<a id="pl.1.3"></a><var>1.3</var>care; children and family services; health reform; public health; assessing <br/>
<a id="pl.1.4"></a><var>1.4</var>administrative penalties; requiring reports; making supplemental appropriations <br/>
<a id="pl.1.5"></a><var>1.5</var>and reductions; amending Minnesota Statutes 2008, sections 3.971, subdivision <br/>
<a id="pl.1.6"></a><var>1.6</var>2; 3.98, by adding a subdivision; 62D.08, by adding a subdivision; 62J.07, <br/>
<a id="pl.1.7"></a><var>1.7</var>subdivision 2, by adding a subdivision; 62J.38; 62Q.19, subdivision 1; <br/>
<a id="pl.1.8"></a><var>1.8</var>62Q.76, subdivision 1; 62U.05; 144.226, subdivision 3; 144.291, subdivision <br/>
<a id="pl.1.9"></a><var>1.9</var>2; 144.651, subdivision 2; 144.9504, by adding a subdivision; 144A.51, <br/>
<a id="pl.1.10"></a><var>1.10</var>subdivision 5; 144E.37; 245C.27, subdivision 2; 245C.28, subdivision 3; <br/>
<a id="pl.1.11"></a><var>1.11</var>254B.01, subdivision 2; 254B.02, subdivisions 1, 5; 254B.03, subdivision 4, <br/>
<a id="pl.1.12"></a><var>1.12</var>by adding a subdivision; 254B.05, subdivision 4; 254B.06, subdivision 2; <br/>
<a id="pl.1.13"></a><var>1.13</var>254B.09, subdivision 8; 256.01, by adding a subdivision; 256.9657, subdivision <br/>
<a id="pl.1.14"></a><var>1.14</var>3; 256B.04, subdivision 14; 256B.055, by adding a subdivision; 256B.056, <br/>
<a id="pl.1.15"></a><var>1.15</var>subdivision 4; 256B.057, subdivision 9; 256B.0625, subdivisions 8, 8a, 8b, <br/>
<a id="pl.1.16"></a><var>1.16</var>18a, 31, by adding subdivisions; 256B.0631, subdivisions 1, 3; 256B.0644, as <br/>
<a id="pl.1.17"></a><var>1.17</var>amended; 256B.0754, by adding a subdivision; 256B.0915, subdivision 3b; <br/>
<a id="pl.1.18"></a><var>1.18</var>256B.19, subdivision 1c; 256B.69, subdivisions 20, as amended, 27, by adding <br/>
<a id="pl.1.19"></a><var>1.19</var>subdivisions; 256B.692, subdivision 1; 256B.75; 256B.76, subdivisions 2, 4, by <br/>
<a id="pl.1.20"></a><var>1.20</var>adding a subdivision; 256D.0515; 256J.20, subdivision 3; 256J.24, subdivision <br/>
<a id="pl.1.21"></a><var>1.21</var>10; 256J.37, subdivision 3a; 256L.02, subdivision 3; 256L.03, subdivision <br/>
<a id="pl.1.22"></a><var>1.22</var>3, by adding a subdivision; 256L.05, by adding a subdivision; 256L.07, by <br/>
<a id="pl.1.23"></a><var>1.23</var>adding a subdivision; 256L.12, subdivisions 5, 6, 9; 626.556, subdivision <br/>
<a id="pl.1.24"></a><var>1.24</var>10i; 626.557, subdivision 9d; Minnesota Statutes 2009 Supplement, sections <br/>
<a id="pl.1.25"></a><var>1.25</var>62J.495, subdivisions 1a, 3, by adding a subdivision; 245C.27, subdivision 1; <br/>
<a id="pl.1.26"></a><var>1.26</var>252.025, subdivision 7; 252.27, subdivision 2a; 256.045, subdivision 3; 256.969, <br/>
<a id="pl.1.27"></a><var>1.27</var>subdivision 3a; 256B.0625, subdivisions 9, 13e; 256B.0653, subdivision 5; <br/>
<a id="pl.1.28"></a><var>1.28</var>256B.0915, subdivision 3a; 256B.69, subdivision 23; 256B.76, subdivision <br/>
<a id="pl.1.29"></a><var>1.29</var>1; 256B.766; 256D.03, subdivision 3, as amended; 256J.425, subdivision 3; <br/>
<a id="pl.1.30"></a><var>1.30</var>256L.03, subdivision 5; 256L.11, subdivision 1; Laws 2009, chapter 79, article 3, <br/>
<a id="pl.1.31"></a><var>1.31</var>section 18; article 5, section 78, subdivision 5; article 13, section 3, subdivisions <br/>
<a id="pl.1.32"></a><var>1.32</var>1, as amended, 3, as amended, 4, as amended, 8, as amended; Laws 2010, chapter <br/>
<a id="pl.1.33"></a><var>1.33</var>200, article 1, sections 12, subdivisions 6, 7, 8; 16; 21; article 2, section 2, <br/>
<a id="pl.1.34"></a><var>1.34</var>subdivisions 1, 8; proposing coding for new law in Minnesota Statutes, chapters <br/>
<a id="pl.1.35"></a><var>1.35</var>62A; 62D; 62E; 62J; 62Q; 144; 245; 254B; 256; 256B; repealing Minnesota <br/>
<a id="pl.1.36"></a><var>1.36</var>Statutes 2008, sections 254B.02, subdivisions 2, 3, 4; 254B.09, subdivisions 4, 5, <br/>
<a id="pl.1.37"></a><var>1.37</var>7; 256D.03, subdivisions 3a, 3b, 5, 6, 7, 8; Minnesota Statutes 2009 Supplement, <br/>
<a id="pl.1.38"></a><var>1.38</var>section 256D.03, subdivision 3; Laws 2009, chapter 79, article 7, section 26, <br/>
<a id="pl.2.1"></a><var>2.1</var>subdivision 3; Laws 2010, chapter 200, article 1, sections 12, subdivisions 1, <br/>
<a id="pl.2.2"></a><var>2.2</var>2, 3, 4, 5, 6, 7, 8, 9; 18; 19.<br/>
<a id="pl.2.3"></a><var>2.3</var>BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:<br/>
<br/>
<a id="bill.1.0.0"></a>

<a id="bill.1.1.0"></a><a id="pl.2.6"></a><var>2.6</var>    Section 1. Minnesota Statutes 2009 Supplement, section 245C.27, subdivision 1, is <br/>
<a id="pl.2.7"></a><var>2.7</var>amended to read:<br/>
<a id="pl.2.8"></a><var>2.8</var>    Subdivision 1. <b>Fair hearing when disqualification is not </b><b>set aside</b><b> rescinded</b><b>.</b> (a) <br/>
<a id="pl.2.9"></a><var>2.9</var>If the commissioner does not set aside rescind a disqualification of an individual under <br/>
<a id="pl.2.10"></a><var>2.10</var>section 
         <statute_ref>245C.22</statute_ref> who is disqualified on the basis of a preponderance of evidence that the <br/>
<a id="pl.2.11"></a><var>2.11</var>individual committed an act or acts that meet the definition of any of the crimes listed in <br/>
<a id="pl.2.12"></a><var>2.12</var>section 
         <statute_ref>245C.15</statute_ref>; for a determination under section 
         <statute_ref>626.556</statute_ref> or 
         <statute_ref>626.557</statute_ref> of substantiated <br/>
<a id="pl.2.13"></a><var>2.13</var>maltreatment that was serious or recurring under section 
         <statute_ref>245C.15</statute_ref>; or for failure to make <br/>
<a id="pl.2.14"></a><var>2.14</var>required reports under section 
         <statute_ref>626.556, subdivision 3</statute_ref>; or 
         <statute_ref>626.557, subdivision 3</statute_ref>, pursuant <br/>
<a id="pl.2.15"></a><var>2.15</var>to section 
         <statute_ref>245C.15, subdivision 4</statute_ref>, paragraph (b), clause (1), the individual may request <br/>
<a id="pl.2.16"></a><var>2.16</var>a fair hearing under section 
         <statute_ref>256.045</statute_ref>, unless the disqualification is deemed conclusive <br/>
<a id="pl.2.17"></a><var>2.17</var>under section 
         <statute_ref>245C.29</statute_ref>.<br/>
<a id="pl.2.18"></a><var>2.18</var>    (b) The fair hearing is the only administrative appeal of the final agency <br/>
<a id="pl.2.19"></a><var>2.19</var>determination for purposes of appeal by the disqualified individual. The disqualified <br/>
<a id="pl.2.20"></a><var>2.20</var>individual does not have the right to challenge the accuracy and completeness of data <br/>
<a id="pl.2.21"></a><var>2.21</var>under section 
         <statute_ref>13.04</statute_ref>.<br/>
<a id="pl.2.22"></a><var>2.22</var>    (c) Except as provided under paragraph (e), if the individual was disqualified based <br/>
<a id="pl.2.23"></a><var>2.23</var>on a conviction of, admission to, or Alford Plea to any crimes listed in section 
         <statute_ref>245C.15, <br/>
<a id="pl.2.24"></a><var>2.24</var>subdivisions 1 to 4
         </statute_ref>, or for a disqualification under section 
         <statute_ref>256.98, subdivision 8</statute_ref>, the <br/>
<a id="pl.2.25"></a><var>2.25</var>reconsideration decision under section 
         <statute_ref>245C.22</statute_ref> is the final agency determination for <br/>
<a id="pl.2.26"></a><var>2.26</var>purposes of appeal by the disqualified individual and is not subject to a hearing under <br/>
<a id="pl.2.27"></a><var>2.27</var>section 
         <statute_ref>256.045</statute_ref>. If the individual was disqualified based on a judicial determination, that <br/>
<a id="pl.2.28"></a><var>2.28</var>determination is treated the same as a conviction for purposes of appeal.<br/>
<a id="pl.2.29"></a><var>2.29</var>    (d) This subdivision does not apply to a public employee's appeal of a disqualification <br/>
<a id="pl.2.30"></a><var>2.30</var>under section 
         <statute_ref>245C.28, subdivision 3</statute_ref>.<br/>
<a id="pl.2.31"></a><var>2.31</var>    (e) Notwithstanding paragraph (c), if the commissioner does not set aside a <br/>
<a id="pl.2.32"></a><var>2.32</var>disqualification of an individual who was disqualified based on both a preponderance <br/>
<a id="pl.2.33"></a><var>2.33</var>of evidence and a conviction or admission, the individual may request a fair hearing <br/>
<a id="pl.2.34"></a><var>2.34</var>under section 
         <statute_ref>256.045</statute_ref>, unless the disqualifications are deemed conclusive under section <br/>
<statute_ref><a id="pl.2.35"></a><var>2.35</var>245C.29
         </statute_ref>. The scope of the hearing conducted under section 
         <statute_ref>256.045</statute_ref> with regard to the <br/>
<a id="pl.3.1"></a><var>3.1</var>disqualification based on a conviction or admission shall be limited solely to whether the <br/>
<a id="pl.3.2"></a><var>3.2</var>individual poses a risk of harm, according to section 
         <statute_ref>256.045, subdivision 3b</statute_ref>. In this case, <br/>
<a id="pl.3.3"></a><var>3.3</var>the reconsideration decision under section 
         <statute_ref>245C.22</statute_ref> is not the final agency decision for <br/>
<a id="pl.3.4"></a><var>3.4</var>purposes of appeal by the disqualified individual.<br/>
<br/>
<a id="bill.1.2.0"></a><a id="pl.3.5"></a><var>3.5</var>    Sec. 2. Minnesota Statutes 2008, section 245C.27, subdivision 2, is amended to read:<br/>
<a id="pl.3.6"></a><var>3.6</var>    Subd. 2. <b>Consolidated fair hearing.</b> (a) If an individual who is disqualified on the <br/>
<a id="pl.3.7"></a><var>3.7</var>bases of serious or recurring maltreatment requests a fair hearing on the maltreatment <br/>
<a id="pl.3.8"></a><var>3.8</var>determination under section 
         <statute_ref>626.556, subdivision 10i</statute_ref>, or 
         <statute_ref>626.557, subdivision 9d</statute_ref>, and <br/>
<a id="pl.3.9"></a><var>3.9</var>requests a fair hearing under this section on the disqualification, which has not been <br/>
<a id="pl.3.10"></a><var>3.10</var>set aside rescinded, the scope of the fair hearing under section 
         <statute_ref>256.045</statute_ref> shall include the <br/>
<a id="pl.3.11"></a><var>3.11</var>maltreatment determination and the disqualification. <br/>
<a id="pl.3.12"></a><var>3.12</var>(b) A fair hearing is the only administrative appeal of the final agency determination. <br/>
<a id="pl.3.13"></a><var>3.13</var>The disqualified individual does not have the right to challenge the accuracy and <br/>
<a id="pl.3.14"></a><var>3.14</var>completeness of data under section 
         <statute_ref>13.04</statute_ref>. <br/>
<a id="pl.3.15"></a><var>3.15</var>(c) This subdivision does not apply to a public employee's appeal of a disqualification <br/>
<a id="pl.3.16"></a><var>3.16</var>under section 
         <statute_ref>245C.28, subdivision 3</statute_ref>. <br/>
<br/>
<a id="bill.1.3.0"></a><a id="pl.3.17"></a><var>3.17</var>    Sec. 3. Minnesota Statutes 2008, section 245C.28, subdivision 3, is amended to read:<br/>
<a id="pl.3.18"></a><var>3.18</var>    Subd. 3. <b>Employees of public employer.</b> (a) If the commissioner does not set <br/>
<a id="pl.3.19"></a><var>3.19</var>aside rescind the disqualification of an individual who is an employee of an employer, as <br/>
<a id="pl.3.20"></a><var>3.20</var>defined in section 
         <statute_ref>179A.03, subdivision 15</statute_ref>, the individual may request a contested case <br/>
<a id="pl.3.21"></a><var>3.21</var>hearing under chapter 14, unless the disqualification is deemed conclusive under section <br/>
<a id="pl.3.22"></a><var>3.22</var>245C.29. The request for a contested case hearing must be made in writing and must be <br/>
<a id="pl.3.23"></a><var>3.23</var>postmarked and sent within 30 calendar days after the employee receives notice that the <br/>
<a id="pl.3.24"></a><var>3.24</var>disqualification has not been set aside rescinded. If the individual was disqualified based <br/>
<a id="pl.3.25"></a><var>3.25</var>on a conviction or admission to any crimes listed in section 
         <statute_ref>245C.15</statute_ref>, the scope of the <br/>
<a id="pl.3.26"></a><var>3.26</var>contested case hearing shall be limited solely to whether the individual poses a risk of <br/>
<a id="pl.3.27"></a><var>3.27</var>harm pursuant to section 
         <statute_ref>245C.22</statute_ref>.<br/>
<a id="pl.3.28"></a><var>3.28</var>(b) If the commissioner does not set aside rescind a disqualification that is based on <br/>
<a id="pl.3.29"></a><var>3.29</var>a maltreatment determination, the scope of the contested case hearing must include the <br/>
<a id="pl.3.30"></a><var>3.30</var>maltreatment determination and the disqualification. In such cases, a fair hearing must <br/>
<a id="pl.3.31"></a><var>3.31</var>not be conducted under section 
         <statute_ref>256.045</statute_ref>.<br/>
<a id="pl.3.32"></a><var>3.32</var>(c) If the commissioner does not rescind a disqualification that is based on a <br/>
<a id="pl.3.33"></a><var>3.33</var>preponderance of evidence that the individual committed an act or acts that meet the <br/>
<a id="pl.3.34"></a><var>3.34</var>definition of any of the crimes listed in section 245C.15, the scope of the contested case <br/>
<a id="pl.4.1"></a><var>4.1</var>hearing must include the disqualification decision. In such cases, a fair hearing must <br/>
<a id="pl.4.2"></a><var>4.2</var>not be conducted under section 256.045.<br/>
<a id="pl.4.3"></a><var>4.3</var>(c) (d) Rules adopted under this chapter may not preclude an employee in a contested <br/>
<a id="pl.4.4"></a><var>4.4</var>case hearing for a disqualification from submitting evidence concerning information <br/>
<a id="pl.4.5"></a><var>4.5</var>gathered under this chapter.<br/>
<a id="pl.4.6"></a><var>4.6</var>(d) (e) When an individual has been disqualified from multiple licensed programs <br/>
<a id="pl.4.7"></a><var>4.7</var>and the disqualifications have not been set aside rescinded under section 
         <statute_ref>245C.22</statute_ref>, if at <br/>
<a id="pl.4.8"></a><var>4.8</var>least one of the disqualifications entitles the person to a contested case hearing under this <br/>
<a id="pl.4.9"></a><var>4.9</var>subdivision, the scope of the contested case hearing shall include all disqualifications from <br/>
<a id="pl.4.10"></a><var>4.10</var>licensed programs which were not set aside rescinded.<br/>
<a id="pl.4.11"></a><var>4.11</var>(e) (f) In determining whether the disqualification should be set aside, the <br/>
<a id="pl.4.12"></a><var>4.12</var>administrative law judge shall consider all of the characteristics that cause the individual <br/>
<a id="pl.4.13"></a><var>4.13</var>to be disqualified in order to determine whether the individual poses a risk of harm. The <br/>
<a id="pl.4.14"></a><var>4.14</var>administrative law judge's recommendation and the commissioner's order to set aside <br/>
<a id="pl.4.15"></a><var>4.15</var>a disqualification that is the subject of the hearing constitutes a determination that the <br/>
<a id="pl.4.16"></a><var>4.16</var>individual does not pose a risk of harm and that the individual may provide direct contact <br/>
<a id="pl.4.17"></a><var>4.17</var>services in the individual program specified in the set aside.<br/>
<br/>
<a id="bill.1.4.0"></a><a id="pl.4.18"></a><var>4.18</var>    Sec. 4. Minnesota Statutes 2009 Supplement, section 256.045, subdivision 3, is <br/>
<a id="pl.4.19"></a><var>4.19</var>amended to read:<br/>
<a id="pl.4.20"></a><var>4.20</var>    Subd. 3. <b>State agency hearings.</b> (a) State agency hearings are available for the <br/>
<a id="pl.4.21"></a><var>4.21</var>following:<br/>
<a id="pl.4.22"></a><var>4.22</var>    (1) any person applying for, receiving or having received public assistance, medical <br/>
<a id="pl.4.23"></a><var>4.23</var>care, or a program of social services granted by the state agency or a county agency or <br/>
<a id="pl.4.24"></a><var>4.24</var>the federal Food Stamp Act whose application for assistance is denied, not acted upon <br/>
<a id="pl.4.25"></a><var>4.25</var>with reasonable promptness, or whose assistance is suspended, reduced, terminated, or <br/>
<a id="pl.4.26"></a><var>4.26</var>claimed to have been incorrectly paid;<br/>
<a id="pl.4.27"></a><var>4.27</var>    (2) any patient or relative aggrieved by an order of the commissioner under section <br/>
<statute_ref><a id="pl.4.28"></a><var>4.28</var>252.27
         </statute_ref>;<br/>
<a id="pl.4.29"></a><var>4.29</var>    (3) a party aggrieved by a ruling of a prepaid health plan;<br/>
<a id="pl.4.30"></a><var>4.30</var>    (4) except as provided under chapter 245C, any individual or facility determined by <br/>
<a id="pl.4.31"></a><var>4.31</var>a lead agency to have maltreated a vulnerable adult under section 
         <statute_ref>626.557</statute_ref> after they have <br/>
<a id="pl.4.32"></a><var>4.32</var>exercised their right to administrative reconsideration under section 
         <statute_ref>626.557</statute_ref>;<br/>
<a id="pl.4.33"></a><var>4.33</var>    (5) any person whose claim for foster care payment according to a placement of the <br/>
<a id="pl.4.34"></a><var>4.34</var>child resulting from a child protection assessment under section 
         <statute_ref>626.556</statute_ref> is denied or not <br/>
<a id="pl.4.35"></a><var>4.35</var>acted upon with reasonable promptness, regardless of funding source;<br/>
<a id="pl.5.1"></a><var>5.1</var>    (6) any person to whom a right of appeal according to this section is given by other <br/>
<a id="pl.5.2"></a><var>5.2</var>provision of law;<br/>
<a id="pl.5.3"></a><var>5.3</var>    (7) an applicant aggrieved by an adverse decision to an application for a hardship <br/>
<a id="pl.5.4"></a><var>5.4</var>waiver under section 
         <statute_ref>256B.15</statute_ref>;<br/>
<a id="pl.5.5"></a><var>5.5</var>    (8) an applicant aggrieved by an adverse decision to an application or redetermination <br/>
<a id="pl.5.6"></a><var>5.6</var>for a Medicare Part D prescription drug subsidy under section 
         <statute_ref>256B.04, subdivision 4a</statute_ref>;<br/>
<a id="pl.5.7"></a><var>5.7</var>    (9) except as provided under chapter 245A, an individual or facility determined <br/>
<a id="pl.5.8"></a><var>5.8</var>to have maltreated a minor under section 
         <statute_ref>626.556</statute_ref>, after the individual or facility has <br/>
<a id="pl.5.9"></a><var>5.9</var>exercised the right to administrative reconsideration under section 
         <statute_ref>626.556</statute_ref>;<br/>
<a id="pl.5.10"></a><var>5.10</var>    (10) except as provided under chapter 245C, an individual disqualified under <br/>
<a id="pl.5.11"></a><var>5.11</var>sections 
         <statute_ref>245C.14</statute_ref> and 
         <statute_ref>245C.15</statute_ref>, which has not been set aside rescinded under sections <br/>
<statute_ref><a id="pl.5.12"></a><var>5.12</var>245C.22
         </statute_ref> and 
         <statute_ref>245C.23</statute_ref>, on the basis of serious or recurring maltreatment; a preponderance <br/>
<a id="pl.5.13"></a><var>5.13</var>of the evidence that the individual has committed an act or acts that meet the definition <br/>
<a id="pl.5.14"></a><var>5.14</var>of any of the crimes listed in section 
         <statute_ref>245C.15, subdivisions 1 to 4</statute_ref>; or for failing to make <br/>
<a id="pl.5.15"></a><var>5.15</var>reports required under section 
         <statute_ref>626.556, subdivision 3</statute_ref>, or 
         <statute_ref>626.557, subdivision 3</statute_ref>. Hearings <br/>
<a id="pl.5.16"></a><var>5.16</var>regarding a maltreatment determination under clause (4) or (9) and a disqualification under <br/>
<a id="pl.5.17"></a><var>5.17</var>this clause in which the basis for a disqualification is serious or recurring maltreatment, <br/>
<a id="pl.5.18"></a><var>5.18</var>which has not been set aside rescinded under sections 
         <statute_ref>245C.22</statute_ref> and 
         <statute_ref>245C.23</statute_ref>, shall be <br/>
<a id="pl.5.19"></a><var>5.19</var>consolidated into a single fair hearing. In such cases, the scope of review by the human <br/>
<a id="pl.5.20"></a><var>5.20</var>services referee shall include both the maltreatment determination and the disqualification. <br/>
<a id="pl.5.21"></a><var>5.21</var>The failure to exercise the right to an administrative reconsideration shall not be a bar to a <br/>
<a id="pl.5.22"></a><var>5.22</var>hearing under this section if federal law provides an individual the right to a hearing to <br/>
<a id="pl.5.23"></a><var>5.23</var>dispute a finding of maltreatment. Individuals and organizations specified in this section <br/>
<a id="pl.5.24"></a><var>5.24</var>may contest the specified action, decision, or final disposition before the state agency by <br/>
<a id="pl.5.25"></a><var>5.25</var>submitting a written request for a hearing to the state agency within 30 days after receiving <br/>
<a id="pl.5.26"></a><var>5.26</var>written notice of the action, decision, or final disposition, or within 90 days of such written <br/>
<a id="pl.5.27"></a><var>5.27</var>notice if the applicant, recipient, patient, or relative shows good cause why the request <br/>
<a id="pl.5.28"></a><var>5.28</var>was not submitted within the 30-day time limit; or<br/>
<a id="pl.5.29"></a><var>5.29</var>    (11) any person with an outstanding debt resulting from receipt of public assistance, <br/>
<a id="pl.5.30"></a><var>5.30</var>medical care, or the federal Food Stamp Act who is contesting a setoff claim by the <br/>
<a id="pl.5.31"></a><var>5.31</var>Department of Human Services or a county agency. The scope of the appeal is the validity <br/>
<a id="pl.5.32"></a><var>5.32</var>of the claimant agency's intention to request a setoff of a refund under chapter 270A <br/>
<a id="pl.5.33"></a><var>5.33</var>against the debt.<br/>
<a id="pl.5.34"></a><var>5.34</var>    (b) The hearing for an individual or facility under paragraph (a), clause (4), (9), or <br/>
<a id="pl.5.35"></a><var>5.35</var>(10), is the only administrative appeal to the final agency determination specifically, <br/>
<a id="pl.5.36"></a><var>5.36</var>including a challenge to the accuracy and completeness of data under section 
         <statute_ref>13.04</statute_ref>. <br/>
<a id="pl.6.1"></a><var>6.1</var>Hearings requested under paragraph (a), clause (4), apply only to incidents of maltreatment <br/>
<a id="pl.6.2"></a><var>6.2</var>that occur on or after October 1, 1995. Hearings requested by nursing assistants in nursing <br/>
<a id="pl.6.3"></a><var>6.3</var>homes alleged to have maltreated a resident prior to October 1, 1995, shall be held as a <br/>
<a id="pl.6.4"></a><var>6.4</var>contested case proceeding under the provisions of chapter 14. Hearings requested under <br/>
<a id="pl.6.5"></a><var>6.5</var>paragraph (a), clause (9), apply only to incidents of maltreatment that occur on or after <br/>
<a id="pl.6.6"></a><var>6.6</var>July 1, 1997. A hearing for an individual or facility under paragraph (a), clause (9), is <br/>
<a id="pl.6.7"></a><var>6.7</var>only available when there is no juvenile court or adult criminal action pending. If such <br/>
<a id="pl.6.8"></a><var>6.8</var>action is filed in either court while an administrative review is pending, the administrative <br/>
<a id="pl.6.9"></a><var>6.9</var>review must be suspended until the judicial actions are completed. If the juvenile court <br/>
<a id="pl.6.10"></a><var>6.10</var>action or criminal charge is dismissed or the criminal action overturned, the matter may be <br/>
<a id="pl.6.11"></a><var>6.11</var>considered in an administrative hearing.<br/>
<a id="pl.6.12"></a><var>6.12</var>    (c) For purposes of this section, bargaining unit grievance procedures are not an <br/>
<a id="pl.6.13"></a><var>6.13</var>administrative appeal.<br/>
<a id="pl.6.14"></a><var>6.14</var>    (d) The scope of hearings involving claims to foster care payments under paragraph <br/>
<a id="pl.6.15"></a><var>6.15</var>(a), clause (5), shall be limited to the issue of whether the county is legally responsible <br/>
<a id="pl.6.16"></a><var>6.16</var>for a child's placement under court order or voluntary placement agreement and, if so, <br/>
<a id="pl.6.17"></a><var>6.17</var>the correct amount of foster care payment to be made on the child's behalf and shall not <br/>
<a id="pl.6.18"></a><var>6.18</var>include review of the propriety of the county's child protection determination or child <br/>
<a id="pl.6.19"></a><var>6.19</var>placement decision.<br/>
<a id="pl.6.20"></a><var>6.20</var>    (e) A vendor of medical care as defined in section 
         <statute_ref>256B.02, subdivision 7</statute_ref>, or a <br/>
<a id="pl.6.21"></a><var>6.21</var>vendor under contract with a county agency to provide social services is not a party and <br/>
<a id="pl.6.22"></a><var>6.22</var>may not request a hearing under this section, except if assisting a recipient as provided in <br/>
<a id="pl.6.23"></a><var>6.23</var>subdivision 4.<br/>
<a id="pl.6.24"></a><var>6.24</var>    (f) An applicant or recipient is not entitled to receive social services beyond the <br/>
<a id="pl.6.25"></a><var>6.25</var>services prescribed under chapter 256M or other social services the person is eligible <br/>
<a id="pl.6.26"></a><var>6.26</var>for under state law.<br/>
<a id="pl.6.27"></a><var>6.27</var>    (g) The commissioner may summarily affirm the county or state agency's proposed <br/>
<a id="pl.6.28"></a><var>6.28</var>action without a hearing when the sole issue is an automatic change due to a change in <br/>
<a id="pl.6.29"></a><var>6.29</var>state or federal law.<br/>
<br/>
<a id="bill.1.5.0"></a><a id="pl.6.30"></a><var>6.30</var>    Sec. 5. Minnesota Statutes 2008, section 626.556, subdivision 10i, is amended to read:<br/>
<a id="pl.6.31"></a><var>6.31</var>    Subd. 10i. <b>Administrative reconsideration; review panel.</b> (a) Administrative <br/>
<a id="pl.6.32"></a><var>6.32</var>reconsideration is not applicable in family assessments since no determination concerning <br/>
<a id="pl.6.33"></a><var>6.33</var>maltreatment is made. For investigations, except as provided under paragraph (e), an <br/>
<a id="pl.6.34"></a><var>6.34</var>individual or facility that the commissioner of human services, a local social service <br/>
<a id="pl.6.35"></a><var>6.35</var>agency, or the commissioner of education determines has maltreated a child, an interested <br/>
<a id="pl.7.1"></a><var>7.1</var>person acting on behalf of the child, regardless of the determination, who contests <br/>
<a id="pl.7.2"></a><var>7.2</var>the investigating agency's final determination regarding maltreatment, may request the <br/>
<a id="pl.7.3"></a><var>7.3</var>investigating agency to reconsider its final determination regarding maltreatment. The <br/>
<a id="pl.7.4"></a><var>7.4</var>request for reconsideration must be submitted in writing to the investigating agency within <br/>
<a id="pl.7.5"></a><var>7.5</var>15 calendar days after receipt of notice of the final determination regarding maltreatment <br/>
<a id="pl.7.6"></a><var>7.6</var>or, if the request is made by an interested person who is not entitled to notice, within <br/>
<a id="pl.7.7"></a><var>7.7</var>15 days after receipt of the notice by the parent or guardian of the child. If mailed, the <br/>
<a id="pl.7.8"></a><var>7.8</var>request for reconsideration must be postmarked and sent to the investigating agency <br/>
<a id="pl.7.9"></a><var>7.9</var>within 15 calendar days of the individual's or facility's receipt of the final determination. If <br/>
<a id="pl.7.10"></a><var>7.10</var>the request for reconsideration is made by personal service, it must be received by the <br/>
<a id="pl.7.11"></a><var>7.11</var>investigating agency within 15 calendar days after the individual's or facility's receipt of the <br/>
<a id="pl.7.12"></a><var>7.12</var>final determination. Effective January 1, 2002, an individual who was determined to have <br/>
<a id="pl.7.13"></a><var>7.13</var>maltreated a child under this section and who was disqualified on the basis of serious or <br/>
<a id="pl.7.14"></a><var>7.14</var>recurring maltreatment under sections 
         <statute_ref>245C.14</statute_ref> and 
         <statute_ref>245C.15</statute_ref>, may request reconsideration <br/>
<a id="pl.7.15"></a><var>7.15</var>of the maltreatment determination and the disqualification. The request for reconsideration <br/>
<a id="pl.7.16"></a><var>7.16</var>of the maltreatment determination and the disqualification must be submitted within 30 <br/>
<a id="pl.7.17"></a><var>7.17</var>calendar days of the individual's receipt of the notice of disqualification under sections <br/>
<statute_ref><a id="pl.7.18"></a><var>7.18</var>245C.16
         </statute_ref> and 
         <statute_ref>245C.17</statute_ref>. If mailed, the request for reconsideration of the maltreatment <br/>
<a id="pl.7.19"></a><var>7.19</var>determination and the disqualification must be postmarked and sent to the investigating <br/>
<a id="pl.7.20"></a><var>7.20</var>agency within 30 calendar days of the individual's receipt of the maltreatment <br/>
<a id="pl.7.21"></a><var>7.21</var>determination and notice of disqualification. If the request for reconsideration is made by <br/>
<a id="pl.7.22"></a><var>7.22</var>personal service, it must be received by the investigating agency within 30 calendar days <br/>
<a id="pl.7.23"></a><var>7.23</var>after the individual's receipt of the notice of disqualification.<br/>
<a id="pl.7.24"></a><var>7.24</var>    (b) Except as provided under paragraphs (e) and (f), if the investigating agency <br/>
<a id="pl.7.25"></a><var>7.25</var>denies the request or fails to act upon the request within 15 working days after receiving <br/>
<a id="pl.7.26"></a><var>7.26</var>the request for reconsideration, the person or facility entitled to a fair hearing under section <br/>
<statute_ref><a id="pl.7.27"></a><var>7.27</var>256.045
         </statute_ref> may submit to the commissioner of human services or the commissioner of <br/>
<a id="pl.7.28"></a><var>7.28</var>education a written request for a hearing under that section. Section 
         <statute_ref>256.045</statute_ref> also governs <br/>
<a id="pl.7.29"></a><var>7.29</var>hearings requested to contest a final determination of the commissioner of education. For <br/>
<a id="pl.7.30"></a><var>7.30</var>reports involving maltreatment of a child in a facility, an interested person acting on behalf <br/>
<a id="pl.7.31"></a><var>7.31</var>of the child may request a review by the Child Maltreatment Review Panel under section <br/>
<statute_ref><a id="pl.7.32"></a><var>7.32</var>256.022
         </statute_ref> if the investigating agency denies the request or fails to act upon the request or <br/>
<a id="pl.7.33"></a><var>7.33</var>if the interested person contests a reconsidered determination. The investigating agency <br/>
<a id="pl.7.34"></a><var>7.34</var>shall notify persons who request reconsideration of their rights under this paragraph. <br/>
<a id="pl.7.35"></a><var>7.35</var>The request must be submitted in writing to the review panel and a copy sent to the <br/>
<a id="pl.7.36"></a><var>7.36</var>investigating agency within 30 calendar days of receipt of notice of a denial of a request <br/>
<a id="pl.8.1"></a><var>8.1</var>for reconsideration or of a reconsidered determination. The request must specifically <br/>
<a id="pl.8.2"></a><var>8.2</var>identify the aspects of the agency determination with which the person is dissatisfied.<br/>
<a id="pl.8.3"></a><var>8.3</var>    (c) If, as a result of a reconsideration or review, the investigating agency changes <br/>
<a id="pl.8.4"></a><var>8.4</var>the final determination of maltreatment, that agency shall notify the parties specified in <br/>
<a id="pl.8.5"></a><var>8.5</var>subdivisions 10b, 10d, and 10f.<br/>
<a id="pl.8.6"></a><var>8.6</var>    (d) Except as provided under paragraph (f), if an individual or facility contests the <br/>
<a id="pl.8.7"></a><var>8.7</var>investigating agency's final determination regarding maltreatment by requesting a fair <br/>
<a id="pl.8.8"></a><var>8.8</var>hearing under section 
         <statute_ref>256.045</statute_ref>, the commissioner of human services shall assure that the <br/>
<a id="pl.8.9"></a><var>8.9</var>hearing is conducted and a decision is reached within 90 days of receipt of the request for <br/>
<a id="pl.8.10"></a><var>8.10</var>a hearing. The time for action on the decision may be extended for as many days as the <br/>
<a id="pl.8.11"></a><var>8.11</var>hearing is postponed or the record is held open for the benefit of either party.<br/>
<a id="pl.8.12"></a><var>8.12</var>    (e) Effective January 1, 2002, If an individual was disqualified under sections <br/>
<statute_ref><a id="pl.8.13"></a><var>8.13</var>245C.14
         </statute_ref> and 
         <statute_ref>245C.15</statute_ref>, on the basis of a determination of maltreatment, which was <br/>
<a id="pl.8.14"></a><var>8.14</var>serious or recurring, and the individual has requested reconsideration of the maltreatment <br/>
<a id="pl.8.15"></a><var>8.15</var>determination under paragraph (a) and requested reconsideration of the disqualification <br/>
<a id="pl.8.16"></a><var>8.16</var>under sections 
         <statute_ref>245C.21</statute_ref> to 
         <statute_ref>245C.27</statute_ref>, reconsideration of the maltreatment determination and <br/>
<a id="pl.8.17"></a><var>8.17</var>reconsideration of the disqualification shall be consolidated into a single reconsideration. <br/>
<a id="pl.8.18"></a><var>8.18</var>If reconsideration of the maltreatment determination is denied or the disqualification is not <br/>
<a id="pl.8.19"></a><var>8.19</var>set aside rescinded under sections 
         <statute_ref>245C.21</statute_ref> to 
         <statute_ref>245C.27</statute_ref>, the individual may request a fair <br/>
<a id="pl.8.20"></a><var>8.20</var>hearing under section 
         <statute_ref>256.045</statute_ref>. If an individual requests a fair hearing on the maltreatment <br/>
<a id="pl.8.21"></a><var>8.21</var>determination and the disqualification, the scope of the fair hearing shall include both the <br/>
<a id="pl.8.22"></a><var>8.22</var>maltreatment determination and the disqualification.<br/>
<a id="pl.8.23"></a><var>8.23</var>    (f) Effective January 1, 2002, If a maltreatment determination or a disqualification <br/>
<a id="pl.8.24"></a><var>8.24</var>based on serious or recurring maltreatment is the basis for a denial of a license under <br/>
<a id="pl.8.25"></a><var>8.25</var>section 
         <statute_ref>245A.05</statute_ref> or a licensing sanction under section 
         <statute_ref>245A.07</statute_ref>, the license holder has the <br/>
<a id="pl.8.26"></a><var>8.26</var>right to a contested case hearing under chapter 14 and Minnesota Rules, parts 1400.8505 <br/>
<a id="pl.8.27"></a><var>8.27</var>to 1400.8612. As provided for under section 
         <statute_ref>245A.08, subdivision 2a</statute_ref>, the scope of the <br/>
<a id="pl.8.28"></a><var>8.28</var>contested case hearing shall include the maltreatment determination, disqualification, <br/>
<a id="pl.8.29"></a><var>8.29</var>and licensing sanction or denial of a license. In such cases, a fair hearing regarding <br/>
<a id="pl.8.30"></a><var>8.30</var>the maltreatment determination and disqualification shall not be conducted under <br/>
<a id="pl.8.31"></a><var>8.31</var>section 
         <statute_ref>256.045</statute_ref>. Except for family child care and child foster care, reconsideration of a <br/>
<a id="pl.8.32"></a><var>8.32</var>maltreatment determination as provided under this subdivision, and reconsideration of a <br/>
<a id="pl.8.33"></a><var>8.33</var>disqualification as provided under section 
         <statute_ref>245C.22</statute_ref>, shall also not be conducted when:<br/>
<a id="pl.8.34"></a><var>8.34</var>    (1) a denial of a license under section 
         <statute_ref>245A.05</statute_ref> or a licensing sanction under section <br/>
<statute_ref><a id="pl.8.35"></a><var>8.35</var>245A.07
         </statute_ref>, is based on a determination that the license holder is responsible for maltreatment <br/>
<a id="pl.8.36"></a><var>8.36</var>or the disqualification of a license holder based on serious or recurring maltreatment;<br/>
<a id="pl.9.1"></a><var>9.1</var>    (2) the denial of a license or licensing sanction is issued at the same time as the <br/>
<a id="pl.9.2"></a><var>9.2</var>maltreatment determination or disqualification; and<br/>
<a id="pl.9.3"></a><var>9.3</var>    (3) the license holder appeals the maltreatment determination or disqualification, and <br/>
<a id="pl.9.4"></a><var>9.4</var>denial of a license or licensing sanction. <br/>
<a id="pl.9.5"></a><var>9.5</var>    Notwithstanding clauses (1) to (3), if the license holder appeals the maltreatment <br/>
<a id="pl.9.6"></a><var>9.6</var>determination or disqualification, but does not appeal the denial of a license or a licensing <br/>
<a id="pl.9.7"></a><var>9.7</var>sanction, reconsideration of the maltreatment determination shall be conducted under <br/>
<a id="pl.9.8"></a><var>9.8</var>sections 
         <statute_ref>626.556, subdivision 10i</statute_ref>, and 
         <statute_ref>626.557, subdivision 9d</statute_ref>, and reconsideration of the <br/>
<a id="pl.9.9"></a><var>9.9</var>disqualification shall be conducted under section 
         <statute_ref>245C.22</statute_ref>. In such cases, a fair hearing <br/>
<a id="pl.9.10"></a><var>9.10</var>shall also be conducted as provided under sections 
         <statute_ref>245C.27</statute_ref>, 
         <statute_ref>626.556, subdivision </statute_ref>10i, and <br/>
<statute_ref><a id="pl.9.11"></a><var>9.11</var>626.557, subdivision 9d
         </statute_ref>.<br/>
<a id="pl.9.12"></a><var>9.12</var>    If the disqualified subject is an individual other than the license holder and upon <br/>
<a id="pl.9.13"></a><var>9.13</var>whom a background study must be conducted under chapter 245C, the hearings of all <br/>
<a id="pl.9.14"></a><var>9.14</var>parties may be consolidated into a single contested case hearing upon consent of all parties <br/>
<a id="pl.9.15"></a><var>9.15</var>and the administrative law judge.<br/>
<a id="pl.9.16"></a><var>9.16</var>    (g) For purposes of this subdivision, "interested person acting on behalf of the <br/>
<a id="pl.9.17"></a><var>9.17</var>child" means a parent or legal guardian; stepparent; grandparent; guardian ad litem; adult <br/>
<a id="pl.9.18"></a><var>9.18</var>stepbrother, stepsister, or sibling; or adult aunt or uncle; unless the person has been <br/>
<a id="pl.9.19"></a><var>9.19</var>determined to be the perpetrator of the maltreatment.<br/>
<br/>
<a id="bill.1.6.0"></a><a id="pl.9.20"></a><var>9.20</var>    Sec. 6. Minnesota Statutes 2008, section 626.557, subdivision 9d, is amended to read:<br/>
<a id="pl.9.21"></a><var>9.21</var>    Subd. 9d. <b>Administrative reconsideration; review panel.</b> (a) Except as provided <br/>
<a id="pl.9.22"></a><var>9.22</var>under paragraph (e), any individual or facility which a lead agency determines has <br/>
<a id="pl.9.23"></a><var>9.23</var>maltreated a vulnerable adult, or the vulnerable adult or an interested person acting on <br/>
<a id="pl.9.24"></a><var>9.24</var>behalf of the vulnerable adult, regardless of the lead agency's determination, who contests <br/>
<a id="pl.9.25"></a><var>9.25</var>the lead agency's final disposition of an allegation of maltreatment, may request the <br/>
<a id="pl.9.26"></a><var>9.26</var>lead agency to reconsider its final disposition. The request for reconsideration must be <br/>
<a id="pl.9.27"></a><var>9.27</var>submitted in writing to the lead agency within 15 calendar days after receipt of notice of <br/>
<a id="pl.9.28"></a><var>9.28</var>final disposition or, if the request is made by an interested person who is not entitled to <br/>
<a id="pl.9.29"></a><var>9.29</var>notice, within 15 days after receipt of the notice by the vulnerable adult or the vulnerable <br/>
<a id="pl.9.30"></a><var>9.30</var>adult's legal guardian. If mailed, the request for reconsideration must be postmarked and <br/>
<a id="pl.9.31"></a><var>9.31</var>sent to the lead agency within 15 calendar days of the individual's or facility's receipt of <br/>
<a id="pl.9.32"></a><var>9.32</var>the final disposition. If the request for reconsideration is made by personal service, it must <br/>
<a id="pl.9.33"></a><var>9.33</var>be received by the lead agency within 15 calendar days of the individual's or facility's <br/>
<a id="pl.9.34"></a><var>9.34</var>receipt of the final disposition. An individual who was determined to have maltreated a <br/>
<a id="pl.9.35"></a><var>9.35</var>vulnerable adult under this section and who was disqualified on the basis of serious or <br/>
<a id="pl.10.1"></a><var>10.1</var>recurring maltreatment under sections 
         <statute_ref>245C.14</statute_ref> and 
         <statute_ref>245C.15</statute_ref>, may request reconsideration <br/>
<a id="pl.10.2"></a><var>10.2</var>of the maltreatment determination and the disqualification. The request for reconsideration <br/>
<a id="pl.10.3"></a><var>10.3</var>of the maltreatment determination and the disqualification must be submitted in writing <br/>
<a id="pl.10.4"></a><var>10.4</var>within 30 calendar days of the individual's receipt of the notice of disqualification <br/>
<a id="pl.10.5"></a><var>10.5</var>under sections 
         <statute_ref>245C.16</statute_ref> and 
         <statute_ref>245C.17</statute_ref>. If mailed, the request for reconsideration of <br/>
<a id="pl.10.6"></a><var>10.6</var>the maltreatment determination and the disqualification must be postmarked and sent <br/>
<a id="pl.10.7"></a><var>10.7</var>to the lead agency within 30 calendar days of the individual's receipt of the notice of <br/>
<a id="pl.10.8"></a><var>10.8</var>disqualification. If the request for reconsideration is made by personal service, it must be <br/>
<a id="pl.10.9"></a><var>10.9</var>received by the lead agency within 30 calendar days after the individual's receipt of the <br/>
<a id="pl.10.10"></a><var>10.10</var>notice of disqualification.<br/>
<a id="pl.10.11"></a><var>10.11</var>    (b) Except as provided under paragraphs (e) and (f), if the lead agency denies the <br/>
<a id="pl.10.12"></a><var>10.12</var>request or fails to act upon the request within 15 working days after receiving the request <br/>
<a id="pl.10.13"></a><var>10.13</var>for reconsideration, the person or facility entitled to a fair hearing under section 
         <statute_ref>256.045</statute_ref>, <br/>
<a id="pl.10.14"></a><var>10.14</var>may submit to the commissioner of human services a written request for a hearing <br/>
<a id="pl.10.15"></a><var>10.15</var>under that statute. The vulnerable adult, or an interested person acting on behalf of the <br/>
<a id="pl.10.16"></a><var>10.16</var>vulnerable adult, may request a review by the Vulnerable Adult Maltreatment Review <br/>
<a id="pl.10.17"></a><var>10.17</var>Panel under section 
         <statute_ref>256.021</statute_ref> if the lead agency denies the request or fails to act upon the <br/>
<a id="pl.10.18"></a><var>10.18</var>request, or if the vulnerable adult or interested person contests a reconsidered disposition. <br/>
<a id="pl.10.19"></a><var>10.19</var>The lead agency shall notify persons who request reconsideration of their rights under this <br/>
<a id="pl.10.20"></a><var>10.20</var>paragraph. The request must be submitted in writing to the review panel and a copy sent <br/>
<a id="pl.10.21"></a><var>10.21</var>to the lead agency within 30 calendar days of receipt of notice of a denial of a request for <br/>
<a id="pl.10.22"></a><var>10.22</var>reconsideration or of a reconsidered disposition. The request must specifically identify the <br/>
<a id="pl.10.23"></a><var>10.23</var>aspects of the agency determination with which the person is dissatisfied.<br/>
<a id="pl.10.24"></a><var>10.24</var>    (c) If, as a result of a reconsideration or review, the lead agency changes the final <br/>
<a id="pl.10.25"></a><var>10.25</var>disposition, it shall notify the parties specified in subdivision 9c, paragraph (d).<br/>
<a id="pl.10.26"></a><var>10.26</var>    (d) For purposes of this subdivision, "interested person acting on behalf of the <br/>
<a id="pl.10.27"></a><var>10.27</var>vulnerable adult" means a person designated in writing by the vulnerable adult to act <br/>
<a id="pl.10.28"></a><var>10.28</var>on behalf of the vulnerable adult, or a legal guardian or conservator or other legal <br/>
<a id="pl.10.29"></a><var>10.29</var>representative, a proxy or health care agent appointed under chapter 145B or 145C, <br/>
<a id="pl.10.30"></a><var>10.30</var>or an individual who is related to the vulnerable adult, as defined in section 
         <statute_ref>245A.02, <br/>
<a id="pl.10.31"></a><var>10.31</var>subdivision 13
         </statute_ref>.<br/>
<a id="pl.10.32"></a><var>10.32</var>    (e) If an individual was disqualified under sections 
         <statute_ref>245C.14</statute_ref> and 
         <statute_ref>245C.15</statute_ref>, on <br/>
<a id="pl.10.33"></a><var>10.33</var>the basis of a determination of maltreatment, which was serious or recurring, and <br/>
<a id="pl.10.34"></a><var>10.34</var>the individual has requested reconsideration of the maltreatment determination under <br/>
<a id="pl.10.35"></a><var>10.35</var>paragraph (a) and reconsideration of the disqualification under sections 
         <statute_ref>245C.21</statute_ref> to <br/>
<statute_ref><a id="pl.10.36"></a><var>10.36</var>245C.27
         </statute_ref>, reconsideration of the maltreatment determination and requested reconsideration <br/>
<a id="pl.11.1"></a><var>11.1</var>of the disqualification shall be consolidated into a single reconsideration. If reconsideration <br/>
<a id="pl.11.2"></a><var>11.2</var>of the maltreatment determination is denied or if the disqualification is not set aside <br/>
<a id="pl.11.3"></a><var>11.3</var>rescinded under sections 
         <statute_ref>245C.21</statute_ref> to 
         <statute_ref>245C.27</statute_ref>, the individual may request a fair hearing <br/>
<a id="pl.11.4"></a><var>11.4</var>under section 
         <statute_ref>256.045</statute_ref>. If an individual requests a fair hearing on the maltreatment <br/>
<a id="pl.11.5"></a><var>11.5</var>determination and the disqualification, the scope of the fair hearing shall include both the <br/>
<a id="pl.11.6"></a><var>11.6</var>maltreatment determination and the disqualification.<br/>
<a id="pl.11.7"></a><var>11.7</var>    (f) If a maltreatment determination or a disqualification based on serious or recurring <br/>
<a id="pl.11.8"></a><var>11.8</var>maltreatment is the basis for a denial of a license under section 
         <statute_ref>245A.05</statute_ref> or a licensing <br/>
<a id="pl.11.9"></a><var>11.9</var>sanction under section 
         <statute_ref>245A.07</statute_ref>, the license holder has the right to a contested case hearing <br/>
<a id="pl.11.10"></a><var>11.10</var>under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. As provided <br/>
<a id="pl.11.11"></a><var>11.11</var>for under section 
         <statute_ref>245A.08</statute_ref>, the scope of the contested case hearing must include the <br/>
<a id="pl.11.12"></a><var>11.12</var>maltreatment determination, disqualification, and licensing sanction or denial of a license. <br/>
<a id="pl.11.13"></a><var>11.13</var>In such cases, a fair hearing must not be conducted under section 
         <statute_ref>256.045</statute_ref>. Except for <br/>
<a id="pl.11.14"></a><var>11.14</var>family child care and child foster care, reconsideration of a maltreatment determination <br/>
<a id="pl.11.15"></a><var>11.15</var>under this subdivision, and reconsideration of a disqualification under section 
         <statute_ref>245C.22</statute_ref>, <br/>
<a id="pl.11.16"></a><var>11.16</var>must not be conducted when:<br/>
<a id="pl.11.17"></a><var>11.17</var>    (1) a denial of a license under section 
         <statute_ref>245A.05</statute_ref>, or a licensing sanction under section <br/>
<statute_ref><a id="pl.11.18"></a><var>11.18</var>245A.07
         </statute_ref>, is based on a determination that the license holder is responsible for maltreatment <br/>
<a id="pl.11.19"></a><var>11.19</var>or the disqualification of a license holder based on serious or recurring maltreatment;<br/>
<a id="pl.11.20"></a><var>11.20</var>    (2) the denial of a license or licensing sanction is issued at the same time as the <br/>
<a id="pl.11.21"></a><var>11.21</var>maltreatment determination or disqualification; and<br/>
<a id="pl.11.22"></a><var>11.22</var>    (3) the license holder appeals the maltreatment determination or disqualification, and <br/>
<a id="pl.11.23"></a><var>11.23</var>denial of a license or licensing sanction.<br/>
<a id="pl.11.24"></a><var>11.24</var>    Notwithstanding clauses (1) to (3), if the license holder appeals the maltreatment <br/>
<a id="pl.11.25"></a><var>11.25</var>determination or disqualification, but does not appeal the denial of a license or a licensing <br/>
<a id="pl.11.26"></a><var>11.26</var>sanction, reconsideration of the maltreatment determination shall be conducted under <br/>
<a id="pl.11.27"></a><var>11.27</var>sections 
         <statute_ref>626.556, subdivision 10i</statute_ref>, and 
         <statute_ref>626.557, subdivision 9d</statute_ref>, and reconsideration of the <br/>
<a id="pl.11.28"></a><var>11.28</var>disqualification shall be conducted under section 
         <statute_ref>245C.22</statute_ref>. In such cases, a fair hearing <br/>
<a id="pl.11.29"></a><var>11.29</var>shall also be conducted as provided under sections 
         <statute_ref>245C.27</statute_ref>, 
         <statute_ref>626.556, subdivision </statute_ref>10i, and <br/>
<statute_ref><a id="pl.11.30"></a><var>11.30</var>626.557, subdivision 9d
         </statute_ref>.<br/>
<a id="pl.11.31"></a><var>11.31</var>    If the disqualified subject is an individual other than the license holder and upon <br/>
<a id="pl.11.32"></a><var>11.32</var>whom a background study must be conducted under chapter 245C, the hearings of all <br/>
<a id="pl.11.33"></a><var>11.33</var>parties may be consolidated into a single contested case hearing upon consent of all parties <br/>
<a id="pl.11.34"></a><var>11.34</var>and the administrative law judge.<br/>
<a id="pl.11.35"></a><var>11.35</var>    (g) Until August 1, 2002, an individual or facility that was determined by the <br/>
<a id="pl.11.36"></a><var>11.36</var>commissioner of human services or the commissioner of health to be responsible for <br/>
<a id="pl.12.1"></a><var>12.1</var>neglect under section 
         <statute_ref>626.5572, subdivision 17</statute_ref>, after October 1, 1995, and before August <br/>
<a id="pl.12.2"></a><var>12.2</var>1, 2001, that believes that the finding of neglect does not meet an amended definition of <br/>
<a id="pl.12.3"></a><var>12.3</var>neglect may request a reconsideration of the determination of neglect. The commissioner <br/>
<a id="pl.12.4"></a><var>12.4</var>of human services or the commissioner of health shall mail a notice to the last known <br/>
<a id="pl.12.5"></a><var>12.5</var>address of individuals who are eligible to seek this reconsideration. The request for <br/>
<a id="pl.12.6"></a><var>12.6</var>reconsideration must state how the established findings no longer meet the elements of <br/>
<a id="pl.12.7"></a><var>12.7</var>the definition of neglect. The commissioner shall review the request for reconsideration <br/>
<a id="pl.12.8"></a><var>12.8</var>and make a determination within 15 calendar days. The commissioner's decision on this <br/>
<a id="pl.12.9"></a><var>12.9</var>reconsideration is the final agency action.<br/>
<a id="pl.12.10"></a><var>12.10</var>    (1) For purposes of compliance with the data destruction schedule under subdivision <br/>
<a id="pl.12.11"></a><var>12.11</var>12b, paragraph (d), when a finding of substantiated maltreatment has been changed as <br/>
<a id="pl.12.12"></a><var>12.12</var>a result of a reconsideration under this paragraph, the date of the original finding of a <br/>
<a id="pl.12.13"></a><var>12.13</var>substantiated maltreatment must be used to calculate the destruction date.<br/>
<a id="pl.12.14"></a><var>12.14</var>    (2) For purposes of any background studies under chapter 245C, when a <br/>
<a id="pl.12.15"></a><var>12.15</var>determination of substantiated maltreatment has been changed as a result of a <br/>
<a id="pl.12.16"></a><var>12.16</var>reconsideration under this paragraph, any prior disqualification of the individual under <br/>
<a id="pl.12.17"></a><var>12.17</var>chapter 245C that was based on this determination of maltreatment shall be rescinded, <br/>
<a id="pl.12.18"></a><var>12.18</var>and for future background studies under chapter 245C the commissioner must not use the <br/>
<a id="pl.12.19"></a><var>12.19</var>previous determination of substantiated maltreatment as a basis for disqualification or as a <br/>
<a id="pl.12.20"></a><var>12.20</var>basis for referring the individual's maltreatment history to a health-related licensing board <br/>
<a id="pl.12.21"></a><var>12.21</var>under section 
         <statute_ref>245C.31</statute_ref>.<br/>
<br/>
<a id="bill.2.0.0"></a>

<a id="bill.2.1.0"></a><a id="pl.12.24"></a><var>12.24</var>    Section 1. Minnesota Statutes 2008, section 144.291, subdivision 2, is amended to read:<br/>
<a id="pl.12.25"></a><var>12.25</var>    Subd. 2. <b>Definitions.</b> For the purposes of sections 
         <statute_ref>144.291</statute_ref> to 
         <statute_ref>144.298</statute_ref>, the following <br/>
<a id="pl.12.26"></a><var>12.26</var>terms have the meanings given.<br/>
<a id="pl.12.27"></a><var>12.27</var>    (a) "Group purchaser" has the meaning given in section 
         <statute_ref>62J.03</statute_ref>, subdivision 6.<br/>
<a id="pl.12.28"></a><var>12.28</var>    (b) "Health information exchange" means a legal arrangement between health care <br/>
<a id="pl.12.29"></a><var>12.29</var>providers and group purchasers to enable and oversee the business and legal issues <br/>
<a id="pl.12.30"></a><var>12.30</var>involved in the electronic exchange of health records between the entities for the delivery <br/>
<a id="pl.12.31"></a><var>12.31</var>of patient care.<br/>
<a id="pl.12.32"></a><var>12.32</var>    (c) "Health record" means any information, whether oral or recorded in any form or <br/>
<a id="pl.12.33"></a><var>12.33</var>medium, that relates to the past, present, or future physical or mental health or condition of <br/>
<a id="pl.12.34"></a><var>12.34</var>a patient; the provision of health care to a patient; or the past, present, or future payment <br/>
<a id="pl.12.35"></a><var>12.35</var>for the provision of health care to a patient.<br/>
<a id="pl.13.1"></a><var>13.1</var>    (d) "Identifying information" means the patient's name, address, date of birth, <br/>
<a id="pl.13.2"></a><var>13.2</var>gender, parent's or guardian's name regardless of the age of the patient, and other <br/>
<a id="pl.13.3"></a><var>13.3</var>nonclinical data which can be used to uniquely identify a patient.<br/>
<a id="pl.13.4"></a><var>13.4</var>    (e) "Individually identifiable form" means a form in which the patient is or can be <br/>
<a id="pl.13.5"></a><var>13.5</var>identified as the subject of the health records.<br/>
<a id="pl.13.6"></a><var>13.6</var>    (f) "Medical emergency" means medically necessary care which is immediately <br/>
<a id="pl.13.7"></a><var>13.7</var>needed to preserve life, prevent serious impairment to bodily functions, organs, or parts, <br/>
<a id="pl.13.8"></a><var>13.8</var>or prevent placing the physical or mental health of the patient in serious jeopardy.<br/>
<a id="pl.13.9"></a><var>13.9</var>    (g) "Patient" means a natural person who has received health care services from a <br/>
<a id="pl.13.10"></a><var>13.10</var>provider for treatment or examination of a medical, psychiatric, or mental condition, the <br/>
<a id="pl.13.11"></a><var>13.11</var>surviving spouse and parents of a deceased patient, or a person the patient appoints in <br/>
<a id="pl.13.12"></a><var>13.12</var>writing as a representative, including a health care agent acting according to chapter 145C, <br/>
<a id="pl.13.13"></a><var>13.13</var>unless the authority of the agent has been limited by the principal in the principal's health <br/>
<a id="pl.13.14"></a><var>13.14</var>care directive. Except for minors who have received health care services under sections <br/>
<statute_ref><a id="pl.13.15"></a><var>13.15</var>144.341
         </statute_ref> to 
         <statute_ref>144.347</statute_ref>, in the case of a minor, patient includes a parent or guardian, or a <br/>
<a id="pl.13.16"></a><var>13.16</var>person acting as a parent or guardian in the absence of a parent or guardian.<br/>
<a id="pl.13.17"></a><var>13.17</var>    (h) "Provider" means: <br/>
<a id="pl.13.18"></a><var>13.18</var>    (1) any person who furnishes health care services and is regulated to furnish the <br/>
<a id="pl.13.19"></a><var>13.19</var>services under chapter 147, 147A, 147B, 147C, 147D, 148, 148B, 148C, 148D, 150A, <br/>
<a id="pl.13.20"></a><var>13.20</var>151, 153, or 153A; <br/>
<a id="pl.13.21"></a><var>13.21</var>    (2) a home care provider licensed under section 
         <statute_ref>144A.46</statute_ref>; <br/>
<a id="pl.13.22"></a><var>13.22</var>    (3) a health care facility licensed under this chapter or chapter 144A; <br/>
<a id="pl.13.23"></a><var>13.23</var>    (4) a physician assistant registered under chapter 147A; and <br/>
<a id="pl.13.24"></a><var>13.24</var>    (5) an unlicensed mental health practitioner regulated under sections 
         <statute_ref>148B.60</statute_ref> to <br/>
<statute_ref><a id="pl.13.25"></a><var>13.25</var>148B.71
         </statute_ref>.<br/>
<a id="pl.13.26"></a><var>13.26</var>    (i) "Record locator service" means an electronic index of patient identifying <br/>
<a id="pl.13.27"></a><var>13.27</var>information that directs providers in a health information exchange to the location of <br/>
<a id="pl.13.28"></a><var>13.28</var>patient health records held by providers and group purchasers.<br/>
<a id="pl.13.29"></a><var>13.29</var>    (j) "Related health care entity" means an affiliate, as defined in section 
         <statute_ref>144.6521, <br/>
<a id="pl.13.30"></a><var>13.30</var>subdivision 3
         </statute_ref>, paragraph (b), of the provider releasing the health records, including, but <br/>
<a id="pl.13.31"></a><var>13.31</var>not limited to, affiliates of providers participating in a coordinated care delivery system <br/>
<a id="pl.13.32"></a><var>13.32</var>established under section 256D.031, subdivision 6.<br/>
<br/>
<a id="bill.2.2.0"></a><a id="pl.13.33"></a><var>13.33</var>    Sec. 2. Minnesota Statutes 2008, section 256.01, is amended by adding a subdivision <br/>
<a id="pl.13.34"></a><var>13.34</var>to read:<br/>
<a id="pl.14.1"></a><var>14.1</var>    Subd. 30. <b>Review and evaluation of studies.</b> The commissioner shall review <br/>
<a id="pl.14.2"></a><var>14.2</var>all published studies, reports, and program evaluations completed by the Department <br/>
<a id="pl.14.3"></a><var>14.3</var>of Human Services, and those requested by the legislature but not completed, for state <br/>
<a id="pl.14.4"></a><var>14.4</var>fiscal years 2000 through 2010. For each item, the commissioner shall report the <br/>
<a id="pl.14.5"></a><var>14.5</var>legislature's original appropriation for that work, if any, and the actual reported cost of the <br/>
<a id="pl.14.6"></a><var>14.6</var>completed work by the Department of Human Services. The commissioner shall make <br/>
<a id="pl.14.7"></a><var>14.7</var>recommendations to the legislature about which studies, reports, and program evaluations <br/>
<a id="pl.14.8"></a><var>14.8</var>required by law are duplicative, unnecessary, or obsolete. The commissioner shall repeat <br/>
<a id="pl.14.9"></a><var>14.9</var>this review every five fiscal years.<br/>
<br/>
<a id="bill.2.3.0"></a><a id="pl.14.10"></a><var>14.10</var>    Sec. 3. Minnesota Statutes 2008, section 256.9657, subdivision 3, is amended to read:<br/>
<a id="pl.14.11"></a><var>14.11</var>    Subd. 3. <b>Surcharge on HMOs and community integrated service networks.</b> (a) <br/>
<a id="pl.14.12"></a><var>14.12</var>Effective October 1, 1992, each health maintenance organization with a certificate of <br/>
<a id="pl.14.13"></a><var>14.13</var>authority issued by the commissioner of health under chapter 62D and each community <br/>
<a id="pl.14.14"></a><var>14.14</var>integrated service network licensed by the commissioner under chapter 62N shall pay to <br/>
<a id="pl.14.15"></a><var>14.15</var>the commissioner of human services a surcharge equal to six-tenths of one percent of the <br/>
<a id="pl.14.16"></a><var>14.16</var>total premium revenues of the health maintenance organization or community integrated <br/>
<a id="pl.14.17"></a><var>14.17</var>service network as reported to the commissioner of health according to the schedule in <br/>
<a id="pl.14.18"></a><var>14.18</var>subdivision 4.<br/>
<a id="pl.14.19"></a><var>14.19</var>(b) Effective June 1, 2010: (1) the surcharge under paragraph (a) is increased to 3.0 <br/>
<a id="pl.14.20"></a><var>14.20</var>percent; and (2) each county-based purchasing plan authorized under section 256B.692 <br/>
<a id="pl.14.21"></a><var>14.21</var>shall pay to the commissioner a surcharge equal to 3.0 percent of the total premium <br/>
<a id="pl.14.22"></a><var>14.22</var>revenues of the plan, as reported to the commissioner of health, according to the payment <br/>
<a id="pl.14.23"></a><var>14.23</var>schedule in subdivision 4.<br/>
<a id="pl.14.24"></a><var>14.24</var>(c) For purposes of this subdivision, total premium revenue means:<br/>
<a id="pl.14.25"></a><var>14.25</var>(1) premium revenue recognized on a prepaid basis from individuals and groups <br/>
<a id="pl.14.26"></a><var>14.26</var>for provision of a specified range of health services over a defined period of time which <br/>
<a id="pl.14.27"></a><var>14.27</var>is normally one month, excluding premiums paid to a health maintenance organization <br/>
<a id="pl.14.28"></a><var>14.28</var>or community integrated service network from the Federal Employees Health Benefit <br/>
<a id="pl.14.29"></a><var>14.29</var>Program;<br/>
<a id="pl.14.30"></a><var>14.30</var>(2) premiums from Medicare wrap-around subscribers for health benefits which <br/>
<a id="pl.14.31"></a><var>14.31</var>supplement Medicare coverage;<br/>
<a id="pl.14.32"></a><var>14.32</var>(3) Medicare revenue, as a result of an arrangement between a health maintenance <br/>
<a id="pl.14.33"></a><var>14.33</var>organization or a community integrated service network and the Centers for Medicare <br/>
<a id="pl.14.34"></a><var>14.34</var>and Medicaid Services of the federal Department of Health and Human Services, for <br/>
<a id="pl.14.35"></a><var>14.35</var>services to a Medicare beneficiary, excluding Medicare revenue that states are prohibited <br/>
<a id="pl.15.1"></a><var>15.1</var>from taxing under sections 1854, 1860D-12, and 1876 of title XVIII of the federal Social <br/>
<a id="pl.15.2"></a><var>15.2</var>Security Act, codified as United States Code, title 42, sections 1395mm, 1395w-112, and <br/>
<a id="pl.15.3"></a><var>15.3</var>1395w-24, respectively, as they may be amended from time to time; and<br/>
<a id="pl.15.4"></a><var>15.4</var>(4) medical assistance revenue, as a result of an arrangement between a health <br/>
<a id="pl.15.5"></a><var>15.5</var>maintenance organization or community integrated service network and a Medicaid state <br/>
<a id="pl.15.6"></a><var>15.6</var>agency, for services to a medical assistance beneficiary.<br/>
<a id="pl.15.7"></a><var>15.7</var>If advance payments are made under clause (1) or (2) to the health maintenance <br/>
<a id="pl.15.8"></a><var>15.8</var>organization or community integrated service network for more than one reporting period, <br/>
<a id="pl.15.9"></a><var>15.9</var>the portion of the payment that has not yet been earned must be treated as a liability.<br/>
<a id="pl.15.10"></a><var>15.10</var>(c) (d) When a health maintenance organization or community integrated service <br/>
<a id="pl.15.11"></a><var>15.11</var>network merges or consolidates with or is acquired by another health maintenance <br/>
<a id="pl.15.12"></a><var>15.12</var>organization or community integrated service network, the surviving corporation or the <br/>
<a id="pl.15.13"></a><var>15.13</var>new corporation shall be responsible for the annual surcharge originally imposed on <br/>
<a id="pl.15.14"></a><var>15.14</var>each of the entities or corporations subject to the merger, consolidation, or acquisition, <br/>
<a id="pl.15.15"></a><var>15.15</var>regardless of whether one of the entities or corporations does not retain a certificate of <br/>
<a id="pl.15.16"></a><var>15.16</var>authority under chapter 62D or a license under chapter 62N.<br/>
<a id="pl.15.17"></a><var>15.17</var>(d) (e) Effective July 1 of each year, the surviving corporation's or the new <br/>
<a id="pl.15.18"></a><var>15.18</var>corporation's surcharge shall be based on the revenues earned in the second previous <br/>
<a id="pl.15.19"></a><var>15.19</var>calendar year by all of the entities or corporations subject to the merger, consolidation, <br/>
<a id="pl.15.20"></a><var>15.20</var>or acquisition regardless of whether one of the entities or corporations does not retain a <br/>
<a id="pl.15.21"></a><var>15.21</var>certificate of authority under chapter 62D or a license under chapter 62N until the total <br/>
<a id="pl.15.22"></a><var>15.22</var>premium revenues of the surviving corporation include the total premium revenues of all <br/>
<a id="pl.15.23"></a><var>15.23</var>the merged entities as reported to the commissioner of health.<br/>
<a id="pl.15.24"></a><var>15.24</var>(e) (f) When a health maintenance organization or community integrated service <br/>
<a id="pl.15.25"></a><var>15.25</var>network, which is subject to liability for the surcharge under this chapter, transfers, <br/>
<a id="pl.15.26"></a><var>15.26</var>assigns, sells, leases, or disposes of all or substantially all of its property or assets, liability <br/>
<a id="pl.15.27"></a><var>15.27</var>for the surcharge imposed by this chapter is imposed on the transferee, assignee, or buyer <br/>
<a id="pl.15.28"></a><var>15.28</var>of the health maintenance organization or community integrated service network.<br/>
<a id="pl.15.29"></a><var>15.29</var>(f) (g) In the event a health maintenance organization or community integrated <br/>
<a id="pl.15.30"></a><var>15.30</var>service network converts its licensure to a different type of entity subject to liability <br/>
<a id="pl.15.31"></a><var>15.31</var>for the surcharge under this chapter, but survives in the same or substantially similar <br/>
<a id="pl.15.32"></a><var>15.32</var>form, the surviving entity remains liable for the surcharge regardless of whether one of <br/>
<a id="pl.15.33"></a><var>15.33</var>the entities or corporations does not retain a certificate of authority under chapter 62D <br/>
<a id="pl.15.34"></a><var>15.34</var>or a license under chapter 62N.<br/>
<a id="pl.16.1"></a><var>16.1</var>(g) (h) The surcharge assessed to a health maintenance organization or community <br/>
<a id="pl.16.2"></a><var>16.2</var>integrated service network ends when the entity ceases providing services for premiums <br/>
<a id="pl.16.3"></a><var>16.3</var>and the cessation is not connected with a merger, consolidation, acquisition, or conversion.<br/>
<a id="pl.16.4"></a><var>16.4</var><b>EFFECTIVE DATE.</b>This section is effective June 1, 2010.<br/>
<br/>
<a id="bill.2.4.0"></a><a id="pl.16.5"></a><var>16.5</var>    Sec. 4. Minnesota Statutes 2009 Supplement, section 256.969, subdivision 3a, is <br/>
<a id="pl.16.6"></a><var>16.6</var>amended to read:<br/>
<a id="pl.16.7"></a><var>16.7</var>    Subd. 3a. <b>Payments.</b> (a) Acute care hospital billings under the medical <br/>
<a id="pl.16.8"></a><var>16.8</var>assistance program must not be submitted until the recipient is discharged. However, <br/>
<a id="pl.16.9"></a><var>16.9</var>the commissioner shall establish monthly interim payments for inpatient hospitals that <br/>
<a id="pl.16.10"></a><var>16.10</var>have individual patient lengths of stay over 30 days regardless of diagnostic category. <br/>
<a id="pl.16.11"></a><var>16.11</var>Except as provided in section 
         <statute_ref>256.9693</statute_ref>, medical assistance reimbursement for treatment <br/>
<a id="pl.16.12"></a><var>16.12</var>of mental illness shall be reimbursed based on diagnostic classifications. Individual <br/>
<a id="pl.16.13"></a><var>16.13</var>hospital payments established under this section and sections 
         <statute_ref>256.9685</statute_ref>, 
         <statute_ref>256.9686</statute_ref>, and <br/>
<statute_ref><a id="pl.16.14"></a><var>16.14</var>256.9695
         </statute_ref>, in addition to third party and recipient liability, for discharges occurring during <br/>
<a id="pl.16.15"></a><var>16.15</var>the rate year shall not exceed, in aggregate, the charges for the medical assistance covered <br/>
<a id="pl.16.16"></a><var>16.16</var>inpatient services paid for the same period of time to the hospital. This payment limitation <br/>
<a id="pl.16.17"></a><var>16.17</var>shall be calculated separately for medical assistance and general assistance medical <br/>
<a id="pl.16.18"></a><var>16.18</var>care services. The limitation on general assistance medical care shall be effective for <br/>
<a id="pl.16.19"></a><var>16.19</var>admissions occurring on or after July 1, 1991. Services that have rates established under <br/>
<a id="pl.16.20"></a><var>16.20</var>subdivision 11 or 12, must be limited separately from other services. After consulting with <br/>
<a id="pl.16.21"></a><var>16.21</var>the affected hospitals, the commissioner may consider related hospitals one entity and <br/>
<a id="pl.16.22"></a><var>16.22</var>may merge the payment rates while maintaining separate provider numbers. The operating <br/>
<a id="pl.16.23"></a><var>16.23</var>and property base rates per admission or per day shall be derived from the best Medicare <br/>
<a id="pl.16.24"></a><var>16.24</var>and claims data available when rates are established. The commissioner shall determine <br/>
<a id="pl.16.25"></a><var>16.25</var>the best Medicare and claims data, taking into consideration variables of recency of the <br/>
<a id="pl.16.26"></a><var>16.26</var>data, audit disposition, settlement status, and the ability to set rates in a timely manner. <br/>
<a id="pl.16.27"></a><var>16.27</var>The commissioner shall notify hospitals of payment rates by December 1 of the year <br/>
<a id="pl.16.28"></a><var>16.28</var>preceding the rate year. The rate setting data must reflect the admissions data used to <br/>
<a id="pl.16.29"></a><var>16.29</var>establish relative values. Base year changes from 1981 to the base year established for the <br/>
<a id="pl.16.30"></a><var>16.30</var>rate year beginning January 1, 1991, and for subsequent rate years, shall not be limited <br/>
<a id="pl.16.31"></a><var>16.31</var>to the limits ending June 30, 1987, on the maximum rate of increase under subdivision <br/>
<a id="pl.16.32"></a><var>16.32</var>1. The commissioner may adjust base year cost, relative value, and case mix index data <br/>
<a id="pl.16.33"></a><var>16.33</var>to exclude the costs of services that have been discontinued by the October 1 of the year <br/>
<a id="pl.16.34"></a><var>16.34</var>preceding the rate year or that are paid separately from inpatient services. Inpatient stays <br/>
<a id="pl.16.35"></a><var>16.35</var>that encompass portions of two or more rate years shall have payments established based <br/>
<a id="pl.17.1"></a><var>17.1</var>on payment rates in effect at the time of admission unless the date of admission preceded <br/>
<a id="pl.17.2"></a><var>17.2</var>the rate year in effect by six months or more. In this case, operating payment rates for <br/>
<a id="pl.17.3"></a><var>17.3</var>services rendered during the rate year in effect and established based on the date of <br/>
<a id="pl.17.4"></a><var>17.4</var>admission shall be adjusted to the rate year in effect by the hospital cost index.<br/>
<a id="pl.17.5"></a><var>17.5</var>    (b) For fee-for-service admissions occurring on or after July 1, 2002, the total <br/>
<a id="pl.17.6"></a><var>17.6</var>payment, before third-party liability and spenddown, made to hospitals for inpatient <br/>
<a id="pl.17.7"></a><var>17.7</var>services is reduced by .5 percent from the current statutory rates.<br/>
<a id="pl.17.8"></a><var>17.8</var>    (c) In addition to the reduction in paragraph (b), the total payment for fee-for-service <br/>
<a id="pl.17.9"></a><var>17.9</var>admissions occurring on or after July 1, 2003, made to hospitals for inpatient services <br/>
<a id="pl.17.10"></a><var>17.10</var>before third-party liability and spenddown, is reduced five percent from the current <br/>
<a id="pl.17.11"></a><var>17.11</var>statutory rates. Mental health services within diagnosis related groups 424 to 432, and <br/>
<a id="pl.17.12"></a><var>17.12</var>facilities defined under subdivision 16 are excluded from this paragraph.<br/>
<a id="pl.17.13"></a><var>17.13</var>    (d) In addition to the reduction in paragraphs (b) and (c), the total payment for <br/>
<a id="pl.17.14"></a><var>17.14</var>fee-for-service admissions occurring on or after August 1, 2005, made to hospitals for <br/>
<a id="pl.17.15"></a><var>17.15</var>inpatient services before third-party liability and spenddown, is reduced 6.0 percent <br/>
<a id="pl.17.16"></a><var>17.16</var>from the current statutory rates. Mental health services within diagnosis related groups <br/>
<a id="pl.17.17"></a><var>17.17</var>424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph. <br/>
<a id="pl.17.18"></a><var>17.18</var>Notwithstanding section 
         <statute_ref>256.9686, subdivision 7</statute_ref>, for purposes of this paragraph, medical <br/>
<a id="pl.17.19"></a><var>17.19</var>assistance does not include general assistance medical care. Payments made to managed <br/>
<a id="pl.17.20"></a><var>17.20</var>care plans shall be reduced for services provided on or after January 1, 2006, to reflect <br/>
<a id="pl.17.21"></a><var>17.21</var>this reduction.<br/>
<a id="pl.17.22"></a><var>17.22</var>    (e) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for <br/>
<a id="pl.17.23"></a><var>17.23</var>fee-for-service admissions occurring on or after July 1, 2008, through June 30, 2009, made <br/>
<a id="pl.17.24"></a><var>17.24</var>to hospitals for inpatient services before third-party liability and spenddown, is reduced <br/>
<a id="pl.17.25"></a><var>17.25</var>3.46 percent from the current statutory rates. Mental health services with diagnosis related <br/>
<a id="pl.17.26"></a><var>17.26</var>groups 424 to 432 and facilities defined under subdivision 16 are excluded from this <br/>
<a id="pl.17.27"></a><var>17.27</var>paragraph. Payments made to managed care plans shall be reduced for services provided <br/>
<a id="pl.17.28"></a><var>17.28</var>on or after January 1, 2009, through June 30, 2009, to reflect this reduction.<br/>
<a id="pl.17.29"></a><var>17.29</var>    (f) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for <br/>
<a id="pl.17.30"></a><var>17.30</var>fee-for-service admissions occurring on or after July 1, 2009, through June 30, 2010, made <br/>
<a id="pl.17.31"></a><var>17.31</var>to hospitals for inpatient services before third-party liability and spenddown, is reduced <br/>
<a id="pl.17.32"></a><var>17.32</var>1.9 percent from the current statutory rates. Mental health services with diagnosis related <br/>
<a id="pl.17.33"></a><var>17.33</var>groups 424 to 432 and facilities defined under subdivision 16 are excluded from this <br/>
<a id="pl.17.34"></a><var>17.34</var>paragraph. Payments made to managed care plans shall be reduced for services provided <br/>
<a id="pl.17.35"></a><var>17.35</var>on or after July 1, 2009, through June 30, 2010, to reflect this reduction.<br/>
<a id="pl.18.1"></a><var>18.1</var>    (g) In addition to the reductions in paragraphs (b), (c), and (d), the total payment <br/>
<a id="pl.18.2"></a><var>18.2</var>for fee-for-service admissions occurring on or after July 1, 2010, made to hospitals for <br/>
<a id="pl.18.3"></a><var>18.3</var>inpatient services before third-party liability and spenddown, is reduced 1.79 percent <br/>
<a id="pl.18.4"></a><var>18.4</var>from the current statutory rates. Mental health services with diagnosis related groups <br/>
<a id="pl.18.5"></a><var>18.5</var>424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph. <br/>
<a id="pl.18.6"></a><var>18.6</var>Payments made to managed care plans shall be reduced for services provided on or after <br/>
<a id="pl.18.7"></a><var>18.7</var>July 1, 2010, to reflect this reduction.<br/>
<a id="pl.18.8"></a><var>18.8</var>(h) In addition to the reductions in paragraphs (b), (c), (d), (f), and (g), the total <br/>
<a id="pl.18.9"></a><var>18.9</var>payment for fee-for-service admissions occurring on or after July 1, 2009, made to <br/>
<a id="pl.18.10"></a><var>18.10</var>hospitals for inpatient services before third-party liability and spenddown, is reduced <br/>
<a id="pl.18.11"></a><var>18.11</var>one percent from the current statutory rates. Facilities defined under subdivision 16 are <br/>
<a id="pl.18.12"></a><var>18.12</var>excluded from this paragraph. Payments made to managed care plans shall be reduced for <br/>
<a id="pl.18.13"></a><var>18.13</var>services provided on or after October 1, 2009, to reflect this reduction.<br/>
<a id="pl.18.14"></a><var>18.14</var>(i) In addition to the reductions in paragraphs (b), (c), (d), (g), and (h), the total <br/>
<a id="pl.18.15"></a><var>18.15</var>payment for fee-for-service admissions occurring on or after July 1, 2011, made to <br/>
<a id="pl.18.16"></a><var>18.16</var>hospitals for inpatient services before third-party liability and spenddown, is reduced <br/>
<a id="pl.18.17"></a><var>18.17</var>seven percent from the current statutory rates. Facilities defined under subdivision 16 are <br/>
<a id="pl.18.18"></a><var>18.18</var>excluded from this paragraph. Payments made to managed care plans shall be reduced <br/>
<a id="pl.18.19"></a><var>18.19</var>for services provided on or after January 1, 2012, to reflect this reduction. Hospitals that, <br/>
<a id="pl.18.20"></a><var>18.20</var>prior to December 31, 2007, received payment to support the training of residents from an <br/>
<a id="pl.18.21"></a><var>18.21</var>approved graduate medical residency training program pursuant to United States Code, <br/>
<a id="pl.18.22"></a><var>18.22</var>title 42, section 256e, are not subject to the provisions of this paragraph.<br/>
<br/>
<a id="bill.2.5.0"></a><a id="pl.18.23"></a><var>18.23</var>    Sec. 5. Minnesota Statutes 2008, section 256B.04, subdivision 14, is amended to read:<br/>
<a id="pl.18.24"></a><var>18.24</var>    Subd. 14. <b>Competitive bidding.</b> (a) When determined to be effective, economical, <br/>
<a id="pl.18.25"></a><var>18.25</var>and feasible, the commissioner may utilize volume purchase through competitive bidding <br/>
<a id="pl.18.26"></a><var>18.26</var>and negotiation under the provisions of chapter 16C, to provide items under the medical <br/>
<a id="pl.18.27"></a><var>18.27</var>assistance program including but not limited to the following:<br/>
<a id="pl.18.28"></a><var>18.28</var>    (1) eyeglasses;<br/>
<a id="pl.18.29"></a><var>18.29</var>    (2) oxygen. The commissioner shall provide for oxygen needed in an emergency <br/>
<a id="pl.18.30"></a><var>18.30</var>situation on a short-term basis, until the vendor can obtain the necessary supply from <br/>
<a id="pl.18.31"></a><var>18.31</var>the contract dealer;<br/>
<a id="pl.18.32"></a><var>18.32</var>    (3) hearing aids and supplies; and<br/>
<a id="pl.18.33"></a><var>18.33</var>    (4) durable medical equipment, including but not limited to:<br/>
<a id="pl.18.34"></a><var>18.34</var>    (i) hospital beds;<br/>
<a id="pl.18.35"></a><var>18.35</var>    (ii) commodes;<br/>
<a id="pl.19.1"></a><var>19.1</var>    (iii) glide-about chairs;<br/>
<a id="pl.19.2"></a><var>19.2</var>    (iv) patient lift apparatus;<br/>
<a id="pl.19.3"></a><var>19.3</var>    (v) wheelchairs and accessories;<br/>
<a id="pl.19.4"></a><var>19.4</var>    (vi) oxygen administration equipment;<br/>
<a id="pl.19.5"></a><var>19.5</var>    (vii) respiratory therapy equipment;<br/>
<a id="pl.19.6"></a><var>19.6</var>    (viii) electronic diagnostic, therapeutic and life-support systems;<br/>
<a id="pl.19.7"></a><var>19.7</var>    (5) nonemergency medical transportation level of need determinations, disbursement <br/>
<a id="pl.19.8"></a><var>19.8</var>of public transportation passes and tokens, and volunteer and recipient mileage and <br/>
<a id="pl.19.9"></a><var>19.9</var>parking reimbursements; and<br/>
<a id="pl.19.10"></a><var>19.10</var>    (6) drugs; and<br/>
<a id="pl.19.11"></a><var>19.11</var>(7) medical supplies.<br/>
<a id="pl.19.12"></a><var>19.12</var>    (b) Rate changes under this chapter and chapters 256D and 256L do not affect <br/>
<a id="pl.19.13"></a><var>19.13</var>contract payments under this subdivision unless specifically identified.<br/>
<a id="pl.19.14"></a><var>19.14</var>    (c) The commissioner may not utilize volume purchase through competitive bidding <br/>
<a id="pl.19.15"></a><var>19.15</var>and negotiation for special transportation services under the provisions of chapter 16C.<br/>
<br/>
<a id="bill.2.6.0"></a><a id="pl.19.16"></a><var>19.16</var>    Sec. 6. Minnesota Statutes 2008, section 256B.055, is amended by adding a <br/>
<a id="pl.19.17"></a><var>19.17</var>subdivision to read:<br/>
<a id="pl.19.18"></a><var>19.18</var>    Subd. 15. <b>Adults without children.</b> Medical assistance may be paid for a person <br/>
<a id="pl.19.19"></a><var>19.19</var>who is over age 21 and under age 65, who is not pregnant, and who is not described in <br/>
<a id="pl.19.20"></a><var>19.20</var>subdivision 4, 7, or another subdivision of this section.<br/>
<a id="pl.19.21"></a><var>19.21</var><b>EFFECTIVE DATE.</b>This section is effective upon federal approval and is <br/>
<a id="pl.19.22"></a><var>19.22</var>retroactive from April 1, 2010.<br/>
<br/>
<a id="bill.2.7.0"></a><a id="pl.19.23"></a><var>19.23</var>    Sec. 7. Minnesota Statutes 2008, section 256B.056, subdivision 4, is amended to read:<br/>
<a id="pl.19.24"></a><var>19.24</var>    Subd. 4. <b>Income.</b> (a) To be eligible for medical assistance, a person eligible under <br/>
<a id="pl.19.25"></a><var>19.25</var>section 
         <statute_ref>256B.055, subdivisions 7, 7a, and 12</statute_ref>, may have income up to 100 percent of <br/>
<a id="pl.19.26"></a><var>19.26</var>the federal poverty guidelines. Effective January 1, 2000, and each successive January, <br/>
<a id="pl.19.27"></a><var>19.27</var>recipients of supplemental security income may have an income up to the supplemental <br/>
