1.1 	A bill for an act
1.2 	relating to state government; establishing the health and human services budget; 
1.3 	making changes to children and family services, Department of Health, health 
1.4 	licensing boards, miscellaneous provisions, health licensing fees, health care, 
1.5 	and continuing care; redesigning service delivery; making changes to chemical 
1.6 	and mental health; modifying fee schedules; modifying program eligibility 
1.7 	requirements; authorizing rulemaking; requiring reports; appropriating money 
1.8 	for the Departments of Health and Human Services and other health-related 
1.9 	boards and councils; making forecast adjustments;amending Minnesota Statutes 
1.10 	2010, sections 3.98, by adding a subdivision; 62D.08, subdivision 7; 62E.08, 
1.11 	subdivision 1; 62E.14, by adding a subdivision; 62J.04, subdivisions 3, 9; 
1.12 	62J.17, subdivision 4a; 62J.495, by adding a subdivision; 62J.497, by adding a 
1.13 	subdivision; 62J.692; 62Q.32; 62U.04, subdivisions 3, 9; 62U.06, subdivision 2; 
1.14 	119B.011, subdivision 13; 119B.035, subdivisions 1, 4; 119B.09, subdivision 
1.15 	10, by adding subdivisions; 119B.13, subdivisions 1, 1a, 7; 144.05, by adding 
1.16 	a subdivision; 144.1499; 144.1501, subdivisions 1, 4; 144.98, subdivisions 
1.17 	2a, 7, by adding subdivisions; 144A.102; 144A.61, by adding a subdivision; 
1.18 	144E.123; 145.928, subdivision 2; 145.986, by adding subdivisions; 145A.17, 
1.19 	subdivision 3; 148.07, subdivision 1; 148.10, subdivision 7; 148.108, by adding a 
1.20 	subdivision; 148.191, subdivision 2; 148.212, subdivision 1; 148.231; 148B.17; 
1.21 	148B.33, subdivision 2; 148B.52; 148B.5301, subdivisions 1, 3, 4; 148B.54, 
1.22 	subdivisions 2, 3; 148E.060, subdivisions 1, 2, 3, 5, by adding a subdivision; 
1.23 	148E.120; 150A.02; 150A.06, subdivisions 1c, 1d, 3, 4, 6; 150A.09, subdivision 
1.24 	3; 150A.091, subdivisions 2, 3, 4, 5, 8, by adding a subdivision; 150A.105, 
1.25 	subdivision 7; 150A.106, subdivision 1; 150A.14; 151.07; 151.101; 151.102, by 
1.26 	adding a subdivision; 151.12; 151.13, subdivision 1; 151.19; 151.25; 151.47, 
1.27 	subdivision 1; 151.48; 152.12, subdivision 3; 157.15, by adding a subdivision; 
1.28 	157.20, by adding a subdivision; 214.09, by adding a subdivision; 214.103; 
1.29 	245A.03, subdivision 2; 245A.14, subdivision 4; 246B.10; 252.025, subdivision 
1.30 	7; 252.27, subdivision 2a; 252.291, subdivision 2; 253B.212; 254B.03, 
1.31 	subdivisions 1, 4; 254B.04, subdivision 1, by adding a subdivision; 254B.06, 
1.32 	subdivision 2; 256.01, subdivisions 14b, 24, 29, by adding subdivisions; 256.045, 
1.33 	subdivision 4a; 256.969, subdivisions 2b, 3a, by adding a subdivision; 256B.04, 
1.34 	subdivision 18; 256B.05, by adding a subdivision; 256B.055, subdivision 
1.35 	15; 256B.056, subdivision 3, by adding a subdivision; 256B.057, subdivision 
1.36 	9; 256B.06, subdivision 4; 256B.0625, subdivisions 8, 8a, 8e, 13e, 13h, 17, 
1.37 	17a, 18, 31a, 41, by adding subdivisions; 256B.0631, subdivisions 1, 2, 3; 
1.38 	256B.0657; 256B.0659, subdivisions 2, 11, 28; 256B.0751, subdivisions 1, 2, 
1.39 	3, 4, by adding subdivisions; 256B.0753, by adding a subdivision; 256B.0754, 
2.1 	by adding a subdivision; 256B.0755, subdivision 4, by adding subdivisions; 
2.2 	256B.0756; 256B.0911, subdivisions 1a, 3a, 4a, 6; 256B.0913, subdivision 
2.3 	4; 256B.0915, subdivisions 3a, 3b, 3e, 3h, 5, 10; 256B.0916, subdivision 
2.4 	6a; 256B.092, subdivisions 1a, 1b, 1e, 1g, 3, 8; 256B.0945, subdivision 4; 
2.5 	256B.14, by adding a subdivision; 256B.19, by adding a subdivision; 256B.37, 
2.6 	subdivision 5; 256B.431, subdivision 2r, by adding a subdivision; 256B.434, 
2.7 	subdivision 4; 256B.437, subdivision 6; 256B.441, by adding subdivisions; 
2.8 	256B.48, subdivision 1; 256B.49, subdivisions 12, 13, 14, 15, by adding a 
2.9 	subdivision; 256B.5012, by adding subdivisions; 256B.69, subdivisions 3a, 4, 
2.10 	5a, 5c, 6, by adding subdivisions; 256B.692, subdivisions 2, 5, 7, by adding 
2.11 	a subdivision; 256B.694; 256B.76, subdivision 4; 256D.05, subdivision 1; 
2.12 	256D.06, subdivisions 1, 1b; 256D.09, subdivision 6; 256D.44, subdivision 
2.13 	5; 256D.49, subdivision 3; 256G.02, subdivision 6; 256I.04, subdivision 2b; 
2.14 	256I.05, subdivision 1a; 256J.20, subdivision 3; 256J.38, subdivision 1; 256J.53, 
2.15 	subdivision 2; 256L.01, subdivision 4a; 256L.02, subdivision 3; 256L.03, 
2.16 	subdivisions 3, 5; 256L.04, subdivisions 1, 7; 256L.05, subdivisions 2, 3a, 5, by 
2.17 	adding a subdivision; 256L.07, subdivision 1; 256L.09, subdivision 4; 256L.11, 
2.18 	subdivision 7; 256L.12, subdivision 9; 256L.15, subdivision 1a; 260C.157, 
2.19 	subdivision 3; 260D.01; 297F.10, subdivision 1; 326B.175; 364.09; 393.07, 
2.20 	subdivisions 10, 10a; 402A.10, subdivisions 4, 5; 402A.15; 402A.18; 402A.20; 
2.21 	Laws 2008, chapter 363, article 18, section 3, subdivision 5; Laws 2009, chapter 
2.22 	79, article 8, sections 4, as amended; 51, as amended; article 13, section 3, 
2.23 	subdivision 8, as amended; Laws 2010, chapter 349, sections 1; 2; Laws 2010, 
2.24 	First Special Session chapter 1, article 15, section 3, subdivision 6; article 25, 
2.25 	section 3, subdivision 6; proposing coding for new law in Minnesota Statutes, 
2.26 	chapters 62E; 62J; 62U; 119B; 137; 144; 145; 148; 151; 214; 256; 256B; 
2.27 	256D; 256L; 326B; 402A; repealing Minnesota Statutes 2010, sections 62J.07, 
2.28 	subdivisions 1, 2, 3; 62J.17, subdivisions 1, 3, 5a, 6a, 8; 62J.321, subdivision 
2.29 	5a; 62J.381; 62J.41, subdivisions 1, 2; 144.1464; 145A.14, subdivisions 1, 2; 
2.30 	150A.22; 256.01, subdivision 2b; 256.979, subdivisions 5, 6, 7, 10; 256.9791; 
2.31 	256.9862, subdivision 2; 256B.055, subdivision 15; 256B.057, subdivision 
2.32 	2c; 256B.0756; 256I.05, subdivisions 1d, 1e, 1f, 1g, 1h, 1i, 1j, 1k, 1l, 1m, 1n; 
2.33 	256L.07, subdivision 7; 402A.30; 402A.45; Laws 2008, chapter 358, article 3, 
2.34 	sections 8; 9; Laws 2009, chapter 79, article 3, section 18, as amended; article 5, 
2.35 	sections 55, as amended; 56; 57; 60; 61; 62; 63; 64; 65; 66; 68; 69; 79; Laws 
2.36 	2010, First Special Session chapter 1, article 16, sections 6; 7; Minnesota Rules, 
2.37 	parts 3400.0130, subpart 8; 4651.0100, subparts 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 
2.38 	12, 14, 15, 16, 16a, 18, 19, 20, 20a, 21, 22, 23; 4651.0110, subparts 2, 2a, 
2.39 	3, 4, 5; 4651.0120; 4651.0130; 4651.0140; 4651.0150; 6310.3100, subpart 2; 
2.40 	6310.3600; 6310.3700, subpart 1; 9500.1243, subpart 3.
2.41 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

2.42 	ARTICLE 1
2.43 	CHILDREN AND FAMILY SERVICES

2.44 	Section 1. Minnesota Statutes 2010, section 119B.011, subdivision 13, is amended to 
2.45 	read:
2.46 		Subd. 13.Family. "Family" means parents, stepparents, guardians and their spouses, 
2.47 	or other eligible relative caregivers and their spouses, and their blood related dependent 
2.48 	children and adoptive siblings under the age of 18 years living in the same home including 
2.49 	children temporarily absent from the household in settings such as schools, foster care, and 
3.1 	residential treatment facilities or parents, stepparents, guardians and their spouses, or other 
3.2 	relative caregivers and their spouses temporarily absent from the household in settings 
3.3 	such as schools, military service, or rehabilitation programs. An adult family member who 
3.4 	is not in an authorized activity under this chapter may be temporarily absent for up to 60 
3.5 	days. When a minor parent or parents and his, her, or their child or children are living with 
3.6 	other relatives, and the minor parent or parents apply for a child care subsidy, "family" 
3.7 	means only the minor parent or parents and their child or children. An adult age 18 or 
3.8 	older who meets this definition of family and is a full-time high school or postsecondary 
3.9 	student may be considered a dependent member of the family unit if 50 percent or more of 
3.10 	the adult's support is provided by the parents, stepparents, guardians, and their spouses or 
3.11 	eligible relative caregivers and their spouses residing in the same household.

3.12 	EFFECTIVE DATE. This section is effective April 16, 2012.

3.13 	Sec. 2. Minnesota Statutes 2010, section 119B.035, subdivision 1, is amended to read:
3.14 		Subdivision 1.Establishment. A family in which a parent provides care for the 
3.15 	family's infant child may receive a subsidy in lieu of assistance if the family is eligible for 
3.16 	or is receiving assistance under the basic sliding fee program. An eligible family must 
3.17 	meet the eligibility factors under section 119B.09, except as provided in subdivision 4, 
3.18 	and the requirements of this section. Subject to federal match and maintenance of effort 
3.19 	requirements for the child care and development fund, and up to available appropriations, 
3.20 	the commissioner shall provide assistance under the at-home infant child care program and 
3.21 	for administrative costs associated with the program. The commissioner shall set aside 
3.22 	two percent of the basic sliding fee child care appropriation under section 119B.03, for 
3.23 	purposes of this section. At the end of a fiscal year, the commissioner may carry forward 
3.24 	any unspent funds under this section to the next fiscal year within the same biennium for 
3.25 	assistance under the basic sliding fee program.

3.26 	Sec. 3. Minnesota Statutes 2010, section 119B.035, subdivision 4, is amended to read:
3.27 		Subd. 4.Assistance. (a) A family is limited to a lifetime total of 12 months of 
3.28 	assistance under subdivision 2. The maximum rate of assistance is equal to 90 64 percent 
3.29 	of the rate established under section 119B.13 for care of infants in licensed family child 
3.30 	care in the applicant's county of residence.
3.31 	(b) A participating family must report income and other family changes as specified 
3.32 	in the county's plan under section 119B.08, subdivision 3.
4.1 	(c) Persons who are admitted to the at-home infant child care program retain their 
4.2 	position in any basic sliding fee program. Persons leaving the at-home infant child care 
4.3 	program reenter the basic sliding fee program at the position they would have occupied.
4.4 	(d) Assistance under this section does not establish an employer-employee 
4.5 	relationship between any member of the assisted family and the county or state.

4.6 	Sec. 4. Minnesota Statutes 2010, section 119B.09, is amended by adding a subdivision 
4.7 	to read:
4.8 		Subd. 9a.Child care centers; assistance. (a) For the purposes of this subdivision, 
4.9 	"qualifying child" means a child who satisfies both of the following:
4.10 	(1) is not a child or dependent of an employee of the child care provider; and
4.11 	(2) does not reside with an employee of the child care provider.
4.12 	(b) Funds distributed under this chapter must not be paid for child care services 
4.13 	that are provided for a child by a child care provider who employs either the parent of 
4.14 	the child or a person who resides with the child, unless at all times at least 50 percent of 
4.15 	the children for whom the child care provider is providing care are qualifying children 
4.16 	under paragraph (a).
4.17 	(c) If a child care provider satisfies the requirements for payment under paragraph 
4.18 	(b), but the percentage of qualifying children under paragraph (a) for whom the provider 
4.19 	is providing care falls below 50 percent, the provider shall have four weeks to raise the 
4.20 	percentage of qualifying children for whom the provider is providing care to at least 50 
4.21 	percent before payments to the provider are discontinued for child care services provided 
4.22 	for a child who is not a qualifying child.

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

4.24 	Sec. 5. Minnesota Statutes 2010, section 119B.09, subdivision 10, is amended to read:
4.25 		Subd. 10.Payment of funds. All federal, state, and local child care funds must 
4.26 	be paid directly to the parent when a provider cares for children in the children's own 
4.27 	home. In all other cases, all federal, state, and local child care funds must be paid directly 
4.28 	to the child care provider, either licensed or legal nonlicensed, on behalf of the eligible 
4.29 	family. Funds distributed under this chapter must not be used for child care services that 
4.30 	are provided for a child by a child care provider who resides in the same household or 
4.31 	occupies the same residence as the child.

4.32 	EFFECTIVE DATE. This section is effective March 5, 2012.

5.1 	Sec. 6. Minnesota Statutes 2010, section 119B.09, is amended by adding a subdivision 
5.2 	to read:
5.3 		Subd. 13.Child care in the child's home. Child care assistance must only be 
5.4 	authorized in the child's home if the child's parents have authorized activities outside of 
5.5 	the home and if one or more of the following circumstances are met:
5.6 	(1) the parents' qualifying activity occurs during times when out-of-home care is 
5.7 	not available. If child care is needed during any period when out-of-home care is not 
5.8 	available, in-home care can be approved for the entire time care is needed;
5.9 	(2) the family lives in an area where out-of-home care is not available; or
5.10 	(3) a child has a verified illness or disability that would place the child or other 
5.11 	children in an out-of-home facility at risk or creates a hardship for the child and the family 
5.12 	to take the child out of the home to a child care home or center.

5.13 	EFFECTIVE DATE. This section is effective March 5, 2012.

5.14 	Sec. 7. Minnesota Statutes 2010, section 119B.13, subdivision 1, is amended to read:
5.15 		Subdivision 1.Subsidy restrictions. (a) Beginning July 1, 2006, the maximum rate 
5.16 	paid for child care assistance in any county or multicounty region under the child care 
5.17 	fund shall be the rate for like-care arrangements in the county effective January 1, 2006, 
5.18 	increased by six percent.
5.19 	(b) Rate changes shall be implemented for services provided in September 2006 
5.20 	unless a participant eligibility redetermination or a new provider agreement is completed 
5.21 	between July 1, 2006, and August 31, 2006.
5.22 	As necessary, appropriate notice of adverse action must be made according to 
5.23 	Minnesota Rules, part 3400.0185, subparts 3 and 4.
5.24 	New cases approved on or after July 1, 2006, shall have the maximum rates under 
5.25 	paragraph (a), implemented immediately.
5.26 	(c) Every year, the commissioner shall survey rates charged by child care providers in 
5.27 	Minnesota to determine the 75th percentile for like-care arrangements in counties. When 
5.28 	the commissioner determines that, using the commissioner's established protocol, the 
5.29 	number of providers responding to the survey is too small to determine the 75th percentile 
5.30 	rate for like-care arrangements in a county or multicounty region, the commissioner may 
5.31 	establish the 75th percentile maximum rate based on like-care arrangements in a county, 
5.32 	region, or category that the commissioner deems to be similar.
5.33 	(d) A rate which includes a special needs rate paid under subdivision 3 or under a 
5.34 	school readiness service agreement paid under section 119B.231, may be in excess of the 
5.35 	maximum rate allowed under this subdivision.
6.1 	(e) The department shall monitor the effect of this paragraph on provider rates. The 
6.2 	county shall pay the provider's full charges for every child in care up to the maximum 
6.3 	established. The commissioner shall determine the maximum rate for each type of care 
6.4 	on an hourly, full-day, and weekly basis, including special needs and disability care. The 
6.5 	maximum payment to a provider for one day of care must not exceed the daily rate. The 
6.6 	maximum payment to a provider for one week of care must not exceed the weekly rate.
6.7 	(f) Child care providers receiving reimbursement under this chapter must not be paid 
6.8 	activity fees or an additional amount above the maximum rates for care provided during 
6.9 	nonstandard hours for families receiving assistance.
6.10 	(f) (g) When the provider charge is greater than the maximum provider rate allowed, 
6.11 	the parent is responsible for payment of the difference in the rates in addition to any 
6.12 	family co-payment fee.
6.13 	(g) (h) All maximum provider rates changes shall be implemented on the Monday 
6.14 	following the effective date of the maximum provider rate.

6.15 	EFFECTIVE DATE. This section is effective September 3, 2012, except the 
6.16 	amendments to paragraph (e) are effective April 16, 2012.

6.17 	Sec. 8. Minnesota Statutes 2010, section 119B.13, subdivision 1a, is amended to read:
6.18 		Subd. 1a.Legal nonlicensed family child care provider rates. (a) Legal 
6.19 	nonlicensed family child care providers receiving reimbursement under this chapter must 
6.20 	be paid on an hourly basis for care provided to families receiving assistance.
6.21 	(b) The maximum rate paid to legal nonlicensed family child care providers must be 
6.22 	80 64 percent of the county maximum hourly rate for licensed family child care providers. 
6.23 	In counties where the maximum hourly rate for licensed family child care providers is 
6.24 	higher than the maximum weekly rate for those providers divided by 50, the maximum 
6.25 	hourly rate that may be paid to legal nonlicensed family child care providers is the rate 
6.26 	equal to the maximum weekly rate for licensed family child care providers divided by 50 
6.27 	and then multiplied by 0.80 0.64. The maximum payment to a provider for one day of care 
6.28 	must not exceed the maximum hourly rate times ten. The maximum payment to a provider 
6.29 	for one week of care must not exceed the maximum hourly rate times 50.
6.30 	(c) A rate which includes a special needs rate paid under subdivision 3 may be in 
6.31 	excess of the maximum rate allowed under this subdivision.
6.32 	(d) Legal nonlicensed family child care providers receiving reimbursement under 
6.33 	this chapter may not be paid registration fees for families receiving assistance.

7.1 	EFFECTIVE DATE. This section is effective April 16, 2012, except the 
7.2 	amendment changing 80 to 64 and 0.80 to 0.64 is effective July 1, 2011.

7.3 	Sec. 9. Minnesota Statutes 2010, section 119B.13, subdivision 7, is amended to read:
7.4 		Subd. 7.Absent days. (a) Licensed child care providers may and license-exempt 
7.5 	centers must not be reimbursed for more than 25 ten full-day absent days per child, 
7.6 	excluding holidays, in a fiscal year, or for more than ten consecutive full-day absent days, 
7.7 	unless the child has a documented medical condition that causes more frequent absences. 
7.8 	Absences due to a documented medical condition of a parent or sibling who lives in the 
7.9 	same residence as the child receiving child care assistance do not count against the 25-day 
7.10 	absent day limit in a fiscal year. Documentation of medical conditions must be on the 
7.11 	forms and submitted according to the timelines established by the commissioner. A public 
7.12 	health nurse or school nurse may verify the illness in lieu of a medical practitioner. If a 
7.13 	provider sends a child home early due to a medical reason, including, but not limited to, 
7.14 	fever or contagious illness, the child care center director or lead teacher may verify the 
7.15 	illness in lieu of a medical practitioner. Legal nonlicensed family child care providers 
7.16 	must not be reimbursed for absent days. If a child attends for part of the time authorized to 
7.17 	be in care in a day, but is absent for part of the time authorized to be in care in that same 
7.18 	day, the absent time will must be reimbursed but the time will must not count toward the 
7.19 	ten consecutive or 25 cumulative absent day limits limit. Children in families where at 
7.20 	least one parent is under the age of 21, does not have a high school or general equivalency 
7.21 	diploma, and is a student in a school district or another similar program that provides or 
7.22 	arranges for child care, as well as parenting, social services, career and employment 
7.23 	supports, and academic support to achieve high school graduation, may be exempt from 
7.24 	the absent day limits upon request of the program and approval of the county. If a child 
7.25 	attends part of an authorized day, payment to the provider must be for the full amount 
7.26 	of care authorized for that day. Child care providers may must only be reimbursed for 
7.27 	absent days if the provider has a written policy for child absences and charges all other 
7.28 	families in care for similar absences.
7.29 	(b) Child care providers must be reimbursed for up to ten federal or state holidays 
7.30 	or designated holidays per year when the provider charges all families for these days 
7.31 	and the holiday or designated holiday falls on a day when the child is authorized to be 
7.32 	in attendance. Parents may substitute other cultural or religious holidays for the ten 
7.33 	recognized state and federal holidays. Holidays do not count toward the ten consecutive 
7.34 	or 25 cumulative absent day limits limit.
8.1 	(c) A family or child care provider may must not be assessed an overpayment for an 
8.2 	absent day payment unless (1) there was an error in the amount of care authorized for the 
8.3 	family, (2) all of the allowed full-day absent payments for the child have been paid, or (3) 
8.4 	the family or provider did not timely report a change as required under law.
8.5 	(d) The provider and family must receive notification of the number of absent days 
8.6 	used upon initial provider authorization for a family and when the family has used 15 
8.7 	cumulative absent days. Upon statewide implementation of the Minnesota Electronic 
8.8 	Child Care System, the provider and family shall receive notification of the number of 
8.9 	absent days used upon initial provider authorization for a family and ongoing notification 
8.10 	of the number of absent days used as of the date of the notification.
8.11 	(e) A county may pay for more absent days than the statewide absent day policy 
8.12 	established under this subdivision if current market practice in the county justifies payment 
8.13 	for those additional days. County policies for payment of absent days in excess of the 
8.14 	statewide absent day policy and justification for these county policies must be included in 
8.15 	the county's child care fund plan under section 119B.08, subdivision 3.

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

8.17 	Sec. 10. [119B.135] QUALITY RATING AND IMPROVEMENT SYSTEM 
8.18 	IMPLEMENTATION.
8.19 		Subdivision 1.Implementation of a quality rating and improvement system.
 8.20 	(a) The commissioner of human services shall phase in the implementation of a voluntary 
8.21 	quality rating and improvement system for child care centers. The system must build 
8.22 	on the quality rating and improvement system in use in fiscal year 2011. The program 
8.23 	must be designed to ensure that Minnesota's children have access to high-quality services 
8.24 	in child care centers so that children entering kindergarten are ready for kindergarten 
8.25 	by 2020, as stated in section 124D.142.
8.26 	(b) The quality rating and improvement system must:
8.27 	(1) set research-based program standards and quality indicators designed to improve 
8.28 	the educational outcomes of children so that they are ready for school;
8.29 	(2) assess program quality using the program standards and indicators and issue 
8.30 	quality ratings to participating child care centers;
8.31 	(3) establish a database to collect, store, analyze, and report data for quality ratings 
8.32 	and to track improvement supports and incentives to programs. The database must 
8.33 	incorporate data from or be linked to related databases, such as those maintained by the 
8.34 	child care resource and referral system;
9.1 	(4) provide rating information to consumers to facilitate informed choices of child 
9.2 	care centers;
9.3 	(5) provide information to child care centers to enable them to measure the results 
9.4 	of their quality improvement efforts; and
9.5 	(6) provide supports to participating programs to help them improve their quality 
9.6 	rating.
9.7 	(c) A program that is accredited or has otherwise been evaluated may submit 
9.8 	information to the commissioner of human services in the form and manner prescribed by 
9.9 	the commissioner and may be rated on the basis of that information.
9.10 	(d) A program that has previously been rated under this section or has been rated 
9.11 	through the Parent Aware pilot program may continue with that rating for two years.
9.12 		Subd. 2.Phase-in of quality rating and improvement system. The commissioner 
9.13 	must continue the quality rating and improvement system in use in fiscal year 2011 in the 
9.14 	original pilot areas and must expand the system to at least two new, rural geographic 
9.15 	locations by June 30, 2012. The commissioner must use a competitive process to select 
9.16 	the new pilot areas by targeting areas that meet one or more of the following criteria: 
9.17 	existence of a local early care and education collaborative, existence of local matching 
9.18 	funds, and demonstration of local support from community-based early learning and care 
9.19 	programs. The commissioner must add one new pilot area per year and work toward 
9.20 	statewide availability of ratings by 2015.

9.21 	Sec. 11. [256.987] ELECTRONIC BENEFIT TRANSFER CARD.
9.22 		Subdivision 1.Electronic benefit transfer (EBT) card. Beginning July 1, 2011, 
9.23 	cash benefits for the general assistance and Minnesota supplemental aid programs under 
9.24 	chapter 256D and programs under chapter 256J must be issued on a separate EBT card 
9.25 	with the name of the head of household printed on the card. This card must be issued 
9.26 	within 30 calendar days of an eligibility determination. During the initial 30 calendar days 
9.27 	of eligibility, a recipient may have cash benefits issued on an EBT card without a name 
9.28 	printed on the card. This card may be the same card on which food support benefits are 
9.29 	issued and does not need to meet the requirements of this section.
9.30 		Subd. 2.EBT card use restricted to Minnesota vendors. EBT cardholders 
9.31 	receiving cash benefits under the general assistance and Minnesota supplemental aid 
9.32 	programs under chapter 256D or programs under chapter 256J are prohibited from using 
9.33 	their EBT cards at vendors located outside of Minnesota. This subdivision does not apply 
9.34 	to food support benefits.

10.1 	Sec. 12. Minnesota Statutes 2010, section 256D.05, subdivision 1, is amended to read:
10.2 		Subdivision 1.Eligibility. (a) Each assistance unit with income and resources 
10.3 	less than the standard of assistance established by the commissioner and with a member 
10.4 	who is a resident of the state shall be eligible for and entitled to general assistance if 
10.5 	the assistance unit is:
10.6 	(1) a person who is suffering from a professionally certified permanent or temporary 
10.7 	illness, injury, or incapacity which is expected to continue for more than 30 90 days and 
10.8 	which prevents the person from obtaining or retaining employment;
10.9 	(2) a person whose presence in the home on a substantially continuous basis is 
10.10 	required because of the professionally certified illness, injury, incapacity, or the age of 
10.11 	another member of the household;
10.12 	(3) (2) a person who has been placed in, and is residing in, a licensed or certified 
10.13 	facility for purposes of physical or mental health or rehabilitation, or in an approved 
10.14 	chemical dependency domiciliary facility, if the placement is based on illness or incapacity 
10.15 	and is according to a plan developed or approved by the county agency through its 
10.16 	director or designated representative;
10.17 	(4) (3) a person who resides in a shelter facility described in subdivision 3;
10.18 	(5) (4) a person not described in clause (1) or (3) (2) who is diagnosed by a licensed 
10.19 	physician, psychological practitioner, or other qualified professional, as developmentally 
10.20 	disabled or mentally ill, and that condition prevents the person from obtaining or retaining 
10.21 	employment;
10.22 	(6) a person who has an application pending for, or is appealing termination of 
10.23 	benefits from, the Social Security disability program or the program of supplemental 
10.24 	security income for the aged, blind, and disabled, provided the person has a professionally 
10.25 	certified permanent or temporary illness, injury, or incapacity which is expected to 
10.26 	continue for more than 30 days and which prevents the person from obtaining or retaining 
10.27 	employment;
10.28 	(7) a person who is unable to obtain or retain employment because advanced age 
10.29 	significantly affects the person's ability to seek or engage in substantial work;
10.30 	(8) (5) a person who has been assessed by a vocational specialist and, in consultation 
10.31 	with the county agency, has been determined to be unemployable for purposes of this 
10.32 	clause; a person is considered employable if there exist positions of employment in the 
10.33 	local labor market, regardless of the current availability of openings for those positions, 
10.34 	that the person is capable of performing. The person's eligibility under this category must 
10.35 	be reassessed at least annually. The county agency must provide notice to the person not 
10.36 	later than 30 days before annual eligibility under this item ends, informing the person of the 
11.1 	date annual eligibility will end and the need for vocational assessment if the person wishes 
11.2 	to continue eligibility under this clause. For purposes of establishing eligibility under this 
11.3 	clause, it is the applicant's or recipient's duty to obtain any needed vocational assessment;
11.4 	(9) (6) a person who is determined by the county agency, according to permanent 
11.5 	rules adopted by the commissioner, to be learning disabled have a condition that qualifies 
11.6 	under Minnesota's special education rules as a specific learning disability, provided that 
11.7 	if a rehabilitation plan for the person is developed or approved by the county agency, 
11.8 	the person is following the plan;
11.9 	(10) a child under the age of 18 who is not living with a parent, stepparent, or legal 
11.10 	custodian, and only if: the child is legally emancipated or living with an adult with the 
11.11 	consent of an agency acting as a legal custodian; the child is at least 16 years of age 
11.12 	and the general assistance grant is approved by the director of the county agency or a 
11.13 	designated representative as a component of a social services case plan for the child; or the 
11.14 	child is living with an adult with the consent of the child's legal custodian and the county 
11.15 	agency. For purposes of this clause, "legally emancipated" means a person under the age 
11.16 	of 18 years who: (i) has been married; (ii) is on active duty in the uniformed services of 
11.17 	the United States; (iii) has been emancipated by a court of competent jurisdiction; or (iv) 
11.18 	is otherwise considered emancipated under Minnesota law, and for whom county social 
11.19 	services has not determined that a social services case plan is necessary, for reasons other 
11.20 	than the child has failed or refuses to cooperate with the county agency in developing 
11.21 	the plan;
11.22 	(11) (7) a person who is eligible for displaced homemaker services, programs, or 
11.23 	assistance under section 116L.96, but only if that person is enrolled as a full-time student;
11.24 	(12) a person who lives more than four hours round-trip traveling time from any 
11.25 	potential suitable employment;
11.26 	(13) (8) a person who is involved with protective or court-ordered services that 
11.27 	prevent the applicant or recipient from working at least four hours per day; or
11.28 	(14) a person over age 18 whose primary language is not English and who is 
11.29 	attending high school at least half time; or
11.30 	(15) (9) a person whose alcohol and drug addiction is a material factor that 
11.31 	contributes to the person's disability; applicants who assert this clause as a basis for 
11.32 	eligibility must be assessed by the county agency to determine if they are amenable 
11.33 	to treatment; if the applicant is determined to be not amenable to treatment, but is 
11.34 	otherwise eligible for benefits, then general assistance must be paid in vendor form, for 
11.35 	the individual's shelter costs up to the limit of the grant amount, with the residual, if 
11.36 	any, paid according to section 256D.09, subdivision 2a; if the applicant is determined 
12.1 	to be amenable to treatment, then in order to receive benefits, the applicant must be in 
12.2 	a treatment program or on a waiting list and the benefits must be paid in vendor form, 
12.3 	for the individual's shelter costs, up to the limit of the grant amount, with the residual, if 
12.4 	any, paid according to section 256D.09, subdivision 2a.
12.5 	(b) As a condition of eligibility under paragraph (a), clauses (1), (3) (2), (5) (4), 
12.6 	(8) (5), and (9) (6), the recipient must complete an interim assistance agreement and 
12.7 	must apply for other maintenance benefits as specified in section 256D.06, subdivision 
12.8 	5, and must comply with efforts to determine the recipient's eligibility for those other 
12.9 	maintenance benefits.
12.10 	(c) As a condition of eligibility under this section, the recipient must complete 
12.11 	at least 20 hours per month of volunteer or paid work. The county of residence shall 
12.12 	determine what may be included as volunteer work. Recipients must provide monthly 
12.13 	proof of volunteer work on the forms established by the county. A person who is unable 
12.14 	to obtain or retain 20 hours per month of volunteer or paid work due to a professionally 
12.15 	certified illness, injury, disability, or incapacity must not be made ineligible for general 
12.16 	assistance under this section.
12.17 	(c) (d) The burden of providing documentation for a county agency to use to verify 
12.18 	eligibility for general assistance or for exemption from the food stamp employment 
12.19 	and training program is upon the applicant or recipient. The county agency shall use 
12.20 	documents already in its possession to verify eligibility, and shall help the applicant or 
12.21 	recipient obtain other existing verification necessary to determine eligibility which the 
12.22 	applicant or recipient does not have and is unable to obtain.

12.23 	Sec. 13. Minnesota Statutes 2010, section 256D.06, subdivision 1, is amended to read:
12.24 		Subdivision 1.Eligibility; amount of assistance. General assistance shall be 
12.25 	granted in an amount that when added to the nonexempt income actually available to the 
12.26 	assistance unit, the total amount equals the applicable standard of assistance for general 
12.27 	assistance. In determining eligibility for and the amount of assistance for an individual or 
12.28 	married couple, the county agency shall disregard the first $50 $150 of earned income 
12.29 	per month.

12.30 	Sec. 14. Minnesota Statutes 2010, section 256D.06, subdivision 1b, is amended to read:
12.31 		Subd. 1b.Earned income savings account. In addition to the $50 $150 disregard 
12.32 	required under subdivision 1, the county agency shall disregard an additional earned 
12.33 	income up to a maximum of $150 $500 per month for: (1) persons residing in facilities 
12.34 	licensed under Minnesota Rules, parts 9520.0500 to 9520.0690 and 9530.2500 to 
13.1 	9530.4000, and for whom discharge and work are part of a treatment plan; (2) persons 
13.2 	living in supervised apartments with services funded under Minnesota Rules, parts 
13.3 	9535.0100 to 9535.1600, and for whom discharge and work are part of a treatment plan; 
13.4 	and (3) persons residing in group residential housing, as that term is defined in section 
13.5 	256I.03, subdivision 3, for whom the county agency has approved a discharge plan 
13.6 	which includes work. The additional amount disregarded must be placed in a separate 
13.7 	savings account by the eligible individual, to be used upon discharge from the residential 
13.8 	facility into the community. For individuals residing in a chemical dependency program 
13.9 	licensed under Minnesota Rules, part 9530.4100, subpart 22, item D, withdrawals from 
13.10 	the savings account require the signature of the individual and for those individuals with 
13.11 	an authorized representative payee, the signature of the payee. A maximum of $1,000
13.12 	$2,000, including interest, of the money in the savings account must be excluded from 
13.13 	the resource limits established by section 256D.08, subdivision 1, clause (1). Amounts in 
13.14 	that account in excess of $1,000 $2,000 must be applied to the resident's cost of care. If 
13.15 	excluded money is removed from the savings account by the eligible individual at any 
13.16 	time before the individual is discharged from the facility into the community, the money is 
13.17 	income to the individual in the month of receipt and a resource in subsequent months. If 
13.18 	an eligible individual moves from a community facility to an inpatient hospital setting, 
13.19 	the separate savings account is an excluded asset for up to 18 months. During that time, 
13.20 	amounts that accumulate in excess of the $1,000 $2,000 savings limit must be applied to 
13.21 	the patient's cost of care. If the patient continues to be hospitalized at the conclusion of the 
13.22 	18-month period, the entire account must be applied to the patient's cost of care.

13.23 	Sec. 15. Minnesota Statutes 2010, section 256D.44, subdivision 5, is amended to read:
13.24 		Subd. 5.Special needs. In addition to the state standards of assistance established in 
13.25 	subdivisions 1 to 4, payments are allowed for the following special needs of recipients of 
13.26 	Minnesota supplemental aid who are not residents of a nursing home, a regional treatment 
13.27 	center, or a group residential housing facility.
13.28 	(a) The county agency shall pay a monthly allowance for medically prescribed 
13.29 	diets if the cost of those additional dietary needs cannot be met through some other 
13.30 	maintenance benefit. The need for special diets or dietary items must be prescribed by 
13.31 	a licensed physician. Costs for special diets shall be determined as percentages of the 
13.32 	allotment for a one-person household under the thrifty food plan as defined by the United 
13.33 	States Department of Agriculture. The types of diets and the percentages of the thrifty 
13.34 	food plan that are covered are as follows:
13.35 	(1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;
14.1 	(2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent 
14.2 	of thrifty food plan;
14.3 	(3) controlled protein diet, less than 40 grams and requires special products, 125 
14.4 	percent of thrifty food plan;
14.5 	(4) low cholesterol diet, 25 percent of thrifty food plan;
14.6 	(5) high residue diet, 20 percent of thrifty food plan;
14.7 	(6) pregnancy and lactation diet, 35 percent of thrifty food plan;
14.8 	(7) gluten-free diet, 25 percent of thrifty food plan;
14.9 	(8) lactose-free diet, 25 percent of thrifty food plan;
14.10 	(9) antidumping diet, 15 percent of thrifty food plan;
14.11 	(10) hypoglycemic diet, 15 percent of thrifty food plan; or
14.12 	(11) ketogenic diet, 25 percent of thrifty food plan.
14.13 	(b) Payment for nonrecurring special needs must be allowed for necessary home 
14.14 	repairs or necessary repairs or replacement of household furniture and appliances using 
14.15 	the payment standard of the AFDC program in effect on July 16, 1996, for these expenses, 
14.16 	as long as other funding sources are not available.
14.17 	(c) A fee for guardian or conservator service is allowed at a reasonable rate 
14.18 	negotiated by the county or approved by the court. This rate shall not exceed five percent 
14.19 	of the assistance unit's gross monthly income up to a maximum of $100 per month. If the 
14.20 	guardian or conservator is a member of the county agency staff, no fee is allowed.
14.21 	(d) The county agency shall continue to pay a monthly allowance of $68 for 
14.22 	restaurant meals for a person who was receiving a restaurant meal allowance on June 1, 
14.23 	1990, and who eats two or more meals in a restaurant daily. The allowance must continue 
14.24 	until the person has not received Minnesota supplemental aid for one full calendar month 
14.25 	or until the person's living arrangement changes and the person no longer meets the criteria 
14.26 	for the restaurant meal allowance, whichever occurs first.
14.27 	(e) A fee of ten percent of the recipient's gross income or $25, whichever is less, 
14.28 	is allowed for representative payee services provided by an agency that meets the 
14.29 	requirements under SSI regulations to charge a fee for representative payee services. This 
14.30 	special need is available to all recipients of Minnesota supplemental aid regardless of 
14.31 	their living arrangement.
14.32 	(f)(1) Notwithstanding the language in this subdivision, an amount equal to the 
14.33 	maximum allotment authorized by the federal Food Stamp Program for a single individual 
14.34 	which is in effect on the first day of July of each year will be added to the standards of 
14.35 	assistance established in subdivisions 1 to 4 for adults under the age of 65 who qualify 
14.36 	as shelter needy and are: (i) relocating from an institution, or an adult mental health 
15.1 	residential treatment program under section 256B.0622; (ii) eligible for the self-directed 
15.2 	supports option as defined under section 256B.0657, subdivision 2; or (iii) home and 
15.3 	community-based waiver recipients living in their own home or rented or leased apartment 
15.4 	which is not owned, operated, or controlled by a provider of service not related by blood 
15.5 	or marriage, unless allowed under paragraph (g).
15.6 	(2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the 
15.7 	shelter needy benefit under this paragraph is considered a household of one. An eligible 
15.8 	individual who receives this benefit prior to age 65 may continue to receive the benefit 
15.9 	after the age of 65.
15.10 	(3) "Shelter needy" means that the assistance unit incurs monthly shelter costs that 
15.11 	exceed 40 percent of the assistance unit's gross income before the application of this 
15.12 	special needs standard. "Gross income" for the purposes of this section is the applicant's 
15.13 	or recipient's prior month's income as defined in section 256D.35, subdivision 10, or the 
15.14 	standard specified in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient 
15.15 	of a federal or state housing subsidy, that limits shelter costs to a percentage of gross 
15.16 	income, shall not be considered shelter needy for purposes of this paragraph.
15.17 	(g) Notwithstanding this subdivision, to access housing and services as provided 
15.18 	in paragraph (f), the recipient may choose housing that may be owned, operated, or 
15.19 	controlled by the recipient's service provider. In a multifamily building of more than four 
15.20 	or more units, the maximum number of apartments at one address that may be used by 
15.21 	recipients of this program shall be 50 percent of the units in a building. This paragraph 
15.22 	expires on June 30, 2012 2014.

15.23 	Sec. 16. [256D.461] EMERGENCY AID.
15.24 	Applicants for or recipients of Supplemental Security Income or Minnesota 
15.25 	supplemental aid who have emergent need may apply for emergency general assistance 
15.26 	under section 256D.06, subdivision 2.

15.27 	Sec. 17. Minnesota Statutes 2010, section 256I.04, subdivision 2b, is amended to read:
15.28 		Subd. 2b.Group residential housing agreements. (a) Agreements between county 
15.29 	agencies and providers of group residential housing must be in writing and must specify 
15.30 	the name and address under which the establishment subject to the agreement does 
15.31 	business and under which the establishment, or service provider, if different from the 
15.32 	group residential housing establishment, is licensed by the Department of Health or the 
15.33 	Department of Human Services; the specific license or registration from the Department 
15.34 	of Health or the Department of Human Services held by the provider and the number 
16.1 	of beds subject to that license; the address of the location or locations at which group 
16.2 	residential housing is provided under this agreement; the per diem and monthly rates that 
16.3 	are to be paid from group residential housing funds for each eligible resident at each 
16.4 	location; the number of beds at each location which are subject to the group residential 
16.5 	housing agreement; whether the license holder is a not-for-profit corporation under section 
16.6 	501(c)(3) of the Internal Revenue Code; and a statement that the agreement is subject to 
16.7 	the provisions of sections 256I.01 to 256I.06 and subject to any changes to those sections. 
16.8 	Group residential housing agreements may be terminated with or without cause by either 
16.9 	the county or the provider with two calendar months prior notice.
16.10 	(b) Beginning July 1, 2011, counties must not enter into agreements with providers of 
16.11 	group residential housing that do not include a residency requirement of at least 20 hours 
16.12 	per week of volunteer or paid work. A person who is unable to obtain or retain 20 hours per 
16.13 	month of volunteer or paid work due to a professionally certified illness, injury, disability, 
16.14 	or incapacity must not be made ineligible for group residential housing under this section.

16.15 	Sec. 18. Minnesota Statutes 2010, section 256I.05, subdivision 1a, is amended to read:
16.16 		Subd. 1a.Supplementary service rates. (a) Subject to the provisions of section 
16.17 	256I.04, subdivision 3, the county agency may negotiate a payment not to exceed $426.37 
16.18 	for other services necessary to provide room and board provided by the group residence 
16.19 	if the residence is licensed by or registered by the Department of Health, or licensed by 
16.20 	the Department of Human Services to provide services in addition to room and board,
16.21 	and can demonstrate a chemical dependency success rate of at least 30 percent for 
16.22 	participants six months after completing the program, and if the provider of services is 
16.23 	not also concurrently receiving funding for services for a recipient under a home and 
16.24 	community-based waiver under title XIX of the Social Security Act; or funding from 
16.25 	the medical assistance program under section 256B.0659, for personal care services for 
16.26 	residents in the setting; or residing in a setting which receives funding under Minnesota 
16.27 	Rules, parts 9535.2000 to 9535.3000. If funding is available for other necessary services 
16.28 	through a home and community-based waiver, or personal care services under section 
16.29 	256B.0659, then the GRH rate is limited to the rate set in subdivision 1. The county 
16.30 	agency is limited to negotiating a payment not to exceed $100 for residences that provide 
16.31 	other services necessary to provide room and board if the residence does not allow alcohol 
16.32 	on the property, provides minimal services, and is unable to demonstrate a chemical 
16.33 	dependency success rate of at least 30 percent for participants six months after completing 
16.34 	the program. Unless otherwise provided in law, in no case may the supplementary service 
16.35 	rate exceed $426.37. The registration and licensure requirement does not apply to 
17.1 	establishments which are exempt from state licensure because they are located on Indian 
17.2 	reservations and for which the tribe has prescribed health and safety requirements. Service 
17.3 	payments under this section may be prohibited under rules to prevent the supplanting of 
17.4 	federal funds with state funds. The commissioner shall pursue the feasibility of obtaining 
17.5 	the approval of the Secretary of Health and Human Services to provide home and 
17.6 	community-based waiver services under title XIX of the Social Security Act for residents 
17.7 	who are not eligible for an existing home and community-based waiver due to a primary 
17.8 	diagnosis of mental illness or chemical dependency and shall apply for a waiver if it is 
17.9 	determined to be cost-effective.
17.10 	(b) The commissioner is authorized to make cost-neutral transfers from the GRH 
17.11 	fund for beds under this section to other funding programs administered by the department 
17.12 	after consultation with the county or counties in which the affected beds are located. 
17.13 	The commissioner may also make cost-neutral transfers from the GRH fund to county 
17.14 	human service agencies for beds permanently removed from the GRH census under a plan 
17.15 	submitted by the county agency and approved by the commissioner. The commissioner 
17.16 	shall report the amount of any transfers under this provision annually to the legislature.
17.17 	(c) The provisions of paragraph (b) do not apply to a facility that has its 
17.18 	reimbursement rate established under section 256B.431, subdivision 4, paragraph (c).

