearing under that section. Section 256.045 also governs 7.29hearings requested to contest a final determination of the commissioner of education. For 7.30reports involving maltreatment of a child in a facility, an interested person acting on behalf 7.31of the child may request a review by the Child Maltreatment Review Panel under section 7.32256.022 if the investigating agency denies the request or fails to act upon the request or 7.33if the interested person contests a reconsidered determination. The investigating agency 7.34shall notify persons who request reconsideration of their rights under this paragraph. 7.35The request must be submitted in writing to the review panel and a copy sent to the 7.36investigating agency within 30 calendar days of receipt of notice of a denial of a request 8.1for reconsideration or of a reconsidered determination. The request must specifically 8.2identify the aspects of the agency determination with which the person is dissatisfied. 8.3    (c) If, as a result of a reconsideration or review, the investigating agency changes 8.4the final determination of maltreatment, that agency shall notify the parties specified in 8.5subdivisions 10b, 10d, and 10f. 8.6    (d) Except as provided under paragraph (f), if an individual or facility contests the 8.7investigating agency's final determination regarding maltreatment by requesting a fair 8.8hearing under section 256.045, the commissioner of human services shall assure that the 8.9hearing is conducted and a decision is reached within 90 days of receipt of the request for 8.10a hearing. The time for action on the decision may be extended for as many days as the 8.11hearing is postponed or the record is held open for the benefit of either party. 8.12    (e) Effective January 1, 2002, If an individual was disqualified under sections 8.13245C.14 and 245C.15, on the basis of a determination of maltreatment, which was 8.14serious or recurring, and the individual has requested reconsideration of the maltreatment 8.15determination under paragraph (a) and requested reconsideration of the disqualification 8.16under sections 245C.21 to 245C.27, reconsideration of the maltreatment determination and 8.17reconsideration of the disqualification shall be consolidated into a single reconsideration. 8.18If reconsideration of the maltreatment determination is denied or the disqualification is not 8.19set aside new text begin rescinded new text end under sections 245C.21 to 245C.27, the individual may request a fair 8.20hearing under section 256.045. If an individual requests a fair hearing on the maltreatment 8.21determination and the disqualification, the scope of the fair hearing shall include both the 8.22maltreatment determination and the disqualification. 8.23    (f) Effective January 1, 2002, If a maltreatment determination or a disqualification 8.24based on serious or recurring maltreatment is the basis for a denial of a license under 8.25section 245A.05 or a licensing sanction under section 245A.07, the license holder has the 8.26right to a contested case hearing under chapter 14 and Minnesota Rules, parts 1400.8505 8.27to 1400.8612. As provided for under section 245A.08, subdivision 2a, the scope of the 8.28contested case hearing shall include the maltreatment determination, disqualification, 8.29and licensing sanction or denial of a license. In such cases, a fair hearing regarding 8.30the maltreatment determination and disqualification shall not be conducted under 8.31section 256.045. Except for family child care and child foster care, reconsideration of a 8.32maltreatment determination as provided under this subdivision, and reconsideration of a 8.33disqualification as provided under section 245C.22, shall also not be conducted when: 8.34    (1) a denial of a license under section 245A.05 or a licensing sanction under section 8.35245A.07 , is based on a determination that the license holder is responsible for maltreatment 8.36or the disqualification of a license holder based on serious or recurring maltreatment; 9.1    (2) the denial of a license or licensing sanction is issued at the same time as the 9.2maltreatment determination or disqualification; and 9.3    (3) the license holder appeals the maltreatment determination or disqualification, and 9.4denial of a license or licensing sanction. 9.5    Notwithstanding clauses (1) to (3), if the license holder appeals the maltreatment 9.6determination or disqualification, but does not appeal the denial of a license or a licensing 9.7sanction, reconsideration of the maltreatment determination shall be conducted under 9.8sections 626.556, subdivision 10i, and 626.557, subdivision 9d, and reconsideration of the 9.9disqualification shall be conducted under section 245C.22. In such cases, a fair hearing 9.10shall also be conducted as provided under sections 245C.27, 626.556, subdivision 10i, and 9.11626.557, subdivision 9d . 9.12    If the disqualified subject is an individual other than the license holder and upon 9.13whom a background study must be conducted under chapter 245C, the hearings of all 9.14parties may be consolidated into a single contested case hearing upon consent of all parties 9.15and the administrative law judge. 9.16    (g) For purposes of this subdivision, "interested person acting on behalf of the 9.17child" means a parent or legal guardian; stepparent; grandparent; guardian ad litem; adult 9.18stepbrother, stepsister, or sibling; or adult aunt or uncle; unless the person has been 9.19determined to be the perpetrator of the maltreatment. 9.20    Sec. 6. Minnesota Statutes 2008, section 626.557, subdivision 9d, is amended to read: 9.21    Subd. 9d. Administrative reconsideration; review panel. (a) Except as provided 9.22under paragraph (e), any individual or facility which a lead agency determines has 9.23maltreated a vulnerable adult, or the vulnerable adult or an interested person acting on 9.24behalf of the vulnerable adult, regardless of the lead agency's determination, who contests 9.25the lead agency's final disposition of an allegation of maltreatment, may request the 9.26lead agency to reconsider its final disposition. The request for reconsideration must be 9.27submitted in writing to the lead agency within 15 calendar days after receipt of notice of 9.28final disposition or, if the request is made by an interested person who is not entitled to 9.29notice, within 15 days after receipt of the notice by the vulnerable adult or the vulnerable 9.30adult's legal guardian. If mailed, the request for reconsideration must be postmarked and 9.31sent to the lead agency within 15 calendar days of the individual's or facility's receipt of 9.32the final disposition. If the request for reconsideration is made by personal service, it must 9.33be received by the lead agency within 15 calendar days of the individual's or facility's 9.34receipt of the final disposition. An individual who was determined to have maltreated a 9.35vulnerable adult under this section and who was disqualified on the basis of serious or 10.1recurring maltreatment under sections 245C.14 and 245C.15, may request reconsideration 10.2of the maltreatment determination and the disqualification. The request for reconsideration 10.3of the maltreatment determination and the disqualification must be submitted in writing 10.4within 30 calendar days of the individual's receipt of the notice of disqualification 10.5under sections 245C.16 and 245C.17. If mailed, the request for reconsideration of 10.6the maltreatment determination and the disqualification must be postmarked and sent 10.7to the lead agency within 30 calendar days of the individual's receipt of the notice of 10.8disqualification. If the request for reconsideration is made by personal service, it must be 10.9received by the lead agency within 30 calendar days after the individual's receipt of the 10.10notice of disqualification. 10.11    (b) Except as provided under paragraphs (e) and (f), if the lead agency denies the 10.12request or fails to act upon the request within 15 working days after receiving the request 10.13for reconsideration, the person or facility entitled to a fair hearing under section 256.045, 10.14may submit to the commissioner of human services a written request for a hearing 10.15under that statute. The vulnerable adult, or an interested person acting on behalf of the 10.16vulnerable adult, may request a review by the Vulnerable Adult Maltreatment Review 10.17Panel under section 256.021 if the lead agency denies the request or fails to act upon the 10.18request, or if the vulnerable adult or interested person contests a reconsidered disposition. 10.19The lead agency shall notify persons who request reconsideration of their rights under this 10.20paragraph. The request must be submitted in writing to the review panel and a copy sent 10.21to the lead agency within 30 calendar days of receipt of notice of a denial of a request for 10.22reconsideration or of a reconsidered disposition. The request must specifically identify the 10.23aspects of the agency determination with which the person is dissatisfied. 10.24    (c) If, as a result of a reconsideration or review, the lead agency changes the final 10.25disposition, it shall notify the parties specified in subdivision 9c, paragraph (d). 10.26    (d) For purposes of this subdivision, "interested person acting on behalf of the 10.27vulnerable adult" means a person designated in writing by the vulnerable adult to act 10.28on behalf of the vulnerable adult, or a legal guardian or conservator or other legal 10.29representative, a proxy or health care agent appointed under chapter 145B or 145C, 10.30or an individual who is related to the vulnerable adult, as defined in section 245A.02, 10.31subdivision 13 . 10.32    (e) If an individual was disqualified under sections 245C.14 and 245C.15, on 10.33the basis of a determination of maltreatment, which was serious or recurring, and 10.34the individual has requested reconsideration of the maltreatment determination under 10.35paragraph (a) and reconsideration of the disqualification under sections 245C.21 to 10.36245C.27 , reconsideration of the maltreatment determination and requested reconsideration 11.1of the disqualification shall be consolidated into a single reconsideration. If reconsideration 11.2of the maltreatment determination is denied or if the disqualification is not set aside new text begin new text end 11.3 new text begin rescinded new text end under sections 245C.21 to 245C.27, the individual may request a fair hearing 11.4under section 256.045. If an individual requests a fair hearing on the maltreatment 11.5determination and the disqualification, the scope of the fair hearing shall include both the 11.6maltreatment determination and the disqualification. 11.7    (f) If a maltreatment determination or a disqualification based on serious or recurring 11.8maltreatment is the basis for a denial of a license under section 245A.05 or a licensing 11.9sanction under section 245A.07, the license holder has the right to a contested case hearing 11.10under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. As provided 11.11for under section 245A.08, the scope of the contested case hearing must include the 11.12maltreatment determination, disqualification, and licensing sanction or denial of a license. 11.13In such cases, a fair hearing must not be conducted under section 256.045. Except for 11.14family child care and child foster care, reconsideration of a maltreatment determination 11.15under this subdivision, and reconsideration of a disqualification under section 245C.22, 11.16must not be conducted when: 11.17    (1) a denial of a license under section 245A.05, or a licensing sanction under section 11.18245A.07 , is based on a determination that the license holder is responsible for maltreatment 11.19or the disqualification of a license holder based on serious or recurring maltreatment; 11.20    (2) the denial of a license or licensing sanction is issued at the same time as the 11.21maltreatment determination or disqualification; and 11.22    (3) the license holder appeals the maltreatment determination or disqualification, and 11.23denial of a license or licensing sanction. 11.24    Notwithstanding clauses (1) to (3), if the license holder appeals the maltreatment 11.25determination or disqualification, but does not appeal the denial of a license or a licensing 11.26sanction, reconsideration of the maltreatment determination shall be conducted under 11.27sections 626.556, subdivision 10i, and 626.557, subdivision 9d, and reconsideration of the 11.28disqualification shall be conducted under section 245C.22. In such cases, a fair hearing 11.29shall also be conducted as provided under sections 245C.27, 626.556, subdivision 10i, and 11.30626.557, subdivision 9d . 11.31    If the disqualified subject is an individual other than the license holder and upon 11.32whom a background study must be conducted under chapter 245C, the hearings of all 11.33parties may be consolidated into a single contested case hearing upon consent of all parties 11.34and the administrative law judge. 11.35    (g) Until August 1, 2002, an individual or facility that was determined by the 11.36commissioner of human services or the commissioner of health to be responsible for 12.1neglect under section 626.5572, subdivision 17, after October 1, 1995, and before August 12.21, 2001, that believes that the finding of neglect does not meet an amended definition of 12.3neglect may request a reconsideration of the determination of neglect. The commissioner 12.4of human services or the commissioner of health shall mail a notice to the last known 12.5address of individuals who are eligible to seek this reconsideration. The request for 12.6reconsideration must state how the established findings no longer meet the elements of 12.7the definition of neglect. The commissioner shall review the request for reconsideration 12.8and make a determination within 15 calendar days. The commissioner's decision on this 12.9reconsideration is the final agency action. 12.10    (1) For purposes of compliance with the data destruction schedule under subdivision 12.1112b, paragraph (d), when a finding of substantiated maltreatment has been changed as 12.12a result of a reconsideration under this paragraph, the date of the original finding of a 12.13substantiated maltreatment must be used to calculate the destruction date. 12.14    (2) For purposes of any background studies under chapter 245C, when a 12.15determination of substantiated maltreatment has been changed as a result of a 12.16reconsideration under this paragraph, any prior disqualification of the individual under 12.17chapter 245C that was based on this determination of maltreatment shall be rescinded, 12.18and for future background studies under chapter 245C the commissioner must not use the 12.19previous determination of substantiated maltreatment as a basis for disqualification or as a 12.20basis for referring the individual's maltreatment history to a health-related licensing board 12.21under section 245C.31. 12.22ARTICLE 2 12.23HEALTH CARE 12.24    Section 1. Minnesota Statutes 2008, section 144.291, subdivision 2, is amended to read: 12.25    Subd. 2. Definitions. For the purposes of sections 144.291 to 144.298, the following 12.26terms have the meanings given. 12.27    (a) "Group purchaser" has the meaning given in section 62J.03, subdivision 6. 12.28    (b) "Health information exchange" means a legal arrangement between health care 12.29providers and group purchasers to enable and oversee the business and legal issues 12.30involved in the electronic exchange of health records between the entities for the delivery 12.31of patient care. 12.32    (c) "Health record" means any information, whether oral or recorded in any form or 12.33medium, that relates to the past, present, or future physical or mental health or condition of 12.34a patient; the provision of health care to a patient; or the past, present, or future payment 12.35for the provision of health care to a patient. 13.1    (d) "Identifying information" means the patient's name, address, date of birth, 13.2gender, parent's or guardian's name regardless of the age of the patient, and other 13.3nonclinical data which can be used to uniquely identify a patient. 13.4    (e) "Individually identifiable form" means a form in which the patient is or can be 13.5identified as the subject of the health records. 13.6    (f) "Medical emergency" means medically necessary care which is immediately 13.7needed to preserve life, prevent serious impairment to bodily functions, organs, or parts, 13.8or prevent placing the physical or mental health of the patient in serious jeopardy. 13.9    (g) "Patient" means a natural person who has received health care services from a 13.10provider for treatment or examination of a medical, psychiatric, or mental condition, the 13.11surviving spouse and parents of a deceased patient, or a person the patient appoints in 13.12writing as a representative, including a health care agent acting according to chapter 145C, 13.13unless the authority of the agent has been limited by the principal in the principal's health 13.14care directive. Except for minors who have received health care services under sections 13.15144.341 to 144.347, in the case of a minor, patient includes a parent or guardian, or a 13.16person acting as a parent or guardian in the absence of a parent or guardian. 13.17    (h) "Provider" means: 13.18    (1) any person who furnishes health care services and is regulated to furnish the 13.19services under chapter 147, 147A, 147B, 147C, 147D, 148, 148B, 148C, 148D, 150A, 13.20151, 153, or 153A; 13.21    (2) a home care provider licensed under section 144A.46; 13.22    (3) a health care facility licensed under this chapter or chapter 144A; 13.23    (4) a physician assistant registered under chapter 147A; and 13.24    (5) an unlicensed mental health practitioner regulated under sections 148B.60 to 13.25148B.71 . 13.26    (i) "Record locator service" means an electronic index of patient identifying 13.27information that directs providers in a health information exchange to the location of 13.28patient health records held by providers and group purchasers. 13.29    (j) "Related health care entity" means an affiliate, as defined in section 144.6521, 13.30subdivision 3 , paragraph (b), of the provider releasing the health records new text begin , including, but new text end 13.31 new text begin not limited to, affiliates of providers participating in a coordinated care delivery system new text end 13.32 new text begin established under section 256D.031, subdivision 6 new text end . 13.33    Sec. 2. Minnesota Statutes 2008, section 256.01, is amended by adding a subdivision 13.34to read: 14.1     new text begin Subd. 30. new text end new text begin Review and evaluation of studies. new text end new text begin The commissioner shall review new text end 14.2 new text begin all published studies, reports, and program evaluations completed by the Department new text end 14.3 new text begin of Human Services, and those requested by the legislature but not completed, for state new text end 14.4 new text begin fiscal years 2000 through 2010. For each item, the commissioner shall report the new text end 14.5 new text begin legislature's original appropriation for that work, if any, and the actual reported cost of the new text end 14.6 new text begin completed work by the Department of Human Services. The commissioner shall make new text end 14.7 new text begin recommendations to the legislature about which studies, reports, and program evaluations new text end 14.8 new text begin required by law are duplicative, unnecessary, or obsolete. The commissioner shall repeat new text end 14.9 new text begin this review every five fiscal years. new text end 14.10    Sec. 3. Minnesota Statutes 2008, section 256.9657, subdivision 3, is amended to read: 14.11    Subd. 3. Surcharge on HMOs and community integrated service networks. (a) 14.12Effective October 1, 1992, each health maintenance organization with a certificate of 14.13authority issued by the commissioner of health under chapter 62D and each community 14.14integrated service network licensed by the commissioner under chapter 62N shall pay to 14.15the commissioner of human services a surcharge equal to six-tenths of one percent of the 14.16total premium revenues of the health maintenance organization or community integrated 14.17service network as reported to the commissioner of health according to the schedule in 14.18subdivision 4. 14.19(b) new text begin Effective June 1, 2010: (1) the surcharge under paragraph (a) is increased to 3.0 new text end 14.20 new text begin percent; and (2) each county-based purchasing plan authorized under section 256B.692 new text end 14.21 new text begin shall pay to the commissioner a surcharge equal to 3.0 percent of the total premium new text end 14.22 new text begin revenues of the plan, as reported to the commissioner of health, according to the payment new text end 14.23 new text begin schedule in subdivision 4. new text end 14.24 new text begin (c) new text end For purposes of this subdivision, total premium revenue means: 14.25(1) premium revenue recognized on a prepaid basis from individuals and groups 14.26for provision of a specified range of health services over a defined period of time which 14.27is normally one month, excluding premiums paid to a health maintenance organization 14.28or community integrated service network from the Federal Employees Health Benefit 14.29Program; 14.30(2) premiums from Medicare wrap-around subscribers for health benefits which 14.31supplement Medicare coverage; 14.32(3) Medicare revenue, as a result of an arrangement between a health maintenance 14.33organization or a community integrated service network and the Centers for Medicare 14.34and Medicaid Services of the federal Department of Health and Human Services, for 14.35services to a Medicare beneficiary, excluding Medicare revenue that states are prohibited 15.1from taxing under sections 1854, 1860D-12, and 1876 of title XVIII of the federal Social 15.2Security Act, codified as United States Code, title 42, sections 1395mm, 1395w-112, and 15.31395w-24, respectively, as they may be amended from time to time; and 15.4(4) medical assistance revenue, as a result of an arrangement between a health 15.5maintenance organization or community integrated service network and a Medicaid state 15.6agency, for services to a medical assistance beneficiary. 15.7If advance payments are made under clause (1) or (2) to the health maintenance 15.8organization or community integrated service network for more than one reporting period, 15.9the portion of the payment that has not yet been earned must be treated as a liability. 15.10(c) new text begin (d) new text end When a health maintenance organization or community integrated service 15.11network merges or consolidates with or is acquired by another health maintenance 15.12organization or community integrated service network, the surviving corporation or the 15.13new corporation shall be responsible for the annual surcharge originally imposed on 15.14each of the entities or corporations subject to the merger, consolidation, or acquisition, 15.15regardless of whether one of the entities or corporations does not retain a certificate of 15.16authority under chapter 62D or a license under chapter 62N. 15.17(d) new text begin (e) new text end Effective July 1 of each year, the surviving corporation's or the new 15.18corporation's surcharge shall be based on the revenues earned in the second previous 15.19calendar year by all of the entities or corporations subject to the merger, consolidation, 15.20or acquisition regardless of whether one of the entities or corporations does not retain a 15.21certificate of authority under chapter 62D or a license under chapter 62N until the total 15.22premium revenues of the surviving corporation include the total premium revenues of all 15.23the merged entities as reported to the commissioner of health. 15.24(e) new text begin (f) new text end When a health maintenance organization or community integrated service 15.25network, which is subject to liability for the surcharge under this chapter, transfers, 15.26assigns, sells, leases, or disposes of all or substantially all of its property or assets, liability 15.27for the surcharge imposed by this chapter is imposed on the transferee, assignee, or buyer 15.28of the health maintenance organization or community integrated service network. 15.29(f) new text begin (g) new text end In the event a health maintenance organization or community integrated 15.30service network converts its licensure to a different type of entity subject to liability 15.31for the surcharge under this chapter, but survives in the same or substantially similar 15.32form, the surviving entity remains liable for the surcharge regardless of whether one of 15.33the entities or corporations does not retain a certificate of authority under chapter 62D 15.34or a license under chapter 62N. 16.1(g) new text begin (h) new text end The surcharge assessed to a health maintenance organization or community 16.2integrated service network ends when the entity ceases providing services for premiums 16.3and the cessation is not connected with a merger, consolidation, acquisition, or conversion. 16.4 new text begin EFFECTIVE DATE. new text end new text begin This section is effective June 1, 2010. new text end 16.5    Sec. 4. Minnesota Statutes 2009 Supplement, section 256.969, subdivision 3a, is 16.6amended to read: 16.7    Subd. 3a. Payments. (a) Acute care hospital billings under the medical 16.8assistance program must not be submitted until the recipient is discharged. However, 16.9the commissioner shall establish monthly interim payments for inpatient hospitals that 16.10have individual patient lengths of stay over 30 days regardless of diagnostic category. 16.11Except as provided in section 256.9693, medical assistance reimbursement for treatment 16.12of mental illness shall be reimbursed based on diagnostic classifications. Individual 16.13hospital payments established under this section and sections 256.9685, 256.9686, and 16.14256.9695 , in addition to third party and recipient liability, for discharges occurring during 16.15the rate year shall not exceed, in aggregate, the charges for the medical assistance covered 16.16inpatient services paid for the same period of time to the hospital. This payment limitation 16.17shall be calculated separately for medical assistance and general assistance medical 16.18care services. The limitation on general assistance medical care shall be effective for 16.19admissions occurring on or after July 1, 1991. Services that have rates established under 16.20subdivision 11 or 12, must be limited separately from other services. After consulting with 16.21the affected hospitals, the commissioner may consider related hospitals one entity and 16.22may merge the payment rates while maintaining separate provider numbers. The operating 16.23and property base rates per admission or per day shall be derived from the best Medicare 16.24and claims data available when rates are established. The commissioner shall determine 16.25the best Medicare and claims data, taking into consideration variables of recency of the 16.26data, audit disposition, settlement status, and the ability to set rates in a timely manner. 16.27The commissioner shall notify hospitals of payment rates by December 1 of the year 16.28preceding the rate year. The rate setting data must reflect the admissions data used to 16.29establish relative values. Base year changes from 1981 to the base year established for the 16.30rate year beginning January 1, 1991, and for subsequent rate years, shall not be limited 16.31to the limits ending June 30, 1987, on the maximum rate of increase under subdivision 16.321. The commissioner may adjust base year cost, relative value, and case mix index data 16.33to exclude the costs of services that have been discontinued by the October 1 of the year 16.34preceding the rate year or that are paid separately from inpatient services. Inpatient stays 16.35that encompass portions of two or more rate years shall have payments established based 17.1on payment rates in effect at the time of admission unless the date of admission preceded 17.2the rate year in effect by six months or more. In this case, operating payment rates for 17.3services rendered during the rate year in effect and established based on the date of 17.4admission shall be adjusted to the rate year in effect by the hospital cost index. 17.5    (b) For fee-for-service admissions occurring on or after July 1, 2002, the total 17.6payment, before third-party liability and spenddown, made to hospitals for inpatient 17.7services is reduced by .5 percent from the current statutory rates. 17.8    (c) In addition to the reduction in paragraph (b), the total payment for fee-for-service 17.9admissions occurring on or after July 1, 2003, made to hospitals for inpatient services 17.10before third-party liability and spenddown, is reduced five percent from the current 17.11statutory rates. Mental health services within diagnosis related groups 424 to 432, and 17.12facilities defined under subdivision 16 are excluded from this paragraph. 17.13    (d) In addition to the reduction in paragraphs (b) and (c), the total payment for 17.14fee-for-service admissions occurring on or after August 1, 2005, made to hospitals for 17.15inpatient services before third-party liability and spenddown, is reduced 6.0 percent 17.16from the current statutory rates. Mental health services within diagnosis related groups 17.17424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph. 17.18Notwithstanding section 256.9686, subdivision 7, for purposes of this paragraph, medical 17.19assistance does not include general assistance medical care. Payments made to managed 17.20care plans shall be reduced for services provided on or after January 1, 2006, to reflect 17.21this reduction. 17.22    (e) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for 17.23fee-for-service admissions occurring on or after July 1, 2008, through June 30, 2009, made 17.24to hospitals for inpatient services before third-party liability and spenddown, is reduced 17.253.46 percent from the current statutory rates. Mental health services with diagnosis related 17.26groups 424 to 432 and facilities defined under subdivision 16 are excluded from this 17.27paragraph. Payments made to managed care plans shall be reduced for services provided 17.28on or after January 1, 2009, through June 30, 2009, to reflect this reduction. 17.29    (f) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for 17.30fee-for-service admissions occurring on or after July 1, 2009, through June 30, 2010, made 17.31to hospitals for inpatient services before third-party liability and spenddown, is reduced 17.321.9 percent from the current statutory rates. Mental health services with diagnosis related 17.33groups 424 to 432 and facilities defined under subdivision 16 are excluded from this 17.34paragraph. Payments made to managed care plans shall be reduced for services provided 17.35on or after July 1, 2009, through June 30, 2010, to reflect this reduction. 18.1    (g) In addition to the reductions in paragraphs (b), (c), and (d), the total payment 18.2for fee-for-service admissions occurring on or after July 1, 2010, made to hospitals for 18.3inpatient services before third-party liability and spenddown, is reduced 1.79 percent 18.4from the current statutory rates. Mental health services with diagnosis related groups 18.5424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph. 18.6Payments made to managed care plans shall be reduced for services provided on or after 18.7July 1, 2010, to reflect this reduction. 18.8(h) In addition to the reductions in paragraphs (b), (c), (d), (f), and (g), the total 18.9payment for fee-for-service admissions occurring on or after July 1, 2009, made to 18.10hospitals for inpatient services before third-party liability and spenddown, is reduced 18.11one percent from the current statutory rates. Facilities defined under subdivision 16 are 18.12excluded from this paragraph. Payments made to managed care plans shall be reduced for 18.13services provided on or after October 1, 2009, to reflect this reduction. 18.14 new text begin (i) In addition to the reductions in paragraphs (b), (c), (d), (g), and (h), the total new text end 18.15 new text begin payment for fee-for-service admissions occurring on or after July 1, 2011, made to new text end 18.16 new text begin hospitals for inpatient services before third-party liability and spenddown, is reduced new text end 18.17 new text begin seven percent from the current statutory rates. Facilities defined under subdivision 16 are new text end 18.18 new text begin excluded from this paragraph. Payments made to managed care plans shall be reduced new text end 18.19 new text begin for services provided on or after January 1, 2012, to reflect this reduction. Hospitals that, new text end 18.20 new text begin prior to December 31, 2007, received payment to support the training of residents from an new text end 18.21 new text begin approved graduate medical residency training program pursuant to United States Code, new text end 18.22 new text begin title 42, section 256e, are not subject to the provisions of this paragraph. new text end 18.23    Sec. 5. Minnesota Statutes 2008, section 256B.04, subdivision 14, is amended to read: 18.24    Subd. 14. Competitive bidding. (a) When determined to be effective, economical, 18.25and feasible, the commissioner may utilize volume purchase through competitive bidding 18.26and negotiation under the provisions of chapter 16C, to provide items under the medical 18.27assistance program including but not limited to the following: 18.28    (1) eyeglasses; 18.29    (2) oxygen. The commissioner shall provide for oxygen needed in an emergency 18.30situation on a short-term basis, until the vendor can obtain the necessary supply from 18.31the contract dealer; 18.32    (3) hearing aids and supplies; and 18.33    (4) durable medical equipment, including but not limited to: 18.34    (i) hospital beds; 18.35    (ii) commodes; 19.1    (iii) glide-about chairs; 19.2    (iv) patient lift apparatus; 19.3    (v) wheelchairs and accessories; 19.4    (vi) oxygen administration equipment; 19.5    (vii) respiratory therapy equipment; 19.6    (viii) electronic diagnostic, therapeutic and life-support systems; 19.7    (5) nonemergency medical transportation level of need determinations, disbursement 19.8of public transportation passes and tokens, and volunteer and recipient mileage and 19.9parking reimbursements; and 19.10    (6) drugs new text begin ; and new text end 19.11 new text begin (7) medical supplies new text end . 19.12    (b) Rate changes under this chapter and chapters 256D and 256L do not affect 19.13contract payments under this subdivision unless specifically identified. 19.14    (c) The commissioner may not utilize volume purchase through competitive bidding 19.15and negotiation for special transportation services under the provisions of chapter 16C. 19.16    Sec. 6. Minnesota Statutes 2008, section 256B.055, is amended by adding a 19.17subdivision to read: 19.18     new text begin Subd. 15. new text end new text begin Adults without children. new text end new text begin Medical assistance may be paid for a person new text end 19.19 new text begin who is over age 21 and under age 65, who is not pregnant, and who is not described in new text end 19.20 new text begin subdivision 4, 7, or another subdivision of this section. new text end 19.21 new text begin EFFECTIVE DATE. new text end new text begin This section is effective upon federal approval and is new text end 19.22 new text begin retroactive from April 1, 2010. new text end 19.23    Sec. 7. Minnesota Statutes 2008, section 256B.056, subdivision 4, is amended to read: 19.24    Subd. 4. Income. (a) To be eligible for medical assistance, a person eligible under 19.25section 256B.055, subdivisions 7, 7a, and 12, may have income up to 100 percent of 19.26the federal poverty guidelines. Effective January 1, 2000, and each successive January, 19.27recipients of supplemental security income may have an income up to the supplemental 19.28security income standard in effect on that date. 19.29(b) To be eligible for medical assistance, families and children may have an income 19.30up to 133-1/3 percent of the AFDC income standard in effect under the July 16, 1996, 19.31AFDC state plan. Effective July 1, 2000, the base AFDC standard in effect on July 16, 19.321996, shall be increased by three percent. 19.33(c) Effective July 1, 2002, to be eligible for medical assistance, families and children 19.34may have an income up to 100 percent of the federal poverty guidelines for the family size. 20.1(d) In computing income to determine eligibility of persons under paragraphs (a) 20.2to (c) new text begin and (e) new text end who are not residents of long-term care facilities, the commissioner shall 20.3disregard increases in income as required by Public Law Numbers 94-566, section 503; 20.499-272; and 99-509. Veterans aid and attendance benefits and Veterans Administration 20.5unusual medical expense payments are considered income to the recipient. 20.6 new text begin (e) To be eligible for medical assistance, a person eligible under section 256B.055, new text end 20.7 new text begin subdivision 15, may have income up to 75 percent of the federal poverty guidelines for new text end 20.8 new text begin family size. new text end 20.9 new text begin EFFECTIVE DATE. new text end new text begin This section is effective upon federal approval and is new text end 20.10 new text begin retroactive from April 1, 2010. new text end 20.11    Sec. 8. Minnesota Statutes 2008, section 256B.0625, subdivision 8, is amended to read: 20.12    Subd. 8. Physical therapy. Medical assistance covers physical therapy and related 20.13services, including specialized maintenance therapy. new text begin Authorization by the commissioner new text end 20.14 new text begin is required to provide services to a recipient beyond any of the following onetime service new text end 20.15 new text begin thresholds: (1) 80 units of any approved CPT code other than modalities; (2) 20 modality new text end 20.16 new text begin sessions; and (3) three evaluations or reevaluations. new text end Services provided by a physical 20.17therapy assistant shall be reimbursed at the same rate as services performed by a physical 20.18therapist when the services of the physical therapy assistant are provided under the 20.19direction of a physical therapist who is on the premises. Services provided by a physical 20.20therapy assistant that are provided under the direction of a physical therapist who is not on 20.21the premises shall be reimbursed at 65 percent of the physical therapist rate. 20.22    Sec. 9. Minnesota Statutes 2008, section 256B.0625, subdivision 8a, is amended to 20.23read: 20.24    Subd. 8a. Occupational therapy. Medical assistance covers occupational therapy 20.25and related services, including specialized maintenance therapy. new text begin Authorization by the new text end 20.26 new text begin commissioner is required to provide services to a recipient beyond any of the following new text end 20.27 new text begin onetime service thresholds: (1) 120 units of any combination of approved CPT codes; new text end 20.28 new text begin and (2) two evaluations or reevaluations. new text end Services provided by an occupational therapy 20.29assistant shall be reimbursed at the same rate as services performed by an occupational 20.30therapist when the services of the occupational therapy assistant are provided under the 20.31direction of the occupational therapist who is on the premises. Services provided by an 20.32occupational therapy assistant that are provided under the direction of an occupational 20.33therapist who is not on the premises shall be reimbursed at 65 percent of the occupational 20.34therapist rate. 21.1    Sec. 10. Minnesota Statutes 2008, section 256B.0625, subdivision 8b, is amended to 21.2read: 21.3    Subd. 8b. Speech language pathology and audiology services. Medical assistance 21.4covers speech language pathology and related services, including specialized maintenance 21.5therapy. new text begin Authorization by the commissioner is required to provide services to a recipient new text end 21.6 new text begin beyond any of the following onetime service thresholds: (1) 50 treatment sessions with new text end 21.7 new text begin any combination of approved CPT codes; and (2) one evaluation. new text end Medical assistance 21.8covers audiology services and related services. Services provided by a person who has 21.9been issued a temporary registration under section 148.5161 shall be reimbursed at the 21.10same rate as services performed by a speech language pathologist or audiologist as long as 21.11the requirements of section 148.5161, subdivision 3, are met. 21.12    Sec. 11. Minnesota Statutes 2008, section 256B.0625, is amended by adding a 21.13subdivision to read: 21.14     new text begin Subd. 8d. new text end new text begin Chiropractic services. new text end new text begin Payment for chiropractic services is limited to new text end 21.15 new text begin one annual evaluation and 12 visits per year unless prior authorization of a greater number new text end 21.16 new text begin of visits is obtained. new text end 21.17    Sec. 12. Minnesota Statutes 2009 Supplement, section 256B.0625, subdivision 9, 21.18is amended to read: 21.19    Subd. 9. Dental services. (a) Medical assistance covers dental services. 21.20(b) Medical assistance dental coverage for nonpregnant adults is limited to the 21.21following services: 21.22(1) comprehensive exams, limited to once every five years; 21.23(2) periodic exams, limited to one per year; 21.24(3) limited exams; 21.25(4) bitewing x-rays, limited to one new text begin set new text end per year; 21.26(5) periapical x-rays; 21.27(6) panoramic x-rays new text begin or full-mouth radiographs new text end , limited to one every five years, 21.28and only if provided in conjunction with a posterior extraction or scheduled outpatient 21.29facility procedure, or as medically necessary for the diagnosis and follow-up of oral and 21.30maxillofacial pathology and trauma. Panoramic x-rays may be taken once every two years 21.31for patients who cannot cooperate for intraoral film due to a developmental disability or 21.32medical condition that does not allow for intraoral film placement; 21.33(7) prophylaxis, limited to one per year; 21.34(8) application of fluoride varnish, limited to one per year; 22.1(9) posterior fillings, all at the amalgam rate; 22.2(10) anterior fillings; 22.3(11) endodontics, limited to root canals on the anterior and premolars only new text begin , and new text end 22.4 new text begin molar root canal therapy as deemed medically necessary for patients that are at high risk new text end 22.5 new text begin of osteonecrosis from molar extractions new text end ; 22.6(12) removable prostheses, each dental arch limited to one every six years; new text begin including: new text end 22.7 new text begin (i) relines of full dentures once every six years per dental arch; new text end 22.8 new text begin (ii) repair of acrylic bases of full dentures and acrylic partial dentures, limited to one new text end 22.9 new text begin per year; and new text end 22.10 new text begin (iii) adding a maximum of two denture teeth and two wrought wire clasps per year to new text end 22.11 new text begin partial dentures per dental arch; new text end 22.12(13) oral surgery, limited to extractions, biopsies, and incision and drainage of 22.13abscesses; 22.14(14) palliative treatment and sedative fillings for relief of pain; and 22.15(15) full-mouth debridement new text begin periodontal scaling and root planing new text end , limited to one 22.16every five years new text begin ; and new text end 22.17 new text begin (16) moderate sedation, deep sedation, and general anesthesia, limited to when new text end 22.18 new text begin provided by an oral maxillofacial surgeon who is board-certified, or actively participating new text end 22.19 new text begin in the American Board of Oral and Maxillofacial Surgery certification process, when new text end 22.20 new text begin medically necessary to allow the surgical management of acute oral and maxillofacial new text end 22.21 new text begin pathology which cannot be accomplished safely with local anesthesia alone and would new text end 22.22 new text begin otherwise require operating room services new text end . 22.23(c) In addition to the services specified in paragraph (b), medical assistance 22.24covers the following services for adults, if provided in an outpatient hospital setting or 22.25freestanding ambulatory surgical center as part of outpatient dental surgery: 22.26(1) periodontics, limited to periodontal scaling and root planing once every two 22.27years; 22.28(2) general anesthesia; and 22.29(3) full-mouth survey once every five new text begin two new text end years. 22.30(d) Medical assistance covers dental services for children that are medically 22.31necessary. The following guidelines apply: 22.32(1) posterior fillings are paid at the amalgam rate; 22.33(2) application of sealants once every five years per permanent molar; and 22.34(3) application of fluoride varnish once every six months. 23.1    Sec. 13. Minnesota Statutes 2009 Supplement, section 256B.0625, subdivision 13e, 23.2is amended to read: 23.3    Subd. 13e. Payment rates. (a) The basis for determining the amount of payment 23.4shall be the lower of the actual acquisition costs of the drugs plus a fixed dispensing fee; 23.5the maximum allowable cost set by the federal government or by the commissioner plus 23.6the fixed dispensing fee; or the usual and customary price charged to the public. The 23.7amount of payment basis must be reduced to reflect all discount amounts applied to the 23.8charge by any provider/insurer agreement or contract for submitted charges to medical 23.9assistance programs. The net submitted charge may not be greater than the patient liability 23.10for the service. The pharmacy dispensing fee shall be $3.65, except that the dispensing fee 23.11for intravenous solutions which must be compounded by the pharmacist shall be $8 per 23.12bag, $14 per bag for cancer chemotherapy products, and $30 per bag for total parenteral 23.13nutritional products dispensed in one liter quantities, or $44 per bag for total parenteral 23.14nutritional products dispensed in quantities greater than one liter. Actual acquisition cost 23.15includes quantity and other special discounts except time and cash discounts. Effective 23.16July 1, 2009 new text begin July 1, 2010 new text end , the actual acquisition cost of a drug shall be estimated by the 23.17commissioner, at average wholesale price minus 15 new text begin 12.5 new text end percent new text begin or wholesale acquisition new text end 23.18 new text begin cost plus 5.0 percent, whichever is lower new text end . The actual acquisition cost of antihemophilic 23.19factor drugs shall be estimated at the average wholesale price minus 30 new text begin 28.12 new text end percent new text begin or new text end 23.20 new text begin wholesale acquisition cost minus 13.76 percent, whichever is lower new text end . new text begin Average wholesale new text end 23.21 new text begin price is defined as the price for a drug product listed as the average wholesale price in the new text end 23.22 new text begin commissioner's primary reference source. Wholesale acquisition cost is defined as the new text end 23.23 new text begin manufacturer's list price for a drug or biological to wholesalers or direct purchasers in the new text end 23.24 new text begin United States, not including prompt pay or other discounts, rebates, or reductions in price, new text end 23.25 new text begin for the most recent month for which information is available, as reported in wholesale price new text end 23.26 new text begin guides or other publications of drug or biological pricing data. new text end The maximum allowable 23.27cost of a multisource drug may be set by the commissioner and it shall be comparable to, 23.28but no higher than, the maximum amount paid by other third-party payors in this state who 23.29have maximum allowable cost programs. Establishment of the amount of payment for 23.30drugs shall not be subject to the requirements of the Administrative Procedure Act. 23.31    (b) An additional dispensing fee of $.30 may be added to the dispensing fee paid 23.32to pharmacists for legend drug prescriptions dispensed to residents of long-term care 23.33facilities when a unit dose blister card system, approved by the department, is used. Under 23.34this type of dispensing system, the pharmacist must dispense a 30-day supply of drug. 23.35The National Drug Code (NDC) from the drug container used to fill the blister card must 23.36be identified on the claim to the department. The unit dose blister card containing the 24.1drug must meet the packaging standards set forth in Minnesota Rules, part 6800.2700, 24.2that govern the return of unused drugs to the pharmacy for reuse. The pharmacy provider 24.3will be required to credit the department for the actual acquisition cost of all unused 24.4drugs that are eligible for reuse. Over-the-counter medications must be dispensed in the 24.5manufacturer's unopened package. The commissioner may permit the drug clozapine to be 24.6dispensed in a quantity that is less than a 30-day supply. 24.7    (c) Whenever a generically equivalent product is available, payment shall be on the 24.8basis of the actual acquisition cost of the generic drug, or on the maximum allowable cost 24.9established by the commissioner. 24.10    (d) The basis for determining the amount of payment for drugs administered in an 24.11outpatient setting shall be the lower of the usual and customary cost submitted by the 24.12provider or the amount established for Medicare by the United States Department of 24.13Health and Human Services pursuant to title XVIII, section 1847a of the federal Social 24.14Security Act. 24.15    (e) The commissioner may negotiate lower reimbursement rates for specialty 24.16pharmacy products than the rates specified in paragraph (a). The commissioner may 24.17require individuals enrolled in the health care programs administered by the department 24.18to obtain specialty pharmacy products from providers with whom the commissioner has 24.19negotiated lower reimbursement rates. Specialty pharmacy products are defined as those 24.20used by a small number of recipients or recipients with complex and chronic diseases 24.21that require expensive and challenging drug regimens. Examples of these conditions 24.22include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis 24.23C, growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms 24.24of cancer. Specialty pharmaceutical products include injectable and infusion therapies, 24.25biotechnology drugs, high-cost therapies, and therapies that require complex care. The 24.26commissioner shall consult with the formulary committee to develop a list of specialty 24.27pharmacy products subject to this paragraph. In consulting with the formulary committee 24.28in developing this list, the commissioner shall take into consideration the population 24.29served by specialty pharmacy products, the current delivery system and standard of care in 24.30the state, and access to care issues. The commissioner shall have the discretion to adjust 24.31the reimbursement rate to prevent access to care issues. 24.32 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2010, or upon federal new text end 24.33 new text begin approval, whichever is later. new text end 24.34    Sec. 14. Minnesota Statutes 2008, section 256B.0625, subdivision 18a, is amended to 24.35read: 25.1    Subd. 18a. Access to medical services. (a) Medical assistance reimbursement for 25.2meals for persons traveling to receive medical care may not exceed $5.50 for breakfast, 25.3$6.50 for lunch, or $8 for dinner. 25.4    (b) Medical assistance reimbursement for lodging for persons traveling to receive 25.5medical care may not exceed $50 per day unless prior authorized by the local agency. 25.6    (c) Medical assistance direct mileage reimbursement to the eligible person or the 25.7eligible person's driver may not exceed 20 cents per mile. 25.8    (d) Regardless of the number of employees that an enrolled health care provider 25.9may have, medical assistance covers sign and oral language interpreter services when 25.10provided by an enrolled health care provider during the course of providing a direct, 25.11person-to-person covered health care service to an enrolled recipient with limited English 25.12proficiency or who has a hearing loss and uses interpreting services. new text begin Coverage for oral new text end 25.13 new text begin language interpreter services shall be provided only if the oral language interpreter used new text end 25.14 new text begin by the enrolled health care provider is listed in the registry or roster established under new text end 25.15 new text begin section 144.058. new text end 25.16 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2010. new text end 25.17    Sec. 15. Minnesota Statutes 2008, section 256B.0625, subdivision 31, is amended to 25.18read: 25.19    Subd. 31. Medical supplies and equipment. Medical assistance covers medical 25.20supplies and equipment. Separate payment outside of the facility's payment rate shall 25.21be made for wheelchairs and wheelchair accessories for recipients who are residents 25.22of intermediate care facilities for the developmentally disabled. Reimbursement for 25.23wheelchairs and wheelchair accessories for ICF/MR recipients shall be subject to the same 25.24conditions and limitations as coverage for recipients who do not reside in institutions. A 25.25wheelchair purchased outside of the facility's payment rate is the property of the recipient. new text begin new text end 25.26 new text begin The commissioner may set reimbursement rates for specified categories of medical new text end 25.27 new text begin supplies at levels below the Medicare payment rate. new text end 25.28    Sec. 16. Minnesota Statutes 2008, section 256B.0625, is amended by adding a 25.29subdivision to read: 25.30     new text begin Subd. 54. new text end new text begin Services provided in birth centers. new text end new text begin (a) Medical assistance covers new text end 25.31 new text begin services provided in a birth center licensed under section 144.615 by a licensed health new text end 25.32 new text begin professional if the service would otherwise be covered if provided in a hospital. new text end 25.33 new text begin (b) Facility services provided by a birth center shall be paid at the lower of billed new text end 25.34 new text begin charges or 70 percent of the statewide average for a facility payment rate made to a new text end 26.1 new text begin hospital for an uncomplicated vaginal birth as determined using the most recent calendar new text end 26.2 new text begin year for which complete claims data is available. If a recipient is transported from a birth new text end 26.3 new text begin center to a hospital prior to the delivery, the payment for facility services to the birth center new text end 26.4 new text begin shall be the lower of billed charges or 15 percent of the average facility payment made to a new text end 26.5 new text begin hospital for the services provided for an uncomplicated vaginal delivery as determined new text end 26.6 new text begin using the most recent calendar year for which complete claims data is available. new text end 26.7 new text begin (c) Professional services provided by traditional midwives licensed under chapter new text end 26.8 new text begin 147D shall be paid at the lower of billed charges or 100 percent of the rate paid to a new text end 26.9 new text begin physician performing the same services. If a recipient is transported from a birth center to new text end 26.10 new text begin a hospital prior to the delivery, a licensed traditional midwife who does not perform the new text end 26.11 new text begin delivery may not bill for any delivery services. Services are not covered if provided by an new text end 26.12 new text begin unlicensed traditional midwife. new text end 26.13 new text begin (d) The commissioner shall apply for any necessary waivers from the Centers for new text end 26.14 new text begin Medicare and Medicaid Services to allow birth centers and birth center providers to be new text end 26.15 new text begin reimbursed. new text end 26.16 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2011, or upon federal new text end 26.17 new text begin approval, whichever is later. new text end 26.18    Sec. 17. Minnesota Statutes 2008, section 256B.0631, subdivision 1, is amended to 26.19read: 26.20    Subdivision 1. Co-payments. (a) Except as provided in subdivision 2, the medical 26.21assistance benefit plan shall include the following co-payments for all recipients, effective 26.22for services provided on or after October 1, 2003, and before January 1, 2009: 26.23    (1) $3 per nonpreventive visit. For purposes of this subdivision, a visit means an 26.24episode of service which is required because of a recipient's symptoms, diagnosis, or 26.25established illness, and which is delivered in an ambulatory setting by a physician or 26.26physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse, 26.27audiologist, optician, or optometrist; 26.28    (2) $3 for eyeglasses; 26.29    (3) $6 for nonemergency visits to a hospital-based emergency room; and 26.30    (4) $3 per brand-name drug prescription and $1 per generic drug prescription, 26.31subject to a $12 per month maximum for prescription drug co-payments. No co-payments 26.32shall apply to antipsychotic drugs when used for the treatment of mental illness. 26.33    (b) Except as provided in subdivision 2, the medical assistance benefit plan shall 26.34include the following co-payments for all recipients, effective for services provided on 26.35or after January 1, 2009: 27.1    (1) $6 new text begin $3.50 new text end for nonemergency visits to a hospital-based emergency room; 27.2    (2) $3 per brand-name drug prescription and $1 per generic drug prescription, subject 27.3to a $7 new text begin $12 new text end per month maximum for prescription drug co-payments. No co-payments shall 27.4apply to antipsychotic drugs when used for the treatment of mental illness; and 27.5    (3) for individuals identified by the commissioner with income at or below 100 27.6percent of the federal poverty guidelines, total monthly co-payments must not exceed five 27.7percent of family income. For purposes of this paragraph, family income is the total 27.8earned and unearned income of the individual and the individual's spouse, if the spouse is 27.9enrolled in medical assistance and also subject to the five percent limit on co-payments. 27.10    (c) Recipients of medical assistance are responsible for all co-payments in this 27.11subdivision. 27.12 new text begin EFFECTIVE DATE. new text end new text begin The amendment to paragraph (b), clause (1), related to the new text end 27.13 new text begin co-payment for nonemergency visits is effective January 1, 2011, and the amendment new text end 27.14 new text begin to paragraph (b), clause (2), related to the per month maximum for prescription drug new text end 27.15 new text begin co-payments is effective July 1, 2010. new text end 27.16    Sec. 18. Minnesota Statutes 2008, section 256B.0631, subdivision 3, is amended to 27.17read: 27.18    Subd. 3. Collection. (a) The medical assistance reimbursement to the provider 27.19shall be reduced by the amount of the co-payment, except that reimbursements shall 27.20not be reduced: 27.21    (1) once a recipient has reached the $12 per month maximum or the $7 per month 27.22maximum effective January 1, 2009, for prescription drug co-payments; or 27.23    (2) for a recipient identified by the commissioner under 100 percent of the federal 27.24poverty guidelines who has met their monthly five percent co-payment limit. 