<a id="pl.19.28"></a><var>19.28</var>security income standard in effect on that date. <br/>
<a id="pl.19.29"></a><var>19.29</var>(b) To be eligible for medical assistance, families and children may have an income <br/>
<a id="pl.19.30"></a><var>19.30</var>up to 133-1/3 percent of the AFDC income standard in effect under the July 16, 1996, <br/>
<a id="pl.19.31"></a><var>19.31</var>AFDC state plan. Effective July 1, 2000, the base AFDC standard in effect on July 16, <br/>
<a id="pl.19.32"></a><var>19.32</var>1996, shall be increased by three percent.<br/>
<a id="pl.19.33"></a><var>19.33</var>(c) Effective July 1, 2002, to be eligible for medical assistance, families and children <br/>
<a id="pl.19.34"></a><var>19.34</var>may have an income up to 100 percent of the federal poverty guidelines for the family size.<br/>
<a id="pl.20.1"></a><var>20.1</var>(d) In computing income to determine eligibility of persons under paragraphs (a) <br/>
<a id="pl.20.2"></a><var>20.2</var>to (c) and (e) who are not residents of long-term care facilities, the commissioner shall <br/>
<a id="pl.20.3"></a><var>20.3</var>disregard increases in income as required by Public Law Numbers 94-566, section 503; <br/>
<a id="pl.20.4"></a><var>20.4</var>99-272; and 99-509. Veterans aid and attendance benefits and Veterans Administration <br/>
<a id="pl.20.5"></a><var>20.5</var>unusual medical expense payments are considered income to the recipient.<br/>
<a id="pl.20.6"></a><var>20.6</var>(e) To be eligible for medical assistance, a person eligible under section 256B.055, <br/>
<a id="pl.20.7"></a><var>20.7</var>subdivision 15, may have income up to 75 percent of the federal poverty guidelines for <br/>
<a id="pl.20.8"></a><var>20.8</var>family size.<br/>
<a id="pl.20.9"></a><var>20.9</var><b>EFFECTIVE DATE.</b>This section is effective upon federal approval and is <br/>
<a id="pl.20.10"></a><var>20.10</var>retroactive from April 1, 2010.<br/>
<br/>
<a id="bill.2.8.0"></a><a id="pl.20.11"></a><var>20.11</var>    Sec. 8. Minnesota Statutes 2008, section 256B.0625, subdivision 8, is amended to read:<br/>
<a id="pl.20.12"></a><var>20.12</var>    Subd. 8. <b>Physical therapy.</b> Medical assistance covers physical therapy and related <br/>
<a id="pl.20.13"></a><var>20.13</var>services, including specialized maintenance therapy. Authorization by the commissioner <br/>
<a id="pl.20.14"></a><var>20.14</var>is required to provide services to a recipient beyond any of the following onetime service <br/>
<a id="pl.20.15"></a><var>20.15</var>thresholds: (1) 80 units of any approved CPT code other than modalities; (2) 20 modality <br/>
<a id="pl.20.16"></a><var>20.16</var>sessions; and (3) three evaluations or reevaluations. Services provided by a physical <br/>
<a id="pl.20.17"></a><var>20.17</var>therapy assistant shall be reimbursed at the same rate as services performed by a physical <br/>
<a id="pl.20.18"></a><var>20.18</var>therapist when the services of the physical therapy assistant are provided under the <br/>
<a id="pl.20.19"></a><var>20.19</var>direction of a physical therapist who is on the premises. Services provided by a physical <br/>
<a id="pl.20.20"></a><var>20.20</var>therapy assistant that are provided under the direction of a physical therapist who is not on <br/>
<a id="pl.20.21"></a><var>20.21</var>the premises shall be reimbursed at 65 percent of the physical therapist rate.<br/>
<br/>
<a id="bill.2.9.0"></a><a id="pl.20.22"></a><var>20.22</var>    Sec. 9. Minnesota Statutes 2008, section 256B.0625, subdivision 8a, is amended to <br/>
<a id="pl.20.23"></a><var>20.23</var>read:<br/>
<a id="pl.20.24"></a><var>20.24</var>    Subd. 8a. <b>Occupational therapy.</b> Medical assistance covers occupational therapy <br/>
<a id="pl.20.25"></a><var>20.25</var>and related services, including specialized maintenance therapy. Authorization by the <br/>
<a id="pl.20.26"></a><var>20.26</var>commissioner is required to provide services to a recipient beyond any of the following <br/>
<a id="pl.20.27"></a><var>20.27</var>onetime service thresholds: (1) 120 units of any combination of approved CPT codes; <br/>
<a id="pl.20.28"></a><var>20.28</var>and (2) two evaluations or reevaluations. Services provided by an occupational therapy <br/>
<a id="pl.20.29"></a><var>20.29</var>assistant shall be reimbursed at the same rate as services performed by an occupational <br/>
<a id="pl.20.30"></a><var>20.30</var>therapist when the services of the occupational therapy assistant are provided under the <br/>
<a id="pl.20.31"></a><var>20.31</var>direction of the occupational therapist who is on the premises. Services provided by an <br/>
<a id="pl.20.32"></a><var>20.32</var>occupational therapy assistant that are provided under the direction of an occupational <br/>
<a id="pl.20.33"></a><var>20.33</var>therapist who is not on the premises shall be reimbursed at 65 percent of the occupational <br/>
<a id="pl.20.34"></a><var>20.34</var>therapist rate.<br/>
<br/>
<a id="bill.2.10.0"></a><a id="pl.21.1"></a><var>21.1</var>    Sec. 10. Minnesota Statutes 2008, section 256B.0625, subdivision 8b, is amended to <br/>
<a id="pl.21.2"></a><var>21.2</var>read:<br/>
<a id="pl.21.3"></a><var>21.3</var>    Subd. 8b. <b>Speech language pathology and audiology services.</b> Medical assistance <br/>
<a id="pl.21.4"></a><var>21.4</var>covers speech language pathology and related services, including specialized maintenance <br/>
<a id="pl.21.5"></a><var>21.5</var>therapy. Authorization by the commissioner is required to provide services to a recipient <br/>
<a id="pl.21.6"></a><var>21.6</var>beyond any of the following onetime service thresholds: (1) 50 treatment sessions with <br/>
<a id="pl.21.7"></a><var>21.7</var>any combination of approved CPT codes; and (2) one evaluation. Medical assistance <br/>
<a id="pl.21.8"></a><var>21.8</var>covers audiology services and related services. Services provided by a person who has <br/>
<a id="pl.21.9"></a><var>21.9</var>been issued a temporary registration under section 
         <statute_ref>148.5161</statute_ref> shall be reimbursed at the <br/>
<a id="pl.21.10"></a><var>21.10</var>same rate as services performed by a speech language pathologist or audiologist as long as <br/>
<a id="pl.21.11"></a><var>21.11</var>the requirements of section 
         <statute_ref>148.5161, subdivision 3</statute_ref>, are met. <br/>
<br/>
<a id="bill.2.11.0"></a><a id="pl.21.12"></a><var>21.12</var>    Sec. 11. Minnesota Statutes 2008, section 256B.0625, is amended by adding a <br/>
<a id="pl.21.13"></a><var>21.13</var>subdivision to read:<br/>
<a id="pl.21.14"></a><var>21.14</var>    Subd. 8d. <b>Chiropractic services.</b> Payment for chiropractic services is limited to <br/>
<a id="pl.21.15"></a><var>21.15</var>one annual evaluation and 12 visits per year unless prior authorization of a greater number <br/>
<a id="pl.21.16"></a><var>21.16</var>of visits is obtained.<br/>
<br/>
<a id="bill.2.12.0"></a><a id="pl.21.17"></a><var>21.17</var>    Sec. 12. Minnesota Statutes 2009 Supplement, section 256B.0625, subdivision 9, <br/>
<a id="pl.21.18"></a><var>21.18</var>is amended to read:<br/>
<a id="pl.21.19"></a><var>21.19</var>    Subd. 9. <b>Dental services.</b> (a) Medical assistance covers dental services.<br/>
<a id="pl.21.20"></a><var>21.20</var>(b) Medical assistance dental coverage for nonpregnant adults is limited to the <br/>
<a id="pl.21.21"></a><var>21.21</var>following services:<br/>
<a id="pl.21.22"></a><var>21.22</var>(1) comprehensive exams, limited to once every five years;<br/>
<a id="pl.21.23"></a><var>21.23</var>(2) periodic exams, limited to one per year;<br/>
<a id="pl.21.24"></a><var>21.24</var>(3) limited exams;<br/>
<a id="pl.21.25"></a><var>21.25</var>(4) bitewing x-rays, limited to one set per year;<br/>
<a id="pl.21.26"></a><var>21.26</var>(5) periapical x-rays;<br/>
<a id="pl.21.27"></a><var>21.27</var>(6) panoramic x-rays or full-mouth radiographs, limited to one every five years, <br/>
<a id="pl.21.28"></a><var>21.28</var>and only if provided in conjunction with a posterior extraction or scheduled outpatient <br/>
<a id="pl.21.29"></a><var>21.29</var>facility procedure, or as medically necessary for the diagnosis and follow-up of oral and <br/>
<a id="pl.21.30"></a><var>21.30</var>maxillofacial pathology and trauma. Panoramic x-rays may be taken once every two years <br/>
<a id="pl.21.31"></a><var>21.31</var>for patients who cannot cooperate for intraoral film due to a developmental disability or <br/>
<a id="pl.21.32"></a><var>21.32</var>medical condition that does not allow for intraoral film placement;<br/>
<a id="pl.21.33"></a><var>21.33</var>(7) prophylaxis, limited to one per year;<br/>
<a id="pl.21.34"></a><var>21.34</var>(8) application of fluoride varnish, limited to one per year;<br/>
<a id="pl.22.1"></a><var>22.1</var>(9) posterior fillings, all at the amalgam rate;<br/>
<a id="pl.22.2"></a><var>22.2</var>(10) anterior fillings;<br/>
<a id="pl.22.3"></a><var>22.3</var>(11) endodontics, limited to root canals on the anterior and premolars only, and <br/>
<a id="pl.22.4"></a><var>22.4</var>molar root canal therapy as deemed medically necessary for patients that are at high risk <br/>
<a id="pl.22.5"></a><var>22.5</var>of osteonecrosis from molar extractions;<br/>
<a id="pl.22.6"></a><var>22.6</var>(12) removable prostheses, each dental arch limited to one every six years; including:<br/>
<a id="pl.22.7"></a><var>22.7</var>(i) relines of full dentures once every six years per dental arch;<br/>
<a id="pl.22.8"></a><var>22.8</var>(ii) repair of acrylic bases of full dentures and acrylic partial dentures, limited to one <br/>
<a id="pl.22.9"></a><var>22.9</var>per year; and<br/>
<a id="pl.22.10"></a><var>22.10</var>(iii) adding a maximum of two denture teeth and two wrought wire clasps per year to <br/>
<a id="pl.22.11"></a><var>22.11</var>partial dentures per dental arch;<br/>
<a id="pl.22.12"></a><var>22.12</var>(13) oral surgery, limited to extractions, biopsies, and incision and drainage of <br/>
<a id="pl.22.13"></a><var>22.13</var>abscesses;<br/>
<a id="pl.22.14"></a><var>22.14</var>(14) palliative treatment and sedative fillings for relief of pain; and<br/>
<a id="pl.22.15"></a><var>22.15</var>(15) full-mouth debridement periodontal scaling and root planing, limited to one <br/>
<a id="pl.22.16"></a><var>22.16</var>every five years; and<br/>
<a id="pl.22.17"></a><var>22.17</var>(16) moderate sedation, deep sedation, and general anesthesia, limited to when <br/>
<a id="pl.22.18"></a><var>22.18</var>provided by an oral maxillofacial surgeon who is board-certified, or actively participating <br/>
<a id="pl.22.19"></a><var>22.19</var>in the American Board of Oral and Maxillofacial Surgery certification process, when <br/>
<a id="pl.22.20"></a><var>22.20</var>medically necessary to allow the surgical management of acute oral and maxillofacial <br/>
<a id="pl.22.21"></a><var>22.21</var>pathology which cannot be accomplished safely with local anesthesia alone and would <br/>
<a id="pl.22.22"></a><var>22.22</var>otherwise require operating room services.<br/>
<a id="pl.22.23"></a><var>22.23</var>(c) In addition to the services specified in paragraph (b), medical assistance <br/>
<a id="pl.22.24"></a><var>22.24</var>covers the following services for adults, if provided in an outpatient hospital setting or <br/>
<a id="pl.22.25"></a><var>22.25</var>freestanding ambulatory surgical center as part of outpatient dental surgery:<br/>
<a id="pl.22.26"></a><var>22.26</var>(1) periodontics, limited to periodontal scaling and root planing once every two <br/>
<a id="pl.22.27"></a><var>22.27</var>years;<br/>
<a id="pl.22.28"></a><var>22.28</var>(2) general anesthesia; and<br/>
<a id="pl.22.29"></a><var>22.29</var>(3) full-mouth survey once every five two years.<br/>
<a id="pl.22.30"></a><var>22.30</var>(d) Medical assistance covers dental services for children that are medically <br/>
<a id="pl.22.31"></a><var>22.31</var>necessary. The following guidelines apply:<br/>
<a id="pl.22.32"></a><var>22.32</var>(1) posterior fillings are paid at the amalgam rate;<br/>
<a id="pl.22.33"></a><var>22.33</var>(2) application of sealants once every five years per permanent molar; and<br/>
<a id="pl.22.34"></a><var>22.34</var>(3) application of fluoride varnish once every six months.<br/>
<br/>
<a id="bill.2.13.0"></a><a id="pl.23.1"></a><var>23.1</var>    Sec. 13. Minnesota Statutes 2009 Supplement, section 256B.0625, subdivision 13e, <br/>
<a id="pl.23.2"></a><var>23.2</var>is amended to read:<br/>
<a id="pl.23.3"></a><var>23.3</var>    Subd. 13e. <b>Payment rates.</b> (a) The basis for determining the amount of payment <br/>
<a id="pl.23.4"></a><var>23.4</var>shall be the lower of the actual acquisition costs of the drugs plus a fixed dispensing fee; <br/>
<a id="pl.23.5"></a><var>23.5</var>the maximum allowable cost set by the federal government or by the commissioner plus <br/>
<a id="pl.23.6"></a><var>23.6</var>the fixed dispensing fee; or the usual and customary price charged to the public. The <br/>
<a id="pl.23.7"></a><var>23.7</var>amount of payment basis must be reduced to reflect all discount amounts applied to the <br/>
<a id="pl.23.8"></a><var>23.8</var>charge by any provider/insurer agreement or contract for submitted charges to medical <br/>
<a id="pl.23.9"></a><var>23.9</var>assistance programs. The net submitted charge may not be greater than the patient liability <br/>
<a id="pl.23.10"></a><var>23.10</var>for the service. The pharmacy dispensing fee shall be $3.65, except that the dispensing fee <br/>
<a id="pl.23.11"></a><var>23.11</var>for intravenous solutions which must be compounded by the pharmacist shall be $8 per <br/>
<a id="pl.23.12"></a><var>23.12</var>bag, $14 per bag for cancer chemotherapy products, and $30 per bag for total parenteral <br/>
<a id="pl.23.13"></a><var>23.13</var>nutritional products dispensed in one liter quantities, or $44 per bag for total parenteral <br/>
<a id="pl.23.14"></a><var>23.14</var>nutritional products dispensed in quantities greater than one liter. Actual acquisition cost <br/>
<a id="pl.23.15"></a><var>23.15</var>includes quantity and other special discounts except time and cash discounts. Effective <br/>
<a id="pl.23.16"></a><var>23.16</var>July 1, 2009 July 1, 2010, the actual acquisition cost of a drug shall be estimated by the <br/>
<a id="pl.23.17"></a><var>23.17</var>commissioner, at average wholesale price minus 15 12.5 percent or wholesale acquisition <br/>
<a id="pl.23.18"></a><var>23.18</var>cost plus 5.0 percent, whichever is lower. The actual acquisition cost of antihemophilic <br/>
<a id="pl.23.19"></a><var>23.19</var>factor drugs shall be estimated at the average wholesale price minus 30 28.12 percent or <br/>
<a id="pl.23.20"></a><var>23.20</var>wholesale acquisition cost minus 13.76 percent, whichever is lower. Average wholesale <br/>
<a id="pl.23.21"></a><var>23.21</var>price is defined as the price for a drug product listed as the average wholesale price in the <br/>
<a id="pl.23.22"></a><var>23.22</var>commissioner's primary reference source. Wholesale acquisition cost is defined as the <br/>
<a id="pl.23.23"></a><var>23.23</var>manufacturer's list price for a drug or biological to wholesalers or direct purchasers in the <br/>
<a id="pl.23.24"></a><var>23.24</var>United States, not including prompt pay or other discounts, rebates, or reductions in price, <br/>
<a id="pl.23.25"></a><var>23.25</var>for the most recent month for which information is available, as reported in wholesale price <br/>
<a id="pl.23.26"></a><var>23.26</var>guides or other publications of drug or biological pricing data. The maximum allowable <br/>
<a id="pl.23.27"></a><var>23.27</var>cost of a multisource drug may be set by the commissioner and it shall be comparable to, <br/>
<a id="pl.23.28"></a><var>23.28</var>but no higher than, the maximum amount paid by other third-party payors in this state who <br/>
<a id="pl.23.29"></a><var>23.29</var>have maximum allowable cost programs. Establishment of the amount of payment for <br/>
<a id="pl.23.30"></a><var>23.30</var>drugs shall not be subject to the requirements of the Administrative Procedure Act.<br/>
<a id="pl.23.31"></a><var>23.31</var>    (b) An additional dispensing fee of $.30 may be added to the dispensing fee paid <br/>
<a id="pl.23.32"></a><var>23.32</var>to pharmacists for legend drug prescriptions dispensed to residents of long-term care <br/>
<a id="pl.23.33"></a><var>23.33</var>facilities when a unit dose blister card system, approved by the department, is used. Under <br/>
<a id="pl.23.34"></a><var>23.34</var>this type of dispensing system, the pharmacist must dispense a 30-day supply of drug. <br/>
<a id="pl.23.35"></a><var>23.35</var>The National Drug Code (NDC) from the drug container used to fill the blister card must <br/>
<a id="pl.23.36"></a><var>23.36</var>be identified on the claim to the department. The unit dose blister card containing the <br/>
<a id="pl.24.1"></a><var>24.1</var>drug must meet the packaging standards set forth in Minnesota Rules, part 6800.2700, <br/>
<a id="pl.24.2"></a><var>24.2</var>that govern the return of unused drugs to the pharmacy for reuse. The pharmacy provider <br/>
<a id="pl.24.3"></a><var>24.3</var>will be required to credit the department for the actual acquisition cost of all unused <br/>
<a id="pl.24.4"></a><var>24.4</var>drugs that are eligible for reuse. Over-the-counter medications must be dispensed in the <br/>
<a id="pl.24.5"></a><var>24.5</var>manufacturer's unopened package. The commissioner may permit the drug clozapine to be <br/>
<a id="pl.24.6"></a><var>24.6</var>dispensed in a quantity that is less than a 30-day supply.<br/>
<a id="pl.24.7"></a><var>24.7</var>    (c) Whenever a generically equivalent product is available, payment shall be on the <br/>
<a id="pl.24.8"></a><var>24.8</var>basis of the actual acquisition cost of the generic drug, or on the maximum allowable cost <br/>
<a id="pl.24.9"></a><var>24.9</var>established by the commissioner.<br/>
<a id="pl.24.10"></a><var>24.10</var>    (d) The basis for determining the amount of payment for drugs administered in an <br/>
<a id="pl.24.11"></a><var>24.11</var>outpatient setting shall be the lower of the usual and customary cost submitted by the <br/>
<a id="pl.24.12"></a><var>24.12</var>provider or the amount established for Medicare by the United States Department of <br/>
<a id="pl.24.13"></a><var>24.13</var>Health and Human Services pursuant to title XVIII, section 1847a of the federal Social <br/>
<a id="pl.24.14"></a><var>24.14</var>Security Act.<br/>
<a id="pl.24.15"></a><var>24.15</var>    (e) The commissioner may negotiate lower reimbursement rates for specialty <br/>
<a id="pl.24.16"></a><var>24.16</var>pharmacy products than the rates specified in paragraph (a). The commissioner may <br/>
<a id="pl.24.17"></a><var>24.17</var>require individuals enrolled in the health care programs administered by the department <br/>
<a id="pl.24.18"></a><var>24.18</var>to obtain specialty pharmacy products from providers with whom the commissioner has <br/>
<a id="pl.24.19"></a><var>24.19</var>negotiated lower reimbursement rates. Specialty pharmacy products are defined as those <br/>
<a id="pl.24.20"></a><var>24.20</var>used by a small number of recipients or recipients with complex and chronic diseases <br/>
<a id="pl.24.21"></a><var>24.21</var>that require expensive and challenging drug regimens. Examples of these conditions <br/>
<a id="pl.24.22"></a><var>24.22</var>include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis <br/>
<a id="pl.24.23"></a><var>24.23</var>C, growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms <br/>
<a id="pl.24.24"></a><var>24.24</var>of cancer. Specialty pharmaceutical products include injectable and infusion therapies, <br/>
<a id="pl.24.25"></a><var>24.25</var>biotechnology drugs, high-cost therapies, and therapies that require complex care. The <br/>
<a id="pl.24.26"></a><var>24.26</var>commissioner shall consult with the formulary committee to develop a list of specialty <br/>
<a id="pl.24.27"></a><var>24.27</var>pharmacy products subject to this paragraph. In consulting with the formulary committee <br/>
<a id="pl.24.28"></a><var>24.28</var>in developing this list, the commissioner shall take into consideration the population <br/>
<a id="pl.24.29"></a><var>24.29</var>served by specialty pharmacy products, the current delivery system and standard of care in <br/>
<a id="pl.24.30"></a><var>24.30</var>the state, and access to care issues. The commissioner shall have the discretion to adjust <br/>
<a id="pl.24.31"></a><var>24.31</var>the reimbursement rate to prevent access to care issues.<br/>
<a id="pl.24.32"></a><var>24.32</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2010, or upon federal <br/>
<a id="pl.24.33"></a><var>24.33</var>approval, whichever is later.<br/>
<br/>
<a id="bill.2.14.0"></a><a id="pl.24.34"></a><var>24.34</var>    Sec. 14. Minnesota Statutes 2008, section 256B.0625, subdivision 18a, is amended to <br/>
<a id="pl.24.35"></a><var>24.35</var>read:<br/>
<a id="pl.25.1"></a><var>25.1</var>    Subd. 18a. <b>Access to medical services.</b> (a) Medical assistance reimbursement for <br/>
<a id="pl.25.2"></a><var>25.2</var>meals for persons traveling to receive medical care may not exceed $5.50 for breakfast, <br/>
<a id="pl.25.3"></a><var>25.3</var>$6.50 for lunch, or $8 for dinner.<br/>
<a id="pl.25.4"></a><var>25.4</var>    (b) Medical assistance reimbursement for lodging for persons traveling to receive <br/>
<a id="pl.25.5"></a><var>25.5</var>medical care may not exceed $50 per day unless prior authorized by the local agency.<br/>
<a id="pl.25.6"></a><var>25.6</var>    (c) Medical assistance direct mileage reimbursement to the eligible person or the <br/>
<a id="pl.25.7"></a><var>25.7</var>eligible person's driver may not exceed 20 cents per mile.<br/>
<a id="pl.25.8"></a><var>25.8</var>    (d) Regardless of the number of employees that an enrolled health care provider <br/>
<a id="pl.25.9"></a><var>25.9</var>may have, medical assistance covers sign and oral language interpreter services when <br/>
<a id="pl.25.10"></a><var>25.10</var>provided by an enrolled health care provider during the course of providing a direct, <br/>
<a id="pl.25.11"></a><var>25.11</var>person-to-person covered health care service to an enrolled recipient with limited English <br/>
<a id="pl.25.12"></a><var>25.12</var>proficiency or who has a hearing loss and uses interpreting services. Coverage for oral <br/>
<a id="pl.25.13"></a><var>25.13</var>language interpreter services shall be provided only if the oral language interpreter used <br/>
<a id="pl.25.14"></a><var>25.14</var>by the enrolled health care provider is listed in the registry or roster established under <br/>
<a id="pl.25.15"></a><var>25.15</var>section 144.058.<br/>
<a id="pl.25.16"></a><var>25.16</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2010.<br/>
<br/>
<a id="bill.2.15.0"></a><a id="pl.25.17"></a><var>25.17</var>    Sec. 15. Minnesota Statutes 2008, section 256B.0625, subdivision 31, is amended to <br/>
<a id="pl.25.18"></a><var>25.18</var>read:<br/>
<a id="pl.25.19"></a><var>25.19</var>    Subd. 31. <b>Medical supplies and equipment.</b> Medical assistance covers medical <br/>
<a id="pl.25.20"></a><var>25.20</var>supplies and equipment. Separate payment outside of the facility's payment rate shall <br/>
<a id="pl.25.21"></a><var>25.21</var>be made for wheelchairs and wheelchair accessories for recipients who are residents <br/>
<a id="pl.25.22"></a><var>25.22</var>of intermediate care facilities for the developmentally disabled. Reimbursement for <br/>
<a id="pl.25.23"></a><var>25.23</var>wheelchairs and wheelchair accessories for ICF/MR recipients shall be subject to the same <br/>
<a id="pl.25.24"></a><var>25.24</var>conditions and limitations as coverage for recipients who do not reside in institutions. A <br/>
<a id="pl.25.25"></a><var>25.25</var>wheelchair purchased outside of the facility's payment rate is the property of the recipient. <br/>
<a id="pl.25.26"></a><var>25.26</var>The commissioner may set reimbursement rates for specified categories of medical <br/>
<a id="pl.25.27"></a><var>25.27</var>supplies at levels below the Medicare payment rate.<br/>
<br/>
<a id="bill.2.16.0"></a><a id="pl.25.28"></a><var>25.28</var>    Sec. 16. Minnesota Statutes 2008, section 256B.0625, is amended by adding a <br/>
<a id="pl.25.29"></a><var>25.29</var>subdivision to read:<br/>
<a id="pl.25.30"></a><var>25.30</var>    Subd. 54. <b>Services provided in birth centers.</b> (a) Medical assistance covers <br/>
<a id="pl.25.31"></a><var>25.31</var>services provided in a birth center licensed under section 144.615 by a licensed health <br/>
<a id="pl.25.32"></a><var>25.32</var>professional if the service would otherwise be covered if provided in a hospital.<br/>
<a id="pl.25.33"></a><var>25.33</var>(b) Facility services provided by a birth center shall be paid at the lower of billed <br/>
<a id="pl.25.34"></a><var>25.34</var>charges or 70 percent of the statewide average for a facility payment rate made to a <br/>
<a id="pl.26.1"></a><var>26.1</var>hospital for an uncomplicated vaginal birth as determined using the most recent calendar <br/>
<a id="pl.26.2"></a><var>26.2</var>year for which complete claims data is available. If a recipient is transported from a birth <br/>
<a id="pl.26.3"></a><var>26.3</var>center to a hospital prior to the delivery, the payment for facility services to the birth center <br/>
<a id="pl.26.4"></a><var>26.4</var>shall be the lower of billed charges or 15 percent of the average facility payment made to a <br/>
<a id="pl.26.5"></a><var>26.5</var>hospital for the services provided for an uncomplicated vaginal delivery as determined <br/>
<a id="pl.26.6"></a><var>26.6</var>using the most recent calendar year for which complete claims data is available.<br/>
<a id="pl.26.7"></a><var>26.7</var>(c) Professional services provided by traditional midwives licensed under chapter <br/>
<a id="pl.26.8"></a><var>26.8</var>147D shall be paid at the lower of billed charges or 100 percent of the rate paid to a <br/>
<a id="pl.26.9"></a><var>26.9</var>physician performing the same services. If a recipient is transported from a birth center to <br/>
<a id="pl.26.10"></a><var>26.10</var>a hospital prior to the delivery, a licensed traditional midwife who does not perform the <br/>
<a id="pl.26.11"></a><var>26.11</var>delivery may not bill for any delivery services. Services are not covered if provided by an <br/>
<a id="pl.26.12"></a><var>26.12</var>unlicensed traditional midwife.<br/>
<a id="pl.26.13"></a><var>26.13</var>(d) The commissioner shall apply for any necessary waivers from the Centers for <br/>
<a id="pl.26.14"></a><var>26.14</var>Medicare and Medicaid Services to allow birth centers and birth center providers to be <br/>
<a id="pl.26.15"></a><var>26.15</var>reimbursed.<br/>
<a id="pl.26.16"></a><var>26.16</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2011, or upon federal <br/>
<a id="pl.26.17"></a><var>26.17</var>approval, whichever is later.<br/>
<br/>
<a id="bill.2.17.0"></a><a id="pl.26.18"></a><var>26.18</var>    Sec. 17. Minnesota Statutes 2008, section 256B.0631, subdivision 1, is amended to <br/>
<a id="pl.26.19"></a><var>26.19</var>read:<br/>
<a id="pl.26.20"></a><var>26.20</var>    Subdivision 1. <b>Co-payments.</b> (a) Except as provided in subdivision 2, the medical <br/>
<a id="pl.26.21"></a><var>26.21</var>assistance benefit plan shall include the following co-payments for all recipients, effective <br/>
<a id="pl.26.22"></a><var>26.22</var>for services provided on or after October 1, 2003, and before January 1, 2009:<br/>
<a id="pl.26.23"></a><var>26.23</var>    (1) $3 per nonpreventive visit. For purposes of this subdivision, a visit means an <br/>
<a id="pl.26.24"></a><var>26.24</var>episode of service which is required because of a recipient's symptoms, diagnosis, or <br/>
<a id="pl.26.25"></a><var>26.25</var>established illness, and which is delivered in an ambulatory setting by a physician or <br/>
<a id="pl.26.26"></a><var>26.26</var>physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse, <br/>
<a id="pl.26.27"></a><var>26.27</var>audiologist, optician, or optometrist;<br/>
<a id="pl.26.28"></a><var>26.28</var>    (2) $3 for eyeglasses;<br/>
<a id="pl.26.29"></a><var>26.29</var>    (3) $6 for nonemergency visits to a hospital-based emergency room; and<br/>
<a id="pl.26.30"></a><var>26.30</var>    (4) $3 per brand-name drug prescription and $1 per generic drug prescription, <br/>
<a id="pl.26.31"></a><var>26.31</var>subject to a $12 per month maximum for prescription drug co-payments. No co-payments <br/>
<a id="pl.26.32"></a><var>26.32</var>shall apply to antipsychotic drugs when used for the treatment of mental illness.<br/>
<a id="pl.26.33"></a><var>26.33</var>    (b) Except as provided in subdivision 2, the medical assistance benefit plan shall <br/>
<a id="pl.26.34"></a><var>26.34</var>include the following co-payments for all recipients, effective for services provided on <br/>
<a id="pl.26.35"></a><var>26.35</var>or after January 1, 2009:<br/>
<a id="pl.27.1"></a><var>27.1</var>    (1) $6 $3.50 for nonemergency visits to a hospital-based emergency room; <br/>
<a id="pl.27.2"></a><var>27.2</var>    (2) $3 per brand-name drug prescription and $1 per generic drug prescription, subject <br/>
<a id="pl.27.3"></a><var>27.3</var>to a $7 $12 per month maximum for prescription drug co-payments. No co-payments shall <br/>
<a id="pl.27.4"></a><var>27.4</var>apply to antipsychotic drugs when used for the treatment of mental illness; and<br/>
<a id="pl.27.5"></a><var>27.5</var>    (3) for individuals identified by the commissioner with income at or below 100 <br/>
<a id="pl.27.6"></a><var>27.6</var>percent of the federal poverty guidelines, total monthly co-payments must not exceed five <br/>
<a id="pl.27.7"></a><var>27.7</var>percent of family income. For purposes of this paragraph, family income is the total <br/>
<a id="pl.27.8"></a><var>27.8</var>earned and unearned income of the individual and the individual's spouse, if the spouse is <br/>
<a id="pl.27.9"></a><var>27.9</var>enrolled in medical assistance and also subject to the five percent limit on co-payments.<br/>
<a id="pl.27.10"></a><var>27.10</var>    (c) Recipients of medical assistance are responsible for all co-payments in this <br/>
<a id="pl.27.11"></a><var>27.11</var>subdivision.<br/>
<a id="pl.27.12"></a><var>27.12</var><b>EFFECTIVE DATE.</b>The amendment to paragraph (b), clause (1), related to the <br/>
<a id="pl.27.13"></a><var>27.13</var>co-payment for nonemergency visits is effective January 1, 2011, and the amendment <br/>
<a id="pl.27.14"></a><var>27.14</var>to paragraph (b), clause (2), related to the per month maximum for prescription drug <br/>
<a id="pl.27.15"></a><var>27.15</var>co-payments is effective July 1, 2010.<br/>
<br/>
<a id="bill.2.18.0"></a><a id="pl.27.16"></a><var>27.16</var>    Sec. 18. Minnesota Statutes 2008, section 256B.0631, subdivision 3, is amended to <br/>
<a id="pl.27.17"></a><var>27.17</var>read:<br/>
<a id="pl.27.18"></a><var>27.18</var>    Subd. 3. <b>Collection.</b> (a) The medical assistance reimbursement to the provider <br/>
<a id="pl.27.19"></a><var>27.19</var>shall be reduced by the amount of the co-payment, except that reimbursements shall <br/>
<a id="pl.27.20"></a><var>27.20</var>not be reduced:<br/>
<a id="pl.27.21"></a><var>27.21</var>    (1) once a recipient has reached the $12 per month maximum or the $7 per month <br/>
<a id="pl.27.22"></a><var>27.22</var>maximum effective January 1, 2009, for prescription drug co-payments; or<br/>
<a id="pl.27.23"></a><var>27.23</var>    (2) for a recipient identified by the commissioner under 100 percent of the federal <br/>
<a id="pl.27.24"></a><var>27.24</var>poverty guidelines who has met their monthly five percent co-payment limit.<br/>
<a id="pl.27.25"></a><var>27.25</var>    (b) The provider collects the co-payment from the recipient. Providers may not deny <br/>
<a id="pl.27.26"></a><var>27.26</var>services to recipients who are unable to pay the co-payment.<br/>
<a id="pl.27.27"></a><var>27.27</var>    (c) Medical assistance reimbursement to fee-for-service providers and payments to <br/>
<a id="pl.27.28"></a><var>27.28</var>managed care plans shall not be increased as a result of the removal of the co-payments <br/>
<a id="pl.27.29"></a><var>27.29</var>effective on or after January 1, 2009.<br/>
<br/>
<a id="bill.2.19.0"></a><a id="pl.27.30"></a><var>27.30</var>    Sec. 19. Minnesota Statutes 2008, section 256B.0644, as amended by Laws 2010, <br/>
<a id="pl.27.31"></a><var>27.31</var>chapter 200, article 1, section 6, is amended to read:<br/>
<a id="pl.27.32"></a><var>27.32</var><b>256B.0644 REIMBURSEMENT UNDER OTHER STATE HEALTH CARE </b><br/>
<a id="pl.27.33"></a><var>27.33</var><b>PROGRAMS.</b><br/>
<a id="pl.28.1"></a><var>28.1</var>    (a) A vendor of medical care, as defined in section 
         <statute_ref>256B.02, subdivision 7</statute_ref>, and a <br/>
<a id="pl.28.2"></a><var>28.2</var>health maintenance organization, as defined in chapter 62D, must participate as a provider <br/>
<a id="pl.28.3"></a><var>28.3</var>or contractor in the medical assistance program, general assistance medical care program, <br/>
<a id="pl.28.4"></a><var>28.4</var>and MinnesotaCare as a condition of participating as a provider in health insurance plans <br/>
<a id="pl.28.5"></a><var>28.5</var>and programs or contractor for state employees established under section 
         <statute_ref>43A.18</statute_ref>, the <br/>
<a id="pl.28.6"></a><var>28.6</var>public employees insurance program under section 
         <statute_ref>43A.316</statute_ref>, for health insurance plans <br/>
<a id="pl.28.7"></a><var>28.7</var>offered to local statutory or home rule charter city, county, and school district employees, <br/>
<a id="pl.28.8"></a><var>28.8</var>the workers' compensation system under section 
         <statute_ref>176.135</statute_ref>, and insurance plans provided <br/>
<a id="pl.28.9"></a><var>28.9</var>through the Minnesota Comprehensive Health Association under sections 
         <statute_ref>62E.01</statute_ref> to <br/>
<statute_ref><a id="pl.28.10"></a><var>28.10</var>62E.19
         </statute_ref>. The limitations on insurance plans offered to local government employees shall <br/>
<a id="pl.28.11"></a><var>28.11</var>not be applicable in geographic areas where provider participation is limited by managed <br/>
<a id="pl.28.12"></a><var>28.12</var>care contracts with the Department of Human Services.<br/>
<a id="pl.28.13"></a><var>28.13</var>    (b) For providers other than health maintenance organizations, participation in the <br/>
<a id="pl.28.14"></a><var>28.14</var>medical assistance program means that:<br/>
<a id="pl.28.15"></a><var>28.15</var>     (1) the provider accepts new medical assistance, general assistance medical care, <br/>
<a id="pl.28.16"></a><var>28.16</var>and MinnesotaCare patients;<br/>
<a id="pl.28.17"></a><var>28.17</var>    (2) for providers other than dental service providers, at least 20 percent of the <br/>
<a id="pl.28.18"></a><var>28.18</var>provider's patients are covered by medical assistance, general assistance medical care, <br/>
<a id="pl.28.19"></a><var>28.19</var>and MinnesotaCare as their primary source of coverage; or<br/>
<a id="pl.28.20"></a><var>28.20</var>    (3) for dental service providers, at least ten percent of the provider's patients are <br/>
<a id="pl.28.21"></a><var>28.21</var>covered by medical assistance, general assistance medical care, and MinnesotaCare as <br/>
<a id="pl.28.22"></a><var>28.22</var>their primary source of coverage, or the provider accepts new medical assistance and <br/>
<a id="pl.28.23"></a><var>28.23</var>MinnesotaCare patients who are children with special health care needs. For purposes <br/>
<a id="pl.28.24"></a><var>28.24</var>of this section, "children with special health care needs" means children up to age 18 <br/>
<a id="pl.28.25"></a><var>28.25</var>who: (i) require health and related services beyond that required by children generally; <br/>
<a id="pl.28.26"></a><var>28.26</var>and (ii) have or are at risk for a chronic physical, developmental, behavioral, or emotional <br/>
<a id="pl.28.27"></a><var>28.27</var>condition, including: bleeding and coagulation disorders; immunodeficiency disorders; <br/>
<a id="pl.28.28"></a><var>28.28</var>cancer; endocrinopathy; developmental disabilities; epilepsy, cerebral palsy, and other <br/>
<a id="pl.28.29"></a><var>28.29</var>neurological diseases; visual impairment or deafness; Down syndrome and other genetic <br/>
<a id="pl.28.30"></a><var>28.30</var>disorders; autism; fetal alcohol syndrome; and other conditions designated by the <br/>
<a id="pl.28.31"></a><var>28.31</var>commissioner after consultation with representatives of pediatric dental providers and <br/>
<a id="pl.28.32"></a><var>28.32</var>consumers.<br/>
<a id="pl.28.33"></a><var>28.33</var>    (c) Patients seen on a volunteer basis by the provider at a location other than <br/>
<a id="pl.28.34"></a><var>28.34</var>the provider's usual place of practice may be considered in meeting the participation <br/>
<a id="pl.28.35"></a><var>28.35</var>requirement in this section. The commissioner shall establish participation requirements <br/>
<a id="pl.28.36"></a><var>28.36</var>for health maintenance organizations. The commissioner shall provide lists of participating <br/>
<a id="pl.29.1"></a><var>29.1</var>medical assistance providers on a quarterly basis to the commissioner of management and <br/>
<a id="pl.29.2"></a><var>29.2</var>budget, the commissioner of labor and industry, and the commissioner of commerce. Each <br/>
<a id="pl.29.3"></a><var>29.3</var>of the commissioners shall develop and implement procedures to exclude as participating <br/>
<a id="pl.29.4"></a><var>29.4</var>providers in the program or programs under their jurisdiction those providers who do <br/>
<a id="pl.29.5"></a><var>29.5</var>not participate in the medical assistance program. The commissioner of management <br/>
<a id="pl.29.6"></a><var>29.6</var>and budget shall implement this section through contracts with participating health and <br/>
<a id="pl.29.7"></a><var>29.7</var>dental carriers.<br/>
<a id="pl.29.8"></a><var>29.8</var>    (d) Any hospital or other provider that is participating in a coordinated care <br/>
<a id="pl.29.9"></a><var>29.9</var>delivery system under section 
<statute_ref>256D.031, subdivision 6</statute_ref>, or receives payments from the <br/>
<a id="pl.29.10"></a><var>29.10</var>uncompensated care pool under section 
<statute_ref>256D.031, subdivision 8</statute_ref>, shall not refuse to <br/>
<a id="pl.29.11"></a><var>29.11</var>provide services to any patient enrolled in general assistance medical care regardless of <br/>
<a id="pl.29.12"></a><var>29.12</var>the availability or the amount of payment.<br/>
<a id="pl.29.13"></a><var>29.13</var>    (e) (d) For purposes of paragraphs (a) and (b), participation in the general assistance <br/>
<a id="pl.29.14"></a><var>29.14</var>medical care program applies only to pharmacy providers dispensing prescription drugs <br/>
<a id="pl.29.15"></a><var>29.15</var>according to section 256D.03, subdivision 3.<br/>
<a id="pl.29.16"></a><var>29.16</var><b>EFFECTIVE DATE.</b>The amendment striking the existing paragraph (d) is effective <br/>
<a id="pl.29.17"></a><var>29.17</var>30 days after federal approval of the amendments in this article to Minnesota Statutes, <br/>
<a id="pl.29.18"></a><var>29.18</var>sections 256B.055, subdivision 15, and 256B.056, subdivision 4, or January 1, 2011, <br/>
<a id="pl.29.19"></a><var>29.19</var>whichever is later. The amendment to the new paragraph (d) is effective June 1, 2010.<br/>
<br/>
<a id="bill.2.20.0"></a><a id="pl.29.20"></a><var>29.20</var>    Sec. 20. Minnesota Statutes 2009 Supplement, section 256B.0653, subdivision 5, <br/>
<a id="pl.29.21"></a><var>29.21</var>is amended to read:<br/>
<a id="pl.29.22"></a><var>29.22</var>    Subd. 5. <b>Home care therapies.</b> (a) Home care therapies include the following: <br/>
<a id="pl.29.23"></a><var>29.23</var>physical therapy, occupational therapy, respiratory therapy, and speech and language <br/>
<a id="pl.29.24"></a><var>29.24</var>pathology therapy services.<br/>
<a id="pl.29.25"></a><var>29.25</var>(b) Home care therapies must be:<br/>
<a id="pl.29.26"></a><var>29.26</var>(1) provided in the recipient's residence after it has been determined the recipient is <br/>
<a id="pl.29.27"></a><var>29.27</var>unable to access outpatient therapy;<br/>
<a id="pl.29.28"></a><var>29.28</var>(2) prescribed, ordered, or referred by a physician and documented in a plan of care <br/>
<a id="pl.29.29"></a><var>29.29</var>and reviewed, according to Minnesota Rules, part 9505.0390;<br/>
<a id="pl.29.30"></a><var>29.30</var>(3) assessed by an appropriate therapist; and<br/>
<a id="pl.29.31"></a><var>29.31</var>(4) provided by a Medicare-certified home health agency enrolled as a Medicaid <br/>
<a id="pl.29.32"></a><var>29.32</var>provider agency.<br/>
<a id="pl.29.33"></a><var>29.33</var>(c) Restorative and specialized maintenance therapies must be provided according to <br/>
<a id="pl.29.34"></a><var>29.34</var>Minnesota Rules, part 9505.0390. Physical and occupational therapy assistants may be <br/>
<a id="pl.29.35"></a><var>29.35</var>used as allowed under Minnesota Rules, part 9505.0390, subpart 1, item B.<br/>
<a id="pl.30.1"></a><var>30.1</var>(d) For both physical and occupational therapies, the therapist and the therapist's <br/>
<a id="pl.30.2"></a><var>30.2</var>assistant may not both bill for services provided to a recipient on the same day.<br/>
<br/>
<a id="bill.2.21.0"></a><a id="pl.30.3"></a><var>30.3</var>    Sec. 21. <b>[256B.0755] PAYMENT REFORM DEMONSTRATION PROJECT FOR </b><br/>
<a id="pl.30.4"></a><var>30.4</var><b>SPECIAL PATIENT POPULATIONS.</b><br/>
<a id="pl.30.5"></a><var>30.5</var>    Subdivision 1. <b>Demonstration project.</b> (a) The commissioner of human services, <br/>
<a id="pl.30.6"></a><var>30.6</var>in consultation with the commissioner of health, shall establish a payment reform <br/>
<a id="pl.30.7"></a><var>30.7</var>demonstration project implementing an alternative payment system for health care <br/>
<a id="pl.30.8"></a><var>30.8</var>providers serving an identified group of patients who are enrolled in a state health <br/>
<a id="pl.30.9"></a><var>30.9</var>care program, and are either high utilizers of high-cost health care services or have <br/>
<a id="pl.30.10"></a><var>30.10</var>characteristics that put them at high risk of becoming high utilizers.  The purpose of the <br/>
<a id="pl.30.11"></a><var>30.11</var>demonstration project is to implement and evaluate methods of reducing hospitalizations, <br/>
<a id="pl.30.12"></a><var>30.12</var>emergency room use, high-cost medications and specialty services, admissions to nursing <br/>
<a id="pl.30.13"></a><var>30.13</var>facilities, or use of long-term home and community-based services, in order to reduce the <br/>
<a id="pl.30.14"></a><var>30.14</var>total cost of care and services for the patients.   <br/>
<a id="pl.30.15"></a><var>30.15</var>(b) The commissioner shall give the highest priority to projects that will serve <br/>
<a id="pl.30.16"></a><var>30.16</var>patients who have chronic medical conditions or complex medical needs that are <br/>
<a id="pl.30.17"></a><var>30.17</var>complicated by a physical disability, serious mental illness, or serious socioeconomic <br/>
<a id="pl.30.18"></a><var>30.18</var>factors such as poverty, homelessness, or language or cultural barriers.  The commissioner <br/>
<a id="pl.30.19"></a><var>30.19</var>shall also give the highest priority to providers or groups of providers who have the <br/>
<a id="pl.30.20"></a><var>30.20</var>highest concentrations of patients with these characteristics. <br/>
<a id="pl.30.21"></a><var>30.21</var>(c) The commissioner must implement this payment reform demonstration project <br/>
<a id="pl.30.22"></a><var>30.22</var>in a manner consistent with the payment reform initiative provided in sections 62U.02 <br/>
<a id="pl.30.23"></a><var>30.23</var>to 62U.04.<br/>
<a id="pl.30.24"></a><var>30.24</var>(d) For purposes of this section, "state health care program" means the medical <br/>
<a id="pl.30.25"></a><var>30.25</var>assistance, MinnesotaCare, and general assistance medical care programs.<br/>
<a id="pl.30.26"></a><var>30.26</var>    Subd. 2. <b>Participation.</b> (a) The commissioner shall request eligible providers or <br/>
<a id="pl.30.27"></a><var>30.27</var>groups of providers to submit a proposal to participate in the demonstration project by <br/>
<a id="pl.30.28"></a><var>30.28</var>September 1, 2010. The providers who are interested in participating shall negotiate with <br/>
<a id="pl.30.29"></a><var>30.29</var>the commissioner to determine: <br/>
<a id="pl.30.30"></a><var>30.30</var>(1) the identified group of patients who are to be enrolled in the program;<br/>
<a id="pl.30.31"></a><var>30.31</var>(2) the services that are to be included in the total cost of care calculation;<br/>
<a id="pl.30.32"></a><var>30.32</var>(3) the methodology for calculating the total cost of care, which may take into <br/>
<a id="pl.30.33"></a><var>30.33</var>consideration the impact on costs to other state or local government programs including, <br/>
<a id="pl.30.34"></a><var>30.34</var>but not limited to, social services and income maintenance programs;<br/>
<a id="pl.30.35"></a><var>30.35</var>(4) the time period to be covered under the bid;<br/>
<a id="pl.31.1"></a><var>31.1</var>(5) the implementation of a risk adjustment mechanism to adjust for factors that are <br/>
<a id="pl.31.2"></a><var>31.2</var>beyond the control of the provider including nonclinical factors that will affect the cost <br/>
<a id="pl.31.3"></a><var>31.3</var>or outcomes of treatment;<br/>
<a id="pl.31.4"></a><var>31.4</var>(6) the payment reforms and payment methods to be used under the project, which <br/>
<a id="pl.31.5"></a><var>31.5</var>may include but are not limited to adjustments in fee-for-service payments, payment of <br/>
<a id="pl.31.6"></a><var>31.6</var>care coordination fees, payments for start-up and implementation costs to be recovered or <br/>
<a id="pl.31.7"></a><var>31.7</var>repaid later in the project, payments adjusted based on a provider's proportion of patients <br/>
<a id="pl.31.8"></a><var>31.8</var>who are enrolled in state health care programs; payments adjusted for the clinical or <br/>
<a id="pl.31.9"></a><var>31.9</var>socioeconomic complexity of the patients served, payment incentives tied to use of <br/>
<a id="pl.31.10"></a><var>31.10</var>inpatient and emergency room services, and periodic settle-up adjustments;<br/>
<a id="pl.31.11"></a><var>31.11</var>(7) methods of sharing financial risk and benefit between the commissioner and <br/>
<a id="pl.31.12"></a><var>31.12</var>the provider or groups of providers, which may include but are not limited to stop-loss <br/>
<a id="pl.31.13"></a><var>31.13</var>arrangements to cover high-cost outlier cases or costs that are beyond the control of the <br/>
<a id="pl.31.14"></a><var>31.14</var>provider, and risk-sharing and benefit-sharing corridors; and<br/>
<a id="pl.31.15"></a><var>31.15</var>(8) performance and outcome benchmarks to be used to measure performance, <br/>
<a id="pl.31.16"></a><var>31.16</var>achievement of cost-savings targets, and quality of care provided.<br/>
<a id="pl.31.17"></a><var>31.17</var>(b) A provider or group of providers may submit a proposal for a demonstration <br/>
<a id="pl.31.18"></a><var>31.18</var>project in partnership with a health maintenance organization or county-based purchasing <br/>
<a id="pl.31.19"></a><var>31.19</var>plan for the purposes of sharing risk, claims processing, or administration of the project, <br/>
<a id="pl.31.20"></a><var>31.20</var>or to extend participation in the project to persons who are enrolled in prepaid health <br/>
<a id="pl.31.21"></a><var>31.21</var>care programs.<br/>
<a id="pl.31.22"></a><var>31.22</var>    Subd. 3. <b>Total cost of care agreement.</b> Based on negotiations, the commissioner <br/>
<a id="pl.31.23"></a><var>31.23</var>must enter into an agreement with interested and eligible providers or groups of providers <br/>
<a id="pl.31.24"></a><var>31.24</var>to implement projects that are designed to reduce the total cost of care for the identified <br/>
<a id="pl.31.25"></a><var>31.25</var>patients. To the extent possible, the projects shall begin implementation on January 1, <br/>
<a id="pl.31.26"></a><var>31.26</var>2011, or upon federal approval, whichever is later.<br/>
<a id="pl.31.27"></a><var>31.27</var>    Subd. 4. <b>Eligibility.</b> To be eligible to participate, providers or groups of providers <br/>
<a id="pl.31.28"></a><var>31.28</var>must meet certification standards for health care homes established by the Department of <br/>
<a id="pl.31.29"></a><var>31.29</var>Health and the Department of Human Services under section 256B.0751.<br/>
<a id="pl.31.30"></a><var>31.30</var>    Subd. 5. <b>Alternative payments.</b> The commissioner shall seek all federal waivers <br/>
<a id="pl.31.31"></a><var>31.31</var>and approvals necessary to implement this section and to obtain federal matching funds. To <br/>
<a id="pl.31.32"></a><var>31.32</var>the extent authorized by federal law, the commissioner may waive existing fee-for-service <br/>
<a id="pl.31.33"></a><var>31.33</var>payment rates, provider contract or performance requirements, consumer incentive <br/>
<a id="pl.31.34"></a><var>31.34</var>policies, or other requirements in statute or rule in order to allow the providers or groups <br/>
<a id="pl.31.35"></a><var>31.35</var>of providers to utilize alternative payment and financing methods that will appropriately <br/>
<a id="pl.31.36"></a><var>31.36</var>fund necessary and cost-effective primary care and care coordination services; establish <br/>
<a id="pl.32.1"></a><var>32.1</var>appropriate incentives for prevention, health promotion, and care coordination; and <br/>
<a id="pl.32.2"></a><var>32.2</var>mitigate financial harm to participating providers caused by the successful reduction in <br/>
<a id="pl.32.3"></a><var>32.3</var>preventable hospitalization, emergency room use, and other costly services.<br/>
<a id="pl.32.4"></a><var>32.4</var>    Subd. 6. <b>Cost neutrality.</b> The total cost, including administrative costs, of this <br/>
<a id="pl.32.5"></a><var>32.5</var>demonstration project must not exceed the costs that would otherwise be incurred by <br/>
<a id="pl.32.6"></a><var>32.6</var>the state had services to the state health care program enrollees participating in the <br/>
<a id="pl.32.7"></a><var>32.7</var>demonstration project been provided, as applicable for the enrollee, under fee-for-service <br/>
<a id="pl.32.8"></a><var>32.8</var>or through managed care or county-based purchasing plans.<br/>
<br/>
<a id="bill.2.22.0"></a><a id="pl.32.9"></a><var>32.9</var>    Sec. 22. <b>[256B.0757] INTENSIVE CARE MANAGEMENT PROGRAM.</b><br/>
<a id="pl.32.10"></a><var>32.10</var>    Subdivision 1. <b>Report.</b> The commissioner shall review medical assistance <br/>
<a id="pl.32.11"></a><var>32.11</var>enrollment and by July 1, 2011, present a report to the legislature that describes the <br/>
<a id="pl.32.12"></a><var>32.12</var>common characteristics and costs of those enrollees age 18 and over whose annual medical <br/>
<a id="pl.32.13"></a><var>32.13</var>costs are greater than 95 percent of all other enrollees, using deidentified data.<br/>
<a id="pl.32.14"></a><var>32.14</var>    Subd. 2. <b>Intensive care management system established.</b> The commissioner shall <br/>
<a id="pl.32.15"></a><var>32.15</var>implement, by January 1, 2012, or upon federal approval, whichever is later, a program <br/>
<a id="pl.32.16"></a><var>32.16</var>to provide intensive care management to medical assistance enrollees age 18 and over <br/>
<a id="pl.32.17"></a><var>32.17</var>currently served under fee-for-service, managed care, or county-based purchasing, whose <br/>
<a id="pl.32.18"></a><var>32.18</var>annual medical care costs are in the top five percent of all medical assistance enrollees. <br/>
<a id="pl.32.19"></a><var>32.19</var>The intensive care management program must reduce these enrollees' medical assistance <br/>
<a id="pl.32.20"></a><var>32.20</var>costs by at least 20 percent on average, improve quality of care through care coordination, <br/>
<a id="pl.32.21"></a><var>32.21</var>and provide financial incentives for providers to deliver care efficiently. The commissioner <br/>
<a id="pl.32.22"></a><var>32.22</var>may require medical assistance enrollees meeting the criteria specified in this subdivision <br/>
<a id="pl.32.23"></a><var>32.23</var>to participate in the intensive care management program, and may reassign enrollees <br/>
<a id="pl.32.24"></a><var>32.24</var>from existing managed care and county-based purchasing plans to those plans that are <br/>
<a id="pl.32.25"></a><var>32.25</var>participating in the demonstration program. The commissioner shall seek all federal <br/>
<a id="pl.32.26"></a><var>32.26</var>approvals and waivers necessary to implement the intensive care management program.<br/>
<a id="pl.32.27"></a><var>32.27</var>    Subd. 3. <b>Request for proposals.</b> The commissioner of human services shall <br/>
<a id="pl.32.28"></a><var>32.28</var>request proposals by September 1, 2011, or upon federal approval, whichever is later, <br/>
<a id="pl.32.29"></a><var>32.29</var>from health care providers, managed care plans, and county-based purchasing plans to <br/>
<a id="pl.32.30"></a><var>32.30</var>provide  intensive care management services under the requirements of subdivision 1. <br/>
<a id="pl.32.31"></a><var>32.31</var>Proposals submitted must:<br/>
<a id="pl.32.32"></a><var>32.32</var>(1) designate the medical assistance population and geographic area of the state <br/>
<a id="pl.32.33"></a><var>32.33</var>to be served;<br/>
<a id="pl.32.34"></a><var>32.34</var>(2) describe in detail the proposed intensive care management program;<br/>
<a id="pl.33.1"></a><var>33.1</var>(3) provide estimates of cost savings to the state and the evidence supporting these <br/>
<a id="pl.33.2"></a><var>33.2</var>estimates;<br/>
<a id="pl.33.3"></a><var>33.3</var>(4) describe the extent to which the intensive care management program is consistent <br/>
<a id="pl.33.4"></a><var>33.4</var>with and builds upon current state health care home, care coordination, and payment <br/>
<a id="pl.33.5"></a><var>33.5</var>reform initiatives; and<br/>
<a id="pl.33.6"></a><var>33.6</var>(5) meet quality assurance, data reporting, and other criteria specified by the <br/>
<a id="pl.33.7"></a><var>33.7</var>commissioner in the request for proposals.<br/>
<a id="pl.33.8"></a><var>33.8</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br/>
<br/>
<a id="bill.2.23.0"></a><a id="pl.33.9"></a><var>33.9</var>    Sec. 23. Minnesota Statutes 2008, section 256B.19, subdivision 1c, is amended to read:<br/>
<a id="pl.33.10"></a><var>33.10</var>    Subd. 1c. <b>Additional portion of nonfederal share.</b> (a) Hennepin County shall <br/>
<a id="pl.33.11"></a><var>33.11</var>be responsible for a monthly transfer payment of $1,500,000, due before noon on the <br/>
<a id="pl.33.12"></a><var>33.12</var>15th of each month and the University of Minnesota shall be responsible for a monthly <br/>
<a id="pl.33.13"></a><var>33.13</var>transfer payment of $500,000 due before noon on the 15th of each month, beginning July <br/>
<a id="pl.33.14"></a><var>33.14</var>15, 1995. These sums shall be part of the designated governmental unit's portion of the <br/>
<a id="pl.33.15"></a><var>33.15</var>nonfederal share of medical assistance costs.<br/>
<a id="pl.33.16"></a><var>33.16</var>(b) Beginning July 1, 2001, Hennepin County's payment under paragraph (a) shall <br/>
<a id="pl.33.17"></a><var>33.17</var>be $2,066,000 each month.<br/>
<a id="pl.33.18"></a><var>33.18</var>(c) Beginning July 1, 2001, the commissioner shall increase annual capitation <br/>
<a id="pl.33.19"></a><var>33.19</var>payments to the metropolitan health plan under section 
         <statute_ref>256B.69</statute_ref> for the prepaid medical <br/>
<a id="pl.33.20"></a><var>33.20</var>assistance program by approximately $3,400,000, plus any available federal matching <br/>
<a id="pl.33.21"></a><var>33.21</var>funds, $6,800,000 to recognize higher than average medical education costs.<br/>
<a id="pl.33.22"></a><var>33.22</var>(d) Effective August 1, 2005, Hennepin County's payment under paragraphs (a) <br/>
<a id="pl.33.23"></a><var>33.23</var>and (b) shall be reduced to $566,000, and the University of Minnesota's payment under <br/>
<a id="pl.33.24"></a><var>33.24</var>paragraph (a) shall be reduced to zero. Effective October 1, 2008, to December 30, 2010, <br/>
<a id="pl.33.25"></a><var>33.25</var>Hennepin County's payment under paragraphs (a) and (b) shall be $434,688.  Effective <br/>
<a id="pl.33.26"></a><var>33.26</var>January 1, 2011, Hennepin County's payment under paragraphs (a) and (b) shall be <br/>
<a id="pl.33.27"></a><var>33.27</var>$566,000.<br/>
<a id="pl.33.28"></a><var>33.28</var>(e) Notwithstanding paragraph (d), upon federal enactment of an extension to June <br/>
<a id="pl.33.29"></a><var>33.29</var>30, 2011, of the enhanced federal medical assistance percentage (FMAP) originally <br/>
<a id="pl.33.30"></a><var>33.30</var>provided under Public Law 111-5, for the six-month period from January 1, 2011, to June <br/>
<a id="pl.33.31"></a><var>33.31</var>30, 2011, Hennepin County's payment under paragraphs (a) and (b) shall be $434,688.<br/>
<br/>
<a id="bill.2.24.0"></a><a id="pl.33.32"></a><var>33.32</var>    Sec. 24. Minnesota Statutes 2008, section 256B.69, is amended by adding a <br/>
<a id="pl.33.33"></a><var>33.33</var>subdivision to read:<br/>
<a id="pl.34.1"></a><var>34.1</var>    Subd. 5k. <b>Payment rate modification.</b> For services rendered on or after August <br/>
<a id="pl.34.2"></a><var>34.2</var>1, 2010, the total payment made to managed care and county-based purchasing plans <br/>
<a id="pl.34.3"></a><var>34.3</var>under the medical assistance program and under MinnesotaCare for families with children <br/>
<a id="pl.34.4"></a><var>34.4</var>shall be increased by 1.4 percent.<br/>
<a id="pl.34.5"></a><var>34.5</var><b>EFFECTIVE DATE.</b>This section is effective August 1, 2010.<br/>
<br/>
<a id="bill.2.25.0"></a><a id="pl.34.6"></a><var>34.6</var>    Sec. 25. Minnesota Statutes 2008, section 256B.69, is amended by adding a <br/>
<a id="pl.34.7"></a><var>34.7</var>subdivision to read:<br/>
<a id="pl.34.8"></a><var>34.8</var>    Subd. 5l. <b>Payment reduction.</b> For services rendered on or after January 1, 2011, <br/>
<a id="pl.34.9"></a><var>34.9</var>the total payment made to managed care plans for providing covered services under <br/>
<a id="pl.34.10"></a><var>34.10</var>the medical assistance, general assistance medical care, and MinnesotaCare programs <br/>
<a id="pl.34.11"></a><var>34.11</var>is reduced by one percent from their current statutory rates. This provision excludes <br/>
<a id="pl.34.12"></a><var>34.12</var>payments for nursing home services, home and community-based waivers, home care <br/>
<a id="pl.34.13"></a><var>34.13</var>services covered under section 256B.0651, subdivision 2, payments to demonstration <br/>
<a id="pl.34.14"></a><var>34.14</var>projects for persons with disabilities, and mental health services added as covered benefits <br/>
<a id="pl.34.15"></a><var>34.15</var>after December 31, 2007.<br/>
<br/>
<a id="bill.2.26.0"></a><a id="pl.34.16"></a><var>34.16</var>    Sec. 26. Minnesota Statutes 2008, section 256B.69, subdivision 20, as amended by <br/>
<a id="pl.34.17"></a><var>34.17</var>Laws 2010, chapter 200, article 1, section 10, is amended to read:<br/>
<a id="pl.34.18"></a><var>34.18</var>    Subd. 20. <b>Ombudsperson.</b> (a) The commissioner shall designate an ombudsperson <br/>
<a id="pl.34.19"></a><var>34.19</var>to advocate for persons required to enroll in prepaid health plans under this section. The <br/>
<a id="pl.34.20"></a><var>34.20</var>ombudsperson shall advocate for recipients enrolled in prepaid health plans through <br/>
<a id="pl.34.21"></a><var>34.21</var>complaint and appeal procedures and ensure that necessary medical services are provided <br/>
<a id="pl.34.22"></a><var>34.22</var>either by the prepaid health plan directly or by referral to appropriate social services. At <br/>
<a id="pl.34.23"></a><var>34.23</var>the time of enrollment in a prepaid health plan, the local agency shall inform recipients <br/>
<a id="pl.34.24"></a><var>34.24</var>about the ombudsperson program and their right to a resolution of a complaint by the <br/>
<a id="pl.34.25"></a><var>34.25</var>prepaid health plan if they experience a problem with the plan or its providers.<br/>
<a id="pl.34.26"></a><var>34.26</var>    (b) The commissioner shall designate an ombudsperson to advocate for persons <br/>
<a id="pl.34.27"></a><var>34.27</var>enrolled in a care coordination delivery system under section 
<statute_ref>256D.031</statute_ref>. The <br/>
<a id="pl.34.28"></a><var>34.28</var>ombudsperson shall advocate for recipients enrolled in a care coordination delivery <br/>
<a id="pl.34.29"></a><var>34.29</var>system through the state appeal process and assist enrollees in accessing necessary <br/>
<a id="pl.34.30"></a><var>34.30</var>medical services through the care coordination delivery systems directly or by referral to <br/>
<a id="pl.34.31"></a><var>34.31</var>appropriate services. At the time of enrollment in a care coordination delivery system, the <br/>
<a id="pl.34.32"></a><var>34.32</var>local agency shall inform recipients about the ombudsperson program.<br/>
<a id="pl.35.1"></a><var>35.1</var><b>EFFECTIVE DATE.</b>This section is effective 30 days after federal approval of the <br/>
<a id="pl.35.2"></a><var>35.2</var>amendments in this article to Minnesota Statutes, sections 256B.055, subdivision 15, and <br/>
<a id="pl.35.3"></a><var>35.3</var>256B.056, subdivision 4, or January 1, 2011, whichever is later.<br/>
<br/>
<a id="bill.2.27.0"></a><a id="pl.35.4"></a><var>35.4</var>    Sec. 27. Minnesota Statutes 2008, section 256B.69, subdivision 27, is amended to read:<br/>
<a id="pl.35.5"></a><var>35.5</var>    Subd. 27.  <b>Information for persons with limited English-language proficiency.</b><br/>
<a id="pl.35.6"></a><var>35.6</var>    Managed care contracts entered into under this section and sections 
<statute_ref>256D.03, subdivision <br/>
<a id="pl.35.7"></a><var>35.7</var>4
</statute_ref>, paragraph (c), and section 
<statute_ref>256L.12</statute_ref> must require demonstration providers to provide <br/>
<a id="pl.35.8"></a><var>35.8</var>language assistance to enrollees that ensures meaningful access to its programs and <br/>
<a id="pl.35.9"></a><var>35.9</var>services according to Title VI of the Civil Rights Act and federal regulations adopted <br/>
<a id="pl.35.10"></a><var>35.10</var>under that law or any guidance from the United States Department of Health and Human <br/>
<a id="pl.35.11"></a><var>35.11</var>Services. <br/>
<a id="pl.35.12"></a><var>35.12</var><b>EFFECTIVE DATE.</b>This section is effective retroactively from April 1, 2010.<br/>
<br/>
<a id="bill.2.28.0"></a><a id="pl.35.13"></a><var>35.13</var>    Sec. 28. Minnesota Statutes 2008, section 256B.692, subdivision 1, is amended to read:<br/>
<a id="pl.35.14"></a><var>35.14</var>    Subdivision 1. <b>In general.</b> County boards or groups of county boards may elect <br/>
<a id="pl.35.15"></a><var>35.15</var>to purchase or provide health care services on behalf of persons eligible for medical <br/>
<a id="pl.35.16"></a><var>35.16</var>assistance and general assistance medical care who would otherwise be required to or may <br/>
<a id="pl.35.17"></a><var>35.17</var>elect to participate in the prepaid medical assistance or prepaid general assistance medical <br/>
<a id="pl.35.18"></a><var>35.18</var>care programs according to sections section 
<statute_ref>256B.69</statute_ref> and 
<statute_ref>256D.03</statute_ref>. Counties that elect to <br/>
<a id="pl.35.19"></a><var>35.19</var>purchase or provide health care under this section must provide all services included in <br/>
<a id="pl.35.20"></a><var>35.20</var>prepaid managed care programs according to sections section 
<statute_ref>256B.69, subdivisions 1 <br/>
<a id="pl.35.21"></a><var>35.21</var>to 22
         </statute_ref>, and 
<statute_ref>256D.03</statute_ref>. County-based purchasing under this section is governed by section <br/>
<statute_ref><a id="pl.35.22"></a><var>35.22</var>256B.69
         </statute_ref>, unless otherwise provided for under this section.  <br/>
<a id="pl.35.23"></a><var>35.23</var><b>EFFECTIVE DATE.</b>This section is effective retroactively from April 1, 2010.<br/>
<br/>
<a id="bill.2.29.0"></a><a id="pl.35.24"></a><var>35.24</var>    Sec. 29. Minnesota Statutes 2008, section 256B.75, is amended to read:<br/>
<a id="pl.35.25"></a><var>35.25</var><b>256B.75 HOSPITAL OUTPATIENT REIMBURSEMENT.</b><br/>
<a id="pl.35.26"></a><var>35.26</var>    (a) For outpatient hospital facility fee payments for services rendered on or after <br/>
<a id="pl.35.27"></a><var>35.27</var>October 1, 1992, the commissioner of human services shall pay the lower of (1) submitted <br/>
<a id="pl.35.28"></a><var>35.28</var>charge, or (2) 32 percent above the rate in effect on June 30, 1992, except for those <br/>
<a id="pl.35.29"></a><var>35.29</var>services for which there is a federal maximum allowable payment. Effective for services <br/>
<a id="pl.35.30"></a><var>35.30</var>rendered on or after January 1, 2000, payment rates for nonsurgical outpatient hospital <br/>
<a id="pl.35.31"></a><var>35.31</var>facility fees and emergency room facility fees shall be increased by eight percent over the <br/>
<a id="pl.35.32"></a><var>35.32</var>rates in effect on December 31, 1999, except for those services for which there is a federal <br/>
<a id="pl.36.1"></a><var>36.1</var>maximum allowable payment. Services for which there is a federal maximum allowable <br/>
<a id="pl.36.2"></a><var>36.2</var>payment shall be paid at the lower of (1) submitted charge, or (2) the federal maximum <br/>
<a id="pl.36.3"></a><var>36.3</var>allowable payment. Total aggregate payment for outpatient hospital facility fee services <br/>
<a id="pl.36.4"></a><var>36.4</var>shall not exceed the Medicare upper limit. If it is determined that a provision of this <br/>
<a id="pl.36.5"></a><var>36.5</var>section conflicts with existing or future requirements of the United States government with <br/>
<a id="pl.36.6"></a><var>36.6</var>respect to federal financial participation in medical assistance, the federal requirements <br/>
<a id="pl.36.7"></a><var>36.7</var>prevail. The commissioner may, in the aggregate, prospectively reduce payment rates to <br/>
<a id="pl.36.8"></a><var>36.8</var>avoid reduced federal financial participation resulting from rates that are in excess of <br/>
<a id="pl.36.9"></a><var>36.9</var>the Medicare upper limitations.<br/>
<a id="pl.36.10"></a><var>36.10</var>    (b) Notwithstanding paragraph (a), payment for outpatient, emergency, and <br/>
<a id="pl.36.11"></a><var>36.11</var>ambulatory surgery hospital facility fee services for critical access hospitals designated <br/>
<a id="pl.36.12"></a><var>36.12</var>under section 
         <statute_ref>144.1483</statute_ref>, clause (10), shall be paid on a cost-based payment system that is <br/>
<a id="pl.36.13"></a><var>36.13</var>based on the cost-finding methods and allowable costs of the Medicare program.<br/>
<a id="pl.36.14"></a><var>36.14</var>    (c) Effective for services provided on or after July 1, 2003, rates that are based <br/>
<a id="pl.36.15"></a><var>36.15</var>on the Medicare outpatient prospective payment system shall be replaced by a budget <br/>
<a id="pl.36.16"></a><var>36.16</var>neutral prospective payment system that is derived using medical assistance data. The <br/>
<a id="pl.36.17"></a><var>36.17</var>commissioner shall provide a proposal to the 2003 legislature to define and implement <br/>
<a id="pl.36.18"></a><var>36.18</var>this provision.<br/>
<a id="pl.36.19"></a><var>36.19</var>    (d) For fee-for-service services provided on or after July 1, 2002, the total payment, <br/>
<a id="pl.36.20"></a><var>36.20</var>before third-party liability and spenddown, made to hospitals for outpatient hospital <br/>
<a id="pl.36.21"></a><var>36.21</var>facility services is reduced by .5 percent from the current statutory rate.<br/>
<a id="pl.36.22"></a><var>36.22</var>    (e) In addition to the reduction in paragraph (d), the total payment for fee-for-service <br/>
<a id="pl.36.23"></a><var>36.23</var>services provided on or after July 1, 2003, made to hospitals for outpatient hospital <br/>
<a id="pl.36.24"></a><var>36.24</var>facility services before third-party liability and spenddown, is reduced five percent from <br/>
<a id="pl.36.25"></a><var>36.25</var>the current statutory rates. Facilities defined under section 
         <statute_ref>256.969, subdivision 16</statute_ref>, are <br/>
<a id="pl.36.26"></a><var>36.26</var>excluded from this paragraph.<br/>
<a id="pl.36.27"></a><var>36.27</var>    (f) In addition to the reductions in paragraphs (d) and (e), the total payment for <br/>
<a id="pl.36.28"></a><var>36.28</var>fee-for-service services provided on or after July 1, 2008, made to hospitals for outpatient <br/>
<a id="pl.36.29"></a><var>36.29</var>hospital facility services before third-party liability and spenddown, is reduced three <br/>
<a id="pl.36.30"></a><var>36.30</var>percent from the current statutory rates. Mental health services and facilities defined under <br/>
<a id="pl.36.31"></a><var>36.31</var>section 
         <statute_ref>256.969, subdivision 16</statute_ref>, are excluded from this paragraph.<br/>
<a id="pl.36.32"></a><var>36.32</var>    (g) Notwithstanding any contrary provision in this section, payment for all outpatient <br/>
<a id="pl.36.33"></a><var>36.33</var>and emergency services provided by any hospital that, prior to December 31, 2007, has <br/>
<a id="pl.36.34"></a><var>36.34</var>received payment to support the training of residents from an approved graduate medical <br/>
<a id="pl.36.35"></a><var>36.35</var>residency training program under United States Code, title 42, section 256e, must be paid <br/>
<a id="pl.37.1"></a><var>37.1</var>for fiscal years 2012 and 2013 an additional $7,000,000. Payment rates for subsequent <br/>
<a id="pl.37.2"></a><var>37.2</var>fiscal years are as follows:<br/>
<a id="pl.37.3"></a><var>37.3</var>    (1) 2014: 50 percent of costs;<br/>
<a id="pl.37.4"></a><var>37.4</var>    (2) 2015: 60 percent of costs;<br/>
<a id="pl.37.5"></a><var>37.5</var>    (3) 2016: 70 percent of costs;<br/>
<a id="pl.37.6"></a><var>37.6</var>    (4) 2017: 80 percent of costs;<br/>
<a id="pl.37.7"></a><var>37.7</var>    (5) 2018: 90 percent of costs; and<br/>
<a id="pl.37.8"></a><var>37.8</var>    (6) 2019 and thereafter: 100 percent of costs.<br/>
<br/>
<a id="bill.2.30.0"></a><a id="pl.37.9"></a><var>37.9</var>    Sec. 30. Minnesota Statutes 2009 Supplement, section 256B.76, subdivision 1, is <br/>
<a id="pl.37.10"></a><var>37.10</var>amended to read:<br/>
<a id="pl.37.11"></a><var>37.11</var>    Subdivision 1. <b>Physician reimbursement. </b> (a) Effective for services rendered on <br/>
<a id="pl.37.12"></a><var>37.12</var>or after October 1, 1992, the commissioner shall make payments for physician services <br/>
<a id="pl.37.13"></a><var>37.13</var>as follows:<br/>
<a id="pl.37.14"></a><var>37.14</var>    (1) payment for level one Centers for Medicare and Medicaid Services' common <br/>
<a id="pl.37.15"></a><var>37.15</var>procedural coding system codes titled "office and other outpatient services," "preventive <br/>
<a id="pl.37.16"></a><var>37.16</var>medicine new and established patient," "delivery, antepartum, and postpartum care," <br/>
<a id="pl.37.17"></a><var>37.17</var>"critical care," cesarean delivery and pharmacologic management provided to psychiatric <br/>
<a id="pl.37.18"></a><var>37.18</var>patients, and level three codes for enhanced services for prenatal high risk, shall be paid <br/>
<a id="pl.37.19"></a><var>37.19</var>at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June <br/>
<a id="pl.37.20"></a><var>37.20</var>30, 1992. If the rate on any procedure code within these categories is different than the <br/>
<a id="pl.37.21"></a><var>37.21</var>rate that would have been paid under the methodology in section 
         <statute_ref>256B.74, subdivision 2</statute_ref>, <br/>
<a id="pl.37.22"></a><var>37.22</var>then the larger rate shall be paid;<br/>
<a id="pl.37.23"></a><var>37.23</var>    (2) payments for all other services shall be paid at the lower of (i) submitted charges, <br/>
<a id="pl.37.24"></a><var>37.24</var>or (ii) 15.4 percent above the rate in effect on June 30, 1992; and<br/>
<a id="pl.37.25"></a><var>37.25</var>    (3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th <br/>
<a id="pl.37.26"></a><var>37.26</var>percentile of 1989, less the percent in aggregate necessary to equal the above increases <br/>
<a id="pl.37.27"></a><var>37.27</var>except that payment rates for home health agency services shall be the rates in effect <br/>
<a id="pl.37.28"></a><var>37.28</var>on September 30, 1992.<br/>
<a id="pl.37.29"></a><var>37.29</var>    (b) Effective for services rendered on or after January 1, 2000, payment rates for <br/>
<a id="pl.37.30"></a><var>37.30</var>physician and professional services shall be increased by three percent over the rates <br/>
<a id="pl.37.31"></a><var>37.31</var>in effect on December 31, 1999, except for home health agency and family planning <br/>
<a id="pl.37.32"></a><var>37.32</var>agency services. The increases in this paragraph shall be implemented January 1, 2000, <br/>
<a id="pl.37.33"></a><var>37.33</var>for managed care.<br/>
<a id="pl.37.34"></a><var>37.34</var>(c) Effective for services rendered on or after July 1, 2009, payment rates for <br/>
<a id="pl.37.35"></a><var>37.35</var>physician and professional services shall be reduced by five percent over the rates in <br/>
<a id="pl.38.1"></a><var>38.1</var>effect on June 30, 2009. This reduction does not apply to office or other outpatient visits, <br/>
<a id="pl.38.2"></a><var>38.2</var>preventive medicine visits and family planning visits billed by physicians, advanced <br/>
<a id="pl.38.3"></a><var>38.3</var>practice nurses, or physician assistants in a family planning agency or in one of the <br/>
<a id="pl.38.4"></a><var>38.4</var>following primary care practices: general practice, general internal medicine, general <br/>
<a id="pl.38.5"></a><var>38.5</var>pediatrics, general geriatrics, and family medicine. This reduction does not apply to <br/>
<a id="pl.38.6"></a><var>38.6</var>federally qualified health centers, rural health centers, and Indian health services. This <br/>
<a id="pl.38.7"></a><var>38.7</var>reduction does not apply to physical therapy services, occupational therapy services, <br/>
<a id="pl.38.8"></a><var>38.8</var>and speech pathology and related services provided on or after July 1, 2010. Effective <br/>
<a id="pl.38.9"></a><var>38.9</var>October 1, 2009, payments made to managed care plans and county-based purchasing <br/>
<a id="pl.38.10"></a><var>38.10</var>plans under sections 
         <statute_ref>256B.69</statute_ref>, 
         <statute_ref>256B.692</statute_ref>, and 
         <statute_ref>256L.12</statute_ref> shall reflect the payment reduction <br/>
<a id="pl.38.11"></a><var>38.11</var>described in this paragraph.<br/>
<a id="pl.38.12"></a><var>38.12</var>(d) Effective for services rendered on or after July 1, 2010, payment rates for <br/>
<a id="pl.38.13"></a><var>38.13</var>physician and professional services shall be reduced by three percent over the rates in <br/>
<a id="pl.38.14"></a><var>38.14</var>effect on June 30, 2010. This reduction does not apply to those providers and entities <br/>
<a id="pl.38.15"></a><var>38.15</var>exempt from the reduction in paragraph (c). Effective October 1, 2010, payments made <br/>
<a id="pl.38.16"></a><var>38.16</var>to managed care plans and county-based purchasing plans under sections 256B.69, <br/>
<a id="pl.38.17"></a><var>38.17</var>256B.692, and 256L.12 shall reflect the payment reductions in this paragraph.<br/>
<a id="pl.38.18"></a><var>38.18</var>(e) Effective for services rendered on or after June 1, 2010, payment rates for <br/>
<a id="pl.38.19"></a><var>38.19</var>physician and professional services billed by physicians employed by and clinics that are <br/>
<a id="pl.38.20"></a><var>38.20</var>owned by a nonprofit health maintenance organization shall be increased by 15 percent. <br/>
<a id="pl.38.21"></a><var>38.21</var>Effective October 1, 2010, payments to managed care and county-based purchasing <br/>
<a id="pl.38.22"></a><var>38.22</var>plans under sections 256B.69, 256B.692, and 256L.12 shall reflect the payment increase <br/>
<a id="pl.38.23"></a><var>38.23</var>described in this paragraph.<br/>
<br/>
<a id="bill.2.31.0"></a><a id="pl.38.24"></a><var>38.24</var>    Sec. 31. Minnesota Statutes 2008, section 256B.76, subdivision 2, is amended to read:<br/>
<a id="pl.38.25"></a><var>38.25</var>    Subd. 2. <b>Dental reimbursement. </b> (a) Effective for services rendered on or after <br/>
<a id="pl.38.26"></a><var>38.26</var>October 1, 1992, the commissioner shall make payments for dental services as follows:<br/>
<a id="pl.38.27"></a><var>38.27</var>    (1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25 <br/>
<a id="pl.38.28"></a><var>38.28</var>percent above the rate in effect on June 30, 1992; and<br/>
<a id="pl.38.29"></a><var>38.29</var>    (2) dental rates shall be converted from the 50th percentile of 1982 to the 50th <br/>
<a id="pl.38.30"></a><var>38.30</var>percentile of 1989, less the percent in aggregate necessary to equal the above increases.<br/>
<a id="pl.38.31"></a><var>38.31</var>    (b) Beginning October 1, 1999, the payment for tooth sealants and fluoride treatments <br/>
<a id="pl.38.32"></a><var>38.32</var>shall be the lower of (1) submitted charge, or (2) 80 percent of median 1997 charges.<br/>
<a id="pl.38.33"></a><var>38.33</var>    (c) Effective for services rendered on or after January 1, 2000, payment rates for <br/>
<a id="pl.38.34"></a><var>38.34</var>dental services shall be increased by three percent over the rates in effect on December <br/>
<a id="pl.38.35"></a><var>38.35</var>31, 1999.<br/>
<a id="pl.39.1"></a><var>39.1</var>    (d) Effective for services provided on or after January 1, 2002, payment for <br/>
<a id="pl.39.2"></a><var>39.2</var>diagnostic examinations and dental x-rays provided to children under age 21 shall be the <br/>
<a id="pl.39.3"></a><var>39.3</var>lower of (1) the submitted charge, or (2) 85 percent of median 1999 charges.<br/>
<a id="pl.39.4"></a><var>39.4</var>    (e) The increases listed in paragraphs (b) and (c) shall be implemented January 1, <br/>
<a id="pl.39.5"></a><var>39.5</var>2000, for managed care.<br/>
<a id="pl.39.6"></a><var>39.6</var>(f) Effective for dental services rendered on or after October 1, 2010, by a <br/>
<a id="pl.39.7"></a><var>39.7</var>state-operated dental clinic, payment shall be paid on a cost-based payment system that <br/>
<a id="pl.39.8"></a><var>39.8</var>is based on the cost-finding methods and allowable costs of the Medicare program. For <br/>
<a id="pl.39.9"></a><var>39.9</var>services performed by a state-operated dental clinic pursuant to a contract between the <br/>
<a id="pl.39.10"></a><var>39.10</var>clinic and a managed care plan or a county-based purchasing plan, a supplemental payment <br/>
<a id="pl.39.11"></a><var>39.11</var>shall be made to the clinic by the commissioner that is equal to the amount by which the <br/>
<a id="pl.39.12"></a><var>39.12</var>amount determined under this paragraph exceeds the amount of the payments provided <br/>
<a id="pl.39.13"></a><var>39.13</var>under the contract. Managed care plans and county-based purchasing plans participating <br/>
<a id="pl.39.14"></a><var>39.14</var>in medical assistance must provide to the commissioner any expenditure, cost, and <br/>
<a id="pl.39.15"></a><var>39.15</var>revenue information deemed necessary by the commissioner for purposes of obtaining <br/>
<a id="pl.39.16"></a><var>39.16</var>federal Medicaid matching funds for cost-based reimbursement for state-operated dental <br/>
<a id="pl.39.17"></a><var>39.17</var>clinics. Cost-based reimbursement shall be implemented in managed care contracts <br/>
<a id="pl.39.18"></a><var>39.18</var>beginning January 1, 2011.<br/>
<a id="pl.39.19"></a><var>39.19</var>(g) Beginning in fiscal year 2011, if the payments to state-operated dental clinics <br/>
<a id="pl.39.20"></a><var>39.20</var>in paragraph (f), including state and federal shares, are less than $1,850,000 per fiscal <br/>
<a id="pl.39.21"></a><var>39.21</var>year, a supplemental state payment equal to the difference between the total payments <br/>
<a id="pl.39.22"></a><var>39.22</var>in paragraph (f) and $1,850,000 shall be paid from the general fund to state-operated <br/>
<a id="pl.39.23"></a><var>39.23</var>services for the operation of the dental clinics.<br/>
<br/>
<a id="bill.2.32.0"></a><a id="pl.39.24"></a><var>39.24</var>    Sec. 32. Minnesota Statutes 2008, section 256B.76, subdivision 4, is amended to read:<br/>
<a id="pl.39.25"></a><var>39.25</var>    Subd. 4. <b>Critical access dental providers. </b>  Effective for dental services rendered <br/>
<a id="pl.39.26"></a><var>39.26</var>on or after January 1, 2002, the commissioner shall increase reimbursements to dentists <br/>
<a id="pl.39.27"></a><var>39.27</var>and dental clinics deemed by the commissioner to be critical access dental providers. <br/>
<a id="pl.39.28"></a><var>39.28</var>For dental services rendered on or after July 1, 2007, the commissioner shall increase <br/>
<a id="pl.39.29"></a><var>39.29</var>reimbursement by 30 percent above the reimbursement rate that would otherwise be paid to <br/>
<a id="pl.39.30"></a><var>39.30</var>the critical access dental provider. The commissioner shall pay the health plan companies <br/>
<a id="pl.39.31"></a><var>39.31</var>in amounts sufficient to reflect increased reimbursements to critical access dental providers <br/>
<a id="pl.39.32"></a><var>39.32</var>as approved by the commissioner. In determining which dentists and dental clinics shall <br/>
<a id="pl.39.33"></a><var>39.33</var>be deemed critical access dental providers, the commissioner shall review:<br/>
<a id="pl.40.1"></a><var>40.1</var>    (1) the utilization rate in the service area in which the dentist or dental clinic operates <br/>
<a id="pl.40.2"></a><var>40.2</var>for dental services to patients covered by medical assistance, general assistance medical <br/>
<a id="pl.40.3"></a><var>40.3</var>care, or MinnesotaCare as their primary source of coverage;<br/>
<a id="pl.40.4"></a><var>40.4</var>    (2) the level of services provided by the dentist or dental clinic to patients covered <br/>