17.19 	Sec. 19. Minnesota Statutes 2010, section 256J.20, subdivision 3, is amended to read:
17.20 		Subd. 3.Other property limitations. To be eligible for MFIP, the equity value of 
17.21 	all nonexcluded real and personal property of the assistance unit must not exceed $2,000 
17.22 	for applicants and $5,000 for ongoing participants. The value of assets in clauses (1) to 
17.23 	(19) must be excluded when determining the equity value of real and personal property:
17.24 	(1) a licensed vehicle up to a loan value of less than or equal to $15,000 $10,000. If 
17.25 	the assistance unit owns more than one licensed vehicle, the county agency shall determine 
17.26 	the loan value of all additional vehicles and exclude the combined loan value of less than 
17.27 	or equal to $7,500. The county agency shall apply any excess loan value as if it were 
17.28 	equity value to the asset limit described in this section, excluding: (i) the value of one 
17.29 	vehicle per physically disabled person when the vehicle is needed to transport the disabled 
17.30 	unit member; this exclusion does not apply to mentally disabled people; (ii) the value of 
17.31 	special equipment for a disabled member of the assistance unit; and (iii) any vehicle used 
17.32 	for long-distance travel, other than daily commuting, for the employment of a unit member.
17.33 	To establish the loan value of vehicles, a county agency must use the N.A.D.A. 
17.34 	Official Used Car Guide, Midwest Edition, for newer model cars. When a vehicle is not 
17.35 	listed in the guidebook, or when the applicant or participant disputes the loan value listed 
18.1 	in the guidebook as unreasonable given the condition of the particular vehicle, the county 
18.2 	agency may require the applicant or participant document the loan value by securing a 
18.3 	written statement from a motor vehicle dealer licensed under section 168.27, stating 
18.4 	the amount that the dealer would pay to purchase the vehicle. The county agency shall 
18.5 	reimburse the applicant or participant for the cost of a written statement that documents 
18.6 	a lower loan value;
18.7 	(2) the value of life insurance policies for members of the assistance unit;
18.8 	(3) one burial plot per member of an assistance unit;
18.9 	(4) the value of personal property needed to produce earned income, including 
18.10 	tools, implements, farm animals, inventory, business loans, business checking and 
18.11 	savings accounts used at least annually and used exclusively for the operation of a 
18.12 	self-employment business, and any motor vehicles if at least 50 percent of the vehicle's use 
18.13 	is to produce income and if the vehicles are essential for the self-employment business;
18.14 	(5) the value of personal property not otherwise specified which is commonly 
18.15 	used by household members in day-to-day living such as clothing, necessary household 
18.16 	furniture, equipment, and other basic maintenance items essential for daily living;
18.17 	(6) the value of real and personal property owned by a recipient of Supplemental 
18.18 	Security Income or Minnesota supplemental aid;
18.19 	(7) the value of corrective payments, but only for the month in which the payment 
18.20 	is received and for the following month;
18.21 	(8) a mobile home or other vehicle used by an applicant or participant as the 
18.22 	applicant's or participant's home;
18.23 	(9) money in a separate escrow account that is needed to pay real estate taxes or 
18.24 	insurance and that is used for this purpose;
18.25 	(10) money held in escrow to cover employee FICA, employee tax withholding, 
18.26 	sales tax withholding, employee worker compensation, business insurance, property rental, 
18.27 	property taxes, and other costs that are paid at least annually, but less often than monthly;
18.28 	(11) monthly assistance payments for the current month's or short-term emergency 
18.29 	needs under section 256J.626, subdivision 2;
18.30 	(12) the value of school loans, grants, or scholarships for the period they are 
18.31 	intended to cover;
18.32 	(13) payments listed in section 256J.21, subdivision 2, clause (9), which are held 
18.33 	in escrow for a period not to exceed three months to replace or repair personal or real 
18.34 	property;
18.35 	(14) income received in a budget month through the end of the payment month;
19.1 	(15) savings from earned income of a minor child or a minor parent that are set aside 
19.2 	in a separate account designated specifically for future education or employment costs;
19.3 	(16) the federal earned income credit, Minnesota working family credit, state and 
19.4 	federal income tax refunds, state homeowners and renters credits under chapter 290A, 
19.5 	property tax rebates and other federal or state tax rebates in the month received and the 
19.6 	following month;
19.7 	(17) payments excluded under federal law as long as those payments are held in a 
19.8 	separate account from any nonexcluded funds;
19.9 	(18) the assets of children ineligible to receive MFIP benefits because foster care or 
19.10 	adoption assistance payments are made on their behalf; and
19.11 	(19) the assets of persons whose income is excluded under section 256J.21, 
19.12 	subdivision 2, clause (43).

19.13 	Sec. 20. Minnesota Statutes 2010, section 256J.53, subdivision 2, is amended to read:
19.14 		Subd. 2.Approval of postsecondary education or training. (a) In order for a 
19.15 	postsecondary education or training program to be an approved activity in an employment 
19.16 	plan, the plan must include additional work activities if the education and training 
19.17 	activities do not meet the minimum hours required to meet the federal work participation 
19.18 	rate under Code of Federal Regulations, title 45, sections 261.31 and 261.35 participant 
19.19 	must be working in unsubsidized employment at least 20 hours per week.
19.20 	(b) Participants seeking approval of a postsecondary education or training plan 
19.21 	must provide documentation that:
19.22 	(1) the employment goal can only be met with the additional education or training;
19.23 	(2) there are suitable employment opportunities that require the specific education or 
19.24 	training in the area in which the participant resides or is willing to reside;
19.25 	(3) the education or training will result in significantly higher wages for the 
19.26 	participant than the participant could earn without the education or training;
19.27 	(4) the participant can meet the requirements for admission into the program; and
19.28 	(5) there is a reasonable expectation that the participant will complete the training 
19.29 	program based on such factors as the participant's MFIP assessment, previous education, 
19.30 	training, and work history; current motivation; and changes in previous circumstances.
19.31 	(c) The hourly unsubsidized employment requirement does not apply for intensive 
19.32 	education or training programs lasting 12 weeks or less when full-time attendance is 
19.33 	required.

19.34 	Sec. 21. Minnesota Statutes 2010, section 260C.157, subdivision 3, is amended to read:
20.1 		Subd. 3.Juvenile treatment screening team. (a) The responsible social services 
20.2 	agency shall establish a juvenile treatment screening team to conduct screenings and 
20.3 	prepare case plans under this subdivision section 245.487, subdivision 3, and chapters 
20.4 	260C and 260D. Screenings shall be conducted within 15 days of a request for a screening. 
20.5 	The team, which may be the team constituted under section 245.4885 or 256B.092 or 
20.6 	Minnesota Rules, parts 9530.6600 to 9530.6655, shall consist of social workers, juvenile 
20.7 	justice professionals, and persons with expertise in the treatment of juveniles who are 
20.8 	emotionally disabled, chemically dependent, or have a developmental disability. The team 
20.9 	shall involve parents or guardians in the screening process as appropriate, and the child's 
20.10 	parent, guardian, or permanent legal custodian under section 260C.201, subdivision 11. 
20.11 	The team may be the same team as defined in section 260B.157, subdivision 3.
20.12 	(b) The social services agency shall determine whether a child brought to its 
20.13 	attention for the purposes described in this section is an Indian child, as defined in section 
20.14 	260C.007, subdivision 21, and shall determine the identity of the Indian child's tribe, as 
20.15 	defined in section 260.755, subdivision 9. When a child to be evaluated is an Indian child, 
20.16 	the team provided in paragraph (a) shall include a designated representative of the Indian 
20.17 	child's tribe, unless the child's tribal authority declines to appoint a representative. The 
20.18 	Indian child's tribe may delegate its authority to represent the child to any other federally 
20.19 	recognized Indian tribe, as defined in section 260.755, subdivision 12.
20.20 	(c) If the court, prior to, or as part of, a final disposition, proposes to place a child:
20.21 	(1) for the primary purpose of treatment for an emotional disturbance, a 
20.22 	developmental disability, or chemical dependency in a residential treatment facility out 
20.23 	of state or in one which is within the state and licensed by the commissioner of human 
20.24 	services under chapter 245A; or
20.25 	(2) in any out-of-home setting potentially exceeding 30 days in duration, including a 
20.26 	postdispositional placement in a facility licensed by the commissioner of corrections or 
20.27 	human services, the court shall ascertain whether the child is an Indian child and shall 
20.28 	notify the county welfare agency and, if the child is an Indian child, shall notify the Indian 
20.29 	child's tribe. The county's juvenile treatment screening team must either: (i) screen and 
20.30 	evaluate the child and file its recommendations with the court within 14 days of receipt 
20.31 	of the notice; or (ii) elect not to screen a given case and notify the court of that decision 
20.32 	within three working days.
20.33 	(d) If the screening team has elected to screen and evaluate the child, The child 
20.34 	may not be placed for the primary purpose of treatment for an emotional disturbance, a 
20.35 	developmental disability, or chemical dependency, in a residential treatment facility out of 
21.1 	state nor in a residential treatment facility within the state that is licensed under chapter 
21.2 	245A, unless one of the following conditions applies:
21.3 	(1) a treatment professional certifies that an emergency requires the placement 
21.4 	of the child in a facility within the state;
21.5 	(2) the screening team has evaluated the child and recommended that a residential 
21.6 	placement is necessary to meet the child's treatment needs and the safety needs of the 
21.7 	community, that it is a cost-effective means of meeting the treatment needs, and that it 
21.8 	will be of therapeutic value to the child; or
21.9 	(3) the court, having reviewed a screening team recommendation against placement, 
21.10 	determines to the contrary that a residential placement is necessary. The court shall state 
21.11 	the reasons for its determination in writing, on the record, and shall respond specifically 
21.12 	to the findings and recommendation of the screening team in explaining why the 
21.13 	recommendation was rejected. The attorney representing the child and the prosecuting 
21.14 	attorney shall be afforded an opportunity to be heard on the matter.
21.15 	(e) When the county's juvenile treatment screening team has elected to screen and 
21.16 	evaluate a child determined to be an Indian child, the team shall provide notice to the 
21.17 	tribe or tribes that accept jurisdiction for the Indian child or that recognize the child as a 
21.18 	member of the tribe or as a person eligible for membership in the tribe, and permit the 
21.19 	tribe's representative to participate in the screening team.
21.20 	(f) When the Indian child's tribe or tribal health care services provider or Indian 
21.21 	Health Services provider proposes to place a child for the primary purpose of treatment 
21.22 	for an emotional disturbance, a developmental disability, or co-occurring emotional 
21.23 	disturbance and chemical dependency, the Indian child's tribe or the tribe delegated by 
21.24 	the child's tribe shall submit necessary documentation to the county juvenile treatment 
21.25 	screening team, which must invite the Indian child's tribe to designate a representative to 
21.26 	the screening team.

21.27 	Sec. 22. Minnesota Statutes 2010, section 260D.01, is amended to read:
21.28 	260D.01 CHILD IN VOLUNTARY FOSTER CARE FOR TREATMENT.
21.29 	(a) Sections 260D.01 to 260D.10, may be cited as the "child in voluntary foster care 
21.30 	for treatment" provisions of the Juvenile Court Act.
21.31 	(b) The juvenile court has original and exclusive jurisdiction over a child in 
21.32 	voluntary foster care for treatment upon the filing of a report or petition required under 
21.33 	this chapter. All obligations of the agency to a child and family in foster care contained in 
21.34 	chapter 260C not inconsistent with this chapter are also obligations of the agency with 
21.35 	regard to a child in foster care for treatment under this chapter.
22.1 	(c) This chapter shall be construed consistently with the mission of the children's 
22.2 	mental health service system as set out in section 245.487, subdivision 3, and the duties 
22.3 	of an agency under section 256B.092, 260C.157, and Minnesota Rules, parts 9525.0004 
22.4 	to 9525.0016, to meet the needs of a child with a developmental disability or related 
22.5 	condition. This chapter:
22.6 	(1) establishes voluntary foster care through a voluntary foster care agreement as the 
22.7 	means for an agency and a parent to provide needed treatment when the child must be in 
22.8 	foster care to receive necessary treatment for an emotional disturbance or developmental 
22.9 	disability or related condition;
22.10 	(2) establishes court review requirements for a child in voluntary foster care for 
22.11 	treatment due to emotional disturbance or developmental disability or a related condition;
22.12 	(3) establishes the ongoing responsibility of the parent as legal custodian to visit the 
22.13 	child, to plan together with the agency for the child's treatment needs, to be available and 
22.14 	accessible to the agency to make treatment decisions, and to obtain necessary medical, 
22.15 	dental, and other care for the child; and
22.16 	(4) applies to voluntary foster care when the child's parent and the agency agree that 
22.17 	the child's treatment needs require foster care either:
22.18 	(i) due to a level of care determination by the agency's screening team informed by 
22.19 	the diagnostic and functional assessment under section 245.4885; or
22.20 	(ii) due to a determination regarding the level of services needed by the responsible 
22.21 	social services' screening team under section 256B.092, and Minnesota Rules, parts 
22.22 	9525.0004 to 9525.0016.
22.23 	(d) This chapter does not apply when there is a current determination under section 
22.24 	626.556 that the child requires child protective services or when the child is in foster care 
22.25 	for any reason other than treatment for the child's emotional disturbance or developmental 
22.26 	disability or related condition. When there is a determination under section 626.556 that 
22.27 	the child requires child protective services based on an assessment that there are safety 
22.28 	and risk issues for the child that have not been mitigated through the parent's engagement 
22.29 	in services or otherwise, or when the child is in foster care for any reason other than 
22.30 	the child's emotional disturbance or developmental disability or related condition, the 
22.31 	provisions of chapter 260C apply.
22.32 	(e) The paramount consideration in all proceedings concerning a child in voluntary 
22.33 	foster care for treatment is the safety, health, and the best interests of the child. The 
22.34 	purpose of this chapter is:
22.35 	(1) to ensure a child with a disability is provided the services necessary to treat or 
22.36 	ameliorate the symptoms of the child's disability;
23.1 	(2) to preserve and strengthen the child's family ties whenever possible and in the 
23.2 	child's best interests, approving the child's placement away from the child's parents only 
23.3 	when the child's need for care or treatment requires it and the child cannot be maintained 
23.4 	in the home of the parent; and
23.5 	(3) to ensure the child's parent retains legal custody of the child and associated 
23.6 	decision-making authority unless the child's parent willfully fails or is unable to make 
23.7 	decisions that meet the child's safety, health, and best interests. The court may not find 
23.8 	that the parent willfully fails or is unable to make decisions that meet the child's needs 
23.9 	solely because the parent disagrees with the agency's choice of foster care facility, unless 
23.10 	the agency files a petition under chapter 260C, and establishes by clear and convincing 
23.11 	evidence that the child is in need of protection or services.
23.12 	(f) The legal parent-child relationship shall be supported under this chapter by 
23.13 	maintaining the parent's legal authority and responsibility for ongoing planning for the 
23.14 	child and by the agency's assisting the parent, where necessary, to exercise the parent's 
23.15 	ongoing right and obligation to visit or to have reasonable contact with the child. Ongoing 
23.16 	planning means:
23.17 	(1) actively participating in the planning and provision of educational services, 
23.18 	medical, and dental care for the child;
23.19 	(2) actively planning and participating with the agency and the foster care facility 
23.20 	for the child's treatment needs; and
23.21 	(3) planning to meet the child's need for safety, stability, and permanency, and the 
23.22 	child's need to stay connected to the child's family and community.
23.23 	(g) The provisions of section 260.012 to ensure placement prevention, family 
23.24 	reunification, and all active and reasonable effort requirements of that section apply. This 
23.25 	chapter shall be construed consistently with the requirements of the Indian Child Welfare 
23.26 	Act of 1978, United States Code, title 25, section 1901, et al., and the provisions of the 
23.27 	Minnesota Indian Family Preservation Act, sections 260.751 to 260.835.

23.28 	Sec. 23. Minnesota Statutes 2010, section 393.07, subdivision 10a, is amended to read:
23.29 		Subd. 10a.Expedited issuance of food stamps. The commissioner of human 
23.30 	services shall continually monitor the expedited issuance of food stamp benefits to ensure 
23.31 	that each county complies with federal regulations and that households eligible for 
23.32 	expedited issuance of food stamps are identified, processed, and certified within the time 
23.33 	frames prescribed in federal regulations.
24.1 	County food stamp offices shall screen and issue food stamps to applicants on the 
24.2 	day of application. Applicants who meet the federal criteria for expedited issuance and 
24.3 	have an immediate need for food assistance shall receive within two working days either:
24.4 	(1) a manual Authorization to Participate (ATP) card; or
24.5 	(2) the immediate issuance of food stamp coupons.
24.6 	The local food stamp agency shall conspicuously post in each food stamp office a 
24.7 	notice of the availability of and the procedure for applying for expedited issuance and 
24.8 	verbally advise each applicant of the availability of the expedited process.

24.9 	Sec. 24. GRANT PROGRAM TO PROMOTE HEALTHY COMMUNITY 
24.10 	INITIATIVES.
 24.11 	(a) The commissioner of human services must contract with the Search Institute to 
24.12 	help local communities develop, expand, and maintain the tools, training, and resources 
24.13 	needed to foster positive community development and effectively engage people in their 
24.14 	community. The Search Institute must: (1) provide training in community mobilization, 
24.15 	youth development, and assets getting to outcomes; (2) provide ongoing technical 
24.16 	assistance to communities receiving grants under this section; (3) use best practices to 
24.17 	promote community development; (4) share best program practices with other interested 
24.18 	communities; (5) create electronic and other opportunities for communities to share 
24.19 	experiences in and resources for promoting healthy community development; and (6) 
24.20 	provide an annual report of the strong communities project.
24.21 	(b) Specifically, the Search Institute must use a competitive grant process to select 
24.22 	four interested communities throughout Minnesota to undertake strong community 
24.23 	mobilization initiatives to support communities wishing to catalyze multiple sectors to 
24.24 	create or strengthen a community collaboration to address issues of poverty in their 
24.25 	communities. The Search Institute must provide the selected communities with the 
24.26 	tools, training, and resources they need for successfully implementing initiatives focused 
24.27 	on strengthening the community. The Search Institute also must use a competitive 
24.28 	grant process to provide four strong community innovation grants to encourage current 
24.29 	community initiatives to bring new innovation approaches to their work to reduce poverty. 
24.30 	Finally, the Search Institute must work to strengthen networking and information sharing 
24.31 	activities among all healthy community initiatives throughout Minnesota, including 
24.32 	sharing best program practices and providing personal and electronic opportunities for 
24.33 	peer learning and ongoing program support.
24.34 	(c) In order to receive a grant under paragraph (b), a community must show 
24.35 	involvement of at least three sectors of their community and the active leadership of both 
25.1 	youth and adults. Sectors may include, but are not limited to, local government, schools, 
25.2 	community action agencies, faith communities, businesses, higher education institutions, 
25.3 	and the medical community. In addition, communities must agree to: (1) attend training 
25.4 	on community mobilization processes and strength-based approaches; (2) apply the assets 
25.5 	getting to outcomes process in their initiative; (3) meet at least two times during the 
25.6 	grant period to share successes and challenges with other grantees; (4) participate on an 
25.7 	electronic listserv to share information throughout the period on their work; and (5) all 
25.8 	communication requirements and reporting processes.
25.9 	(d) The commissioner of human services must evaluate the effectiveness of this 
25.10 	program and must recommend to the committees of the legislature with jurisdiction over 
25.11 	health and human services reform and finance by February 15, 2013, whether or not 
25.12 	to make the program available statewide. The Search Institute annually must report to 
25.13 	the commissioner of human services on the services it provided and the grant money 
25.14 	it expended under this section.

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

25.16 	Sec. 25. CIRCLES OF SUPPORT GRANTS.
 25.17 	The commissioner of human services must provide grants to community action 
25.18 	agencies to help local communities develop, expand, and maintain the tools, training, and 
25.19 	resources needed to foster social assets to assist people out of poverty through circles of 
25.20 	support. The circles of support model must provide a framework for a community to build 
25.21 	relationships across class and race lines so that people can work together to advocate for 
25.22 	change in their communities and move individuals toward self-sufficiency.
25.23 	Specifically, circles of support initiatives must focus on increasing social capital, 
25.24 	income, educational attainment, and individual accountability, while reducing debt, 
25.25 	service dependency, and addressing systemic disparities that hold poverty in place. The 
25.26 	effort must support the development of local guiding coalitions as the link between the 
25.27 	community and circles of support for resource development and funding leverage.

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

25.29 	Sec. 26. PILOT PROJECT FOR HOMELESS ADULTS TO BE IN-HOME 
25.30 	CARETAKERS OF FORECLOSED HOMES.
 25.31 	(a) Stepping Stone Emergency Housing may form a partnership with local banks 
25.32 	who own foreclosed homes to:
26.1 	(1) utilize foreclosed homes for graduates of Stepping Stone Emergency Housing to 
26.2 	become in-home caretakers of those homes;
26.3 	(2) provide the security needed by the homes' banking owners and others to help 
26.4 	stabilize neighborhoods through carefully maintained homes that will prevent vandalism, 
26.5 	squatters, and drug houses;
26.6 	(3) provide transitional housing to up to four homeless clients per home after they 
26.7 	graduate from emergency housing allowing the clients time to find permanent housing 
26.8 	in a tight affordable housing market; and
26.9 	(4) provide management of the project to ensure proper oversight for the homes' 
26.10 	owners and support of the caretakers.
26.11 	(b) This section expires June 30, 2013.

26.12 	Sec. 27. HOMELESS SHELTERS; SCHOOL DISTRICTS.
 26.13 	School districts may coordinate with local units of government and homeless 
26.14 	services providers to use empty school buildings as homeless shelters.

26.15 	Sec. 28. REQUIREMENT FOR LIQUOR STORES, TOBACCO STORES, 
26.16 	GAMBLING ESTABLISHMENTS, AND TATTOO PARLORS.
 26.17 	Liquor stores, tobacco stores, gambling establishments, and tattoo parlors must 
26.18 	negotiate with their third-party processors to block EBT card cash transactions at their 
26.19 	places of business and withdrawals of cash at automatic teller machines located in their 
26.20 	places of business.

26.21 	Sec. 29. MINNESOTA EBT BUSINESS TASK FORCE.
 26.22 		Subdivision 1.Members. The Minnesota EBT Business Task Force includes seven 
26.23 	members, appointed as follows:
26.24 	(1) two members of the Minnesota house of representatives, one appointed by the 
26.25 	speaker of the house and one appointed by the minority leader;
26.26 	(2) two members of the Minnesota senate, one appointed by the senate majority 
26.27 	leader and one appointed by the senate minority leader;
26.28 	(3) the commissioner of human services, or designee;
26.29 	(4) an appointee of the Minnesota Grocers Association; and
26.30 	(5) a credit card processor, appointed by the commissioner of human services.
26.31 		Subd. 2.Duties. The Minnesota EBT Business Task Force shall create a workable 
26.32 	strategy to eliminate the purchase of tobacco and alcoholic beverages by recipients of the 
26.33 	general assistance program and Minnesota supplemental aid program under Minnesota 
27.1 	Statutes, chapter 256D, and programs under Minnesota Statutes, chapter 256J, using EBT 
27.2 	cards. The task force will consider cost to the state, feasibility of execution at retail, and 
27.3 	ease of use and privacy for EBT cardholders.
27.4 		Subd. 3.Report. The task force will report back to the legislative committees with 
27.5 	jurisdiction over health and human services policy and finance by April 1, 2012, with 
27.6 	recommendations related to the task force duties under subdivision 2.
27.7 		Subd. 4.Expiration. The task force expires on June 30, 2012.

27.8 	Sec. 30.  REPEALER.
 27.9 	(a) Minnesota Statutes 2010, sections 256.979, subdivisions 5, 6, 7, and 10; 
27.10 	256.9791; 256.9862, subdivision 2; and 256I.05, subdivisions 1d, 1e, 1f, 1g, 1h, 1i, 1j, 
27.11 	1k, 1l, 1m, and 1n, are repealed.
27.12 	(b) Minnesota Rules, part 3400.0130, subpart 8, is repealed effective September 
27.13 	3, 2012.

27.14 	ARTICLE 2
27.15 	DEPARTMENT OF HEALTH

27.16 	Section 1. Minnesota Statutes 2010, section 62D.08, subdivision 7, is amended to read:
27.17 		Subd. 7.Consistent administrative expenses and investment income reporting.
 27.18 	(a) Every health maintenance organization must directly allocate administrative expenses 
27.19 	to specific lines of business or products when such information is available. The definition 
27.20 	of administrative expenses must be consistent with that of the National Association of 
27.21 	Insurance Commissioners (NAIC) as provided in the most current NAIC blank. Remaining 
27.22 	expenses that cannot be directly allocated must be allocated based on other methods, as 
27.23 	recommended by the Advisory Group on Administrative Expenses. Health maintenance 
27.24 	organizations must submit this information, including administrative expenses for dental 
27.25 	services, using the reporting template provided by the commissioner of health.
27.26 	(b) Every health maintenance organization must allocate investment income based 
27.27 	on cumulative net income over time by business line or product and must submit this 
27.28 	information, including investment income for dental services, using the reporting template 
27.29 	provided by the commissioner of health.

27.30 	Sec. 2. Minnesota Statutes 2010, section 62J.04, subdivision 3, is amended to read:
27.31 		Subd. 3.Cost containment duties. The commissioner shall:
28.1 	(1) establish statewide and regional cost containment goals for total health care 
28.2 	spending under this section and collect data as described in sections 62J.38to 62J.41 and 
28.3 	62J.40 to monitor statewide achievement of the cost containment goals; 
28.4 	(2) divide the state into no fewer than four regions, with one of those regions being 
28.5 	the Minneapolis/St. Paul metropolitan statistical area but excluding Chisago, Isanti, 
28.6 	Wright, and Sherburne Counties, for purposes of fostering the development of regional 
28.7 	health planning and coordination of health care delivery among regional health care 
28.8 	systems and working to achieve the cost containment goals;
28.9 	(3) monitor the quality of health care throughout the state and take action as 
28.10 	necessary to ensure an appropriate level of quality;
28.11 	(4) issue recommendations regarding uniform billing forms, uniform electronic 
28.12 	billing procedures and data interchanges, patient identification cards, and other uniform 
28.13 	claims and administrative procedures for health care providers and private and public 
28.14 	sector payers. In developing the recommendations, the commissioner shall review the 
28.15 	work of the work group on electronic data interchange (WEDI) and the American National 
28.16 	Standards Institute (ANSI) at the national level, and the work being done at the state and 
28.17 	local level. The commissioner may adopt rules requiring the use of the Uniform Bill 
28.18 	82/92 form, the National Council of Prescription Drug Providers (NCPDP) 3.2 electronic 
28.19 	version, the Centers for Medicare and Medicaid Services 1500 form, or other standardized 
28.20 	forms or procedures;
28.21 	(5) undertake health planning responsibilities;
28.22 	(6) authorize, fund, or promote research and experimentation on new technologies 
28.23 	and health care procedures;
28.24 	(7) within the limits of appropriations for these purposes, administer or contract for 
28.25 	statewide consumer education and wellness programs that will improve the health of 
28.26 	Minnesotans and increase individual responsibility relating to personal health and the 
28.27 	delivery of health care services, undertake prevention programs including initiatives to 
28.28 	improve birth outcomes, expand childhood immunization efforts, and provide start-up 
28.29 	grants for worksite wellness programs;
28.30 	(8) undertake other activities to monitor and oversee the delivery of health care 
28.31 	services in Minnesota with the goal of improving affordability, quality, and accessibility of 
28.32 	health care for all Minnesotans; and
28.33 	(9) make the cost containment goal data available to the public in a 
28.34 	consumer-oriented manner.

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

29.1 	Sec. 3. Minnesota Statutes 2010, section 62J.17, subdivision 4a, is amended to read:
29.2 		Subd. 4a.Expenditure reporting. Each hospital, outpatient surgical center, 
29.3 	and diagnostic imaging center, and physician clinic shall report annually to the 
29.4 	commissioner on all major spending commitments, in the form and manner specified by 
29.5 	the commissioner. The report shall include the following information:
29.6 	(a) a description of major spending commitments made during the previous year, 
29.7 	including the total dollar amount of major spending commitments and purpose of the 
29.8 	expenditures;
29.9 	(b) the cost of land acquisition, construction of new facilities, and renovation of 
29.10 	existing facilities;
29.11 	(c) the cost of purchased or leased medical equipment, by type of equipment;
29.12 	(d) expenditures by type for specialty care and new specialized services;
29.13 	(e) information on the amount and types of added capacity for diagnostic imaging 
29.14 	services, outpatient surgical services, and new specialized services; and
29.15 	(f) information on investments in electronic medical records systems.
29.16 	For hospitals and outpatient surgical centers, this information shall be included in reports 
29.17 	to the commissioner that are required under section 144.698. For diagnostic imaging 
29.18 	centers, this information shall be included in reports to the commissioner that are required 
29.19 	under section 144.565. For physician clinics, this information shall be included in reports 
29.20 	to the commissioner that are required under section 62J.41. For all other health care 
29.21 	providers that are subject to this reporting requirement, reports must be submitted to the 
29.22 	commissioner by March 1 each year for the preceding calendar year.

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

29.24 	Sec. 4. Minnesota Statutes 2010, section 62J.495, is amended by adding a subdivision 
29.25 	to read:
29.26 		Subd. 7.Exemption. Any clinical practice with a total annual net revenue of less 
29.27 	than $500,000, and that has not received a state or federal grant for implementation 
29.28 	of electronic health records, is exempt from the requirements of subdivision 1. This 
29.29 	subdivision expires December 31, 2020.

29.30 	Sec. 5. Minnesota Statutes 2010, section 62J.497, is amended by adding a subdivision 
29.31 	to read:
29.32 		Subd. 6.Additional standards for electronic prescribing. By January 1, 2012, 
29.33 	the commissioner of health, in consultation with the Minnesota e-Health Advisory 
30.1 	Committee, must develop a method for incorporation of the following transactions into the 
30.2 	requirements and standards for electronic prescribing provided in subdivisions 2 and 3:
30.3 	(1) submission of requests for a formulary exception based on information required 
30.4 	on the form developed according to subdivision 4; and
30.5 	(2) submission of prior authorization requests based on information required on the 
30.6 	form developed according to subdivision 5.

30.7 	Sec. 6. Minnesota Statutes 2010, section 62J.692, is amended to read:
30.8 	62J.692 MEDICAL EDUCATION.
30.9 		Subdivision 1.Definitions. For purposes of this section, the following definitions 
30.10 	apply:
30.11 	(a) "Accredited clinical training" means the clinical training provided by a 
30.12 	medical education program that is accredited through an organization recognized by the 
30.13 	Department of Education, the Centers for Medicare and Medicaid Services, or another 
30.14 	national body who reviews the accrediting organizations for multiple disciplines and 
30.15 	whose standards for recognizing accrediting organizations are reviewed and approved by 
30.16 	the commissioner of health in consultation with the Medical Education and Research 
30.17 	Advisory Committee.
30.18 	(b) "Commissioner" means the commissioner of health.
30.19 	(c) "Clinical medical education program" means the accredited clinical training of 
30.20 	physicians (medical students and residents), doctor of pharmacy practitioners, doctors 
30.21 	of chiropractic, dentists, advanced practice nurses (clinical nurse specialists, certified 
30.22 	registered nurse anesthetists, nurse practitioners, and certified nurse midwives), and 
30.23 	physician assistants.
30.24 	(d) "Sponsoring institution" means a hospital, school, or consortium located in 
30.25 	Minnesota that sponsors and maintains primary organizational and financial responsibility 
30.26 	for a clinical medical education program in Minnesota and which is accountable to the 
30.27 	accrediting body.
30.28 	(e) "Teaching institution" means a hospital, medical center, clinic, or other 
30.29 	organization that conducts a clinical medical education program in Minnesota.
30.30 	(f) "Trainee" means a student or resident involved in a clinical medical education 
30.31 	program.
30.32 	(g) "Eligible trainee FTE's" means the number of trainees, as measured by full-time 
30.33 	equivalent counts, that are at training sites located in Minnesota with currently active 
30.34 	medical assistance enrollment status and a National Provider Identification (NPI) number 
30.35 	where training occurs in either an inpatient or ambulatory patient care setting and where 
31.1 	the training is funded, in part, by patient care revenues. Training that occurs in nursing 
31.2 	facility settings is not eligible for funding under this section.
31.3 		Subd. 3.Application process. (a) A clinical medical education program conducted 
31.4 	in Minnesota by a teaching institution to train physicians, doctor of pharmacy practitioners, 
31.5 	dentists, advanced dental therapists, chiropractors, or physician assistants is eligible for 
31.6 	funds under subdivision 4 or 11, as appropriate, if the program:
31.7 	(1) is funded, in part, by patient care revenues;
31.8 	(2) occurs in patient care settings that face increased financial pressure as a result of 
31.9 	competition with nonteaching patient care entities training activities; and
31.10 	(3) emphasizes primary care or specialties that are in undersupply in Minnesota in 
31.11 	rural areas or for racial, ethnic, or cultural populations in the state experiencing health 
31.12 	disparities.
31.13 	A clinical medical education program that trains pediatricians is requested to include 
31.14 	in its program curriculum training in case management and medication management for 
31.15 	children suffering from mental illness to be eligible for funds under subdivision 4.
31.16 	(b) A clinical medical education program for advanced practice nursing, registered 
31.17 	nurses, or licensed practical nurses is eligible for funds under subdivision 4 or 11, as 
31.18 	appropriate, if the program meets the eligibility requirements in paragraph (a), clauses 
31.19 	(1) to (3), and is sponsored by the University of Minnesota Academic Health Center, 
31.20 	the Mayo Foundation, or institutions that are part of the Minnesota State Colleges and 
31.21 	Universities system or members of the Minnesota Private College Council.
31.22 	(c) Applications must be submitted to the commissioner by a sponsoring institution 
31.23 	on behalf of an eligible clinical medical education program and must be received by 
31.24 	October 31 of each year for distribution in the following year. An application for funds 
31.25 	must contain the following information:
31.26 	(1) the official name and address of the sponsoring institution and the official 
31.27 	name and site address of the clinical medical education programs on whose behalf the 
31.28 	sponsoring institution is applying;
31.29 	(2) the name, title, and business address of those persons responsible for 
31.30 	administering the funds;
31.31 	(3) for each clinical medical education program for which funds are being sought; 
31.32 	the type and specialty orientation of trainees in the program; the name, site address, and 
31.33 	medical assistance provider number or National Provider Identification number (NPI) of 
31.34 	each training site used in the program; the total number of trainees at each training site; 
31.35 	and the total number of eligible trainee FTEs at each site; and
32.1 	(4) other supporting information the commissioner deems necessary to determine 
32.2 	program eligibility based on the criteria in paragraphs (a) and (b) and to ensure the 
32.3 	equitable appropriate distribution of funds.
32.4 	(d) An application must include the information specified in clauses (1) to (3) for 
32.5 	each clinical medical education program on an annual basis for three consecutive years. 
32.6 	After that time, an application must include the information specified in clauses (1) to (3) 
32.7 	when requested, at the discretion of the commissioner:
32.8 	(1) audited clinical training costs per trainee for each clinical medical education 
32.9 	program when available or estimates of clinical training costs based on audited financial 
32.10 	data;
32.11 	(2) a description of current sources of funding for clinical medical education costs, 
32.12 	including a description and dollar amount of all state and federal financial support, 
32.13 	including Medicare direct and indirect payments; and
32.14 	(3) other revenue received for the purposes of clinical training.
32.15 	(e) An applicant that does not provide information requested by the commissioner 
32.16 	shall not be eligible for funds for the current funding cycle.
32.17 		Subd. 4.Distribution of funds. (a) Following the distribution described under 
32.18 	paragraph (b), the commissioner shall annually distribute the available medical education 
32.19 	funds to all qualifying applicants based on a distribution formula that reflects a summation 
32.20 	of two factors:
32.21 	(1) a public program volume factor, which is determined by the total volume of 
32.22 	public program revenue received by each training site as a percentage of all public 
32.23 	program revenue received by all training sites in the fund pool; and.
32.24 	(2) a supplemental public program volume factor, which is determined by providing 
32.25 	a supplemental payment of 20 percent of each training site's grant to training sites whose 
32.26 	public program revenue accounted for at least 0.98 percent of the total public program 
32.27 	revenue received by all eligible training sites. Grants to training sites whose public 
32.28 	program revenue accounted for less than 0.98 percent of the total public program revenue 
32.29 	received by all eligible training sites shall be reduced by an amount equal to the total 
32.30 	value of the supplemental payment.
32.31 	Public program revenue for the distribution formula includes revenue from medical 
32.32 	assistance, prepaid medical assistance, general assistance medical care, and prepaid 
32.33 	general assistance medical care. Training sites that receive no public program revenue 
32.34 	are ineligible for funds available under this subdivision. For purposes of determining 
32.35 	training-site level grants to be distributed under paragraph (a), total statewide average 
32.36 	costs per trainee for medical residents is based on audited clinical training costs per trainee 
33.1 	in primary care clinical medical education programs for medical residents. Total statewide 
33.2 	average costs per trainee for dental residents is based on audited clinical training costs 
33.3 	per trainee in clinical medical education programs for dental students. Total statewide 
33.4 	average costs per trainee for pharmacy residents is based on audited clinical training costs 
33.5 	per trainee in clinical medical education programs for pharmacy students. Training sites 
33.6 	whose training-site level grant is less than $1,000, based on the formula described in this 
33.7 	paragraph, are ineligible for funds available under this subdivision.
33.8 	(b) $5,350,000 $4,900,000 of the available medical education funds in fiscal year 
33.9 	2012 and $3,044,000 beginning in fiscal year 2013 shall be distributed to fund training 
33.10 	designed to address health disparities as follows:
33.11 	(1) $1,475,000 $500,000 in fiscal year 2012 and $200,000 beginning in fiscal year 
33.12 	2013 to the University of Minnesota Medical Center-Fairview the White Earth Band of 
33.13 	Ojibwe Indians according to section 145.9271;
33.14 	(2) $2,075,000 $600,000 in fiscal year 2012 and $200,000 beginning in fiscal 
33.15 	year 2013 to the University of Minnesota School of Dentistry University of Minnesota 
33.16 	according to section 137.395; and
33.17 	(3) $500,000 in fiscal year 2012 and $200,000 beginning in fiscal year 2013 shall 
33.18 	be distributed to the community health centers development grants program according 
33.19 	to section 145.987;
33.20 	(4) $500,000 in fiscal year 2012 and $200,000 beginning in fiscal year 2013 shall be 
33.21 	distributed to the community mental health centers grant program according to section 
33.22 	145.9272;
33.23 	(5) $1,000,000 in fiscal year 2012 and $444,000 beginning in fiscal year 2013 shall 
33.24 	be distributed to the health careers opportunities grant program according to section 
33.25 	144.1499; and
33.26 	(3) (6) $1,800,000 to the Academic Health Center. $150,000 of the funds distributed 
33.27 	to the Academic Health Center under this paragraph shall be used for a program to assist 
33.28 	internationally trained physicians who are legal residents and who commit to serving 
33.29 	underserved Minnesota communities in a health professional shortage area to successfully 
33.30 	compete for family medicine residency programs at the University of Minnesota.
33.31 	(c) Funds distributed shall not be used to displace current funding appropriations 
33.32 	from federal or state sources.
33.33 	(d) Funds shall be distributed to the sponsoring institutions indicating the amount 
33.34 	to be distributed to each of the sponsor's clinical medical education programs based on 
33.35 	the criteria in this subdivision and in accordance with the commissioner's approval letter. 
33.36 	Each clinical medical education program must distribute funds allocated under paragraph 
34.1 	(a) to the training sites as specified in the commissioner's approval letter. Sponsoring 
34.2 	institutions, which are accredited through an organization recognized by the Department 
34.3 	of Education or the Centers for Medicare and Medicaid Services, may contract directly 
34.4 	with training sites to provide clinical training. To ensure the quality of clinical training, 
34.5 	those accredited sponsoring institutions must:
34.6 	(1) develop contracts specifying the terms, expectations, and outcomes of the clinical 
34.7 	training conducted at sites; and
34.8 	(2) take necessary action if the contract requirements are not met. Action may 
34.9 	include the withholding of payments under this section or the removal of students from 
34.10 	the site.
34.11 	(e) Any funds not distributed in accordance with the commissioner's approval letter 
34.12 	must be returned to the medical education and research fund within 30 days of receiving 
34.13 	notice from the commissioner. The commissioner shall distribute returned funds to the 
34.14 	appropriate training sites in accordance with the commissioner's approval letter.
34.15 	(f) A maximum of $150,000 of the funds dedicated to the commissioner under 
34.16 	section 297F.10, subdivision 1, clause (2), may be used by the commissioner for 
34.17 	administrative expenses associated with implementing this section.
34.18 		Subd. 5.Report. (a) Sponsoring institutions receiving funds under this section 
34.19 	must sign and submit a medical education grant verification report (GVR) to verify that 
34.20 	the correct grant amount was forwarded to each eligible training site. If the sponsoring 
34.21 	institution fails to submit the GVR by the stated deadline, or to request and meet 
34.22 	the deadline for an extension, the sponsoring institution is required to return the full 
34.23 	amount of funds received to the commissioner within 30 days of receiving notice from 
34.24 	the commissioner. The commissioner shall distribute returned funds to the appropriate 
34.25 	training sites in accordance with the commissioner's approval letter.
34.26 	(b) The reports must provide verification of the distribution of the funds and must 
34.27 	include:
34.28 	(1) the total number of eligible trainee FTEs in each clinical medical education 
34.29 	program;
34.30 	(2) the name of each funded program and, for each program, the dollar amount 
34.31 	distributed to each training site;
34.32 	(3) documentation of any discrepancies between the initial grant distribution notice 
34.33 	included in the commissioner's approval letter and the actual distribution;
34.34 	(4) a statement by the sponsoring institution stating that the completed grant 
34.35 	verification report is valid and accurate; and
35.1 	(5) other information the commissioner, with advice from the advisory committee, 
35.2 	deems appropriate to evaluate the effectiveness of the use of funds for medical education.
35.3 	(c) By February 15 of each year, the commissioner, with advice from the 
35.4 	advisory committee, shall provide an annual summary report to the legislature on the 
35.5 	implementation of this section.
35.6 		Subd. 6.Other available funds. The commissioner is authorized to distribute, in 
35.7 	accordance with subdivision 4, funds made available through:
35.8 	(1) voluntary contributions by employers or other entities;
35.9 	(2) allocations for the commissioner of human services to support medical education 
35.10 	and research; and
35.11 	(3) other sources as identified and deemed appropriate by the legislature for 
35.12 	inclusion in the fund.
35.13 		Subd. 7.Transfers from the commissioner of human services. Of the amount 
35.14 	transferred according to section 256B.69, subdivision 5c, paragraph (a), clauses (1) to (4), 
35.15 	$21,714,000 shall be distributed as follows:
35.16 	(1) $2,157,000 shall be distributed by the commissioner to the University of 
35.17 	Minnesota Board of Regents for the purposes described in sections 137.38 to 137.40;
35.18 	(2) $1,035,360 shall be distributed by the commissioner to the Hennepin County 
35.19 	Medical Center for clinical medical education;
35.20 	(3) $17,400,000 shall be distributed by the commissioner to the University of 
35.21 	Minnesota Board of Regents for purposes of medical education;
35.22 	(4) $1,121,640 $1,021,640 shall be distributed by the commissioner to clinical 
35.23 	medical education dental innovation grants in accordance with subdivision 7a; and
35.24 	(5) $100,000 shall be distributed to the health careers opportunities grant program 
35.25 	according to section 144.1499; and
35.26 	(6) the remainder of the amount transferred according to section 256B.69, 
35.27 	subdivision 5c, clauses (1) to (4), shall be distributed by the commissioner annually to 
35.28 	clinical medical education programs that meet the qualifications of subdivision 3 based on 
35.29 	the formula in subdivision 4, paragraph (a), or subdivision 11, as appropriate.
35.30 		Subd. 7a.Clinical medical education innovations grants. (a) The commissioner 
35.31 	shall award grants to teaching institutions and clinical training sites for projects that
35.32 	provide training to  increase dental access for underserved populations and promote 
35.33 	innovative clinical training of dental professionals and for racial, ethnic, or cultural 
35.34 	populations in the state experiencing health disparities. In awarding the grants, the 
35.35 	commissioner, in consultation with the commissioner of human services, shall consider 
35.36 	the following:
36.1 	(1) potential to successfully increase access to an underserved population;
36.2 	(2) the long-term viability of the project to improve access beyond the period 
36.3 	of initial funding;
36.4 	(3) evidence of collaboration between the applicant and local communities; and
36.5 	(4) the efficiency in the use of the funding; and
36.6 	(5) (3) the priority level of the project in relation to state clinical education, access, 
36.7 	and health disparity workforce goals.
36.8 	(b) The commissioner shall periodically evaluate the priorities in awarding the 
36.9 	innovations grants in order to ensure that the priorities meet the changing workforce 
36.10 	needs of the state.
36.11 		Subd. 8.Federal financial participation.  The commissioner of human services 
36.12 	shall seek to maximize federal financial participation in payments for medical education 
36.13 	and research costs.
36.14 	The commissioner shall use physician clinic rates where possible to maximize 
36.15 	federal financial participation. Any additional funds that become available must be 
36.16 	distributed under subdivision 4, paragraph (a), or 11, as appropriate.
36.17 		Subd. 9.Review of eligible providers. The commissioner and the Medical 
36.18 	Education and Research Costs Advisory Committee may review provider groups included 
36.19 	in the definition of a clinical medical education program to assure that the distribution of 
36.20 	the funds continue to be consistent with the purpose of this section. The results of any 
36.21 	such reviews must be reported to the Legislative Commission on Health Care Access.
36.22 		Subd. 11.Distribution of funds. (a) Upon receiving federal approval, the 
36.23 	commissioner shall annually distribute the available medical education funds to all 
36.24 	qualifying applicants based on the following distribution formula, which supersedes the 
36.25 	formula described in subdivision 4, paragraphs (a) and (b):
36.26 	(1) funds received pursuant to section 297F.10 shall be distributed to eligible clinical 
36.27 	training sites using a public program volume factor, which is determined by the total 
36.28 	volume of public program revenue received by each eligible training site as a percentage 
36.29 	of all public program revenue received by all eligible training sites in the fund pool. Only 
36.30 	clinical training that occurs in a hospital that reports financial, utilization, and services 
36.31 	data to the commissioner of health, pursuant to sections 144.564 and 144.695 to 144.703 
36.32 	and Minnesota Rules, chapter 4650, is eligible for funding under this clause; and
36.33 	(2) funds transferred according to section 256B.69, subdivision 5c, paragraph (a), 
36.34 	clauses (1) to (4), shall be distributed to eligible training sites based on the total number of 
36.35 	eligible trainee FTEs and the total statewide average costs per FTE, by type of trainee, in 
37.1 	each clinical medical education program. The number of eligible trainee FTEs for funds 
37.2 	distributed under this clause is determined using the following steps:
37.3 	(i) each FTE trainee from an advanced practice nursing, physician assistant, family 
37.4 	medicine, internal medicine, general pediatrics, or psychiatry program is weighted at 1.25. 
37.5 	Each FTE trainee from any other eligible training program is weighted at 1.0;
37.6 	(ii) each FTE trainee at a clinical training site located in an isolated rural area 
37.7 	according to the four category classification of the Rural Urban Commuting Area (RUCA) 
37.8 	system developed for the United States Health Resources and Services Administration 
37.9 	shall be weighted at the weight in item (i) multiplied by 1.5; each FTE trainee at a clinical 
37.10 	training site located in a small rural area according to the RUCA system shall be weighted 
37.11 	at the weight in item (i) multiplied by 1.25; each FTE trainee at a clinical training site 
37.12 	located in a large rural area according to the RUCA system shall be weighted at the weight 
37.13 	in item (i) multiplied by 1.1; and each FTE trainee at a clinical training site located in an 
37.14 	urban area according to the RUCA system shall be weighted at the weight in item (i) 
37.15 	multiplied by 1.0;
37.16 	(iii) each FTE trainee at a clinical training site that is a hospital eligible for funding 
37.17 	under clause (1) shall be weighted at the weight in item (ii) multiplied by 0.85; and each 
37.18 	FTE trainee at a clinical training site that is an ambulatory, nursing home, or other eligible 
37.19 	nonhospital setting shall be weighted at the weight in item (ii) multiplied by 1.15; and
37.20 	(iv) grants to hospitals under this item are limited to a percentage share of the total 
37.21 	pool of funds available under this item that is no more than 1.5 times the percentage of the 
37.22 	hospital's total revenue that comes from public programs. Grants to hospitals in excess of 
37.23 	this amount will be redistributed to other sites eligible for funding under this item. Each 
37.24 	eligible clinical training site's grant under this item will be calculated by multiplying the 
37.25 	training site's adjusted FTE count upon completion of items (i) to (iv) by the statewide 
37.26 	average cost per trainee for each provider type to determine an adjusted clinical training 
37.27 	cost for each site. The grant to each eligible clinical training site under this item shall 
37.28 	equal that site's share of total adjusted clinical training costs for all eligible training sites 
37.29 	receiving funding under this item. Any clinical training site with fewer than 0.1 FTE 
37.30 	eligible trainees from all programs upon completion of items (i) to (iv) and any clinical 
37.31 	training site that would receive less than a cumulative $1,000 under clauses (1) and (2) 
37.32 	will be eliminated from the distribution.
37.33 	(b) Public program revenue for the distribution formula includes revenue for the 
37.34 	relevant MERC reporting period from medical assistance, prepaid medical assistance, 
37.35 	general assistance medical care, MinnesotaCare, and prepaid general assistance medical 
37.36 	care, as reported to the Department of Health pursuant to sections 144.562, 144.564, 
38.1 	and 144.695 to 144.703 and Minnesota Rules, chapter 4650, by December 31 of the 
38.2 	year in which the MERC application is submitted. Training sites that receive no public 
38.3 	program revenue are ineligible for funds available under this subdivision. For purposes 
38.4 	of determining training-site level grants to be distributed under paragraph (a), clause 
38.5 	(2), total statewide average costs per trainee for medical residents is based on audited 
38.6 	clinical training costs per trainee in primary care clinical medical education programs for 
38.7 	medical residents. Total statewide average costs per trainee for dental residents is based 
38.8 	on audited clinical training costs per trainee in clinical medical education programs for 
38.9 	dental students. Total statewide average costs per trainee for pharmacy residents is based 
38.10 	on audited clinical training costs per trainee in clinical medical education programs for 
38.11 	pharmacy students.