27.25    (b) The provider collects the co-payment from the recipient. Providers may not deny 27.26services to recipients who are unable to pay the co-payment. 27.27    (c) Medical assistance reimbursement to fee-for-service providers and payments to 27.28managed care plans shall not be increased as a result of the removal of the co-payments 27.29effective new text begin on or after new text end January 1, 2009. 27.30    Sec. 19. Minnesota Statutes 2008, section 256B.0644, as amended by Laws 2010, 27.31chapter 200, article 1, section 6, is amended to read: 27.32256B.0644 REIMBURSEMENT UNDER OTHER STATE HEALTH CARE 27.33PROGRAMS. 28.1    (a) A vendor of medical care, as defined in section 256B.02, subdivision 7, and a 28.2health maintenance organization, as defined in chapter 62D, must participate as a provider 28.3or contractor in the medical assistance program, general assistance medical care program, 28.4and MinnesotaCare as a condition of participating as a provider in health insurance plans 28.5and programs or contractor for state employees established under section 43A.18, the 28.6public employees insurance program under section 43A.316, for health insurance plans 28.7offered to local statutory or home rule charter city, county, and school district employees, 28.8the workers' compensation system under section 176.135, and insurance plans provided 28.9through the Minnesota Comprehensive Health Association under sections 62E.01 to 28.1062E.19 . The limitations on insurance plans offered to local government employees shall 28.11not be applicable in geographic areas where provider participation is limited by managed 28.12care contracts with the Department of Human Services. 28.13    (b) For providers other than health maintenance organizations, participation in the 28.14medical assistance program means that: 28.15     (1) the provider accepts new medical assistance, general assistance medical care, 28.16and MinnesotaCare patients; 28.17    (2) for providers other than dental service providers, at least 20 percent of the 28.18provider's patients are covered by medical assistance, general assistance medical care, 28.19and MinnesotaCare as their primary source of coverage; or 28.20    (3) for dental service providers, at least ten percent of the provider's patients are 28.21covered by medical assistance, general assistance medical care, and MinnesotaCare as 28.22their primary source of coverage, or the provider accepts new medical assistance and 28.23MinnesotaCare patients who are children with special health care needs. For purposes 28.24of this section, "children with special health care needs" means children up to age 18 28.25who: (i) require health and related services beyond that required by children generally; 28.26and (ii) have or are at risk for a chronic physical, developmental, behavioral, or emotional 28.27condition, including: bleeding and coagulation disorders; immunodeficiency disorders; 28.28cancer; endocrinopathy; developmental disabilities; epilepsy, cerebral palsy, and other 28.29neurological diseases; visual impairment or deafness; Down syndrome and other genetic 28.30disorders; autism; fetal alcohol syndrome; and other conditions designated by the 28.31commissioner after consultation with representatives of pediatric dental providers and 28.32consumers. 28.33    (c) Patients seen on a volunteer basis by the provider at a location other than 28.34the provider's usual place of practice may be considered in meeting the participation 28.35requirement in this section. The commissioner shall establish participation requirements 28.36for health maintenance organizations. The commissioner shall provide lists of participating 29.1medical assistance providers on a quarterly basis to the commissioner of management and 29.2budget, the commissioner of labor and industry, and the commissioner of commerce. Each 29.3of the commissioners shall develop and implement procedures to exclude as participating 29.4providers in the program or programs under their jurisdiction those providers who do 29.5not participate in the medical assistance program. The commissioner of management 29.6and budget shall implement this section through contracts with participating health and 29.7dental carriers. 29.8    (d) Any hospital or other provider that is participating in a coordinated care 29.9delivery system under section 256D.031, subdivision 6, or receives payments from the 29.10uncompensated care pool under section 256D.031, subdivision 8, shall not refuse to 29.11provide services to any patient enrolled in general assistance medical care regardless of 29.12the availability or the amount of payment. 29.13    (e) new text begin (d) new text end For purposes of paragraphs (a) and (b), participation in the general assistance 29.14medical care program applies only to pharmacy providers new text begin dispensing prescription drugs new text end 29.15 new text begin according to section 256D.03, subdivision 3 new text end . 29.16 new text begin EFFECTIVE DATE. new text end new text begin The amendment striking the existing paragraph (d) is effective new text end 29.17 new text begin 30 days after federal approval of the amendments in this article to Minnesota Statutes, new text end 29.18 new text begin sections 256B.055, subdivision 15, and 256B.056, subdivision 4, or January 1, 2011, new text end 29.19 new text begin whichever is later. The amendment to the new paragraph (d) is effective June 1, 2010. new text end 29.20    Sec. 20. Minnesota Statutes 2009 Supplement, section 256B.0653, subdivision 5, 29.21is amended to read: 29.22    Subd. 5. Home care therapies. (a) Home care therapies include the following: 29.23physical therapy, occupational therapy, respiratory therapy, and speech and language 29.24pathology therapy services. 29.25(b) Home care therapies must be: 29.26(1) provided in the recipient's residence after it has been determined the recipient is 29.27unable to access outpatient therapy; 29.28(2) prescribed, ordered, or referred by a physician and documented in a plan of care 29.29and reviewed, according to Minnesota Rules, part 9505.0390; 29.30(3) assessed by an appropriate therapist; and 29.31(4) provided by a Medicare-certified home health agency enrolled as a Medicaid 29.32provider agency. 29.33(c) Restorative and specialized maintenance therapies must be provided according to 29.34Minnesota Rules, part 9505.0390. Physical and occupational therapy assistants may be 29.35used as allowed under Minnesota Rules, part 9505.0390, subpart 1, item B. 30.1(d) For both physical and occupational therapies, the therapist and the therapist's 30.2assistant may not both bill for services provided to a recipient on the same day. 30.3    Sec. 21. new text begin [256B.0755] PAYMENT REFORM DEMONSTRATION PROJECT FOR new text end 30.4 new text begin SPECIAL PATIENT POPULATIONS. new text end 30.5     new text begin Subdivision 1. new text end new text begin Demonstration project. new text end new text begin (a) The commissioner of human services, new text end 30.6 new text begin in consultation with the commissioner of health, shall establish a payment reform new text end 30.7 new text begin demonstration project implementing an alternative payment system for health care new text end 30.8 new text begin providers serving an identified group of patients who are enrolled in a state health new text end 30.9 new text begin care program, and are either high utilizers of high-cost health care services or have new text end 30.10 new text begin characteristics that put them at high risk of becoming high utilizers. The purpose of the new text end 30.11 new text begin demonstration project is to implement and evaluate methods of reducing hospitalizations, new text end 30.12 new text begin emergency room use, high-cost medications and specialty services, admissions to nursing new text end 30.13 new text begin facilities, or use of long-term home and community-based services, in order to reduce the new text end 30.14 new text begin total cost of care and services for the patients. new text end 30.15 new text begin (b) The commissioner shall give the highest priority to projects that will serve new text end 30.16 new text begin patients who have chronic medical conditions or complex medical needs that are new text end 30.17 new text begin complicated by a physical disability, serious mental illness, or serious socioeconomic new text end 30.18 new text begin factors such as poverty, homelessness, or language or cultural barriers. The commissioner new text end 30.19 new text begin shall also give the highest priority to providers or groups of providers who have the new text end 30.20 new text begin highest concentrations of patients with these characteristics. new text end 30.21 new text begin (c) The commissioner must implement this payment reform demonstration project new text end 30.22 new text begin in a manner consistent with the payment reform initiative provided in sections 62U.02 new text end 30.23 new text begin to 62U.04. new text end 30.24 new text begin (d) For purposes of this section, "state health care program" means the medical new text end 30.25 new text begin assistance, MinnesotaCare, and general assistance medical care programs. new text end 30.26     new text begin Subd. 2. new text end new text begin Participation. new text end new text begin (a) The commissioner shall request eligible providers or new text end 30.27 new text begin groups of providers to submit a proposal to participate in the demonstration project by new text end 30.28 new text begin September 1, 2010. The providers who are interested in participating shall negotiate with new text end 30.29 new text begin the commissioner to determine: new text end 30.30 new text begin (1) the identified group of patients who are to be enrolled in the program; new text end 30.31 new text begin (2) the services that are to be included in the total cost of care calculation; new text end 30.32 new text begin (3) the methodology for calculating the total cost of care, which may take into new text end 30.33 new text begin consideration the impact on costs to other state or local government programs including, new text end 30.34 new text begin but not limited to, social services and income maintenance programs; new text end 30.35 new text begin (4) the time period to be covered under the bid; new text end 31.1 new text begin (5) the implementation of a risk adjustment mechanism to adjust for factors that are new text end 31.2 new text begin beyond the control of the provider including nonclinical factors that will affect the cost new text end 31.3 new text begin or outcomes of treatment; new text end 31.4 new text begin (6) the payment reforms and payment methods to be used under the project, which new text end 31.5 new text begin may include but are not limited to adjustments in fee-for-service payments, payment of new text end 31.6 new text begin care coordination fees, payments for start-up and implementation costs to be recovered or new text end 31.7 new text begin repaid later in the project, payments adjusted based on a provider's proportion of patients new text end 31.8 new text begin who are enrolled in state health care programs; payments adjusted for the clinical or new text end 31.9 new text begin socioeconomic complexity of the patients served, payment incentives tied to use of new text end 31.10 new text begin inpatient and emergency room services, and periodic settle-up adjustments; new text end 31.11 new text begin (7) methods of sharing financial risk and benefit between the commissioner and new text end 31.12 new text begin the provider or groups of providers, which may include but are not limited to stop-loss new text end 31.13 new text begin arrangements to cover high-cost outlier cases or costs that are beyond the control of the new text end 31.14 new text begin provider, and risk-sharing and benefit-sharing corridors; and new text end 31.15 new text begin (8) performance and outcome benchmarks to be used to measure performance, new text end 31.16 new text begin achievement of cost-savings targets, and quality of care provided. new text end 31.17 new text begin (b) A provider or group of providers may submit a proposal for a demonstration new text end 31.18 new text begin project in partnership with a health maintenance organization or county-based purchasing new text end 31.19 new text begin plan for the purposes of sharing risk, claims processing, or administration of the project, new text end 31.20 new text begin or to extend participation in the project to persons who are enrolled in prepaid health new text end 31.21 new text begin care programs. new text end 31.22     new text begin Subd. 3. new text end new text begin Total cost of care agreement. new text end new text begin Based on negotiations, the commissioner new text end 31.23 new text begin must enter into an agreement with interested and eligible providers or groups of providers new text end 31.24 new text begin to implement projects that are designed to reduce the total cost of care for the identified new text end 31.25 new text begin patients. To the extent possible, the projects shall begin implementation on January 1, new text end 31.26 new text begin 2011, or upon federal approval, whichever is later. new text end 31.27     new text begin Subd. 4. new text end new text begin Eligibility. new text end new text begin To be eligible to participate, providers or groups of providers new text end 31.28 new text begin must meet certification standards for health care homes established by the Department of new text end 31.29 new text begin Health and the Department of Human Services under section 256B.0751. new text end 31.30     new text begin Subd. 5. new text end new text begin Alternative payments. new text end new text begin The commissioner shall seek all federal waivers new text end 31.31 new text begin and approvals necessary to implement this section and to obtain federal matching funds. To new text end 31.32 new text begin the extent authorized by federal law, the commissioner may waive existing fee-for-service new text end 31.33 new text begin payment rates, provider contract or performance requirements, consumer incentive new text end 31.34 new text begin policies, or other requirements in statute or rule in order to allow the providers or groups new text end 31.35 new text begin of providers to utilize alternative payment and financing methods that will appropriately new text end 31.36 new text begin fund necessary and cost-effective primary care and care coordination services; establish new text end 32.1 new text begin appropriate incentives for prevention, health promotion, and care coordination; and new text end 32.2 new text begin mitigate financial harm to participating providers caused by the successful reduction in new text end 32.3 new text begin preventable hospitalization, emergency room use, and other costly services. new text end 32.4     new text begin Subd. 6. new text end new text begin Cost neutrality. new text end new text begin The total cost, including administrative costs, of this new text end 32.5 new text begin demonstration project must not exceed the costs that would otherwise be incurred by new text end 32.6 new text begin the state had services to the state health care program enrollees participating in the new text end 32.7 new text begin demonstration project been provided, as applicable for the enrollee, under fee-for-service new text end 32.8 new text begin or through managed care or county-based purchasing plans. new text end 32.9    Sec. 22. new text begin [256B.0757] INTENSIVE CARE MANAGEMENT PROGRAM. new text end 32.10     new text begin Subdivision 1. new text end new text begin Report. new text end new text begin The commissioner shall review medical assistance new text end 32.11 new text begin enrollment and by July 1, 2011, present a report to the legislature that describes the new text end 32.12 new text begin common characteristics and costs of those enrollees age 18 and over whose annual medical new text end 32.13 new text begin costs are greater than 95 percent of all other enrollees, using deidentified data. new text end 32.14     new text begin Subd. 2. new text end new text begin Intensive care management system established. new text end new text begin The commissioner shall new text end 32.15 new text begin implement, by January 1, 2012, or upon federal approval, whichever is later, a program new text end 32.16 new text begin to provide intensive care management to medical assistance enrollees age 18 and over new text end 32.17 new text begin currently served under fee-for-service, managed care, or county-based purchasing, whose new text end 32.18 new text begin annual medical care costs are in the top five percent of all medical assistance enrollees. new text end 32.19 new text begin The intensive care management program must reduce these enrollees' medical assistance new text end 32.20 new text begin costs by at least 20 percent on average, improve quality of care through care coordination, new text end 32.21 new text begin and provide financial incentives for providers to deliver care efficiently. The commissioner new text end 32.22 new text begin may require medical assistance enrollees meeting the criteria specified in this subdivision new text end 32.23 new text begin to participate in the intensive care management program, and may reassign enrollees new text end 32.24 new text begin from existing managed care and county-based purchasing plans to those plans that are new text end 32.25 new text begin participating in the demonstration program. The commissioner shall seek all federal new text end 32.26 new text begin approvals and waivers necessary to implement the intensive care management program. new text end 32.27     new text begin Subd. 3. new text end new text begin Request for proposals. new text end new text begin The commissioner of human services shall new text end 32.28 new text begin request proposals by September 1, 2011, or upon federal approval, whichever is later, new text end 32.29 new text begin from health care providers, managed care plans, and county-based purchasing plans to new text end 32.30 new text begin provide intensive care management services under the requirements of subdivision 1. new text end 32.31 new text begin Proposals submitted must: new text end 32.32 new text begin (1) designate the medical assistance population and geographic area of the state new text end 32.33 new text begin to be served; new text end 32.34 new text begin (2) describe in detail the proposed intensive care management program; new text end 33.1 new text begin (3) provide estimates of cost savings to the state and the evidence supporting these new text end 33.2 new text begin estimates; new text end 33.3 new text begin (4) describe the extent to which the intensive care management program is consistent new text end 33.4 new text begin with and builds upon current state health care home, care coordination, and payment new text end 33.5 new text begin reform initiatives; and new text end 33.6 new text begin (5) meet quality assurance, data reporting, and other criteria specified by the new text end 33.7 new text begin commissioner in the request for proposals. new text end 33.8 new text begin EFFECTIVE DATE. new text end new text begin This section is effective the day following final enactment. new text end 33.9    Sec. 23. Minnesota Statutes 2008, section 256B.19, subdivision 1c, is amended to read: 33.10    Subd. 1c. Additional portion of nonfederal share. (a) Hennepin County shall 33.11be responsible for a monthly transfer payment of $1,500,000, due before noon on the 33.1215th of each month and the University of Minnesota shall be responsible for a monthly 33.13transfer payment of $500,000 due before noon on the 15th of each month, beginning July 33.1415, 1995. These sums shall be part of the designated governmental unit's portion of the 33.15nonfederal share of medical assistance costs. 33.16(b) Beginning July 1, 2001, Hennepin County's payment under paragraph (a) shall 33.17be $2,066,000 each month. 33.18(c) Beginning July 1, 2001, the commissioner shall increase annual capitation 33.19payments to the metropolitan health plan under section 256B.69 for the prepaid medical 33.20assistance program by approximately $3,400,000, plus any available federal matching 33.21funds, new text begin $6,800,000 new text end to recognize higher than average medical education costs. 33.22(d) Effective August 1, 2005, Hennepin County's payment under paragraphs (a) 33.23and (b) shall be reduced to $566,000, and the University of Minnesota's payment under 33.24paragraph (a) shall be reduced to zero. new text begin Effective October 1, 2008, to December 30, 2010, new text end 33.25 new text begin Hennepin County's payment under paragraphs (a) and (b) shall be $434,688. Effective new text end 33.26 new text begin January 1, 2011, Hennepin County's payment under paragraphs (a) and (b) shall be new text end 33.27 new text begin $566,000. new text end 33.28 new text begin (e) Notwithstanding paragraph (d), upon federal enactment of an extension to June new text end 33.29 new text begin 30, 2011, of the enhanced federal medical assistance percentage (FMAP) originally new text end 33.30 new text begin provided under Public Law 111-5, for the six-month period from January 1, 2011, to June new text end 33.31 new text begin 30, 2011, Hennepin County's payment under paragraphs (a) and (b) shall be $434,688. new text end 33.32    Sec. 24. Minnesota Statutes 2008, section 256B.69, is amended by adding a 33.33subdivision to read: 34.1     new text begin Subd. 5k. new text end new text begin Payment rate modification. new text end new text begin For services rendered on or after August new text end 34.2 new text begin 1, 2010, the total payment made to managed care and county-based purchasing plans new text end 34.3 new text begin under the medical assistance program and under MinnesotaCare for families with children new text end 34.4 new text begin shall be increased by 1.4 percent. new text end 34.5 new text begin EFFECTIVE DATE. new text end new text begin This section is effective August 1, 2010. new text end 34.6    Sec. 25. Minnesota Statutes 2008, section 256B.69, is amended by adding a 34.7subdivision to read: 34.8     new text begin Subd. 5l. new text end new text begin Payment reduction. new text end new text begin For services rendered on or after January 1, 2011, new text end 34.9 new text begin the total payment made to managed care plans for providing covered services under new text end 34.10 new text begin the medical assistance, general assistance medical care, and MinnesotaCare programs new text end 34.11 new text begin is reduced by one percent from their current statutory rates. This provision excludes new text end 34.12 new text begin payments for nursing home services, home and community-based waivers, home care new text end 34.13 new text begin services covered under section 256B.0651, subdivision 2, payments to demonstration new text end 34.14 new text begin projects for persons with disabilities, and mental health services added as covered benefits new text end 34.15 new text begin after December 31, 2007. new text end 34.16    Sec. 26. Minnesota Statutes 2008, section 256B.69, subdivision 20, as amended by 34.17Laws 2010, chapter 200, article 1, section 10, is amended to read: 34.18    Subd. 20. Ombudsperson. (a) The commissioner shall designate an ombudsperson 34.19to advocate for persons required to enroll in prepaid health plans under this section. The 34.20ombudsperson shall advocate for recipients enrolled in prepaid health plans through 34.21complaint and appeal procedures and ensure that necessary medical services are provided 34.22either by the prepaid health plan directly or by referral to appropriate social services. At 34.23the time of enrollment in a prepaid health plan, the local agency shall inform recipients 34.24about the ombudsperson program and their right to a resolution of a complaint by the 34.25prepaid health plan if they experience a problem with the plan or its providers. 34.26    (b) The commissioner shall designate an ombudsperson to advocate for persons 34.27enrolled in a care coordination delivery system under section . The 34.28ombudsperson shall advocate for recipients enrolled in a care coordination delivery 34.29system through the state appeal process and assist enrollees in accessing necessary 34.30medical services through the care coordination delivery systems directly or by referral to 34.31appropriate services. At the time of enrollment in a care coordination delivery system, the 34.32local agency shall inform recipients about the ombudsperson program. 35.1 new text begin EFFECTIVE DATE. new text end new text begin This section is effective 30 days after federal approval of the new text end 35.2 new text begin amendments in this article to Minnesota Statutes, sections 256B.055, subdivision 15, and new text end 35.3 new text begin 256B.056, subdivision 4, or January 1, 2011, whichever is later. new text end 35.4    Sec. 27. Minnesota Statutes 2008, section 256B.69, subdivision 27, is amended to read: 35.5    Subd. 27. Information for persons with limited English-language proficiency. 35.6    Managed care contracts entered into under this section and sections 256D.03, subdivision 35.74 , paragraph (c), and new text begin section new text end 256L.12 must require demonstration providers to provide 35.8language assistance to enrollees that ensures meaningful access to its programs and 35.9services according to Title VI of the Civil Rights Act and federal regulations adopted 35.10under that law or any guidance from the United States Department of Health and Human 35.11Services. 35.12 new text begin EFFECTIVE DATE. new text end new text begin This section is effective retroactively from April 1, 2010. new text end 35.13    Sec. 28. Minnesota Statutes 2008, section 256B.692, subdivision 1, is amended to read: 35.14    Subdivision 1. In general. County boards or groups of county boards may elect 35.15to purchase or provide health care services on behalf of persons eligible for medical 35.16assistance and general assistance medical care who would otherwise be required to or may 35.17elect to participate in the prepaid medical assistance or prepaid general assistance medical 35.18care programs according to sections new text begin section new text end 256B.69 and . Counties that elect to 35.19purchase or provide health care under this section must provide all services included in 35.20prepaid managed care programs according to sections new text begin section new text end 256B.69, subdivisions 1 35.21to 22 , and . County-based purchasing under this section is governed by section 35.22256B.69 , unless otherwise provided for under this section. 35.23 new text begin EFFECTIVE DATE. new text end new text begin This section is effective retroactively from April 1, 2010. new text end 35.24    Sec. 29. Minnesota Statutes 2008, section 256B.75, is amended to read: 35.25256B.75 HOSPITAL OUTPATIENT REIMBURSEMENT. 35.26    (a) For outpatient hospital facility fee payments for services rendered on or after 35.27October 1, 1992, the commissioner of human services shall pay the lower of (1) submitted 35.28charge, or (2) 32 percent above the rate in effect on June 30, 1992, except for those 35.29services for which there is a federal maximum allowable payment. Effective for services 35.30rendered on or after January 1, 2000, payment rates for nonsurgical outpatient hospital 35.31facility fees and emergency room facility fees shall be increased by eight percent over the 35.32rates in effect on December 31, 1999, except for those services for which there is a federal 36.1maximum allowable payment. Services for which there is a federal maximum allowable 36.2payment shall be paid at the lower of (1) submitted charge, or (2) the federal maximum 36.3allowable payment. Total aggregate payment for outpatient hospital facility fee services 36.4shall not exceed the Medicare upper limit. If it is determined that a provision of this 36.5section conflicts with existing or future requirements of the United States government with 36.6respect to federal financial participation in medical assistance, the federal requirements 36.7prevail. The commissioner may, in the aggregate, prospectively reduce payment rates to 36.8avoid reduced federal financial participation resulting from rates that are in excess of 36.9the Medicare upper limitations. 36.10    (b) Notwithstanding paragraph (a), payment for outpatient, emergency, and 36.11ambulatory surgery hospital facility fee services for critical access hospitals designated 36.12under section 144.1483, clause (10), shall be paid on a cost-based payment system that is 36.13based on the cost-finding methods and allowable costs of the Medicare program. 36.14    (c) Effective for services provided on or after July 1, 2003, rates that are based 36.15on the Medicare outpatient prospective payment system shall be replaced by a budget 36.16neutral prospective payment system that is derived using medical assistance data. The 36.17commissioner shall provide a proposal to the 2003 legislature to define and implement 36.18this provision. 36.19    (d) For fee-for-service services provided on or after July 1, 2002, the total payment, 36.20before third-party liability and spenddown, made to hospitals for outpatient hospital 36.21facility services is reduced by .5 percent from the current statutory rate. 36.22    (e) In addition to the reduction in paragraph (d), the total payment for fee-for-service 36.23services provided on or after July 1, 2003, made to hospitals for outpatient hospital 36.24facility services before third-party liability and spenddown, is reduced five percent from 36.25the current statutory rates. Facilities defined under section 256.969, subdivision 16, are 36.26excluded from this paragraph. 36.27    (f) In addition to the reductions in paragraphs (d) and (e), the total payment for 36.28fee-for-service services provided on or after July 1, 2008, made to hospitals for outpatient 36.29hospital facility services before third-party liability and spenddown, is reduced three 36.30percent from the current statutory rates. Mental health services and facilities defined under 36.31section 256.969, subdivision 16, are excluded from this paragraph. 36.32     new text begin (g) Notwithstanding any contrary provision in this section, payment for all outpatient new text end 36.33 new text begin and emergency services provided by any hospital that, prior to December 31, 2007, has new text end 36.34 new text begin received payment to support the training of residents from an approved graduate medical new text end 36.35 new text begin residency training program under United States Code, title 42, section 256e, must be paid new text end 37.1 new text begin for fiscal years 2012 and 2013 an additional $7,000,000. Payment rates for subsequent new text end 37.2 new text begin fiscal years are as follows: new text end 37.3     new text begin (1) 2014: 50 percent of costs; new text end 37.4     new text begin (2) 2015: 60 percent of costs; new text end 37.5     new text begin (3) 2016: 70 percent of costs; new text end 37.6     new text begin (4) 2017: 80 percent of costs; new text end 37.7     new text begin (5) 2018: 90 percent of costs; and new text end 37.8     new text begin (6) 2019 and thereafter: 100 percent of costs. new text end 37.9    Sec. 30. Minnesota Statutes 2009 Supplement, section 256B.76, subdivision 1, is 37.10amended to read: 37.11    Subdivision 1. Physician reimbursement. (a) Effective for services rendered on 37.12or after October 1, 1992, the commissioner shall make payments for physician services 37.13as follows: 37.14    (1) payment for level one Centers for Medicare and Medicaid Services' common 37.15procedural coding system codes titled "office and other outpatient services," "preventive 37.16medicine new and established patient," "delivery, antepartum, and postpartum care," 37.17"critical care," cesarean delivery and pharmacologic management provided to psychiatric 37.18patients, and level three codes for enhanced services for prenatal high risk, shall be paid 37.19at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June 37.2030, 1992. If the rate on any procedure code within these categories is different than the 37.21rate that would have been paid under the methodology in section 256B.74, subdivision 2, 37.22then the larger rate shall be paid; 37.23    (2) payments for all other services shall be paid at the lower of (i) submitted charges, 37.24or (ii) 15.4 percent above the rate in effect on June 30, 1992; and 37.25    (3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th 37.26percentile of 1989, less the percent in aggregate necessary to equal the above increases 37.27except that payment rates for home health agency services shall be the rates in effect 37.28on September 30, 1992. 37.29    (b) Effective for services rendered on or after January 1, 2000, payment rates for 37.30physician and professional services shall be increased by three percent over the rates 37.31in effect on December 31, 1999, except for home health agency and family planning 37.32agency services. The increases in this paragraph shall be implemented January 1, 2000, 37.33for managed care. 37.34(c) Effective for services rendered on or after July 1, 2009, payment rates for 37.35physician and professional services shall be reduced by five percent over the rates in 38.1effect on June 30, 2009. This reduction does not apply to office or other outpatient visits, 38.2preventive medicine visits and family planning visits billed by physicians, advanced 38.3practice nurses, or physician assistants in a family planning agency or in one of the 38.4following primary care practices: general practice, general internal medicine, general 38.5pediatrics, general geriatrics, and family medicine. This reduction does not apply to 38.6federally qualified health centers, rural health centers, and Indian health services. new text begin This new text end 38.7 new text begin reduction does not apply to physical therapy services, occupational therapy services, new text end 38.8 new text begin and speech pathology and related services provided on or after July 1, 2010. new text end Effective 38.9October 1, 2009, payments made to managed care plans and county-based purchasing 38.10plans under sections 256B.69, 256B.692, and 256L.12 shall reflect the payment reduction 38.11described in this paragraph. 38.12 new text begin (d) Effective for services rendered on or after July 1, 2010, payment rates for new text end 38.13 new text begin physician and professional services shall be reduced by three percent over the rates in new text end 38.14 new text begin effect on June 30, 2010. This reduction does not apply to those providers and entities new text end 38.15 new text begin exempt from the reduction in paragraph (c). Effective October 1, 2010, payments made new text end 38.16 new text begin to managed care plans and county-based purchasing plans under sections 256B.69, new text end 38.17 new text begin 256B.692, and 256L.12 shall reflect the payment reductions in this paragraph. new text end 38.18 new text begin (e) Effective for services rendered on or after June 1, 2010, payment rates for new text end 38.19 new text begin physician and professional services billed by physicians employed by and clinics that are new text end 38.20 new text begin owned by a nonprofit health maintenance organization shall be increased by 15 percent. new text end 38.21 new text begin Effective October 1, 2010, payments to managed care and county-based purchasing new text end 38.22 new text begin plans under sections 256B.69, 256B.692, and 256L.12 shall reflect the payment increase new text end 38.23 new text begin described in this paragraph. new text end 38.24    Sec. 31. Minnesota Statutes 2008, section 256B.76, subdivision 2, is amended to read: 38.25    Subd. 2. Dental reimbursement. (a) Effective for services rendered on or after 38.26October 1, 1992, the commissioner shall make payments for dental services as follows: 38.27    (1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25 38.28percent above the rate in effect on June 30, 1992; and 38.29    (2) dental rates shall be converted from the 50th percentile of 1982 to the 50th 38.30percentile of 1989, less the percent in aggregate necessary to equal the above increases. 38.31    (b) Beginning October 1, 1999, the payment for tooth sealants and fluoride treatments 38.32shall be the lower of (1) submitted charge, or (2) 80 percent of median 1997 charges. 38.33    (c) Effective for services rendered on or after January 1, 2000, payment rates for 38.34dental services shall be increased by three percent over the rates in effect on December 38.3531, 1999. 39.1    (d) Effective for services provided on or after January 1, 2002, payment for 39.2diagnostic examinations and dental x-rays provided to children under age 21 shall be the 39.3lower of (1) the submitted charge, or (2) 85 percent of median 1999 charges. 39.4    (e) The increases listed in paragraphs (b) and (c) shall be implemented January 1, 39.52000, for managed care. 39.6 new text begin (f) Effective for dental services rendered on or after October 1, 2010, by a new text end 39.7 new text begin state-operated dental clinic, payment shall be paid on a cost-based payment system that new text end 39.8 new text begin is based on the cost-finding methods and allowable costs of the Medicare program. For new text end 39.9 new text begin services performed by a state-operated dental clinic pursuant to a contract between the new text end 39.10 new text begin clinic and a managed care plan or a county-based purchasing plan, a supplemental payment new text end 39.11 new text begin shall be made to the clinic by the commissioner that is equal to the amount by which the new text end 39.12 new text begin amount determined under this paragraph exceeds the amount of the payments provided new text end 39.13 new text begin under the contract. Managed care plans and county-based purchasing plans participating new text end 39.14 new text begin in medical assistance must provide to the commissioner any expenditure, cost, and new text end 39.15 new text begin revenue information deemed necessary by the commissioner for purposes of obtaining new text end 39.16 new text begin federal Medicaid matching funds for cost-based reimbursement for state-operated dental new text end 39.17 new text begin clinics. Cost-based reimbursement shall be implemented in managed care contracts new text end 39.18 new text begin beginning January 1, 2011. new text end 39.19 new text begin (g) Beginning in fiscal year 2011, if the payments to state-operated dental clinics new text end 39.20 new text begin in paragraph (f), including state and federal shares, are less than $1,850,000 per fiscal new text end 39.21 new text begin year, a supplemental state payment equal to the difference between the total payments new text end 39.22 new text begin in paragraph (f) and $1,850,000 shall be paid from the general fund to state-operated new text end 39.23 new text begin services for the operation of the dental clinics. new text end 39.24    Sec. 32. Minnesota Statutes 2008, section 256B.76, subdivision 4, is amended to read: 39.25    Subd. 4. Critical access dental providers. Effective for dental services rendered 39.26on or after January 1, 2002, the commissioner shall increase reimbursements to dentists 39.27and dental clinics deemed by the commissioner to be critical access dental providers. 39.28For dental services rendered on or after July 1, 2007, the commissioner shall increase 39.29reimbursement by 30 percent above the reimbursement rate that would otherwise be paid to 39.30the critical access dental provider. The commissioner shall pay the health plan companies 39.31in amounts sufficient to reflect increased reimbursements to critical access dental providers 39.32as approved by the commissioner. In determining which dentists and dental clinics shall 39.33be deemed critical access dental providers, the commissioner shall review: 40.1    (1) the utilization rate in the service area in which the dentist or dental clinic operates 40.2for dental services to patients covered by medical assistance, general assistance medical 40.3care, or MinnesotaCare as their primary source of coverage; 40.4    (2) the level of services provided by the dentist or dental clinic to patients covered 40.5by medical assistance, general assistance medical care, or MinnesotaCare as their primary 40.6source of coverage; and new text begin . The commissioner shall pay critical access dental provider new text end 40.7 new text begin payments to a dentist or dental clinic that meets any one of the following criteria: new text end 40.8     new text begin (i) at least 40 percent of patient encounters are with patients who are uninsured or new text end 40.9 new text begin covered by medical assistance, general assistance medical care, or MinnesotaCare; new text end 40.10     new text begin (ii) the dental clinic or dental group is owned and operated by a nonprofit operation new text end 40.11 new text begin under chapter 317A with more than 10,000 patient encounters per year with patients new text end 40.12 new text begin who are uninsured or covered by medical assistance, general assistance medical care, new text end 40.13 new text begin or MinnesotaCare; new text end 40.14     new text begin (iii) the dental clinic is associated with an oral health or dental education program new text end 40.15 new text begin operated by the University of Minnesota or an institution within the Minnesota State new text end 40.16 new text begin Colleges and Universities system; or new text end 40.17 new text begin (iv) the dental clinic is a state-operated dental clinic; new text end 40.18    (3) whether the level of services provided by the dentist or dental clinic is critical to 40.19maintaining adequate levels of patient access within the new text begin a geographic new text end service area new text begin , and new text end 40.20 new text begin to ensure that the maximum travel distance or travel time is the lesser of 60 miles or 60 new text end 40.21 new text begin minutes; new text end 40.22     new text begin (4) whether the provider has completed the application for critical access dental new text end 40.23 new text begin provider designation by the due date, and has provided correct information; new text end 40.24     new text begin (5) whether the dentist or dental clinic meets the quality and continuity of care new text end 40.25 new text begin criteria recommended by the dental services advisory committee and adopted by the new text end 40.26 new text begin department; and new text end 40.27 new text begin (6) whether the dentist or dental clinic serves people in all Minnesota health care new text end 40.28 new text begin programs new text end . 40.29In the absence of a critical access dental provider in a service area, the commissioner may 40.30designate a dentist or dental clinic as a critical access dental provider if the dentist or 40.31dental clinic is willing to provide care to patients covered by medical assistance, general 40.32assistance medical care, or MinnesotaCare at a level which significantly increases access 40.33to dental care in the service area. 40.34 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2011. new text end 41.1    Sec. 33. Minnesota Statutes 2008, section 256B.76, is amended by adding a 41.2subdivision to read: 41.3     new text begin Subd. 4a. new text end new text begin Designation and termination of critical access dental providers. new text end new text begin (a) new text end 41.4 new text begin Notwithstanding the provisions in subdivision 4, the commissioner may review and not new text end 41.5 new text begin designate an individual dentist or dental clinic as a critical access dental provider under new text end 41.6 new text begin subdivision 4 or section 256L.11, subdivision 7, when the dentist or clinic: new text end 41.7 new text begin (1) has been subject to a corrective or disciplinary action by the Board of Dentistry new text end 41.8 new text begin related to fraud or direct patient care. Designation shall not be made until the provider is no new text end 41.9 new text begin longer subject to a corrective or disciplinary action related to fraud or direct patient care; or new text end 41.10 new text begin (2) has been subject, within the past three years, to a postinvestigation action by the new text end 41.11 new text begin commissioner of human services or issuance of a warning as specified in Minnesota Rules, new text end 41.12 new text begin parts 9505.2160 to 9505.2245. The provider shall not be considered for critical access new text end 41.13 new text begin dental designation until the January following the year in which the action has ended. new text end 41.14 new text begin (b) The commissioner may terminate a critical access designation of an individual new text end 41.15 new text begin dentist or clinic if the dentist or clinic: new text end 41.16 new text begin (1) becomes subject to a disciplinary or corrective action by the Board of Dentistry new text end 41.17 new text begin related to fraud or direct patient care. The provider shall not be considered for critical new text end 41.18 new text begin access designation until the January following the year in which the action has ended; new text end 41.19 new text begin (2) becomes subject to a postinvestigation action by the commissioner of human new text end 41.20 new text begin services or issuance of a warning as specified in Minnesota Rules, parts 9505.2160 new text end 41.21 new text begin to 9505.2245; new text end 41.22 new text begin (3) does not meet the quality and continuity of care criteria that have been new text end 41.23 new text begin recommended by the Dental Services Advisory Committee and adopted by the department; new text end 41.24 new text begin or new text end 41.25 new text begin (4) does not serve people in all Minnesota public health care programs. new text end 41.26 new text begin (c) Any termination is effective on the date of notification of the: new text end 41.27 new text begin (1) postinvestigative action; new text end 41.28 new text begin (2) disciplinary or corrective action by the Minnesota Board of Dentistry; or new text end 41.29 new text begin (3) determination of not meeting quality and continuity of care criteria. new text end 41.30 new text begin The commissioner may review postinvestigative actions taken by a health plan new text end 41.31 new text begin under contract to provide dental services to Minnesota health care program enrollees. new text end 41.32 new text begin After an investigation conducted by the Department of Human Services surveillance unit, new text end 41.33 new text begin the findings of the health plan may be incorporated to determine if a provider will be new text end 41.34 new text begin designated or terminated from the program. new text end 41.35 new text begin (d) A provider who has been terminated or not designated under this section may new text end 41.36 new text begin appeal only through the contested hearing process as defined in section 14.02, subdivision new text end 42.1 new text begin 3, by filing with the commissioner a written request of appeal. The appeal request must new text end 42.2 new text begin be received by the commissioner no later than 30 days after notification of termination new text end 42.3 new text begin or nondesignation. new text end 42.4 new text begin (e) The commissioner may make an exception to paragraphs (a) and (b) if an action new text end 42.5 new text begin taken by the Board of Dentistry or the commissioner is the result of events not directly new text end 42.6 new text begin related to patient care or that will not affect direct patient care to Minnesota health care new text end 42.7 new text begin program enrollees. new text end 42.8 new text begin EFFECTIVE DATE. new text end new text begin This section is effective the day following final enactment. new text end 42.9    Sec. 34. Minnesota Statutes 2009 Supplement, section 256B.766, is amended to read: 42.10256B.766 REIMBURSEMENT FOR BASIC CARE SERVICES. 42.11(a) Effective for services provided on or after July 1, 2009, total payments for 42.12basic care services, shall be reduced by three percent, prior to third-party liability and 42.13spenddown calculation. new text begin This reduction applies to physical therapy services, occupational new text end 42.14 new text begin therapy services, and speech language pathology and related services provided on or after new text end 42.15 new text begin July 1, 2010. Effective July 1, 2010, the commissioner shall classify physical therapy new text end 42.16 new text begin services, occupational therapy services, and speech language pathology and related new text end 42.17 new text begin services as basic care services. new text end Payments made to managed care plans and county-based 42.18purchasing plans shall be reduced for services provided on or after October 1, 2009, 42.19to reflect this reduction. 42.20(b) This section does not apply to physician and professional services, inpatient 42.21hospital services, family planning services, mental health services, dental services, 42.22prescription drugs, medical transportation, federally qualified health centers, rural health 42.23centers, Indian health services, and Medicare cost-sharing. 42.24    Sec. 35. new text begin [256B.767] MEDICARE PAYMENT LIMIT. new text end 42.25 new text begin Effective for services rendered on or after July 1, 2010, fee-for-service payment new text end 42.26 new text begin rates for physician and professional services under section 256B.76, subdivision 1, and new text end 42.27 new text begin basic care services subject to the rate reduction specified in section 256B.766, shall not new text end 42.28 new text begin exceed the Medicare payment rate for the applicable service. new text end 42.29    Sec. 36. new text begin [256B.768] FEE-FOR-SERVICE PAYMENT INCREASE. new text end 42.30 new text begin Effective for services rendered on or after January 1, 2011, the commissioner shall new text end 42.31 new text begin increase fee-for-service payment rates by seven percent for physician and professional new text end 43.1 new text begin services under section 256B.76, subdivision 1, and basic care services subject to the rate new text end 43.2 new text begin reduction specified in section 256B.766. new text end 43.3    Sec. 37. Minnesota Statutes 2009 Supplement, section 256D.03, subdivision 3, as 43.4amended by Laws 2010, chapter 200, article 1, section 11, is amended to read: 43.5    Subd. 3. General assistance medical care; eligibility. (a) Beginning April 1, 2010, 43.6the general assistance medical care program shall be administered according to section 43.7256D.031 , unless otherwise stated, except for outpatient prescription drug coverage, 43.8which shall continue to be administered under this section and funded under section 43.9256D.031, subdivision 9 , beginning June 1, 2010. 43.10(b) Outpatient prescription drug coverage under general assistance medical care is 43.11limited to prescription drugs that: 43.12(1) are covered under the medical assistance program as described in section 43.13256B.0625, subdivisions 13 and 13d; and 43.14(2) are provided by manufacturers that have fully executed general assistance 43.15medical care rebate agreements with the commissioner and comply with the agreements. 43.16Outpatient prescription drug coverage under general assistance medical care must conform 43.17to coverage under the medical assistance program according to section 256B.0625, 43.18subdivisions 13 to 13g new text begin 13h new text end . 43.19    (c) Outpatient prescription drug coverage does not include drugs administered in a 43.20clinic or other outpatient setting. 43.21 new text begin (d) For the period beginning April 1, 2010, to May 31, 2010, general assistance new text end 43.22 new text begin medical care covers the services listed in subdivision 4. new text end 43.23 new text begin EFFECTIVE DATE. new text end new text begin This section is effective retroactively from April 1, 2010. new text end 43.24    Sec. 38. Minnesota Statutes 2008, section 256L.02, subdivision 3, is amended to read: 43.25    Subd. 3. Financial management. (a) The commissioner shall manage spending for 43.26the MinnesotaCare program in a manner that maintains a minimum reserve. As part of 43.27each state revenue and expenditure forecast, the commissioner must make an assessment 43.28of the expected expenditures for the covered services for the remainder of the current 43.29biennium and for the following biennium. The estimated expenditure, including the 43.30reserve, shall be compared to an estimate of the revenues that will be available in the health 43.31care access fund. Based on this comparison, and after consulting with the chairs of the 43.32house of representatives Ways and Means Committee and the senate Finance Committee, 43.33and the Legislative Commission on Health Care Access, the commissioner shall, as 43.34necessary, make the adjustments specified in paragraph (b) to ensure that expenditures 44.1remain within the limits of available revenues for the remainder of the current biennium 44.2and for the following biennium. The commissioner shall not hire additional staff using 44.3appropriations from the health care access fund until the commissioner of management 44.4and budget makes a determination that the adjustments implemented under paragraph (b) 44.5are sufficient to allow MinnesotaCare expenditures to remain within the limits of available 44.6revenues for the remainder of the current biennium and for the following biennium. 44.7(b) The adjustments the commissioner shall use must be implemented in this order new text begin , new text end 44.8 new text begin but shall not be implemented before July 1, 2014 new text end : first, stop enrollment of single adults 44.9and households without children; new text begin and new text end second, upon 45 days' notice, stop coverage of 44.10single adults and households without children already enrolled in the MinnesotaCare 44.11program; third, upon 90 days' notice, decrease the premium subsidy amounts by ten 44.12percent for families with gross annual income above 200 percent of the federal poverty 44.13guidelines; fourth, upon 90 days' notice, decrease the premium subsidy amounts by ten 44.14percent for families with gross annual income at or below 200 percent; and fifth, require 44.15applicants to be uninsured for at least six months prior to eligibility in the MinnesotaCare 44.16program. If these measures are insufficient to limit the expenditures to the estimated 44.17amount of revenue, the commissioner shall further limit enrollment or decrease premium 44.18subsidies new text begin notify the chairs of the house of representatives Ways and Means Committee and new text end 44.19 new text begin the senate Finance Committee, and the Legislative Commission on Health Care Access, new text end 44.20 new text begin and present recommendations to the chairs and commission for limiting expenditures to new text end 44.21 new text begin the estimated amount of revenue new text end . 44.22 new text begin EFFECTIVE DATE. new text end new text begin This section is effective upon federal approval of the new text end 44.23 new text begin amendments in this article to Minnesota Statutes, sections 256B.055, subdivision 15, and new text end 44.24 new text begin 256B.056, subdivision 4. new text end 44.25    Sec. 39. Minnesota Statutes 2008, section 256L.03, subdivision 3, is amended to read: 44.26    Subd. 3. Inpatient hospital services. (a) Covered health services shall include 44.27inpatient hospital services, including inpatient hospital mental health services and inpatient 44.28hospital and residential chemical dependency treatment, subject to those limitations 44.29necessary to coordinate the provision of these services with eligibility under the medical 44.30assistance spenddown. The inpatient hospital benefit for adult enrollees who qualify under 44.31section 256L.04, subdivision 7, or who qualify under section 256L.04, subdivisions 1 and 44.322 , with family gross income that exceeds 200 percent of the federal poverty guidelines or 44.33215 percent of the federal poverty guidelines on or after July 1, 2009, and who are not 44.34pregnant, is subject to an annual limit of $10,000 new text begin , unless supplemental hospital coverage new text end 44.35 new text begin has been purchased under subdivision 3c new text end . 45.1    (b) Admissions for inpatient hospital services paid for under section 256L.11, 45.2subdivision 3 , must be certified as medically necessary in accordance with Minnesota 45.3Rules, parts 9505.0500 to 9505.0540, except as provided in clauses (1) and (2): 45.4    (1) all admissions must be certified, except those authorized under rules established 45.5under section 254A.03, subdivision 3, or approved under Medicare; and 45.6    (2) payment under section 256L.11, subdivision 3, shall be reduced by five percent 45.7for admissions for which certification is requested more than 30 days after the day of 45.8admission. The hospital may not seek payment from the enrollee for the amount of the 45.9payment reduction under this clause. 45.10 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2011, or upon federal new text end 45.11 new text begin approval, whichever is later. new text end 45.12    Sec. 40. Minnesota Statutes 2008, section 256L.03, is amended by adding a subdivision 45.13to read: 45.14     new text begin Subd. 3c. new text end new text begin Supplemental hospital coverage. new text end new text begin (a) Effective January 1, 2011, or upon new text end 45.15 new text begin federal approval, whichever is later, the commissioner shall offer all MinnesotaCare new text end 45.16 new text begin applicants, and all enrollees during the open enrollment periods specified in paragraph new text end 45.17 new text begin (b), the opportunity to purchase at full cost, supplemental hospital coverage to cover new text end 45.18 new text begin inpatient hospital expenses in excess of the inpatient hospital annual limit established new text end 45.19 new text begin under subdivision 3. Premiums for this coverage may vary only for age and shall be new text end 45.20 new text begin collected by the commissioner using the procedures established for the sliding scale new text end 45.21 new text begin premium determined under section 256L.15. new text end 45.22 new text begin (b) The commissioner shall notify all persons submitting applications of the option to new text end 45.23 new text begin purchase this coverage at the time of application. The commissioner shall provide persons new text end 45.24 new text begin enrolled in MinnesotaCare on the effective date of this subdivision with the opportunity to new text end 45.25 new text begin purchase this supplemental coverage during an initial open enrollment period. Following new text end 45.26 new text begin this initial open enrollment period, the commissioner shall provide all enrollees with the new text end 45.27 new text begin opportunity to purchase this supplemental coverage during an annual open enrollment new text end 45.28 new text begin period during the month of November with coverage to take effect the following January 1. new text end 45.29    Sec. 41. Minnesota Statutes 2009 Supplement, section 256L.03, subdivision 5, is 45.30amended to read: 45.31    Subd. 5. Co-payments and coinsurance. (a) Except as provided in paragraphs (b) 45.32and (c), the MinnesotaCare benefit plan shall include the following co-payments and 45.33coinsurance requirements for all enrollees: 46.1    (1) ten percent of the paid charges for inpatient hospital services for adult enrollees, 46.2subject to an annual inpatient out-of-pocket maximum of $1,000 per individual; 46.3    (2) $3 per prescription for adult enrollees; 46.4    (3) $25 for eyeglasses for adult enrollees; 46.5    (4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an 46.6episode of service which is required because of a recipient's symptoms, diagnosis, or 46.7established illness, and which is delivered in an ambulatory setting by a physician or 46.8physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse, 46.9audiologist, optician, or optometrist; and 46.10    (5) $6 for nonemergency visits to a hospital-based emergency room new text begin for services new text end 46.11 new text begin provided through December 31, 2010, and $3.50 effective January 1, 2011 new text end . 