<a id="pl.40.5"></a><var>40.5</var>by medical assistance, general assistance medical care, or MinnesotaCare as their primary <br/>
<a id="pl.40.6"></a><var>40.6</var>source of coverage; and. The commissioner shall pay critical access dental provider <br/>
<a id="pl.40.7"></a><var>40.7</var>payments to a dentist or dental clinic that meets any one of the following criteria: <br/>
<a id="pl.40.8"></a><var>40.8</var>    (i) at least 40 percent of patient encounters are with patients who are uninsured or <br/>
<a id="pl.40.9"></a><var>40.9</var>covered by medical assistance, general assistance medical care, or MinnesotaCare;<br/>
<a id="pl.40.10"></a><var>40.10</var>    (ii) the dental clinic or dental group is owned and operated by a nonprofit operation <br/>
<a id="pl.40.11"></a><var>40.11</var>under chapter 317A with more than 10,000 patient encounters per year with patients <br/>
<a id="pl.40.12"></a><var>40.12</var>who are uninsured or covered by medical assistance, general assistance medical care, <br/>
<a id="pl.40.13"></a><var>40.13</var>or MinnesotaCare; <br/>
<a id="pl.40.14"></a><var>40.14</var>    (iii) the dental clinic is associated with an oral health or dental education program <br/>
<a id="pl.40.15"></a><var>40.15</var>operated by the University of Minnesota or an institution within the Minnesota State <br/>
<a id="pl.40.16"></a><var>40.16</var>Colleges and Universities system; or<br/>
<a id="pl.40.17"></a><var>40.17</var>(iv) the dental clinic is a state-operated dental clinic;<br/>
<a id="pl.40.18"></a><var>40.18</var>    (3) whether the level of services provided by the dentist or dental clinic is critical to <br/>
<a id="pl.40.19"></a><var>40.19</var>maintaining adequate levels of patient access within the a geographic service area, and <br/>
<a id="pl.40.20"></a><var>40.20</var>to ensure that the maximum travel distance or travel time is the lesser of 60 miles or 60 <br/>
<a id="pl.40.21"></a><var>40.21</var>minutes;<br/>
<a id="pl.40.22"></a><var>40.22</var>    (4) whether the provider has completed the application for critical access dental <br/>
<a id="pl.40.23"></a><var>40.23</var>provider designation by the due date, and has provided correct information;<br/>
<a id="pl.40.24"></a><var>40.24</var>    (5) whether the dentist or dental clinic meets the quality and continuity of care <br/>
<a id="pl.40.25"></a><var>40.25</var>criteria recommended by the dental services advisory committee and adopted by the <br/>
<a id="pl.40.26"></a><var>40.26</var>department; and<br/>
<a id="pl.40.27"></a><var>40.27</var>(6) whether the dentist or dental clinic serves people in all Minnesota health care <br/>
<a id="pl.40.28"></a><var>40.28</var>programs. <br/>
<a id="pl.40.29"></a><var>40.29</var>In the absence of a critical access dental provider in a service area, the commissioner may <br/>
<a id="pl.40.30"></a><var>40.30</var>designate a dentist or dental clinic as a critical access dental provider if the dentist or <br/>
<a id="pl.40.31"></a><var>40.31</var>dental clinic is willing to provide care to patients covered by medical assistance, general <br/>
<a id="pl.40.32"></a><var>40.32</var>assistance medical care, or MinnesotaCare at a level which significantly increases access <br/>
<a id="pl.40.33"></a><var>40.33</var>to dental care in the service area.<br/>
<a id="pl.40.34"></a><var>40.34</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2011.<br/>
<br/>
<a id="bill.2.33.0"></a><a id="pl.41.1"></a><var>41.1</var>    Sec. 33. Minnesota Statutes 2008, section 256B.76, is amended by adding a <br/>
<a id="pl.41.2"></a><var>41.2</var>subdivision to read:<br/>
<a id="pl.41.3"></a><var>41.3</var>    Subd. 4a. <b>Designation and termination of critical access dental providers.</b> (a) <br/>
<a id="pl.41.4"></a><var>41.4</var>Notwithstanding the provisions in subdivision 4, the commissioner may review and not <br/>
<a id="pl.41.5"></a><var>41.5</var>designate an individual dentist or dental clinic as a critical access dental provider under <br/>
<a id="pl.41.6"></a><var>41.6</var>subdivision 4 or section 256L.11, subdivision 7, when the dentist or clinic:<br/>
<a id="pl.41.7"></a><var>41.7</var>(1) has been subject to a corrective or disciplinary action by the Board of Dentistry <br/>
<a id="pl.41.8"></a><var>41.8</var>related to fraud or direct patient care. Designation shall not be made until the provider is no <br/>
<a id="pl.41.9"></a><var>41.9</var>longer subject to a corrective or disciplinary action related to fraud or direct patient care; or<br/>
<a id="pl.41.10"></a><var>41.10</var>(2) has been subject, within the past three years, to a postinvestigation action by the <br/>
<a id="pl.41.11"></a><var>41.11</var>commissioner of human services or issuance of a warning as specified in Minnesota Rules, <br/>
<a id="pl.41.12"></a><var>41.12</var>parts 9505.2160 to 9505.2245. The provider shall not be considered for critical access <br/>
<a id="pl.41.13"></a><var>41.13</var>dental designation until the January following the year in which the action has ended.<br/>
<a id="pl.41.14"></a><var>41.14</var>(b) The commissioner may terminate a critical access designation of an individual <br/>
<a id="pl.41.15"></a><var>41.15</var>dentist or clinic if the dentist or clinic:<br/>
<a id="pl.41.16"></a><var>41.16</var>(1) becomes subject to a disciplinary or corrective action by the Board of Dentistry <br/>
<a id="pl.41.17"></a><var>41.17</var>related to fraud or direct patient care. The provider shall not be considered for critical <br/>
<a id="pl.41.18"></a><var>41.18</var>access designation until the January following the year in which the action has ended;<br/>
<a id="pl.41.19"></a><var>41.19</var>(2) becomes subject to a postinvestigation action by the commissioner of human <br/>
<a id="pl.41.20"></a><var>41.20</var>services or issuance of a warning as specified in Minnesota Rules, parts 9505.2160 <br/>
<a id="pl.41.21"></a><var>41.21</var>to 9505.2245;<br/>
<a id="pl.41.22"></a><var>41.22</var>(3) does not meet the quality and continuity of care criteria that have been <br/>
<a id="pl.41.23"></a><var>41.23</var>recommended by the Dental Services Advisory Committee and adopted by the department; <br/>
<a id="pl.41.24"></a><var>41.24</var>or<br/>
<a id="pl.41.25"></a><var>41.25</var>(4) does not serve people in all Minnesota public health care programs.<br/>
<a id="pl.41.26"></a><var>41.26</var>(c) Any termination is effective on the date of notification of the:<br/>
<a id="pl.41.27"></a><var>41.27</var>(1) postinvestigative action;<br/>
<a id="pl.41.28"></a><var>41.28</var>(2) disciplinary or corrective action by the Minnesota Board of Dentistry; or<br/>
<a id="pl.41.29"></a><var>41.29</var>(3) determination of not meeting quality and continuity of care criteria.<br/>
<a id="pl.41.30"></a><var>41.30</var>The commissioner may review postinvestigative actions taken by a health plan <br/>
<a id="pl.41.31"></a><var>41.31</var>under contract to provide dental services to Minnesota health care program enrollees. <br/>
<a id="pl.41.32"></a><var>41.32</var>After an investigation conducted by the Department of Human Services surveillance unit, <br/>
<a id="pl.41.33"></a><var>41.33</var>the findings of the health plan may be incorporated to determine if a provider will be <br/>
<a id="pl.41.34"></a><var>41.34</var>designated or terminated from the program.<br/>
<a id="pl.41.35"></a><var>41.35</var>(d) A provider who has been terminated or not designated under this section may <br/>
<a id="pl.41.36"></a><var>41.36</var>appeal only through the contested hearing process as defined in section 14.02, subdivision <br/>
<a id="pl.42.1"></a><var>42.1</var>3, by filing with the commissioner a written request of appeal. The appeal request must <br/>
<a id="pl.42.2"></a><var>42.2</var>be received by the commissioner no later than 30 days after notification of termination <br/>
<a id="pl.42.3"></a><var>42.3</var>or nondesignation.<br/>
<a id="pl.42.4"></a><var>42.4</var>(e) The commissioner may make an exception to paragraphs (a) and (b) if an action <br/>
<a id="pl.42.5"></a><var>42.5</var>taken by the Board of Dentistry or the commissioner is the result of events not directly <br/>
<a id="pl.42.6"></a><var>42.6</var>related to patient care or that will not affect direct patient care to Minnesota health care <br/>
<a id="pl.42.7"></a><var>42.7</var>program enrollees.<br/>
<a id="pl.42.8"></a><var>42.8</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br/>
<br/>
<a id="bill.2.34.0"></a><a id="pl.42.9"></a><var>42.9</var>    Sec. 34. Minnesota Statutes 2009 Supplement, section 256B.766, is amended to read: <br/>
<a id="pl.42.10"></a><var>42.10</var><b>256B.766 REIMBURSEMENT FOR BASIC CARE SERVICES.</b><br/>
<a id="pl.42.11"></a><var>42.11</var>(a) Effective for services provided on or after July 1, 2009, total payments for <br/>
<a id="pl.42.12"></a><var>42.12</var>basic care services, shall be reduced by three percent, prior to third-party liability and <br/>
<a id="pl.42.13"></a><var>42.13</var>spenddown calculation. This reduction applies to physical therapy services, occupational <br/>
<a id="pl.42.14"></a><var>42.14</var>therapy services, and speech language pathology and related services provided on or after <br/>
<a id="pl.42.15"></a><var>42.15</var>July 1, 2010. Effective July 1, 2010, the commissioner shall classify physical therapy <br/>
<a id="pl.42.16"></a><var>42.16</var>services, occupational therapy services, and speech language pathology and related <br/>
<a id="pl.42.17"></a><var>42.17</var>services as basic care services. Payments made to managed care plans and county-based <br/>
<a id="pl.42.18"></a><var>42.18</var>purchasing plans shall be reduced for services provided on or after October 1, 2009, <br/>
<a id="pl.42.19"></a><var>42.19</var>to reflect this reduction.<br/>
<a id="pl.42.20"></a><var>42.20</var>(b) This section does not apply to physician and professional services, inpatient <br/>
<a id="pl.42.21"></a><var>42.21</var>hospital services, family planning services, mental health services, dental services, <br/>
<a id="pl.42.22"></a><var>42.22</var>prescription drugs, medical transportation, federally qualified health centers, rural health <br/>
<a id="pl.42.23"></a><var>42.23</var>centers, Indian health services, and Medicare cost-sharing.<br/>
<br/>
<a id="bill.2.35.0"></a><a id="pl.42.24"></a><var>42.24</var>    Sec. 35. <b>[256B.767] MEDICARE PAYMENT LIMIT.</b><br/>
<a id="pl.42.25"></a><var>42.25</var>Effective for services rendered on or after July 1, 2010, fee-for-service payment <br/>
<a id="pl.42.26"></a><var>42.26</var>rates for physician and professional services under section 256B.76, subdivision 1, and <br/>
<a id="pl.42.27"></a><var>42.27</var>basic care services subject to the rate reduction specified in section 256B.766, shall not <br/>
<a id="pl.42.28"></a><var>42.28</var>exceed the Medicare payment rate for the applicable service.<br/>
<br/>
<a id="bill.2.36.0"></a><a id="pl.42.29"></a><var>42.29</var>    Sec. 36. <b>[256B.768] FEE-FOR-SERVICE PAYMENT INCREASE.</b><br/>
<a id="pl.42.30"></a><var>42.30</var>Effective for services rendered on or after January 1, 2011, the commissioner shall <br/>
<a id="pl.42.31"></a><var>42.31</var>increase fee-for-service payment rates by seven percent for physician and professional <br/>
<a id="pl.43.1"></a><var>43.1</var>services under section 256B.76, subdivision 1, and basic care services subject to the rate <br/>
<a id="pl.43.2"></a><var>43.2</var>reduction specified in section 256B.766.<br/>
<br/>
<a id="bill.2.37.0"></a><a id="pl.43.3"></a><var>43.3</var>    Sec. 37. Minnesota Statutes 2009 Supplement, section 256D.03, subdivision 3, as <br/>
<a id="pl.43.4"></a><var>43.4</var>amended by Laws 2010, chapter 200, article 1, section 11, is amended to read:<br/>
<a id="pl.43.5"></a><var>43.5</var>    Subd. 3. <b>General assistance medical care; eligibility.</b> (a) Beginning April 1, 2010, <br/>
<a id="pl.43.6"></a><var>43.6</var>the general assistance medical care program shall be administered according to section <br/>
<statute_ref><a id="pl.43.7"></a><var>43.7</var>256D.031
         </statute_ref>, unless otherwise stated, except for outpatient prescription drug coverage, <br/>
<a id="pl.43.8"></a><var>43.8</var>which shall continue to be administered under this section and funded under section <br/>
<statute_ref><a id="pl.43.9"></a><var>43.9</var>256D.031, subdivision 9
         </statute_ref>, beginning June 1, 2010.<br/>
<a id="pl.43.10"></a><var>43.10</var>(b) Outpatient prescription drug coverage under general assistance medical care is <br/>
<a id="pl.43.11"></a><var>43.11</var>limited to prescription drugs that:<br/>
<a id="pl.43.12"></a><var>43.12</var>(1) are covered under the medical assistance program as described in section <br/>
<statute_ref><a id="pl.43.13"></a><var>43.13</var>256B.0625, subdivisions 13
         </statute_ref> and 13d; and<br/>
<a id="pl.43.14"></a><var>43.14</var>(2) are provided by manufacturers that have fully executed general assistance <br/>
<a id="pl.43.15"></a><var>43.15</var>medical care rebate agreements with the commissioner and comply with the agreements. <br/>
<a id="pl.43.16"></a><var>43.16</var>Outpatient prescription drug coverage under general assistance medical care must conform <br/>
<a id="pl.43.17"></a><var>43.17</var>to coverage under the medical assistance program according to section 
         <statute_ref>256B.0625, <br/>
<a id="pl.43.18"></a><var>43.18</var>subdivisions 13
         </statute_ref> to 13g 13h.<br/>
<a id="pl.43.19"></a><var>43.19</var>    (c) Outpatient prescription drug coverage does not include drugs administered in a <br/>
<a id="pl.43.20"></a><var>43.20</var>clinic or other outpatient setting.<br/>
<a id="pl.43.21"></a><var>43.21</var>(d) For the period beginning April 1, 2010, to May 31, 2010, general assistance <br/>
<a id="pl.43.22"></a><var>43.22</var>medical care covers the services listed in subdivision 4.<br/>
<a id="pl.43.23"></a><var>43.23</var><b>EFFECTIVE DATE.</b>This section is effective retroactively from April 1, 2010.<br/>
<br/>
<a id="bill.2.38.0"></a><a id="pl.43.24"></a><var>43.24</var>    Sec. 38. Minnesota Statutes 2008, section 256L.02, subdivision 3, is amended to read:<br/>
<a id="pl.43.25"></a><var>43.25</var>    Subd. 3. <b>Financial management.</b> (a) The commissioner shall manage spending for <br/>
<a id="pl.43.26"></a><var>43.26</var>the MinnesotaCare program in a manner that maintains a minimum reserve. As part of <br/>
<a id="pl.43.27"></a><var>43.27</var>each state revenue and expenditure forecast, the commissioner must make an assessment <br/>
<a id="pl.43.28"></a><var>43.28</var>of the expected expenditures for the covered services for the remainder of the current <br/>
<a id="pl.43.29"></a><var>43.29</var>biennium and for the following biennium. The estimated expenditure, including the <br/>
<a id="pl.43.30"></a><var>43.30</var>reserve, shall be compared to an estimate of the revenues that will be available in the health <br/>
<a id="pl.43.31"></a><var>43.31</var>care access fund. Based on this comparison, and after consulting with the chairs of the <br/>
<a id="pl.43.32"></a><var>43.32</var>house of representatives Ways and Means Committee and the senate Finance Committee, <br/>
<a id="pl.43.33"></a><var>43.33</var>and the Legislative Commission on Health Care Access, the commissioner shall, as <br/>
<a id="pl.43.34"></a><var>43.34</var>necessary, make the adjustments specified in paragraph (b) to ensure that expenditures <br/>
<a id="pl.44.1"></a><var>44.1</var>remain within the limits of available revenues for the remainder of the current biennium <br/>
<a id="pl.44.2"></a><var>44.2</var>and for the following biennium. The commissioner shall not hire additional staff using <br/>
<a id="pl.44.3"></a><var>44.3</var>appropriations from the health care access fund until the commissioner of management <br/>
<a id="pl.44.4"></a><var>44.4</var>and budget makes a determination that the adjustments implemented under paragraph (b) <br/>
<a id="pl.44.5"></a><var>44.5</var>are sufficient to allow MinnesotaCare expenditures to remain within the limits of available <br/>
<a id="pl.44.6"></a><var>44.6</var>revenues for the remainder of the current biennium and for the following biennium.<br/>
<a id="pl.44.7"></a><var>44.7</var>(b) The adjustments the commissioner shall use must be implemented in this order, <br/>
<a id="pl.44.8"></a><var>44.8</var>but shall not be implemented before July 1, 2014: first, stop enrollment of single adults <br/>
<a id="pl.44.9"></a><var>44.9</var>and households without children; and second, upon 45 days' notice, stop coverage of <br/>
<a id="pl.44.10"></a><var>44.10</var>single adults and households without children already enrolled in the MinnesotaCare <br/>
<a id="pl.44.11"></a><var>44.11</var>program; third, upon 90 days' notice, decrease the premium subsidy amounts by ten <br/>
<a id="pl.44.12"></a><var>44.12</var>percent for families with gross annual income above 200 percent of the federal poverty <br/>
<a id="pl.44.13"></a><var>44.13</var>guidelines; fourth, upon 90 days' notice, decrease the premium subsidy amounts by ten <br/>
<a id="pl.44.14"></a><var>44.14</var>percent for families with gross annual income at or below 200 percent; and fifth, require <br/>
<a id="pl.44.15"></a><var>44.15</var>applicants to be uninsured for at least six months prior to eligibility in the MinnesotaCare <br/>
<a id="pl.44.16"></a><var>44.16</var>program. If these measures are insufficient to limit the expenditures to the estimated <br/>
<a id="pl.44.17"></a><var>44.17</var>amount of revenue, the commissioner shall further limit enrollment or decrease premium <br/>
<a id="pl.44.18"></a><var>44.18</var>subsidies notify the chairs of the house of representatives Ways and Means Committee and <br/>
<a id="pl.44.19"></a><var>44.19</var>the senate Finance Committee, and the Legislative Commission on Health Care Access, <br/>
<a id="pl.44.20"></a><var>44.20</var>and present recommendations to the chairs and commission for limiting expenditures to <br/>
<a id="pl.44.21"></a><var>44.21</var>the estimated amount of revenue.<br/>
<a id="pl.44.22"></a><var>44.22</var><b>EFFECTIVE DATE.</b>This section is effective upon federal approval of the <br/>
<a id="pl.44.23"></a><var>44.23</var>amendments in this article to Minnesota Statutes, sections 256B.055, subdivision 15, and <br/>
<a id="pl.44.24"></a><var>44.24</var>256B.056, subdivision 4.<br/>
<br/>
<a id="bill.2.39.0"></a><a id="pl.44.25"></a><var>44.25</var>    Sec. 39. Minnesota Statutes 2008, section 256L.03, subdivision 3, is amended to read:<br/>
<a id="pl.44.26"></a><var>44.26</var>    Subd. 3. <b>Inpatient hospital services.</b> (a) Covered health services shall include <br/>
<a id="pl.44.27"></a><var>44.27</var>inpatient hospital services, including inpatient hospital mental health services and inpatient <br/>
<a id="pl.44.28"></a><var>44.28</var>hospital and residential chemical dependency treatment, subject to those limitations <br/>
<a id="pl.44.29"></a><var>44.29</var>necessary to coordinate the provision of these services with eligibility under the medical <br/>
<a id="pl.44.30"></a><var>44.30</var>assistance spenddown. The inpatient hospital benefit for adult enrollees who qualify under <br/>
<a id="pl.44.31"></a><var>44.31</var>section 
         <statute_ref>256L.04, subdivision 7</statute_ref>, or who qualify under section 
         <statute_ref>256L.04, subdivisions 1 and <br/>
<a id="pl.44.32"></a><var>44.32</var>2
         </statute_ref>, with family gross income that exceeds 200 percent of the federal poverty guidelines or <br/>
<a id="pl.44.33"></a><var>44.33</var>215 percent of the federal poverty guidelines on or after July 1, 2009, and who are not <br/>
<a id="pl.44.34"></a><var>44.34</var>pregnant, is subject to an annual limit of $10,000, unless supplemental hospital coverage <br/>
<a id="pl.44.35"></a><var>44.35</var>has been purchased under subdivision 3c. <br/>
<a id="pl.45.1"></a><var>45.1</var>    (b) Admissions for inpatient hospital services paid for under section 
         <statute_ref>256L.11, <br/>
<a id="pl.45.2"></a><var>45.2</var>subdivision 3
         </statute_ref>, must be certified as medically necessary in accordance with Minnesota <br/>
<a id="pl.45.3"></a><var>45.3</var>Rules, parts 9505.0500 to 9505.0540, except as provided in clauses (1) and (2): <br/>
<a id="pl.45.4"></a><var>45.4</var>    (1) all admissions must be certified, except those authorized under rules established <br/>
<a id="pl.45.5"></a><var>45.5</var>under section 
         <statute_ref>254A.03, subdivision 3</statute_ref>, or approved under Medicare; and <br/>
<a id="pl.45.6"></a><var>45.6</var>    (2) payment under section 
         <statute_ref>256L.11, subdivision 3</statute_ref>, shall be reduced by five percent <br/>
<a id="pl.45.7"></a><var>45.7</var>for admissions for which certification is requested more than 30 days after the day of <br/>
<a id="pl.45.8"></a><var>45.8</var>admission. The hospital may not seek payment from the enrollee for the amount of the <br/>
<a id="pl.45.9"></a><var>45.9</var>payment reduction under this clause. <br/>
<a id="pl.45.10"></a><var>45.10</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2011, or upon federal <br/>
<a id="pl.45.11"></a><var>45.11</var>approval, whichever is later.<br/>
<br/>
<a id="bill.2.40.0"></a><a id="pl.45.12"></a><var>45.12</var>    Sec. 40. Minnesota Statutes 2008, section 256L.03, is amended by adding a subdivision <br/>
<a id="pl.45.13"></a><var>45.13</var>to read:<br/>
<a id="pl.45.14"></a><var>45.14</var>    Subd. 3c. <b>Supplemental hospital coverage.</b> (a) Effective January 1, 2011, or upon <br/>
<a id="pl.45.15"></a><var>45.15</var>federal approval, whichever is later, the commissioner shall offer all MinnesotaCare <br/>
<a id="pl.45.16"></a><var>45.16</var>applicants, and all enrollees during the open enrollment periods specified in paragraph <br/>
<a id="pl.45.17"></a><var>45.17</var>(b), the opportunity to purchase at full cost, supplemental hospital coverage to cover <br/>
<a id="pl.45.18"></a><var>45.18</var>inpatient hospital expenses in excess of the inpatient hospital annual limit established <br/>
<a id="pl.45.19"></a><var>45.19</var>under subdivision 3. Premiums for this coverage may vary only for age and shall be <br/>
<a id="pl.45.20"></a><var>45.20</var>collected by the commissioner using the procedures established for the sliding scale <br/>
<a id="pl.45.21"></a><var>45.21</var>premium determined under section 256L.15.<br/>
<a id="pl.45.22"></a><var>45.22</var>(b) The commissioner shall notify all persons submitting applications of the option to <br/>
<a id="pl.45.23"></a><var>45.23</var>purchase this coverage at the time of application. The commissioner shall provide persons <br/>
<a id="pl.45.24"></a><var>45.24</var>enrolled in MinnesotaCare on the effective date of this subdivision with the opportunity to <br/>
<a id="pl.45.25"></a><var>45.25</var>purchase this supplemental coverage during an initial open enrollment period. Following <br/>
<a id="pl.45.26"></a><var>45.26</var>this initial open enrollment period, the commissioner shall provide all enrollees with the <br/>
<a id="pl.45.27"></a><var>45.27</var>opportunity to purchase this supplemental coverage during an annual open enrollment <br/>
<a id="pl.45.28"></a><var>45.28</var>period during the month of November with coverage to take effect the following January 1.<br/>
<br/>
<a id="bill.2.41.0"></a><a id="pl.45.29"></a><var>45.29</var>    Sec. 41. Minnesota Statutes 2009 Supplement, section 256L.03, subdivision 5, is <br/>
<a id="pl.45.30"></a><var>45.30</var>amended to read:<br/>
<a id="pl.45.31"></a><var>45.31</var>    Subd. 5. <b>Co-payments and coinsurance.</b> (a) Except as provided in paragraphs (b) <br/>
<a id="pl.45.32"></a><var>45.32</var>and (c), the MinnesotaCare benefit plan shall include the following co-payments and <br/>
<a id="pl.45.33"></a><var>45.33</var>coinsurance requirements for all enrollees:<br/>
<a id="pl.46.1"></a><var>46.1</var>    (1) ten percent of the paid charges for inpatient hospital services for adult enrollees, <br/>
<a id="pl.46.2"></a><var>46.2</var>subject to an annual inpatient out-of-pocket maximum of $1,000 per individual;<br/>
<a id="pl.46.3"></a><var>46.3</var>    (2) $3 per prescription for adult enrollees;<br/>
<a id="pl.46.4"></a><var>46.4</var>    (3) $25 for eyeglasses for adult enrollees;<br/>
<a id="pl.46.5"></a><var>46.5</var>    (4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an <br/>
<a id="pl.46.6"></a><var>46.6</var>episode of service which is required because of a recipient's symptoms, diagnosis, or <br/>
<a id="pl.46.7"></a><var>46.7</var>established illness, and which is delivered in an ambulatory setting by a physician or <br/>
<a id="pl.46.8"></a><var>46.8</var>physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse, <br/>
<a id="pl.46.9"></a><var>46.9</var>audiologist, optician, or optometrist; and<br/>
<a id="pl.46.10"></a><var>46.10</var>    (5) $6 for nonemergency visits to a hospital-based emergency room for services <br/>
<a id="pl.46.11"></a><var>46.11</var>provided through December 31, 2010, and $3.50 effective January 1, 2011.<br/>
<a id="pl.46.12"></a><var>46.12</var>    (b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of <br/>
<a id="pl.46.13"></a><var>46.13</var>children under the age of 21.<br/>
<a id="pl.46.14"></a><var>46.14</var>    (c) Paragraph (a) does not apply to pregnant women and children under the age of 21.<br/>
<a id="pl.46.15"></a><var>46.15</var>    (d) Paragraph (a), clause (4), does not apply to mental health services.<br/>
<a id="pl.46.16"></a><var>46.16</var>    (e) Adult enrollees with family gross income that exceeds 200 percent of the federal <br/>
<a id="pl.46.17"></a><var>46.17</var>poverty guidelines or 215 percent of the federal poverty guidelines on or after July 1, 2009, <br/>
<a id="pl.46.18"></a><var>46.18</var>and who are not pregnant shall be financially responsible for the coinsurance amount, if <br/>
<a id="pl.46.19"></a><var>46.19</var>applicable, and if supplemental coverage has not been purchased under subdivision 3c, <br/>
<a id="pl.46.20"></a><var>46.20</var>amounts which exceed the $10,000 inpatient hospital benefit limit.<br/>
<a id="pl.46.21"></a><var>46.21</var>    (f) When a MinnesotaCare enrollee becomes a member of a prepaid health plan, <br/>
<a id="pl.46.22"></a><var>46.22</var>or changes from one prepaid health plan to another during a calendar year, any charges <br/>
<a id="pl.46.23"></a><var>46.23</var>submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket <br/>
<a id="pl.46.24"></a><var>46.24</var>expenses incurred by the enrollee for inpatient services, that were submitted or incurred <br/>
<a id="pl.46.25"></a><var>46.25</var>prior to enrollment, or prior to the change in health plans, shall be disregarded.<br/>
<a id="pl.46.26"></a><var>46.26</var>(g) MinnesotaCare reimbursement to fee-for-service providers and payments to <br/>
<a id="pl.46.27"></a><var>46.27</var>managed care plans shall not be increased as a result of the reduction of the co-payments <br/>
<a id="pl.46.28"></a><var>46.28</var>in paragraph (a), clause (5), effective January 1, 2011.<br/>
<a id="pl.46.29"></a><var>46.29</var><b>EFFECTIVE DATE.</b>The amendment to paragraph (e) is effective January 1, 2011, <br/>
<a id="pl.46.30"></a><var>46.30</var>or upon federal approval, whichever is later.<br/>
<br/>
<a id="bill.2.42.0"></a><a id="pl.46.31"></a><var>46.31</var>    Sec. 42. Minnesota Statutes 2008, section 256L.05, is amended by adding a subdivision <br/>
<a id="pl.46.32"></a><var>46.32</var>to read:<br/>
<a id="pl.46.33"></a><var>46.33</var>    Subd. 6. <b>Disclosure statement for inpatient hospital limit.</b> The commissioner <br/>
<a id="pl.46.34"></a><var>46.34</var>shall develop, and include with MinnesotaCare application and renewal materials, a <br/>
<a id="pl.46.35"></a><var>46.35</var>disclosure statement that contains the following or similar language: "For adults without <br/>
<a id="pl.47.1"></a><var>47.1</var>children, and for parents and relative caretakers with family gross income that exceeds <br/>
<a id="pl.47.2"></a><var>47.2</var>215 percent of the federal poverty guidelines, who are not pregnant, coverage of inpatient <br/>
<a id="pl.47.3"></a><var>47.3</var>hospital services under MinnesotaCare is subject to an annual limit of $10,000. Enrollees <br/>
<a id="pl.47.4"></a><var>47.4</var>subject to the limit may be responsible for inpatient hospital costs that exceed the $10,000 <br/>
<a id="pl.47.5"></a><var>47.5</var>annual limit."<br/>
<br/>
<a id="bill.2.43.0"></a><a id="pl.47.6"></a><var>47.6</var>    Sec. 43. Minnesota Statutes 2008, section 256L.07, is amended by adding a subdivision <br/>
<a id="pl.47.7"></a><var>47.7</var>to read:<br/>
<a id="pl.47.8"></a><var>47.8</var>    Subd. 9. <b>Firefighters; volunteer ambulance attendants.</b> (a) For purposes of this <br/>
<a id="pl.47.9"></a><var>47.9</var>subdivision, "qualified individual" means:<br/>
<a id="pl.47.10"></a><var>47.10</var>(1) a volunteer firefighter with a department as defined in section 299N.01, <br/>
<a id="pl.47.11"></a><var>47.11</var>subdivision 2, who has passed the probationary period; and<br/>
<a id="pl.47.12"></a><var>47.12</var>(2) a volunteer ambulance attendant as defined in section 144E.001, subdivision 15.<br/>
<a id="pl.47.13"></a><var>47.13</var>(b) A qualified individual who documents to the satisfaction of the commissioner <br/>
<a id="pl.47.14"></a><var>47.14</var>status as a qualified individual by completing and submitting a one-page form developed <br/>
<a id="pl.47.15"></a><var>47.15</var>by the commissioner is eligible for MinnesotaCare without meeting other eligibility <br/>
<a id="pl.47.16"></a><var>47.16</var>requirements of this chapter, but must pay premiums equal to the average expected <br/>
<a id="pl.47.17"></a><var>47.17</var>capitation rate for adults with no children paid under section 256L.12. Individuals eligible <br/>
<a id="pl.47.18"></a><var>47.18</var>under this subdivision shall receive coverage for the benefit set provided to adults with no <br/>
<a id="pl.47.19"></a><var>47.19</var>children.<br/>
<br/>
<a id="bill.2.44.0"></a><a id="pl.47.20"></a><var>47.20</var>    Sec. 44. Minnesota Statutes 2009 Supplement, section 256L.11, subdivision 1, is <br/>
<a id="pl.47.21"></a><var>47.21</var>amended to read:<br/>
<a id="pl.47.22"></a><var>47.22</var>    Subdivision 1. <b>Medical assistance rate to be used.</b> (a) Payment to providers under <br/>
<a id="pl.47.23"></a><var>47.23</var>sections 
         <statute_ref>256L.01</statute_ref> to 
         <statute_ref>256L.11</statute_ref> shall be at the same rates and conditions established for <br/>
<a id="pl.47.24"></a><var>47.24</var>medical assistance, except as provided in subdivisions 2 to 6.<br/>
<a id="pl.47.25"></a><var>47.25</var>(b) Effective for services provided on or after July 1, 2009, total payments for basic <br/>
<a id="pl.47.26"></a><var>47.26</var>care services shall be reduced by three percent, in accordance with section 
         <statute_ref>256B.766</statute_ref>. <br/>
<a id="pl.47.27"></a><var>47.27</var>Payments made to managed care and county-based purchasing plans shall be reduced for <br/>
<a id="pl.47.28"></a><var>47.28</var>services provided on or after October 1, 2009, to reflect this reduction.<br/>
<a id="pl.47.29"></a><var>47.29</var>(c) Effective for services provided on or after July 1, 2009, payment rates for <br/>
<a id="pl.47.30"></a><var>47.30</var>physician and professional services shall be reduced as described under section 
         <statute_ref>256B.76</statute_ref>, <br/>
<a id="pl.47.31"></a><var>47.31</var>subdivision 1, paragraph (c). Payments made to managed care and county-based <br/>
<a id="pl.47.32"></a><var>47.32</var>purchasing plans shall be reduced for services provided on or after October 1, 2009, <br/>
<a id="pl.47.33"></a><var>47.33</var>to reflect this reduction.<br/>
<a id="pl.48.1"></a><var>48.1</var>(d) Effective for services provided on or after July 1, 2010, payment rates for <br/>
<a id="pl.48.2"></a><var>48.2</var>physician and professional services shall be reduced as described under section 256B.76, <br/>
<a id="pl.48.3"></a><var>48.3</var>subdivision 1, paragraph (d). Payments made to managed care plans and county-based <br/>
<a id="pl.48.4"></a><var>48.4</var>purchasing plans shall be reduced for services provided on or after October 1, 2010, <br/>
<a id="pl.48.5"></a><var>48.5</var>to reflect this reduction.<br/>
<br/>
<a id="bill.2.45.0"></a><a id="pl.48.6"></a><var>48.6</var>    Sec. 45. Minnesota Statutes 2008, section 256L.12, subdivision 5, is amended to read:<br/>
<a id="pl.48.7"></a><var>48.7</var>    Subd. 5. <b>Eligibility for other state programs.</b> MinnesotaCare enrollees who <br/>
<a id="pl.48.8"></a><var>48.8</var>become eligible for medical assistance or general assistance medical care will remain in <br/>
<a id="pl.48.9"></a><var>48.9</var>the same managed care plan if the managed care plan has a contract for that population. <br/>
<a id="pl.48.10"></a><var>48.10</var>Effective January 1, 1998, MinnesotaCare enrollees who were formerly eligible for <br/>
<a id="pl.48.11"></a><var>48.11</var>general assistance medical care pursuant to section 
         <statute_ref>256D.03, subdivision 3</statute_ref>, within six <br/>
<a id="pl.48.12"></a><var>48.12</var>months of MinnesotaCare enrollment and were enrolled in a prepaid health plan pursuant <br/>
<a id="pl.48.13"></a><var>48.13</var>to section 
         <statute_ref>256D.03, subdivision 4</statute_ref>, paragraph (c), must remain in the same managed care <br/>
<a id="pl.48.14"></a><var>48.14</var>plan if the managed care plan has a contract for that population. Managed care plans must <br/>
<a id="pl.48.15"></a><var>48.15</var>participate in the MinnesotaCare and general assistance medical care programs program <br/>
<a id="pl.48.16"></a><var>48.16</var>under a contract with the Department of Human Services in service areas where they <br/>
<a id="pl.48.17"></a><var>48.17</var>participate in the medical assistance program.  <br/>
<a id="pl.48.18"></a><var>48.18</var><b>EFFECTIVE DATE.</b>This section is effective retroactively from April 1, 2010.<br/>
<br/>
<a id="bill.2.46.0"></a><a id="pl.48.19"></a><var>48.19</var>    Sec. 46. Minnesota Statutes 2008, section 256L.12, subdivision 6, is amended to read:<br/>
<a id="pl.48.20"></a><var>48.20</var>    Subd. 6. <b>Co-payments and benefit limits.</b> Enrollees are responsible for all <br/>
<a id="pl.48.21"></a><var>48.21</var>co-payments in sections 
         <statute_ref>256L.03, subdivision 5</statute_ref>, and 
         <statute_ref>256L.035</statute_ref>, and shall pay co-payments <br/>
<a id="pl.48.22"></a><var>48.22</var>to the managed care plan or to its participating providers. The enrollee is also responsible <br/>
<a id="pl.48.23"></a><var>48.23</var>for payment of inpatient hospital charges which exceed the MinnesotaCare benefit limit, <br/>
<a id="pl.48.24"></a><var>48.24</var>unless supplemental hospital coverage has been purchased under subdivision 3c.  <br/>
<a id="pl.48.25"></a><var>48.25</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2011, or upon federal <br/>
<a id="pl.48.26"></a><var>48.26</var>approval, whichever is later.<br/>
<br/>
<a id="bill.2.47.0"></a><a id="pl.48.27"></a><var>48.27</var>    Sec. 47. Minnesota Statutes 2008, section 256L.12, subdivision 9, is amended to read:<br/>
<a id="pl.48.28"></a><var>48.28</var>    Subd. 9. <b>Rate setting; performance withholds.</b> (a) Rates will be prospective, <br/>
<a id="pl.48.29"></a><var>48.29</var>per capita, where possible. The commissioner may allow health plans to arrange for <br/>
<a id="pl.48.30"></a><var>48.30</var>inpatient hospital services on a risk or nonrisk basis. The commissioner shall consult with <br/>
<a id="pl.48.31"></a><var>48.31</var>an independent actuary to determine appropriate rates.<br/>
<a id="pl.49.1"></a><var>49.1</var>    (b) For services rendered on or after January 1, 2003, to December 31, 2003, the <br/>
<a id="pl.49.2"></a><var>49.2</var>commissioner shall withhold .5 percent of managed care plan payments under this section <br/>
<a id="pl.49.3"></a><var>49.3</var>pending completion of performance targets. The withheld funds must be returned no <br/>
<a id="pl.49.4"></a><var>49.4</var>sooner than July 1 and no later than July 31 of the following year if performance targets <br/>
<a id="pl.49.5"></a><var>49.5</var>in the contract are achieved. A managed care plan may include as admitted assets under <br/>
<a id="pl.49.6"></a><var>49.6</var>section 
         <statute_ref>62D.044</statute_ref> any amount withheld under this paragraph that is reasonably expected <br/>
<a id="pl.49.7"></a><var>49.7</var>to be returned. <br/>
<a id="pl.49.8"></a><var>49.8</var>    (c) For services rendered on or after January 1, 2004, the commissioner shall <br/>
<a id="pl.49.9"></a><var>49.9</var>withhold five percent of managed care plan payments under this section pending <br/>
<a id="pl.49.10"></a><var>49.10</var>completion of performance targets. Each performance target must be quantifiable, <br/>
<a id="pl.49.11"></a><var>49.11</var>objective, measurable, and reasonably attainable, except in the case of a performance target <br/>
<a id="pl.49.12"></a><var>49.12</var>based on a federal or state law or rule. Criteria for assessment of each performance target <br/>
<a id="pl.49.13"></a><var>49.13</var>must be outlined in writing prior to the contract effective date. The managed care plan <br/>
<a id="pl.49.14"></a><var>49.14</var>must demonstrate, to the commissioner's satisfaction, that the data submitted regarding <br/>
<a id="pl.49.15"></a><var>49.15</var>attainment of the performance target is accurate. The commissioner shall periodically <br/>
<a id="pl.49.16"></a><var>49.16</var>change the administrative measures used as performance targets in order to improve plan <br/>
<a id="pl.49.17"></a><var>49.17</var>performance across a broader range of administrative services. The performance targets <br/>
<a id="pl.49.18"></a><var>49.18</var>must include measurement of plan efforts to contain spending on health care services and <br/>
<a id="pl.49.19"></a><var>49.19</var>administrative activities. The commissioner may adopt plan-specific performance targets <br/>
<a id="pl.49.20"></a><var>49.20</var>that take into account factors affecting only one plan, such as characteristics of the plan's <br/>
<a id="pl.49.21"></a><var>49.21</var>enrollee population. The withheld funds must be returned no sooner than July 1 and no <br/>
<a id="pl.49.22"></a><var>49.22</var>later than July 31 of the following calendar year if performance targets in the contract are <br/>
<a id="pl.49.23"></a><var>49.23</var>achieved. A managed care plan or a county-based purchasing plan under section 
<statute_ref>256B.692 <br/>
<a id="pl.49.24"></a><var>49.24</var></statute_ref>may include as admitted assets under section 
<statute_ref>62D.044</statute_ref> any amount withheld under this <br/>
<a id="pl.49.25"></a><var>49.25</var>paragraph that is reasonably expected to be returned. <br/>
<a id="pl.49.26"></a><var>49.26</var>(d) For services rendered on or after January 1, 2011, the commissioner shall <br/>
<a id="pl.49.27"></a><var>49.27</var>withhold an additional three percent of managed care plan payments under this section. <br/>
<a id="pl.49.28"></a><var>49.28</var>The withheld funds must be returned no sooner than July 1, and no later than July 31 of <br/>
<a id="pl.49.29"></a><var>49.29</var>the following calendar year. The return of the withhold under this paragraph is not subject <br/>
<a id="pl.49.30"></a><var>49.30</var>to the requirements of paragraph (b) or (c).<br/>
<a id="pl.49.31"></a><var>49.31</var>(e) A managed care plan or a county-based purchasing plan under section 256B.692 <br/>
<a id="pl.49.32"></a><var>49.32</var>may include as admitted assets under section 62D.044 any amount withheld under this <br/>
<a id="pl.49.33"></a><var>49.33</var>section.<br/>
<br/>
<a id="bill.2.48.0"></a><a id="pl.49.34"></a><var>49.34</var>    Sec. 48. Laws 2009, chapter 79, article 5, section 78, subdivision 5, is amended to read:<br/>
<a id="pl.50.1"></a><var>50.1</var>    Subd. 5. <b>Expiration.</b> This section, with the exception of subdivision 4, expires <br/>
<a id="pl.50.2"></a><var>50.2</var>December 31, 2010 June 30, 2011. Subdivision 4 expires December 31, 2011.<br/>
<br/>
<a id="bill.2.49.0"></a><a id="pl.50.3"></a><var>50.3</var>    Sec. 49. Laws 2010, chapter 200, article 1, section 12, subdivision 6, is amended to <br/>
<a id="pl.50.4"></a><var>50.4</var>read:<br/>
<a id="pl.50.5"></a><var>50.5</var>    Subd. 6. <b>Coordinated care delivery systems.</b> (a) Effective June 1, 2010, the <br/>
<a id="pl.50.6"></a><var>50.6</var>commissioner shall contract with hospitals or groups of hospitals that qualify under <br/>
<a id="pl.50.7"></a><var>50.7</var>paragraph (b) and agree to deliver services according to this subdivision. Contracting <br/>
<a id="pl.50.8"></a><var>50.8</var>hospitals shall develop and implement a coordinated care delivery system to provide health <br/>
<a id="pl.50.9"></a><var>50.9</var>care services to individuals who are eligible for general assistance medical care under this <br/>
<a id="pl.50.10"></a><var>50.10</var>section and who either choose to receive services through the coordinated care delivery <br/>
<a id="pl.50.11"></a><var>50.11</var>system or who are enrolled by the commissioner under paragraph (c). A contracting <br/>
<a id="pl.50.12"></a><var>50.12</var>hospital may negotiate a limit to the number of general assistance medical care enrollees it <br/>
<a id="pl.50.13"></a><var>50.13</var>serves, but must comply with the emergency care requirements of United States Code, title <br/>
<a id="pl.50.14"></a><var>50.14</var>42, 1395dd (EMTALA). The health care services provided by the system must include: <br/>
<a id="pl.50.15"></a><var>50.15</var>(1) the services described in subdivision 4 with the exception of outpatient prescription <br/>
<a id="pl.50.16"></a><var>50.16</var>drug coverage but shall include drugs administered in a clinic or other outpatient setting; <br/>
<a id="pl.50.17"></a><var>50.17</var>or (2) a set of comprehensive and medically necessary health services that the recipients <br/>
<a id="pl.50.18"></a><var>50.18</var>might reasonably require to be maintained in good health and that has been approved by <br/>
<a id="pl.50.19"></a><var>50.19</var>the commissioner, including at a minimum, but not limited to, emergency care, medical <br/>
<a id="pl.50.20"></a><var>50.20</var>transportation services, inpatient hospital and physician care, outpatient health services, <br/>
<a id="pl.50.21"></a><var>50.21</var>preventive health services, mental health services, and prescription drugs administered <br/>
<a id="pl.50.22"></a><var>50.22</var>in a clinic or other outpatient setting. Outpatient prescription drug coverage is covered <br/>
<a id="pl.50.23"></a><var>50.23</var>on a fee-for-service basis in accordance with section 
         <statute_ref>256D.03, subdivision 3</statute_ref>, and funded <br/>
<a id="pl.50.24"></a><var>50.24</var>under subdivision 9. A hospital establishing a coordinated care delivery system under this <br/>
<a id="pl.50.25"></a><var>50.25</var>subdivision must ensure that the requirements of this subdivision are met.<br/>
<a id="pl.50.26"></a><var>50.26</var>(b) A hospital or group of hospitals may contract with the commissioner to develop <br/>
<a id="pl.50.27"></a><var>50.27</var>and implement a coordinated care delivery system as follows:<br/>
<a id="pl.50.28"></a><var>50.28</var>(1) effective June 1, 2010, a hospital qualifies under this subdivision if: (i) during <br/>
<a id="pl.50.29"></a><var>50.29</var>calendar year 2008, it received fee-for-service payments for services to general assistance <br/>
<a id="pl.50.30"></a><var>50.30</var>medical care recipients (A) equal to or greater than $1,500,000, or (B) equal to or greater <br/>
<a id="pl.50.31"></a><var>50.31</var>than 1.3 percent of net patient revenue; or (ii) a contract with the hospital is necessary to <br/>
<a id="pl.50.32"></a><var>50.32</var>provide geographic access or to ensure that at least 80 percent of enrollees have access to <br/>
<a id="pl.50.33"></a><var>50.33</var>a coordinated care delivery system; and<br/>
<a id="pl.51.1"></a><var>51.1</var>(2) effective December 1, 2010, a Minnesota hospital not qualified under clause <br/>
<a id="pl.51.2"></a><var>51.2</var>(1) may contract with the commissioner under this subdivision if it agrees to satisfy the <br/>
<a id="pl.51.3"></a><var>51.3</var>requirements of this subdivision.<br/>
<a id="pl.51.4"></a><var>51.4</var>Participation by hospitals shall become effective quarterly on June 1, September 1, <br/>
<a id="pl.51.5"></a><var>51.5</var>December 1, or March 1. Hospital participation is effective for a period of 12 months and <br/>
<a id="pl.51.6"></a><var>51.6</var>may be renewed for successive 12-month periods.<br/>
<a id="pl.51.7"></a><var>51.7</var>Coordinated care delivery system contracts are in effect from June 1, 2010, to <br/>
<a id="pl.51.8"></a><var>51.8</var>December 31, 2010, or upon the effective date of the expansion of medical assistance <br/>
<a id="pl.51.9"></a><var>51.9</var>coverage to include adults without children, whichever is later.<br/>
<a id="pl.51.10"></a><var>51.10</var>(c) Applicants and recipients may enroll in any available coordinated care delivery <br/>
<a id="pl.51.11"></a><var>51.11</var>system statewide. If more than one coordinated care delivery system is available, the <br/>
<a id="pl.51.12"></a><var>51.12</var>applicant or recipient shall be allowed to choose among the systems that provide services <br/>
<a id="pl.51.13"></a><var>51.13</var>within 25 miles of the individual's community of residence. The commissioner may assign <br/>
<a id="pl.51.14"></a><var>51.14</var>an applicant or recipient to a coordinated care delivery system that provides services <br/>
<a id="pl.51.15"></a><var>51.15</var>within 25 miles of the individual's community of residence, if no choice is made by the <br/>
<a id="pl.51.16"></a><var>51.16</var>applicant or recipient. The commissioner shall consider a recipient's zip code, city of <br/>
<a id="pl.51.17"></a><var>51.17</var>residence, county of residence, or distance from a participating coordinated care delivery <br/>
<a id="pl.51.18"></a><var>51.18</var>system when determining default assignment. An applicant or recipient may decline <br/>
<a id="pl.51.19"></a><var>51.19</var>enrollment in a coordinated care delivery system. Upon enrollment into a coordinated care <br/>
<a id="pl.51.20"></a><var>51.20</var>delivery system, the recipient must agree to receive all nonemergency services through the <br/>
<a id="pl.51.21"></a><var>51.21</var>coordinated care delivery system. Enrollment in a coordinated care delivery system is <br/>
<a id="pl.51.22"></a><var>51.22</var>for six months and may be renewed for additional six-month periods, except that initial <br/>
<a id="pl.51.23"></a><var>51.23</var>enrollment is for six months or until the end of a recipient's period of general assistance <br/>
<a id="pl.51.24"></a><var>51.24</var>medical care eligibility, whichever occurs first. A recipient who continues to meet the <br/>
<a id="pl.51.25"></a><var>51.25</var>eligibility requirements of this section is not eligible to enroll in MinnesotaCare during <br/>
<a id="pl.51.26"></a><var>51.26</var>a period of enrollment in a coordinated care delivery system. From June 1, 2010, to <br/>
<a id="pl.51.27"></a><var>51.27</var>November 30, 2010, applicants and recipients not enrolled in a coordinated care delivery <br/>
<a id="pl.51.28"></a><var>51.28</var>system may seek services from a hospital eligible for reimbursement under the temporary <br/>
<a id="pl.51.29"></a><var>51.29</var>uncompensated care pool established under subdivision 8. After November 30, 2010, <br/>
<a id="pl.51.30"></a><var>51.30</var>services are available only through a coordinated care delivery system.<br/>
<a id="pl.51.31"></a><var>51.31</var>(d) A hospital must provide access to cost-effective outpatient services available <br/>
<a id="pl.51.32"></a><var>51.32</var>in its service area. The hospital may contract and coordinate with providers and clinics <br/>
<a id="pl.51.33"></a><var>51.33</var>for the delivery of services and shall contract with federally qualified health centers and <br/>
<a id="pl.51.34"></a><var>51.34</var>essential community providers as defined under section 
         <statute_ref>62Q.19, subdivision 1</statute_ref>, paragraph <br/>
<a id="pl.51.35"></a><var>51.35</var>(a), clauses (1) and (2), to the extent practicable. If a provider or clinic contracts with a <br/>
<a id="pl.51.36"></a><var>51.36</var>hospital to provide services through the coordinated care delivery system, the provider <br/>
<a id="pl.52.1"></a><var>52.1</var>may not refuse to provide services to any recipient enrolled in the system, and payment for <br/>
<a id="pl.52.2"></a><var>52.2</var>services shall be negotiated with the hospital and paid by the hospital from the system's <br/>
<a id="pl.52.3"></a><var>52.3</var>allocation under subdivision 7.<br/>
<a id="pl.52.4"></a><var>52.4</var>(e) A coordinated care delivery system must:<br/>
<a id="pl.52.5"></a><var>52.5</var>(1) provide the covered services required under paragraph (a) to recipients enrolled <br/>
<a id="pl.52.6"></a><var>52.6</var>in the coordinated care delivery system, and comply with the requirements of subdivision <br/>
<a id="pl.52.7"></a><var>52.7</var>4, paragraphs (b) to (g);<br/>
<a id="pl.52.8"></a><var>52.8</var>(2) establish a process to monitor enrollment and ensure the quality of care provided; <br/>
<a id="pl.52.9"></a><var>52.9</var>and<br/>
<a id="pl.52.10"></a><var>52.10</var>(3) in cooperation with counties, coordinate the delivery of health care services with <br/>
<a id="pl.52.11"></a><var>52.11</var>existing homeless prevention, supportive housing, and rent subsidy programs and funding <br/>
<a id="pl.52.12"></a><var>52.12</var>administered by the Minnesota Housing Finance Agency under chapter 462A; and<br/>
<a id="pl.52.13"></a><var>52.13</var>(4) adopt innovative and cost-effective methods of care delivery and coordination, <br/>
<a id="pl.52.14"></a><var>52.14</var>which may include the use of allied health professionals, telemedicine, patient educators, <br/>
<a id="pl.52.15"></a><var>52.15</var>care coordinators, and community health workers.<br/>
<a id="pl.52.16"></a><var>52.16</var>(f) The hospital may require a recipient to designate a primary care provider or <br/>
<a id="pl.52.17"></a><var>52.17</var>a primary care clinic. The hospital may limit the delivery of services to a network of <br/>
<a id="pl.52.18"></a><var>52.18</var>providers who have contracted with the hospital to deliver services in accordance with <br/>
<a id="pl.52.19"></a><var>52.19</var>this subdivision, and require a recipient to seek services only within this network. The <br/>
<a id="pl.52.20"></a><var>52.20</var>hospital may also require a referral to a provider before the service is eligible for payment. <br/>
<a id="pl.52.21"></a><var>52.21</var>A coordinated care delivery system is not required to provide payment to a provider who <br/>
<a id="pl.52.22"></a><var>52.22</var>is not employed by or under contract with the system for services provided to a recipient <br/>
<a id="pl.52.23"></a><var>52.23</var>enrolled in the system, except in cases of an emergency. For purposes of this section, <br/>
<a id="pl.52.24"></a><var>52.24</var>emergency services are defined in accordance with Code of Federal Regulations, title <br/>
<a id="pl.52.25"></a><var>52.25</var>42, section 
         <statute_ref>438.114 </statute_ref>(a).<br/>
<a id="pl.52.26"></a><var>52.26</var>(g) A recipient enrolled in a coordinated care delivery system has the right to appeal <br/>
<a id="pl.52.27"></a><var>52.27</var>to the commissioner according to section 
         <statute_ref>256.045</statute_ref>.<br/>
<a id="pl.52.28"></a><var>52.28</var>(h) The state shall not be liable for the payment of any cost or obligation incurred <br/>
<a id="pl.52.29"></a><var>52.29</var>by the coordinated care delivery system.<br/>
<a id="pl.52.30"></a><var>52.30</var>(i) The hospital must provide the commissioner with data necessary for assessing <br/>
<a id="pl.52.31"></a><var>52.31</var>enrollment, quality of care, cost, and utilization of services. Each hospital must provide, <br/>
<a id="pl.52.32"></a><var>52.32</var>on a quarterly basis on a form prescribed by the commissioner for each recipient served by <br/>
<a id="pl.52.33"></a><var>52.33</var>the coordinated care delivery system, the services provided, the cost of services provided, <br/>
<a id="pl.52.34"></a><var>52.34</var>and the actual payment amount for the services provided and any other information the <br/>
<a id="pl.52.35"></a><var>52.35</var>commissioner deems necessary to claim federal Medicaid match. The commissioner must <br/>
<a id="pl.52.36"></a><var>52.36</var>provide this data to the legislature on a quarterly basis.<br/>
<a id="pl.53.1"></a><var>53.1</var>(j) Effective June 1, 2010, the provisions of section 
         <statute_ref>256.9695, subdivision 2</statute_ref>, <br/>
<a id="pl.53.2"></a><var>53.2</var>paragraph (b), do not apply to general assistance medical care provided under this section.<br/>
<a id="pl.53.3"></a><var>53.3</var>(k) If a recipient is transferred from a hospital that is not participating in a <br/>
<a id="pl.53.4"></a><var>53.4</var>coordinated care delivery system to a hospital participating in a coordinated care delivery <br/>
<a id="pl.53.5"></a><var>53.5</var>system, in order to receive a higher level of care, the transferring hospital remains eligible <br/>
<a id="pl.53.6"></a><var>53.6</var>to receive any available funding through the temporary uncompensated care pool for the <br/>
<a id="pl.53.7"></a><var>53.7</var>care initially provided at that hospital. The hospital participating in the coordinated care <br/>
<a id="pl.53.8"></a><var>53.8</var>delivery system shall be responsible only for care provided at that hospital, and is not <br/>
<a id="pl.53.9"></a><var>53.9</var>financially liable for the initial care provided by the transferring hospital.<br/>
<br/>
<a id="bill.2.50.0"></a><a id="pl.53.10"></a><var>53.10</var>    Sec. 50. Laws 2010, chapter 200, article 1, section 12, subdivision 7, is amended to <br/>
<a id="pl.53.11"></a><var>53.11</var>read:<br/>
<a id="pl.53.12"></a><var>53.12</var>    Subd. 7. <b>Payments; rate setting for the hospital coordinated care delivery </b><br/>
<a id="pl.53.13"></a><var>53.13</var><b>system.</b> (a) Effective for general assistance medical care services, with the exception <br/>
<a id="pl.53.14"></a><var>53.14</var>of outpatient prescription drug coverage, provided on or after June 1, 2010, through a <br/>
<a id="pl.53.15"></a><var>53.15</var>coordinated care delivery system, the commissioner shall allocate the annual appropriation <br/>
<a id="pl.53.16"></a><var>53.16</var>for the coordinated care delivery system to hospitals participating under subdivision <br/>
<a id="pl.53.17"></a><var>53.17</var>6 in quarterly payments, beginning on the first scheduled warrant on or after June 1, <br/>
<a id="pl.53.18"></a><var>53.18</var>2010. The payment shall be allocated among all hospitals qualified to participate on the <br/>
<a id="pl.53.19"></a><var>53.19</var>allocation date. Each hospital or group of hospitals shall receive a pro rata share of the <br/>
<a id="pl.53.20"></a><var>53.20</var>allocation based on the hospital's or group of hospitals' calendar year 2008 payments for <br/>
<a id="pl.53.21"></a><var>53.21</var>general assistance medical care services, adjusted for any limits on the number of general <br/>
<a id="pl.53.22"></a><var>53.22</var>assistance medical care enrollees accepted by a hospital, provided that, for the purposes of <br/>
<a id="pl.53.23"></a><var>53.23</var>this allocation, payments to Hennepin County Medical Center, Regions Hospital, Saint <br/>
<a id="pl.53.24"></a><var>53.24</var>Mary's Medical Center, and University of Minnesota Medical Center, Fairview, shall be <br/>
<a id="pl.53.25"></a><var>53.25</var>weighted at 110 percent of the actual amount. The commissioner may prospectively <br/>
<a id="pl.53.26"></a><var>53.26</var>reallocate payments to participating hospitals on a biannual basis to ensure that final <br/>
<a id="pl.53.27"></a><var>53.27</var>allocations reflect actual coordinated care delivery system enrollment. The 2008 base year <br/>
<a id="pl.53.28"></a><var>53.28</var>shall be updated by one calendar year each June 1, beginning June 1, 2011.<br/>
<a id="pl.53.29"></a><var>53.29</var>(b) Beginning June 1, 2010, and every quarter beginning in June thereafter, the <br/>
<a id="pl.53.30"></a><var>53.30</var>commissioner shall make one-third of the quarterly payment in June and the remaining <br/>
<a id="pl.53.31"></a><var>53.31</var>two-thirds of the quarterly payment in July to each participating hospital or group of <br/>
<a id="pl.53.32"></a><var>53.32</var>hospitals.<br/>
<a id="pl.53.33"></a><var>53.33</var>(b) (c) In order to be reimbursed under this section, nonhospital providers of health <br/>
<a id="pl.53.34"></a><var>53.34</var>care services shall contract with one or more hospitals described in paragraph (a) to <br/>
<a id="pl.53.35"></a><var>53.35</var>provide services to general assistance medical care recipients through the coordinated care <br/>
<a id="pl.54.1"></a><var>54.1</var>delivery system established by the hospital. The hospital shall reimburse bills submitted <br/>
<a id="pl.54.2"></a><var>54.2</var>by nonhospital providers participating under this paragraph at a rate negotiated between <br/>
<a id="pl.54.3"></a><var>54.3</var>the hospital and the nonhospital provider.<br/>
<a id="pl.54.4"></a><var>54.4</var>(c) (d) The commissioner shall apply for federal matching funds under section <br/>
<statute_ref><a id="pl.54.5"></a><var>54.5</var>256B.199
         </statute_ref>, paragraphs (a) to (d), for expenditures under this subdivision.<br/>
<a id="pl.54.6"></a><var>54.6</var>(d) (e) Outpatient prescription drug coverage is provided in accordance with section <br/>
<statute_ref><a id="pl.54.7"></a><var>54.7</var>256D.03, subdivision 3
         </statute_ref>, and paid on a fee-for-service basis under subdivision 9.<br/>
<br/>
<a id="bill.2.51.0"></a><a id="pl.54.8"></a><var>54.8</var>    Sec. 51. Laws 2010, chapter 200, article 1, section 12, subdivision 8, is amended to <br/>
<a id="pl.54.9"></a><var>54.9</var>read:<br/>
<a id="pl.54.10"></a><var>54.10</var>    Subd. 8. <b>Temporary uncompensated care pool.</b> (a) The commissioner shall <br/>
<a id="pl.54.11"></a><var>54.11</var>establish a temporary uncompensated care pool, effective June 1, 2010. Payments from <br/>
<a id="pl.54.12"></a><var>54.12</var>the pool must be distributed, within the limits of the available appropriation, to hospitals <br/>
<a id="pl.54.13"></a><var>54.13</var>that are not part of a coordinated care delivery system established under subdivision <br/>
<a id="pl.54.14"></a><var>54.14</var>6. Payments from the pool must also be distributed, within the limits of the available <br/>
<a id="pl.54.15"></a><var>54.15</var>appropriation, to ambulance services licensed under chapter 144E that respond to a request <br/>
<a id="pl.54.16"></a><var>54.16</var>for an emergency ambulance call or interfacility transfer for a general assistance medical <br/>
<a id="pl.54.17"></a><var>54.17</var>care enrollee, if the call or transfer originates from a location more than 25 miles from the <br/>
<a id="pl.54.18"></a><var>54.18</var>health care facility that receives the enrollee.<br/>
<a id="pl.54.19"></a><var>54.19</var>(b) Hospitals seeking reimbursement from this pool must submit an invoice to <br/>
<a id="pl.54.20"></a><var>54.20</var>the commissioner in a form prescribed by the commissioner for payment for services <br/>
<a id="pl.54.21"></a><var>54.21</var>provided to an applicant or recipient not enrolled in a coordinated care delivery system. A <br/>
<a id="pl.54.22"></a><var>54.22</var>payment amount, as calculated under current law, must be determined, but not paid, for <br/>
<a id="pl.54.23"></a><var>54.23</var>each admission of or service provided to a general assistance medical care recipient on <br/>
<a id="pl.54.24"></a><var>54.24</var>or after June 1, 2010, to November 30 December 31, 2010, or until medical assistance <br/>
<a id="pl.54.25"></a><var>54.25</var>coverage is expanded to include adults without children, whichever is later.<br/>
<a id="pl.54.26"></a><var>54.26</var>(c) The aggregated payment amounts for each hospital must be calculated as a <br/>
<a id="pl.54.27"></a><var>54.27</var>percentage of the total calculated amount for all hospitals.<br/>
<a id="pl.54.28"></a><var>54.28</var>(d) Distributions from the uncompensated care pool for each hospital must be <br/>
<a id="pl.54.29"></a><var>54.29</var>determined by multiplying the factor in paragraph (c) by the amount of money in the <br/>
<a id="pl.54.30"></a><var>54.30</var>uncompensated care pool that is available for the six-month period.<br/>
<a id="pl.54.31"></a><var>54.31</var>(e) The commissioner shall apply for federal matching funds under section <br/>
<statute_ref><a id="pl.54.32"></a><var>54.32</var>256B.199
         </statute_ref>, paragraphs (a) to (d), for expenditures under this subdivision.<br/>
<a id="pl.54.33"></a><var>54.33</var>(f) Outpatient prescription drugs are not eligible for payment under this subdivision.<br/>
<br/>
<a id="bill.2.52.0"></a><a id="pl.55.1"></a><var>55.1</var>    Sec. 52. Laws 2010, chapter 200, article 1, section 12, the effective date, is amended to <br/>
<a id="pl.55.2"></a><var>55.2</var>read:<br/>
<a id="pl.55.3"></a><var>55.3</var><b>EFFECTIVE DATE.</b>This section is effective for services rendered on or after <br/>
<a id="pl.55.4"></a><var>55.4</var>April 1, 2010, except that subdivision 4 is effective June 1, 2010.<br/>
<a id="pl.55.5"></a><var>55.5</var><b>EFFECTIVE DATE.</b>This section is effective retroactively from April 1, 2010.<br/>
<br/>
<a id="bill.2.53.0"></a><a id="pl.55.6"></a><var>55.6</var>    Sec. 53. Laws 2010, chapter 200, article 1, section 16, is amended to read:<br/>
<a id="pl.55.7"></a><var>55.7</var>    Sec. 16. Minnesota Statutes 2008, section 256L.05, subdivision 3c, is amended to <br/>
<a id="pl.55.8"></a><var>55.8</var>read:<br/>
<a id="pl.55.9"></a><var>55.9</var>    Subd. 3c. <b>Retroactive coverage.</b> Notwithstanding subdivision 3, the effective <br/>
<a id="pl.55.10"></a><var>55.10</var>date of coverage shall be the first day of the month following termination from medical <br/>
<a id="pl.55.11"></a><var>55.11</var>assistance for families and individuals who are eligible for MinnesotaCare and who <br/>
<a id="pl.55.12"></a><var>55.12</var>submitted a written request for retroactive MinnesotaCare coverage with a completed <br/>
<a id="pl.55.13"></a><var>55.13</var>application within 30 days of the mailing of notification of termination from medical <br/>
<a id="pl.55.14"></a><var>55.14</var>assistance. The applicant must provide all required verifications within 30 days of the <br/>
<a id="pl.55.15"></a><var>55.15</var>written request for verification. For retroactive coverage, premiums must be paid in full <br/>
<a id="pl.55.16"></a><var>55.16</var>for any retroactive month, current month, and next month within 30 days of the premium <br/>
<a id="pl.55.17"></a><var>55.17</var>billing. General assistance medical care recipients may qualify for retroactive coverage <br/>
<a id="pl.55.18"></a><var>55.18</var>under this subdivision at six-month renewal.<br/>
<a id="pl.55.19"></a><var>55.19</var><b>EFFECTIVE DATE.</b>This section is effective June 1, 2010.<br/>
<br/>
<a id="bill.2.54.0"></a><a id="pl.55.20"></a><var>55.20</var>    Sec. 54. Laws 2010, chapter 200, article 1, section 21, is amended to read:<br/>
<a id="pl.55.21"></a><var>55.21</var>    Sec. 21. <b>REPEALER.</b><br/>
<a id="pl.55.22"></a><var>55.22</var>(a) Minnesota Statutes 2008, sections 256.742; 256.979, subdivision 8; and 256D.03, <br/>
<a id="pl.55.23"></a><var>55.23</var>subdivision 9, are repealed effective April 1, 2010.<br/>
<a id="pl.55.24"></a><var>55.24</var>(b) Minnesota Statutes 2009 Supplement, section 256D.03, subdivision 4, is repealed <br/>
<a id="pl.55.25"></a><var>55.25</var>effective April June 1, 2010.<br/>
<a id="pl.55.26"></a><var>55.26</var>(c) Minnesota Statutes 2008, section 256B.195, subdivisions 4 and 5, are repealed <br/>
<a id="pl.55.27"></a><var>55.27</var>effective for federal fiscal year 2010.<br/>
<a id="pl.55.28"></a><var>55.28</var>(d) Minnesota Statutes 2009 Supplement, section 256B.195, subdivisions 1, 2, and <br/>
<a id="pl.55.29"></a><var>55.29</var>3, are repealed effective for federal fiscal year 2010.<br/>
<a id="pl.55.30"></a><var>55.30</var>(e) Minnesota Statutes 2008, sections 256L.07, subdivision 6; 256L.15, subdivision <br/>
<a id="pl.55.31"></a><var>55.31</var>4; and 256L.17, subdivision 7, are repealed January 1, 2011.<br/>
<a id="pl.55.32"></a><var>55.32</var><b>EFFECTIVE DATE.</b>This section is effective retroactively from April 1, 2010.<br/>
<br/>
<a id="bill.2.55.0"></a><a id="pl.56.1"></a><var>56.1</var>    Sec. 55. Laws 2010, chapter 200, article 2, section 2, subdivision 1, is amended to read:<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.56.2"></a><var>56.2</var><br/>
</td>
<td align="left" colspan="3">Subdivision 1.<b>Total Appropriation</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>(7,985,000)</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>(93,128,000)</b><br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="95px"/>
<col width="96px"/>
<tr>
<td><a id="pl.56.3"></a><var>56.3</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.56.4"></a><var>56.4</var><br/>
</td>
<td align="left"></td>
<td align="center">2010<br/>
</td>
<td align="center">2011<br/>
</td>
</tr>
<tr>
<td><a id="pl.56.5"></a><var>56.5</var><br/>
</td>
<td align="left">General<br/>
</td>
<td align="right">34,807,000<br/>
</td>
<td align="right">118,493,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.56.6"></a><var>56.6</var><br/>
</td>
<td align="left">Health Care Access<br/>
</td>
<td align="right">(42,792,000)<br/>
</td>
<td align="right">(211,621,000)<br/>
</td>
</tr>
</table><a id="pl.56.7"></a><var>56.7</var>The amounts that may be spent for each <br/>
<a id="pl.56.8"></a><var>56.8</var>purpose are specified in the following <br/>
<a id="pl.56.9"></a><var>56.9</var>subdivisions.<br/>
<a id="pl.56.10"></a><var>56.10</var><b>Special Revenue Fund Transfers.</b><br/>
<a id="pl.56.11"></a><var>56.11</var>(1) The commissioner shall transfer the <br/>
<a id="pl.56.12"></a><var>56.12</var>following amounts from special revenue <br/>
<a id="pl.56.13"></a><var>56.13</var>fund balances to the general fund by June <br/>
<a id="pl.56.14"></a><var>56.14</var>30 of each respective fiscal year: $410,000 <br/>
<a id="pl.56.15"></a><var>56.15</var>for fiscal year 2010, and $412,000 for fiscal <br/>
<a id="pl.56.16"></a><var>56.16</var>year 2011.<br/>
<a id="pl.56.17"></a><var>56.17</var>(2) Actual transfers made under clause (1) <br/>
<a id="pl.56.18"></a><var>56.18</var>must be separately identified and reported as <br/>
<a id="pl.56.19"></a><var>56.19</var>part of the quarterly reporting of transfers <br/>
<a id="pl.56.20"></a><var>56.20</var>to the chairs of the relevant senate budget <br/>
<a id="pl.56.21"></a><var>56.21</var>division and house of representatives finance <br/>
<a id="pl.56.22"></a><var>56.22</var>division.<br/>
<a id="pl.56.23"></a><var>56.23</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br/>
<br/>
<a id="bill.2.56.0"></a><a id="pl.56.24"></a><var>56.24</var>    Sec. 56. Laws 2010, chapter 200, article 2, section 2, subdivision 8, is amended to read:<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.56.25"></a><var>56.25</var><br/>
</td>
<td align="left" colspan="3">Subd. 8.<b>Transfers</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table><a id="pl.56.26"></a><var>56.26</var>The commissioner must transfer $29,538,000 <br/>
<a id="pl.56.27"></a><var>56.27</var>in fiscal year 2010 and $18,462,000 in fiscal <br/>
<a id="pl.56.28"></a><var>56.28</var>year 2011 from the health care access fund to <br/>
<a id="pl.56.29"></a><var>56.29</var>the general fund. This is a onetime transfer.<br/>
<a id="pl.56.30"></a><var>56.30</var>The commissioner must transfer $4,800,000 <br/>
<a id="pl.56.31"></a><var>56.31</var>from the consolidated chemical dependency <br/>
<a id="pl.56.32"></a><var>56.32</var>treatment fund to the general fund by June <br/>
<a id="pl.56.33"></a><var>56.33</var>30, 2010.<br/>
<a id="pl.57.1"></a><var>57.1</var><b>Compulsive Gambling </b><b>Special Revenue</b><b> </b><br/>
<a id="pl.57.2"></a><var>57.2</var><b>Administration.</b> The lottery prize fund <br/>
<a id="pl.57.3"></a><var>57.3</var>appropriation for compulsive gambling <br/>
<a id="pl.57.4"></a><var>57.4</var>administration is reduced by $6,000 for fiscal <br/>
<a id="pl.57.5"></a><var>57.5</var>year 2010 and $4,000 for fiscal year 2011 <br/>
<a id="pl.57.6"></a><var>57.6</var>must be transferred from the lottery prize <br/>
<a id="pl.57.7"></a><var>57.7</var>fund appropriation for compulsive gambling <br/>
<a id="pl.57.8"></a><var>57.8</var>administration to the general fund by June <br/>
<a id="pl.57.9"></a><var>57.9</var>30 of each respective fiscal year. These are <br/>
<a id="pl.57.10"></a><var>57.10</var>onetime reductions.<br/>
<a id="pl.57.11"></a><var>57.11</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br/>
<br/>
<a id="bill.2.57.0"></a><a id="pl.57.12"></a><var>57.12</var>    Sec. 57. <b>EARLY EXPANSION.</b><br/>
<a id="pl.57.13"></a><var>57.13</var>All costs related to implementation of Minnesota Statutes, sections 256B.055, <br/>
<a id="pl.57.14"></a><var>57.14</var>subdivision 15, and 256B.056, subdivision 4, paragraph (e), shall be paid from the health <br/>
<a id="pl.57.15"></a><var>57.15</var>care access fund.<br/>
<a id="pl.57.16"></a><var>57.16</var><b>EFFECTIVE DATE.</b>This section is effective upon federal approval and is <br/>
<a id="pl.57.17"></a><var>57.17</var>retroactive to April 1, 2010.<br/>
<br/>
<a id="bill.2.58.0"></a><a id="pl.57.18"></a><var>57.18</var>    Sec. 58. <b>FISCAL AND ACTUARIAL ANALYSIS.</b><br/>
<a id="pl.57.19"></a><var>57.19</var>The commissioner of human services shall offer a request for proposal and accept <br/>
<a id="pl.57.20"></a><var>57.20</var>bids for the completion of a complete fiscal and actuarial analysis of 2010 House File 135 <br/>
<a id="pl.57.21"></a><var>57.21</var>and 2010 Senate File 118. The commissioner shall report this analysis to the chairs of the <br/>
<a id="pl.57.22"></a><var>57.22</var>health and human services finance and policy divisions in the house of representatives and <br/>
<a id="pl.57.23"></a><var>57.23</var>senate no later than December 15, 2010.<br/>
<br/>
<a id="bill.2.59.0"></a><a id="pl.57.24"></a><var>57.24</var>    Sec. 59. <b> REPEALER; TRANSFER.</b><br/>
<a id="pl.57.25"></a><var>57.25</var>(a) Laws 2010, chapter 200, article 1, section 12, subdivisions 1, 2, 3, 4, 5, 6, 7, 8, <br/>
<a id="pl.57.26"></a><var>57.26</var>and 9, are repealed.<br/>
<a id="pl.57.27"></a><var>57.27</var>(b) Laws 2010, chapter 200, article 1, sections 18; and 19, are repealed.<br/>
<a id="pl.57.28"></a><var>57.28</var>(c) Minnesota Statutes 2008, section 256D.03, subdivisions 3a, 3b, 5, 6, 7, and 8, <br/>
<a id="pl.57.29"></a><var>57.29</var>and Minnesota Statutes 2009 Supplement, section 256D.03, subdivision 3, are repealed.<br/>
<a id="pl.57.30"></a><var>57.30</var><b>EFFECTIVE DATE.</b>Paragraphs (a) and (b) are effective 30 days after federal <br/>
<a id="pl.57.31"></a><var>57.31</var>approval of the amendments in this article to Minnesota Statutes, sections 256B.055, <br/>
<a id="pl.57.32"></a><var>57.32</var>subdivision 15, and 256B.056, subdivision 4, or January 1, 2011, whichever is later, <br/>
<a id="pl.58.1"></a><var>58.1</var>and all remaining unspent appropriations for the program established by Laws 2010, <br/>
<a id="pl.58.2"></a><var>58.2</var>chapter 200, are transferred to the health care access fund. Paragraph (c) is effective <br/>
<a id="pl.58.3"></a><var>58.3</var>30 days after federal approval of the amendments in this article to Minnesota Statutes, <br/>
<a id="pl.58.4"></a><var>58.4</var>sections 256B.055, subdivision 15, and 256B.056, subdivision 4, or January 1, 2011, <br/>
<a id="pl.58.5"></a><var>58.5</var>whichever is later.<br/>
<br/>
<a id="bill.3.0.0"></a>

<a id="bill.3.1.0"></a><a id="pl.58.8"></a><var>58.8</var>    Section 1. Minnesota Statutes 2009 Supplement, section 252.27, subdivision 2a, <br/>
<a id="pl.58.9"></a><var>58.9</var>is amended to read:<br/>
<a id="pl.58.10"></a><var>58.10</var>    Subd. 2a. <b>Contribution amount.</b> (a) The natural or adoptive parents of a minor <br/>
<a id="pl.58.11"></a><var>58.11</var>child, including a child determined eligible for medical assistance without consideration of <br/>
<a id="pl.58.12"></a><var>58.12</var>parental income, must contribute to the cost of services used by making monthly payments <br/>
<a id="pl.58.13"></a><var>58.13</var>on a sliding scale based on income, unless the child is married or has been married, <br/>
<a id="pl.58.14"></a><var>58.14</var>parental rights have been terminated, or the child's adoption is subsidized according to <br/>
<a id="pl.58.15"></a><var>58.15</var>section 
         <statute_ref>259.67</statute_ref> or through title IV-E of the Social Security Act. The parental contribution <br/>
<a id="pl.58.16"></a><var>58.16</var>is a partial or full payment for medical services provided for diagnostic, therapeutic, <br/>
<a id="pl.58.17"></a><var>58.17</var>curing, treating, mitigating, rehabilitation, maintenance, and personal care services as <br/>
<a id="pl.58.18"></a><var>58.18</var>defined in United States Code, title 26, section 213, needed by the child with a chronic <br/>
<a id="pl.58.19"></a><var>58.19</var>illness or disability.<br/>
<a id="pl.58.20"></a><var>58.20</var>    (b) For households with adjusted gross income equal to or greater than 100 percent <br/>
<a id="pl.58.21"></a><var>58.21</var>of federal poverty guidelines, the parental contribution shall be computed by applying the <br/>
<a id="pl.58.22"></a><var>58.22</var>following schedule of rates to the adjusted gross income of the natural or adoptive parents:<br/>
<a id="pl.58.23"></a><var>58.23</var>    (1) if the adjusted gross income is equal to or greater than 100 percent of federal <br/>
<a id="pl.58.24"></a><var>58.24</var>poverty guidelines and less than 175 percent of federal poverty guidelines, the parental <br/>
<a id="pl.58.25"></a><var>58.25</var>contribution is $4 per month;<br/>
<a id="pl.58.26"></a><var>58.26</var>    (2) if the adjusted gross income is equal to or greater than 175 percent of federal <br/>
<a id="pl.58.27"></a><var>58.27</var>poverty guidelines and less than or equal to 545 percent of federal poverty guidelines, <br/>
<a id="pl.58.28"></a><var>58.28</var>the parental contribution shall be determined using a sliding fee scale established by the <br/>
<a id="pl.58.29"></a><var>58.29</var>commissioner of human services which begins at one percent of adjusted gross income <br/>
<a id="pl.58.30"></a><var>58.30</var>at 175 percent of federal poverty guidelines and increases to 7.5 percent of adjusted <br/>
<a id="pl.58.31"></a><var>58.31</var>gross income for those with adjusted gross income up to 545 percent of federal poverty <br/>
<a id="pl.58.32"></a><var>58.32</var>guidelines; and<br/>
<a id="pl.58.33"></a><var>58.33</var>    (3) if the adjusted gross income is greater than 545 percent of federal poverty <br/>
<a id="pl.58.34"></a><var>58.34</var>guidelines and less than 675 percent of federal poverty guidelines, the parental <br/>
<a id="pl.58.35"></a><var>58.35</var>contribution shall be 7.5 12.5 percent of adjusted gross income;.<br/>
<a id="pl.59.1"></a><var>59.1</var>    (4) if the adjusted gross income is equal to or greater than 675 percent of federal <br/>
<a id="pl.59.2"></a><var>59.2</var>poverty guidelines and less than 975 percent of federal poverty guidelines, the parental <br/>
<a id="pl.59.3"></a><var>59.3</var>contribution shall be determined using a sliding fee scale established by the commissioner <br/>
<a id="pl.59.4"></a><var>59.4</var>of human services which begins at 7.5 percent of adjusted gross income at 675 percent of <br/>
<a id="pl.59.5"></a><var>59.5</var>federal poverty guidelines and increases to ten percent of adjusted gross income for those <br/>
<a id="pl.59.6"></a><var>59.6</var>with adjusted gross income up to 975 percent of federal poverty guidelines; and<br/>
<a id="pl.59.7"></a><var>59.7</var>    (5) if the adjusted gross income is equal to or greater than 975 percent of federal <br/>
<a id="pl.59.8"></a><var>59.8</var>poverty guidelines, the parental contribution shall be 12.5 percent of adjusted gross <br/>
<a id="pl.59.9"></a><var>59.9</var>income.<br/>
<a id="pl.59.10"></a><var>59.10</var>    If the child lives with the parent, the annual adjusted gross income is reduced by <br/>
<a id="pl.59.11"></a><var>59.11</var>$2,400 prior to calculating the parental contribution. If the child resides in an institution <br/>
<a id="pl.59.12"></a><var>59.12</var>specified in section 
         <statute_ref>256B.35</statute_ref>, the parent is responsible for the personal needs allowance <br/>
<a id="pl.59.13"></a><var>59.13</var>specified under that section in addition to the parental contribution determined under this <br/>
<a id="pl.59.14"></a><var>59.14</var>section. The parental contribution is reduced by any amount required to be paid directly to <br/>
<a id="pl.59.15"></a><var>59.15</var>the child pursuant to a court order, but only if actually paid.<br/>
<a id="pl.59.16"></a><var>59.16</var>    (c) The household size to be used in determining the amount of contribution under <br/>
<a id="pl.59.17"></a><var>59.17</var>paragraph (b) includes natural and adoptive parents and their dependents, including the <br/>
<a id="pl.59.18"></a><var>59.18</var>child receiving services. Adjustments in the contribution amount due to annual changes <br/>
<a id="pl.59.19"></a><var>59.19</var>in the federal poverty guidelines shall be implemented on the first day of July following <br/>
<a id="pl.59.20"></a><var>59.20</var>publication of the changes.<br/>
<a id="pl.59.21"></a><var>59.21</var>    (d) For purposes of paragraph (b), "income" means the adjusted gross income of the <br/>
<a id="pl.59.22"></a><var>59.22</var>natural or adoptive parents determined according to the previous year's federal tax form, <br/>
<a id="pl.59.23"></a><var>59.23</var>except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds <br/>
<a id="pl.59.24"></a><var>59.24</var>have been used to purchase a home shall not be counted as income.<br/>
<a id="pl.59.25"></a><var>59.25</var>    (e) The contribution shall be explained in writing to the parents at the time eligibility <br/>
<a id="pl.59.26"></a><var>59.26</var>for services is being determined. The contribution shall be made on a monthly basis <br/>
<a id="pl.59.27"></a><var>59.27</var>effective with the first month in which the child receives services. Annually upon <br/>
<a id="pl.59.28"></a><var>59.28</var>redetermination or at termination of eligibility, if the contribution exceeded the cost of <br/>
<a id="pl.59.29"></a><var>59.29</var>services provided, the local agency or the state shall reimburse that excess amount to <br/>
<a id="pl.59.30"></a><var>59.30</var>the parents, either by direct reimbursement if the parent is no longer required to pay a <br/>
<a id="pl.59.31"></a><var>59.31</var>contribution, or by a reduction in or waiver of parental fees until the excess amount is <br/>
<a id="pl.59.32"></a><var>59.32</var>exhausted. All reimbursements must include a notice that the amount reimbursed may be <br/>
<a id="pl.59.33"></a><var>59.33</var>taxable income if the parent paid for the parent's fees through an employer's health care <br/>
<a id="pl.59.34"></a><var>59.34</var>flexible spending account under the Internal Revenue Code, section 125, and that the <br/>
<a id="pl.59.35"></a><var>59.35</var>parent is responsible for paying the taxes owed on the amount reimbursed.<br/>
<a id="pl.60.1"></a><var>60.1</var>    (f) The monthly contribution amount must be reviewed at least every 12 months; <br/>
<a id="pl.60.2"></a><var>60.2</var>when there is a change in household size; and when there is a loss of or gain in income <br/>
<a id="pl.60.3"></a><var>60.3</var>from one month to another in excess of ten percent. The local agency shall mail a written <br/>
<a id="pl.60.4"></a><var>60.4</var>notice 30 days in advance of the effective date of a change in the contribution amount. <br/>
<a id="pl.60.5"></a><var>60.5</var>A decrease in the contribution amount is effective in the month that the parent verifies a <br/>
<a id="pl.60.6"></a><var>60.6</var>reduction in income or change in household size.<br/>
<a id="pl.60.7"></a><var>60.7</var>    (g) Parents of a minor child who do not live with each other shall each pay the <br/>
<a id="pl.60.8"></a><var>60.8</var>contribution required under paragraph (a). An amount equal to the annual court-ordered <br/>
<a id="pl.60.9"></a><var>60.9</var>child support payment actually paid on behalf of the child receiving services shall be <br/>
<a id="pl.60.10"></a><var>60.10</var>deducted from the adjusted gross income of the parent making the payment prior to <br/>
<a id="pl.60.11"></a><var>60.11</var>calculating the parental contribution under paragraph (b).<br/>
<a id="pl.60.12"></a><var>60.12</var>    (h) The contribution under paragraph (b) shall be increased by an additional five <br/>
<a id="pl.60.13"></a><var>60.13</var>percent if the local agency determines that insurance coverage is available but not <br/>
<a id="pl.60.14"></a><var>60.14</var>obtained for the child. For purposes of this section, "available" means the insurance is a <br/>
<a id="pl.60.15"></a><var>60.15</var>benefit of employment for a family member at an annual cost of no more than five percent <br/>
<a id="pl.60.16"></a><var>60.16</var>of the family's annual income. For purposes of this section, "insurance" means health <br/>
<a id="pl.60.17"></a><var>60.17</var>and accident insurance coverage, enrollment in a nonprofit health service plan, health <br/>
<a id="pl.60.18"></a><var>60.18</var>maintenance organization, self-insured plan, or preferred provider organization.<br/>
<a id="pl.60.19"></a><var>60.19</var>    Parents who have more than one child receiving services shall not be required <br/>
<a id="pl.60.20"></a><var>60.20</var>to pay more than the amount for the child with the highest expenditures. There shall <br/>
<a id="pl.60.21"></a><var>60.21</var>be no resource contribution from the parents. The parent shall not be required to pay <br/>
<a id="pl.60.22"></a><var>60.22</var>a contribution in excess of the cost of the services provided to the child, not counting <br/>
<a id="pl.60.23"></a><var>60.23</var>payments made to school districts for education-related services. Notice of an increase in <br/>
<a id="pl.60.24"></a><var>60.24</var>fee payment must be given at least 30 days before the increased fee is due.<br/>