38.12 	Sec. 7. [62U.15] ALZHEIMER'S DISEASE; PREVALENCE AND SCREENING 
38.13 	MEASURES.
38.14 		Subdivision 1.Data from providers. (a) By July 1, 2012, the commissioner 
38.15 	shall review currently available quality measures and make recommendations for future 
38.16 	measurement aimed at improving assessment and care related to Alzheimer's disease and 
38.17 	other dementia diagnoses, including improved rates and results of cognitive screening, 
38.18 	rates of Alzheimer's and other dementia diagnoses, and prescribed care and treatment 
38.19 	plans.
38.20 	(b) The commissioner may contract with a private entity to complete the 
38.21 	requirements in this subdivision. If the commissioner contracts with a private entity 
38.22 	already under contract through section 62U.02, then the commissioner may use a sole 
38.23 	source contract and is exempt from competitive procurement processes.
38.24 		Subd. 2.Learning collaborative. By July 1, 2012, the commissioner shall 
38.25 	develop a health care home learning collaborative curriculum that includes screening and 
38.26 	education on best practices regarding identification and management of Alzheimer's and 
38.27 	other dementia patients under section 256B.0751, subdivision 5, for providers, clinics, 
38.28 	care coordinators, clinic administrators, patient partners and families, and community 
38.29 	resources including public health.
38.30 		Subd. 3.Comparison data. The commissioner, with the commissioner of human 
38.31 	services, the Minnesota Board on Aging, and other appropriate state offices, shall jointly 
38.32 	review existing and forthcoming literature in order to estimate differences in the outcomes 
38.33 	and costs of current practices for caring for those with Alzheimer's disease and other 
38.34 	dementias, compared to the outcomes and costs resulting from:
38.35 	(1) earlier identification of Alzheimer's and other dementias;
39.1 	(2) improved support of family caregivers; and
39.2 	(3) improved collaboration between medical care management and community-based 
39.3 	supports.
39.4 		Subd. 4.Reporting. By January 15, 2013, the commissioner must report to the 
39.5 	legislature on progress toward establishment and collection of quality measures required 
39.6 	under this section.

39.7 	Sec. 8. [137.395] EDUCATION AND TRAINING FOR HEALTH DISPARITY 
39.8 	POPULATIONS.
39.9 		Subdivision 1.Condition. If the Board of Regents accepts the amount transferred 
39.10 	under section 62J.692, subdivision 4, paragraph (b), clause (2), then it must be used for the 
39.11 	purposes provided in this section.
39.12 		Subd. 2.Purpose. The Board of Regents, through the Academic Health Center, 
39.13 	is required to implement a scholarship program in order to increase the number of 
39.14 	graduates of the Academic Health Center programs who are from racial, ethnic, or cultural 
39.15 	populations in the state that experience health disparities.
39.16 		Subd. 3.Scholarships. The Board of Regents is required to provide full 
39.17 	scholarships to Academic Health Center programs for students who are from racial, ethnic, 
39.18 	or cultural populations that experience health disparities. One-third of the scholarship 
39.19 	funding available under this program must go to students at the University of Minnesota, 
39.20 	Medical School, Duluth.

39.21 	Sec. 9. Minnesota Statutes 2010, section 144.05, is amended by adding a subdivision 
39.22 	to read:
39.23 		Subd. 6.Elimination of certain provider reporting requirements; sunset of new 
39.24 	requirements. (a) Notwithstanding any other law, rule, or provision to the contrary, 
39.25 	effective July 1, 2012, the commissioner shall cease collecting from health care providers 
39.26 	and purchasers all reports and data related to health care costs, quality, utilization, access, 
39.27 	patient encounters, and disease surveillance and public health, and related to provider 
39.28 	licensure, monitoring, finances, and regulation, unless the reports or data are necessary for 
39.29 	federal compliance. For purposes of this subdivision, the term "health care providers and 
39.30 	purchasers" has the meaning provided in section 62J.03, subdivision 8, except that it also 
39.31 	includes nursing homes, health plan companies as defined in section 62Q.01, subdivision 
39.32 	4, and managed care and county-based purchasing plans delivering services under sections 
39.33 	256B.69 and 256B.692.
40.1 	(b) The commissioner shall present to the 2012 legislature draft legislation to repeal, 
40.2 	effective July 1, 2012, the provider reporting requirements identified under paragraph (a) 
40.3 	that are not necessary for federal compliance.
40.4 	(c) The commissioner may establish new provider reporting requirements to take 
40.5 	effect on or after July 1, 2012. These new reporting requirements must sunset five years 
40.6 	from their effective date, unless they are renewed by the commissioner. All new provider 
40.7 	reporting requirements and requests for their renewal shall not take effect unless they 
40.8 	are enacted in state law.

40.9 	Sec. 10. Minnesota Statutes 2010, section 144.1499, is amended to read:
40.10 	144.1499 PROMOTION OF HEALTH CARE AND LONG-TERM CARE 
40.11 	CAREERS HEALTH CAREERS OPPORTUNITIES GRANT PROGRAM.
40.12 		Subdivision. 1.Program. The commissioner of health, in consultation with 
40.13 	an organization representing health care employers, long-term care employers, and 
40.14 	educational institutions, may make grants to qualifying consortia as defined in section 
40.15 	116L.11, subdivision 4, for intergenerational programs to encourage middle and high 
40.16 	school students to work and volunteer in health care and long-term care settings. 
40.17 	To qualify for a grant under this section, a consortium shall:health care employers, 
40.18 	educational institutions, and related organizations for eligible activities intended to 
40.19 	increase the number of people from racial, ethnic, or cultural populations that experience 
40.20 	health disparities who are entering health careers in Minnesota.
40.21 	(1) develop a health and long-term care careers curriculum that provides career 
40.22 	exploration and training in national skill standards for health care and long-term care and 
40.23 	that is consistent with Minnesota graduation standards and other related requirements;
40.24 	(2) offer programs for high school students that provide training in health and 
40.25 	long-term care careers with credits that articulate into postsecondary programs; and
40.26 	(3) provide technical support to the participating health care and long-term care 
40.27 	employer to enable the use of the employer's facilities and programs for kindergarten to 
40.28 	grade 12 health and long-term care careers education.
40.29 		Subd. 2.Eligible activities. Eligible activities must focus on students from racial, 
40.30 	ethnic, or cultural populations experiencing health disparities. Eligible activities include 
40.31 	the following:
40.32 	(1) health careers exploration activities for students from racial, ethnic, or cultural 
40.33 	populations experiencing health disparities;
41.1 	(2) elementary, secondary, and postsecondary education activities to improve the 
41.2 	academic readiness to enter health professions education programs for students from 
41.3 	racial, ethnic, or cultural populations experiencing health disparities;
41.4 	(3) health careers mentoring for students from racial, ethnic, or cultural populations 
41.5 	experiencing health disparities, including support for faculty involved in mentoring these 
41.6 	students enrolled in or interested in entering health professions education programs;
41.7 	(4) secondary and postsecondary summer health care internships that provide 
41.8 	students from racial, ethnic, or cultural populations experiencing health disparities with 
41.9 	formal exposure to a health care profession in an employment setting;
41.10 	(5) health careers preparation, guidance, and support for students from racial, ethnic, 
41.11 	or cultural populations experiencing health disparities who are interested in entering health 
41.12 	professions education programs;
41.13 	(6) health careers preparation, guidance, and support for students from racial, 
41.14 	ethnic, or cultural populations experiencing health disparities who are enrolled in health 
41.15 	professions education programs and other activities to improve retention of these students 
41.16 	in health professions education programs; or
41.17 	(7) other activities the commissioner has reason to believe will prepare, attract, and 
41.18 	educate for health careers students from racial, ethnic, or cultural populations experiencing 
41.19 	health disparities.
41.20 		Subd. 3.Applications. Applicants seeking a grant must apply to the commissioner. 
41.21 	Applications must include the following:
41.22 	(1) a description of the need, challenges, or barriers that the proposed project will 
41.23 	address;
41.24 	(2) a detailed description of the project and how it proposes to address the challenges 
41.25 	or barriers;
41.26 	(3) a budget detailing all sources of funds for the project and how project funds 
41.27 	will be used;
41.28 	(4) baseline data showing the current percentage of program applicants and current 
41.29 	students who are from racial, ethnic, or cultural populations experiencing health disparities;
41.30 	(5) a description of achievable objectives that demonstrate how the project will 
41.31 	contribute to increasing the number of students from racial, ethnic, or cultural populations 
41.32 	experiencing health disparities who are entering health professions in Minnesota;
41.33 	(6) a timeline for completion of the project;
41.34 	(7) roles and capabilities of responsible individuals and organizations, including 
41.35 	partner organizations;
41.36 	(8) a plan to evaluate project outcomes; and 
42.1 	(9) other information the commissioner believes necessary to evaluate the 
42.2 	application.
42.3 		Subd. 4.Consideration of applications. The commissioner must review each 
42.4 	application to determine whether or not the application is complete and whether 
42.5 	the applicant and the project are eligible for a grant. In evaluating applications, the 
42.6 	commissioner must evaluate each application based on the following:
42.7 	(1) the extent to which the applicant has demonstrated that its project is likely 
42.8 	to contribute to increasing the number of American Indians and underrepresented 
42.9 	populations of color entering health professions in Minnesota;
42.10 	(2) the application's clarity and thoroughness in describing the challenges and 
42.11 	barriers it is addressing;
42.12 	(3) the extent to which the applicant appears likely to coordinate  project efforts 
42.13 	with other organizations;
42.14 	(4) the reasonableness of the project budget; and
42.15 	(5) the organizational capacity of the applicant and its partners.
42.16 	The commissioner may also take into account other relevant factors. During 
42.17 	application review the commissioner may request additional information about a proposed 
42.18 	project, including information on project cost. Failure to provide the information requested 
42.19 	disqualifies an applicant.
42.20 		Subd. 5.Program oversight. The commissioner shall determine the amount of a 
42.21 	grant to be given to an eligible applicant based on the relative strength of each eligible 
42.22 	application and the funds available to the commissioner. The commissioner may collect 
42.23 	from grantees any information necessary to evaluate the program.

42.24 	Sec. 11. Minnesota Statutes 2010, section 144.1501, subdivision 1, is amended to read:
42.25 		Subdivision 1.Definitions. (a) For purposes of this section, the following definitions 
42.26 	apply.
42.27 	(b) "Dentist" means an individual who is licensed to practice dentistry.
42.28 	(c) "Designated rural area" means:
42.29 	(1) an area in Minnesota outside the counties of Anoka, Carver, Dakota, Hennepin, 
42.30 	Ramsey, Scott, and Washington, excluding the cities of Duluth, Mankato, Moorhead, 
42.31 	Rochester, and St. Cloud; or
42.32 	(2) a municipal corporation, as defined under section 471.634, that is physically 
42.33 	located, in whole or in part, in an area defined as a designated rural area under clause (1).
42.34 	an area defined as a small rural area or isolated rural area according to the four category 
43.1 	classifications of the Rural Urban Commuting Area system developed for the United 
43.2 	States Health Resources and Services Administration.
43.3 	(d) "Emergency circumstances" means those conditions that make it impossible for 
43.4 	the participant to fulfill the service commitment, including death, total and permanent 
43.5 	disability, or temporary disability lasting more than two years.
43.6 	(e) "Medical resident" means an individual participating in a medical residency in 
43.7 	family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.
43.8 	(f) "Midlevel practitioner" means a nurse practitioner, nurse-midwife, nurse 
43.9 	anesthetist, advanced clinical nurse specialist, or physician assistant.
43.10 	(g) "Nurse" means an individual who has completed training and received all 
43.11 	licensing or certification necessary to perform duties as a licensed practical nurse or 
43.12 	registered nurse.
43.13 	(h) "Nurse-midwife" means a registered nurse who has graduated from a program of 
43.14 	study designed to prepare registered nurses for advanced practice as nurse-midwives.
43.15 	(i) "Nurse practitioner" means a registered nurse who has graduated from a program 
43.16 	of study designed to prepare registered nurses for advanced practice as nurse practitioners.
43.17 	(j) "Pharmacist" means an individual with a valid license issued under chapter 151.
43.18 	(k) "Physician" means an individual who is licensed to practice medicine in the areas 
43.19 	of family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.
43.20 	(l) "Physician assistant" means a person licensed under chapter 147A.
43.21 	(m) "Qualified educational loan" means a government, commercial, or foundation 
43.22 	loan for actual costs paid for tuition, reasonable education expenses, and reasonable living 
43.23 	expenses related to the graduate or undergraduate education of a health care professional.
43.24 	(n) "Underserved urban community" means a Minnesota urban area or population 
43.25 	included in the list of designated primary medical care health professional shortage areas 
43.26 	(HPSAs), medically underserved areas (MUAs), or medically underserved populations 
43.27 	(MUPs) maintained and updated by the United States Department of Health and Human 
43.28 	Services.

43.29 	Sec. 12. Minnesota Statutes 2010, section 144.1501, subdivision 4, is amended to read:
43.30 		Subd. 4.Loan forgiveness. The commissioner of health may select applicants 
43.31 	each year for participation in the loan forgiveness program, within the limits of available 
43.32 	funding. The commissioner shall distribute available funds for loan forgiveness 
43.33 	proportionally among the eligible professions according to the vacancy rate for each 
43.34 	profession in the required geographic area, facility type, teaching area, patient group, 
43.35 	or specialty type specified in subdivision 2. The commissioner shall allocate funds for 
44.1 	physician loan forgiveness so that 75 percent of the funds available are used for rural 
44.2 	physician loan forgiveness and 25 percent of the funds available are used for underserved 
44.3 	urban communities and pediatric psychiatry loan forgiveness. If the commissioner does 
44.4 	not receive enough qualified applicants each year to use the entire allocation of funds for 
44.5 	any eligible profession, the remaining funds may be allocated proportionally among the 
44.6 	other eligible professions according to the vacancy rate for each profession in the required 
44.7 	geographic area, patient group, or facility type specified in subdivision 2. Applicants are 
44.8 	responsible for securing their own qualified educational loans. The commissioner shall 
44.9 	select participants based on their suitability for practice serving the required geographic 
44.10 	area or facility type specified in subdivision 2, as indicated by experience or training. 
44.11 	The commissioner shall give preference to applicants from racial, ethnic, or cultural 
44.12 	populations experiencing health disparities who are closest to completing their training
44.13 	and who agree to serve in settings in Minnesota that provide health care services to at least 
44.14 	50 percent American Indian or other populations of color, such as a federally recognized 
44.15 	Native American reservation. For each year that a participant meets the service obligation 
44.16 	required under subdivision 3, up to a maximum of four years, the commissioner shall make 
44.17 	annual disbursements directly to the participant equivalent to 15 percent of the average 
44.18 	educational debt for indebted graduates in their profession in the year closest to the 
44.19 	applicant's selection for which information is available, not to exceed the balance of the 
44.20 	participant's qualifying educational loans. Before receiving loan repayment disbursements 
44.21 	and as requested, the participant must complete and return to the commissioner an affidavit 
44.22 	of practice form provided by the commissioner verifying that the participant is practicing 
44.23 	as required under subdivisions 2 and 3. The participant must provide the commissioner 
44.24 	with verification that the full amount of loan repayment disbursement received by the 
44.25 	participant has been applied toward the designated loans. After each disbursement, 
44.26 	verification must be received by the commissioner and approved before the next loan 
44.27 	repayment disbursement is made. Participants who move their practice remain eligible for 
44.28 	loan repayment as long as they practice as required under subdivision 2.

44.29 	Sec. 13. [144.1503] HEALTH PROFESSIONS OPPORTUNITIES 
44.30 	SCHOLARSHIP PROGRAM.
44.31 		Subdivision 1.Definitions. For purposes of this section, the following definitions 
44.32 	apply: 
44.33 	(a) "Certified clinical nurse specialist" means an individual licensed in Minnesota as 
44.34 	a registered nurse and certified by a national nurse certification organization acceptable to 
44.35 	the Minnesota Board of Nursing to practice as a clinical nurse specialist.
45.1 	(b) "Certified nurse midwife" means an individual licensed in Minnesota as a 
45.2 	registered nurse and certified by a national nurse certification organization acceptable to 
45.3 	the Minnesota Board of Nursing to practice as a nurse midwife.
45.4 	(c) "Certified nurse practitioner" means an individual licensed in Minnesota as a 
45.5 	registered nurse and certified by a national nurse certification organization acceptable to 
45.6 	the Minnesota Board of Nursing to practice as a nurse practitioner.
45.7 	(d) "Chiropractor" means an individual licensed and regulated under sections 148.02 
45.8 	to 148.108.
45.9 	(e) "Dental therapist" means an individual licensed in the state and includes 
45.10 	advanced dental therapists certified under section 150A.106.
45.11 	(f) "Dentist" means an individual licensed in Minnesota as a dentist under chapter 
45.12 	150A.
45.13 	(g) "Eligible scholarship placement site" means a nonprofit, private, or public 
45.14 	entity located in Minnesota that provides at least 50 percent of its health care services to 
45.15 	American Indian or other populations of color, such as federally recognized American 
45.16 	Indian reservations.
45.17 	(h) "Emergency circumstances" means those conditions that make it impossible for 
45.18 	the participant to fulfill the contractual requirements, including death, total and permanent 
45.19 	disability, or temporary disability lasting more than two years.
45.20 	(i) "Participant" means an individual receiving a scholarship under this program.
45.21 	(j) "Physician assistant" means a person licensed in Minnesota under chapter 147A.
45.22 	(k) "Primary care physician" means an individual licensed in Minnesota as a 
45.23 	physician and board-certified in family practice, internal medicine, obstetrics and 
45.24 	gynecology, pediatrics, geriatrics, emergency medicine, hospital medicine, or psychiatry.
45.25 	(l) "Registered nurse" means an individual licensed by the Minnesota Board of 
45.26 	Nursing to practice professional nursing.
45.27 		Subd. 2.Establishment and purpose. The commissioner shall establish a health 
45.28 	professions opportunities scholarship program. The purpose of the program is to increase 
45.29 	the number of students from racial, ethnic, or cultural populations experiencing health 
45.30 	disparities who enter health professions.
45.31 		Subd. 3.Eligible students. To be eligible to apply to the commissioner for the 
45.32 	scholarship program, an applicant must be:
45.33 	(1) accepted for full-time study in a program of study that will result in licensure as 
45.34 	a primary care physician, certified nurse practitioner, certified nurse midwife, certified 
45.35 	clinical nurse specialist, chiropractor, physician assistant, registered nurse, dentist, or 
45.36 	dental therapist;
46.1 	(2) a Minnesota resident; and
46.2 	(3) an individual from a racial, ethnic, or cultural population experiencing health 
46.3 	disparities in the state.
46.4 		Subd. 4.Scholarship. The commissioner may award a scholarship for the cost of 
46.5 	full tuition, fees, and living expenses up to $40,000 per year to eligible students. The 
46.6 	commissioner will subtract the amount of other scholarship, grant, and gift awards to the 
46.7 	participant from the award made by this program. Scholarship awards will be limited to 
46.8 	the number of years for full-time enrollment in the applicant's program of study but will 
46.9 	not include any years completed prior to applying. The commissioner shall determine the 
46.10 	number of new scholarship awards made per fiscal year based on availability of state 
46.11 	funding. Scholarship awards will be paid by the commissioner directly to the participant's 
46.12 	educational institution after full-time enrollment is verified. Appropriations made to the 
46.13 	scholarship program do not cancel and are available until expended.
46.14 		Subd. 5.Obligated service. A participant shall agree in contract to fulfill a 
46.15 	three-year service obligation at an eligible scholar placement site upon completion of 
46.16 	training, including residency, and obtaining Minnesota licensure. Participants must 
46.17 	provide at least 32 hours of direct patient care per week for at least 45 weeks per year. 
46.18 	Obligated service must start by March 31 of the year following completion of required 
46.19 	training.
46.20 		Subd. 6.Affidavit of service required. Before starting a service obligation and 
46.21 	annually thereafter, participants shall submit to the commissioner an affidavit of practice 
46.22 	signed by a representative of their eligible scholar placement site verifying employment 
46.23 	status and the number of weekly hours of direct patient care provided by the participant. 
46.24 	Participants must also provide written notice to the commissioner within 30 days of:
46.25 	(1) a change in name or address;
46.26 	(2) a decision not to fulfill a service obligation; or
46.27 	(3) cessation of obligated practice.
46.28 		Subd. 7.Penalty for nonfulfillment. If a participant does not complete the 
46.29 	educational program, successfully obtain licensure, or fulfill the required minimum 
46.30 	commitment of service according to subdivision 6, the commissioner of health shall collect 
46.31 	from the participant the total amount awarded to the participant under the scholarship 
46.32 	program plus interest at a rate established according to section 270C.40. Funds collected 
46.33 	for nonfulfillment shall be credited to the health professions opportunities scholarship 
46.34 	program. The commissioner shall allow waivers of all or part of the money owed the 
46.35 	commissioner as a result of a nonfulfillment penalty due to emergency circumstances.

47.1 	Sec. 14. [144.586] PATIENT SAFETY SURVEY.
47.2 	Hospitals licensed under section 144.55 must submit necessary information to the 
47.3 	Leapfrog Group patient safety survey on an annual basis in order to publicly report patient 
47.4 	safety information and track the progress of each hospital to improve quality, safety, 
47.5 	and efficiency of care delivery.

47.6 	Sec. 15. Minnesota Statutes 2010, section 144.98, subdivision 2a, is amended to read:
47.7 		Subd. 2a.Standards. Notwithstanding the exemptions in subdivisions 8 and 9, the 
47.8 	commissioner shall accredit laboratories according to the most current environmental 
47.9 	laboratory accreditation standards under subdivision 1 and as accepted by the accreditation 
47.10 	bodies recognized by the National Environmental Laboratory Accreditation Program 
47.11 	(NELAP) of the NELAC Institute.

47.12 	Sec. 16. Minnesota Statutes 2010, section 144.98, subdivision 7, is amended to read:
47.13 		Subd. 7.Initial accreditation and annual accreditation renewal. (a) The 
47.14 	commissioner shall issue or renew accreditation after receipt of the completed application 
47.15 	and documentation required in this section, provided the laboratory maintains compliance 
47.16 	with the standards specified in subdivision 2a, notwithstanding any exemptions under 
47.17 	subdivisions 8 and 9, and attests to the compliance on the application form.
47.18 	(b) The commissioner shall prorate the fees in subdivision 3 for laboratories 
47.19 	applying for accreditation after December 31. The fees are prorated on a quarterly basis 
47.20 	beginning with the quarter in which the commissioner receives the completed application 
47.21 	from the laboratory.
47.22 	(c) Applications for renewal of accreditation must be received by November 1 and 
47.23 	no earlier than October 1 of each year. The commissioner shall send annual renewal 
47.24 	notices to laboratories 90 days before expiration. Failure to receive a renewal notice does 
47.25 	not exempt laboratories from meeting the annual November 1 renewal date.
47.26 	(d) The commissioner shall issue all accreditations for the calendar year for which 
47.27 	the application is made, and the accreditation shall expire on December 31 of that year.
47.28 	(e) The accreditation of any laboratory that fails to submit a renewal application 
47.29 	and fees to the commissioner expires automatically on December 31 without notice or 
47.30 	further proceeding. Any person who operates a laboratory as accredited after expiration of 
47.31 	accreditation or without having submitted an application and paid the fees is in violation 
47.32 	of the provisions of this section and is subject to enforcement action under sections 
47.33 	144.989 to 144.993, the Health Enforcement Consolidation Act. A laboratory with expired 
47.34 	accreditation may reapply under subdivision 6.

48.1 	Sec. 17. Minnesota Statutes 2010, section 144.98, is amended by adding a subdivision 
48.2 	to read:
48.3 		Subd. 8.Exemption from national standards for quality control and personnel 
48.4 	requirements. Effective January 1, 2012, a laboratory that analyzes samples for 
48.5 	compliance with a permit issued under section 115.03, subdivision 5, may request 
48.6 	exemption from the personnel requirements and specific quality control provisions for 
48.7 	microbiology and chemistry stated in the national standards as incorporated by reference 
48.8 	in subdivision 2a. The commissioner shall grant the exemption if the laboratory:
48.9 	(1) complies with the methodology and quality control requirements, where 
48.10 	available, in the most recent, approved edition of the Standard Methods for the 
48.11 	Examination of Water and Wastewater as published by the Water Environment Federation; 
48.12 	and
48.13 	(2) supplies the name of the person meeting the requirements in section 115.73, or 
48.14 	the personnel requirements in the national standard pursuant to subdivision 2a.
48.15 	A laboratory applying for this exemption shall not apply for simultaneous 
48.16 	accreditation under the national standard.

48.17 	Sec. 18. Minnesota Statutes 2010, section 144.98, is amended by adding a subdivision 
48.18 	to read:
48.19 		Subd. 9.Exemption from national standards for proficiency testing frequency.
 48.20 	(a) Effective January 1, 2012, a laboratory applying for or requesting accreditation under 
48.21 	the exemption in subdivision 8 must obtain an acceptable proficiency test result for each 
48.22 	of the laboratory's accredited or requested fields of testing. The laboratory must analyze 
48.23 	proficiency samples selected from one of two annual proficiency testing studies scheduled 
48.24 	by the commissioner.
48.25 	(b) If a laboratory fails to successfully complete the first scheduled proficiency 
48.26 	study, the laboratory shall:
48.27 	(1) obtain and analyze a supplemental test sample within 15 days of receiving the 
48.28 	test report for the initial failed attempt; and
48.29 	(2) participate in the second annual study as scheduled by the commissioner.
48.30 	(c) If a laboratory does not submit results or fails two consecutive proficiency 
48.31 	samples, the commissioner will revoke the laboratory's accreditation for the affected 
48.32 	fields of testing.
48.33 	(d) The commissioner may require a laboratory to analyze additional proficiency 
48.34 	testing samples beyond what is required in this subdivision if information available to 
49.1 	the commissioner indicates that the laboratory's analysis for the field of testing does not 
49.2 	meet the requirements for accreditation.
49.3 	(e) The commissioner may collect from laboratories accredited under the exemption 
49.4 	in subdivision 8 any additional costs required to administer this subdivision and 
49.5 	subdivision 8.

49.6 	Sec. 19. Minnesota Statutes 2010, section 144A.102, is amended to read:
49.7 	144A.102 WAIVER FROM FEDERAL RULES AND REGULATIONS; 
49.8 	PENALTIES.
49.9 	(a) By January 2000, the commissioner of health shall work with providers to 
49.10 	examine state and federal rules and regulations governing the provision of care in licensed 
49.11 	nursing facilities and apply for federal waivers and identify necessary changes in state 
49.12 	law to:
49.13 	(1) allow the use of civil money penalties imposed upon nursing facilities to abate 
49.14 	any deficiencies identified in a nursing facility's plan of correction; and
49.15 	(2) stop the accrual of any fine imposed by the Health Department when a follow-up 
49.16 	inspection survey is not conducted by the department within the regulatory deadline.
49.17 	(b) By January 2012, the commissioner of health shall work with providers to 
49.18 	examine state and federal rules and regulations governing the provision of care in licensed 
49.19 	nursing facilities and apply for federal waivers and identify necessary changes in state 
49.20 	law to:
49.21 	(1) eliminate the requirement for written plans of correction from nursing homes for 
49.22 	federal deficiencies issued at a scope and severity that is not widespread or in immediate 
49.23 	jeopardy; and
49.24 	(2) issue the federal survey form electronically to nursing homes.
49.25 	The commissioner shall issue a report to the legislative chairs of the committees 
49.26 	with jurisdiction over health and human services by January 31, 2012, on the status of 
49.27 	implementation of this paragraph.

49.28 	Sec. 20. Minnesota Statutes 2010, section 144A.61, is amended by adding a 
49.29 	subdivision to read:
49.30 		Subd. 9.Electronic transmission. The commissioner of health must accept 
49.31 	electronic transmission of applications and supporting documentation for interstate 
49.32 	endorsement for the nursing assistant registry.

50.1 	Sec. 21. Minnesota Statutes 2010, section 144E.123, is amended to read:
50.2 	144E.123 PREHOSPITAL CARE DATA.
50.3 		Subdivision 1.Collection and maintenance.  Until July 1, 2014, a licensee shall
50.4 	may collect and provide prehospital care data to the board in a manner prescribed by the 
50.5 	board. At a minimum, the data must include items identified by the board that are part of 
50.6 	the National Uniform Emergency Medical Services Data Set. A licensee shall maintain 
50.7 	prehospital care data for every response.
50.8 		Subd. 2.Copy to receiving hospital. If a patient is transported to a hospital, a copy 
50.9 	of the ambulance report delineating prehospital medical care given shall be provided 
50.10 	to the receiving hospital.
50.11 		Subd. 3.Review. Prehospital care data may be reviewed by the board or its 
50.12 	designees. The data shall be classified as private data on individuals under chapter 13, the 
50.13 	Minnesota Government Data Practices Act.
50.14 		Subd. 4.Penalty. Failure to report all information required by the board under this 
50.15 	section shall constitute grounds for license revocation.
50.16 		Subd. 5.Working group. By October 1, 2011, the board must convene a working 
50.17 	group composed of six members, three of which must be appointed by the board and three 
50.18 	of which must be appointed by the Minnesota Ambulance Association, to redesign the 
50.19 	board's policies related to collection of data from licenses. The issues to be considered 
50.20 	include, but are not limited to, the following: user-friendly reporting requirements; data 
50.21 	sets; improved accuracy of reported information; appropriate use of information gathered 
50.22 	through the reporting system; and methods for minimizing the financial impact of data 
50.23 	reporting on licenses, particularly for rural volunteer services. The working group must 
50.24 	report its findings and recommendations to the board no later than January 1, 2014.

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

50.26 	Sec. 22. [145.9271] WHITE EARTH BAND URBAN CLINIC.
50.27 		Subdivision 1.Condition. If the White Earth Band of Ojibwe Indians accepts the 
50.28 	amount transferred under section 62J.692, subdivision 4, paragraph (b), clause (1), then it 
50.29 	must use the funds for purposes of this section.
50.30 		Subd. 2.Establish urban clinic. The White Earth Band of Ojibwe Indians shall 
50.31 	establish and operate one or more health care clinics in the Minneapolis area or greater 
50.32 	Minnesota to serve members of the White Earth Tribe and may use funds received under 
50.33 	section 62J.692, subdivision 4, paragraph (b), clause (1), for application to qualify as a 
50.34 	federally qualified health center.
51.1 		Subd. 3.Grant agreements. Before receiving the funds to be transferred under 
51.2 	section 62J.692, subdivision 4, paragraph (b), clause (1), the White Earth Band of Ojibwe 
51.3 	Indians is requested to submit to the commissioner of health a work plan and budget that 
51.4 	describes its annual plan for the funds. The commissioner will incorporate the work 
51.5 	plan and budget into a grant agreement between the commissioner and the White Earth 
51.6 	Band of Ojibwe Indians. Before each successive disbursement, the White Earth Band of 
51.7 	Ojibwe Indians is requested to submit a narrative progress report and an expenditure 
51.8 	report to the commissioner.

51.9 	Sec. 23. [145.9272] COMMUNITY MENTAL HEALTH CENTER GRANTS.
51.10 		Subdivision 1.Definitions. For purposes of this section, "community mental 
51.11 	health center" means an entity that is eligible for payment under section 256B.0625, 
51.12 	subdivision 5.
51.13 		Subd. 2.Allocation of subsidies. The commissioner of health shall distribute, from 
51.14 	money appropriated for this purpose, grants to community mental health centers operating 
51.15 	in the state on July 1 of the year 2011 and each subsequent year for community mental 
51.16 	health center services to low-income consumers and patients with mental illness. The 
51.17 	amount of each grant shall be in proportion to each community mental health center's 
51.18 	revenues received from state health care programs in the most recent calendar year for 
51.19 	which data is available.

51.20 	Sec. 24. Minnesota Statutes 2010, section 145.928, subdivision 2, is amended to read:
51.21 		Subd. 2.State-community partnerships; plan. The commissioner, in partnership 
51.22 	with culturally based community organizations; the Indian Affairs Council under section 
51.23 	3.922; the Council on Affairs of Chicano/Latino People under section 3.9223; the Council 
51.24 	on Black Minnesotans under section 3.9225; the Council on Asian-Pacific Minnesotans 
51.25 	under section 3.9226; the Alliance for Racial and Cultural Health Equity; community 
51.26 	health boards as defined in section 145A.02; and tribal governments, shall develop and 
51.27 	implement a comprehensive, coordinated plan to reduce health disparities in the health 
51.28 	disparity priority areas identified in subdivision 1. 

51.29 	Sec. 25. [145.929] PROFESSIONALS FROM POPULATIONS WITH HEALTH 
51.30 	DISPARITIES.
51.31 	The commissioner of health shall survey the diversity of the work force for 
51.32 	health-related professions and compare proportions in the allied health professions 
51.33 	among populations experiencing health disparities, including cultural, racial, ethnic, 
52.1 	and geographic factors, compared to the population of the state. Based on this survey, 
52.2 	the commissioner shall determine on an annual basis the ratio of training and residency 
52.3 	positions needed versus those available based on funding capacity.

52.4 	Sec. 26. Minnesota Statutes 2010, section 145.986, is amended by adding a subdivision 
52.5 	to read:
52.6 		Subd. 7.Consultation and engagement of consumers and communities with 
52.7 	poorer health and outcomes. Communities who receive statewide health improvement 
52.8 	grants must demonstrate to the commissioner that the applicant or grantee consulted 
52.9 	with and engaged local consumers, community organizations, and leaders representing 
52.10 	the subgroups of the community that experience the greatest health disparities in the 
52.11 	development of the local plan and that the plan incorporates components and activities 
52.12 	that reflect the needs and preferences of these communities.  The plan must also include 
52.13 	a process for ongoing consultation and engagement of these consumers, community 
52.14 	organizations, and leaders in the implementation of the plan and activities funded by 
52.15 	state grants.

52.16 	Sec. 27. Minnesota Statutes 2010, section 145.986, is amended by adding a subdivision 
52.17 	to read:
52.18 		Subd. 8.Coordination with payment reform demonstration projects. A 
52.19 	community who received a health improvement plan grant under this section and 
52.20 	a payment reform demonstration project authorized under section 256B.0755 shall 
52.21 	coordinate activities to improve the health of the communities and patients served by both 
52.22 	the health improvement plan and the demonstration project provider.

52.23 	Sec. 28. [145.987] COMMUNITY HEALTH CENTERS DEVELOPMENT 
52.24 	GRANTS FOR UNDERSERVED COMMUNITIES.
52.25 	(a) The commissioner of health shall award grants from money appropriated for this 
52.26 	purpose to expand community health centers, as defined in section 145.9269, subdivision 
52.27 	1, in the state through the establishment of new community health centers or sites in 
52.28 	areas defined as small rural areas or isolated rural areas according to the four category 
52.29 	classification of the Rural Urban Commuting Area system developed for the United States 
52.30 	Health Resources and Services Administration or serving underserved patient populations 
52.31 	who experience the greatest disparities in health outcomes.
52.32 	(b) Grant funds may be used to pay for:
53.1 	(1) costs for an organization to develop and submit a proposal to the federal 
53.2 	government for the designation of a new community health center or site;
53.3 	(2) costs of engaging underserved communities, health care providers, local 
53.4 	government agencies, or businesses in a process of developing a plan for a new center or 
53.5 	site to serve people in that community; and
53.6 	(3) costs of planning, designing, remodeling, constructing, or purchasing equipment 
53.7 	for a new center or site.
53.8 	Funds may not be used for operating costs.
53.9 	(d) A proposal must demonstrate that racial and ethnic communities to be served by 
53.10 	the community health center were consulted with and participated in the development of 
53.11 	the proposal.
53.12 	(e) The commissioner shall award grants on a competitive basis based on the 
53.13 	following criteria: 
53.14 	(1) the unmet need in the underserved community;
53.15 	(2) the degree of disparities in health outcomes in the underserved community; and
53.16 	(3) the extent to which people from the underserved community participated in 
53.17 	the development of the proposal.

53.18 	Sec. 29. Minnesota Statutes 2010, section 145A.17, subdivision 3, is amended to read:
53.19 		Subd. 3.Requirements for programs; process. (a) Community health boards 
53.20 	and tribal governments that receive funding under this section must submit a plan to 
53.21 	the commissioner describing a multidisciplinary approach to targeted home visiting for 
53.22 	families. The plan must be submitted on forms provided by the commissioner. At a 
53.23 	minimum, the plan must include the following:
53.24 	(1) a description of outreach strategies to families prenatally or at birth;
53.25 	(2) provisions for the seamless delivery of health, safety, and early learning services;
53.26 	(3) methods to promote continuity of services when families move within the state;
53.27 	(4) a description of the community demographics;
53.28 	(5) a plan for meeting outcome measures; and
53.29 	(6) a proposed work plan that includes:
53.30 	(i) coordination to ensure nonduplication of services for children and families;
53.31 	(ii) a description of the strategies to ensure that children and families at greatest risk 
53.32 	receive appropriate services; and
53.33 	(iii) collaboration with multidisciplinary partners including public health, 
53.34 	ECFE, Head Start, community health workers, social workers, community home 
54.1 	visiting programs, school districts, and other relevant partners. Letters of intent from 
54.2 	multidisciplinary partners must be submitted with the plan.
54.3 	(b) Each program that receives funds must accomplish the following program 
54.4 	requirements:
54.5 	(1) use a community-based strategy to provide preventive and early intervention 
54.6 	home visiting services;
54.7 	(2) offer a home visit by a trained home visitor. If a home visit is accepted, the first 
54.8 	home visit must occur prenatally or as soon after birth as possible and must include a 
54.9 	public health nursing assessment by a public health nurse;
54.10 	(3) offer, at a minimum, information on infant care, child growth and development, 
54.11 	positive parenting, preventing diseases, preventing exposure to environmental hazards, 
54.12 	and support services available in the community;
54.13 	(4) provide information on and referrals to health care services, if needed, including 
54.14 	information on and assistance in applying for health care coverage for which the child or 
54.15 	family may be eligible; and provide information on preventive services, developmental 
54.16 	assessments, and the availability of public assistance programs as appropriate;
54.17 	(5) provide youth development programs when appropriate;
54.18 	(6) recruit home visitors who will represent, to the extent possible, the races, 
54.19 	cultures, and languages spoken by families that may be served;
54.20 	(7) train and supervise home visitors in accordance with the requirements established 
54.21 	under subdivision 4;
54.22 	(8) maximize resources and minimize duplication by coordinating or contracting 
54.23 	with local social and human services organizations, education organizations, and other 
54.24 	appropriate governmental entities and community-based organizations and agencies;
54.25 	(9) utilize appropriate racial and ethnic approaches to providing home visiting 
54.26 	services; and
54.27 	(10) connect eligible families, as needed, to additional resources available in the 
54.28 	community, including, but not limited to, early care and education programs, health or 
54.29 	mental health services, family literacy programs, employment agencies, social services, 
54.30 	and child care resources and referral agencies.
54.31 	(c) When available, programs that receive funds under this section must offer or 
54.32 	provide the family with a referral to center-based or group meetings that meet at least 
54.33 	once per month for those families identified with additional needs. The meetings must 
54.34 	focus on further enhancing the information, activities, and skill-building addressed during 
54.35 	home visitation; offering opportunities for parents to meet with and support each other; 
55.1 	and offering infants and toddlers a safe, nurturing, and stimulating environment for 
55.2 	socialization and supervised play with qualified teachers.
55.3 	(d) Funds available under this section shall not be used for medical services. The 
55.4 	commissioner shall establish an administrative cost limit for recipients of funds. The 
55.5 	outcome measures established under subdivision 6 must be specified to recipients of 
55.6 	funds at the time the funds are distributed.
55.7 	(e) Data collected on individuals served by the home visiting programs must remain 
55.8 	confidential and must not be disclosed by providers of home visiting services without a 
55.9 	specific informed written consent that identifies disclosures to be made. Upon request, 
55.10 	agencies providing home visiting services must provide recipients with information on 
55.11 	disclosures, including the names of entities and individuals receiving the information and 
55.12 	the general purpose of the disclosure. Prospective and current recipients of home visiting 
55.13 	services must be told and informed in writing that written consent for disclosure of data is 
55.14 	not required for access to home visiting services.
55.15 	(f) Upon initial contact with a family, programs that receive funding under this 
55.16 	section must request permission from the family to share with other family service 
55.17 	providers information about services the family is receiving and unmet needs of the family 
55.18 	in order to select a lead agency for the family and coordinate available resources. For 
55.19 	purposes of this paragraph, the term "family service providers" includes local public 
55.20 	health, social services, school districts, Head Start programs, health care providers, and 
55.21 	other public agencies.