46.12    (b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of 46.13children under the age of 21. 46.14    (c) Paragraph (a) does not apply to pregnant women and children under the age of 21. 46.15    (d) Paragraph (a), clause (4), does not apply to mental health services. 46.16    (e) Adult enrollees with family gross income that exceeds 200 percent of the federal 46.17poverty guidelines or 215 percent of the federal poverty guidelines on or after July 1, 2009, 46.18and who are not pregnant shall be financially responsible for the coinsurance amount, if 46.19applicable, and new text begin if supplemental coverage has not been purchased under subdivision 3c, new text end 46.20amounts which exceed the $10,000 inpatient hospital benefit limit. 46.21    (f) When a MinnesotaCare enrollee becomes a member of a prepaid health plan, 46.22or changes from one prepaid health plan to another during a calendar year, any charges 46.23submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket 46.24expenses incurred by the enrollee for inpatient services, that were submitted or incurred 46.25prior to enrollment, or prior to the change in health plans, shall be disregarded. 46.26 new text begin (g) MinnesotaCare reimbursement to fee-for-service providers and payments to new text end 46.27 new text begin managed care plans shall not be increased as a result of the reduction of the co-payments new text end 46.28 new text begin in paragraph (a), clause (5), effective January 1, 2011. new text end 46.29 new text begin EFFECTIVE DATE. new text end new text begin The amendment to paragraph (e) is effective January 1, 2011, new text end 46.30 new text begin or upon federal approval, whichever is later. new text end 46.31    Sec. 42. Minnesota Statutes 2008, section 256L.05, is amended by adding a subdivision 46.32to read: 46.33     new text begin Subd. 6. new text end new text begin Disclosure statement for inpatient hospital limit. new text end new text begin The commissioner new text end 46.34 new text begin shall develop, and include with MinnesotaCare application and renewal materials, a new text end 46.35 new text begin disclosure statement that contains the following or similar language: "For adults without new text end 47.1 new text begin children, and for parents and relative caretakers with family gross income that exceeds new text end 47.2 new text begin 215 percent of the federal poverty guidelines, who are not pregnant, coverage of inpatient new text end 47.3 new text begin hospital services under MinnesotaCare is subject to an annual limit of $10,000. Enrollees new text end 47.4 new text begin subject to the limit may be responsible for inpatient hospital costs that exceed the $10,000 new text end 47.5 new text begin annual limit." new text end 47.6    Sec. 43. Minnesota Statutes 2008, section 256L.07, is amended by adding a subdivision 47.7to read: 47.8     new text begin Subd. 9. new text end new text begin Firefighters; volunteer ambulance attendants. new text end new text begin (a) For purposes of this new text end 47.9 new text begin subdivision, "qualified individual" means: new text end 47.10 new text begin (1) a volunteer firefighter with a department as defined in section 299N.01, new text end 47.11 new text begin subdivision 2, who has passed the probationary period; and new text end 47.12 new text begin (2) a volunteer ambulance attendant as defined in section 144E.001, subdivision 15. new text end 47.13 new text begin (b) A qualified individual who documents to the satisfaction of the commissioner new text end 47.14 new text begin status as a qualified individual by completing and submitting a one-page form developed new text end 47.15 new text begin by the commissioner is eligible for MinnesotaCare without meeting other eligibility new text end 47.16 new text begin requirements of this chapter, but must pay premiums equal to the average expected new text end 47.17 new text begin capitation rate for adults with no children paid under section 256L.12. Individuals eligible new text end 47.18 new text begin under this subdivision shall receive coverage for the benefit set provided to adults with no new text end 47.19 new text begin children. new text end 47.20    Sec. 44. Minnesota Statutes 2009 Supplement, section 256L.11, subdivision 1, is 47.21amended to read: 47.22    Subdivision 1. Medical assistance rate to be used. (a) Payment to providers under 47.23sections 256L.01 to 256L.11 shall be at the same rates and conditions established for 47.24medical assistance, except as provided in subdivisions 2 to 6. 47.25(b) Effective for services provided on or after July 1, 2009, total payments for basic 47.26care services shall be reduced by three percent, in accordance with section 256B.766. 47.27Payments made to managed care and county-based purchasing plans shall be reduced for 47.28services provided on or after October 1, 2009, to reflect this reduction. 47.29(c) Effective for services provided on or after July 1, 2009, payment rates for 47.30physician and professional services shall be reduced as described under section 256B.76, 47.31subdivision 1, paragraph (c). Payments made to managed care and county-based 47.32purchasing plans shall be reduced for services provided on or after October 1, 2009, 47.33to reflect this reduction. 48.1 new text begin (d) Effective for services provided on or after July 1, 2010, payment rates for new text end 48.2 new text begin physician and professional services shall be reduced as described under section 256B.76, new text end 48.3 new text begin subdivision 1, paragraph (d). Payments made to managed care plans and county-based new text end 48.4 new text begin purchasing plans shall be reduced for services provided on or after October 1, 2010, new text end 48.5 new text begin to reflect this reduction. new text end 48.6    Sec. 45. Minnesota Statutes 2008, section 256L.12, subdivision 5, is amended to read: 48.7    Subd. 5. Eligibility for other state programs. MinnesotaCare enrollees who 48.8become eligible for medical assistance or general assistance medical care will remain in 48.9the same managed care plan if the managed care plan has a contract for that population. 48.10Effective January 1, 1998, MinnesotaCare enrollees who were formerly eligible for 48.11general assistance medical care pursuant to section 256D.03, subdivision 3, within six 48.12months of MinnesotaCare enrollment and were enrolled in a prepaid health plan pursuant 48.13to section 256D.03, subdivision 4, paragraph (c), must remain in the same managed care 48.14plan if the managed care plan has a contract for that population. Managed care plans must 48.15participate in the MinnesotaCare and general assistance medical care programs new text begin program new text end 48.16under a contract with the Department of Human Services in service areas where they 48.17participate in the medical assistance program. 48.18 new text begin EFFECTIVE DATE. new text end new text begin This section is effective retroactively from April 1, 2010. new text end 48.19    Sec. 46. Minnesota Statutes 2008, section 256L.12, subdivision 6, is amended to read: 48.20    Subd. 6. Co-payments and benefit limits. Enrollees are responsible for all 48.21co-payments in sections 256L.03, subdivision 5, and 256L.035, and shall pay co-payments 48.22to the managed care plan or to its participating providers. The enrollee is also responsible 48.23for payment of inpatient hospital charges which exceed the MinnesotaCare benefit limit new text begin , new text end 48.24 new text begin unless supplemental hospital coverage has been purchased under subdivision 3c new text end . 48.25 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2011, or upon federal new text end 48.26 new text begin approval, whichever is later. new text end 48.27    Sec. 47. Minnesota Statutes 2008, section 256L.12, subdivision 9, is amended to read: 48.28    Subd. 9. Rate setting; performance withholds. (a) Rates will be prospective, 48.29per capita, where possible. The commissioner may allow health plans to arrange for 48.30inpatient hospital services on a risk or nonrisk basis. The commissioner shall consult with 48.31an independent actuary to determine appropriate rates. 49.1    (b) For services rendered on or after January 1, 2003, to December 31, 2003, the 49.2commissioner shall withhold .5 percent of managed care plan payments under this section 49.3pending completion of performance targets. The withheld funds must be returned no 49.4sooner than July 1 and no later than July 31 of the following year if performance targets 49.5in the contract are achieved. A managed care plan may include as admitted assets under 49.6section 62D.044 any amount withheld under this paragraph that is reasonably expected 49.7to be returned. 49.8    (c) For services rendered on or after January 1, 2004, the commissioner shall 49.9withhold five percent of managed care plan payments under this section pending 49.10completion of performance targets. Each performance target must be quantifiable, 49.11objective, measurable, and reasonably attainable, except in the case of a performance target 49.12based on a federal or state law or rule. Criteria for assessment of each performance target 49.13must be outlined in writing prior to the contract effective date. The managed care plan 49.14must demonstrate, to the commissioner's satisfaction, that the data submitted regarding 49.15attainment of the performance target is accurate. The commissioner shall periodically 49.16change the administrative measures used as performance targets in order to improve plan 49.17performance across a broader range of administrative services. The performance targets 49.18must include measurement of plan efforts to contain spending on health care services and 49.19administrative activities. The commissioner may adopt plan-specific performance targets 49.20that take into account factors affecting only one plan, such as characteristics of the plan's 49.21enrollee population. The withheld funds must be returned no sooner than July 1 and no 49.22later than July 31 of the following calendar year if performance targets in the contract are 49.23achieved. A managed care plan or a county-based purchasing plan under section 256B.692 49.24may include as admitted assets under section any amount withheld under this 49.25paragraph that is reasonably expected to be returned. 49.26 new text begin (d) For services rendered on or after January 1, 2011, the commissioner shall new text end 49.27 new text begin withhold an additional three percent of managed care plan payments under this section. new text end 49.28 new text begin The withheld funds must be returned no sooner than July 1, and no later than July 31 of new text end 49.29 new text begin the following calendar year. The return of the withhold under this paragraph is not subject new text end 49.30 new text begin to the requirements of paragraph (b) or (c). new text end 49.31 new text begin (e) A managed care plan or a county-based purchasing plan under section 256B.692 new text end 49.32 new text begin may include as admitted assets under section 62D.044 any amount withheld under this new text end 49.33 new text begin section. new text end 49.34    Sec. 48. Laws 2009, chapter 79, article 5, section 78, subdivision 5, is amended to read: 50.1    Subd. 5. Expiration. This section new text begin , with the exception of subdivision 4, new text end expires 50.2December 31, 2010 new text begin June 30, 2011. Subdivision 4 expires December 31, 2011 new text end . 50.3    Sec. 49. Laws 2010, chapter 200, article 1, section 12, subdivision 6, is amended to 50.4read: 50.5    Subd. 6. Coordinated care delivery systems. (a) Effective June 1, 2010, the 50.6commissioner shall contract with hospitals or groups of hospitals that qualify under 50.7paragraph (b) and agree to deliver services according to this subdivision. Contracting 50.8hospitals shall develop and implement a coordinated care delivery system to provide health 50.9care services to individuals who are eligible for general assistance medical care under this 50.10section and who either choose to receive services through the coordinated care delivery 50.11system or who are enrolled by the commissioner under paragraph (c). new text begin A contracting new text end 50.12 new text begin hospital may negotiate a limit to the number of general assistance medical care enrollees it new text end 50.13 new text begin serves, but must comply with the emergency care requirements of United States Code, title new text end 50.14 new text begin 42, 1395dd (EMTALA). new text end The health care services provided by the system must include: 50.15(1) the services described in subdivision 4 with the exception of outpatient prescription 50.16drug coverage but shall include drugs administered in a clinic or other outpatient setting; 50.17or (2) a set of comprehensive and medically necessary health services that the recipients 50.18might reasonably require to be maintained in good health and that has been approved by 50.19the commissioner, including at a minimum, but not limited to, emergency care, medical 50.20transportation services, inpatient hospital and physician care, outpatient health services, 50.21preventive health services, mental health services, and prescription drugs administered 50.22in a clinic or other outpatient setting. Outpatient prescription drug coverage is covered 50.23on a fee-for-service basis in accordance with section 256D.03, subdivision 3, and funded 50.24under subdivision 9. A hospital establishing a coordinated care delivery system under this 50.25subdivision must ensure that the requirements of this subdivision are met. 50.26(b) A hospital or group of hospitals may contract with the commissioner to develop 50.27and implement a coordinated care delivery system as follows: 50.28(1) effective June 1, 2010, a hospital qualifies under this subdivision if: (i) during 50.29calendar year 2008, it received fee-for-service payments for services to general assistance 50.30medical care recipients (A) equal to or greater than $1,500,000, or (B) equal to or greater 50.31than 1.3 percent of net patient revenue; or (ii) a contract with the hospital is necessary to 50.32provide geographic access or to ensure that at least 80 percent of enrollees have access to 50.33a coordinated care delivery system; and 51.1(2) effective December 1, 2010, a Minnesota hospital not qualified under clause 51.2(1) may contract with the commissioner under this subdivision if it agrees to satisfy the 51.3requirements of this subdivision. 51.4Participation by hospitals shall become effective quarterly on June 1, September 1, 51.5December 1, or March 1. Hospital participation is effective for a period of 12 months and 51.6may be renewed for successive 12-month periods. 51.7 new text begin Coordinated care delivery system contracts are in effect from June 1, 2010, to new text end 51.8 new text begin December 31, 2010, or upon the effective date of the expansion of medical assistance new text end 51.9 new text begin coverage to include adults without children, whichever is later. new text end 51.10(c) Applicants and recipients may enroll in any available coordinated care delivery 51.11system statewide. If more than one coordinated care delivery system is available, the 51.12applicant or recipient shall be allowed to choose among the systems new text begin that provide services new text end 51.13 new text begin within 25 miles of the individual's community of residence new text end . The commissioner may assign 51.14an applicant or recipient to a coordinated care delivery system new text begin that provides services new text end 51.15 new text begin within 25 miles of the individual's community of residence, new text end if no choice is made by the 51.16applicant or recipient. The commissioner shall consider a recipient's zip code, city of 51.17residence, county of residence, or distance from a participating coordinated care delivery 51.18system when determining default assignment. An applicant or recipient may decline 51.19enrollment in a coordinated care delivery system. Upon enrollment into a coordinated care 51.20delivery system, the recipient must agree to receive all nonemergency services through the 51.21coordinated care delivery system. Enrollment in a coordinated care delivery system is 51.22for six months and may be renewed for additional six-month periods, except that initial 51.23enrollment is for six months or until the end of a recipient's period of general assistance 51.24medical care eligibility, whichever occurs first. A recipient who continues to meet the 51.25eligibility requirements of this section is not eligible to enroll in MinnesotaCare during 51.26a period of enrollment in a coordinated care delivery system. From June 1, 2010, to 51.27November 30, 2010, applicants and recipients not enrolled in a coordinated care delivery 51.28system may seek services from a hospital eligible for reimbursement under the temporary 51.29uncompensated care pool established under subdivision 8. After November 30, 2010, 51.30services are available only through a coordinated care delivery system. 51.31(d) new text begin A hospital must provide access to cost-effective outpatient services available new text end 51.32 new text begin in its service area. new text end The hospital may contract and coordinate with providers and clinics 51.33for the delivery of services and shall contract with new text begin federally qualified health centers and new text end 51.34essential community providers as defined under section 62Q.19, subdivision 1, paragraph 51.35(a), clauses (1) and (2), to the extent practicable. If a provider or clinic contracts with a 51.36hospital to provide services through the coordinated care delivery system, the provider 52.1may not refuse to provide services to any recipient enrolled in the system, and payment for 52.2services shall be negotiated with the hospital and paid by the hospital from the system's 52.3allocation under subdivision 7. 52.4(e) A coordinated care delivery system must: 52.5(1) provide the covered services required under paragraph (a) to recipients enrolled 52.6in the coordinated care delivery system, and comply with the requirements of subdivision 52.74, paragraphs (b) to (g); 52.8(2) establish a process to monitor enrollment and ensure the quality of care provided; 52.9and 52.10(3) in cooperation with counties, coordinate the delivery of health care services with 52.11existing homeless prevention, supportive housing, and rent subsidy programs and funding 52.12administered by the Minnesota Housing Finance Agency under chapter 462A; and 52.13(4) adopt innovative and cost-effective methods of care delivery and coordination, 52.14which may include the use of allied health professionals, telemedicine, patient educators, 52.15care coordinators, and community health workers. 52.16(f) The hospital may require a recipient to designate a primary care provider or 52.17a primary care clinic. The hospital may limit the delivery of services to a network of 52.18providers who have contracted with the hospital to deliver services in accordance with 52.19this subdivision, and require a recipient to seek services only within this network. The 52.20hospital may also require a referral to a provider before the service is eligible for payment. 52.21A coordinated care delivery system is not required to provide payment to a provider who 52.22is not employed by or under contract with the system for services provided to a recipient 52.23enrolled in the system, except in cases of an emergency. For purposes of this section, 52.24emergency services are defined in accordance with Code of Federal Regulations, title 52.2542, section 438.114 (a). 52.26(g) A recipient enrolled in a coordinated care delivery system has the right to appeal 52.27to the commissioner according to section 256.045. 52.28(h) The state shall not be liable for the payment of any cost or obligation incurred 52.29by the coordinated care delivery system. 52.30(i) The hospital must provide the commissioner with data necessary for assessing 52.31enrollment, quality of care, cost, and utilization of services. Each hospital must provide, 52.32on a quarterly basis on a form prescribed by the commissioner for each recipient served by 52.33the coordinated care delivery system, the services provided, the cost of services provided, 52.34and the actual payment amount for the services provided and any other information the 52.35commissioner deems necessary to claim federal Medicaid match. The commissioner must 52.36provide this data to the legislature on a quarterly basis. 53.1(j) Effective June 1, 2010, the provisions of section 256.9695, subdivision 2, 53.2paragraph (b), do not apply to general assistance medical care provided under this section. 53.3 new text begin (k) If a recipient is transferred from a hospital that is not participating in a new text end 53.4 new text begin coordinated care delivery system to a hospital participating in a coordinated care delivery new text end 53.5 new text begin system, in order to receive a higher level of care, the transferring hospital remains eligible new text end 53.6 new text begin to receive any available funding through the temporary uncompensated care pool for the new text end 53.7 new text begin care initially provided at that hospital. The hospital participating in the coordinated care new text end 53.8 new text begin delivery system shall be responsible only for care provided at that hospital, and is not new text end 53.9 new text begin financially liable for the initial care provided by the transferring hospital. new text end 53.10    Sec. 50. Laws 2010, chapter 200, article 1, section 12, subdivision 7, is amended to 53.11read: 53.12    Subd. 7. Payments; rate setting for the hospital coordinated care delivery 53.13system. (a) Effective for general assistance medical care services, with the exception 53.14of outpatient prescription drug coverage, provided on or after June 1, 2010, through a 53.15coordinated care delivery system, the commissioner shall allocate the annual appropriation 53.16for the coordinated care delivery system to hospitals participating under subdivision 53.176 in quarterly payments, beginning on the first scheduled warrant on or after June 1, 53.182010. The payment shall be allocated among all hospitals qualified to participate on the 53.19allocation date. Each hospital or group of hospitals shall receive a pro rata share of the 53.20allocation based on the hospital's or group of hospitals' calendar year 2008 payments for 53.21general assistance medical care services, new text begin adjusted for any limits on the number of general new text end 53.22 new text begin assistance medical care enrollees accepted by a hospital, new text end provided that, for the purposes of 53.23this allocation, payments to Hennepin County Medical Center, Regions Hospital, Saint 53.24Mary's Medical Center, and University of Minnesota Medical Center, Fairview, shall be 53.25weighted at 110 percent of the actual amount. The commissioner may prospectively 53.26reallocate payments to participating hospitals on a biannual basis to ensure that final 53.27allocations reflect actual coordinated care delivery system enrollment. The 2008 base year 53.28shall be updated by one calendar year each June 1, beginning June 1, 2011. 53.29 new text begin (b) Beginning June 1, 2010, and every quarter beginning in June thereafter, the new text end 53.30 new text begin commissioner shall make one-third of the quarterly payment in June and the remaining new text end 53.31 new text begin two-thirds of the quarterly payment in July to each participating hospital or group of new text end 53.32 new text begin hospitals. new text end 53.33(b) new text begin (c) new text end In order to be reimbursed under this section, nonhospital providers of health 53.34care services shall contract with one or more hospitals described in paragraph (a) to 53.35provide services to general assistance medical care recipients through the coordinated care 54.1delivery system established by the hospital. The hospital shall reimburse bills submitted 54.2by nonhospital providers participating under this paragraph at a rate negotiated between 54.3the hospital and the nonhospital provider. 54.4(c) new text begin (d) new text end The commissioner shall apply for federal matching funds under section 54.5256B.199 , paragraphs (a) to (d), for expenditures under this subdivision. 54.6(d) new text begin (e) new text end Outpatient prescription drug coverage is provided in accordance with section 54.7256D.03, subdivision 3 , and paid on a fee-for-service basis under subdivision 9. 54.8    Sec. 51. Laws 2010, chapter 200, article 1, section 12, subdivision 8, is amended to 54.9read: 54.10    Subd. 8. Temporary uncompensated care pool. (a) The commissioner shall 54.11establish a temporary uncompensated care pool, effective June 1, 2010. Payments from 54.12the pool must be distributed, within the limits of the available appropriation, to hospitals 54.13that are not part of a coordinated care delivery system established under subdivision 54.146. new text begin Payments from the pool must also be distributed, within the limits of the available new text end 54.15 new text begin appropriation, to ambulance services licensed under chapter 144E that respond to a request new text end 54.16 new text begin for an emergency ambulance call or interfacility transfer for a general assistance medical new text end 54.17 new text begin care enrollee, if the call or transfer originates from a location more than 25 miles from the new text end 54.18 new text begin health care facility that receives the enrollee. new text end 54.19(b) Hospitals seeking reimbursement from this pool must submit an invoice to 54.20the commissioner in a form prescribed by the commissioner for payment for services 54.21provided to an applicant or recipient not enrolled in a coordinated care delivery system. A 54.22payment amount, as calculated under current law, must be determined, but not paid, for 54.23each admission of or service provided to a general assistance medical care recipient on 54.24or after June 1, 2010, to November 30 new text begin December 31 new text end , 2010 new text begin , or until medical assistance new text end 54.25 new text begin coverage is expanded to include adults without children, whichever is later new text end . 54.26(c) The aggregated payment amounts for each hospital must be calculated as a 54.27percentage of the total calculated amount for all hospitals. 54.28(d) Distributions from the uncompensated care pool for each hospital must be 54.29determined by multiplying the factor in paragraph (c) by the amount of money in the 54.30uncompensated care pool that is available for the six-month period. 54.31(e) The commissioner shall apply for federal matching funds under section 54.32256B.199 , paragraphs (a) to (d), for expenditures under this subdivision. 54.33(f) Outpatient prescription drugs are not eligible for payment under this subdivision. 55.1    Sec. 52. Laws 2010, chapter 200, article 1, section 12, the effective date, is amended to 55.2read: 55.3EFFECTIVE DATE.This section is effective for services rendered on or after 55.4April 1, 2010 new text begin , except that subdivision 4 is effective June 1, 2010 new text end . 55.5 new text begin EFFECTIVE DATE. new text end new text begin This section is effective retroactively from April 1, 2010. new text end 55.6    Sec. 53. Laws 2010, chapter 200, article 1, section 16, is amended to read: 55.7    Sec. 16. Minnesota Statutes 2008, section 256L.05, subdivision 3c, is amended to 55.8read: 55.9    Subd. 3c. Retroactive coverage. Notwithstanding subdivision 3, the effective 55.10date of coverage shall be the first day of the month following termination from medical 55.11assistance for families and individuals who are eligible for MinnesotaCare and who 55.12submitted a written request for retroactive MinnesotaCare coverage with a completed 55.13application within 30 days of the mailing of notification of termination from medical 55.14assistance. The applicant must provide all required verifications within 30 days of the 55.15written request for verification. For retroactive coverage, premiums must be paid in full 55.16for any retroactive month, current month, and next month within 30 days of the premium 55.17billing. General assistance medical care recipients may qualify for retroactive coverage 55.18under this subdivision at six-month renewal. 55.19 new text begin EFFECTIVE DATE. new text end new text begin This section is effective June 1, 2010. new text end 55.20    Sec. 54. Laws 2010, chapter 200, article 1, section 21, is amended to read: 55.21    Sec. 21. REPEALER. 55.22(a) Minnesota Statutes 2008, sections 256.742; 256.979, subdivision 8; and 256D.03, 55.23subdivision 9, are repealed effective April 1, 2010. 55.24(b) Minnesota Statutes 2009 Supplement, section 256D.03, subdivision 4, is repealed 55.25effective April new text begin June new text end 1, 2010. 55.26(c) Minnesota Statutes 2008, section 256B.195, subdivisions 4 and 5, are repealed 55.27effective for federal fiscal year 2010. 55.28(d) Minnesota Statutes 2009 Supplement, section 256B.195, subdivisions 1, 2, and 55.293, are repealed effective for federal fiscal year 2010. 55.30(e) Minnesota Statutes 2008, sections 256L.07, subdivision 6; 256L.15, subdivision 55.314; and 256L.17, subdivision 7, are repealed January 1, 2011. 55.32 new text begin EFFECTIVE DATE. new text end new text begin This section is effective retroactively from April 1, 2010. new text end 56.1    Sec. 55. Laws 2010, chapter 200, article 2, section 2, subdivision 1, is amended to read: 56.2 Subdivision 1.Total Appropriation$(7,985,000)$(93,128,000) 56.3 Appropriations by Fund 56.4 2010 2011 56.5 General 34,807,000 118,493,000 56.6 Health Care Access (42,792,000) (211,621,000) 56.7The amounts that may be spent for each 56.8purpose are specified in the following 56.9subdivisions. 56.10 new text begin Special Revenue Fund Transfers. new text end 56.11 new text begin (1) The commissioner shall transfer the new text end 56.12 new text begin following amounts from special revenue new text end 56.13 new text begin fund balances to the general fund by June new text end 56.14 new text begin 30 of each respective fiscal year: $410,000 new text end 56.15 new text begin for fiscal year 2010, and $412,000 for fiscal new text end 56.16 new text begin year 2011. new text end 56.17 new text begin (2) Actual transfers made under clause (1) new text end 56.18 new text begin must be separately identified and reported as new text end 56.19 new text begin part of the quarterly reporting of transfers new text end 56.20 new text begin to the chairs of the relevant senate budget new text end 56.21 new text begin division and house of representatives finance new text end 56.22 new text begin division. new text end 56.23 new text begin EFFECTIVE DATE. new text end new text begin This section is effective the day following final enactment. new text end 56.24    Sec. 56. Laws 2010, chapter 200, article 2, section 2, subdivision 8, is amended to read: 56.25 Subd. 8.Transfers56.26The commissioner must transfer $29,538,000 56.27in fiscal year 2010 and $18,462,000 in fiscal 56.28year 2011 from the health care access fund to 56.29the general fund. This is a onetime transfer. 56.30The commissioner must transfer $4,800,000 56.31from the consolidated chemical dependency 56.32treatment fund to the general fund by June 56.3330, 2010. 57.1Compulsive Gambling Special Revenue 57.2Administration. new text begin The lottery prize fund new text end 57.3 new text begin appropriation for compulsive gambling new text end 57.4 new text begin administration is reduced by new text end $6,000 for fiscal 57.5year 2010 and $4,000 for fiscal year 2011 57.6must be transferred from the lottery prize 57.7fund appropriation for compulsive gambling 57.8administration to the general fund by June 57.930 of each respective fiscal year. new text begin These are new text end 57.10 new text begin onetime reductions. new text end 57.11 new text begin EFFECTIVE DATE. new text end new text begin This section is effective the day following final enactment. new text end 57.12    Sec. 57. new text begin EARLY EXPANSION. new text end 57.13 new text begin All costs related to implementation of Minnesota Statutes, sections 256B.055, new text end 57.14 new text begin subdivision 15, and 256B.056, subdivision 4, paragraph (e), shall be paid from the health new text end 57.15 new text begin care access fund. new text end 57.16 new text begin EFFECTIVE DATE. new text end new text begin This section is effective upon federal approval and is new text end 57.17 new text begin retroactive to April 1, 2010. new text end 57.18    Sec. 58. new text begin FISCAL AND ACTUARIAL ANALYSIS. new text end 57.19 new text begin The commissioner of human services shall offer a request for proposal and accept new text end 57.20 new text begin bids for the completion of a complete fiscal and actuarial analysis of 2010 House File 135 new text end 57.21 new text begin and 2010 Senate File 118. The commissioner shall report this analysis to the chairs of the new text end 57.22 new text begin health and human services finance and policy divisions in the house of representatives and new text end 57.23 new text begin senate no later than December 15, 2010. new text end 57.24    Sec. 59. new text begin REPEALER; TRANSFER. new text end 57.25 new text begin (a) Laws 2010, chapter 200, article 1, section 12, subdivisions 1, 2, 3, 4, 5, 6, 7, 8, new text end 57.26 new text begin and 9, new text end new text begin are repealed. new text end 57.27 new text begin (b) Laws 2010, chapter 200, article 1, sections 18; and 19, new text end new text begin are repealed. new text end 57.28 new text begin (c) Minnesota Statutes 2008, section 256D.03, subdivisions 3a, 3b, 5, 6, 7, and 8, new text end new text begin new text end 57.29 new text begin and new text end new text begin Minnesota Statutes 2009 Supplement, section 256D.03, subdivision 3, new text end new text begin are repealed. new text end 57.30 new text begin EFFECTIVE DATE. new text end new text begin Paragraphs (a) and (b) are effective 30 days after federal new text end 57.31 new text begin approval of the amendments in this article to Minnesota Statutes, sections 256B.055, new text end 57.32 new text begin subdivision 15, and 256B.056, subdivision 4, or January 1, 2011, whichever is later, new text end 58.1 new text begin and all remaining unspent appropriations for the program established by Laws 2010, new text end 58.2 new text begin chapter 200, are transferred to the health care access fund. Paragraph (c) is effective new text end 58.3 new text begin 30 days after federal approval of the amendments in this article to Minnesota Statutes, new text end 58.4 new text begin sections 256B.055, subdivision 15, and 256B.056, subdivision 4, or January 1, 2011, new text end 58.5 new text begin whichever is later. new text end 58.6ARTICLE 3 58.7CONTINUING CARE 58.8    Section 1. Minnesota Statutes 2009 Supplement, section 252.27, subdivision 2a, 58.9is amended to read: 58.10    Subd. 2a. Contribution amount. (a) The natural or adoptive parents of a minor 58.11child, including a child determined eligible for medical assistance without consideration of 58.12parental income, must contribute to the cost of services used by making monthly payments 58.13on a sliding scale based on income, unless the child is married or has been married, 58.14parental rights have been terminated, or the child's adoption is subsidized according to 58.15section 259.67 or through title IV-E of the Social Security Act. The parental contribution 58.16is a partial or full payment for medical services provided for diagnostic, therapeutic, 58.17curing, treating, mitigating, rehabilitation, maintenance, and personal care services as 58.18defined in United States Code, title 26, section 213, needed by the child with a chronic 58.19illness or disability. 58.20    (b) For households with adjusted gross income equal to or greater than 100 percent 58.21of federal poverty guidelines, the parental contribution shall be computed by applying the 58.22following schedule of rates to the adjusted gross income of the natural or adoptive parents: 58.23    (1) if the adjusted gross income is equal to or greater than 100 percent of federal 58.24poverty guidelines and less than 175 percent of federal poverty guidelines, the parental 58.25contribution is $4 per month; 58.26    (2) if the adjusted gross income is equal to or greater than 175 percent of federal 58.27poverty guidelines and less than or equal to 545 percent of federal poverty guidelines, 58.28the parental contribution shall be determined using a sliding fee scale established by the 58.29commissioner of human services which begins at one percent of adjusted gross income 58.30at 175 percent of federal poverty guidelines and increases to 7.5 percent of adjusted 58.31gross income for those with adjusted gross income up to 545 percent of federal poverty 58.32guidelines; new text begin and new text end 58.33    (3) if the adjusted gross income is greater than 545 percent of federal poverty 58.34guidelines and less than 675 percent of federal poverty guidelines, the parental 58.35contribution shall be 7.5 new text begin 12.5 new text end percent of adjusted gross income; new text begin . new text end 59.1    (4) if the adjusted gross income is equal to or greater than 675 percent of federal 59.2poverty guidelines and less than 975 percent of federal poverty guidelines, the parental 59.3contribution shall be determined using a sliding fee scale established by the commissioner 59.4of human services which begins at 7.5 percent of adjusted gross income at 675 percent of 59.5federal poverty guidelines and increases to ten percent of adjusted gross income for those 59.6with adjusted gross income up to 975 percent of federal poverty guidelines; and 59.7    (5) if the adjusted gross income is equal to or greater than 975 percent of federal 59.8poverty guidelines, the parental contribution shall be 12.5 percent of adjusted gross 59.9income. 59.10    If the child lives with the parent, the annual adjusted gross income is reduced by 59.11$2,400 prior to calculating the parental contribution. If the child resides in an institution 59.12specified in section 256B.35, the parent is responsible for the personal needs allowance 59.13specified under that section in addition to the parental contribution determined under this 59.14section. The parental contribution is reduced by any amount required to be paid directly to 59.15the child pursuant to a court order, but only if actually paid. 59.16    (c) The household size to be used in determining the amount of contribution under 59.17paragraph (b) includes natural and adoptive parents and their dependents, including the 59.18child receiving services. Adjustments in the contribution amount due to annual changes 59.19in the federal poverty guidelines shall be implemented on the first day of July following 59.20publication of the changes. 59.21    (d) For purposes of paragraph (b), "income" means the adjusted gross income of the 59.22natural or adoptive parents determined according to the previous year's federal tax form, 59.23except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds 59.24have been used to purchase a home shall not be counted as income. 59.25    (e) The contribution shall be explained in writing to the parents at the time eligibility 59.26for services is being determined. The contribution shall be made on a monthly basis 59.27effective with the first month in which the child receives services. Annually upon 59.28redetermination or at termination of eligibility, if the contribution exceeded the cost of 59.29services provided, the local agency or the state shall reimburse that excess amount to 59.30the parents, either by direct reimbursement if the parent is no longer required to pay a 59.31contribution, or by a reduction in or waiver of parental fees until the excess amount is 59.32exhausted. All reimbursements must include a notice that the amount reimbursed may be 59.33taxable income if the parent paid for the parent's fees through an employer's health care 59.34flexible spending account under the Internal Revenue Code, section 125, and that the 59.35parent is responsible for paying the taxes owed on the amount reimbursed. 60.1    (f) The monthly contribution amount must be reviewed at least every 12 months; 60.2when there is a change in household size; and when there is a loss of or gain in income 60.3from one month to another in excess of ten percent. The local agency shall mail a written 60.4notice 30 days in advance of the effective date of a change in the contribution amount. 60.5A decrease in the contribution amount is effective in the month that the parent verifies a 60.6reduction in income or change in household size. 60.7    (g) Parents of a minor child who do not live with each other shall each pay the 60.8contribution required under paragraph (a). An amount equal to the annual court-ordered 60.9child support payment actually paid on behalf of the child receiving services shall be 60.10deducted from the adjusted gross income of the parent making the payment prior to 60.11calculating the parental contribution under paragraph (b). 60.12    (h) The contribution under paragraph (b) shall be increased by an additional five 60.13percent if the local agency determines that insurance coverage is available but not 60.14obtained for the child. For purposes of this section, "available" means the insurance is a 60.15benefit of employment for a family member at an annual cost of no more than five percent 60.16of the family's annual income. For purposes of this section, "insurance" means health 60.17and accident insurance coverage, enrollment in a nonprofit health service plan, health 60.18maintenance organization, self-insured plan, or preferred provider organization. 60.19    Parents who have more than one child receiving services shall not be required 60.20to pay more than the amount for the child with the highest expenditures. There shall 60.21be no resource contribution from the parents. The parent shall not be required to pay 60.22a contribution in excess of the cost of the services provided to the child, not counting 60.23payments made to school districts for education-related services. Notice of an increase in 60.24fee payment must be given at least 30 days before the increased fee is due. 60.25    (i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if, 60.26in the 12 months prior to July 1: 60.27    (1) the parent applied for insurance for the child; 60.28    (2) the insurer denied insurance; 60.29    (3) the parents submitted a complaint or appeal, in writing to the insurer, submitted 60.30a complaint or appeal, in writing, to the commissioner of health or the commissioner of 60.31commerce, or litigated the complaint or appeal; and 60.32    (4) as a result of the dispute, the insurer reversed its decision and granted insurance. 60.33    For purposes of this section, "insurance" has the meaning given in paragraph (h). 60.34    A parent who has requested a reduction in the contribution amount under this 60.35paragraph shall submit proof in the form and manner prescribed by the commissioner or 60.36county agency, including, but not limited to, the insurer's denial of insurance, the written 61.1letter or complaint of the parents, court documents, and the written response of the insurer 61.2approving insurance. The determinations of the commissioner or county agency under this 61.3paragraph are not rules subject to chapter 14. 61.4    Sec. 2. Minnesota Statutes 2008, section 256B.057, subdivision 9, is amended to read: 61.5    Subd. 9. Employed persons with disabilities. (a) Medical assistance may be paid 61.6for a person who is employed and who: 61.7(1) new text begin but for excess earnings or assets, new text end meets the definition of disabled under the 61.8supplemental security income program; 61.9(2) is at least 16 but less than 65 years of age; 61.10(3) meets the asset limits in paragraph (c); and 61.11(4) effective November 1, 2003, pays a premium and other obligations under 61.12paragraph (e). 61.13Any spousal income or assets shall be disregarded for purposes of eligibility and premium 61.14determinations. 61.15(b) After the month of enrollment, a person enrolled in medical assistance under 61.16this subdivision who: 61.17(1) is temporarily unable to work and without receipt of earned income due to a 61.18medical condition, as verified by a physician, may retain eligibility for up to four calendar 61.19months; or 61.20(2) effective January 1, 2004, loses employment for reasons not attributable to the 61.21enrollee, may retain eligibility for up to four consecutive months after the month of job 61.22loss. To receive a four-month extension, enrollees must verify the medical condition or 61.23provide notification of job loss. All other eligibility requirements must be met and the 61.24enrollee must pay all calculated premium costs for continued eligibility. 61.25(c) For purposes of determining eligibility under this subdivision, a person's assets 61.26must not exceed $20,000, excluding: 61.27(1) all assets excluded under section 256B.056; 61.28(2) retirement accounts, including individual accounts, 401(k) plans, 403(b) plans, 61.29Keogh plans, and pension plans; and 61.30(3) medical expense accounts set up through the person's employer. 61.31(d)(1) Effective January 1, 2004, for purposes of eligibility, there will be a $65 61.32earned income disregard. To be eligible, a person applying for medical assistance under 61.33this subdivision must have earned income above the disregard level. 62.1(2) Effective January 1, 2004, to be considered earned income, Medicare, Social 62.2Security, and applicable state and federal income taxes must be withheld. To be eligible, 62.3a person must document earned income tax withholding. 62.4(e)(1) A person whose earned and unearned income is equal to or greater than 100 62.5percent of federal poverty guidelines for the applicable family size must pay a premium 62.6to be eligible for medical assistance under this subdivision. The premium shall be based 62.7on the person's gross earned and unearned income and the applicable family size using a 62.8sliding fee scale established by the commissioner, which begins at one percent of income 62.9at 100 percent of the federal poverty guidelines and increases to 7.5 percent of income 62.10for those with incomes at or above 300 percent of the federal poverty guidelines. Annual 62.11adjustments in the premium schedule based upon changes in the federal poverty guidelines 62.12shall be effective for premiums due in July of each year. 62.13(2) Effective January 1, 2004, all enrollees must pay a premium to be eligible for 62.14medical assistance under this subdivision. An enrollee shall pay the greater of a $35 new text begin $50 new text end 62.15premium or the premium calculated in clause (1). 62.16(3) Effective November 1, 2003, all enrollees who receive unearned income must 62.17pay one-half of one new text begin 2.5 new text end percent of unearned income in addition to the premium amount. 62.18(4) Effective November 1, 2003, for enrollees whose income does not exceed 200 62.19percent of the federal poverty guidelines and who are also enrolled in Medicare, the 62.20commissioner must reimburse the enrollee for Medicare Part B premiums under section 62.21256B.0625, subdivision 15 , paragraph (a). 62.22(5) Increases in benefits under title II of the Social Security Act shall not be counted 62.23as income for purposes of this subdivision until July 1 of each year. 62.24(f) A person's eligibility and premium shall be determined by the local county 62.25agency. Premiums must be paid to the commissioner. All premiums are dedicated to 62.26the commissioner. 62.27(g) Any required premium shall be determined at application and redetermined at 62.28the enrollee's six-month income review or when a change in income or household size is 62.29reported. Enrollees must report any change in income or household size within ten days 62.30of when the change occurs. A decreased premium resulting from a reported change in 62.31income or household size shall be effective the first day of the next available billing month 62.32after the change is reported. Except for changes occurring from annual cost-of-living 62.33increases, a change resulting in an increased premium shall not affect the premium amount 62.34until the next six-month review. 63.1(h) Premium payment is due upon notification from the commissioner of the 63.2premium amount required. Premiums may be paid in installments at the discretion of 63.3the commissioner. 63.4(i) Nonpayment of the premium shall result in denial or termination of medical 63.5assistance unless the person demonstrates good cause for nonpayment. Good cause exists 63.6if the requirements specified in Minnesota Rules, part 9506.0040, subpart 7, items B to 63.7D, are met. Except when an installment agreement is accepted by the commissioner, 63.8all persons disenrolled for nonpayment of a premium must pay any past due premiums 63.9as well as current premiums due prior to being reenrolled. Nonpayment shall include 63.10payment with a returned, refused, or dishonored instrument. The commissioner may 63.11require a guaranteed form of payment as the only means to replace a returned, refused, 63.12or dishonored instrument. 63.13 new text begin (j) The commissioner shall notify enrollees annually beginning at least 24 months new text end 63.14 new text begin before the person's 65th birthday of the medical assistance eligibility rules affecting new text end 63.15 new text begin income, assets, and treatment of a spouse's income and assets that will be applied upon new text end 63.16 new text begin reaching age 65. new text end 63.17 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2011. new text end 63.18    Sec. 3. Minnesota Statutes 2009 Supplement, section 256B.0915, subdivision 3a, 63.19is amended to read: 63.20    Subd. 3a. Elderly waiver cost limits. (a) The monthly limit for the cost of 63.21waivered services to an individual elderly waiver client except for individuals described 63.22in paragraph (b) shall be the weighted average monthly nursing facility rate of the case 63.23mix resident class to which the elderly waiver client would be assigned under Minnesota 63.24Rules, parts 9549.0050 to 9549.0059, less the recipient's maintenance needs allowance 63.25as described in subdivision 1d, paragraph (a), until the first day of the state fiscal year in 63.26which the resident assessment system as described in section 256B.438 for nursing home 63.27rate determination is implemented. Effective on the first day of the state fiscal year in 63.28which the resident assessment system as described in section 256B.438 for nursing home 63.29rate determination is implemented and the first day of each subsequent state fiscal year, the 63.30monthly limit for the cost of waivered services to an individual elderly waiver client shall 63.31be the rate of the case mix resident class to which the waiver client would be assigned 63.32under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect on the last day of the 63.33previous state fiscal year, adjusted by the greater of any legislatively adopted home and 63.34community-based services percentage rate increase or the average statewide percentage 63.35increase in nursing facility payment rates new text begin adjustment new text end . 64.1    (b) The monthly limit for the cost of waivered services to an individual elderly 64.2waiver client assigned to a case mix classification A under paragraph (a) with (1) no 64.3dependencies in activities of daily living, (2) only one dependency in bathing, dressing, 64.4grooming, or walking, or (3) a dependency score of less than three if eating is the only 64.5dependency, shall be the lower of the case mix classification amount for case mix A as 64.6determined under paragraph (a) or the case mix classification amount for case mix A 64.7effective on October 1, 2008, per month for all new participants enrolled in the program 64.8on or after July 1, 2009. This monthly limit shall be applied to all other participants who 64.9meet this criteria at reassessment. 64.10(c) If extended medical supplies and equipment or environmental modifications are 64.11or will be purchased for an elderly waiver client, the costs may be prorated for up to 64.1212 consecutive months beginning with the month of purchase. If the monthly cost of a 64.13recipient's waivered services exceeds the monthly limit established in paragraph (a) or 64.14(b), the annual cost of all waivered services shall be determined. In this event, the annual 64.15cost of all waivered services shall not exceed 12 times the monthly limit of waivered 64.16services as described in paragraph (a) or (b). 64.17    Sec. 4. Minnesota Statutes 2008, section 256B.0915, subdivision 3b, is amended to 64.18read: 64.19    Subd. 3b. Cost limits for elderly waiver applicants who reside in a nursing 64.20facility. (a) For a person who is a nursing facility resident at the time of requesting a 64.21determination of eligibility for elderly waivered services, a monthly conversion limit for 64.22the cost of elderly waivered services may be requested. The monthly conversion limit for 64.23the cost of elderly waiver services shall be the resident class assigned under Minnesota 64.24Rules, parts 9549.0050 to 9549.0059, for that resident in the nursing facility where 64.25the resident currently resides until July 1 of the state fiscal year in which the resident 64.26assessment system as described in section 256B.438 for nursing home rate determination 64.27is implemented. Effective on July 1 of the state fiscal year in which the resident 64.28assessment system as described in section 256B.438 for nursing home rate determination 64.29is implemented, the monthly conversion limit for the cost of elderly waiver services shall 64.30be the per diem nursing facility rate as determined by the resident assessment system as 64.31described in section 256B.438 for that resident new text begin residents new text end in the nursing facility where the 64.32resident currently resides new text begin , but in effect on June 30, 2010, and adjusted annually by any new text end 64.33 new text begin legislatively adopted percentage change in the elderly waiver services rates. That per new text end 64.34 new text begin diem shall be new text end multiplied by 365 and new text begin , new text end divided by 12, less new text begin and reduced by new text end the recipient's 64.35maintenance needs allowance as described in subdivision 1d. The initially approved 65.1conversion rate may new text begin must new text end be adjusted by the greater of any subsequent legislatively 65.2adopted home and community-based services percentage rate increase or the average 65.3statewide percentage increase in nursing facility payment rates new text begin adjustment new text end . The limit 65.4under this subdivision only applies to persons discharged from a nursing facility after a 65.5minimum 30-day stay and found eligible for waivered services on or after July 1, 1997. 65.6For conversions from the nursing home to the elderly waiver with consumer directed 65.7community support services, the conversion rate limit is equal to the nursing facility rate 65.8reduced by a percentage equal to the percentage difference between the consumer directed 65.9services budget limit that would be assigned according to the federally approved waiver 65.10plan and the corresponding community case mix cap, but not to exceed 50 percent. 65.11    (b) The following costs must be included in determining the total monthly costs 65.12for the waiver client: 65.13    (1) cost of all waivered services, including extended medical new text begin specialized new text end supplies 65.14and equipment and environmental modifications and new text begin accessibility new text end adaptations; and 65.15    (2) cost of skilled nursing, home health aide, and personal care services reimbursable 65.16by medical assistance. 65.17    Sec. 5. Minnesota Statutes 2009 Supplement, section 256B.69, subdivision 23, is 65.18amended to read: 65.19    Subd. 23. Alternative services; elderly and disabled persons. (a) The 65.20commissioner may implement demonstration projects to create alternative integrated 65.21delivery systems for acute and long-term care services to elderly persons and persons 65.22with disabilities as defined in section 256B.77, subdivision 7a, that provide increased 65.23coordination, improve access to quality services, and mitigate future cost increases. 65.24The commissioner may seek federal authority to combine Medicare and Medicaid 65.25capitation payments for the purpose of such demonstrations and may contract with 65.26Medicare-approved special needs plans to provide Medicaid services. Medicare funds and 65.27services shall be administered according to the terms and conditions of the federal contract 65.28and demonstration provisions. For the purpose of administering medical assistance funds, 65.29demonstrations under this subdivision are subject to subdivisions 1 to 22. The provisions 65.30of Minnesota Rules, parts 9500.1450 to 9500.1464, apply to these demonstrations, 65.31with the exceptions of parts 9500.1452, subpart 2, item B; and 9500.1457, subpart 1, 65.32items B and C, which do not apply to persons enrolling in demonstrations under this 65.33section. An initial open enrollment period may be provided. Persons who disenroll from 65.34demonstrations under this subdivision remain subject to Minnesota Rules, parts 9500.1450 65.35to 9500.1464. When a person is enrolled in a health plan under these demonstrations and 66.1the health plan's participation is subsequently terminated for any reason, the person shall 66.2be provided an opportunity to select a new health plan and shall have the right to change 66.3health plans within the first 60 days of enrollment in the second health plan. Persons 66.4required to participate in health plans under this section who fail to make a choice of 66.5health plan shall not be randomly assigned to health plans under these demonstrations. 66.6Notwithstanding section 256L.12, subdivision 5, and Minnesota Rules, part 9505.5220, 66.7subpart 1, item A, if adopted, for the purpose of demonstrations under this subdivision, 66.8the commissioner may contract with managed care organizations, including counties, to 66.9serve only elderly persons eligible for medical assistance, elderly and disabled persons, or 66.10disabled persons only. For persons with a primary diagnosis of developmental disability, 66.11serious and persistent mental illness, or serious emotional disturbance, the commissioner 66.12must ensure that the county authority has approved the demonstration and contracting 66.13design. Enrollment in these projects for persons with disabilities shall be voluntary. The 66.14commissioner shall not implement any demonstration project under this subdivision for 66.15persons with a primary diagnosis of developmental disabilities, serious and persistent 66.16mental illness, or serious emotional disturbance, without approval of the county board of 66.17the county in which the demonstration is being implemented. 