<a id="pl.60.25"></a><var>60.25</var>    (i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if, <br/>
<a id="pl.60.26"></a><var>60.26</var>in the 12 months prior to July 1:<br/>
<a id="pl.60.27"></a><var>60.27</var>    (1) the parent applied for insurance for the child;<br/>
<a id="pl.60.28"></a><var>60.28</var>    (2) the insurer denied insurance;<br/>
<a id="pl.60.29"></a><var>60.29</var>    (3) the parents submitted a complaint or appeal, in writing to the insurer, submitted <br/>
<a id="pl.60.30"></a><var>60.30</var>a complaint or appeal, in writing, to the commissioner of health or the commissioner of <br/>
<a id="pl.60.31"></a><var>60.31</var>commerce, or litigated the complaint or appeal; and<br/>
<a id="pl.60.32"></a><var>60.32</var>    (4) as a result of the dispute, the insurer reversed its decision and granted insurance.<br/>
<a id="pl.60.33"></a><var>60.33</var>    For purposes of this section, "insurance" has the meaning given in paragraph (h).<br/>
<a id="pl.60.34"></a><var>60.34</var>    A parent who has requested a reduction in the contribution amount under this <br/>
<a id="pl.60.35"></a><var>60.35</var>paragraph shall submit proof in the form and manner prescribed by the commissioner or <br/>
<a id="pl.60.36"></a><var>60.36</var>county agency, including, but not limited to, the insurer's denial of insurance, the written <br/>
<a id="pl.61.1"></a><var>61.1</var>letter or complaint of the parents, court documents, and the written response of the insurer <br/>
<a id="pl.61.2"></a><var>61.2</var>approving insurance. The determinations of the commissioner or county agency under this <br/>
<a id="pl.61.3"></a><var>61.3</var>paragraph are not rules subject to chapter 14.<br/>
<br/>
<a id="bill.3.2.0"></a><a id="pl.61.4"></a><var>61.4</var>    Sec. 2. Minnesota Statutes 2008, section 256B.057, subdivision 9, is amended to read:<br/>
<a id="pl.61.5"></a><var>61.5</var>    Subd. 9. <b>Employed persons with disabilities.</b> (a) Medical assistance may be paid <br/>
<a id="pl.61.6"></a><var>61.6</var>for a person who is employed and who:<br/>
<a id="pl.61.7"></a><var>61.7</var>(1) but for excess earnings or assets, meets the definition of disabled under the <br/>
<a id="pl.61.8"></a><var>61.8</var>supplemental security income program;<br/>
<a id="pl.61.9"></a><var>61.9</var>(2) is at least 16 but less than 65 years of age;<br/>
<a id="pl.61.10"></a><var>61.10</var>(3) meets the asset limits in paragraph (c); and<br/>
<a id="pl.61.11"></a><var>61.11</var>(4) effective November 1, 2003, pays a premium and other obligations under <br/>
<a id="pl.61.12"></a><var>61.12</var>paragraph (e).<br/>
<a id="pl.61.13"></a><var>61.13</var>Any spousal income or assets shall be disregarded for purposes of eligibility and premium <br/>
<a id="pl.61.14"></a><var>61.14</var>determinations.<br/>
<a id="pl.61.15"></a><var>61.15</var>(b) After the month of enrollment, a person enrolled in medical assistance under <br/>
<a id="pl.61.16"></a><var>61.16</var>this subdivision who:<br/>
<a id="pl.61.17"></a><var>61.17</var>(1) is temporarily unable to work and without receipt of earned income due to a <br/>
<a id="pl.61.18"></a><var>61.18</var>medical condition, as verified by a physician, may retain eligibility for up to four calendar <br/>
<a id="pl.61.19"></a><var>61.19</var>months; or<br/>
<a id="pl.61.20"></a><var>61.20</var>(2) effective January 1, 2004, loses employment for reasons not attributable to the <br/>
<a id="pl.61.21"></a><var>61.21</var>enrollee, may retain eligibility for up to four consecutive months after the month of job <br/>
<a id="pl.61.22"></a><var>61.22</var>loss. To receive a four-month extension, enrollees must verify the medical condition or <br/>
<a id="pl.61.23"></a><var>61.23</var>provide notification of job loss. All other eligibility requirements must be met and the <br/>
<a id="pl.61.24"></a><var>61.24</var>enrollee must pay all calculated premium costs for continued eligibility.<br/>
<a id="pl.61.25"></a><var>61.25</var>(c) For purposes of determining eligibility under this subdivision, a person's assets <br/>
<a id="pl.61.26"></a><var>61.26</var>must not exceed $20,000, excluding:<br/>
<a id="pl.61.27"></a><var>61.27</var>(1) all assets excluded under section 
         <statute_ref>256B.056</statute_ref>;<br/>
<a id="pl.61.28"></a><var>61.28</var>(2) retirement accounts, including individual accounts, 401(k) plans, 403(b) plans, <br/>
<a id="pl.61.29"></a><var>61.29</var>Keogh plans, and pension plans; and<br/>
<a id="pl.61.30"></a><var>61.30</var>(3) medical expense accounts set up through the person's employer.<br/>
<a id="pl.61.31"></a><var>61.31</var>(d)(1) Effective January 1, 2004, for purposes of eligibility, there will be a $65 <br/>
<a id="pl.61.32"></a><var>61.32</var>earned income disregard. To be eligible, a person applying for medical assistance under <br/>
<a id="pl.61.33"></a><var>61.33</var>this subdivision must have earned income above the disregard level.<br/>
<a id="pl.62.1"></a><var>62.1</var>(2) Effective January 1, 2004, to be considered earned income, Medicare, Social <br/>
<a id="pl.62.2"></a><var>62.2</var>Security, and applicable state and federal income taxes must be withheld. To be eligible, <br/>
<a id="pl.62.3"></a><var>62.3</var>a person must document earned income tax withholding.<br/>
<a id="pl.62.4"></a><var>62.4</var>(e)(1) A person whose earned and unearned income is equal to or greater than 100 <br/>
<a id="pl.62.5"></a><var>62.5</var>percent of federal poverty guidelines for the applicable family size must pay a premium <br/>
<a id="pl.62.6"></a><var>62.6</var>to be eligible for medical assistance under this subdivision. The premium shall be based <br/>
<a id="pl.62.7"></a><var>62.7</var>on the person's gross earned and unearned income and the applicable family size using a <br/>
<a id="pl.62.8"></a><var>62.8</var>sliding fee scale established by the commissioner, which begins at one percent of income <br/>
<a id="pl.62.9"></a><var>62.9</var>at 100 percent of the federal poverty guidelines and increases to 7.5 percent of income <br/>
<a id="pl.62.10"></a><var>62.10</var>for those with incomes at or above 300 percent of the federal poverty guidelines. Annual <br/>
<a id="pl.62.11"></a><var>62.11</var>adjustments in the premium schedule based upon changes in the federal poverty guidelines <br/>
<a id="pl.62.12"></a><var>62.12</var>shall be effective for premiums due in July of each year.<br/>
<a id="pl.62.13"></a><var>62.13</var>(2) Effective January 1, 2004, all enrollees must pay a premium to be eligible for <br/>
<a id="pl.62.14"></a><var>62.14</var>medical assistance under this subdivision. An enrollee shall pay the greater of a $35 $50 <br/>
<a id="pl.62.15"></a><var>62.15</var>premium or the premium calculated in clause (1).<br/>
<a id="pl.62.16"></a><var>62.16</var>(3) Effective November 1, 2003, all enrollees who receive unearned income must <br/>
<a id="pl.62.17"></a><var>62.17</var>pay one-half of one 2.5 percent of unearned income in addition to the premium amount.<br/>
<a id="pl.62.18"></a><var>62.18</var>(4) Effective November 1, 2003, for enrollees whose income does not exceed 200 <br/>
<a id="pl.62.19"></a><var>62.19</var>percent of the federal poverty guidelines and who are also enrolled in Medicare, the <br/>
<a id="pl.62.20"></a><var>62.20</var>commissioner must reimburse the enrollee for Medicare Part B premiums under section <br/>
<statute_ref><a id="pl.62.21"></a><var>62.21</var>256B.0625, subdivision 15
         </statute_ref>, paragraph (a).<br/>
<a id="pl.62.22"></a><var>62.22</var>(5) Increases in benefits under title II of the Social Security Act shall not be counted <br/>
<a id="pl.62.23"></a><var>62.23</var>as income for purposes of this subdivision until July 1 of each year.<br/>
<a id="pl.62.24"></a><var>62.24</var>(f) A person's eligibility and premium shall be determined by the local county <br/>
<a id="pl.62.25"></a><var>62.25</var>agency. Premiums must be paid to the commissioner. All premiums are dedicated to <br/>
<a id="pl.62.26"></a><var>62.26</var>the commissioner.<br/>
<a id="pl.62.27"></a><var>62.27</var>(g) Any required premium shall be determined at application and redetermined at <br/>
<a id="pl.62.28"></a><var>62.28</var>the enrollee's six-month income review or when a change in income or household size is <br/>
<a id="pl.62.29"></a><var>62.29</var>reported. Enrollees must report any change in income or household size within ten days <br/>
<a id="pl.62.30"></a><var>62.30</var>of when the change occurs. A decreased premium resulting from a reported change in <br/>
<a id="pl.62.31"></a><var>62.31</var>income or household size shall be effective the first day of the next available billing month <br/>
<a id="pl.62.32"></a><var>62.32</var>after the change is reported. Except for changes occurring from annual cost-of-living <br/>
<a id="pl.62.33"></a><var>62.33</var>increases, a change resulting in an increased premium shall not affect the premium amount <br/>
<a id="pl.62.34"></a><var>62.34</var>until the next six-month review.<br/>
<a id="pl.63.1"></a><var>63.1</var>(h) Premium payment is due upon notification from the commissioner of the <br/>
<a id="pl.63.2"></a><var>63.2</var>premium amount required. Premiums may be paid in installments at the discretion of <br/>
<a id="pl.63.3"></a><var>63.3</var>the commissioner.<br/>
<a id="pl.63.4"></a><var>63.4</var>(i) Nonpayment of the premium shall result in denial or termination of medical <br/>
<a id="pl.63.5"></a><var>63.5</var>assistance unless the person demonstrates good cause for nonpayment. Good cause exists <br/>
<a id="pl.63.6"></a><var>63.6</var>if the requirements specified in Minnesota Rules, part 9506.0040, subpart 7, items B to <br/>
<a id="pl.63.7"></a><var>63.7</var>D, are met. Except when an installment agreement is accepted by the commissioner, <br/>
<a id="pl.63.8"></a><var>63.8</var>all persons disenrolled for nonpayment of a premium must pay any past due premiums <br/>
<a id="pl.63.9"></a><var>63.9</var>as well as current premiums due prior to being reenrolled. Nonpayment shall include <br/>
<a id="pl.63.10"></a><var>63.10</var>payment with a returned, refused, or dishonored instrument. The commissioner may <br/>
<a id="pl.63.11"></a><var>63.11</var>require a guaranteed form of payment as the only means to replace a returned, refused, <br/>
<a id="pl.63.12"></a><var>63.12</var>or dishonored instrument.<br/>
<a id="pl.63.13"></a><var>63.13</var>(j) The commissioner shall notify enrollees annually beginning at least 24 months <br/>
<a id="pl.63.14"></a><var>63.14</var>before the person's 65th birthday of the medical assistance eligibility rules affecting <br/>
<a id="pl.63.15"></a><var>63.15</var>income, assets, and treatment of a spouse's income and assets that will be applied upon <br/>
<a id="pl.63.16"></a><var>63.16</var>reaching age 65.<br/>
<a id="pl.63.17"></a><var>63.17</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2011.<br/>
<br/>
<a id="bill.3.3.0"></a><a id="pl.63.18"></a><var>63.18</var>    Sec. 3. Minnesota Statutes 2009 Supplement, section 256B.0915, subdivision 3a, <br/>
<a id="pl.63.19"></a><var>63.19</var>is amended to read:<br/>
<a id="pl.63.20"></a><var>63.20</var>    Subd. 3a. <b>Elderly waiver cost limits.</b> (a) The monthly limit for the cost of <br/>
<a id="pl.63.21"></a><var>63.21</var>waivered services to an individual elderly waiver client except for individuals described <br/>
<a id="pl.63.22"></a><var>63.22</var>in paragraph (b) shall be the weighted average monthly nursing facility rate of the case <br/>
<a id="pl.63.23"></a><var>63.23</var>mix resident class to which the elderly waiver client would be assigned under Minnesota <br/>
<a id="pl.63.24"></a><var>63.24</var>Rules, parts 9549.0050 to 9549.0059, less the recipient's maintenance needs allowance <br/>
<a id="pl.63.25"></a><var>63.25</var>as described in subdivision 1d, paragraph (a), until the first day of the state fiscal year in <br/>
<a id="pl.63.26"></a><var>63.26</var>which the resident assessment system as described in section 
         <statute_ref>256B.438</statute_ref> for nursing home <br/>
<a id="pl.63.27"></a><var>63.27</var>rate determination is implemented. Effective on the first day of the state fiscal year in <br/>
<a id="pl.63.28"></a><var>63.28</var>which the resident assessment system as described in section 
         <statute_ref>256B.438</statute_ref> for nursing home <br/>
<a id="pl.63.29"></a><var>63.29</var>rate determination is implemented and the first day of each subsequent state fiscal year, the <br/>
<a id="pl.63.30"></a><var>63.30</var>monthly limit for the cost of waivered services to an individual elderly waiver client shall <br/>
<a id="pl.63.31"></a><var>63.31</var>be the rate of the case mix resident class to which the waiver client would be assigned <br/>
<a id="pl.63.32"></a><var>63.32</var>under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect on the last day of the <br/>
<a id="pl.63.33"></a><var>63.33</var>previous state fiscal year, adjusted by the greater of any legislatively adopted home and <br/>
<a id="pl.63.34"></a><var>63.34</var>community-based services percentage rate increase or the average statewide percentage <br/>
<a id="pl.63.35"></a><var>63.35</var>increase in nursing facility payment rates adjustment.<br/>
<a id="pl.64.1"></a><var>64.1</var>    (b) The monthly limit for the cost of waivered services to an individual elderly <br/>
<a id="pl.64.2"></a><var>64.2</var>waiver client assigned to a case mix classification A under paragraph (a) with (1) no <br/>
<a id="pl.64.3"></a><var>64.3</var>dependencies in activities of daily living, (2) only one dependency in bathing, dressing, <br/>
<a id="pl.64.4"></a><var>64.4</var>grooming, or walking, or (3) a dependency score of less than three if eating is the only <br/>
<a id="pl.64.5"></a><var>64.5</var>dependency, shall be the lower of the case mix classification amount for case mix A as <br/>
<a id="pl.64.6"></a><var>64.6</var>determined under paragraph (a) or the case mix classification amount for case mix A <br/>
<a id="pl.64.7"></a><var>64.7</var>effective on October 1, 2008, per month for all new participants enrolled in the program <br/>
<a id="pl.64.8"></a><var>64.8</var>on or after July 1, 2009. This monthly limit shall be applied to all other participants who <br/>
<a id="pl.64.9"></a><var>64.9</var>meet this criteria at reassessment.<br/>
<a id="pl.64.10"></a><var>64.10</var>(c) If extended medical supplies and equipment or environmental modifications are <br/>
<a id="pl.64.11"></a><var>64.11</var>or will be purchased for an elderly waiver client, the costs may be prorated for up to <br/>
<a id="pl.64.12"></a><var>64.12</var>12 consecutive months beginning with the month of purchase. If the monthly cost of a <br/>
<a id="pl.64.13"></a><var>64.13</var>recipient's waivered services exceeds the monthly limit established in paragraph (a) or <br/>
<a id="pl.64.14"></a><var>64.14</var>(b), the annual cost of all waivered services shall be determined. In this event, the annual <br/>
<a id="pl.64.15"></a><var>64.15</var>cost of all waivered services shall not exceed 12 times the monthly limit of waivered <br/>
<a id="pl.64.16"></a><var>64.16</var>services as described in paragraph (a) or (b).<br/>
<br/>
<a id="bill.3.4.0"></a><a id="pl.64.17"></a><var>64.17</var>    Sec. 4. Minnesota Statutes 2008, section 256B.0915, subdivision 3b, is amended to <br/>
<a id="pl.64.18"></a><var>64.18</var>read:<br/>
<a id="pl.64.19"></a><var>64.19</var>    Subd. 3b. <b>Cost limits for elderly waiver applicants who reside in a nursing </b><br/>
<a id="pl.64.20"></a><var>64.20</var><b>facility.</b> (a) For a person who is a nursing facility resident at the time of requesting a <br/>
<a id="pl.64.21"></a><var>64.21</var>determination of eligibility for elderly waivered services, a monthly conversion limit for <br/>
<a id="pl.64.22"></a><var>64.22</var>the cost of elderly waivered services may be requested. The monthly conversion limit for <br/>
<a id="pl.64.23"></a><var>64.23</var>the cost of elderly waiver services shall be the resident class assigned under Minnesota <br/>
<a id="pl.64.24"></a><var>64.24</var>Rules, parts 9549.0050 to 9549.0059, for that resident in the nursing facility where <br/>
<a id="pl.64.25"></a><var>64.25</var>the resident currently resides until July 1 of the state fiscal year in which the resident <br/>
<a id="pl.64.26"></a><var>64.26</var>assessment system as described in section 
         <statute_ref>256B.438</statute_ref> for nursing home rate determination <br/>
<a id="pl.64.27"></a><var>64.27</var>is implemented. Effective on July 1 of the state fiscal year in which the resident <br/>
<a id="pl.64.28"></a><var>64.28</var>assessment system as described in section 
         <statute_ref>256B.438</statute_ref> for nursing home rate determination <br/>
<a id="pl.64.29"></a><var>64.29</var>is implemented, the monthly conversion limit for the cost of elderly waiver services shall <br/>
<a id="pl.64.30"></a><var>64.30</var>be the per diem nursing facility rate as determined by the resident assessment system as <br/>
<a id="pl.64.31"></a><var>64.31</var>described in section 
         <statute_ref>256B.438</statute_ref> for that resident residents in the nursing facility where the <br/>
<a id="pl.64.32"></a><var>64.32</var>resident currently resides, but in effect on June 30, 2010, and adjusted annually by any <br/>
<a id="pl.64.33"></a><var>64.33</var>legislatively adopted percentage change in the elderly waiver services rates. That per <br/>
<a id="pl.64.34"></a><var>64.34</var>diem shall be multiplied by 365 and, divided by 12, less and reduced by the recipient's <br/>
<a id="pl.64.35"></a><var>64.35</var>maintenance needs allowance as described in subdivision 1d. The initially approved <br/>
<a id="pl.65.1"></a><var>65.1</var>conversion rate may must be adjusted by the greater of any subsequent legislatively <br/>
<a id="pl.65.2"></a><var>65.2</var>adopted home and community-based services percentage rate increase or the average <br/>
<a id="pl.65.3"></a><var>65.3</var>statewide percentage increase in nursing facility payment rates adjustment. The limit <br/>
<a id="pl.65.4"></a><var>65.4</var>under this subdivision only applies to persons discharged from a nursing facility after a <br/>
<a id="pl.65.5"></a><var>65.5</var>minimum 30-day stay and found eligible for waivered services on or after July 1, 1997. <br/>
<a id="pl.65.6"></a><var>65.6</var>For conversions from the nursing home to the elderly waiver with consumer directed <br/>
<a id="pl.65.7"></a><var>65.7</var>community support services, the conversion rate limit is equal to the nursing facility rate <br/>
<a id="pl.65.8"></a><var>65.8</var>reduced by a percentage equal to the percentage difference between the consumer directed <br/>
<a id="pl.65.9"></a><var>65.9</var>services budget limit that would be assigned according to the federally approved waiver <br/>
<a id="pl.65.10"></a><var>65.10</var>plan and the corresponding community case mix cap, but not to exceed 50 percent.<br/>
<a id="pl.65.11"></a><var>65.11</var>    (b) The following costs must be included in determining the total monthly costs <br/>
<a id="pl.65.12"></a><var>65.12</var>for the waiver client:<br/>
<a id="pl.65.13"></a><var>65.13</var>    (1) cost of all waivered services, including extended medical specialized supplies <br/>
<a id="pl.65.14"></a><var>65.14</var>and equipment and environmental modifications and accessibility adaptations; and<br/>
<a id="pl.65.15"></a><var>65.15</var>    (2) cost of skilled nursing, home health aide, and personal care services reimbursable <br/>
<a id="pl.65.16"></a><var>65.16</var>by medical assistance.<br/>
<br/>
<a id="bill.3.5.0"></a><a id="pl.65.17"></a><var>65.17</var>    Sec. 5. Minnesota Statutes 2009 Supplement, section 256B.69, subdivision 23, is <br/>
<a id="pl.65.18"></a><var>65.18</var>amended to read:<br/>
<a id="pl.65.19"></a><var>65.19</var>    Subd. 23. <b>Alternative services; elderly and disabled persons.</b> (a) The <br/>
<a id="pl.65.20"></a><var>65.20</var>commissioner may implement demonstration projects to create alternative integrated <br/>
<a id="pl.65.21"></a><var>65.21</var>delivery systems for acute and long-term care services to elderly persons and persons <br/>
<a id="pl.65.22"></a><var>65.22</var>with disabilities as defined in section 
         <statute_ref>256B.77, subdivision 7a</statute_ref>, that provide increased <br/>
<a id="pl.65.23"></a><var>65.23</var>coordination, improve access to quality services, and mitigate future cost increases. <br/>
<a id="pl.65.24"></a><var>65.24</var>The commissioner may seek federal authority to combine Medicare and Medicaid <br/>
<a id="pl.65.25"></a><var>65.25</var>capitation payments for the purpose of such demonstrations and may contract with <br/>
<a id="pl.65.26"></a><var>65.26</var>Medicare-approved special needs plans to provide Medicaid services. Medicare funds and <br/>
<a id="pl.65.27"></a><var>65.27</var>services shall be administered according to the terms and conditions of the federal contract <br/>
<a id="pl.65.28"></a><var>65.28</var>and demonstration provisions. For the purpose of administering medical assistance funds, <br/>
<a id="pl.65.29"></a><var>65.29</var>demonstrations under this subdivision are subject to subdivisions 1 to 22. The provisions <br/>
<a id="pl.65.30"></a><var>65.30</var>of Minnesota Rules, parts 
         <statute_ref>9500.1450</statute_ref> to 
         <statute_ref>9500.1464</statute_ref>, apply to these demonstrations, <br/>
<a id="pl.65.31"></a><var>65.31</var>with the exceptions of parts 
         <statute_ref>9500.1452</statute_ref>, subpart 2, item B; and 
         <statute_ref>9500.1457</statute_ref>, subpart 1, <br/>
<a id="pl.65.32"></a><var>65.32</var>items B and C, which do not apply to persons enrolling in demonstrations under this <br/>
<a id="pl.65.33"></a><var>65.33</var>section. An initial open enrollment period may be provided. Persons who disenroll from <br/>
<a id="pl.65.34"></a><var>65.34</var>demonstrations under this subdivision remain subject to Minnesota Rules, parts 9500.1450 <br/>
<a id="pl.65.35"></a><var>65.35</var>to 9500.1464. When a person is enrolled in a health plan under these demonstrations and <br/>
<a id="pl.66.1"></a><var>66.1</var>the health plan's participation is subsequently terminated for any reason, the person shall <br/>
<a id="pl.66.2"></a><var>66.2</var>be provided an opportunity to select a new health plan and shall have the right to change <br/>
<a id="pl.66.3"></a><var>66.3</var>health plans within the first 60 days of enrollment in the second health plan. Persons <br/>
<a id="pl.66.4"></a><var>66.4</var>required to participate in health plans under this section who fail to make a choice of <br/>
<a id="pl.66.5"></a><var>66.5</var>health plan shall not be randomly assigned to health plans under these demonstrations. <br/>
<a id="pl.66.6"></a><var>66.6</var>Notwithstanding section 
         <statute_ref>256L.12, subdivision 5</statute_ref>, and Minnesota Rules, part 
         <statute_ref>9505.5220</statute_ref>, <br/>
<a id="pl.66.7"></a><var>66.7</var>subpart 1, item A, if adopted, for the purpose of demonstrations under this subdivision, <br/>
<a id="pl.66.8"></a><var>66.8</var>the commissioner may contract with managed care organizations, including counties, to <br/>
<a id="pl.66.9"></a><var>66.9</var>serve only elderly persons eligible for medical assistance, elderly and disabled persons, or <br/>
<a id="pl.66.10"></a><var>66.10</var>disabled persons only. For persons with a primary diagnosis of developmental disability, <br/>
<a id="pl.66.11"></a><var>66.11</var>serious and persistent mental illness, or serious emotional disturbance, the commissioner <br/>
<a id="pl.66.12"></a><var>66.12</var>must ensure that the county authority has approved the demonstration and contracting <br/>
<a id="pl.66.13"></a><var>66.13</var>design. Enrollment in these projects for persons with disabilities shall be voluntary. The <br/>
<a id="pl.66.14"></a><var>66.14</var>commissioner shall not implement any demonstration project under this subdivision for <br/>
<a id="pl.66.15"></a><var>66.15</var>persons with a primary diagnosis of developmental disabilities, serious and persistent <br/>
<a id="pl.66.16"></a><var>66.16</var>mental illness, or serious emotional disturbance, without approval of the county board of <br/>
<a id="pl.66.17"></a><var>66.17</var>the county in which the demonstration is being implemented.<br/>
<a id="pl.66.18"></a><var>66.18</var>    (b) Notwithstanding chapter 245B, sections 
         <statute_ref>252.40</statute_ref> to 
         <statute_ref>252.46</statute_ref>, 
         <statute_ref>256B.092</statute_ref>, 
         <statute_ref>256B.501 <br/>
</statute_ref><a id="pl.66.19"></a><var>66.19</var>to 
         <statute_ref>256B.5015</statute_ref>, and Minnesota Rules, parts 9525.0004 to 9525.0036, 9525.1200 to <br/>
<a id="pl.66.20"></a><var>66.20</var>9525.1330, 9525.1580, and 9525.1800 to 9525.1930, the commissioner may implement <br/>
<a id="pl.66.21"></a><var>66.21</var>under this section projects for persons with developmental disabilities. The commissioner <br/>
<a id="pl.66.22"></a><var>66.22</var>may capitate payments for ICF/MR services, waivered services for developmental <br/>
<a id="pl.66.23"></a><var>66.23</var>disabilities, including case management services, day training and habilitation and <br/>
<a id="pl.66.24"></a><var>66.24</var>alternative active treatment services, and other services as approved by the state and by the <br/>
<a id="pl.66.25"></a><var>66.25</var>federal government. Case management and active treatment must be individualized and <br/>
<a id="pl.66.26"></a><var>66.26</var>developed in accordance with a person-centered plan. Costs under these projects may not <br/>
<a id="pl.66.27"></a><var>66.27</var>exceed costs that would have been incurred under fee-for-service. Beginning July 1, 2003, <br/>
<a id="pl.66.28"></a><var>66.28</var>and until four years after the pilot project implementation date, subcontractor participation <br/>
<a id="pl.66.29"></a><var>66.29</var>in the long-term care developmental disability pilot is limited to a nonprofit long-term <br/>
<a id="pl.66.30"></a><var>66.30</var>care system providing ICF/MR services, home and community-based waiver services, <br/>
<a id="pl.66.31"></a><var>66.31</var>and in-home services to no more than 120 consumers with developmental disabilities in <br/>
<a id="pl.66.32"></a><var>66.32</var>Carver, Hennepin, and Scott Counties. The commissioner shall report to the legislature <br/>
<a id="pl.66.33"></a><var>66.33</var>prior to expansion of the developmental disability pilot project. This paragraph expires <br/>
<a id="pl.66.34"></a><var>66.34</var>four years after the implementation date of the pilot project.<br/>
<a id="pl.66.35"></a><var>66.35</var>    (c) Before implementation of a demonstration project for disabled persons, the <br/>
<a id="pl.66.36"></a><var>66.36</var>commissioner must provide information to appropriate committees of the house of <br/>
<a id="pl.67.1"></a><var>67.1</var>representatives and senate and must involve representatives of affected disability groups <br/>
<a id="pl.67.2"></a><var>67.2</var>in the design of the demonstration projects.<br/>
<a id="pl.67.3"></a><var>67.3</var>    (d) A nursing facility reimbursed under the alternative reimbursement methodology <br/>
<a id="pl.67.4"></a><var>67.4</var>in section 
         <statute_ref>256B.434</statute_ref> may, in collaboration with a hospital, clinic, or other health care entity <br/>
<a id="pl.67.5"></a><var>67.5</var>provide services under paragraph (a). The commissioner shall amend the state plan and <br/>
<a id="pl.67.6"></a><var>67.6</var>seek any federal waivers necessary to implement this paragraph.<br/>
<a id="pl.67.7"></a><var>67.7</var>    (e) The commissioner, in consultation with the commissioners of commerce and <br/>
<a id="pl.67.8"></a><var>67.8</var>health, may approve and implement programs for all-inclusive care for the elderly (PACE) <br/>
<a id="pl.67.9"></a><var>67.9</var>according to federal laws and regulations governing that program and state laws or rules <br/>
<a id="pl.67.10"></a><var>67.10</var>applicable to participating providers. The process for approval of these programs shall <br/>
<a id="pl.67.11"></a><var>67.11</var>begin only after the commissioner receives grant money in an amount sufficient to cover <br/>
<a id="pl.67.12"></a><var>67.12</var>the state share of the administrative and actuarial costs to implement the programs during <br/>
<a id="pl.67.13"></a><var>67.13</var>state fiscal years 2006 and 2007. Grant amounts for this purpose shall be deposited in an <br/>
<a id="pl.67.14"></a><var>67.14</var>account in the special revenue fund and are appropriated to the commissioner to be used <br/>
<a id="pl.67.15"></a><var>67.15</var>solely for the purpose of PACE administrative and actuarial costs. A PACE provider is <br/>
<a id="pl.67.16"></a><var>67.16</var>not required to be licensed or certified as a health plan company as defined in section <br/>
<statute_ref><a id="pl.67.17"></a><var>67.17</var>62Q.01, subdivision 4
         </statute_ref>. Persons age 55 and older who have been screened by the county <br/>
<a id="pl.67.18"></a><var>67.18</var>and found to be eligible for services under the elderly waiver or community alternatives <br/>
<a id="pl.67.19"></a><var>67.19</var>for disabled individuals or who are already eligible for Medicaid but meet level of <br/>
<a id="pl.67.20"></a><var>67.20</var>care criteria for receipt of waiver services may choose to enroll in the PACE program. <br/>
<a id="pl.67.21"></a><var>67.21</var>Medicare and Medicaid services will be provided according to this subdivision and <br/>
<a id="pl.67.22"></a><var>67.22</var>federal Medicare and Medicaid requirements governing PACE providers and programs. <br/>
<a id="pl.67.23"></a><var>67.23</var>PACE enrollees will receive Medicaid home and community-based services through the <br/>
<a id="pl.67.24"></a><var>67.24</var>PACE provider as an alternative to services for which they would otherwise be eligible <br/>
<a id="pl.67.25"></a><var>67.25</var>through home and community-based waiver programs and Medicaid State Plan Services. <br/>
<a id="pl.67.26"></a><var>67.26</var>The commissioner shall establish Medicaid rates for PACE providers that do not exceed <br/>
<a id="pl.67.27"></a><var>67.27</var>costs that would have been incurred under fee-for-service or other relevant managed care <br/>
<a id="pl.67.28"></a><var>67.28</var>programs operated by the state.<br/>
<a id="pl.67.29"></a><var>67.29</var>    (f) The commissioner shall seek federal approval to expand the Minnesota disability <br/>
<a id="pl.67.30"></a><var>67.30</var>health options (MnDHO) program established under this subdivision in stages, first to <br/>
<a id="pl.67.31"></a><var>67.31</var>regional population centers outside the seven-county metro area and then to all areas of <br/>
<a id="pl.67.32"></a><var>67.32</var>the state. Until July 1, 2009, expansion for MnDHO projects that include home and <br/>
<a id="pl.67.33"></a><var>67.33</var>community-based services is limited to the two projects and service areas in effect on <br/>
<a id="pl.67.34"></a><var>67.34</var>March 1, 2006. Enrollment in integrated MnDHO programs that include home and <br/>
<a id="pl.67.35"></a><var>67.35</var>community-based services shall remain voluntary. Costs for home and community-based <br/>
<a id="pl.67.36"></a><var>67.36</var>services included under MnDHO must not exceed costs that would have been incurred <br/>
<a id="pl.68.1"></a><var>68.1</var>under the fee-for-service program. Notwithstanding whether expansion occurs under <br/>
<a id="pl.68.2"></a><var>68.2</var>this paragraph, in determining MnDHO payment rates and risk adjustment methods for <br/>
<a id="pl.68.3"></a><var>68.3</var>contract years starting in 2012, the commissioner must consider the methods used to <br/>
<a id="pl.68.4"></a><var>68.4</var>determine county allocations for home and community-based program participants. If <br/>
<a id="pl.68.5"></a><var>68.5</var>necessary to reduce MnDHO rates to comply with the provision regarding MnDHO costs <br/>
<a id="pl.68.6"></a><var>68.6</var>for home and community-based services, the commissioner shall achieve the reduction by <br/>
<a id="pl.68.7"></a><var>68.7</var>maintaining the base rate for contract years 2010 and 2011 for services provided under the <br/>
<a id="pl.68.8"></a><var>68.8</var>community alternatives for disabled individuals waiver at the same level as for contract <br/>
<a id="pl.68.9"></a><var>68.9</var>year 2009. The commissioner may apply other reductions to MnDHO rates to implement <br/>
<a id="pl.68.10"></a><var>68.10</var>decreases in provider payment rates required by state law. In developing program <br/>
<a id="pl.68.11"></a><var>68.11</var>specifications for expansion of integrated programs, the commissioner shall involve and <br/>
<a id="pl.68.12"></a><var>68.12</var>consult the state-level stakeholder group established in subdivision 28, paragraph (d), <br/>
<a id="pl.68.13"></a><var>68.13</var>including consultation on whether and how to include home and community-based waiver <br/>
<a id="pl.68.14"></a><var>68.14</var>programs. Plans for further expansion of MnDHO projects shall be presented to the chairs <br/>
<a id="pl.68.15"></a><var>68.15</var>of the house of representatives and senate committees with jurisdiction over health and <br/>
<a id="pl.68.16"></a><var>68.16</var>human services policy and finance by February 1, 2007.<br/>
<a id="pl.68.17"></a><var>68.17</var>    (g) Notwithstanding section 
         <statute_ref>256B.0261</statute_ref>, health plans providing services under this <br/>
<a id="pl.68.18"></a><var>68.18</var>section are responsible for home care targeted case management and relocation targeted <br/>
<a id="pl.68.19"></a><var>68.19</var>case management. Services must be provided according to the terms of the waivers and <br/>
<a id="pl.68.20"></a><var>68.20</var>contracts approved by the federal government.<br/>
<br/>
<a id="bill.3.6.0"></a><a id="pl.68.21"></a><var>68.21</var>    Sec. 6. <b>CASE MANAGEMENT REFORM.</b><br/>
<a id="pl.68.22"></a><var>68.22</var>(a) By February 1, 2011, the commissioner of human services shall provide specific <br/>
<a id="pl.68.23"></a><var>68.23</var>recommendations and language for proposed legislation to:<br/>
<a id="pl.68.24"></a><var>68.24</var>(1) define the administrative and the service functions of case management and make <br/>
<a id="pl.68.25"></a><var>68.25</var>changes to improve the funding for administrative functions;<br/>
<a id="pl.68.26"></a><var>68.26</var>(2) standardize and simplify processes, standards, and timelines for administrative <br/>
<a id="pl.68.27"></a><var>68.27</var>functions of case management within the Department of Human Services, Disability <br/>
<a id="pl.68.28"></a><var>68.28</var>Services Division, including eligibility determinations, resource allocation, management <br/>
<a id="pl.68.29"></a><var>68.29</var>of dollars, provision for assignment of one case manager at a time per person, waiting lists, <br/>
<a id="pl.68.30"></a><var>68.30</var>quality assurance, host county concurrence requirements, county of financial responsibility <br/>
<a id="pl.68.31"></a><var>68.31</var>provisions, and waiver compliance; and<br/>
<a id="pl.68.32"></a><var>68.32</var>(3) increase opportunities for consumer choice of case management functions <br/>
<a id="pl.68.33"></a><var>68.33</var>involving service coordination.<br/>
<a id="pl.68.34"></a><var>68.34</var>(b) In developing these recommendations, the commissioner shall consider the <br/>
<a id="pl.68.35"></a><var>68.35</var>recommendations of the 2007 Redesigning Case Management Services for Persons <br/>
<a id="pl.69.1"></a><var>69.1</var>with Disabilities report and consult with existing stakeholder groups, which include <br/>
<a id="pl.69.2"></a><var>69.2</var>representatives of counties, disability and senior advocacy groups, service providers, and <br/>
<a id="pl.69.3"></a><var>69.3</var>representatives of agencies which provide contracted case management.<br/>
<a id="pl.69.4"></a><var>69.4</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br/>
<br/>
<a id="bill.3.7.0"></a><a id="pl.69.5"></a><var>69.5</var>    Sec. 7. <b>[256.4825] REPORT REGARDING PROGRAMS AND SERVICES FOR </b><br/>
<a id="pl.69.6"></a><var>69.6</var><b>PEOPLE WITH DISABILITIES.</b><br/>
<a id="pl.69.7"></a><var>69.7</var>The Minnesota State Council on Disability, the Minnesota Consortium for Citizens <br/>
<a id="pl.69.8"></a><var>69.8</var>with Disabilities, and the Arc of Minnesota may submit an annual report by January 15 of <br/>
<a id="pl.69.9"></a><var>69.9</var>each year, beginning in 2012, to the chairs and ranking minority members of the legislative <br/>
<a id="pl.69.10"></a><var>69.10</var>committees with jurisdiction over programs serving people with disabilities as provided in <br/>
<a id="pl.69.11"></a><var>69.11</var>this section. The report must describe the existing state policies and goals for programs <br/>
<a id="pl.69.12"></a><var>69.12</var>serving people with disabilities including, but not limited to, programs for employment, <br/>
<a id="pl.69.13"></a><var>69.13</var>transportation, housing, education, quality assurance, consumer direction, physical and <br/>
<a id="pl.69.14"></a><var>69.14</var>programmatic access, and health. The report must provide data and measurements to <br/>
<a id="pl.69.15"></a><var>69.15</var>assess the extent to which the policies and goals are being met. The commissioner of <br/>
<a id="pl.69.16"></a><var>69.16</var>human services and the commissioners of other state agencies administering programs for <br/>
<a id="pl.69.17"></a><var>69.17</var>people with disabilities shall cooperate with the Minnesota State Council on Disability, <br/>
<a id="pl.69.18"></a><var>69.18</var>the Minnesota Consortium for Citizens with Disabilities, and the Arc of Minnesota and <br/>
<a id="pl.69.19"></a><var>69.19</var>provide those organizations with existing published information and reports that will assist <br/>
<a id="pl.69.20"></a><var>69.20</var>in the preparation of the report.<br/>
<br/>
<a id="bill.3.8.0"></a><a id="pl.69.21"></a><var>69.21</var>    Sec. 8. <b>COMMISSIONER TO SEEK FEDERAL MATCH.</b><br/>
<a id="pl.69.22"></a><var>69.22</var>(a) The commissioner of human services shall seek federal financial participation <br/>
<a id="pl.69.23"></a><var>69.23</var>for eligible activity related to fiscal years 2010 and 2011 grants to Advocating Change <br/>
<a id="pl.69.24"></a><var>69.24</var>Together to establish a statewide self-advocacy network for persons with developmental <br/>
<a id="pl.69.25"></a><var>69.25</var>disabilities and for eligible activities under any future grants to the organization.<br/>
<a id="pl.69.26"></a><var>69.26</var>(b) The commissioner shall report to the chairs of the senate Health and Human <br/>
<a id="pl.69.27"></a><var>69.27</var>Services Budget Division and the house of representatives Health Care and Human <br/>
<a id="pl.69.28"></a><var>69.28</var>Services Finance Division by December 15, 2010, with the results of the application for <br/>
<a id="pl.69.29"></a><var>69.29</var>federal matching funds.<br/>
<br/>
<a id="bill.4.0.0"></a>

<a id="bill.4.1.0"></a><a id="pl.70.3"></a><var>70.3</var>    Section 1. Minnesota Statutes 2008, section 256D.0515, is amended to read:<br/>
<a id="pl.70.4"></a><var>70.4</var><b>256D.0515 ASSET LIMITATIONS FOR FOOD STAMP HOUSEHOLDS.</b><br/>
<a id="pl.70.5"></a><var>70.5</var>All food stamp households must be determined eligible for the benefit discussed <br/>
<a id="pl.70.6"></a><var>70.6</var>under section 
         <statute_ref>256.029</statute_ref>. Food stamp households must demonstrate that:<br/>
<a id="pl.70.7"></a><var>70.7</var>(1) their gross income meets the federal Food Stamp requirements under United <br/>
<a id="pl.70.8"></a><var>70.8</var>States Code, title 7, section 2014(c); and is equal to or less than 165 percent of the federal <br/>
<a id="pl.70.9"></a><var>70.9</var>poverty guidelines for the same family size.<br/>
<a id="pl.70.10"></a><var>70.10</var>(2) they have financial resources, excluding vehicles, of less than $7,000.<br/>
<br/>
<a id="bill.4.2.0"></a><a id="pl.70.11"></a><var>70.11</var>    Sec. 2. Minnesota Statutes 2008, section 256J.20, subdivision 3, is amended to read:<br/>
<a id="pl.70.12"></a><var>70.12</var>    Subd. 3. <b>Other property limitations.</b> To be eligible for MFIP, the equity value of <br/>
<a id="pl.70.13"></a><var>70.13</var>all nonexcluded real and personal property of the assistance unit must not exceed $2,000 <br/>
<a id="pl.70.14"></a><var>70.14</var>for applicants and $5,000 for ongoing participants. The value of assets in clauses (1) to <br/>
<a id="pl.70.15"></a><var>70.15</var>(19) must be excluded when determining the equity value of real and personal property:<br/>
<a id="pl.70.16"></a><var>70.16</var>    (1) a licensed vehicle up to a loan value of less than or equal to $15,000 $7,500. If the <br/>
<a id="pl.70.17"></a><var>70.17</var>assistance unit owns more than one licensed vehicle, the county agency shall determine the <br/>
<a id="pl.70.18"></a><var>70.18</var>loan value of all additional vehicles and exclude the combined loan value of less than or <br/>
<a id="pl.70.19"></a><var>70.19</var>equal to $7,500. The county agency shall apply any excess loan value as if it were equity <br/>
<a id="pl.70.20"></a><var>70.20</var>value to the asset limit described in this section,. If the assistance unit owns more than <br/>
<a id="pl.70.21"></a><var>70.21</var>one licensed vehicle, the county agency shall determine the vehicle with the highest loan <br/>
<a id="pl.70.22"></a><var>70.22</var>value and count only the loan value over $7,500, excluding: (i) the value of one vehicle <br/>
<a id="pl.70.23"></a><var>70.23</var>per physically disabled person when the vehicle is needed to transport the disabled unit <br/>
<a id="pl.70.24"></a><var>70.24</var>member; this exclusion does not apply to mentally disabled people; (ii) the value of special <br/>
<a id="pl.70.25"></a><var>70.25</var>equipment for a disabled member of the assistance unit; and (iii) any vehicle used for <br/>
<a id="pl.70.26"></a><var>70.26</var>long-distance travel, other than daily commuting, for the employment of a unit member.<br/>
<a id="pl.70.27"></a><var>70.27</var>    The county agency shall count the loan value of all other vehicles and apply this <br/>
<a id="pl.70.28"></a><var>70.28</var>amount as if it were equity value to the asset limit described in this section. To establish the <br/>
<a id="pl.70.29"></a><var>70.29</var>loan value of vehicles, a county agency must use the N.A.D.A. Official Used Car Guide, <br/>
<a id="pl.70.30"></a><var>70.30</var>Midwest Edition, for newer model cars. When a vehicle is not listed in the guidebook, <br/>
<a id="pl.70.31"></a><var>70.31</var>or when the applicant or participant disputes the loan value listed in the guidebook as <br/>
<a id="pl.70.32"></a><var>70.32</var>unreasonable given the condition of the particular vehicle, the county agency may require <br/>
<a id="pl.70.33"></a><var>70.33</var>the applicant or participant document the loan value by securing a written statement from <br/>
<a id="pl.70.34"></a><var>70.34</var>a motor vehicle dealer licensed under section 
         <statute_ref>168.27</statute_ref>, stating the amount that the dealer <br/>
<a id="pl.71.1"></a><var>71.1</var>would pay to purchase the vehicle. The county agency shall reimburse the applicant or <br/>
<a id="pl.71.2"></a><var>71.2</var>participant for the cost of a written statement that documents a lower loan value; <br/>
<a id="pl.71.3"></a><var>71.3</var>    (2) the value of life insurance policies for members of the assistance unit;<br/>
<a id="pl.71.4"></a><var>71.4</var>    (3) one burial plot per member of an assistance unit;<br/>
<a id="pl.71.5"></a><var>71.5</var>    (4) the value of personal property needed to produce earned income, including <br/>
<a id="pl.71.6"></a><var>71.6</var>tools, implements, farm animals, inventory, business loans, business checking and <br/>
<a id="pl.71.7"></a><var>71.7</var>savings accounts used at least annually and used exclusively for the operation of a <br/>
<a id="pl.71.8"></a><var>71.8</var>self-employment business, and any motor vehicles if at least 50 percent of the vehicle's use <br/>
<a id="pl.71.9"></a><var>71.9</var>is to produce income and if the vehicles are essential for the self-employment business;<br/>
<a id="pl.71.10"></a><var>71.10</var>    (5) the value of personal property not otherwise specified which is commonly <br/>
<a id="pl.71.11"></a><var>71.11</var>used by household members in day-to-day living such as clothing, necessary household <br/>
<a id="pl.71.12"></a><var>71.12</var>furniture, equipment, and other basic maintenance items essential for daily living;<br/>
<a id="pl.71.13"></a><var>71.13</var>    (6) the value of real and personal property owned by a recipient of Supplemental <br/>
<a id="pl.71.14"></a><var>71.14</var>Security Income or Minnesota supplemental aid;<br/>
<a id="pl.71.15"></a><var>71.15</var>    (7) the value of corrective payments, but only for the month in which the payment <br/>
<a id="pl.71.16"></a><var>71.16</var>is received and for the following month;<br/>
<a id="pl.71.17"></a><var>71.17</var>    (8) a mobile home or other vehicle used by an applicant or participant as the <br/>
<a id="pl.71.18"></a><var>71.18</var>applicant's or participant's home;<br/>
<a id="pl.71.19"></a><var>71.19</var>    (9) money in a separate escrow account that is needed to pay real estate taxes or <br/>
<a id="pl.71.20"></a><var>71.20</var>insurance and that is used for this purpose;<br/>
<a id="pl.71.21"></a><var>71.21</var>    (10) money held in escrow to cover employee FICA, employee tax withholding, <br/>
<a id="pl.71.22"></a><var>71.22</var>sales tax withholding, employee worker compensation, business insurance, property rental, <br/>
<a id="pl.71.23"></a><var>71.23</var>property taxes, and other costs that are paid at least annually, but less often than monthly;<br/>
<a id="pl.71.24"></a><var>71.24</var>    (11) monthly assistance payments for the current month's or short-term emergency <br/>
<a id="pl.71.25"></a><var>71.25</var>needs under section 
         <statute_ref>256J.626, subdivision 2</statute_ref>; <br/>
<a id="pl.71.26"></a><var>71.26</var>    (12) the value of school loans, grants, or scholarships for the period they are <br/>
<a id="pl.71.27"></a><var>71.27</var>intended to cover;<br/>
<a id="pl.71.28"></a><var>71.28</var>    (13) payments listed in section 
         <statute_ref>256J.21, subdivision 2</statute_ref>, clause (9), which are held <br/>
<a id="pl.71.29"></a><var>71.29</var>in escrow for a period not to exceed three months to replace or repair personal or real <br/>
<a id="pl.71.30"></a><var>71.30</var>property; <br/>
<a id="pl.71.31"></a><var>71.31</var>    (14) income received in a budget month through the end of the payment month;<br/>
<a id="pl.71.32"></a><var>71.32</var>    (15) savings from earned income of a minor child or a minor parent that are set aside <br/>
<a id="pl.71.33"></a><var>71.33</var>in a separate account designated specifically for future education or employment costs;<br/>
<a id="pl.71.34"></a><var>71.34</var>    (16) the federal earned income credit, Minnesota working family credit, state and <br/>
<a id="pl.71.35"></a><var>71.35</var>federal income tax refunds, state homeowners and renters credits under chapter 290A, <br/>
<a id="pl.72.1"></a><var>72.1</var>property tax rebates and other federal or state tax rebates in the month received and the <br/>
<a id="pl.72.2"></a><var>72.2</var>following month;<br/>
<a id="pl.72.3"></a><var>72.3</var>    (17) payments excluded under federal law as long as those payments are held in a <br/>
<a id="pl.72.4"></a><var>72.4</var>separate account from any nonexcluded funds;<br/>
<a id="pl.72.5"></a><var>72.5</var>    (18) the assets of children ineligible to receive MFIP benefits because foster care or <br/>
<a id="pl.72.6"></a><var>72.6</var>adoption assistance payments are made on their behalf; and<br/>
<a id="pl.72.7"></a><var>72.7</var>    (19) the assets of persons whose income is excluded under section 
         <statute_ref>256J.21, <br/>
<a id="pl.72.8"></a><var>72.8</var>subdivision 2
         </statute_ref>, clause (43). <br/>
<a id="pl.72.9"></a><var>72.9</var><b>EFFECTIVE DATE.</b>This section is effective October 1, 2010.<br/>
<br/>
<a id="bill.4.3.0"></a><a id="pl.72.10"></a><var>72.10</var>    Sec. 3. Minnesota Statutes 2008, section 256J.24, subdivision 10, is amended to read:<br/>
<a id="pl.72.11"></a><var>72.11</var>    Subd. 10. <b>MFIP exit level.</b> The commissioner shall adjust the MFIP earned income <br/>
<a id="pl.72.12"></a><var>72.12</var>disregard to ensure that most participants do not lose eligibility for MFIP until their <br/>
<a id="pl.72.13"></a><var>72.13</var>income reaches at least 115 110 percent of the federal poverty guidelines in effect in <br/>
<a id="pl.72.14"></a><var>72.14</var>October of each fiscal year at the time of the adjustment. The adjustment to the disregard <br/>
<a id="pl.72.15"></a><var>72.15</var>shall be based on a household size of three, and the resulting earned income disregard <br/>
<a id="pl.72.16"></a><var>72.16</var>percentage must be applied to all household sizes. The adjustment under this subdivision <br/>
<a id="pl.72.17"></a><var>72.17</var>must be implemented at the same time as the October food stamp or whenever there is a <br/>
<a id="pl.72.18"></a><var>72.18</var>food support cost-of-living adjustment is reflected in the food portion of MFIP transitional <br/>
<a id="pl.72.19"></a><var>72.19</var>standard as required under subdivision 5a.<br/>
<a id="pl.72.20"></a><var>72.20</var><b>EFFECTIVE DATE.</b>This section is effective October 1, 2010.<br/>
<br/>
<a id="bill.4.4.0"></a><a id="pl.72.21"></a><var>72.21</var>    Sec. 4. Minnesota Statutes 2008, section 256J.37, subdivision 3a, is amended to read:<br/>
<a id="pl.72.22"></a><var>72.22</var>    Subd. 3a. <b>Rental subsidies; unearned income.</b> (a) Effective July 1, 2003, The <br/>
<a id="pl.72.23"></a><var>72.23</var>county agency shall count $50 $100 of the value of public and assisted rental subsidies <br/>
<a id="pl.72.24"></a><var>72.24</var>provided through the Department of Housing and Urban Development (HUD) as unearned <br/>
<a id="pl.72.25"></a><var>72.25</var>income to the cash portion of the MFIP grant. The full amount of the subsidy must be <br/>
<a id="pl.72.26"></a><var>72.26</var>counted as unearned income when the subsidy is less than $50 $100. The income from <br/>
<a id="pl.72.27"></a><var>72.27</var>this subsidy shall be budgeted according to section 
         <statute_ref>256J.34</statute_ref>. <br/>
<a id="pl.72.28"></a><var>72.28</var>(b) The provisions of this subdivision shall not apply to an MFIP assistance unit <br/>
<a id="pl.72.29"></a><var>72.29</var>which includes a participant who is:<br/>
<a id="pl.72.30"></a><var>72.30</var>(1) age 60 or older;<br/>
<a id="pl.72.31"></a><var>72.31</var>(2) a caregiver who is suffering from an illness, injury, or incapacity that has been <br/>
<a id="pl.72.32"></a><var>72.32</var>certified by a qualified professional when the illness, injury, or incapacity is expected <br/>
<a id="pl.73.1"></a><var>73.1</var>to continue for more than 30 days and prevents the person from obtaining or retaining <br/>
<a id="pl.73.2"></a><var>73.2</var>employment; or<br/>
<a id="pl.73.3"></a><var>73.3</var>(3) a caregiver whose presence in the home is required due to the illness or <br/>
<a id="pl.73.4"></a><var>73.4</var>incapacity of another member in the assistance unit, a relative in the household, or a foster <br/>
<a id="pl.73.5"></a><var>73.5</var>child in the household when the illness or incapacity and the need for the participant's <br/>
<a id="pl.73.6"></a><var>73.6</var>presence in the home has been certified by a qualified professional and is expected to <br/>
<a id="pl.73.7"></a><var>73.7</var>continue for more than 30 days.<br/>
<a id="pl.73.8"></a><var>73.8</var>(c) The provisions of this subdivision shall not apply to an MFIP assistance unit <br/>
<a id="pl.73.9"></a><var>73.9</var>where the parental caregiver is an SSI recipient.<br/>
<a id="pl.73.10"></a><var>73.10</var>(d) Prior to implementing this provision, the commissioner must identify the MFIP <br/>
<a id="pl.73.11"></a><var>73.11</var>participants subject to this provision and provide written notice to these participants at <br/>
<a id="pl.73.12"></a><var>73.12</var>least 30 days before the first grant reduction. The notice must inform the participant of the <br/>
<a id="pl.73.13"></a><var>73.13</var>basis for the potential grant reduction, the exceptions to the provision, if any, and inform <br/>
<a id="pl.73.14"></a><var>73.14</var>the participant of the steps necessary to claim an exception. A person who is found not to <br/>
<a id="pl.73.15"></a><var>73.15</var>meet one of the exceptions to the provision must be notified and informed of the right to a <br/>
<a id="pl.73.16"></a><var>73.16</var>fair hearing under section 
         <statute_ref>256J.40</statute_ref>. The notice must also inform the participant that the <br/>
<a id="pl.73.17"></a><var>73.17</var>participant may be eligible for a rent reduction resulting from a reduction in the MFIP <br/>
<a id="pl.73.18"></a><var>73.18</var>grant and encourage the participant to contact the local housing authority. <br/>
<a id="pl.73.19"></a><var>73.19</var><b>EFFECTIVE DATE.</b>This section is effective October 1, 2010.<br/>
<br/>
<a id="bill.4.5.0"></a><a id="pl.73.20"></a><var>73.20</var>    Sec. 5. Minnesota Statutes 2009 Supplement, section 256J.425, subdivision 3, is <br/>
<a id="pl.73.21"></a><var>73.21</var>amended to read:<br/>
<a id="pl.73.22"></a><var>73.22</var>    Subd. 3. <b>Hard-to-employ participants.</b> (a) An assistance unit subject to the time <br/>
<a id="pl.73.23"></a><var>73.23</var>limit in section 
         <statute_ref>256J.42, subdivision 1</statute_ref>, is eligible to receive months of assistance under <br/>
<a id="pl.73.24"></a><var>73.24</var>a hardship extension if the participant who reached the time limit belongs to any of the <br/>
<a id="pl.73.25"></a><var>73.25</var>following groups: <br/>
<a id="pl.73.26"></a><var>73.26</var>    (1) a person who is diagnosed by a licensed physician, psychological practitioner, or <br/>
<a id="pl.73.27"></a><var>73.27</var>other qualified professional, as developmentally disabled or mentally ill, and the condition <br/>
<a id="pl.73.28"></a><var>73.28</var>severely limits the person's ability to obtain or maintain suitable employment;<br/>
<a id="pl.73.29"></a><var>73.29</var>    (2) a person who:<br/>
<a id="pl.73.30"></a><var>73.30</var>    (i) has been assessed by a vocational specialist or the county agency to be <br/>
<a id="pl.73.31"></a><var>73.31</var>unemployable for purposes of this subdivision; or<br/>
<a id="pl.73.32"></a><var>73.32</var>    (ii) has an IQ below 80 who has been assessed by a vocational specialist or a county <br/>
<a id="pl.73.33"></a><var>73.33</var>agency to be employable, but the condition severely limits the person's ability to obtain or <br/>
<a id="pl.73.34"></a><var>73.34</var>maintain suitable employment. The determination of IQ level must be made by a qualified <br/>
<a id="pl.73.35"></a><var>73.35</var>professional. In the case of a non-English-speaking person: (A) the determination must <br/>
<a id="pl.74.1"></a><var>74.1</var>be made by a qualified professional with experience conducting culturally appropriate <br/>
<a id="pl.74.2"></a><var>74.2</var>assessments, whenever possible; (B) the county may accept reports that identify an <br/>
<a id="pl.74.3"></a><var>74.3</var>IQ range as opposed to a specific score; (C) these reports must include a statement of <br/>
<a id="pl.74.4"></a><var>74.4</var>confidence in the results;<br/>
<a id="pl.74.5"></a><var>74.5</var>    (3) a person who is determined by a qualified professional to be learning disabled, <br/>
<a id="pl.74.6"></a><var>74.6</var>and the condition severely limits the person's ability to obtain or maintain suitable <br/>
<a id="pl.74.7"></a><var>74.7</var>employment. For purposes of the initial approval of a learning disability extension, the <br/>
<a id="pl.74.8"></a><var>74.8</var>determination must have been made or confirmed within the previous 12 months. In the <br/>
<a id="pl.74.9"></a><var>74.9</var>case of a non-English-speaking person: (i) the determination must be made by a qualified <br/>
<a id="pl.74.10"></a><var>74.10</var>professional with experience conducting culturally appropriate assessments, whenever <br/>
<a id="pl.74.11"></a><var>74.11</var>possible; and (ii) these reports must include a statement of confidence in the results. If a <br/>
<a id="pl.74.12"></a><var>74.12</var>rehabilitation plan for a participant extended as learning disabled is developed or approved <br/>
<a id="pl.74.13"></a><var>74.13</var>by the county agency, the plan must be incorporated into the employment plan. However, <br/>
<a id="pl.74.14"></a><var>74.14</var>a rehabilitation plan does not replace the requirement to develop and comply with an <br/>
<a id="pl.74.15"></a><var>74.15</var>employment plan under section 
         <statute_ref>256J.521</statute_ref>; or <br/>
<a id="pl.74.16"></a><var>74.16</var>    (4) a person who has been granted a family violence waiver, and who is complying <br/>
<a id="pl.74.17"></a><var>74.17</var>with an employment plan under section 
         <statute_ref>256J.521, subdivision 3</statute_ref>. <br/>
<a id="pl.74.18"></a><var>74.18</var>    (b) For purposes of this section chapter, "severely limits the person's ability to obtain <br/>
<a id="pl.74.19"></a><var>74.19</var>or maintain suitable employment" means: <br/>
<a id="pl.74.20"></a><var>74.20</var>    (1) that a qualified professional has determined that the person's condition prevents <br/>
<a id="pl.74.21"></a><var>74.21</var>the person from working 20 or more hours per week; or <br/>
<a id="pl.74.22"></a><var>74.22</var>    (2) for a person who meets the requirements of paragraph (a), clause (2), item (ii), or <br/>
<a id="pl.74.23"></a><var>74.23</var>clause (3), a qualified professional has determined the person's condition:<br/>
<a id="pl.74.24"></a><var>74.24</var>    (i) significantly restricts the range of employment that the person is able to perform; <br/>
<a id="pl.74.25"></a><var>74.25</var>or <br/>
<a id="pl.74.26"></a><var>74.26</var>    (ii) significantly interferes with the person's ability to obtain or maintain suitable <br/>
<a id="pl.74.27"></a><var>74.27</var>employment for 20 or more hours per week.<br/>
<br/>
<a id="bill.5.0.0"></a>

<a id="bill.5.1.0"></a><a id="pl.74.30"></a><var>74.30</var>    Section 1. Minnesota Statutes 2008, section 3.971, subdivision 2, is amended to read:<br/>
<a id="pl.74.31"></a><var>74.31</var>    Subd. 2.  <b>Staff; compensation.</b> The legislative auditor shall establish a Financial <br/>
<a id="pl.74.32"></a><var>74.32</var>Audits Division and a Program Evaluation Division to fulfill the duties prescribed in <br/>
<a id="pl.74.33"></a><var>74.33</var>this section. The legislative auditor shall establish a Legislative Budget Office Division <br/>
<a id="pl.74.34"></a><var>74.34</var>to fulfill the duties in section 3.98, subdivision 5. Each division may be supervised by a <br/>
<a id="pl.74.35"></a><var>74.35</var>deputy auditor, appointed by the legislative auditor, with the approval of the commission, <br/>
<a id="pl.75.1"></a><var>75.1</var>for a term coterminous with the legislative auditor's term. The deputy auditors may be <br/>
<a id="pl.75.2"></a><var>75.2</var>removed before the expiration of their terms only for cause. The legislative auditor <br/>
<a id="pl.75.3"></a><var>75.3</var>and deputy auditors may each appoint a confidential secretary to serve at pleasure. <br/>
<a id="pl.75.4"></a><var>75.4</var>The salaries and benefits of the legislative auditor, deputy auditors and confidential <br/>
<a id="pl.75.5"></a><var>75.5</var>secretaries shall be determined by the compensation plan approved by the Legislative <br/>
<a id="pl.75.6"></a><var>75.6</var>Coordinating Commission. The deputy auditors may perform and exercise the powers, <br/>
<a id="pl.75.7"></a><var>75.7</var>duties and responsibilities imposed by law on the legislative auditor when authorized by <br/>
<a id="pl.75.8"></a><var>75.8</var>the legislative auditor. The deputy auditors and the confidential secretaries serve in the <br/>
<a id="pl.75.9"></a><var>75.9</var>unclassified civil service, but all other employees of the legislative auditor are in the <br/>
<a id="pl.75.10"></a><var>75.10</var>classified civil service. Compensation for employees of the legislative auditor in the <br/>
<a id="pl.75.11"></a><var>75.11</var>classified service shall be governed by a plan prepared by the legislative auditor and <br/>
<a id="pl.75.12"></a><var>75.12</var>approved by the Legislative Coordinating Commission and the legislature under section <br/>
<statute_ref><a id="pl.75.13"></a><var>75.13</var>3.855, subdivision 3
         </statute_ref>. While in office, a person appointed deputy for the Financial Audit <br/>
<a id="pl.75.14"></a><var>75.14</var>Division must hold an active license as a certified public accountant. <br/>
<a id="pl.75.15"></a><var>75.15</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2011.<br/>
<br/>
<a id="bill.5.2.0"></a><a id="pl.75.16"></a><var>75.16</var>    Sec. 2. Minnesota Statutes 2008, section 3.98, is amended by adding a subdivision to <br/>
<a id="pl.75.17"></a><var>75.17</var>read:<br/>
<a id="pl.75.18"></a><var>75.18</var>    Subd. 5. <b>Fiscal notes; Department of Human Services.</b> (a) The responsibilities of <br/>
<a id="pl.75.19"></a><var>75.19</var>the Department of Human Services for the preparation of fiscal notes under this chapter <br/>
<a id="pl.75.20"></a><var>75.20</var>are transferred to the Legislative Budget Office Division under section 3.971.<br/>
<a id="pl.75.21"></a><var>75.21</var>(b) The Legislative Budget Office Division shall prepare a fiscal note for any bill that <br/>
<a id="pl.75.22"></a><var>75.22</var>increases or decreases expenditures at the Department of Human Services at the request of <br/>
<a id="pl.75.23"></a><var>75.23</var>the chair of the budget or finance division to which a bill relating to the department has <br/>
<a id="pl.75.24"></a><var>75.24</var>been referred, or at the request of either the chair of the house of representatives Ways and <br/>
<a id="pl.75.25"></a><var>75.25</var>Means Committee, or the chair of the senate Finance Committee. At the request of the <br/>
<a id="pl.75.26"></a><var>75.26</var>commissioner of human services, the Legislative Budget Office Division shall include a <br/>
<a id="pl.75.27"></a><var>75.27</var>statement from the commissioner:<br/>
<a id="pl.75.28"></a><var>75.28</var>(1) concurring with the information provided;<br/>
<a id="pl.75.29"></a><var>75.29</var>(2) suggesting alternative dollar amounts for a specific program or function; or<br/>
<a id="pl.75.30"></a><var>75.30</var>(3) indicating any other information which the commissioner deems relevant.<br/>
<br/>
<a id="bill.5.3.0"></a><a id="pl.75.31"></a><var>75.31</var>    Sec. 3. <b>[62A.3075] CANCER CHEMOTHERAPY TREATMENT COVERAGE.</b><br/>
<a id="pl.75.32"></a><var>75.32</var>(a) A health plan company that provides coverage under a health plan for cancer <br/>
<a id="pl.75.33"></a><var>75.33</var>chemotherapy treatment shall not require a higher co-payment, deductible, or coinsurance <br/>
<a id="pl.75.34"></a><var>75.34</var>amount for a prescribed, orally administered anticancer medication that is used to kill or <br/>
<a id="pl.76.1"></a><var>76.1</var>slow the growth of cancerous cells than what the health plan requires for an intravenously <br/>
<a id="pl.76.2"></a><var>76.2</var>administered or injected cancer medication that is provided, regardless of formulation or <br/>
<a id="pl.76.3"></a><var>76.3</var>benefit category determination by the health plan company.<br/>
<a id="pl.76.4"></a><var>76.4</var>(b) A health plan company must not achieve compliance with this section <br/>
<a id="pl.76.5"></a><var>76.5</var>by imposing an increase in co-payment, deductible, or coinsurance amount for an <br/>
<a id="pl.76.6"></a><var>76.6</var>intravenously administered or injected cancer chemotherapy agent covered under the <br/>
<a id="pl.76.7"></a><var>76.7</var>health plan.<br/>
<a id="pl.76.8"></a><var>76.8</var>(c) Nothing in this section shall be interpreted to prohibit a health plan company <br/>
<a id="pl.76.9"></a><var>76.9</var>from requiring prior authorization or imposing other appropriate utilization controls in <br/>
<a id="pl.76.10"></a><var>76.10</var>approving coverage for any chemotherapy.<br/>
<a id="pl.76.11"></a><var>76.11</var>(d) A plan offered by the commissioner of management and budget under section <br/>
<a id="pl.76.12"></a><var>76.12</var>43A.23 is deemed to be at parity and in compliance with this section.<br/>
<a id="pl.76.13"></a><var>76.13</var><b>EFFECTIVE DATE.</b>Paragraphs (a) and (c) are effective August 1, 2010, and apply <br/>
<a id="pl.76.14"></a><var>76.14</var>to health plans providing coverage to a Minnesota resident offered, issued, sold, renewed, <br/>
<a id="pl.76.15"></a><var>76.15</var>or continued as defined in Minnesota Statutes, section 60A.02, subdivision 2a, on or after <br/>
<a id="pl.76.16"></a><var>76.16</var>that date. Paragraph (b) is effective the day following final enactment.<br/>
<br/>
<a id="bill.5.4.0"></a><a id="pl.76.17"></a><var>76.17</var>    Sec. 4. <b>[62A.3094] COVERAGE FOR AUTISM SPECTRUM DISORDERS.</b><br/>
<a id="pl.76.18"></a><var>76.18</var>    Subdivision 1. <b>Definitions.</b> (a) For purposes of this section, the terms defined in <br/>
<a id="pl.76.19"></a><var>76.19</var>paragraphs (b) to (e) have the meanings given.<br/>
<a id="pl.76.20"></a><var>76.20</var>(b) "Autism spectrum disorder" means the following conditions as determined by <br/>
<a id="pl.76.21"></a><var>76.21</var>criteria set forth in the most recent edition of the Diagnostic and Statistical Manual of <br/>
<a id="pl.76.22"></a><var>76.22</var>Mental Disorders of the American Psychiatric Association:<br/>
<a id="pl.76.23"></a><var>76.23</var>(1) autism or autistic disorder;<br/>
<a id="pl.76.24"></a><var>76.24</var>(2) Asperger's syndrome; or<br/>
<a id="pl.76.25"></a><var>76.25</var>(3) pervasive developmental disorder - not otherwise specified.<br/>
<a id="pl.76.26"></a><var>76.26</var>(c) "Board-certified behavior analyst" means an individual certified by the Behavior <br/>
<a id="pl.76.27"></a><var>76.27</var>Analyst Certification Board as a board-certified behavior analyst.<br/>
<a id="pl.76.28"></a><var>76.28</var>(d) "Evidence-based," for purposes of this section only, is as described in subdivision <br/>
<a id="pl.76.29"></a><var>76.29</var>2, paragraph (c), clause (2).<br/>
<a id="pl.76.30"></a><var>76.30</var>(e) "Health plan" has the meaning given in section 62Q.01, subdivision 3.<br/>
<a id="pl.76.31"></a><var>76.31</var>(f) "Manualized approach" means a self-contained volume, text, or set of <br/>
<a id="pl.76.32"></a><var>76.32</var>instructional media, which may include videos or compact discs, that codifies in <br/>
<a id="pl.76.33"></a><var>76.33</var>reasonable detail the procedures for implementing treatment.<br/>
<a id="pl.76.34"></a><var>76.34</var>(g) "Medical necessity" or "medically necessary care" has the meaning given in <br/>
<a id="pl.76.35"></a><var>76.35</var>section 62Q.53, subdivision 2.<br/>
<a id="pl.77.1"></a><var>77.1</var>(h) "Mental health professional" has the meaning given in section 245.4871, <br/>
<a id="pl.77.2"></a><var>77.2</var>subdivision 27, clauses (1) to (6).<br/>
<a id="pl.77.3"></a><var>77.3</var>(i) "Qualified mental health behavioral aide" means a mental health behavioral aide <br/>
<a id="pl.77.4"></a><var>77.4</var>as defined in section 256B.0943, subdivision 7.<br/>
<a id="pl.77.5"></a><var>77.5</var>(j) "Qualified mental health practitioner" means a mental health practitioner as <br/>
<a id="pl.77.6"></a><var>77.6</var>defined in section 245.4871, subdivision 26.<br/>
<a id="pl.77.7"></a><var>77.7</var>(k) "Statistically superior outcomes" means a research study in which the probability <br/>
<a id="pl.77.8"></a><var>77.8</var>that the results would be obtained under the null hypothesis is less than five percent.<br/>
<a id="pl.77.9"></a><var>77.9</var>    Subd. 2. <b>Coverage required.</b> (a) For coverage requirements to apply, an individual <br/>
<a id="pl.77.10"></a><var>77.10</var>must have a diagnosis of autism spectrum disorder made through an evaluation of the <br/>
<a id="pl.77.11"></a><var>77.11</var>patient, completed within the six months prior to the start of treatment, which includes <br/>
<a id="pl.77.12"></a><var>77.12</var>all of the following:<br/>
<a id="pl.77.13"></a><var>77.13</var>(1) a complete medical and psychological evaluation performed by a licensed <br/>
<a id="pl.77.14"></a><var>77.14</var>physician and psychologist using empirically validated tools or tests that incorporate <br/>
<a id="pl.77.15"></a><var>77.15</var>measures for intellectual functioning, language development, adaptive skills, and <br/>
<a id="pl.77.16"></a><var>77.16</var>behavioral problems, which must include:<br/>
<a id="pl.77.17"></a><var>77.17</var>(i) a developmental history of the child, focusing on developmental milestones <br/>
<a id="pl.77.18"></a><var>77.18</var>and delays;<br/>
<a id="pl.77.19"></a><var>77.19</var>(ii) a family history, including whether there are other family members with an <br/>
<a id="pl.77.20"></a><var>77.20</var>autism spectrum disorder, developmental disability, fragile X syndrome, or tuberous <br/>
<a id="pl.77.21"></a><var>77.21</var>sclerosis;<br/>
<a id="pl.77.22"></a><var>77.22</var>(iii) a medical history, including signs of deterioration, seizure activity, brain injury, <br/>
<a id="pl.77.23"></a><var>77.23</var>and head circumference;<br/>
<a id="pl.77.24"></a><var>77.24</var>(iv) a physical examination completed within the past 12 months;<br/>
<a id="pl.77.25"></a><var>77.25</var>(v) an evaluation for intellectual functioning;<br/>
<a id="pl.77.26"></a><var>77.26</var>(vi) a lead screening for those children with a developmental disability; and<br/>
<a id="pl.77.27"></a><var>77.27</var>(vii) other evaluations and testing as indicated by the medical evaluation, which <br/>
<a id="pl.77.28"></a><var>77.28</var>may include neuropsychological testing, occupational therapy, physical therapy, family <br/>
<a id="pl.77.29"></a><var>77.29</var>functioning, genetic testing, imaging laboratory tests, and electrophysiological testing;<br/>
<a id="pl.77.30"></a><var>77.30</var>(2) a communication assessment conducted by a speech pathologist; and<br/>
<a id="pl.77.31"></a><var>77.31</var>(3) a comprehensive hearing test conducted by an audiologist with experience in <br/>
<a id="pl.77.32"></a><var>77.32</var>testing very young children.<br/>
<a id="pl.77.33"></a><var>77.33</var>(b) A health plan must provide coverage for the diagnosis, evaluation, assessment, <br/>
<a id="pl.77.34"></a><var>77.34</var>and medically necessary care of autism spectrum disorders that is evidence-based, <br/>
<a id="pl.77.35"></a><var>77.35</var>including but not limited to:<br/>
<a id="pl.78.1"></a><var>78.1</var>(1) neurodevelopmental and behavioral health treatments, instruction, and <br/>
<a id="pl.78.2"></a><var>78.2</var>management;<br/>
<a id="pl.78.3"></a><var>78.3</var>(2) applied behavior analysis and intensive early intervention services, including <br/>
<a id="pl.78.4"></a><var>78.4</var>service package models such as intensive early intervention behavior therapy services <br/>
<a id="pl.78.5"></a><var>78.5</var>and Lovaas therapy;<br/>
<a id="pl.78.6"></a><var>78.6</var>(3) speech therapy;<br/>
<a id="pl.78.7"></a><var>78.7</var>(4) occupational therapy;<br/>
<a id="pl.78.8"></a><var>78.8</var>(5) physical therapy; and<br/>
<a id="pl.78.9"></a><var>78.9</var>(6) prescription medications.<br/>
<a id="pl.78.10"></a><var>78.10</var>(c) Coverage required under this section shall include treatment that is in accordance <br/>
<a id="pl.78.11"></a><var>78.11</var>with:<br/>
<a id="pl.78.12"></a><var>78.12</var>(1) an individualized treatment plan prescribed by the insured's treating physician or <br/>
<a id="pl.78.13"></a><var>78.13</var>mental health professional as defined in this section; and<br/>
<a id="pl.78.14"></a><var>78.14</var>(2) medically and scientifically accepted evidence that meets the criteria of a <br/>
<a id="pl.78.15"></a><var>78.15</var>peer-reviewed, published study that is one of the following:<br/>
<a id="pl.78.16"></a><var>78.16</var>(i) a randomized study with adequate statistical power, including a sample size of <br/>
<a id="pl.78.17"></a><var>78.17</var>30 or more for each group, that shows statistically superior outcomes to a pill placebo <br/>
<a id="pl.78.18"></a><var>78.18</var>group, psychological placebo group, another treatment group, or a wait list control group, <br/>
<a id="pl.78.19"></a><var>78.19</var>or that is equivalent to another evidence-based treatment that meets the above standard <br/>
<a id="pl.78.20"></a><var>78.20</var>for the specified problem area; or<br/>
<a id="pl.78.21"></a><var>78.21</var>(ii) a series of at least three single-case design experiments with clear specification <br/>
<a id="pl.78.22"></a><var>78.22</var>of the subjects and with clear specification of the treatment approach that:<br/>
<a id="pl.78.23"></a><var>78.23</var>(A) use robust experimental designs;<br/>
<a id="pl.78.24"></a><var>78.24</var>(B) show statistically superior outcomes to pill placebo, psychological placebo, <br/>
<a id="pl.78.25"></a><var>78.25</var>or another treatment group; and <br/>
<a id="pl.78.26"></a><var>78.26</var>(C) either use a manualized approach or are conducted by at least two independent <br/>
<a id="pl.78.27"></a><var>78.27</var>investigators or teams; or<br/>
<a id="pl.78.28"></a><var>78.28</var>(3) where evidence meeting the standards of this subdivision does not exist for <br/>
<a id="pl.78.29"></a><var>78.29</var>the treatment of a diagnosed condition or for an individual matching the demographic <br/>
<a id="pl.78.30"></a><var>78.30</var>characteristics for which the evidence is valid, practice guidelines based on consensus <br/>
<a id="pl.78.31"></a><var>78.31</var>of Minnesota health care professionals knowledgeable in the treatment of individuals <br/>
<a id="pl.78.32"></a><var>78.32</var>with autism spectrum disorders. <br/>
<a id="pl.78.33"></a><var>78.33</var>(d) Early intensive behavior therapies that meet the criteria set forth in paragraphs <br/>
<a id="pl.78.34"></a><var>78.34</var>(b) and (c) must also meet the following best practices standards:<br/>
<a id="pl.78.35"></a><var>78.35</var>(1) the services must be prescribed by a mental health professional as an appropriate <br/>
<a id="pl.78.36"></a><var>78.36</var>treatment option for the individual child;<br/>
<a id="pl.79.1"></a><var>79.1</var>(2) regular reporting of services provided and the child's progress must be submitted <br/>
<a id="pl.79.2"></a><var>79.2</var>to the prescribing mental health professional;<br/>
<a id="pl.79.3"></a><var>79.3</var>(3) care must include appropriate parent or legal guardian education and <br/>
<a id="pl.79.4"></a><var>79.4</var>involvement;<br/>
<a id="pl.79.5"></a><var>79.5</var>(4) the medically prescribed treatment and frequency of services should be <br/>
<a id="pl.79.6"></a><var>79.6</var>coordinated between the school and provider for all children up to age 21; and<br/>
<a id="pl.79.7"></a><var>79.7</var>(5) services must be provided by a mental health professional or, as appropriate, a <br/>
<a id="pl.79.8"></a><var>79.8</var>board-certified behavior analyst, a qualified mental health practitioner, or a qualified <br/>
<a id="pl.79.9"></a><var>79.9</var>mental health behavioral aide.<br/>
<a id="pl.79.10"></a><var>79.10</var>(e) Providers under this section must work with the commissioner in implementing <br/>
<a id="pl.79.11"></a><var>79.11</var>evidence-based practices and, specifically for children under age 21, the Minnesota <br/>
<a id="pl.79.12"></a><var>79.12</var>Evidence-Based Practice Database of research-informed practice elements and specific <br/>
<a id="pl.79.13"></a><var>79.13</var>constituent practices.<br/>
<a id="pl.79.14"></a><var>79.14</var>(f) A health plan company may not refuse to renew or reissue, or otherwise terminate <br/>
<a id="pl.79.15"></a><var>79.15</var>or restrict coverage of an individual solely because the individual is diagnosed with an <br/>
<a id="pl.79.16"></a><var>79.16</var>autism spectrum disorder.<br/>
<a id="pl.79.17"></a><var>79.17</var>(g) A health plan company may request an updated treatment plan only once every <br/>
<a id="pl.79.18"></a><var>79.18</var>six months, unless the health plan company and the treating physician or mental health <br/>
<a id="pl.79.19"></a><var>79.19</var>professional agree that a more frequent review is necessary due to emerging circumstances.<br/>
<a id="pl.79.20"></a><var>79.20</var>    Subd. 3. <b>Supervision, delegation of duties, and observation of qualified mental </b><br/>
<a id="pl.79.21"></a><var>79.21</var><b>health practitioner, board-certified behavior analyst, or mental health behavioral </b><br/>
<a id="pl.79.22"></a><var>79.22</var><b>aide.</b>  A mental health professional who uses the services of a qualified mental health <br/>
<a id="pl.79.23"></a><var>79.23</var>practitioner, board-certified behavior analyst, or qualified mental health behavioral aide for <br/>
<a id="pl.79.24"></a><var>79.24</var>the purpose of assisting in the provision of services to patients who have autism spectrum <br/>
<a id="pl.79.25"></a><var>79.25</var>disorder is responsible for functions performed by these service providers. The qualified <br/>
<a id="pl.79.26"></a><var>79.26</var>mental health professional must maintain clinical supervision of services they provide <br/>
<a id="pl.79.27"></a><var>79.27</var>and accept full responsibility for their actions. The services provided must be medically <br/>
<a id="pl.79.28"></a><var>79.28</var>necessary and identified in the child's individual treatment plan. Service providers must <br/>
<a id="pl.79.29"></a><var>79.29</var>document their activities in written progress notes that reflect implementation of the <br/>
<a id="pl.79.30"></a><var>79.30</var>individual treatment plan.<br/>
<a id="pl.79.31"></a><var>79.31</var>    Subd. 4. <b>State health care programs.</b> This section does not affect benefits <br/>
<a id="pl.79.32"></a><var>79.32</var>available under the medical assistance, MinnesotaCare, and general assistance medical <br/>
<a id="pl.79.33"></a><var>79.33</var>care programs, and the state employee group insurance plan offered under sections <br/>
<a id="pl.79.34"></a><var>79.34</var>43A.22 to 43A.30. These programs and the state employee group insurance plan must <br/>
<a id="pl.79.35"></a><var>79.35</var>maintain current levels of coverage, and section 256B.0644 shall continue to apply. <br/>
<a id="pl.79.36"></a><var>79.36</var>The commissioner shall monitor these services and report to the chairs of the house <br/>
<a id="pl.80.1"></a><var>80.1</var>of representatives and senate standing committees that have jurisdiction over health <br/>
<a id="pl.80.2"></a><var>80.2</var>and human services by February 1, 2011, whether there are gaps in the level of service <br/>
<a id="pl.80.3"></a><var>80.3</var>provided by these programs and the state employee group insurance plan, and the level of <br/>
<a id="pl.80.4"></a><var>80.4</var>service provided by private health plans following enactment of this section.<br/>
<a id="pl.80.5"></a><var>80.5</var>    Subd. 5. <b>No effect on other law.</b> Nothing in this section limits in any way the <br/>
<a id="pl.80.6"></a><var>80.6</var>coverage required under sections 62Q.47 and 62Q.53.<br/>
<a id="pl.80.7"></a><var>80.7</var><b>EFFECTIVE DATE.</b>This section is effective August 1, 2010, and applies to <br/>
<a id="pl.80.8"></a><var>80.8</var>coverage offered, issued, sold, renewed, or continued as defined in Minnesota Statutes, <br/>
<a id="pl.80.9"></a><var>80.9</var>section 60A.02, subdivision 2a, on or after that date.<br/>
<br/>
<a id="bill.5.5.0"></a><a id="pl.80.10"></a><var>80.10</var>    Sec. 5. Minnesota Statutes 2008, section 62J.38, is amended to read:<br/>
<a id="pl.80.11"></a><var>80.11</var><b>62J.38 COST CONTAINMENT DATA FROM GROUP PURCHASERS.</b><br/>
<a id="pl.80.12"></a><var>80.12</var>(a) The commissioner shall require group purchasers to submit detailed data on total <br/>
<a id="pl.80.13"></a><var>80.13</var>health care spending for each calendar year. Group purchasers shall submit data for the <br/>
<a id="pl.80.14"></a><var>80.14</var>1993 calendar year by April 1, 1994, and each April 1 thereafter shall submit data for the <br/>
<a id="pl.80.15"></a><var>80.15</var>preceding calendar year.<br/>
<a id="pl.80.16"></a><var>80.16</var>(b) The commissioner shall require each group purchaser to submit data on revenue, <br/>
<a id="pl.80.17"></a><var>80.17</var>expenses, and member months, as applicable. Revenue data must distinguish between <br/>
<a id="pl.80.18"></a><var>80.18</var>premium revenue and revenue from other sources and must also include information <br/>
<a id="pl.80.19"></a><var>80.19</var>on the amount of revenue in reserves and changes in reserves. Expenditure data must <br/>
<a id="pl.80.20"></a><var>80.20</var>distinguish between costs incurred for patient care and administrative costs, including <br/>
<a id="pl.80.21"></a><var>80.21</var>amounts paid to contractors, subcontractors, and other entities for the purpose of managing <br/>
<a id="pl.80.22"></a><var>80.22</var>provider utilization or distributing provider payments. Patient care and administrative <br/>
<a id="pl.80.23"></a><var>80.23</var>costs must include only expenses incurred on behalf of health plan members and must <br/>
<a id="pl.80.24"></a><var>80.24</var>not include the cost of providing health care services for nonmembers at facilities owned <br/>
<a id="pl.80.25"></a><var>80.25</var>by the group purchaser or affiliate. Expenditure data must be provided separately <br/>
<a id="pl.80.26"></a><var>80.26</var>for the following categories and for other categories required by the commissioner: <br/>
<a id="pl.80.27"></a><var>80.27</var>physician services, dental services, other professional services, inpatient hospital services, <br/>
<a id="pl.80.28"></a><var>80.28</var>outpatient hospital services, emergency, pharmacy services and other nondurable medical <br/>
<a id="pl.80.29"></a><var>80.29</var>goods, mental health, and chemical dependency services, other expenditures, subscriber <br/>
<a id="pl.80.30"></a><var>80.30</var>liability, and administrative costs. Administrative costs must include costs for marketing; <br/>
<a id="pl.80.31"></a><var>80.31</var>advertising; overhead; salaries and benefits of central office staff who do not provide <br/>