55.22 	Sec. 30. Minnesota Statutes 2010, section 157.15, is amended by adding a subdivision 
55.23 	to read:
55.24 		Subd. 21.Limited food establishment. "Limited food establishment" means a food 
55.25 	establishment that is low risk, as defined by section 157.20, subdivision 2a, paragraph 
55.26 	(c), and where the operation consists primarily of combining dry mixes and water or ice 
55.27 	for immediate service to the consumer. Limited food establishments are exempt from the 
55.28 	NSF International food service equipment standards and the room finish requirements of 
55.29 	Minnesota Rules, chapter 4626.

55.30 	Sec. 31. Minnesota Statutes 2010, section 157.20, is amended by adding a subdivision 
55.31 	to read:
55.32 		Subd. 5.Waivers during inspection. Notwithstanding any provision of this chapter 
55.33 	or Minnesota Rules, chapter 4626, any plumbing or other facility requirement may be 
55.34 	waived by the inspector if the inspector deems a waiver appropriate and reasonable and 
56.1 	determines that no significant adverse effect on public health, safety, or the environment 
56.2 	would result from such waiver.

56.3 	Sec. 32. Minnesota Statutes 2010, section 297F.10, subdivision 1, is amended to read:
56.4 		Subdivision 1.Tax and use tax on cigarettes. Revenue received from cigarette 
56.5 	taxes, as well as related penalties, interest, license fees, and miscellaneous sources of 
56.6 	revenue shall be deposited by the commissioner in the state treasury and credited as 
56.7 	follows:
56.8 	(1) $22,220,000 for fiscal year 2006 and $22,250,000 for fiscal year 2007 and each 
56.9 	year thereafter must be credited to the Academic Health Center special revenue fund 
56.10 	hereby created and is annually appropriated to the Board of Regents at the University of 
56.11 	Minnesota for Academic Health Center funding at the University of Minnesota; and
56.12 	(2) $8,553,000 for fiscal year 2006 and, $8,550,000 for fiscal year 2007 and, 
56.13 	$8,337,000 for fiscal year 2012, and $6,781,000 each year thereafter must be credited to 
56.14 	the medical education and research costs account hereby created in the special revenue 
56.15 	fund and is annually appropriated to the commissioner of health for distribution under 
56.16 	section 62J.692, subdivision 4 or 11, as appropriate; and
56.17 	(3) the balance of the revenues derived from taxes, penalties, and interest (under 
56.18 	this chapter) and from license fees and miscellaneous sources of revenue shall be credited 
56.19 	to the general fund.

56.20 	Sec. 33. TRANSFER OF HEALTH QUALITY DATA COLLECTION.
 56.21 		Subdivision 1.Transfer. The duties and activities of the commissioner of 
56.22 	health conducted pursuant to Minnesota Statutes, chapter 62U, are transferred to the 
56.23 	commissioner of human services.
56.24 		Subd. 2.Effect of transfer. Minnesota Statutes, section 15.039 applies to the 
56.25 	transfer required in subdivision 1.
56.26 		Subd. 3.Effective date. The transfer required in subdivision 1 is effective July 1, 
56.27 	2011.
56.28 		Subd. 4.Suspended data collection. Data collection under Minnesota Statutes, 
56.29 	section 62U.04, subdivision 4, is suspended, effective July 1, 2011.
56.30 		Subd. 5.Commissioner of human services. (a) During the 2012 legislative session, 
56.31 	the commissioner of human services, in consultation with the revisor of statutes, shall 
56.32 	submit to the legislature a bill making all statutory changes required by the reorganization 
56.33 	required under subdivision 1.
57.1 	(b) By July 1, 2013, the commissioner must make recommendations to the legislature 
57.2 	for collection of encounter data for state health care programs, including SEGIP, through a 
57.3 	mechanism that allows a third-party contractor to capture data as it is transmitted through 
57.4 	existing claims processing mechanisms.

57.5 	Sec. 34. PATIENT AND COMMUNITY ENGAGEMENT IN PAYMENT 
57.6 	REFORM AND HEALTH CARE PROGRAM REFORMS.
 57.7 		Subdivision 1.Implementation of data system improvements. The commissioners 
57.8 	of health and human services shall implement the recommendations regarding data on 
57.9 	health disparities that were contained in the report prepared under Laws 2010, First 
57.10 	Special Session chapter 1, article 19, section 23, in consultation with an advisory work 
57.11 	group representing racial and ethnic groups and representatives of government and private 
57.12 	sector health care organizations. Among other activities, the commissioners shall:
57.13 	(1) continue engagement with diverse communities on collection of and access to 
57.14 	racial and ethnic data from state agencies, health care providers, and health plans;
57.15 	(2) develop a plan to make data more accessible to communities;
57.16 	(3) develop consistent data elements across programs when feasible; and
57.17 	(4) develop consistent policies on data sampling.
57.18 		Subd. 2.Patient and community engagement. The commissioner of health, in 
57.19 	cooperation with the commissioners of human services and commerce, shall consult with 
57.20 	an advisory committee representing racial and ethnic groups regarding the implementation 
57.21 	of subdivision 1 and major agency activities related to state and federal health care reform, 
57.22 	payment reform demonstration projects, state health care program reforms, improvements 
57.23 	in quality and patient satisfaction measures, and major changes in state public health 
57.24 	priorities and strategies.  At the request of the advisory committee established under Laws 
57.25 	2010, First Special Session chapter 1, article 19, section 23, the commissioner shall 
57.26 	designate a private sector organization of multiple racial and ethnic groups to serve as the 
57.27 	advisory committee under this subdivision.

57.28 	Sec. 35. EVALUATION OF HEALTH AND HUMAN SERVICES REGULATORY 
57.29 	RESPONSIBILITIES.
 57.30 	(a) The commissioner of health, in consultation with the commissioner of human 
57.31 	services, shall evaluate and recommend options for reorganizing health and human 
57.32 	services regulatory responsibilities in both agencies to provide better efficiency and 
57.33 	operational cost savings while maintaining the protection of the health, safety, and welfare 
57.34 	of the public. Regulatory responsibilities that are to be evaluated are those found in 
58.1 	Minnesota Statutes, chapters 62D, 62N, 62R, 62T, 144A, 144D, 144G, 146A, 146B, 
58.2 	149A, 153A, 245A, 245B, and 245C, and sections 62Q.19, 144.058, 144.0722, 144.50, 
58.3 	144.651, 148.511, 148.6401, 148.995, 256B.692, 626.556, and 626.557.
58.4 	(b) The evaluation and recommendations shall be submitted in a report to the 
58.5 	legislative committees with jurisdiction over health and human services no later than 
58.6 	February 15, 2012, and shall include, at a minimum, the following:
58.7 	(1) whether the regulatory responsibilities of each agency should be combined into 
58.8 	a separate agency;
58.9 	(2) whether the regulatory responsibilities of each agency should be merged into 
58.10 	an existing agency;
58.11 	(3) what cost savings would result by merging the activities regardless of where 
58.12 	they are located;
58.13 	(4) what additional costs would result if the activities were merged;
58.14 	(5) whether there are additional regulatory responsibilities in both agencies that 
58.15 	should be considered in any reorganization; and
58.16 	(6) for each option recommended, projected cost and a timetable and identification 
58.17 	of the necessary steps and requirements for a successful transition period.

58.18 	Sec. 36. TRANSFER OF THE HEALTH ECONOMICS PROGRAM.
 58.19 		Subdivision 1.Transfer. The duties and activities of the health economics program 
58.20 	at the Minnesota Department of Health conducted pursuant to Minnesota Statutes, chapter 
58.21 	62J, are transferred to the commissioner of commerce.
58.22 		Subd. 2.Effect of transfer. Minnesota Statutes, section 15.039, applies to the 
58.23 	transfer required in subdivision 1.
58.24 		Subd. 3.Commissioner of commerce. During the 2012 legislative session, the 
58.25 	commissioner of commerce, in consultation with the revisor of statutes, shall submit to 
58.26 	the legislature a bill making all statutory changes required by the reorganization required 
58.27 	under subdivision 1.
58.28 		Subd. 4.Effective date. The transfer required in subdivision 1 is effective July 1, 
58.29 	2011.

58.30 	Sec. 37. STUDY OF FOR-PROFIT HEALTH MAINTENANCE 
58.31 	ORGANIZATIONS.
 58.32 	The commissioner of health shall contract with an entity with expertise in health 
58.33 	economics and health care delivery and quality to study the efficiency, costs, service 
58.34 	quality, and enrollee satisfaction of for-profit health maintenance organizations, relative to 
59.1 	not-for-profit health maintenance organizations operating in Minnesota and other states. 
59.2 	The study findings must address whether the state of Minnesota could: (1) reduce medical 
59.3 	assistance and MinnesotaCare costs and costs of providing coverage to state employees; 
59.4 	and (2) maintain or improve the quality of care provided to state health care program 
59.5 	enrollees and state employees if for-profit health maintenance organizations were allowed 
59.6 	to operate in the state. The commissioner shall require the entity under contract to report 
59.7 	study findings to the commissioner and the legislature by January 15, 2012.

59.8 	Sec. 38. MINNESOTA TASK FORCE ON PREMATURITY.
 59.9 		Subdivision 1.Establishment. The Minnesota Task Force on Prematurity is 
59.10 	established to evaluate and make recommendations on methods for reducing prematurity 
59.11 	and improving premature infant health care in the state.
59.12 		Subd. 2.Membership; meetings; staff. (a) The task force shall be composed of at 
59.13 	least the following members, who serve at the pleasure of their appointing authority:
59.14 	(1) 15 representatives of the Minnesota Prematurity Coalition including, but not 
59.15 	limited to, health care providers who treat pregnant women or neonates, organizations 
59.16 	focused on preterm births, early childhood education and development professionals, and 
59.17 	families affected by prematurity;
59.18 	(2) one representative appointed by the commissioner of human services;
59.19 	(3) two representatives appointed by the commissioner of health;
59.20 	(4) one representative appointed by the commissioner of education; 
59.21 	(5) two members of the house of representatives, one appointed by the speaker of 
59.22 	the house and one appointed by the minority leader; and
59.23 	(6) two members of the senate, appointed according to the rules of the senate.
59.24 	(b) Members of the task force serve without compensation or payment of expenses.
59.25 	(c) The commissioner of health must convene the first meeting of the Minnesota 
59.26 	Task Force on Prematurity by July 31, 2011. The task force must continue to meet at 
59.27 	least quarterly. Staffing and technical assistance shall be provided by the Minnesota 
59.28 	Perinatal Coalition.
59.29 		Subd. 3.Duties. The task force must report the current state of prematurity in 
59.30 	Minnesota and develop recommendations on strategies for reducing prematurity and 
59.31 	improving premature infant health care in the state by considering the following:
59.32 	(1) standards of care for premature infants born less than 37 weeks gestational age, 
59.33 	including recommendations to improve hospital discharge and follow-up care procedures;
59.34 	(2) coordination of information among appropriate professional and advocacy 
59.35 	organizations on measures to improve health care for infants born prematurely;
60.1 	(3) identification and centralization of available resources to improve access and 
60.2 	awareness for caregivers of premature infants;
60.3 	(4) development and dissemination of evidence-based practices through networking 
60.4 	and educational opportunities; 
60.5 	(5) a review of relevant evidence-based research regarding the causes and effects of 
60.6 	premature births in Minnesota;
60.7 	(6) a review of relevant evidence-based research regarding premature infant health 
60.8 	care, including methods for improving quality of and access to care for premature infants; 
60.9 	and
60.10 	(7) identification of gaps in public reporting measures and possible effects of these 
60.11 	measures on prematurity rates.
60.12 		Subd. 4.Report; expiration. (a) By November 30, 2011, the task force must submit 
60.13 	a report on the current state of prematurity in Minnesota to the chairs of the legislative 
60.14 	policy committees on health and human services.
60.15 	(b) By January 15, 2013, the task force must report its final recommendations, 
60.16 	including any draft legislation necessary for implementation, to the chairs of the legislative 
60.17 	policy committees on health and human services.
60.18 	(c) This task force expires on January 31, 2013, or upon submission of the final 
60.19 	report required in paragraph (b), whichever is earlier.

60.20 	Sec. 39. NURSING HOME REGULATORY EFFICIENCY.
 60.21 	The commissioner of health shall work with stakeholders to review, develop, 
60.22 	implement, and recommend legislative changes in the nursing home licensure process that 
60.23 	address efficiency, eliminate duplication, and ensure positive resident clinical outcomes. 
60.24 	The commissioner shall ensure that the changes are cost-neutral.

60.25 	Sec. 40.  REPEALER.
 60.26 	(a) Minnesota Statutes 2010, sections 62J.17, subdivisions 1, 3, 5a, 6a, and 8; 
60.27 	62J.321, subdivision 5a; 62J.381; 62J.41, subdivisions 1 and 2; 144.1464; and 150A.22,
60.28 	are repealed.
60.29 	(b) Minnesota Statutes 2010, section 145A.14, subdivisions 1 and 2, are repealed 
60.30 	effective January 1, 2012.
60.31 	(c) Minnesota Rules, parts 4651.0100, subparts 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 
60.32 	14, 15, 16, 16a, 18, 19, 20, 20a, 21, 22, and 23; 4651.0110, subparts 2, 2a, 3, 4, and 5; 
60.33 	4651.0120; 4651.0130; 4651.0140; and 4651.0150, are repealed effective July 1, 2011.

61.1 	ARTICLE 3
61.2 	HEALTH BOARDS

61.3 	Section 1. Minnesota Statutes 2010, section 148.10, subdivision 7, is amended to read:
61.4 		Subd. 7.Conviction of a felony-level criminal sexual conduct offense. (a) Except 
61.5 	as provided in paragraph (e) (f), the board shall not grant or renew a license to practice 
61.6 	chiropractic to any person who has been convicted on or after August 1, 2010, of any 
61.7 	of the provisions of sections 609.342, subdivision 1, 609.343, subdivision 1, 609.344, 
61.8 	subdivision 1, paragraphs (c) to (o), or 609.345, subdivision 1, paragraphs (b) to (o).
61.9 	(b) The board shall not grant or renew a license to practice chiropractic to any 
61.10 	person who has been convicted in any other state or country on or after August 1, 2011, 
61.11 	of an offense where the elements of the offense are substantially similar to any of the 
61.12 	offenses listed in paragraph (a).
61.13 	(b) (c) A license to practice chiropractic is automatically revoked if the licensee is 
61.14 	convicted of an offense listed in paragraph (a) of this section.
61.15 	(c) (d) A license to practice chiropractic that has been denied or revoked under this 
61.16 	subdivision is not subject to chapter 364.
61.17 	(d) (e) For purposes of this subdivision, "conviction" means a plea of guilty, a 
61.18 	verdict of guilty by a jury, or a finding of guilty by the court, unless the court stays 
61.19 	imposition or execution of the sentence and final disposition of the case is accomplished at 
61.20 	a nonfelony level.
61.21 	(e) (f) The board may establish criteria whereby an individual convicted of an offense 
61.22 	listed in paragraph (a) of this subdivision may become licensed provided that the criteria:
61.23 	(1) utilize a rebuttable presumption that the applicant is not suitable for licensing or 
61.24 	credentialing;
61.25 	(2) provide a standard for overcoming the presumption; and
61.26 	(3) require that a minimum of ten years has elapsed since the applicant was released 
61.27 	from any incarceration or supervisory jurisdiction related to the offense.
61.28 	The board shall not consider an application under this paragraph if the board 
61.29 	determines that the victim involved in the offense was a patient or a client of the applicant 
61.30 	at the time of the offense.

61.31 	Sec. 2. Minnesota Statutes 2010, section 148.231, is amended to read:
61.32 	148.231 REGISTRATION; FAILURE TO REGISTER; REREGISTRATION; 
61.33 	VERIFICATION.
62.1 		Subdivision 1.Registration. Every person licensed to practice professional or 
62.2 	practical nursing must maintain with the board a current registration for practice as a 
62.3 	registered nurse or licensed practical nurse which must be renewed at regular intervals 
62.4 	established by the board by rule. No certificate of registration shall be issued by the board 
62.5 	to a nurse until the nurse has submitted satisfactory evidence of compliance with the 
62.6 	procedures and minimum requirements established by the board.
62.7 	The fee for periodic registration for practice as a nurse shall be determined by the 
62.8 	board by rule law. A penalty fee shall be added for any application received after the 
62.9 	required date as specified by the board by rule. Upon receipt of the application and the 
62.10 	required fees, the board shall verify the application and the evidence of completion of 
62.11 	continuing education requirements in effect, and thereupon issue to the nurse a certificate 
62.12 	of registration for the next renewal period.
62.13 		Subd. 4.Failure to register. Any person licensed under the provisions of sections 
62.14 	148.171 to 148.285 who fails to register within the required period shall not be entitled to 
62.15 	practice nursing in this state as a registered nurse or licensed practical nurse. 
62.16 		Subd. 5.Reregistration. A person whose registration has lapsed desiring to 
62.17 	resume practice shall make application for reregistration, submit satisfactory evidence of 
62.18 	compliance with the procedures and requirements established by the board, and pay the 
62.19 	registration reregistration fee for the current period to the board. A penalty fee shall be 
62.20 	required from a person who practiced nursing without current registration. Thereupon, the
62.21 	registration certificate shall be issued to the person who shall immediately be placed on 
62.22 	the practicing list as a registered nurse or licensed practical nurse.
62.23 		Subd. 6.Verification. A person licensed under the provisions of sections 148.171 to 
62.24 	148.285 who requests the board to verify a Minnesota license to another state, territory, 
62.25 	or country or to an agency, facility, school, or institution shall pay a fee to the board
62.26 	for each verification. 

62.27 	Sec. 3. Minnesota Statutes 2010, section 148B.5301, subdivision 1, is amended to read:
62.28 		Subdivision 1.General requirements. (a) To be licensed as a licensed professional 
62.29 	clinical counselor (LPCC), an applicant must provide satisfactory evidence to the board 
62.30 	that the applicant:
62.31 	(1) is at least 18 years of age;
62.32 	(2) is of good moral character;
62.33 	(3) has completed a master's or doctoral degree program in counseling or a 
62.34 	related field, as determined by the board based on the criteria in items (i) to (x), that 
62.35 	includes a minimum of 48 semester hours or 72 quarter hours and a supervised field 
63.1 	experience in counseling that is not fewer than 700 hours. The degree must be from 
63.2 	a counseling program recognized by the Council for Accreditation of Counseling and 
63.3 	Related Education Programs (CACREP) or from an institution of higher education that is 
63.4 	accredited by a regional accrediting organization recognized by the Council for Higher 
63.5 	Education Accreditation (CHEA). Specific academic course content and training must 
63.6 	include coursework in each of the following subject areas:
63.7 	(i) helping relationship, including counseling theory and practice;
63.8 	(ii) human growth and development;
63.9 	(iii) lifestyle and career development;
63.10 	(iv) group dynamics, processes, counseling, and consulting;
63.11 	(v) assessment and appraisal;
63.12 	(vi) social and cultural foundations, including multicultural issues;
63.13 	(vii) principles of etiology, treatment planning, and prevention of mental and 
63.14 	emotional disorders and dysfunctional behavior;
63.15 	(viii) family counseling and therapy;
63.16 	(ix) research and evaluation; and
63.17 	(x) professional counseling orientation and ethics;
63.18 	(4) has demonstrated competence in professional counseling by passing the National 
63.19 	Clinical Mental Health Counseling Examination (NCMHCE), administered by the 
63.20 	National Board for Certified Counselors, Inc. (NBCC) and ethical, oral, and situational 
63.21 	examinations as prescribed by the board. In lieu of the NCMHCE, applicants who have 
63.22 	taken and passed the National Counselor Examination (NCE) administered by the NBCC, 
63.23 	or another board-approved examination, need only take and pass the Examination of 
63.24 	Clinical Counseling Practice (ECCP) administered by the NBCC;
63.25 	(5) has earned graduate-level semester credits or quarter-credit equivalents in the 
63.26 	following clinical content areas as follows:
63.27 	(i) six credits in diagnostic assessment for child or adult mental disorders; normative 
63.28 	development; and psychopathology, including developmental psychopathology;
63.29 	(ii) three credits in clinical treatment planning, with measurable goals;
63.30 	(iii) six credits in clinical intervention methods informed by research evidence and 
63.31 	community standards of practice;
63.32 	(iv) three credits in evaluation methodologies regarding the effectiveness of 
63.33 	interventions;
63.34 	(v) three credits in professional ethics applied to clinical practice; and
63.35 	(vi) three credits in cultural diversity; and
64.1 	(6) has demonstrated successful completion of 4,000 hours of supervised, 
64.2 	post-master's degree professional practice in the delivery of clinical services in the 
64.3 	diagnosis and treatment of child and adult mental illnesses and disorders, conducted 
64.4 	according to subdivision 2.
64.5 	(b) If coursework in paragraph (a) was not completed as part of the degree program 
64.6 	required by paragraph (a), clause (3), the coursework must be taken and passed for credit, 
64.7 	and must be earned from a counseling program or institution that meets the requirements 
64.8 	of paragraph (a), clause (3).

64.9 	Sec. 4. Minnesota Statutes 2010, section 148B.5301, subdivision 3, is amended to read:
64.10 		Subd. 3.Conversion from licensed professional counselor to licensed 
64.11 	professional clinical counselor. (a) Until August 1, 2011 2013, an individual currently 
64.12 	licensed in the state of Minnesota as a licensed professional counselor may convert to a 
64.13 	LPCC by providing evidence satisfactory to the board that the applicant has met the 
64.14 	following requirements:
64.15 	(1) is at least 18 years of age;
64.16 	(2) is of good moral character;
64.17 	(3) has a license that is active and in good standing;
64.18 	(4) has no complaints pending, uncompleted disciplinary orders, or corrective 
64.19 	action agreements;
64.20 	(5) has completed a master's or doctoral degree program in counseling or a related 
64.21 	field, as determined by the board, and whose degree was from a counseling program 
64.22 	recognized by CACREP or from an institution of higher education that is accredited by a 
64.23 	regional accrediting organization recognized by CHEA;
64.24 	(6) has earned 24 graduate-level semester credits or quarter-credit equivalents in 
64.25 	clinical coursework which includes content in the following clinical areas:
64.26 	(i) diagnostic assessment for child and adult mental disorders; normative 
64.27 	development; and psychopathology, including developmental psychopathology;
64.28 	(ii) clinical treatment planning, with measurable goals;
64.29 	(iii) clinical intervention methods informed by research evidence and community 
64.30 	standards of practice;
64.31 	(iv) evaluation methodologies regarding the effectiveness of interventions;
64.32 	(v) professional ethics applied to clinical practice; and
64.33 	(vi) cultural diversity;
64.34 	(7) has demonstrated, to the satisfaction of the board, successful completion of 
64.35 	4,000 hours of supervised, post-master's degree professional practice in the delivery of 
65.1 	clinical services in the diagnosis and treatment of child and adult mental illnesses and 
65.2 	disorders; and
65.3 	(8) has paid the LPCC application and licensure fees required in section 148B.53, 
65.4 	subdivision 3.
65.5 	(b) If the coursework in paragraph (a) was not completed as part of the degree 
65.6 	program required by paragraph (a), clause (5), the coursework must be taken and passed 
65.7 	for credit, and must be earned from a counseling program or institution that meets the 
65.8 	requirements in paragraph (a), clause (5).
65.9 	(c) This subdivision expires August 1, 2011 2013.

65.10 	Sec. 5. Minnesota Statutes 2010, section 148B.5301, subdivision 4, is amended to read:
65.11 		Subd. 4.Conversion to licensed professional clinical counselor after August 1, 
65.12 	2011 2013. An individual licensed in the state of Minnesota as a licensed professional 
65.13 	counselor may convert to a LPCC by providing evidence satisfactory to the board that the 
65.14 	applicant has met the requirements of subdivisions 1 and 2, subject to the following:
65.15 	(1) the individual's license must be active and in good standing;
65.16 	(2) the individual must not have any complaints pending, uncompleted disciplinary 
65.17 	orders, or corrective action agreements; and
65.18 	(3) the individual has paid the LPCC application and licensure fees required in 
65.19 	section 148B.53, subdivision 3.

65.20 	Sec. 6. Minnesota Statutes 2010, section 148B.54, subdivision 2, is amended to read:
65.21 		Subd. 2.Continuing education. At the completion of the first four years of 
65.22 	licensure, a licensee must provide evidence satisfactory to the board of completion of 
65.23 	12 additional postgraduate semester credit hours or its equivalent in counseling as 
65.24 	determined by the board, except that no licensee shall be required to show evidence of 
65.25 	greater than 60 semester hours or its equivalent. In addition to completing the requisite 
65.26 	graduate coursework, each licensee shall also complete in the first four years of licensure 
65.27 	a minimum of 40 hours of continuing education activities approved by the board under 
65.28 	Minnesota Rules, part 2150.2540. Graduate credit hours successfully completed in the 
65.29 	first four years of licensure may be applied to both the graduate credit requirement and to 
65.30 	the requirement for 40 hours of continuing education activities. A licensee may receive 15 
65.31 	continuing education hours per semester credit hour or ten continuing education hours 
65.32 	per quarter credit hour. Thereafter, at the time of renewal, each licensee shall provide 
65.33 	evidence satisfactory to the board that the licensee has completed during each two-year 
65.34 	period at least the equivalent of 40 clock hours of professional postdegree continuing 
66.1 	education in programs approved by the board and continues to be qualified to practice 
66.2 	under sections 148B.50 to 148B.593.

66.3 	Sec. 7. Minnesota Statutes 2010, section 148B.54, subdivision 3, is amended to read:
66.4 		Subd. 3.Relicensure following termination. An individual whose license was 
66.5 	terminated prior to August 1, 2010, and who can demonstrate completion of the graduate 
66.6 	credit requirement in subdivision 2, does not need to comply with the continuing education 
66.7 	requirement of Minnesota Rules, part 2150.2520, subpart 4, or with the continuing 
66.8 	education requirements for relicensure following termination in Minnesota Rules, part 
66.9 	2150.0130, subpart 2. This section does not apply to an individual whose license has 
66.10 	been canceled.

66.11 	Sec. 8. Minnesota Statutes 2010, section 148E.060, subdivision 1, is amended to read:
66.12 		Subdivision 1.Students and other persons not currently licensed in another 
66.13 	jurisdiction. (a) The board may issue a temporary license to practice social work to an 
66.14 	applicant who is not licensed or credentialed to practice social work in any jurisdiction 
66.15 	but has:
66.16 	(1) applied for a license under section 148E.055;
66.17 	(2) applied for a temporary license on a form provided by the board;
66.18 	(3) submitted a form provided by the board authorizing the board to complete a 
66.19 	criminal background check;
66.20 	(4) passed the applicable licensure examination provided for in section 148E.055;
66.21 	(5) attested on a form provided by the board that the applicant has completed the 
66.22 	requirements for a baccalaureate or graduate degree in social work from a program 
66.23 	accredited by the Council on Social Work Education, the Canadian Association of Schools 
66.24 	of Social Work, or a similar accreditation accrediting body designated by the board, or a 
66.25 	doctorate in social work from an accredited university; and
66.26 	(6) not engaged in conduct that was or would be in violation of the standards of 
66.27 	practice specified in sections 148E.195 to 148E.240. If the applicant has engaged in 
66.28 	conduct that was or would be in violation of the standards of practice, the board may take 
66.29 	action according to sections 148E.255 to 148E.270.
66.30 	(b) A temporary license issued under this subdivision expires after six months.

66.31 	EFFECTIVE DATE. This section is effective August 1, 2011.

66.32 	Sec. 9. Minnesota Statutes 2010, section 148E.060, subdivision 2, is amended to read:
67.1 		Subd. 2.Emergency situations and persons currently licensed in another 
67.2 	jurisdiction. (a) The board may issue a temporary license to practice social work to an 
67.3 	applicant who is licensed or credentialed to practice social work in another jurisdiction, 
67.4 	may or may not have applied for a license under section 148E.055, and has:
67.5 	(1) applied for a temporary license on a form provided by the board;
67.6 	(2) submitted a form provided by the board authorizing the board to complete a 
67.7 	criminal background check;
67.8 	(3) submitted evidence satisfactory to the board that the applicant is currently 
67.9 	licensed or credentialed to practice social work in another jurisdiction;
67.10 	(4) attested on a form provided by the board that the applicant has completed the 
67.11 	requirements for a baccalaureate or graduate degree in social work from a program 
67.12 	accredited by the Council on Social Work Education, the Canadian Association of Schools 
67.13 	of Social Work, or a similar accreditation accrediting body designated by the board, or a 
67.14 	doctorate in social work from an accredited university; and
67.15 	(5) not engaged in conduct that was or would be in violation of the standards of 
67.16 	practice specified in sections 148E.195 to 148E.240. If the applicant has engaged in 
67.17 	conduct that was or would be in violation of the standards of practice, the board may take 
67.18 	action according to sections 148E.255 to 148E.270.
67.19 	(b) A temporary license issued under this subdivision expires after six months.

67.20 	EFFECTIVE DATE. This section is effective August 1, 2011.

67.21 	Sec. 10. Minnesota Statutes 2010, section 148E.060, is amended by adding a 
67.22 	subdivision to read:
67.23 		Subd. 2a.Programs in candidacy status. (a) The board may issue a temporary 
67.24 	license to practice social work to an applicant who has completed the requirements for a 
67.25 	baccalaureate or graduate degree in social work from a program in candidacy status with 
67.26 	the Council on Social Work Education, the Canadian Association of Schools of Social 
67.27 	Work, or a similar accrediting body designated by the board, and has:
67.28 	(1) applied for a license under section 148E.055;
67.29 	(2) applied for a temporary license on a form provided by the board;
67.30 	(3) submitted a form provided by the board authorizing the board to complete a 
67.31 	criminal background check;
67.32 	(4) passed the applicable licensure examination provided for in section 148E.055; 
67.33 	and
67.34 	(5) not engaged in conduct that is in violation of the standards of practice specified 
67.35 	in sections 148E.195 to 148E.240. If the applicant has engaged in conduct that is in 
68.1 	violation of the standards of practice, the board may take action according to sections 
68.2 	148E.255 to 148E.270.
68.3 	(b) A temporary license issued under this subdivision expires after 12 months but 
68.4 	may be extended at the board's discretion upon a showing that the social work program 
68.5 	remains in good standing with the Council on Social Work Education, the Canadian 
68.6 	Association of Schools of Social Work, or a similar accrediting body designated by the 
68.7 	board. If the board receives notice from the Council on Social Work Education, the 
68.8 	Canadian Association of Schools of Social Work, or a similar accrediting body designated 
68.9 	by the board that the social work program is not in good standing, or that the accreditation 
68.10 	will not be granted to the social work program, the temporary license is immediately 
68.11 	revoked.

68.12 	EFFECTIVE DATE. This section is effective August 1, 2011.

68.13 	Sec. 11. Minnesota Statutes 2010, section 148E.060, subdivision 3, is amended to read:
68.14 		Subd. 3.Teachers. (a) The board may issue a temporary license to practice social 
68.15 	work to an applicant whose permanent residence is outside the United States, who is 
68.16 	teaching social work at an academic institution in Minnesota for a period not to exceed 
68.17 	12 months, who may or may not have applied for a license under section 148E.055, and 
68.18 	who has:
68.19 	(1) applied for a temporary license on a form provided by the board;
68.20 	(2) submitted a form provided by the board authorizing the board to complete a 
68.21 	criminal background check;
68.22 	(3) attested on a form provided by the board that the applicant has completed the 
68.23 	requirements for a baccalaureate or graduate degree in social work; and
68.24 	(4) has not engaged in conduct that was or would be in violation of the standards 
68.25 	of practice specified in sections 148E.195 to 148E.240. If the applicant has engaged in 
68.26 	conduct that was or would be in violation of the standards of practice, the board may take 
68.27 	action according to sections 148E.255 to 148E.270.
68.28 	(b) A temporary license issued under this subdivision expires after 12 months.

68.29 	EFFECTIVE DATE. This section is effective August 1, 2011.

68.30 	Sec. 12. Minnesota Statutes 2010, section 148E.060, subdivision 5, is amended to read:
68.31 		Subd. 5.Temporary license term. (a) A temporary license is valid until expiration, 
68.32 	or until the board issues or denies the license according to section 148E.055, or until 
69.1 	the board revokes the temporary license, whichever comes first. A temporary license is 
69.2 	nonrenewable.
69.3 	(b) A temporary license issued according to subdivision 1 or 2 expires after six 
69.4 	months.
69.5 	(c) A temporary license issued according to subdivision 3 expires after 12 months.

69.6 	EFFECTIVE DATE. This section is effective August 1, 2011.

69.7 	Sec. 13. Minnesota Statutes 2010, section 148E.120, is amended to read:
69.8 	148E.120 REQUIREMENTS OF SUPERVISORS.
69.9 		Subdivision 1.Supervisors licensed as social workers. (a) Except as provided in 
69.10 	paragraph (d) subdivision 2, to be eligible to provide supervision under this section, a 
69.11 	social worker must:
69.12 	(1) have completed 30 hours of training in supervision through coursework from 
69.13 	an accredited college or university, or through continuing education in compliance with 
69.14 	sections 148E.130 to 148E.170;
69.15 	(2) be competent in the activities being supervised; and
69.16 	(3) attest, on a form provided by the board, that the social worker has met the 
69.17 	applicable requirements specified in this section and sections 148E.100 to 148E.115. The 
69.18 	board may audit the information provided to determine compliance with the requirements 
69.19 	of this section.
69.20 	(b) A licensed independent clinical social worker providing clinical licensing 
69.21 	supervision to a licensed graduate social worker or a licensed independent social worker 
69.22 	must have at least 2,000 hours of experience in authorized social work practice, including 
69.23 	1,000 hours of experience in clinical practice after obtaining a licensed independent 
69.24 	clinical social worker license.
69.25 	(c) A licensed social worker, licensed graduate social worker, licensed independent 
69.26 	social worker, or licensed independent clinical social worker providing nonclinical 
69.27 	licensing supervision must have completed the supervised practice requirements specified 
69.28 	in section 148E.100, 148E.105, 148E.106, 148E.110, or 148E.115, as applicable.
69.29 	(d) If the board determines that supervision is not obtainable from an individual 
69.30 	meeting the requirements specified in paragraph (a), the board may approve an alternate 
69.31 	supervisor according to subdivision 2.
69.32 		Subd. 2.Alternate supervisors. (a) The board may approve an alternate supervisor 
69.33 	if: The board may approve an alternate supervisor as determined in this subdivision. The 
69.34 	board shall approve up to 25 percent of the required supervision hours by a licensed mental 
70.1 	health professional who is competent and qualified to provide supervision according to the 
70.2 	mental health professional's respective licensing board, as established by section 245.462, 
70.3 	subdivision 18, clauses (1) to (6), or 245.4871, subdivision 27, clauses (1) to (6).
70.4 	(1) the board determines that supervision is not obtainable according to paragraph 
70.5 	(b);
70.6 	(2) the licensee requests in the supervision plan submitted according to section 
70.7 	148E.125, subdivision 1, that an alternate supervisor conduct the supervision;
70.8 	(3) the licensee describes the proposed supervision and the name and qualifications 
70.9 	of the proposed alternate supervisor; and
70.10 	(4) the requirements of paragraph (d) are met.
70.11 	(b) The board may determine that supervision is not obtainable if:
70.12 	(1) the licensee provides documentation as an attachment to the supervision plan 
70.13 	submitted according to section 148E.125, subdivision 1, that the licensee has conducted a 
70.14 	thorough search for a supervisor meeting the applicable licensure requirements specified 
70.15 	in sections 148E.100 to 148E.115;
70.16 	(2) the licensee demonstrates to the board's satisfaction that the search was 
70.17 	unsuccessful; and
70.18 	(3) the licensee describes the extent of the search and the names and locations of 
70.19 	the persons and organizations contacted.
70.20 	(c) The requirements specified in paragraph (b) do not apply to obtaining licensing 
70.21 	supervision for social work practice if the board determines that there are five or fewer 
70.22 	supervisors meeting the applicable licensure requirements in sections 148E.100 to 
70.23 	148E.115 in the county where the licensee practices social work.
70.24 	(d) An alternate supervisor must:
70.25 	(1) be an unlicensed social worker who is employed in, and provides the supervision 
70.26 	in, a setting exempt from licensure by section 148E.065, and who has qualifications 
70.27 	equivalent to the applicable requirements specified in sections 148E.100 to 148E.115;
70.28 	(2) be a social worker engaged in authorized practice in Iowa, Manitoba, North 
70.29 	Dakota, Ontario, South Dakota, or Wisconsin, and has the qualifications equivalent to the 
70.30 	applicable requirements specified in sections 148E.100 to 148E.115; or
70.31 	(3) be a licensed marriage and family therapist or a mental health professional 
70.32 	as established by section 245.462, subdivision 18, or 245.4871, subdivision 27, or an 
70.33 	equivalent mental health professional, as determined by the board, who is licensed or 
70.34 	credentialed by a state, territorial, provincial, or foreign licensing agency.
70.35 	(e) In order to qualify to provide clinical supervision of a licensed graduate social 
70.36 	worker or licensed independent social worker engaged in clinical practice, the alternate 
71.1 	supervisor must be a mental health professional as established by section 245.462, 
71.2 	subdivision 18, or 245.4871, subdivision 27, or an equivalent mental health professional, 
71.3 	as determined by the board, who is licensed or credentialed by a state, territorial, 
71.4 	provincial, or foreign licensing agency.
71.5 	(b) The board shall approve up to 100 percent of the required supervision hours by 
71.6 	an alternate supervisor if the board determines that:
71.7 	(1) there are five or fewer supervisors in the county where the licensee practices 
71.8 	social work who meet the applicable licensure requirements in subdivision 1;
71.9 	(2) the supervisor is an unlicensed social worker who is employed in, and provides 
71.10 	the supervision in, a setting exempt from licensure by section 148E.065, and who has 
71.11 	qualifications equivalent to the applicable requirements specified in sections 148E.100 to 
71.12 	148E.115;
71.13 	(3) the supervisor is a social worker engaged in authorized social work practice 
71.14 	in Iowa, Manitoba, North Dakota, Ontario, South Dakota, or Wisconsin, and has the 
71.15 	qualifications equivalent to the applicable requirements in sections 148E.100 to 148E.115; 
71.16 	or
71.17 	(4) the applicant or licensee is engaged in nonclinical authorized social work 
71.18 	practice outside of Minnesota and the supervisor meets the qualifications equivalent to 
71.19 	the applicable requirements in sections 148E.100 to 148E.115, or the supervisor is an 
71.20 	equivalent mental health professional, as determined by the board, who is credentialed by 
71.21 	a state, territorial, provincial, or foreign licensing agency; or
71.22 	(5) the applicant or licensee is engaged in clinical authorized social work practice 
71.23 	outside of Minnesota and the supervisor meets qualifications equivalent to the applicable 
71.24 	requirements in section 148E.115, or the supervisor is an equivalent mental health 
71.25 	professional, as determined by the board, who is credentialed by a state, territorial, 
71.26 	provincial, or foreign licensing agency.
71.27 	(c) In order for the board to consider an alternate supervisor under this section, 
71.28 	the licensee must:
71.29 	(1) request in the supervision plan and verification submitted according to section 
71.30 	148E.125 that an alternate supervisor conduct the supervision; and
71.31 	(2) describe the proposed supervision and the name and qualifications of the 
71.32 	proposed alternate supervisor. The board may audit the information provided to determine 
71.33 	compliance with the requirements of this section.

71.34 	EFFECTIVE DATE. This section is effective August 1, 2011.

72.1 	Sec. 14. Minnesota Statutes 2010, section 150A.02, is amended to read:
72.2 	150A.02 BOARD OF DENTISTRY.
72.3 		Subdivision 1.Generally. There is hereby created a Board of Dentistry whose duty 
72.4 	it shall be to carry out the purposes and enforce the provisions of sections 150A.01 to 
72.5 	150A.12. The board shall consist of two public members as defined by section 214.02, 
72.6 	and the following dental professionals who are licensed and reside in Minnesota: five 
72.7 	qualified resident dentists, one qualified resident licensed dental assistant, and one 
72.8 	qualified resident dental hygienist appointed by the governor. One qualified dentist must 
72.9 	be involved with the education, employment, or utilization of a dental therapist or an 
72.10 	advanced dental therapist. Membership terms, compensation of members, removal of 
72.11 	members, the filling of membership vacancies, and fiscal year and reporting requirements 
72.12 	shall be as provided in sections 214.07 to 214.09. The provision of staff, administrative 
72.13 	services and office space; the review and processing of board complaints; the setting 
72.14 	of board fees; and other provisions relating to board operations shall be as provided in 
72.15 	chapter 214. Each board member who is a dentist, licensed dental assistant, or dental 
72.16 	hygienist shall have been lawfully in active practice in this state for five years immediately 
72.17 	preceding appointment; and no board member shall be eligible for appointment to more 
72.18 	than two consecutive four-year terms, and members serving on the board at the time of 
72.19 	the enactment hereof shall be eligible to reappointment provided they shall not have 
72.20 	served more than nine consecutive years at the expiration of the term to which they are to 
72.21 	be appointed. At least 90 days prior to the expiration of the terms of dentists, licensed 
72.22 	dental assistants, or dental hygienists, the Minnesota Dental Association, Minnesota 
72.23 	Dental Assistants Association, or the Minnesota State Dental Hygiene Association shall 
72.24 	recommend to the governor for each term expiring not less than two dentists, two licensed 
72.25 	dental assistants, or two dental hygienists, respectively, who are qualified to serve on the 
72.26 	board, and from the list so recommended the governor may appoint members to the board 
72.27 	for the term of four years, the appointments to be made within 30 days after the expiration 
72.28 	of the terms. Within 60 days after the occurrence of a dentist, licensed dental assistant, or 
72.29 	dental hygienist vacancy, prior to the expiration of the term, in the board, the Minnesota 
72.30 	Dental Association, the Minnesota Dental Assistants Association, or the Minnesota State 
72.31 	Dental Hygiene Association shall recommend to the governor not less than two dentists, 
72.32 	two licensed dental assistants, or two dental hygienists, who are qualified to serve on the 
72.33 	board and from the list so recommended the governor, within 30 days after receiving such 
72.34 	list of dentists, may appoint one member to the board for the unexpired term occasioned 
72.35 	by such vacancy. Any appointment to fill a vacancy shall be made within 90 days after the 
73.1 	occurrence of such vacancy. The first four-year term of the dental hygienist and of the 
73.2 	licensed dental assistant shall commence on the first Monday in January, 1977.

73.3 	Sec. 15. Minnesota Statutes 2010, section 150A.06, subdivision 1c, is amended to read:
73.4 		Subd. 1c.Specialty dentists. (a) The board may grant a specialty license in the 
73.5 	specialty areas of dentistry that are recognized by the American Dental Association.
73.6 	(b) An applicant for a specialty license shall:
73.7 	(1) have successfully completed a postdoctoral specialty education program 
73.8 	accredited by the Commission on Dental Accreditation of the American Dental 
73.9 	Association, or have announced a limitation of practice before 1967;
73.10 	(2) have been certified by a specialty examining board approved by the Minnesota 
73.11 	Board of Dentistry, or provide evidence of having passed a clinical examination for 
73.12 	licensure required for practice in any state or Canadian province, or in the case of oral and 
73.13 	maxillofacial surgeons only, have a Minnesota medical license in good standing;
73.14 	(3) have been in active practice or a postdoctoral specialty education program or 
73.15 	United States government service at least 2,000 hours in the 36 months prior to applying 
73.16 	for a specialty license;
73.17 	(4) if requested by the board, be interviewed by a committee of the board, which 
73.18 	may include the assistance of specialists in the evaluation process, and satisfactorily 
73.19 	respond to questions designed to determine the applicant's knowledge of dental subjects 
73.20 	and ability to practice;
73.21 	(5) if requested by the board, present complete records on a sample of patients 
73.22 	treated by the applicant. The sample must be drawn from patients treated by the applicant 
73.23 	during the 36 months preceding the date of application. The number of records shall be 
73.24 	established by the board. The records shall be reasonably representative of the treatment 
73.25 	typically provided by the applicant;
73.26 	(6) at board discretion, pass a board-approved English proficiency test if English is 
73.27 	not the applicant's primary language;
73.28 	(7) pass all components of the National Dental Board Dental Examinations;
73.29 	(8) pass the Minnesota Board of Dentistry jurisprudence examination;
73.30 	(9) abide by professional ethical conduct requirements; and
73.31 	(10) meet all other requirements prescribed by the Board of Dentistry.
73.32 	(c) The application must include:
73.33 	(1) a completed application furnished by the board;
74.1 	(2) at least two character references from two different dentists, one of whom must 
74.2 	be a dentist practicing in the same specialty area, and the other the director of the specialty 
74.3 	program attended;
74.4 	(3) a licensed physician's statement attesting to the applicant's physical and mental 
74.5 	condition;
74.6 	(4) a statement from a licensed ophthalmologist or optometrist attesting to the 
74.7 	applicant's visual acuity;
74.8 	(5) a nonrefundable fee; and
74.9 	(6) a notarized, unmounted passport-type photograph, three inches by three inches, 
74.10 	taken not more than six months before the date of application.
74.11 	(d) A specialty dentist holding a specialty license is limited to practicing in the 
74.12 	dentist's designated specialty area. The scope of practice must be defined by each national 
74.13 	specialty board recognized by the American Dental Association.
74.14 	(e) A specialty dentist holding a general dentist license is limited to practicing in the 
74.15 	dentist's designated specialty area if the dentist has announced a limitation of practice. 
74.16 	The scope of practice must be defined by each national specialty board recognized by 
74.17 	the American Dental Association.
74.18 	(f) All specialty dentists who have fulfilled the specialty dentist requirements and 
74.19 	who intend to limit their practice to a particular specialty area may apply for a specialty 
74.20 	license.