66.18    (b) Notwithstanding chapter 245B, sections 252.40 to 252.46, 256B.092, 256B.501 66.19to 256B.5015, and Minnesota Rules, parts 9525.0004 to 9525.0036, 9525.1200 to 66.209525.1330, 9525.1580, and 9525.1800 to 9525.1930, the commissioner may implement 66.21under this section projects for persons with developmental disabilities. The commissioner 66.22may capitate payments for ICF/MR services, waivered services for developmental 66.23disabilities, including case management services, day training and habilitation and 66.24alternative active treatment services, and other services as approved by the state and by the 66.25federal government. Case management and active treatment must be individualized and 66.26developed in accordance with a person-centered plan. Costs under these projects may not 66.27exceed costs that would have been incurred under fee-for-service. Beginning July 1, 2003, 66.28and until four years after the pilot project implementation date, subcontractor participation 66.29in the long-term care developmental disability pilot is limited to a nonprofit long-term 66.30care system providing ICF/MR services, home and community-based waiver services, 66.31and in-home services to no more than 120 consumers with developmental disabilities in 66.32Carver, Hennepin, and Scott Counties. The commissioner shall report to the legislature 66.33prior to expansion of the developmental disability pilot project. This paragraph expires 66.34four years after the implementation date of the pilot project. 66.35    (c) Before implementation of a demonstration project for disabled persons, the 66.36commissioner must provide information to appropriate committees of the house of 67.1representatives and senate and must involve representatives of affected disability groups 67.2in the design of the demonstration projects. 67.3    (d) A nursing facility reimbursed under the alternative reimbursement methodology 67.4in section 256B.434 may, in collaboration with a hospital, clinic, or other health care entity 67.5provide services under paragraph (a). The commissioner shall amend the state plan and 67.6seek any federal waivers necessary to implement this paragraph. 67.7    (e) The commissioner, in consultation with the commissioners of commerce and 67.8health, may approve and implement programs for all-inclusive care for the elderly (PACE) 67.9according to federal laws and regulations governing that program and state laws or rules 67.10applicable to participating providers. The process for approval of these programs shall 67.11begin only after the commissioner receives grant money in an amount sufficient to cover 67.12the state share of the administrative and actuarial costs to implement the programs during 67.13state fiscal years 2006 and 2007. Grant amounts for this purpose shall be deposited in an 67.14account in the special revenue fund and are appropriated to the commissioner to be used 67.15solely for the purpose of PACE administrative and actuarial costs. A PACE provider is 67.16not required to be licensed or certified as a health plan company as defined in section 67.1762Q.01, subdivision 4 . Persons age 55 and older who have been screened by the county 67.18and found to be eligible for services under the elderly waiver or community alternatives 67.19for disabled individuals or who are already eligible for Medicaid but meet level of 67.20care criteria for receipt of waiver services may choose to enroll in the PACE program. 67.21Medicare and Medicaid services will be provided according to this subdivision and 67.22federal Medicare and Medicaid requirements governing PACE providers and programs. 67.23PACE enrollees will receive Medicaid home and community-based services through the 67.24PACE provider as an alternative to services for which they would otherwise be eligible 67.25through home and community-based waiver programs and Medicaid State Plan Services. 67.26The commissioner shall establish Medicaid rates for PACE providers that do not exceed 67.27costs that would have been incurred under fee-for-service or other relevant managed care 67.28programs operated by the state. 67.29    (f) The commissioner shall seek federal approval to expand the Minnesota disability 67.30health options (MnDHO) program established under this subdivision in stages, first to 67.31regional population centers outside the seven-county metro area and then to all areas of 67.32the state. Until July 1, 2009, expansion for MnDHO projects that include home and 67.33community-based services is limited to the two projects and service areas in effect on 67.34March 1, 2006. Enrollment in integrated MnDHO programs that include home and 67.35community-based services shall remain voluntary. Costs for home and community-based 67.36services included under MnDHO must not exceed costs that would have been incurred 68.1under the fee-for-service program. Notwithstanding whether expansion occurs under 68.2this paragraph, in determining MnDHO payment rates and risk adjustment methods for 68.3contract years starting in 2012, the commissioner must consider the methods used to 68.4determine county allocations for home and community-based program participants. If 68.5necessary to reduce MnDHO rates to comply with the provision regarding MnDHO costs 68.6for home and community-based services, the commissioner shall achieve the reduction by 68.7maintaining the base rate for contract years 2010 and 2011 for services provided under the 68.8community alternatives for disabled individuals waiver at the same level as for contract 68.9year 2009. The commissioner may apply other reductions to MnDHO rates to implement 68.10decreases in provider payment rates required by state law. In developing program 68.11specifications for expansion of integrated programs, the commissioner shall involve and 68.12consult the state-level stakeholder group established in subdivision 28, paragraph (d), 68.13including consultation on whether and how to include home and community-based waiver 68.14programs. Plans for further expansion of MnDHO projects shall be presented to the chairs 68.15of the house of representatives and senate committees with jurisdiction over health and 68.16human services policy and finance by February 1, 2007. 68.17    (g) Notwithstanding section 256B.0261, health plans providing services under this 68.18section are responsible for home care targeted case management and relocation targeted 68.19case management. Services must be provided according to the terms of the waivers and 68.20contracts approved by the federal government. 68.21    Sec. 6. new text begin CASE MANAGEMENT REFORM. new text end 68.22 new text begin (a) By February 1, 2011, the commissioner of human services shall provide specific new text end 68.23 new text begin recommendations and language for proposed legislation to: new text end 68.24 new text begin (1) define the administrative and the service functions of case management and make new text end 68.25 new text begin changes to improve the funding for administrative functions; new text end 68.26 new text begin (2) standardize and simplify processes, standards, and timelines for administrative new text end 68.27 new text begin functions of case management within the Department of Human Services, Disability new text end 68.28 new text begin Services Division, including eligibility determinations, resource allocation, management new text end 68.29 new text begin of dollars, provision for assignment of one case manager at a time per person, waiting lists, new text end 68.30 new text begin quality assurance, host county concurrence requirements, county of financial responsibility new text end 68.31 new text begin provisions, and waiver compliance; and new text end 68.32 new text begin (3) increase opportunities for consumer choice of case management functions new text end 68.33 new text begin involving service coordination. new text end 68.34 new text begin (b) In developing these recommendations, the commissioner shall consider the new text end 68.35 new text begin recommendations of the 2007 Redesigning Case Management Services for Persons new text end 69.1 new text begin with Disabilities report and consult with existing stakeholder groups, which include new text end 69.2 new text begin representatives of counties, disability and senior advocacy groups, service providers, and new text end 69.3 new text begin representatives of agencies which provide contracted case management. new text end 69.4 new text begin EFFECTIVE DATE. new text end new text begin This section is effective the day following final enactment. new text end 69.5    Sec. 7. new text begin [256.4825] REPORT REGARDING PROGRAMS AND SERVICES FOR new text end 69.6 new text begin PEOPLE WITH DISABILITIES. new text end 69.7 new text begin The Minnesota State Council on Disability, the Minnesota Consortium for Citizens new text end 69.8 new text begin with Disabilities, and the Arc of Minnesota may submit an annual report by January 15 of new text end 69.9 new text begin each year, beginning in 2012, to the chairs and ranking minority members of the legislative new text end 69.10 new text begin committees with jurisdiction over programs serving people with disabilities as provided in new text end 69.11 new text begin this section. The report must describe the existing state policies and goals for programs new text end 69.12 new text begin serving people with disabilities including, but not limited to, programs for employment, new text end 69.13 new text begin transportation, housing, education, quality assurance, consumer direction, physical and new text end 69.14 new text begin programmatic access, and health. The report must provide data and measurements to new text end 69.15 new text begin assess the extent to which the policies and goals are being met. The commissioner of new text end 69.16 new text begin human services and the commissioners of other state agencies administering programs for new text end 69.17 new text begin people with disabilities shall cooperate with the Minnesota State Council on Disability, new text end 69.18 new text begin the Minnesota Consortium for Citizens with Disabilities, and the Arc of Minnesota and new text end 69.19 new text begin provide those organizations with existing published information and reports that will assist new text end 69.20 new text begin in the preparation of the report. new text end 69.21    Sec. 8. new text begin COMMISSIONER TO SEEK FEDERAL MATCH. new text end 69.22 new text begin (a) The commissioner of human services shall seek federal financial participation new text end 69.23 new text begin for eligible activity related to fiscal years 2010 and 2011 grants to Advocating Change new text end 69.24 new text begin Together to establish a statewide self-advocacy network for persons with developmental new text end 69.25 new text begin disabilities and for eligible activities under any future grants to the organization. new text end 69.26 new text begin (b) The commissioner shall report to the chairs of the senate Health and Human new text end 69.27 new text begin Services Budget Division and the house of representatives Health Care and Human new text end 69.28 new text begin Services Finance Division by December 15, 2010, with the results of the application for new text end 69.29 new text begin federal matching funds. new text end 70.1ARTICLE 4 70.2CHILDREN AND FAMILY SERVICES 70.3    Section 1. Minnesota Statutes 2008, section 256D.0515, is amended to read: 70.4256D.0515 ASSET LIMITATIONS FOR FOOD STAMP HOUSEHOLDS. 70.5All food stamp households must be determined eligible for the benefit discussed 70.6under section 256.029. Food stamp households must demonstrate that: 70.7(1) their gross income meets the federal Food Stamp requirements under United 70.8States Code, title 7, section 2014(c); and new text begin is equal to or less than 165 percent of the federal new text end 70.9 new text begin poverty guidelines for the same family size. new text end 70.10(2) they have financial resources, excluding vehicles, of less than $7,000. 70.11    Sec. 2. Minnesota Statutes 2008, section 256J.20, subdivision 3, is amended to read: 70.12    Subd. 3. Other property limitations. To be eligible for MFIP, the equity value of 70.13all nonexcluded real and personal property of the assistance unit must not exceed $2,000 70.14for applicants and $5,000 for ongoing participants. The value of assets in clauses (1) to 70.15(19) must be excluded when determining the equity value of real and personal property: 70.16    (1) a licensed vehicle up to a loan value of less than or equal to $15,000 new text begin $7,500 new text end . If the 70.17assistance unit owns more than one licensed vehicle, the county agency shall determine the 70.18loan value of all additional vehicles and exclude the combined loan value of less than or 70.19equal to $7,500. The county agency shall apply any excess loan value as if it were equity 70.20value to the asset limit described in this section, new text begin . If the assistance unit owns more than new text end 70.21 new text begin one licensed vehicle, the county agency shall determine the vehicle with the highest loan new text end 70.22 new text begin value and count only the loan value over $7,500, new text end excluding: (i) the value of one vehicle 70.23per physically disabled person when the vehicle is needed to transport the disabled unit 70.24member; this exclusion does not apply to mentally disabled people; (ii) the value of special 70.25equipment for a disabled member of the assistance unit; and (iii) any vehicle used for 70.26long-distance travel, other than daily commuting, for the employment of a unit member. 70.27     new text begin The county agency shall count the loan value of all other vehicles and apply this new text end 70.28 new text begin amount as if it were equity value to the asset limit described in this section. new text end To establish the 70.29loan value of vehicles, a county agency must use the N.A.D.A. Official Used Car Guide, 70.30Midwest Edition, for newer model cars. When a vehicle is not listed in the guidebook, 70.31or when the applicant or participant disputes the loan value listed in the guidebook as 70.32unreasonable given the condition of the particular vehicle, the county agency may require 70.33the applicant or participant document the loan value by securing a written statement from 70.34a motor vehicle dealer licensed under section 168.27, stating the amount that the dealer 71.1would pay to purchase the vehicle. The county agency shall reimburse the applicant or 71.2participant for the cost of a written statement that documents a lower loan value; 71.3    (2) the value of life insurance policies for members of the assistance unit; 71.4    (3) one burial plot per member of an assistance unit; 71.5    (4) the value of personal property needed to produce earned income, including 71.6tools, implements, farm animals, inventory, business loans, business checking and 71.7savings accounts used at least annually and used exclusively for the operation of a 71.8self-employment business, and any motor vehicles if at least 50 percent of the vehicle's use 71.9is to produce income and if the vehicles are essential for the self-employment business; 71.10    (5) the value of personal property not otherwise specified which is commonly 71.11used by household members in day-to-day living such as clothing, necessary household 71.12furniture, equipment, and other basic maintenance items essential for daily living; 71.13    (6) the value of real and personal property owned by a recipient of Supplemental 71.14Security Income or Minnesota supplemental aid; 71.15    (7) the value of corrective payments, but only for the month in which the payment 71.16is received and for the following month; 71.17    (8) a mobile home or other vehicle used by an applicant or participant as the 71.18applicant's or participant's home; 71.19    (9) money in a separate escrow account that is needed to pay real estate taxes or 71.20insurance and that is used for this purpose; 71.21    (10) money held in escrow to cover employee FICA, employee tax withholding, 71.22sales tax withholding, employee worker compensation, business insurance, property rental, 71.23property taxes, and other costs that are paid at least annually, but less often than monthly; 71.24    (11) monthly assistance payments for the current month's or short-term emergency 71.25needs under section 256J.626, subdivision 2; 71.26    (12) the value of school loans, grants, or scholarships for the period they are 71.27intended to cover; 71.28    (13) payments listed in section 256J.21, subdivision 2, clause (9), which are held 71.29in escrow for a period not to exceed three months to replace or repair personal or real 71.30property; 71.31    (14) income received in a budget month through the end of the payment month; 71.32    (15) savings from earned income of a minor child or a minor parent that are set aside 71.33in a separate account designated specifically for future education or employment costs; 71.34    (16) the federal earned income credit, Minnesota working family credit, state and 71.35federal income tax refunds, state homeowners and renters credits under chapter 290A, 72.1property tax rebates and other federal or state tax rebates in the month received and the 72.2following month; 72.3    (17) payments excluded under federal law as long as those payments are held in a 72.4separate account from any nonexcluded funds; 72.5    (18) the assets of children ineligible to receive MFIP benefits because foster care or 72.6adoption assistance payments are made on their behalf; and 72.7    (19) the assets of persons whose income is excluded under section 256J.21, 72.8subdivision 2 , clause (43). 72.9 new text begin EFFECTIVE DATE. new text end new text begin This section is effective October 1, 2010. new text end 72.10    Sec. 3. Minnesota Statutes 2008, section 256J.24, subdivision 10, is amended to read: 72.11    Subd. 10. MFIP exit level. The commissioner shall adjust the MFIP earned income 72.12disregard to ensure that most participants do not lose eligibility for MFIP until their 72.13income reaches at least 115 new text begin 110 new text end percent of the federal poverty guidelines in effect in 72.14October of each fiscal year new text begin at the time of the adjustment new text end . The adjustment to the disregard 72.15shall be based on a household size of three, and the resulting earned income disregard 72.16percentage must be applied to all household sizes. The adjustment under this subdivision 72.17must be implemented at the same time as the October food stamp or new text begin whenever there is a new text end 72.18food support cost-of-living adjustment is reflected in the food portion of MFIP transitional 72.19standard as required under subdivision 5a. 72.20 new text begin EFFECTIVE DATE. new text end new text begin This section is effective October 1, 2010. new text end 72.21    Sec. 4. Minnesota Statutes 2008, section 256J.37, subdivision 3a, is amended to read: 72.22    Subd. 3a. Rental subsidies; unearned income. (a) Effective July 1, 2003, The 72.23county agency shall count $50 new text begin $100 new text end of the value of public and assisted rental subsidies 72.24provided through the Department of Housing and Urban Development (HUD) as unearned 72.25income to the cash portion of the MFIP grant. The full amount of the subsidy must be 72.26counted as unearned income when the subsidy is less than $50 new text begin $100 new text end . The income from 72.27this subsidy shall be budgeted according to section 256J.34. 72.28(b) The provisions of this subdivision shall not apply to an MFIP assistance unit 72.29which includes a participant who is: 72.30(1) age 60 or older; 72.31(2) a caregiver who is suffering from an illness, injury, or incapacity that has been 72.32certified by a qualified professional when the illness, injury, or incapacity is expected 73.1to continue for more than 30 days and prevents the person from obtaining or retaining 73.2employment; or 73.3(3) a caregiver whose presence in the home is required due to the illness or 73.4incapacity of another member in the assistance unit, a relative in the household, or a foster 73.5child in the household when the illness or incapacity and the need for the participant's 73.6presence in the home has been certified by a qualified professional and is expected to 73.7continue for more than 30 days. 73.8(c) The provisions of this subdivision shall not apply to an MFIP assistance unit 73.9where the parental caregiver is an SSI recipient. 73.10(d) Prior to implementing this provision, the commissioner must identify the MFIP 73.11participants subject to this provision and provide written notice to these participants at 73.12least 30 days before the first grant reduction. The notice must inform the participant of the 73.13basis for the potential grant reduction, the exceptions to the provision, if any, and inform 73.14the participant of the steps necessary to claim an exception. A person who is found not to 73.15meet one of the exceptions to the provision must be notified and informed of the right to a 73.16fair hearing under section 256J.40. The notice must also inform the participant that the 73.17participant may be eligible for a rent reduction resulting from a reduction in the MFIP 73.18grant and encourage the participant to contact the local housing authority. 73.19 new text begin EFFECTIVE DATE. new text end new text begin This section is effective October 1, 2010. new text end 73.20    Sec. 5. Minnesota Statutes 2009 Supplement, section 256J.425, subdivision 3, is 73.21amended to read: 73.22    Subd. 3. Hard-to-employ participants. (a) An assistance unit subject to the time 73.23limit in section 256J.42, subdivision 1, is eligible to receive months of assistance under 73.24a hardship extension if the participant who reached the time limit belongs to any of the 73.25following groups: 73.26    (1) a person who is diagnosed by a licensed physician, psychological practitioner, or 73.27other qualified professional, as developmentally disabled or mentally ill, and the condition 73.28severely limits the person's ability to obtain or maintain suitable employment; 73.29    (2) a person who: 73.30    (i) has been assessed by a vocational specialist or the county agency to be 73.31unemployable for purposes of this subdivision; or 73.32    (ii) has an IQ below 80 who has been assessed by a vocational specialist or a county 73.33agency to be employable, but the condition severely limits the person's ability to obtain or 73.34maintain suitable employment. The determination of IQ level must be made by a qualified 73.35professional. In the case of a non-English-speaking person: (A) the determination must 74.1be made by a qualified professional with experience conducting culturally appropriate 74.2assessments, whenever possible; (B) the county may accept reports that identify an 74.3IQ range as opposed to a specific score; (C) these reports must include a statement of 74.4confidence in the results; 74.5    (3) a person who is determined by a qualified professional to be learning disabled, 74.6and the condition severely limits the person's ability to obtain or maintain suitable 74.7employment. For purposes of the initial approval of a learning disability extension, the 74.8determination must have been made or confirmed within the previous 12 months. In the 74.9case of a non-English-speaking person: (i) the determination must be made by a qualified 74.10professional with experience conducting culturally appropriate assessments, whenever 74.11possible; and (ii) these reports must include a statement of confidence in the results. If a 74.12rehabilitation plan for a participant extended as learning disabled is developed or approved 74.13by the county agency, the plan must be incorporated into the employment plan. However, 74.14a rehabilitation plan does not replace the requirement to develop and comply with an 74.15employment plan under section 256J.521; or 74.16    (4) a person who has been granted a family violence waiver, and who is complying 74.17with an employment plan under section 256J.521, subdivision 3. 74.18    (b) For purposes of this section new text begin chapter new text end , "severely limits the person's ability to obtain 74.19or maintain suitable employment" means new text begin : new text end 74.20     new text begin (1) new text end that a qualified professional has determined that the person's condition prevents 74.21the person from working 20 or more hours per week new text begin ; or new text end 74.22     new text begin (2) for a person who meets the requirements of paragraph (a), clause (2), item (ii), or new text end 74.23 new text begin clause (3), a qualified professional has determined the person's condition: new text end 74.24     new text begin (i) significantly restricts the range of employment that the person is able to perform; new text end 74.25 new text begin or new text end 74.26     new text begin (ii) significantly interferes with the person's ability to obtain or maintain suitable new text end 74.27 new text begin employment for 20 or more hours per week new text end . 74.28ARTICLE 5 74.29MISCELLANEOUS 74.30    Section 1. Minnesota Statutes 2008, section 3.971, subdivision 2, is amended to read: 74.31    Subd. 2. Staff; compensation. The legislative auditor shall establish a Financial 74.32Audits Division and a Program Evaluation Division to fulfill the duties prescribed in 74.33this section. new text begin The legislative auditor shall establish a Legislative Budget Office Division new text end 74.34 new text begin to fulfill the duties in section 3.98, subdivision 5. new text end Each division may be supervised by a 74.35deputy auditor, appointed by the legislative auditor, with the approval of the commission, 75.1for a term coterminous with the legislative auditor's term. The deputy auditors may be 75.2removed before the expiration of their terms only for cause. The legislative auditor 75.3and deputy auditors may each appoint a confidential secretary to serve at pleasure. 75.4The salaries and benefits of the legislative auditor, deputy auditors and confidential 75.5secretaries shall be determined by the compensation plan approved by the Legislative 75.6Coordinating Commission. The deputy auditors may perform and exercise the powers, 75.7duties and responsibilities imposed by law on the legislative auditor when authorized by 75.8the legislative auditor. The deputy auditors and the confidential secretaries serve in the 75.9unclassified civil service, but all other employees of the legislative auditor are in the 75.10classified civil service. Compensation for employees of the legislative auditor in the 75.11classified service shall be governed by a plan prepared by the legislative auditor and 75.12approved by the Legislative Coordinating Commission and the legislature under section 75.133.855, subdivision 3 . While in office, a person appointed deputy for the Financial Audit 75.14Division must hold an active license as a certified public accountant. 75.15 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2011. new text end 75.16    Sec. 2. Minnesota Statutes 2008, section 3.98, is amended by adding a subdivision to 75.17read: 75.18     new text begin Subd. 5. new text end new text begin Fiscal notes; Department of Human Services. new text end new text begin (a) The responsibilities of new text end 75.19 new text begin the Department of Human Services for the preparation of fiscal notes under this chapter new text end 75.20 new text begin are transferred to the Legislative Budget Office Division under section 3.971. new text end 75.21 new text begin (b) The Legislative Budget Office Division shall prepare a fiscal note for any bill that new text end 75.22 new text begin increases or decreases expenditures at the Department of Human Services at the request of new text end 75.23 new text begin the chair of the budget or finance division to which a bill relating to the department has new text end 75.24 new text begin been referred, or at the request of either the chair of the house of representatives Ways and new text end 75.25 new text begin Means Committee, or the chair of the senate Finance Committee. At the request of the new text end 75.26 new text begin commissioner of human services, the Legislative Budget Office Division shall include a new text end 75.27 new text begin statement from the commissioner: new text end 75.28 new text begin (1) concurring with the information provided; new text end 75.29 new text begin (2) suggesting alternative dollar amounts for a specific program or function; or new text end 75.30 new text begin (3) indicating any other information which the commissioner deems relevant. new text end 75.31    Sec. 3. new text begin [62A.3075] CANCER CHEMOTHERAPY TREATMENT COVERAGE. new text end 75.32 new text begin (a) A health plan company that provides coverage under a health plan for cancer new text end 75.33 new text begin chemotherapy treatment shall not require a higher co-payment, deductible, or coinsurance new text end 75.34 new text begin amount for a prescribed, orally administered anticancer medication that is used to kill or new text end 76.1 new text begin slow the growth of cancerous cells than what the health plan requires for an intravenously new text end 76.2 new text begin administered or injected cancer medication that is provided, regardless of formulation or new text end 76.3 new text begin benefit category determination by the health plan company. new text end 76.4 new text begin (b) A health plan company must not achieve compliance with this section new text end 76.5 new text begin by imposing an increase in co-payment, deductible, or coinsurance amount for an new text end 76.6 new text begin intravenously administered or injected cancer chemotherapy agent covered under the new text end 76.7 new text begin health plan. new text end 76.8 new text begin (c) Nothing in this section shall be interpreted to prohibit a health plan company new text end 76.9 new text begin from requiring prior authorization or imposing other appropriate utilization controls in new text end 76.10 new text begin approving coverage for any chemotherapy. new text end 76.11 new text begin (d) A plan offered by the commissioner of management and budget under section new text end 76.12 new text begin 43A.23 is deemed to be at parity and in compliance with this section. new text end 76.13 new text begin EFFECTIVE DATE. new text end new text begin Paragraphs (a) and (c) are effective August 1, 2010, and apply new text end 76.14 new text begin to health plans providing coverage to a Minnesota resident offered, issued, sold, renewed, new text end 76.15 new text begin or continued as defined in Minnesota Statutes, section 60A.02, subdivision 2a, on or after new text end 76.16 new text begin that date. Paragraph (b) is effective the day following final enactment. new text end 76.17    Sec. 4. new text begin [62A.3094] COVERAGE FOR AUTISM SPECTRUM DISORDERS. new text end 76.18     new text begin Subdivision 1. new text end new text begin Definitions. new text end new text begin (a) For purposes of this section, the terms defined in new text end 76.19 new text begin paragraphs (b) to (e) have the meanings given. new text end 76.20 new text begin (b) "Autism spectrum disorder" means the following conditions as determined by new text end 76.21 new text begin criteria set forth in the most recent edition of the Diagnostic and Statistical Manual of new text end 76.22 new text begin Mental Disorders of the American Psychiatric Association: new text end 76.23 new text begin (1) autism or autistic disorder; new text end 76.24 new text begin (2) Asperger's syndrome; or new text end 76.25 new text begin (3) pervasive developmental disorder - not otherwise specified. new text end 76.26 new text begin (c) "Board-certified behavior analyst" means an individual certified by the Behavior new text end 76.27 new text begin Analyst Certification Board as a board-certified behavior analyst. new text end 76.28 new text begin (d) "Evidence-based," for purposes of this section only, is as described in subdivision new text end 76.29 new text begin 2, paragraph (c), clause (2). new text end 76.30 new text begin (e) "Health plan" has the meaning given in section 62Q.01, subdivision 3. new text end 76.31 new text begin (f) "Manualized approach" means a self-contained volume, text, or set of new text end 76.32 new text begin instructional media, which may include videos or compact discs, that codifies in new text end 76.33 new text begin reasonable detail the procedures for implementing treatment. new text end 76.34 new text begin (g) "Medical necessity" or "medically necessary care" has the meaning given in new text end 76.35 new text begin section 62Q.53, subdivision 2. new text end 77.1 new text begin (h) "Mental health professional" has the meaning given in section 245.4871, new text end 77.2 new text begin subdivision 27, clauses (1) to (6). new text end 77.3 new text begin (i) "Qualified mental health behavioral aide" means a mental health behavioral aide new text end 77.4 new text begin as defined in section 256B.0943, subdivision 7. new text end 77.5 new text begin (j) "Qualified mental health practitioner" means a mental health practitioner as new text end 77.6 new text begin defined in section 245.4871, subdivision 26. new text end 77.7 new text begin (k) "Statistically superior outcomes" means a research study in which the probability new text end 77.8 new text begin that the results would be obtained under the null hypothesis is less than five percent. new text end 77.9     new text begin Subd. 2. new text end new text begin Coverage required. new text end new text begin (a) For coverage requirements to apply, an individual new text end 77.10 new text begin must have a diagnosis of autism spectrum disorder made through an evaluation of the new text end 77.11 new text begin patient, completed within the six months prior to the start of treatment, which includes new text end 77.12 new text begin all of the following: new text end 77.13 new text begin (1) a complete medical and psychological evaluation performed by a licensed new text end 77.14 new text begin physician and psychologist using empirically validated tools or tests that incorporate new text end 77.15 new text begin measures for intellectual functioning, language development, adaptive skills, and new text end 77.16 new text begin behavioral problems, which must include: new text end 77.17 new text begin (i) a developmental history of the child, focusing on developmental milestones new text end 77.18 new text begin and delays; new text end 77.19 new text begin (ii) a family history, including whether there are other family members with an new text end 77.20 new text begin autism spectrum disorder, developmental disability, fragile X syndrome, or tuberous new text end 77.21 new text begin sclerosis; new text end 77.22 new text begin (iii) a medical history, including signs of deterioration, seizure activity, brain injury, new text end 77.23 new text begin and head circumference; new text end 77.24 new text begin (iv) a physical examination completed within the past 12 months; new text end 77.25 new text begin (v) an evaluation for intellectual functioning; new text end 77.26 new text begin (vi) a lead screening for those children with a developmental disability; and new text end 77.27 new text begin (vii) other evaluations and testing as indicated by the medical evaluation, which new text end 77.28 new text begin may include neuropsychological testing, occupational therapy, physical therapy, family new text end 77.29 new text begin functioning, genetic testing, imaging laboratory tests, and electrophysiological testing; new text end 77.30 new text begin (2) a communication assessment conducted by a speech pathologist; and new text end 77.31 new text begin (3) a comprehensive hearing test conducted by an audiologist with experience in new text end 77.32 new text begin testing very young children. new text end 77.33 new text begin (b) A health plan must provide coverage for the diagnosis, evaluation, assessment, new text end 77.34 new text begin and medically necessary care of autism spectrum disorders that is evidence-based, new text end 77.35 new text begin including but not limited to: new text end 78.1 new text begin (1) neurodevelopmental and behavioral health treatments, instruction, and new text end 78.2 new text begin management; new text end 78.3 new text begin (2) applied behavior analysis and intensive early intervention services, including new text end 78.4 new text begin service package models such as intensive early intervention behavior therapy services new text end 78.5 new text begin and Lovaas therapy; new text end 78.6 new text begin (3) speech therapy; new text end 78.7 new text begin (4) occupational therapy; new text end 78.8 new text begin (5) physical therapy; and new text end 78.9 new text begin (6) prescription medications. new text end 78.10 new text begin (c) Coverage required under this section shall include treatment that is in accordance new text end 78.11 new text begin with: new text end 78.12 new text begin (1) an individualized treatment plan prescribed by the insured's treating physician or new text end 78.13 new text begin mental health professional as defined in this section; and new text end 78.14 new text begin (2) medically and scientifically accepted evidence that meets the criteria of a new text end 78.15 new text begin peer-reviewed, published study that is one of the following: new text end 78.16 new text begin (i) a randomized study with adequate statistical power, including a sample size of new text end 78.17 new text begin 30 or more for each group, that shows statistically superior outcomes to a pill placebo new text end 78.18 new text begin group, psychological placebo group, another treatment group, or a wait list control group, new text end 78.19 new text begin or that is equivalent to another evidence-based treatment that meets the above standard new text end 78.20 new text begin for the specified problem area; or new text end 78.21 new text begin (ii) a series of at least three single-case design experiments with clear specification new text end 78.22 new text begin of the subjects and with clear specification of the treatment approach that: new text end 78.23 new text begin (A) use robust experimental designs; new text end 78.24 new text begin (B) show statistically superior outcomes to pill placebo, psychological placebo, new text end 78.25 new text begin or another treatment group; and new text end 78.26 new text begin (C) either use a manualized approach or are conducted by at least two independent new text end 78.27 new text begin investigators or teams; or new text end 78.28 new text begin (3) where evidence meeting the standards of this subdivision does not exist for new text end 78.29 new text begin the treatment of a diagnosed condition or for an individual matching the demographic new text end 78.30 new text begin characteristics for which the evidence is valid, practice guidelines based on consensus new text end 78.31 new text begin of Minnesota health care professionals knowledgeable in the treatment of individuals new text end 78.32 new text begin with autism spectrum disorders. new text end 78.33 new text begin (d) Early intensive behavior therapies that meet the criteria set forth in paragraphs new text end 78.34 new text begin (b) and (c) must also meet the following best practices standards: new text end 78.35 new text begin (1) the services must be prescribed by a mental health professional as an appropriate new text end 78.36 new text begin treatment option for the individual child; new text end 79.1 new text begin (2) regular reporting of services provided and the child's progress must be submitted new text end 79.2 new text begin to the prescribing mental health professional; new text end 79.3 new text begin (3) care must include appropriate parent or legal guardian education and new text end 79.4 new text begin involvement; new text end 79.5 new text begin (4) the medically prescribed treatment and frequency of services should be new text end 79.6 new text begin coordinated between the school and provider for all children up to age 21; and new text end 79.7 new text begin (5) services must be provided by a mental health professional or, as appropriate, a new text end 79.8 new text begin board-certified behavior analyst, a qualified mental health practitioner, or a qualified new text end 79.9 new text begin mental health behavioral aide. new text end 79.10 new text begin (e) Providers under this section must work with the commissioner in implementing new text end 79.11 new text begin evidence-based practices and, specifically for children under age 21, the Minnesota new text end 79.12 new text begin Evidence-Based Practice Database of research-informed practice elements and specific new text end 79.13 new text begin constituent practices. new text end 79.14 new text begin (f) A health plan company may not refuse to renew or reissue, or otherwise terminate new text end 79.15 new text begin or restrict coverage of an individual solely because the individual is diagnosed with an new text end 79.16 new text begin autism spectrum disorder. new text end 79.17 new text begin (g) A health plan company may request an updated treatment plan only once every new text end 79.18 new text begin six months, unless the health plan company and the treating physician or mental health new text end 79.19 new text begin professional agree that a more frequent review is necessary due to emerging circumstances. new text end 79.20     new text begin Subd. 3. new text end new text begin Supervision, delegation of duties, and observation of qualified mental new text end 79.21 new text begin health practitioner, board-certified behavior analyst, or mental health behavioral new text end 79.22 new text begin aide. new text end new text begin A mental health professional who uses the services of a qualified mental health new text end 79.23 new text begin practitioner, board-certified behavior analyst, or qualified mental health behavioral aide for new text end 79.24 new text begin the purpose of assisting in the provision of services to patients who have autism spectrum new text end 79.25 new text begin disorder is responsible for functions performed by these service providers. The qualified new text end 79.26 new text begin mental health professional must maintain clinical supervision of services they provide new text end 79.27 new text begin and accept full responsibility for their actions. The services provided must be medically new text end 79.28 new text begin necessary and identified in the child's individual treatment plan. Service providers must new text end 79.29 new text begin document their activities in written progress notes that reflect implementation of the new text end 79.30 new text begin individual treatment plan. new text end 79.31     new text begin Subd. 4. new text end new text begin State health care programs. new text end new text begin This section does not affect benefits new text end 79.32 new text begin available under the medical assistance, MinnesotaCare, and general assistance medical new text end 79.33 new text begin care programs, and the state employee group insurance plan offered under sections new text end 79.34 new text begin 43A.22 to 43A.30. These programs and the state employee group insurance plan must new text end 79.35 new text begin maintain current levels of coverage, and section 256B.0644 shall continue to apply. new text end 79.36 new text begin The commissioner shall monitor these services and report to the chairs of the house new text end 80.1 new text begin of representatives and senate standing committees that have jurisdiction over health new text end 80.2 new text begin and human services by February 1, 2011, whether there are gaps in the level of service new text end 80.3 new text begin provided by these programs and the state employee group insurance plan, and the level of new text end 80.4 new text begin service provided by private health plans following enactment of this section. new text end 80.5     new text begin Subd. 5. new text end new text begin No effect on other law. new text end new text begin Nothing in this section limits in any way the new text end 80.6 new text begin coverage required under sections 62Q.47 and 62Q.53. new text end 80.7 new text begin EFFECTIVE DATE. new text end new text begin This section is effective August 1, 2010, and applies to new text end 80.8 new text begin coverage offered, issued, sold, renewed, or continued as defined in Minnesota Statutes, new text end 80.9 new text begin section 60A.02, subdivision 2a, on or after that date. new text end 80.10    Sec. 5. Minnesota Statutes 2008, section 62J.38, is amended to read: 80.1162J.38 COST CONTAINMENT DATA FROM GROUP PURCHASERS. 80.12(a) The commissioner shall require group purchasers to submit detailed data on total 80.13health care spending for each calendar year. Group purchasers shall submit data for the 80.141993 calendar year by April 1, 1994, and each April 1 thereafter shall submit data for the 80.15preceding calendar year. 80.16(b) The commissioner shall require each group purchaser to submit data on revenue, 80.17expenses, and member months, as applicable. Revenue data must distinguish between 80.18premium revenue and revenue from other sources and must also include information 80.19on the amount of revenue in reserves and changes in reserves. Expenditure data must 80.20distinguish between costs incurred for patient care and administrative costs new text begin , including new text end 80.21 new text begin amounts paid to contractors, subcontractors, and other entities for the purpose of managing new text end 80.22 new text begin provider utilization or distributing provider payments new text end . Patient care and administrative 80.23costs must include only expenses incurred on behalf of health plan members and must 80.24not include the cost of providing health care services for nonmembers at facilities owned 80.25by the group purchaser or affiliate. Expenditure data must be provided separately 80.26for the following categories and for other categories required by the commissioner: 80.27physician services, dental services, other professional services, inpatient hospital services, 80.28outpatient hospital services, emergency, pharmacy services and other nondurable medical 80.29goods, mental health, and chemical dependency services, other expenditures, subscriber 80.30liability, and administrative costs. Administrative costs must include costs for marketing; 80.31advertising; overhead; salaries and benefits of central office staff who do not provide 80.32direct patient care; underwriting; lobbying; claims processing; provider contracting and 80.33credentialing; detection and prevention of payment for fraudulent or unjustified requests 80.34for reimbursement or services; clinical quality assurance and other types of medical care 81.1quality improvement efforts; concurrent or prospective utilization review as defined in 81.2section 62M.02; costs incurred to acquire a hospital, clinic, or health care facility, or the 81.3assets thereof; capital costs incurred on behalf of a hospital or clinic; lease payments; or 81.4any other costs incurred pursuant to a partnership, joint venture, integration, or affiliation 81.5agreement with a hospital, clinic, or other health care provider. Capital costs and costs 81.6incurred must be recorded according to standard accounting principles. The reports of 81.7this data must also separately identify expenses for local, state, and federal taxes, fees, 81.8and assessments. The commissioner may require each group purchaser to submit any 81.9other data, including data in unaggregated form, for the purposes of developing spending 81.10estimates, setting spending limits, and monitoring actual spending and costs. In addition to 81.11reporting administrative costs incurred to acquire a hospital, clinic, or health care facility, 81.12or the assets thereof; or any other costs incurred pursuant to a partnership, joint venture, 81.13integration, or affiliation agreement with a hospital, clinic, or other health care provider; 81.14reports submitted under this section also must include the payments made during the 81.15calendar year for these purposes. The commissioner shall make public, by group purchaser 81.16data collected under this paragraph in accordance with section 62J.321, subdivision 5. 81.17Workers' compensation insurance plans and automobile insurance plans are exempt from 81.18complying with this paragraph as it relates to the submission of administrative costs. 81.19(c) The commissioner may collect information on: 81.20(1) premiums, benefit levels, managed care procedures, and other features of health 81.21plan companies; 81.22(2) prices, provider experience, and other information for services less commonly 81.23covered by insurance or for which patients commonly face significant out-of-pocket 81.24expenses; and 81.25(3) information on health care services not provided through health plan companies, 81.26including information on prices, costs, expenditures, and utilization. 81.27(d) All group purchasers shall provide the required data using a uniform format and 81.28uniform definitions, as prescribed by the commissioner. 81.29    Sec. 6. new text begin [62Q.545] COVERAGE OF PRIVATE DUTY NURSING SERVICES. new text end 81.30 new text begin (a) A health plan must cover private duty nursing services as provided under section new text end 81.31 new text begin 256B.0625, subdivision 7, for persons who are covered under the health plan and require new text end 81.32 new text begin private duty nursing services. new text end 81.33 new text begin (b) For purposes of this section, a period of private duty nursing services may new text end 81.34 new text begin be subject to the co-payment, coinsurance, deductible, or other enrollee cost-sharing new text end 81.35 new text begin requirements that apply under the health plan. Cost-sharing requirements for private duty new text end 82.1 new text begin nursing services must not place a greater financial burden on the insured or enrollee than new text end 82.2 new text begin those requirements applied by the health plan to other similar services or benefits. new text end 82.3 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2010, and applies to health new text end 82.4 new text begin plans offered, sold, issued, or renewed on or after that date. new text end 82.5    Sec. 7. Minnesota Statutes 2008, section 62Q.76, subdivision 1, is amended to read: 82.6    Subdivision 1. Applicability. For purposes of sections 62Q.76 to new text begin 62Q.791 new text end , 82.7the terms defined in this section new text begin contract, health care provider, dental plan, dental new text end 82.8 new text begin organization, dentist, and enrollee new text end have the meanings given them new text begin in sections 62Q.733 new text end 82.9 new text begin and 62Q.76 new text end . 82.10    Sec. 8. new text begin [62Q.791] CONTRACTS WITH DENTAL CARE PROVIDERS. new text end 82.11     new text begin (a) Notwithstanding any other provision of law, no contract of any dental new text end 82.12 new text begin organization licensed under chapter 62C for provision of dental care services may: new text end 82.13     new text begin (1) require, directly or indirectly, that a dentist or health care provider provide dental new text end 82.14 new text begin care services to its enrollees at a fee set by the dental organization, unless the services new text end 82.15 new text begin provided are covered dental care services for enrollees under the dental plan or contract; or new text end 82.16     new text begin (2) prohibit, directly or indirectly, the dentist or health care provider from offering or new text end 82.17 new text begin providing dental care services that are not covered dental care services under the dental new text end 82.18 new text begin plan or contract, on terms and conditions acceptable to the enrollee and the dentist or new text end 82.19 new text begin health care provider. For purposes of this section, "covered dental care services" means new text end 82.20 new text begin dental care services that are expressly covered under the dental plan or contract, including new text end 82.21 new text begin dental care services that are subject to contractual limitations such as deductibles, new text end 82.22 new text begin co-payments, annual maximums, and waiting periods. new text end 82.23     new text begin (b) When making payment or otherwise adjudicating any claim for dental care new text end 82.24 new text begin services provided to an enrollee, a dental organization or dental plan must clearly identify new text end 82.25 new text begin on an explanation of benefits form or other form of claim resolution the amount, if any, new text end 82.26 new text begin that is the enrollee's responsibility to pay to the enrollee's dentist or health care provider. new text end 82.27     new text begin (c) This section does not apply to any contract for the provision of dental care new text end 82.28 new text begin services under any public program sponsored or funded by the state or federal government. new text end 82.29 new text begin EFFECTIVE DATE. new text end new text begin This section is effective August 1, 2010. new text end 82.30    Sec. 9. new text begin [245.6971] ADVISORY GROUP ON STATE-OPERATED SERVICES new text end 82.31 new text begin REDESIGN. new text end 83.1     new text begin Subdivision 1. new text end new text begin Establishment. new text end new text begin The Advisory Group on State-Operated Services new text end 83.2 new text begin Redesign is established to make recommendations to the commissioner of human services new text end 83.3 new text begin and the legislature on the continuum of services needed to provide individuals with new text end 83.4 new text begin complex conditions including mental illness and developmental disabilities access to new text end 83.5 new text begin quality care and the appropriate level of care across the state to promote wellness, reduce new text end 83.6 new text begin cost, and improve efficiency. new text end 83.7     new text begin Subd. 2. new text end new text begin Duties. new text end new text begin The Advisory Group on State-Operated Services Redesign shall new text end 83.8 new text begin make recommendations to the commissioner and the legislature no later than December new text end 83.9 new text begin 15, 2010, on the following: new text end 83.10 new text begin (1) transformation needed to improve service delivery and provide a continuum of new text end 83.11 new text begin care, such as transition of current facilities, closure of current facilities, or the development new text end 83.12 new text begin of new models of care; new text end 83.13 new text begin (2) gaps and barriers to accessing quality care, system inefficiencies, and cost new text end 83.14 new text begin pressures; new text end 83.15 new text begin (3) services that are best provided by the state and those that are best provided new text end 83.16 new text begin in the community; new text end 83.17 new text begin (4) an implementation plan to achieve integrated service delivery across the public, new text end 83.18 new text begin private, and nonprofit sectors; new text end 83.19 new text begin (5) an implementation plan to ensure that individuals with complex chemical and new text end 83.20 new text begin mental health needs receive the appropriate level of care to achieve recovery and wellness; new text end 83.21 new text begin and new text end 83.22 new text begin (6) financing mechanisms that include all possible revenue sources to maximize new text end 83.23 new text begin federal funding and promote cost efficiencies and sustainability. new text end 83.24     new text begin Subd. 3. new text end new text begin Membership. new text end new text begin The advisory group shall be composed of the following, new text end 83.25 new text begin who will serve at the pleasure of their appointing authority: new text end 83.26 new text begin (1) the commissioner of human services or the commissioner's designee, and two new text end 83.27 new text begin additional representatives from the department; new text end 83.28 new text begin (2) two legislators appointed by the speaker of the house, one from the minority new text end 83.29 new text begin and one from the majority; new text end 83.30 new text begin (3) two legislators appointed by the senate rules committee, one from the minority new text end 83.31 new text begin and one from the majority; new text end 83.32 new text begin (4) one representative appointed by AFSCME Council 5; new text end 83.33 new text begin (5) one representative appointed by the ombudsman for mental health and new text end 83.34 new text begin developmental disabilities; new text end 83.35 new text begin (6) one representative appointed by the Minnesota Association of Professional new text end 83.36 new text begin Employees; new text end 84.1 new text begin (7) one representative appointed by the Minnesota Hospital Association; new text end 84.2 new text begin (8) one representative appointed by the Minnesota Nurses Association; new text end 84.3 new text begin (9) one representative appointed by NAMI-MN; new text end 84.4 new text begin (10) one representative appointed by the Mental Health Association of Minnesota; new text end 84.5 new text begin (11) one representative appointed by the Minnesota Association Of Community new text end 84.6 new text begin Mental Health Programs; new text end 84.7 new text begin (12) one representative appointed by the Minnesota Dental Association; new text end 84.8 new text begin (13) three clients or client family members representing different populations new text end 84.9 new text begin receiving services from state-operated services, who are appointed by the commissioner; new text end 84.10 new text begin (14) one representative appointed by the chair of the state-operated services new text end 84.11 new text begin governing board; and new text end 84.12 new text begin (15) one representative appointed by the Minnesota Disability Law Center. new text end 84.13     new text begin Subd. 4. new text end new text begin Administration. new text end new text begin The commissioner shall convene the first meeting of the new text end 84.14 new text begin advisory group and shall provide administrative support and staff. new text end 84.15     new text begin Subd. 5. new text end new text begin Recommendations. new text end new text begin The advisory group must report its recommendations new text end 84.16 new text begin to the commissioner and to the legislature no later than December 15, 2010. new text end 84.17     new text begin Subd. 6. new text end new text begin Expiration. new text end new text begin This section expires January 31, 2011. new text end 84.18    Sec. 10. new text begin [245.6972] LEGISLATIVE APPROVAL REQUIRED. new text end 84.19 new text begin The commissioner of human services shall not redesign or move state-operated new text end 84.20 new text begin services programs without specific legislative approval. The commissioner may proceed new text end 84.21 new text begin with redesign at the Mankato Crisis Center and the closure of the Community Behavioral new text end 84.22 new text begin Health Hospital in Cold Spring. new text end 84.23    Sec. 11. Minnesota Statutes 2009 Supplement, section 252.025, subdivision 7, is 84.24amended to read: 84.25    Subd. 7. Minnesota extended treatment options. The commissioner shall develop 84.26by July 1, 1997, the Minnesota extended treatment options to serve Minnesotans who have 84.27developmental disabilities and exhibit severe behaviors which present a risk to public 84.28safety. This program is statewide and must provide specialized residential services in 84.29Cambridge and an array of community-based services with sufficient levels of care and a 84.30sufficient number of specialists to ensure that individuals referred to the program receive 84.31the appropriate care. new text begin The number of beds at the Cambridge facility may be reorganized new text end 84.32 new text begin into two 16-bed facilities, one for individuals with developmental disabilities and one new text end 84.33 new text begin for individuals with developmental disabilities and a co-occurring mental illness, with new text end 84.34 new text begin the remaining beds converted into transitional intensive treatment foster homes. new text end The 85.1individuals working in the community-based services under this section are state 85.2employees supervised by the commissioner of human services. No layoffs shall occur as a 85.3result of restructuring under this section. 