<a id="pl.80.32"></a><var>80.32</var>direct patient care; underwriting; lobbying; claims processing; provider contracting and <br/>
<a id="pl.80.33"></a><var>80.33</var>credentialing; detection and prevention of payment for fraudulent or unjustified requests <br/>
<a id="pl.80.34"></a><var>80.34</var>for reimbursement or services; clinical quality assurance and other types of medical care <br/>
<a id="pl.81.1"></a><var>81.1</var>quality improvement efforts; concurrent or prospective utilization review as defined in <br/>
<a id="pl.81.2"></a><var>81.2</var>section 
         <statute_ref>62M.02</statute_ref>; costs incurred to acquire a hospital, clinic, or health care facility, or the <br/>
<a id="pl.81.3"></a><var>81.3</var>assets thereof; capital costs incurred on behalf of a hospital or clinic; lease payments; or <br/>
<a id="pl.81.4"></a><var>81.4</var>any other costs incurred pursuant to a partnership, joint venture, integration, or affiliation <br/>
<a id="pl.81.5"></a><var>81.5</var>agreement with a hospital, clinic, or other health care provider. Capital costs and costs <br/>
<a id="pl.81.6"></a><var>81.6</var>incurred must be recorded according to standard accounting principles. The reports of <br/>
<a id="pl.81.7"></a><var>81.7</var>this data must also separately identify expenses for local, state, and federal taxes, fees, <br/>
<a id="pl.81.8"></a><var>81.8</var>and assessments. The commissioner may require each group purchaser to submit any <br/>
<a id="pl.81.9"></a><var>81.9</var>other data, including data in unaggregated form, for the purposes of developing spending <br/>
<a id="pl.81.10"></a><var>81.10</var>estimates, setting spending limits, and monitoring actual spending and costs. In addition to <br/>
<a id="pl.81.11"></a><var>81.11</var>reporting administrative costs incurred to acquire a hospital, clinic, or health care facility, <br/>
<a id="pl.81.12"></a><var>81.12</var>or the assets thereof; or any other costs incurred pursuant to a partnership, joint venture, <br/>
<a id="pl.81.13"></a><var>81.13</var>integration, or affiliation agreement with a hospital, clinic, or other health care provider; <br/>
<a id="pl.81.14"></a><var>81.14</var>reports submitted under this section also must include the payments made during the <br/>
<a id="pl.81.15"></a><var>81.15</var>calendar year for these purposes. The commissioner shall make public, by group purchaser <br/>
<a id="pl.81.16"></a><var>81.16</var>data collected under this paragraph in accordance with section 
         <statute_ref>62J.321, subdivision 5</statute_ref>. <br/>
<a id="pl.81.17"></a><var>81.17</var>Workers' compensation insurance plans and automobile insurance plans are exempt from <br/>
<a id="pl.81.18"></a><var>81.18</var>complying with this paragraph as it relates to the submission of administrative costs.  <br/>
<a id="pl.81.19"></a><var>81.19</var>(c) The commissioner may collect information on:<br/>
<a id="pl.81.20"></a><var>81.20</var>(1) premiums, benefit levels, managed care procedures, and other features of health <br/>
<a id="pl.81.21"></a><var>81.21</var>plan companies;<br/>
<a id="pl.81.22"></a><var>81.22</var>(2) prices, provider experience, and other information for services less commonly <br/>
<a id="pl.81.23"></a><var>81.23</var>covered by insurance or for which patients commonly face significant out-of-pocket <br/>
<a id="pl.81.24"></a><var>81.24</var>expenses; and<br/>
<a id="pl.81.25"></a><var>81.25</var>(3) information on health care services not provided through health plan companies, <br/>
<a id="pl.81.26"></a><var>81.26</var>including information on prices, costs, expenditures, and utilization.<br/>
<a id="pl.81.27"></a><var>81.27</var>(d) All group purchasers shall provide the required data using a uniform format and <br/>
<a id="pl.81.28"></a><var>81.28</var>uniform definitions, as prescribed by the commissioner.<br/>
<br/>
<a id="bill.5.6.0"></a><a id="pl.81.29"></a><var>81.29</var>    Sec. 6. <b>[62Q.545] COVERAGE OF PRIVATE DUTY NURSING SERVICES.</b><br/>
<a id="pl.81.30"></a><var>81.30</var>(a) A health plan must cover private duty nursing services as provided under section <br/>
<a id="pl.81.31"></a><var>81.31</var>256B.0625, subdivision 7, for persons who are covered under the health plan and require <br/>
<a id="pl.81.32"></a><var>81.32</var>private duty nursing services.<br/>
<a id="pl.81.33"></a><var>81.33</var>(b) For purposes of this section, a period of private duty nursing services may <br/>
<a id="pl.81.34"></a><var>81.34</var>be subject to the co-payment, coinsurance, deductible, or other enrollee cost-sharing <br/>
<a id="pl.81.35"></a><var>81.35</var>requirements that apply under the health plan. Cost-sharing requirements for private duty <br/>
<a id="pl.82.1"></a><var>82.1</var>nursing services must not place a greater financial burden on the insured or enrollee than <br/>
<a id="pl.82.2"></a><var>82.2</var>those requirements applied by the health plan to other similar services or benefits.<br/>
<a id="pl.82.3"></a><var>82.3</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2010, and applies to health <br/>
<a id="pl.82.4"></a><var>82.4</var>plans offered, sold, issued, or renewed on or after that date.<br/>
<br/>
<a id="bill.5.7.0"></a><a id="pl.82.5"></a><var>82.5</var>    Sec. 7. Minnesota Statutes 2008, section 62Q.76, subdivision 1, is amended to read:<br/>
<a id="pl.82.6"></a><var>82.6</var>    Subdivision 1. <b>Applicability.</b> For purposes of sections 
         <statute_ref>62Q.76</statute_ref> to 
         <statute_ref>62Q.79</statute_ref> 62Q.791, <br/>
<a id="pl.82.7"></a><var>82.7</var>the terms defined in this section contract, health care provider, dental plan, dental <br/>
<a id="pl.82.8"></a><var>82.8</var>organization, dentist, and enrollee have the meanings given them in sections 62Q.733 <br/>
<a id="pl.82.9"></a><var>82.9</var>and 62Q.76.  <br/>
<br/>
<a id="bill.5.8.0"></a><a id="pl.82.10"></a><var>82.10</var>    Sec. 8. <b>[62Q.791] CONTRACTS WITH DENTAL CARE PROVIDERS.</b><br/>
<a id="pl.82.11"></a><var>82.11</var>    (a) Notwithstanding any other provision of law, no contract of any dental <br/>
<a id="pl.82.12"></a><var>82.12</var>organization licensed under chapter 62C for provision of dental care services may:<br/>
<a id="pl.82.13"></a><var>82.13</var>    (1) require, directly or indirectly, that a dentist or health care provider provide dental <br/>
<a id="pl.82.14"></a><var>82.14</var>care services to its enrollees at a fee set by the dental organization, unless the services <br/>
<a id="pl.82.15"></a><var>82.15</var>provided are covered dental care services for enrollees under the dental plan or contract; or<br/>
<a id="pl.82.16"></a><var>82.16</var>    (2) prohibit, directly or indirectly, the dentist or health care provider from offering or <br/>
<a id="pl.82.17"></a><var>82.17</var>providing dental care services that are not covered dental care services under the dental <br/>
<a id="pl.82.18"></a><var>82.18</var>plan or contract, on terms and conditions acceptable to the enrollee and the dentist or <br/>
<a id="pl.82.19"></a><var>82.19</var>health care provider. For purposes of this section, "covered dental care services" means <br/>
<a id="pl.82.20"></a><var>82.20</var>dental care services that are expressly covered under the dental plan or contract, including <br/>
<a id="pl.82.21"></a><var>82.21</var>dental care services that are subject to contractual limitations such as deductibles, <br/>
<a id="pl.82.22"></a><var>82.22</var>co-payments, annual maximums, and waiting periods.<br/>
<a id="pl.82.23"></a><var>82.23</var>    (b) When making payment or otherwise adjudicating any claim for dental care <br/>
<a id="pl.82.24"></a><var>82.24</var>services provided to an enrollee, a dental organization or dental plan must clearly identify <br/>
<a id="pl.82.25"></a><var>82.25</var>on an explanation of benefits form or other form of claim resolution the amount, if any, <br/>
<a id="pl.82.26"></a><var>82.26</var>that is the enrollee's responsibility to pay to the enrollee's dentist or health care provider.<br/>
<a id="pl.82.27"></a><var>82.27</var>    (c) This section does not apply to any contract for the provision of dental care <br/>
<a id="pl.82.28"></a><var>82.28</var>services under any public program sponsored or funded by the state or federal government.<br/>
<a id="pl.82.29"></a><var>82.29</var><b>EFFECTIVE DATE.</b>This section is effective August 1, 2010.<br/>
<br/>
<a id="bill.5.9.0"></a><a id="pl.82.30"></a><var>82.30</var>    Sec. 9. <b>[245.6971] ADVISORY GROUP ON STATE-OPERATED SERVICES </b><br/>
<a id="pl.82.31"></a><var>82.31</var><b>REDESIGN.</b><br/>
<a id="pl.83.1"></a><var>83.1</var>    Subdivision 1. <b>Establishment.</b> The Advisory Group on State-Operated Services <br/>
<a id="pl.83.2"></a><var>83.2</var>Redesign is established to make recommendations to the commissioner of human services <br/>
<a id="pl.83.3"></a><var>83.3</var>and the legislature on the continuum of services needed to provide individuals with <br/>
<a id="pl.83.4"></a><var>83.4</var>complex conditions including mental illness and developmental disabilities access to <br/>
<a id="pl.83.5"></a><var>83.5</var>quality care and the appropriate level of care across the state to promote wellness, reduce <br/>
<a id="pl.83.6"></a><var>83.6</var>cost, and improve efficiency.<br/>
<a id="pl.83.7"></a><var>83.7</var>    Subd. 2. <b>Duties.</b> The Advisory Group on State-Operated Services Redesign shall <br/>
<a id="pl.83.8"></a><var>83.8</var>make recommendations to the commissioner and the legislature no later than December <br/>
<a id="pl.83.9"></a><var>83.9</var>15, 2010, on the following:<br/>
<a id="pl.83.10"></a><var>83.10</var>(1) transformation needed to improve service delivery and provide a continuum of <br/>
<a id="pl.83.11"></a><var>83.11</var>care, such as transition of current facilities, closure of current facilities, or the development <br/>
<a id="pl.83.12"></a><var>83.12</var>of new models of care;<br/>
<a id="pl.83.13"></a><var>83.13</var>(2) gaps and barriers to accessing quality care, system inefficiencies, and cost <br/>
<a id="pl.83.14"></a><var>83.14</var>pressures;<br/>
<a id="pl.83.15"></a><var>83.15</var>(3) services that are best provided by the state and those that are best provided <br/>
<a id="pl.83.16"></a><var>83.16</var>in the community;<br/>
<a id="pl.83.17"></a><var>83.17</var>(4) an implementation plan to achieve integrated service delivery across the public, <br/>
<a id="pl.83.18"></a><var>83.18</var>private, and nonprofit sectors;<br/>
<a id="pl.83.19"></a><var>83.19</var>(5) an implementation plan to ensure that individuals with complex chemical and <br/>
<a id="pl.83.20"></a><var>83.20</var>mental health needs receive the appropriate level of care to achieve recovery and wellness; <br/>
<a id="pl.83.21"></a><var>83.21</var>and<br/>
<a id="pl.83.22"></a><var>83.22</var>(6) financing mechanisms that include all possible revenue sources to maximize <br/>
<a id="pl.83.23"></a><var>83.23</var>federal funding and promote cost efficiencies and sustainability.<br/>
<a id="pl.83.24"></a><var>83.24</var>    Subd. 3. <b>Membership.</b> The advisory group shall be composed of the following, <br/>
<a id="pl.83.25"></a><var>83.25</var>who will serve at the pleasure of their appointing authority:<br/>
<a id="pl.83.26"></a><var>83.26</var>(1) the commissioner of human services or the commissioner's designee, and two <br/>
<a id="pl.83.27"></a><var>83.27</var>additional representatives from the department;<br/>
<a id="pl.83.28"></a><var>83.28</var>(2) two legislators appointed by the speaker of the house, one from the minority <br/>
<a id="pl.83.29"></a><var>83.29</var>and one from the majority;<br/>
<a id="pl.83.30"></a><var>83.30</var>(3) two legislators appointed by the senate rules committee, one from the minority <br/>
<a id="pl.83.31"></a><var>83.31</var>and one from the majority;<br/>
<a id="pl.83.32"></a><var>83.32</var>(4) one representative appointed by AFSCME Council 5;<br/>
<a id="pl.83.33"></a><var>83.33</var>(5) one representative appointed by the ombudsman for mental health and <br/>
<a id="pl.83.34"></a><var>83.34</var>developmental disabilities;<br/>
<a id="pl.83.35"></a><var>83.35</var>(6) one representative appointed by the Minnesota Association of Professional <br/>
<a id="pl.83.36"></a><var>83.36</var>Employees;<br/>
<a id="pl.84.1"></a><var>84.1</var>(7) one representative appointed by the Minnesota Hospital Association;<br/>
<a id="pl.84.2"></a><var>84.2</var>(8) one representative appointed by the Minnesota Nurses Association;<br/>
<a id="pl.84.3"></a><var>84.3</var>(9) one representative appointed by NAMI-MN;<br/>
<a id="pl.84.4"></a><var>84.4</var>(10) one representative appointed by the Mental Health Association of Minnesota;<br/>
<a id="pl.84.5"></a><var>84.5</var>(11) one representative appointed by the Minnesota Association Of Community <br/>
<a id="pl.84.6"></a><var>84.6</var>Mental Health Programs;<br/>
<a id="pl.84.7"></a><var>84.7</var>(12) one representative appointed by the Minnesota Dental Association;<br/>
<a id="pl.84.8"></a><var>84.8</var>(13) three clients or client family members representing different populations <br/>
<a id="pl.84.9"></a><var>84.9</var>receiving services from state-operated services, who are appointed by the commissioner;<br/>
<a id="pl.84.10"></a><var>84.10</var>(14) one representative appointed by the chair of the state-operated services <br/>
<a id="pl.84.11"></a><var>84.11</var>governing board; and<br/>
<a id="pl.84.12"></a><var>84.12</var>(15) one representative appointed by the Minnesota Disability Law Center.<br/>
<a id="pl.84.13"></a><var>84.13</var>    Subd. 4. <b>Administration.</b> The commissioner shall convene the first meeting of the <br/>
<a id="pl.84.14"></a><var>84.14</var>advisory group and shall provide administrative support and staff.<br/>
<a id="pl.84.15"></a><var>84.15</var>    Subd. 5. <b>Recommendations.</b> The advisory group must report its recommendations <br/>
<a id="pl.84.16"></a><var>84.16</var>to the commissioner and to the legislature no later than December 15, 2010.<br/>
<a id="pl.84.17"></a><var>84.17</var>    Subd. 6. <b>Expiration.</b> This section expires January 31, 2011.<br/>
<br/>
<a id="bill.5.10.0"></a><a id="pl.84.18"></a><var>84.18</var>    Sec. 10. <b>[245.6972] LEGISLATIVE APPROVAL REQUIRED.</b><br/>
<a id="pl.84.19"></a><var>84.19</var>The commissioner of human services shall not redesign or move state-operated <br/>
<a id="pl.84.20"></a><var>84.20</var>services programs without specific legislative approval. The commissioner may proceed <br/>
<a id="pl.84.21"></a><var>84.21</var>with redesign at the Mankato Crisis Center and the closure of the Community Behavioral <br/>
<a id="pl.84.22"></a><var>84.22</var>Health Hospital in Cold Spring.<br/>
<br/>
<a id="bill.5.11.0"></a><a id="pl.84.23"></a><var>84.23</var>    Sec. 11. Minnesota Statutes 2009 Supplement, section 252.025, subdivision 7, is <br/>
<a id="pl.84.24"></a><var>84.24</var>amended to read:<br/>
<a id="pl.84.25"></a><var>84.25</var>    Subd. 7. <b>Minnesota extended treatment options.</b> The commissioner shall develop <br/>
<a id="pl.84.26"></a><var>84.26</var>by July 1, 1997, the Minnesota extended treatment options to serve Minnesotans who have <br/>
<a id="pl.84.27"></a><var>84.27</var>developmental disabilities and exhibit severe behaviors which present a risk to public <br/>
<a id="pl.84.28"></a><var>84.28</var>safety. This program is statewide and must provide specialized residential services in <br/>
<a id="pl.84.29"></a><var>84.29</var>Cambridge and an array of community-based services with sufficient levels of care and a <br/>
<a id="pl.84.30"></a><var>84.30</var>sufficient number of specialists to ensure that individuals referred to the program receive <br/>
<a id="pl.84.31"></a><var>84.31</var>the appropriate care. The number of beds at the Cambridge facility may be reorganized <br/>
<a id="pl.84.32"></a><var>84.32</var>into two 16-bed facilities, one for individuals with developmental disabilities and one <br/>
<a id="pl.84.33"></a><var>84.33</var>for individuals with developmental disabilities and a co-occurring mental illness, with <br/>
<a id="pl.84.34"></a><var>84.34</var>the remaining beds converted into transitional intensive treatment foster homes.The <br/>
<a id="pl.85.1"></a><var>85.1</var>individuals working in the community-based services under this section are state <br/>
<a id="pl.85.2"></a><var>85.2</var>employees supervised by the commissioner of human services. No layoffs shall occur as a <br/>
<a id="pl.85.3"></a><var>85.3</var>result of restructuring under this section.<br/>
<a id="pl.85.4"></a><var>85.4</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br/>
<br/>
<a id="bill.5.12.0"></a><a id="pl.85.5"></a><var>85.5</var>    Sec. 12. Minnesota Statutes 2008, section 254B.01, subdivision 2, is amended to read:<br/>
<a id="pl.85.6"></a><var>85.6</var>    Subd. 2. <b>American Indian.</b> For purposes of services provided under section <br/>
<statute_ref><a id="pl.85.7"></a><var>85.7</var>254B.09, subdivision 7
</statute_ref> 254B.09, subdivision 8, "American Indian" means a person who is <br/>
<a id="pl.85.8"></a><var>85.8</var>a member of an Indian tribe, and the commissioner shall use the definitions of "Indian" <br/>
<a id="pl.85.9"></a><var>85.9</var>and "Indian tribe" and "Indian organization" provided in Public Law 93-638. For purposes <br/>
<a id="pl.85.10"></a><var>85.10</var>of services provided under section 
         <statute_ref>254B.09, subdivision 4</statute_ref> 254B.09, subdivision 6, <br/>
<a id="pl.85.11"></a><var>85.11</var>"American Indian" means a resident of federally recognized tribal lands who is recognized <br/>
<a id="pl.85.12"></a><var>85.12</var>as an Indian person by the federally recognized tribal governing body.  <br/>
<br/>
<a id="bill.5.13.0"></a><a id="pl.85.13"></a><var>85.13</var>    Sec. 13. Minnesota Statutes 2008, section 254B.02, subdivision 1, is amended to read:<br/>
<a id="pl.85.14"></a><var>85.14</var>    Subdivision 1. <b>Chemical dependency treatment allocation.</b> The chemical <br/>
<a id="pl.85.15"></a><var>85.15</var>dependency funds appropriated for allocation treatment appropriation shall be placed in <br/>
<a id="pl.85.16"></a><var>85.16</var>a special revenue account. The commissioner shall annually transfer funds from the <br/>
<a id="pl.85.17"></a><var>85.17</var>chemical dependency fund to pay for operation of the drug and alcohol abuse normative <br/>
<a id="pl.85.18"></a><var>85.18</var>evaluation system and to pay for all costs incurred by adding two positions for licensing <br/>
<a id="pl.85.19"></a><var>85.19</var>of chemical dependency treatment and rehabilitation programs located in hospitals for <br/>
<a id="pl.85.20"></a><var>85.20</var>which funds are not otherwise appropriated. Six percent of the remaining money must <br/>
<a id="pl.85.21"></a><var>85.21</var>be reserved for tribal allocation under section 
<statute_ref>254B.09, subdivisions 4</statute_ref> and 5. The <br/>
<a id="pl.85.22"></a><var>85.22</var>commissioner shall annually divide the money available in the chemical dependency <br/>
<a id="pl.85.23"></a><var>85.23</var>fund that is not held in reserve by counties from a previous allocation, or allocated to <br/>
<a id="pl.85.24"></a><var>85.24</var>the American Indian chemical dependency tribal account. Six percent of the remaining <br/>
<a id="pl.85.25"></a><var>85.25</var>money must be reserved for the nonreservation American Indian chemical dependency <br/>
<a id="pl.85.26"></a><var>85.26</var>allocation for treatment of American Indians by eligible vendors under section 
<statute_ref>254B.05, <br/>
<a id="pl.85.27"></a><var>85.27</var>subdivision 1
</statute_ref>. The remainder of the money must be allocated among the counties <br/>
<a id="pl.85.28"></a><var>85.28</var>according to the following formula, using state demographer data and other data sources <br/>
<a id="pl.85.29"></a><var>85.29</var>determined by the commissioner: in the special revenue account must be used according <br/>
<a id="pl.85.30"></a><var>85.30</var>to the requirements in this chapter. <br/>
<a id="pl.85.31"></a><var>85.31</var>    (a) For purposes of this formula, American Indians and children under age 14 are <br/>
<a id="pl.85.32"></a><var>85.32</var>subtracted from the population of each county to determine the restricted population.<br/>
<a id="pl.85.33"></a><var>85.33</var>    (b) The amount of chemical dependency fund expenditures for entitled persons for <br/>
<a id="pl.85.34"></a><var>85.34</var>services not covered by prepaid plans governed by section 
<statute_ref>256B.69</statute_ref> in the previous year is <br/>
<a id="pl.86.1"></a><var>86.1</var>divided by the amount of chemical dependency fund expenditures for entitled persons for <br/>
<a id="pl.86.2"></a><var>86.2</var>all services to determine the proportion of exempt service expenditures for each county. <br/>
<a id="pl.86.3"></a><var>86.3</var>    (c) The prepaid plan months of eligibility is multiplied by the proportion of exempt <br/>
<a id="pl.86.4"></a><var>86.4</var>service expenditures to determine the adjusted prepaid plan months of eligibility for <br/>
<a id="pl.86.5"></a><var>86.5</var>each county.<br/>
<a id="pl.86.6"></a><var>86.6</var>    (d) The adjusted prepaid plan months of eligibility is added to the number of <br/>
<a id="pl.86.7"></a><var>86.7</var>restricted population fee for service months of eligibility for the Minnesota family <br/>
<a id="pl.86.8"></a><var>86.8</var>investment program, general assistance, and medical assistance and divided by the county <br/>
<a id="pl.86.9"></a><var>86.9</var>restricted population to determine county per capita months of covered service eligibility.<br/>
<a id="pl.86.10"></a><var>86.10</var>    (e) The number of adjusted prepaid plan months of eligibility for the state is added <br/>
<a id="pl.86.11"></a><var>86.11</var>to the number of fee for service months of eligibility for the Minnesota family investment <br/>
<a id="pl.86.12"></a><var>86.12</var>program, general assistance, and medical assistance for the state restricted population and <br/>
<a id="pl.86.13"></a><var>86.13</var>divided by the state restricted population to determine state per capita months of covered <br/>
<a id="pl.86.14"></a><var>86.14</var>service eligibility.<br/>
<a id="pl.86.15"></a><var>86.15</var>    (f) The county per capita months of covered service eligibility is divided by the <br/>
<a id="pl.86.16"></a><var>86.16</var>state per capita months of covered service eligibility to determine the county welfare <br/>
<a id="pl.86.17"></a><var>86.17</var>caseload factor.<br/>
<a id="pl.86.18"></a><var>86.18</var>    (g) The median married couple income for the most recent three-year period <br/>
<a id="pl.86.19"></a><var>86.19</var>available for the state is divided by the median married couple income for the same period <br/>
<a id="pl.86.20"></a><var>86.20</var>for each county to determine the income factor for each county.<br/>
<a id="pl.86.21"></a><var>86.21</var>    (h) The county restricted population is multiplied by the sum of the county welfare <br/>
<a id="pl.86.22"></a><var>86.22</var>caseload factor and the county income factor to determine the adjusted population.<br/>
<a id="pl.86.23"></a><var>86.23</var>    (i) $15,000 shall be allocated to each county.<br/>
<a id="pl.86.24"></a><var>86.24</var>    (j) The remaining funds shall be allocated proportional to the county adjusted <br/>
<a id="pl.86.25"></a><var>86.25</var>population.<br/>
<br/>
<a id="bill.5.14.0"></a><a id="pl.86.26"></a><var>86.26</var>    Sec. 14. Minnesota Statutes 2008, section 254B.02, subdivision 5, is amended to read:<br/>
<a id="pl.86.27"></a><var>86.27</var>    Subd. 5. <b>Administrative adjustment.</b> The commissioner may make payments to <br/>
<a id="pl.86.28"></a><var>86.28</var>local agencies from money allocated under this section to support administrative activities <br/>
<a id="pl.86.29"></a><var>86.29</var>under sections 
         <statute_ref>254B.03</statute_ref> and 
         <statute_ref>254B.04</statute_ref>. The administrative payment must not exceed <br/>
<a id="pl.86.30"></a><var>86.30</var>the lesser of (1) five percent of the first $50,000, four percent of the next $50,000, and <br/>
<a id="pl.86.31"></a><var>86.31</var>three percent of the remaining payments for services from the allocation special revenue <br/>
<a id="pl.86.32"></a><var>86.32</var>account according to subdivision 1; or (2) the local agency administrative payment for <br/>
<a id="pl.86.33"></a><var>86.33</var>the fiscal year ending June 30, 2009, adjusted in proportion to the statewide change in <br/>
<a id="pl.86.34"></a><var>86.34</var>the appropriation for this chapter. <br/>
<br/>
<a id="bill.5.15.0"></a><a id="pl.87.1"></a><var>87.1</var>    Sec. 15. Minnesota Statutes 2008, section 254B.03, subdivision 4, is amended to read:<br/>
<a id="pl.87.2"></a><var>87.2</var>    Subd. 4. <b>Division of costs.</b> Except for services provided by a county under <br/>
<a id="pl.87.3"></a><var>87.3</var>section 
         <statute_ref>254B.09, subdivision 1</statute_ref>, or services provided under section 
         <statute_ref>256B.69</statute_ref> or 
         <statute_ref>256D.03, <br/>
<a id="pl.87.4"></a><var>87.4</var>subdivision 4
         </statute_ref>, paragraph (b), the county shall, out of local money, pay the state for <br/>
<a id="pl.87.5"></a><var>87.5</var>15 16.14 percent of the cost of chemical dependency services, including those services <br/>
<a id="pl.87.6"></a><var>87.6</var>provided to persons eligible for medical assistance under chapter 256B and general <br/>
<a id="pl.87.7"></a><var>87.7</var>assistance medical care under chapter 256D. Counties may use the indigent hospitalization <br/>
<a id="pl.87.8"></a><var>87.8</var>levy for treatment and hospital payments made under this section. Fifteen 16.14 percent <br/>
<a id="pl.87.9"></a><var>87.9</var>of any state collections from private or third-party pay, less 15 percent of for the cost <br/>
<a id="pl.87.10"></a><var>87.10</var>of payment and collections, must be distributed to the county that paid for a portion of <br/>
<a id="pl.87.11"></a><var>87.11</var>the treatment under this section. If all funds allocated according to section 
<statute_ref>254B.02</statute_ref> are <br/>
<a id="pl.87.12"></a><var>87.12</var>exhausted by a county and the county has met or exceeded the base level of expenditures <br/>
<a id="pl.87.13"></a><var>87.13</var>under section 
<statute_ref>254B.02, subdivision 3</statute_ref>, the county shall pay the state for 15 percent of the <br/>
<a id="pl.87.14"></a><var>87.14</var>costs paid by the state under this section. The commissioner may refuse to pay state funds <br/>
<a id="pl.87.15"></a><var>87.15</var>for services to persons not eligible under section 
<statute_ref>254B.04, subdivision 1</statute_ref>, if the county <br/>
<a id="pl.87.16"></a><var>87.16</var>financially responsible for the persons has exhausted its allocation.  <br/>
<br/>
<a id="bill.5.16.0"></a><a id="pl.87.17"></a><var>87.17</var>    Sec. 16. Minnesota Statutes 2008, section 254B.03, is amended by adding a <br/>
<a id="pl.87.18"></a><var>87.18</var>subdivision to read:<br/>
<a id="pl.87.19"></a><var>87.19</var>    Subd. 4a. <b>Division of costs for medical assistance services.</b> Notwithstanding <br/>
<a id="pl.87.20"></a><var>87.20</var>subdivision 4, for chemical dependency services provided on or after October 1, 2008, and <br/>
<a id="pl.87.21"></a><var>87.21</var>reimbursed by medical assistance, the county share is 30 percent of the nonfederal share.<br/>
<br/>
<a id="bill.5.17.0"></a><a id="pl.87.22"></a><var>87.22</var>    Sec. 17. Minnesota Statutes 2008, section 254B.05, subdivision 4, is amended to read:<br/>
<a id="pl.87.23"></a><var>87.23</var>    Subd. 4. <b>Regional treatment centers.</b> Regional treatment center chemical <br/>
<a id="pl.87.24"></a><var>87.24</var>dependency treatment units are eligible vendors. The commissioner may expand the <br/>
<a id="pl.87.25"></a><var>87.25</var>capacity of chemical dependency treatment units beyond the capacity funded by direct <br/>
<a id="pl.87.26"></a><var>87.26</var>legislative appropriation to serve individuals who are referred for treatment by counties <br/>
<a id="pl.87.27"></a><var>87.27</var>and whose treatment will be paid for with a county's allocation under section 
<statute_ref>254B.02</statute_ref> by <br/>
<a id="pl.87.28"></a><var>87.28</var>funding under this chapter or other funding sources. Notwithstanding the provisions of <br/>
<a id="pl.87.29"></a><var>87.29</var>sections 
         <statute_ref>254B.03</statute_ref> to 
         <statute_ref>254B.041</statute_ref>, payment for any person committed at county request to <br/>
<a id="pl.87.30"></a><var>87.30</var>a regional treatment center under chapter 253B for chemical dependency treatment and <br/>
<a id="pl.87.31"></a><var>87.31</var>determined to be ineligible under the chemical dependency consolidated treatment fund, <br/>
<a id="pl.87.32"></a><var>87.32</var>shall become the responsibility of the county.  <br/>
<br/>
<a id="bill.5.18.0"></a><a id="pl.87.33"></a><var>87.33</var>    Sec. 18. Minnesota Statutes 2008, section 254B.06, subdivision 2, is amended to read:<br/>
<a id="pl.88.1"></a><var>88.1</var>    Subd. 2. <b>Allocation of collections.</b> The commissioner shall allocate all federal <br/>
<a id="pl.88.2"></a><var>88.2</var>financial participation collections to the reserve fund under section 
<statute_ref>254B.02, subdivision 3</statute_ref> <br/>
<a id="pl.88.3"></a><var>88.3</var>a special revenue account. The commissioner shall retain 85 allocate 83.86 percent of <br/>
<a id="pl.88.4"></a><var>88.4</var>patient payments and third-party payments to the special revenue account and allocate <br/>
<a id="pl.88.5"></a><var>88.5</var>the collections to the treatment allocation for the county that is financially responsible <br/>
<a id="pl.88.6"></a><var>88.6</var>for the person. Fifteen 16.14 percent of patient and third-party payments must be paid <br/>
<a id="pl.88.7"></a><var>88.7</var>to the county financially responsible for the patient. Collections for patient payment and <br/>
<a id="pl.88.8"></a><var>88.8</var>third-party payment for services provided under section 
<statute_ref>254B.09</statute_ref> shall be allocated to the <br/>
<a id="pl.88.9"></a><var>88.9</var>allocation of the tribal unit which placed the person. Collections of federal financial <br/>
<a id="pl.88.10"></a><var>88.10</var>participation for services provided under section 
<statute_ref>254B.09</statute_ref> shall be allocated to the tribal <br/>
<a id="pl.88.11"></a><var>88.11</var>reserve account under section 
<statute_ref>254B.09, subdivision 5</statute_ref>. <br/>
<br/>
<a id="bill.5.19.0"></a><a id="pl.88.12"></a><var>88.12</var>    Sec. 19. Minnesota Statutes 2008, section 254B.09, subdivision 8, is amended to read:<br/>
<a id="pl.88.13"></a><var>88.13</var>    Subd. 8. <b>Payments to improve services to American Indians.</b> The commissioner <br/>
<a id="pl.88.14"></a><var>88.14</var>may set rates for chemical dependency services to American Indians according to the <br/>
<a id="pl.88.15"></a><var>88.15</var>American Indian Health Improvement Act, Public Law 94-437, for eligible vendors. <br/>
<a id="pl.88.16"></a><var>88.16</var>These rates shall supersede rates set in county purchase of service agreements when <br/>
<a id="pl.88.17"></a><var>88.17</var>payments are made on behalf of clients eligible according to Public Law 94-437.<br/>
<br/>
<a id="bill.5.20.0"></a><a id="pl.88.18"></a><var>88.18</var>    Sec. 20. <b>[254B.13] PILOT PROJECTS; CHEMICAL HEALTH CARE.</b><br/>
<a id="pl.88.19"></a><var>88.19</var>    Subdivision 1. <b>Authorization for pilot projects.</b> The commissioner of human <br/>
<a id="pl.88.20"></a><var>88.20</var>services may approve and implement pilot projects developed under the planning process <br/>
<a id="pl.88.21"></a><var>88.21</var>required under Laws 2009, chapter 79, article 7, section 26, to provide alternatives to and <br/>
<a id="pl.88.22"></a><var>88.22</var>enhance coordination of the delivery of chemical health services required under section <br/>
<a id="pl.88.23"></a><var>88.23</var>254B.03.<br/>
<a id="pl.88.24"></a><var>88.24</var>    Subd. 2. <b>Program design and implementation.</b> (a) The commissioner of <br/>
<a id="pl.88.25"></a><var>88.25</var>human services and counties participating in the pilot projects shall continue to work in <br/>
<a id="pl.88.26"></a><var>88.26</var>partnership to refine and implement the pilot projects initiated under Laws 2009, chapter <br/>
<a id="pl.88.27"></a><var>88.27</var>79, article 7, section 26.<br/>
<a id="pl.88.28"></a><var>88.28</var>    (b) The commissioner and counties participating in the pilot projects shall <br/>
<a id="pl.88.29"></a><var>88.29</var>complete the planning phase by June 30, 2010, and, if approved by the commissioner for <br/>
<a id="pl.88.30"></a><var>88.30</var>implementation, enter into agreements governing the operation of the pilot projects with <br/>
<a id="pl.88.31"></a><var>88.31</var>implementation scheduled no earlier than July 1, 2010.<br/>
<a id="pl.88.32"></a><var>88.32</var>    Subd. 3. <b>Program evaluation.</b>  The commissioner of human services shall evaluate <br/>
<a id="pl.88.33"></a><var>88.33</var>pilot projects under this section and report the results of the evaluation to the legislative <br/>
<a id="pl.88.34"></a><var>88.34</var>committees with jurisdiction over chemical health by June 30, 2013. Evaluation of the <br/>
<a id="pl.89.1"></a><var>89.1</var>pilot projects must be based on outcome evaluation criteria negotiated with the projects <br/>
<a id="pl.89.2"></a><var>89.2</var>prior to implementation.<br/>
<a id="pl.89.3"></a><var>89.3</var>    Subd. 4. <b>Notice of project discontinuation.</b> Each county's participation in the <br/>
<a id="pl.89.4"></a><var>89.4</var>pilot project may be discontinued for any reason by the county or the commissioner of <br/>
<a id="pl.89.5"></a><var>89.5</var>human services after 30 days' written notice to the other party. Any unspent funds held <br/>
<a id="pl.89.6"></a><var>89.6</var>for the exiting county's pro rata share in the special revenue fund under the authority <br/>
<a id="pl.89.7"></a><var>89.7</var>in subdivision 5, paragraph (c), shall be transferred to the general fund following <br/>
<a id="pl.89.8"></a><var>89.8</var>discontinuation of the pilot project.<br/>
<a id="pl.89.9"></a><var>89.9</var>    Subd. 5. <b>Duties of commissioner.</b> (a) Notwithstanding any other provisions in <br/>
<a id="pl.89.10"></a><var>89.10</var>this chapter, the commissioner may authorize pilot projects to use chemical dependency <br/>
<a id="pl.89.11"></a><var>89.11</var>treatment funds to pay for services:<br/>
<a id="pl.89.12"></a><var>89.12</var>    (1) in addition to those authorized under section 254B.03, subdivision 2, paragraph <br/>
<a id="pl.89.13"></a><var>89.13</var>(a); and<br/>
<a id="pl.89.14"></a><var>89.14</var>    (2) by vendors in addition to those authorized under section 254B.05 when not <br/>
<a id="pl.89.15"></a><var>89.15</var>providing chemical dependency treatment services.<br/>
<a id="pl.89.16"></a><var>89.16</var>    (b) State expenditures for chemical dependency services and any other services <br/>
<a id="pl.89.17"></a><var>89.17</var>provided by or through the pilot projects must not be greater than chemical dependency <br/>
<a id="pl.89.18"></a><var>89.18</var>treatment fund expenditures expected in the absence of the pilot projects. The <br/>
<a id="pl.89.19"></a><var>89.19</var>commissioner may restructure the schedule of payments between the state and participating <br/>
<a id="pl.89.20"></a><var>89.20</var>counties under the local agency share and division of cost provisions under section <br/>
<a id="pl.89.21"></a><var>89.21</var>254B.03, subdivisions 3 and 4, as necessary to facilitate the operation of the pilot projects.<br/>
<a id="pl.89.22"></a><var>89.22</var>    (c) To the extent that state fiscal year expenditures within a pilot project region are <br/>
<a id="pl.89.23"></a><var>89.23</var>less than expected in the absence of the pilot projects, the commissioner may deposit <br/>
<a id="pl.89.24"></a><var>89.24</var>these unexpended funds in the special revenue fund and make these funds available for <br/>
<a id="pl.89.25"></a><var>89.25</var>expenditure by the pilot counties the following year. To the extent that treatment and pilot <br/>
<a id="pl.89.26"></a><var>89.26</var>project ancillary services expenditures within the pilot project exceed the amount expected <br/>
<a id="pl.89.27"></a><var>89.27</var>in the absence of the pilot projects, the pilot counties are responsible for the portion of <br/>
<a id="pl.89.28"></a><var>89.28</var>nontreatment expenditures in excess of otherwise expected expenditures.<br/>
<a id="pl.89.29"></a><var>89.29</var>    (d) The commissioner may waive administrative rule requirements which are <br/>
<a id="pl.89.30"></a><var>89.30</var>incompatible with the implementation of the pilot project.<br/>
<a id="pl.89.31"></a><var>89.31</var>    (e) The commissioner shall not approve or enter into any agreement related to pilot <br/>
<a id="pl.89.32"></a><var>89.32</var>projects authorized under this section which puts current or future federal funding at risk.<br/>
<a id="pl.89.33"></a><var>89.33</var>    Subd. 6. <b>Duties of county board.</b> The county board, or other county entity that is <br/>
<a id="pl.89.34"></a><var>89.34</var>approved to administer a pilot project, shall:<br/>
<a id="pl.89.35"></a><var>89.35</var>    (1) administer the pilot project in a manner consistent with the objectives described <br/>
<a id="pl.89.36"></a><var>89.36</var>in subdivision 2 and the planning process in subdivision 5;<br/>
<a id="pl.90.1"></a><var>90.1</var>    (2) ensure that no one is denied chemical dependency treatment services for which <br/>
<a id="pl.90.2"></a><var>90.2</var>they would otherwise be eligible under section 254A.03, subdivision 3; and<br/>
<a id="pl.90.3"></a><var>90.3</var>    (3) provide the commissioner of human services with timely and pertinent <br/>
<a id="pl.90.4"></a><var>90.4</var>information as negotiated in agreements governing operation of the pilot projects.<br/>
<br/>
<a id="bill.5.21.0"></a><a id="pl.90.5"></a><var>90.5</var>    Sec. 21. Minnesota Statutes 2008, section 256.01, is amended by adding a subdivision <br/>
<a id="pl.90.6"></a><var>90.6</var>to read:<br/>
<a id="pl.90.7"></a><var>90.7</var>    Subd. 30. <b>Office of Health Care Inspector General.</b> (a) The commissioner shall <br/>
<a id="pl.90.8"></a><var>90.8</var>create within the Department of Human Services an Office of Health Care Inspector <br/>
<a id="pl.90.9"></a><var>90.9</var>General to enhance antifraud activities and to protect the integrity of the state health care <br/>
<a id="pl.90.10"></a><var>90.10</var>programs, as well as the health and welfare of the beneficiaries of those programs. The <br/>
<a id="pl.90.11"></a><var>90.11</var>Office of Health Care Inspector General must periodically report to the commissioner and <br/>
<a id="pl.90.12"></a><var>90.12</var>to the legislature program and management problems and recommendations to correct <br/>
<a id="pl.90.13"></a><var>90.13</var>them.<br/>
<a id="pl.90.14"></a><var>90.14</var>(b) The duties of the Office of Health Care Inspector General include, but are not <br/>
<a id="pl.90.15"></a><var>90.15</var>limited to:<br/>
<a id="pl.90.16"></a><var>90.16</var>(1) promoting economy, efficiency, and effectiveness through the elimination of <br/>
<a id="pl.90.17"></a><var>90.17</var>waste, fraud, and abuse;<br/>
<a id="pl.90.18"></a><var>90.18</var>(2) conducting and supervising audits, investigations, inspections, and evaluations <br/>
<a id="pl.90.19"></a><var>90.19</var>relating to the state health care programs under chapters 256B, 256D, and 256L;<br/>
<a id="pl.90.20"></a><var>90.20</var>(3) identifying weaknesses giving rise to opportunities for fraud and abuse in the <br/>
<a id="pl.90.21"></a><var>90.21</var>state health care programs and operations and making recommendations to prevent their <br/>
<a id="pl.90.22"></a><var>90.22</var>recurrence;<br/>
<a id="pl.90.23"></a><var>90.23</var>(4) leading and coordinating activities to prevent and detect fraud and abuse in the <br/>
<a id="pl.90.24"></a><var>90.24</var>state health care programs and operations;<br/>
<a id="pl.90.25"></a><var>90.25</var>(5) detecting wrongdoers and abusers of the state health care programs and <br/>
<a id="pl.90.26"></a><var>90.26</var>beneficiaries so appropriate remedies may be brought;<br/>
<a id="pl.90.27"></a><var>90.27</var>(6) keeping the commissioner and the legislature fully and currently informed about <br/>
<a id="pl.90.28"></a><var>90.28</var>problems and deficiencies in the administration of the state health care programs and <br/>
<a id="pl.90.29"></a><var>90.29</var>operations and about the need for and progress of corrective action;<br/>
<a id="pl.90.30"></a><var>90.30</var>(7) operating a toll-free hotline to permit individuals to call in suspected fraud, <br/>
<a id="pl.90.31"></a><var>90.31</var>waste, or abuse, referring the calls for appropriate action by the agency, and analyzing the <br/>
<a id="pl.90.32"></a><var>90.32</var>calls to identify trends and patterns of fraud and abuse needing attention;<br/>
<a id="pl.90.33"></a><var>90.33</var>(8) developing and reviewing legislative, regulatory, and program proposals to <br/>
<a id="pl.90.34"></a><var>90.34</var>reduce vulnerabilities to fraud, waste, and mismanagement; and<br/>
<a id="pl.91.1"></a><var>91.1</var>(9) recommending changes in program policies, regulations, and laws to improve <br/>
<a id="pl.91.2"></a><var>91.2</var>efficiency and effectiveness, and to prevent fraud, waste, abuse, and mismanagement.<br/>
<a id="pl.91.3"></a><var>91.3</var>(c) Beginning July 1, 2011, the commissioner, in consultation with the Office of <br/>
<a id="pl.91.4"></a><var>91.4</var>Health Care Inspector General, shall annually report to the legislature and the governor <br/>
<a id="pl.91.5"></a><var>91.5</var>new results from the two ongoing federal Medicaid audits. The commissioner shall report <br/>
<a id="pl.91.6"></a><var>91.6</var>(1) the most recent Medicaid Integrity Program (MIP) audit results, with any corrective <br/>
<a id="pl.91.7"></a><var>91.7</var>actions needed, and (2) certify the rate of errors determined for the state health care <br/>
<a id="pl.91.8"></a><var>91.8</var>programs under chapters 256B, 256D, and 256L, as determined from the most recent <br/>
<a id="pl.91.9"></a><var>91.9</var>Payment Error Rate Measurement (PERM) audit results for Minnesota. When the PERM <br/>
<a id="pl.91.10"></a><var>91.10</var>audit rate for Minnesota is greater than the national rate for the year or the MIP audit <br/>
<a id="pl.91.11"></a><var>91.11</var>determines the need for corrective action, the commissioner shall present a plan to the <br/>
<a id="pl.91.12"></a><var>91.12</var>legislature and the governor for the corrective actions and reduction of the error rate <br/>
<a id="pl.91.13"></a><var>91.13</var>in the next calendar year.<br/>
<br/>
<a id="bill.5.22.0"></a><a id="pl.91.14"></a><var>91.14</var>    Sec. 22. Laws 2009, chapter 79, article 3, section 18, is amended to read:<br/>
<a id="pl.91.15"></a><var>91.15</var>    Sec. 18. <b>REQUIRING THE DEVELOPMENT OF COMMUNITY-BASED </b><br/>
<a id="pl.91.16"></a><var>91.16</var><b>MENTAL HEALTH SERVICES FOR PATIENTS COMMITTED TO THE </b><br/>
<a id="pl.91.17"></a><var>91.17</var><b>ANOKA-METRO REGIONAL TREATMENT CENTER.</b><br/>
<a id="pl.91.18"></a><var>91.18</var>In consultation with community partners, the commissioner of human services The <br/>
<a id="pl.91.19"></a><var>91.19</var>Advisory Group on State-Operated Services Redesign shall develop recommend an array <br/>
<a id="pl.91.20"></a><var>91.20</var>of community-based services to transform the current services now provided to patients <br/>
<a id="pl.91.21"></a><var>91.21</var>at the Anoka-Metro Regional Treatment Center. The community-based services may <br/>
<a id="pl.91.22"></a><var>91.22</var>be provided in facilities with 16 or fewer beds, and must provide the appropriate level <br/>
<a id="pl.91.23"></a><var>91.23</var>of care for the patients being admitted to the facilities. The planning for this transition <br/>
<a id="pl.91.24"></a><var>91.24</var>must be completed by October 1, 2009 2010, with an initial report to the committee chairs <br/>
<a id="pl.91.25"></a><var>91.25</var>of health and human services by November 30, 2009 2010, and a semiannual report on <br/>
<a id="pl.91.26"></a><var>91.26</var>progress until the transition is completed. The commissioner of human services shall <br/>
<a id="pl.91.27"></a><var>91.27</var>solicit interest from stakeholders and potential community partners. The individuals <br/>
<a id="pl.91.28"></a><var>91.28</var>working in the community-based services facilities under this section are state employees <br/>
<a id="pl.91.29"></a><var>91.29</var>supervised by the commissioner of human services. No layoffs shall occur as a result of <br/>
<a id="pl.91.30"></a><var>91.30</var>restructuring under this section.<br/>
<a id="pl.91.31"></a><var>91.31</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br/>
<br/>
<a id="bill.5.23.0"></a><a id="pl.91.32"></a><var>91.32</var>    Sec. 23. <b>NONSUBMISSION OF HEALTH CARE CLAIM BY </b><br/>
<a id="pl.91.33"></a><var>91.33</var><b>CLEARINGHOUSE; SIGNIFICANT DISRUPTION.</b><br/>
<a id="pl.92.1"></a><var>92.1</var>(a) A situation shall be considered a significant disruption to normal operations that <br/>
<a id="pl.92.2"></a><var>92.2</var>materially affects the provider's or facility's ability to conduct business in a normal manner <br/>
<a id="pl.92.3"></a><var>92.3</var>and to submit claims on a timely basis under Minnesota Statutes, section 62Q.75, if: <br/>
<a id="pl.92.4"></a><var>92.4</var>(1) a clearinghouse loses, or otherwise does not submit, a health care claim as <br/>
<a id="pl.92.5"></a><var>92.5</var>required by Minnesota Statutes, section 62J.536; and<br/>
<a id="pl.92.6"></a><var>92.6</var>(2) the provider or facility can substantiate that it submitted a complete claim to the <br/>
<a id="pl.92.7"></a><var>92.7</var>clearinghouse within provisions stated in contract or six months of the date of service, <br/>
<a id="pl.92.8"></a><var>92.8</var>whichever is less.<br/>
<a id="pl.92.9"></a><var>92.9</var>(b) This section expires January 1, 2012.<br/>
<br/>
<a id="bill.5.24.0"></a><a id="pl.92.10"></a><var>92.10</var>    Sec. 24. <b> REPEALER.</b><br/>
<a id="pl.92.11"></a><var>92.11</var>Minnesota Statutes 2008, sections 254B.02, subdivisions 2, 3, and 4; and 254B.09, <br/>
<a id="pl.92.12"></a><var>92.12</var>subdivisions 4, 5, and 7, and Laws 2009, chapter 79, article 7, section 26, subdivision <br/>
<a id="pl.92.13"></a><var>92.13</var>3,  are repealed.<br/>
<br/>
<a id="bill.5.25.0"></a><a id="pl.92.14"></a><var>92.14</var>    Sec. 25. <b>EFFECTIVE DATE.</b><br/>
<a id="pl.92.15"></a><var>92.15</var>Sections 12 to 17 and 24 are effective for claims paid on or after July 1, 2010.<br/>
<br/>
<a id="bill.6.0.0"></a>

<a id="bill.6.1.0"></a><a id="pl.92.18"></a><var>92.18</var>    Section 1. Minnesota Statutes 2008, section 62D.08, is amended by adding a <br/>
<a id="pl.92.19"></a><var>92.19</var>subdivision to read:<br/>
<a id="pl.92.20"></a><var>92.20</var>    Subd. 7. <b>Consistent administrative expenses and investment income reporting.</b><br/>
<a id="pl.92.21"></a><var>92.21</var>(a) Every health maintenance organization must directly allocate administrative expenses <br/>
<a id="pl.92.22"></a><var>92.22</var>to specific lines of business or products when such information is available. Remaining <br/>
<a id="pl.92.23"></a><var>92.23</var>expenses that cannot be directly allocated must be allocated based on other methods, as <br/>
<a id="pl.92.24"></a><var>92.24</var>recommended by the Advisory Group on Administrative Expenses. Health maintenance <br/>
<a id="pl.92.25"></a><var>92.25</var>organizations must submit this information, including administrative expenses for dental <br/>
<a id="pl.92.26"></a><var>92.26</var>services, using the reporting template provided by the commissioner of health.<br/>
<a id="pl.92.27"></a><var>92.27</var>(b) Every health maintenance organization must allocate investment income based <br/>
<a id="pl.92.28"></a><var>92.28</var>on cumulative net income over time by business line or product and must submit this <br/>
<a id="pl.92.29"></a><var>92.29</var>information, including investment income for dental services, using the reporting template <br/>
<a id="pl.92.30"></a><var>92.30</var>provided by the commissioner of health.<br/>
<a id="pl.92.31"></a><var>92.31</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2012.<br/>
<br/>
<a id="bill.6.2.0"></a><a id="pl.93.1"></a><var>93.1</var>    Sec. 2. <b>[62D.31] ADVISORY GROUP ON ADMINISTRATIVE EXPENSES.</b><br/>
<a id="pl.93.2"></a><var>93.2</var>    Subdivision 1. <b>Establishment.</b> The Advisory Group on Administrative Expenses <br/>
<a id="pl.93.3"></a><var>93.3</var>is established to make recommendations on the development of consistent guidelines <br/>
<a id="pl.93.4"></a><var>93.4</var>and reporting requirements, including development of a reporting template, for health <br/>
<a id="pl.93.5"></a><var>93.5</var>maintenance organizations and county-based purchasers that participate in publicly <br/>
<a id="pl.93.6"></a><var>93.6</var>funded programs. <br/>
<a id="pl.93.7"></a><var>93.7</var>    Subd. 2. <b>Membership.</b> The membership of the advisory group shall be comprised <br/>
<a id="pl.93.8"></a><var>93.8</var>of the following, who serve at the pleasure of their appointing authority:<br/>
<a id="pl.93.9"></a><var>93.9</var>(1) the commissioner of health or the commissioner's designee;<br/>
<a id="pl.93.10"></a><var>93.10</var>(2) the commissioner of human services or the commissioner's designee;<br/>
<a id="pl.93.11"></a><var>93.11</var>(3) the commissioner of commerce or the commissioner's designee; and<br/>
<a id="pl.93.12"></a><var>93.12</var>(4) representatives of health maintenance organizations and county-based purchasers <br/>
<a id="pl.93.13"></a><var>93.13</var>appointed by the commissioner of health.<br/>
<a id="pl.93.14"></a><var>93.14</var>    Subd. 3. <b>Administration.</b> The commissioner of health shall convene the first <br/>
<a id="pl.93.15"></a><var>93.15</var>meeting of the advisory group by September 1, 2010, and shall provide administrative <br/>
<a id="pl.93.16"></a><var>93.16</var>support and staff. The commissioner of health may contract with a consultant to provide <br/>
<a id="pl.93.17"></a><var>93.17</var>professional assistance and expertise to the advisory group.<br/>
<a id="pl.93.18"></a><var>93.18</var>    Subd. 4. <b>Recommendations.</b> The Advisory Group on Administrative Expenses <br/>
<a id="pl.93.19"></a><var>93.19</var>must report its recommendations, including any proposed legislation necessary to <br/>
<a id="pl.93.20"></a><var>93.20</var>implement the recommendations, to the commissioner of health and to the chairs and <br/>
<a id="pl.93.21"></a><var>93.21</var>ranking minority members of the legislative committees and divisions with jurisdiction <br/>
<a id="pl.93.22"></a><var>93.22</var>over health policy and finance by July 1, 2011.<br/>
<a id="pl.93.23"></a><var>93.23</var>    Subd. 5. <b>Expiration.</b> This section expires after submission of the report required <br/>
<a id="pl.93.24"></a><var>93.24</var>under subdivision 4 or June 30, 2012, whichever is sooner.<br/>
<br/>
<a id="bill.6.3.0"></a><a id="pl.93.25"></a><var>93.25</var>    Sec. 3. Minnesota Statutes 2009 Supplement, section 62J.495, subdivision 1a, is <br/>
<a id="pl.93.26"></a><var>93.26</var>amended to read:<br/>
<a id="pl.93.27"></a><var>93.27</var>    Subd. 1a. <b>Definitions.</b> (a) "Certified electronic health record technology" means an <br/>
<a id="pl.93.28"></a><var>93.28</var>electronic health record that is certified pursuant to section 3001(c)(5) of the HITECH <br/>
<a id="pl.93.29"></a><var>93.29</var>Act to meet the standards and implementation specifications adopted under section 3004 <br/>
<a id="pl.93.30"></a><var>93.30</var>as applicable.<br/>
<a id="pl.93.31"></a><var>93.31</var>(b) "Commissioner" means the commissioner of health.<br/>
<a id="pl.93.32"></a><var>93.32</var>(c) "Pharmaceutical electronic data intermediary" means any entity that provides <br/>
<a id="pl.93.33"></a><var>93.33</var>the infrastructure to connect computer systems or other electronic devices utilized <br/>
<a id="pl.93.34"></a><var>93.34</var>by prescribing practitioners with those used by pharmacies, health plans, third-party <br/>
<a id="pl.93.35"></a><var>93.35</var>administrators, and pharmacy benefit managers in order to facilitate the secure <br/>
<a id="pl.94.1"></a><var>94.1</var>transmission of electronic prescriptions, refill authorization requests, communications, <br/>
<a id="pl.94.2"></a><var>94.2</var>and other prescription-related information between such entities.<br/>
<a id="pl.94.3"></a><var>94.3</var>(d) "HITECH Act" means the Health Information Technology for Economic and <br/>
<a id="pl.94.4"></a><var>94.4</var>Clinical Health Act in division A, title XIII and division B, title IV of the American <br/>
<a id="pl.94.5"></a><var>94.5</var>Recovery and Reinvestment Act of 2009, including federal regulations adopted under <br/>
<a id="pl.94.6"></a><var>94.6</var>that act.<br/>
<a id="pl.94.7"></a><var>94.7</var>(e) "Interoperable electronic health record" means an electronic health record that <br/>
<a id="pl.94.8"></a><var>94.8</var>securely exchanges health information with another electronic health record system that <br/>
<a id="pl.94.9"></a><var>94.9</var>meets requirements specified in subdivision 3, and national requirements for certification <br/>
<a id="pl.94.10"></a><var>94.10</var>under the HITECH Act.<br/>
<a id="pl.94.11"></a><var>94.11</var>(f) "Qualified electronic health record" means an electronic record of health-related <br/>
<a id="pl.94.12"></a><var>94.12</var>information on an individual that includes patient demographic and clinical health <br/>
<a id="pl.94.13"></a><var>94.13</var>information and has the capacity to:<br/>
<a id="pl.94.14"></a><var>94.14</var>(1) provide clinical decision support;<br/>
<a id="pl.94.15"></a><var>94.15</var>(2) support physician order entry;<br/>
<a id="pl.94.16"></a><var>94.16</var>(3) capture and query information relevant to health care quality; and<br/>
<a id="pl.94.17"></a><var>94.17</var>(4) exchange electronic health information with, and integrate such information <br/>
<a id="pl.94.18"></a><var>94.18</var>from, other sources.<br/>
<br/>
<a id="bill.6.4.0"></a><a id="pl.94.19"></a><var>94.19</var>    Sec. 4. Minnesota Statutes 2009 Supplement, section 62J.495, subdivision 3, is <br/>
<a id="pl.94.20"></a><var>94.20</var>amended to read:<br/>
<a id="pl.94.21"></a><var>94.21</var>    Subd. 3. <b>Interoperable electronic health record requirements.</b>  To meet the <br/>
<a id="pl.94.22"></a><var>94.22</var>requirements of subdivision 1, hospitals and health care providers must meet the following <br/>
<a id="pl.94.23"></a><var>94.23</var>criteria when implementing an interoperable electronic health records system within their <br/>
<a id="pl.94.24"></a><var>94.24</var>hospital system or clinical practice setting.<br/>
<a id="pl.94.25"></a><var>94.25</var>(a) The electronic health record must be a qualified electronic health record.<br/>
<a id="pl.94.26"></a><var>94.26</var>    (b) The electronic health record must be certified by the Office of the National <br/>
<a id="pl.94.27"></a><var>94.27</var>Coordinator pursuant to the HITECH Act. This criterion only applies to hospitals and <br/>
<a id="pl.94.28"></a><var>94.28</var>health care providers only if a certified electronic health record product for the provider's <br/>
<a id="pl.94.29"></a><var>94.29</var>particular practice setting is available. This criterion shall be considered met if a hospital <br/>
<a id="pl.94.30"></a><var>94.30</var>or health care provider is using an electronic health records system that has been certified <br/>
<a id="pl.94.31"></a><var>94.31</var>within the last three years, even if a more current version of the system has been certified <br/>
<a id="pl.94.32"></a><var>94.32</var>within the three-year period.<br/>
<a id="pl.94.33"></a><var>94.33</var>(c) The electronic health record must meet the standards established according to <br/>
<a id="pl.94.34"></a><var>94.34</var>section 3004 of the HITECH Act as applicable.<br/>
<a id="pl.95.1"></a><var>95.1</var>(d) The electronic health record must have the ability to generate information on <br/>
<a id="pl.95.2"></a><var>95.2</var>clinical quality measures and other measures reported under sections 4101, 4102, and <br/>
<a id="pl.95.3"></a><var>95.3</var>4201 of the HITECH Act.<br/>
<a id="pl.95.4"></a><var>95.4</var>(e) The electronic health record system must be connected to a state-certified <br/>
<a id="pl.95.5"></a><var>95.5</var>health information organization either directly or through a connection facilitated by a <br/>
<a id="pl.95.6"></a><var>95.6</var>state-certified health data intermediary as defined in section 62J.498.<br/>
<a id="pl.95.7"></a><var>95.7</var>    (e) (f) A health care provider who is a prescriber or dispenser of legend drugs must <br/>
<a id="pl.95.8"></a><var>95.8</var>have an electronic health record system that meets the requirements of section 
         <statute_ref>62J.497</statute_ref>.<br/>
<br/>
<a id="bill.6.5.0"></a><a id="pl.95.9"></a><var>95.9</var>    Sec. 5. Minnesota Statutes 2009 Supplement, section 62J.495, is amended by adding a <br/>
<a id="pl.95.10"></a><var>95.10</var>subdivision to read:<br/>
<a id="pl.95.11"></a><var>95.11</var>    Subd. 6. <b>State agency information system.</b> Development of a state agency <br/>
<a id="pl.95.12"></a><var>95.12</var>information system necessary to implement this section is subject to the authority of the <br/>
<a id="pl.95.13"></a><var>95.13</var>Office of Enterprise Technology in chapter 16E, including, but not limited to:<br/>
<a id="pl.95.14"></a><var>95.14</var>(1) evaluation and approval of the system as specified in section 16E.03, subdivisions <br/>
<a id="pl.95.15"></a><var>95.15</var>3 and 4;<br/>
<a id="pl.95.16"></a><var>95.16</var>(2) review of the system to ensure compliance with security policies, guidelines, and <br/>
<a id="pl.95.17"></a><var>95.17</var>standards as specified in section 16E.03, subdivision 7; and<br/>
<a id="pl.95.18"></a><var>95.18</var>(3) assurance that the system complies with accessibility standards developed under <br/>
<a id="pl.95.19"></a><var>95.19</var>section 16E.03, subdivision 9.<br/>
<br/>
<a id="bill.6.6.0"></a><a id="pl.95.20"></a><var>95.20</var>    Sec. 6. <b>[62J.498] HEALTH INFORMATION EXCHANGE.</b><br/>
<a id="pl.95.21"></a><var>95.21</var>    Subdivision 1. <b> Definitions.</b>  The following definitions apply to sections 62J.498 to <br/>
<a id="pl.95.22"></a><var>95.22</var>62J.4982:<br/>
<a id="pl.95.23"></a><var>95.23</var>(a) "Clinical transaction" means any meaningful use transaction that is not covered <br/>
<a id="pl.95.24"></a><var>95.24</var>by section 62J.536.<br/>
<a id="pl.95.25"></a><var>95.25</var>(b) "Commissioner" means the commissioner of health.<br/>
<a id="pl.95.26"></a><var>95.26</var>(c) "Direct health information exchange" means the electronic transmission of <br/>
<a id="pl.95.27"></a><var>95.27</var>health-related information through a direct connection between the electronic health <br/>
<a id="pl.95.28"></a><var>95.28</var>record systems of health care providers without the use of a health data intermediary.<br/>
<a id="pl.95.29"></a><var>95.29</var>(d) "Health care provider" or "provider" means a health care provider or provider as <br/>
<a id="pl.95.30"></a><var>95.30</var>defined in section 62J.03, subdivision 8.<br/>
<a id="pl.95.31"></a><var>95.31</var>(e) "Health data intermediary" means an entity that provides the infrastructure to <br/>
<a id="pl.95.32"></a><var>95.32</var>connect computer systems or other electronic devices used by health care providers, <br/>
<a id="pl.95.33"></a><var>95.33</var>laboratories, pharmacies, health plans, third-party administrators, or pharmacy benefit <br/>
<a id="pl.95.34"></a><var>95.34</var>managers to facilitate the secure transmission of health information, including <br/>
<a id="pl.96.1"></a><var>96.1</var>pharmaceutical electronic data intermediaries as defined in section 62J.495.  This does not <br/>
<a id="pl.96.2"></a><var>96.2</var>include health care providers engaged in a direct health information exchange.<br/>
<a id="pl.96.3"></a><var>96.3</var>(f) "Health information exchange" means the electronic transmission of <br/>
<a id="pl.96.4"></a><var>96.4</var>health-related information between organizations according to nationally recognized <br/>
<a id="pl.96.5"></a><var>96.5</var>standards.<br/>
<a id="pl.96.6"></a><var>96.6</var>(g) "Health information exchange service provider" means a health data intermediary <br/>
<a id="pl.96.7"></a><var>96.7</var>or health information organization that has been issued a certificate of authority by the <br/>
<a id="pl.96.8"></a><var>96.8</var>commissioner under section 62J.4981.<br/>
<a id="pl.96.9"></a><var>96.9</var>(h) "Health information organization" means an organization that oversees, governs, <br/>
<a id="pl.96.10"></a><var>96.10</var>and facilitates the exchange of health-related information among organizations according <br/>
<a id="pl.96.11"></a><var>96.11</var>to nationally recognized standards.<br/>
<a id="pl.96.12"></a><var>96.12</var>(i) "HITECH Act" means the Health Information Technology for Economic and <br/>
<a id="pl.96.13"></a><var>96.13</var>Clinical Health Act as defined in section 62J.495.<br/>
<a id="pl.96.14"></a><var>96.14</var>(j) "Major participating entity" means:<br/>
<a id="pl.96.15"></a><var>96.15</var>(1) a participating entity that receives compensation for services that is greater <br/>
<a id="pl.96.16"></a><var>96.16</var>than 30 percent of the health information organization's gross annual revenues from the <br/>
<a id="pl.96.17"></a><var>96.17</var>health information exchange service provider;<br/>
<a id="pl.96.18"></a><var>96.18</var>(2) a participating entity providing administrative, financial, or management services <br/>
<a id="pl.96.19"></a><var>96.19</var>to the health information organization, if the total payment for all services provided by the <br/>
<a id="pl.96.20"></a><var>96.20</var>participating entity exceeds three percent of the gross revenue of the health information <br/>
<a id="pl.96.21"></a><var>96.21</var>organization; and<br/>
<a id="pl.96.22"></a><var>96.22</var>(3) a participating entity that nominates or appoints 30 percent or more of the board <br/>
<a id="pl.96.23"></a><var>96.23</var>of directors of the health information organization.<br/>
<a id="pl.96.24"></a><var>96.24</var>(k) "Meaningful use" means use of certified electronic health record technology that <br/>
<a id="pl.96.25"></a><var>96.25</var>includes e-prescribing, and is connected in a manner that provides for the electronic <br/>
<a id="pl.96.26"></a><var>96.26</var>exchange of health information and used for the submission of clinical quality measures <br/>
<a id="pl.96.27"></a><var>96.27</var>as established by the Center for Medicare and Medicaid Services and the Minnesota <br/>
<a id="pl.96.28"></a><var>96.28</var>Department of Human Services pursuant to sections 4101, 4102, and 4201 of the HITECH <br/>
<a id="pl.96.29"></a><var>96.29</var>Act.<br/>
<a id="pl.96.30"></a><var>96.30</var>(l) "Meaningful use transaction" means an electronic transaction that a health care <br/>
<a id="pl.96.31"></a><var>96.31</var>provider must exchange to receive Medicare or Medicaid incentives or avoid Medicare <br/>
<a id="pl.96.32"></a><var>96.32</var>penalties pursuant to sections 4101, 4102, and 4201 of the HITECH Act.<br/>
<a id="pl.96.33"></a><var>96.33</var>(m) "Participating entity" means any of the following persons, health care providers, <br/>
<a id="pl.96.34"></a><var>96.34</var>companies, or other organizations with which a health information organization or health <br/>
<a id="pl.96.35"></a><var>96.35</var>data intermediary has contracts or other agreements for the provision of health information <br/>
<a id="pl.96.36"></a><var>96.36</var>exchange service providers: <br/>
<a id="pl.97.1"></a><var>97.1</var>(1) a health care facility licensed under sections 144.50 to 144.56, a nursing home <br/>
<a id="pl.97.2"></a><var>97.2</var>licensed under sections 144A.02 to 144A.10, and any other health care facility otherwise <br/>
<a id="pl.97.3"></a><var>97.3</var>licensed under the laws of this state or registered with the commissioner;<br/>
<a id="pl.97.4"></a><var>97.4</var>(2) a health care provider, and any other health care professional otherwise licensed <br/>
<a id="pl.97.5"></a><var>97.5</var>under the laws of this state or registered with the commissioner;<br/>
<a id="pl.97.6"></a><var>97.6</var>(3) a group, professional corporation, or other organization that provides the <br/>
<a id="pl.97.7"></a><var>97.7</var>services of individuals or entities identified in clause (2), including but not limited to a <br/>
<a id="pl.97.8"></a><var>97.8</var>medical clinic, a medical group, a home health care agency, an urgent care center, and <br/>
<a id="pl.97.9"></a><var>97.9</var>an emergent care center;<br/>
<a id="pl.97.10"></a><var>97.10</var>(4) a health plan as defined in section 62A.011, subdivision 3; and<br/>
<a id="pl.97.11"></a><var>97.11</var>(5) a state agency as defined in section 13.02, subdivision 17.<br/>
<a id="pl.97.12"></a><var>97.12</var>(n) "Reciprocal agreement" means an arrangement in which two or more health <br/>
<a id="pl.97.13"></a><var>97.13</var>information exchange service providers agree to share in-kind services and resources to <br/>
<a id="pl.97.14"></a><var>97.14</var>allow for the pass-through of meaningful use transactions.<br/>
<a id="pl.97.15"></a><var>97.15</var>(o) "State-certified health data intermediary" means a health data intermediary that:<br/>
<a id="pl.97.16"></a><var>97.16</var>(1) provides a subset of the meaningful use transaction capabilities necessary for <br/>
<a id="pl.97.17"></a><var>97.17</var>hospitals and providers to achieve meaningful use of electronic health records;<br/>
<a id="pl.97.18"></a><var>97.18</var>(2) is not exclusively engaged in the exchange of meaningful use transactions <br/>
<a id="pl.97.19"></a><var>97.19</var>covered by section 62J.536; and<br/>
<a id="pl.97.20"></a><var>97.20</var>(3) has been issued a certificate of authority to operate in Minnesota.<br/>
<a id="pl.97.21"></a><var>97.21</var>(p) "State-certified health information organization" means a nonprofit health <br/>
<a id="pl.97.22"></a><var>97.22</var>information organization that provides transaction capabilities necessary to fully support <br/>
<a id="pl.97.23"></a><var>97.23</var>clinical transactions required for meaningful use of electronic health records that has been <br/>
<a id="pl.97.24"></a><var>97.24</var>issued a certificate of authority to operate in Minnesota.<br/>
<a id="pl.97.25"></a><var>97.25</var>    Subd. 2. <b> Health information exchange oversight.</b>  (a) The commissioner shall <br/>
<a id="pl.97.26"></a><var>97.26</var>protect the public interest on matters pertaining to health information exchange. The <br/>
<a id="pl.97.27"></a><var>97.27</var>commissioner shall:<br/>
<a id="pl.97.28"></a><var>97.28</var>(1) review and act on applications from health data intermediaries and health <br/>
<a id="pl.97.29"></a><var>97.29</var>information organizations for certificates of authority to operate in Minnesota;<br/>
<a id="pl.97.30"></a><var>97.30</var>(2) provide ongoing monitoring to ensure compliance with criteria established under <br/>
<a id="pl.97.31"></a><var>97.31</var>sections 62J.498 to 62J.4982;<br/>
<a id="pl.97.32"></a><var>97.32</var>(3) respond to public complaints related to health information exchange services;<br/>
<a id="pl.97.33"></a><var>97.33</var>(4) take enforcement actions as necessary, including the imposition of fines, <br/>
<a id="pl.97.34"></a><var>97.34</var>suspension, or revocation of certificates of authority as outlined in section 62J.4982;<br/>
<a id="pl.97.35"></a><var>97.35</var>(5) provide a biannual report on the status of health information exchange services <br/>
<a id="pl.97.36"></a><var>97.36</var>that includes but is not limited to:<br/>
<a id="pl.98.1"></a><var>98.1</var>(i) recommendations on actions necessary to ensure that health information exchange <br/>
<a id="pl.98.2"></a><var>98.2</var>services are adequate to meet the needs of Minnesota citizens and providers statewide;<br/>
<a id="pl.98.3"></a><var>98.3</var>(ii) recommendations on enforcement actions to ensure that health information <br/>
<a id="pl.98.4"></a><var>98.4</var>exchange service providers act in the public interest without causing disruption in health <br/>
<a id="pl.98.5"></a><var>98.5</var>information exchange services;<br/>
<a id="pl.98.6"></a><var>98.6</var>(iii) recommendations on updates to criteria for obtaining certificates of authority <br/>
<a id="pl.98.7"></a><var>98.7</var>under this section; and<br/>
<a id="pl.98.8"></a><var>98.8</var>(iv) recommendations on standard operating procedures for health information <br/>
<a id="pl.98.9"></a><var>98.9</var>exchange, including but not limited to the management of consumer preferences; and<br/>
<a id="pl.98.10"></a><var>98.10</var>(6) other duties necessary to protect the public interest.<br/>
<a id="pl.98.11"></a><var>98.11</var>(b) As part of the application review process for certification under paragraph (a), <br/>
<a id="pl.98.12"></a><var>98.12</var>prior to issuing a certificate of authority, the commissioner shall:<br/>
<a id="pl.98.13"></a><var>98.13</var>(1) hold public hearings that provide an adequate opportunity for participating <br/>
<a id="pl.98.14"></a><var>98.14</var>entities and consumers to provide feedback and recommendations on the application under <br/>
<a id="pl.98.15"></a><var>98.15</var>consideration. The commissioner shall make all portions of the application classified <br/>
<a id="pl.98.16"></a><var>98.16</var>as public data available to the public at least ten days in advance of the hearing. The <br/>
<a id="pl.98.17"></a><var>98.17</var>applicant shall participate in the hearing by presenting an application overview and <br/>
<a id="pl.98.18"></a><var>98.18</var>responding to questions from interested parties;<br/>
<a id="pl.98.19"></a><var>98.19</var>(2) make available all feedback and recommendations from the hearing available to <br/>
<a id="pl.98.20"></a><var>98.20</var>the public prior to issuing a certificate of authority; and<br/>
<a id="pl.98.21"></a><var>98.21</var>(3) consult with hospitals, physicians, and other professionals eligible to receive <br/>
<a id="pl.98.22"></a><var>98.22</var>meaningful use incentive payments or are subject to penalties as established in the <br/>
<a id="pl.98.23"></a><var>98.23</var>HITECH Act, and their respective statewide associations, prior to issuing a certificate of <br/>
<a id="pl.98.24"></a><var>98.24</var>authority.<br/>
<a id="pl.98.25"></a><var>98.25</var>(c)(1) When the commissioner is actively considering a suspension or revocation of <br/>
<a id="pl.98.26"></a><var>98.26</var>a certificate of authority as described in section 62J.4982, subdivision 3, all investigatory <br/>
<a id="pl.98.27"></a><var>98.27</var>data that are collected, created, or maintained related to the suspension or revocation <br/>
<a id="pl.98.28"></a><var>98.28</var>are classified as confidential data on individuals and as protected nonpublic data in the <br/>
<a id="pl.98.29"></a><var>98.29</var>case of data not on individuals.<br/>
<a id="pl.98.30"></a><var>98.30</var>(2) The commissioner may disclose data classified as protected nonpublic or <br/>
<a id="pl.98.31"></a><var>98.31</var>confidential under this paragraph if disclosing the data will protect the health or safety of <br/>
<a id="pl.98.32"></a><var>98.32</var>patients.<br/>
<a id="pl.98.33"></a><var>98.33</var>(d) After the commissioner makes a final determination regarding a suspension or <br/>
<a id="pl.98.34"></a><var>98.34</var>revocation of a certificate of authority, all minutes, orders for hearing, findings of fact, <br/>
<a id="pl.98.35"></a><var>98.35</var>conclusions of law, and the specification of the final disciplinary action, are classified <br/>
<a id="pl.98.36"></a><var>98.36</var>as public data.<br/>
<br/>
<a id="bill.6.7.0"></a><a id="pl.99.1"></a><var>99.1</var>    Sec. 7. <b>[62J.4981] CERTIFICATE OF AUTHORITY TO PROVIDE HEALTH </b><br/>
<a id="pl.99.2"></a><var>99.2</var><b>INFORMATION EXCHANGE SERVICES.</b><br/>
<a id="pl.99.3"></a><var>99.3</var>    Subdivision 1. <b> Authority to require organizations to apply.</b>  The commissioner <br/>
<a id="pl.99.4"></a><var>99.4</var>shall require an entity providing health information exchange services to apply for a <br/>
<a id="pl.99.5"></a><var>99.5</var>certificate of authority under this section. An applicant may continue to operate until <br/>
<a id="pl.99.6"></a><var>99.6</var>the commissioner acts on the application. If the application is denied, the applicant is <br/>
<a id="pl.99.7"></a><var>99.7</var>considered a health information organization whose certificate of authority has been <br/>
<a id="pl.99.8"></a><var>99.8</var>revoked under section 62J.4982, subdivision 2, paragraph (d).<br/>
<a id="pl.99.9"></a><var>99.9</var>    Subd. 2. <b> Certificate of authority for health data intermediaries.</b>  (a) A health <br/>
<a id="pl.99.10"></a><var>99.10</var>data intermediary that provides health information exchange services for the transmission <br/>
<a id="pl.99.11"></a><var>99.11</var>of one or more clinical transactions necessary for hospitals, providers, or eligible <br/>
<a id="pl.99.12"></a><var>99.12</var>professionals to achieve meaningful use must be registered with the state and comply with <br/>
<a id="pl.99.13"></a><var>99.13</var>requirements established in this section.<br/>
<a id="pl.99.14"></a><var>99.14</var>(b) Notwithstanding any law to the contrary, any corporation organized to do so <br/>
<a id="pl.99.15"></a><var>99.15</var>may apply to the commissioner for a certificate of authority to establish and operate as <br/>
<a id="pl.99.16"></a><var>99.16</var>a health data intermediary in compliance with this section. No person shall establish or <br/>
<a id="pl.99.17"></a><var>99.17</var>operate a health data intermediary in this state, nor sell or offer to sell, or solicit offers <br/>
<a id="pl.99.18"></a><var>99.18</var>to purchase or receive advance or periodic consideration in conjunction with a health <br/>
<a id="pl.99.19"></a><var>99.19</var>data intermediary contract unless the organization has a certificate of authority or has an <br/>
<a id="pl.99.20"></a><var>99.20</var>application under active consideration under  this section.<br/>
<a id="pl.99.21"></a><var>99.21</var>(c) In issuing the certificate of authority, the commissioner shall determine whether <br/>
<a id="pl.99.22"></a><var>99.22</var>the applicant for the certificate of authority has demonstrated that the applicant meets <br/>
<a id="pl.99.23"></a><var>99.23</var>the following minimum criteria:<br/>
<a id="pl.99.24"></a><var>99.24</var>(1) can interoperate with at least one state-certified health information organization;<br/>
<a id="pl.99.25"></a><var>99.25</var>(2) can provide an option for Minnesota entities to connect to their services through <br/>
<a id="pl.99.26"></a><var>99.26</var>at least one state-certified health information organization;<br/>
<a id="pl.99.27"></a><var>99.27</var>(3) has a record locator service as defined in section 144.291, subdivision 2, <br/>
<a id="pl.99.28"></a><var>99.28</var>paragraph (i), that is compliant with the requirements of section 144.293, subdivision 8, <br/>
<a id="pl.99.29"></a><var>99.29</var>when conducting meaningful use transactions; and<br/>
<a id="pl.99.30"></a><var>99.30</var>(4) holds reciprocal agreements with at least one state-certified health information <br/>
<a id="pl.99.31"></a><var>99.31</var>organization to enable access to record locator services to find patient data, and for the <br/>
<a id="pl.99.32"></a><var>99.32</var>transmission and receipt of meaningful use transactions consistent with the format and <br/>
<a id="pl.99.33"></a><var>99.33</var>content required by national standards established by Centers for Medicare and Medicaid <br/>
<a id="pl.99.34"></a><var>99.34</var>Services. Reciprocal agreements must meet the requirements established in subdivision 5.<br/>
<a id="pl.99.35"></a><var>99.35</var>    Subd. 3. <b> Certificate of authority for health information organizations.</b><br/>
<a id="pl.99.36"></a><var>99.36</var>(a) A health information organization that provides all electronic capabilities for the <br/>
<a id="pl.100.1"></a><var>100.1</var>transmission of clinical transactions necessary for meaningful use of electronic health <br/>
<a id="pl.100.2"></a><var>100.2</var>records must obtain a certificate of authority from the commissioner and demonstrate <br/>
<a id="pl.100.3"></a><var>100.3</var>compliance with the criteria in paragraph (c).<br/>
<a id="pl.100.4"></a><var>100.4</var>(b) Notwithstanding any law to the contrary, a nonprofit corporation organized to do <br/>
<a id="pl.100.5"></a><var>100.5</var>so may apply for a certificate of authority to establish and operate a health information <br/>
<a id="pl.100.6"></a><var>100.6</var>organization under this section. No person shall establish or operate a health information <br/>
<a id="pl.100.7"></a><var>100.7</var>organization in this state, or sell or offer to sell, or solicit offers to purchase or receive <br/>
<a id="pl.100.8"></a><var>100.8</var>advance or periodic consideration in conjunction with a health information organization <br/>
<a id="pl.100.9"></a><var>100.9</var>or health information contract unless the organization has a certificate of authority under <br/>
<a id="pl.100.10"></a><var>100.10</var>this section.<br/>
<a id="pl.100.11"></a><var>100.11</var>(c) In issuing the certificate of authority, the commissioner shall determine whether <br/>
<a id="pl.100.12"></a><var>100.12</var>the applicant for the certificate of authority has demonstrated that the applicant meets <br/>
<a id="pl.100.13"></a><var>100.13</var>the following minimum criteria:<br/>
<a id="pl.100.14"></a><var>100.14</var>(1) the entity is a legally established, nonprofit organization;<br/>
<a id="pl.100.15"></a><var>100.15</var>(2) has appropriate insurance, including liability insurance, for the operation of the <br/>
<a id="pl.100.16"></a><var>100.16</var>health information organization is in place and sufficient to protect the interest of the <br/>
<a id="pl.100.17"></a><var>100.17</var>public and participating entities;<br/>
<a id="pl.100.18"></a><var>100.18</var>(3) has strategic and operational plans that clearly address how the organization will <br/>
<a id="pl.100.19"></a><var>100.19</var>expand technical capacity of the health information organization to support providers in <br/>
<a id="pl.100.20"></a><var>100.20</var>achieving meaningful use of electronic health records over time;<br/>
<a id="pl.100.21"></a><var>100.21</var>(4) the entity addresses the parameters to be used with participating entities and <br/>
<a id="pl.100.22"></a><var>100.22</var>other health information organizations for meaningful use transactions, compliance with <br/>
<a id="pl.100.23"></a><var>100.23</var>Minnesota law, and interstate health information exchange in trust agreements;<br/>
<a id="pl.100.24"></a><var>100.24</var>(5) the entity's board of directors is comprised of members that broadly represent the <br/>
<a id="pl.100.25"></a><var>100.25</var>health information organization's participating entities and consumers;<br/>
<a id="pl.100.26"></a><var>100.26</var>(6) the entity maintains a professional staff responsible to the board of directors with <br/>
<a id="pl.100.27"></a><var>100.27</var>the capacity to ensure accountability to the organization's mission;<br/>
<a id="pl.100.28"></a><var>100.28</var>(7) the entity is compliant with criteria established under the Health Information <br/>
<a id="pl.100.29"></a><var>100.29</var>Exchange Accreditation Program of the Electronic Healthcare Network Accreditation <br/>
<a id="pl.100.30"></a><var>100.30</var>Commission (EHNAC) or equivalent criteria established by the commissioner;<br/>
<a id="pl.100.31"></a><var>100.31</var>(8) the entity maintains a record locator service as defined in section 144.291, <br/>
<a id="pl.100.32"></a><var>100.32</var>subdivision 2, paragraph (i), that is compliant with the requirements of section 144.293, <br/>
<a id="pl.100.33"></a><var>100.33</var>subdivision 8, when conducting meaningful use transactions;<br/>
<a id="pl.100.34"></a><var>100.34</var>(9) the organization demonstrates interoperability with all other state-certified health <br/>
<a id="pl.100.35"></a><var>100.35</var>information organizations using nationally recognized standards;<br/>
<a id="pl.101.1"></a><var>101.1</var>(10) the organization demonstrates compliance with all privacy and security <br/>
<a id="pl.101.2"></a><var>101.2</var>requirements required by state and federal law; and<br/>
<a id="pl.101.3"></a><var>101.3</var>(11) the organization uses financial policies and procedures consistent with generally <br/>
<a id="pl.101.4"></a><var>101.4</var>accepted accounting principles and has an independent audit of the organization's <br/>
<a id="pl.101.5"></a><var>101.5</var>financials on an annual basis.<br/>
<a id="pl.101.6"></a><var>101.6</var>(d) Health information organizations that have obtained a certificate of authority <br/>
<a id="pl.101.7"></a><var>101.7</var>must:<br/>
<a id="pl.101.8"></a><var>101.8</var>(1) meet the requirements established for connecting to the Nationwide Health <br/>
<a id="pl.101.9"></a><var>101.9</var>Information Network (NHIN) within the federally mandated timeline or within a time <br/>
<a id="pl.101.10"></a><var>101.10</var>frame established by the commissioner and published in the State Register. If the state <br/>
<a id="pl.101.11"></a><var>101.11</var>timeline for implementation varies from the federal timeline, the State Register notice <br/>
<a id="pl.101.12"></a><var>101.12</var>shall include an explanation for the variation;<br/>
<a id="pl.101.13"></a><var>101.13</var>(2) annually submit strategic and operational plans for review by the commissioner <br/>
<a id="pl.101.14"></a><var>101.14</var>that address:<br/>
<a id="pl.101.15"></a><var>101.15</var>(i) increasing adoption rates to include a sufficient number of participating entities to <br/>
<a id="pl.101.16"></a><var>101.16</var>achieve financial sustainability; and<br/>
<a id="pl.101.17"></a><var>101.17</var>(ii) progress in achieving objectives included in previously submitted strategic <br/>
<a id="pl.101.18"></a><var>101.18</var>and operational plans across the following domains:  business and technical operations, <br/>
<a id="pl.101.19"></a><var>101.19</var>technical infrastructure, legal and policy issues, finance, and organizational governance;<br/>