74.21 	Sec. 16. Minnesota Statutes 2010, section 150A.06, subdivision 1d, is amended to read:
74.22 		Subd. 1d.Dental therapists. A person of good moral character who has graduated 
74.23 	with a baccalaureate degree or a master's degree from a dental therapy education program 
74.24 	that has been approved by the board or accredited by the American Dental Association 
74.25 	Commission on Dental Accreditation or another board-approved national accreditation 
74.26 	organization may apply for licensure.
74.27 	The applicant must submit an application and fee as prescribed by the board and a 
74.28 	diploma or certificate from a dental therapy education program. Prior to being licensed, 
74.29 	the applicant must pass a comprehensive, competency-based clinical examination that is 
74.30 	approved by the board and administered independently of an institution providing dental 
74.31 	therapy education. The clinical examinations for competencies for dental therapy and 
74.32 	advanced dental therapy must be comparable to those administered to dental students 
74.33 	for the same competencies. The applicant must also pass an examination testing the 
74.34 	applicant's knowledge of the Minnesota laws and rules relating to the practice of dentistry. 
74.35 	An applicant who has failed the clinical examination twice is ineligible to retake the 
75.1 	clinical examination until further education and training are obtained as specified by the 
75.2 	board. A separate, nonrefundable fee may be charged for each time a person applies. 
75.3 	An applicant who passes the examination in compliance with subdivision 2b, abides by 
75.4 	professional ethical conduct requirements, and meets all the other requirements of the 
75.5 	board shall be licensed as a dental therapist.

75.6 	Sec. 17. Minnesota Statutes 2010, section 150A.06, subdivision 3, is amended to read:
75.7 		Subd. 3.Waiver of examination. (a) All or any part of the examination for dentists 
75.8 	or dental hygienists, except that pertaining to the law of Minnesota relating to dentistry 
75.9 	and the rules of the board, may, at the discretion of the board, be waived for an applicant 
75.10 	who presents a certificate of qualification from having passed all components of the 
75.11 	National Board of Dental Examiners Examinations or evidence of having maintained an 
75.12 	adequate scholastic standing as determined by the board, in dental school as to dentists, or 
75.13 	dental hygiene school as to dental hygienists.
75.14 	(b) The board shall waive the clinical examination required for licensure for any 
75.15 	dentist applicant who is a graduate of a dental school accredited by the Commission 
75.16 	on Dental Accreditation of the American Dental Association, who has successfully 
75.17 	completed passed all components of the National Dental Board Examination Dental 
75.18 	Examinations, and who has satisfactorily completed a Minnesota-based postdoctoral 
75.19 	general dentistry residency program (GPR) or an advanced education in general dentistry 
75.20 	(AEGD) program after January 1, 2004. The postdoctoral program must be accredited 
75.21 	by the Commission on Dental Accreditation of the American Dental Association, be of 
75.22 	at least one year's duration, and include an outcome assessment evaluation assessing 
75.23 	the resident's competence to practice dentistry. The board may require the applicant to 
75.24 	submit any information deemed necessary by the board to determine whether the waiver is 
75.25 	applicable. The board may waive the clinical examination for an applicant who meets the 
75.26 	requirements of this paragraph and has satisfactorily completed an accredited postdoctoral 
75.27 	general dentistry residency program located outside of Minnesota.

75.28 	Sec. 18. Minnesota Statutes 2010, section 150A.06, subdivision 4, is amended to read:
75.29 		Subd. 4.Licensure by credentials. (a) Any dentist or dental hygienist may, upon 
75.30 	application and payment of a fee established by the board, apply for licensure based on 
75.31 	the applicant's performance record in lieu of passing an examination approved by the 
75.32 	board according to section 150A.03, subdivision 1, and be interviewed by the board to 
75.33 	determine if the applicant:
75.34 	(1) has passed all components of the National Board Dental Examinations;
76.1 	(1) (2) has been in active practice at least 2,000 hours within 36 months of the 
76.2 	application date, or passed a board-approved reentry program within 36 months of the 
76.3 	application date;
76.4 	(2) (3) currently has a license in another state or Canadian province and is not subject 
76.5 	to any pending or final disciplinary action, or if not currently licensed, previously had a 
76.6 	license in another state or Canadian province in good standing that was not subject to any 
76.7 	final or pending disciplinary action at the time of surrender;
76.8 	(3) (4) is of good moral character and abides by professional ethical conduct 
76.9 	requirements;
76.10 	(4) (5) at board discretion, has passed a board-approved English proficiency test if 
76.11 	English is not the applicant's primary language; and
76.12 	(5) (6) meets other credentialing requirements specified in board rule.
76.13 	(b) An applicant who fulfills the conditions of this subdivision and demonstrates 
76.14 	the minimum knowledge in dental subjects required for licensure under subdivision 1 or 
76.15 	2 must be licensed to practice the applicant's profession.
76.16 	(c) If the applicant does not demonstrate the minimum knowledge in dental subjects 
76.17 	required for licensure under subdivision 1 or 2, the application must be denied. When 
76.18 	denying a license, the board may notify the applicant of any specific remedy that the 
76.19 	applicant could take which, when passed, would qualify the applicant for licensure. A 
76.20 	denial does not prohibit the applicant from applying for licensure under subdivision 1 or 2.
76.21 	(d) A candidate whose application has been denied may appeal the decision to the 
76.22 	board according to subdivision 4a.

76.23 	Sec. 19. Minnesota Statutes 2010, section 150A.06, subdivision 6, is amended to read:
76.24 		Subd. 6.Display of name and certificates. (a) The initial license and subsequent 
76.25 	renewal, or current registration certificate, of every dentist, a dental therapist, dental 
76.26 	hygienist, or dental assistant shall be conspicuously displayed in every office in which that 
76.27 	person practices, in plain sight of patients. When available from the board, the board shall 
76.28 	allow the display of a wallet-sized initial license and wallet-sized subsequent renewal 
76.29 	certificate only at nonprimary practice locations instead of displaying an original-sized 
76.30 	initial license and subsequent renewal certificate.
76.31 	(b) Near or on the entrance door to every office where dentistry is practiced, the 
76.32 	name of each dentist practicing there, as inscribed on the current license certificate, shall 
76.33 	be displayed in plain sight.

76.34 	Sec. 20. Minnesota Statutes 2010, section 150A.09, subdivision 3, is amended to read:
77.1 		Subd. 3.Current address, change of address. Every dentist, dental therapist, 
77.2 	dental hygienist, and dental assistant shall maintain with the board a correct and current 
77.3 	mailing address and electronic mail address. For dentists engaged in the practice of 
77.4 	dentistry, the postal address shall be that of the location of the primary dental practice. 
77.5 	Within 30 days after changing postal or electronic mail addresses, every dentist, dental 
77.6 	therapist, dental hygienist, and dental assistant shall provide the board written notice of 
77.7 	the new address either personally or by first class mail.

77.8 	Sec. 21. Minnesota Statutes 2010, section 150A.105, subdivision 7, is amended to read:
77.9 		Subd. 7.Use of dental assistants. (a) A licensed dental therapist may supervise 
77.10 	dental assistants to the extent permitted in the collaborative management agreement and 
77.11 	according to section 150A.10, subdivision 2.
77.12 	(b) Notwithstanding paragraph (a), a licensed dental therapist is limited to 
77.13 	supervising no more than four registered licensed dental assistants or nonregistered
77.14 	nonlicensed dental assistants at any one practice setting.

77.15 	Sec. 22. Minnesota Statutes 2010, section 150A.106, subdivision 1, is amended to read:
77.16 		Subdivision 1.General. In order to be certified by the board to practice as an 
77.17 	advanced dental therapist, a person must:
77.18 	(1) complete a dental therapy education program;
77.19 	(2) pass an examination to demonstrate competency under the dental therapy scope 
77.20 	of practice;
77.21 	(3) be licensed as a dental therapist;
77.22 	(4) complete 2,000 hours of dental therapy clinical practice under direct or indirect 
77.23 	supervision;
77.24 	(5) graduate from a master's advanced dental therapy education program;
77.25 	(6) pass a board-approved certification examination, comparable to those 
77.26 	administered to dental students, to demonstrate competency under the advanced scope of 
77.27 	practice; and
77.28 	(7) submit an application and fee for certification as prescribed by the board.

77.29 	Sec. 23. Minnesota Statutes 2010, section 150A.14, is amended to read:
77.30 	150A.14 IMMUNITY.
77.31 		Subdivision 1.Reporting immunity. A person, health care facility, business, or 
77.32 	organization is immune from civil liability or criminal prosecution for submitting a report 
77.33 	in good faith to the board under section 150A.13, or for cooperating with an investigation 
78.1 	of a report or with staff of the board relative to violations or alleged violations of section 
78.2 	150A.08. Reports are confidential data on individuals under section 13.02, subdivision 3, 
78.3 	and are privileged communications. 
78.4 		Subd. 2.Program Investigation immunity. (a) Members of the board, persons 
78.5 	employed by the board, and board consultants retained by the board are immune from 
78.6 	civil liability and criminal prosecution for any actions, transactions, or publications in 
78.7 	the execution of, or relating to, their duties under section 150A.13 sections 150A.02 to 
78.8 	150A.21, 214.10, and 214.103. 
78.9 	(b) For purposes of this section, a member of the board or a consultant described in 
78.10 	paragraph (a) is considered a state employee under section 3.736, subdivision 9.

78.11 	Sec. 24. Minnesota Statutes 2010, section 214.09, is amended by adding a subdivision 
78.12 	to read:
78.13 		Subd. 5.Health-related boards. No current member of a health-related licensing 
78.14 	board may seek a paid employment position with that board.

78.15 	Sec. 25. Minnesota Statutes 2010, section 214.103, is amended to read:
78.16 	214.103 HEALTH-RELATED LICENSING BOARDS; COMPLAINT, 
78.17 	INVESTIGATION, AND HEARING.
78.18 		Subdivision 1.Application. For purposes of this section, "board" means 
78.19 	"health-related licensing board" and does not include the non-health-related licensing 
78.20 	boards. Nothing in this section supersedes section 214.10, subdivisions 2a, 3, 8, and 9, as 
78.21 	they apply to the health-related licensing boards.
78.22 		Subd. 1a.Notifications and resolution. (a) No more than 14 calendar days after 
78.23 	receiving a complaint regarding a licensee, the board shall notify the complainant that 
78.24 	the board has received the complaint and shall provide the complainant with the written 
78.25 	description of the board's complaint process. The board shall periodically, but no less 
78.26 	than every 120 days, notify the complainant of the status of the complaint consistent 
78.27 	with section 13.41.
78.28 	(b) Except as provided in paragraph (d), no more than 60 calendar days after 
78.29 	receiving a complaint regarding a licensee, the board must notify the licensee that the 
78.30 	board has received a complaint and inform the licensee of:
78.31 	(1) the substance of the complaint;
78.32 	(2) the sections of the law that have allegedly been violated;
78.33 	(3) the sections of the professional rules that have allegedly been violated; and
78.34 	(4) whether an investigation is being conducted.
79.1 	(c) The board shall periodically, but not less than every 120 days, notify the licensee 
79.2 	of the status of the complaint consistent with section 13.41.
79.3 	(d) Paragraphs (b) and (c) do not apply if the board determines that such notice 
79.4 	would compromise the board's investigation and that such notice cannot reasonably be 
79.5 	accomplished within this time.
79.6 	(e) No more than one year after receiving a complaint regarding a licensee, the 
79.7 	board must resolve or dismiss the complaint unless the board determines that resolving or 
79.8 	dismissing the complaint cannot reasonably be accomplished in this time and is not in 
79.9 	the public interest.
79.10 	(f) Failure to make notifications or to resolve the complaint within the time 
79.11 	established in this subdivision shall not deprive the board of jurisdiction to complete the 
79.12 	investigation or to take corrective, disciplinary, or other action against the licensee that is 
79.13 	authorized by law. Such a failure by the board shall not be the basis for a licensee's request 
79.14 	for the board to dismiss a complaint, and shall not be considered by an administrative law 
79.15 	judge, the board, or any reviewing court.
79.16 		Subd. 2.Receipt of complaint. The boards shall receive and resolve complaints 
79.17 	or other communications, whether oral or written, against regulated persons. Before 
79.18 	resolving an oral complaint, the executive director or a board member designated by the 
79.19 	board to review complaints may shall  require the complainant to state the complaint in 
79.20 	writing or authorize transcribing the complaint. The executive director or the designated 
79.21 	board member shall determine whether the complaint alleges or implies a violation of 
79.22 	a statute or rule which the board is empowered to enforce. The executive director or 
79.23 	the designated board member may consult with the designee of the attorney general as 
79.24 	to a board's jurisdiction over a complaint. If the executive director or the designated 
79.25 	board member determines that it is necessary, the executive director may seek additional 
79.26 	information to determine whether the complaint is jurisdictional or to clarify the nature 
79.27 	of the allegations by obtaining records or other written material, obtaining a handwriting 
79.28 	sample from the regulated person, clarifying the alleged facts with the complainant, and 
79.29 	requesting a written response from the subject of the complaint.
79.30 		Subd. 3.Referral to other agencies. The executive director shall forward to 
79.31 	another governmental agency any complaints received by the board which do not relate 
79.32 	to the board's jurisdiction but which relate to matters within the jurisdiction of another 
79.33 	governmental agency. The agency shall advise the executive director of the disposition 
79.34 	of the complaint. A complaint or other information received by another governmental 
79.35 	agency relating to a statute or rule which a board is empowered to enforce must be 
79.36 	forwarded to the executive director of the board to be processed in accordance with this 
80.1 	section. Governmental agencies may coordinate and conduct joint investigations of 
80.2 	complaints that involve more than one governmental agency.
80.3 		Subd. 4.Role of the attorney general. The executive director or the designated 
80.4 	board member shall forward a complaint and any additional information to the designee 
80.5 	of the attorney general when the executive director or the designated board member 
80.6 	determines that a complaint is jurisdictional and:
80.7 	(1) requires investigation before the executive director or the designated board 
80.8 	member may resolve the complaint;
80.9 	(2) that attempts at resolution for disciplinary action or the initiation of a contested 
80.10 	case hearing is appropriate;
80.11 	(3) that an agreement for corrective action is warranted; or
80.12 	(4) that the complaint should be dismissed, consistent with subdivision 8.
80.13 		Subd. 5.Investigation by attorney general. (a) If the executive director or the 
80.14 	designated board member determines that investigation is necessary before resolving 
80.15 	the complaint, the executive director shall forward the complaint and any additional 
80.16 	information to the designee of the attorney general. The designee of the attorney general 
80.17 	shall evaluate the communications forwarded and investigate as appropriate. 
80.18 	(b) The designee of the attorney general may also investigate any other complaint 
80.19 	forwarded under subdivision 3 when the designee of the attorney general determines that 
80.20 	investigation is necessary. 
80.21 	(c) In the process of evaluation and investigation, the designee shall consult with 
80.22 	or seek the assistance of the executive director or the designated board member. The 
80.23 	designee may also consult with or seek the assistance of other qualified persons who are 
80.24 	not members of the board who the designee believes will materially aid in the process of 
80.25 	evaluation or investigation. 
80.26 	(d) Upon completion of the investigation, the designee shall forward the investigative 
80.27 	report to the executive director with recommendations for further consideration or 
80.28 	dismissal.
80.29 		Subd. 6.Attempts at resolution. (a) At any time after receipt of a complaint, the 
80.30 	executive director or the designated board member may attempt to resolve the complaint 
80.31 	with the regulated person. The available means for resolution include a conference or 
80.32 	any other written or oral communication with the regulated person. A conference may 
80.33 	be held for the purposes of investigation, negotiation, education, or conciliation. Neither 
80.34 	the executive director nor any member of a board's staff shall be a voting member in any 
80.35 	attempts at resolutions which may result in disciplinary or corrective action. The results 
80.36 	of attempts at resolution with the regulated person may include a recommendation to 
81.1 	the board for disciplinary action, an agreement between the executive director or the 
81.2 	designated board member and the regulated person for corrective action, or the dismissal 
81.3 	of a complaint. If attempts at resolution are not in the public interest or are not satisfactory 
81.4 	to the executive director or the designated board member, then the executive director or 
81.5 	the designated board member may initiate a contested case hearing may be initiated.
81.6 	(1) The designee of the attorney general shall represent the board in all attempts at 
81.7 	resolution which the executive director or the designated board member anticipate may 
81.8 	result in disciplinary action. A stipulation between the executive director or the designated 
81.9 	board member and the regulated person shall be presented to the board for the board's 
81.10 	consideration. An approved stipulation and resulting order shall become public data.
81.11 	(2) The designee of the attorney general shall represent the board upon the request of 
81.12 	the executive director or the designated board member in all attempts at resolution which 
81.13 	the executive director or the designated board member anticipate may result in corrective 
81.14 	action. Any agreement between the executive director or the designated board member 
81.15 	and the regulated person for corrective action shall be in writing and shall be reviewed by 
81.16 	the designee of the attorney general prior to its execution. The agreement for corrective 
81.17 	action shall provide for dismissal of the complaint upon successful completion by the 
81.18 	regulated person of the corrective action.
81.19 	(b) Upon receipt of a complaint alleging sexual contact or sexual conduct with a 
81.20 	client, the board must forward the complaint to the designee of the attorney general for 
81.21 	an investigation. If, after it is investigated, the complaint appears to provide a basis for 
81.22 	disciplinary action, the board shall resolve the complaint by disciplinary action or initiate 
81.23 	a contested case hearing. Notwithstanding paragraph (a), clause (2), a board may not take 
81.24 	corrective action or dismiss a complaint alleging sexual contact or sexual conduct with a 
81.25 	client unless, in the opinion of the executive director, the designated board member, and the 
81.26 	designee of the attorney general, there is insufficient evidence to justify disciplinary action.
81.27 		Subd. 7.Contested case hearing. If the executive director or the designated board 
81.28 	member determines that attempts at resolution of a complaint are not in the public interest 
81.29 	or are not satisfactory to the executive director or the designated board member, the 
81.30 	executive director or the designated board member, after consultation with the designee 
81.31 	of the attorney general, and the concurrence of a second board member, may initiate a 
81.32 	contested case hearing under chapter 14. The designated board member or any board 
81.33 	member who was consulted during the course of an investigation may participate at the 
81.34 	contested case hearing. A designated or consulted board member may not deliberate or 
81.35 	vote in any proceeding before the board pertaining to the case.
82.1 		Subd. 8.Dismissal and reopening of a complaint. (a) A complaint may not be 
82.2 	dismissed without the concurrence of at least two board members and, upon the request 
82.3 	of the complainant, a review by a representative of the attorney general's office. The 
82.4 	designee of the attorney general must review before dismissal any complaints which 
82.5 	allege any violation of chapter 609, any conduct which would be required to be reported 
82.6 	under section 626.556 or 626.557, any sexual contact or sexual conduct with a client, 
82.7 	any violation of a federal law, any actual or potential inability to practice the regulated 
82.8 	profession or occupation by reason of illness, use of alcohol, drugs, chemicals, or any other 
82.9 	materials, or as a result of any mental or physical condition, any violation of state medical 
82.10 	assistance laws, or any disciplinary action related to credentialing in another jurisdiction 
82.11 	or country which was based on the same or related conduct specified in this subdivision.
82.12 	(b) The board may reopen a dismissed complaint if the board receives newly 
82.13 	discovered information that was not available to the board during the initial investigation 
82.14 	of the complaint, or if the board receives a new complaint that indicates a pattern of 
82.15 	behavior or conduct.
82.16 		Subd. 9.Information to complainant. A board shall furnish to a person who made 
82.17 	a complaint a written description of the board's complaint process, and actions of the 
82.18 	board relating to the complaint.
82.19 		Subd. 10.Prohibited participation by board member. A board member who 
82.20 	has actual bias or a current or former direct financial or professional connection with a 
82.21 	regulated person may not vote in board actions relating to the regulated person.

82.22 	Sec. 26. [214.107] CONVICTION OF A FELONY-LEVEL CRIMINAL SEXUAL 
82.23 	CONDUCT OFFENSE.
82.24 		Subdivision 1.Applicability. This section applies to the health-related licensing 
82.25 	boards, as defined in section 214.01, subdivision 2, except the Board of Medical Practice; 
82.26 	the Board of Chiropractic Examiners; the Board of Barber Examiners; the Board of 
82.27 	Cosmetologist Examiners; and professions credentialed by the Minnesota Department 
82.28 	of Health: (1) speech-language pathologists and audiologists; (2) hearing instrument 
82.29 	dispensers; and (3) occupational therapists and occupational therapy assistants.
82.30 		Subd. 2.Issuing and renewing a credential to practice. (a) Except as provided in 
82.31 	paragraph (f), a credentialing authority listed in subdivision 1 shall not issue or renew a 
82.32 	credential to practice to any person who has been convicted on or after August 1, 2011, of 
82.33 	any of the provisions of section 609.342, subdivision 1; 609.343, subdivision 1; 609.344, 
82.34 	subdivision 1, paragraphs (c) to (o); or 609.345, subdivision 1, paragraphs (b) to (o).
83.1 	(b) A credentialing authority listed in subdivision 1 shall not issue or renew a 
83.2 	credential to practice to any person who has been convicted in any other state or country on 
83.3 	or after August 1, 2011, of an offense where the elements of the offense are substantially 
83.4 	similar to any of the offenses listed in paragraph (a).
83.5 	(c) A credential to practice is automatically revoked if the credentialed person is 
83.6 	convicted of an offense listed in paragraph (a).
83.7 	(d) A credential to practice that has been denied or revoked under this section is 
83.8 	not subject to chapter 364.
83.9 	(e) For purposes of this section, "conviction" means a plea of guilty, a verdict of 
83.10 	guilty by a jury, or a finding of guilty by the court, unless the court stays imposition or 
83.11 	execution of the sentence and final disposition of the case is accomplished at a nonfelony 
83.12 	level.
83.13 	(f) A credentialing authority listed in subdivision 1 may establish criteria whereby 
83.14 	an individual convicted of an offense listed in paragraph (a) of this subdivision may 
83.15 	become credentialed provided that the criteria:
83.16 	(1) utilize a rebuttable presumption that the applicant is not suitable for credentialing;
83.17 	(2) provide a standard for overcoming the presumption; and
83.18 	(3) require that a minimum of ten years has elapsed since the applicant was released 
83.19 	from any incarceration or supervisory jurisdiction related to the offense.
83.20 	A credentialing authority listed in subdivision 1 shall not consider an application under 
83.21 	this paragraph if the board determines that the victim involved in the offense was a patient 
83.22 	or a client of the applicant at the time of the offense.

83.23 	EFFECTIVE DATE. This section is effective for credentials issued or renewed on 
83.24 	or after August 1, 2011.

83.25 	Sec. 27. [214.108] HEALTH-RELATED LICENSING BOARDS; LICENSEE 
83.26 	GUIDANCE.
83.27 	A health-related licensing board may offer guidance to current licensees about the 
83.28 	application of laws and rules the board is empowered to enforce. This guidance shall not 
83.29 	bind any court or other adjudicatory body.

83.30 	Sec. 28. [214.109] RECORD KEEPING.
83.31 	(a) A board may take administrative action against a regulated person whose records 
83.32 	do not meet the standards of professional practice. Records that are fraudulent or could 
83.33 	result in patient harm may be handled through disciplinary or other corrective action.
84.1 	(b) For the first offense, a board shall issue a warning to the regulated person that 
84.2 	identifies the specific record-keeping deficiencies. The board may require the regulated 
84.3 	person to attend a remedial class.
84.4 	(c) For a second offense, a board shall require additional training as determined by 
84.5 	the board and impose a $50 penalty on the regulated person.
84.6 	(d) For a third offense, a board shall require additional training as determined by the 
84.7 	board and impose a $100 penalty on the regulated person.
84.8 	(e) Action under this section shall not be considered disciplinary action.

84.9 	Sec. 29. Minnesota Statutes 2010, section 364.09, is amended to read:
84.10 	364.09 EXCEPTIONS.
84.11 	(a) This chapter does not apply to the licensing process for peace officers; to law 
84.12 	enforcement agencies as defined in section 626.84, subdivision 1, paragraph (f); to fire 
84.13 	protection agencies; to eligibility for a private detective or protective agent license; to the 
84.14 	licensing and background study process under chapters 245A and 245C; to eligibility 
84.15 	for school bus driver endorsements; to eligibility for special transportation service 
84.16 	endorsements; to eligibility for a commercial driver training instructor license, which is 
84.17 	governed by section 171.35 and rules adopted under that section; to emergency medical 
84.18 	services personnel, or to the licensing by political subdivisions of taxicab drivers, if the 
84.19 	applicant for the license has been discharged from sentence for a conviction within the ten 
84.20 	years immediately preceding application of a violation of any of the following:
84.21 	(1) sections 609.185 to 609.21, 609.221 to 609.223, 609.342 to 609.3451, or 617.23, 
84.22 	subdivision 2 or 3;
84.23 	(2) any provision of chapter 152 that is punishable by a maximum sentence of 
84.24 	15 years or more; or
84.25 	(3) a violation of chapter 169 or 169A involving driving under the influence, leaving 
84.26 	the scene of an accident, or reckless or careless driving.
84.27 	This chapter also shall not apply to eligibility for juvenile corrections employment, where 
84.28 	the offense involved child physical or sexual abuse or criminal sexual conduct.
84.29 	(b) This chapter does not apply to a school district or to eligibility for a license 
84.30 	issued or renewed by the Board of Teaching or the commissioner of education.
84.31 	(c) Nothing in this section precludes the Minnesota Police and Peace Officers 
84.32 	Training Board or the state fire marshal from recommending policies set forth in this 
84.33 	chapter to the attorney general for adoption in the attorney general's discretion to apply to 
84.34 	law enforcement or fire protection agencies.
85.1 	(d) This chapter does not apply to a license to practice medicine that has been denied 
85.2 	or revoked by the Board of Medical Practice pursuant to section 147.091, subdivision 1a.
85.3 	(e) This chapter does not apply to any person who has been denied a license to 
85.4 	practice chiropractic or whose license to practice chiropractic has been revoked by the 
85.5 	board in accordance with section 148.10, subdivision 7.
85.6 	(f) This chapter does not apply to a person who has been denied a license to practice 
85.7 	nursing by the board or whose license has been revoked by the board pursuant to section 
85.8 	148.192.
85.9 	(g) This chapter does not apply to any person who has been denied a credential to 
85.10 	practice or whose credential to practice has been revoked by a credentialing authority in 
85.11 	accordance with section 214.107.

85.12 	EFFECTIVE DATE. This section is effective for credentials issued or renewed on 
85.13 	or after August 1, 2011.

85.14 	Sec. 30. Laws 2010, chapter 349, section 1, the effective date, is amended to read:

85.15 	EFFECTIVE DATE. This section is effective for new licenses issued or renewed 
85.16 	on or after August 1, 2010.

85.17 	Sec. 31. Laws 2010, chapter 349, section 2, the effective date, is amended to read:

85.18 	EFFECTIVE DATE. This section is effective for new licenses issued or renewed
85.19 	on or after August 1, 2010.

85.20 	Sec. 32. WORKING GROUP; PSYCHIATRIC MEDICATIONS.
 85.21 	(a) The commissioner of health shall convene a working group composed of the 
85.22 	executive directors of the Boards of Medical Practice, Psychology, Social Work, and 
85.23 	Behavioral Health and Therapy and one representative from each professional association 
85.24 	to make recommendations on the feasibility of developing collaborative agreements 
85.25 	between psychiatrists and psychologists, social workers, and licensed professional clinical 
85.26 	counselors for administration and management of psychiatric medications.
85.27 	(b) The executive directors shall take the lead in setting the agenda, convening 
85.28 	subsequent meetings, and presenting a written report to the chairs and ranking minority 
85.29 	members of the legislative committees with jurisdiction over health and human services. 
85.30 	The report and recommendations for legislation shall be submitted no later than January 
85.31 	1, 2012.
85.32 	(c) The working group is not subject to the provisions of section 15.059.

86.1 	Sec. 33. REPORT.
 86.2 	The executive directors of the health-related licensing boards shall issue a report to 
86.3 	the legislature with recommendations for use of nondisciplinary cease and desist letters 
86.4 	which can be issued to licensees when the board receives an allegation against a licensee, 
86.5 	but the allegation does not rise to the level of a complaint, does not involve patient harm, 
86.6 	and does not involve fraud. This report shall be issued no later than December 15, 2011.

86.7 	Sec. 34. REVISOR'S INSTRUCTION.
 86.8 	In each practice act regulated by a credentialing authority listed in Minnesota 
86.9 	Statutes, section 214.107, the revisor shall insert the following as either a new section 
86.10 	or new subdivision: 
86.11 	Applicants for a credential to practice and individuals renewing a credential to 
86.12 	practice are subject to the provisions of the conviction of felony-level criminal sexual 
86.13 	conduct offenses in section 214.107.

86.14 	Sec. 35.  REPEALER.
 86.15 	Minnesota Rules, parts 6310.3100, subpart 2; 6310.3600; and 6310.3700, subpart 
86.16 	1, are repealed.

86.17 	ARTICLE 4
86.18 	MISCELLANEOUS

86.19 	Section 1. Minnesota Statutes 2010, section 3.98, is amended by adding a subdivision 
86.20 	to read:
86.21 		Subd. 5.Health note. The commissioner of health, in consultation with other state 
86.22 	agencies, shall develop a report and recommendations for the legislature for a process 
86.23 	through which a health impact review of proposed legislation may be requested by a 
86.24 	legislative committee chair and ranking minority members of the house of representatives 
86.25 	and senate committees with jurisdiction over health and human services finance and 
86.26 	policy issues to estimate the impact of the proposed legislation on costs of health care for 
86.27 	public employees, state health care programs, private employers, local governments, or 
86.28 	Minnesota individuals and families, including costs related to the impact of the legislation 
86.29 	on the health status of the state or a community. The commissioner may consult with 
86.30 	local and private public health organizations and other persons or organizations in the 
86.31 	development of the report and recommendations. The report and recommendations shall 
86.32 	be provided to the legislature by January 15, 2012.

87.1 	Sec. 2. Minnesota Statutes 2010, section 245A.14, subdivision 4, is amended to read:
87.2 		Subd. 4.Special family day care homes. Nonresidential child care programs 
87.3 	serving 14 or fewer children that are conducted at a location other than the license holder's 
87.4 	own residence shall be licensed under this section and the rules governing family day 
87.5 	care or group family day care if:
87.6 	(a) the license holder is the primary provider of care and the nonresidential child 
87.7 	care program is conducted in a dwelling that is located on a residential lot;
87.8 	(b) the license holder is an employer who may or may not be the primary provider 
87.9 	of care, and the purpose for the child care program is to provide child care services to 
87.10 	children of the license holder's employees;
87.11 	(c) the license holder is a church or religious organization;
87.12 	(d) the license holder is a community collaborative child care provider. For 
87.13 	purposes of this subdivision, a community collaborative child care provider is a provider 
87.14 	participating in a cooperative agreement with a community action agency as defined in 
87.15 	section 256E.31; or
87.16 	(e) the license holder is a not-for-profit agency that provides child care in a dwelling 
87.17 	located on a residential lot and the license holder maintains two or more contracts with 
87.18 	community employers or other community organizations to provide child care services. 
87.19 	The county licensing agency may grant a capacity variance to a license holder licensed 
87.20 	under this paragraph to exceed the licensed capacity of 14 children by no more than five 
87.21 	children during transition periods related to the work schedules of parents, if the license 
87.22 	holder meets the following requirements:
87.23 	(1) the program does not exceed a capacity of 14 children more than a cumulative 
87.24 	total of four hours per day;
87.25 	(2) the program meets a one to seven staff-to-child ratio during the variance period;
87.26 	(3) all employees receive at least an extra four hours of training per year than 
87.27 	required in the rules governing family child care each year;
87.28 	(4) the facility has square footage required per child under Minnesota Rules, part 
87.29 	9502.0425;
87.30 	(5) the program is in compliance with local zoning regulations;
87.31 	(6) the program is in compliance with the applicable fire code as follows:
87.32 	(i) if the program serves more than five children older than 2-1/2 years of age, 
87.33 	but no more than five children 2-1/2 years of age or less, the applicable fire code is 
87.34 	educational occupancy, as provided in Group E Occupancy under the Minnesota State 
87.35 	Fire Code 2003, Section 202; or
88.1 	(ii) if the program serves more than five children 2-1/2 years of age or less, the 
88.2 	applicable fire code is Group I-4 Occupancies, as provided in the Minnesota State Fire 
88.3 	Code 2003, Section 202; and
88.4 	(7) any age and capacity limitations required by the fire code inspection and square 
88.5 	footage determinations shall be printed on the license.; or
88.6 	(f) the license holder is the primary provider of care and has located the licensed 
88.7 	child care program in a commercial space, if the license holder meets the following 
88.8 	requirements:
88.9 	(1) the program is in compliance with local zoning regulations;
88.10 	(2) the program is in compliance with the applicable fire code as follows:
88.11 	(i) if the program serves more than five children older than 2-1/2 years of age, 
88.12 	but no more than five children 2-1/2 years of age or less, the applicable fire code is 
88.13 	educational occupancy, as provided in Group E Occupancy under the Minnesota State 
88.14 	Fire Code 2003, Section 202; or
88.15 	(ii) if the program serves more than five children 2-1/2 years of age or less, the 
88.16 	applicable fire code is Group I-4 Occupancies, as provided under the Minnesota State Fire 
88.17 	Code 2003, Section 202;
88.18 	(3) any age and capacity limitations required by the fire code inspection and square 
88.19 	footage determinations are printed on the license; and
88.20 	(4) the license holder prominently displays the license issued by the commissioner 
88.21 	which contains the statement "This special family child care provider is not licensed as a 
88.22 	child care center."

88.23 	Sec. 3. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision 
88.24 	to read:
88.25 		Subd. 33.Combined application form; referral of veterans. The commissioner 
88.26 	shall modify the combined application form to add a question asking applicants: "Are 
88.27 	you a United States military veteran?" The commissioner shall ensure that all applicants 
88.28 	who identify themselves as veterans are referred to a county veterans service officer for 
88.29 	assistance in applying to the United States Department of Veterans Affairs for any benefits 
88.30 	for which they may be eligible.

88.31 	Sec. 4. Minnesota Statutes 2010, section 256B.14, is amended by adding a subdivision 
88.32 	to read:
88.33 		Subd. 3a.Spousal contribution. (a) For purposes of this subdivision, the following 
88.34 	terms have the meanings given:
89.1 	(1) "commissioner" means the commissioner of human services;
89.2 	(2) "community spouse" means the spouse, who lives in the community, of an 
89.3 	individual receiving long-term care services in a long-term care facility or home care 
89.4 	services pursuant to the Medicaid waiver for elderly services under section 256B.0915 
89.5 	or the alternative care program under section 256B.0913. A community spouse does not 
89.6 	include a spouse living in the community who receives a monthly income allowance 
89.7 	under section 256B.058, subdivision 2, or who receives home care services or home 
89.8 	and community-based services under section 256B.0915, 256B.092, or 256B.49, or the 
89.9 	alternative care program under section 256B.0913;
89.10 	(3) "cost of care" means the actual fee-for-service costs or capitated payments for 
89.11 	the long-term care spouse;
89.12 	(4) "department" means the Department of Human Services;
89.13 	(5) "disabled child" means a blind or permanently and totally disabled son or 
89.14 	daughter of any age as defined in the Supplemental Security Income program or the state 
89.15 	medical review team;
89.16 	(6) "income" means earned and unearned income, attributable to the community 
89.17 	spouse, used to calculate the adjusted gross income on the prior year's income tax return. 
89.18 	Evidence of income includes, but is not limited to, W-2 and 1099 forms; and
89.19 	(7) "long-term care spouse" means the spouse who is receiving long-term care 
89.20 	services in a long-term care facility or home care services pursuant to the Medicaid 
89.21 	waiver for elderly services under section 256B.0915 or the alternative care program under 
89.22 	section 256B.0913.
89.23 	(b) The community spouse of a long-term care spouse who receives medical 
89.24 	assistance or alternative care services has an obligation to contribute to the cost of care. 
89.25 	The community spouse must pay a monthly fee on a sliding fee scale based on the 
89.26 	community spouse's income. If a minor or disabled child resides with and receives care 
89.27 	from the community spouse, then no fee shall be assessed.
89.28 	(c) For a community spouse with an income equal to or greater than 250 percent of 
89.29 	the federal poverty guidelines for a family of two and less than 545 percent of the federal 
89.30 	poverty guidelines for a family of two, the spousal contribution shall be determined using 
89.31 	a sliding fee scale established by the commissioner that begins at 7.5 percent of the 
89.32 	community spouse's income and increases to 15 percent for those with an income of up to 
89.33 	545 percent of the federal poverty guidelines for a family of two.
89.34 	(d) For a community spouse with an income equal to or greater than 545 percent of 
89.35 	the federal poverty guidelines for a family of two and less than 750 percent of the federal 
89.36 	poverty guidelines for a family of two, the spousal contribution shall be determined using 
90.1 	a sliding fee scale established by the commissioner that begins at 15 percent of the 
90.2 	community spouse's income and increases to 25 percent for those with an income of up to 
90.3 	750 percent of the federal poverty guidelines for a family of two.
90.4 	(e) For a community spouse with an income equal to or greater than 750 percent of 
90.5 	the federal poverty guidelines for a family of two and less than 975 percent of the federal 
90.6 	poverty guidelines for a family of two, the spousal contribution shall be determined using 
90.7 	a sliding fee scale established by the commissioner that begins at 25 percent of the 
90.8 	community spouse's income and increases to 33 percent for those with an income of up to 
90.9 	975 percent of the federal poverty guidelines for a family of two.
90.10 	(f) For a community spouse with an income equal to or greater than 975 percent of 
90.11 	the federal poverty guidelines for a family of two, the spousal contribution shall be 33 
90.12 	percent of the community spouse's income.
90.13 	(g) The spousal contribution shall be explained in writing at the time eligibility for 
90.14 	medical assistance or alternative care is being determined. In addition to explaining the 
90.15 	formula used to determine the fee, the commissioner shall provide written information 
90.16 	describing how to request a variance for undue hardship, how a contribution may be 
90.17 	reviewed or redetermined, the right to appeal a contribution determination, and that 
90.18 	the consequences for not complying with a request to provide information shall be an 
90.19 	assessment against the community spouse for the full cost of care for the long-term care 
90.20 	spouse.
90.21 	(h) The contribution shall be assessed for each month the long-term care spouse 
90.22 	has a community spouse and is eligible for medical assistance payment of long-term 
90.23 	care services or alternative care.
90.24 	(i) The spousal contribution shall be reviewed at least once every 12 months and 
90.25 	when there is a loss or gain in income in excess of ten percent. Thirty days prior to a 
90.26 	review or redetermination, written notice must be provided to the community spouse 
90.27 	and must contain the amount the spouse is required to contribute, notice of the right to 
90.28 	redetermination and appeal, and the telephone number of the division at the department 
90.29 	that is responsible for redetermination and review. If, after review, the contribution amount 
90.30 	is to be adjusted, the commissioner shall mail a written notice to the community spouse 30 
90.31 	days in advance of the effective date of the change in the amount of the contribution.
90.32 	(1) The spouse shall notify the commissioner within 30 days of a gain or loss in 
90.33 	income in excess of ten percent and provide the department supporting documentation to 
90.34 	verify the need for redetermination of the fee.
91.1 	(2) When a spouse requests a review or redetermination of the contribution amount, 
91.2 	a request for information shall be sent to the spouse within ten calendar days after the 
91.3 	commissioner receives the request for review.
91.4 	(3) No action shall be taken on a review or redetermination until the required 
91.5 	information is received by the commissioner.
91.6 	(4) The review of the spousal contribution shall be completed within ten days after 
91.7 	the commissioner receives completed information that verifies a loss or gain in income 
91.8 	in excess of ten percent.
91.9 	(5) An increase in the contribution amount is effective in the month in which the 
91.10 	increase in spousal income occurs.
91.11 	(6) A decrease in the contribution amount is effective in the month the spouse 
91.12 	verifies the reduction in income, retroactive to no longer than six months.
91.13 	(j) In no case shall the spousal contribution exceed the amount of medical assistance 
91.14 	expended or the cost of alternative care services for the care of the long-term care spouse. 
91.15 	Annually, upon redetermination, or at termination of eligibility, the total amount of 
91.16 	medical assistance paid or costs of alternative care for the care of the long-term care spouse 
91.17 	and the total amount of the spousal contribution shall be compared. If the total amount of 
91.18 	the spousal contribution exceeds the total amount of medical assistance expended or cost 
91.19 	of alternative care, then the department shall reimburse the community spouse the excess 
91.20 	amount if the long-term care spouse is no longer receiving services, or apply the excess 
91.21 	amount to the spousal contribution due until the excess amount is exhausted.
91.22 	(k) A community spouse may request a variance by submitting a written request 
91.23 	and supporting documentation that payment of the calculated contribution would cause 
91.24 	an undue hardship. An undue hardship is defined as the inability to pay the calculated 
91.25 	contribution due to medical expenses incurred by the community spouse. Documentation 
91.26 	must include proof of medical expenses incurred by the community spouse since the last 
91.27 	annual redetermination of the contribution amount that are not reimbursable by any public 
91.28 	or private source, and are a type, regardless of amount, that would be allowable as a 
91.29 	federal tax deduction under the Internal Revenue Code.
91.30 	(1) A spouse who requests a variance from a notice of an increase in the amount 
91.31 	of spousal contribution shall continue to make monthly payments at the lower amount 
91.32 	pending determination of the variance request. A spouse who requests a variance from 
91.33 	the initial determination shall not be required to make a payment pending determination 
91.34 	of the variance request. Payments made pending outcome of the variance request that 
91.35 	result in overpayment must be returned to the spouse, if the community spouse is no 
91.36 	longer receiving services, or applied to the spousal contribution in the current year. If the 
92.1 	variance is denied, the spouse shall pay the additional amount due from the effective date 
92.2 	of the increase or the total amount due from the effective date of the original notice of 
92.3 	determination of the spousal contribution.
92.4 	(2) A spouse who is granted a variance shall sign a written agreement in which the 
92.5 	spouse agrees to report to the commissioner any changes in circumstances that gave rise 
92.6 	to the undue hardship variance.
92.7 	(3) When the commissioner receives a request for a variance, written notice of a 
92.8 	grant or denial of the variance shall be mailed to the spouse within 30 calendar days 
92.9 	after the commissioner receives the financial information required in this clause. The 
92.10 	granting of a variance will necessitate a written agreement between the spouse and the 
92.11 	commissioner with regard to the specific terms of the variance. The variance will not 
92.12 	become effective until the written agreement is signed by the spouse. If the commissioner 
92.13 	denies in whole or in part the request for a variance, the denial notice shall set forth in 
92.14 	writing the reasons for the denial that address the specific hardship and right to appeal.
92.15 	(4) If a variance is granted, the term of the variance shall not exceed 12 months 
92.16 	unless otherwise determined by the commissioner.
92.17 	(5) Undue hardship does not include action taken by a spouse which divested or 
92.18 	diverted income in order to avoid being assessed a spousal contribution.
92.19 	(l) A spouse aggrieved by an action under this subdivision has the right to appeal 
92.20 	under subdivision 4. If the spouse appeals on or before the effective date of an increase in 
92.21 	the spousal fee, the spouse shall continue to make payments to the commissioner in the 
92.22 	lower amount while the appeal is pending. A spouse appealing an initial determination 
92.23 	of a spousal contribution shall not be required to make monthly payments pending an 
92.24 	appeal decision. Payments made that result in an overpayment shall be reimbursed to the 
92.25 	spouse if the long-term care spouse is no longer receiving services, or applied to the 
92.26 	spousal contribution remaining in the current year. If the commissioner's determination is 
92.27 	affirmed, the community spouse shall pay within 90 calendar days of the order the total 
92.28 	amount due from the effective date of the original notice of determination of the spousal 
92.29 	contribution. The commissioner's order is binding on the spouse and the department and 
92.30 	shall be implemented subject to section 256.045, subdivision 7. No additional notice is 
92.31 	required to enforce the commissioner's order.
92.32 	(m) If the commissioner finds that notice of the payment obligation was given to 
92.33 	the community spouse and the spouse was determined to be able to pay, but that the 
92.34 	spouse failed or refused to pay, a cause of action exists against the community spouse 
92.35 	for that portion of medical assistance payment of long-term care services or alternative 
92.36 	care services granted after notice was given to the community spouse. The action may 
93.1 	be brought by the commissioner in the county where assistance was granted for the 
93.2 	assistance together with the costs of disbursements incurred due to the action. In addition 
93.3 	to granting the commissioner a money judgment, the court may, upon a motion or order to 
93.4 	show cause, order continuing contributions by a community spouse found able to repay 
93.5 	the commissioner. The order shall be effective only for the period of time during which 
93.6 	a contribution shall be assessed.

93.7 	Sec. 5. Minnesota Statutes 2010, section 326B.175, is amended to read:
93.8 	326B.175 ELEVATORS, ENTRANCES SEALED.
93.9 	Except as provided in section 326B.188, it shall be the duty of the department and 
93.10 	the licensing authority of any municipality which adopts any such ordinance whenever 
93.11 	it finds any such elevator under its jurisdiction in use in violation of any provision of 
93.12 	sections 326B.163 to 326B.178 to seal the entrances of such elevator and attach a notice 
93.13 	forbidding the use of such elevator until the provisions thereof are complied with.