85.4 new text begin EFFECTIVE DATE. new text end new text begin This section is effective the day following final enactment. new text end 85.5    Sec. 12. Minnesota Statutes 2008, section 254B.01, subdivision 2, is amended to read: 85.6    Subd. 2. American Indian. For purposes of services provided under section 85.7254B.09, subdivision 7 new text begin 254B.09, subdivision 8 new text end , "American Indian" means a person who is 85.8a member of an Indian tribe, and the commissioner shall use the definitions of "Indian" 85.9and "Indian tribe" and "Indian organization" provided in Public Law 93-638. For purposes 85.10of services provided under section 254B.09, subdivision 4 new text begin 254B.09, subdivision 6 new text end , 85.11"American Indian" means a resident of federally recognized tribal lands who is recognized 85.12as an Indian person by the federally recognized tribal governing body. 85.13    Sec. 13. Minnesota Statutes 2008, section 254B.02, subdivision 1, is amended to read: 85.14    Subdivision 1. Chemical dependency treatment allocation. The chemical 85.15dependency funds appropriated for allocation new text begin treatment appropriation new text end shall be placed in 85.16a special revenue account. The commissioner shall annually transfer funds from the 85.17chemical dependency fund to pay for operation of the drug and alcohol abuse normative 85.18evaluation system and to pay for all costs incurred by adding two positions for licensing 85.19of chemical dependency treatment and rehabilitation programs located in hospitals for 85.20which funds are not otherwise appropriated. Six percent of the remaining money must 85.21be reserved for tribal allocation under section 254B.09, subdivisions 4 and 5. The 85.22commissioner shall annually divide the money available in the chemical dependency 85.23fund that is not held in reserve by counties from a previous allocation, or allocated to 85.24the American Indian chemical dependency tribal account. Six percent of the remaining 85.25money must be reserved for the nonreservation American Indian chemical dependency 85.26allocation for treatment of American Indians by eligible vendors under section 254B.05, 85.27subdivision 1 . The remainder of the money must be allocated among the counties 85.28according to the following formula, using state demographer data and other data sources 85.29determined by the commissioner: new text begin in the special revenue account must be used according new text end 85.30 new text begin to the requirements in this chapter. new text end 85.31    (a) For purposes of this formula, American Indians and children under age 14 are 85.32subtracted from the population of each county to determine the restricted population. 85.33    (b) The amount of chemical dependency fund expenditures for entitled persons for 85.34services not covered by prepaid plans governed by section in the previous year is 86.1divided by the amount of chemical dependency fund expenditures for entitled persons for 86.2all services to determine the proportion of exempt service expenditures for each county. 86.3    (c) The prepaid plan months of eligibility is multiplied by the proportion of exempt 86.4service expenditures to determine the adjusted prepaid plan months of eligibility for 86.5each county. 86.6    (d) The adjusted prepaid plan months of eligibility is added to the number of 86.7restricted population fee for service months of eligibility for the Minnesota family 86.8investment program, general assistance, and medical assistance and divided by the county 86.9restricted population to determine county per capita months of covered service eligibility. 86.10    (e) The number of adjusted prepaid plan months of eligibility for the state is added 86.11to the number of fee for service months of eligibility for the Minnesota family investment 86.12program, general assistance, and medical assistance for the state restricted population and 86.13divided by the state restricted population to determine state per capita months of covered 86.14service eligibility. 86.15    (f) The county per capita months of covered service eligibility is divided by the 86.16state per capita months of covered service eligibility to determine the county welfare 86.17caseload factor. 86.18    (g) The median married couple income for the most recent three-year period 86.19available for the state is divided by the median married couple income for the same period 86.20for each county to determine the income factor for each county. 86.21    (h) The county restricted population is multiplied by the sum of the county welfare 86.22caseload factor and the county income factor to determine the adjusted population. 86.23    (i) $15,000 shall be allocated to each county. 86.24    (j) The remaining funds shall be allocated proportional to the county adjusted 86.25population. 86.26    Sec. 14. Minnesota Statutes 2008, section 254B.02, subdivision 5, is amended to read: 86.27    Subd. 5. Administrative adjustment. The commissioner may make payments to 86.28local agencies from money allocated under this section to support administrative activities 86.29under sections 254B.03 and 254B.04. The administrative payment must not exceed 86.30 new text begin the lesser of (1) new text end five percent of the first $50,000, four percent of the next $50,000, and 86.31three percent of the remaining payments for services from the allocation new text begin special revenue new text end 86.32 new text begin account according to subdivision 1; or (2) the local agency administrative payment for new text end 86.33 new text begin the fiscal year ending June 30, 2009, adjusted in proportion to the statewide change in new text end 86.34 new text begin the appropriation for this chapter new text end . 87.1    Sec. 15. Minnesota Statutes 2008, section 254B.03, subdivision 4, is amended to read: 87.2    Subd. 4. Division of costs. Except for services provided by a county under 87.3section 254B.09, subdivision 1, or services provided under section 256B.69 or 256D.03, 87.4subdivision 4 , paragraph (b), the county shall, out of local money, pay the state for 87.515 new text begin 16.14 new text end percent of the cost of chemical dependency services, including those services 87.6provided to persons eligible for medical assistance under chapter 256B and general 87.7assistance medical care under chapter 256D. Counties may use the indigent hospitalization 87.8levy for treatment and hospital payments made under this section. Fifteen new text begin 16.14 new text end percent 87.9of any state collections from private or third-party pay, less 15 percent of new text begin for new text end the cost 87.10of payment and collections, must be distributed to the county that paid for a portion of 87.11the treatment under this section. If all funds allocated according to section are 87.12exhausted by a county and the county has met or exceeded the base level of expenditures 87.13under section 254B.02, subdivision 3, the county shall pay the state for 15 percent of the 87.14costs paid by the state under this section. The commissioner may refuse to pay state funds 87.15for services to persons not eligible under section 254B.04, subdivision 1, if the county 87.16financially responsible for the persons has exhausted its allocation. 87.17    Sec. 16. Minnesota Statutes 2008, section 254B.03, is amended by adding a 87.18subdivision to read: 87.19     new text begin Subd. 4a. new text end new text begin Division of costs for medical assistance services. new text end new text begin Notwithstanding new text end 87.20 new text begin subdivision 4, for chemical dependency services provided on or after October 1, 2008, and new text end 87.21 new text begin reimbursed by medical assistance, the county share is 30 percent of the nonfederal share. new text end 87.22    Sec. 17. Minnesota Statutes 2008, section 254B.05, subdivision 4, is amended to read: 87.23    Subd. 4. Regional treatment centers. Regional treatment center chemical 87.24dependency treatment units are eligible vendors. The commissioner may expand the 87.25capacity of chemical dependency treatment units beyond the capacity funded by direct 87.26legislative appropriation to serve individuals who are referred for treatment by counties 87.27and whose treatment will be paid for with a county's allocation under section new text begin by new text end 87.28 new text begin funding under this chapter new text end or other funding sources. Notwithstanding the provisions of 87.29sections 254B.03 to 254B.041, payment for any person committed at county request to 87.30a regional treatment center under chapter 253B for chemical dependency treatment and 87.31determined to be ineligible under the chemical dependency consolidated treatment fund, 87.32shall become the responsibility of the county. 87.33    Sec. 18. Minnesota Statutes 2008, section 254B.06, subdivision 2, is amended to read: 88.1    Subd. 2. Allocation of collections. The commissioner shall allocate all federal 88.2financial participation collections to the reserve fund under section 254B.02, subdivision 3 new text begin new text end 88.3 new text begin a special revenue account new text end . The commissioner shall retain 85 new text begin allocate 83.86 new text end percent of 88.4patient payments and third-party payments new text begin to the special revenue account new text end and allocate 88.5the collections to the treatment allocation for the county that is financially responsible 88.6for the person. Fifteen new text begin 16.14 new text end percent of patient and third-party payments must be paid 88.7to the county financially responsible for the patient. Collections for patient payment and 88.8third-party payment for services provided under section shall be allocated to the 88.9allocation of the tribal unit which placed the person. Collections of federal financial 88.10participation for services provided under section shall be allocated to the tribal 88.11reserve account under section 254B.09, subdivision 5. 88.12    Sec. 19. Minnesota Statutes 2008, section 254B.09, subdivision 8, is amended to read: 88.13    Subd. 8. Payments to improve services to American Indians. The commissioner 88.14may set rates for chemical dependency services new text begin to American Indians new text end according to the 88.15American Indian Health Improvement Act, Public Law 94-437, for eligible vendors. 88.16These rates shall supersede rates set in county purchase of service agreements when 88.17payments are made on behalf of clients eligible according to Public Law 94-437. 88.18    Sec. 20. new text begin [254B.13] PILOT PROJECTS; CHEMICAL HEALTH CARE. new text end 88.19     new text begin Subdivision 1. new text end new text begin Authorization for pilot projects. new text end new text begin The commissioner of human new text end 88.20 new text begin services may approve and implement pilot projects developed under the planning process new text end 88.21 new text begin required under Laws 2009, chapter 79, article 7, section 26, to provide alternatives to and new text end 88.22 new text begin enhance coordination of the delivery of chemical health services required under section new text end 88.23 new text begin 254B.03. new text end 88.24     new text begin Subd. 2. new text end new text begin Program design and implementation. new text end new text begin (a) The commissioner of new text end 88.25 new text begin human services and counties participating in the pilot projects shall continue to work in new text end 88.26 new text begin partnership to refine and implement the pilot projects initiated under Laws 2009, chapter new text end 88.27 new text begin 79, article 7, section 26. new text end 88.28     new text begin (b) The commissioner and counties participating in the pilot projects shall new text end 88.29 new text begin complete the planning phase by June 30, 2010, and, if approved by the commissioner for new text end 88.30 new text begin implementation, enter into agreements governing the operation of the pilot projects with new text end 88.31 new text begin implementation scheduled no earlier than July 1, 2010. new text end 88.32     new text begin Subd. 3. new text end new text begin Program evaluation. new text end new text begin The commissioner of human services shall evaluate new text end 88.33 new text begin pilot projects under this section and report the results of the evaluation to the legislative new text end 88.34 new text begin committees with jurisdiction over chemical health by June 30, 2013. Evaluation of the new text end 89.1 new text begin pilot projects must be based on outcome evaluation criteria negotiated with the projects new text end 89.2 new text begin prior to implementation. new text end 89.3     new text begin Subd. 4. new text end new text begin Notice of project discontinuation. new text end new text begin Each county's participation in the new text end 89.4 new text begin pilot project may be discontinued for any reason by the county or the commissioner of new text end 89.5 new text begin human services after 30 days' written notice to the other party. Any unspent funds held new text end 89.6 new text begin for the exiting county's pro rata share in the special revenue fund under the authority new text end 89.7 new text begin in subdivision 5, paragraph (c), shall be transferred to the general fund following new text end 89.8 new text begin discontinuation of the pilot project. new text end 89.9     new text begin Subd. 5. new text end new text begin Duties of commissioner. new text end new text begin (a) Notwithstanding any other provisions in new text end 89.10 new text begin this chapter, the commissioner may authorize pilot projects to use chemical dependency new text end 89.11 new text begin treatment funds to pay for services: new text end 89.12     new text begin (1) in addition to those authorized under section 254B.03, subdivision 2, paragraph new text end 89.13 new text begin (a); and new text end 89.14     new text begin (2) by vendors in addition to those authorized under section 254B.05 when not new text end 89.15 new text begin providing chemical dependency treatment services. new text end 89.16     new text begin (b) State expenditures for chemical dependency services and any other services new text end 89.17 new text begin provided by or through the pilot projects must not be greater than chemical dependency new text end 89.18 new text begin treatment fund expenditures expected in the absence of the pilot projects. The new text end 89.19 new text begin commissioner may restructure the schedule of payments between the state and participating new text end 89.20 new text begin counties under the local agency share and division of cost provisions under section new text end 89.21 new text begin 254B.03, subdivisions 3 and 4, as necessary to facilitate the operation of the pilot projects. new text end 89.22     new text begin (c) To the extent that state fiscal year expenditures within a pilot project region are new text end 89.23 new text begin less than expected in the absence of the pilot projects, the commissioner may deposit new text end 89.24 new text begin these unexpended funds in the special revenue fund and make these funds available for new text end 89.25 new text begin expenditure by the pilot counties the following year. To the extent that treatment and pilot new text end 89.26 new text begin project ancillary services expenditures within the pilot project exceed the amount expected new text end 89.27 new text begin in the absence of the pilot projects, the pilot counties are responsible for the portion of new text end 89.28 new text begin nontreatment expenditures in excess of otherwise expected expenditures. new text end 89.29     new text begin (d) The commissioner may waive administrative rule requirements which are new text end 89.30 new text begin incompatible with the implementation of the pilot project. new text end 89.31     new text begin (e) The commissioner shall not approve or enter into any agreement related to pilot new text end 89.32 new text begin projects authorized under this section which puts current or future federal funding at risk. new text end 89.33     new text begin Subd. 6. new text end new text begin Duties of county board. new text end new text begin The county board, or other county entity that is new text end 89.34 new text begin approved to administer a pilot project, shall: new text end 89.35     new text begin (1) administer the pilot project in a manner consistent with the objectives described new text end 89.36 new text begin in subdivision 2 and the planning process in subdivision 5; new text end 90.1     new text begin (2) ensure that no one is denied chemical dependency treatment services for which new text end 90.2 new text begin they would otherwise be eligible under section 254A.03, subdivision 3; and new text end 90.3     new text begin (3) provide the commissioner of human services with timely and pertinent new text end 90.4 new text begin information as negotiated in agreements governing operation of the pilot projects. new text end 90.5    Sec. 21. Minnesota Statutes 2008, section 256.01, is amended by adding a subdivision 90.6to read: 90.7     new text begin Subd. 30. new text end new text begin Office of Health Care Inspector General. new text end new text begin (a) The commissioner shall new text end 90.8 new text begin create within the Department of Human Services an Office of Health Care Inspector new text end 90.9 new text begin General to enhance antifraud activities and to protect the integrity of the state health care new text end 90.10 new text begin programs, as well as the health and welfare of the beneficiaries of those programs. The new text end 90.11 new text begin Office of Health Care Inspector General must periodically report to the commissioner and new text end 90.12 new text begin to the legislature program and management problems and recommendations to correct new text end 90.13 new text begin them. new text end 90.14 new text begin (b) The duties of the Office of Health Care Inspector General include, but are not new text end 90.15 new text begin limited to: new text end 90.16 new text begin (1) promoting economy, efficiency, and effectiveness through the elimination of new text end 90.17 new text begin waste, fraud, and abuse; new text end 90.18 new text begin (2) conducting and supervising audits, investigations, inspections, and evaluations new text end 90.19 new text begin relating to the state health care programs under chapters 256B, 256D, and 256L; new text end 90.20 new text begin (3) identifying weaknesses giving rise to opportunities for fraud and abuse in the new text end 90.21 new text begin state health care programs and operations and making recommendations to prevent their new text end 90.22 new text begin recurrence; new text end 90.23 new text begin (4) leading and coordinating activities to prevent and detect fraud and abuse in the new text end 90.24 new text begin state health care programs and operations; new text end 90.25 new text begin (5) detecting wrongdoers and abusers of the state health care programs and new text end 90.26 new text begin beneficiaries so appropriate remedies may be brought; new text end 90.27 new text begin (6) keeping the commissioner and the legislature fully and currently informed about new text end 90.28 new text begin problems and deficiencies in the administration of the state health care programs and new text end 90.29 new text begin operations and about the need for and progress of corrective action; new text end 90.30 new text begin (7) operating a toll-free hotline to permit individuals to call in suspected fraud, new text end 90.31 new text begin waste, or abuse, referring the calls for appropriate action by the agency, and analyzing the new text end 90.32 new text begin calls to identify trends and patterns of fraud and abuse needing attention; new text end 90.33 new text begin (8) developing and reviewing legislative, regulatory, and program proposals to new text end 90.34 new text begin reduce vulnerabilities to fraud, waste, and mismanagement; and new text end 91.1 new text begin (9) recommending changes in program policies, regulations, and laws to improve new text end 91.2 new text begin efficiency and effectiveness, and to prevent fraud, waste, abuse, and mismanagement. new text end 91.3 new text begin (c) Beginning July 1, 2011, the commissioner, in consultation with the Office of new text end 91.4 new text begin Health Care Inspector General, shall annually report to the legislature and the governor new text end 91.5 new text begin new results from the two ongoing federal Medicaid audits. The commissioner shall report new text end 91.6 new text begin (1) the most recent Medicaid Integrity Program (MIP) audit results, with any corrective new text end 91.7 new text begin actions needed, and (2) certify the rate of errors determined for the state health care new text end 91.8 new text begin programs under chapters 256B, 256D, and 256L, as determined from the most recent new text end 91.9 new text begin Payment Error Rate Measurement (PERM) audit results for Minnesota. When the PERM new text end 91.10 new text begin audit rate for Minnesota is greater than the national rate for the year or the MIP audit new text end 91.11 new text begin determines the need for corrective action, the commissioner shall present a plan to the new text end 91.12 new text begin legislature and the governor for the corrective actions and reduction of the error rate new text end 91.13 new text begin in the next calendar year. new text end 91.14    Sec. 22. Laws 2009, chapter 79, article 3, section 18, is amended to read: 91.15    Sec. 18. REQUIRING THE DEVELOPMENT OF COMMUNITY-BASED 91.16MENTAL HEALTH SERVICES FOR PATIENTS COMMITTED TO THE 91.17ANOKA-METRO REGIONAL TREATMENT CENTER. 91.18In consultation with community partners, the commissioner of human services new text begin The new text end 91.19 new text begin Advisory Group on State-Operated Services Redesign new text end shall develop new text begin recommend new text end an array 91.20of community-based services to transform the current services now provided to patients 91.21at the Anoka-Metro Regional Treatment Center. The community-based services may 91.22be provided in facilities with 16 or fewer beds, and must provide the appropriate level 91.23of care for the patients being admitted to the facilities. The planning for this transition 91.24must be completed by October 1, 2009 new text begin 2010 new text end , with an initial report to the committee chairs 91.25of health and human services by November 30, 2009 new text begin 2010 new text end , and a semiannual report on 91.26progress until the transition is completed. The commissioner of human services shall 91.27solicit interest from stakeholders and potential community partners. The individuals 91.28working in the community-based services facilities under this section are state employees 91.29supervised by the commissioner of human services. No layoffs shall occur as a result of 91.30restructuring under this section. 91.31 new text begin EFFECTIVE DATE. new text end new text begin This section is effective the day following final enactment. new text end 91.32    Sec. 23. new text begin NONSUBMISSION OF HEALTH CARE CLAIM BY new text end 91.33 new text begin CLEARINGHOUSE; SIGNIFICANT DISRUPTION. new text end 92.1 new text begin (a) A situation shall be considered a significant disruption to normal operations that new text end 92.2 new text begin materially affects the provider's or facility's ability to conduct business in a normal manner new text end 92.3 new text begin and to submit claims on a timely basis under Minnesota Statutes, section 62Q.75, if: new text end 92.4 new text begin (1) a clearinghouse loses, or otherwise does not submit, a health care claim as new text end 92.5 new text begin required by Minnesota Statutes, section 62J.536; and new text end 92.6 new text begin (2) the provider or facility can substantiate that it submitted a complete claim to the new text end 92.7 new text begin clearinghouse within provisions stated in contract or six months of the date of service, new text end 92.8 new text begin whichever is less. new text end 92.9 new text begin (b) This section expires January 1, 2012. new text end 92.10    Sec. 24. new text begin REPEALER. new text end 92.11 new text begin Minnesota Statutes 2008, sections 254B.02, subdivisions 2, 3, and 4; and 254B.09, new text end 92.12 new text begin subdivisions 4, 5, and 7, new text end new text begin and new text end new text begin Laws 2009, chapter 79, article 7, section 26, subdivision new text end 92.13 new text begin 3, new text end new text begin are repealed. new text end 92.14    Sec. 25. new text begin EFFECTIVE DATE. new text end 92.15 new text begin Sections 12 to 17 and 24 are effective for claims paid on or after July 1, 2010. new text end 92.16ARTICLE 6 92.17DEPARTMENT OF HEALTH 92.18    Section 1. Minnesota Statutes 2008, section 62D.08, is amended by adding a 92.19subdivision to read: 92.20     new text begin Subd. 7. new text end new text begin Consistent administrative expenses and investment income reporting. new text end 92.21 new text begin (a) Every health maintenance organization must directly allocate administrative expenses new text end 92.22 new text begin to specific lines of business or products when such information is available. Remaining new text end 92.23 new text begin expenses that cannot be directly allocated must be allocated based on other methods, as new text end 92.24 new text begin recommended by the Advisory Group on Administrative Expenses. Health maintenance new text end 92.25 new text begin organizations must submit this information, including administrative expenses for dental new text end 92.26 new text begin services, using the reporting template provided by the commissioner of health. new text end 92.27 new text begin (b) Every health maintenance organization must allocate investment income based new text end 92.28 new text begin on cumulative net income over time by business line or product and must submit this new text end 92.29 new text begin information, including investment income for dental services, using the reporting template new text end 92.30 new text begin provided by the commissioner of health. new text end 92.31 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2012. new text end 93.1    Sec. 2. new text begin [62D.31] ADVISORY GROUP ON ADMINISTRATIVE EXPENSES. new text end 93.2     new text begin Subdivision 1. new text end new text begin Establishment. new text end new text begin The Advisory Group on Administrative Expenses new text end 93.3 new text begin is established to make recommendations on the development of consistent guidelines new text end 93.4 new text begin and reporting requirements, including development of a reporting template, for health new text end 93.5 new text begin maintenance organizations and county-based purchasers that participate in publicly new text end 93.6 new text begin funded programs. new text end 93.7     new text begin Subd. 2. new text end new text begin Membership. new text end new text begin The membership of the advisory group shall be comprised new text end 93.8 new text begin of the following, who serve at the pleasure of their appointing authority: new text end 93.9 new text begin (1) the commissioner of health or the commissioner's designee; new text end 93.10 new text begin (2) the commissioner of human services or the commissioner's designee; new text end 93.11 new text begin (3) the commissioner of commerce or the commissioner's designee; and new text end 93.12 new text begin (4) representatives of health maintenance organizations and county-based purchasers new text end 93.13 new text begin appointed by the commissioner of health. new text end 93.14     new text begin Subd. 3. new text end new text begin Administration. new text end new text begin The commissioner of health shall convene the first new text end 93.15 new text begin meeting of the advisory group by September 1, 2010, and shall provide administrative new text end 93.16 new text begin support and staff. The commissioner of health may contract with a consultant to provide new text end 93.17 new text begin professional assistance and expertise to the advisory group. new text end 93.18     new text begin Subd. 4. new text end new text begin Recommendations. new text end new text begin The Advisory Group on Administrative Expenses new text end 93.19 new text begin must report its recommendations, including any proposed legislation necessary to new text end 93.20 new text begin implement the recommendations, to the commissioner of health and to the chairs and new text end 93.21 new text begin ranking minority members of the legislative committees and divisions with jurisdiction new text end 93.22 new text begin over health policy and finance by July 1, 2011. new text end 93.23     new text begin Subd. 5. new text end new text begin Expiration. new text end new text begin This section expires after submission of the report required new text end 93.24 new text begin under subdivision 4 or June 30, 2012, whichever is sooner. new text end 93.25    Sec. 3. Minnesota Statutes 2009 Supplement, section 62J.495, subdivision 1a, is 93.26amended to read: 93.27    Subd. 1a. Definitions. (a) "Certified electronic health record technology" means an 93.28electronic health record that is certified pursuant to section 3001(c)(5) of the HITECH 93.29Act to meet the standards and implementation specifications adopted under section 3004 93.30as applicable. 93.31(b) "Commissioner" means the commissioner of health. 93.32(c) "Pharmaceutical electronic data intermediary" means any entity that provides 93.33the infrastructure to connect computer systems or other electronic devices utilized 93.34by prescribing practitioners with those used by pharmacies, health plans, third-party 93.35administrators, and pharmacy benefit managers in order to facilitate the secure 94.1transmission of electronic prescriptions, refill authorization requests, communications, 94.2and other prescription-related information between such entities. 94.3(d) "HITECH Act" means the Health Information Technology for Economic and 94.4Clinical Health Act in division A, title XIII and division B, title IV of the American 94.5Recovery and Reinvestment Act of 2009, including federal regulations adopted under 94.6that act. 94.7(e) "Interoperable electronic health record" means an electronic health record that 94.8securely exchanges health information with another electronic health record system that 94.9meets new text begin requirements specified in subdivision 3, and new text end national requirements for certification 94.10under the HITECH Act. 94.11(f) "Qualified electronic health record" means an electronic record of health-related 94.12information on an individual that includes patient demographic and clinical health 94.13information and has the capacity to: 94.14(1) provide clinical decision support; 94.15(2) support physician order entry; 94.16(3) capture and query information relevant to health care quality; and 94.17(4) exchange electronic health information with, and integrate such information 94.18from, other sources. 94.19    Sec. 4. Minnesota Statutes 2009 Supplement, section 62J.495, subdivision 3, is 94.20amended to read: 94.21    Subd. 3. Interoperable electronic health record requirements. To meet the 94.22requirements of subdivision 1, hospitals and health care providers must meet the following 94.23criteria when implementing an interoperable electronic health records system within their 94.24hospital system or clinical practice setting. 94.25(a) The electronic health record must be a qualified electronic health record. 94.26    (b) The electronic health record must be certified by the Office of the National 94.27Coordinator pursuant to the HITECH Act. This criterion only applies to hospitals and 94.28health care providers only if a certified electronic health record product for the provider's 94.29particular practice setting is available. This criterion shall be considered met if a hospital 94.30or health care provider is using an electronic health records system that has been certified 94.31within the last three years, even if a more current version of the system has been certified 94.32within the three-year period. 94.33(c) The electronic health record must meet the standards established according to 94.34section 3004 of the HITECH Act as applicable. 95.1(d) The electronic health record must have the ability to generate information on 95.2clinical quality measures and other measures reported under sections 4101, 4102, and 95.34201 of the HITECH Act. 95.4 new text begin (e) The electronic health record system must be connected to a state-certified new text end 95.5 new text begin health information organization either directly or through a connection facilitated by a new text end 95.6 new text begin state-certified health data intermediary as defined in section 62J.498. new text end 95.7    (e) new text begin (f) new text end A health care provider who is a prescriber or dispenser of legend drugs must 95.8have an electronic health record system that meets the requirements of section 62J.497. 95.9    Sec. 5. Minnesota Statutes 2009 Supplement, section 62J.495, is amended by adding a 95.10subdivision to read: 95.11     new text begin Subd. 6. new text end new text begin State agency information system. new text end new text begin Development of a state agency new text end 95.12 new text begin information system necessary to implement this section is subject to the authority of the new text end 95.13 new text begin Office of Enterprise Technology in chapter 16E, including, but not limited to: new text end 95.14 new text begin (1) evaluation and approval of the system as specified in section 16E.03, subdivisions new text end 95.15 new text begin 3 and 4; new text end 95.16 new text begin (2) review of the system to ensure compliance with security policies, guidelines, and new text end 95.17 new text begin standards as specified in section 16E.03, subdivision 7; and new text end 95.18 new text begin (3) assurance that the system complies with accessibility standards developed under new text end 95.19 new text begin section 16E.03, subdivision 9. new text end 95.20    Sec. 6. new text begin [62J.498] HEALTH INFORMATION EXCHANGE. new text end 95.21     new text begin Subdivision 1. new text end new text begin Definitions. new text end new text begin The following definitions apply to sections 62J.498 to new text end 95.22 new text begin 62J.4982: new text end 95.23 new text begin (a) "Clinical transaction" means any meaningful use transaction that is not covered new text end 95.24 new text begin by section 62J.536. new text end 95.25 new text begin (b) "Commissioner" means the commissioner of health. new text end 95.26 new text begin (c) "Direct health information exchange" means the electronic transmission of new text end 95.27 new text begin health-related information through a direct connection between the electronic health new text end 95.28 new text begin record systems of health care providers without the use of a health data intermediary. new text end 95.29 new text begin (d) "Health care provider" or "provider" means a health care provider or provider as new text end 95.30 new text begin defined in section 62J.03, subdivision 8. new text end 95.31 new text begin (e) "Health data intermediary" means an entity that provides the infrastructure to new text end 95.32 new text begin connect computer systems or other electronic devices used by health care providers, new text end 95.33 new text begin laboratories, pharmacies, health plans, third-party administrators, or pharmacy benefit new text end 95.34 new text begin managers to facilitate the secure transmission of health information, including new text end 96.1 new text begin pharmaceutical electronic data intermediaries as defined in section 62J.495. This does not new text end 96.2 new text begin include health care providers engaged in a direct health information exchange. new text end 96.3 new text begin (f) "Health information exchange" means the electronic transmission of new text end 96.4 new text begin health-related information between organizations according to nationally recognized new text end 96.5 new text begin standards. new text end 96.6 new text begin (g) "Health information exchange service provider" means a health data intermediary new text end 96.7 new text begin or health information organization that has been issued a certificate of authority by the new text end 96.8 new text begin commissioner under section 62J.4981. new text end 96.9 new text begin (h) "Health information organization" means an organization that oversees, governs, new text end 96.10 new text begin and facilitates the exchange of health-related information among organizations according new text end 96.11 new text begin to nationally recognized standards. new text end 96.12 new text begin (i) "HITECH Act" means the Health Information Technology for Economic and new text end 96.13 new text begin Clinical Health Act as defined in section 62J.495. new text end 96.14 new text begin (j) "Major participating entity" means: new text end 96.15 new text begin (1) a participating entity that receives compensation for services that is greater new text end 96.16 new text begin than 30 percent of the health information organization's gross annual revenues from the new text end 96.17 new text begin health information exchange service provider; new text end 96.18 new text begin (2) a participating entity providing administrative, financial, or management services new text end 96.19 new text begin to the health information organization, if the total payment for all services provided by the new text end 96.20 new text begin participating entity exceeds three percent of the gross revenue of the health information new text end 96.21 new text begin organization; and new text end 96.22 new text begin (3) a participating entity that nominates or appoints 30 percent or more of the board new text end 96.23 new text begin of directors of the health information organization. new text end 96.24 new text begin (k) "Meaningful use" means use of certified electronic health record technology that new text end 96.25 new text begin includes e-prescribing, and is connected in a manner that provides for the electronic new text end 96.26 new text begin exchange of health information and used for the submission of clinical quality measures new text end 96.27 new text begin as established by the Center for Medicare and Medicaid Services and the Minnesota new text end 96.28 new text begin Department of Human Services pursuant to sections 4101, 4102, and 4201 of the HITECH new text end 96.29 new text begin Act. new text end 96.30 new text begin (l) "Meaningful use transaction" means an electronic transaction that a health care new text end 96.31 new text begin provider must exchange to receive Medicare or Medicaid incentives or avoid Medicare new text end 96.32 new text begin penalties pursuant to sections 4101, 4102, and 4201 of the HITECH Act. new text end 96.33 new text begin (m) "Participating entity" means any of the following persons, health care providers, new text end 96.34 new text begin companies, or other organizations with which a health information organization or health new text end 96.35 new text begin data intermediary has contracts or other agreements for the provision of health information new text end 96.36 new text begin exchange service providers: new text end 97.1 new text begin (1) a health care facility licensed under sections 144.50 to 144.56, a nursing home new text end 97.2 new text begin licensed under sections 144A.02 to 144A.10, and any other health care facility otherwise new text end 97.3 new text begin licensed under the laws of this state or registered with the commissioner; new text end 97.4 new text begin (2) a health care provider, and any other health care professional otherwise licensed new text end 97.5 new text begin under the laws of this state or registered with the commissioner; new text end 97.6 new text begin (3) a group, professional corporation, or other organization that provides the new text end 97.7 new text begin services of individuals or entities identified in clause (2), including but not limited to a new text end 97.8 new text begin medical clinic, a medical group, a home health care agency, an urgent care center, and new text end 97.9 new text begin an emergent care center; new text end 97.10 new text begin (4) a health plan as defined in section 62A.011, subdivision 3; and new text end 97.11 new text begin (5) a state agency as defined in section 13.02, subdivision 17. new text end 97.12 new text begin (n) "Reciprocal agreement" means an arrangement in which two or more health new text end 97.13 new text begin information exchange service providers agree to share in-kind services and resources to new text end 97.14 new text begin allow for the pass-through of meaningful use transactions. new text end 97.15 new text begin (o) "State-certified health data intermediary" means a health data intermediary that: new text end 97.16 new text begin (1) provides a subset of the meaningful use transaction capabilities necessary for new text end 97.17 new text begin hospitals and providers to achieve meaningful use of electronic health records; new text end 97.18 new text begin (2) is not exclusively engaged in the exchange of meaningful use transactions new text end 97.19 new text begin covered by section 62J.536; and new text end 97.20 new text begin (3) has been issued a certificate of authority to operate in Minnesota. new text end 97.21 new text begin (p) "State-certified health information organization" means a nonprofit health new text end 97.22 new text begin information organization that provides transaction capabilities necessary to fully support new text end 97.23 new text begin clinical transactions required for meaningful use of electronic health records that has been new text end 97.24 new text begin issued a certificate of authority to operate in Minnesota. new text end 97.25     new text begin Subd. 2. new text end new text begin Health information exchange oversight. new text end new text begin (a) The commissioner shall new text end 97.26 new text begin protect the public interest on matters pertaining to health information exchange. The new text end 97.27 new text begin commissioner shall: new text end 97.28 new text begin (1) review and act on applications from health data intermediaries and health new text end 97.29 new text begin information organizations for certificates of authority to operate in Minnesota; new text end 97.30 new text begin (2) provide ongoing monitoring to ensure compliance with criteria established under new text end 97.31 new text begin sections 62J.498 to 62J.4982; new text end 97.32 new text begin (3) respond to public complaints related to health information exchange services; new text end 97.33 new text begin (4) take enforcement actions as necessary, including the imposition of fines, new text end 97.34 new text begin suspension, or revocation of certificates of authority as outlined in section 62J.4982; new text end 97.35 new text begin (5) provide a biannual report on the status of health information exchange services new text end 97.36 new text begin that includes but is not limited to: new text end 98.1 new text begin (i) recommendations on actions necessary to ensure that health information exchange new text end 98.2 new text begin services are adequate to meet the needs of Minnesota citizens and providers statewide; new text end 98.3 new text begin (ii) recommendations on enforcement actions to ensure that health information new text end 98.4 new text begin exchange service providers act in the public interest without causing disruption in health new text end 98.5 new text begin information exchange services; new text end 98.6 new text begin (iii) recommendations on updates to criteria for obtaining certificates of authority new text end 98.7 new text begin under this section; and new text end 98.8 new text begin (iv) recommendations on standard operating procedures for health information new text end 98.9 new text begin exchange, including but not limited to the management of consumer preferences; and new text end 98.10 new text begin (6) other duties necessary to protect the public interest. new text end 98.11 new text begin (b) As part of the application review process for certification under paragraph (a), new text end 98.12 new text begin prior to issuing a certificate of authority, the commissioner shall: new text end 98.13 new text begin (1) hold public hearings that provide an adequate opportunity for participating new text end 98.14 new text begin entities and consumers to provide feedback and recommendations on the application under new text end 98.15 new text begin consideration. The commissioner shall make all portions of the application classified new text end 98.16 new text begin as public data available to the public at least ten days in advance of the hearing. The new text end 98.17 new text begin applicant shall participate in the hearing by presenting an application overview and new text end 98.18 new text begin responding to questions from interested parties; new text end 98.19 new text begin (2) make available all feedback and recommendations from the hearing available to new text end 98.20 new text begin the public prior to issuing a certificate of authority; and new text end 98.21 new text begin (3) consult with hospitals, physicians, and other professionals eligible to receive new text end 98.22 new text begin meaningful use incentive payments or are subject to penalties as established in the new text end 98.23 new text begin HITECH Act, and their respective statewide associations, prior to issuing a certificate of new text end 98.24 new text begin authority. new text end 98.25 new text begin (c)(1) When the commissioner is actively considering a suspension or revocation of new text end 98.26 new text begin a certificate of authority as described in section 62J.4982, subdivision 3, all investigatory new text end 98.27 new text begin data that are collected, created, or maintained related to the suspension or revocation new text end 98.28 new text begin are classified as confidential data on individuals and as protected nonpublic data in the new text end 98.29 new text begin case of data not on individuals. new text end 98.30 new text begin (2) The commissioner may disclose data classified as protected nonpublic or new text end 98.31 new text begin confidential under this paragraph if disclosing the data will protect the health or safety of new text end 98.32 new text begin patients. new text end 98.33 new text begin (d) After the commissioner makes a final determination regarding a suspension or new text end 98.34 new text begin revocation of a certificate of authority, all minutes, orders for hearing, findings of fact, new text end 98.35 new text begin conclusions of law, and the specification of the final disciplinary action, are classified new text end 98.36 new text begin as public data. new text end 99.1    Sec. 7. new text begin [62J.4981] CERTIFICATE OF AUTHORITY TO PROVIDE HEALTH new text end 99.2 new text begin INFORMATION EXCHANGE SERVICES. new text end 99.3     new text begin Subdivision 1. new text end new text begin Authority to require organizations to apply. new text end new text begin The commissioner new text end 99.4 new text begin shall require an entity providing health information exchange services to apply for a new text end 99.5 new text begin certificate of authority under this section. An applicant may continue to operate until new text end 99.6 new text begin the commissioner acts on the application. If the application is denied, the applicant is new text end 99.7 new text begin considered a health information organization whose certificate of authority has been new text end 99.8 new text begin revoked under section 62J.4982, subdivision 2, paragraph (d). new text end 99.9     new text begin Subd. 2. new text end new text begin Certificate of authority for health data intermediaries. new text end new text begin (a) A health new text end 99.10 new text begin data intermediary that provides health information exchange services for the transmission new text end 99.11 new text begin of one or more clinical transactions necessary for hospitals, providers, or eligible new text end 99.12 new text begin professionals to achieve meaningful use must be registered with the state and comply with new text end 99.13 new text begin requirements established in this section. new text end 99.14 new text begin (b) Notwithstanding any law to the contrary, any corporation organized to do so new text end 99.15 new text begin may apply to the commissioner for a certificate of authority to establish and operate as new text end 99.16 new text begin a health data intermediary in compliance with this section. No person shall establish or new text end 99.17 new text begin operate a health data intermediary in this state, nor sell or offer to sell, or solicit offers new text end 99.18 new text begin to purchase or receive advance or periodic consideration in conjunction with a health new text end 99.19 new text begin data intermediary contract unless the organization has a certificate of authority or has an new text end 99.20 new text begin application under active consideration under this section. new text end 99.21 new text begin (c) In issuing the certificate of authority, the commissioner shall determine whether new text end 99.22 new text begin the applicant for the certificate of authority has demonstrated that the applicant meets new text end 99.23 new text begin the following minimum criteria: new text end 99.24 new text begin (1) can interoperate with at least one state-certified health information organization; new text end 99.25 new text begin (2) can provide an option for Minnesota entities to connect to their services through new text end 99.26 new text begin at least one state-certified health information organization; new text end 99.27 new text begin (3) has a record locator service as defined in section 144.291, subdivision 2, new text end 99.28 new text begin paragraph (i), that is compliant with the requirements of section 144.293, subdivision 8, new text end 99.29 new text begin when conducting meaningful use transactions; and new text end 99.30 new text begin (4) holds reciprocal agreements with at least one state-certified health information new text end 99.31 new text begin organization to enable access to record locator services to find patient data, and for the new text end 99.32 new text begin transmission and receipt of meaningful use transactions consistent with the format and new text end 99.33 new text begin content required by national standards established by Centers for Medicare and Medicaid new text end 99.34 new text begin Services. Reciprocal agreements must meet the requirements established in subdivision 5. new text end 99.35     new text begin Subd. 3. new text end new text begin Certificate of authority for health information organizations. new text end 99.36 new text begin (a) A health information organization that provides all electronic capabilities for the new text end 100.1 new text begin transmission of clinical transactions necessary for meaningful use of electronic health new text end 100.2 new text begin records must obtain a certificate of authority from the commissioner and demonstrate new text end 100.3 new text begin compliance with the criteria in paragraph (c). new text end 100.4 new text begin (b) Notwithstanding any law to the contrary, a nonprofit corporation organized to do new text end 100.5 new text begin so may apply for a certificate of authority to establish and operate a health information new text end 100.6 new text begin organization under this section. No person shall establish or operate a health information new text end 100.7 new text begin organization in this state, or sell or offer to sell, or solicit offers to purchase or receive new text end 100.8 new text begin advance or periodic consideration in conjunction with a health information organization new text end 100.9 new text begin or health information contract unless the organization has a certificate of authority under new text end 100.10 new text begin this section. new text end 100.11 new text begin (c) In issuing the certificate of authority, the commissioner shall determine whether new text end 100.12 new text begin the applicant for the certificate of authority has demonstrated that the applicant meets new text end 100.13 new text begin the following minimum criteria: new text end 100.14 new text begin (1) the entity is a legally established, nonprofit organization; new text end 100.15 new text begin (2) has appropriate insurance, including liability insurance, for the operation of the new text end 100.16 new text begin health information organization is in place and sufficient to protect the interest of the new text end 100.17 new text begin public and participating entities; new text end 100.18 new text begin (3) has strategic and operational plans that clearly address how the organization will new text end 100.19 new text begin expand technical capacity of the health information organization to support providers in new text end 100.20 new text begin achieving meaningful use of electronic health records over time; new text end 100.21 new text begin (4) the entity addresses the parameters to be used with participating entities and new text end 100.22 new text begin other health information organizations for meaningful use transactions, compliance with new text end 100.23 new text begin Minnesota law, and interstate health information exchange in trust agreements; new text end 100.24 new text begin (5) the entity's board of directors is comprised of members that broadly represent the new text end 100.25 new text begin health information organization's participating entities and consumers; new text end 100.26 new text begin (6) the entity maintains a professional staff responsible to the board of directors with new text end 100.27 new text begin the capacity to ensure accountability to the organization's mission; new text end 100.28 new text begin (7) the entity is compliant with criteria established under the Health Information new text end 100.29 new text begin Exchange Accreditation Program of the Electronic Healthcare Network Accreditation new text end 100.30 new text begin Commission (EHNAC) or equivalent criteria established by the commissioner; new text end 100.31 new text begin (8) the entity maintains a record locator service as defined in section 144.291, new text end 100.32 new text begin subdivision 2, paragraph (i), that is compliant with the requirements of section 144.293, new text end 100.33 new text begin subdivision 8, when conducting meaningful use transactions; new text end 100.34 new text begin (9) the organization demonstrates interoperability with all other state-certified health new text end 100.35 new text begin information organizations using nationally recognized standards; new text end 101.1 new text begin (10) the organization demonstrates compliance with all privacy and security new text end 101.2 new text begin requirements required by state and federal law; and new text end 101.3 new text begin (11) the organization uses financial policies and procedures consistent with generally new text end 101.4 new text begin accepted accounting principles and has an independent audit of the organization's new text end 101.5 new text begin financials on an annual basis. new text end 101.6 new text begin (d) Health information organizations that have obtained a certificate of authority new text end 101.7 new text begin must: new text end 101.8 new text begin (1) meet the requirements established for connecting to the Nationwide Health new text end 101.9 new text begin Information Network (NHIN) within the federally mandated timeline or within a time new text end 101.10 new text begin frame established by the commissioner and published in the State Register. If the state new text end 101.11 new text begin timeline for implementation varies from the federal timeline, the State Register notice new text end 101.12 new text begin shall include an explanation for the variation; new text end 101.13 new text begin (2) annually submit strategic and operational plans for review by the commissioner new text end 101.14 new text begin that address: new text end 101.15 new text begin (i) increasing adoption rates to include a sufficient number of participating entities to new text end 101.16 new text begin achieve financial sustainability; and new text end 101.17 new text begin (ii) progress in achieving objectives included in previously submitted strategic new text end 101.18 new text begin and operational plans across the following domains: business and technical operations, new text end 101.19 new text begin technical infrastructure, legal and policy issues, finance, and organizational governance; new text end 101.20 new text begin (3) develop and maintain a business plan that addresses: new text end 101.21 new text begin (i) plans for ensuring the necessary capacity to support meaningful use transactions; new text end 101.22 new text begin (ii) approach for attaining financial sustainability, including public and private new text end 101.23 new text begin financing strategies, and rate structures; new text end 101.24 new text begin (iii) rates of adoption, utilization, and transaction volume, and mechanisms to new text end 101.25 new text begin support health information exchange; and new text end 101.26 new text begin (iv) an explanation of methods employed to address the needs of community clinics, new text end 101.27 new text begin critical access hospitals, and free clinics in accessing health information exchange services; new text end 101.28 new text begin (4) annually submit a rate plan outlining fee structures for health information new text end 101.29 new text begin exchange services for approval by the commissioner. The commissioner shall approve the new text end 101.30 new text begin rate plan if it: new text end 101.31 new text begin (i) distributes costs equitably among users of health information services; new text end 101.32 new text begin (ii) provides predictable costs for participating entities; new text end 101.33 new text begin (iii) covers all costs associated with conducting the full range of meaningful use new text end 101.34 new text begin clinical transactions, including access to health information retrieved through other new text end 101.35 new text begin state-certified