<a id="pl.101.20"></a><var>101.20</var>(3) develop and maintain a business plan that addresses:<br/>
<a id="pl.101.21"></a><var>101.21</var>(i) plans for ensuring the necessary capacity to support meaningful use transactions;<br/>
<a id="pl.101.22"></a><var>101.22</var>(ii) approach for attaining financial sustainability, including public and private <br/>
<a id="pl.101.23"></a><var>101.23</var>financing strategies, and rate structures;<br/>
<a id="pl.101.24"></a><var>101.24</var>(iii) rates of adoption, utilization, and transaction volume, and mechanisms to <br/>
<a id="pl.101.25"></a><var>101.25</var>support health information exchange; and<br/>
<a id="pl.101.26"></a><var>101.26</var>(iv) an explanation of methods employed to address the needs of community clinics, <br/>
<a id="pl.101.27"></a><var>101.27</var>critical access hospitals, and free clinics in accessing health information exchange services;<br/>
<a id="pl.101.28"></a><var>101.28</var>(4) annually submit a rate plan outlining fee structures for health information <br/>
<a id="pl.101.29"></a><var>101.29</var>exchange services for approval by the commissioner. The commissioner shall approve the <br/>
<a id="pl.101.30"></a><var>101.30</var>rate plan if it:<br/>
<a id="pl.101.31"></a><var>101.31</var>(i) distributes costs equitably among users of health information services;<br/>
<a id="pl.101.32"></a><var>101.32</var>(ii) provides predictable costs for participating entities;<br/>
<a id="pl.101.33"></a><var>101.33</var>(iii) covers all costs associated with conducting the full range of meaningful use <br/>
<a id="pl.101.34"></a><var>101.34</var>clinical transactions, including access to health information retrieved through other <br/>
<a id="pl.101.35"></a><var>101.35</var>state-certified health information exchange service providers; and<br/>
<a id="pl.102.1"></a><var>102.1</var>(iv) provides for a predictable revenue stream for the health information organization <br/>
<a id="pl.102.2"></a><var>102.2</var>and generates sufficient resources to maintain operating costs and develop technical <br/>
<a id="pl.102.3"></a><var>102.3</var>infrastructure necessary to serve the public interest;<br/>
<a id="pl.102.4"></a><var>102.4</var>(5) enter into reciprocal agreements with all other state-certified health information <br/>
<a id="pl.102.5"></a><var>102.5</var>organizations to enable access to record locator services to find patient data, and <br/>
<a id="pl.102.6"></a><var>102.6</var>transmission and receipt of meaningful use transactions consistent with the format and <br/>
<a id="pl.102.7"></a><var>102.7</var>content required by national standards established by Centers for Medicare and Medicaid <br/>
<a id="pl.102.8"></a><var>102.8</var>Services. Reciprocal agreements must meet the requirements in subdivision 5; and<br/>
<a id="pl.102.9"></a><var>102.9</var>(6) comply with additional requirements for the certification or recertification of <br/>
<a id="pl.102.10"></a><var>102.10</var>health information organizations that may be established by the commissioner.<br/>
<a id="pl.102.11"></a><var>102.11</var>    Subd. 4. <b> Application for certificate of authority for health information exchange </b><br/>
<a id="pl.102.12"></a><var>102.12</var><b>service providers.</b> (a)  Each application for a certificate of authority shall be in a form <br/>
<a id="pl.102.13"></a><var>102.13</var>prescribed by the commissioner and verified by an officer or authorized representative of <br/>
<a id="pl.102.14"></a><var>102.14</var>the applicant. Each application shall include the following:<br/>
<a id="pl.102.15"></a><var>102.15</var>(1) a copy of the basic organizational document, if any, of the applicant and of <br/>
<a id="pl.102.16"></a><var>102.16</var>each major participating entity, such as the articles of incorporation, or other applicable <br/>
<a id="pl.102.17"></a><var>102.17</var>documents, and all amendments to it;<br/>
<a id="pl.102.18"></a><var>102.18</var>(2) a list of the names, addresses, and official positions of the following:<br/>
<a id="pl.102.19"></a><var>102.19</var>(i) all members of the board of directors and the principal officers and, if applicable, <br/>
<a id="pl.102.20"></a><var>102.20</var>shareholders of the applicant organization; and<br/>
<a id="pl.102.21"></a><var>102.21</var>(ii) all members of the board of directors and the principal officers of each major <br/>
<a id="pl.102.22"></a><var>102.22</var>participating entity and, if applicable, each shareholder beneficially owning more than ten <br/>
<a id="pl.102.23"></a><var>102.23</var>percent of any voting stock of the major participating entity;<br/>
<a id="pl.102.24"></a><var>102.24</var>(3) the name and address of each participating entity and the agreed-upon duration <br/>
<a id="pl.102.25"></a><var>102.25</var>of each contract or agreement if applicable;<br/>
<a id="pl.102.26"></a><var>102.26</var>(4) a copy of each standard agreement or contract intended to bind the participating <br/>
<a id="pl.102.27"></a><var>102.27</var>entities and the health information organization. Contractual provisions shall be consistent <br/>
<a id="pl.102.28"></a><var>102.28</var>with the purposes of this section in regard to the services to be performed under the <br/>
<a id="pl.102.29"></a><var>102.29</var>standard agreement or contract, the manner in which payment for services is determined, <br/>
<a id="pl.102.30"></a><var>102.30</var>the nature and extent of responsibilities to be retained by the health information <br/>
<a id="pl.102.31"></a><var>102.31</var>organization, and contractual termination provisions;<br/>
<a id="pl.102.32"></a><var>102.32</var>(5) a copy of each contract intended to bind major participating entities and the <br/>
<a id="pl.102.33"></a><var>102.33</var>health information organization. Contract information filed with the commissioner under <br/>
<a id="pl.102.34"></a><var>102.34</var>this section shall be nonpublic as defined in section 13.02, subdivision 9;<br/>
<a id="pl.102.35"></a><var>102.35</var>(6) a statement generally describing the health information organization, its health <br/>
<a id="pl.102.36"></a><var>102.36</var>information exchange contracts, facilities, and personnel, including a statement describing <br/>
<a id="pl.103.1"></a><var>103.1</var>the manner in which the applicant proposes to provide participants with comprehensive <br/>
<a id="pl.103.2"></a><var>103.2</var>health information exchange services;<br/>
<a id="pl.103.3"></a><var>103.3</var>(7) financial statements showing the applicant's assets, liabilities, and sources <br/>
<a id="pl.103.4"></a><var>103.4</var>of financial support, including a copy of the applicant's most recent certified financial <br/>
<a id="pl.103.5"></a><var>103.5</var>statement;<br/>
<a id="pl.103.6"></a><var>103.6</var>(8) strategic and operational plans that specifically address how the organization <br/>
<a id="pl.103.7"></a><var>103.7</var>will expand technical capacity of the health information organization to support providers <br/>
<a id="pl.103.8"></a><var>103.8</var>in achieving meaningful use of electronic health records over time, a description of <br/>
<a id="pl.103.9"></a><var>103.9</var>the proposed method of marketing the services, a schedule of proposed charges, and a <br/>
<a id="pl.103.10"></a><var>103.10</var>financial plan that includes a three-year projection of the expenses and income and other <br/>
<a id="pl.103.11"></a><var>103.11</var>sources of future capital;<br/>
<a id="pl.103.12"></a><var>103.12</var>(9) a statement reasonably describing the geographic area or areas to be served and <br/>
<a id="pl.103.13"></a><var>103.13</var>the type or types of participants to be served;<br/>
<a id="pl.103.14"></a><var>103.14</var>(10) a description of the complaint procedures to be used as required under this <br/>
<a id="pl.103.15"></a><var>103.15</var>section;<br/>
<a id="pl.103.16"></a><var>103.16</var>(11) a description of the mechanism by which participating entities will have an <br/>
<a id="pl.103.17"></a><var>103.17</var>opportunity to participate in matters of policy and operation;<br/>
<a id="pl.103.18"></a><var>103.18</var>(12) a copy of any pertinent agreements between the health information organization <br/>
<a id="pl.103.19"></a><var>103.19</var>and insurers, including liability insurers, demonstrating coverage is in place;<br/>
<a id="pl.103.20"></a><var>103.20</var>(13) a copy of the conflict of interest policy that applies to all members of the board <br/>
<a id="pl.103.21"></a><var>103.21</var>of directors and the principal officers of the health information organization; and<br/>
<a id="pl.103.22"></a><var>103.22</var>(14) other information as the commissioner may reasonably require to be provided.<br/>
<a id="pl.103.23"></a><var>103.23</var>(b) Thirty days after the receipt of the application for a certificate of authority, <br/>
<a id="pl.103.24"></a><var>103.24</var>the commissioner shall determine whether or not the application submitted meets the <br/>
<a id="pl.103.25"></a><var>103.25</var>requirements for completion in paragraph (a), and notify the applicant of any further <br/>
<a id="pl.103.26"></a><var>103.26</var>information required for the application to be processed.<br/>
<a id="pl.103.27"></a><var>103.27</var>(c) Ninety days after the receipt of a complete application for a certificate of <br/>
<a id="pl.103.28"></a><var>103.28</var>authority, the commissioner shall issue a certificate of authority to the applicant if the <br/>
<a id="pl.103.29"></a><var>103.29</var>commissioner determines that the applicant meets the minimum criteria requirements <br/>
<a id="pl.103.30"></a><var>103.30</var>of subdivision 2 for health data intermediaries or subdivision 3 for health information <br/>
<a id="pl.103.31"></a><var>103.31</var>organizations. If the commissioner determines that the applicant is not qualified, the <br/>
<a id="pl.103.32"></a><var>103.32</var>commissioner shall notify the applicant and specify the reasons for disqualification.<br/>
<a id="pl.103.33"></a><var>103.33</var>(d) Upon being granted a certificate of authority to operate as a health information <br/>
<a id="pl.103.34"></a><var>103.34</var>organization, the organization must operate in compliance with the provisions of this <br/>
<a id="pl.103.35"></a><var>103.35</var>section. Noncompliance may result in the imposition of a fine or the suspension or <br/>
<a id="pl.103.36"></a><var>103.36</var>revocation of the certificate of authority according to section 62J.4982.<br/>
<a id="pl.104.1"></a><var>104.1</var>    Subd. 5. <b> Reciprocal agreements between health information exchange entities.</b><br/>
<a id="pl.104.2"></a><var>104.2</var>(a) Reciprocal agreements between two health information organizations or between a <br/>
<a id="pl.104.3"></a><var>104.3</var>health information organization and a health data intermediary must include a fair and <br/>
<a id="pl.104.4"></a><var>104.4</var>equitable model for charges between the entities that:<br/>
<a id="pl.104.5"></a><var>104.5</var>(1) does not impede the secure transmission of transactions necessary to achieve <br/>
<a id="pl.104.6"></a><var>104.6</var>meaningful use;<br/>
<a id="pl.104.7"></a><var>104.7</var>(2) does not charge a fee for the exchange of meaningful use transactions transmitted <br/>
<a id="pl.104.8"></a><var>104.8</var>according to nationally recognized standards where no additional value-added service <br/>
<a id="pl.104.9"></a><var>104.9</var>is rendered to the sending or receiving health information organization or health data <br/>
<a id="pl.104.10"></a><var>104.10</var>intermediary either directly or on behalf of the client;<br/>
<a id="pl.104.11"></a><var>104.11</var>(3) is consistent with fair market value and proportionately reflects the value-added <br/>
<a id="pl.104.12"></a><var>104.12</var>services accessed as a result of the agreement; and<br/>
<a id="pl.104.13"></a><var>104.13</var>(4) prevents health care stakeholders from being charged multiple times for the <br/>
<a id="pl.104.14"></a><var>104.14</var>same service.<br/>
<a id="pl.104.15"></a><var>104.15</var>(b) Reciprocal agreements must include comparable quality of service standards that <br/>
<a id="pl.104.16"></a><var>104.16</var>ensure equitable levels of services.<br/>
<a id="pl.104.17"></a><var>104.17</var>(c) Reciprocal agreements are subject to review and approval by the commissioner.<br/>
<a id="pl.104.18"></a><var>104.18</var>(d) Nothing in this section precludes a state-certified health information organization <br/>
<a id="pl.104.19"></a><var>104.19</var>or state-certified health data intermediary from entering into contractual agreements for <br/>
<a id="pl.104.20"></a><var>104.20</var>the provision of value-added services beyond meaningful use. <br/>
<a id="pl.104.21"></a><var>104.21</var>(e) The commissioner of human services or health, when providing access to data or <br/>
<a id="pl.104.22"></a><var>104.22</var>services through a certified health information organization, must offer the same data or <br/>
<a id="pl.104.23"></a><var>104.23</var>services directly through any certified health information organization at the same pricing, <br/>
<a id="pl.104.24"></a><var>104.24</var>if the health information organization pays for all connection costs to the state data or <br/>
<a id="pl.104.25"></a><var>104.25</var>service. For all external connectivity to the respective agencies through existing or future <br/>
<a id="pl.104.26"></a><var>104.26</var>information exchange implementations, the respective agency shall establish the required <br/>
<a id="pl.104.27"></a><var>104.27</var>connectivity methods as well as protocol standards to be utilized.<br/>
<a id="pl.104.28"></a><var>104.28</var>    Subd. 6. <b>State participation in health information exchange.</b> A state agency <br/>
<a id="pl.104.29"></a><var>104.29</var>that connects to a health information exchange service provider for the purpose of <br/>
<a id="pl.104.30"></a><var>104.30</var>exchanging meaningful use transactions must ensure that the contracted health information <br/>
<a id="pl.104.31"></a><var>104.31</var>exchange service provider has reciprocal agreements in place as required by this section. <br/>
<a id="pl.104.32"></a><var>104.32</var>The reciprocal agreements must provide equal access to information supplied by the <br/>
<a id="pl.104.33"></a><var>104.33</var>agency and necessary for meaningful use by the participating entities of the other health <br/>
<a id="pl.104.34"></a><var>104.34</var>information service providers.<br/>
<br/>
<a id="bill.6.8.0"></a><a id="pl.104.35"></a><var>104.35</var>    Sec. 8. <b>[62J.4982] ENFORCEMENT AUTHORITY; COMPLIANCE.</b><br/>
<a id="pl.105.1"></a><var>105.1</var>    Subdivision 1. <b> Penalties and enforcement.</b>  (a) The commissioner may, for any <br/>
<a id="pl.105.2"></a><var>105.2</var>violation of statute or rule applicable to a health information exchange service provider, <br/>
<a id="pl.105.3"></a><var>105.3</var>levy an administrative penalty in an amount up to $25,000 for each violation. In <br/>
<a id="pl.105.4"></a><var>105.4</var>determining the level of an administrative penalty, the commissioner shall consider the <br/>
<a id="pl.105.5"></a><var>105.5</var>following factors:<br/>
<a id="pl.105.6"></a><var>105.6</var>(1) the number of participating entities affected by the violation;<br/>
<a id="pl.105.7"></a><var>105.7</var>(2) the effect of the violation on participating entities' access to health information <br/>
<a id="pl.105.8"></a><var>105.8</var>exchange services;<br/>
<a id="pl.105.9"></a><var>105.9</var>(3) if only one participating entity is affected, the effect of the violation on the <br/>
<a id="pl.105.10"></a><var>105.10</var>patients of that entity;<br/>
<a id="pl.105.11"></a><var>105.11</var>(4) whether the violation is an isolated incident or part of a pattern of violations;<br/>
<a id="pl.105.12"></a><var>105.12</var>(5) the economic benefits derived by the health information organization or a health <br/>
<a id="pl.105.13"></a><var>105.13</var>data intermediary by virtue of the violation;<br/>
<a id="pl.105.14"></a><var>105.14</var>(6) whether the violation hindered or facilitated an individual's ability to obtain <br/>
<a id="pl.105.15"></a><var>105.15</var>health care;<br/>
<a id="pl.105.16"></a><var>105.16</var>(7) whether the violation was intentional;<br/>
<a id="pl.105.17"></a><var>105.17</var>(8) whether the violation was beyond the direct control of the health information <br/>
<a id="pl.105.18"></a><var>105.18</var>exchange service provider;<br/>
<a id="pl.105.19"></a><var>105.19</var>(9) any history of prior compliance with the provisions of this section, including <br/>
<a id="pl.105.20"></a><var>105.20</var>violations;<br/>
<a id="pl.105.21"></a><var>105.21</var>(10) whether and to what extent the health information exchange service provider <br/>
<a id="pl.105.22"></a><var>105.22</var>attempted to correct previous violations;<br/>
<a id="pl.105.23"></a><var>105.23</var>(11) how the health information exchange service provider responded to technical <br/>
<a id="pl.105.24"></a><var>105.24</var>assistance from the commissioner provided in the context of a compliance effort; and<br/>
<a id="pl.105.25"></a><var>105.25</var>(12) the financial condition of the health information exchange service provider <br/>
<a id="pl.105.26"></a><var>105.26</var>including, but not limited to, whether the health information exchange service provider <br/>
<a id="pl.105.27"></a><var>105.27</var>had financial difficulties that affected its ability to comply or whether the imposition of an <br/>
<a id="pl.105.28"></a><var>105.28</var>administrative monetary penalty would jeopardize the ability of the health information <br/>
<a id="pl.105.29"></a><var>105.29</var>exchange service provider to continue to deliver health information exchange services.<br/>
<a id="pl.105.30"></a><var>105.30</var>Reasonable notice in writing shall be given to the health information exchange <br/>
<a id="pl.105.31"></a><var>105.31</var>service provider of the intent to levy the penalty and the reasons for them. A health <br/>
<a id="pl.105.32"></a><var>105.32</var>information exchange service provider may have 15 days within which to contest whether <br/>
<a id="pl.105.33"></a><var>105.33</var>the finding of facts constitute a violation of this section and section 62J.4981, according to <br/>
<a id="pl.105.34"></a><var>105.34</var>the contested case and judicial review provisions of sections 14.57 to 14.69.<br/>
<a id="pl.105.35"></a><var>105.35</var>(b) If the commissioner has reason to believe that a violation of this section or <br/>
<a id="pl.105.36"></a><var>105.36</var>section 62J.4981 has occurred or is likely, the commissioner may confer with the persons <br/>
<a id="pl.106.1"></a><var>106.1</var>involved before commencing action under subdivision 2. The commissioner may notify <br/>
<a id="pl.106.2"></a><var>106.2</var>the health information exchange service provider and the representatives, or other persons <br/>
<a id="pl.106.3"></a><var>106.3</var>who appear to be involved in the suspected violation, to arrange a voluntary conference <br/>
<a id="pl.106.4"></a><var>106.4</var>with the alleged violators or their authorized representatives. The purpose of the <br/>
<a id="pl.106.5"></a><var>106.5</var>conference is to attempt to learn the facts about the suspected violation and if it appears <br/>
<a id="pl.106.6"></a><var>106.6</var>that a violation has occurred or is threatened, to find a way to correct or prevent it. The <br/>
<a id="pl.106.7"></a><var>106.7</var>conference is not governed by any formal procedural requirements and may be conducted <br/>
<a id="pl.106.8"></a><var>106.8</var>as the commissioner considers appropriate.<br/>
<a id="pl.106.9"></a><var>106.9</var>(c) The commissioner may issue an order directing a health information exchange <br/>
<a id="pl.106.10"></a><var>106.10</var>service provider or a representative of a health information exchange service provider to <br/>
<a id="pl.106.11"></a><var>106.11</var>cease and desist from engaging in any act or practice in violation of this section and <br/>
<a id="pl.106.12"></a><var>106.12</var>section 62J.4981.<br/>
<a id="pl.106.13"></a><var>106.13</var>(d) Within 20 days after service of the order to cease and desist, a health information <br/>
<a id="pl.106.14"></a><var>106.14</var>exchange service provider may contest whether the finding of facts constitutes a violation <br/>
<a id="pl.106.15"></a><var>106.15</var>of this section and section 62J.4981 according to the contested case and judicial review <br/>
<a id="pl.106.16"></a><var>106.16</var>provisions of sections 14.57 to 14.69.<br/>
<a id="pl.106.17"></a><var>106.17</var>(e) In the event of noncompliance with a cease and desist order issued under this <br/>
<a id="pl.106.18"></a><var>106.18</var>subdivision, the commissioner may institute a proceeding to obtain injunctive relief or <br/>
<a id="pl.106.19"></a><var>106.19</var>other appropriate relief in Ramsey County District Court.<br/>
<a id="pl.106.20"></a><var>106.20</var>    Subd. 2. <b> Suspension or revocation of certificates of authority.</b> (a) The <br/>
<a id="pl.106.21"></a><var>106.21</var>commissioner may suspend or revoke a certificate of authority issued to a health <br/>
<a id="pl.106.22"></a><var>106.22</var>data intermediary or health information organization under section 62J.4981 if the <br/>
<a id="pl.106.23"></a><var>106.23</var>commissioner finds that:<br/>
<a id="pl.106.24"></a><var>106.24</var>(1) the health information exchange service provider is operating significantly <br/>
<a id="pl.106.25"></a><var>106.25</var>in contravention of its basic organizational document, or in a manner contrary to that <br/>
<a id="pl.106.26"></a><var>106.26</var>described in and reasonably inferred from any other information submitted under section <br/>
<a id="pl.106.27"></a><var>106.27</var>62J.4981, unless amendments to the submissions have been filed with and approved by <br/>
<a id="pl.106.28"></a><var>106.28</var>the commissioner;<br/>
<a id="pl.106.29"></a><var>106.29</var>(2) the health information exchange service provider is unable to fulfill its <br/>
<a id="pl.106.30"></a><var>106.30</var>obligations to furnish comprehensive health information exchange services as required <br/>
<a id="pl.106.31"></a><var>106.31</var>under its health information exchange contract;<br/>
<a id="pl.106.32"></a><var>106.32</var>(3) the health information exchange service provider is no longer financially solvent <br/>
<a id="pl.106.33"></a><var>106.33</var>or may not reasonably be expected to meet its obligations to participating entities;<br/>
<a id="pl.106.34"></a><var>106.34</var>(4) the health information exchange service provider has failed to implement the <br/>
<a id="pl.106.35"></a><var>106.35</var>complaint system in a manner designed to reasonably resolve valid complaints;<br/>
<a id="pl.107.1"></a><var>107.1</var>(5) the health information exchange service provider, or any person acting with its <br/>
<a id="pl.107.2"></a><var>107.2</var>sanction, has advertised or merchandised its services in an untrue, misleading, deceptive, <br/>
<a id="pl.107.3"></a><var>107.3</var>or unfair manner;<br/>
<a id="pl.107.4"></a><var>107.4</var>(6) the continued operation of the health information exchange service provider <br/>
<a id="pl.107.5"></a><var>107.5</var>would be hazardous to its participating entities or the patients served by the participating <br/>
<a id="pl.107.6"></a><var>107.6</var>entities; or<br/>
<a id="pl.107.7"></a><var>107.7</var>(7) the health information exchange service provider has otherwise failed to <br/>
<a id="pl.107.8"></a><var>107.8</var>substantially comply with section 62J.4981 or with any other statute or administrative <br/>
<a id="pl.107.9"></a><var>107.9</var>rule applicable to health information exchange service providers, or has submitted false <br/>
<a id="pl.107.10"></a><var>107.10</var>information in any report required under sections 62J.498 to 62J.4982.<br/>
<a id="pl.107.11"></a><var>107.11</var>(b) A certificate of authority shall be suspended or revoked only after meeting the <br/>
<a id="pl.107.12"></a><var>107.12</var>requirements of subdivision 3.<br/>
<a id="pl.107.13"></a><var>107.13</var>(c) If the certificate of authority of a health information exchange service provider is <br/>
<a id="pl.107.14"></a><var>107.14</var>suspended, the health information exchange service provider shall not, during the period <br/>
<a id="pl.107.15"></a><var>107.15</var>of suspension, enroll any additional participating entities, and shall not engage in any <br/>
<a id="pl.107.16"></a><var>107.16</var>advertising or solicitation.<br/>
<a id="pl.107.17"></a><var>107.17</var>(d) If the certificate of authority of a health information exchange service provider is <br/>
<a id="pl.107.18"></a><var>107.18</var>revoked, the organization shall proceed, immediately following the effective date of the <br/>
<a id="pl.107.19"></a><var>107.19</var>order of revocation, to wind up its affairs and shall conduct no further business except as <br/>
<a id="pl.107.20"></a><var>107.20</var>necessary to the orderly conclusion of the affairs of the organization. The organization <br/>
<a id="pl.107.21"></a><var>107.21</var>shall engage in no further advertising or solicitation. The commissioner may, by written <br/>
<a id="pl.107.22"></a><var>107.22</var>order, permit further operation of the organization as the commissioner finds to be in the <br/>
<a id="pl.107.23"></a><var>107.23</var>best interest of participating entities, to the end that participating entities will be given the <br/>
<a id="pl.107.24"></a><var>107.24</var>greatest practical opportunity to access continuing health information exchange services.<br/>
<a id="pl.107.25"></a><var>107.25</var>    Subd. 3. <b> Denial, suspension, and revocation; administrative procedures.</b>  (a) <br/>
<a id="pl.107.26"></a><var>107.26</var>When the commissioner has cause to believe that grounds for the denial, suspension, <br/>
<a id="pl.107.27"></a><var>107.27</var>or revocation of a certificate of authority exists, the commissioner shall notify the <br/>
<a id="pl.107.28"></a><var>107.28</var>health information exchange service provider in writing stating the grounds for denial, <br/>
<a id="pl.107.29"></a><var>107.29</var>suspension, or revocation and setting a time within 20 days for a hearing on the matter.<br/>
<a id="pl.107.30"></a><var>107.30</var>(b) After a hearing before the commissioner at which the health information <br/>
<a id="pl.107.31"></a><var>107.31</var>exchange service provider may respond to the grounds for denial, suspension, or <br/>
<a id="pl.107.32"></a><var>107.32</var>revocation, or upon the failure of the health information exchange service provider to <br/>
<a id="pl.107.33"></a><var>107.33</var>appear at the hearing, the commissioner shall take action as deemed necessary and shall <br/>
<a id="pl.107.34"></a><var>107.34</var>issue written findings that shall be mailed to the health information exchange service <br/>
<a id="pl.107.35"></a><var>107.35</var>provider.<br/>
<a id="pl.108.1"></a><var>108.1</var>(c) If suspension, revocation, or an administrative penalty is proposed according <br/>
<a id="pl.108.2"></a><var>108.2</var>to this section, the commissioner must deliver, or send by certified mail with return <br/>
<a id="pl.108.3"></a><var>108.3</var>receipt requested, to the health information exchange service provider written notice of <br/>
<a id="pl.108.4"></a><var>108.4</var>the commissioner's intent to impose a penalty. This notice of proposed determination <br/>
<a id="pl.108.5"></a><var>108.5</var>must include:<br/>
<a id="pl.108.6"></a><var>108.6</var>(1) a reference to the statutory basis for the penalty;<br/>
<a id="pl.108.7"></a><var>108.7</var>(2) a description of the findings of fact regarding the violations with respect to <br/>
<a id="pl.108.8"></a><var>108.8</var>which the penalty is proposed;<br/>
<a id="pl.108.9"></a><var>108.9</var>(3) the nature and amount of the proposed penalty;<br/>
<a id="pl.108.10"></a><var>108.10</var>(4) any circumstances described in subdivision 1, paragraph (a), that were considered <br/>
<a id="pl.108.11"></a><var>108.11</var>in determining the amount of the proposed penalty;<br/>
<a id="pl.108.12"></a><var>108.12</var>(5) instructions for responding to the notice, including a statement of the health <br/>
<a id="pl.108.13"></a><var>108.13</var>information exchange service provider's right to a contested case proceeding and a <br/>
<a id="pl.108.14"></a><var>108.14</var>statement that failure to request a contested case proceeding within 30 calendar days <br/>
<a id="pl.108.15"></a><var>108.15</var>permits the imposition of the proposed penalty; and<br/>
<a id="pl.108.16"></a><var>108.16</var>(6) the address to which the contested case proceeding request must be sent.<br/>
<a id="pl.108.17"></a><var>108.17</var>    Subd. 4. <b> Coordination.</b> (a) To the extent possible when implementing sections <br/>
<a id="pl.108.18"></a><var>108.18</var>62J.498 to 62J.4982, the commissioner shall seek the advice of the Minnesota e-Health <br/>
<a id="pl.108.19"></a><var>108.19</var>Advisory Committee, in the review and update of criteria for the certification and <br/>
<a id="pl.108.20"></a><var>108.20</var>recertification of health information exchange service providers.<br/>
<a id="pl.108.21"></a><var>108.21</var>(b) By January 1, 2011, the commissioner shall report to the governor and the <br/>
<a id="pl.108.22"></a><var>108.22</var>chairs of the senate and house of representatives committees having jurisdiction over <br/>
<a id="pl.108.23"></a><var>108.23</var>health information policy issues on the status of the health information exchange in <br/>
<a id="pl.108.24"></a><var>108.24</var>Minnesota and provide recommendations on further action necessary to facilitate the <br/>
<a id="pl.108.25"></a><var>108.25</var>secure electronic movement of health information among health providers that will enable <br/>
<a id="pl.108.26"></a><var>108.26</var>Minnesota providers and hospitals to meet meaningful use exchange requirements.<br/>
<a id="pl.108.27"></a><var>108.27</var>    Subd. 5. <b> Fees and monetary penalties.</b>  (a) Every health information exchange <br/>
<a id="pl.108.28"></a><var>108.28</var>service provider subject to this section and section 62J.4981 shall be assessed fees as <br/>
<a id="pl.108.29"></a><var>108.29</var>follows:<br/>
<a id="pl.108.30"></a><var>108.30</var>(1) filing an application for certificate of authority to operate as a health information <br/>
<a id="pl.108.31"></a><var>108.31</var>organization, $10,500;<br/>
<a id="pl.108.32"></a><var>108.32</var>(2) filing an application for certificate of authority to operate as a health data <br/>
<a id="pl.108.33"></a><var>108.33</var>intermediary, $7,000;<br/>
<a id="pl.108.34"></a><var>108.34</var>(3) annual health information organization certificate fee, $14,000;<br/>
<a id="pl.108.35"></a><var>108.35</var>(4) annual health data intermediary certificate fee, $7,000; and<br/>
<a id="pl.108.36"></a><var>108.36</var>(5) fees for other filings, as specified by rule.<br/>
<a id="pl.109.1"></a><var>109.1</var>(b) Administrative monetary penalties imposed under this subdivision shall be <br/>
<a id="pl.109.2"></a><var>109.2</var>deposited into a revolving fund and are appropriated to the commissioner for the purposes <br/>
<a id="pl.109.3"></a><var>109.3</var>of sections 62J.498 to 62J.4982.<br/>
<br/>
<a id="bill.6.9.0"></a><a id="pl.109.4"></a><var>109.4</var>    Sec. 9. Minnesota Statutes 2008, section 62Q.19, subdivision 1, is amended to read:<br/>
<a id="pl.109.5"></a><var>109.5</var>    Subdivision 1. <b>Designation.</b> (a) The commissioner shall designate essential <br/>
<a id="pl.109.6"></a><var>109.6</var>community providers. The criteria for essential community provider designation shall be <br/>
<a id="pl.109.7"></a><var>109.7</var>the following:<br/>
<a id="pl.109.8"></a><var>109.8</var>(1) a demonstrated ability to integrate applicable supportive and stabilizing services <br/>
<a id="pl.109.9"></a><var>109.9</var>with medical care for uninsured persons and high-risk and special needs populations, <br/>
<a id="pl.109.10"></a><var>109.10</var>underserved, and other special needs populations; and<br/>
<a id="pl.109.11"></a><var>109.11</var>(2) a commitment to serve low-income and underserved populations by meeting the <br/>
<a id="pl.109.12"></a><var>109.12</var>following requirements:<br/>
<a id="pl.109.13"></a><var>109.13</var>(i) has nonprofit status in accordance with chapter 317A;<br/>
<a id="pl.109.14"></a><var>109.14</var>(ii) has tax exempt status in accordance with the Internal Revenue Service Code, <br/>
<a id="pl.109.15"></a><var>109.15</var>section 501(c)(3);<br/>
<a id="pl.109.16"></a><var>109.16</var>(iii) charges for services on a sliding fee schedule based on current poverty income <br/>
<a id="pl.109.17"></a><var>109.17</var>guidelines; and<br/>
<a id="pl.109.18"></a><var>109.18</var>(iv) does not restrict access or services because of a client's financial limitation;<br/>
<a id="pl.109.19"></a><var>109.19</var>(3) status as a local government unit as defined in section 
         <statute_ref>62D.02, subdivision 11</statute_ref>, a <br/>
<a id="pl.109.20"></a><var>109.20</var>hospital district created or reorganized under sections 
         <statute_ref>447.31</statute_ref> to 
         <statute_ref>447.37</statute_ref>, an Indian tribal <br/>
<a id="pl.109.21"></a><var>109.21</var>government, an Indian health service unit, or a community health board as defined in <br/>
<a id="pl.109.22"></a><var>109.22</var>chapter 145A;  <br/>
<a id="pl.109.23"></a><var>109.23</var>(4) a former state hospital that specializes in the treatment of cerebral palsy, spina <br/>
<a id="pl.109.24"></a><var>109.24</var>bifida, epilepsy, closed head injuries, specialized orthopedic problems, and other disabling <br/>
<a id="pl.109.25"></a><var>109.25</var>conditions; or<br/>
<a id="pl.109.26"></a><var>109.26</var>(5) a sole community hospital. For these rural hospitals, the essential community <br/>
<a id="pl.109.27"></a><var>109.27</var>provider designation applies to all health services provided, including both inpatient and <br/>
<a id="pl.109.28"></a><var>109.28</var>outpatient services. For purposes of this section, "sole community hospital" means a <br/>
<a id="pl.109.29"></a><var>109.29</var>rural hospital that:<br/>
<a id="pl.109.30"></a><var>109.30</var>(i) is eligible to be classified as a sole community hospital according to Code <br/>
<a id="pl.109.31"></a><var>109.31</var>of Federal Regulations, title 42, section 
         <statute_ref>412.92</statute_ref>, or is located in a community with a <br/>
<a id="pl.109.32"></a><var>109.32</var>population of less than 5,000 and located more than 25 miles from a like hospital currently <br/>
<a id="pl.109.33"></a><var>109.33</var>providing acute short-term services;  <br/>
<a id="pl.110.1"></a><var>110.1</var>(ii) has experienced net operating income losses in two of the previous three <br/>
<a id="pl.110.2"></a><var>110.2</var>most recent consecutive hospital fiscal years for which audited financial information is <br/>
<a id="pl.110.3"></a><var>110.3</var>available; and<br/>
<a id="pl.110.4"></a><var>110.4</var>(iii) consists of 40 or fewer licensed beds; or<br/>
<a id="pl.110.5"></a><var>110.5</var>(6) a birth center licensed under section 144.615.<br/>
<a id="pl.110.6"></a><var>110.6</var>(b) Prior to designation, the commissioner shall publish the names of all applicants <br/>
<a id="pl.110.7"></a><var>110.7</var>in the State Register. The public shall have 30 days from the date of publication to submit <br/>
<a id="pl.110.8"></a><var>110.8</var>written comments to the commissioner on the application. No designation shall be made <br/>
<a id="pl.110.9"></a><var>110.9</var>by the commissioner until the 30-day period has expired.<br/>
<a id="pl.110.10"></a><var>110.10</var>(c) The commissioner may designate an eligible provider as an essential community <br/>
<a id="pl.110.11"></a><var>110.11</var>provider for all the services offered by that provider or for specific services designated by <br/>
<a id="pl.110.12"></a><var>110.12</var>the commissioner.<br/>
<a id="pl.110.13"></a><var>110.13</var>(d) For the purpose of this subdivision, supportive and stabilizing services include at <br/>
<a id="pl.110.14"></a><var>110.14</var>a minimum, transportation, child care, cultural, and linguistic services where appropriate.<br/>
<br/>
<a id="bill.6.10.0"></a><a id="pl.110.15"></a><var>110.15</var>    Sec. 10. Minnesota Statutes 2008, section 144.226, subdivision 3, is amended to read:<br/>
<a id="pl.110.16"></a><var>110.16</var>    Subd. 3. <b>Birth record surcharge.</b> (a) In addition to any fee prescribed under <br/>
<a id="pl.110.17"></a><var>110.17</var>subdivision 1, there shall be a nonrefundable surcharge of $3 for each certified birth or <br/>
<a id="pl.110.18"></a><var>110.18</var>stillbirth record and for a certification that the vital record cannot be found. The local or <br/>
<a id="pl.110.19"></a><var>110.19</var>state registrar shall forward this amount to the commissioner of management and budget <br/>
<a id="pl.110.20"></a><var>110.20</var>for deposit into the account for the children's trust fund for the prevention of child abuse <br/>
<a id="pl.110.21"></a><var>110.21</var>established under section 
         <statute_ref>256E.22</statute_ref>. This surcharge shall not be charged under those <br/>
<a id="pl.110.22"></a><var>110.22</var>circumstances in which no fee for a certified birth or stillbirth record is permitted under <br/>
<a id="pl.110.23"></a><var>110.23</var>subdivision 1, paragraph (a). Upon certification by the commissioner of management and <br/>
<a id="pl.110.24"></a><var>110.24</var>budget that the assets in that fund exceed $20,000,000, this surcharge shall be discontinued.<br/>
<a id="pl.110.25"></a><var>110.25</var>(b) In addition to any fee prescribed under subdivision 1, there shall be a <br/>
<a id="pl.110.26"></a><var>110.26</var>nonrefundable surcharge of $10 for each certified birth record. The local or state registrar <br/>
<a id="pl.110.27"></a><var>110.27</var>shall forward this amount to the commissioner of finance for deposit in the general fund <br/>
<a id="pl.110.28"></a><var>110.28</var>for the Minnesota Birth Defects Information System established under section 144.2215. <br/>
<a id="pl.110.29"></a><var>110.29</var>This surcharge shall not be charged under those circumstances in which no fee for a <br/>
<a id="pl.110.30"></a><var>110.30</var>certified birth record is permitted under subdivision 1, paragraph (a).<br/>
<a id="pl.110.31"></a><var>110.31</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2010.<br/>
<br/>
<a id="bill.6.11.0"></a><a id="pl.110.32"></a><var>110.32</var>    Sec. 11. <b>[144.615] BIRTH CENTERS.</b><br/>
<a id="pl.110.33"></a><var>110.33</var>    Subdivision 1. <b>Definitions.</b> (a) For purposes of this section, the following definitions <br/>
<a id="pl.110.34"></a><var>110.34</var>have the meanings given them.<br/>
<a id="pl.111.1"></a><var>111.1</var>(b) "Birth center" means a facility licensed for the primary purpose of performing <br/>
<a id="pl.111.2"></a><var>111.2</var>low-risk deliveries that is not a hospital or licensed as part of a hospital and where births are <br/>
<a id="pl.111.3"></a><var>111.3</var>planned to occur away from the mother's usual residence following a low-risk pregnancy.<br/>
<a id="pl.111.4"></a><var>111.4</var>(c) "CABC" means the Commission for the Accreditation of Birth Centers.<br/>
<a id="pl.111.5"></a><var>111.5</var>(d) "Low-risk pregnancy" means a normal, uncomplicated prenatal course as <br/>
<a id="pl.111.6"></a><var>111.6</var>determined by documentation of adequate prenatal care and the anticipation of a normal <br/>
<a id="pl.111.7"></a><var>111.7</var>uncomplicated labor and birth, as defined by reasonable and generally accepted criteria <br/>
<a id="pl.111.8"></a><var>111.8</var>adopted by professional groups for maternal, fetal, and neonatal health care.<br/>
<a id="pl.111.9"></a><var>111.9</var>    Subd. 2. <b>License required.</b> (a) Beginning January 1, 2011, no birth center shall be <br/>
<a id="pl.111.10"></a><var>111.10</var>established, operated, or maintained in the state without first obtaining a license from the <br/>
<a id="pl.111.11"></a><var>111.11</var>commissioner of health according to this section.<br/>
<a id="pl.111.12"></a><var>111.12</var>(b) A license issued under this section is not transferable or assignable and is subject <br/>
<a id="pl.111.13"></a><var>111.13</var>to suspension or revocation at any time for failure to comply with this section.<br/>
<a id="pl.111.14"></a><var>111.14</var>(c) A birth center licensed under this section shall not assert, represent, offer, <br/>
<a id="pl.111.15"></a><var>111.15</var>provide, or imply that the center is or may render care or services other than the services it <br/>
<a id="pl.111.16"></a><var>111.16</var>is permitted to render within the scope of the license or the accreditation issued.<br/>
<a id="pl.111.17"></a><var>111.17</var>(d) The license must be conspicuously posted in an area where patients are admitted.<br/>
<a id="pl.111.18"></a><var>111.18</var>    Subd. 3. <b>Temporary license.</b> For new birth centers planning to begin operations <br/>
<a id="pl.111.19"></a><var>111.19</var>after January 1, 2011, the commissioner may issue a temporary license to the birth center <br/>
<a id="pl.111.20"></a><var>111.20</var>that is valid for a period of six months from the date of issuance. The birth center must <br/>
<a id="pl.111.21"></a><var>111.21</var>submit to the commissioner an application and applicable fee for licensure as required <br/>
<a id="pl.111.22"></a><var>111.22</var>under subdivision 4. The application must include the information required in subdivision <br/>
<a id="pl.111.23"></a><var>111.23</var>4, clauses (1) to (3) and (5) to (7), and documentation that the birth center has submitted <br/>
<a id="pl.111.24"></a><var>111.24</var>an application for accreditation to the CABC. Upon receipt of accreditation from the <br/>
<a id="pl.111.25"></a><var>111.25</var>CABC, the birth center must submit to the commissioner the information required in <br/>
<a id="pl.111.26"></a><var>111.26</var>subdivision 4, clause (4), and the applicable fee under subdivision 8. The commissioner <br/>
<a id="pl.111.27"></a><var>111.27</var>shall issue a new license.<br/>
<a id="pl.111.28"></a><var>111.28</var>    Subd. 4. <b>Application.</b> An application for a license to operate a birth center and the <br/>
<a id="pl.111.29"></a><var>111.29</var>applicable fee under subdivision 8 must be submitted to the commissioner on a form <br/>
<a id="pl.111.30"></a><var>111.30</var>provided by the commissioner and must contain:<br/>
<a id="pl.111.31"></a><var>111.31</var>(1) the name of the applicant;<br/>
<a id="pl.111.32"></a><var>111.32</var>(2) the site location of the birth center;<br/>
<a id="pl.111.33"></a><var>111.33</var>(3) the name of the person in charge of the center;<br/>
<a id="pl.111.34"></a><var>111.34</var>(4) documentation that the accreditation described under subdivision 6 has been <br/>
<a id="pl.111.35"></a><var>111.35</var>issued, including the effective date and the expiration date of the accreditation, and the <br/>
<a id="pl.111.36"></a><var>111.36</var>date of the last site visit by the CABC;<br/>
<a id="pl.112.1"></a><var>112.1</var>(5) the number of patients the birth center is capable of serving at a given time;<br/>
<a id="pl.112.2"></a><var>112.2</var>(6) the names and license numbers, if applicable, of the health care professionals <br/>
<a id="pl.112.3"></a><var>112.3</var>on staff at the birth center; and<br/>
<a id="pl.112.4"></a><var>112.4</var>(7) any other information the commissioner deems necessary.<br/>
<a id="pl.112.5"></a><var>112.5</var>    Subd. 5. <b>Suspension, revocation, and refusal to renew.</b> The commissioner may <br/>
<a id="pl.112.6"></a><var>112.6</var>refuse to grant or renew, or may suspend or revoke, a license on any of the grounds <br/>
<a id="pl.112.7"></a><var>112.7</var>described under section 144.55, subdivision 6, paragraph (a), clause (2), (3), or (4), or <br/>
<a id="pl.112.8"></a><var>112.8</var>upon the loss of accreditation by the CABC. The applicant or licensee is entitled to notice <br/>
<a id="pl.112.9"></a><var>112.9</var>and a hearing as described under section 144.55, subdivision 7, and a new license may be <br/>
<a id="pl.112.10"></a><var>112.10</var>issued after proper inspection of the birth center has been conducted.<br/>
<a id="pl.112.11"></a><var>112.11</var>    Subd. 6. <b>Standards for licensure.</b> (a) To be eligible for licensure under this <br/>
<a id="pl.112.12"></a><var>112.12</var>section, a birth center must be accredited by the CABC or must obtain accreditation <br/>
<a id="pl.112.13"></a><var>112.13</var>within six months of the date of the application for licensure. If the birth center loses its <br/>
<a id="pl.112.14"></a><var>112.14</var>accreditation, the birth center must immediately notify the commissioner.<br/>
<a id="pl.112.15"></a><var>112.15</var>(b) The center must have procedures in place specifying criteria by which risk status <br/>
<a id="pl.112.16"></a><var>112.16</var>will be established and applied to each woman at admission and during labor.<br/>
<a id="pl.112.17"></a><var>112.17</var>(c) Upon request, the birth center shall provide the commissioner of health with any <br/>
<a id="pl.112.18"></a><var>112.18</var>material submitted by the birth center to the CABC as part of the accreditation process, <br/>
<a id="pl.112.19"></a><var>112.19</var>including the accreditation application, the self-evaluation report, the accreditation <br/>
<a id="pl.112.20"></a><var>112.20</var>decision letter from the CABC, and any reports from the CABC following a site visit.<br/>
<a id="pl.112.21"></a><var>112.21</var>    Subd. 7. <b>Limitations of services.</b> (a) The following limitations apply to the services <br/>
<a id="pl.112.22"></a><var>112.22</var>performed at a birth center:<br/>
<a id="pl.112.23"></a><var>112.23</var>(1) surgical procedures must be limited to those normally accomplished during an <br/>
<a id="pl.112.24"></a><var>112.24</var>uncomplicated birth, including episiotomy and repair;<br/>
<a id="pl.112.25"></a><var>112.25</var>(2) no abortions may be administered; and<br/>
<a id="pl.112.26"></a><var>112.26</var>(3) no general or regional anesthesia may be administered.<br/>
<a id="pl.112.27"></a><var>112.27</var>(b) Notwithstanding paragraph (a), local anesthesia may be administered at a birth <br/>
<a id="pl.112.28"></a><var>112.28</var>center if the administration of the anesthetic is performed within the scope of practice of a <br/>
<a id="pl.112.29"></a><var>112.29</var>health care professional.<br/>
<a id="pl.112.30"></a><var>112.30</var>    Subd. 8. <b>Fees.</b> (a) The biennial license fee for a birth center is $365.<br/>
<a id="pl.112.31"></a><var>112.31</var>(b) The temporary license fee is $365.<br/>
<a id="pl.112.32"></a><var>112.32</var>(c) Fees shall be collected and deposited according to section 144.122.<br/>
<a id="pl.112.33"></a><var>112.33</var>    Subd. 9. <b>Renewal.</b> (a) Except as provided in paragraph (b), a license issued under <br/>
<a id="pl.112.34"></a><var>112.34</var>this section expires two years from the date of issue.<br/>
<a id="pl.112.35"></a><var>112.35</var>(b) A temporary license issued under subdivision 3 expires six months from the date <br/>
<a id="pl.112.36"></a><var>112.36</var>of issue, and may be renewed for one additional six-month period.<br/>
<a id="pl.113.1"></a><var>113.1</var>(c) An application for renewal shall be submitted at least 60 days prior to expiration <br/>
<a id="pl.113.2"></a><var>113.2</var>of the license on forms prescribed by the commissioner of health.<br/>
<a id="pl.113.3"></a><var>113.3</var>    Subd. 10. <b>Records.</b> All health records maintained on each client by a birth center <br/>
<a id="pl.113.4"></a><var>113.4</var>are subject to sections 144.292 to 144.298.<br/>
<a id="pl.113.5"></a><var>113.5</var>    Subd. 11. <b>Report.</b> (a) The commissioner of health, in consultation with the <br/>
<a id="pl.113.6"></a><var>113.6</var>commissioner of human services and representatives of the licensed birth centers, <br/>
<a id="pl.113.7"></a><var>113.7</var>the American College of Obstetricians and Gynecologists, the American Academy <br/>
<a id="pl.113.8"></a><var>113.8</var>of Pediatrics, the Minnesota Hospital Association, and the Minnesota Ambulance <br/>
<a id="pl.113.9"></a><var>113.9</var>Association, shall evaluate the quality of care and outcomes for services provided in <br/>
<a id="pl.113.10"></a><var>113.10</var>licensed birth centers, including, but not limited to, the utilization of services provided at a <br/>
<a id="pl.113.11"></a><var>113.11</var>birth center, the outcomes of care provided to both mothers and newborns, and the numbers <br/>
<a id="pl.113.12"></a><var>113.12</var>of transfers to other health care facilities that are required and the reasons for the transfers. <br/>
<a id="pl.113.13"></a><var>113.13</var>The commissioner shall work with the birth centers to establish a process to gather and <br/>
<a id="pl.113.14"></a><var>113.14</var>analyze the data within protocols that protect the confidentiality of patient identification.<br/>
<a id="pl.113.15"></a><var>113.15</var>(b) The commissioner of health shall report the findings of the evaluation to the <br/>
<a id="pl.113.16"></a><var>113.16</var>legislature by January 15, 2014.<br/>
<br/>
<a id="bill.6.12.0"></a><a id="pl.113.17"></a><var>113.17</var>    Sec. 12. Minnesota Statutes 2008, section 144.651, subdivision 2, is amended to read:<br/>
<a id="pl.113.18"></a><var>113.18</var>    Subd. 2. <b>Definitions.</b> For the purposes of this section, "patient" means a person <br/>
<a id="pl.113.19"></a><var>113.19</var>who is admitted to an acute care inpatient facility for a continuous period longer than <br/>
<a id="pl.113.20"></a><var>113.20</var>24 hours, for the purpose of diagnosis or treatment bearing on the physical or mental <br/>
<a id="pl.113.21"></a><var>113.21</var>health of that person. For purposes of subdivisions 4 to 9, 12, 13, 15, 16, and 18 to 20, <br/>
<a id="pl.113.22"></a><var>113.22</var>"patient" also means a person who receives health care services at an outpatient surgical <br/>
<a id="pl.113.23"></a><var>113.23</var>center or at a birth center licensed under section 144.615. "Patient" also means a minor <br/>
<a id="pl.113.24"></a><var>113.24</var>who is admitted to a residential program as defined in section 
         <statute_ref>253C.01</statute_ref>. For purposes of <br/>
<a id="pl.113.25"></a><var>113.25</var>subdivisions 1, 3 to 16, 18, 20 and 30, "patient" also means any person who is receiving <br/>
<a id="pl.113.26"></a><var>113.26</var>mental health treatment on an outpatient basis or in a community support program or other <br/>
<a id="pl.113.27"></a><var>113.27</var>community-based program. "Resident" means a person who is admitted to a nonacute care <br/>
<a id="pl.113.28"></a><var>113.28</var>facility including extended care facilities, nursing homes, and boarding care homes for <br/>
<a id="pl.113.29"></a><var>113.29</var>care required because of prolonged mental or physical illness or disability, recovery from <br/>
<a id="pl.113.30"></a><var>113.30</var>injury or disease, or advancing age. For purposes of all subdivisions except subdivisions <br/>
<a id="pl.113.31"></a><var>113.31</var>28 and 29, "resident" also means a person who is admitted to a facility licensed as a board <br/>
<a id="pl.113.32"></a><var>113.32</var>and lodging facility under Minnesota Rules, parts 4625.0100 to 4625.2355, or a supervised <br/>
<a id="pl.113.33"></a><var>113.33</var>living facility under Minnesota Rules, parts 4665.0100 to 4665.9900, and which operates <br/>
<a id="pl.113.34"></a><var>113.34</var>a rehabilitation program licensed under Minnesota Rules, parts 9530.4100 to 9530.4450. <br/>
<br/>
<a id="bill.6.13.0"></a><a id="pl.114.1"></a><var>114.1</var>    Sec. 13. Minnesota Statutes 2008, section 144.9504, is amended by adding a <br/>
<a id="pl.114.2"></a><var>114.2</var>subdivision to read:<br/>
<a id="pl.114.3"></a><var>114.3</var>    Subd. 12. <b>Blood lead level guidelines.</b> (a) By January 1, 2011, the commissioner <br/>
<a id="pl.114.4"></a><var>114.4</var>must revise clinical and case management guidelines to include recommendations <br/>
<a id="pl.114.5"></a><var>114.5</var>for protective health actions and follow-up services when a child's blood lead level <br/>
<a id="pl.114.6"></a><var>114.6</var>exceeds five micrograms of lead per deciliter of blood. The revised guidelines must be <br/>
<a id="pl.114.7"></a><var>114.7</var>implemented to the extent possible using available resources.<br/>
<a id="pl.114.8"></a><var>114.8</var>(b) In revising the clinical and case management guidelines for blood lead levels <br/>
<a id="pl.114.9"></a><var>114.9</var>greater than five micrograms of lead per deciliter of blood under this subdivision, <br/>
<a id="pl.114.10"></a><var>114.10</var>the commissioner of health must consult with a statewide organization representing <br/>
<a id="pl.114.11"></a><var>114.11</var>physicians, the public health department of Minneapolis and other public health <br/>
<a id="pl.114.12"></a><var>114.12</var>departments, and a nonprofit organization with expertise in lead abatement.<br/>
<br/>
<a id="bill.6.14.0"></a><a id="pl.114.13"></a><var>114.13</var>    Sec. 14. Minnesota Statutes 2008, section 144A.51, subdivision 5, is amended to read:<br/>
<a id="pl.114.14"></a><var>114.14</var>    Subd. 5. <b>Health facility.</b> "Health facility" means a facility or that part of a facility <br/>
<a id="pl.114.15"></a><var>114.15</var>which is required to be licensed pursuant to sections 
         <statute_ref>144.50</statute_ref> to 
         <statute_ref>144.58</statute_ref>, 144.615, and a <br/>
<a id="pl.114.16"></a><var>114.16</var>facility or that part of a facility which is required to be licensed under any law of this state <br/>
<a id="pl.114.17"></a><var>114.17</var>which provides for the licensure of nursing homes. <br/>
<br/>
<a id="bill.6.15.0"></a><a id="pl.114.18"></a><var>114.18</var>    Sec. 15. Minnesota Statutes 2008, section 144E.37, is amended to read:<br/>
<a id="pl.114.19"></a><var>114.19</var><b>144E.37 COMPREHENSIVE ADVANCED LIFE SUPPORT.</b><br/>
<a id="pl.114.20"></a><var>114.20</var>The board commissioner of health shall establish a comprehensive advanced <br/>
<a id="pl.114.21"></a><var>114.21</var>life-support educational program to train rural medical personnel, including physicians, <br/>
<a id="pl.114.22"></a><var>114.22</var>physician assistants, nurses, and allied health care providers, in a team approach to <br/>
<a id="pl.114.23"></a><var>114.23</var>anticipate, recognize, and treat life-threatening emergencies before serious injury or <br/>
<a id="pl.114.24"></a><var>114.24</var>cardiac arrest occurs.<br/>
<a id="pl.114.25"></a><var>114.25</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2010.<br/>
<br/>
<a id="bill.6.16.0"></a><a id="pl.114.26"></a><var>114.26</var>    Sec. 16. <b>HEALTH PLAN AND COUNTY ADMINISTRATIVE COST </b><br/>
<a id="pl.114.27"></a><var>114.27</var><b>REDUCTION; REPORTING REQUIREMENTS.</b><br/>
<a id="pl.114.28"></a><var>114.28</var>(a) Minnesota health plans and county-based purchasing plans may complete an <br/>
<a id="pl.114.29"></a><var>114.29</var>inventory of existing data collection and reporting requirements for health plans and <br/>
<a id="pl.114.30"></a><var>114.30</var>county-based purchasing plans and submit to the commissioners of health and human <br/>
<a id="pl.114.31"></a><var>114.31</var>services a list of data, documentation, and reports that:<br/>
<a id="pl.115.1"></a><var>115.1</var>(1) are collected from the same health plan or county-based purchasing plan more <br/>
<a id="pl.115.2"></a><var>115.2</var>than once;<br/>
<a id="pl.115.3"></a><var>115.3</var>(2) are collected directly from the health plan or county-based purchasing plan but <br/>
<a id="pl.115.4"></a><var>115.4</var>are available to the state agencies from other sources;<br/>
<a id="pl.115.5"></a><var>115.5</var>(3) are not currently being used by state agencies; or<br/>
<a id="pl.115.6"></a><var>115.6</var>(4) collect similar information more than once in different formats, at different <br/>
<a id="pl.115.7"></a><var>115.7</var>times, or by more than one state agency.<br/>
<a id="pl.115.8"></a><var>115.8</var>(b) The report to the commissioners may also identify the percentage of health <br/>
<a id="pl.115.9"></a><var>115.9</var>plan and county-based purchasing plan administrative time and expense attributed to <br/>
<a id="pl.115.10"></a><var>115.10</var>fulfilling reporting requirements and include recommendations regarding ways to reduce <br/>
<a id="pl.115.11"></a><var>115.11</var>duplicative reporting requirements.<br/>
<a id="pl.115.12"></a><var>115.12</var>(c) Upon receipt, the commissioners shall submit the inventory and recommendations <br/>
<a id="pl.115.13"></a><var>115.13</var>to the chairs of the appropriate legislative committees, along with their comments <br/>
<a id="pl.115.14"></a><var>115.14</var>and recommendations as to whether any action should be taken by the legislature to <br/>
<a id="pl.115.15"></a><var>115.15</var>establish a consolidated and streamlined reporting system under which data, reports, and <br/>
<a id="pl.115.16"></a><var>115.16</var>documentation are collected only once and only when needed for the state agencies to <br/>
<a id="pl.115.17"></a><var>115.17</var>fulfill their duties under law and applicable regulations.<br/>
<br/>
<a id="bill.6.17.0"></a><a id="pl.115.18"></a><var>115.18</var>    Sec. 17. <b>APPLICATION PROCESS FOR HEALTH INFORMATION </b><br/>
<a id="pl.115.19"></a><var>115.19</var><b>EXCHANGE.</b><br/>
<a id="pl.115.20"></a><var>115.20</var>To the extent that the commissioner of health applies for additional federal funding <br/>
<a id="pl.115.21"></a><var>115.21</var>to support the commissioner's responsibilities of developing and maintaining state level <br/>
<a id="pl.115.22"></a><var>115.22</var>health information exchange under section 3013 of the HITECH Act, the commissioner of <br/>
<a id="pl.115.23"></a><var>115.23</var>health shall ensure that applications are made through an open process that provides health <br/>
<a id="pl.115.24"></a><var>115.24</var>information exchange service providers equal opportunity to receive funding.<br/>
<br/>
<a id="bill.6.18.0"></a><a id="pl.115.25"></a><var>115.25</var>    Sec. 18. <b>TRANSFER.</b><br/>
<a id="pl.115.26"></a><var>115.26</var>The powers and duties of the Emergency Medical Services Regulatory Board with <br/>
<a id="pl.115.27"></a><var>115.27</var>respect to the comprehensive advanced life-support educational program under Minnesota <br/>
<a id="pl.115.28"></a><var>115.28</var>Statutes, section 144E.37, are transferred to the commissioner of health under Minnesota <br/>
<a id="pl.115.29"></a><var>115.29</var>Statutes, section 15.039.<br/>
<a id="pl.115.30"></a><var>115.30</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2010.<br/>
<br/>
<a id="bill.6.19.0"></a><a id="pl.115.31"></a><var>115.31</var>    Sec. 19. <b>REVISOR'S INSTRUCTION.</b><br/>
<a id="pl.116.1"></a><var>116.1</var>The revisor of statutes shall renumber Minnesota Statutes, section 144E.37, as <br/>
<a id="pl.116.2"></a><var>116.2</var>Minnesota Statutes, section 144.6062, and make all necessary changes in statutory <br/>
<a id="pl.116.3"></a><var>116.3</var>cross-references in Minnesota Statutes and Minnesota Rules.<br/>
<a id="pl.116.4"></a><var>116.4</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2010.<br/>
<br/>
<a id="bill.7.0.0"></a>

<a id="bill.7.1.0"></a><a id="pl.116.7"></a><var>116.7</var>    Section 1. <b>[62E.20] RELATIONSHIP TO TEMPORARY FEDERAL HIGH-RISK </b><br/>
<a id="pl.116.8"></a><var>116.8</var><b>POOL.</b><br/>
<a id="pl.116.9"></a><var>116.9</var>    Subdivision 1. <b>Definitions.</b> (a) For purposes of this section, the terms defined in <br/>
<a id="pl.116.10"></a><var>116.10</var>this subdivision have the meanings given.<br/>
<a id="pl.116.11"></a><var>116.11</var>(b) "Association" means the Minnesota Comprehensive Health Association.<br/>
<a id="pl.116.12"></a><var>116.12</var>(c) "Federal law" means Title I, subtitle B, section 1101, of the federal Patient <br/>
<a id="pl.116.13"></a><var>116.13</var>Protection and Affordable Care Act, Public Law 111-148, including any federal <br/>
<a id="pl.116.14"></a><var>116.14</var>regulations adopted under it.<br/>
<a id="pl.116.15"></a><var>116.15</var>(d) "Federal qualified high-risk pool" means an arrangement established by the <br/>
<a id="pl.116.16"></a><var>116.16</var>federal secretary of health and human services that meets the requirements of the federal <br/>
<a id="pl.116.17"></a><var>116.17</var>law.<br/>
<a id="pl.116.18"></a><var>116.18</var>    Subd. 2. <b>Timing of this section.</b> This section applies beginning as of the date the <br/>
<a id="pl.116.19"></a><var>116.19</var>temporary federal qualified high risk health pool created under the federal law begins <br/>
<a id="pl.116.20"></a><var>116.20</var>to provide coverage in this state.<br/>
<a id="pl.116.21"></a><var>116.21</var>    Subd. 3. <b>Maintenance of effort.</b> The assessments made by the comprehensive <br/>
<a id="pl.116.22"></a><var>116.22</var>health association on its member insurers must comply with the maintenance of effort <br/>
<a id="pl.116.23"></a><var>116.23</var>requirement contained in paragraph (b), clause (3), of the federal law, to the extent that <br/>
<a id="pl.116.24"></a><var>116.24</var>requirement applies to assessments made by the association.<br/>
<a id="pl.116.25"></a><var>116.25</var>    Subd. 4. <b>Coordination with federal law.</b> Upon the date a federal qualified high-risk <br/>
<a id="pl.116.26"></a><var>116.26</var>pool begins to provide coverage in this state, the comprehensive health association must <br/>
<a id="pl.116.27"></a><var>116.27</var>not enroll new enrollees, notwithstanding section 62E.14 or other law to the contrary. If <br/>
<a id="pl.116.28"></a><var>116.28</var>the lack of new enrollees would otherwise lead to noncompliance with subdivision 3, the <br/>
<a id="pl.116.29"></a><var>116.29</var>association shall reduce the premiums to levels below those otherwise required under <br/>
<a id="pl.116.30"></a><var>116.30</var>section 62E.08, to the extent necessary to comply with subdivision 3.<br/>
<a id="pl.116.31"></a><var>116.31</var>    Subd. 5. <b>Coordination with state health care programs.</b> The commissioner of <br/>
<a id="pl.116.32"></a><var>116.32</var>human services, in consultation with the commissioner of commerce and the Minnesota <br/>
<a id="pl.116.33"></a><var>116.33</var>Comprehensive Health Association, shall coordinate enrollment between medical <br/>
<a id="pl.117.1"></a><var>117.1</var>assistance, MinnesotaCare, the federal qualified high-risk pool, and the Minnesota <br/>
<a id="pl.117.2"></a><var>117.2</var>Comprehensive Health Association, to ensure that:<br/>
<a id="pl.117.3"></a><var>117.3</var>(1) applicants for coverage through the federal qualified high-risk pool, or through <br/>
<a id="pl.117.4"></a><var>117.4</var>the Minnesota Comprehensive Health Association to the extent the association is enrolling <br/>
<a id="pl.117.5"></a><var>117.5</var>new members, are referred to the medical assistance or MinnesotaCare programs if they <br/>
<a id="pl.117.6"></a><var>117.6</var>are determined to be potentially eligible for coverage through those programs; and<br/>
<a id="pl.117.7"></a><var>117.7</var>(2) applicants for coverage under medical assistance or MinnesotaCare who are <br/>
<a id="pl.117.8"></a><var>117.8</var>determined not to be eligible for those programs are provided information about coverage <br/>
<a id="pl.117.9"></a><var>117.9</var>through the federal qualified high-risk pool and the Minnesota Comprehensive Health <br/>
<a id="pl.117.10"></a><var>117.10</var>Association.<br/>
<br/>
<a id="bill.7.2.0"></a><a id="pl.117.11"></a><var>117.11</var>    Sec. 2. Minnesota Statutes 2008, section 62J.07, subdivision 2, is amended to read:<br/>
<a id="pl.117.12"></a><var>117.12</var>    Subd. 2. <b>Membership.</b> The Legislative Commission on Health Care Access <br/>
<a id="pl.117.13"></a><var>117.13</var>consists of five seven members of the senate appointed under the rules of the senate and <br/>
<a id="pl.117.14"></a><var>117.14</var>five seven members of the house of representatives appointed under the rules of the house <br/>
<a id="pl.117.15"></a><var>117.15</var>of representatives. The Legislative Commission on Health Care Access must include three <br/>
<a id="pl.117.16"></a><var>117.16</var>five members of the majority party and two members of the minority party in each house.<br/>
<br/>
<a id="bill.7.3.0"></a><a id="pl.117.17"></a><var>117.17</var>    Sec. 3. Minnesota Statutes 2008, section 62J.07, is amended by adding a subdivision to <br/>
<a id="pl.117.18"></a><var>117.18</var>read:<br/>
<a id="pl.117.19"></a><var>117.19</var>    Subd. 5. <b>Federal health care reform.</b> (a) The Legislative Commission on <br/>
<a id="pl.117.20"></a><var>117.20</var>Health Care Access shall analyze  options  and make recommendations regarding the <br/>
<a id="pl.117.21"></a><var>117.21</var>implementation of provisions of the Patient Protection and Affordable Health Care Act, <br/>
<a id="pl.117.22"></a><var>117.22</var>Public Law 111-148, and the health care reform provisions in the Health Care and <br/>
<a id="pl.117.23"></a><var>117.23</var>Education Reconciliation Act of 2010, Public Law 111-152, including:<br/>
<a id="pl.117.24"></a><var>117.24</var>(1) development of accountable care organizations;<br/>
<a id="pl.117.25"></a><var>117.25</var>(2) health insurance reform, including options related to coverage, purchasing, <br/>
<a id="pl.117.26"></a><var>117.26</var>exchange development, and coverage for high-risk individuals; and<br/>
<a id="pl.117.27"></a><var>117.27</var>(3) other provisions that will require changes in state law.<br/>
<a id="pl.117.28"></a><var>117.28</var>(b) Before finalizing and submitting federal applications for pilot projects authorized <br/>
<a id="pl.117.29"></a><var>117.29</var>under federal health care reform, the governor and state agencies shall seek review and <br/>
<a id="pl.117.30"></a><var>117.30</var>advice from the commission.<br/>
<a id="pl.117.31"></a><var>117.31</var>(c) The commission may create and make appointments to work groups to assist the <br/>
<a id="pl.117.32"></a><var>117.32</var>commission in its work. Work group members may include legislators, representatives <br/>
<a id="pl.117.33"></a><var>117.33</var>of businesses and nonprofit agencies impacted by federal health care reform, academic <br/>
<a id="pl.117.34"></a><var>117.34</var>experts, and consumer representatives.<br/>
<br/>
<a id="bill.7.4.0"></a><a id="pl.118.1"></a><var>118.1</var>    Sec. 4. Minnesota Statutes 2008, section 62U.05, is amended to read:<br/>
<a id="pl.118.2"></a><var>118.2</var><b>62U.05 PROVIDER PRICING FOR BASKETS OF CARE</b><b>; ACCOUNTABLE </b><br/>
<a id="pl.118.3"></a><var>118.3</var><b>CARE ORGANIZATIONS</b><b>.</b><br/>
<a id="pl.118.4"></a><var>118.4</var>    Subdivision 1. <b>Establishment of definitions.</b> (a) By July 1, 2009, the commissioner <br/>
<a id="pl.118.5"></a><var>118.5</var>of health shall establish uniform definitions for baskets of care beginning with a minimum <br/>
<a id="pl.118.6"></a><var>118.6</var>of seven baskets of care. In selecting health conditions for which baskets of care should <br/>
<a id="pl.118.7"></a><var>118.7</var>be defined, the commissioner shall consider coronary artery and heart disease, diabetes, <br/>
<a id="pl.118.8"></a><var>118.8</var>asthma, and depression. In selecting health conditions, the commissioner shall also <br/>
<a id="pl.118.9"></a><var>118.9</var>consider the prevalence of the health conditions, the cost of treating the health conditions, <br/>
<a id="pl.118.10"></a><var>118.10</var>and the potential for innovations to reduce cost and improve quality.<br/>
<a id="pl.118.11"></a><var>118.11</var>    (b) The commissioner shall convene one or more work groups to assist in <br/>
<a id="pl.118.12"></a><var>118.12</var>establishing these definitions. Each work group shall include members appointed by <br/>
<a id="pl.118.13"></a><var>118.13</var>statewide associations representing relevant health care providers and health plan <br/>
<a id="pl.118.14"></a><var>118.14</var>companies, and organizations that work to improve health care quality in Minnesota.<br/>
<a id="pl.118.15"></a><var>118.15</var>    (c) To the extent possible, the baskets of care must incorporate a patient-directed, <br/>
<a id="pl.118.16"></a><var>118.16</var>decision-making support model.<br/>
<a id="pl.118.17"></a><var>118.17</var>(d) By January 1, 2012, the commissioner shall establish uniform definitions for the <br/>
<a id="pl.118.18"></a><var>118.18</var>total cost of providing all necessary services to a patient through an accountable care <br/>
<a id="pl.118.19"></a><var>118.19</var>organization meeting the standards specified in section 3022 of the Patient Protection <br/>
<a id="pl.118.20"></a><var>118.20</var>and Affordable Care Act, Public Law 111-148, and shall develop a standard method <br/>
<a id="pl.118.21"></a><var>118.21</var>and format for accountable care organizations to use for submitting package prices for <br/>
<a id="pl.118.22"></a><var>118.22</var>the total cost of care. This method must be published in the State Register and must be <br/>
<a id="pl.118.23"></a><var>118.23</var>made available to all providers.<br/>
<a id="pl.118.24"></a><var>118.24</var>    Subd. 2. <b>Package prices.</b> (a) Beginning January 1, 2010, health care providers may <br/>
<a id="pl.118.25"></a><var>118.25</var>establish package prices for the baskets of care defined under subdivision 1. Beginning <br/>
<a id="pl.118.26"></a><var>118.26</var>July 1, 2012, accountable care organizations may establish package prices for the total <br/>
<a id="pl.118.27"></a><var>118.27</var>cost of care defined under subdivision 1.<br/>
<a id="pl.118.28"></a><var>118.28</var>    (b) Beginning January 1, 2010, no health care provider or group of providers that <br/>
<a id="pl.118.29"></a><var>118.29</var>has established a package price for a basket of care under this section, and beginning <br/>
<a id="pl.118.30"></a><var>118.30</var>July 1, 2012, no accountable care organization that has established a package price for <br/>
<a id="pl.118.31"></a><var>118.31</var>the total cost of care under this section, shall vary the payment amount that the provider <br/>
<a id="pl.118.32"></a><var>118.32</var>or organization accepts as full payment for a health care service based upon the identity of <br/>
<a id="pl.118.33"></a><var>118.33</var>the payer, upon a contractual relationship with a payer, upon the identity of the patient, <br/>
<a id="pl.118.34"></a><var>118.34</var>or upon whether the patient has coverage through a group purchaser. This paragraph <br/>
<a id="pl.118.35"></a><var>118.35</var>applies only to health care services provided to Minnesota residents or to non-Minnesota <br/>
<a id="pl.118.36"></a><var>118.36</var>residents who obtain health insurance through a Minnesota employer. This paragraph does <br/>
<a id="pl.119.1"></a><var>119.1</var>not apply to services paid for by Medicare, state public health care programs through <br/>
<a id="pl.119.2"></a><var>119.2</var>fee-for-service or prepaid arrangements, workers' compensation, or no-fault automobile <br/>
<a id="pl.119.3"></a><var>119.3</var>insurance. This paragraph does not affect the right of a provider to provide charity care <br/>
<a id="pl.119.4"></a><var>119.4</var>or care for a reduced price due to financial hardship of the patient or due to the patient <br/>
<a id="pl.119.5"></a><var>119.5</var>being a relative or friend of the provider. <br/>
<a id="pl.119.6"></a><var>119.6</var>    Subd. 3. <b>Quality measurements for baskets of care.</b> (a) The commissioner shall <br/>
<a id="pl.119.7"></a><var>119.7</var>establish quality measurements for the defined baskets of care by December 31, 2009. <br/>
<a id="pl.119.8"></a><var>119.8</var>The commissioner shall establish quality measures for the total cost of care for services <br/>
<a id="pl.119.9"></a><var>119.9</var>delivered through an accountable care organization by June 30, 2012. The commissioner <br/>
<a id="pl.119.10"></a><var>119.10</var>may contract with an organization that works to improve health care quality to make <br/>
<a id="pl.119.11"></a><var>119.11</var>recommendations about the use of existing measures or establishing new measures where <br/>
<a id="pl.119.12"></a><var>119.12</var>no measures currently exist.<br/>
<a id="pl.119.13"></a><var>119.13</var>    (b) Beginning July 1, 2010, the commissioner or the commissioner's designee shall <br/>
<a id="pl.119.14"></a><var>119.14</var>publish comparative price and quality information on the baskets of care in a manner <br/>
<a id="pl.119.15"></a><var>119.15</var>that is easily accessible and understandable to the public, as this information becomes <br/>
<a id="pl.119.16"></a><var>119.16</var>available. Beginning January 1, 2013, the commissioner or the commissioner's designee <br/>
<a id="pl.119.17"></a><var>119.17</var>shall publish comparative price and quality information on the total cost of care for <br/>
<a id="pl.119.18"></a><var>119.18</var>services delivered through an accountable care organization in a manner that is easily <br/>
<a id="pl.119.19"></a><var>119.19</var>accessible and understandable to the public, as this information becomes available.<br/>
<br/>
<a id="bill.7.5.0"></a><a id="pl.119.20"></a><var>119.20</var>    Sec. 5. Minnesota Statutes 2008, section 256B.0754, is amended by adding a <br/>
<a id="pl.119.21"></a><var>119.21</var>subdivision to read:<br/>
<a id="pl.119.22"></a><var>119.22</var>    Subd. 3. <b>Accountable care organizations.</b> By July 1, 2012, the commissioner of <br/>
<a id="pl.119.23"></a><var>119.23</var>human services shall deliver services to enrollees in state health care programs through <br/>
<a id="pl.119.24"></a><var>119.24</var>accountable care organizations, and shall provide incentive payments to accountable care <br/>
<a id="pl.119.25"></a><var>119.25</var>organizations that meet or exceed annual quality and performance targets. Accountable <br/>
<a id="pl.119.26"></a><var>119.26</var>care organizations and incentive payments must meet the standards specified in the Patient <br/>
<a id="pl.119.27"></a><var>119.27</var>Protection and Affordable Care Act, Public Law 111-148.<br/>
<br/>
<a id="bill.7.6.0"></a><a id="pl.119.28"></a><var>119.28</var>    Sec. 6. <b>[256B.0756] COORDINATED CARE THROUGH A HEALTH HOME.</b><br/>
<a id="pl.119.29"></a><var>119.29</var>    Subdivision 1. <b>Provision of coverage.</b> (a) The commissioner shall provide <br/>
<a id="pl.119.30"></a><var>119.30</var>medical assistance coverage of health home services for eligible individuals with chronic <br/>
<a id="pl.119.31"></a><var>119.31</var>conditions who select a designated provider, a team of health care professionals, or a <br/>
<a id="pl.119.32"></a><var>119.32</var>health team as the individual's health home.<br/>
<a id="pl.119.33"></a><var>119.33</var>(b) The commissioner shall implement this section in compliance with the <br/>
<a id="pl.119.34"></a><var>119.34</var>requirements of the state option to provide health homes for enrollees with chronic <br/>
<a id="pl.120.1"></a><var>120.1</var>conditions, as provided under the Patient Protection and Affordable Care Act, Public <br/>
<a id="pl.120.2"></a><var>120.2</var>Law 111-148, sections 2703 and 3502. Terms used in this section have the meaning <br/>
<a id="pl.120.3"></a><var>120.3</var>provided in that act.<br/>
<a id="pl.120.4"></a><var>120.4</var>    Subd. 2. <b>Eligible individual.</b> An individual is eligible for health home services <br/>
<a id="pl.120.5"></a><var>120.5</var>under this section if the individual is eligible for medical assistance under this chapter <br/>
<a id="pl.120.6"></a><var>120.6</var>and has at least:<br/>
<a id="pl.120.7"></a><var>120.7</var>(1) two chronic conditions;<br/>
<a id="pl.120.8"></a><var>120.8</var>(2) one chronic condition and is at risk of having a second chronic condition; or<br/>
<a id="pl.120.9"></a><var>120.9</var>(3) one serious and persistent mental health condition.<br/>
<a id="pl.120.10"></a><var>120.10</var>    Subd. 3. <b>Health home services.</b> (a) Health home services means comprehensive and <br/>
<a id="pl.120.11"></a><var>120.11</var>timely high-quality services that are provided by a health home. These services include:<br/>
<a id="pl.120.12"></a><var>120.12</var>(1) comprehensive care management;<br/>
<a id="pl.120.13"></a><var>120.13</var>(2) care coordination and health promotion;<br/>
<a id="pl.120.14"></a><var>120.14</var>(3) comprehensive transitional care, including appropriate follow-up, from inpatient <br/>
<a id="pl.120.15"></a><var>120.15</var>to other settings;<br/>
<a id="pl.120.16"></a><var>120.16</var>(4) patient and family support, including authorized representatives;<br/>
<a id="pl.120.17"></a><var>120.17</var>(5) referral to community and social support services, if relevant; and<br/>
<a id="pl.120.18"></a><var>120.18</var>(6) use of health information technology to link services, as feasible and appropriate.<br/>
<a id="pl.120.19"></a><var>120.19</var>(b) The commissioner shall maximize the number and type of services <br/>
<a id="pl.120.20"></a><var>120.20</var>included in this subdivision to the extent permissible under federal law, including <br/>
<a id="pl.120.21"></a><var>120.21</var>physician, outpatient, mental health treatment, and rehabilitation services necessary for <br/>
<a id="pl.120.22"></a><var>120.22</var>comprehensive transitional care following hospitalization.<br/>
<a id="pl.120.23"></a><var>120.23</var>    Subd. 4. <b>Health teams.</b> The commissioner shall establish health teams to support <br/>
<a id="pl.120.24"></a><var>120.24</var>the patient-centered health home and provide the services described in subdivision 3 to <br/>
<a id="pl.120.25"></a><var>120.25</var>individuals eligible under subdivision 2. The commissioner shall apply for grants or <br/>
<a id="pl.120.26"></a><var>120.26</var>contracts as provided under section 3502 of the Patient Protection and Affordable Care <br/>
<a id="pl.120.27"></a><var>120.27</var>Act to establish health teams and provide capitated payments to primary care providers. <br/>
<a id="pl.120.28"></a><var>120.28</var>For purposes of this section, "health teams" means community-based, interdisciplinary, <br/>
<a id="pl.120.29"></a><var>120.29</var>inter-professional teams of health care providers that support primary care practices. <br/>
<a id="pl.120.30"></a><var>120.30</var>These providers may include medical specialists, nurses, advanced practice registered <br/>
<a id="pl.120.31"></a><var>120.31</var>nurses, pharmacists, nutritionists, social workers, behavioral and mental health providers, <br/>
<a id="pl.120.32"></a><var>120.32</var>doctors of chiropractic, licensed complementary and alternative medicine practitioners, <br/>
<a id="pl.120.33"></a><var>120.33</var>and physician's assistants.<br/>
<a id="pl.120.34"></a><var>120.34</var>    Subd. 5. <b>Payments.</b> The commissioner shall make payments to each health home <br/>
<a id="pl.120.35"></a><var>120.35</var>and each health team for the provision of health home services to each eligible individual <br/>
<a id="pl.120.36"></a><var>120.36</var>with chronic conditions that selects the health home as a provider.<br/>
<a id="pl.121.1"></a><var>121.1</var>    Subd. 6. <b>Coordination.</b> The commissioner, to the extent feasible, shall ensure that <br/>
<a id="pl.121.2"></a><var>121.2</var>the requirements and payment methods for health homes and health teams developed <br/>
<a id="pl.121.3"></a><var>121.3</var>under this section are consistent with the requirements and payment methods for health <br/>
<a id="pl.121.4"></a><var>121.4</var>care homes established under sections 256B.0751 and 256B.0753. The commissioner may <br/>
<a id="pl.121.5"></a><var>121.5</var>modify requirements and payment methods under sections 256B.0751 and 256B.0753 in <br/>
<a id="pl.121.6"></a><var>121.6</var>order to be consistent with federal health home requirements and payment methods.<br/>
<a id="pl.121.7"></a><var>121.7</var>    Subd. 7. <b>State plan amendment.</b> The commissioner shall submit a state plan <br/>
<a id="pl.121.8"></a><var>121.8</var>amendment to implement this section to the federal Centers for Medicare and Medicaid <br/>
<a id="pl.121.9"></a><var>121.9</var>Services by January 1, 2011.<br/>
<a id="pl.121.10"></a><var>121.10</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2011, or upon federal <br/>
<a id="pl.121.11"></a><var>121.11</var>approval, whichever is later.<br/>
<br/>
<a id="bill.7.7.0"></a><a id="pl.121.12"></a><var>121.12</var>    Sec. 7. <b>FEDERAL HEALTH CARE REFORM DEMONSTRATION PROJECTS </b><br/>
<a id="pl.121.13"></a><var>121.13</var><b>AND GRANTS.</b><br/>
<a id="pl.121.14"></a><var>121.14</var>(a) The commissioner of human services shall seek to participate in the following <br/>
<a id="pl.121.15"></a><var>121.15</var>demonstration projects, or apply for the following grants, as described in the federal <br/>
<a id="pl.121.16"></a><var>121.16</var>Patient Protection and Affordable Care Act, Public Law 111-148:<br/>
<a id="pl.121.17"></a><var>121.17</var>(1) the demonstration project to evaluate integrated care around a hospitalization, <br/>
<a id="pl.121.18"></a><var>121.18</var>Public Law 111-148, section 2704;<br/>
<a id="pl.121.19"></a><var>121.19</var>(2) the Medicaid global payment system demonstration project, Public Law 111-148, <br/>
<a id="pl.121.20"></a><var>121.20</var>section 2705;<br/>
<a id="pl.121.21"></a><var>121.21</var>(3) the pediatric accountable care organization demonstration project, Public Law <br/>
<a id="pl.121.22"></a><var>121.22</var>111-148, section 2706;<br/>
<a id="pl.121.23"></a><var>121.23</var>(4) the Medicaid emergency psychiatric demonstration project, Public Law 111-148, <br/>
<a id="pl.121.24"></a><var>121.24</var>section 2707; and<br/>
<a id="pl.121.25"></a><var>121.25</var>(5) grants to provide incentives for prevention of chronic diseases in Medicaid, <br/>
<a id="pl.121.26"></a><var>121.26</var>Public Law 111-148, section 4108.<br/>
<a id="pl.121.27"></a><var>121.27</var>(b) The commissioner of human services shall report to the chairs and ranking <br/>
<a id="pl.121.28"></a><var>121.28</var>minority members of the house of representatives and senate committees or divisions with <br/>
<a id="pl.121.29"></a><var>121.29</var>jurisdiction over health care policy and finance on the status of the demonstration project <br/>
<a id="pl.121.30"></a><var>121.30</var>and grant applications. If the state is accepted as a demonstration project participant, or is <br/>