93.14 	Sec. 6. [326B.188] COMPLIANCE WITH ELEVATOR CODE CHANGES.
93.15 	(a) This section applies to code requirements for existing elevators and related 
93.16 	devices under Minnesota Rules, chapter 1307, where the deadline set by law for meeting 
93.17 	the code requirements is January 29, 2012, or later.
93.18 	(b) If the department or municipality conducting elevator inspections within its 
93.19 	jurisdiction notifies the owner of an existing elevator or related device of the code 
93.20 	requirements before the effective date of this section, the owner may submit a compliance 
93.21 	plan by December 30, 2011. If the department or municipality does not notify the owner 
93.22 	of an existing elevator or related device of the code requirements before the effective 
93.23 	date of this section, the department or municipality shall notify the owner of the code 
93.24 	requirements and permit the owner to submit a compliance plan by December 30, 2011, or 
93.25 	within 60 days after the date of notification, whichever is later.
93.26 	(c) Any compliance plan submitted under this section must result in compliance with 
93.27 	the code requirements by the later of January 29, 2012, or three years after submission of 
93.28 	the compliance plan. Elevators and related devices that are not in compliance with the 
93.29 	code requirements by the later of January 29, 2012, or three years after the submission of 
93.30 	the compliance plan may be taken out of service as provided in section 326B.175.

93.31 	Sec. 7. DEVELOPMENTAL DISABILITY WAIVERED SERVICES.
 93.32 		Subdivision 1.Purpose. All individuals in the state of Minnesota who are eligible 
93.33 	for developmental disability waivered services are entitled to receive adequate services, 
94.1 	within the limits of available funding, to ensure their basic needs for housing, food, health, 
94.2 	and safety are met.
94.3 		Subd. 2.Instructions to commissioner. (a) No later than November 1, 2011, 
94.4 	the commissioner of human services shall convene a workgroup to define the essential 
94.5 	services required to adequately meet the needs of individuals who receive developmental 
94.6 	disability waivered services. The commissioner shall identify the essential services in 
94.7 	each of the following tiers:
94.8 	(1) tier 1, services and costs associated with safety, food, housing, and health care;
94.9 	(2) tier 2, services and costs associated with enhancements toward self-sufficiency; 
94.10 	and
94.11 	(3) tier 3, services and costs associated with quality of life improvements.
94.12 	(b) The commissioner, or designee, and a representative designated by the counties 
94.13 	shall cochair the workgroup. The workgroup shall consider Tier 1 services to be the most 
94.14 	important and of highest priority for available funds, and may choose to implement a policy 
94.15 	that all waiver-eligible individuals receive Tier 1 services within the limits of available 
94.16 	funding before services from Tier 2 or 3 are offered to waiver-eligible individuals.

94.17 	Sec. 8. ANALYSIS OF PROGRAMS AND THEIR EFFECT ON MARRIAGES; 
94.18 	REPORT.
 94.19 	(a) The commissioner of human services shall conduct an analysis of how current 
94.20 	human services programs affect the motivation and capacity of individuals to form and 
94.21 	sustain marriages in which to raise children. Programs to be examined in this marriage 
94.22 	impact analysis may include, but are not limited to, medical assistance, MinnesotaCare, 
94.23 	Minnesota family investment program, child protection, child support enforcement, and 
94.24 	child welfare services.
94.25 	(b) Before January 1, 2012, the commissioner shall submit a report to the legislature 
94.26 	describing the results of this analysis and outline proposals to improve the ability of 
94.27 	human services programs to help people who are interested in marriage to form and 
94.28 	sustain marriages in which to raise children. The commissioner shall ensure that experts 
94.29 	on marriage are consulted on the process of conducting the analysis and writing the report.

94.30 	Sec. 9. INSTRUCTIONS TO COMMISSIONER.
 94.31 	To offset the cost of implementing Minnesota Statutes, section 256B.14, subdivision 
94.32 	3a, the commissioner of human services shall collect from each county its proportionate 
94.33 	share of the cost based on population of the county. At the end of each fiscal year, the 
94.34 	commissioner shall divide ten percent of all collections made under Minnesota Statutes, 
95.1 	section 256B.14, subdivision 3a, between the counties based on the population of the 
95.2 	county.

95.3 	Sec. 10. LEGISLATIVE APPROVAL FOR FEDERAL FUNDS.
 95.4 	The commissioners of human services and health shall not expend any funding 
95.5 	received through federal grants or subsequent renewal of federal grants without the 
95.6 	approval of three of the four chairs and ranking minority members of the legislative 
95.7 	committees with jurisdiction over health and human services finance.

95.8 	ARTICLE 5
95.9 	HEALTH LICENSING FEES

95.10 	Section 1. Minnesota Statutes 2010, section 148.07, subdivision 1, is amended to read:
95.11 		Subdivision 1.Renewal fees. All persons practicing chiropractic within this state, 
95.12 	or licensed so to do, shall pay, on or before the date of expiration of their licenses, to the 
95.13 	Board of Chiropractic Examiners a renewal fee set by the board in accordance with section 
95.14 	16A.1283, with a penalty set by the board for each month or portion thereof for which a 
95.15 	license fee is in arrears and upon payment of the renewal and upon compliance with all the 
95.16 	rules of the board, shall be entitled to renewal of their license.

95.17 	Sec. 2. Minnesota Statutes 2010, section 148.108, is amended by adding a subdivision 
95.18 	to read:
95.19 		Subd. 4.Animal chiropractic. (a) Animal chiropractic registration fee is $125.
95.20 	(b) Animal chiropractic registration renewal fee is $75.
95.21 	(c) Animal chiropractic inactive renewal fee is $25.

95.22 	Sec. 3. Minnesota Statutes 2010, section 148.191, subdivision 2, is amended to read:
95.23 		Subd. 2.Powers. (a) The board is authorized to adopt and, from time to time, revise 
95.24 	rules not inconsistent with the law, as may be necessary to enable it to carry into effect the 
95.25 	provisions of sections 148.171 to 148.285. The board shall prescribe by rule curricula 
95.26 	and standards for schools and courses preparing persons for licensure under sections 
95.27 	148.171 to 148.285. It shall conduct or provide for surveys of such schools and courses 
95.28 	at such times as it may deem necessary. It shall approve such schools and courses as 
95.29 	meet the requirements of sections 148.171 to 148.285 and board rules. It shall examine, 
95.30 	license, and renew the license of duly qualified applicants. It shall hold examinations 
95.31 	at least once in each year at such time and place as it may determine. It shall by rule 
95.32 	adopt, evaluate, and periodically revise, as necessary, requirements for licensure and for 
96.1 	registration and renewal of registration as defined in section 148.231. It shall maintain a 
96.2 	record of all persons licensed by the board to practice professional or practical nursing and 
96.3 	all registered nurses who hold Minnesota licensure and registration and are certified as 
96.4 	advanced practice registered nurses. It shall cause the prosecution of all persons violating 
96.5 	sections 148.171 to 148.285 and have power to incur such necessary expense therefor. 
96.6 	It shall register public health nurses who meet educational and other requirements 
96.7 	established by the board by rule, including payment of a fee. Prior to the adoption of rules, 
96.8 	the board shall use the same procedures used by the Department of Health to certify public 
96.9 	health nurses. It shall have power to issue subpoenas, and to compel the attendance of 
96.10 	witnesses and the production of all necessary documents and other evidentiary material. 
96.11 	Any board member may administer oaths to witnesses, or take their affirmation. It shall 
96.12 	keep a record of all its proceedings. 
96.13 	(b) The board shall have access to hospital, nursing home, and other medical records 
96.14 	of a patient cared for by a nurse under review. If the board does not have a written consent 
96.15 	from a patient permitting access to the patient's records, the nurse or facility shall delete 
96.16 	any data in the record that identifies the patient before providing it to the board. The board 
96.17 	shall have access to such other records as reasonably requested by the board to assist the 
96.18 	board in its investigation. Nothing herein may be construed to allow access to any records 
96.19 	protected by section 145.64. The board shall maintain any records obtained pursuant to 
96.20 	this paragraph as investigative data under chapter 13. 
96.21 	(c) The board may accept and expend grants or gifts of money or in-kind services 
96.22 	from a person, a public or private entity, or any other source for purposes consistent with 
96.23 	the board's role and within the scope of its statutory authority.
96.24 	(d) The board may accept registration fees for meetings and conferences conducted 
96.25 	for the purposes of board activities that are within the scope of its authority.

96.26 	Sec. 4. Minnesota Statutes 2010, section 148.212, subdivision 1, is amended to read:
96.27 		Subdivision 1.Issuance. Upon receipt of the applicable licensure or reregistration 
96.28 	fee and permit fee, and in accordance with rules of the board, the board may issue 
96.29 	a nonrenewable temporary permit to practice professional or practical nursing to an 
96.30 	applicant for licensure or reregistration who is not the subject of a pending investigation 
96.31 	or disciplinary action, nor disqualified for any other reason, under the following 
96.32 	circumstances:
96.33 	(a) The applicant for licensure by examination under section 148.211, subdivision 
96.34 	1, has graduated from an approved nursing program within the 60 days preceding board 
96.35 	receipt of an affidavit of graduation or transcript and has been authorized by the board to 
97.1 	write the licensure examination for the first time in the United States. The permit holder 
97.2 	must practice professional or practical nursing under the direct supervision of a registered 
97.3 	nurse. The permit is valid from the date of issue until the date the board takes action on 
97.4 	the application or for 60 days whichever occurs first. 
97.5 	(b) The applicant for licensure by endorsement under section 148.211, subdivision 2, 
97.6 	is currently licensed to practice professional or practical nursing in another state, territory, 
97.7 	or Canadian province. The permit is valid from submission of a proper request until the 
97.8 	date of board action on the application or for 60 days, whichever comes first. 
97.9 	(c) (b) The applicant for licensure by endorsement under section 148.211, 
97.10 	subdivision 2, or for reregistration under section 148.231, subdivision 5, is currently 
97.11 	registered in a formal, structured refresher course or its equivalent for nurses that includes 
97.12 	clinical practice. 
97.13 	(d) The applicant for licensure by examination under section 148.211, subdivision 
97.14 	1, who graduated from a nursing program in a country other than the United States or 
97.15 	Canada has completed all requirements for licensure except registering for and taking the 
97.16 	nurse licensure examination for the first time in the United States. The permit holder must 
97.17 	practice professional nursing under the direct supervision of a registered nurse. The permit 
97.18 	is valid from the date of issue until the date the board takes action on the application or for 
97.19 	60 days, whichever occurs first. 

97.20 	Sec. 5. Minnesota Statutes 2010, section 148.231, is amended to read:
97.21 	148.231 REGISTRATION; FAILURE TO REGISTER; REREGISTRATION; 
97.22 	VERIFICATION.
97.23 		Subdivision 1.Registration. Every person licensed to practice professional or 
97.24 	practical nursing must maintain with the board a current registration for practice as a 
97.25 	registered nurse or licensed practical nurse which must be renewed at regular intervals 
97.26 	established by the board by rule. No certificate of registration shall be issued by the board 
97.27 	to a nurse until the nurse has submitted satisfactory evidence of compliance with the 
97.28 	procedures and minimum requirements established by the board.
97.29 	The fee for periodic registration for practice as a nurse shall be determined by the 
97.30 	board by rule law. A penalty fee shall be added for any application received after the 
97.31 	required date as specified by the board by rule. Upon receipt of the application and the 
97.32 	required fees, the board shall verify the application and the evidence of completion of 
97.33 	continuing education requirements in effect, and thereupon issue to the nurse a certificate 
97.34 	of registration for the next renewal period.
98.1 		Subd. 4.Failure to register. Any person licensed under the provisions of sections 
98.2 	148.171 to 148.285 who fails to register within the required period shall not be entitled to 
98.3 	practice nursing in this state as a registered nurse or licensed practical nurse. 
98.4 		Subd. 5.Reregistration. A person whose registration has lapsed desiring to 
98.5 	resume practice shall make application for reregistration, submit satisfactory evidence of 
98.6 	compliance with the procedures and requirements established by the board, and pay the 
98.7 	registration reregistration fee for the current period to the board. A penalty fee shall be 
98.8 	required from a person who practiced nursing without current registration. Thereupon, the
98.9 	registration certificate shall be issued to the person who shall immediately be placed on 
98.10 	the practicing list as a registered nurse or licensed practical nurse.
98.11 		Subd. 6.Verification. A person licensed under the provisions of sections 148.171 to 
98.12 	148.285 who requests the board to verify a Minnesota license to another state, territory, 
98.13 	or country or to an agency, facility, school, or institution shall pay a fee to the board
98.14 	for each verification. 

98.15 	Sec. 6. [148.242] FEES.
98.16 	The fees specified in section 148.243 are nonrefundable and must be deposited in 
98.17 	the state government special revenue fund.

98.18 	Sec. 7. [148.243] FEE AMOUNTS.
98.19 		Subdivision 1.Licensure by examination. The fee for licensure by examination is 
98.20 	$105.
98.21 		Subd. 2.Reexamination fee. The reexamination fee is $60.
98.22 		Subd. 3.Licensure by endorsement. The fee for licensure by endorsement is $105.
98.23 		Subd. 4.Registration renewal. The fee for registration renewal is $85.
98.24 		Subd. 5.Reregistration. The fee for reregistration is $105.
98.25 		Subd. 6.Replacement license. The fee for a replacement license is $20.
98.26 		Subd. 7.Public health nurse certification. The fee for public health nurse 
98.27 	certification is $30.
98.28 		Subd. 8.Drug Enforcement Administration verification for Advanced Practice 
98.29 	Registered Nurse (APRN). The Drug Enforcement Administration verification for 
98.30 	APRN is $50.
98.31 		Subd. 9.Licensure verification other than through Nursys. The fee for 
98.32 	verification of licensure status other than through Nursys verification is $20.
98.33 		Subd. 10.Verification of examination scores. The fee for verification of 
98.34 	examination scores is $20.
99.1 		Subd. 11.Microfilmed licensure application materials. The fee for a copy of 
99.2 	microfilmed licensure application materials is $20.
99.3 		Subd. 12.Nursing business registration; initial application. The fee for the initial 
99.4 	application for nursing business registration is $100.
99.5 		Subd. 13.Nursing business registration; annual application. The fee for the 
99.6 	annual application for nursing business registration is $25.
99.7 		Subd. 14.Practicing without current registration. The fee for practicing without 
99.8 	current registration is two times the amount of the current registration renewal fee for any 
99.9 	part of the first calendar month, plus the current registration renewal fee for any part of 
99.10 	any subsequent month up to 24 months.
99.11 		Subd. 15.Practicing without current APRN certification. The fee for practicing 
99.12 	without current APRN certification is $200 for the first month or any part thereof, plus 
99.13 	$100 for each subsequent month or part thereof.
99.14 		Subd. 16.Dishonored check fee. The service fee for a dishonored check is as 
99.15 	provided in section 604.113.
99.16 		Subd. 17.Border state registry fee. The initial application fee for border state 
99.17 	registration is $50. Any subsequent notice of employment change to remain or be 
99.18 	reinstated on the registry is $50.

99.19 	Sec. 8. Minnesota Statutes 2010, section 148B.17, is amended to read:
99.20 	148B.17 FEES.
99.21 		Subdivision. 1.Fees; Board of Marriage and Family Therapy. Each board shall 
99.22 	by rule establish The board's fees, including late fees, for licenses and renewals are 
99.23 	established so that the total fees collected by the board will as closely as possible equal 
99.24 	anticipated expenditures during the fiscal biennium, as provided in section 16A.1285. 
99.25 	Fees must be credited to accounts the board's account in the state government special 
99.26 	revenue fund. 
99.27 		Subd. 2.Licensure and application fees. Nonrefundable licensure and application 
99.28 	fees charged by the board are as follows:
99.29 	(1) application fee for national examination is $220;
99.30 	(2) application fee for Licensed Marriage and Family Therapist (LMFT) state 
99.31 	examination is $110;
99.32 	(3) initial LMFT license fee is prorated, but cannot exceed $125;
99.33 	(4) annual renewal fee for LMFT license is $125;
99.34 	(5) late fee for initial Licensed Associate Marriage and Family Therapist LAMFT 
99.35 	license renewal is $50;
100.1 	(6) application fee for LMFT licensure by reciprocity is $340;
100.2 	(7) fee for initial Licensed Associate Marriage and Family Therapist (LAMFT) 
100.3 	license is $75;
100.4 	(8) annual renewal fee for LAMFT license is $75;
100.5 	(9) late fee for LAMFT renewal is $50;
100.6 	(10) fee for reinstatement of license is $150; and 
100.7 	(11) fee for emeritus status is $125.
100.8 		Subd. 3.Other fees. Other fees charged by the board are as follows:
100.9 	(1) sponsor application fee for approval of a continuing education course is $60;
100.10 	(2) fee for license verification by mail is $10;
100.11 	(3) duplicate license fee is $25;
100.12 	(4) duplicate renewal card fee is $10;
100.13 	(5) fee for licensee mailing list is $60;
100.14 	(6) fee for a rule book is $10; and
100.15 	(7) fees as authorized by section 148B.175, subdivision 6, clause (7).

100.16 	Sec. 9. Minnesota Statutes 2010, section 148B.33, subdivision 2, is amended to read:
100.17 		Subd. 2.Fee. Each applicant shall pay a nonrefundable application fee set by 
100.18 	the board under section 148B.17.

100.19 	Sec. 10. Minnesota Statutes 2010, section 148B.52, is amended to read:
100.20 	148B.52 DUTIES OF THE BOARD.
100.21 	(a) The Board of Behavioral Health and Therapy shall:
100.22 	(1) establish by rule appropriate techniques, including examinations and other 
100.23 	methods, for determining whether applicants and licensees are qualified under sections 
100.24 	148B.50 to 148B.593; 
100.25 	(2) establish by rule standards for professional conduct, including adoption of a 
100.26 	Code of Professional Ethics and requirements for continuing education and supervision;
100.27 	(3) issue licenses to individuals qualified under sections 148B.50 to 148B.593; 
100.28 	(4) establish by rule standards for initial education including coursework for 
100.29 	licensure and content of professional education;
100.30 	(5) establish, maintain, and publish annually a register of current licensees and 
100.31 	approved supervisors;
100.32 	(6) establish initial and renewal application and examination fees sufficient to cover 
100.33 	operating expenses of the board and its agents in accordance with section 16A.1283;
101.1 	(7) educate the public about the existence and content of the laws and rules for 
101.2 	licensed professional counselors to enable consumers to file complaints against licensees 
101.3 	who may have violated the rules; and
101.4 	(8) periodically evaluate its rules in order to refine the standards for licensing 
101.5 	professional counselors and to improve the methods used to enforce the board's standards.
101.6 	(b) The board may appoint a professional discipline committee for each occupational 
101.7 	licensure regulated by the board, and may appoint a board member as chair. The 
101.8 	professional discipline committee shall consist of five members representative of the 
101.9 	licensed occupation and shall provide recommendations to the board with regard to rule 
101.10 	techniques, standards, procedures, and related issues specific to the licensed occupation.

101.11 	Sec. 11. Minnesota Statutes 2010, section 150A.091, subdivision 2, is amended to read:
101.12 		Subd. 2.Application fees. Each applicant shall submit with a license, advanced 
101.13 	dental therapist certificate, or permit application a nonrefundable fee in the following 
101.14 	amounts in order to administratively process an application:
101.15 	(1) dentist, $140;
101.16 	(2) full faculty dentist, $140;
101.17 	(2) (3) limited faculty dentist, $140;
101.18 	(3) (4) resident dentist or dental provider, $55;
101.19 	(5) advanced dental therapist, $100;
101.20 	(4) (6) dental therapist, $100;
101.21 	(5) (7) dental hygienist, $55;
101.22 	(6) (8) licensed dental assistant, $55; and
101.23 	(7) (9) dental assistant with a permit as described in Minnesota Rules, part 
101.24 	3100.8500, subpart 3, $15.

101.25 	Sec. 12. Minnesota Statutes 2010, section 150A.091, subdivision 3, is amended to read:
101.26 		Subd. 3.Initial license or permit fees. Along with the application fee, each of the 
101.27 	following applicants shall submit a separate prorated initial license or permit fee. The 
101.28 	prorated initial fee shall be established by the board based on the number of months of the 
101.29 	applicant's initial term as described in Minnesota Rules, part 3100.1700, subpart 1a, not to 
101.30 	exceed the following monthly fee amounts:
101.31 	(1) dentist or full faculty dentist, $14 times the number of months of the initial term;
101.32 	(2) dental therapist, $10 times the number of months of the initial term;
101.33 	(3) dental hygienist, $5 times the number of months of the initial term;
101.34 	(4) licensed dental assistant, $3 times the number of months of the initial term; and
102.1 	(5) dental assistant with a permit as described in Minnesota Rules, part 3100.8500, 
102.2 	subpart 3, $1 times the number of months of the initial term.

102.3 	Sec. 13. Minnesota Statutes 2010, section 150A.091, subdivision 4, is amended to read:
102.4 		Subd. 4.Annual license fees. Each limited faculty or resident dentist shall submit 
102.5 	with an annual license renewal application a fee established by the board not to exceed 
102.6 	the following amounts:
102.7 	(1) limited faculty dentist, $168; and
102.8 	(2) resident dentist or dental provider, $59.

102.9 	Sec. 14. Minnesota Statutes 2010, section 150A.091, subdivision 5, is amended to read:
102.10 		Subd. 5.Biennial license or permit fees. Each of the following applicants shall 
102.11 	submit with a biennial license or permit renewal application a fee as established by the 
102.12 	board, not to exceed the following amounts:
102.13 	(1) dentist or full faculty dentist, $336;
102.14 	(2) dental therapist, $180;
102.15 	(3) dental hygienist, $118;
102.16 	(4) licensed dental assistant, $80; and
102.17 	(5) dental assistant with a permit as described in Minnesota Rules, part 3100.8500, 
102.18 	subpart 3, $24.

102.19 	Sec. 15. Minnesota Statutes 2010, section 150A.091, subdivision 8, is amended to read:
102.20 		Subd. 8.Duplicate license or certificate fee. Each applicant shall submit, with 
102.21 	a request for issuance of a duplicate of the original license, or of an annual or biennial 
102.22 	renewal certificate for a license or permit, a fee in the following amounts:
102.23 	(1) original dentist, full faculty dentist, dental therapist, dental hygiene, or dental 
102.24 	assistant license, $35; and
102.25 	(2) annual or biennial renewal certificates, $10.

102.26 	Sec. 16. Minnesota Statutes 2010, section 150A.091, is amended by adding a 
102.27 	subdivision to read:
102.28 		Subd. 16.Failure of professional development portfolio audit. A licensee shall 
102.29 	submit a fee as established by the board not to exceed the amount of $250 after failing 
102.30 	two consecutive professional development portfolio audits and, thereafter, for each failed 
102.31 	professional development portfolio audit under Minnesota Rules, part 3100.5300.

103.1 	Sec. 17. [151.065] FEE AMOUNTS.
103.2 		Subdivision 1.Application fees. Application fees for licensure and registration 
103.3 	are as follows:
103.4 	(1) pharmacist licensed by examination, $130;
103.5 	(2) pharmacist licensed by reciprocity, $225;
103.6 	(3) pharmacy intern, $30;
103.7 	(4) pharmacy technician, $30;
103.8 	(5) pharmacy, $190;
103.9 	(6) drug wholesaler, legend drugs only, $200;
103.10 	(7) drug wholesaler, legend and nonlegend drugs, $200;
103.11 	(8) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, $175;
103.12 	(9) drug wholesaler, medical gases, $150;
103.13 	(10) drug wholesaler, also licensed as a pharmacy in Minnesota, $125;
103.14 	(11) drug manufacturer, legend drugs only, $200;
103.15 	(12) drug manufacturer, legend and nonlegend drugs, $200;
103.16 	(13) drug manufacturer, nonlegend or veterinary legend drugs, $175;
103.17 	(14) drug manufacturer, medical gases, $150;
103.18 	(15) drug manufacturer, also licensed as a pharmacy in Minnesota, $125;
103.19 	(16) medical gas distributor, $75;
103.20 	(17) controlled substance researcher, $50; and
103.21 	(18) pharmacy professional corporation, $100.
103.22 		Subd. 2.Original license fee. The pharmacist original licensure fee, $130.
103.23 		Subd. 3.Annual renewal fees. Annual licensure and registration renewal fees 
103.24 	are as follows:
103.25 	(1) pharmacist, $130;
103.26 	(2) pharmacy technician, $30;
103.27 	(3) pharmacy, $190;
103.28 	(4) drug wholesaler, legend drugs only, $200;
103.29 	(5) drug wholesaler, legend and nonlegend drugs, $200;
103.30 	(6) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, $175;
103.31 	(7) drug wholesaler, medical gases, $150;
103.32 	(8) drug wholesaler, also licensed as a pharmacy in Minnesota, $125;
103.33 	(9) drug manufacturer, legend drugs only, $200;
103.34 	(10) drug manufacturer, legend and nonlegend drugs, $200;
103.35 	(11) drug manufacturer, nonlegend, veterinary legend drugs, or both, $175;
103.36 	(12) drug manufacturer, medical gases, $150;
104.1 	(13) drug manufacturer, also licensed as a pharmacy in Minnesota, $125;
104.2 	(14) medical gas distributor, $75;
104.3 	(15) controlled substance researcher, $50; and
104.4 	(16) pharmacy professional corporation, $45.
104.5 		Subd. 4.Miscellaneous fees. Fees for issuance of affidavits and duplicate licenses 
104.6 	and certificates are as follows:
104.7 	(1) intern affidavit, $15;
104.8 	(2) duplicate small license, $15; and
104.9 	(3) duplicate large certificate, $25.
104.10 		Subd. 5.Late fees. All annual renewal fees are subject to a 50 percent late fee if 
104.11 	the renewal fee and application are not received by the board prior to the date specified 
104.12 	by the board.
104.13 		Subd. 6.Reinstatement fees. (a) A pharmacist who has allowed the pharmacist's 
104.14 	license to lapse may reinstate the license with board approval and upon payment of any 
104.15 	fees and late fees in arrears, up to a maximum of $1,000.
104.16 	(b) A pharmacy technician who has allowed the technician's registration to lapse 
104.17 	may reinstate the registration with board approval and upon payment of any fees and late 
104.18 	fees in arrears, up to a maximum of $90.
104.19 	(c) An owner of a pharmacy, a drug wholesaler, a drug manufacturer, or a medical 
104.20 	gas distributor who has allowed the license of the establishment to lapse may reinstate the 
104.21 	license with board approval and upon payment of any fees and late fees in arrears.
104.22 	(d) A controlled substance researcher who has allowed the researcher's registration 
104.23 	to lapse may reinstate the registration with board approval and upon payment of any fees 
104.24 	and late fees in arrears.
104.25 	(e) A pharmacist owner of a professional corporation who has allowed the 
104.26 	corporation's registration to lapse may reinstate the registration with board approval and 
104.27 	upon payment of any fees and late fees in arrears.

104.28 	Sec. 18. Minnesota Statutes 2010, section 151.07, is amended to read:
104.29 	151.07 MEETINGS; EXAMINATION FEE.
104.30 	The board shall meet at times as may be necessary and as it may determine to 
104.31 	examine applicants for licensure and to transact its other business, giving reasonable 
104.32 	notice of all examinations by mail to known applicants therefor. The secretary shall record 
104.33 	the names of all persons licensed by the board, together with the grounds upon which 
104.34 	the right of each to licensure was claimed. The fee for examination shall be in such the 
105.1 	 amount as the board may determine specified in section 151.065, which fee may in the 
105.2 	discretion of the board be returned to applicants not taking the examination.

105.3 	Sec. 19. Minnesota Statutes 2010, section 151.101, is amended to read:
105.4 	151.101 INTERNSHIP.
105.5 	Upon payment of the fee specified in section 151.065, the board may license register
105.6 	as an intern any natural persons who have satisfied the board that they are of good moral 
105.7 	character, not physically or mentally unfit, and who have successfully completed the 
105.8 	educational requirements for intern licensure registration prescribed by the board. The 
105.9 	board shall prescribe standards and requirements for interns, pharmacist-preceptors, and 
105.10 	internship training but may not require more than one year of such training.
105.11 	The board in its discretion may accept internship experience obtained in another 
105.12 	state provided the internship requirements in such other state are in the opinion of the 
105.13 	board equivalent to those herein provided.

105.14 	Sec. 20. Minnesota Statutes 2010, section 151.102, is amended by adding a subdivision 
105.15 	to read:
105.16 		Subd. 3.Registration fee. The board shall not register an individual as a pharmacy 
105.17 	technician unless all applicable fees specified in section 151.065 have been paid.

105.18 	Sec. 21. Minnesota Statutes 2010, section 151.12, is amended to read:
105.19 	151.12 RECIPROCITY; LICENSURE.
105.20 	The board may in its discretion grant licensure without examination to any 
105.21 	pharmacist licensed by the Board of Pharmacy or a similar board of another state which 
105.22 	accords similar recognition to licensees of this state; provided, the requirements for 
105.23 	licensure in such other state are in the opinion of the board equivalent to those herein 
105.24 	provided. The fee for licensure shall be in such the amount as the board may determine by 
105.25 	rule specified in section 151.065.

105.26 	Sec. 22. Minnesota Statutes 2010, section 151.13, subdivision 1, is amended to read:
105.27 		Subdivision 1.Renewal fee. Every person licensed by the board as a pharmacist 
105.28 	shall pay to the board a the annual renewal fee to be fixed by it specified in section 
105.29 	151.065. The board may promulgate by rule a charge to be assessed for the delinquent 
105.30 	payment of a fee. the late fee specified in section 151.065 if the renewal fee and 
105.31 	application are not received by the board prior to the date specified by the board. It shall 
105.32 	be unlawful for any person licensed as a pharmacist who refuses or fails to pay such any 
106.1 	applicable  renewal or late fee to practice pharmacy in this state. Every certificate and 
106.2 	license shall expire at the time therein prescribed.

106.3 	Sec. 23. Minnesota Statutes 2010, section 151.19, is amended to read:
106.4 	151.19 REGISTRATION; FEES.
106.5 		Subdivision 1.Pharmacy registration. The board shall require and provide for the 
106.6 	annual registration of every pharmacy now or hereafter doing business within this state. 
106.7 	Upon the payment of a any applicable  fee to be set by the board specified in section 
106.8 	151.065, the board shall issue a registration certificate in such form as it may prescribe to 
106.9 	such persons as may be qualified by law to conduct a pharmacy. Such certificate shall be 
106.10 	displayed in a conspicuous place in the pharmacy for which it is issued and expire on the 
106.11 	30th day of June following the date of issue. It shall be unlawful for any person to conduct 
106.12 	a pharmacy unless such certificate has been issued to the person by the board.
106.13 		Subd. 2.Nonresident pharmacies. The board shall require and provide for an 
106.14 	annual nonresident special pharmacy registration for all pharmacies located outside of this 
106.15 	state that regularly dispense medications for Minnesota residents and mail, ship, or deliver 
106.16 	prescription medications into this state. Nonresident special pharmacy registration shall 
106.17 	be granted by the board upon payment of any applicable fee specified in section 151.065 
106.18 	and the disclosure and certification by a pharmacy:
106.19 	(1) that it is licensed in the state in which the dispensing facility is located and from 
106.20 	which the drugs are dispensed;
106.21 	(2) the location, names, and titles of all principal corporate officers and all 
106.22 	pharmacists who are dispensing drugs to residents of this state;
106.23 	(3) that it complies with all lawful directions and requests for information from 
106.24 	the Board of Pharmacy of all states in which it is licensed or registered, except that it 
106.25 	shall respond directly to all communications from the board concerning emergency 
106.26 	circumstances arising from the dispensing of drugs to residents of this state;
106.27 	(4) that it maintains its records of drugs dispensed to residents of this state so that the 
106.28 	records are readily retrievable from the records of other drugs dispensed;
106.29 	(5) that it cooperates with the board in providing information to the Board of 
106.30 	Pharmacy of the state in which it is licensed concerning matters related to the dispensing 
106.31 	of drugs to residents of this state;
106.32 	(6) that during its regular hours of operation, but not less than six days per week, for 
106.33 	a minimum of 40 hours per week, a toll-free telephone service is provided to facilitate 
106.34 	communication between patients in this state and a pharmacist at the pharmacy who has 
107.1 	access to the patients' records; the toll-free number must be disclosed on the label affixed 
107.2 	to each container of drugs dispensed to residents of this state; and
107.3 	(7) that, upon request of a resident of a long-term care facility located within the 
107.4 	state of Minnesota, the resident's authorized representative, or a contract pharmacy or 
107.5 	licensed health care facility acting on behalf of the resident, the pharmacy will dispense 
107.6 	medications prescribed for the resident in unit-dose packaging or, alternatively, comply 
107.7 	with the provisions of section 151.415, subdivision 5.
107.8 		Subd. 3.Sale of federally restricted medical gases. The board shall require and 
107.9 	provide for the annual registration of every person or establishment not licensed as a 
107.10 	pharmacy or a practitioner engaged in the retail sale or distribution of federally restricted 
107.11 	medical gases. Upon the payment of a any applicable  fee to be set by the board specified 
107.12 	in section 151.065, the board shall issue a registration certificate in such form as it may 
107.13 	prescribe to those persons or places that may be qualified to sell or distribute federally 
107.14 	restricted medical gases. The certificate shall be displayed in a conspicuous place in the 
107.15 	business for which it is issued and expire on the date set by the board. It is unlawful for 
107.16 	a person to sell or distribute federally restricted medical gases unless a certificate has 
107.17 	been issued to that person by the board.

107.18 	Sec. 24. Minnesota Statutes 2010, section 151.25, is amended to read:
107.19 	151.25 REGISTRATION OF MANUFACTURERS; FEE; PROHIBITIONS.
107.20 	The board shall require and provide for the annual registration of every person 
107.21 	engaged in manufacturing drugs, medicines, chemicals, or poisons for medicinal purposes, 
107.22 	now or hereafter doing business with accounts in this state. Upon a payment of a any 
107.23 	applicable fee as set by the board specified in section 151.065, the board shall issue a 
107.24 	registration certificate in such form as it may prescribe to such manufacturer. Such 
107.25 	registration certificate shall be displayed in a conspicuous place in such manufacturer's 
107.26 	or wholesaler's place of business for which it is issued and expire on the date set by the 
107.27 	board. It shall be unlawful for any person to manufacture drugs, medicines, chemicals, 
107.28 	or poisons for medicinal purposes unless such a certificate has been issued to the person 
107.29 	by the board. It shall be unlawful for any person engaged in the manufacture of drugs, 
107.30 	medicines, chemicals, or poisons for medicinal purposes, or the person's agent, to sell 
107.31 	legend drugs to other than a pharmacy, except as provided in this chapter.

107.32 	Sec. 25. Minnesota Statutes 2010, section 151.47, subdivision 1, is amended to read:
107.33 		Subdivision 1.Requirements. All wholesale drug distributors are subject to the 
107.34 	requirements in paragraphs (a) to (f).
108.1 	(a) No person or distribution outlet shall act as a wholesale drug distributor without 
108.2 	first obtaining a license from the board and paying the required any applicable  fee
108.3 	specified in section 151.065.
108.4 	(b) No license shall be issued or renewed for a wholesale drug distributor to operate 
108.5 	unless the applicant agrees to operate in a manner prescribed by federal and state law and 
108.6 	according to the rules adopted by the board.
108.7 	(c) The board may require a separate license for each facility directly or indirectly 
108.8 	owned or operated by the same business entity within the state, or for a parent entity 
108.9 	with divisions, subsidiaries, or affiliate companies within the state, when operations 
108.10 	are conducted at more than one location and joint ownership and control exists among 
108.11 	all the entities.
108.12 	(d) As a condition for receiving and retaining a wholesale drug distributor license 
108.13 	issued under sections 151.42 to 151.51, an applicant shall satisfy the board that it has 
108.14 	and will continuously maintain: 
108.15 	(1) adequate storage conditions and facilities;
108.16 	(2) minimum liability and other insurance as may be required under any applicable 
108.17 	federal or state law;
108.18 	(3) a viable security system that includes an after hours central alarm, or comparable 
108.19 	entry detection capability; restricted access to the premises; comprehensive employment 
108.20 	applicant screening; and safeguards against all forms of employee theft;
108.21 	(4) a system of records describing all wholesale drug distributor activities set forth 
108.22 	in section 151.44 for at least the most recent two-year period, which shall be reasonably 
108.23 	accessible as defined by board regulations in any inspection authorized by the board; 
108.24 	(5) principals and persons, including officers, directors, primary shareholders, 
108.25 	and key management executives, who must at all times demonstrate and maintain their 
108.26 	capability of conducting business in conformity with sound financial practices as well 
108.27 	as state and federal law;
108.28 	(6) complete, updated information, to be provided to the board as a condition for 
108.29 	obtaining and retaining a license, about each wholesale drug distributor to be licensed, 
108.30 	including all pertinent corporate licensee information, if applicable, or other ownership, 
108.31 	principal, key personnel, and facilities information found to be necessary by the board;
108.32 	(7) written policies and procedures that assure reasonable wholesale drug distributor 
108.33 	preparation for, protection against, and handling of any facility security or operation 
108.34 	problems, including, but not limited to, those caused by natural disaster or government 
108.35 	emergency, inventory inaccuracies or product shipping and receiving, outdated product 
109.1 	or other unauthorized product control, appropriate disposition of returned goods, and 
109.2 	product recalls;
109.3 	(8) sufficient inspection procedures for all incoming and outgoing product 
109.4 	shipments; and
109.5 	(9) operations in compliance with all federal requirements applicable to wholesale 
109.6 	drug distribution.
109.7 	(e) An agent or employee of any licensed wholesale drug distributor need not seek 
109.8 	licensure under this section.
109.9 	(f) A wholesale drug distributor shall file with the board an annual report, in a 
109.10 	form and on the date prescribed by the board, identifying all payments, honoraria, 
109.11 	reimbursement or other compensation authorized under section 151.461, clauses (3) to 
109.12 	(5), paid to practitioners in Minnesota during the preceding calendar year. The report 
109.13 	shall identify the nature and value of any payments totaling $100 or more, to a particular 
109.14 	practitioner during the year, and shall identify the practitioner. Reports filed under this 
109.15 	provision are public data. 

109.16 	Sec. 26. Minnesota Statutes 2010, section 151.48, is amended to read:
109.17 	151.48 OUT-OF-STATE WHOLESALE DRUG DISTRIBUTOR LICENSING.
109.18 	(a) It is unlawful for an out-of-state wholesale drug distributor to conduct business 
109.19 	in the state without first obtaining a license from the board and paying the required any 
109.20 	applicable fee specified in section 151.065.
109.21 	(b) Application for an out-of-state wholesale drug distributor license under this 
109.22 	section shall be made on a form furnished by the board.
109.23 	(c) No person acting as principal or agent for any out-of-state wholesale drug 
109.24 	distributor may sell or distribute drugs in the state unless the distributor has obtained 
109.25 	a license.
109.26 	(d) The board may adopt regulations that permit out-of-state wholesale drug 
109.27 	distributors to obtain a license on the basis of reciprocity to the extent that an out-of-state 
109.28 	wholesale drug distributor:
109.29 	(1) possesses a valid license granted by another state under legal standards 
109.30 	comparable to those that must be met by a wholesale drug distributor of this state as 
109.31 	prerequisites for obtaining a license under the laws of this state; and
109.32 	(2) can show that the other state would extend reciprocal treatment under its own 
109.33 	laws to a wholesale drug distributor of this state.

109.34 	Sec. 27. Minnesota Statutes 2010, section 152.12, subdivision 3, is amended to read:
110.1 		Subd. 3.Research project use of controlled substances. Any qualified person 
110.2 	may use controlled substances in the course of a bona fide research project but cannot 
110.3 	administer or dispense such drugs to human beings unless such drugs are prescribed, 
110.4 	dispensed and administered by a person lawfully authorized to do so. Every person 
110.5 	who engages in research involving the use of such substances shall apply annually for 
110.6 	registration by the state Board of Pharmacy and shall pay any applicable fee specified in 
110.7 	section 151.065, provided that such registration shall not be required if the person is 
110.8 	covered by and has complied with federal laws covering such research projects.

110.9 	ARTICLE 6
110.10 	HEALTH CARE

110.11 	Section 1. Minnesota Statutes 2010, section 62E.08, subdivision 1, is amended to read:
110.12 		Subdivision 1.Establishment. The association shall establish the following 
110.13 	maximum premiums to be charged for membership in the comprehensive health insurance 
110.14 	plan:
110.15 	(a) the premium for the number one qualified plan shall range from a minimum of 
110.16 	101 percent to a maximum of 125 percent of the weighted average of rates charged by 
110.17 	those insurers and health maintenance organizations with individuals enrolled in:
110.18 	(1) $1,000 annual deductible individual plans of insurance in force in Minnesota;
110.19 	(2) individual health maintenance organization contracts of coverage with a $1,000 
110.20 	annual deductible which are in force in Minnesota; and
110.21 	(3) other plans of coverage similar to plans offered by the association based on 
110.22 	generally accepted actuarial principles;
110.23 	(b) the premium for the number two qualified plan shall range from a minimum of 
110.24 	101 percent to a maximum of 125 percent of the weighted average of rates charged by 
110.25 	those insurers and health maintenance organizations with individuals enrolled in:
110.26 	(1) $500 annual deductible individual plans of insurance in force in Minnesota;
110.27 	(2) individual health maintenance organization contracts of coverage with a $500 
110.28 	annual deductible which are in force in Minnesota; and
110.29 	(3) other plans of coverage similar to plans offered by the association based on 
110.30 	generally accepted actuarial principles;
110.31 	(c) the premiums for the plans with a $2,000, $5,000, or $10,000 annual deductible 
110.32 	shall range from a minimum of 101 percent to a maximum of 125 percent of the weighted 
110.33 	average of rates charged by those insurers and health maintenance organizations with 
110.34 	individuals enrolled in:
111.1 	(1) $2,000, $5,000, or $10,000 annual deductible individual plans, respectively, in 
111.2 	force in Minnesota; and
111.3 	(2) individual health maintenance organization contracts of coverage with a $2,000, 
111.4 	$5,000, or $10,000 annual deductible, respectively, which are in force in Minnesota; or
111.5 	(3) other plans of coverage similar to plans offered by the association based on 
111.6 	generally accepted actuarial principles;
111.7 	(d) the premium for each type of Medicare supplement plan required to be offered 
111.8 	by the association pursuant to section 62E.12 shall range from a minimum of 101 percent 
111.9 	to a maximum of 125 percent of the weighted average of rates charged by those insurers 
111.10 	and health maintenance organizations with individuals enrolled in: 
111.11 	(1) Medicare supplement plans in force in Minnesota;
111.12 	(2) health maintenance organization Medicare supplement contracts of coverage 
111.13 	which are in force in Minnesota; and
111.14 	(3) other plans of coverage similar to plans offered by the association based on 
111.15 	generally accepted actuarial principles; and
111.16 	(e) the charge for health maintenance organization coverage shall be based on 
111.17 	generally accepted actuarial principles.; and
111.18 	(f) the premium for a high-deductible, basic plan offered under section 62E.121 shall 
111.19 	range from a minimum of 101 percent to a maximum of 125 percent of the weighted 
111.20 	average of rates charged by those insurers and health maintenance organizations offering 
111.21 	comparable plans outside of the Minnesota Comprehensive Health Association.
111.22 	The list of insurers and health maintenance organizations whose rates are used to 
111.23 	establish the premium for coverage offered by the association pursuant to paragraphs (a) 
111.24 	to (d) and (f) shall be established by the commissioner on the basis of information which 
111.25 	shall be provided to the association by all insurers and health maintenance organizations 
111.26 	annually at the commissioner's request. This information shall include the number of 
111.27 	individuals covered by each type of plan or contract specified in paragraphs (a) to (d) and 
111.28 	(f) that is sold, issued, and renewed by the insurers and health maintenance organizations, 
111.29 	including those plans or contracts available only on a renewal basis. The information shall 
111.30 	also include the rates charged for each type of plan or contract.
111.31 	In establishing premiums pursuant to this section, the association shall utilize 
111.32 	generally accepted actuarial principles, provided that the association shall not discriminate 
111.33 	in charging premiums based upon sex. In order to compute a weighted average for each 
111.34 	type of plan or contract specified under paragraphs (a) to (d) and (f), the association 
111.35 	shall, using the information collected pursuant to this subdivision, list insurers and health 
111.36 	maintenance organizations in rank order of the total number of individuals covered by 
112.1 	each insurer or health maintenance organization. The association shall then compute 
112.2 	a weighted average of the rates charged for coverage by all the insurers and health 
112.3 	maintenance organizations by:
112.4 	(1) multiplying the numbers of individuals covered by each insurer or health 
112.5 	maintenance organization by the rates charged for coverage;
112.6 	(2) separately summing both the number of individuals covered by all the insurers 
112.7 	and health maintenance organizations and all the products computed under clause (1); and
112.8 	(3) dividing the total of the products computed under clause (1) by the total number 
112.9 	of individuals covered.
112.10 	The association may elect to use a sample of information from the insurers and 
112.11 	health maintenance organizations for purposes of computing a weighted average. In no 
112.12 	case, however, may a sample used by the association to compute a weighted average 
112.13 	include information from fewer than the two insurers or health maintenance organizations 
112.14 	highest in rank order.