health information exchange service providers; and new text end 102.1 new text begin (iv) provides for a predictable revenue stream for the health information organization new text end 102.2 new text begin and generates sufficient resources to maintain operating costs and develop technical new text end 102.3 new text begin infrastructure necessary to serve the public interest; new text end 102.4 new text begin (5) enter into reciprocal agreements with all other state-certified health information new text end 102.5 new text begin organizations to enable access to record locator services to find patient data, and new text end 102.6 new text begin transmission and receipt of meaningful use transactions consistent with the format and new text end 102.7 new text begin content required by national standards established by Centers for Medicare and Medicaid new text end 102.8 new text begin Services. Reciprocal agreements must meet the requirements in subdivision 5; and new text end 102.9 new text begin (6) comply with additional requirements for the certification or recertification of new text end 102.10 new text begin health information organizations that may be established by the commissioner. new text end 102.11     new text begin Subd. 4. new text end new text begin Application for certificate of authority for health information exchange new text end 102.12 new text begin service providers. new text end new text begin (a) Each application for a certificate of authority shall be in a form new text end 102.13 new text begin prescribed by the commissioner and verified by an officer or authorized representative of new text end 102.14 new text begin the applicant. Each application shall include the following: new text end 102.15 new text begin (1) a copy of the basic organizational document, if any, of the applicant and of new text end 102.16 new text begin each major participating entity, such as the articles of incorporation, or other applicable new text end 102.17 new text begin documents, and all amendments to it; new text end 102.18 new text begin (2) a list of the names, addresses, and official positions of the following: new text end 102.19 new text begin (i) all members of the board of directors and the principal officers and, if applicable, new text end 102.20 new text begin shareholders of the applicant organization; and new text end 102.21 new text begin (ii) all members of the board of directors and the principal officers of each major new text end 102.22 new text begin participating entity and, if applicable, each shareholder beneficially owning more than ten new text end 102.23 new text begin percent of any voting stock of the major participating entity; new text end 102.24 new text begin (3) the name and address of each participating entity and the agreed-upon duration new text end 102.25 new text begin of each contract or agreement if applicable; new text end 102.26 new text begin (4) a copy of each standard agreement or contract intended to bind the participating new text end 102.27 new text begin entities and the health information organization. Contractual provisions shall be consistent new text end 102.28 new text begin with the purposes of this section in regard to the services to be performed under the new text end 102.29 new text begin standard agreement or contract, the manner in which payment for services is determined, new text end 102.30 new text begin the nature and extent of responsibilities to be retained by the health information new text end 102.31 new text begin organization, and contractual termination provisions; new text end 102.32 new text begin (5) a copy of each contract intended to bind major participating entities and the new text end 102.33 new text begin health information organization. Contract information filed with the commissioner under new text end 102.34 new text begin this section shall be nonpublic as defined in section 13.02, subdivision 9; new text end 102.35 new text begin (6) a statement generally describing the health information organization, its health new text end 102.36 new text begin information exchange contracts, facilities, and personnel, including a statement describing new text end 103.1 new text begin the manner in which the applicant proposes to provide participants with comprehensive new text end 103.2 new text begin health information exchange services; new text end 103.3 new text begin (7) financial statements showing the applicant's assets, liabilities, and sources new text end 103.4 new text begin of financial support, including a copy of the applicant's most recent certified financial new text end 103.5 new text begin statement; new text end 103.6 new text begin (8) strategic and operational plans that specifically address how the organization new text end 103.7 new text begin will expand technical capacity of the health information organization to support providers new text end 103.8 new text begin in achieving meaningful use of electronic health records over time, a description of new text end 103.9 new text begin the proposed method of marketing the services, a schedule of proposed charges, and a new text end 103.10 new text begin financial plan that includes a three-year projection of the expenses and income and other new text end 103.11 new text begin sources of future capital; new text end 103.12 new text begin (9) a statement reasonably describing the geographic area or areas to be served and new text end 103.13 new text begin the type or types of participants to be served; new text end 103.14 new text begin (10) a description of the complaint procedures to be used as required under this new text end 103.15 new text begin section; new text end 103.16 new text begin (11) a description of the mechanism by which participating entities will have an new text end 103.17 new text begin opportunity to participate in matters of policy and operation; new text end 103.18 new text begin (12) a copy of any pertinent agreements between the health information organization new text end 103.19 new text begin and insurers, including liability insurers, demonstrating coverage is in place; new text end 103.20 new text begin (13) a copy of the conflict of interest policy that applies to all members of the board new text end 103.21 new text begin of directors and the principal officers of the health information organization; and new text end 103.22 new text begin (14) other information as the commissioner may reasonably require to be provided. new text end 103.23 new text begin (b) Thirty days after the receipt of the application for a certificate of authority, new text end 103.24 new text begin the commissioner shall determine whether or not the application submitted meets the new text end 103.25 new text begin requirements for completion in paragraph (a), and notify the applicant of any further new text end 103.26 new text begin information required for the application to be processed. new text end 103.27 new text begin (c) Ninety days after the receipt of a complete application for a certificate of new text end 103.28 new text begin authority, the commissioner shall issue a certificate of authority to the applicant if the new text end 103.29 new text begin commissioner determines that the applicant meets the minimum criteria requirements new text end 103.30 new text begin of subdivision 2 for health data intermediaries or subdivision 3 for health information new text end 103.31 new text begin organizations. If the commissioner determines that the applicant is not qualified, the new text end 103.32 new text begin commissioner shall notify the applicant and specify the reasons for disqualification. new text end 103.33 new text begin (d) Upon being granted a certificate of authority to operate as a health information new text end 103.34 new text begin organization, the organization must operate in compliance with the provisions of this new text end 103.35 new text begin section. Noncompliance may result in the imposition of a fine or the suspension or new text end 103.36 new text begin revocation of the certificate of authority according to section 62J.4982. new text end 104.1     new text begin Subd. 5. new text end new text begin Reciprocal agreements between health information exchange entities. new text end 104.2 new text begin (a) Reciprocal agreements between two health information organizations or between a new text end 104.3 new text begin health information organization and a health data intermediary must include a fair and new text end 104.4 new text begin equitable model for charges between the entities that: new text end 104.5 new text begin (1) does not impede the secure transmission of transactions necessary to achieve new text end 104.6 new text begin meaningful use; new text end 104.7 new text begin (2) does not charge a fee for the exchange of meaningful use transactions transmitted new text end 104.8 new text begin according to nationally recognized standards where no additional value-added service new text end 104.9 new text begin is rendered to the sending or receiving health information organization or health data new text end 104.10 new text begin intermediary either directly or on behalf of the client; new text end 104.11 new text begin (3) is consistent with fair market value and proportionately reflects the value-added new text end 104.12 new text begin services accessed as a result of the agreement; and new text end 104.13 new text begin (4) prevents health care stakeholders from being charged multiple times for the new text end 104.14 new text begin same service. new text end 104.15 new text begin (b) Reciprocal agreements must include comparable quality of service standards that new text end 104.16 new text begin ensure equitable levels of services. new text end 104.17 new text begin (c) Reciprocal agreements are subject to review and approval by the commissioner. new text end 104.18 new text begin (d) Nothing in this section precludes a state-certified health information organization new text end 104.19 new text begin or state-certified health data intermediary from entering into contractual agreements for new text end 104.20 new text begin the provision of value-added services beyond meaningful use. new text end 104.21 new text begin (e) The commissioner of human services or health, when providing access to data or new text end 104.22 new text begin services through a certified health information organization, must offer the same data or new text end 104.23 new text begin services directly through any certified health information organization at the same pricing, new text end 104.24 new text begin if the health information organization pays for all connection costs to the state data or new text end 104.25 new text begin service. For all external connectivity to the respective agencies through existing or future new text end 104.26 new text begin information exchange implementations, the respective agency shall establish the required new text end 104.27 new text begin connectivity methods as well as protocol standards to be utilized. new text end 104.28     new text begin Subd. 6. new text end new text begin State participation in health information exchange. new text end new text begin A state agency new text end 104.29 new text begin that connects to a health information exchange service provider for the purpose of new text end 104.30 new text begin exchanging meaningful use transactions must ensure that the contracted health information new text end 104.31 new text begin exchange service provider has reciprocal agreements in place as required by this section. new text end 104.32 new text begin The reciprocal agreements must provide equal access to information supplied by the new text end 104.33 new text begin agency and necessary for meaningful use by the participating entities of the other health new text end 104.34 new text begin information service providers. new text end 104.35    Sec. 8. new text begin [62J.4982] ENFORCEMENT AUTHORITY; COMPLIANCE. new text end 105.1     new text begin Subdivision 1. new text end new text begin Penalties and enforcement. new text end new text begin (a) The commissioner may, for any new text end 105.2 new text begin violation of statute or rule applicable to a health information exchange service provider, new text end 105.3 new text begin levy an administrative penalty in an amount up to $25,000 for each violation. In new text end 105.4 new text begin determining the level of an administrative penalty, the commissioner shall consider the new text end 105.5 new text begin following factors: new text end 105.6 new text begin (1) the number of participating entities affected by the violation; new text end 105.7 new text begin (2) the effect of the violation on participating entities' access to health information new text end 105.8 new text begin exchange services; new text end 105.9 new text begin (3) if only one participating entity is affected, the effect of the violation on the new text end 105.10 new text begin patients of that entity; new text end 105.11 new text begin (4) whether the violation is an isolated incident or part of a pattern of violations; new text end 105.12 new text begin (5) the economic benefits derived by the health information organization or a health new text end 105.13 new text begin data intermediary by virtue of the violation; new text end 105.14 new text begin (6) whether the violation hindered or facilitated an individual's ability to obtain new text end 105.15 new text begin health care; new text end 105.16 new text begin (7) whether the violation was intentional; new text end 105.17 new text begin (8) whether the violation was beyond the direct control of the health information new text end 105.18 new text begin exchange service provider; new text end 105.19 new text begin (9) any history of prior compliance with the provisions of this section, including new text end 105.20 new text begin violations; new text end 105.21 new text begin (10) whether and to what extent the health information exchange service provider new text end 105.22 new text begin attempted to correct previous violations; new text end 105.23 new text begin (11) how the health information exchange service provider responded to technical new text end 105.24 new text begin assistance from the commissioner provided in the context of a compliance effort; and new text end 105.25 new text begin (12) the financial condition of the health information exchange service provider new text end 105.26 new text begin including, but not limited to, whether the health information exchange service provider new text end 105.27 new text begin had financial difficulties that affected its ability to comply or whether the imposition of an new text end 105.28 new text begin administrative monetary penalty would jeopardize the ability of the health information new text end 105.29 new text begin exchange service provider to continue to deliver health information exchange services. new text end 105.30 new text begin Reasonable notice in writing shall be given to the health information exchange new text end 105.31 new text begin service provider of the intent to levy the penalty and the reasons for them. A health new text end 105.32 new text begin information exchange service provider may have 15 days within which to contest whether new text end 105.33 new text begin the finding of facts constitute a violation of this section and section 62J.4981, according to new text end 105.34 new text begin the contested case and judicial review provisions of sections 14.57 to 14.69. new text end 105.35 new text begin (b) If the commissioner has reason to believe that a violation of this section or new text end 105.36 new text begin section 62J.4981 has occurred or is likely, the commissioner may confer with the persons new text end 106.1 new text begin involved before commencing action under subdivision 2. The commissioner may notify new text end 106.2 new text begin the health information exchange service provider and the representatives, or other persons new text end 106.3 new text begin who appear to be involved in the suspected violation, to arrange a voluntary conference new text end 106.4 new text begin with the alleged violators or their authorized representatives. The purpose of the new text end 106.5 new text begin conference is to attempt to learn the facts about the suspected violation and if it appears new text end 106.6 new text begin that a violation has occurred or is threatened, to find a way to correct or prevent it. The new text end 106.7 new text begin conference is not governed by any formal procedural requirements and may be conducted new text end 106.8 new text begin as the commissioner considers appropriate. new text end 106.9 new text begin (c) The commissioner may issue an order directing a health information exchange new text end 106.10 new text begin service provider or a representative of a health information exchange service provider to new text end 106.11 new text begin cease and desist from engaging in any act or practice in violation of this section and new text end 106.12 new text begin section 62J.4981. new text end 106.13 new text begin (d) Within 20 days after service of the order to cease and desist, a health information new text end 106.14 new text begin exchange service provider may contest whether the finding of facts constitutes a violation new text end 106.15 new text begin of this section and section 62J.4981 according to the contested case and judicial review new text end 106.16 new text begin provisions of sections 14.57 to 14.69. new text end 106.17 new text begin (e) In the event of noncompliance with a cease and desist order issued under this new text end 106.18 new text begin subdivision, the commissioner may institute a proceeding to obtain injunctive relief or new text end 106.19 new text begin other appropriate relief in Ramsey County District Court. new text end 106.20     new text begin Subd. 2. new text end new text begin Suspension or revocation of certificates of authority. new text end new text begin (a) The new text end 106.21 new text begin commissioner may suspend or revoke a certificate of authority issued to a health new text end 106.22 new text begin data intermediary or health information organization under section 62J.4981 if the new text end 106.23 new text begin commissioner finds that: new text end 106.24 new text begin (1) the health information exchange service provider is operating significantly new text end 106.25 new text begin in contravention of its basic organizational document, or in a manner contrary to that new text end 106.26 new text begin described in and reasonably inferred from any other information submitted under section new text end 106.27 new text begin 62J.4981, unless amendments to the submissions have been filed with and approved by new text end 106.28 new text begin the commissioner; new text end 106.29 new text begin (2) the health information exchange service provider is unable to fulfill its new text end 106.30 new text begin obligations to furnish comprehensive health information exchange services as required new text end 106.31 new text begin under its health information exchange contract; new text end 106.32 new text begin (3) the health information exchange service provider is no longer financially solvent new text end 106.33 new text begin or may not reasonably be expected to meet its obligations to participating entities; new text end 106.34 new text begin (4) the health information exchange service provider has failed to implement the new text end 106.35 new text begin complaint system in a manner designed to reasonably resolve valid complaints; new text end 107.1 new text begin (5) the health information exchange service provider, or any person acting with its new text end 107.2 new text begin sanction, has advertised or merchandised its services in an untrue, misleading, deceptive, new text end 107.3 new text begin or unfair manner; new text end 107.4 new text begin (6) the continued operation of the health information exchange service provider new text end 107.5 new text begin would be hazardous to its participating entities or the patients served by the participating new text end 107.6 new text begin entities; or new text end 107.7 new text begin (7) the health information exchange service provider has otherwise failed to new text end 107.8 new text begin substantially comply with section 62J.4981 or with any other statute or administrative new text end 107.9 new text begin rule applicable to health information exchange service providers, or has submitted false new text end 107.10 new text begin information in any report required under sections 62J.498 to 62J.4982. new text end 107.11 new text begin (b) A certificate of authority shall be suspended or revoked only after meeting the new text end 107.12 new text begin requirements of subdivision 3. new text end 107.13 new text begin (c) If the certificate of authority of a health information exchange service provider is new text end 107.14 new text begin suspended, the health information exchange service provider shall not, during the period new text end 107.15 new text begin of suspension, enroll any additional participating entities, and shall not engage in any new text end 107.16 new text begin advertising or solicitation. new text end 107.17 new text begin (d) If the certificate of authority of a health information exchange service provider is new text end 107.18 new text begin revoked, the organization shall proceed, immediately following the effective date of the new text end 107.19 new text begin order of revocation, to wind up its affairs and shall conduct no further business except as new text end 107.20 new text begin necessary to the orderly conclusion of the affairs of the organization. The organization new text end 107.21 new text begin shall engage in no further advertising or solicitation. The commissioner may, by written new text end 107.22 new text begin order, permit further operation of the organization as the commissioner finds to be in the new text end 107.23 new text begin best interest of participating entities, to the end that participating entities will be given the new text end 107.24 new text begin greatest practical opportunity to access continuing health information exchange services. new text end 107.25     new text begin Subd. 3. new text end new text begin Denial, suspension, and revocation; administrative procedures. new text end new text begin (a) new text end 107.26 new text begin When the commissioner has cause to believe that grounds for the denial, suspension, new text end 107.27 new text begin or revocation of a certificate of authority exists, the commissioner shall notify the new text end 107.28 new text begin health information exchange service provider in writing stating the grounds for denial, new text end 107.29 new text begin suspension, or revocation and setting a time within 20 days for a hearing on the matter. new text end 107.30 new text begin (b) After a hearing before the commissioner at which the health information new text end 107.31 new text begin exchange service provider may respond to the grounds for denial, suspension, or new text end 107.32 new text begin revocation, or upon the failure of the health information exchange service provider to new text end 107.33 new text begin appear at the hearing, the commissioner shall take action as deemed necessary and shall new text end 107.34 new text begin issue written findings that shall be mailed to the health information exchange service new text end 107.35 new text begin provider. new text end 108.1 new text begin (c) If suspension, revocation, or an administrative penalty is proposed according new text end 108.2 new text begin to this section, the commissioner must deliver, or send by certified mail with return new text end 108.3 new text begin receipt requested, to the health information exchange service provider written notice of new text end 108.4 new text begin the commissioner's intent to impose a penalty. This notice of proposed determination new text end 108.5 new text begin must include: new text end 108.6 new text begin (1) a reference to the statutory basis for the penalty; new text end 108.7 new text begin (2) a description of the findings of fact regarding the violations with respect to new text end 108.8 new text begin which the penalty is proposed; new text end 108.9 new text begin (3) the nature and amount of the proposed penalty; new text end 108.10 new text begin (4) any circumstances described in subdivision 1, paragraph (a), that were considered new text end 108.11 new text begin in determining the amount of the proposed penalty; new text end 108.12 new text begin (5) instructions for responding to the notice, including a statement of the health new text end 108.13 new text begin information exchange service provider's right to a contested case proceeding and a new text end 108.14 new text begin statement that failure to request a contested case proceeding within 30 calendar days new text end 108.15 new text begin permits the imposition of the proposed penalty; and new text end 108.16 new text begin (6) the address to which the contested case proceeding request must be sent. new text end 108.17     new text begin Subd. 4. new text end new text begin Coordination. new text end new text begin (a) To the extent possible when implementing sections new text end 108.18 new text begin 62J.498 to 62J.4982, the commissioner shall seek the advice of the Minnesota e-Health new text end 108.19 new text begin Advisory Committee, in the review and update of criteria for the certification and new text end 108.20 new text begin recertification of health information exchange service providers. new text end 108.21 new text begin (b) By January 1, 2011, the commissioner shall report to the governor and the new text end 108.22 new text begin chairs of the senate and house of representatives committees having jurisdiction over new text end 108.23 new text begin health information policy issues on the status of the health information exchange in new text end 108.24 new text begin Minnesota and provide recommendations on further action necessary to facilitate the new text end 108.25 new text begin secure electronic movement of health information among health providers that will enable new text end 108.26 new text begin Minnesota providers and hospitals to meet meaningful use exchange requirements. new text end 108.27     new text begin Subd. 5. new text end new text begin Fees and monetary penalties. new text end new text begin (a) Every health information exchange new text end 108.28 new text begin service provider subject to this section and section 62J.4981 shall be assessed fees as new text end 108.29 new text begin follows: new text end 108.30 new text begin (1) filing an application for certificate of authority to operate as a health information new text end 108.31 new text begin organization, $10,500; new text end 108.32 new text begin (2) filing an application for certificate of authority to operate as a health data new text end 108.33 new text begin intermediary, $7,000; new text end 108.34 new text begin (3) annual health information organization certificate fee, $14,000; new text end 108.35 new text begin (4) annual health data intermediary certificate fee, $7,000; and new text end 108.36 new text begin (5) fees for other filings, as specified by rule. new text end 109.1 new text begin (b) Administrative monetary penalties imposed under this subdivision shall be new text end 109.2 new text begin deposited into a revolving fund and are appropriated to the commissioner for the purposes new text end 109.3 new text begin of sections 62J.498 to 62J.4982. new text end 109.4    Sec. 9. Minnesota Statutes 2008, section 62Q.19, subdivision 1, is amended to read: 109.5    Subdivision 1. Designation. (a) The commissioner shall designate essential 109.6community providers. The criteria for essential community provider designation shall be 109.7the following: 109.8(1) a demonstrated ability to integrate applicable supportive and stabilizing services 109.9with medical care for uninsured persons and high-risk and special needs populations, 109.10underserved, and other special needs populations; and 109.11(2) a commitment to serve low-income and underserved populations by meeting the 109.12following requirements: 109.13(i) has nonprofit status in accordance with chapter 317A; 109.14(ii) has tax exempt status in accordance with the Internal Revenue Service Code, 109.15section 501(c)(3); 109.16(iii) charges for services on a sliding fee schedule based on current poverty income 109.17guidelines; and 109.18(iv) does not restrict access or services because of a client's financial limitation; 109.19(3) status as a local government unit as defined in section 62D.02, subdivision 11, a 109.20hospital district created or reorganized under sections 447.31 to 447.37, an Indian tribal 109.21government, an Indian health service unit, or a community health board as defined in 109.22chapter 145A; 109.23(4) a former state hospital that specializes in the treatment of cerebral palsy, spina 109.24bifida, epilepsy, closed head injuries, specialized orthopedic problems, and other disabling 109.25conditions; or 109.26(5) a sole community hospital. For these rural hospitals, the essential community 109.27provider designation applies to all health services provided, including both inpatient and 109.28outpatient services. For purposes of this section, "sole community hospital" means a 109.29rural hospital that: 109.30(i) is eligible to be classified as a sole community hospital according to Code 109.31of Federal Regulations, title 42, section 412.92, or is located in a community with a 109.32population of less than 5,000 and located more than 25 miles from a like hospital currently 109.33providing acute short-term services; 110.1(ii) has experienced net operating income losses in two of the previous three 110.2most recent consecutive hospital fiscal years for which audited financial information is 110.3available; and 110.4(iii) consists of 40 or fewer licensed beds new text begin ; or new text end 110.5 new text begin (6) a birth center licensed under section 144.615 new text end . 110.6(b) Prior to designation, the commissioner shall publish the names of all applicants 110.7in the State Register. The public shall have 30 days from the date of publication to submit 110.8written comments to the commissioner on the application. No designation shall be made 110.9by the commissioner until the 30-day period has expired. 110.10(c) The commissioner may designate an eligible provider as an essential community 110.11provider for all the services offered by that provider or for specific services designated by 110.12the commissioner. 110.13(d) For the purpose of this subdivision, supportive and stabilizing services include at 110.14a minimum, transportation, child care, cultural, and linguistic services where appropriate. 110.15    Sec. 10. Minnesota Statutes 2008, section 144.226, subdivision 3, is amended to read: 110.16    Subd. 3. Birth record surcharge. new text begin (a) new text end In addition to any fee prescribed under 110.17subdivision 1, there shall be a nonrefundable surcharge of $3 for each certified birth or 110.18stillbirth record and for a certification that the vital record cannot be found. The local or 110.19state registrar shall forward this amount to the commissioner of management and budget 110.20for deposit into the account for the children's trust fund for the prevention of child abuse 110.21established under section 256E.22. This surcharge shall not be charged under those 110.22circumstances in which no fee for a certified birth or stillbirth record is permitted under 110.23subdivision 1, paragraph (a). Upon certification by the commissioner of management and 110.24budget that the assets in that fund exceed $20,000,000, this surcharge shall be discontinued. 110.25 new text begin (b) In addition to any fee prescribed under subdivision 1, there shall be a new text end 110.26 new text begin nonrefundable surcharge of $10 for each certified birth record. The local or state registrar new text end 110.27 new text begin shall forward this amount to the commissioner of finance for deposit in the general fund new text end 110.28 new text begin for the Minnesota Birth Defects Information System established under section 144.2215. new text end 110.29 new text begin This surcharge shall not be charged under those circumstances in which no fee for a new text end 110.30 new text begin certified birth record is permitted under subdivision 1, paragraph (a). new text end 110.31 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2010. new text end 110.32    Sec. 11. new text begin [144.615] BIRTH CENTERS. new text end 110.33     new text begin Subdivision 1. new text end new text begin Definitions. new text end new text begin (a) For purposes of this section, the following definitions new text end 110.34 new text begin have the meanings given them. new text end 111.1 new text begin (b) "Birth center" means a facility licensed for the primary purpose of performing new text end 111.2 new text begin low-risk deliveries that is not a hospital or licensed as part of a hospital and where births are new text end 111.3 new text begin planned to occur away from the mother's usual residence following a low-risk pregnancy. new text end 111.4 new text begin (c) "CABC" means the Commission for the Accreditation of Birth Centers. new text end 111.5 new text begin (d) "Low-risk pregnancy" means a normal, uncomplicated prenatal course as new text end 111.6 new text begin determined by documentation of adequate prenatal care and the anticipation of a normal new text end 111.7 new text begin uncomplicated labor and birth, as defined by reasonable and generally accepted criteria new text end 111.8 new text begin adopted by professional groups for maternal, fetal, and neonatal health care. new text end 111.9     new text begin Subd. 2. new text end new text begin License required. new text end new text begin (a) Beginning January 1, 2011, no birth center shall be new text end 111.10 new text begin established, operated, or maintained in the state without first obtaining a license from the new text end 111.11 new text begin commissioner of health according to this section. new text end 111.12 new text begin (b) A license issued under this section is not transferable or assignable and is subject new text end 111.13 new text begin to suspension or revocation at any time for failure to comply with this section. new text end 111.14 new text begin (c) A birth center licensed under this section shall not assert, represent, offer, new text end 111.15 new text begin provide, or imply that the center is or may render care or services other than the services it new text end 111.16 new text begin is permitted to render within the scope of the license or the accreditation issued. new text end 111.17 new text begin (d) The license must be conspicuously posted in an area where patients are admitted. new text end 111.18     new text begin Subd. 3. new text end new text begin Temporary license. new text end new text begin For new birth centers planning to begin operations new text end 111.19 new text begin after January 1, 2011, the commissioner may issue a temporary license to the birth center new text end 111.20 new text begin that is valid for a period of six months from the date of issuance. The birth center must new text end 111.21 new text begin submit to the commissioner an application and applicable fee for licensure as required new text end 111.22 new text begin under subdivision 4. The application must include the information required in subdivision new text end 111.23 new text begin 4, clauses (1) to (3) and (5) to (7), and documentation that the birth center has submitted new text end 111.24 new text begin an application for accreditation to the CABC. Upon receipt of accreditation from the new text end 111.25 new text begin CABC, the birth center must submit to the commissioner the information required in new text end 111.26 new text begin subdivision 4, clause (4), and the applicable fee under subdivision 8. The commissioner new text end 111.27 new text begin shall issue a new license. new text end 111.28     new text begin Subd. 4. new text end new text begin Application. new text end new text begin An application for a license to operate a birth center and the new text end 111.29 new text begin applicable fee under subdivision 8 must be submitted to the commissioner on a form new text end 111.30 new text begin provided by the commissioner and must contain: new text end 111.31 new text begin (1) the name of the applicant; new text end 111.32 new text begin (2) the site location of the birth center; new text end 111.33 new text begin (3) the name of the person in charge of the center; new text end 111.34 new text begin (4) documentation that the accreditation described under subdivision 6 has been new text end 111.35 new text begin issued, including the effective date and the expiration date of the accreditation, and the new text end 111.36 new text begin date of the last site visit by the CABC; new text end 112.1 new text begin (5) the number of patients the birth center is capable of serving at a given time; new text end 112.2 new text begin (6) the names and license numbers, if applicable, of the health care professionals new text end 112.3 new text begin on staff at the birth center; and new text end 112.4 new text begin (7) any other information the commissioner deems necessary. new text end 112.5     new text begin Subd. 5. new text end new text begin Suspension, revocation, and refusal to renew. new text end new text begin The commissioner may new text end 112.6 new text begin refuse to grant or renew, or may suspend or revoke, a license on any of the grounds new text end 112.7 new text begin described under section 144.55, subdivision 6, paragraph (a), clause (2), (3), or (4), or new text end 112.8 new text begin upon the loss of accreditation by the CABC. The applicant or licensee is entitled to notice new text end 112.9 new text begin and a hearing as described under section 144.55, subdivision 7, and a new license may be new text end 112.10 new text begin issued after proper inspection of the birth center has been conducted. new text end 112.11     new text begin Subd. 6. new text end new text begin Standards for licensure. new text end new text begin (a) To be eligible for licensure under this new text end 112.12 new text begin section, a birth center must be accredited by the CABC or must obtain accreditation new text end 112.13 new text begin within six months of the date of the application for licensure. If the birth center loses its new text end 112.14 new text begin accreditation, the birth center must immediately notify the commissioner. new text end 112.15 new text begin (b) The center must have procedures in place specifying criteria by which risk status new text end 112.16 new text begin will be established and applied to each woman at admission and during labor. new text end 112.17 new text begin (c) Upon request, the birth center shall provide the commissioner of health with any new text end 112.18 new text begin material submitted by the birth center to the CABC as part of the accreditation process, new text end 112.19 new text begin including the accreditation application, the self-evaluation report, the accreditation new text end 112.20 new text begin decision letter from the CABC, and any reports from the CABC following a site visit. new text end 112.21     new text begin Subd. 7. new text end new text begin Limitations of services. new text end new text begin (a) The following limitations apply to the services new text end 112.22 new text begin performed at a birth center: new text end 112.23 new text begin (1) surgical procedures must be limited to those normally accomplished during an new text end 112.24 new text begin uncomplicated birth, including episiotomy and repair; new text end 112.25 new text begin (2) no abortions may be administered; and new text end 112.26 new text begin (3) no general or regional anesthesia may be administered. new text end 112.27 new text begin (b) Notwithstanding paragraph (a), local anesthesia may be administered at a birth new text end 112.28 new text begin center if the administration of the anesthetic is performed within the scope of practice of a new text end 112.29 new text begin health care professional. new text end 112.30     new text begin Subd. 8. new text end new text begin Fees. new text end new text begin (a) The biennial license fee for a birth center is $365. new text end 112.31 new text begin (b) The temporary license fee is $365. new text end 112.32 new text begin (c) Fees shall be collected and deposited according to section 144.122. new text end 112.33     new text begin Subd. 9. new text end new text begin Renewal. new text end new text begin (a) Except as provided in paragraph (b), a license issued under new text end 112.34 new text begin this section expires two years from the date of issue. new text end 112.35 new text begin (b) A temporary license issued under subdivision 3 expires six months from the date new text end 112.36 new text begin of issue, and may be renewed for one additional six-month period. new text end 113.1 new text begin (c) An application for renewal shall be submitted at least 60 days prior to expiration new text end 113.2 new text begin of the license on forms prescribed by the commissioner of health. new text end 113.3     new text begin Subd. 10. new text end new text begin Records. new text end new text begin All health records maintained on each client by a birth center new text end 113.4 new text begin are subject to sections 144.292 to 144.298. new text end 113.5     new text begin Subd. 11. new text end new text begin Report. new text end new text begin (a) The commissioner of health, in consultation with the new text end 113.6 new text begin commissioner of human services and representatives of the licensed birth centers, new text end 113.7 new text begin the American College of Obstetricians and Gynecologists, the American Academy new text end 113.8 new text begin of Pediatrics, the Minnesota Hospital Association, and the Minnesota Ambulance new text end 113.9 new text begin Association, shall evaluate the quality of care and outcomes for services provided in new text end 113.10 new text begin licensed birth centers, including, but not limited to, the utilization of services provided at a new text end 113.11 new text begin birth center, the outcomes of care provided to both mothers and newborns, and the numbers new text end 113.12 new text begin of transfers to other health care facilities that are required and the reasons for the transfers. new text end 113.13 new text begin The commissioner shall work with the birth centers to establish a process to gather and new text end 113.14 new text begin analyze the data within protocols that protect the confidentiality of patient identification. new text end 113.15 new text begin (b) The commissioner of health shall report the findings of the evaluation to the new text end 113.16 new text begin legislature by January 15, 2014. new text end 113.17    Sec. 12. Minnesota Statutes 2008, section 144.651, subdivision 2, is amended to read: 113.18    Subd. 2. Definitions. For the purposes of this section, "patient" means a person 113.19who is admitted to an acute care inpatient facility for a continuous period longer than 113.2024 hours, for the purpose of diagnosis or treatment bearing on the physical or mental 113.21health of that person. For purposes of subdivisions 4 to 9, 12, 13, 15, 16, and 18 to 20, 113.22"patient" also means a person who receives health care services at an outpatient surgical 113.23center new text begin or at a birth center licensed under section 144.615 new text end . "Patient" also means a minor 113.24who is admitted to a residential program as defined in section 253C.01. For purposes of 113.25subdivisions 1, 3 to 16, 18, 20 and 30, "patient" also means any person who is receiving 113.26mental health treatment on an outpatient basis or in a community support program or other 113.27community-based program. "Resident" means a person who is admitted to a nonacute care 113.28facility including extended care facilities, nursing homes, and boarding care homes for 113.29care required because of prolonged mental or physical illness or disability, recovery from 113.30injury or disease, or advancing age. For purposes of all subdivisions except subdivisions 113.3128 and 29, "resident" also means a person who is admitted to a facility licensed as a board 113.32and lodging facility under Minnesota Rules, parts 4625.0100 to 4625.2355, or a supervised 113.33living facility under Minnesota Rules, parts 4665.0100 to 4665.9900, and which operates 113.34a rehabilitation program licensed under Minnesota Rules, parts 9530.4100 to 9530.4450. 114.1    Sec. 13. Minnesota Statutes 2008, section 144.9504, is amended by adding a 114.2subdivision to read: 114.3     new text begin Subd. 12. new text end new text begin Blood lead level guidelines. new text end new text begin (a) By January 1, 2011, the commissioner new text end 114.4 new text begin must revise clinical and case management guidelines to include recommendations new text end 114.5 new text begin for protective health actions and follow-up services when a child's blood lead level new text end 114.6 new text begin exceeds five micrograms of lead per deciliter of blood. The revised guidelines must be new text end 114.7 new text begin implemented to the extent possible using available resources. new text end 114.8 new text begin (b) In revising the clinical and case management guidelines for blood lead levels new text end 114.9 new text begin greater than five micrograms of lead per deciliter of blood under this subdivision, new text end 114.10 new text begin the commissioner of health must consult with a statewide organization representing new text end 114.11 new text begin physicians, the public health department of Minneapolis and other public health new text end 114.12 new text begin departments, and a nonprofit organization with expertise in lead abatement. new text end 114.13    Sec. 14. Minnesota Statutes 2008, section 144A.51, subdivision 5, is amended to read: 114.14    Subd. 5. Health facility. "Health facility" means a facility or that part of a facility 114.15which is required to be licensed pursuant to sections 144.50 to 144.58, new text begin 144.615, new text end and a 114.16facility or that part of a facility which is required to be licensed under any law of this state 114.17which provides for the licensure of nursing homes. 114.18    Sec. 15. Minnesota Statutes 2008, section 144E.37, is amended to read: 114.19144E.37 COMPREHENSIVE ADVANCED LIFE SUPPORT. 114.20The board new text begin commissioner of health new text end shall establish a comprehensive advanced 114.21life-support educational program to train rural medical personnel, including physicians, 114.22physician assistants, nurses, and allied health care providers, in a team approach to 114.23anticipate, recognize, and treat life-threatening emergencies before serious injury or 114.24cardiac arrest occurs. 114.25 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2010. new text end 114.26    Sec. 16. new text begin HEALTH PLAN AND COUNTY ADMINISTRATIVE COST new text end 114.27 new text begin REDUCTION; REPORTING REQUIREMENTS. new text end 114.28 new text begin (a) Minnesota health plans and county-based purchasing plans may complete an new text end 114.29 new text begin inventory of existing data collection and reporting requirements for health plans and new text end 114.30 new text begin county-based purchasing plans and submit to the commissioners of health and human new text end 114.31 new text begin services a list of data, documentation, and reports that: new text end 115.1 new text begin (1) are collected from the same health plan or county-based purchasing plan more new text end 115.2 new text begin than once; new text end 115.3 new text begin (2) are collected directly from the health plan or county-based purchasing plan but new text end 115.4 new text begin are available to the state agencies from other sources; new text end 115.5 new text begin (3) are not currently being used by state agencies; or new text end 115.6 new text begin (4) collect similar information more than once in different formats, at different new text end 115.7 new text begin times, or by more than one state agency. new text end 115.8 new text begin (b) The report to the commissioners may also identify the percentage of health new text end 115.9 new text begin plan and county-based purchasing plan administrative time and expense attributed to new text end 115.10 new text begin fulfilling reporting requirements and include recommendations regarding ways to reduce new text end 115.11 new text begin duplicative reporting requirements. new text end 115.12 new text begin (c) Upon receipt, the commissioners shall submit the inventory and recommendations new text end 115.13 new text begin to the chairs of the appropriate legislative committees, along with their comments new text end 115.14 new text begin and recommendations as to whether any action should be taken by the legislature to new text end 115.15 new text begin establish a consolidated and streamlined reporting system under which data, reports, and new text end 115.16 new text begin documentation are collected only once and only when needed for the state agencies to new text end 115.17 new text begin fulfill their duties under law and applicable regulations. new text end 115.18    Sec. 17. new text begin APPLICATION PROCESS FOR HEALTH INFORMATION new text end 115.19 new text begin EXCHANGE. new text end 115.20 new text begin To the extent that the commissioner of health applies for additional federal funding new text end 115.21 new text begin to support the commissioner's responsibilities of developing and maintaining state level new text end 115.22 new text begin health information exchange under section 3013 of the HITECH Act, the commissioner of new text end 115.23 new text begin health shall ensure that applications are made through an open process that provides health new text end 115.24 new text begin information exchange service providers equal opportunity to receive funding. new text end 115.25    Sec. 18. new text begin TRANSFER. new text end 115.26 new text begin The powers and duties of the Emergency Medical Services Regulatory Board with new text end 115.27 new text begin respect to the comprehensive advanced life-support educational program under Minnesota new text end 115.28 new text begin Statutes, section 144E.37, are transferred to the commissioner of health under Minnesota new text end 115.29 new text begin Statutes, section 15.039. new text end 115.30 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2010. new text end 115.31    Sec. 19. new text begin REVISOR'S INSTRUCTION. new text end 116.1 new text begin The revisor of statutes shall renumber Minnesota Statutes, section 144E.37, as new text end 116.2 new text begin Minnesota Statutes, section 144.6062, and make all necessary changes in statutory new text end 116.3 new text begin cross-references in Minnesota Statutes and Minnesota Rules. new text end 116.4 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2010. new text end 116.5ARTICLE 7 116.6HEALTH CARE REFORM 116.7    Section 1. new text begin [62E.20] RELATIONSHIP TO TEMPORARY FEDERAL HIGH-RISK new text end 116.8 new text begin POOL. new text end 116.9     new text begin Subdivision 1. new text end new text begin Definitions. new text end new text begin (a) For purposes of this section, the terms defined in new text end 116.10 new text begin this subdivision have the meanings given. new text end 116.11 new text begin (b) "Association" means the Minnesota Comprehensive Health Association. new text end 116.12 new text begin (c) "Federal law" means Title I, subtitle B, section 1101, of the federal Patient new text end 116.13 new text begin Protection and Affordable Care Act, Public Law 111-148, including any federal new text end 116.14 new text begin regulations adopted under it. new text end 116.15 new text begin (d) "Federal qualified high-risk pool" means an arrangement established by the new text end 116.16 new text begin federal secretary of health and human services that meets the requirements of the federal new text end 116.17 new text begin law. new text end 116.18     new text begin Subd. 2. new text end new text begin Timing of this section. new text end new text begin This section applies beginning as of the date the new text end 116.19 new text begin temporary federal qualified high risk health pool created under the federal law begins new text end 116.20 new text begin to provide coverage in this state. new text end 116.21     new text begin Subd. 3. new text end new text begin Maintenance of effort. new text end new text begin The assessments made by the comprehensive new text end 116.22 new text begin health association on its member insurers must comply with the maintenance of effort new text end 116.23 new text begin requirement contained in paragraph (b), clause (3), of the federal law, to the extent that new text end 116.24 new text begin requirement applies to assessments made by the association. new text end 116.25     new text begin Subd. 4. new text end new text begin Coordination with federal law. new text end new text begin Upon the date a federal qualified high-risk new text end 116.26 new text begin pool begins to provide coverage in this state, the comprehensive health association must new text end 116.27 new text begin not enroll new enrollees, notwithstanding section 62E.14 or other law to the contrary. If new text end 116.28 new text begin the lack of new enrollees would otherwise lead to noncompliance with subdivision 3, the new text end 116.29 new text begin association shall reduce the premiums to levels below those otherwise required under new text end 116.30 new text begin section 62E.08, to the extent necessary to comply with subdivision 3. new text end 116.31     new text begin Subd. 5. new text end new text begin Coordination with state health care programs. new text end new text begin The commissioner of new text end 116.32 new text begin human services, in consultation with the commissioner of commerce and the Minnesota new text end 116.33 new text begin Comprehensive Health Association, shall coordinate enrollment between medical new text end 117.1 new text begin assistance, MinnesotaCare, the federal qualified high-risk pool, and the Minnesota new text end 117.2 new text begin Comprehensive Health Association, to ensure that: new text end 117.3 new text begin (1) applicants for coverage through the federal qualified high-risk pool, or through new text end 117.4 new text begin the Minnesota Comprehensive Health Association to the extent the association is enrolling new text end 117.5 new text begin new members, are referred to the medical assistance or MinnesotaCare programs if they new text end 117.6 new text begin are determined to be potentially eligible for coverage through those programs; and new text end 117.7 new text begin (2) applicants for coverage under medical assistance or MinnesotaCare who are new text end 117.8 new text begin determined not to be eligible for those programs are provided information about coverage new text end 117.9 new text begin through the federal qualified high-risk pool and the Minnesota Comprehensive Health new text end 117.10 new text begin Association. new text end 117.11    Sec. 2. Minnesota Statutes 2008, section 62J.07, subdivision 2, is amended to read: 117.12    Subd. 2. Membership. The Legislative Commission on Health Care Access 117.13consists of five new text begin seven new text end members of the senate appointed under the rules of the senate and 117.14five new text begin seven new text end members of the house of representatives appointed under the rules of the house 117.15of representatives. The Legislative Commission on Health Care Access must include three new text begin new text end 117.16 new text begin five new text end members of the majority party and two members of the minority party in each house. 117.17    Sec. 3. Minnesota Statutes 2008, section 62J.07, is amended by adding a subdivision to 117.18read: 117.19     new text begin Subd. 5. new text end new text begin Federal health care reform. new text end new text begin (a) The Legislative Commission on new text end 117.20 new text begin Health Care Access shall analyze options and make recommendations regarding the new text end 117.21 new text begin implementation of provisions of the Patient Protection and Affordable Health Care Act, new text end 117.22 new text begin Public Law 111-148, and the health care reform provisions in the Health Care and new text end 117.23 new text begin Education Reconciliation Act of 2010, Public Law 111-152, including: new text end 117.24 new text begin (1) development of accountable care organizations; new text end 117.25 new text begin (2) health insurance reform, including options related to coverage, purchasing, new text end 117.26 new text begin exchange development, and coverage for high-risk individuals; and new text end 117.27 new text begin (3) other provisions that will require changes in state law. new text end 117.28 new text begin (b) Before finalizing and submitting federal applications for pilot projects authorized new text end 117.29 new text begin under federal health care reform, the governor and state agencies shall seek review and new text end 117.30 new text begin advice from the commission. new text end 117.31 new text begin (c) The commission may create and make appointments to work groups to assist the new text end 117.32 new text begin commission in its work. Work group members may include legislators, representatives new text end 117.33 new text begin of businesses and nonprofit agencies impacted by federal health care reform, academic new text end 117.34 new text begin experts, and consumer representatives. new text end 118.1    Sec. 4. Minnesota Statutes 2008, section 62U.05, is amended to read: 118.262U.05 PROVIDER PRICING FOR BASKETS OF CARE new text begin ; ACCOUNTABLE new text end 118.3 new text begin CARE ORGANIZATIONS new text end . 118.4    Subdivision 1. Establishment of definitions. (a) By July 1, 2009, the commissioner 118.5of health shall establish uniform definitions for baskets of care beginning with a minimum 118.6of seven baskets of care. In selecting health conditions for which baskets of care should 118.7be defined, the commissioner shall consider coronary artery and heart disease, diabetes, 118.8asthma, and depression. In selecting health conditions, the commissioner shall also 118.9consider the prevalence of the health conditions, the cost of treating the health conditions, 118.10and the potential for innovations to reduce cost and improve quality. 118.11    (b) The commissioner shall convene one or more work groups to assist in 118.12establishing these definitions. Each work group shall include members appointed by 118.13statewide associations representing relevant health care providers and health plan 118.14companies, and organizations that work to improve health care quality in Minnesota. 118.15    (c) To the extent possible, the baskets of care must incorporate a patient-directed, 118.16decision-making support model. 