<a id="pl.121.31"></a><var>121.31</var>awarded a grant, the commissioner shall notify the chairs and ranking minority members <br/>
<a id="pl.121.32"></a><var>121.32</var>of those committees or divisions of any legislative changes necessary to implement the <br/>
<a id="pl.121.33"></a><var>121.33</var>demonstration projects or grants.<br/>
<br/>
<a id="bill.7.8.0"></a><a id="pl.121.34"></a><var>121.34</var>    Sec. 8. <b>HEALTH CARE REFORM TASK FORCE.</b><br/>
<a id="pl.122.1"></a><var>122.1</var>    Subdivision 1. <b>Task force.</b> (a) The governor shall convene a Health Care <br/>
<a id="pl.122.2"></a><var>122.2</var>Reform Task Force to advise and assist the governor and the legislature regarding state <br/>
<a id="pl.122.3"></a><var>122.3</var>implementation of federal health care reform legislation. For purposes of this section, <br/>
<a id="pl.122.4"></a><var>122.4</var>"federal health care reform legislation" means the Patient Protection and Affordable Care <br/>
<a id="pl.122.5"></a><var>122.5</var>Act, Public Law 111-148, and the health care reform provisions in the Health Care and <br/>
<a id="pl.122.6"></a><var>122.6</var>Education Reconciliation Act of 2010, Public Law 111-152. The task force shall consist of:<br/>
<a id="pl.122.7"></a><var>122.7</var>(1) two legislators from the house of representatives appointed by the speaker and <br/>
<a id="pl.122.8"></a><var>122.8</var>two legislators from the senate appointed by the Subcommittee on Committees of the <br/>
<a id="pl.122.9"></a><var>122.9</var>Committee on Rules and Administration;<br/>
<a id="pl.122.10"></a><var>122.10</var>    (2) two representatives appointed by the governor to represent the governor and <br/>
<a id="pl.122.11"></a><var>122.11</var>state agencies;<br/>
<a id="pl.122.12"></a><var>122.12</var>    (3) three persons appointed by the governor who have demonstrated leadership in <br/>
<a id="pl.122.13"></a><var>122.13</var>health care organizations, health plan companies, or health care trade or professional <br/>
<a id="pl.122.14"></a><var>122.14</var>associations;<br/>
<a id="pl.122.15"></a><var>122.15</var>    (4) three persons appointed by the governor who have demonstrated leadership in <br/>
<a id="pl.122.16"></a><var>122.16</var>employer and group purchaser activities related to health system improvement of whom at <br/>
<a id="pl.122.17"></a><var>122.17</var>least two must be from a labor organization; and<br/>
<a id="pl.122.18"></a><var>122.18</var>    (5) five persons appointed by the governor who have demonstrated expertise in the <br/>
<a id="pl.122.19"></a><var>122.19</var>areas of health care financing, access, and quality.<br/>
<a id="pl.122.20"></a><var>122.20</var>    The governor is exempt from the requirements of the open appointments process <br/>
<a id="pl.122.21"></a><var>122.21</var>for purposes of appointing task force members. Members shall be appointed for one-year <br/>
<a id="pl.122.22"></a><var>122.22</var>terms and may be reappointed.<br/>
<a id="pl.122.23"></a><var>122.23</var>    (b) The Department of Health, Department of Human Services, and Department of <br/>
<a id="pl.122.24"></a><var>122.24</var>Commerce shall provide staff support to the task force. The task force may accept outside <br/>
<a id="pl.122.25"></a><var>122.25</var>resources to help support its efforts.<br/>
<a id="pl.122.26"></a><var>122.26</var>    (c) Task force members must be appointed by July 1, 2010.  The task force must hold <br/>
<a id="pl.122.27"></a><var>122.27</var>its first meeting by July 15, 2010.<br/>
<a id="pl.122.28"></a><var>122.28</var>    Subd. 2. <b>Duties.</b> (a) By December 15, 2010, the task force shall develop and <br/>
<a id="pl.122.29"></a><var>122.29</var>present to the legislature and the governor a preliminary report and recommendations on <br/>
<a id="pl.122.30"></a><var>122.30</var>state implementation of federal health care reform legislation. The report must include <br/>
<a id="pl.122.31"></a><var>122.31</var>recommendations for state law and program changes necessary to comply with the federal <br/>
<a id="pl.122.32"></a><var>122.32</var>health care reform legislation, and also recommendations for implementing provisions of <br/>
<a id="pl.122.33"></a><var>122.33</var>the federal legislation that are optional for states. In developing recommendations, the task <br/>
<a id="pl.122.34"></a><var>122.34</var>force shall consider the extent to which an approach maximizes federal funding to the state.<br/>
<a id="pl.123.1"></a><var>123.1</var>(b) The task force, in consultation with the governor and the legislature, shall also <br/>
<a id="pl.123.2"></a><var>123.2</var>establish timelines and criteria for future reports on state implementation of the federal <br/>
<a id="pl.123.3"></a><var>123.3</var>health care reform legislation.<br/>
<br/>
<a id="bill.7.9.0"></a><a id="pl.123.4"></a><var>123.4</var>    Sec. 9. <b>AMERICAN HEALTH BENEFIT EXCHANGE; PLANNING </b><br/>
<a id="pl.123.5"></a><var>123.5</var><b>PROVISIONS.</b><br/>
<a id="pl.123.6"></a><var>123.6</var>    Subdivision 1. <b>Federal planning grants.</b> The commissioners of commerce, health, <br/>
<a id="pl.123.7"></a><var>123.7</var>and human services shall jointly or separately apply to the federal secretary of health and <br/>
<a id="pl.123.8"></a><var>123.8</var>human services for one or more planning and establishment grants, including renewal <br/>
<a id="pl.123.9"></a><var>123.9</var>grants, authorized under section 1311 of the Patient Protection and Affordable Care Act, <br/>
<a id="pl.123.10"></a><var>123.10</var>Public Law 111-148, including any future amendments of that provision, relating to state <br/>
<a id="pl.123.11"></a><var>123.11</var>creation of American Health Benefit Exchanges.<br/>
<a id="pl.123.12"></a><var>123.12</var>    Subd. 2. <b>Consideration of early creation and operation of exchange.</b> (a) The <br/>
<a id="pl.123.13"></a><var>123.13</var>commissioners referenced in subdivision 1 shall analyze the advantages and disadvantages <br/>
<a id="pl.123.14"></a><var>123.14</var>to the state of planning to have a state health insurance exchange, similar to an American <br/>
<a id="pl.123.15"></a><var>123.15</var>Health Benefit Exchange referenced in subdivision 1, begin prior to the federal deadline <br/>
<a id="pl.123.16"></a><var>123.16</var>of January 1, 2014.<br/>
<a id="pl.123.17"></a><var>123.17</var>(b) The commissioners shall provide a written report to the legislature on the results <br/>
<a id="pl.123.18"></a><var>123.18</var>of the analysis required under paragraph (a) no later than December 15, 2010. The written <br/>
<a id="pl.123.19"></a><var>123.19</var>report must comply with Minnesota Statutes, sections 3.195 and 3.197.<br/>
<br/>
<a id="bill.8.0.0"></a>

<a id="bill.8.1.0"></a><table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.123.22"></a><var>123.22</var><br/>
<a id="pl.123.23"></a><var>123.23</var><br/>
</td>
<td colspan="7">Section 1. <b>SUMMARY OF APPROPRIATIONS; DEPARTMENT OF HUMAN </b><br/>
<b>SERVICES FORECAST ADJUSTMENT.</b><br/>
</td>
</tr>
</table><a id="pl.123.24"></a><var>123.24</var>The dollar amounts shown are added to or if shown in parentheses, are subtracted <br/>
<a id="pl.123.25"></a><var>123.25</var>from the appropriations in Laws 2009, chapter 79, article 13, as amended by Laws 2009, <br/>
<a id="pl.123.26"></a><var>123.26</var>chapter 173, article 2, from the general fund or any fund named to the Department of <br/>
<a id="pl.123.27"></a><var>123.27</var>Human Services for the purposes specified in this article, to be available for the fiscal <br/>
<a id="pl.123.28"></a><var>123.28</var>year indicated for each purpose. The figure "2010" used in this article means that the <br/>
<a id="pl.123.29"></a><var>123.29</var>appropriation or appropriations listed are available for the fiscal year ending June 30, <br/>
<a id="pl.123.30"></a><var>123.30</var>2010. The figure "2011" used in this article means that the appropriation or appropriations <br/>
<a id="pl.123.31"></a><var>123.31</var>listed are available for the fiscal year ending June 30, 2011.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.123.32"></a><var>123.32</var><br/>
</td>
<td></td>
<td></td>
<td align="center"></td>
<td></td>
<td align="center"><b>2010</b><br/>
</td>
<td></td>
<td align="center"><b>2011</b><br/>
</td>
</tr>
<tr>
<td><a id="pl.123.33"></a><var>123.33</var><br/>
</td>
<td>General<br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center">$<br/>
</td>
<td align="right">(109,876,000)<br/>
</td>
<td align="center">$<br/>
</td>
<td align="right">(28,344,000)<br/>
</td>
</tr>
<tr>
<td><a id="pl.123.34"></a><var>123.34</var><br/>
</td>
<td>Health Care Access<br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right">99,654,000<br/>
</td>
<td align="center"></td>
<td align="right">276,500,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.124.1"></a><var>124.1</var><br/>
</td>
<td>Federal TANF<br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"> (9,830,000)<br/>
</td>
<td align="center"></td>
<td align="right">15,133,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.124.2"></a><var>124.2</var><br/>
</td>
<td><b>Total</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>(20,052,000)</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>263,289,000</b><br/>
</td>
</tr>
</table><br/>
<a id="bill.8.2.0"></a><table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.124.3"></a><var>124.3</var><br/>
<a id="pl.124.4"></a><var>124.4</var><br/>
</td>
<td colspan="3">Sec. 2. <b>COMMISSIONER OF HUMAN </b><br/>
<b>SERVICES</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.124.5"></a><var>124.5</var><br/>
</td>
<td colspan="3">Subdivision 1.<b>Total Appropriation</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>(20,052,000)</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>263,289,000</b><br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="95px"/>
<col width="96px"/>
<tr>
<td><a id="pl.124.6"></a><var>124.6</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.124.7"></a><var>124.7</var><br/>
</td>
<td></td>
<td align="center">2010<br/>
</td>
<td align="center">2011<br/>
</td>
</tr>
<tr>
<td><a id="pl.124.8"></a><var>124.8</var><br/>
</td>
<td>General<br/>
</td>
<td align="right">(109,876,000)<br/>
</td>
<td align="right">(28,344,000)<br/>
</td>
</tr>
<tr>
<td><a id="pl.124.9"></a><var>124.9</var><br/>
</td>
<td>Health Care Access<br/>
</td>
<td align="right">99,654,000<br/>
</td>
<td align="right">276,500,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.124.10"></a><var>124.10</var><br/>
</td>
<td>Federal TANF<br/>
</td>
<td align="right"> (9,830,000)<br/>
</td>
<td align="right">15,133,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.124.11"></a><var>124.11</var><br/>
</td>
<td colspan="3">Subd. 2.<b> Revenue and Pass-Through</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="95px"/>
<col width="96px"/>
<tr>
<td><a id="pl.124.12"></a><var>124.12</var><br/>
</td>
<td>Federal TANF<br/>
</td>
<td align="right">390,000<br/>
</td>
<td align="right">(251,000)<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.124.13"></a><var>124.13</var><br/>
<a id="pl.124.14"></a><var>124.14</var><br/>
</td>
<td colspan="3">Subd. 3.<b>Children and Economic Assistance </b><br/>
<b>Grants</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="95px"/>
<col width="96px"/>
<tr>
<td><a id="pl.124.15"></a><var>124.15</var><br/>
</td>
<td>General Fund<br/>
</td>
<td align="right">4,489,000<br/>
</td>
<td align="right">(4,140,000)<br/>
</td>
</tr>
<tr>
<td><a id="pl.124.16"></a><var>124.16</var><br/>
</td>
<td>Federal TANF<br/>
</td>
<td align="right">(10,220,000)<br/>
</td>
<td align="right">15,384,000<br/>
</td>
</tr>
</table><a id="pl.124.17"></a><var>124.17</var>The amounts that may be spent from this <br/>
<a id="pl.124.18"></a><var>124.18</var>appropriation are as follows:<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.124.19"></a><var>124.19</var><br/>
</td>
<td colspan="3">(a) <b>MFIP Grants</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="95px"/>
<col width="96px"/>
<tr>
<td><a id="pl.124.20"></a><var>124.20</var><br/>
</td>
<td>General Fund<br/>
</td>
<td align="right">7,916,000<br/>
</td>
<td align="right">(14,481,000)<br/>
</td>
</tr>
<tr>
<td><a id="pl.124.21"></a><var>124.21</var><br/>
</td>
<td>TANF Fund<br/>
</td>
<td align="right">(10,220,000)<br/>
</td>
<td align="right">15,384,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.124.22"></a><var>124.22</var><br/>
</td>
<td colspan="3">(b) <b>MFIP Child Care Assistance Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">(7,832,000)<br/>
</td>
<td align="center"></td>
<td align="right">2,579,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.124.23"></a><var>124.23</var><br/>
</td>
<td colspan="3">(c) <b>General Assistance Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">875,000<br/>
</td>
<td align="center"></td>
<td align="right">1,339,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.124.24"></a><var>124.24</var><br/>
</td>
<td colspan="3">(d) <b>Minnesota Supplemental Aid Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">2,454,000<br/>
</td>
<td align="center"></td>
<td align="right">3,843,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.124.25"></a><var>124.25</var><br/>
</td>
<td colspan="3">(e) <b>Group Residential Housing Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">1,076,000<br/>
</td>
<td align="center"></td>
<td align="right">2,580,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.124.26"></a><var>124.26</var><br/>
</td>
<td colspan="3">Subd. 4.<b>Basic Health Care Grants</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="95px"/>
<col width="96px"/>
<tr>
<td><a id="pl.124.27"></a><var>124.27</var><br/>
</td>
<td>General Fund<br/>
</td>
<td align="right">(62,770,000)<br/>
</td>
<td align="right">29,192,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.124.28"></a><var>124.28</var><br/>
</td>
<td>TANF Fund<br/>
</td>
<td align="right">99,654,000<br/>
</td>
<td align="right">276,500,000<br/>
</td>
</tr>
</table><a id="pl.124.29"></a><var>124.29</var>The amounts that may be spent from this <br/>
<a id="pl.124.30"></a><var>124.30</var>appropriation are as follows:<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.124.31"></a><var>124.31</var><br/>
</td>
<td colspan="3">(a) <b>MinnesotaCare Grants</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="95px"/>
<col width="96px"/>
<tr>
<td><a id="pl.125.1"></a><var>125.1</var><br/>
<a id="pl.125.2"></a><var>125.2</var><br/>
</td>
<td>Health Care Access <br/>
Fund<br/>
</td>
<td align="right">99,654,000<br/>
</td>
<td align="right">276,500,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.125.3"></a><var>125.3</var><br/>
<a id="pl.125.4"></a><var>125.4</var><br/>
</td>
<td colspan="3">(b) <b>Medical Assistance Basic Health Care – </b><br/>
<b>Families and Children</b><br/>
</td>
<td align="center"></td>
<td align="right">1,165,000<br/>
</td>
<td align="center"></td>
<td align="right">24,146,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.125.5"></a><var>125.5</var><br/>
<a id="pl.125.6"></a><var>125.6</var><br/>
</td>
<td colspan="3">(c) <b>Medical Assistance Basic Health Care – </b><br/>
<b>Elderly and Disabled</b><br/>
</td>
<td align="center"></td>
<td align="right">(63,935,000)<br/>
</td>
<td align="center"></td>
<td align="right">5,046,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.125.7"></a><var>125.7</var><br/>
</td>
<td colspan="3">Subd. 5.<b>Continuing Care Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">(51,595,000)<br/>
</td>
<td align="center"></td>
<td align="right">(53,396,000)<br/>
</td>
</tr>
</table><a id="pl.125.8"></a><var>125.8</var>The amounts that may be spent from this <br/>
<a id="pl.125.9"></a><var>125.9</var>appropriation are as follows:<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.125.10"></a><var>125.10</var><br/>
<a id="pl.125.11"></a><var>125.11</var><br/>
</td>
<td colspan="3">(a) <b>Medical Assistance Long-Term Care </b><br/>
<b>Facilities</b><br/>
</td>
<td align="center"></td>
<td align="right">(3,774,000)<br/>
</td>
<td align="center"></td>
<td align="right">(8,275,000)<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.125.12"></a><var>125.12</var><br/>
<a id="pl.125.13"></a><var>125.13</var><br/>
</td>
<td colspan="3">(b) <b>Medical Assistance Long-Term Care </b><br/>
<b>Waivers</b><br/>
</td>
<td align="center"></td>
<td align="right">(27,710,000)<br/>
</td>
<td align="center"></td>
<td align="right">(22,452,000)<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.125.14"></a><var>125.14</var><br/>
</td>
<td colspan="3">(c) <b>Chemical Dependency Entitlement Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">(20,111,000)<br/>
</td>
<td align="center"></td>
<td align="right">(22,669,000)<br/>
</td>
</tr>
</table><br/>
<a id="bill.8.3.0"></a><a id="pl.125.15"></a><var>125.15</var>    Sec. 3. <b>EFFECTIVE DATE.</b><br/>
<a id="pl.125.16"></a><var>125.16</var>Sections 1 and 2 are effective the date following final enactment.<br/>
<br/>
<a id="bill.9.0.0"></a>

<a id="bill.9.1.0"></a><table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.125.19"></a><var>125.19</var><br/>
</td>
<td colspan="7">Section 1. <b> SUMMARY OF APPROPRIATIONS.</b><br/>
</td>
</tr>
</table><a id="pl.125.20"></a><var>125.20</var>The amounts shown in this section summarize direct appropriations, by fund, made <br/>
<a id="pl.125.21"></a><var>125.21</var>in this article.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.125.22"></a><var>125.22</var><br/>
</td>
<td></td>
<td></td>
<td align="center"><b>2010</b><br/>
</td>
<td></td>
<td align="center"><b>2011</b><br/>
</td>
<td></td>
<td align="center"><b>Total</b><br/>
</td>
</tr>
<tr>
<td><a id="pl.125.23"></a><var>125.23</var><br/>
</td>
<td>General<br/>
</td>
<td align="center">$<br/>
</td>
<td align="right">(10,162,000)<br/>
</td>
<td align="center">$<br/>
</td>
<td align="right">(99,234,000)<br/>
</td>
<td align="center">$<br/>
</td>
<td align="right">(109,396,000)<br/>
</td>
</tr>
<tr>
<td><a id="pl.125.24"></a><var>125.24</var><br/>
<a id="pl.125.25"></a><var>125.25</var><br/>
</td>
<td>State Government Special <br/>
Revenue<br/>
</td>
<td align="center"></td>
<td align="right">(608,000)<br/>
</td>
<td align="center"></td>
<td align="right">(275,000)<br/>
</td>
<td align="center"></td>
<td align="right">(883,000)<br/>
</td>
</tr>
<tr>
<td><a id="pl.125.26"></a><var>125.26</var><br/>
</td>
<td>Health Care Access<br/>
</td>
<td align="center"></td>
<td align="right">(1,094,000)<br/>
</td>
<td align="center"></td>
<td align="right">72,459,000<br/>
</td>
<td align="center"></td>
<td align="right">71,365,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.125.27"></a><var>125.27</var><br/>
</td>
<td>Federal TANF<br/>
</td>
<td align="center"></td>
<td align="right">-0-<br/>
</td>
<td align="center"></td>
<td align="right">27,918,000<br/>
</td>
<td align="center"></td>
<td align="right">27,918,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.125.28"></a><var>125.28</var><br/>
</td>
<td><b>Total</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>(11,864,000)</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>(867,000)</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>(10,997,000)</b><br/>
</td>
</tr>
</table><br/>
<a id="bill.9.2.0"></a><table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.125.29"></a><var>125.29</var><br/>
</td>
<td colspan="7">Sec. 2. <b>HEALTH AND HUMAN SERVICES APPROPRIATIONS.</b><br/>
</td>
</tr>
</table><a id="pl.125.30"></a><var>125.30</var>The sums shown in the columns marked "Appropriations" are added to or, if shown <br/>
<a id="pl.125.31"></a><var>125.31</var>in parentheses, subtracted from the appropriations in Laws 2009, chapter 79, article 13, <br/>
<a id="pl.125.32"></a><var>125.32</var>as amended by Laws 2009, chapter 173, article 2, to the agencies and for the purposes <br/>
<a id="pl.125.33"></a><var>125.33</var>specified in this article. The appropriations are from the general fund and are available <br/>
<a id="pl.126.1"></a><var>126.1</var>for the fiscal years indicated for each purpose. The figures "2010" and "2011" used in <br/>
<a id="pl.126.2"></a><var>126.2</var>this article mean that the addition to or subtraction from the appropriation listed under <br/>
<a id="pl.126.3"></a><var>126.3</var>them is available for the fiscal year ending June 30, 2010, or June 30, 2011, respectively. <br/>
<a id="pl.126.4"></a><var>126.4</var>Supplemental appropriations and reductions to appropriations for the fiscal year ending <br/>
<a id="pl.126.5"></a><var>126.5</var>June 30, 2010, are effective the day following final enactment unless a different effective <br/>
<a id="pl.126.6"></a><var>126.6</var>date is explicit.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.126.7"></a><var>126.7</var><br/>
</td>
<td></td>
<td></td>
<td></td>
<td align="center" colspan="4"><b>APPROPRIATIONS</b><br/>
</td>
</tr>
<tr>
<td><a id="pl.126.8"></a><var>126.8</var><br/>
</td>
<td></td>
<td></td>
<td></td>
<td align="center" colspan="4"><b>Available for the Year</b><br/>
</td>
</tr>
<tr>
<td><a id="pl.126.9"></a><var>126.9</var><br/>
</td>
<td></td>
<td></td>
<td></td>
<td align="center" colspan="4"><b>Ending June 30</b><br/>
</td>
</tr>
<tr>
<td><a id="pl.126.10"></a><var>126.10</var><br/>
</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td align="center"><b>2010</b><br/>
</td>
<td></td>
<td align="center"><b>2011</b><br/>
</td>
</tr>
</table><br/>
<a id="bill.9.3.0"></a><table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.126.11"></a><var>126.11</var><br/>
<a id="pl.126.12"></a><var>126.12</var><br/>
</td>
<td colspan="3">Sec. 3. <b>COMMISSIONER OF HUMAN </b><br/>
<b>SERVICES</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.126.13"></a><var>126.13</var><br/>
</td>
<td colspan="3">Subdivision 1.<b>Total Appropriation</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>(9,467,000)</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>(5,084,000)</b><br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.126.14"></a><var>126.14</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.126.15"></a><var>126.15</var><br/>
</td>
<td></td>
<td align="right">2010<br/>
</td>
<td align="right">2011<br/>
</td>
</tr>
<tr>
<td><a id="pl.126.16"></a><var>126.16</var><br/>
</td>
<td>General<br/>
</td>
<td align="right">(8,365,000)<br/>
</td>
<td align="right">(105,244,000)<br/>
</td>
</tr>
<tr>
<td><a id="pl.126.17"></a><var>126.17</var><br/>
<a id="pl.126.18"></a><var>126.18</var><br/>
</td>
<td>State Government <br/>
Special Revenue<br/>
</td>
<td align="right">(8,000)<br/>
</td>
<td align="right">(16,000)<br/>
</td>
</tr>
<tr>
<td><a id="pl.126.19"></a><var>126.19</var><br/>
</td>
<td>Health Care Access<br/>
</td>
<td align="right">(1,094,000)<br/>
</td>
<td align="right">72,259,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.126.20"></a><var>126.20</var><br/>
</td>
<td>Federal TANF<br/>
</td>
<td align="right">-0-<br/>
</td>
<td align="right">27,918,000<br/>
</td>
</tr>
</table><a id="pl.126.21"></a><var>126.21</var><b>Working Family Credit Expenditures to </b><br/>
<a id="pl.126.22"></a><var>126.22</var><b>be Claimed for TANF/MOE.</b> For fiscal year <br/>
<a id="pl.126.23"></a><var>126.23</var>2011, the commissioner may count $38,000 <br/>
<a id="pl.126.24"></a><var>126.24</var>of working family credit expenditures as <br/>
<a id="pl.126.25"></a><var>126.25</var>TANF/MOE. Notwithstanding any provision <br/>
<a id="pl.126.26"></a><var>126.26</var>to the contrary, this rider expires June 30, <br/>
<a id="pl.126.27"></a><var>126.27</var>2013.<br/>
<a id="pl.126.28"></a><var>126.28</var><b>TANF Financing and Maintenance of </b><br/>
<a id="pl.126.29"></a><var>126.29</var><b>Effort.</b> The commissioner of human <br/>
<a id="pl.126.30"></a><var>126.30</var>services, with the approval of the <br/>
<a id="pl.126.31"></a><var>126.31</var>commissioner of management and budget, <br/>
<a id="pl.126.32"></a><var>126.32</var>and after notification of the chairs of the <br/>
<a id="pl.126.33"></a><var>126.33</var>relevant senate budget division and house of <br/>
<a id="pl.126.34"></a><var>126.34</var>representatives finance division, may adjust <br/>
<a id="pl.126.35"></a><var>126.35</var>the amount of TANF transfers between the <br/>
<a id="pl.126.36"></a><var>126.36</var>MFIP transition year child care assistance <br/>
<a id="pl.126.37"></a><var>126.37</var>program and MFIP grant programs within the <br/>
<a id="pl.127.1"></a><var>127.1</var>fiscal year, and within the current biennium <br/>
<a id="pl.127.2"></a><var>127.2</var>and the biennium ending June 30, 2013, <br/>
<a id="pl.127.3"></a><var>127.3</var>to ensure that state and federal match and <br/>
<a id="pl.127.4"></a><var>127.4</var>maintenance of effort requirements are <br/>
<a id="pl.127.5"></a><var>127.5</var>met. These transfers and amounts must be <br/>
<a id="pl.127.6"></a><var>127.6</var>reported to the chairs of the senate and house <br/>
<a id="pl.127.7"></a><var>127.7</var>of representatives Finance Committees, the <br/>
<a id="pl.127.8"></a><var>127.8</var>senate Health and Human Services Budget <br/>
<a id="pl.127.9"></a><var>127.9</var>Division, the house of representatives Health <br/>
<a id="pl.127.10"></a><var>127.10</var>Care and Human Services Finance Division, <br/>
<a id="pl.127.11"></a><var>127.11</var>and Early Childhood Finance and Policy <br/>
<a id="pl.127.12"></a><var>127.12</var>Division by December 1 of each fiscal <br/>
<a id="pl.127.13"></a><var>127.13</var>year. Notwithstanding any provision to the <br/>
<a id="pl.127.14"></a><var>127.14</var>contrary, this rider expires June 30, 2013.<br/>
<a id="pl.127.15"></a><var>127.15</var>The appropriation reductions for each <br/>
<a id="pl.127.16"></a><var>127.16</var>purpose are shown in the following <br/>
<a id="pl.127.17"></a><var>127.17</var>subdivisions.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.127.18"></a><var>127.18</var><br/>
<a id="pl.127.19"></a><var>127.19</var><br/>
</td>
<td colspan="3">Subd. 2.<b>Agency Management; Financial </b><br/>
<b>Operations</b><br/>
</td>
<td align="center"></td>
<td align="right">(8,000)<br/>
</td>
<td align="center"></td>
<td align="right">(16,000)<br/>
</td>
</tr>
</table><a id="pl.127.20"></a><var>127.20</var>This appropriation reduction is from the state <br/>
<a id="pl.127.21"></a><var>127.21</var>government special revenue fund.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.127.22"></a><var>127.22</var><br/>
<a id="pl.127.23"></a><var>127.23</var><br/>
</td>
<td colspan="3">Subd. 3.<b>Revenue and Pass-Through Revenue </b><br/>
<b>Expenditures</b><br/>
</td>
<td align="center"></td>
<td align="right">-0-<br/>
</td>
<td align="center"></td>
<td align="right">28,000,000<br/>
</td>
</tr>
</table><a id="pl.127.24"></a><var>127.24</var><b>TANF Funding for the Working Family </b><br/>
<a id="pl.127.25"></a><var>127.25</var><b>Tax Credit.</b> In addition to the amounts <br/>
<a id="pl.127.26"></a><var>127.26</var>specified in Minnesota Statutes, section <br/>
<a id="pl.127.27"></a><var>127.27</var>290.0671, subdivision 6, $18,722,000 <br/>
<a id="pl.127.28"></a><var>127.28</var>of TANF funds in fiscal year 2010 and <br/>
<a id="pl.127.29"></a><var>127.29</var>$18,689,000 of TANF funds in fiscal year <br/>
<a id="pl.127.30"></a><var>127.30</var>2011 are appropriated to the commissioner <br/>
<a id="pl.127.31"></a><var>127.31</var>of human services to reimburse the cost of <br/>
<a id="pl.127.32"></a><var>127.32</var>the working family tax credit for eligible <br/>
<a id="pl.127.33"></a><var>127.33</var>families. Beginning January 1, 2011, the <br/>
<a id="pl.127.34"></a><var>127.34</var>commissioner shall reimburse the general <br/>
<a id="pl.127.35"></a><var>127.35</var>fund on a monthly basis according to a <br/>
<a id="pl.127.36"></a><var>127.36</var>schedule based on the pattern of working <br/>
<a id="pl.128.1"></a><var>128.1</var>family credit expenditures through June 20, <br/>
<a id="pl.128.2"></a><var>128.2</var>2011. This rider is effective upon enactment.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.128.3"></a><var>128.3</var><br/>
<a id="pl.128.4"></a><var>128.4</var><br/>
</td>
<td colspan="3">Subd. 4.<b>Children and Economic Assistance </b><br/>
<b>Grants</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.128.5"></a><var>128.5</var><br/>
<a id="pl.128.6"></a><var>128.6</var><br/>
</td>
<td colspan="3">(a) <b>MFIP and Diversionary Work Program </b><br/>
<b>Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">-0-<br/>
</td>
<td align="center"></td>
<td align="right">(2,033,000)<br/>
</td>
</tr>
</table><a id="pl.128.7"></a><var>128.7</var>This appropriation reduces the general <br/>
<a id="pl.128.8"></a><var>128.8</var>fund appropriation by $5,691,000 and <br/>
<a id="pl.128.9"></a><var>128.9</var>increases the federal TANF appropriation by <br/>
<a id="pl.128.10"></a><var>128.10</var>$3,658,000.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.128.11"></a><var>128.11</var><br/>
</td>
<td colspan="3">(b) <b>Support Services Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">-0-<br/>
</td>
<td align="center"></td>
<td align="right">(7,646,000)<br/>
</td>
</tr>
</table><a id="pl.128.12"></a><var>128.12</var><b>Supported Work.</b> The fiscal year 2011 <br/>
<a id="pl.128.13"></a><var>128.13</var>TANF appropriation to the commissioner of <br/>
<a id="pl.128.14"></a><var>128.14</var>human services for supported work for MFIP <br/>
<a id="pl.128.15"></a><var>128.15</var>recipients is reduced by $4,000,000. This <br/>
<a id="pl.128.16"></a><var>128.16</var>reduction is onetime.<br/>
<a id="pl.128.17"></a><var>128.17</var><b>Base Adjustment.</b> The general fund base <br/>
<a id="pl.128.18"></a><var>128.18</var>shall be increased by $2,642,000 for fiscal <br/>
<a id="pl.128.19"></a><var>128.19</var>years 2012 and 2013.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.128.20"></a><var>128.20</var><br/>
</td>
<td colspan="3">(c) <b>MFIP Child Care Assistance Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">-0-<br/>
</td>
<td align="center"></td>
<td align="right">(38,000)<br/>
</td>
</tr>
</table><a id="pl.128.21"></a><var>128.21</var>This appropriation reduces the general <br/>
<a id="pl.128.22"></a><var>128.22</var>fund appropriation by $4,000,000 and <br/>
<a id="pl.128.23"></a><var>128.23</var>increases the federal TANF appropriation by <br/>
<a id="pl.128.24"></a><var>128.24</var>$3,962,000.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.128.25"></a><var>128.25</var><br/>
</td>
<td colspan="3">(d) <b>Children and Community Services Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">-0-<br/>
</td>
<td align="center"></td>
<td align="right">(9,900,000)<br/>
</td>
</tr>
</table><a id="pl.128.26"></a><var>128.26</var><b>Children and Community Services Grant </b><br/>
<a id="pl.128.27"></a><var>128.27</var><b>Reduction.</b> The fiscal year 2011 general <br/>
<a id="pl.128.28"></a><var>128.28</var>fund appropriation to the commissioner <br/>
<a id="pl.128.29"></a><var>128.29</var>of human services for the children and <br/>
<a id="pl.128.30"></a><var>128.30</var>community services grants under Minnesota <br/>
<a id="pl.128.31"></a><var>128.31</var>Statutes, section 256M.40, is reduced by <br/>
<a id="pl.128.32"></a><var>128.32</var>$9,900,000. This reduction is ongoing and is <br/>
<a id="pl.128.33"></a><var>128.33</var>subtracted from the base.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.128.34"></a><var>128.34</var><br/>
</td>
<td colspan="3">(e) <b>Children's Mental Health Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">-0-<br/>
</td>
<td align="center"></td>
<td align="right">(8,028,000)<br/>
</td>
</tr>
</table><a id="pl.129.1"></a><var>129.1</var>(1) The general fund appropriation for <br/>
<a id="pl.129.2"></a><var>129.2</var>respite care services for children with <br/>
<a id="pl.129.3"></a><var>129.3</var>severe emotional disturbance who are at <br/>
<a id="pl.129.4"></a><var>129.4</var>risk of out-of-home placement is reduced <br/>
<a id="pl.129.5"></a><var>129.5</var>by $1,024,000 for fiscal year 2011. This <br/>
<a id="pl.129.6"></a><var>129.6</var>reduction is onetime.<br/>
<a id="pl.129.7"></a><var>129.7</var>(2) The general fund appropriation for <br/>
<a id="pl.129.8"></a><var>129.8</var>children's early intervention services is <br/>
<a id="pl.129.9"></a><var>129.9</var>reduced by $1,024,000 for fiscal year 2011. <br/>
<a id="pl.129.10"></a><var>129.10</var>This reduction is onetime.<br/>
<a id="pl.129.11"></a><var>129.11</var>(3) The general fund appropriation for <br/>
<a id="pl.129.12"></a><var>129.12</var>children's capacity school-based services is <br/>
<a id="pl.129.13"></a><var>129.13</var>reduced by $4,777,000 for fiscal year 2011.<br/>
<a id="pl.129.14"></a><var>129.14</var>(4) The general fund appropriation for <br/>
<a id="pl.129.15"></a><var>129.15</var>children's mental health targeted case <br/>
<a id="pl.129.16"></a><var>129.16</var>management grants is reduced by $1,210,000 <br/>
<a id="pl.129.17"></a><var>129.17</var>for fiscal year 2011.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.129.18"></a><var>129.18</var><br/>
<a id="pl.129.19"></a><var>129.19</var><br/>
</td>
<td colspan="3">Subd. 5.<b>Children and Economic Assistance </b><br/>
<b>Management</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.129.20"></a><var>129.20</var><br/>
<a id="pl.129.21"></a><var>129.21</var><br/>
</td>
<td colspan="3">(a) <b>Children and Economic Assistance </b><br/>
<b>Administration</b><br/>
</td>
<td align="center"></td>
<td align="right">-0-<br/>
</td>
<td align="center"></td>
<td align="right">-0-<br/>
</td>
</tr>
</table><a id="pl.129.22"></a><var>129.22</var>The general fund appropriation is reduced by <br/>
<a id="pl.129.23"></a><var>129.23</var>$172,000 in fiscal year 2010 and by $176,000 <br/>
<a id="pl.129.24"></a><var>129.24</var>in fiscal year 2011.<br/>
<a id="pl.129.25"></a><var>129.25</var>The federal TANF appropriation is increased <br/>
<a id="pl.129.26"></a><var>129.26</var>by $172,000 in fiscal year 2010 and by <br/>
<a id="pl.129.27"></a><var>129.27</var>$176,000 in fiscal year 2011. The TANF <br/>
<a id="pl.129.28"></a><var>129.28</var>fund base shall be reduced by $700,000 in <br/>
<a id="pl.129.29"></a><var>129.29</var>fiscal years 2012 and 2013.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.129.30"></a><var>129.30</var><br/>
<a id="pl.129.31"></a><var>129.31</var><br/>
</td>
<td colspan="3">(b) <b>Children and Economic Assistance </b><br/>
<b>Operations</b><br/>
</td>
<td align="center"></td>
<td align="right">(1,580,000)<br/>
</td>
<td align="center"></td>
<td align="right">(1,692,000)<br/>
</td>
</tr>
</table><a id="pl.129.32"></a><var>129.32</var>The general fund appropriation is reduced <br/>
<a id="pl.129.33"></a><var>129.33</var>by $1,408,000 in fiscal year 2010 and by <br/>
<a id="pl.129.34"></a><var>129.34</var>$1,534,000 in fiscal year 2011. The general <br/>
<a id="pl.130.1"></a><var>130.1</var>fund base is reduced by $26,000 in each of <br/>
<a id="pl.130.2"></a><var>130.2</var>fiscal years 2012 and 2013.<br/>
<a id="pl.130.3"></a><var>130.3</var>$74,000 in fiscal year 2011 is appropriated <br/>
<a id="pl.130.4"></a><var>130.4</var>from the health care access fund. This <br/>
<a id="pl.130.5"></a><var>130.5</var>appropriation is onetime.<br/>
<a id="pl.130.6"></a><var>130.6</var>The federal TANF appropriation is reduced <br/>
<a id="pl.130.7"></a><var>130.7</var>by $172,000 in fiscal year 2010 and by <br/>
<a id="pl.130.8"></a><var>130.8</var>$232,000 in fiscal year 2011.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.130.9"></a><var>130.9</var><br/>
</td>
<td colspan="3">Subd. 6.<b>Basic Health Care Grants</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.130.10"></a><var>130.10</var><br/>
</td>
<td colspan="3">(a) <b>MinnesotaCare Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">-0-<br/>
</td>
<td align="center"></td>
<td align="right">(67,549,000)<br/>
</td>
</tr>
</table><a id="pl.130.11"></a><var>130.11</var>This appropriation reduction is from the <br/>
<a id="pl.130.12"></a><var>130.12</var>health care access fund.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.130.13"></a><var>130.13</var><br/>
<a id="pl.130.14"></a><var>130.14</var><br/>
</td>
<td colspan="3">(b) <b>Medical Assistance Basic Health Care </b><br/>
<b>Grants - Families and Children</b><br/>
</td>
<td align="center"></td>
<td align="right">-0-<br/>
</td>
<td align="center"></td>
<td align="right">(1,108,000)<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.130.15"></a><var>130.15</var><br/>
<a id="pl.130.16"></a><var>130.16</var><br/>
</td>
<td colspan="3">(c) <b>Medical Assistance Basic Health Care </b><br/>
<b>Grants - Elderly and Disabled</b><br/>
</td>
<td align="center"></td>
<td align="right">-0-<br/>
</td>
<td align="center"></td>
<td align="right">(2,817,000)<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.130.17"></a><var>130.17</var><br/>
</td>
<td colspan="3">(d) <b>General Assistance Medical Care Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">-0-<br/>
</td>
<td align="center"></td>
<td align="right">(52,614,000)<br/>
</td>
</tr>
</table><a id="pl.130.18"></a><var>130.18</var><b>Funding Reduction; Coordinated Care </b><br/>
<a id="pl.130.19"></a><var>130.19</var><b>Delivery Systems.</b> The appropriation for <br/>
<a id="pl.130.20"></a><var>130.20</var>payments to coordinated care delivery <br/>
<a id="pl.130.21"></a><var>130.21</var>systems in Laws 2010, chapter 200, article <br/>
<a id="pl.130.22"></a><var>130.22</var>2, section 2, subdivision 4, paragraph (d), is <br/>
<a id="pl.130.23"></a><var>130.23</var>reduced by $20,000,000 in fiscal year 2011.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.6"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.130.24"></a><var>130.24</var><br/>
<a id="pl.130.25"></a><var>130.25</var><br/>
</td>
<td colspan="3">(e) <b>Medical Assistance; Adults Without </b><br/>
<b>Children</b><br/>
</td>
<td align="center"></td>
<td align="right">-0-<br/>
</td>
<td align="center"></td>
<td align="right">144,114,000<br/>
</td>
</tr>
</table><a id="pl.130.26"></a><var>130.26</var>Of this appropriation, $142,768,000 is from <br/>
<a id="pl.130.27"></a><var>130.27</var>the health care access fund.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.130.28"></a><var>130.28</var><br/>
</td>
<td colspan="3">(f) <b>Other Health Care Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">-0-<br/>
</td>
<td align="center"></td>
<td align="right">(1,831,000)<br/>
</td>
</tr>
</table><a id="pl.130.29"></a><var>130.29</var>Of this appropriation, the general fund is <br/>
<a id="pl.130.30"></a><var>130.30</var>increased by $19,000 and the health care <br/>
<a id="pl.130.31"></a><var>130.31</var>access fund appropriation is reduced by <br/>
<a id="pl.130.32"></a><var>130.32</var>$1,850,000. This appropriation is onetime.<br/>
<a id="pl.131.1"></a><var>131.1</var><b>COBRA Carryforward.</b> Unexpended <br/>
<a id="pl.131.2"></a><var>131.2</var>funds appropriated in fiscal year 2010 for <br/>
<a id="pl.131.3"></a><var>131.3</var>COBRA grants under Laws 2009, chapter <br/>
<a id="pl.131.4"></a><var>131.4</var>79, article 5, section 78, do not cancel and <br/>
<a id="pl.131.5"></a><var>131.5</var>are available to the commissioner of human <br/>
<a id="pl.131.6"></a><var>131.6</var>services for fiscal year 2011 COBRA grant <br/>
<a id="pl.131.7"></a><var>131.7</var>expenditures. Up to $110,000 of the fiscal <br/>
<a id="pl.131.8"></a><var>131.8</var>year 2011 appropriation for COBRA grants <br/>
<a id="pl.131.9"></a><var>131.9</var>provided in Laws 2009, chapter 79, article <br/>
<a id="pl.131.10"></a><var>131.10</var>13, section 3, subdivision 6, may be used <br/>
<a id="pl.131.11"></a><var>131.11</var>by the commissioner of human services for <br/>
<a id="pl.131.12"></a><var>131.12</var>costs related to administration of the COBRA <br/>
<a id="pl.131.13"></a><var>131.13</var>grants.<br/>
<a id="pl.131.14"></a><var>131.14</var><b>Transfer.</b> The commissioner shall transfer <br/>
<a id="pl.131.15"></a><var>131.15</var>$19,000 to the commissioner of commerce <br/>
<a id="pl.131.16"></a><var>131.16</var>for regulation of Minnesota Statutes, section <br/>
<a id="pl.131.17"></a><var>131.17</var>62A.3075.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.131.18"></a><var>131.18</var><br/>
</td>
<td colspan="3">Subd. 7.<b>Health Care Management</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.131.19"></a><var>131.19</var><br/>
</td>
<td colspan="3">(a) <b>Health Care Administration</b><br/>
</td>
<td align="center"></td>
<td align="right">(2,853,000)<br/>
</td>
<td align="center"></td>
<td align="right">(4,783,000)<br/>
</td>
</tr>
</table><a id="pl.131.20"></a><var>131.20</var>For fiscal year 2011 the health care access <br/>
<a id="pl.131.21"></a><var>131.21</var>fund appropriation is increased by $250,000 <br/>
<a id="pl.131.22"></a><var>131.22</var>and the general fund appropriation is reduced <br/>
<a id="pl.131.23"></a><var>131.23</var>by $4,633,000.<br/>
<a id="pl.131.24"></a><var>131.24</var><b>Reduction in Appropriation.</b> The base <br/>
<a id="pl.131.25"></a><var>131.25</var>funding under the current law forecast used <br/>
<a id="pl.131.26"></a><var>131.26</var>to calculate the state appropriation for the <br/>
<a id="pl.131.27"></a><var>131.27</var>medical assistance program is reduced by <br/>
<a id="pl.131.28"></a><var>131.28</var>one percent for the 2012-2013 biennium. <br/>
<a id="pl.131.29"></a><var>131.29</var>This reduction is subject to federal approval <br/>
<a id="pl.131.30"></a><var>131.30</var>of the intensive care management program <br/>
<a id="pl.131.31"></a><var>131.31</var>authorized under Minnesota Statutes, section <br/>
<a id="pl.131.32"></a><var>131.32</var>256B.0755, and is ongoing and shall apply <br/>
<a id="pl.131.33"></a><var>131.33</var>to future bienniums, or for as long as the <br/>
<a id="pl.131.34"></a><var>131.34</var>intensive care management program is <br/>
<a id="pl.132.1"></a><var>132.1</var>determined to be cost-effective by the <br/>
<a id="pl.132.2"></a><var>132.2</var>commissioner of human services.<br/>
<a id="pl.132.3"></a><var>132.3</var><b>PACE Implementation Funding.</b> For fiscal <br/>
<a id="pl.132.4"></a><var>132.4</var>year 2011, $145,000 is appropriated from <br/>
<a id="pl.132.5"></a><var>132.5</var>the general fund to the commissioner of <br/>
<a id="pl.132.6"></a><var>132.6</var>human services to complete the actuarial and <br/>
<a id="pl.132.7"></a><var>132.7</var>administrative work necessary to begin the <br/>
<a id="pl.132.8"></a><var>132.8</var>operation of PACE under Minnesota Statutes, <br/>
<a id="pl.132.9"></a><var>132.9</var>section 256B.69, subdivision 23, paragraph <br/>
<a id="pl.132.10"></a><var>132.10</var>(e). Base level funding for this activity shall <br/>
<a id="pl.132.11"></a><var>132.11</var>be $130,000 in fiscal year 2012 and $0 in <br/>
<a id="pl.132.12"></a><var>132.12</var>fiscal year 2013.<br/>
<a id="pl.132.13"></a><var>132.13</var><b>Minnesota Senior Health Options </b><br/>
<a id="pl.132.14"></a><var>132.14</var><b>Reimbursement.</b> Effective July 1, 2011, <br/>
<a id="pl.132.15"></a><var>132.15</var>federal administrative reimbursement <br/>
<a id="pl.132.16"></a><var>132.16</var>resulting from the Minnesota senior <br/>
<a id="pl.132.17"></a><var>132.17</var>health options project is appropriated <br/>
<a id="pl.132.18"></a><var>132.18</var>to the commissioner for this activity. <br/>
<a id="pl.132.19"></a><var>132.19</var>Notwithstanding any contrary provision, this <br/>
<a id="pl.132.20"></a><var>132.20</var>provision expires June 30, 2013.<br/>
<a id="pl.132.21"></a><var>132.21</var><b>Health Care Inspector General.</b> $120,000 <br/>
<a id="pl.132.22"></a><var>132.22</var>from the general fund in fiscal year 2011 <br/>
<a id="pl.132.23"></a><var>132.23</var>is for the Office of Health Care Inspector <br/>
<a id="pl.132.24"></a><var>132.24</var>General, established under Minnesota <br/>
<a id="pl.132.25"></a><var>132.25</var>Statutes, section 256.01, subdivision 30.<br/>
<a id="pl.132.26"></a><var>132.26</var><b>Fiscal and Actuarial Analysis.</b> $250,000 <br/>
<a id="pl.132.27"></a><var>132.27</var>from the general fund is for the fiscal and <br/>
<a id="pl.132.28"></a><var>132.28</var>actuarial analysis of 2010 House File No. <br/>
<a id="pl.132.29"></a><var>132.29</var>135 and 2010 Senate File No. 118. This <br/>
<a id="pl.132.30"></a><var>132.30</var>appropriation is onetime.<br/>
<a id="pl.132.31"></a><var>132.31</var><b>Utilization Review.</b> Effective July 1, <br/>
<a id="pl.132.32"></a><var>132.32</var>2011, federal administrative reimbursement <br/>
<a id="pl.132.33"></a><var>132.33</var>resulting from prior authorization and <br/>
<a id="pl.132.34"></a><var>132.34</var>inpatient admission certification by a <br/>
<a id="pl.132.35"></a><var>132.35</var>professional review organization shall be <br/>
<a id="pl.133.1"></a><var>133.1</var>dedicated to, and is appropriated to, the <br/>
<a id="pl.133.2"></a><var>133.2</var>commissioner for these activities. A portion <br/>
<a id="pl.133.3"></a><var>133.3</var>of these funds must be used for activities to <br/>
<a id="pl.133.4"></a><var>133.4</var>decrease unnecessary pharmaceutical costs <br/>
<a id="pl.133.5"></a><var>133.5</var>in medical assistance. Notwithstanding any <br/>
<a id="pl.133.6"></a><var>133.6</var>contrary provision, this provision expires <br/>
<a id="pl.133.7"></a><var>133.7</var>June 30, 2013.<br/>
<a id="pl.133.8"></a><var>133.8</var><b>Base Adjustment.</b> The health care access <br/>
<a id="pl.133.9"></a><var>133.9</var>fund base is reduced by $50,000 in each of <br/>
<a id="pl.133.10"></a><var>133.10</var>fiscal years 2012 and 2013.<br/>
<a id="pl.133.11"></a><var>133.11</var>The general fund base is reduced by $416,000 <br/>
<a id="pl.133.12"></a><var>133.12</var>in each of fiscal years 2012 and 2013.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.133.13"></a><var>133.13</var><br/>
</td>
<td colspan="3">(b) <b>Health Care Operations</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.133.14"></a><var>133.14</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.133.15"></a><var>133.15</var><br/>
</td>
<td>General<br/>
</td>
<td align="right">-0-<br/>
</td>
<td align="right">64,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.133.16"></a><var>133.16</var><br/>
</td>
<td>Health Care Access<br/>
</td>
<td align="right">(1,094,000)<br/>
</td>
<td align="right">(1,234,000)<br/>
</td>
</tr>
</table><a id="pl.133.17"></a><var>133.17</var><b>Base Adjustment.</b> The health care access <br/>
<a id="pl.133.18"></a><var>133.18</var>fund base for health care operations is <br/>
<a id="pl.133.19"></a><var>133.19</var>reduced by $1,272,000 in fiscal year 2012 <br/>
<a id="pl.133.20"></a><var>133.20</var>and $1,337,000 in fiscal year 2013. The <br/>
<a id="pl.133.21"></a><var>133.21</var>general fund appropriation is onetime.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.133.22"></a><var>133.22</var><br/>
</td>
<td colspan="3">Subd. 8.<b>Continuing Care Grants</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.133.23"></a><var>133.23</var><br/>
</td>
<td colspan="3">(a) <b>Aging and Adult Services Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">(154,000)<br/>
</td>
<td align="center"></td>
<td align="right">(139,000)<br/>
</td>
</tr>
</table><a id="pl.133.24"></a><var>133.24</var>This reduction is onetime and must not be <br/>
<a id="pl.133.25"></a><var>133.25</var>applied to the base.<br/>
<a id="pl.133.26"></a><var>133.26</var><b>Community Service Development </b><br/>
<a id="pl.133.27"></a><var>133.27</var><b>Reduction.</b> The appropriation in Laws <br/>
<a id="pl.133.28"></a><var>133.28</var>2009, chapter 79, article 13, section 3, <br/>
<a id="pl.133.29"></a><var>133.29</var>subdivision 8, paragraph (a), for community <br/>
<a id="pl.133.30"></a><var>133.30</var>service development grants, as amended by <br/>
<a id="pl.133.31"></a><var>133.31</var>Laws 2009, chapter 173, article 2, section <br/>
<a id="pl.133.32"></a><var>133.32</var>1, subdivision 8, paragraph (a), is reduced <br/>
<a id="pl.133.33"></a><var>133.33</var>by $154,000 in fiscal year 2011. The <br/>
<a id="pl.133.34"></a><var>133.34</var>appropriation base is reduced by $139,000 <br/>
<a id="pl.134.1"></a><var>134.1</var>for fiscal year 2012 and $0 for fiscal year <br/>
<a id="pl.134.2"></a><var>134.2</var>2013. Notwithstanding any law or rule to <br/>
<a id="pl.134.3"></a><var>134.3</var>the contrary, this provision expires June 30, <br/>
<a id="pl.134.4"></a><var>134.4</var>2012.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.134.5"></a><var>134.5</var><br/>
<a id="pl.134.6"></a><var>134.6</var><br/>
</td>
<td colspan="3">(b) <b>Medical Assistance Long-Term Care </b><br/>
<b>Facilities Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">-0-<br/>
</td>
<td align="center"></td>
<td align="right">551,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.134.7"></a><var>134.7</var><br/>
<a id="pl.134.8"></a><var>134.8</var><br/>
</td>
<td colspan="3">(c) <b>Medical Assistance Long-Term Care </b><br/>
<b>Waivers and Home Care Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">-0-<br/>
</td>
<td align="center"></td>
<td align="right">(2,747,000)<br/>
</td>
</tr>
</table><a id="pl.134.9"></a><var>134.9</var><b>Manage Growth in Traumatic Brain </b><br/>
<a id="pl.134.10"></a><var>134.10</var><b>Injury and Community Alternatives for </b><br/>
<a id="pl.134.11"></a><var>134.11</var><b>Disabled Individuals' Waivers.</b> During <br/>
<a id="pl.134.12"></a><var>134.12</var>the fiscal year beginning July 1, 2010, the <br/>
<a id="pl.134.13"></a><var>134.13</var>commissioner shall allocate money for home <br/>
<a id="pl.134.14"></a><var>134.14</var>and community-based waiver programs <br/>
<a id="pl.134.15"></a><var>134.15</var>under Minnesota Statutes, section 256B.49, <br/>
<a id="pl.134.16"></a><var>134.16</var>to ensure a reduction in state spending that is <br/>
<a id="pl.134.17"></a><var>134.17</var>equivalent to limiting the caseload growth <br/>
<a id="pl.134.18"></a><var>134.18</var>of the traumatic brain injury waiver to six <br/>
<a id="pl.134.19"></a><var>134.19</var>allocations per month and the community <br/>
<a id="pl.134.20"></a><var>134.20</var>alternatives for disabled individuals waiver <br/>
<a id="pl.134.21"></a><var>134.21</var>to 60 allocations per month. The limits do not <br/>
<a id="pl.134.22"></a><var>134.22</var>apply: (1) when there is an approved plan for <br/>
<a id="pl.134.23"></a><var>134.23</var>nursing facility bed closures for individuals <br/>
<a id="pl.134.24"></a><var>134.24</var>under age 65 who require relocation due to <br/>
<a id="pl.134.25"></a><var>134.25</var>the bed closure; (2) to fiscal year 2009 waiver <br/>
<a id="pl.134.26"></a><var>134.26</var>allocations delayed due to unallotment; or (3) <br/>
<a id="pl.134.27"></a><var>134.27</var>to transfers authorized by the commissioner <br/>
<a id="pl.134.28"></a><var>134.28</var>from the personal care assistance program <br/>
<a id="pl.134.29"></a><var>134.29</var>of individuals having a home care rating of <br/>
<a id="pl.134.30"></a><var>134.30</var>CS, MT, or HL. Priorities for the allocation <br/>
<a id="pl.134.31"></a><var>134.31</var>of funds must be for individuals anticipated <br/>
<a id="pl.134.32"></a><var>134.32</var>to be discharged from institutional settings or <br/>
<a id="pl.134.33"></a><var>134.33</var>who are at imminent risk of a placement in <br/>
<a id="pl.134.34"></a><var>134.34</var>an institutional setting.<br/>
<a id="pl.134.35"></a><var>134.35</var><b>Manage Growth in the Developmental </b><br/>
<a id="pl.134.36"></a><var>134.36</var><b>Disability (DD) Waiver.</b> The commissioner <br/>
<a id="pl.135.1"></a><var>135.1</var>shall manage the growth in the developmental <br/>
<a id="pl.135.2"></a><var>135.2</var>disability waiver by limiting the allocations <br/>
<a id="pl.135.3"></a><var>135.3</var>included in the November 2010 forecast to <br/>
<a id="pl.135.4"></a><var>135.4</var>six additional diversion allocations each <br/>
<a id="pl.135.5"></a><var>135.5</var>month for the calendar year that begins on <br/>
<a id="pl.135.6"></a><var>135.6</var>January 1, 2011. Additional allocations must <br/>
<a id="pl.135.7"></a><var>135.7</var>be made available for transfers authorized <br/>
<a id="pl.135.8"></a><var>135.8</var>by the commissioner from the personal care <br/>
<a id="pl.135.9"></a><var>135.9</var>assistance program of individuals having a <br/>
<a id="pl.135.10"></a><var>135.10</var>home care rating of CS, MT, or HL. This <br/>
<a id="pl.135.11"></a><var>135.11</var>provision is effective through December 31, <br/>
<a id="pl.135.12"></a><var>135.12</var>2011.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.135.13"></a><var>135.13</var><br/>
</td>
<td colspan="3">(d) <b>Adult Mental Health Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">(3,500,000)<br/>
</td>
<td align="center"></td>
<td align="right">(9,903,000)<br/>
</td>
</tr>
</table><a id="pl.135.14"></a><var>135.14</var><b>Compulsive Gambling Special Revenue </b><br/>
<a id="pl.135.15"></a><var>135.15</var><b>Account.</b> $149,000 for fiscal year 2010 <br/>
<a id="pl.135.16"></a><var>135.16</var>and $27,000 for fiscal year 2011 from <br/>
<a id="pl.135.17"></a><var>135.17</var>the compulsive gambling special revenue <br/>
<a id="pl.135.18"></a><var>135.18</var>account established under Minnesota <br/>
<a id="pl.135.19"></a><var>135.19</var>Statutes, section 245.982, must be transferred <br/>
<a id="pl.135.20"></a><var>135.20</var>and deposited into the general fund by June <br/>
<a id="pl.135.21"></a><var>135.21</var>30 of each respective fiscal year.<br/>
<a id="pl.135.22"></a><var>135.22</var><b>Compulsive Gambling Lottery Prize Fund </b><br/>
<a id="pl.135.23"></a><var>135.23</var><b>Appropriation.</b> The lottery prize fund <br/>
<a id="pl.135.24"></a><var>135.24</var>appropriation for compulsive gambling, is <br/>
<a id="pl.135.25"></a><var>135.25</var>reduced by $80,000 in fiscal year 2010 and <br/>
<a id="pl.135.26"></a><var>135.26</var>$79,000 in fiscal year 2011. This is a onetime <br/>
<a id="pl.135.27"></a><var>135.27</var>reduction.<br/>
<a id="pl.135.28"></a><var>135.28</var><b>Adult Mental Health.</b> (1) The general <br/>
<a id="pl.135.29"></a><var>135.29</var>fund appropriation for adult mental health <br/>
<a id="pl.135.30"></a><var>135.30</var>evidence-based practices, including but not <br/>
<a id="pl.135.31"></a><var>135.31</var>limited to, assertive community treatment <br/>
<a id="pl.135.32"></a><var>135.32</var>and integrated dual diagnosis treatment <br/>
<a id="pl.135.33"></a><var>135.33</var>services, is reduced by $750,000 for fiscal <br/>
<a id="pl.135.34"></a><var>135.34</var>year 2011. This reduction is onetime.<br/>
<a id="pl.136.1"></a><var>136.1</var>(2) The general fund appropriation for <br/>
<a id="pl.136.2"></a><var>136.2</var>mental health grants to increase availability <br/>
<a id="pl.136.3"></a><var>136.3</var>of culturally specific adult mental health <br/>
<a id="pl.136.4"></a><var>136.4</var>services is reduced by $300,000 for fiscal <br/>
<a id="pl.136.5"></a><var>136.5</var>year 2011. This reduction is onetime.<br/>
<a id="pl.136.6"></a><var>136.6</var>(3) The general fund appropriation for <br/>
<a id="pl.136.7"></a><var>136.7</var>grants to community hospitals to provide <br/>
<a id="pl.136.8"></a><var>136.8</var>alternatives to residential treatment center <br/>
<a id="pl.136.9"></a><var>136.9</var>mental health programs is reduced by <br/>
<a id="pl.136.10"></a><var>136.10</var>$2,653,000 for fiscal year 2011. This <br/>
<a id="pl.136.11"></a><var>136.11</var>reduction is onetime.<br/>
<a id="pl.136.12"></a><var>136.12</var>(4) The general fund appropriation for grants <br/>
<a id="pl.136.13"></a><var>136.13</var>to counties for adult mental health services is <br/>
<a id="pl.136.14"></a><var>136.14</var>reduced by $6,200,000 for fiscal year 2011, <br/>
<a id="pl.136.15"></a><var>136.15</var>and $6,000,000 in each of fiscal years 2012 <br/>
<a id="pl.136.16"></a><var>136.16</var>and 2013.<br/>
<a id="pl.136.17"></a><var>136.17</var>(5) Of the fiscal year 2010 general fund <br/>
<a id="pl.136.18"></a><var>136.18</var>appropriation for grants to counties for <br/>
<a id="pl.136.19"></a><var>136.19</var>housing with support services for adults <br/>
<a id="pl.136.20"></a><var>136.20</var>with serious and persistent mental illness, <br/>
<a id="pl.136.21"></a><var>136.21</var>$3,300,000 is canceled and returned to the <br/>
<a id="pl.136.22"></a><var>136.22</var>general fund.<br/>
<a id="pl.136.23"></a><var>136.23</var>(6) Of the fiscal year 2010 general <br/>
<a id="pl.136.24"></a><var>136.24</var>fund appropriation for additional crisis <br/>
<a id="pl.136.25"></a><var>136.25</var>intervention team training for law <br/>
<a id="pl.136.26"></a><var>136.26</var>enforcement, $200,000 is canceled and <br/>
<a id="pl.136.27"></a><var>136.27</var>returned to the general fund.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.136.28"></a><var>136.28</var><br/>
</td>
<td colspan="3">(e) <b>Chemical Dependency Entitlement Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">-0-<br/>
</td>
<td align="center"></td>
<td align="right">(3,986,000)<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.136.29"></a><var>136.29</var><br/>
<a id="pl.136.30"></a><var>136.30</var><br/>
</td>
<td colspan="3">(f) <b>Chemical Dependency Nonentitlement </b><br/>
<b>Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">(389,000)<br/>
</td>
<td align="center"></td>
<td align="right">-0-<br/>
</td>
</tr>
</table><a id="pl.136.31"></a><var>136.31</var><b>Chemical Health.</b> Of the fiscal year 2010 <br/>
<a id="pl.136.32"></a><var>136.32</var>general fund appropriation to Mother's First <br/>
<a id="pl.136.33"></a><var>136.33</var>and the Native American Program, $389,000 <br/>
<a id="pl.136.34"></a><var>136.34</var>is canceled and returned to the general fund.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.137.1"></a><var>137.1</var><br/>
</td>
<td colspan="3">(g) <b>Other Continuing Care Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">-0-<br/>
</td>
<td align="center"></td>
<td align="right">100,000<br/>
</td>
</tr>
</table><a id="pl.137.2"></a><var>137.2</var><b>Intermediate Care Facilities for the </b><br/>
<a id="pl.137.3"></a><var>137.3</var><b>Developmentally Disabled Payment Rates.</b> <br/>
<a id="pl.137.4"></a><var>137.4</var>$36,000 is appropriated from the general <br/>
<a id="pl.137.5"></a><var>137.5</var>fund in fiscal year 2011 and $4,000 in fiscal <br/>
<a id="pl.137.6"></a><var>137.6</var>year 2012 to increase payment rates for an <br/>
<a id="pl.137.7"></a><var>137.7</var>ICF/MR licensed for six beds and located in <br/>
<a id="pl.137.8"></a><var>137.8</var>Kandiyohi County to serve persons with high <br/>
<a id="pl.137.9"></a><var>137.9</var>behavioral needs. The payment rate increase <br/>
<a id="pl.137.10"></a><var>137.10</var>shall be effective for services provided from <br/>
<a id="pl.137.11"></a><var>137.11</var>July 1, 2010, through June 30, 2011. These <br/>
<a id="pl.137.12"></a><var>137.12</var>appropriations are onetime.<br/>
<a id="pl.137.13"></a><var>137.13</var><b>Region 10 Quality Assurance Commission.</b> <br/>
<a id="pl.137.14"></a><var>137.14</var>$100,000 is appropriated from the general <br/>
<a id="pl.137.15"></a><var>137.15</var>fund in fiscal year 2011 to the commissioner <br/>
<a id="pl.137.16"></a><var>137.16</var>of human services for the purposes <br/>
<a id="pl.137.17"></a><var>137.17</var>of the Region 10 Quality Assurance <br/>
<a id="pl.137.18"></a><var>137.18</var>Commission under Minnesota Statutes, <br/>
<a id="pl.137.19"></a><var>137.19</var>section 256B.0951. This appropriation is <br/>
<a id="pl.137.20"></a><var>137.20</var>onetime.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.137.21"></a><var>137.21</var><br/>
</td>
<td colspan="3">Subd. 9.<b>Continuing Care Management</b><br/>
</td>
<td align="center"></td>
<td align="right">111,000<br/>
</td>
<td align="center"></td>
<td align="right">101,000<br/>
</td>
</tr>
</table><a id="pl.137.22"></a><var>137.22</var><b>PACE Implementation Funding.</b> For fiscal <br/>
<a id="pl.137.23"></a><var>137.23</var>year 2011, $111,000 is appropriated from <br/>
<a id="pl.137.24"></a><var>137.24</var>the general fund to the commissioner of <br/>
<a id="pl.137.25"></a><var>137.25</var>human services to complete the actuarial <br/>
<a id="pl.137.26"></a><var>137.26</var>and administrative work necessary to begin <br/>
<a id="pl.137.27"></a><var>137.27</var>the operation of PACE under Minnesota <br/>
<a id="pl.137.28"></a><var>137.28</var>Statutes, section 256B.69, subdivision 23, <br/>
<a id="pl.137.29"></a><var>137.29</var>paragraph (e). Base level funding for this <br/>
<a id="pl.137.30"></a><var>137.30</var>activity shall be $101,000 in fiscal year 2012 <br/>
<a id="pl.137.31"></a><var>137.31</var>and $0 in fiscal year 2013. For fiscal year <br/>
<a id="pl.137.32"></a><var>137.32</var>2013 and beyond, the commissioner must <br/>
<a id="pl.137.33"></a><var>137.33</var>work with stakeholders to develop financing <br/>
<a id="pl.137.34"></a><var>137.34</var>mechanisms to complete the actuarial <br/>
<a id="pl.137.35"></a><var>137.35</var>and administrative costs of PACE. The <br/>
<a id="pl.138.1"></a><var>138.1</var>commissioner shall inform the chairs and <br/>
<a id="pl.138.2"></a><var>138.2</var>ranking minority members of the legislative <br/>
<a id="pl.138.3"></a><var>138.3</var>committee with jurisdiction over health care <br/>
<a id="pl.138.4"></a><var>138.4</var>funding by January 15, 2011, on progress to <br/>
<a id="pl.138.5"></a><var>138.5</var>develop financing mechanisms.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.138.6"></a><var>138.6</var><br/>
</td>
<td colspan="3">Subd. 10.<b>State-Operated Services</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table><a id="pl.138.7"></a><var>138.7</var><b>Obsolete Laundry Depreciation Account.</b> <br/>
<a id="pl.138.8"></a><var>138.8</var>$669,000, or the balance, whichever is <br/>
<a id="pl.138.9"></a><var>138.9</var>greater, must be transferred from the <br/>
<a id="pl.138.10"></a><var>138.10</var>state-operated services laundry depreciation <br/>
<a id="pl.138.11"></a><var>138.11</var>account in the special revenue fund and <br/>
<a id="pl.138.12"></a><var>138.12</var>deposited into the general fund by June 30, <br/>
<a id="pl.138.13"></a><var>138.13</var>2010.<br/>
<a id="pl.138.14"></a><var>138.14</var><b>State-operated Services Programs.</b> Of <br/>
<a id="pl.138.15"></a><var>138.15</var>the fiscal year 2011 appropriation for <br/>
<a id="pl.138.16"></a><var>138.16</var>the Minnesota sex offender program, <br/>
<a id="pl.138.17"></a><var>138.17</var>$12,600,000 is transferred to state-operated <br/>
<a id="pl.138.18"></a><var>138.18</var>services to maintain the METO program and <br/>
<a id="pl.138.19"></a><var>138.19</var>other residential adult mental health services.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.138.20"></a><var>138.20</var><br/>
</td>
<td colspan="3">Subd. 11.<b>Adult Mental Health Services</b><br/>
</td>
<td align="center"></td>
<td align="right">-0-<br/>
</td>
<td align="center"></td>
<td align="right">12,600,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.138.21"></a><var>138.21</var><br/>
</td>
<td colspan="3">Subd. 12.<b>Minnesota Sex Offender Services</b><br/>
</td>
<td align="center"></td>
<td align="right">-0-<br/>
</td>
<td align="center"></td>
<td align="right">(12,600,000)<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.138.22"></a><var>138.22</var><br/>
<a id="pl.138.23"></a><var>138.23</var><br/>
</td>
<td colspan="3">Subd. 13.<b>Contingent Appropriations </b><br/>
<b>Reductions</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table><a id="pl.138.24"></a><var>138.24</var>Upon enactment of the extension of <br/>
<a id="pl.138.25"></a><var>138.25</var>the enhanced federal medical assistance <br/>
<a id="pl.138.26"></a><var>138.26</var>percentage (FMAP) under Public Law 111-5 <br/>
<a id="pl.138.27"></a><var>138.27</var>to June 30, 2011, that is contained in the <br/>
<a id="pl.138.28"></a><var>138.28</var>president's budget for federal fiscal year 2011 <br/>
<a id="pl.138.29"></a><var>138.29</var>or contained in House Resolution 2847, the <br/>
<a id="pl.138.30"></a><var>138.30</var>federal "Jobs for Main Street Act of 2010," or <br/>
<a id="pl.138.31"></a><var>138.31</var>subsequent federal legislation, the reductions <br/>
<a id="pl.138.32"></a><var>138.32</var>identified in each clause shall be made to <br/>
<a id="pl.138.33"></a><var>138.33</var>the specified general fund appropriations <br/>
<a id="pl.138.34"></a><var>138.34</var>for fiscal year 2011. These contingent <br/>
<a id="pl.138.35"></a><var>138.35</var>reductions, if implemented, are in addition <br/>
<a id="pl.139.1"></a><var>139.1</var>to the reductions specified in subdivision 6, <br/>
<a id="pl.139.2"></a><var>139.2</var>paragraphs (a), (b), and (c), and subdivision <br/>
<a id="pl.139.3"></a><var>139.3</var>8, paragraphs (c) and (d), respectively.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.139.4"></a><var>139.4</var><br/>
</td>
<td colspan="3">(1) MinnesotaCare Grants<br/>
</td>
<td align="center"></td>
<td align="right">-0-<br/>
</td>
<td align="center"></td>
<td align="right">(9,200,000)<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.139.5"></a><var>139.5</var><br/>
<a id="pl.139.6"></a><var>139.6</var><br/>
</td>
<td colspan="3">(2) Medical Assistance Basic Health Care Grants <br/>
- Families and Children<br/>
</td>
<td align="center"></td>
<td align="right">-0-<br/>
</td>
<td align="center"></td>
<td align="right">(109,662,500)<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.139.7"></a><var>139.7</var><br/>
<a id="pl.139.8"></a><var>139.8</var><br/>
</td>
<td colspan="3">(3) Medical Assistance Basic Health Care Grants <br/>
- Elderly and Disabled<br/>
</td>
<td align="center"></td>
<td align="right">-0-<br/>
</td>
<td align="center"></td>
<td align="right">(110,437,500)<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.139.9"></a><var>139.9</var><br/>
<a id="pl.139.10"></a><var>139.10</var><br/>
</td>
<td colspan="3">(4) Medical Assistance Long-Term Care Facilities <br/>
Grants<br/>
</td>
<td align="center"></td>
<td align="right">-0-<br/>
</td>
<td align="center"></td>
<td align="right">(51,925,000)<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.139.11"></a><var>139.11</var><br/>
<a id="pl.139.12"></a><var>139.12</var><br/>
</td>
<td colspan="3">(5) Medical Assistance Long-Term Care Waivers <br/>
and Home Care Grants<br/>
</td>
<td align="center"></td>
<td align="right">-0-<br/>
</td>
<td align="center"></td>
<td align="right">(115,475,000)<br/>
</td>
</tr>
</table><br/>
<a id="bill.9.4.0"></a><table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.139.13"></a><var>139.13</var><br/>
</td>
<td colspan="3">Sec. 4. <b>COMMISSIONER OF HEALTH</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.139.14"></a><var>139.14</var><br/>
</td>
<td></td>
<td></td>
<td></td>
<td align="center" colspan="4"><b>APPROPRIATIONS</b><br/>
</td>
</tr>
<tr>
<td><a id="pl.139.15"></a><var>139.15</var><br/>
</td>
<td></td>
<td></td>
<td></td>
<td align="center" colspan="4"><b>Available for the Year</b><br/>
</td>
</tr>
<tr>
<td><a id="pl.139.16"></a><var>139.16</var><br/>
</td>
<td></td>
<td></td>
<td></td>
<td align="center" colspan="4"><b>Ending June 30</b><br/>
</td>
</tr>
<tr>
<td><a id="pl.139.17"></a><var>139.17</var><br/>
</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td align="center"><b>2010</b><br/>
</td>
<td></td>
<td align="center"><b>2011</b><br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.139.18"></a><var>139.18</var><br/>
</td>
<td colspan="3">Subdivision 1.<b>Total Appropriation</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>(2,397,000)</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>5,751,000</b><br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="95px"/>
<col width="96px"/>
<tr>
<td><a id="pl.139.19"></a><var>139.19</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.139.20"></a><var>139.20</var><br/>
</td>
<td></td>
<td align="center">2010<br/>
</td>
<td align="center">2011<br/>
</td>
</tr>
<tr>
<td><a id="pl.139.21"></a><var>139.21</var><br/>
</td>
<td>General<br/>
</td>
<td align="right">(1,797,000)<br/>
</td>
<td align="right">5,810,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.139.22"></a><var>139.22</var><br/>
<a id="pl.139.23"></a><var>139.23</var><br/>
</td>
<td>State Government <br/>
Special Revenue<br/>
</td>
<td align="right">(600,000)<br/>
</td>
<td align="right">(259,000)<br/>
</td>
</tr>
<tr>
<td><a id="pl.139.24"></a><var>139.24</var><br/>
<a id="pl.139.25"></a><var>139.25</var><br/>
</td>
<td>Health Care Access <br/>
Fund<br/>
</td>
<td align="right">-0-<br/>
</td>
<td align="right">200,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.139.26"></a><var>139.26</var><br/>
</td>
<td colspan="3">Subd. 2.<b>Community and Family Health</b><br/>
</td>
<td align="center"></td>
<td align="right">-0-<br/>
</td>
<td align="center"></td>
<td align="right">100,000<br/>
</td>
</tr>
</table><a id="pl.139.27"></a><var>139.27</var><b>Grant for Memory Care Clinic.</b> $100,000 <br/>
<a id="pl.139.28"></a><var>139.28</var>from the general fund in fiscal year 2011 <br/>
<a id="pl.139.29"></a><var>139.29</var>is for a grant to a nonprofit, multispecialty <br/>
<a id="pl.139.30"></a><var>139.30</var>clinic located in the city of St. Cloud that <br/>
<a id="pl.139.31"></a><var>139.31</var>provides early identification, diagnosis, and <br/>
<a id="pl.139.32"></a><var>139.32</var>treatment of memory loss, and information <br/>
<a id="pl.139.33"></a><var>139.33</var>and support for family members who care for <br/>
<a id="pl.139.34"></a><var>139.34</var>persons with memory impairment. In order <br/>
<a id="pl.139.35"></a><var>139.35</var>to receive the grant, the clinic must certify to <br/>
<a id="pl.139.36"></a><var>139.36</var>the commissioner that it has a commitment <br/>
<a id="pl.140.1"></a><var>140.1</var>from a private foundation to provide a 50 <br/>
<a id="pl.140.2"></a><var>140.2</var>percent match of the grant amount. This <br/>
<a id="pl.140.3"></a><var>140.3</var>appropriation is onetime.<br/>
<a id="pl.140.4"></a><var>140.4</var><b>Statewide Health Improvement Program.</b> <br/>
<a id="pl.140.5"></a><var>140.5</var>$8,500,000 from the health care access <br/>
<a id="pl.140.6"></a><var>140.6</var>fund in fiscal year 2012 and $8,500,000 in <br/>
<a id="pl.140.7"></a><var>140.7</var>fiscal year 2013 is for the statewide health <br/>
<a id="pl.140.8"></a><var>140.8</var>improvement program under Minnesota <br/>
<a id="pl.140.9"></a><var>140.9</var>Statutes, section 145.986. These additions <br/>
<a id="pl.140.10"></a><var>140.10</var>are onetime.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.140.11"></a><var>140.11</var><br/>
</td>
<td colspan="3">Subd. 3.<b>Policy, Quality, and Compliance</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.140.12"></a><var>140.12</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.140.13"></a><var>140.13</var><br/>
</td>
<td></td>
<td align="right">2010<br/>
</td>
<td align="right">2011<br/>
</td>
</tr>
<tr>
<td><a id="pl.140.14"></a><var>140.14</var><br/>
</td>
<td>General<br/>
</td>
<td align="right">(1,797,000)<br/>
</td>
<td align="right">5,210,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.140.15"></a><var>140.15</var><br/>
<a id="pl.140.16"></a><var>140.16</var><br/>
</td>
<td>State Government <br/>
Special Revenue<br/>
</td>
<td align="right">(600,000)<br/>
</td>
<td align="right">(268,000)<br/>
</td>
</tr>
<tr>
<td><a id="pl.140.17"></a><var>140.17</var><br/>
<a id="pl.140.18"></a><var>140.18</var><br/>
</td>
<td>Health Care Access <br/>
Fund<br/>
</td>
<td align="right">-0-<br/>
</td>
<td align="right">200,000<br/>
</td>
</tr>
</table><a id="pl.140.19"></a><var>140.19</var>Of this appropriation, $74,000 in fiscal <br/>
<a id="pl.140.20"></a><var>140.20</var>year 2011 is to restore unallotments for the <br/>
<a id="pl.140.21"></a><var>140.21</var>Office of Unlicensed Complementary and <br/>
<a id="pl.140.22"></a><var>140.22</var>Alternative Health Care Practice.<br/>
<a id="pl.140.23"></a><var>140.23</var><b>Health Care Reform.</b> Funds appropriated <br/>
<a id="pl.140.24"></a><var>140.24</var>in Laws 2008, chapter 358, article 5, section <br/>
<a id="pl.140.25"></a><var>140.25</var>4, subdivision 3, for health reform activities <br/>
<a id="pl.140.26"></a><var>140.26</var>to implement Laws 2008, chapter 358, <br/>
<a id="pl.140.27"></a><var>140.27</var>article 4, are available until expended. <br/>
<a id="pl.140.28"></a><var>140.28</var>Notwithstanding any contrary provision in <br/>
<a id="pl.140.29"></a><var>140.29</var>this article, this provision shall not expire.<br/>
<a id="pl.140.30"></a><var>140.30</var><b>Health Care Reform Task Force.</b> $200,000 <br/>
<a id="pl.140.31"></a><var>140.31</var>from the general fund is for expenses related <br/>
<a id="pl.140.32"></a><var>140.32</var>to the Health Care Reform Task Force <br/>
<a id="pl.140.33"></a><var>140.33</var>established under article 7, section 8.<br/>
<a id="pl.140.34"></a><var>140.34</var><b>Autism Coverage Study.</b> $50,000 in <br/>
<a id="pl.140.35"></a><var>140.35</var>fiscal year 2011 is appropriated to the <br/>
<a id="pl.140.36"></a><var>140.36</var>commissioner of health to monitor the gaps <br/>
<a id="pl.141.1"></a><var>141.1</var>in the level of service provided by state <br/>
<a id="pl.141.2"></a><var>141.2</var>health programs, the state employee group <br/>
<a id="pl.141.3"></a><var>141.3</var>insurance plan, and private health plans for <br/>
<a id="pl.141.4"></a><var>141.4</var>autism spectrum disorder. This appropriation <br/>
<a id="pl.141.5"></a><var>141.5</var>is onetime.<br/>
<a id="pl.141.6"></a><var>141.6</var><b>Rural Hospital Capital Improvement </b><br/>
<a id="pl.141.7"></a><var>141.7</var><b>Grants.</b> Of the general fund reductions in <br/>
<a id="pl.141.8"></a><var>141.8</var>fiscal year 2010, $1,755,000 is for the rural <br/>
<a id="pl.141.9"></a><var>141.9</var>hospital capital improvement grant program.<br/>
<a id="pl.141.10"></a><var>141.10</var><b>Health Information Exchange Oversight.</b> <br/>
<a id="pl.141.11"></a><var>141.11</var>Of the state government special revenue fund <br/>
<a id="pl.141.12"></a><var>141.12</var>appropriations, $104,000 in fiscal year 2011 <br/>
<a id="pl.141.13"></a><var>141.13</var>is for the duties required under Minnesota <br/>
<a id="pl.141.14"></a><var>141.14</var>Statutes, sections 62J.498 to 62J.4982.<br/>
<a id="pl.141.15"></a><var>141.15</var><b>Birth Centers.</b> Of the state government <br/>
<a id="pl.141.16"></a><var>141.16</var>special revenue fund appropriations, $9,000 <br/>
<a id="pl.141.17"></a><var>141.17</var>is for licensing birth centers under Minnesota <br/>
<a id="pl.141.18"></a><var>141.18</var>Statutes, section 144.651. Base funding shall <br/>
<a id="pl.141.19"></a><var>141.19</var>be $7,000 in fiscal year 2012 and $7,000 in <br/>
<a id="pl.141.20"></a><var>141.20</var>fiscal year 2013.<br/>
<a id="pl.141.21"></a><var>141.21</var><b>Advisory Group on Administrative </b><br/>
<a id="pl.141.22"></a><var>141.22</var><b>Expenses.</b> Of the general fund appropriation, <br/>
<a id="pl.141.23"></a><var>141.23</var>$40,000 in fiscal year 2011 is for the advisory <br/>
<a id="pl.141.24"></a><var>141.24</var>group established under Minnesota Statutes, <br/>
<a id="pl.141.25"></a><var>141.25</var>section 62D.31.<br/>
<a id="pl.141.26"></a><var>141.26</var><b>Community Clinic Grants.</b> Of this <br/>
<a id="pl.141.27"></a><var>141.27</var>appropriation, $2,500,000 in fiscal <br/>
<a id="pl.141.28"></a><var>141.28</var>year 2011 is for the commissioner to <br/>
<a id="pl.141.29"></a><var>141.29</var>provide community clinic grants under <br/>
<a id="pl.141.30"></a><var>141.30</var>Minnesota Statutes, section 145.9268. This <br/>
<a id="pl.141.31"></a><var>141.31</var>appropriation is onetime. In awarding grants <br/>
<a id="pl.141.32"></a><var>141.32</var>using this funding, the commissioner shall <br/>
<a id="pl.141.33"></a><var>141.33</var>give priority to proposals that seek to serve <br/>
<a id="pl.141.34"></a><var>141.34</var>medically underserved areas of the state that <br/>
<a id="pl.141.35"></a><var>141.35</var>are not served by a coordinated care delivery <br/>
<a id="pl.142.1"></a><var>142.1</var>system established under Minnesota Statutes, <br/>
<a id="pl.142.2"></a><var>142.2</var>section 256D.031, subdivision 6.<br/>
<a id="pl.142.3"></a><var>142.3</var><b>Federally Qualified Health Center </b><br/>
<a id="pl.142.4"></a><var>142.4</var><b>Subsidies.</b> Of this appropriation, $2,500,000 <br/>
<a id="pl.142.5"></a><var>142.5</var>in fiscal year 2011 is for the commissioner to <br/>
<a id="pl.142.6"></a><var>142.6</var>increase subsidies to federally qualified health <br/>
<a id="pl.142.7"></a><var>142.7</var>centers provided under Minnesota Statutes, <br/>
<a id="pl.142.8"></a><var>142.8</var>section 145.9269. This appropriation is <br/>
<a id="pl.142.9"></a><var>142.9</var>onetime. In awarding subsidies using this <br/>
<a id="pl.142.10"></a><var>142.10</var>funding, the commissioner shall give priority <br/>
<a id="pl.142.11"></a><var>142.11</var>to federally qualified health centers that serve <br/>
<a id="pl.142.12"></a><var>142.12</var>medically underserved areas of the state that <br/>
<a id="pl.142.13"></a><var>142.13</var>are not served by a coordinated care delivery <br/>
<a id="pl.142.14"></a><var>142.14</var>system established under Minnesota Statutes, <br/>
<a id="pl.142.15"></a><var>142.15</var>section 256D.031, subdivision 6.<br/>
<a id="pl.142.16"></a><var>142.16</var><b>Base Level Adjustment.</b> The general fund <br/>
<a id="pl.142.17"></a><var>142.17</var>base is increased by $76,000 in each of fiscal <br/>
<a id="pl.142.18"></a><var>142.18</var>years 2012 and 2013. The state government <br/>
<a id="pl.142.19"></a><var>142.19</var>special revenue fund base is increased by <br/>
<a id="pl.142.20"></a><var>142.20</var>$97,000 in each of fiscal years 2012 and <br/>
<a id="pl.142.21"></a><var>142.21</var>2013.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.142.22"></a><var>142.22</var><br/>
</td>
<td colspan="3">Subd. 4.<b>Health Protection</b><br/>
</td>
<td align="center"></td>
<td align="right">-0-<br/>
</td>
<td align="center"></td>
<td align="right">500,000<br/>
</td>
</tr>
</table><a id="pl.142.23"></a><var>142.23</var><b>Birth Defects Information System.</b> Of <br/>
<a id="pl.142.24"></a><var>142.24</var>the general fund appropriation, $500,000 in <br/>
<a id="pl.142.25"></a><var>142.25</var>fiscal year 2011 is for the Minnesota Birth <br/>
<a id="pl.142.26"></a><var>142.26</var>Defects Information System established <br/>
<a id="pl.142.27"></a><var>142.27</var>under Minnesota Statutes, section 144.2215.<br/>
<br/>
<a id="bill.9.5.0"></a><table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.142.28"></a><var>142.28</var><br/>
</td>
<td align="left" colspan="3">Sec. 5. <b>Office of the Legislative Auditor</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>-0-</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>200,000</b><br/>
</td>
</tr>
</table><a id="pl.142.29"></a><var>142.29</var>$200,000 or an amount equal to 90 percent <br/>
<a id="pl.142.30"></a><var>142.30</var>of the nonfederal administrative staff funds <br/>
<a id="pl.142.31"></a><var>142.31</var>expended by the commissioner of human <br/>
<a id="pl.142.32"></a><var>142.32</var>services related to the preparation and <br/>
<a id="pl.142.33"></a><var>142.33</var>drafting of fiscal notes during fiscal year <br/>
<a id="pl.142.34"></a><var>142.34</var>2009, is transferred from the Department <br/>
<a id="pl.143.1"></a><var>143.1</var>of Human Services to the Office of the <br/>
<a id="pl.143.2"></a><var>143.2</var>Legislative Auditor, and appropriated for <br/>
<a id="pl.143.3"></a><var>143.3</var>the fiscal year beginning July 1, 2011, <br/>
<a id="pl.143.4"></a><var>143.4</var>for completion of the duties described in <br/>
<a id="pl.143.5"></a><var>143.5</var>Minnesota Statutes, section 3.98.<br/>
<br/>
<a id="bill.9.6.0"></a><a id="pl.143.6"></a><var>143.6</var>    Sec. 6. Laws 2009, chapter 79, article 13, section 3, subdivision 1, as amended by <br/>
<a id="pl.143.7"></a><var>143.7</var>Laws 2009, chapter 173, article 2, section 1, subdivision 1, is amended to read:<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.143.8"></a><var>143.8</var><br/>
</td>
<td align="left" colspan="3">Subdivision 1.<b>Total Appropriation</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>5,225,451,000</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>6,002,864,000</b><br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="95px"/>
<col width="96px"/>
<tr>
<td><a id="pl.143.9"></a><var>143.9</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.143.10"></a><var>143.10</var><br/>
</td>
<td align="left"></td>
<td align="center">2010<br/>
</td>
<td align="center">2011<br/>
</td>
</tr>
<tr>
<td><a id="pl.143.11"></a><var>143.11</var><br/>
</td>
<td align="left">General<br/>
</td>
<td align="right">4,375,689,000<br/>
</td>
<td align="right">5,209,765,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.143.12"></a><var>143.12</var><br/>
<a id="pl.143.13"></a><var>143.13</var><br/>
</td>
<td align="left">State Government <br/>
                  		Special Revenue<br/>
</td>
<td align="right">565,000<br/>
</td>
<td align="right">565,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.143.14"></a><var>143.14</var><br/>
</td>
<td align="left">Health Care Access<br/>
</td>
<td align="right">450,662,000<br/>
</td>
<td align="right">527,411,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.143.15"></a><var>143.15</var><br/>
</td>
<td align="left">Federal TANF<br/>
</td>
<td align="right">286,770,000<br/>
</td>
<td align="right">263,458,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.143.16"></a><var>143.16</var><br/>
</td>
<td align="left">Lottery Prize<br/>
</td>
<td align="right">1,665,000<br/>
</td>
<td align="right">1,665,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.143.17"></a><var>143.17</var><br/>
</td>
<td align="left">Federal Fund<br/>
</td>
<td align="right">110,000,000<br/>
</td>
<td align="right">0<br/>
</td>
</tr>
</table><a id="pl.143.18"></a><var>143.18</var><b>Receipts for Systems Projects.</b> <br/>
<a id="pl.143.19"></a><var>143.19</var>Appropriations and federal receipts for <br/>
<a id="pl.143.20"></a><var>143.20</var>information systems projects for MAXIS, <br/>
<a id="pl.143.21"></a><var>143.21</var>PRISM, MMIS, and SSIS must be deposited <br/>
<a id="pl.143.22"></a><var>143.22</var>in the state system account authorized in <br/>
<a id="pl.143.23"></a><var>143.23</var>Minnesota Statutes, section 
         <statute_ref>256.014</statute_ref>. Money <br/>
<a id="pl.143.24"></a><var>143.24</var>appropriated for computer projects approved <br/>
<a id="pl.143.25"></a><var>143.25</var>by the Minnesota Office of Enterprise <br/>
<a id="pl.143.26"></a><var>143.26</var>Technology, funded by the legislature, and <br/>
<a id="pl.143.27"></a><var>143.27</var>approved by the commissioner of finance, <br/>