112.15 	Sec. 2. [62E.121] HIGH-DEDUCTIBLE, BASIC PLAN.
112.16 		Subdivision 1.Required offering. The Minnesota Comprehensive Health 
112.17 	Association shall offer a high-deductible, basic plan that meets the requirements specified 
112.18 	in this section. The high-deductible, basic plan is a one-person plan. Any dependents 
112.19 	must be covered separately.
112.20 		Subd. 2.Annual deductible; out-of-pocket maximum. (a) The plan shall provide 
112.21 	the following in-network annual deductible options: $3,000, $6,000, $9,000, and $12,000. 
112.22 	The in-network annual out-of-pocket maximum for each annual deductible option shall be 
112.23 	$1,000 greater than the amount of the annual deductible.
112.24 	(b) The deductible is subject to an annual increase based on the change in the 
112.25 	Consumer Price Index (CPI).
112.26 		Subd. 3.Office visits for nonpreventive care. The following co-payments shall 
112.27 	apply for each of the first three office visits per calendar year for nonpreventive care:
112.28 	(1) $30 per visit for the $3,000 annual deductible option;
112.29 	(2) $40 per visit for the $6,000 annual deductible option;
112.30 	(3) $50 per visit for the $9,000 annual deductible option; and
112.31 	(4) $60 per visit for the $12,000 annual deductible option.
112.32 	For the fourth and subsequent visits during the calendar year, 80 percent coverage is 
112.33 	provided under all deductible options, after the deductible is met.
112.34 		Subd. 4.Preventive care. One hundred percent coverage is provided for preventive 
112.35 	care, and no co-payment, coinsurance, or deductible requirements apply.
113.1 		Subd. 5.Prescription drugs. A $10 co-payment applies to preferred generic drugs. 
113.2 	Preferred brand-name drugs require an enrollee payment of 100 percent of the health 
113.3 	plan's discounted rate.
113.4 		Subd. 6.Convenience care center visits. A $20 co-payment applies for the first 
113.5 	three convenience care center visits during a calendar year. For the fourth and subsequent 
113.6 	visits during a calendar year, 80 percent coverage is provided after the deductible is met.
113.7 		Subd. 7.Urgent care center visits. A $100 co-payment applies for the first urgent 
113.8 	care center visit during a calendar year. For the second and subsequent visits during a 
113.9 	calendar year, 80 percent coverage is provided after the deductible is met.
113.10 		Subd. 8.Emergency room visits. A $200 co-payment applies for the first 
113.11 	emergency room visit during a calendar year. For the second and subsequent visits during 
113.12 	a calendar year, 80 percent coverage is provided after the deductible is met.
113.13 		Subd. 9.Lab and x-ray; hospital services; ambulance; surgery. Lab and x-ray 
113.14 	services, hospital services, ambulance services, and surgery are covered at 80 percent 
113.15 	after the deductible is met.
113.16 		Subd. 10.Eyewear. The health plan pays up to $50 per calendar year for eyewear.
113.17 		Subd. 11.Maternity. Maternity, labor and delivery, and postpartum care are not 
113.18 	covered. One hundred percent coverage is provided for prenatal care and no deductible 
113.19 	applies.
113.20 		Subd. 12.Other eligible health care services. Other eligible health care services 
113.21 	are covered at 80 percent after the deductible is met.
113.22 		Subd. 13.Option to remove mental health and substance abuse coverage.
 113.23 	Enrollees have the option of removing mental health and substance abuse coverage in 
113.24 	exchange for a reduced premium.
113.25 		Subd. 14.Option to upgrade prescription drug coverage. Enrollees have 
113.26 	the option to upgrade prescription drug coverage to include coverage for preferred 
113.27 	brand-name drugs with a $50 co-payment and coverage for nonpreferred drugs with a 
113.28 	$100 co-payment in exchange for an increased premium.
113.29 		Subd. 15.Out-of-network services. (a) The out-of-network annual deductible is 
113.30 	double the in-network annual deductible.
113.31 	(b) There is no out-of-pocket maximum for out-of-network services.
113.32 	(c) Benefits for out-of-network services are covered at 60 percent after the deductible 
113.33 	is met.
113.34 	(d) The lifetime maximum benefit for out-of-network services is $1,000,000.
113.35 		Subd. 16.Services not covered. Services not covered include: custodial care 
113.36 	or rest care; most dental services; cosmetic services; refractive eye surgery; infertility 
114.1 	services; and services that are investigational, not medically necessary, or received while 
114.2 	on military duty.

114.3 	Sec. 3. Minnesota Statutes 2010, section 62E.14, is amended by adding a subdivision 
114.4 	to read:
114.5 		Subd. 4f.Waiver of preexisting conditions for persons covered by healthy 
114.6 	Minnesota contribution program. A person may enroll in the comprehensive plan with 
114.7 	a waiver of the preexisting condition limitation in subdivision 3 if the person is eligible for 
114.8 	the healthy Minnesota contribution program, and has been denied coverage as described 
114.9 	under section 256L.031, subdivision 6.

114.10 	Sec. 4. Minnesota Statutes 2010, section 62J.04, subdivision 9, is amended to read:
114.11 		Subd. 9.Growth limits; federal programs. The commissioners of health and 
114.12 	human services shall establish a rate methodology for Medicare and Medicaid risk-based 
114.13 	contracting with health plan companies that is consistent with statewide growth limits. 
114.14 	The methodology shall be presented for review by the Minnesota Health Care Commission 
114.15 	and the Legislative Commission on Health Care Access prior to the submission of a 
114.16 	waiver request to the Centers for Medicare and Medicaid Services and subsequent 
114.17 	implementation of the methodology.

114.18 	Sec. 5. Minnesota Statutes 2010, section 62J.692, subdivision 9, is amended to read:
114.19 		Subd. 9.Review of eligible providers. The commissioner and the Medical 
114.20 	Education and Research Costs Advisory Committee may review provider groups included 
114.21 	in the definition of a clinical medical education program to assure that the distribution of 
114.22 	the funds continue to be consistent with the purpose of this section. The results of any 
114.23 	such reviews must be reported to the Legislative Commission on Health Care Access
114.24 	chairs and ranking minority members of the legislative committees with jurisdiction over 
114.25 	health care policy and finance.

114.26 	Sec. 6. [62J.824] BILLING FOR PROCEDURES TO CORRECT MEDICAL 
114.27 	ERRORS PROHIBITED.
114.28 	A health care provider shall not bill a patient, and shall not be reimbursed, for 
114.29 	any operation, treatment, or other care that is provided to reverse, correct, or otherwise 
114.30 	minimize the affects of an adverse health care event, as described in section 144.7065, 
114.31 	subdivisions 2 to 7, for which that health care provider is responsible.

115.1 	Sec. 7. Minnesota Statutes 2010, section 62Q.32, is amended to read:
115.2 	62Q.32 LOCAL OMBUDSPERSON.
115.3 	County board or community health service agencies may establish an office of 
115.4 	ombudsperson to provide a system of consumer advocacy for persons receiving health 
115.5 	care services through a health plan company. The ombudsperson's functions may include, 
115.6 	but are not limited to:
115.7 	(a) mediation or advocacy on behalf of a person accessing the complaint and appeal 
115.8 	procedures to ensure that necessary medical services are provided by the health plan 
115.9 	company; and
115.10 	(b) investigation of the quality of services provided to a person and determine the 
115.11 	extent to which quality assurance mechanisms are needed or any other system change 
115.12 	may be needed. The commissioner of health shall make recommendations for funding 
115.13 	these functions including the amount of funding needed and a plan for distribution. The 
115.14 	commissioner shall submit these recommendations to the Legislative Commission on 
115.15 	Health Care Access by January 15, 1996.

115.16 	Sec. 8. Minnesota Statutes 2010, section 62U.04, subdivision 3, is amended to read:
115.17 		Subd. 3.Provider peer grouping. (a) The commissioner shall develop a peer 
115.18 	grouping system for providers based on a combined measure that incorporates both 
115.19 	provider risk-adjusted cost of care and quality of care, and for specific conditions as 
115.20 	determined by the commissioner. In developing this system, the commissioner shall 
115.21 	consult and coordinate with health care providers, health plan companies, state agencies, 
115.22 	and organizations that work to improve health care quality in Minnesota. For purposes of 
115.23 	the final establishment of the peer grouping system, the commissioner shall not contract 
115.24 	with any private entity, organization, or consortium of entities that has or will have a direct 
115.25 	financial interest in the outcome of the system.
115.26 	(b) By no later than October 15, 2010, the commissioner shall disseminate 
115.27 	information to providers on their total cost of care, total resource use, total quality of care, 
115.28 	and the total care results of the grouping developed under this subdivision in comparison 
115.29 	to an appropriate peer group. Any analyses or reports that identify providers may only be 
115.30 	published after the provider has been provided the opportunity by the commissioner to 
115.31 	review the underlying data and submit comments. Providers may be given any data for 
115.32 	which they are the subject of the data. The provider shall have 30 days to review the data 
115.33 	for accuracy and initiate an appeal as specified in paragraph (d).
115.34 	(c) By no later than January 1, 2011, the commissioner shall disseminate information 
115.35 	to providers on their condition-specific cost of care, condition-specific resource use, 
116.1 	condition-specific quality of care, and the condition-specific results of the grouping 
116.2 	developed under this subdivision in comparison to an appropriate peer group. Any 
116.3 	analyses or reports that identify providers may only be published after the provider has 
116.4 	been provided the opportunity by the commissioner to review the underlying data and 
116.5 	submit comments. Providers may be given any data for which they are the subject of the 
116.6 	data. The provider shall have 30 days to review the data for accuracy and initiate an 
116.7 	appeal as specified in paragraph (d).
116.8 	(d) The commissioner shall establish an appeals process to resolve disputes from 
116.9 	providers regarding the accuracy of the data used to develop analyses or reports. When 
116.10 	a provider appeals the accuracy of the data used to calculate the peer grouping system 
116.11 	results, the provider shall:
116.12 	(1) clearly indicate the reason they believe the data used to calculate the peer group 
116.13 	system results are not accurate;
116.14 	(2) provide evidence and documentation to support the reason that data was not 
116.15 	accurate; and
116.16 	(3) cooperate with the commissioner, including allowing the commissioner access to 
116.17 	data necessary and relevant to resolving the dispute.
116.18 	If a provider does not meet the requirements of this paragraph, a provider's appeal shall be 
116.19 	considered withdrawn. The commissioner shall not publish results for a specific provider 
116.20 	under paragraph (e) or (f) while that provider has an unresolved appeal.
116.21 	(e) Beginning January 1, 2011, the commissioner shall, no less than annually, 
116.22 	publish information on providers' total cost, total resource use, total quality, and the results 
116.23 	of the total care portion of the peer grouping process. The results that are published must 
116.24 	be on a risk-adjusted basis.
116.25 	(f) Beginning March 30, 2011, the commissioner shall no less than annually publish 
116.26 	information on providers' condition-specific cost, condition-specific resource use, and 
116.27 	condition-specific quality, and the results of the condition-specific portion of the peer 
116.28 	grouping process. The results that are published must be on a risk-adjusted basis.
116.29 	(g) Prior to disseminating data to providers under paragraph (b) or (c) or publishing 
116.30 	information under paragraph (e) or (f), the commissioner shall ensure the scientific 
116.31 	validity and reliability of the results according to the standards described in paragraph (h). 
116.32 	If additional time is needed to establish the scientific validity and reliability of the results, 
116.33 	the commissioner may delay the dissemination of data to providers under paragraph (b) 
116.34 	or (c), or the publication of information under paragraph (e) or (f). If the delay is more 
116.35 	than 60 days, the commissioner shall report in writing to the Legislative Commission on 
117.1 	Health Care Access chairs and ranking minority members of the legislative committees 
117.2 	with jurisdiction over health care policy and finance the following information:
117.3 	(1) the reason for the delay;
117.4 	(2) the actions being taken to resolve the delay and establish the scientific validity 
117.5 	and reliability of the results; and
117.6 	(3) the new dates by which the results shall be disseminated.
117.7 	If there is a delay under this paragraph, the commissioner must disseminate the 
117.8 	information to providers under paragraph (b) or (c) at least 90 days before publishing 
117.9 	results under paragraph (e) or (f).
117.10 	(h) The commissioner's assurance of valid and reliable clinic and hospital peer 
117.11 	grouping performance results shall include, at a minimum, the following:
117.12 	(1) use of the best available evidence, research, and methodologies; and
117.13 	(2) establishment of an explicit minimum reliability threshold developed in 
117.14 	collaboration with the subjects of the data and the users of the data, at a level not below 
117.15 	nationally accepted standards where such standards exist.
117.16 	In achieving these thresholds, the commissioner shall not aggregate clinics that are not 
117.17 	part of the same system or practice group. The commissioner shall consult with and solicit 
117.18 	feedback from representatives of physician clinics and hospitals during the peer grouping 
117.19 	data analysis process to obtain input on the methodological options prior to final analysis 
117.20 	and on the design, development, and testing of provider reports.

117.21 	Sec. 9. Minnesota Statutes 2010, section 62U.04, subdivision 9, is amended to read:
117.22 		Subd. 9.Uses of information. (a) By no later As coverage is offered, sold, issued, 
117.23 	or renewed, but not less  than 12 months after the commissioner publishes the information 
117.24 	in subdivision 3, paragraph (e):
117.25 	(1) the commissioner of management and budget shall use the information and 
117.26 	methods developed under subdivision 3 to strengthen incentives for members of the state 
117.27 	employee group insurance program to use high-quality, low-cost providers;
117.28 	(2) all political subdivisions, as defined in section 13.02, subdivision 11, that offer 
117.29 	health benefits to their employees must offer plans that differentiate providers on their 
117.30 	cost and quality performance and create incentives for members to use better-performing 
117.31 	providers;
117.32 	(3) all health plan companies shall use the information and methods developed 
117.33 	under subdivision 3 to develop products that encourage consumers to use high-quality, 
117.34 	low-cost providers; and
118.1 	(4) health plan companies that issue health plans in the individual market or the 
118.2 	small employer market must offer at least one health plan that uses the information 
118.3 	developed under subdivision 3 to establish financial incentives for consumers to choose 
118.4 	higher-quality, lower-cost providers through enrollee cost-sharing or selective provider 
118.5 	networks.
118.6 	(b) By January 1, 2011, the commissioner of health shall report to the governor 
118.7 	and the legislature on recommendations to encourage health plan companies to promote 
118.8 	widespread adoption of products that encourage the use of high-quality, low-cost providers. 
118.9 	The commissioner's recommendations may include tax incentives, public reporting of 
118.10 	health plan performance, regulatory incentives or changes, and other strategies.

118.11 	Sec. 10. Minnesota Statutes 2010, section 62U.06, subdivision 2, is amended to read:
118.12 		Subd. 2.Legislative oversight. Beginning January 15, 2009, the commissioner 
118.13 	of health shall submit to the Legislative Commission on Health Care Access chairs and 
118.14 	ranking minority members of the legislative committees with jurisdiction over health care 
118.15 	policy and finance periodic progress reports on the implementation of this chapter and 
118.16 	sections 256B.0751 to 256B.0754.

118.17 	Sec. 11. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision 
118.18 	to read:
118.19 		Subd. 33.Contingency contract fees. When the commissioner enters into 
118.20 	a contingency-based contract for the purpose of recovering medical assistance or 
118.21 	MinnesotaCare funds, the commissioner may retain that portion of the recovered funds 
118.22 	equal to the amount of the contingency fee.

118.23 	Sec. 12. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision 
118.24 	to read:
118.25 		Subd. 34.Elimination of certain provider reporting requirements; sunset of 
118.26 	new requirements. (a) Notwithstanding any other law, rule, or provision to the contrary, 
118.27 	effective July 1, 2012, the commissioner shall cease collecting from health care providers 
118.28 	and purchasers all reports and data related to health care costs, quality, utilization, access, 
118.29 	patient encounters, and disease surveillance and public health, and related to provider 
118.30 	licensure, monitoring, finances, and regulation, unless the reports or data are necessary for 
118.31 	federal compliance. For purposes of this subdivision, the term "health care providers and 
118.32 	purchasers" has the meaning provided in section 62J.03, subdivision 8, except that it also 
118.33 	includes nursing homes, health plan companies as defined in section 62Q.01, subdivision 
119.1 	4, and managed care and county-based purchasing plans delivering services under sections 
119.2 	256B.69 and 256B.692.
119.3 	(b) The commissioner shall present to the 2012 legislature draft legislation to repeal, 
119.4 	effective July 1, 2012, the provider reporting requirements identified under paragraph (a) 
119.5 	that are not necessary for federal compliance.
119.6 	(c) The commissioner may establish new provider reporting requirements to take 
119.7 	effect on or after July 1, 2012. These new reporting requirements must sunset five years 
119.8 	from their effective date, unless they are renewed by the commissioner. All new provider 
119.9 	reporting requirements and requests for their renewal shall not take effect unless they 
119.10 	are enacted in state law.

119.11 	Sec. 13. Minnesota Statutes 2010, section 256.969, subdivision 2b, is amended to read:
119.12 		Subd. 2b.Operating payment rates. In determining operating payment rates for 
119.13 	admissions occurring on or after the rate year beginning January 1, 1991, and every two 
119.14 	years after, or more frequently as determined by the commissioner, the commissioner 
119.15 	shall obtain operating data from an updated base year and establish operating payment 
119.16 	rates per admission for each hospital based on the cost-finding methods and allowable 
119.17 	costs of the Medicare program in effect during the base year. Rates under the general 
119.18 	assistance medical care, medical assistance, and MinnesotaCare programs shall not be 
119.19 	rebased to more current data on January 1, 1997, January 1, 2005, for the first 24 months 
119.20 	of the rebased period beginning January 1, 2009. For the first 24 months of the rebased 
119.21 	period beginning January 1, 2011, rates shall not be rebased, except that a Minnesota 
119.22 	long-term hospital shall be rebased effective January 1, 2011, based on its most recent 
119.23 	Medicare cost report ending on or before September 1, 2008, with the provisions under 
119.24 	subdivisions 9 and 23, based on the rates in effect on December 31, 2010. For subsequent 
119.25 	rate setting periods in which the base years are updated, a Minnesota long-term hospital's 
119.26 	base year shall remain within the same period as other hospitals. Effective January 1, 
119.27 	2013, rates shall be rebased at full value Rates must not be rebased to more current data 
119.28 	for the first six months of the rebased period beginning January 1, 2013. The base year 
119.29 	operating payment rate per admission is standardized by the case mix index and adjusted 
119.30 	by the hospital cost index, relative values, and disproportionate population adjustment. 
119.31 	The cost and charge data used to establish operating rates shall only reflect inpatient 
119.32 	services covered by medical assistance and shall not include property cost information 
119.33 	and costs recognized in outlier payments.

119.34 	Sec. 14. Minnesota Statutes 2010, section 256.969, subdivision 3a, is amended to read:
120.1 		Subd. 3a.Payments. (a) Acute care hospital billings under the medical 
120.2 	assistance program must not be submitted until the recipient is discharged. However, 
120.3 	the commissioner shall establish monthly interim payments for inpatient hospitals that 
120.4 	have individual patient lengths of stay over 30 days regardless of diagnostic category. 
120.5 	Except as provided in section 256.9693, medical assistance reimbursement for treatment 
120.6 	of mental illness shall be reimbursed based on diagnostic classifications. Individual 
120.7 	hospital payments established under this section and sections 256.9685, 256.9686, and 
120.8 	256.9695, in addition to third-party and recipient liability, for discharges occurring during 
120.9 	the rate year shall not exceed, in aggregate, the charges for the medical assistance covered 
120.10 	inpatient services paid for the same period of time to the hospital. This payment limitation 
120.11 	shall be calculated separately for medical assistance and general assistance medical 
120.12 	care services. The limitation on general assistance medical care shall be effective for 
120.13 	admissions occurring on or after July 1, 1991. Services that have rates established under 
120.14 	subdivision 11 or 12, must be limited separately from other services. After consulting with 
120.15 	the affected hospitals, the commissioner may consider related hospitals one entity and 
120.16 	may merge the payment rates while maintaining separate provider numbers. The operating 
120.17 	and property base rates per admission or per day shall be derived from the best Medicare 
120.18 	and claims data available when rates are established. The commissioner shall determine 
120.19 	the best Medicare and claims data, taking into consideration variables of recency of the 
120.20 	data, audit disposition, settlement status, and the ability to set rates in a timely manner. 
120.21 	The commissioner shall notify hospitals of payment rates by December 1 of the year 
120.22 	preceding the rate year. The rate setting data must reflect the admissions data used to 
120.23 	establish relative values. Base year changes from 1981 to the base year established for the 
120.24 	rate year beginning January 1, 1991, and for subsequent rate years, shall not be limited 
120.25 	to the limits ending June 30, 1987, on the maximum rate of increase under subdivision 
120.26 	1. The commissioner may adjust base year cost, relative value, and case mix index data 
120.27 	to exclude the costs of services that have been discontinued by the October 1 of the year 
120.28 	preceding the rate year or that are paid separately from inpatient services. Inpatient stays 
120.29 	that encompass portions of two or more rate years shall have payments established based 
120.30 	on payment rates in effect at the time of admission unless the date of admission preceded 
120.31 	the rate year in effect by six months or more. In this case, operating payment rates for 
120.32 	services rendered during the rate year in effect and established based on the date of 
120.33 	admission shall be adjusted to the rate year in effect by the hospital cost index.
120.34 	(b) For fee-for-service admissions occurring on or after July 1, 2002, the total 
120.35 	payment, before third-party liability and spenddown, made to hospitals for inpatient 
120.36 	services is reduced by .5 percent from the current statutory rates.
121.1 	(c) In addition to the reduction in paragraph (b), the total payment for fee-for-service 
121.2 	admissions occurring on or after July 1, 2003, made to hospitals for inpatient services 
121.3 	before third-party liability and spenddown, is reduced five percent from the current 
121.4 	statutory rates. Mental health services within diagnosis related groups 424 to 432, and 
121.5 	facilities defined under subdivision 16 are excluded from this paragraph.
121.6 	(d) In addition to the reduction in paragraphs (b) and (c), the total payment for 
121.7 	fee-for-service admissions occurring on or after August 1, 2005, made to hospitals for 
121.8 	inpatient services before third-party liability and spenddown, is reduced 6.0 percent 
121.9 	from the current statutory rates. Mental health services within diagnosis related groups 
121.10 	424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph. 
121.11 	Notwithstanding section 256.9686, subdivision 7, for purposes of this paragraph, medical 
121.12 	assistance does not include general assistance medical care. Payments made to managed 
121.13 	care plans shall be reduced for services provided on or after January 1, 2006, to reflect 
121.14 	this reduction.
121.15 	(e) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for 
121.16 	fee-for-service admissions occurring on or after July 1, 2008, through June 30, 2009, made 
121.17 	to hospitals for inpatient services before third-party liability and spenddown, is reduced 
121.18 	3.46 percent from the current statutory rates. Mental health services with diagnosis related 
121.19 	groups 424 to 432 and facilities defined under subdivision 16 are excluded from this 
121.20 	paragraph. Payments made to managed care plans shall be reduced for services provided 
121.21 	on or after January 1, 2009, through June 30, 2009, to reflect this reduction.
121.22 	(f) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for 
121.23 	fee-for-service admissions occurring on or after July 1, 2009, through June 30, 2011, made 
121.24 	to hospitals for inpatient services before third-party liability and spenddown, is reduced 
121.25 	1.9 percent from the current statutory rates. Mental health services with diagnosis related 
121.26 	groups 424 to 432 and facilities defined under subdivision 16 are excluded from this 
121.27 	paragraph. Payments made to managed care plans shall be reduced for services provided 
121.28 	on or after July 1, 2009, through June 30, 2011, to reflect this reduction.
121.29 	(g) In addition to the reductions in paragraphs (b), (c), and (d), the total payment 
121.30 	for fee-for-service admissions occurring on or after July 1, 2011, made to hospitals for 
121.31 	inpatient services before third-party liability and spenddown, is reduced 1.79 percent 
121.32 	from the current statutory rates. Mental health services with diagnosis related groups 
121.33 	424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph. 
121.34 	Payments made to managed care plans shall be reduced for services provided on or after 
121.35 	July 1, 2011, to reflect this reduction.
122.1 	(h) In addition to the reductions in paragraphs (b), (c), (d), (f), and (g), the total 
122.2 	payment for fee-for-service admissions occurring on or after July 1, 2009, made to 
122.3 	hospitals for inpatient services before third-party liability and spenddown, is reduced 
122.4 	one percent from the current statutory rates. Facilities defined under subdivision 16 are 
122.5 	excluded from this paragraph. Payments made to managed care plans shall be reduced for 
122.6 	services provided on or after October 1, 2009, to reflect this reduction.
122.7 	(i) In addition to the reductions in paragraphs (b), (c), (d), (g), and (h), the total 
122.8 	payment for fee-for-service admissions occurring on or after July 1, 2011, made to 
122.9 	hospitals for inpatient services before third-party liability and spenddown, is reduced 
122.10 	1.96 percent from the current statutory rates. Facilities defined under subdivision 16 are 
122.11 	excluded from this paragraph. Payments made to managed care plans shall be reduced for 
122.12 	services provided on or after January 1, 2011, to reflect this reduction.
122.13 	(j) In addition to the reductions in paragraphs (b), (c), (d), (g), (h), and (i), the total 
122.14 	payment for medical assistance fee-for-service admissions occurring on or after July 1, 
122.15 	2011, through June 30, 2013, made to hospitals for inpatient services before third-party 
122.16 	liability and spenddown, is reduced by 7.04 percent from the current statutory rates. 
122.17 	Inpatient hospital fee-for-service payments to hospitals located in the seven-county 
122.18 	metropolitan area that are not government-owned with a disproportionate population 
122.19 	adjustment under section 256.969, subdivision 9, paragraph (b), that is greater than 17 
122.20 	percent on January 1, 2011, are excluded from this reduction. Payments made to managed 
122.21 	care plans shall be reduced for services provided on or after January 1, 2012, through June 
122.22 	30, 2013, to reflect the full 24-month reduction in fee-for-service rates.

122.23 	Sec. 15. Minnesota Statutes 2010, section 256.969, is amended by adding a subdivision 
122.24 	to read:
122.25 		Subd. 31.Initiatives to reduce incidence of low birth-weight. The commissioner 
122.26 	shall require hospitals with a level III neonatal intensive care unit located in the 
122.27 	seven-county metropolitan area, as a condition of contract, to implement strategies 
122.28 	to reduce the incidence of low birth-weight in geographic areas identified by the 
122.29 	commissioner as having a higher than average incidence of low birth-weight, with special 
122.30 	emphasis on areas within a one-mile radius of the hospital. These strategies may focus on 
122.31 	smoking prevention and cessation, ensuring that pregnant women get adequate nutrition, 
122.32 	and addressing demographic, social, and environmental risk factors. The strategies must 
122.33 	coordinate health care with social services and the local public health system, and offer 
122.34 	patient education through appropriate means. The commissioner shall require hospitals to 
122.35 	submit proposed initiatives for approval to the commissioner by January 1, 2012, and the 
123.1 	commissioner shall require hospitals to implement approved initiatives by July 1, 2012. 
123.2 	The commissioner shall evaluate the strategies adopted to reduce low birth-weight, and 
123.3 	shall require hospitals to submit outcome and other data necessary for the evaluation.

123.4 	Sec. 16. Minnesota Statutes 2010, section 256B.04, subdivision 18, is amended to read:
123.5 		Subd. 18.Applications for medical assistance. (a) The state agency may 
123.6 	take applications for medical assistance and conduct eligibility determinations for 
123.7 	MinnesotaCare enrollees.
123.8 	(b) The commissioner of human services shall modify the Minnesota health care 
123.9 	programs application form to add a question asking applicants: "Are you a United States 
123.10 	military veteran?"

123.11 	Sec. 17. Minnesota Statutes 2010, section 256B.05, is amended by adding a 
123.12 	subdivision to read:
123.13 		Subd. 5.Technical assistance. The commissioner shall provide technical assistance 
123.14 	to county agencies in processing complex medical assistance applications, including but 
123.15 	not limited to applications for long-term care services. The commissioner shall provide 
123.16 	this technical assistance using existing financial resources.

123.17 	Sec. 18. Minnesota Statutes 2010, section 256B.055, subdivision 15, is amended to 
123.18 	read:
123.19 		Subd. 15.Adults without children. (a) Medical assistance may be paid for a 
123.20 	person who is:
123.21 	(1) at least age 21 and under age 65;
123.22 	(2) not pregnant;
123.23 	(3) not entitled to Medicare Part A or enrolled in Medicare Part B under Title XVIII 
123.24 	of the Social Security Act;
123.25 	(4) not an adult in a family with children as defined in section 256L.01, subdivision 
123.26 	3a; and
123.27 	(5) not described in another subdivision of this section.
123.28 	(b) If the federal government eliminates the federal Medicaid match or reduces the 
123.29 	federal Medicaid matching rate beyond any adjustment required as part of the annual 
123.30 	recalculation of the state's overall Medicaid matching rate for persons eligible under this 
123.31 	subdivision, the commissioner shall eliminate coverage for persons enrolled under this 
123.32 	subdivision and suspend new enrollment under this subdivision effective on the date 
123.33 	of the elimination or reduction.

124.1 	EFFECTIVE DATE. This section is effective the day following final enactment 
124.2 	and expires January 1, 2014.

124.3 	Sec. 19. Minnesota Statutes 2010, section 256B.06, subdivision 4, is amended to read:
124.4 		Subd. 4.Citizenship requirements. (a) Eligibility for medical assistance is limited 
124.5 	to citizens of the United States, qualified noncitizens as defined in this subdivision, and 
124.6 	other persons residing lawfully in the United States. Citizens or nationals of the United 
124.7 	States must cooperate in obtaining satisfactory documentary evidence of citizenship or 
124.8 	nationality according to the requirements of the federal Deficit Reduction Act of 2005, 
124.9 	Public Law 109-171.
124.10 	(b) "Qualified noncitizen" means a person who meets one of the following 
124.11 	immigration criteria:
124.12 	(1) admitted for lawful permanent residence according to United States Code, title 8;
124.13 	(2) admitted to the United States as a refugee according to United States Code, 
124.14 	title 8, section 1157;
124.15 	(3) granted asylum according to United States Code, title 8, section 1158;
124.16 	(4) granted withholding of deportation according to United States Code, title 8, 
124.17 	section 1253(h);
124.18 	(5) paroled for a period of at least one year according to United States Code, title 8, 
124.19 	section 1182(d)(5);
124.20 	(6) granted conditional entrant status according to United States Code, title 8, 
124.21 	section 1153(a)(7);
124.22 	(7) determined to be a battered noncitizen by the United States Attorney General 
124.23 	according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, 
124.24 	title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;
124.25 	(8) is a child of a noncitizen determined to be a battered noncitizen by the United 
124.26 	States Attorney General according to the Illegal Immigration Reform and Immigrant 
124.27 	Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill, 
124.28 	Public Law 104-200; or
124.29 	(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public 
124.30 	Law 96-422, the Refugee Education Assistance Act of 1980.
124.31 	(c) All qualified noncitizens who were residing in the United States before August 
124.32 	22, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for 
124.33 	medical assistance with federal financial participation.
125.1 	(d) All qualified noncitizens who entered the United States on or after August 22, 
125.2 	1996, and who otherwise meet the eligibility requirements of this chapter, are eligible for 
125.3 	medical assistance with federal financial participation through November 30, 1996.
125.4 	Beginning December 1, 1996, qualified noncitizens who entered the United States 
125.5 	on or after August 22, 1996, and who otherwise meet the eligibility requirements of this 
125.6 	chapter are eligible for medical assistance with federal participation for five years if they 
125.7 	meet one of the following criteria:
125.8 	(i) refugees admitted to the United States according to United States Code, title 8, 
125.9 	section 1157;
125.10 	(ii) persons granted asylum according to United States Code, title 8, section 1158;
125.11 	(iii) persons granted withholding of deportation according to United States Code, 
125.12 	title 8, section 1253(h);
125.13 	(iv) veterans of the United States armed forces with an honorable discharge for 
125.14 	a reason other than noncitizen status, their spouses and unmarried minor dependent 
125.15 	children; or
125.16 	(v) persons on active duty in the United States armed forces, other than for training, 
125.17 	their spouses and unmarried minor dependent children.
125.18 	Beginning December 1, 1996, qualified noncitizens who do not meet one of the 
125.19 	criteria in items (i) to (v) are eligible for medical assistance without federal financial 
125.20 	participation as described in paragraph (j).
125.21 	Notwithstanding paragraph (j), beginning July 1, 2010, children and pregnant 
125.22 	women who are noncitizens described in paragraph (b) or (e), are eligible for medical 
125.23 	assistance with federal financial participation as provided by the federal Children's Health 
125.24 	Insurance Program Reauthorization Act of 2009, Public Law 111-3.
125.25 	(e) Noncitizens who are not qualified noncitizens as defined in paragraph (b), who 
125.26 	are lawfully present in the United States, as defined in Code of Federal Regulations, title 
125.27 	8, section 103.12, and who otherwise meet the eligibility requirements of this chapter, are 
125.28 	eligible for medical assistance under clauses (1) to (3). These individuals must cooperate 
125.29 	with the United States Citizenship and Immigration Services to pursue any applicable 
125.30 	immigration status, including citizenship, that would qualify them for medical assistance 
125.31 	with federal financial participation.
125.32 	(1) Persons who were medical assistance recipients on August 22, 1996, are eligible 
125.33 	for medical assistance with federal financial participation through December 31, 1996.
125.34 	(2) Beginning January 1, 1997, persons described in clause (1) are eligible for 
125.35 	medical assistance without federal financial participation as described in paragraph (j).
126.1 	(3) Beginning December 1, 1996, persons residing in the United States prior to 
126.2 	August 22, 1996, who were not receiving medical assistance and persons who arrived on 
126.3 	or after August 22, 1996, are eligible for medical assistance without federal financial 
126.4 	participation as described in paragraph (j).
126.5 	(f) Nonimmigrants who otherwise meet the eligibility requirements of this chapter 
126.6 	are eligible for the benefits as provided in paragraphs (g) to (i). For purposes of this 
126.7 	subdivision, a "nonimmigrant" is a person in one of the classes listed in United States 
126.8 	Code, title 8, section 1101(a)(15).
126.9 	(g) Payment shall also be made for care and services that are furnished to noncitizens, 
126.10 	regardless of immigration status, who otherwise meet the eligibility requirements of 
126.11 	this chapter, if such care and services are necessary for the treatment of an emergency 
126.12 	medical condition, except for organ transplants and related care and services and routine 
126.13 	prenatal care.
126.14 	(h) For purposes of this subdivision, the term "emergency medical condition" means 
126.15 	a medical condition that meets the requirements of United States Code, title 42, section 
126.16 	1396b(v).
126.17 	(i)(1) Notwithstanding paragraph (h), services that are necessary for the treatment of 
126.18 	an emergency medical condition are limited to the following:
126.19 	(i) services delivered in an emergency room that are directly related to the treatment 
126.20 	of an emergency medical condition;
126.21 	(ii) services delivered in an inpatient hospital setting following admission from an 
126.22 	emergency room or clinic for an acute emergency condition; and
126.23 	(iii) follow-up services that are directly related to the original service provided to 
126.24 	treat the emergency medical condition and that are covered by the global payment made 
126.25 	to the provider.
126.26 	(2) Services for the treatment of emergency medical conditions do not include:
126.27 	(i) services delivered in an emergency room or inpatient setting to treat a 
126.28 	nonemergency condition;
126.29 	(ii) organ transplants and related care;
126.30 	(iii) services for routine prenatal care;
126.31 	(iv) continuing care, including long-term care, nursing facility services, home health 
126.32 	care, adult day care, day training, or supportive living services;
126.33 	(v) elective surgery;
126.34 	(vi) outpatient prescription drugs, unless the drugs are administered or dispensed as 
126.35 	part of an emergency room visit;
126.36 	(vii) preventative health care and family planning services;
127.1 	(viii) dialysis;
127.2 	(ix) chemotherapy or therapeutic radiation services;
127.3 	(x) rehabilitation services;
127.4 	(xi) physical, occupational, or speech therapy;
127.5 	(xii) transportation services;
127.6 	(xiii) case management;
127.7 	(xiv) prosthetics, orthotics, durable medical equipment, or medical supplies;
127.8 	(xv) dental services;
127.9 	(xvi) hospice care;
127.10 	(xvii) audiology services and hearing aids;
127.11 	(xviii) podiatry services;
127.12 	(xix) chiropractic services;
127.13 	(xx) immunizations;
127.14 	(xxi) vision services and eyeglasses;
127.15 	(xxii) waiver services;
127.16 	(xxiii) individualized education programs; or
127.17 	(xxiv) chemical dependency treatment.
127.18 	(i) (j) Beginning July 1, 2009, pregnant noncitizens who are undocumented, 
127.19 	nonimmigrants, or lawfully present as designated in paragraph (e) and who are not 
127.20 	covered by a group health plan or health insurance coverage according to Code of 
127.21 	Federal Regulations, title 42, section 457.310, and who otherwise meet the eligibility 
127.22 	requirements of this chapter, are eligible for medical assistance through the period of 
127.23 	pregnancy, including labor and delivery, and 60 days postpartum, to the extent federal 
127.24 	funds are available under title XXI of the Social Security Act, and the state children's 
127.25 	health insurance program.
127.26 	(j) (k) Qualified noncitizens as described in paragraph (d), and all other noncitizens 
127.27 	lawfully residing in the United States as described in paragraph (e), who are ineligible 
127.28 	for medical assistance with federal financial participation and who otherwise meet the 
127.29 	eligibility requirements of chapter 256B and of this paragraph, are eligible for medical 
127.30 	assistance without federal financial participation. Qualified noncitizens as described 
127.31 	in paragraph (d) are only eligible for medical assistance without federal financial 
127.32 	participation for five years from their date of entry into the United States.
127.33 	(k) (l) Beginning October 1, 2003, persons who are receiving care and rehabilitation 
127.34 	services from a nonprofit center established to serve victims of torture and are otherwise 
127.35 	ineligible for medical assistance under this chapter are eligible for medical assistance 
127.36 	without federal financial participation. These individuals are eligible only for the period 
128.1 	during which they are receiving services from the center. Individuals eligible under this 
128.2 	paragraph shall not be required to participate in prepaid medical assistance.

128.3 	Sec. 20. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 
128.4 	subdivision to read:
128.5 		Subd. 1b.Care coordination services provided through pediatric hospitals.
 128.6 	(a) Medical assistance covers care coordination services provided by certain pediatric 
128.7 	hospitals to children with high-cost medical conditions and children at risk of recurrent 
128.8 	hospitalization for acute or chronic illnesses. There must be Level I and Level II pediatric 
128.9 	care coordination services.
128.10 	(b) Level I pediatric care coordination services are provided by advanced practice 
128.11 	nurses employed by or under contract with pediatric hospitals that have a neonatal 
128.12 	intensive care unit and are either recipients of payments to support the training of residents 
128.13 	from an approved graduate medical residency program under United States Code, title 
128.14 	42, section 256e, or the major pediatric teaching hospital affiliate of the University of 
128.15 	Minnesota Medical School, and that meet the criteria in this subdivision.
128.16 	(c) The services in paragraph (b) must be available through in-home video telehealth 
128.17 	management and other methods, and must be designed to improve patient outcomes 
128.18 	and reduce unnecessary hospital and emergency room utilization. The services must 
128.19 	streamline communication, reduce redundancy, and eliminate unnecessary documentation 
128.20 	through the use of a Web-accessible, uniform document that contains critical patient care 
128.21 	management information, and which is accessible to all providers with patient consent. 
128.22 	The commissioner shall develop the uniform document and associated Web site and shall 
128.23 	implement procedures to assess patient outcomes and evaluate the effectiveness of the 
128.24 	care coordination services provided under this subdivision.
128.25 	(d) Medical assistance also covers, as durable medical equipment, computers, 
128.26 	webcams, and other technology necessary to allow in-home video telehealth management.
128.27 	(e) For purposes of paragraph (b), a child has a high-cost medical condition if 
128.28 	inpatient hospital expenses for that child related to complex or chronic illnesses or 
128.29 	conditions for the most recent calendar year exceeded $100,000, or if the expenses for that 
128.30 	child are projected to exceed $100,000 for the current calendar year. For purposes of this 
128.31 	subdivision, a child is at risk of recurrent hospitalization if the child was hospitalized three 
128.32 	or more times for acute or chronic illness in the most recent calendar year.
128.33 	(f) For purposes of paragraph (b), "care coordination" means collaboration between 
128.34 	the advanced practice nurse and primary care physicians and specialists to manage 
128.35 	care and reduce hospitalizations, patient case management, development of medical 
129.1 	management plans for chronic illnesses and recurrent acute illnesses, oversight and 
129.2 	coordination of all aspects of care in partnership with families, organization of medical 
129.3 	information into a summary of critical information, coordination and appropriate 
129.4 	sequencing of tests and multiple appointments, information and assistance with accessing 
129.5 	resources, and telephone triage for acute illnesses or problems.
129.6 	(g) The commissioner shall adjust managed care and county-based purchasing plan 
129.7 	capitation rates to reflect savings from the coverage of this service.
129.8 	(h) Level II pediatric care coordination services are provided by registered nurses 
129.9 	employed by or under contract with a pediatric hospital that has been designated as 
129.10 	an essential community provider under section 62Q.19, subdivision 1, clause (4), and 
129.11 	has been a recipient of payments to support the training of residents from an approved 
129.12 	graduate medical residency program pursuant to United States Code, title 42, section 
129.13 	256e, and that meets the following criteria: 
129.14 	(1) the services must be provided through telehealth management and other methods, 
129.15 	be available on a regular schedule seven days per week, and be designed to provide 
129.16 	collaboration in patient care as provided by the patient's family, primary care providers, 
129.17 	and the hospital and specialized physicians;
129.18 	(2) for purposes of this paragraph, a child has a high-cost medical condition if the 
129.19 	child has a serious chronic physical disability caused by a congenital anomaly, birth 
129.20 	injury or traumatic injury, complications which can be expected to cause further injury, 
129.21 	hospitalization, or death, but that can be effectively addressed through ongoing family 
129.22 	and primary care supported by communication of ongoing care information and care 
129.23 	coordination; and 
129.24 	(3) for purposes of this paragraph, "care coordination" means the ready availability 
129.25 	of telehealth management services to support collaboration through a registered nurse 
129.26 	between a child's family, the primary care professional that is available to care for the 
129.27 	child, and appropriate professionals to address urgent questions about and minimize the 
129.28 	consequences of medical complications, develop medical management plans for complex 
129.29 	conditions, and avoid serious health consequences and hospitalizations to treat such 
129.30 	complications.

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

129.32 	Sec. 21. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 
129.33 	subdivision to read:
129.34 		Subd. 3q.Evidence-based childbirth program. (a) The commissioner shall 
129.35 	implement a program to reduce the number of elective inductions of labor prior to 39 
130.1 	weeks' gestation. In this subdivision, the term "elective induction of labor" means the 
130.2 	use of artificial means to stimulate labor in a woman without the presence of a medical 
130.3 	condition affecting the woman or the child that makes the onset of labor a medical 
130.4 	necessity. The program must promote the implementation of policies within hospitals 
130.5 	providing services to recipients of medical assistance or MinnesotaCare that prohibit the 
130.6 	use of elective inductions prior to 39 weeks' gestation, and adherence to such policies by 
130.7 	the attending providers.
130.8 	(b) For all births covered by medical assistance or MinnesotaCare on or after 
130.9 	January 1, 2012, a payment for professional services associated with the delivery of a 
130.10 	child in a hospital must not be made unless the provider has submitted information about 
130.11 	the nature of the labor and delivery including any induction of labor that was performed 
130.12 	in conjunction with that specific birth. The information must be on a form prescribed by 
130.13 	the commissioner.
130.14 	(c) The requirements in paragraph (b) must not apply to deliveries performed 
130.15 	at a hospital that has policies and processes in place that have been approved by the 
130.16 	commissioner which prohibit elective inductions prior to 39 weeks' gestation. A process 
130.17 	for review of hospital induction policies must be established by the commissioner and 
130.18 	review of policies must occur at the discretion of the commissioner. The commissioner's 
130.19 	decision to approve or rescind approval must include verification and review of items 
130.20 	including, but not limited to:
130.21 	(1) policies that prohibit use of elective inductions for gestation less than 39 weeks;
130.22 	(2) policies that encourage providers to document and communicate with patients a 
130.23 	final expected date of delivery by 20 weeks' gestation that includes data from ultrasound 
130.24 	measurements as applicable;
130.25 	(3) policies that encourage patient education regarding elective inductions, and 
130.26 	requires documentation of the processes used to educate patients;
130.27 	(4) ongoing quality improvement review as determined by the commissioner; and
130.28 	(5) any data that has been collected by the commissioner.
130.29 	(d) All hospitals must report annually to the commissioner induction information 
130.30 	for all births that were covered by medical assistance or MinnesotaCare in a format and 
130.31 	manner to be established by the commissioner.
130.32 	(e) The commissioner at any time may choose not to implement or may discontinue 
130.33 	any or all aspects of the program if the commissioner is able to determine that hospitals 
130.34 	representing at least 90 percent of births covered by medical assistance or MinnesotaCare 
130.35 	have approved policies in place.