118.17 new text begin (d) By January 1, 2012, the commissioner shall establish uniform definitions for the new text end 118.18 new text begin total cost of providing all necessary services to a patient through an accountable care new text end 118.19 new text begin organization meeting the standards specified in section 3022 of the Patient Protection new text end 118.20 new text begin and Affordable Care Act, Public Law 111-148, and shall develop a standard method new text end 118.21 new text begin and format for accountable care organizations to use for submitting package prices for new text end 118.22 new text begin the total cost of care. This method must be published in the State Register and must be new text end 118.23 new text begin made available to all providers. new text end 118.24    Subd. 2. Package prices. (a) Beginning January 1, 2010, health care providers may 118.25establish package prices for the baskets of care defined under subdivision 1. new text begin Beginning new text end 118.26 new text begin July 1, 2012, accountable care organizations may establish package prices for the total new text end 118.27 new text begin cost of care defined under subdivision 1. new text end 118.28    (b) Beginning January 1, 2010, no health care provider or group of providers that 118.29has established a package price for a basket of care under this section new text begin , and beginning new text end 118.30 new text begin July 1, 2012, no accountable care organization that has established a package price for new text end 118.31 new text begin the total cost of care under this section, new text end shall vary the payment amount that the provider 118.32 new text begin or organization new text end accepts as full payment for a health care service based upon the identity of 118.33the payer, upon a contractual relationship with a payer, upon the identity of the patient, 118.34or upon whether the patient has coverage through a group purchaser. This paragraph 118.35applies only to health care services provided to Minnesota residents or to non-Minnesota 118.36residents who obtain health insurance through a Minnesota employer. This paragraph does 119.1not apply to services paid for by Medicare, state public health care programs through 119.2fee-for-service or prepaid arrangements, workers' compensation, or no-fault automobile 119.3insurance. This paragraph does not affect the right of a provider to provide charity care 119.4or care for a reduced price due to financial hardship of the patient or due to the patient 119.5being a relative or friend of the provider. 119.6    Subd. 3. Quality measurements for baskets of care. (a) The commissioner shall 119.7establish quality measurements for the defined baskets of care by December 31, 2009. new text begin new text end 119.8 new text begin The commissioner shall establish quality measures for the total cost of care for services new text end 119.9 new text begin delivered through an accountable care organization by June 30, 2012. new text end The commissioner 119.10may contract with an organization that works to improve health care quality to make 119.11recommendations about the use of existing measures or establishing new measures where 119.12no measures currently exist. 119.13    (b) Beginning July 1, 2010, the commissioner or the commissioner's designee shall 119.14publish comparative price and quality information on the baskets of care in a manner 119.15that is easily accessible and understandable to the public, as this information becomes 119.16available. new text begin Beginning January 1, 2013, the commissioner or the commissioner's designee new text end 119.17 new text begin shall publish comparative price and quality information on the total cost of care for new text end 119.18 new text begin services delivered through an accountable care organization in a manner that is easily new text end 119.19 new text begin accessible and understandable to the public, as this information becomes available. new text end 119.20    Sec. 5. Minnesota Statutes 2008, section 256B.0754, is amended by adding a 119.21subdivision to read: 119.22     new text begin Subd. 3. new text end new text begin Accountable care organizations. new text end new text begin By July 1, 2012, the commissioner of new text end 119.23 new text begin human services shall deliver services to enrollees in state health care programs through new text end 119.24 new text begin accountable care organizations, and shall provide incentive payments to accountable care new text end 119.25 new text begin organizations that meet or exceed annual quality and performance targets. Accountable new text end 119.26 new text begin care organizations and incentive payments must meet the standards specified in the Patient new text end 119.27 new text begin Protection and Affordable Care Act, Public Law 111-148. new text end 119.28    Sec. 6. new text begin [256B.0756] COORDINATED CARE THROUGH A HEALTH HOME. new text end 119.29     new text begin Subdivision 1. new text end new text begin Provision of coverage. new text end new text begin (a) The commissioner shall provide new text end 119.30 new text begin medical assistance coverage of health home services for eligible individuals with chronic new text end 119.31 new text begin conditions who select a designated provider, a team of health care professionals, or a new text end 119.32 new text begin health team as the individual's health home. new text end 119.33 new text begin (b) The commissioner shall implement this section in compliance with the new text end 119.34 new text begin requirements of the state option to provide health homes for enrollees with chronic new text end 120.1 new text begin conditions, as provided under the Patient Protection and Affordable Care Act, Public new text end 120.2 new text begin Law 111-148, sections 2703 and 3502. Terms used in this section have the meaning new text end 120.3 new text begin provided in that act. new text end 120.4     new text begin Subd. 2. new text end new text begin Eligible individual. new text end new text begin An individual is eligible for health home services new text end 120.5 new text begin under this section if the individual is eligible for medical assistance under this chapter new text end 120.6 new text begin and has at least: new text end 120.7 new text begin (1) two chronic conditions; new text end 120.8 new text begin (2) one chronic condition and is at risk of having a second chronic condition; or new text end 120.9 new text begin (3) one serious and persistent mental health condition. new text end 120.10     new text begin Subd. 3. new text end new text begin Health home services. new text end new text begin (a) Health home services means comprehensive and new text end 120.11 new text begin timely high-quality services that are provided by a health home. These services include: new text end 120.12 new text begin (1) comprehensive care management; new text end 120.13 new text begin (2) care coordination and health promotion; new text end 120.14 new text begin (3) comprehensive transitional care, including appropriate follow-up, from inpatient new text end 120.15 new text begin to other settings; new text end 120.16 new text begin (4) patient and family support, including authorized representatives; new text end 120.17 new text begin (5) referral to community and social support services, if relevant; and new text end 120.18 new text begin (6) use of health information technology to link services, as feasible and appropriate. new text end 120.19 new text begin (b) The commissioner shall maximize the number and type of services new text end 120.20 new text begin included in this subdivision to the extent permissible under federal law, including new text end 120.21 new text begin physician, outpatient, mental health treatment, and rehabilitation services necessary for new text end 120.22 new text begin comprehensive transitional care following hospitalization. new text end 120.23     new text begin Subd. 4. new text end new text begin Health teams. new text end new text begin The commissioner shall establish health teams to support new text end 120.24 new text begin the patient-centered health home and provide the services described in subdivision 3 to new text end 120.25 new text begin individuals eligible under subdivision 2. The commissioner shall apply for grants or new text end 120.26 new text begin contracts as provided under section 3502 of the Patient Protection and Affordable Care new text end 120.27 new text begin Act to establish health teams and provide capitated payments to primary care providers. new text end 120.28 new text begin For purposes of this section, "health teams" means community-based, interdisciplinary, new text end 120.29 new text begin inter-professional teams of health care providers that support primary care practices. new text end 120.30 new text begin These providers may include medical specialists, nurses, advanced practice registered new text end 120.31 new text begin nurses, pharmacists, nutritionists, social workers, behavioral and mental health providers, new text end 120.32 new text begin doctors of chiropractic, licensed complementary and alternative medicine practitioners, new text end 120.33 new text begin and physician's assistants. new text end 120.34     new text begin Subd. 5. new text end new text begin Payments. new text end new text begin The commissioner shall make payments to each health home new text end 120.35 new text begin and each health team for the provision of health home services to each eligible individual new text end 120.36 new text begin with chronic conditions that selects the health home as a provider. new text end 121.1     new text begin Subd. 6. new text end new text begin Coordination. new text end new text begin The commissioner, to the extent feasible, shall ensure that new text end 121.2 new text begin the requirements and payment methods for health homes and health teams developed new text end 121.3 new text begin under this section are consistent with the requirements and payment methods for health new text end 121.4 new text begin care homes established under sections 256B.0751 and 256B.0753. The commissioner may new text end 121.5 new text begin modify requirements and payment methods under sections 256B.0751 and 256B.0753 in new text end 121.6 new text begin order to be consistent with federal health home requirements and payment methods. new text end 121.7     new text begin Subd. 7. new text end new text begin State plan amendment. new text end new text begin The commissioner shall submit a state plan new text end 121.8 new text begin amendment to implement this section to the federal Centers for Medicare and Medicaid new text end 121.9 new text begin Services by January 1, 2011. new text end 121.10 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2011, or upon federal new text end 121.11 new text begin approval, whichever is later. new text end 121.12    Sec. 7. new text begin FEDERAL HEALTH CARE REFORM DEMONSTRATION PROJECTS new text end 121.13 new text begin AND GRANTS. new text end 121.14 new text begin (a) The commissioner of human services shall seek to participate in the following new text end 121.15 new text begin demonstration projects, or apply for the following grants, as described in the federal new text end 121.16 new text begin Patient Protection and Affordable Care Act, Public Law 111-148: new text end 121.17 new text begin (1) the demonstration project to evaluate integrated care around a hospitalization, new text end 121.18 new text begin Public Law 111-148, section 2704; new text end 121.19 new text begin (2) the Medicaid global payment system demonstration project, Public Law 111-148, new text end 121.20 new text begin section 2705; new text end 121.21 new text begin (3) the pediatric accountable care organization demonstration project, Public Law new text end 121.22 new text begin 111-148, section 2706; new text end 121.23 new text begin (4) the Medicaid emergency psychiatric demonstration project, Public Law 111-148, new text end 121.24 new text begin section 2707; and new text end 121.25 new text begin (5) grants to provide incentives for prevention of chronic diseases in Medicaid, new text end 121.26 new text begin Public Law 111-148, section 4108. new text end 121.27 new text begin (b) The commissioner of human services shall report to the chairs and ranking new text end 121.28 new text begin minority members of the house of representatives and senate committees or divisions with new text end 121.29 new text begin jurisdiction over health care policy and finance on the status of the demonstration project new text end 121.30 new text begin and grant applications. If the state is accepted as a demonstration project participant, or is new text end 121.31 new text begin awarded a grant, the commissioner shall notify the chairs and ranking minority members new text end 121.32 new text begin of those committees or divisions of any legislative changes necessary to implement the new text end 121.33 new text begin demonstration projects or grants. new text end 121.34    Sec. 8. new text begin HEALTH CARE REFORM TASK FORCE. new text end 122.1     new text begin Subdivision 1. new text end new text begin Task force. new text end new text begin (a) The governor shall convene a Health Care new text end 122.2 new text begin Reform Task Force to advise and assist the governor and the legislature regarding state new text end 122.3 new text begin implementation of federal health care reform legislation. For purposes of this section, new text end 122.4 new text begin "federal health care reform legislation" means the Patient Protection and Affordable Care new text end 122.5 new text begin Act, Public Law 111-148, and the health care reform provisions in the Health Care and new text end 122.6 new text begin Education Reconciliation Act of 2010, Public Law 111-152. The task force shall consist of: new text end 122.7 new text begin (1) two legislators from the house of representatives appointed by the speaker and new text end 122.8 new text begin two legislators from the senate appointed by the Subcommittee on Committees of the new text end 122.9 new text begin Committee on Rules and Administration; new text end 122.10     new text begin (2) two representatives appointed by the governor to represent the governor and new text end 122.11 new text begin state agencies; new text end 122.12     new text begin (3) three persons appointed by the governor who have demonstrated leadership in new text end 122.13 new text begin health care organizations, health plan companies, or health care trade or professional new text end 122.14 new text begin associations; new text end 122.15     new text begin (4) three persons appointed by the governor who have demonstrated leadership in new text end 122.16 new text begin employer and group purchaser activities related to health system improvement of whom at new text end 122.17 new text begin least two must be from a labor organization; and new text end 122.18     new text begin (5) five persons appointed by the governor who have demonstrated expertise in the new text end 122.19 new text begin areas of health care financing, access, and quality. new text end 122.20     new text begin The governor is exempt from the requirements of the open appointments process new text end 122.21 new text begin for purposes of appointing task force members. Members shall be appointed for one-year new text end 122.22 new text begin terms and may be reappointed. new text end 122.23     new text begin (b) The Department of Health, Department of Human Services, and Department of new text end 122.24 new text begin Commerce shall provide staff support to the task force. The task force may accept outside new text end 122.25 new text begin resources to help support its efforts. new text end 122.26     new text begin (c) Task force members must be appointed by July 1, 2010. The task force must hold new text end 122.27 new text begin its first meeting by July 15, 2010. new text end 122.28     new text begin Subd. 2. new text end new text begin Duties. new text end new text begin (a) By December 15, 2010, the task force shall develop and new text end 122.29 new text begin present to the legislature and the governor a preliminary report and recommendations on new text end 122.30 new text begin state implementation of federal health care reform legislation. The report must include new text end 122.31 new text begin recommendations for state law and program changes necessary to comply with the federal new text end 122.32 new text begin health care reform legislation, and also recommendations for implementing provisions of new text end 122.33 new text begin the federal legislation that are optional for states. In developing recommendations, the task new text end 122.34 new text begin force shall consider the extent to which an approach maximizes federal funding to the state. new text end 123.1 new text begin (b) The task force, in consultation with the governor and the legislature, shall also new text end 123.2 new text begin establish timelines and criteria for future reports on state implementation of the federal new text end 123.3 new text begin health care reform legislation. new text end 123.4    Sec. 9. new text begin AMERICAN HEALTH BENEFIT EXCHANGE; PLANNING new text end 123.5 new text begin PROVISIONS. new text end 123.6     new text begin Subdivision 1. new text end new text begin Federal planning grants. new text end new text begin The commissioners of commerce, health, new text end 123.7 new text begin and human services shall jointly or separately apply to the federal secretary of health and new text end 123.8 new text begin human services for one or more planning and establishment grants, including renewal new text end 123.9 new text begin grants, authorized under section 1311 of the Patient Protection and Affordable Care Act, new text end 123.10 new text begin Public Law 111-148, including any future amendments of that provision, relating to state new text end 123.11 new text begin creation of American Health Benefit Exchanges. new text end 123.12     new text begin Subd. 2. new text end new text begin Consideration of early creation and operation of exchange. new text end new text begin (a) The new text end 123.13 new text begin commissioners referenced in subdivision 1 shall analyze the advantages and disadvantages new text end 123.14 new text begin to the state of planning to have a state health insurance exchange, similar to an American new text end 123.15 new text begin Health Benefit Exchange referenced in subdivision 1, begin prior to the federal deadline new text end 123.16 new text begin of January 1, 2014. new text end 123.17 new text begin (b) The commissioners shall provide a written report to the legislature on the results new text end 123.18 new text begin of the analysis required under paragraph (a) no later than December 15, 2010. The written new text end 123.19 new text begin report must comply with Minnesota Statutes, sections 3.195 and 3.197. new text end 123.20ARTICLE 8 123.21HUMAN SERVICES FORECAST ADJUSTMENTS 123.22 123.23 Section 1. new text begin SUMMARY OF APPROPRIATIONS; DEPARTMENT OF HUMAN new text end new text begin SERVICES FORECAST ADJUSTMENT. new text end 123.24 new text begin The dollar amounts shown are added to or if shown in parentheses, are subtracted new text end 123.25 new text begin from the appropriations in Laws 2009, chapter 79, article 13, as amended by Laws 2009, new text end 123.26 new text begin chapter 173, article 2, from the general fund or any fund named to the Department of new text end 123.27 new text begin Human Services for the purposes specified in this article, to be available for the fiscal new text end 123.28 new text begin year indicated for each purpose. The figure "2010" used in this article means that the new text end 123.29 new text begin appropriation or appropriations listed are available for the fiscal year ending June 30, new text end 123.30 new text begin 2010. The figure "2011" used in this article means that the appropriation or appropriations new text end 123.31 new text begin listed are available for the fiscal year ending June 30, 2011. new text end 123.32 new text begin 2010 new text end new text begin 2011 new text end 123.33 new text begin General new text end new text begin $ new text end new text begin (109,876,000) new text end new text begin $ new text end new text begin (28,344,000) new text end 123.34 new text begin Health Care Access new text end new text begin 99,654,000 new text end new text begin 276,500,000 new text end 124.1 new text begin Federal TANF new text end new text begin (9,830,000) new text end new text begin 15,133,000 new text end 124.2 new text begin Total new text end new text begin $ new text end new text begin (20,052,000) new text end new text begin $ new text end new text begin 263,289,000 new text end 124.3 124.4 Sec. 2. new text begin COMMISSIONER OF HUMAN new text end new text begin SERVICES new text end 124.5 new text begin Subdivision 1. new text end new text begin Total Appropriation new text end new text begin $ new text end new text begin (20,052,000) new text end new text begin $ new text end new text begin 263,289,000 new text end 124.6 new text begin Appropriations by Fund new text end 124.7 new text begin 2010 new text end new text begin 2011 new text end 124.8 new text begin General new text end new text begin (109,876,000) new text end new text begin (28,344,000) new text end 124.9 new text begin Health Care Access new text end new text begin 99,654,000 new text end new text begin 276,500,000 new text end 124.10 new text begin Federal TANF new text end new text begin (9,830,000) new text end new text begin 15,133,000 new text end 124.11 new text begin Subd. 2. new text end new text begin Revenue and Pass-Through new text end 124.12 new text begin Federal TANF new text end new text begin 390,000 new text end new text begin (251,000) new text end 124.13 124.14 new text begin Subd. 3. new text end new text begin Children and Economic Assistance new text end new text begin Grants new text end 124.15 new text begin General Fund new text end new text begin 4,489,000 new text end new text begin (4,140,000) new text end 124.16 new text begin Federal TANF new text end new text begin (10,220,000) new text end new text begin 15,384,000 new text end 124.17 new text begin The amounts that may be spent from this new text end 124.18 new text begin appropriation are as follows: new text end 124.19 new text begin (a) new text end new text begin MFIP Grants new text end 124.20 new text begin General Fund new text end new text begin 7,916,000 new text end new text begin (14,481,000) new text end 124.21 new text begin TANF Fund new text end new text begin (10,220,000) new text end new text begin 15,384,000 new text end 124.22 new text begin (b) new text end new text begin MFIP Child Care Assistance Grants new text end new text begin (7,832,000) new text end new text begin 2,579,000 new text end 124.23 new text begin (c) new text end new text begin General Assistance Grants new text end new text begin 875,000 new text end new text begin 1,339,000 new text end 124.24 new text begin (d) new text end new text begin Minnesota Supplemental Aid Grants new text end new text begin 2,454,000 new text end new text begin 3,843,000 new text end 124.25 new text begin (e) new text end new text begin Group Residential Housing Grants new text end new text begin 1,076,000 new text end new text begin 2,580,000 new text end 124.26 new text begin Subd. 4. new text end new text begin Basic Health Care Grants new text end 124.27 new text begin General Fund new text end new text begin (62,770,000) new text end new text begin 29,192,000 new text end 124.28 new text begin TANF Fund new text end new text begin 99,654,000 new text end new text begin 276,500,000 new text end 124.29 new text begin The amounts that may be spent from this new text end 124.30 new text begin appropriation are as follows: new text end 124.31 new text begin (a) new text end new text begin MinnesotaCare Grants new text end 125.1 125.2 new text begin Health Care Access new text end new text begin Fund new text end new text begin 99,654,000 new text end new text begin 276,500,000 new text end 125.3 125.4 new text begin (b) new text end new text begin Medical Assistance Basic Health Care – new text end new text begin Families and Children new text end new text begin 1,165,000 new text end new text begin 24,146,000 new text end 125.5 125.6 new text begin (c) new text end new text begin Medical Assistance Basic Health Care – new text end new text begin Elderly and Disabled new text end new text begin (63,935,000) new text end new text begin 5,046,000 new text end 125.7 new text begin Subd. 5. new text end new text begin Continuing Care Grants new text end new text begin (51,595,000) new text end new text begin (53,396,000) new text end 125.8 new text begin The amounts that may be spent from this new text end 125.9 new text begin appropriation are as follows: new text end 125.10 125.11 new text begin (a) new text end new text begin Medical Assistance Long-Term Care new text end new text begin Facilities new text end new text begin (3,774,000) new text end new text begin (8,275,000) new text end 125.12 125.13 new text begin (b) new text end new text begin Medical Assistance Long-Term Care new text end new text begin Waivers new text end new text begin (27,710,000) new text end new text begin (22,452,000) new text end 125.14 new text begin (c) new text end new text begin Chemical Dependency Entitlement Grants new text end new text begin (20,111,000) new text end new text begin (22,669,000) new text end 125.15    Sec. 3. new text begin EFFECTIVE DATE. new text end 125.16 new text begin Sections 1 and 2 are effective the date following final enactment. new text end 125.17ARTICLE 9 125.18HEALTH AND HUMAN SERVICES APPROPRIATIONS 125.19 Section 1. new text begin SUMMARY OF APPROPRIATIONS. new text end 125.20 new text begin The amounts shown in this section summarize direct appropriations, by fund, made new text end 125.21 new text begin in this article. new text end 125.22 new text begin 2010 new text end new text begin 2011 new text end new text begin Total new text end 125.23 new text begin General new text end new text begin $ new text end new text begin (10,162,000) new text end new text begin $ new text end new text begin (99,234,000) new text end new text begin $ new text end new text begin (109,396,000) new text end 125.24 125.25 new text begin State Government Special new text end new text begin Revenue new text end new text begin (608,000) new text end new text begin (275,000) new text end new text begin (883,000) new text end 125.26 new text begin Health Care Access new text end new text begin (1,094,000) new text end new text begin 72,459,000 new text end new text begin 71,365,000 new text end 125.27 new text begin Federal TANF new text end new text begin -0- new text end new text begin 27,918,000 new text end new text begin 27,918,000 new text end 125.28 new text begin Total new text end new text begin $ new text end new text begin (11,864,000) new text end new text begin $ new text end new text begin (867,000) new text end new text begin $ new text end new text begin (10,997,000) new text end 125.29 Sec. 2. new text begin HEALTH AND HUMAN SERVICES APPROPRIATIONS. new text end 125.30 new text begin The sums shown in the columns marked "Appropriations" are added to or, if shown new text end 125.31 new text begin in parentheses, subtracted from the appropriations in Laws 2009, chapter 79, article 13, new text end 125.32 new text begin as amended by Laws 2009, chapter 173, article 2, to the agencies and for the purposes new text end 125.33 new text begin specified in this article. The appropriations are from the general fund and are available new text end 126.1 new text begin for the fiscal years indicated for each purpose. The figures "2010" and "2011" used in new text end 126.2 new text begin this article mean that the addition to or subtraction from the appropriation listed under new text end 126.3 new text begin them is available for the fiscal year ending June 30, 2010, or June 30, 2011, respectively. new text end 126.4 new text begin Supplemental appropriations and reductions to appropriations for the fiscal year ending new text end 126.5 new text begin June 30, 2010, are effective the day following final enactment unless a different effective new text end 126.6 new text begin date is explicit. new text end 126.7 new text begin APPROPRIATIONS new text end 126.8 new text begin Available for the Year new text end 126.9 new text begin Ending June 30 new text end 126.10 new text begin 2010 new text end new text begin 2011 new text end 126.11 126.12 Sec. 3. new text begin COMMISSIONER OF HUMAN new text end new text begin SERVICES new text end 126.13 new text begin Subdivision 1. new text end new text begin Total Appropriation new text end new text begin $ new text end new text begin (9,467,000) new text end new text begin $ new text end new text begin (5,084,000) new text end 126.14 new text begin Appropriations by Fund new text end 126.15 new text begin 2010 new text end new text begin 2011 new text end 126.16 new text begin General new text end new text begin (8,365,000) new text end new text begin (105,244,000) new text end 126.17 126.18 new text begin State Government new text end new text begin Special Revenue new text end new text begin (8,000) new text end new text begin (16,000) new text end 126.19 new text begin Health Care Access new text end new text begin (1,094,000) new text end new text begin 72,259,000 new text end 126.20 new text begin Federal TANF new text end new text begin -0- new text end new text begin 27,918,000 new text end 126.21 new text begin Working Family Credit Expenditures to new text end 126.22 new text begin be Claimed for TANF/MOE. new text end new text begin For fiscal year new text end 126.23 new text begin 2011, the commissioner may count $38,000 new text end 126.24 new text begin of working family credit expenditures as new text end 126.25 new text begin TANF/MOE. Notwithstanding any provision new text end 126.26 new text begin to the contrary, this rider expires June 30, new text end 126.27 new text begin 2013. new text end 126.28 new text begin TANF Financing and Maintenance of new text end 126.29 new text begin Effort. new text end new text begin The commissioner of human new text end 126.30 new text begin services, with the approval of the new text end 126.31 new text begin commissioner of management and budget, new text end 126.32 new text begin and after notification of the chairs of the new text end 126.33 new text begin relevant senate budget division and house of new text end 126.34 new text begin representatives finance division, may adjust new text end 126.35 new text begin the amount of TANF transfers between the new text end 126.36 new text begin MFIP transition year child care assistance new text end 126.37 new text begin program and MFIP grant programs within the new text end 127.1 new text begin fiscal year, and within the current biennium new text end 127.2 new text begin and the biennium ending June 30, 2013, new text end 127.3 new text begin to ensure that state and federal match and new text end 127.4 new text begin maintenance of effort requirements are new text end 127.5 new text begin met. These transfers and amounts must be new text end 127.6 new text begin reported to the chairs of the senate and house new text end 127.7 new text begin of representatives Finance Committees, the new text end 127.8 new text begin senate Health and Human Services Budget new text end 127.9 new text begin Division, the house of representatives Health new text end 127.10 new text begin Care and Human Services Finance Division, new text end 127.11 new text begin and Early Childhood Finance and Policy new text end 127.12 new text begin Division by December 1 of each fiscal new text end 127.13 new text begin year. Notwithstanding any provision to the new text end 127.14 new text begin contrary, this rider expires June 30, 2013. new text end 127.15 new text begin The appropriation reductions for each new text end 127.16 new text begin purpose are shown in the following new text end 127.17 new text begin subdivisions. new text end 127.18 127.19 new text begin Subd. 2. new text end new text begin Agency Management; Financial new text end new text begin Operations new text end new text begin (8,000) new text end new text begin (16,000) new text end 127.20 new text begin This appropriation reduction is from the state new text end 127.21 new text begin government special revenue fund. new text end 127.22 127.23 new text begin Subd. 3. new text end new text begin Revenue and Pass-Through Revenue new text end new text begin Expenditures new text end new text begin -0- new text end new text begin 28,000,000 new text end 127.24 new text begin TANF Funding for the Working Family new text end 127.25 new text begin Tax Credit. new text end new text begin In addition to the amounts new text end 127.26 new text begin specified in Minnesota Statutes, section new text end 127.27 new text begin 290.0671, subdivision 6, $18,722,000 new text end 127.28 new text begin of TANF funds in fiscal year 2010 and new text end 127.29 new text begin $18,689,000 of TANF funds in fiscal year new text end 127.30 new text begin 2011 are appropriated to the commissioner new text end 127.31 new text begin of human services to reimburse the cost of new text end 127.32 new text begin the working family tax credit for eligible new text end 127.33 new text begin families. Beginning January 1, 2011, the new text end 127.34 new text begin commissioner shall reimburse the general new text end 127.35 new text begin fund on a monthly basis according to a new text end 127.36 new text begin schedule based on the pattern of working new text end 128.1 new text begin family credit expenditures through June 20, new text end 128.2 new text begin 2011. This rider is effective upon enactment. new text end 128.3 128.4 new text begin Subd. 4. new text end new text begin Children and Economic Assistance new text end new text begin Grants new text end 128.5 128.6 new text begin (a) new text end new text begin MFIP and Diversionary Work Program new text end new text begin Grants new text end new text begin -0- new text end new text begin (2,033,000) new text end 128.7 new text begin This appropriation reduces the general new text end 128.8 new text begin fund appropriation by $5,691,000 and new text end 128.9 new text begin increases the federal TANF appropriation by new text end 128.10 new text begin $3,658,000. new text end 128.11 new text begin (b) new text end new text begin Support Services Grants new text end new text begin -0- new text end new text begin (7,646,000) new text end 128.12 new text begin Supported Work. new text end new text begin The fiscal year 2011 new text end 128.13 new text begin TANF appropriation to the commissioner of new text end 128.14 new text begin human services for supported work for MFIP new text end 128.15 new text begin recipients is reduced by $4,000,000. This new text end 128.16 new text begin reduction is onetime. new text end 128.17 new text begin Base Adjustment. new text end new text begin The general fund base new text end 128.18 new text begin shall be increased by $2,642,000 for fiscal new text end 128.19 new text begin years 2012 and 2013. new text end 128.20 new text begin (c) new text end new text begin MFIP Child Care Assistance Grants new text end new text begin -0- new text end new text begin (38,000) new text end 128.21 new text begin This appropriation reduces the general new text end 128.22 new text begin fund appropriation by $4,000,000 and new text end 128.23 new text begin increases the federal TANF appropriation by new text end 128.24 new text begin $3,962,000. new text end 128.25 new text begin (d) new text end new text begin Children and Community Services Grants new text end new text begin -0- new text end new text begin (9,900,000) new text end 128.26 new text begin Children and Community Services Grant new text end 128.27 new text begin Reduction. new text end new text begin The fiscal year 2011 general new text end 128.28 new text begin fund appropriation to the commissioner new text end 128.29 new text begin of human services for the children and new text end 128.30 new text begin community services grants under Minnesota new text end 128.31 new text begin Statutes, section 256M.40, is reduced by new text end 128.32 new text begin $9,900,000. This reduction is ongoing and is new text end 128.33 new text begin subtracted from the base. new text end 128.34 new text begin (e) new text end new text begin Children's Mental Health Grants new text end new text begin -0- new text end new text begin (8,028,000) new text end 129.1 new text begin (1) The general fund appropriation for new text end 129.2 new text begin respite care services for children with new text end 129.3 new text begin severe emotional disturbance who are at new text end 129.4 new text begin risk of out-of-home placement is reduced new text end 129.5 new text begin by $1,024,000 for fiscal year 2011. This new text end 129.6 new text begin reduction is onetime. new text end 129.7 new text begin (2) The general fund appropriation for new text end 129.8 new text begin children's early intervention services is new text end 129.9 new text begin reduced by $1,024,000 for fiscal year 2011. new text end 129.10 new text begin This reduction is onetime. new text end 129.11 new text begin (3) The general fund appropriation for new text end 129.12 new text begin children's capacity school-based services is new text end 129.13 new text begin reduced by $4,777,000 for fiscal year 2011. new text end 129.14 new text begin (4) The general fund appropriation for new text end 129.15 new text begin children's mental health targeted case new text end 129.16 new text begin management grants is reduced by $1,210,000 new text end 129.17 new text begin for fiscal year 2011. new text end 129.18 129.19 new text begin Subd. 5. new text end new text begin Children and Economic Assistance new text end new text begin Management new text end 129.20 129.21 new text begin (a) new text end new text begin Children and Economic Assistance new text end new text begin Administration new text end new text begin -0- new text end new text begin -0- new text end 129.22 new text begin The general fund appropriation is reduced by new text end 129.23 new text begin $172,000 in fiscal year 2010 and by $176,000 new text end 129.24 new text begin in fiscal year 2011. new text end 129.25 new text begin The federal TANF appropriation is increased new text end 129.26 new text begin by $172,000 in fiscal year 2010 and by new text end 129.27 new text begin $176,000 in fiscal year 2011. The TANF new text end 129.28 new text begin fund base shall be reduced by $700,000 in new text end 129.29 new text begin fiscal years 2012 and 2013. new text end 129.30 129.31 new text begin (b) new text end new text begin Children and Economic Assistance new text end new text begin Operations new text end new text begin (1,580,000) new text end new text begin (1,692,000) new text end 129.32 new text begin The general fund appropriation is reduced new text end 129.33 new text begin by $1,408,000 in fiscal year 2010 and by new text end 129.34 new text begin $1,534,000 in fiscal year 2011. The general new text end 130.1 new text begin fund base is reduced by $26,000 in each of new text end 130.2 new text begin fiscal years 2012 and 2013. new text end 130.3 new text begin $74,000 in fiscal year 2011 is appropriated new text end 130.4 new text begin from the health care access fund. This new text end 130.5 new text begin appropriation is onetime. new text end 130.6 new text begin The federal TANF appropriation is reduced new text end 130.7 new text begin by $172,000 in fiscal year 2010 and by new text end 130.8 new text begin $232,000 in fiscal year 2011. new text end 130.9 new text begin Subd. 6. new text end new text begin Basic Health Care Grants new text end 130.10 new text begin (a) new text end new text begin MinnesotaCare Grants new text end new text begin -0- new text end new text begin (67,549,000) new text end 130.11 new text begin This appropriation reduction is from the new text end 130.12 new text begin health care access fund. new text end 130.13 130.14 new text begin (b) new text end new text begin Medical Assistance Basic Health Care new text end new text begin Grants - Families and Children new text end new text begin -0- new text end new text begin (1,108,000) new text end 130.15 130.16 new text begin (c) new text end new text begin Medical Assistance Basic Health Care new text end new text begin Grants - Elderly and Disabled new text end new text begin -0- new text end new text begin (2,817,000) new text end 130.17 new text begin (d) new text end new text begin General Assistance Medical Care Grants new text end new text begin -0- new text end new text begin (52,614,000) new text end 130.18 new text begin Funding Reduction; Coordinated Care new text end 130.19 new text begin Delivery Systems. new text end new text begin The appropriation for new text end 130.20 new text begin payments to coordinated care delivery new text end 130.21 new text begin systems in Laws 2010, chapter 200, article new text end 130.22 new text begin 2, section 2, subdivision 4, paragraph (d), is new text end 130.23 new text begin reduced by $20,000,000 in fiscal year 2011. new text end 130.24 130.25 new text begin (e) new text end new text begin Medical Assistance; Adults Without new text end new text begin Children new text end new text begin -0- new text end new text begin 144,114,000 new text end 130.26 new text begin Of this appropriation, $142,768,000 is from new text end 130.27 new text begin the health care access fund. new text end 130.28 new text begin (f) new text end new text begin Other Health Care Grants new text end new text begin -0- new text end new text begin (1,831,000) new text end 130.29 new text begin Of this appropriation, the general fund is new text end 130.30 new text begin increased by $19,000 and the health care new text end 130.31 new text begin access fund appropriation is reduced by new text end 130.32 new text begin $1,850,000. This appropriation is onetime. new text end 131.1 new text begin COBRA Carryforward. new text end new text begin Unexpended new text end 131.2 new text begin funds appropriated in fiscal year 2010 for new text end 131.3 new text begin COBRA grants under Laws 2009, chapter new text end 131.4 new text begin 79, article 5, section 78, do not cancel and new text end 131.5 new text begin are available to the commissioner of human new text end 131.6 new text begin services for fiscal year 2011 COBRA grant new text end 131.7 new text begin expenditures. Up to $110,000 of the fiscal new text end 131.8 new text begin year 2011 appropriation for COBRA grants new text end 131.9 new text begin provided in Laws 2009, chapter 79, article new text end 131.10 new text begin 13, section 3, subdivision 6, may be used new text end 131.11 new text begin by the commissioner of human services for new text end 131.12 new text begin costs related to administration of the COBRA new text end 131.13 new text begin grants. new text end 131.14 new text begin Transfer. new text end new text begin The commissioner shall transfer new text end 131.15 new text begin $19,000 to the commissioner of commerce new text end 131.16 new text begin for regulation of Minnesota Statutes, section new text end 131.17 new text begin 62A.3075. new text end 131.18 new text begin Subd. 7. new text end new text begin Health Care Management new text end 131.19 new text begin (a) new text end new text begin Health Care Administration new text end new text begin (2,853,000) new text end new text begin (4,783,000) new text end 131.20 new text begin For fiscal year 2011 the health care access new text end 131.21 new text begin fund appropriation is increased by $250,000 new text end 131.22 new text begin and the general fund appropriation is reduced new text end 131.23 new text begin by $4,633,000. new text end 131.24 new text begin Reduction in Appropriation. new text end new text begin The base new text end 131.25 new text begin funding under the current law forecast used new text end 131.26 new text begin to calculate the state appropriation for the new text end 131.27 new text begin medical assistance program is reduced by new text end 131.28 new text begin one percent for the 2012-2013 biennium. new text end 131.29 new text begin This reduction is subject to federal approval new text end 131.30 new text begin of the intensive care management program new text end 131.31 new text begin authorized under Minnesota Statutes, section new text end 131.32 new text begin 256B.0755, and is ongoing and shall apply new text end 131.33 new text begin to future bienniums, or for as long as the new text end 131.34 new text begin intensive care management program is new text end 132.1 new text begin determined to be cost-effective by the new text end 132.2 new text begin commissioner of human services. new text end 132.3 new text begin PACE Implementation Funding. new text end new text begin For fiscal new text end 132.4 new text begin year 2011, $145,000 is appropriated from new text end 132.5 new text begin the general fund to the commissioner of new text end 132.6 new text begin human services to complete the actuarial and new text end 132.7 new text begin administrative work necessary to begin the new text end 132.8 new text begin operation of PACE under Minnesota Statutes, new text end 132.9 new text begin section 256B.69, subdivision 23, paragraph new text end 132.10 new text begin (e). Base level funding for this activity shall new text end 132.11 new text begin be $130,000 in fiscal year 2012 and $0 in new text end 132.12 new text begin fiscal year 2013. new text end 132.13 new text begin Minnesota Senior Health Options new text end 132.14 new text begin Reimbursement. new text end new text begin Effective July 1, 2011, new text end 132.15 new text begin federal administrative reimbursement new text end 132.16 new text begin resulting from the Minnesota senior new text end 132.17 new text begin health options project is appropriated new text end 132.18 new text begin to the commissioner for this activity. new text end 132.19 new text begin Notwithstanding any contrary provision, this new text end 132.20 new text begin provision expires June 30, 2013. new text end 132.21 new text begin Health Care Inspector General. new text end new text begin $120,000 new text end 132.22 new text begin from the general fund in fiscal year 2011 new text end 132.23 new text begin is for the Office of Health Care Inspector new text end 132.24 new text begin General, established under Minnesota new text end 132.25 new text begin Statutes, section 256.01, subdivision 30. new text end 132.26 new text begin Fiscal and Actuarial Analysis. new text end new text begin $250,000 new text end 132.27 new text begin from the general fund is for the fiscal and new text end 132.28 new text begin actuarial analysis of 2010 House File No. new text end 132.29 new text begin 135 and 2010 Senate File No. 118. This new text end 132.30 new text begin appropriation is onetime. new text end 132.31 new text begin Utilization Review. new text end new text begin Effective July 1, new text end 132.32 new text begin 2011, federal administrative reimbursement new text end 132.33 new text begin resulting from prior authorization and new text end 132.34 new text begin inpatient admission certification by a new text end 132.35 new text begin professional review organization shall be new text end 133.1 new text begin dedicated to, and is appropriated to, the new text end 133.2 new text begin commissioner for these activities. A portion new text end 133.3 new text begin of these funds must be used for activities to new text end 133.4 new text begin decrease unnecessary pharmaceutical costs new text end 133.5 new text begin in medical assistance. Notwithstanding any new text end 133.6 new text begin contrary provision, this provision expires new text end 133.7 new text begin June 30, 2013. new text end 133.8 new text begin Base Adjustment. new text end new text begin The health care access new text end 133.9 new text begin fund base is reduced by $50,000 in each of new text end 133.10 new text begin fiscal years 2012 and 2013. new text end 133.11 new text begin The general fund base is reduced by $416,000 new text end 133.12 new text begin in each of fiscal years 2012 and 2013. new text end 133.13 new text begin (b) new text end new text begin Health Care Operations new text end 133.14 new text begin Appropriations by Fund new text end 133.15 new text begin General new text end new text begin -0- new text end new text begin 64,000 new text end 133.16 new text begin Health Care Access new text end new text begin (1,094,000) new text end new text begin (1,234,000) new text end 133.17 new text begin Base Adjustment. new text end new text begin The health care access new text end 133.18 new text begin fund base for health care operations is new text end 133.19 new text begin reduced by $1,272,000 in fiscal year 2012 new text end 133.20 new text begin and $1,337,000 in fiscal year 2013. The new text end 133.21 new text begin general fund appropriation is onetime. new text end 133.22 new text begin Subd. 8. new text end new text begin Continuing Care Grants new text end 133.23 new text begin (a) new text end new text begin Aging and Adult Services Grants new text end new text begin (154,000) new text end new text begin (139,000) new text end 133.24 new text begin This reduction is onetime and must not be new text end 133.25 new text begin applied to the base. new text end 133.26 new text begin Community Service Development new text end 133.27 new text begin Reduction. new text end new text begin The appropriation in Laws new text end 133.28 new text begin 2009, chapter 79, article 13, section 3, new text end 133.29 new text begin subdivision 8, paragraph (a), for community new text end 133.30 new text begin service development grants, as amended by new text end 133.31 new text begin Laws 2009, chapter 173, article 2, section new text end 133.32 new text begin 1, subdivision 8, paragraph (a), is reduced new text end 133.33 new text begin by $154,000 in fiscal year 2011. The new text end 133.34 new text begin appropriation base is reduced by $139,000 new text end 134.1 new text begin for fiscal year 2012 and $0 for fiscal year new text end 134.2 new text begin 2013. Notwithstanding any law or rule to new text end 134.3 new text begin the contrary, this provision expires June 30, new text end 134.4 new text begin 2012. new text end 134.5 134.6 new text begin (b) new text end new text begin Medical Assistance Long-Term Care new text end new text begin Facilities Grants new text end new text begin -0- new text end new text begin 551,000 new text end 134.7 134.8 new text begin (c) new text end new text begin Medical Assistance Long-Term Care new text end new text begin Waivers and Home Care Grants new text end new text begin -0- new text end new text begin (2,747,000) new text end 134.9 new text begin Manage Growth in Traumatic Brain new text end 134.10 new text begin Injury and Community Alternatives for new text end 134.11 new text begin Disabled Individuals' Waivers. new text end new text begin During new text end 134.12 new text begin the fiscal year beginning July 1, 2010, the new text end 134.13 new text begin commissioner shall allocate money for home new text end 134.14 new text begin and community-based waiver programs new text end 134.15 new text begin under Minnesota Statutes, section 256B.49, new text end 134.16 new text begin to ensure a reduction in state spending that is new text end 134.17 new text begin equivalent to limiting the caseload growth new text end 134.18 new text begin of the traumatic brain injury waiver to six new text end 134.19 new text begin allocations per month and the community new text end 134.20 new text begin alternatives for disabled individuals waiver new text end 134.21 new text begin to 60 allocations per month. The limits do not new text end 134.22 new text begin apply: (1) when there is an approved plan for new text end 134.23 new text begin nursing facility bed closures for individuals new text end 134.24 new text begin under age 65 who require relocation due to new text end 134.25 new text begin the bed closure; (2) to fiscal year 2009 waiver new text end 134.26 new text begin allocations delayed due to unallotment; or (3) new text end 134.27 new text begin to transfers authorized by the commissioner new text end 134.28 new text begin from the personal care assistance program new text end 134.29 new text begin of individuals having a home care rating of new text end 134.30 new text begin CS, MT, or HL. Priorities for the allocation new text end 134.31 new text begin of funds must be for individuals anticipated new text end 134.32 new text begin to be discharged from institutional settings or new text end 134.33 new text begin who are at imminent risk of a placement in new text end 134.34 new text begin an institutional setting. new text end 134.35 new text begin Manage Growth in the Developmental new text end 134.36 new text begin Disability (DD) Waiver. new text end new text begin The commissioner new text end 135.1 new text begin shall manage the growth in the developmental new text end 135.2 new text begin disability waiver by limiting the allocations new text end 135.3 new text begin included in the November 2010 forecast to new text end 135.4 new text begin six additional diversion allocations each new text end 135.5 new text begin month for the calendar year that begins on new text end 135.6 new text begin January 1, 2011. Additional allocations must new text end 135.7 new text begin be made available for transfers authorized new text end 135.8 new text begin by the commissioner from the personal care new text end 135.9 new text begin assistance program of individuals having a new text end 135.10 new text begin home care rating of CS, MT, or HL. This new text end 135.11 new text begin provision is effective through December 31, new text end 135.12 new text begin 2011. new text end 135.13 new text begin (d) new text end new text begin Adult Mental Health Grants new text end new text begin (3,500,000) new text end new text begin (9,903,000) new text end 135.14 new text begin Compulsive Gambling Special Revenue new text end 135.15 new text begin Account. new text end new text begin $149,000 for fiscal year 2010 new text end 135.16 new text begin and $27,000 for fiscal year 2011 from new text end 135.17 new text begin the compulsive gambling special revenue new text end 135.18 new text begin account established under Minnesota new text end 135.19 new text begin Statutes, section 245.982, must be transferred new text end 135.20 new text begin and deposited into the general fund by June new text end 135.21 new text begin 30 of each respective fiscal year. new text end 135.22 new text begin Compulsive Gambling Lottery Prize Fund new text end 135.23 new text begin Appropriation. new text end new text begin The lottery prize fund new text end 135.24 new text begin appropriation for compulsive gambling, is new text end 135.25 new text begin reduced by $80,000 in fiscal year 2010 and new text end 135.26 new text begin $79,000 in fiscal year 2011. This is a onetime new text end 135.27 new text begin reduction. new text end 135.28 new text begin Adult Mental Health. new text end new text begin (1) The general new text end 135.29 new text begin fund appropriation for adult mental health new text end 135.30 new text begin evidence-based practices, including but not new text end 135.31 new text begin limited to, assertive community treatment new text end 135.32 new text begin and integrated dual diagnosis treatment new text end 135.33 new text begin services, is reduced by $750,000 for fiscal new text end 135.34 new text begin year 2011. This reduction is onetime. new text end 136.1 new text begin (2) The general fund appropriation for new text end 136.2 new text begin mental health grants to increase availability new text end 136.3 new text begin of culturally specific adult mental health new text end 136.4 new text begin services is reduced by $300,000 for fiscal new text end 136.5 new text begin year 2011. This reduction is onetime. new text end 136.6 new text begin (3) The general fund appropriation for new text end 136.7 new text begin grants to community hospitals to provide new text end 136.8 new text begin alternatives to residential treatment center new text end 136.9 new text begin mental health programs is reduced by new text end 136.10 new text begin $2,653,000 for fiscal year 2011. This new text end 136.11 new text begin reduction is onetime. new text end 136.12 new text begin (4) The general fund appropriation for grants new text end 136.13 new text begin to counties for adult mental health services is new text end 136.14 new text begin reduced by $6,200,000 for fiscal year 2011, new text end 136.15 new text begin and $6,000,000 in each of fiscal years 2012 new text end 136.16 new text begin and 2013. new text end 136.17 new text begin (5) Of the fiscal year 2010 general fund new text end 136.18 new text begin appropriation for grants to counties for new text end 136.19 new text begin housing with support services for adults new text end 136.20 new text begin with serious and persistent mental illness, new text end 136.21 new text begin $3,300,000 is canceled and returned to the new text end 136.22 new text begin general fund. new text end 136.23 new text begin (6) Of the fiscal year 2010 general new text end 136.24 new text begin fund appropriation for additional crisis new text end 136.25 new text begin intervention team training for law new text end 136.26 new text begin enforcement, $200,000 is canceled and new text end 136.27 new text begin returned to the general fund. new text end 136.28 new text begin (e) new text end new text begin Chemical Dependency Entitlement Grants new text end new text begin -0- new text end new text begin (3,986,000) new text end 136.29 136.30 new text begin (f) new text end new text begin Chemical Dependency Nonentitlement new text end new text begin Grants new text end new text begin (389,000) new text end new text begin -0- new text end 136.31 new text begin Chemical Health. new text end new text begin Of the fiscal year 2010 new text end 136.32 new text begin general fund appropriation to Mother's First new text end 136.33 new text begin and the Native American Program, $389,000 new text end 136.34 new text begin is canceled and returned to the general fund. new text end 137.1 new text begin (g) new text end new text begin Other Continuing Care Grants new text end new text begin -0- new text end new text begin 100,000 new text end 137.2 new text begin Intermediate Care Facilities for the new text end 137.3 new text begin Developmentally Disabled Payment Rates. new text end new text begin new text end 137.4 new text begin $36,000 is appropriated from the general new text end 137.5 new text begin fund in fiscal year 2011 and $4,000 in fiscal new text end 137.6 new text begin year 2012 to increase payment rates for an new text end 137.7 new text begin ICF/MR licensed for six beds and located in new text end 137.8 new text begin Kandiyohi County to serve persons with high new text end 137.9 new text begin behavioral needs. The payment rate increase new text end 137.10 new text begin shall be effective for services provided from new text end 137.11 new text begin July 1, 2010, through June 30, 2011. These new text end 137.12 new text begin appropriations are onetime. new text end 137.13 new text begin Region 10 Quality Assurance Commission. new text end new text begin new text end 137.14 new text begin $100,000 is appropriated from the general new text end 137.15 new text begin fund in fiscal year 2011 to the commissioner new text end 137.16 new text begin of human services for the purposes new text end 137.17 new text begin of the Region 10 Quality Assurance new text end 137.18 new text begin Commission under Minnesota Statutes, new text end 137.19 new text begin section 256B.0951. This appropriation is new text end 137.20 new text begin onetime. new text end 137.21 new text begin Subd. 9. new text end new text begin Continuing Care Management new