<a id="pl.143.28"></a><var>143.28</var>may be transferred from one project to <br/>
<a id="pl.143.29"></a><var>143.29</var>another and from development to operations <br/>
<a id="pl.143.30"></a><var>143.30</var>as the commissioner of human services <br/>
<a id="pl.143.31"></a><var>143.31</var>considers necessary, except that any transfers <br/>
<a id="pl.143.32"></a><var>143.32</var>to one project that exceed $1,000,000 or <br/>
<a id="pl.143.33"></a><var>143.33</var>multiple transfers to one project that exceed <br/>
<a id="pl.143.34"></a><var>143.34</var>$1,000,000 in total require the express <br/>
<a id="pl.143.35"></a><var>143.35</var>approval of the legislature. The preceding <br/>
<a id="pl.143.36"></a><var>143.36</var>requirement for legislative approval does not <br/>
<a id="pl.144.1"></a><var>144.1</var>apply to transfers made to establish a project's <br/>
<a id="pl.144.2"></a><var>144.2</var>initial operating budget each year; instead, <br/>
<a id="pl.144.3"></a><var>144.3</var>the requirements of section 11, subdivision <br/>
<a id="pl.144.4"></a><var>144.4</var>2, of this article apply to those transfers. Any <br/>
<a id="pl.144.5"></a><var>144.5</var>unexpended balance in the appropriation <br/>
<a id="pl.144.6"></a><var>144.6</var>for these projects does not cancel but is <br/>
<a id="pl.144.7"></a><var>144.7</var>available for ongoing development and <br/>
<a id="pl.144.8"></a><var>144.8</var>operations. Any computer project with a <br/>
<a id="pl.144.9"></a><var>144.9</var>total cost exceeding $1,000,000, including, <br/>
<a id="pl.144.10"></a><var>144.10</var>but not limited to, a replacement for the <br/>
<a id="pl.144.11"></a><var>144.11</var>proposed HealthMatch system, shall not be <br/>
<a id="pl.144.12"></a><var>144.12</var>commenced without the express approval of <br/>
<a id="pl.144.13"></a><var>144.13</var>the legislature.<br/>
<a id="pl.144.14"></a><var>144.14</var><b>HealthMatch Systems Project.</b> In fiscal <br/>
<a id="pl.144.15"></a><var>144.15</var>year 2010, $3,054,000 shall be transferred <br/>
<a id="pl.144.16"></a><var>144.16</var>from the HealthMatch account in the state <br/>
<a id="pl.144.17"></a><var>144.17</var>systems account in the special revenue fund <br/>
<a id="pl.144.18"></a><var>144.18</var>to the general fund.<br/>
<a id="pl.144.19"></a><var>144.19</var><b>Nonfederal Share Transfers.</b> The <br/>
<a id="pl.144.20"></a><var>144.20</var>nonfederal share of activities for which <br/>
<a id="pl.144.21"></a><var>144.21</var>federal administrative reimbursement is <br/>
<a id="pl.144.22"></a><var>144.22</var>appropriated to the commissioner may be <br/>
<a id="pl.144.23"></a><var>144.23</var>transferred to the special revenue fund.<br/>
<a id="pl.144.24"></a><var>144.24</var><b>TANF Maintenance of Effort.</b><br/>
<a id="pl.144.25"></a><var>144.25</var>(a) In order to meet the basic maintenance <br/>
<a id="pl.144.26"></a><var>144.26</var>of effort (MOE) requirements of the TANF <br/>
<a id="pl.144.27"></a><var>144.27</var>block grant specified under Code of Federal <br/>
<a id="pl.144.28"></a><var>144.28</var>Regulations, title 45, section 263.1, the <br/>
<a id="pl.144.29"></a><var>144.29</var>commissioner may only report nonfederal <br/>
<a id="pl.144.30"></a><var>144.30</var>money expended for allowable activities <br/>
<a id="pl.144.31"></a><var>144.31</var>listed in the following clauses as TANF/MOE <br/>
<a id="pl.144.32"></a><var>144.32</var>expenditures:<br/>
<a id="pl.144.33"></a><var>144.33</var>(1) MFIP cash, diversionary work program, <br/>
<a id="pl.144.34"></a><var>144.34</var>and food assistance benefits under Minnesota <br/>
<a id="pl.144.35"></a><var>144.35</var>Statutes, chapter 256J;<br/>
<a id="pl.145.1"></a><var>145.1</var>(2) the child care assistance programs <br/>
<a id="pl.145.2"></a><var>145.2</var>under Minnesota Statutes, sections 
         <statute_ref>119B.03</statute_ref> <br/>
<a id="pl.145.3"></a><var>145.3</var>and 
         <statute_ref>119B.05</statute_ref>, and county child care <br/>
<a id="pl.145.4"></a><var>145.4</var>administrative costs under Minnesota <br/>
<a id="pl.145.5"></a><var>145.5</var>Statutes, section 
         <statute_ref>119B.15</statute_ref>;<br/>
<a id="pl.145.6"></a><var>145.6</var>(3) state and county MFIP administrative <br/>
<a id="pl.145.7"></a><var>145.7</var>costs under Minnesota Statutes, chapters <br/>
<a id="pl.145.8"></a><var>145.8</var>256J and 256K;<br/>
<a id="pl.145.9"></a><var>145.9</var>(4) state, county, and tribal MFIP <br/>
<a id="pl.145.10"></a><var>145.10</var>employment services under Minnesota <br/>
<a id="pl.145.11"></a><var>145.11</var>Statutes, chapters 256J and 256K;<br/>
<a id="pl.145.12"></a><var>145.12</var>(5) expenditures made on behalf of <br/>
<a id="pl.145.13"></a><var>145.13</var>noncitizen MFIP recipients who qualify <br/>
<a id="pl.145.14"></a><var>145.14</var>for the medical assistance without federal <br/>
<a id="pl.145.15"></a><var>145.15</var>financial participation program under <br/>
<a id="pl.145.16"></a><var>145.16</var>Minnesota Statutes, section 
         <statute_ref>256B.06, <br/>
<a id="pl.145.17"></a><var>145.17</var>subdivision 4
         </statute_ref>, paragraphs (d), (e), and (j); <br/>
<a id="pl.145.18"></a><var>145.18</var>and<br/>
<a id="pl.145.19"></a><var>145.19</var>(6) qualifying working family credit <br/>
<a id="pl.145.20"></a><var>145.20</var>expenditures under Minnesota Statutes, <br/>
<a id="pl.145.21"></a><var>145.21</var>section 
         <statute_ref>290.0671</statute_ref>.; and<br/>
<a id="pl.145.22"></a><var>145.22</var>(7) qualifying Minnesota education credit <br/>
<a id="pl.145.23"></a><var>145.23</var>expenditures under Minnesota Statutes, <br/>
<a id="pl.145.24"></a><var>145.24</var>section 290.0674.<br/>
<a id="pl.145.25"></a><var>145.25</var>(b) The commissioner shall ensure that <br/>
<a id="pl.145.26"></a><var>145.26</var>sufficient qualified nonfederal expenditures <br/>
<a id="pl.145.27"></a><var>145.27</var>are made each year to meet the state's <br/>
<a id="pl.145.28"></a><var>145.28</var>TANF/MOE requirements. For the activities <br/>
<a id="pl.145.29"></a><var>145.29</var>listed in paragraph (a), clauses (2) to <br/>
<a id="pl.145.30"></a><var>145.30</var>(6), the commissioner may only report <br/>
<a id="pl.145.31"></a><var>145.31</var>expenditures that are excluded from the <br/>
<a id="pl.145.32"></a><var>145.32</var>definition of assistance under Code of <br/>
<a id="pl.145.33"></a><var>145.33</var>Federal Regulations, title 45, section 
         <statute_ref>260.31</statute_ref>.<br/>
<a id="pl.146.1"></a><var>146.1</var>(c) For fiscal years beginning with state <br/>
<a id="pl.146.2"></a><var>146.2</var>fiscal year 2003, the commissioner shall <br/>
<a id="pl.146.3"></a><var>146.3</var>ensure that the maintenance of effort used <br/>
<a id="pl.146.4"></a><var>146.4</var>by the commissioner of finance for the <br/>
<a id="pl.146.5"></a><var>146.5</var>February and November forecasts required <br/>
<a id="pl.146.6"></a><var>146.6</var>under Minnesota Statutes, section 
         <statute_ref>16A.103</statute_ref>, <br/>
<a id="pl.146.7"></a><var>146.7</var>contains expenditures under paragraph (a), <br/>
<a id="pl.146.8"></a><var>146.8</var>clause (1), equal to at least 16 percent of <br/>
<a id="pl.146.9"></a><var>146.9</var>the total required under Code of Federal <br/>
<a id="pl.146.10"></a><var>146.10</var>Regulations, title 45, section 263.1.<br/>
<a id="pl.146.11"></a><var>146.11</var>(d) For the federal fiscal years beginning on <br/>
<a id="pl.146.12"></a><var>146.12</var>or after October 1, 2007, the commissioner <br/>
<a id="pl.146.13"></a><var>146.13</var>may not claim an amount of TANF/MOE in <br/>
<a id="pl.146.14"></a><var>146.14</var>excess of the 75 percent standard in Code <br/>
<a id="pl.146.15"></a><var>146.15</var>of Federal Regulations, title 45, section <br/>
<a id="pl.146.16"></a><var>146.16</var>263.1(a)(2), except:<br/>
<a id="pl.146.17"></a><var>146.17</var>(1) to the extent necessary to meet the 80 <br/>
<a id="pl.146.18"></a><var>146.18</var>percent standard under Code of Federal <br/>
<a id="pl.146.19"></a><var>146.19</var>Regulations, title 45, section 263.1(a)(1), <br/>
<a id="pl.146.20"></a><var>146.20</var>if it is determined by the commissioner <br/>
<a id="pl.146.21"></a><var>146.21</var>that the state will not meet the TANF work <br/>
<a id="pl.146.22"></a><var>146.22</var>participation target rate for the current year;<br/>
<a id="pl.146.23"></a><var>146.23</var>(2) to provide any additional amounts <br/>
<a id="pl.146.24"></a><var>146.24</var>under Code of Federal Regulations, title 45, <br/>
<a id="pl.146.25"></a><var>146.25</var>section 264.5, that relate to replacement of <br/>
<a id="pl.146.26"></a><var>146.26</var>TANF funds due to the operation of TANF <br/>
<a id="pl.146.27"></a><var>146.27</var>penalties; and<br/>
<a id="pl.146.28"></a><var>146.28</var>(3) to provide any additional amounts that <br/>
<a id="pl.146.29"></a><var>146.29</var>may contribute to avoiding or reducing <br/>
<a id="pl.146.30"></a><var>146.30</var>TANF work participation penalties through <br/>
<a id="pl.146.31"></a><var>146.31</var>the operation of the excess MOE provisions <br/>
<a id="pl.146.32"></a><var>146.32</var>of Code of Federal Regulations, title 45, <br/>
<a id="pl.146.33"></a><var>146.33</var>section 
         <statute_ref>261.43 </statute_ref>(a)(2).<br/>
<a id="pl.146.34"></a><var>146.34</var>For the purposes of clauses (1) to (3), <br/>
<a id="pl.146.35"></a><var>146.35</var>the commissioner may supplement the <br/>
<a id="pl.147.1"></a><var>147.1</var>MOE claim with working family credit <br/>
<a id="pl.147.2"></a><var>147.2</var>expenditures to the extent such expenditures <br/>
<a id="pl.147.3"></a><var>147.3</var>or other qualified expenditures are otherwise <br/>
<a id="pl.147.4"></a><var>147.4</var>available after considering the expenditures <br/>
<a id="pl.147.5"></a><var>147.5</var>allowed in this section.<br/>
<a id="pl.147.6"></a><var>147.6</var>(e) Minnesota Statutes, section 
         <statute_ref>256.011, <br/>
<a id="pl.147.7"></a><var>147.7</var>subdivision 3
         </statute_ref>, which requires that federal <br/>
<a id="pl.147.8"></a><var>147.8</var>grants or aids secured or obtained under that <br/>
<a id="pl.147.9"></a><var>147.9</var>subdivision be used to reduce any direct <br/>
<a id="pl.147.10"></a><var>147.10</var>appropriations provided by law, do not apply <br/>
<a id="pl.147.11"></a><var>147.11</var>if the grants or aids are federal TANF funds.<br/>
<a id="pl.147.12"></a><var>147.12</var>(f) Notwithstanding any contrary provision <br/>
<a id="pl.147.13"></a><var>147.13</var>in this article, this provision expires June 30, <br/>
<a id="pl.147.14"></a><var>147.14</var>2013.<br/>
<a id="pl.147.15"></a><var>147.15</var><b>Working Family Credit Expenditures as </b><br/>
<a id="pl.147.16"></a><var>147.16</var><b>TANF/MOE.</b> The commissioner may claim <br/>
<a id="pl.147.17"></a><var>147.17</var>as TANF/MOE up to $6,707,000 per year of <br/>
<a id="pl.147.18"></a><var>147.18</var>working family credit expenditures for fiscal <br/>
<a id="pl.147.19"></a><var>147.19</var>year 2010 through fiscal year 2011.<br/>
<a id="pl.147.20"></a><var>147.20</var><b>Working Family Credit Expenditures </b><br/>
<a id="pl.147.21"></a><var>147.21</var><b>to be Claimed for TANF/MOE.</b> The <br/>
<a id="pl.147.22"></a><var>147.22</var>commissioner may count the following <br/>
<a id="pl.147.23"></a><var>147.23</var>amounts of working family credit expenditure <br/>
<a id="pl.147.24"></a><var>147.24</var>as TANF/MOE:<br/>
<a id="pl.147.25"></a><var>147.25</var>(1) fiscal year 2010, $50,973,000 <br/>
<a id="pl.147.26"></a><var>147.26</var>$50,897,000;<br/>
<a id="pl.147.27"></a><var>147.27</var>(2) fiscal year 2011, $53,793,000 <br/>
<a id="pl.147.28"></a><var>147.28</var>$54,243,000;<br/>
<a id="pl.147.29"></a><var>147.29</var>(3) fiscal year 2012, $23,516,000 <br/>
<a id="pl.147.30"></a><var>147.30</var>$23,345,000; and<br/>
<a id="pl.147.31"></a><var>147.31</var>(4) fiscal year 2013, $16,808,000 <br/>
<a id="pl.147.32"></a><var>147.32</var>$16,585,000.<br/>
<a id="pl.147.33"></a><var>147.33</var>Notwithstanding any contrary provision in <br/>
<a id="pl.147.34"></a><var>147.34</var>this article, this rider expires June 30, 2013.<br/>
<a id="pl.148.1"></a><var>148.1</var><b>Food Stamps Employment and Training.</b> <br/>
<a id="pl.148.2"></a><var>148.2</var>(a) The commissioner shall apply for and <br/>
<a id="pl.148.3"></a><var>148.3</var>claim the maximum allowable federal <br/>
<a id="pl.148.4"></a><var>148.4</var>matching funds under United States Code, <br/>
<a id="pl.148.5"></a><var>148.5</var>title 7, section 2025, paragraph (h), for <br/>
<a id="pl.148.6"></a><var>148.6</var>state expenditures made on behalf of family <br/>
<a id="pl.148.7"></a><var>148.7</var>stabilization services participants voluntarily <br/>
<a id="pl.148.8"></a><var>148.8</var>engaged in food stamp employment and <br/>
<a id="pl.148.9"></a><var>148.9</var>training activities, where appropriate.<br/>
<a id="pl.148.10"></a><var>148.10</var>(b) Notwithstanding Minnesota Statutes, <br/>
<a id="pl.148.11"></a><var>148.11</var>sections 
         <statute_ref>256D.051, subdivisions 1a</statute_ref>, 6b, <br/>
<a id="pl.148.12"></a><var>148.12</var>and 6c, and 
         <statute_ref>256J.626</statute_ref>, federal food stamps <br/>
<a id="pl.148.13"></a><var>148.13</var>employment and training funds received <br/>
<a id="pl.148.14"></a><var>148.14</var>as reimbursement of MFIP consolidated <br/>
<a id="pl.148.15"></a><var>148.15</var>fund grant expenditures for diversionary <br/>
<a id="pl.148.16"></a><var>148.16</var>work program participants and child <br/>
<a id="pl.148.17"></a><var>148.17</var>care assistance program expenditures for <br/>
<a id="pl.148.18"></a><var>148.18</var>two-parent families must be deposited in the <br/>
<a id="pl.148.19"></a><var>148.19</var>general fund. The amount of funds must be <br/>
<a id="pl.148.20"></a><var>148.20</var>limited to $3,350,000 in fiscal year 2010 <br/>
<a id="pl.148.21"></a><var>148.21</var>and $4,440,000 in fiscal years 2011 through <br/>
<a id="pl.148.22"></a><var>148.22</var>2013, contingent on approval by the federal <br/>
<a id="pl.148.23"></a><var>148.23</var>Food and Nutrition Service. <br/>
<a id="pl.148.24"></a><var>148.24</var>(c) Consistent with the receipt of these federal <br/>
<a id="pl.148.25"></a><var>148.25</var>funds, the commissioner may adjust the <br/>
<a id="pl.148.26"></a><var>148.26</var>level of working family credit expenditures <br/>
<a id="pl.148.27"></a><var>148.27</var>claimed as TANF maintenance of effort. <br/>
<a id="pl.148.28"></a><var>148.28</var>Notwithstanding any contrary provision in <br/>
<a id="pl.148.29"></a><var>148.29</var>this article, this rider expires June 30, 2013.<br/>
<a id="pl.148.30"></a><var>148.30</var><b>ARRA Food Support Administration.</b> <br/>
<a id="pl.148.31"></a><var>148.31</var>The funds available for food support <br/>
<a id="pl.148.32"></a><var>148.32</var>administration under the American Recovery <br/>
<a id="pl.148.33"></a><var>148.33</var>and Reinvestment Act (ARRA) of 2009 <br/>
<a id="pl.148.34"></a><var>148.34</var>are appropriated to the commissioner <br/>
<a id="pl.148.35"></a><var>148.35</var>to pay actual costs of implementing the <br/>
<a id="pl.149.1"></a><var>149.1</var>food support benefit increases, increased <br/>
<a id="pl.149.2"></a><var>149.2</var>eligibility determinations, and outreach. Of <br/>
<a id="pl.149.3"></a><var>149.3</var>these funds, 20 percent shall be allocated <br/>
<a id="pl.149.4"></a><var>149.4</var>to the commissioner and 80 percent shall <br/>
<a id="pl.149.5"></a><var>149.5</var>be allocated to counties. The commissioner <br/>
<a id="pl.149.6"></a><var>149.6</var>shall allocate the county portion based on <br/>
<a id="pl.149.7"></a><var>149.7</var>caseload. Reimbursement shall be based on <br/>
<a id="pl.149.8"></a><var>149.8</var>actual costs reported by counties through <br/>
<a id="pl.149.9"></a><var>149.9</var>existing processes. Tribal reimbursement <br/>
<a id="pl.149.10"></a><var>149.10</var>must be made from the state portion based <br/>
<a id="pl.149.11"></a><var>149.11</var>on a caseload factor equivalent to that of a <br/>
<a id="pl.149.12"></a><var>149.12</var>county.<br/>
<a id="pl.149.13"></a><var>149.13</var><b>ARRA Food Support Benefit Increases.</b> <br/>
<a id="pl.149.14"></a><var>149.14</var>The funds provided for food support benefit <br/>
<a id="pl.149.15"></a><var>149.15</var>increases under the Supplemental Nutrition <br/>
<a id="pl.149.16"></a><var>149.16</var>Assistance Program provisions of the <br/>
<a id="pl.149.17"></a><var>149.17</var>American Recovery and Reinvestment Act <br/>
<a id="pl.149.18"></a><var>149.18</var>(ARRA) of 2009 must be used for benefit <br/>
<a id="pl.149.19"></a><var>149.19</var>increases beginning July 1, 2009.<br/>
<a id="pl.149.20"></a><var>149.20</var><b>Emergency Fund for the TANF Program.</b> <br/>
<a id="pl.149.21"></a><var>149.21</var>TANF Emergency Contingency funds <br/>
<a id="pl.149.22"></a><var>149.22</var>available under the American Recovery <br/>
<a id="pl.149.23"></a><var>149.23</var>and Reinvestment Act of 2009 (Public Law <br/>
<a id="pl.149.24"></a><var>149.24</var>111-5) are appropriated to the commissioner. <br/>
<a id="pl.149.25"></a><var>149.25</var>The commissioner must request TANF <br/>
<a id="pl.149.26"></a><var>149.26</var>Emergency Contingency funds from the <br/>
<a id="pl.149.27"></a><var>149.27</var>Secretary of the Department of Health <br/>
<a id="pl.149.28"></a><var>149.28</var>and Human Services to the extent the <br/>
<a id="pl.149.29"></a><var>149.29</var>commissioner meets or expects to meet the <br/>
<a id="pl.149.30"></a><var>149.30</var>requirements of section 403(c) of the Social <br/>
<a id="pl.149.31"></a><var>149.31</var>Security Act. The commissioner must seek <br/>
<a id="pl.149.32"></a><var>149.32</var>to maximize such grants. The funds received <br/>
<a id="pl.149.33"></a><var>149.33</var>must be used as appropriated. Each county <br/>
<a id="pl.149.34"></a><var>149.34</var>must maintain the county's current level of <br/>
<a id="pl.149.35"></a><var>149.35</var>emergency assistance funding under the <br/>
<a id="pl.149.36"></a><var>149.36</var>MFIP consolidated fund and use the funds <br/>
<a id="pl.150.1"></a><var>150.1</var>under this paragraph to supplement existing <br/>
<a id="pl.150.2"></a><var>150.2</var>emergency assistance funding levels.<br/>
<br/>
<a id="bill.9.7.0"></a><a id="pl.150.3"></a><var>150.3</var>    Sec. 7. Laws 2009, chapter 79, article 13, section 3, subdivision 3, as amended by <br/>
<a id="pl.150.4"></a><var>150.4</var>Laws 2009, chapter 173, article 2, section 1, subdivision 3, is amended to read:<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.150.5"></a><var>150.5</var><br/>
<a id="pl.150.6"></a><var>150.6</var><br/>
</td>
<td align="left" colspan="3">Subd. 3.<b>Revenue and Pass-Through Revenue </b><br/>
<b>Expenditures</b><br/>
</td>
<td align="center"></td>
<td align="right">68,337,000<br/>
</td>
<td align="center"></td>
<td align="right">70,505,000<br/>
</td>
</tr>
</table><a id="pl.150.7"></a><var>150.7</var>This appropriation is from the federal TANF <br/>
<a id="pl.150.8"></a><var>150.8</var>fund.<br/>
<a id="pl.150.9"></a><var>150.9</var><b>TANF Transfer to Federal Child Care </b><br/>
<a id="pl.150.10"></a><var>150.10</var><b>and Development Fund.</b> The following <br/>
<a id="pl.150.11"></a><var>150.11</var>TANF fund amounts are appropriated to the <br/>
<a id="pl.150.12"></a><var>150.12</var>commissioner for the purposes of MFIP and <br/>
<a id="pl.150.13"></a><var>150.13</var>transition year child care under Minnesota <br/>
<a id="pl.150.14"></a><var>150.14</var>Statutes, section 
         <statute_ref>119B.05</statute_ref>: <br/>
<a id="pl.150.15"></a><var>150.15</var>(1) fiscal year 2010, $6,531,000 $862,000;<br/>
<a id="pl.150.16"></a><var>150.16</var>(2) fiscal year 2011, $10,241,000 $978,000;<br/>
<a id="pl.150.17"></a><var>150.17</var>(3) fiscal year 2012, $10,826,000 $0; and<br/>
<a id="pl.150.18"></a><var>150.18</var>(4) fiscal year 2013, $4,046,000 $0.<br/>
<a id="pl.150.19"></a><var>150.19</var>The commissioner shall authorize the <br/>
<a id="pl.150.20"></a><var>150.20</var>transfer of sufficient TANF funds to the <br/>
<a id="pl.150.21"></a><var>150.21</var>federal child care and development fund to <br/>
<a id="pl.150.22"></a><var>150.22</var>meet this appropriation and shall ensure that <br/>
<a id="pl.150.23"></a><var>150.23</var>all transferred funds are expended according <br/>
<a id="pl.150.24"></a><var>150.24</var>to federal child care and development fund <br/>
<a id="pl.150.25"></a><var>150.25</var>regulations.<br/>
<br/>
<a id="bill.9.8.0"></a><a id="pl.150.26"></a><var>150.26</var>    Sec. 8. Laws 2009, chapter 79, article 13, section 3, subdivision 4, as amended by <br/>
<a id="pl.150.27"></a><var>150.27</var>Laws 2009, chapter 173, article 2, section 1, subdivision 4, is amended to read:<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.150.28"></a><var>150.28</var><br/>
<a id="pl.150.29"></a><var>150.29</var><br/>
</td>
<td colspan="3">Subd. 4.<b>Children and Economic Assistance </b><br/>
<b>Grants</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table><a id="pl.150.30"></a><var>150.30</var>The amounts that may be spent from this <br/>
<a id="pl.150.31"></a><var>150.31</var>appropriation for each purpose are as follows:<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.150.32"></a><var>150.32</var><br/>
</td>
<td colspan="3"><b>(a) MFIP/DWP Grants</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.151.1"></a><var>151.1</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.151.2"></a><var>151.2</var><br/>
</td>
<td>General<br/>
</td>
<td align="right">63,205,000<br/>
</td>
<td align="right">89,033,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.151.3"></a><var>151.3</var><br/>
</td>
<td>Federal TANF<br/>
</td>
<td align="right">100,818,000<br/>
</td>
<td align="right">84,538,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.151.4"></a><var>151.4</var><br/>
</td>
<td colspan="3"><b>(b) Support Services Grants</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.151.5"></a><var>151.5</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.151.6"></a><var>151.6</var><br/>
</td>
<td>General<br/>
</td>
<td align="right">8,715,000<br/>
</td>
<td align="right">12,498,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.151.7"></a><var>151.7</var><br/>
</td>
<td>Federal TANF<br/>
</td>
<td align="right">116,557,000<br/>
</td>
<td align="right">107,457,000<br/>
</td>
</tr>
</table><a id="pl.151.8"></a><var>151.8</var><b>MFIP Consolidated Fund.</b> The MFIP <br/>
<a id="pl.151.9"></a><var>151.9</var>consolidated fund TANF appropriation is <br/>
<a id="pl.151.10"></a><var>151.10</var>reduced by $1,854,000 in fiscal year 2010 <br/>
<a id="pl.151.11"></a><var>151.11</var>and fiscal year 2011.<br/>
<a id="pl.151.12"></a><var>151.12</var>Notwithstanding Minnesota Statutes, section <br/>
<statute_ref><a id="pl.151.13"></a><var>151.13</var>256J.626, subdivision 8
         </statute_ref>, paragraph (b), the <br/>
<a id="pl.151.14"></a><var>151.14</var>commissioner shall reduce proportionately <br/>
<a id="pl.151.15"></a><var>151.15</var>the reimbursement to counties for <br/>
<a id="pl.151.16"></a><var>151.16</var>administrative expenses.<br/>
<a id="pl.151.17"></a><var>151.17</var><b>Subsidized Employment Funding Through </b><br/>
<a id="pl.151.18"></a><var>151.18</var><b>ARRA.</b> The commissioner is authorized to <br/>
<a id="pl.151.19"></a><var>151.19</var>apply for TANF emergency fund grants for <br/>
<a id="pl.151.20"></a><var>151.20</var>subsidized employment activities. Growth <br/>
<a id="pl.151.21"></a><var>151.21</var>in expenditures for subsidized employment <br/>
<a id="pl.151.22"></a><var>151.22</var>within the supported work program and the <br/>
<a id="pl.151.23"></a><var>151.23</var>MFIP consolidated fund over the amount <br/>
<a id="pl.151.24"></a><var>151.24</var>expended in the calendar quarters in the <br/>
<a id="pl.151.25"></a><var>151.25</var>TANF emergency fund base year shall be <br/>
<a id="pl.151.26"></a><var>151.26</var>used to leverage the TANF emergency fund <br/>
<a id="pl.151.27"></a><var>151.27</var>grants for subsidized employment and to <br/>
<a id="pl.151.28"></a><var>151.28</var>fund supported work. The commissioner <br/>
<a id="pl.151.29"></a><var>151.29</var>shall develop procedures to maximize <br/>
<a id="pl.151.30"></a><var>151.30</var>reimbursement of these expenditures over the <br/>
<a id="pl.151.31"></a><var>151.31</var>TANF emergency fund base year quarters, <br/>
<a id="pl.151.32"></a><var>151.32</var>and may contract directly with employers <br/>
<a id="pl.151.33"></a><var>151.33</var>and providers to maximize these TANF <br/>
<a id="pl.151.34"></a><var>151.34</var>emergency fund grants.<br/>
<a id="pl.152.1"></a><var>152.1</var><b>Supported Work.</b> Of the TANF <br/>
<a id="pl.152.2"></a><var>152.2</var>appropriation, $4,700,000 in fiscal year 2010 <br/>
<a id="pl.152.3"></a><var>152.3</var>and $4,700,000 in fiscal year 2011 are to the <br/>
<a id="pl.152.4"></a><var>152.4</var>commissioner for supported work for MFIP <br/>
<a id="pl.152.5"></a><var>152.5</var>recipients and is available until expended. <br/>
<a id="pl.152.6"></a><var>152.6</var>Supported work includes paid transitional <br/>
<a id="pl.152.7"></a><var>152.7</var>work experience and a continuum of <br/>
<a id="pl.152.8"></a><var>152.8</var>employment assistance, including outreach <br/>
<a id="pl.152.9"></a><var>152.9</var>and recruitment, program orientation <br/>
<a id="pl.152.10"></a><var>152.10</var>and intake, testing and assessment, job <br/>
<a id="pl.152.11"></a><var>152.11</var>development and marketing, preworksite <br/>
<a id="pl.152.12"></a><var>152.12</var>training, supported worksite experience, <br/>
<a id="pl.152.13"></a><var>152.13</var>job coaching, and postplacement follow-up, <br/>
<a id="pl.152.14"></a><var>152.14</var>in addition to extensive case management <br/>
<a id="pl.152.15"></a><var>152.15</var>and referral services. This is a onetime <br/>
<a id="pl.152.16"></a><var>152.16</var>appropriation.<br/>
<a id="pl.152.17"></a><var>152.17</var><b>Base Adjustment.</b> The general fund base <br/>
<a id="pl.152.18"></a><var>152.18</var>is reduced by $3,783,000 in each of fiscal <br/>
<a id="pl.152.19"></a><var>152.19</var>years 2012 and 2013. The TANF fund base <br/>
<a id="pl.152.20"></a><var>152.20</var>is increased by $5,004,000 in each of fiscal <br/>
<a id="pl.152.21"></a><var>152.21</var>years 2012 and 2013.<br/>
<a id="pl.152.22"></a><var>152.22</var><b>Integrated Services Program Funding.</b> <br/>
<a id="pl.152.23"></a><var>152.23</var>The TANF appropriation for integrated <br/>
<a id="pl.152.24"></a><var>152.24</var>services program funding is $1,250,000 in <br/>
<a id="pl.152.25"></a><var>152.25</var>fiscal year 2010 and $0 in fiscal year 2011 <br/>
<a id="pl.152.26"></a><var>152.26</var>and the base for fiscal years 2012 and 2013 <br/>
<a id="pl.152.27"></a><var>152.27</var>is $0.<br/>
<a id="pl.152.28"></a><var>152.28</var><b>TANF Emergency Fund; Nonrecurrent </b><br/>
<a id="pl.152.29"></a><var>152.29</var><b>Short-Term Benefits.</b> (1) TANF emergency <br/>
<a id="pl.152.30"></a><var>152.30</var>contingency fund grants received due to <br/>
<a id="pl.152.31"></a><var>152.31</var>increases in expenditures for nonrecurrent <br/>
<a id="pl.152.32"></a><var>152.32</var>short-term benefits must be used to offset the <br/>
<a id="pl.152.33"></a><var>152.33</var>increase in these expenditures for counties <br/>
<a id="pl.152.34"></a><var>152.34</var>under the MFIP consolidated fund, under <br/>
<a id="pl.152.35"></a><var>152.35</var>Minnesota Statutes, section 
         <statute_ref>256J.626</statute_ref>, <br/>
<a id="pl.153.1"></a><var>153.1</var>and the diversionary work program. The <br/>
<a id="pl.153.2"></a><var>153.2</var>commissioner shall develop procedures <br/>
<a id="pl.153.3"></a><var>153.3</var>to maximize reimbursement of these <br/>
<a id="pl.153.4"></a><var>153.4</var>expenditures over the TANF emergency fund <br/>
<a id="pl.153.5"></a><var>153.5</var>base year quarters. Growth in expenditures <br/>
<a id="pl.153.6"></a><var>153.6</var>for the diversionary work program over the <br/>
<a id="pl.153.7"></a><var>153.7</var>amount expended in the calendar quarters in <br/>
<a id="pl.153.8"></a><var>153.8</var>the TANF emergency fund base year shall be <br/>
<a id="pl.153.9"></a><var>153.9</var>used to leverage these funds.<br/>
<a id="pl.153.10"></a><var>153.10</var>(2) To the extent that the commissioner <br/>
<a id="pl.153.11"></a><var>153.11</var>can claim eligible tax credit growth as <br/>
<a id="pl.153.12"></a><var>153.12</var>nonrecurrent short-term benefits, the <br/>
<a id="pl.153.13"></a><var>153.13</var>commissioner shall use those funds to <br/>
<a id="pl.153.14"></a><var>153.14</var>leverage the increased expenditures in clause <br/>
<a id="pl.153.15"></a><var>153.15</var>(1).<br/>
<a id="pl.153.16"></a><var>153.16</var>(3) TANF emergency funds for nonrecurrent <br/>
<a id="pl.153.17"></a><var>153.17</var>short-term benefits received in excess of the <br/>
<a id="pl.153.18"></a><var>153.18</var>amounts necessary for clauses (1) and (2) <br/>
<a id="pl.153.19"></a><var>153.19</var>shall be used to reimburse the general fund <br/>
<a id="pl.153.20"></a><var>153.20</var>for the costs of eligible tax credits in fiscal <br/>
<a id="pl.153.21"></a><var>153.21</var>year 2011. The amount of such funds shall <br/>
<a id="pl.153.22"></a><var>153.22</var>not exceed $28,000,000.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.153.23"></a><var>153.23</var><br/>
</td>
<td colspan="3"><b>(c) MFIP Child Care Assistance Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">61,171,000<br/>
</td>
<td align="center"></td>
<td align="right">65,214,000<br/>
</td>
</tr>
</table><a id="pl.153.24"></a><var>153.24</var><b>Acceleration of ARRA Child Care and </b><br/>
<a id="pl.153.25"></a><var>153.25</var><b>Development Fund Expenditure.</b> The <br/>
<a id="pl.153.26"></a><var>153.26</var>commissioner must liquidate all child care <br/>
<a id="pl.153.27"></a><var>153.27</var>and development money available under <br/>
<a id="pl.153.28"></a><var>153.28</var>the American Recovery and Reinvestment <br/>
<a id="pl.153.29"></a><var>153.29</var>Act (ARRA) of 2009, Public Law 111-5, <br/>
<a id="pl.153.30"></a><var>153.30</var>by September 30, 2010. In order to expend <br/>
<a id="pl.153.31"></a><var>153.31</var>those funds by September 30, 2010, the <br/>
<a id="pl.153.32"></a><var>153.32</var>commissioner may redesignate and expend <br/>
<a id="pl.153.33"></a><var>153.33</var>the ARRA child care and development funds <br/>
<a id="pl.153.34"></a><var>153.34</var>appropriated in fiscal year 2011 for purposes <br/>
<a id="pl.153.35"></a><var>153.35</var>under this section for related purposes that <br/>
<a id="pl.154.1"></a><var>154.1</var>will allow liquidation by September 30, <br/>
<a id="pl.154.2"></a><var>154.2</var>2010. Child care and development funds <br/>
<a id="pl.154.3"></a><var>154.3</var>otherwise available to the commissioner <br/>
<a id="pl.154.4"></a><var>154.4</var>for those related purposes shall be used to <br/>
<a id="pl.154.5"></a><var>154.5</var>fund the purposes from which the ARRA <br/>
<a id="pl.154.6"></a><var>154.6</var>child care and development funds had been <br/>
<a id="pl.154.7"></a><var>154.7</var>redesignated.<br/>
<a id="pl.154.8"></a><var>154.8</var><b>School Readiness Service Agreements.</b> <br/>
<a id="pl.154.9"></a><var>154.9</var>$400,000 in fiscal year 2010 and $400,000 <br/>
<a id="pl.154.10"></a><var>154.10</var>in fiscal year 2011 are from the federal <br/>
<a id="pl.154.11"></a><var>154.11</var>TANF fund to the commissioner of human <br/>
<a id="pl.154.12"></a><var>154.12</var>services consistent with federal regulations <br/>
<a id="pl.154.13"></a><var>154.13</var>for the purpose of school readiness service <br/>
<a id="pl.154.14"></a><var>154.14</var>agreements under Minnesota Statutes, <br/>
<a id="pl.154.15"></a><var>154.15</var>section 
         <statute_ref>119B.231</statute_ref>. This is a onetime <br/>
<a id="pl.154.16"></a><var>154.16</var>appropriation. Any unexpended balance the <br/>
<a id="pl.154.17"></a><var>154.17</var>first year is available in the second year.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.154.18"></a><var>154.18</var><br/>
<a id="pl.154.19"></a><var>154.19</var><br/>
</td>
<td colspan="3"><b>(d) Basic Sliding Fee Child Care Assistance </b><br/>
<b>Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">40,100,000<br/>
</td>
<td align="center"></td>
<td align="right">45,092,000<br/>
</td>
</tr>
</table><a id="pl.154.20"></a><var>154.20</var><b>School Readiness Service Agreements.</b> <br/>
<a id="pl.154.21"></a><var>154.21</var>$257,000 in fiscal year 2010 and $257,000 <br/>
<a id="pl.154.22"></a><var>154.22</var>in fiscal year 2011 are from the general <br/>
<a id="pl.154.23"></a><var>154.23</var>fund for the purpose of school readiness <br/>
<a id="pl.154.24"></a><var>154.24</var>service agreements under Minnesota <br/>
<a id="pl.154.25"></a><var>154.25</var>Statutes, section 
         <statute_ref>119B.231</statute_ref>. This is a onetime <br/>
<a id="pl.154.26"></a><var>154.26</var>appropriation. Any unexpended balance the <br/>
<a id="pl.154.27"></a><var>154.27</var>first year is available in the second year.<br/>
<a id="pl.154.28"></a><var>154.28</var><b>Child Care Development Fund </b><br/>
<a id="pl.154.29"></a><var>154.29</var><b>Unexpended Balance.</b> In addition to <br/>
<a id="pl.154.30"></a><var>154.30</var>the amount provided in this section, the <br/>
<a id="pl.154.31"></a><var>154.31</var>commissioner shall expend $5,244,000 in <br/>
<a id="pl.154.32"></a><var>154.32</var>fiscal year 2010 from the federal child care <br/>
<a id="pl.154.33"></a><var>154.33</var>development fund unexpended balance <br/>
<a id="pl.154.34"></a><var>154.34</var>for basic sliding fee child care under <br/>
<a id="pl.154.35"></a><var>154.35</var>Minnesota Statutes, section 
         <statute_ref>119B.03</statute_ref>. The <br/>
<a id="pl.154.36"></a><var>154.36</var>commissioner shall ensure that all child <br/>
<a id="pl.155.1"></a><var>155.1</var>care and development funds are expended <br/>
<a id="pl.155.2"></a><var>155.2</var>according to the federal child care and <br/>
<a id="pl.155.3"></a><var>155.3</var>development fund regulations.<br/>
<a id="pl.155.4"></a><var>155.4</var><b>Basic Sliding Fee.</b> $4,000,000 in fiscal year <br/>
<a id="pl.155.5"></a><var>155.5</var>2010 and $4,000,000 in fiscal year 2011 are <br/>
<a id="pl.155.6"></a><var>155.6</var>from the federal child care development <br/>
<a id="pl.155.7"></a><var>155.7</var>funds received from the American Recovery <br/>
<a id="pl.155.8"></a><var>155.8</var>and Reinvestment Act of 2009, Public <br/>
<a id="pl.155.9"></a><var>155.9</var>Law 111-5, to the commissioner of human <br/>
<a id="pl.155.10"></a><var>155.10</var>services consistent with federal regulations <br/>
<a id="pl.155.11"></a><var>155.11</var>for the purpose of basic sliding fee child care <br/>
<a id="pl.155.12"></a><var>155.12</var>assistance under Minnesota Statutes, section <br/>
<statute_ref><a id="pl.155.13"></a><var>155.13</var>119B.03
         </statute_ref>. This is a onetime appropriation. <br/>
<a id="pl.155.14"></a><var>155.14</var>Any unexpended balance the first year is <br/>
<a id="pl.155.15"></a><var>155.15</var>available in the second year.<br/>
<a id="pl.155.16"></a><var>155.16</var><b>Basic Sliding Fee Allocation for Calendar </b><br/>
<a id="pl.155.17"></a><var>155.17</var><b>Year 2010.</b> Notwithstanding Minnesota <br/>
<a id="pl.155.18"></a><var>155.18</var>Statutes, section 
         <statute_ref>119B.03, subdivision 6</statute_ref>, <br/>
<a id="pl.155.19"></a><var>155.19</var>in calendar year 2010, basic sliding fee <br/>
<a id="pl.155.20"></a><var>155.20</var>funds shall be distributed according to <br/>
<a id="pl.155.21"></a><var>155.21</var>this provision. Funds shall be allocated <br/>
<a id="pl.155.22"></a><var>155.22</var>first in amounts equal to each county's <br/>
<a id="pl.155.23"></a><var>155.23</var>guaranteed floor, according to Minnesota <br/>
<a id="pl.155.24"></a><var>155.24</var>Statutes, section 
         <statute_ref>119B.03, subdivision 8</statute_ref>, <br/>
<a id="pl.155.25"></a><var>155.25</var>with any remaining available funds allocated <br/>
<a id="pl.155.26"></a><var>155.26</var>according to the following formula:<br/>
<a id="pl.155.27"></a><var>155.27</var>(a) Up to one-fourth of the funds shall be <br/>
<a id="pl.155.28"></a><var>155.28</var>allocated in proportion to the number of <br/>
<a id="pl.155.29"></a><var>155.29</var>families participating in the transition year <br/>
<a id="pl.155.30"></a><var>155.30</var>child care program as reported during and <br/>
<a id="pl.155.31"></a><var>155.31</var>averaged over the most recent six months <br/>
<a id="pl.155.32"></a><var>155.32</var>completed at the time of the notice of <br/>
<a id="pl.155.33"></a><var>155.33</var>allocation. Funds in excess of the amount <br/>
<a id="pl.155.34"></a><var>155.34</var>necessary to serve all families in this category <br/>
<a id="pl.155.35"></a><var>155.35</var>shall be allocated according to paragraph (d).<br/>
<a id="pl.156.1"></a><var>156.1</var>(b) Up to three-fourths of the funds shall <br/>
<a id="pl.156.2"></a><var>156.2</var>be allocated in proportion to the average <br/>
<a id="pl.156.3"></a><var>156.3</var>of each county's most recent six months of <br/>
<a id="pl.156.4"></a><var>156.4</var>reported waiting list as defined in Minnesota <br/>
<a id="pl.156.5"></a><var>156.5</var>Statutes, section 
         <statute_ref>119B.03, subdivision 2</statute_ref>, and <br/>
<a id="pl.156.6"></a><var>156.6</var>the reinstatement list of those families whose <br/>
<a id="pl.156.7"></a><var>156.7</var>assistance was terminated with the approval <br/>
<a id="pl.156.8"></a><var>156.8</var>of the commissioner under Minnesota Rules, <br/>
<a id="pl.156.9"></a><var>156.9</var>part 3400.0183, subpart 1. Funds in excess <br/>
<a id="pl.156.10"></a><var>156.10</var>of the amount necessary to serve all families <br/>
<a id="pl.156.11"></a><var>156.11</var>in this category shall be allocated according <br/>
<a id="pl.156.12"></a><var>156.12</var>to paragraph (d).<br/>
<a id="pl.156.13"></a><var>156.13</var>(c) The amount necessary to serve all families <br/>
<a id="pl.156.14"></a><var>156.14</var>in paragraphs (a) and (b) shall be calculated <br/>
<a id="pl.156.15"></a><var>156.15</var>based on the basic sliding fee average cost of <br/>
<a id="pl.156.16"></a><var>156.16</var>care per family in the county with the highest <br/>
<a id="pl.156.17"></a><var>156.17</var>cost in the most recently completed calendar <br/>
<a id="pl.156.18"></a><var>156.18</var>year.<br/>
<a id="pl.156.19"></a><var>156.19</var>(d) Funds in excess of the amount necessary <br/>
<a id="pl.156.20"></a><var>156.20</var>to serve all families in paragraphs (a) and <br/>
<a id="pl.156.21"></a><var>156.21</var>(b) shall be allocated in proportion to each <br/>
<a id="pl.156.22"></a><var>156.22</var>county's total expenditures for the basic <br/>
<a id="pl.156.23"></a><var>156.23</var>sliding fee child care program reported <br/>
<a id="pl.156.24"></a><var>156.24</var>during the most recent fiscal year completed <br/>
<a id="pl.156.25"></a><var>156.25</var>at the time of the notice of allocation. To <br/>
<a id="pl.156.26"></a><var>156.26</var>the extent that funds are available, and <br/>
<a id="pl.156.27"></a><var>156.27</var>notwithstanding Minnesota Statutes, section <br/>
<statute_ref><a id="pl.156.28"></a><var>156.28</var>119B.03, subdivision 8
         </statute_ref>, for the period <br/>
<a id="pl.156.29"></a><var>156.29</var>January 1, 2011, to December 31, 2011, each <br/>
<a id="pl.156.30"></a><var>156.30</var>county's guaranteed floor must be equal to its <br/>
<a id="pl.156.31"></a><var>156.31</var>original calendar year 2010 allocation.<br/>
<a id="pl.156.32"></a><var>156.32</var><b>Base Adjustment.</b> The general fund base is <br/>
<a id="pl.156.33"></a><var>156.33</var>decreased by $257,000 in each of fiscal years <br/>
<a id="pl.156.34"></a><var>156.34</var>2012 and 2013.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.156.35"></a><var>156.35</var><br/>
</td>
<td colspan="3"><b>(e) Child Care Development Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">1,487,000<br/>
</td>
<td align="center"></td>
<td align="right">1,487,000<br/>
</td>
</tr>
</table><a id="pl.157.1"></a><var>157.1</var><b>Family, friends, and neighbor grants.</b> <br/>
<a id="pl.157.2"></a><var>157.2</var>$375,000 in fiscal year 2010 and $375,000 <br/>
<a id="pl.157.3"></a><var>157.3</var>in fiscal year 2011 are from the child <br/>
<a id="pl.157.4"></a><var>157.4</var>care development fund required targeted <br/>
<a id="pl.157.5"></a><var>157.5</var>quality funds for quality expansion and <br/>
<a id="pl.157.6"></a><var>157.6</var>infant/toddler from the American Recovery <br/>
<a id="pl.157.7"></a><var>157.7</var>and Reinvestment Act of 2009, Public <br/>
<a id="pl.157.8"></a><var>157.8</var>Law 111-5, to the commissioner of human <br/>
<a id="pl.157.9"></a><var>157.9</var>services for family, friends, and neighbor <br/>
<a id="pl.157.10"></a><var>157.10</var>grants under Minnesota Statutes, section <br/>
<statute_ref><a id="pl.157.11"></a><var>157.11</var>119B.232
         </statute_ref>. This appropriation may be used <br/>
<a id="pl.157.12"></a><var>157.12</var>on programs receiving family, friends, and <br/>
<a id="pl.157.13"></a><var>157.13</var>neighbor grant funds as of June 30, 2009, <br/>
<a id="pl.157.14"></a><var>157.14</var>or on new programs or projects. This is a <br/>
<a id="pl.157.15"></a><var>157.15</var>onetime appropriation. Any unexpended <br/>
<a id="pl.157.16"></a><var>157.16</var>balance the first year is available in the <br/>
<a id="pl.157.17"></a><var>157.17</var>second year.<br/>
<a id="pl.157.18"></a><var>157.18</var><b>Voluntary quality rating system training, </b><br/>
<a id="pl.157.19"></a><var>157.19</var><b>coaching, consultation, and supports.</b> <br/>
<a id="pl.157.20"></a><var>157.20</var>$633,000 in fiscal year 2010 and $633,000 <br/>
<a id="pl.157.21"></a><var>157.21</var>in fiscal year 2011 are from the federal child <br/>
<a id="pl.157.22"></a><var>157.22</var>care development fund required targeted <br/>
<a id="pl.157.23"></a><var>157.23</var>quality funds for quality expansion and <br/>
<a id="pl.157.24"></a><var>157.24</var>infant/toddler from the American Recovery <br/>
<a id="pl.157.25"></a><var>157.25</var>and Reinvestment Act of 2009, Public <br/>
<a id="pl.157.26"></a><var>157.26</var>Law 111-5, to the commissioner of human <br/>
<a id="pl.157.27"></a><var>157.27</var>services consistent with federal regulations <br/>
<a id="pl.157.28"></a><var>157.28</var>for the purpose of providing grants to provide <br/>
<a id="pl.157.29"></a><var>157.29</var>statewide child-care provider training, <br/>
<a id="pl.157.30"></a><var>157.30</var>coaching, consultation, and supports to <br/>
<a id="pl.157.31"></a><var>157.31</var>prepare for the voluntary Minnesota quality <br/>
<a id="pl.157.32"></a><var>157.32</var>rating system rating tool. This is a onetime <br/>
<a id="pl.157.33"></a><var>157.33</var>appropriation. Any unexpended balance the <br/>
<a id="pl.157.34"></a><var>157.34</var>first year is available in the second year.<br/>
<a id="pl.157.35"></a><var>157.35</var><b>Voluntary quality rating system.</b> $184,000 <br/>
<a id="pl.157.36"></a><var>157.36</var>in fiscal year 2010 and $1,200,000 in fiscal <br/>
<a id="pl.158.1"></a><var>158.1</var>year 2011 are from the federal child care <br/>
<a id="pl.158.2"></a><var>158.2</var>development fund required targeted funds for <br/>
<a id="pl.158.3"></a><var>158.3</var>quality expansion and infant/toddler from the <br/>
<a id="pl.158.4"></a><var>158.4</var>American Recovery and Reinvestment Act of <br/>
<a id="pl.158.5"></a><var>158.5</var>2009, Public Law 111-5, to the commissioner <br/>
<a id="pl.158.6"></a><var>158.6</var>of human services consistent with federal <br/>
<a id="pl.158.7"></a><var>158.7</var>regulations for the purpose of implementing <br/>
<a id="pl.158.8"></a><var>158.8</var>the voluntary Parent Aware quality star <br/>
<a id="pl.158.9"></a><var>158.9</var>rating system pilot in coordination with the <br/>
<a id="pl.158.10"></a><var>158.10</var>Minnesota Early Learning Foundation. The <br/>
<a id="pl.158.11"></a><var>158.11</var>appropriation for the first year is to complete <br/>
<a id="pl.158.12"></a><var>158.12</var>and promote the voluntary Parent Aware <br/>
<a id="pl.158.13"></a><var>158.13</var>quality rating system pilot program through <br/>
<a id="pl.158.14"></a><var>158.14</var>June 30, 2010, and the appropriation for <br/>
<a id="pl.158.15"></a><var>158.15</var>the second year is to continue the voluntary <br/>
<a id="pl.158.16"></a><var>158.16</var>Minnesota quality rating system pilot <br/>
<a id="pl.158.17"></a><var>158.17</var>through June 30, 2011. This is a onetime <br/>
<a id="pl.158.18"></a><var>158.18</var>appropriation. Any unexpended balance the <br/>
<a id="pl.158.19"></a><var>158.19</var>first year is available in the second year.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.158.20"></a><var>158.20</var><br/>
</td>
<td colspan="3"><b>(f) Child Support Enforcement Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">3,705,000<br/>
</td>
<td align="center"></td>
<td align="right">3,705,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12.1"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.158.21"></a><var>158.21</var><br/>
</td>
<td colspan="3"><b>(g) Children's Services Grants</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.158.22"></a><var>158.22</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.158.23"></a><var>158.23</var><br/>
</td>
<td>General<br/>
</td>
<td align="right">48,333,000<br/>
</td>
<td align="right">50,498,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.158.24"></a><var>158.24</var><br/>
</td>
<td>Federal TANF<br/>
</td>
<td align="right">340,000<br/>
</td>
<td align="right">240,000<br/>
</td>
</tr>
</table><a id="pl.158.25"></a><var>158.25</var><b>Base Adjustment.</b> The general fund base is <br/>
<a id="pl.158.26"></a><var>158.26</var>decreased by $5,371,000 in fiscal year 2012 <br/>
<a id="pl.158.27"></a><var>158.27</var>and decreased $5,371,000 in fiscal year 2013.<br/>
<a id="pl.158.28"></a><var>158.28</var><b>Privatized Adoption Grants.</b> Federal <br/>
<a id="pl.158.29"></a><var>158.29</var>reimbursement for privatized adoption grant <br/>
<a id="pl.158.30"></a><var>158.30</var>and foster care recruitment grant expenditures <br/>
<a id="pl.158.31"></a><var>158.31</var>is appropriated to the commissioner for <br/>
<a id="pl.158.32"></a><var>158.32</var>adoption grants and foster care and adoption <br/>
<a id="pl.158.33"></a><var>158.33</var>administrative purposes.<br/>
<a id="pl.158.34"></a><var>158.34</var><b>Adoption Assistance Incentive Grants.</b> <br/>
<a id="pl.158.35"></a><var>158.35</var>Federal funds available during fiscal year <br/>
<a id="pl.159.1"></a><var>159.1</var>2010 and fiscal year 2011 for the adoption <br/>
<a id="pl.159.2"></a><var>159.2</var>incentive grants are appropriated to the <br/>
<a id="pl.159.3"></a><var>159.3</var>commissioner for postadoption services <br/>
<a id="pl.159.4"></a><var>159.4</var>including parent support groups.<br/>
<a id="pl.159.5"></a><var>159.5</var><b>Adoption Assistance and Relative Custody </b><br/>
<a id="pl.159.6"></a><var>159.6</var><b>Assistance.</b> The commissioner may transfer <br/>
<a id="pl.159.7"></a><var>159.7</var>unencumbered appropriation balances for <br/>
<a id="pl.159.8"></a><var>159.8</var>adoption assistance and relative custody <br/>
<a id="pl.159.9"></a><var>159.9</var>assistance between fiscal years and between <br/>
<a id="pl.159.10"></a><var>159.10</var>programs.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.159.11"></a><var>159.11</var><br/>
</td>
<td colspan="3"><b>(h) Children and Community Services Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">67,663,000<br/>
</td>
<td align="center"></td>
<td align="right">67,542,000<br/>
</td>
</tr>
</table><a id="pl.159.12"></a><var>159.12</var><b>Targeted Case Management Temporary </b><br/>
<a id="pl.159.13"></a><var>159.13</var><b>Funding Adjustment.</b> The commissioner <br/>
<a id="pl.159.14"></a><var>159.14</var>shall recover from each county and tribe <br/>
<a id="pl.159.15"></a><var>159.15</var>receiving a targeted case management <br/>
<a id="pl.159.16"></a><var>159.16</var>temporary funding payment in fiscal year <br/>
<a id="pl.159.17"></a><var>159.17</var>2008 an amount equal to that payment. The <br/>
<a id="pl.159.18"></a><var>159.18</var>commissioner shall recover one-half of the <br/>
<a id="pl.159.19"></a><var>159.19</var>funds by February 1, 2010, and the remainder <br/>
<a id="pl.159.20"></a><var>159.20</var>by February 1, 2011. At the commissioner's <br/>
<a id="pl.159.21"></a><var>159.21</var>discretion and at the request of a county <br/>
<a id="pl.159.22"></a><var>159.22</var>or tribe, the commissioner may revise <br/>
<a id="pl.159.23"></a><var>159.23</var>the payment schedule, but full payment <br/>
<a id="pl.159.24"></a><var>159.24</var>must not be delayed beyond May 1, 2011. <br/>
<a id="pl.159.25"></a><var>159.25</var>The commissioner may use the recovery <br/>
<a id="pl.159.26"></a><var>159.26</var>procedure under Minnesota Statutes, section <br/>
<statute_ref><a id="pl.159.27"></a><var>159.27</var>256.017
         </statute_ref>, to recover the funds. Recovered <br/>
<a id="pl.159.28"></a><var>159.28</var>funds must be deposited into the general <br/>
<a id="pl.159.29"></a><var>159.29</var>fund.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.159.30"></a><var>159.30</var><br/>
</td>
<td colspan="3"><b>(i) General Assistance Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">48,215,000<br/>
</td>
<td align="center"></td>
<td align="right">48,608,000<br/>
</td>
</tr>
</table><a id="pl.159.31"></a><var>159.31</var><b>General Assistance Standard.</b> The <br/>
<a id="pl.159.32"></a><var>159.32</var>commissioner shall set the monthly standard <br/>
<a id="pl.159.33"></a><var>159.33</var>of assistance for general assistance units <br/>
<a id="pl.159.34"></a><var>159.34</var>consisting of an adult recipient who is <br/>
<a id="pl.159.35"></a><var>159.35</var>childless and unmarried or living apart <br/>
<a id="pl.160.1"></a><var>160.1</var>from parents or a legal guardian at $203. <br/>
<a id="pl.160.2"></a><var>160.2</var>The commissioner may reduce this amount <br/>
<a id="pl.160.3"></a><var>160.3</var>according to Laws 1997, chapter 85, article <br/>
<a id="pl.160.4"></a><var>160.4</var>3, section 54.<br/>
<a id="pl.160.5"></a><var>160.5</var><b>Emergency General Assistance.</b> The <br/>
<a id="pl.160.6"></a><var>160.6</var>amount appropriated for emergency general <br/>
<a id="pl.160.7"></a><var>160.7</var>assistance funds is limited to no more <br/>
<a id="pl.160.8"></a><var>160.8</var>than $7,889,812 in fiscal year 2010 and <br/>
<a id="pl.160.9"></a><var>160.9</var>$7,889,812 in fiscal year 2011. Funds <br/>
<a id="pl.160.10"></a><var>160.10</var>to counties must be allocated by the <br/>
<a id="pl.160.11"></a><var>160.11</var>commissioner using the allocation method <br/>
<a id="pl.160.12"></a><var>160.12</var>specified in Minnesota Statutes, section <br/>
<statute_ref><a id="pl.160.13"></a><var>160.13</var>256D.06
         </statute_ref>.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.160.14"></a><var>160.14</var><br/>
</td>
<td colspan="3"><b>(j) Minnesota Supplemental Aid Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">33,930,000<br/>
</td>
<td align="center"></td>
<td align="right">35,191,000<br/>
</td>
</tr>
</table><a id="pl.160.15"></a><var>160.15</var><b>Emergency Minnesota Supplemental </b><br/>
<a id="pl.160.16"></a><var>160.16</var><b>Aid Funds.</b> The amount appropriated for <br/>
<a id="pl.160.17"></a><var>160.17</var>emergency Minnesota supplemental aid <br/>
<a id="pl.160.18"></a><var>160.18</var>funds is limited to no more than $1,100,000 <br/>
<a id="pl.160.19"></a><var>160.19</var>in fiscal year 2010 and $1,100,000 in fiscal <br/>
<a id="pl.160.20"></a><var>160.20</var>year 2011. Funds to counties must be <br/>
<a id="pl.160.21"></a><var>160.21</var>allocated by the commissioner using the <br/>
<a id="pl.160.22"></a><var>160.22</var>allocation method specified in Minnesota <br/>
<a id="pl.160.23"></a><var>160.23</var>Statutes, section 
         <statute_ref>256D.46</statute_ref>.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.160.24"></a><var>160.24</var><br/>
</td>
<td colspan="3"><b>(k) Group Residential Housing Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">111,778,000<br/>
</td>
<td align="center"></td>
<td align="right">114,034,000<br/>
</td>
</tr>
</table><a id="pl.160.25"></a><var>160.25</var><b>Group Residential Housing Costs </b><br/>
<a id="pl.160.26"></a><var>160.26</var><b>Refinanced.</b> (a) Effective July 1, 2011, the <br/>
<a id="pl.160.27"></a><var>160.27</var>commissioner shall increase the home and <br/>
<a id="pl.160.28"></a><var>160.28</var>community-based service rates and county <br/>
<a id="pl.160.29"></a><var>160.29</var>allocations provided to programs for persons <br/>
<a id="pl.160.30"></a><var>160.30</var>with disabilities established under section <br/>
<a id="pl.160.31"></a><var>160.31</var>1915(c) of the Social Security Act to the <br/>
<a id="pl.160.32"></a><var>160.32</var>extent that these programs will be paying <br/>
<a id="pl.160.33"></a><var>160.33</var>for the costs above the rate established <br/>
<a id="pl.160.34"></a><var>160.34</var>in Minnesota Statutes, section 
         <statute_ref>256I.05, <br/>
<a id="pl.160.35"></a><var>160.35</var>subdivision 1
         </statute_ref>.<br/>
<a id="pl.161.1"></a><var>161.1</var>(b) For persons receiving services under <br/>
<a id="pl.161.2"></a><var>161.2</var>Minnesota Statutes, section 
         <statute_ref>245A.02</statute_ref>, who <br/>
<a id="pl.161.3"></a><var>161.3</var>reside in licensed adult foster care beds <br/>
<a id="pl.161.4"></a><var>161.4</var>for which a difficulty of care payment <br/>
<a id="pl.161.5"></a><var>161.5</var>was being made under Minnesota Statutes, <br/>
<a id="pl.161.6"></a><var>161.6</var>section 
         <statute_ref>256I.05, subdivision 1c</statute_ref>, paragraph <br/>
<a id="pl.161.7"></a><var>161.7</var>(b), counties may request an exception to <br/>
<a id="pl.161.8"></a><var>161.8</var>the individual's service authorization not to <br/>
<a id="pl.161.9"></a><var>161.9</var>exceed the difference between the client's <br/>
<a id="pl.161.10"></a><var>161.10</var>monthly service expenditures plus the <br/>
<a id="pl.161.11"></a><var>161.11</var>amount of the difficulty of care payment.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.161.12"></a><var>161.12</var><br/>
</td>
<td colspan="3"><b>(l) Children's Mental Health Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">16,885,000<br/>
</td>
<td align="center"></td>
<td align="right">16,882,000<br/>
</td>
</tr>
</table><a id="pl.161.13"></a><var>161.13</var><b>Funding Usage.</b> Up to 75 percent of a fiscal <br/>
<a id="pl.161.14"></a><var>161.14</var>year's appropriation for children's mental <br/>
<a id="pl.161.15"></a><var>161.15</var>health grants may be used to fund allocations <br/>
<a id="pl.161.16"></a><var>161.16</var>in that portion of the fiscal year ending <br/>
<a id="pl.161.17"></a><var>161.17</var>December 31.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.161.18"></a><var>161.18</var><br/>
<a id="pl.161.19"></a><var>161.19</var><br/>
</td>
<td colspan="3"><b>(m) Other Children and Economic Assistance </b><br/>
<b>Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">16,047,000<br/>
</td>
<td align="center"></td>
<td align="right">15,339,000<br/>
</td>
</tr>
</table><a id="pl.161.20"></a><var>161.20</var><b>Fraud Prevention Grants.</b> Of this <br/>
<a id="pl.161.21"></a><var>161.21</var>appropriation, $228,000 in fiscal year 2010 <br/>
<a id="pl.161.22"></a><var>161.22</var>and $228,000 in fiscal year 2011 is to the <br/>
<a id="pl.161.23"></a><var>161.23</var>commissioner for fraud prevention grants to <br/>
<a id="pl.161.24"></a><var>161.24</var>counties.<br/>
<a id="pl.161.25"></a><var>161.25</var><b>Homeless and Runaway Youth.</b> $218,000 <br/>
<a id="pl.161.26"></a><var>161.26</var>in fiscal year 2010 is for the Runaway <br/>
<a id="pl.161.27"></a><var>161.27</var>and Homeless Youth Act under Minnesota <br/>
<a id="pl.161.28"></a><var>161.28</var>Statutes, section 
         <statute_ref>256K.45</statute_ref>. Funds shall be <br/>
<a id="pl.161.29"></a><var>161.29</var>spent in each area of the continuum of care <br/>
<a id="pl.161.30"></a><var>161.30</var>to ensure that programs are meeting the <br/>
<a id="pl.161.31"></a><var>161.31</var>greatest need. Any unexpended balance in <br/>
<a id="pl.161.32"></a><var>161.32</var>the first year is available in the second year. <br/>
<a id="pl.161.33"></a><var>161.33</var>Beginning July 1, 2011, the base is increased <br/>
<a id="pl.161.34"></a><var>161.34</var>by $119,000 each year.<br/>
<a id="pl.162.1"></a><var>162.1</var><b>ARRA Homeless Youth Funds.</b> To the <br/>
<a id="pl.162.2"></a><var>162.2</var>extent permitted under federal law, the <br/>
<a id="pl.162.3"></a><var>162.3</var>commissioner shall designate $2,500,000 <br/>
<a id="pl.162.4"></a><var>162.4</var>of the Homeless Prevention and Rapid <br/>
<a id="pl.162.5"></a><var>162.5</var>Re-Housing Program funds provided under <br/>
<a id="pl.162.6"></a><var>162.6</var>the American Recovery and Reinvestment <br/>
<a id="pl.162.7"></a><var>162.7</var>Act of 2009, Public Law 111-5, for agencies <br/>
<a id="pl.162.8"></a><var>162.8</var>providing homelessness prevention and rapid <br/>
<a id="pl.162.9"></a><var>162.9</var>rehousing services to youth.<br/>
<a id="pl.162.10"></a><var>162.10</var><b>Supportive Housing Services.</b> $1,500,000 <br/>
<a id="pl.162.11"></a><var>162.11</var>each year is for supportive services under <br/>
<a id="pl.162.12"></a><var>162.12</var>Minnesota Statutes, section 
         <statute_ref>256K.26</statute_ref>. This is <br/>
<a id="pl.162.13"></a><var>162.13</var>a onetime appropriation. <br/>
<a id="pl.162.14"></a><var>162.14</var><b>Community Action Grants.</b> Community <br/>
<a id="pl.162.15"></a><var>162.15</var>action grants are reduced one time by <br/>
<a id="pl.162.16"></a><var>162.16</var>$1,794,000 each year. This reduction is due <br/>
<a id="pl.162.17"></a><var>162.17</var>to the availability of federal funds under the <br/>
<a id="pl.162.18"></a><var>162.18</var>American Recovery and Reinvestment Act.<br/>
<a id="pl.162.19"></a><var>162.19</var><b>Base Adjustment.</b> The general fund base <br/>
<a id="pl.162.20"></a><var>162.20</var>is increased by $773,000 in fiscal year 2012 <br/>
<a id="pl.162.21"></a><var>162.21</var>and $773,000 in fiscal year 2013.<br/>
<a id="pl.162.22"></a><var>162.22</var><b>Federal ARRA Funds for Existing </b><br/>
<a id="pl.162.23"></a><var>162.23</var><b>Programs.</b> (a) (1) Federal funds received by <br/>
<a id="pl.162.24"></a><var>162.24</var>the commissioner for the emergency food <br/>
<a id="pl.162.25"></a><var>162.25</var>and shelter program from the American <br/>
<a id="pl.162.26"></a><var>162.26</var>Recovery and Reinvestment Act of 2009, <br/>
<a id="pl.162.27"></a><var>162.27</var>Public Law 111-5, but not previously <br/>
<a id="pl.162.28"></a><var>162.28</var>approved by the legislature are appropriated <br/>
<a id="pl.162.29"></a><var>162.29</var>to the commissioner for the purposes of the <br/>
<a id="pl.162.30"></a><var>162.30</var>grant program.<br/>
<a id="pl.162.31"></a><var>162.31</var>(b) (2) Federal funds received by the <br/>
<a id="pl.162.32"></a><var>162.32</var>commissioner for the emergency shelter <br/>
<a id="pl.162.33"></a><var>162.33</var>grant program including the Homelessness <br/>
<a id="pl.162.34"></a><var>162.34</var>Prevention and Rapid Re-Housing <br/>
<a id="pl.162.35"></a><var>162.35</var>Program from the American Recovery and <br/>
<a id="pl.163.1"></a><var>163.1</var>Reinvestment Act of 2009, Public Law <br/>
<a id="pl.163.2"></a><var>163.2</var>111-5, are appropriated to the commissioner <br/>
<a id="pl.163.3"></a><var>163.3</var>for the purposes of the grant programs.<br/>
<a id="pl.163.4"></a><var>163.4</var>(c) (3) Federal funds received by the <br/>
<a id="pl.163.5"></a><var>163.5</var>commissioner for the emergency food <br/>
<a id="pl.163.6"></a><var>163.6</var>assistance program from the American <br/>
<a id="pl.163.7"></a><var>163.7</var>Recovery and Reinvestment Act of 2009, <br/>
<a id="pl.163.8"></a><var>163.8</var>Public Law 111-5, are appropriated to the <br/>
<a id="pl.163.9"></a><var>163.9</var>commissioner for the purposes of the grant <br/>
<a id="pl.163.10"></a><var>163.10</var>program.<br/>
<a id="pl.163.11"></a><var>163.11</var>(d) (4) Federal funds received by the <br/>
<a id="pl.163.12"></a><var>163.12</var>commissioner for senior congregate meals <br/>
<a id="pl.163.13"></a><var>163.13</var>and senior home-delivered meals from the <br/>
<a id="pl.163.14"></a><var>163.14</var>American Recovery and Reinvestment Act <br/>
<a id="pl.163.15"></a><var>163.15</var>of 2009, Public Law 111-5, are appropriated <br/>
<a id="pl.163.16"></a><var>163.16</var>to the commissioner for the Minnesota Board <br/>
<a id="pl.163.17"></a><var>163.17</var>on Aging, for purposes of the grant programs.<br/>
<a id="pl.163.18"></a><var>163.18</var>(e) (5) Federal funds received by the <br/>
<a id="pl.163.19"></a><var>163.19</var>commissioner for the community services <br/>
<a id="pl.163.20"></a><var>163.20</var>block grant program from the American <br/>
<a id="pl.163.21"></a><var>163.21</var>Recovery and Reinvestment Act of 2009, <br/>
<a id="pl.163.22"></a><var>163.22</var>Public Law 111-5, are appropriated to the <br/>
<a id="pl.163.23"></a><var>163.23</var>commissioner for the purposes of the grant <br/>
<a id="pl.163.24"></a><var>163.24</var>program.<br/>
<a id="pl.163.25"></a><var>163.25</var><b>Long-Term Homeless Supportive </b><br/>
<a id="pl.163.26"></a><var>163.26</var><b>Service Fund Appropriation.</b> To the <br/>
<a id="pl.163.27"></a><var>163.27</var>extent permitted under federal law, the <br/>
<a id="pl.163.28"></a><var>163.28</var>commissioner shall designate $3,000,000 <br/>
<a id="pl.163.29"></a><var>163.29</var>of the Homelessness Prevention and Rapid <br/>
<a id="pl.163.30"></a><var>163.30</var>Re-Housing Program funds provided under <br/>
<a id="pl.163.31"></a><var>163.31</var>the American Recovery and Reinvestment <br/>
<a id="pl.163.32"></a><var>163.32</var>Act of 2009, Public Law, 111-5, to the <br/>
<a id="pl.163.33"></a><var>163.33</var>long-term homeless service fund under <br/>
<a id="pl.163.34"></a><var>163.34</var>Minnesota Statutes, section 
         <statute_ref>256K.26</statute_ref>. This <br/>
<a id="pl.163.35"></a><var>163.35</var>appropriation shall become available by July <br/>
<a id="pl.164.1"></a><var>164.1</var>1, 2009. This paragraph is effective the day <br/>
<a id="pl.164.2"></a><var>164.2</var>following final enactment.<br/>
<br/>
<a id="bill.9.9.0"></a><a id="pl.164.3"></a><var>164.3</var>    Sec. 9. Laws 2009, chapter 79, article 13, section 3, subdivision 8, as amended by <br/>
<a id="pl.164.4"></a><var>164.4</var>Laws 2009, chapter 173, article 2, section 1, subdivision 8, is amended to read:<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.164.5"></a><var>164.5</var><br/>
</td>
<td align="left" colspan="3">Subd. 8.<b>Continuing Care Grants</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table><a id="pl.164.6"></a><var>164.6</var>The amounts that may be spent from the <br/>
<a id="pl.164.7"></a><var>164.7</var>appropriation for each purpose are as follows:<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.164.8"></a><var>164.8</var><br/>
</td>
<td align="left" colspan="3"><b>(a) Aging and Adult Services Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">13,499,000<br/>
</td>
<td align="center"></td>
<td align="right">15,805,000<br/>
</td>
</tr>
</table><a id="pl.164.9"></a><var>164.9</var><b>Base Adjustment.</b> The general fund base is <br/>
<a id="pl.164.10"></a><var>164.10</var>increased by $5,751,000 in fiscal year 2012 <br/>
<a id="pl.164.11"></a><var>164.11</var>and $6,705,000 in fiscal year 2013.<br/>
<a id="pl.164.12"></a><var>164.12</var><b>Information and Assistance </b><br/>
<a id="pl.164.13"></a><var>164.13</var><b>Reimbursement.</b> Federal administrative <br/>
<a id="pl.164.14"></a><var>164.14</var>reimbursement obtained from information <br/>
<a id="pl.164.15"></a><var>164.15</var>and assistance services provided by the <br/>
<a id="pl.164.16"></a><var>164.16</var>Senior LinkAge or Disability Linkage lines <br/>
<a id="pl.164.17"></a><var>164.17</var>to people who are identified as eligible for <br/>
<a id="pl.164.18"></a><var>164.18</var>medical assistance shall be appropriated to <br/>
<a id="pl.164.19"></a><var>164.19</var>the commissioner for this activity.<br/>
<a id="pl.164.20"></a><var>164.20</var><b>Community Service Development Grant </b><br/>
<a id="pl.164.21"></a><var>164.21</var><b>Reduction.</b> Funding for community service <br/>
<a id="pl.164.22"></a><var>164.22</var>development grants must be reduced by <br/>
<a id="pl.164.23"></a><var>164.23</var>$260,000 for fiscal year 2010; $284,000 in <br/>
<a id="pl.164.24"></a><var>164.24</var>fiscal year 2011; $43,000 in fiscal year 2012; <br/>
<a id="pl.164.25"></a><var>164.25</var>and $43,000 in fiscal year 2013. Base level <br/>
<a id="pl.164.26"></a><var>164.26</var>funding shall be restored in fiscal year 2014.<br/>
<a id="pl.164.27"></a><var>164.27</var><b>Community Service Development Grant </b><br/>
<a id="pl.164.28"></a><var>164.28</var><b>Community Initiative.</b> Funding for <br/>
<a id="pl.164.29"></a><var>164.29</var>community service development grants shall <br/>
<a id="pl.164.30"></a><var>164.30</var>be used to offset the cost of aging support <br/>
<a id="pl.164.31"></a><var>164.31</var>grants. Base level funding shall be restored <br/>
<a id="pl.164.32"></a><var>164.32</var>in fiscal year 2014.<br/>
<a id="pl.165.1"></a><var>165.1</var><b>Senior Nutrition Use of Federal Funds.</b> <br/>
<a id="pl.165.2"></a><var>165.2</var>For fiscal year 2010, general fund grants <br/>
<a id="pl.165.3"></a><var>165.3</var>for home-delivered meals and congregate <br/>
<a id="pl.165.4"></a><var>165.4</var>dining shall be reduced by $500,000. The <br/>
<a id="pl.165.5"></a><var>165.5</var>commissioner must replace these general <br/>
<a id="pl.165.6"></a><var>165.6</var>fund reductions with equal amounts from <br/>
<a id="pl.165.7"></a><var>165.7</var>federal funding for senior nutrition from the <br/>
<a id="pl.165.8"></a><var>165.8</var>American Recovery and Reinvestment Act <br/>
<a id="pl.165.9"></a><var>165.9</var>of 2009.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.165.10"></a><var>165.10</var><br/>
</td>
<td align="left" colspan="3"><b>(b) Alternative Care Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">50,234,000<br/>
</td>
<td align="center"></td>
<td align="right">48,576,000<br/>
</td>
</tr>
</table><a id="pl.165.11"></a><var>165.11</var><b>Base Adjustment.</b> The general fund base is <br/>
<a id="pl.165.12"></a><var>165.12</var>decreased by $3,598,000 in fiscal year 2012 <br/>
<a id="pl.165.13"></a><var>165.13</var>and $3,470,000 in fiscal year 2013.<br/>
<a id="pl.165.14"></a><var>165.14</var><b>Alternative Care Transfer.</b> Any money <br/>
<a id="pl.165.15"></a><var>165.15</var>allocated to the alternative care program that <br/>
<a id="pl.165.16"></a><var>165.16</var>is not spent for the purposes indicated does <br/>
<a id="pl.165.17"></a><var>165.17</var>not cancel but must be transferred to the <br/>
<a id="pl.165.18"></a><var>165.18</var>medical assistance account.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.165.19"></a><var>165.19</var><br/>
<a id="pl.165.20"></a><var>165.20</var><br/>
</td>
<td align="left" colspan="3"><b>(c) Medical Assistance Grants; Long-Term </b><br/>
<b>Care Facilities.</b><br/>
</td>
<td align="center"></td>
<td align="right">367,444,000<br/>
</td>
<td align="center"></td>
<td align="right">419,749,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.165.21"></a><var>165.21</var><br/>
<a id="pl.165.22"></a><var>165.22</var><br/>
</td>
<td align="left" colspan="3"><b>(d) Medical Assistance Long-Term Care </b><br/>
<b>Waivers and Home Care Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">853,567,000<br/>
</td>
<td align="center"></td>
<td align="right">1,039,517,000<br/>
</td>
</tr>
</table><a id="pl.165.23"></a><var>165.23</var><b>Manage Growth in TBI and CADI </b><br/>
<a id="pl.165.24"></a><var>165.24</var><b>Waivers.</b> During the fiscal years beginning <br/>
<a id="pl.165.25"></a><var>165.25</var>on July 1, 2009, and July 1, 2010, the <br/>
<a id="pl.165.26"></a><var>165.26</var>commissioner shall allocate money for home <br/>
<a id="pl.165.27"></a><var>165.27</var>and community-based waiver programs <br/>
<a id="pl.165.28"></a><var>165.28</var>under Minnesota Statutes, section 
         <statute_ref>256B.49</statute_ref>, <br/>
<a id="pl.165.29"></a><var>165.29</var>to ensure a reduction in state spending that is <br/>
<a id="pl.165.30"></a><var>165.30</var>equivalent to limiting the caseload growth of <br/>
<a id="pl.165.31"></a><var>165.31</var>the TBI waiver to 12.5 allocations per month <br/>
<a id="pl.165.32"></a><var>165.32</var>each year of the biennium and the CADI <br/>
<a id="pl.165.33"></a><var>165.33</var>waiver to 95 allocations per month each year <br/>
<a id="pl.165.34"></a><var>165.34</var>of the biennium. Limits do not apply: (1) <br/>
<a id="pl.165.35"></a><var>165.35</var>when there is an approved plan for nursing <br/>
<a id="pl.166.1"></a><var>166.1</var>facility bed closures for individuals under <br/>
<a id="pl.166.2"></a><var>166.2</var>age 65 who require relocation due to the <br/>
<a id="pl.166.3"></a><var>166.3</var>bed closure; (2) to fiscal year 2009 waiver <br/>
<a id="pl.166.4"></a><var>166.4</var>allocations delayed due to unallotment; or (3) <br/>
<a id="pl.166.5"></a><var>166.5</var>to transfers authorized by the commissioner <br/>
<a id="pl.166.6"></a><var>166.6</var>from the personal care assistance program <br/>
<a id="pl.166.7"></a><var>166.7</var>of individuals having a home care rating <br/>
<a id="pl.166.8"></a><var>166.8</var>of "CS," "MT," or "HL." Priorities for the <br/>
<a id="pl.166.9"></a><var>166.9</var>allocation of funds must be for individuals <br/>
<a id="pl.166.10"></a><var>166.10</var>anticipated to be discharged from institutional <br/>
<a id="pl.166.11"></a><var>166.11</var>settings or who are at imminent risk of a <br/>
<a id="pl.166.12"></a><var>166.12</var>placement in an institutional setting.<br/>
<a id="pl.166.13"></a><var>166.13</var><b>Manage Growth in </b><b>DD</b><b> Developmental </b><br/>
<a id="pl.166.14"></a><var>166.14</var><b>Disability</b><b> Waiver.</b> The commissioner <br/>
<a id="pl.166.15"></a><var>166.15</var>shall manage the growth in the DD waiver <br/>
<a id="pl.166.16"></a><var>166.16</var>by limiting the allocations included in the <br/>
<a id="pl.166.17"></a><var>166.17</var>February 2009 forecast to 15 additional <br/>
<a id="pl.166.18"></a><var>166.18</var>diversion allocations each month for the <br/>
<a id="pl.166.19"></a><var>166.19</var>calendar years that begin on January 1, 2010, <br/>
<a id="pl.166.20"></a><var>166.20</var>and January 1, 2011. Additional allocations <br/>
<a id="pl.166.21"></a><var>166.21</var>must be made available for transfers <br/>
<a id="pl.166.22"></a><var>166.22</var>authorized by the commissioner from the <br/>
<a id="pl.166.23"></a><var>166.23</var>personal care program of individuals having <br/>
<a id="pl.166.24"></a><var>166.24</var>a home care rating of "CS," "MT," or "HL."<br/>
<a id="pl.166.25"></a><var>166.25</var><b>Adjustment to Lead Agency Waiver </b><br/>
<a id="pl.166.26"></a><var>166.26</var><b>Allocations.</b> Prior to the availability of the <br/>
<a id="pl.166.27"></a><var>166.27</var>alternative license defined in Minnesota <br/>
<a id="pl.166.28"></a><var>166.28</var>Statutes, section 
         <statute_ref>245A.11, subdivision 8</statute_ref>, <br/>
<a id="pl.166.29"></a><var>166.29</var>the commissioner shall reduce lead agency <br/>
<a id="pl.166.30"></a><var>166.30</var>waiver allocations for the purposes of <br/>
<a id="pl.166.31"></a><var>166.31</var>implementing a moratorium on corporate <br/>
<a id="pl.166.32"></a><var>166.32</var>foster care.<br/>
<a id="pl.166.33"></a><var>166.33</var><b>Alternatives to Personal Care Assistance </b><br/>
<a id="pl.166.34"></a><var>166.34</var><b>Services.</b> Base level funding of $3,237,000 <br/>
<a id="pl.166.35"></a><var>166.35</var>in fiscal year 2012 and $4,856,000 in <br/>
<a id="pl.167.1"></a><var>167.1</var>fiscal year 2013 is to implement alternative <br/>
<a id="pl.167.2"></a><var>167.2</var>services to personal care assistance services <br/>
<a id="pl.167.3"></a><var>167.3</var>for persons with mental health and other <br/>
<a id="pl.167.4"></a><var>167.4</var>behavioral challenges who can benefit <br/>
<a id="pl.167.5"></a><var>167.5</var>from other services that more appropriately <br/>
<a id="pl.167.6"></a><var>167.6</var>meet their needs and assist them in living <br/>
<a id="pl.167.7"></a><var>167.7</var>independently in the community. These <br/>
<a id="pl.167.8"></a><var>167.8</var>services may include, but not be limited to, a <br/>
<a id="pl.167.9"></a><var>167.9</var>1915(i) state plan option.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.167.10"></a><var>167.10</var><br/>
</td>
<td align="left" colspan="3"><b>(e) Mental Health Grants</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.167.11"></a><var>167.11</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.167.12"></a><var>167.12</var><br/>
</td>
<td align="left">General<br/>
</td>
<td align="right">77,739,000<br/>
</td>
<td align="right">77,739,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.167.13"></a><var>167.13</var><br/>
</td>
<td align="left">Health Care Access<br/>
</td>
<td align="right">750,000<br/>
</td>
<td align="right">750,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.167.14"></a><var>167.14</var><br/>
</td>
<td align="left">Lottery Prize<br/>
</td>
<td align="right">1,508,000<br/>
</td>
<td align="right">1,508,000<br/>
</td>
</tr>
</table><a id="pl.167.15"></a><var>167.15</var><b>Funding Usage.</b> Up to 75 percent of a fiscal <br/>
<a id="pl.167.16"></a><var>167.16</var>year's appropriation for adult mental health <br/>
<a id="pl.167.17"></a><var>167.17</var>grants may be used to fund allocations in that <br/>
<a id="pl.167.18"></a><var>167.18</var>portion of the fiscal year ending December <br/>
<a id="pl.167.19"></a><var>167.19</var>31.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.167.20"></a><var>167.20</var><br/>
</td>
<td align="left" colspan="3"><b>(f) Deaf and Hard-of-Hearing Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">1,930,000<br/>
</td>
<td align="center"></td>
<td align="right">1,917,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.167.21"></a><var>167.21</var><br/>
</td>
<td align="left" colspan="3"><b>(g) Chemical Dependency Entitlement Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">111,303,000<br/>
</td>
<td align="center"></td>
<td align="right">122,822,000<br/>
</td>
</tr>
</table><a id="pl.167.22"></a><var>167.22</var><b>Payments for Substance Abuse Treatment.</b> <br/>
<a id="pl.167.23"></a><var>167.23</var>For services provided during fiscal years <br/>
<a id="pl.167.24"></a><var>167.24</var>2010 and 2011, county-negotiated rates <br/>
<a id="pl.167.25"></a><var>167.25</var>and provider claims to the consolidated <br/>
<a id="pl.167.26"></a><var>167.26</var>chemical dependency fund must not exceed <br/>
<a id="pl.167.27"></a><var>167.27</var>the lesser of: (1) rates charged for these <br/>
<a id="pl.167.28"></a><var>167.28</var>services on January 1, 2009; or (2) 160 <br/>
<a id="pl.167.29"></a><var>167.29</var>percent of the average rate on January 1, <br/>
<a id="pl.167.30"></a><var>167.30</var>2009, for each group of vendors with similar <br/>
<a id="pl.167.31"></a><var>167.31</var>attributes. For services provided in fiscal <br/>
<a id="pl.167.32"></a><var>167.32</var>years 2012 and 2013, the statewide average <br/>
<a id="pl.167.33"></a><var>167.33</var>rates aggregate payment under the new <br/>
<a id="pl.167.34"></a><var>167.34</var>rate methodology to be developed under <br/>
<a id="pl.167.35"></a><var>167.35</var>Minnesota Statutes, section 
         <statute_ref>254B.12</statute_ref>, must <br/>
<a id="pl.168.1"></a><var>168.1</var>not exceed the average rates charged for <br/>
<a id="pl.168.2"></a><var>168.2</var>these services on January 1, 2009, plus a <br/>
<a id="pl.168.3"></a><var>168.3</var>state share increase of $3,787,000 for fiscal <br/>
<a id="pl.168.4"></a><var>168.4</var>year 2012 and $5,023,000 for fiscal year <br/>
<a id="pl.168.5"></a><var>168.5</var>2013 projected aggregate payment under <br/>
<a id="pl.168.6"></a><var>168.6</var>the rates in effect for fiscal year 2010 minus <br/>
<a id="pl.168.7"></a><var>168.7</var>1.25 percent. Notwithstanding any provision <br/>
<a id="pl.168.8"></a><var>168.8</var>to the contrary in this article, this provision <br/>
<a id="pl.168.9"></a><var>168.9</var>expires on June 30, 2013.<br/>
<a id="pl.168.10"></a><var>168.10</var><b>Chemical Dependency Special Revenue </b><br/>
<a id="pl.168.11"></a><var>168.11</var><b>Account.</b> For fiscal year 2010, $750,000 <br/>
<a id="pl.168.12"></a><var>168.12</var>must be transferred from the consolidated <br/>
<a id="pl.168.13"></a><var>168.13</var>chemical dependency treatment fund <br/>
<a id="pl.168.14"></a><var>168.14</var>administrative account and deposited into the <br/>
<a id="pl.168.15"></a><var>168.15</var>general fund.<br/>
<a id="pl.168.16"></a><var>168.16</var><b>County CD Share of MA Costs for </b><br/>
<a id="pl.168.17"></a><var>168.17</var><b>ARRA Compliance.</b> Notwithstanding the <br/>
<a id="pl.168.18"></a><var>168.18</var>provisions of Minnesota Statutes, chapter <br/>
<a id="pl.168.19"></a><var>168.19</var>254B, for chemical dependency services <br/>
<a id="pl.168.20"></a><var>168.20</var>provided during the period October 1, 2008, <br/>
<a id="pl.168.21"></a><var>168.21</var>to December 31, 2010, and reimbursed by <br/>
<a id="pl.168.22"></a><var>168.22</var>medical assistance at the enhanced federal <br/>
<a id="pl.168.23"></a><var>168.23</var>matching rate provided under the American <br/>
<a id="pl.168.24"></a><var>168.24</var>Recovery and Reinvestment Act of 2009, the <br/>
<a id="pl.168.25"></a><var>168.25</var>county share is 30 percent of the nonfederal <br/>
<a id="pl.168.26"></a><var>168.26</var>share. This provision is effective the day <br/>
<a id="pl.168.27"></a><var>168.27</var>following final enactment.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.168.28"></a><var>168.28</var><br/>
<a id="pl.168.29"></a><var>168.29</var><br/>
</td>
<td align="left" colspan="3"><b>(h) Chemical Dependency Nonentitlement </b><br/>
<b>Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">1,729,000<br/>
</td>
<td align="center"></td>
<td align="right">1,729,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="11.899999999999999"/>
<tr>
<td><a id="pl.168.30"></a><var>168.30</var><br/>
</td>
<td align="left" colspan="3"><b>(i) Other Continuing Care Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">19,201,000<br/>
</td>
<td align="center"></td>
<td align="right">17,528,000<br/>
</td>
</tr>
</table><a id="pl.168.31"></a><var>168.31</var><b>Base Adjustment.</b> The general fund base is <br/>
<a id="pl.168.32"></a><var>168.32</var>increased by $2,639,000 in fiscal year 2012 <br/>
<a id="pl.168.33"></a><var>168.33</var>and increased by $3,854,000 in fiscal year <br/>
<a id="pl.168.34"></a><var>168.34</var>2013.<br/>
<a id="pl.169.1"></a><var>169.1</var><b>Technology Grants.</b> $650,000 in fiscal <br/>
<a id="pl.169.2"></a><var>169.2</var>year 2010 and $1,000,000 in fiscal year <br/>
<a id="pl.169.3"></a><var>169.3</var>2011 are for technology grants, case <br/>
<a id="pl.169.4"></a><var>169.4</var>consultation, evaluation, and consumer <br/>
<a id="pl.169.5"></a><var>169.5</var>information grants related to developing and <br/>
<a id="pl.169.6"></a><var>169.6</var>supporting alternatives to shift-staff foster <br/>
<a id="pl.169.7"></a><var>169.7</var>care residential service models.<br/>
<a id="pl.169.8"></a><var>169.8</var><b>Other Continuing Care Grants; HIV </b><br/>
<a id="pl.169.9"></a><var>169.9</var><b>Grants.</b> Money appropriated for the HIV <br/>
<a id="pl.169.10"></a><var>169.10</var>drug and insurance grant program in fiscal <br/>
<a id="pl.169.11"></a><var>169.11</var>year 2010 may be used in either year of the <br/>
<a id="pl.169.12"></a><var>169.12</var>biennium.<br/>
<a id="pl.169.13"></a><var>169.13</var><b>Quality Assurance Commission.</b> Effective <br/>
<a id="pl.169.14"></a><var>169.14</var>July 1, 2009, state funding for the quality <br/>
<a id="pl.169.15"></a><var>169.15</var>assurance commission under Minnesota <br/>
<a id="pl.169.16"></a><var>169.16</var>Statutes, section 
         <statute_ref>256B.0951</statute_ref>, is canceled.<br/>
<br/>
<a id="bill.9.10.0"></a><a id="pl.169.17"></a><var>169.17</var>    Sec. 10. <b>CANCELLATIONS.</b><br/>
<a id="pl.169.18"></a><var>169.18</var>The remaining balance from Laws 2008, chapter 358, article 5, section 4, subdivision <br/>
<a id="pl.169.19"></a><var>169.19</var>3, appropriation for Section 125 employer incentives, is canceled.<br/>
<br/>
<a id="bill.9.11.0"></a><a id="pl.169.20"></a><var>169.20</var>    Sec. 11. <b>TRANSFERS.</b><br/>
<a id="pl.169.21"></a><var>169.21</var>The commissioner of management and budget shall transfer from the general fund to <br/>
<a id="pl.169.22"></a><var>169.22</var>the health care access fund $38,475,000 in fiscal year 2011, $14,758,000 in fiscal year <br/>
<a id="pl.169.23"></a><var>169.23</var>2012, and $35,058,000 in fiscal year 2013.<br/>
<a id="pl.169.24"></a><var>169.24</var><b>EFFECTIVE DATE.</b>This section is effective upon federal approval of the <br/>
<a id="pl.169.25"></a><var>169.25</var>amendments to Minnesota Statutes, sections 256B.055, subdivision 15, and 256B.056, <br/>
<a id="pl.169.26"></a><var>169.26</var>subdivision 4.<br/>
<br/>
<a id="bill.9.12.0"></a><a id="pl.169.27"></a><var>169.27</var>    Sec. 12. <b>EXPIRATION OF UNCODIFIED LANGUAGE.</b><br/>
<a id="pl.169.28"></a><var>169.28</var>All uncodified language contained in this article expires on June 30, 2011, unless a <br/>
<a id="pl.169.29"></a><var>169.29</var>different expiration date is explicit.<br/>
<br/>
<a id="bill.9.13.0"></a><a id="pl.169.30"></a><var>169.30</var>    Sec. 13. <b>EFFECTIVE DATE.</b><br/>
<a id="pl.170.1"></a><var>170.1</var>The provisions in this article are effective July 1, 2010, unless a different effective <br/>
<a id="pl.170.2"></a><var>170.2</var>date is explicit.<br/>