text end new text begin 111,000 new text end new text begin 101,000 new text end 137.22 new text begin PACE Implementation Funding. new text end new text begin For fiscal new text end 137.23 new text begin year 2011, $111,000 is appropriated from new text end 137.24 new text begin the general fund to the commissioner of new text end 137.25 new text begin human services to complete the actuarial new text end 137.26 new text begin and administrative work necessary to begin new text end 137.27 new text begin the operation of PACE under Minnesota new text end 137.28 new text begin Statutes, section 256B.69, subdivision 23, new text end 137.29 new text begin paragraph (e). Base level funding for this new text end 137.30 new text begin activity shall be $101,000 in fiscal year 2012 new text end 137.31 new text begin and $0 in fiscal year 2013. For fiscal year new text end 137.32 new text begin 2013 and beyond, the commissioner must new text end 137.33 new text begin work with stakeholders to develop financing new text end 137.34 new text begin mechanisms to complete the actuarial new text end 137.35 new text begin and administrative costs of PACE. The new text end 138.1 new text begin commissioner shall inform the chairs and new text end 138.2 new text begin ranking minority members of the legislative new text end 138.3 new text begin committee with jurisdiction over health care new text end 138.4 new text begin funding by January 15, 2011, on progress to new text end 138.5 new text begin develop financing mechanisms. new text end 138.6 new text begin Subd. 10. new text end new text begin State-Operated Services new text end 138.7 new text begin Obsolete Laundry Depreciation Account. new text end new text begin new text end 138.8 new text begin $669,000, or the balance, whichever is new text end 138.9 new text begin greater, must be transferred from the new text end 138.10 new text begin state-operated services laundry depreciation new text end 138.11 new text begin account in the special revenue fund and new text end 138.12 new text begin deposited into the general fund by June 30, new text end 138.13 new text begin 2010. new text end 138.14 new text begin State-operated Services Programs. new text end new text begin Of new text end 138.15 new text begin the fiscal year 2011 appropriation for new text end 138.16 new text begin the Minnesota sex offender program, new text end 138.17 new text begin $12,600,000 is transferred to state-operated new text end 138.18 new text begin services to maintain the METO program and new text end 138.19 new text begin other residential adult mental health services. new text end 138.20 new text begin Subd. 11. new text end new text begin Adult Mental Health Services new text end new text begin -0- new text end new text begin 12,600,000 new text end 138.21 new text begin Subd. 12. new text end new text begin Minnesota Sex Offender Services new text end new text begin -0- new text end new text begin (12,600,000) new text end 138.22 138.23 new text begin Subd. 13. new text end new text begin Contingent Appropriations new text end new text begin Reductions new text end 138.24 new text begin Upon enactment of the extension of new text end 138.25 new text begin the enhanced federal medical assistance new text end 138.26 new text begin percentage (FMAP) under Public Law 111-5 new text end 138.27 new text begin to June 30, 2011, that is contained in the new text end 138.28 new text begin president's budget for federal fiscal year 2011 new text end 138.29 new text begin or contained in House Resolution 2847, the new text end 138.30 new text begin federal "Jobs for Main Street Act of 2010," or new text end 138.31 new text begin subsequent federal legislation, the reductions new text end 138.32 new text begin identified in each clause shall be made to new text end 138.33 new text begin the specified general fund appropriations new text end 138.34 new text begin for fiscal year 2011. These contingent new text end 138.35 new text begin reductions, if implemented, are in addition new text end 139.1 new text begin to the reductions specified in subdivision 6, new text end 139.2 new text begin paragraphs (a), (b), and (c), and subdivision new text end 139.3 new text begin 8, paragraphs (c) and (d), respectively. new text end 139.4 new text begin (1) MinnesotaCare Grants new text end new text begin -0- new text end new text begin (9,200,000) new text end 139.5 139.6 new text begin (2) Medical Assistance Basic Health Care Grants new text end new text begin - Families and Children new text end new text begin -0- new text end new text begin (109,662,500) new text end 139.7 139.8 new text begin (3) Medical Assistance Basic Health Care Grants new text end new text begin - Elderly and Disabled new text end new text begin -0- new text end new text begin (110,437,500) new text end 139.9 139.10 new text begin (4) Medical Assistance Long-Term Care Facilities new text end new text begin Grants new text end new text begin -0- new text end new text begin (51,925,000) new text end 139.11 139.12 new text begin (5) Medical Assistance Long-Term Care Waivers new text end new text begin and Home Care Grants new text end new text begin -0- new text end new text begin (115,475,000) new text end 139.13 Sec. 4. new text begin COMMISSIONER OF HEALTH new text end 139.14 new text begin APPROPRIATIONS new text end 139.15 new text begin Available for the Year new text end 139.16 new text begin Ending June 30 new text end 139.17 new text begin 2010 new text end new text begin 2011 new text end 139.18 new text begin Subdivision 1. new text end new text begin Total Appropriation new text end new text begin $ new text end new text begin (2,397,000) new text end new text begin $ new text end new text begin 5,751,000 new text end 139.19 new text begin Appropriations by Fund new text end 139.20 new text begin 2010 new text end new text begin 2011 new text end 139.21 new text begin General new text end new text begin (1,797,000) new text end new text begin 5,810,000 new text end 139.22 139.23 new text begin State Government new text end new text begin Special Revenue new text end new text begin (600,000) new text end new text begin (259,000) new text end 139.24 139.25 new text begin Health Care Access new text end new text begin Fund new text end new text begin -0- new text end new text begin 200,000 new text end 139.26 new text begin Subd. 2. new text end new text begin Community and Family Health new text end new text begin -0- new text end new text begin 100,000 new text end 139.27 new text begin Grant for Memory Care Clinic. new text end new text begin $100,000 new text end 139.28 new text begin from the general fund in fiscal year 2011 new text end 139.29 new text begin is for a grant to a nonprofit, multispecialty new text end 139.30 new text begin clinic located in the city of St. Cloud that new text end 139.31 new text begin provides early identification, diagnosis, and new text end 139.32 new text begin treatment of memory loss, and information new text end 139.33 new text begin and support for family members who care for new text end 139.34 new text begin persons with memory impairment. In order new text end 139.35 new text begin to receive the grant, the clinic must certify to new text end 139.36 new text begin the commissioner that it has a commitment new text end 140.1 new text begin from a private foundation to provide a 50 new text end 140.2 new text begin percent match of the grant amount. This new text end 140.3 new text begin appropriation is onetime. new text end 140.4 new text begin Statewide Health Improvement Program. new text end new text begin new text end 140.5 new text begin $8,500,000 from the health care access new text end 140.6 new text begin fund in fiscal year 2012 and $8,500,000 in new text end 140.7 new text begin fiscal year 2013 is for the statewide health new text end 140.8 new text begin improvement program under Minnesota new text end 140.9 new text begin Statutes, section 145.986. These additions new text end 140.10 new text begin are onetime. new text end 140.11 new text begin Subd. 3. new text end new text begin Policy, Quality, and Compliance new text end 140.12 new text begin Appropriations by Fund new text end 140.13 new text begin 2010 new text end new text begin 2011 new text end 140.14 new text begin General new text end new text begin (1,797,000) new text end new text begin 5,210,000 new text end 140.15 140.16 new text begin State Government new text end new text begin Special Revenue new text end new text begin (600,000) new text end new text begin (268,000) new text end 140.17 140.18 new text begin Health Care Access new text end new text begin Fund new text end new text begin -0- new text end new text begin 200,000 new text end 140.19 new text begin Of this appropriation, $74,000 in fiscal new text end 140.20 new text begin year 2011 is to restore unallotments for the new text end 140.21 new text begin Office of Unlicensed Complementary and new text end 140.22 new text begin Alternative Health Care Practice. new text end 140.23 new text begin Health Care Reform. new text end new text begin Funds appropriated new text end 140.24 new text begin in Laws 2008, chapter 358, article 5, section new text end 140.25 new text begin 4, subdivision 3, for health reform activities new text end 140.26 new text begin to implement Laws 2008, chapter 358, new text end 140.27 new text begin article 4, are available until expended. new text end 140.28 new text begin Notwithstanding any contrary provision in new text end 140.29 new text begin this article, this provision shall not expire. new text end 140.30 new text begin Health Care Reform Task Force. new text end new text begin $200,000 new text end 140.31 new text begin from the general fund is for expenses related new text end 140.32 new text begin to the Health Care Reform Task Force new text end 140.33 new text begin established under article 7, section 8. new text end 140.34 new text begin Autism Coverage Study. new text end new text begin $50,000 in new text end 140.35 new text begin fiscal year 2011 is appropriated to the new text end 140.36 new text begin commissioner of health to monitor the gaps new text end 141.1 new text begin in the level of service provided by state new text end 141.2 new text begin health programs, the state employee group new text end 141.3 new text begin insurance plan, and private health plans for new text end 141.4 new text begin autism spectrum disorder. This appropriation new text end 141.5 new text begin is onetime. new text end 141.6 new text begin Rural Hospital Capital Improvement new text end 141.7 new text begin Grants. new text end new text begin Of the general fund reductions in new text end 141.8 new text begin fiscal year 2010, $1,755,000 is for the rural new text end 141.9 new text begin hospital capital improvement grant program. new text end 141.10 new text begin Health Information Exchange Oversight. new text end new text begin new text end 141.11 new text begin Of the state government special revenue fund new text end 141.12 new text begin appropriations, $104,000 in fiscal year 2011 new text end 141.13 new text begin is for the duties required under Minnesota new text end 141.14 new text begin Statutes, sections 62J.498 to 62J.4982. new text end 141.15 new text begin Birth Centers. new text end new text begin Of the state government new text end 141.16 new text begin special revenue fund appropriations, $9,000 new text end 141.17 new text begin is for licensing birth centers under Minnesota new text end 141.18 new text begin Statutes, section 144.651. Base funding shall new text end 141.19 new text begin be $7,000 in fiscal year 2012 and $7,000 in new text end 141.20 new text begin fiscal year 2013. new text end 141.21 new text begin Advisory Group on Administrative new text end 141.22 new text begin Expenses. new text end new text begin Of the general fund appropriation, new text end 141.23 new text begin $40,000 in fiscal year 2011 is for the advisory new text end 141.24 new text begin group established under Minnesota Statutes, new text end 141.25 new text begin section 62D.31. new text end 141.26 new text begin Community Clinic Grants. new text end new text begin Of this new text end 141.27 new text begin appropriation, $2,500,000 in fiscal new text end 141.28 new text begin year 2011 is for the commissioner to new text end 141.29 new text begin provide community clinic grants under new text end 141.30 new text begin Minnesota Statutes, section 145.9268. This new text end 141.31 new text begin appropriation is onetime. In awarding grants new text end 141.32 new text begin using this funding, the commissioner shall new text end 141.33 new text begin give priority to proposals that seek to serve new text end 141.34 new text begin medically underserved areas of the state that new text end 141.35 new text begin are not served by a coordinated care delivery new text end 142.1 new text begin system established under Minnesota Statutes, new text end 142.2 new text begin section 256D.031, subdivision 6. new text end 142.3 new text begin Federally Qualified Health Center new text end 142.4 new text begin Subsidies. new text end new text begin Of this appropriation, $2,500,000 new text end 142.5 new text begin in fiscal year 2011 is for the commissioner to new text end 142.6 new text begin increase subsidies to federally qualified health new text end 142.7 new text begin centers provided under Minnesota Statutes, new text end 142.8 new text begin section 145.9269. This appropriation is new text end 142.9 new text begin onetime. In awarding subsidies using this new text end 142.10 new text begin funding, the commissioner shall give priority new text end 142.11 new text begin to federally qualified health centers that serve new text end 142.12 new text begin medically underserved areas of the state that new text end 142.13 new text begin are not served by a coordinated care delivery new text end 142.14 new text begin system established under Minnesota Statutes, new text end 142.15 new text begin section 256D.031, subdivision 6. new text end 142.16 new text begin Base Level Adjustment. new text end new text begin The general fund new text end 142.17 new text begin base is increased by $76,000 in each of fiscal new text end 142.18 new text begin years 2012 and 2013. The state government new text end 142.19 new text begin special revenue fund base is increased by new text end 142.20 new text begin $97,000 in each of fiscal years 2012 and new text end 142.21 new text begin 2013. new text end 142.22 new text begin Subd. 4. new text end new text begin Health Protection new text end new text begin -0- new text end new text begin 500,000 new text end 142.23 new text begin Birth Defects Information System. new text end new text begin Of new text end 142.24 new text begin the general fund appropriation, $500,000 in new text end 142.25 new text begin fiscal year 2011 is for the Minnesota Birth new text end 142.26 new text begin Defects Information System established new text end 142.27 new text begin under Minnesota Statutes, section 144.2215. new text end 142.28 Sec. 5. new text begin Office of the Legislative Auditor new text end new text begin $ new text end new text begin -0- new text end new text begin $ new text end new text begin 200,000 new text end 142.29 new text begin $200,000 or an amount equal to 90 percent new text end 142.30 new text begin of the nonfederal administrative staff funds new text end 142.31 new text begin expended by the commissioner of human new text end 142.32 new text begin services related to the preparation and new text end 142.33 new text begin drafting of fiscal notes during fiscal year new text end 142.34 new text begin 2009, is transferred from the Department new text end 143.1 new text begin of Human Services to the Office of the new text end 143.2 new text begin Legislative Auditor, and appropriated for new text end 143.3 new text begin the fiscal year beginning July 1, 2011, new text end 143.4 new text begin for completion of the duties described in new text end 143.5 new text begin Minnesota Statutes, section 3.98. new text end 143.6    Sec. 6. Laws 2009, chapter 79, article 13, section 3, subdivision 1, as amended by 143.7Laws 2009, chapter 173, article 2, section 1, subdivision 1, is amended to read: 143.8 Subdivision 1.Total Appropriation$5,225,451,000$6,002,864,000 143.9 Appropriations by Fund 143.10 2010 2011 143.11 General 4,375,689,000 5,209,765,000 143.12 143.13 State Government Special Revenue 565,000 565,000 143.14 Health Care Access 450,662,000 527,411,000 143.15 Federal TANF 286,770,000 263,458,000 143.16 Lottery Prize 1,665,000 1,665,000 143.17 Federal Fund 110,000,000 0 143.18Receipts for Systems Projects. 143.19Appropriations and federal receipts for 143.20information systems projects for MAXIS, 143.21PRISM, MMIS, and SSIS must be deposited 143.22in the state system account authorized in 143.23Minnesota Statutes, section 256.014. Money 143.24appropriated for computer projects approved 143.25by the Minnesota Office of Enterprise 143.26Technology, funded by the legislature, and 143.27approved by the commissioner of finance, 143.28may be transferred from one project to 143.29another and from development to operations 143.30as the commissioner of human services 143.31considers necessary, except that any transfers 143.32to one project that exceed $1,000,000 or 143.33multiple transfers to one project that exceed 143.34$1,000,000 in total require the express 143.35approval of the legislature. The preceding 143.36requirement for legislative approval does not 144.1apply to transfers made to establish a project's 144.2initial operating budget each year; instead, 144.3the requirements of section 11, subdivision 144.42, of this article apply to those transfers. Any 144.5unexpended balance in the appropriation 144.6for these projects does not cancel but is 144.7available for ongoing development and 144.8operations. Any computer project with a 144.9total cost exceeding $1,000,000, including, 144.10but not limited to, a replacement for the 144.11proposed HealthMatch system, shall not be 144.12commenced without the express approval of 144.13the legislature. 144.14HealthMatch Systems Project. In fiscal 144.15year 2010, $3,054,000 shall be transferred 144.16from the HealthMatch account in the state 144.17systems account in the special revenue fund 144.18to the general fund. 144.19Nonfederal Share Transfers. The 144.20nonfederal share of activities for which 144.21federal administrative reimbursement is 144.22appropriated to the commissioner may be 144.23transferred to the special revenue fund. 144.24TANF Maintenance of Effort. 144.25(a) In order to meet the basic maintenance 144.26of effort (MOE) requirements of the TANF 144.27block grant specified under Code of Federal 144.28Regulations, title 45, section 263.1, the 144.29commissioner may only report nonfederal 144.30money expended for allowable activities 144.31listed in the following clauses as TANF/MOE 144.32expenditures: 144.33(1) MFIP cash, diversionary work program, 144.34and food assistance benefits under Minnesota 144.35Statutes, chapter 256J; 145.1(2) the child care assistance programs 145.2under Minnesota Statutes, sections 119B.03 145.3and 119B.05, and county child care 145.4administrative costs under Minnesota 145.5Statutes, section 119B.15; 145.6(3) state and county MFIP administrative 145.7costs under Minnesota Statutes, chapters 145.8256J and 256K; 145.9(4) state, county, and tribal MFIP 145.10employment services under Minnesota 145.11Statutes, chapters 256J and 256K; 145.12(5) expenditures made on behalf of 145.13noncitizen MFIP recipients who qualify 145.14for the medical assistance without federal 145.15financial participation program under 145.16Minnesota Statutes, section 256B.06, 145.17subdivision 4 , paragraphs (d), (e), and (j); 145.18and 145.19(6) qualifying working family credit 145.20expenditures under Minnesota Statutes, 145.21section 290.0671. new text begin ; and new text end 145.22 new text begin (7) qualifying Minnesota education credit new text end 145.23 new text begin expenditures under Minnesota Statutes, new text end 145.24 new text begin section 290.0674. new text end 145.25(b) The commissioner shall ensure that 145.26sufficient qualified nonfederal expenditures 145.27are made each year to meet the state's 145.28TANF/MOE requirements. For the activities 145.29listed in paragraph (a), clauses (2) to 145.30(6), the commissioner may only report 145.31expenditures that are excluded from the 145.32definition of assistance under Code of 145.33Federal Regulations, title 45, section 260.31. 146.1(c) For fiscal years beginning with state 146.2fiscal year 2003, the commissioner shall 146.3ensure that the maintenance of effort used 146.4by the commissioner of finance for the 146.5February and November forecasts required 146.6under Minnesota Statutes, section 16A.103, 146.7contains expenditures under paragraph (a), 146.8clause (1), equal to at least 16 percent of 146.9the total required under Code of Federal 146.10Regulations, title 45, section 263.1. 146.11(d) For the federal fiscal years beginning on 146.12or after October 1, 2007, the commissioner 146.13may not claim an amount of TANF/MOE in 146.14excess of the 75 percent standard in Code 146.15of Federal Regulations, title 45, section 146.16263.1(a)(2), except: 146.17(1) to the extent necessary to meet the 80 146.18percent standard under Code of Federal 146.19Regulations, title 45, section 263.1(a)(1), 146.20if it is determined by the commissioner 146.21that the state will not meet the TANF work 146.22participation target rate for the current year; 146.23(2) to provide any additional amounts 146.24under Code of Federal Regulations, title 45, 146.25section 264.5, that relate to replacement of 146.26TANF funds due to the operation of TANF 146.27penalties; and 146.28(3) to provide any additional amounts that 146.29may contribute to avoiding or reducing 146.30TANF work participation penalties through 146.31the operation of the excess MOE provisions 146.32of Code of Federal Regulations, title 45, 146.33section 261.43 (a)(2). 146.34For the purposes of clauses (1) to (3), 146.35the commissioner may supplement the 147.1MOE claim with working family credit 147.2expenditures to the extent such expenditures 147.3or other qualified expenditures are otherwise 147.4available after considering the expenditures 147.5allowed in this section. 147.6(e) Minnesota Statutes, section 256.011, 147.7subdivision 3 , which requires that federal 147.8grants or aids secured or obtained under that 147.9subdivision be used to reduce any direct 147.10appropriations provided by law, do not apply 147.11if the grants or aids are federal TANF funds. 147.12(f) Notwithstanding any contrary provision 147.13in this article, this provision expires June 30, 147.142013. 147.15Working Family Credit Expenditures as 147.16TANF/MOE. The commissioner may claim 147.17as TANF/MOE up to $6,707,000 per year of 147.18working family credit expenditures for fiscal 147.19year 2010 through fiscal year 2011. 147.20Working Family Credit Expenditures 147.21to be Claimed for TANF/MOE. The 147.22commissioner may count the following 147.23amounts of working family credit expenditure 147.24as TANF/MOE: 147.25(1) fiscal year 2010, $50,973,000 new text begin new text end 147.26 new text begin $50,897,000 new text end ; 147.27(2) fiscal year 2011, $53,793,000 new text begin new text end 147.28 new text begin $54,243,000 new text end ; 147.29(3) fiscal year 2012, $23,516,000 new text begin new text end 147.30 new text begin $23,345,000 new text end ; and 147.31(4) fiscal year 2013, $16,808,000 new text begin new text end 147.32 new text begin $16,585,000 new text end . 147.33Notwithstanding any contrary provision in 147.34this article, this rider expires June 30, 2013. 148.1Food Stamps Employment and Training. 148.2(a) The commissioner shall apply for and 148.3claim the maximum allowable federal 148.4matching funds under United States Code, 148.5title 7, section 2025, paragraph (h), for 148.6state expenditures made on behalf of family 148.7stabilization services participants voluntarily 148.8engaged in food stamp employment and 148.9training activities, where appropriate. 148.10(b) Notwithstanding Minnesota Statutes, 148.11sections 256D.051, subdivisions 1a, 6b, 148.12and 6c, and 256J.626, federal food stamps 148.13employment and training funds received 148.14as reimbursement of MFIP consolidated 148.15fund grant expenditures for diversionary 148.16work program participants and child 148.17care assistance program expenditures for 148.18two-parent families must be deposited in the 148.19general fund. The amount of funds must be 148.20limited to $3,350,000 in fiscal year 2010 148.21and $4,440,000 in fiscal years 2011 through 148.222013, contingent on approval by the federal 148.23Food and Nutrition Service. 148.24(c) Consistent with the receipt of these federal 148.25funds, the commissioner may adjust the 148.26level of working family credit expenditures 148.27claimed as TANF maintenance of effort. 148.28Notwithstanding any contrary provision in 148.29this article, this rider expires June 30, 2013. 148.30ARRA Food Support Administration. 148.31The funds available for food support 148.32administration under the American Recovery 148.33and Reinvestment Act (ARRA) of 2009 148.34are appropriated to the commissioner 148.35to pay actual costs of implementing the 149.1food support benefit increases, increased 149.2eligibility determinations, and outreach. Of 149.3these funds, 20 percent shall be allocated 149.4to the commissioner and 80 percent shall 149.5be allocated to counties. The commissioner 149.6shall allocate the county portion based on 149.7caseload. Reimbursement shall be based on 149.8actual costs reported by counties through 149.9existing processes. Tribal reimbursement 149.10must be made from the state portion based 149.11on a caseload factor equivalent to that of a 149.12county. 149.13ARRA Food Support Benefit Increases. 149.14The funds provided for food support benefit 149.15increases under the Supplemental Nutrition 149.16Assistance Program provisions of the 149.17American Recovery and Reinvestment Act 149.18(ARRA) of 2009 must be used for benefit 149.19increases beginning July 1, 2009. 149.20Emergency Fund for the TANF Program. 149.21TANF Emergency Contingency funds 149.22available under the American Recovery 149.23and Reinvestment Act of 2009 (Public Law 149.24111-5) are appropriated to the commissioner. 149.25The commissioner must request TANF 149.26Emergency Contingency funds from the 149.27Secretary of the Department of Health 149.28and Human Services to the extent the 149.29commissioner meets or expects to meet the 149.30requirements of section 403(c) of the Social 149.31Security Act. The commissioner must seek 149.32to maximize such grants. The funds received 149.33must be used as appropriated. Each county 149.34must maintain the county's current level of 149.35emergency assistance funding under the 149.36MFIP consolidated fund and use the funds 150.1under this paragraph to supplement existing 150.2emergency assistance funding levels. 150.3    Sec. 7. Laws 2009, chapter 79, article 13, section 3, subdivision 3, as amended by 150.4Laws 2009, chapter 173, article 2, section 1, subdivision 3, is amended to read: 150.5 150.6 Subd. 3.Revenue and Pass-Through Revenue Expenditures 68,337,000 70,505,000 150.7This appropriation is from the federal TANF 150.8fund. 150.9TANF Transfer to Federal Child Care 150.10and Development Fund. The following 150.11TANF fund amounts are appropriated to the 150.12commissioner for the purposes of MFIP and 150.13transition year child care under Minnesota 150.14Statutes, section 119B.05: 150.15(1) fiscal year 2010, $6,531,000 new text begin $862,000 new text end ; 150.16(2) fiscal year 2011, $10,241,000 new text begin $978,000 new text end ; 150.17(3) fiscal year 2012, $10,826,000 new text begin $0 new text end ; and 150.18(4) fiscal year 2013, $4,046,000 new text begin $0 new text end . 150.19The commissioner shall authorize the 150.20transfer of sufficient TANF funds to the 150.21federal child care and development fund to 150.22meet this appropriation and shall ensure that 150.23all transferred funds are expended according 150.24to federal child care and development fund 150.25regulations. 150.26    Sec. 8. Laws 2009, chapter 79, article 13, section 3, subdivision 4, as amended by 150.27Laws 2009, chapter 173, article 2, section 1, subdivision 4, is amended to read: 150.28 150.29 Subd. 4.Children and Economic Assistance Grants150.30The amounts that may be spent from this 150.31appropriation for each purpose are as follows: 150.32 (a) MFIP/DWP Grants 151.1 Appropriations by Fund 151.2 General 63,205,000 89,033,000 151.3 Federal TANF 100,818,000 84,538,000 151.4 (b) Support Services Grants 151.5 Appropriations by Fund 151.6 General 8,715,000 12,498,000 151.7 Federal TANF 116,557,000 107,457,000 151.8MFIP Consolidated Fund. The MFIP 151.9consolidated fund TANF appropriation is 151.10reduced by $1,854,000 in fiscal year 2010 151.11and fiscal year 2011. 151.12Notwithstanding Minnesota Statutes, section 151.13256J.626, subdivision 8 , paragraph (b), the 151.14commissioner shall reduce proportionately 151.15the reimbursement to counties for 151.16administrative expenses. 151.17Subsidized Employment Funding Through 151.18ARRA. The commissioner is authorized to 151.19apply for TANF emergency fund grants for 151.20subsidized employment activities. Growth 151.21in expenditures for subsidized employment 151.22within the supported work program and the 151.23MFIP consolidated fund over the amount 151.24expended in the calendar quarters in the 151.25TANF emergency fund base year shall be 151.26used to leverage the TANF emergency fund 151.27grants for subsidized employment and to 151.28fund supported work. The commissioner 151.29shall develop procedures to maximize 151.30reimbursement of these expenditures over the 151.31TANF emergency fund base year quarters, 151.32and may contract directly with employers 151.33and providers to maximize these TANF 151.34emergency fund grants. 152.1Supported Work. Of the TANF 152.2appropriation, $4,700,000 in fiscal year 2010 152.3and $4,700,000 in fiscal year 2011 are to the 152.4commissioner for supported work for MFIP 152.5recipients and is available until expended. 152.6Supported work includes paid transitional 152.7work experience and a continuum of 152.8employment assistance, including outreach 152.9and recruitment, program orientation 152.10and intake, testing and assessment, job 152.11development and marketing, preworksite 152.12training, supported worksite experience, 152.13job coaching, and postplacement follow-up, 152.14in addition to extensive case management 152.15and referral services. This is a onetime 152.16appropriation. 152.17Base Adjustment. The general fund base 152.18is reduced by $3,783,000 in each of fiscal 152.19years 2012 and 2013. The TANF fund base 152.20is increased by $5,004,000 in each of fiscal 152.21years 2012 and 2013. 152.22Integrated Services Program Funding. 152.23The TANF appropriation for integrated 152.24services program funding is $1,250,000 in 152.25fiscal year 2010 and $0 in fiscal year 2011 152.26and the base for fiscal years 2012 and 2013 152.27is $0. 152.28TANF Emergency Fund; Nonrecurrent 152.29Short-Term Benefits. new text begin (1) new text end TANF emergency 152.30contingency fund grants received due to 152.31increases in expenditures for nonrecurrent 152.32short-term benefits must be used to offset the 152.33increase in these expenditures for counties 152.34under the MFIP consolidated fund, under 152.35Minnesota Statutes, section 256J.626, 153.1and the diversionary work program. The 153.2commissioner shall develop procedures 153.3to maximize reimbursement of these 153.4expenditures over the TANF emergency fund 153.5base year quarters. Growth in expenditures 153.6for the diversionary work program over the 153.7amount expended in the calendar quarters in 153.8the TANF emergency fund base year shall be 153.9used to leverage these funds. 153.10 new text begin (2) To the extent that the commissioner new text end 153.11 new text begin can claim eligible tax credit growth as new text end 153.12 new text begin nonrecurrent short-term benefits, the new text end 153.13 new text begin commissioner shall use those funds to new text end 153.14 new text begin leverage the increased expenditures in clause new text end 153.15 new text begin (1). new text end 153.16 new text begin (3) TANF emergency funds for nonrecurrent new text end 153.17 new text begin short-term benefits received in excess of the new text end 153.18 new text begin amounts necessary for clauses (1) and (2) new text end 153.19 new text begin shall be used to reimburse the general fund new text end 153.20 new text begin for the costs of eligible tax credits in fiscal new text end 153.21 new text begin year 2011. The amount of such funds shall new text end 153.22 new text begin not exceed $28,000,000. new text end 153.23 (c) MFIP Child Care Assistance Grants 61,171,000 65,214,000 153.24Acceleration of ARRA Child Care and 153.25Development Fund Expenditure. The 153.26commissioner must liquidate all child care 153.27and development money available under 153.28the American Recovery and Reinvestment 153.29Act (ARRA) of 2009, Public Law 111-5, 153.30by September 30, 2010. In order to expend 153.31those funds by September 30, 2010, the 153.32commissioner may redesignate and expend 153.33the ARRA child care and development funds 153.34appropriated in fiscal year 2011 for purposes 153.35under this section for related purposes that 154.1will allow liquidation by September 30, 154.22010. Child care and development funds 154.3otherwise available to the commissioner 154.4for those related purposes shall be used to 154.5fund the purposes from which the ARRA 154.6child care and development funds had been 154.7redesignated. 154.8School Readiness Service Agreements. 154.9$400,000 in fiscal year 2010 and $400,000 154.10in fiscal year 2011 are from the federal 154.11TANF fund to the commissioner of human 154.12services consistent with federal regulations 154.13for the purpose of school readiness service 154.14agreements under Minnesota Statutes, 154.15section 119B.231. This is a onetime 154.16appropriation. Any unexpended balance the 154.17first year is available in the second year. 154.18 154.19 (d) Basic Sliding Fee Child Care Assistance Grants 40,100,000 45,092,000 154.20School Readiness Service Agreements. 154.21$257,000 in fiscal year 2010 and $257,000 154.22in fiscal year 2011 are from the general 154.23fund for the purpose of school readiness 154.24service agreements under Minnesota 154.25Statutes, section 119B.231. This is a onetime 154.26appropriation. Any unexpended balance the 154.27first year is available in the second year. 154.28Child Care Development Fund 154.29Unexpended Balance. In addition to 154.30the amount provided in this section, the 154.31commissioner shall expend $5,244,000 in 154.32fiscal year 2010 from the federal child care 154.33development fund unexpended balance 154.34for basic sliding fee child care under 154.35Minnesota Statutes, section 119B.03. The 154.36commissioner shall ensure that all child 155.1care and development funds are expended 155.2according to the federal child care and 155.3development fund regulations. 155.4Basic Sliding Fee. $4,000,000 in fiscal year 155.52010 and $4,000,000 in fiscal year 2011 are 155.6from the federal child care development 155.7funds received from the American Recovery 155.8and Reinvestment Act of 2009, Public 155.9Law 111-5, to the commissioner of human 155.10services consistent with federal regulations 155.11for the purpose of basic sliding fee child care 155.12assistance under Minnesota Statutes, section 155.13119B.03 . This is a onetime appropriation. 155.14Any unexpended balance the first year is 155.15available in the second year. 155.16Basic Sliding Fee Allocation for Calendar 155.17Year 2010. Notwithstanding Minnesota 155.18Statutes, section 119B.03, subdivision 6, 155.19in calendar year 2010, basic sliding fee 155.20funds shall be distributed according to 155.21this provision. Funds shall be allocated 155.22first in amounts equal to each county's 155.23guaranteed floor, according to Minnesota 155.24Statutes, section 119B.03, subdivision 8, 155.25with any remaining available funds allocated 155.26according to the following formula: 155.27(a) Up to one-fourth of the funds shall be 155.28allocated in proportion to the number of 155.29families participating in the transition year 155.30child care program as reported during and 155.31averaged over the most recent six months 155.32completed at the time of the notice of 155.33allocation. Funds in excess of the amount 155.34necessary to serve all families in this category 155.35shall be allocated according to paragraph (d). 156.1(b) Up to three-fourths of the funds shall 156.2be allocated in proportion to the average 156.3of each county's most recent six months of 156.4reported waiting list as defined in Minnesota 156.5Statutes, section 119B.03, subdivision 2, and 156.6the reinstatement list of those families whose 156.7assistance was terminated with the approval 156.8of the commissioner under Minnesota Rules, 156.9part 3400.0183, subpart 1. Funds in excess 156.10of the amount necessary to serve all families 156.11in this category shall be allocated according 156.12to paragraph (d). 156.13(c) The amount necessary to serve all families 156.14in paragraphs (a) and (b) shall be calculated 156.15based on the basic sliding fee average cost of 156.16care per family in the county with the highest 156.17cost in the most recently completed calendar 156.18year. 156.19(d) Funds in excess of the amount necessary 156.20to serve all families in paragraphs (a) and 156.21(b) shall be allocated in proportion to each 156.22county's total expenditures for the basic 156.23sliding fee child care program reported 156.24during the most recent fiscal year completed 156.25at the time of the notice of allocation. To 156.26the extent that funds are available, and 156.27notwithstanding Minnesota Statutes, section 156.28119B.03, subdivision 8 , for the period 156.29January 1, 2011, to December 31, 2011, each 156.30county's guaranteed floor must be equal to its 156.31original calendar year 2010 allocation. 156.32Base Adjustment. The general fund base is 156.33decreased by $257,000 in each of fiscal years 156.342012 and 2013. 156.35 (e) Child Care Development Grants 1,487,000 1,487,000 157.1Family, friends, and neighbor grants. 157.2$375,000 in fiscal year 2010 and $375,000 157.3in fiscal year 2011 are from the child 157.4care development fund required targeted 157.5quality funds for quality expansion and 157.6infant/toddler from the American Recovery 157.7and Reinvestment Act of 2009, Public 157.8Law 111-5, to the commissioner of human 157.9services for family, friends, and neighbor 157.10grants under Minnesota Statutes, section 157.11119B.232 . This appropriation may be used 157.12on programs receiving family, friends, and 157.13neighbor grant funds as of June 30, 2009, 157.14or on new programs or projects. This is a 157.15onetime appropriation. Any unexpended 157.16balance the first year is available in the 157.17second year. 157.18Voluntary quality rating system training, 157.19coaching, consultation, and supports. 157.20$633,000 in fiscal year 2010 and $633,000 157.21in fiscal year 2011 are from the federal child 157.22care development fund required targeted 157.23quality funds for quality expansion and 157.24infant/toddler from the American Recovery 157.25and Reinvestment Act of 2009, Public 157.26Law 111-5, to the commissioner of human 157.27services consistent with federal regulations 157.28for the purpose of providing grants to provide 157.29statewide child-care provider training, 157.30coaching, consultation, and supports to 157.31prepare for the voluntary Minnesota quality 157.32rating system rating tool. This is a onetime 157.33appropriation. Any unexpended balance the 157.34first year is available in the second year. 157.35Voluntary quality rating system. $184,000 157.36in fiscal year 2010 and $1,200,000 in fiscal 158.1year 2011 are from the federal child care 158.2development fund required targeted funds for 158.3quality expansion and infant/toddler from the 158.4American Recovery and Reinvestment Act of 158.52009, Public Law 111-5, to the commissioner 158.6of human services consistent with federal 158.7regulations for the purpose of implementing 158.8the voluntary Parent Aware quality star 158.9rating system pilot in coordination with the 158.10Minnesota Early Learning Foundation. The 158.11appropriation for the first year is to complete 158.12and promote the voluntary Parent Aware 158.13quality rating system pilot program through 158.14June 30, 2010, and the appropriation for 158.15the second year is to continue the voluntary 158.16Minnesota quality rating system pilot 158.17through June 30, 2011. This is a onetime 158.18appropriation. Any unexpended balance the 158.19first year is available in the second year. 158.20 (f) Child Support Enforcement Grants 3,705,000 3,705,000 158.21 (g) Children's Services Grants 158.22 Appropriations by Fund 158.23 General 48,333,000 50,498,000 158.24 Federal TANF 340,000 240,000 158.25Base Adjustment. The general fund base is 158.26decreased by $5,371,000 in fiscal year 2012 158.27and decreased $5,371,000 in fiscal year 2013. 158.28Privatized Adoption Grants. Federal 158.29reimbursement for privatized adoption grant 158.30and foster care recruitment grant expenditures 158.31is appropriated to the commissioner for 158.32adoption grants and foster care and adoption 158.33administrative purposes. 158.34Adoption Assistance Incentive Grants. 158.35Federal funds available during fiscal year 159.12010 and fiscal year 2011 for the adoption 159.2incentive grants are appropriated to the 159.3commissioner for postadoption services 159.4including parent support groups. 159.5Adoption Assistance and Relative Custody 159.6Assistance. The commissioner may transfer 159.7unencumbered appropriation balances for 159.8adoption assistance and relative custody 159.9assistance between fiscal years and between 159.10programs. 159.11 (h) Children and Community Services Grants 67,663,000 67,542,000 159.12Targeted Case Management Temporary 159.13Funding Adjustment. The commissioner 159.14shall recover from each county and tribe 159.15receiving a targeted case management 159.16temporary funding payment in fiscal year 159.172008 an amount equal to that payment. The 159.18commissioner shall recover one-half of the 159.19funds by February 1, 2010, and the remainder 159.20by February 1, 2011. At the commissioner's 159.21discretion and at the request of a county 159.22or tribe, the commissioner may revise 159.23the payment schedule, but full payment 159.24must not be delayed beyond May 1, 2011. 159.25The commissioner may use the recovery 159.26procedure under Minnesota Statutes, section 159.27256.017 , to recover the funds. Recovered 159.28funds must be deposited into the general 159.29fund. 159.30 (i) General Assistance Grants 48,215,000 48,608,000 159.31General Assistance Standard. The 159.32commissioner shall set the monthly standard 159.33of assistance for general assistance units 159.34consisting of an adult recipient who is 159.35childless and unmarried or living apart 160.1from parents or a legal guardian at $203. 160.2The commissioner may reduce this amount 160.3according to Laws 1997, chapter 85, article 160.43, section 54. 160.5Emergency General Assistance. The 160.6amount appropriated for emergency general 160.7assistance funds is limited to no more 160.8than $7,889,812 in fiscal year 2010 and 160.9$7,889,812 in fiscal year 2011. Funds 160.10to counties must be allocated by the 160.11commissioner using the allocation method 160.12specified in Minnesota Statutes, section 160.13256D.06 . 160.14 (j) Minnesota Supplemental Aid Grants 33,930,000 35,191,000 160.15Emergency Minnesota Supplemental 160.16Aid Funds. The amount appropriated for 160.17emergency Minnesota supplemental aid 160.18funds is limited to no more than $1,100,000 160.19in fiscal year 2010 and $1,100,000 in fiscal 160.20year 2011. Funds to counties must be 160.21allocated by the commissioner using the 160.22allocation method specified in Minnesota 160.23Statutes, section 256D.46. 160.24 (k) Group Residential Housing Grants 111,778,000 114,034,000 160.25Group Residential Housing Costs 160.26Refinanced. (a) Effective July 1, 2011, the 160.27commissioner shall increase the home and 160.28community-based service rates and county 160.29allocations provided to programs for persons 160.30with disabilities established under section 160.311915(c) of the Social Security Act to the 160.32extent that these programs will be paying 160.33for the costs above the rate established 160.34in Minnesota Statutes, section 256I.05, 160.35subdivision 1 . 161.1(b) For persons receiving services under 161.2Minnesota Statutes, section 245A.02, who 161.3reside in licensed adult foster care beds 161.4for which a difficulty of care payment 161.5was being made under Minnesota Statutes, 161.6section 256I.05, subdivision 1c, paragraph 161.7(b), counties may request an exception to 161.8the individual's service authorization not to 161.9exceed the difference between the client's 161.10monthly service expenditures plus the 161.11amount of the difficulty of care payment. 161.12 (l) Children's Mental Health Grants 16,885,000 16,882,000 161.13Funding Usage. Up to 75 percent of a fiscal 161.14year's appropriation for children's mental 161.15health grants may be used to fund allocations 161.16in that portion of the fiscal year ending 161.17December 31. 161.18 161.19 (m) Other Children and Economic Assistance Grants 16,047,000 15,339,000 161.20Fraud Prevention Grants. Of this 161.21appropriation, $228,000 in fiscal year 2010 161.22and $228,000 in fiscal year 2011 is to the 161.23commissioner for fraud prevention grants to 161.24counties. 161.25Homeless and Runaway Youth. $218,000 161.26in fiscal year 2010 is for the Runaway 161.27and Homeless Youth Act under Minnesota 161.28Statutes, section 256K.45. Funds shall be 161.29spent in each area of the continuum of care 161.30to ensure that programs are meeting the 161.31greatest need. Any unexpended balance in 161.32the first year is available in the second year. 161.33Beginning July 1, 2011, the base is increased 161.34by $119,000 each year. 162.1ARRA Homeless Youth Funds. To the 162.2extent permitted under federal law, the 162.3commissioner shall designate $2,500,000 162.4of the Homeless Prevention and Rapid 162.5Re-Housing Program funds provided under 162.6the American Recovery and Reinvestment 162.7Act of 2009, Public Law 111-5, for agencies 162.8providing homelessness prevention and rapid 162.9rehousing services to youth. 162.10Supportive Housing Services. $1,500,000 162.11each year is for supportive services under 162.12Minnesota Statutes, section 256K.26. This is 162.13a onetime appropriation. 162.14Community Action Grants. Community 162.15action grants are reduced one time by 162.16$1,794,000 each year. This reduction is due 162.17to the availability of federal funds under the 162.18American Recovery and Reinvestment Act. 162.19Base Adjustment. The general fund base 162.20is increased by $773,000 in fiscal year 2012 162.21and $773,000 in fiscal year 2013. 162.22Federal ARRA Funds for Existing 162.23Programs. (a) new text begin (1) new text end Federal funds received by 162.24the commissioner for the emergency food 162.25and shelter program from the American 162.26Recovery and Reinvestment Act of 2009, 162.27Public Law 111-5, but not previously 162.28approved by the legislature are appropriated 162.29to the commissioner for the purposes of the 162.30grant program. 162.31(b) new text begin (2) new text end Federal funds received by the 162.32commissioner for the emergency shelter 162.33grant program including the Homelessness 162.34Prevention and Rapid Re-Housing 162.35Program from the American Recovery and 163.1Reinvestment Act of 2009, Public Law 163.2111-5, are appropriated to the commissioner 163.3for the purposes of the grant programs. 163.4(c) new text begin (3) new text end Federal funds received by the 163.5commissioner for the emergency food 163.6assistance program from the American 163.7Recovery and Reinvestment Act of 2009, 163.8Public Law 111-5, are appropriated to the 163.9commissioner for the purposes of the grant 163.10program. 163.11(d) new text begin (4) new text end Federal funds received by the 163.12commissioner for senior congregate meals 163.13and senior home-delivered meals from the 163.14American Recovery and Reinvestment Act 163.15of 2009, Public Law 111-5, are appropriated 163.16to the commissioner for the Minnesota Board 163.17on Aging, for purposes of the grant programs. 163.18(e) new text begin (5) new text end Federal funds received by the 163.19commissioner for the community services 163.20block grant program from the American 163.21Recovery and Reinvestment Act of 2009, 163.22Public Law 111-5, are appropriated to the 163.23commissioner for the purposes of the grant 163.24program. 163.25Long-Term Homeless Supportive 163.26Service Fund Appropriation. To the 163.27extent permitted under federal law, the 163.28commissioner shall designate $3,000,000 163.29of the Homelessness Prevention and Rapid 163.30Re-Housing Program funds provided under 163.31the American Recovery and Reinvestment 163.32Act of 2009, Public Law, 111-5, to the 163.33long-term homeless service fund under 163.34Minnesota Statutes, section 256K.26. This 163.35appropriation shall become available by July 164.11, 2009. This paragraph is effective the day 164.2following final enactment. 164.3    Sec. 9. Laws 2009, chapter 79, article 13, section 3, subdivision 8, as amended by 164.4Laws 2009, chapter 173, article 2, section 1, subdivision 8, is amended to read: 164.5 Subd. 8.Continuing Care Grants164.6The amounts that may be spent from the 164.7appropriation for each purpose are as follows: 164.8 (a) Aging and Adult Services Grants 13,499,000 15,805,000 164.9Base Adjustment. The general fund base is 164.10increased by $5,751,000 in fiscal year 2012 164.11and $6,705,000 in fiscal year 2013. 164.12Information and Assistance 164.13Reimbursement. Federal administrative 164.14reimbursement obtained from information 164.15and assistance services provided by the 164.16Senior LinkAge or Disability Linkage lines 164.17to people who are identified as eligible for 164.18medical assistance shall be appropriated to 164.19the commissioner for this activity. 164.20Community Service Development Grant 164.21Reduction. Funding for community service 164.22development grants must be reduced by 164.23$260,000 for fiscal year 2010; $284,000 in 164.24fiscal year 2011; $43,000 in fiscal year 2012; 164.25and $43,000 in fiscal year 2013. Base level 164.26funding shall be restored in fiscal year 2014. 164.27Community Service Development Grant 164.28Community Initiative. Funding for 164.29community service development grants shall 164.30be used to offset the cost of aging support 164.31grants. Base level funding shall be restored 164.32in fiscal year 2014. 165.1Senior Nutrition Use of Federal Funds. 165.2For fiscal year 2010, general fund grants 165.3for home-delivered meals and congregate 165.4dining shall be reduced by $500,000. The 165.5commissioner must replace these general 165.6fund reductions with equal amounts from 165.7federal funding for senior nutrition from the 165.8American Recovery and Reinvestment Act 165.9of 2009. 165.10 (b) Alternative Care Grants 50,234,000 48,576,000 165.11Base Adjustment. The general fund base is 165.12decreased by $3,598,000 in fiscal year 2012 165.13and $3,470,000 in fiscal year 2013. 165.14Alternative Care Transfer. Any money 165.15allocated to the alternative care program that 165.16is not spent for the purposes indicated does 165.17not cancel but must be transferred to the 165.18medical assistance account. 165.19 165.20 (c) Medical Assistance Grants; Long-Term Care Facilities. 367,444,000 419,749,000 165.21 165.22 (d) Medical Assistance Long-Term Care Waivers and Home Care Grants 853,567,000 1,039,517,000 165.23Manage Growth in TBI and CADI 165.24Waivers. During the fiscal years beginning 165.25on July 1, 2009, and July 1, 2010, the 165.26commissioner shall allocate money for home 165.27and community-based waiver programs 165.28under Minnesota Statutes, section 256B.49, 165.29to ensure a reduction in state spending that is 165.30equivalent to limiting the caseload growth of 165.31the TBI waiver to 12.5 allocations per month 165.32each year of the biennium and the CADI 165.33waiver to 95 allocations per month each year 165.34of the biennium. Limits do not apply: (1) 165.35when there is an approved plan for nursing 166.1facility bed closures for individuals under 166.2age 65 who require relocation due to the 166.3bed closure; (2) to fiscal year 2009 waiver 166.4allocations delayed due to unallotment; or (3) 166.5to transfers authorized by the commissioner 166.6from the personal care assistance program 166.7of individuals having a home care rating 166.8of "CS," "MT," or "HL." Priorities for the 166.9allocation of funds must be for individuals 166.10anticipated to be discharged from institutional 166.11settings or who are at imminent risk of a 166.12placement in an institutional setting. 166.13Manage Growth in DD new text begin Developmental new text end 166.14 new text begin Disability new text end Waiver. The commissioner 166.15shall manage the growth in the DD waiver 166.16by limiting the allocations included in the 166.17February 2009 forecast to 15 additional 166.18diversion allocations each month for the 166.19calendar years that begin on January 1, 2010, 166.20and January 1, 2011. Additional allocations 166.21must be made available for transfers 166.22authorized by the commissioner from the 166.23personal care program of individuals having 166.24a home care rating of "CS," "MT," or "HL." 166.25Adjustment to Lead Agency Waiver 166.26Allocations. Prior to the availability of the 166.27alternative license defined in Minnesota 166.28Statutes, section 245A.11, subdivision 8, 166.29the commissioner shall reduce lead agency 166.30waiver allocations for the purposes of 166.31implementing a moratorium on corporate 166.32foster care. 166.33Alternatives to Personal Care Assistance 166.34Services. Base level funding of $3,237,000 166.35in fiscal year 2012 and $4,856,000 in 167.1fiscal year 2013 is to implement alternative 167.2services to personal care assistance services 167.3for persons with mental health and other 167.4behavioral challenges who can benefit 167.5from other services that more appropriately 167.6meet their needs and assist them in living 167.7independently in the community. These 167.8services may include, but not be limited to, a 167.91915(i) state plan option. 167.10 (e) Mental Health Grants 167.11 Appropriations by Fund 167.12 General 77,739,000 77,739,000 167.13 Health Care Access 750,000 750,000 167.14 Lottery Prize 1,508,000 1,508,000 167.15Funding Usage. Up to 75 percent of a fiscal 167.16year's appropriation for adult mental health 167.17grants may be used to fund allocations in that 167.18portion of the fiscal year ending December 167.1931. 167.20 (f) Deaf and Hard-of-Hearing Grants 1,930,000 1,917,000 167.21 (g) Chemical Dependency Entitlement Grants 111,303,000 122,822,000 167.22Payments for Substance Abuse Treatment. 167.23For services provided during fiscal years 167.242010 and 2011, county-negotiated rates 167.25and provider claims to the consolidated 167.26chemical dependency fund must not exceed new text begin new text end 167.27 new text begin the lesser of: (1) new text end rates charged for these 167.28services on January 1, 2009 new text begin ; or (2) 160 new text end 167.29 new text begin percent of the average rate on January 1, new text end 167.30 new text begin 2009, for each group of vendors with similar new text end 167.31 new text begin attributes new text end . For services provided in fiscal 167.32years 2012 and 2013, new text begin the new text end statewide average 167.33rates new text begin aggregate payment new text end under the new 167.34rate methodology to be developed under 167.35Minnesota Statutes, section 254B.12, must 168.1not exceed the average rates charged for 168.2these services on January 1, 2009, plus a 168.3state share increase of $3,787,000 for fiscal 168.4year 2012 and $5,023,000 for fiscal year 168.52013 new text begin projected aggregate payment under new text end 168.6 new text begin the rates in effect for fiscal year 2010 minus new text end 168.7 new text begin 1.25 percent new text end . Notwithstanding any provision 168.8to the contrary in this article, this provision 168.9expires on June 30, 2013. 168.10Chemical Dependency Special Revenue 168.11Account. For fiscal year 2010, $750,000 168.12must be transferred from the consolidated 168.13chemical dependency treatment fund 168.14administrative account and deposited into the 168.15general fund. 168.16County CD Share of MA Costs for 168.17ARRA Compliance. Notwithstanding the 168.18provisions of Minnesota Statutes, chapter 168.19254B, for chemical dependency services 168.20provided during the period October 1, 2008, 168.21to December 31, 2010, and reimbursed by 168.22medical assistance at the enhanced federal 168.23matching rate provided under the American 168.24Recovery and Reinvestment Act of 2009, the 168.25county share is 30 percent of the nonfederal 168.26share. This provision is effective the day 168.27following final enactment. 168.28 168.29 (h) Chemical Dependency Nonentitlement Grants 1,729,000 1,729,000 168.30 (i) Other Continuing Care Grants 19,201,000 17,528,000 168.31Base Adjustment. The general fund base is 168.32increased by $2,639,000 in fiscal year 2012 168.33and increased by $3,854,000 in fiscal year 168.342013. 169.1Technology Grants. $650,000 in fiscal 169.2year 2010 and $1,000,000 in fiscal year 169.32011 are for technology grants, case 169.4consultation, evaluation, and consumer 169.5information grants related to developing and 169.6supporting alternatives to shift-staff foster 169.7care residential service models. 169.8Other Continuing Care Grants; HIV 169.9Grants. Money appropriated for the HIV 169.10drug and insurance grant program in fiscal 169.11year 2010 may be used in either year of the 169.12biennium. 169.13Quality Assurance Commission. Effective 169.14July 1, 2009, state funding for the quality 169.15assurance commission under Minnesota 169.16Statutes, section 256B.0951, is canceled. 169.17    Sec. 10. new text begin CANCELLATIONS. new text end 169.18 new text begin The remaining balance from Laws 2008, chapter 358, article 5, section 4, subdivision new text end 169.19 new text begin 3, appropriation for Section 125 employer incentives, is canceled. new text end 169.20    Sec. 11. new text begin TRANSFERS. new text end 169.21 new text begin The commissioner of management and budget shall transfer from the general fund to new text end 169.22 new text begin the health care access fund $38,475,000 in fiscal year 2011, $14,758,000 in fiscal year new text end 169.23 new text begin 2012, and $35,058,000 in fiscal year 2013. new text end 169.24 new text begin EFFECTIVE DATE. new text end new text begin This section is effective upon federal approval of the new text end 169.25 new text begin amendments to Minnesota Statutes, sections 256B.055, subdivision 15, and 256B.056, new text end 169.26 new text begin subdivision 4. new text end 169.27    Sec. 12. new text begin EXPIRATION OF UNCODIFIED LANGUAGE. new text end 169.28 new text begin All uncodified language contained in this article expires on June 30, 2011, unless a new text end 169.29 new text begin different expiration date is explicit. new text end 169.30    Sec. 13. new text begin EFFECTIVE DATE. new text end 170.1 new text begin The provisions in this article are effective July 1, 2010, unless a different effective new text end 170.2 new text begin date is explicit. new text end