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

131.1 	Sec. 22. Minnesota Statutes 2010, section 256B.0625, subdivision 8, is amended to 
131.2 	read:
131.3 		Subd. 8.Physical therapy. Medical assistance covers physical therapy and related 
131.4 	services, including specialized maintenance therapy. Authorization by the commissioner is 
131.5 	required to provide medically necessary services to a recipient beyond any of the following 
131.6 	onetime service thresholds, or a lower threshold where one has been established by the 
131.7 	commissioner for a specified service: (1) 80 units of any approved CPT code other than 
131.8 	modalities; (2) 20 modality sessions; and (3) three evaluations or reevaluations. Services 
131.9 	provided by a physical therapy assistant shall be reimbursed at the same rate as services 
131.10 	performed by a physical therapist when the services of the physical therapy assistant are 
131.11 	provided under the direction of a physical therapist who is on the premises.Authorization 
131.12 	determinations must be communicated within three working days. Services provided by 
131.13 	a physical therapy assistant that are provided under the direction of a physical therapist 
131.14 	who is not on the premises shall be reimbursed at 65 percent of the physical therapist rate.

131.15 	Sec. 23. Minnesota Statutes 2010, section 256B.0625, subdivision 8a, is amended to 
131.16 	read:
131.17 		Subd. 8a.Occupational therapy. Medical assistance covers occupational therapy 
131.18 	and related services, including specialized maintenance therapy. Authorization by the 
131.19 	commissioner is required to provide medically necessary services to a recipient beyond 
131.20 	any of the following onetime service thresholds, or a lower threshold where one has been 
131.21 	established by the commissioner for a specified service: (1) 120 units of any combination 
131.22 	of approved CPT codes; and (2) two evaluations or reevaluations. Services provided by an 
131.23 	occupational therapy assistant shall be reimbursed at the same rate as services performed 
131.24 	by an occupational therapist when the services of the occupational therapy assistant are 
131.25 	provided under the direction of the occupational therapist who is on the premises. Services 
131.26 	provided by an occupational therapy assistant that are provided under the direction of an 
131.27 	occupational therapist who is not on the premises shall be reimbursed at 65 percent of 
131.28 	the occupational therapist rate.

131.29 	Sec. 24. Minnesota Statutes 2010, section 256B.0625, subdivision 8e, is amended to 
131.30 	read:
131.31 		Subd. 8e.Chiropractic services. Payment for chiropractic services is limited to 
131.32 	one annual evaluation and 12 24 visits per year unless prior authorization of a greater 
131.33 	number of visits is obtained.

132.1 	Sec. 25. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 
132.2 	subdivision to read:
132.3 		Subd. 8f.Acupuncture services. Medical assistance covers acupuncture, as defined 
132.4 	in section 147B.01, subdivision 3, only when provided by a licensed acupuncturist or by 
132.5 	another Minnesota licensed practitioner for whom acupuncture is within the practitioner's 
132.6 	scope of practice and who has specific acupuncture training or credentialing.

132.7 	Sec. 26. Minnesota Statutes 2010, section 256B.0625, subdivision 13e, is amended to 
132.8 	read:
132.9 		Subd. 13e.Payment rates. (a) The basis for determining the amount of payment 
132.10 	shall be the lower of the actual acquisition costs of the drugs plus a fixed dispensing fee; 
132.11 	the maximum allowable cost set by the federal government or by the commissioner plus 
132.12 	the fixed dispensing fee; or the usual and customary price charged to the public. The 
132.13 	amount of payment basis must be reduced to reflect all discount amounts applied to the 
132.14 	charge by any provider/insurer agreement or contract for submitted charges to medical 
132.15 	assistance programs. The net submitted charge may not be greater than the patient liability 
132.16 	for the service. The pharmacy dispensing fee shall be $3.65, except that the dispensing fee 
132.17 	for intravenous solutions which must be compounded by the pharmacist shall be $8 per 
132.18 	bag, $14 per bag for cancer chemotherapy products, and $30 per bag for total parenteral 
132.19 	nutritional products dispensed in one liter quantities, or $44 per bag for total parenteral 
132.20 	nutritional products dispensed in quantities greater than one liter. Actual acquisition cost 
132.21 	includes quantity and other special discounts except time and cash discounts. Effective 
132.22 	July 1, 2009, The actual acquisition cost of a drug shall be estimated by the commissioner,
132.23 	at average wholesale price minus 15 percent. The actual acquisition cost of antihemophilic 
132.24 	factor drugs shall be estimated at the average wholesale price minus 30 percent. wholesale 
132.25 	acquisition cost plus four percent for independently owned pharmacies located in a 
132.26 	designated rural area within Minnesota, and at wholesale acquisition cost plus two percent 
132.27 	for all other pharmacies. A pharmacy is "independently owned" if it is one of four or 
132.28 	fewer pharmacies under the same ownership nationally. A "designated rural area" means 
132.29 	an area defined as a small rural area or isolated rural area according to the four-category 
132.30 	classification of the Rural Urban Commuting Area system developed for the United States 
132.31 	Health Resources and Services Administration. Wholesale acquisition cost is defined as 
132.32 	the manufacturer's list price for a drug or biological to wholesalers or direct purchasers 
132.33 	in the United States, not including prompt pay or other discounts, rebates, or reductions 
132.34 	in price, for the most recent month for which information is available, as reported in 
132.35 	wholesale price guides or other publications of drug or biological pricing data. The 
133.1 	maximum allowable cost of a multisource drug may be set by the commissioner and it 
133.2 	shall be comparable to, but no higher than, the maximum amount paid by other third-party 
133.3 	payors in this state who have maximum allowable cost programs. Establishment of the 
133.4 	amount of payment for drugs shall not be subject to the requirements of the Administrative 
133.5 	Procedure Act.
133.6 	(b) An additional dispensing fee of $.30 may be added to the dispensing fee paid 
133.7 	to pharmacists for legend drug prescriptions dispensed to residents of long-term care 
133.8 	facilities when a unit dose blister card system, approved by the department, is used. Under 
133.9 	this type of dispensing system, the pharmacist must dispense a 30-day supply of drug. 
133.10 	The National Drug Code (NDC) from the drug container used to fill the blister card must 
133.11 	be identified on the claim to the department. The unit dose blister card containing the 
133.12 	drug must meet the packaging standards set forth in Minnesota Rules, part 6800.2700, 
133.13 	that govern the return of unused drugs to the pharmacy for reuse. The pharmacy provider 
133.14 	will be required to credit the department for the actual acquisition cost of all unused 
133.15 	drugs that are eligible for reuse. Over-the-counter medications must be dispensed in the 
133.16 	manufacturer's unopened package. The commissioner may permit the drug clozapine to be 
133.17 	dispensed in a quantity that is less than a 30-day supply.
133.18 	(c) Whenever a maximum allowable cost has been set for a multisource drug, 
133.19 	payment shall be on the basis of the maximum allowable cost established by the 
133.20 	commissioner unless prior authorization for the brand name product has been granted 
133.21 	according to the criteria established by the Drug Formulary Committee as required by 
133.22 	subdivision 13f, paragraph (a), and the prescriber has indicated "dispense as written" on 
133.23 	the prescription in a manner consistent with section 151.21, subdivision 2.
133.24 	(d) The basis for determining the amount of payment for drugs administered in an 
133.25 	outpatient setting shall be the lower of the usual and customary cost submitted by the 
133.26 	provider or the amount established for Medicare by the106 percent of the average sales 
133.27 	price as determined by the United States Department of Health and Human Services 
133.28 	pursuant to title XVIII, section 1847a of the federal Social Security Act. If average sales 
133.29 	price is unavailable, the amount of payment must be lower of the usual and customary cost 
133.30 	submitted by the provider or the wholesale acquisition cost.
133.31 	(e) The commissioner may negotiate lower reimbursement rates for specialty 
133.32 	pharmacy products than the rates specified in paragraph (a). The commissioner may 
133.33 	require individuals enrolled in the health care programs administered by the department 
133.34 	to obtain specialty pharmacy products from providers with whom the commissioner has 
133.35 	negotiated lower reimbursement rates. Specialty pharmacy products are defined as those 
133.36 	used by a small number of recipients or recipients with complex and chronic diseases 
134.1 	that require expensive and challenging drug regimens. Examples of these conditions 
134.2 	include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis 
134.3 	C, growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms 
134.4 	of cancer. Specialty pharmaceutical products include injectable and infusion therapies, 
134.5 	biotechnology drugs, antihemophilic factor products, high-cost therapies, and therapies 
134.6 	that require complex care. The commissioner shall consult with the formulary committee 
134.7 	to develop a list of specialty pharmacy products subject to this paragraph. In consulting 
134.8 	with the formulary committee in developing this list, the commissioner shall take into 
134.9 	consideration the population served by specialty pharmacy products, the current delivery 
134.10 	system and standard of care in the state, and access to care issues. The commissioner shall 
134.11 	have the discretion to adjust the reimbursement rate to prevent access to care issues.
134.12 	(f) Home infusion therapy services provided by home infusion therapy pharmacies 
134.13 	must be paid at rates according to subdivision 8d.

134.14 	EFFECTIVE DATE. This section is effective July 1, 2011, or upon federal 
134.15 	approval, whichever is later.

134.16 	Sec. 27. Minnesota Statutes 2010, section 256B.0625, subdivision 13h, is amended to 
134.17 	read:
134.18 		Subd. 13h.Medication therapy management services. (a) Medical assistance 
134.19 	and general assistance medical care cover medication therapy management services for 
134.20 	a recipient taking four three or more prescriptions to treat or prevent two one or more 
134.21 	chronic medical conditions, or; a recipient with a drug therapy problem that is identified
134.22 	by the commissioner or identified by a pharmacist and approved by the commissioner; or 
134.23 	prior authorized by the commissioner that has resulted or is likely to result in significant 
134.24 	nondrug program costs. The commissioner may cover medical therapy management 
134.25 	services under MinnesotaCare if the commissioner determines this is cost-effective. For 
134.26 	purposes of this subdivision, "medication therapy management" means the provision 
134.27 	of the following pharmaceutical care services by a licensed pharmacist to optimize the 
134.28 	therapeutic outcomes of the patient's medications:
134.29 	(1) performing or obtaining necessary assessments of the patient's health status;
134.30 	(2) formulating a medication treatment plan;
134.31 	(3) monitoring and evaluating the patient's response to therapy, including safety 
134.32 	and effectiveness;
134.33 	(4) performing a comprehensive medication review to identify, resolve, and prevent 
134.34 	medication-related problems, including adverse drug events;
135.1 	(5) documenting the care delivered and communicating essential information to 
135.2 	the patient's other primary care providers;
135.3 	(6) providing verbal education and training designed to enhance patient 
135.4 	understanding and appropriate use of the patient's medications;
135.5 	(7) providing information, support services, and resources designed to enhance 
135.6 	patient adherence with the patient's therapeutic regimens; and
135.7 	(8) coordinating and integrating medication therapy management services within the 
135.8 	broader health care management services being provided to the patient.
135.9 	Nothing in this subdivision shall be construed to expand or modify the scope of practice of 
135.10 	the pharmacist as defined in section 151.01, subdivision 27.
135.11 	(b) To be eligible for reimbursement for services under this subdivision, a pharmacist 
135.12 	must meet the following requirements:
135.13 	(1) have a valid license issued under chapter 151;
135.14 	(2) have graduated from an accredited college of pharmacy on or after May 1996, or 
135.15 	completed a structured and comprehensive education program approved by the Board of 
135.16 	Pharmacy and the American Council of Pharmaceutical Education for the provision and 
135.17 	documentation of pharmaceutical care management services that has both clinical and 
135.18 	didactic elements;
135.19 	(3) be practicing in an ambulatory care setting as part of a multidisciplinary team or 
135.20 	have developed a structured patient care process that is offered in a private or semiprivate 
135.21 	patient care area that is separate from the commercial business that also occurs in the 
135.22 	setting, or in home settings, excluding including long-term care and settings, group homes, 
135.23 	if the service is ordered by the provider-directed care coordination team and facilities 
135.24 	providing assisted living services; and
135.25 	(4) make use of an electronic patient record system that meets state standards.
135.26 	(c) For purposes of reimbursement for medication therapy management services, 
135.27 	the commissioner may enroll individual pharmacists as medical assistance and general 
135.28 	assistance medical care providers. The commissioner may also establish contact 
135.29 	requirements between the pharmacist and recipient, including limiting the number of 
135.30 	reimbursable consultations per recipient.
135.31 	(d) If there are no pharmacists who meet the requirements of paragraph (b) practicing 
135.32 	within a reasonable geographic distance of the patient, a pharmacist who meets the 
135.33 	requirements may provide the services via two-way interactive video. Reimbursement 
135.34 	shall be at the same rates and under the same conditions that would otherwise apply to 
135.35 	the services provided. To qualify for reimbursement under this paragraph, the pharmacist 
135.36 	providing the services must meet the requirements of paragraph (b), and must be located 
136.1 	within an ambulatory care setting approved by the commissioner. The patient must also 
136.2 	be located within an ambulatory care setting approved by the commissioner. Services 
136.3 	provided under this paragraph may not be transmitted into the patient's residence.
136.4 	(e) The commissioner shall establish a pilot project for an intensive medication 
136.5 	therapy management program for patients identified by the commissioner with multiple 
136.6 	chronic conditions and a high number of medications who are at high risk of preventable 
136.7 	hospitalizations, emergency room use, medication complications, and suboptimal 
136.8 	treatment outcomes due to medication-related problems. For purposes of the pilot 
136.9 	project, medication therapy management services may be provided in a patient's home 
136.10 	or community setting, in addition to other authorized settings. The commissioner may 
136.11 	waive existing payment policies and establish special payment rates for the pilot project. 
136.12 	The pilot project must be designed to produce a net savings to the state compared to the 
136.13 	estimated costs that would otherwise be incurred for similar patients without the program. 
136.14 	The pilot project must begin by January 1, 2010, and end June 30, 2012.

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

136.16 	Sec. 28. Minnesota Statutes 2010, section 256B.0625, subdivision 17, is amended to 
136.17 	read:
136.18 		Subd. 17.Transportation costs. (a) Medical assistance covers medical 
136.19 	transportation costs incurred solely for obtaining emergency medical care or transportation 
136.20 	costs incurred by eligible persons in obtaining emergency or nonemergency medical 
136.21 	care when paid directly to an ambulance company, common carrier, or other recognized 
136.22 	providers of transportation services. Medical transportation must be provided by:
136.23 	(1) an ambulance, as defined in section 144E.001, subdivision 2;
136.24 	(2) special transportation; or
136.25 	(3) common carrier including, but not limited to, bus, taxicab, other commercial 
136.26 	carrier, or private automobile.
136.27 	(b) Medical assistance covers special transportation, as defined in Minnesota Rules, 
136.28 	part 9505.0315, subpart 1, item F, if the recipient has a physical or mental impairment that 
136.29 	would prohibit the recipient from safely accessing and using a bus, taxi, other commercial 
136.30 	transportation, or private automobile.
136.31 	The commissioner may use an order by the recipient's attending physician to certify that 
136.32 	the recipient requires special transportation services. Special transportation providers shall 
136.33 	perform driver-assisted services for eligible individuals. Driver-assisted service includes 
136.34 	passenger pickup at and return to the individual's residence or place of business, assistance 
137.1 	with admittance of the individual to the medical facility, and assistance in passenger 
137.2 	securement or in securing of wheelchairs or stretchers in the vehicle. Special transportation 
137.3 	providers must obtain written documentation from the health care service provider who 
137.4 	is serving the recipient being transported, identifying the time that the recipient arrived. 
137.5 	Special transportation providers may not bill for separate base rates for the continuation of 
137.6 	a trip beyond the original destination. Special transportation providers must take recipients 
137.7 	to the nearest appropriate health care provider, using the most direct route. The minimum 
137.8 	medical assistance reimbursement rates for special transportation services are:
137.9 	(1) (i) $17 for the base rate and $1.35 per mile for special transportation services to 
137.10 	eligible persons who need a wheelchair-accessible van;
137.11 	(ii) $11.50 for the base rate and $1.30 per mile for special transportation services to 
137.12 	eligible persons who do not need a wheelchair-accessible van; and
137.13 	(iii) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, for 
137.14 	special transportation services to eligible persons who need a stretcher-accessible vehicle;
137.15 	(2) the base rates for special transportation services in areas defined under RUCA 
137.16 	to be super rural shall be equal to the reimbursement rate established in clause (1) plus 
137.17 	11.3 percent; and
137.18 	(3) for special transportation services in areas defined under RUCA to be rural 
137.19 	or super rural areas:
137.20 	(i) for a trip equal to 17 miles or less, mileage reimbursement shall be equal to 125 
137.21 	percent of the respective mileage rate in clause (1); and
137.22 	(ii) for a trip between 18 and 50 miles, mileage reimbursement shall be equal to 
137.23 	112.5 percent of the respective mileage rate in clause (1).
137.24 	(c) For purposes of reimbursement rates for special transportation services under 
137.25 	paragraph (b), the zip code of the recipient's place of residence shall determine whether 
137.26 	the urban, rural, or super rural reimbursement rate applies.
137.27 	(d) For purposes of this subdivision, "rural urban commuting area" or "RUCA" 
137.28 	means a census-tract based classification system under which a geographical area is 
137.29 	determined to be urban, rural, or super rural.
137.30 	(e) Effective for services provided on or after July 1, 2011, nonemergency 
137.31 	transportation rates, including special transportation, taxi, and other commercial carriers, 
137.32 	are reduced 4.5 percent. Payments made to managed care plans and county-based 
137.33 	purchasing plans must be reduced for services provided on or after January 1, 2012, 
137.34 	to reflect this reduction.

138.1 	Sec. 29. Minnesota Statutes 2010, section 256B.0625, subdivision 17a, is amended to 
138.2 	read:
138.3 		Subd. 17a.Payment for ambulance services. (a) Medical assistance covers 
138.4 	ambulance services. Providers shall bill ambulance services according to Medicare 
138.5 	criteria. Nonemergency ambulance services shall not be paid as emergencies. Effective 
138.6 	for services rendered on or after July 1, 2001, medical assistance payments for ambulance 
138.7 	services shall be paid at the Medicare reimbursement rate or at the medical assistance 
138.8 	payment rate in effect on July 1, 2000, whichever is greater.
138.9 	(b) Effective for services provided on or after July 1, 2011, ambulance services 
138.10 	payment rates are reduced 4.5 percent. Payments made to managed care plans and 
138.11 	county-based purchasing plans must be reduced for services provided on or after January 
138.12 	1, 2012, to reflect this reduction.

138.13 	Sec. 30. Minnesota Statutes 2010, section 256B.0625, subdivision 18, is amended to 
138.14 	read:
138.15 		Subd. 18.Bus or taxicab transportation. To the extent authorized by rule of the 
138.16 	state agency, medical assistance covers costs of the most appropriate and cost-effective 
138.17 	form of transportation incurred by any ambulatory eligible person for obtaining 
138.18 	nonemergency medical care.

138.19 	Sec. 31. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 
138.20 	subdivision to read:
138.21 		Subd. 25b.Authorization with third-party liability. (a) Except as otherwise 
138.22 	allowed under this subdivision or required under federal or state regulations, the 
138.23 	commissioner must not consider a request for authorization of a service when the recipient 
138.24 	has coverage from a third-party payer unless the provider requesting authorization has 
138.25 	made a good faith effort to receive payment or authorization from the third-party payer. 
138.26 	A good faith effort is established by supplying with the authorization request to the 
138.27 	commissioner the following:
138.28 	(1) a determination of payment for the service from the third-party payer, a 
138.29 	determination of authorization for the service from the third-party payer, or a verification 
138.30 	of noncoverage of the service by the third-party payer; and
138.31 	(2) the information or records required by the department to document the reason for 
138.32 	the determination or to validate noncoverage from the third-party payer.
138.33 	(b) A provider requesting authorization for services covered by Medicare is not 
138.34 	required to bill Medicare before requesting authorization from the commissioner if the 
139.1 	provider has reason to believe that a service covered by Medicare is not eligible for 
139.2 	payment. The provider must document that, because of recent claim experiences with 
139.3 	Medicare or because of written communication from Medicare, coverage is not available 
139.4 	for the service.
139.5 	(c) Authorization is not required if a third-party payer has made payment that is 
139.6 	equal to or greater than 60 percent of the maximum payment amount for the service 
139.7 	allowed under medical assistance.

139.8 	Sec. 32. Minnesota Statutes 2010, section 256B.0625, subdivision 31a, is amended to 
139.9 	read:
139.10 		Subd. 31a.Augmentative and alternative communication systems. (a) Medical 
139.11 	assistance covers augmentative and alternative communication systems consisting of 
139.12 	electronic or nonelectronic devices and the related components necessary to enable a 
139.13 	person with severe expressive communication limitations to produce or transmit messages 
139.14 	or symbols in a manner that compensates for that disability.
139.15 	(b) Until the volume of systems purchased increases to allow a discount price, the 
139.16 	commissioner shall reimburse augmentative and alternative communication manufacturers 
139.17 	and vendors at the manufacturer's suggested retail price for augmentative and alternative 
139.18 	communication systems and related components. The commissioner shall separately 
139.19 	reimburse providers for purchasing and integrating individual communication systems 
139.20 	which are unavailable as a package from an augmentative and alternative communication 
139.21 	vendor. Augmentative and alternative communication systems must be paid the lower 
139.22 	of the: 
139.23 	(1) submitted charge; or
139.24 	(2)(i) manufacturer's suggested retail price minus 20 percent for providers that are 
139.25 	manufacturers of augmentative and alternative communication systems; or
139.26 	(ii) manufacturer's invoice charge plus 20 percent for providers that are not 
139.27 	manufacturers of augmentative and alternative communication systems.
139.28 	(c) Reimbursement rates established by this purchasing program are not subject to 
139.29 	Minnesota Rules, part 9505.0445, item S or T.

139.30 	Sec. 33. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 
139.31 	subdivision to read:
139.32 		Subd. 55.Payment for multiple services provided on same day. The 
139.33 	commissioner shall not prohibit payment, including any supplemental payments, for 
139.34 	mental health services or dental services provided to a patient by a clinic or health care 
140.1 	professional solely because the mental health services or dental services were provided on 
140.2 	the same day as other covered health care services furnished by the same provider.

140.3 	Sec. 34. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 
140.4 	subdivision to read:
140.5 		Subd. 56.Medical care coordination. (a) Medical assistance covers in-reach 
140.6 	community-based care coordination that is performed in a hospital emergency department 
140.7 	as an eligible procedure under a state health care program or private insurance for a 
140.8 	frequent user. A frequent user is defined as an individual who has frequented the hospital 
140.9 	emergency department for services three or more times in the previous four consecutive 
140.10 	months. In-reach community-based care coordination includes navigating services to 
140.11 	address a client's mental health, chemical health, social, economic, and housing needs, 
140.12 	or any other activity targeted at reducing the incidence of emergency room and other 
140.13 	nonmedically necessary health care utilization.
140.14 	(b) Reimbursement must be made in 15-minute increments under current Medicaid 
140.15 	mental health social work reimbursement methodology and allowed for up to 60 days 
140.16 	posthospital discharge based upon the specific identified emergency department visit or 
140.17 	inpatient admitting event. A frequent user who is participating in care coordination within 
140.18 	a health care home framework is ineligible for reimbursement under this subdivision. 
140.19 	Eligible in-reach care coordinators must hold a minimum of a bachelor's degree in social 
140.20 	work, public health, corrections, or related field. The commissioner shall submit any 
140.21 	necessary application for waivers to the Centers for Medicare and Medicaid Services to 
140.22 	implement this subdivision.
140.23 	(c) For the purposes of this subdivision, "in-reach community-based care 
140.24 	coordination" means the practice of a community-based worker with training, knowledge, 
140.25 	skills, and ability to access a continuum of services, including housing, transportation, 
140.26 	chemical and mental health treatment, employment, and peer support services, by working 
140.27 	with an organization's staff to transition an individual back into the individual's living 
140.28 	environment. In-reach community-based care coordination includes working with the 
140.29 	individual during their discharge and for up to a defined amount of time in the individual's 
140.30 	living environment, reducing the individual's need for readmittance.

140.31 	Sec. 35. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 
140.32 	subdivision to read:
140.33 		Subd. 57.Payment for Part B Medicare crossover claims. Effective for services 
140.34 	provided on or after January 1, 2012, medical assistance payment for an enrollee's cost 
141.1 	sharing associated with Medicare Part B is limited to an amount up to the medical 
141.2 	assistance total allowed, when the medical assistance rate exceeds the amount paid by 
141.3 	Medicare.

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

141.5 	Sec. 36. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 
141.6 	subdivision to read:
141.7 		Subd. 58.Early and periodic screening, diagnosis, and treatment services.
 141.8 	Medical assistance covers early and periodic screening, diagnosis, and treatment services 
141.9 	(EPSDT). The payment amount for a complete EPSDT screening shall not exceed the rate 
141.10 	established per Minnesota Rules, part 9505.0445, item M, effective October 1, 2010.

141.11 	Sec. 37. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 
141.12 	subdivision to read:
141.13 		Subd. 59.Services provided by advanced dental therapists and dental 
141.14 	therapists. Medical assistance covers services provided by advanced dental therapists 
141.15 	and dental therapists when provided within the scope of practice identified in sections 
141.16 	150A.105 and 150A.106.

141.17 	Sec. 38. Minnesota Statutes 2010, section 256B.0631, subdivision 1, is amended to 
141.18 	read:
141.19 		Subdivision 1.Co-payments Cost-sharing. (a) Except as provided in subdivision 
141.20 	2, the medical assistance benefit plan shall include the following co-payments cost-sharing
141.21 	for all recipients, effective for services provided on or after October 1, 2003, and before 
141.22 	January 1, 2009 July 1, 2011:
141.23 	(1) $3 per nonpreventive visit, except as provided in paragraph (c). For purposes 
141.24 	of this subdivision, a visit means an episode of service which is required because of 
141.25 	a recipient's symptoms, diagnosis, or established illness, and which is delivered in an 
141.26 	ambulatory setting by a physician or physician ancillary, chiropractor, podiatrist, nurse 
141.27 	midwife, advanced practice nurse, audiologist, optician, or optometrist;
141.28 	(2) $3 for eyeglasses;
141.29 	(3) $6 $3.50 for nonemergency visits to a hospital-based emergency room, except 
141.30 	that this co-payment shall be increased to $20 upon federal approval; and
141.31 	(4) $3 per brand-name drug prescription and $1 per generic drug prescription, 
141.32 	subject to a $12 per month maximum for prescription drug co-payments. No co-payments 
141.33 	shall apply to antipsychotic drugs when used for the treatment of mental illness.;
142.1 	(5) a family deductible equal to the maximum amount allowed under Code of 
142.2 	Federal Regulations, title 42, part 447.54; and
142.3 	(b) Except as provided in subdivision 2, the medical assistance benefit plan shall 
142.4 	include the following co-payments for all recipients, effective for services provided on 
142.5 	or after January 1, 2009:
142.6 	(1) $3.50 for nonemergency visits to a hospital-based emergency room;
142.7 	(2) $3 per brand-name drug prescription and $1 per generic drug prescription, 
142.8 	subject to a $7 per month maximum for prescription drug co-payments. No co-payments 
142.9 	shall apply to antipsychotic drugs when used for the treatment of mental illness; and
142.10 	(3) (6) for individuals identified by the commissioner with income at or below 100 
142.11 	percent of the federal poverty guidelines, total monthly co-payments cost-sharing must 
142.12 	not exceed five percent of family income. For purposes of this paragraph, family income 
142.13 	is the total earned and unearned income of the individual and the individual's spouse, if 
142.14 	the spouse is enrolled in medical assistance and also subject to the five percent limit on 
142.15 	co-payments cost-sharing.
142.16 	(c) (b) Recipients of medical assistance are responsible for all co-payments  and 
142.17 	deductibles in this subdivision.
142.18 	(c) Effective January 1, 2012, or upon federal approval, whichever is later, the 
142.19 	following co-payments for nonpreventive visits shall apply to providers included in 
142.20 	provider peer grouping:
142.21 	(1) $3 for visits to providers whose average, risk-adjusted, total annual cost of 
142.22 	care per medical assistance enrollee is at the 60th percentile or lower for providers of 
142.23 	the same type;
142.24 	(2) $6 for visits to providers whose average, risk-adjusted, total annual cost of care 
142.25 	per medical assistance enrollee is greater than the 60th percentile but does not exceed the 
142.26 	80th percentile for providers of the same type; and
142.27 	(3) $10 for visits to providers whose average, risk-adjusted, total annual cost of 
142.28 	care per medical assistance enrollee is greater than the 80th percentile for providers of 
142.29 	the same type.
142.30 	Each managed care and county-based purchasing plan shall calculate the average, 
142.31 	risk-adjusted, total annual cost of care for providers under this paragraph using a 
142.32 	methodology approved by the commissioner. The commissioner shall develop a 
142.33 	methodology for calculating the average, risk-adjusted, total annual cost of care for 
142.34 	fee-for-service providers.
143.1 	(d) The commissioner shall seek any federal waivers and approvals necessary to 
143.2 	increase the co-payment for nonemergency visits to a hospital-based emergency room 
143.3 	under paragraph (a), clause (3), and to implement paragraph (c).

143.4 	Sec. 39. Minnesota Statutes 2010, section 256B.0631, subdivision 2, is amended to 
143.5 	read:
143.6 		Subd. 2.Exceptions. Co-payments and deductibles shall be subject to the following 
143.7 	exceptions:
143.8 	(1) children under the age of 21;
143.9 	(2) pregnant women for services that relate to the pregnancy or any other medical 
143.10 	condition that may complicate the pregnancy;
143.11 	(3) recipients expected to reside for at least 30 days in a hospital, nursing home, or 
143.12 	intermediate care facility for the developmentally disabled;
143.13 	(4) recipients receiving hospice care;
143.14 	(5) 100 percent federally funded services provided by an Indian health service;
143.15 	(6) emergency services;
143.16 	(7) family planning services;
143.17 	(8) services that are paid by Medicare, resulting in the medical assistance program 
143.18 	paying for the coinsurance and deductible; and
143.19 	(9) co-payments that exceed one per day per provider for nonpreventive visits, 
143.20 	eyeglasses, and nonemergency visits to a hospital-based emergency room.

143.21 	Sec. 40. Minnesota Statutes 2010, section 256B.0631, subdivision 3, is amended to 
143.22 	read:
143.23 		Subd. 3.Collection. (a) The medical assistance reimbursement to the provider shall 
143.24 	be reduced by the amount of the co-payment or deductible, except that reimbursements 
143.25 	shall not be reduced:
143.26 	(1) once a recipient has reached the $12 per month maximum or the $7 per month 
143.27 	maximum effective January 1, 2009, for prescription drug co-payments; or
143.28 	(2) for a recipient identified by the commissioner under 100 percent of the federal 
143.29 	poverty guidelines who has met their monthly five percent co-payment cost-sharing limit.
143.30 	(b) The provider collects the co-payment or deductible from the recipient. Providers 
143.31 	may not deny services to recipients who are unable to pay the co-payment or deductible.
143.32 	(c) Medical assistance reimbursement to fee-for-service providers and payments to 
143.33 	managed care plans shall not be increased as a result of the removal of co-payments or 
143.34 	deductibles effective on or after January 1, 2009.

144.1 	Sec. 41. Minnesota Statutes 2010, section 256B.0751, subdivision 1, is amended to 
144.2 	read:
144.3 		Subdivision 1.Definitions. (a) For purposes of sections 256B.0751 to 256B.0753, 
144.4 	the following definitions apply.
144.5 	(b) "Commissioner" means the commissioner of human services.
144.6 	(c) "Commissioners" means the commissioner of humans services and the 
144.7 	commissioner of health, acting jointly.
144.8 	(d) "Health plan company" has the meaning provided in section 62Q.01, subdivision 
144.9 	4.
144.10 	(e) "Personal clinician" means a physician licensed under chapter 147, a physician 
144.11 	assistant licensed and practicing under chapter 147A, ora mental health professional 
144.12 	licensed under section 245.462, subdivision 18, clauses (1) to (6); or 245.4871, subdivision 
144.13 	27, clauses (1) to (6), an advanced practice nurse licensed and registered to practice 
144.14 	under chapter 148, or a chiropractor working in cooperation with a physician, physician 
144.15 	assistant, or advanced practice nurse.
144.16 	(f) "State health care program" means the medical assistance, MinnesotaCare, and 
144.17 	general assistance medical care programs.

144.18 	Sec. 42. Minnesota Statutes 2010, section 256B.0751, subdivision 2, is amended to 
144.19 	read:
144.20 		Subd. 2.Development and implementation of standards. (a) By July 1, 2009, 
144.21 	the commissioners of health and human services shall develop and implement standards 
144.22 	of certification for health care homes for state health care programs. In developing these 
144.23 	standards, the commissioners shall consider existing standards developed by national 
144.24 	independent accrediting and medical home organizations. The standards developed by the 
144.25 	commissioners must meet the following criteria:
144.26 	(1) emphasize, enhance, and encourage the use of primary care, and include 
144.27 	the use of primary care physicians, advanced practice nurses, andmental health 
144.28 	professionals, physician assistants, and chiropractors as personal clinicians but permitting 
144.29 	multidisciplinary teams of other health professionals;
144.30 	(2) focus on delivering high-quality, efficient, and effective health care services
144.31 	and providing, arranging, or coordinating related social and public health services and 
144.32 	other services that directly affect an individual's health, access to services, quality and 
144.33 	outcomes, and patient satisfaction;
144.34 	(3) encourage patient-centered care and services, including active participation by 
144.35 	the patient and family or a legal guardian, or a health care agent as defined in chapter 
145.1 	145C, as appropriate in decision making and care plan development, and providing care 
145.2 	that is appropriate to the patient's race, ethnicity, and language;
145.3 	(4) provide patients with a consistent, ongoing contact with a personal clinician or 
145.4 	team of clinical professionals to ensure continuous and appropriate care for the patient's 
145.5 	condition;
145.6 	(5) ensure that health care homes develop and maintain appropriate comprehensive 
145.7 	care and wellness plans for their patients with complex or chronic conditions, including an 
145.8 	assessment of health risks and, chronic conditions, and socioeconomic factors affecting 
145.9 	health and treatment;
145.10 	(6) enable and encourage utilization of a range of qualified health care professionals
145.11 	and other professionals or services related to the health and treatment of the patient, 
145.12 	including dedicated care coordinators, in a manner that enables providers to practice to 
145.13 	the fullest extent of their license;
145.14 	(7) focus initially on patients who have or are at risk of developing chronic health 
145.15 	conditions;
145.16 	(8) incorporate measures of quality, resource use, cost of care, and patient 
145.17 	experience, with appropriate adjustments for socioeconomic factors;
145.18 	(9) ensure the use of health information technology and systematic follow-up, 
145.19 	including the use of patient registries; and
145.20 	(10) encourage the use of scientifically based health care, patient decision-making 
145.21 	aids that provide patients with information about treatment and service options and their 
145.22 	associated benefits, risks, costs, and comparative outcomes, and other clinical decision 
145.23 	support tools.
145.24 	(b) In developing these standards, the commissioners shall consult with national 
145.25 	and local organizations working on health care home models, physicians, relevant 
145.26 	state agencies, health plan companies, hospitals, other providers, patients, and patient 
145.27 	advocates. The commissioners may satisfy this requirement by continuing the provider 
145.28 	directed care coordination advisory committee.
145.29 	(c) For the purposes of developing and implementing these standards, the 
145.30 	commissioners may use the expedited rulemaking process under section 14.389.

145.31 	Sec. 43. Minnesota Statutes 2010, section 256B.0751, subdivision 3, is amended to 
145.32 	read:
145.33 		Subd. 3.Requirements for clinicians certified as health care homes. (a) A 
145.34 	personal clinician or, a primary care clinic, or community mental health center eligible for 
145.35 	payment under section 256B.0625, subdivision 5, may be certified as a health care home. 
146.1 	If a primary care clinic or mental health center is certified, all of the primary care clinic's 
146.2 	or mental health center's clinicians who may provide care to persons enrolled with the 
146.3 	health care home must meet the criteria of a health care home. In order to be certified as 
146.4 	a health care home, a clinician or, clinic, or community mental health center must meet 
146.5 	the standards set by the commissioners in accordance with this section. Certification as 
146.6 	a health care home is voluntary. In order to maintain their status as health care homes, 
146.7 	clinicians or clinics must renew their certification annually.
146.8 	(b) Clinicians or, clinics, or mental health centers certified as health care homes must 
146.9 	offer their health care home services to all their patients with complex or chronic health 
146.10 	conditions who are interested in participation.
146.11 	(c) Health care homes must participate in the health care home collaborative 
146.12 	established under subdivision 5.

146.13 	Sec. 44. Minnesota Statutes 2010, section 256B.0751, subdivision 4, is amended to 
146.14 	read:
146.15 		Subd. 4.Alternative models and waivers of requirements. (a) Nothing in this 
146.16 	section shall preclude the continued development of existing medical or health care 
146.17 	home projects currently operating or under development by the commissioner of human 
146.18 	services or preclude the commissioner from establishing alternative models and payment 
146.19 	mechanisms for persons who are enrolled in integrated Medicare and Medicaid programs 
146.20 	under section 256B.69, subdivisions 23 and 28, are enrolled in managed care long-term 
146.21 	care programs under section 256B.69, subdivision 6b, are dually eligible for Medicare and 
146.22 	medical assistance, are in the waiting period for Medicare, or who have other primary 
146.23 	coverage.
146.24 	(b) The commissioner of health shall modify the health care homes application for 
146.25 	certification to add an item allowing an applicant to indicate status as a federally qualified 
146.26 	health center or a federally qualified health center look-alike, as defined in section 
146.27 	145.9269, subdivision 1. The commissioner shall certify as a health care home each 
146.28 	applicant that indicates this status on a completed application for certification, without 
146.29 	requiring the applicant to meet the standards in Minnesota Rules, part 4764.0040. In order 
146.30 	to retain certification, a federally qualified health center or federally qualified health center 
146.31 	look-alike certified under this paragraph must seek annual recertification by submitting a 
146.32 	letter of intent stating its desire to be recertified but is not required to meet the standards 
146.33 	for recertification in Minnesota Rules, part 4764.0040.
146.34 	(c) The commissioner of health shall waive health care home certification 
146.35 	requirements if an applicant demonstrates that compliance with a certification requirement 
147.1 	will create a major financial hardship or is not feasible, and the applicant establishes an 
147.2 	alternative way to accomplish the objectives of the certification requirement.

147.3 	Sec. 45. Minnesota Statutes 2010, section 256B.0751, is amended by adding a 
147.4 	subdivision to read:
147.5 		Subd. 8.Coordination with local services. The health care home and the county 
147.6 	shall coordinate care and services provided to patients enrolled with a health care home 
147.7 	who have complex medical or socioeconomic needs or a disability, and who need and are 
147.8 	eligible for additional local services administered by counties, including but not limited 
147.9 	to waivered services, mental health services, social services, public health services, 
147.10 	transportation, and  housing.  The coordination of care and services must be as provided in 
147.11 	the plan established by the patient and health care home.

147.12 	Sec. 46. Minnesota Statutes 2010, section 256B.0751, is amended by adding a 
147.13 	subdivision to read:
147.14 		Subd. 9.Patient choice of health care home. Notwithstanding section 256B.69, 
147.15 	subdivisions 4 and 23, and subject to any necessary federal approval, the commissioner 
147.16 	may require a patient enrolled in a state health care program through a managed care 
147.17 	plan, county-based purchasing plan, fee-for-service, or demonstration project under 
147.18 	section 256B.0755 to select a health care home and agree to receive primary care and 
147.19 	care coordination services through the health care home as a condition of enrollment in 
147.20 	the state health care program.  The patient must be allowed to choose from among all 
147.21 	available qualified health care providers, including an essential community provider as 
147.22 	defined in section  62Q.19,  if the provider is certified as a health care home and agrees to 
147.23 	accept the terms, conditions, and payment rates for participation in the managed care plan, 
147.24 	county-based purchasing plan, fee-for-service program, or demonstration project, except 
147.25 	that reimbursement to federally qualified health centers and federally qualified health 
147.26 	center look-alikes as defined in section 145.9269 must comply with federal law. 

147.27 	Sec. 47. Minnesota Statutes 2010, section 256B.0751, is amended by adding a 
147.28 	subdivision to read:
147.29 		Subd. 10.Engagement of patients and communities in health care home. The 
147.30 	commissioner of health shall require health care homes to demonstrate that their health 
147.31 	care home patients, and the racial and ethnic communities of current or potential patients, 
147.32 	participate in evaluating the health care home and recommending improvements and 
147.33 	changes to the health care home's methods and procedures in order to improve health, 
148.1 	quality, and patient satisfaction for patients from those communities. The commissioner 
148.2 	shall consult with racial and ethnic communities to determine whether the requirements of 
148.3 	this section and rules adopted under it are barriers to effective health care home methods 
148.4 	and procedures for serving patients of racial and ethnic communities.

148.5 	Sec. 48. Minnesota Statutes 2010, section 256B.0753, is amended by adding a 
148.6 	subdivision to read:
148.7 		Subd. 4.Waiver recipients. A health care home shall receive the highest care 
148.8 	coordination payment established under section 256B.0753 for providing services to an 
148.9 	enrollee receiving home and community-based waiver services.

148.10 	Sec. 49. Minnesota Statutes 2010, section 256B.0754, is amended by adding a 
148.11 	subdivision to read:
148.12 		Subd. 3.Primary care provider tiering. (a) The commissioner shall establish 
148.13 	a tiering system for all providers participating in Minnesota health care programs. 
148.14 	The tiering system must differentiate providers on the basis of their ability to provide 
148.15 	cost-effective, quality care and must incorporate the provider peer grouping measures 
148.16 	established under section 62U.04. The tier assignments must be established annually based 
148.17 	on the most recent peer grouping measures available. Differentiation of tier assignments 
148.18 	must be statistically valid. The commissioner may set specific quality standards for 
148.19 	providers designated as high-performing providers under this subdivision.
148.20 	(b) The commissioner may adjust the rates paid to providers within each tier group 
148.21 	established under paragraph (a) on an annual basis. Adjustments to rates shall not include 
148.22 	the rate paid for care coordination services to certified health care homes under section 
148.23 	256B.0753. Providers designated high-performing providers under paragraph (c) are not 
148.24 	eligible for rate increases unless the provider also meets the cost and quality criteria 
148.25 	associated with that tier level.
148.26 	(c) Health care homes certified under section 256B.0751, rural health clinics, and 
148.27 	federally qualified health care clinics are designated as high-performing providers under 
148.28 	this subdivision.
148.29 	(d) Providers reimbursed on a cost basis are subject to rate adjustments under this 
148.30 	section.
148.31 	(e) The commissioner may phase in the tiering system by service type. 

148.32 	EFFECTIVE DATE. This section is effective one year from the public release of 
148.33 	provider peer grouping measures under Minnesota Statutes, section 62U.04, or upon 
148.34 	federal approval, whichever is later.

149.1 	Sec. 50. Minnesota Statutes 2010, section 256B.0755, subdivision 4, is amended to 
149.2 	read:
149.3 		Subd. 4.Payment system. (a) In developing a payment system for health care 
149.4 	delivery systems, the commissioner shall establish a total cost of care benchmark or a 
149.5 	risk/gain sharing payment model to be paid for services provided to the recipients enrolled 
149.6 	in a health care delivery system.
149.7 	(b) The payment system may include incentive payments to health care delivery 
149.8 	systems that meet or exceed annual quality and performance targets realized through 
149.9 	the coordination of care.
149.10 	(c) An amount equal to the savings realized to the general fund as a result of the 
149.11 	demonstration project shall be transferred each fiscal year to the health care access fund.
149.12 	(d) The total cost of care benchmark for demonstration projects must be no 
149.13 	greater than the capitation rate that would have been paid to a managed care plan for a 
149.14 	substantially similar enrollee population based on the per-member per-month rate in 
149.15 	effect on December 31, 2010.  The commissioner shall  adjust benchmark payment rates 
149.16 	for demonstration projects as necessary to reflect the higher level of service and cost 
149.17 	necessary to serve a patient population with a higher incidence of socioeconomic barriers 
149.18 	and complexity, and shall make corresponding reductions in payment rates for projects 
149.19 	with a lower concentration of patients with socioeconomic barriers and complexity.

149.20 	Sec. 51. Minnesota Statutes 2010, section 256B.0755, is amended by adding a 
149.21 	subdivision to read:
149.22 		Subd. 8.Coordination with local services. The health care home and the county 
149.23 	shall coordinate care and services provided to patients enrolled in a demonstration project 
149.24 	who have complex medical or socioeconomic needs or a disability, and who need and are 
149.25 	eligible for additional local services administered by counties, including but not limited 
149.26 	to waivered services, mental health services, social services, public health services, 
149.27 	transportation, or housing.  The coordination of care and services must be as provided in 
149.28 	the plan established by the patient and primary care provider or health care home.

149.29 	Sec. 52. Minnesota Statutes 2010, section 256B.0755, is amended by adding a 
149.30 	subdivision to read:
149.31 		Subd. 9.Rural demonstration projects. For demonstration projects serving 
149.32 	rural areas, the commissioner shall consult with rural hospitals, primary care providers, 
149.33 	county boards, health plans, and other key stakeholders primarily domiciled in the 
149.34 	service area regarding the development and approval of alternative rural health care 
150.1 	delivery demonstration projects under this section. In addition to organizations eligible 
150.2 	to establish a demonstration project under subdivision 1, a rural demonstration project 
150.3 	may be established by a county public health or social services agency or a county-based 
150.4 	purchasing plan. In a rural area where multiple, competing provider-based demonstration 
150.5 	projects are not possible, the commissioner shall not approve more than one demonstration 
150.6 	project to serve the primary geographic area and shall follow the applicable procedures 
150.7 	and requirements in section 256B.692 regarding participation of county boards in 
150.8 	reviewing and approving demonstration project proposals.

150.9 	Sec. 53. Minnesota Statutes 2010, section 256B.0755, is amended by adding a 
150.10 	subdivision to read:
150.11 		Subd. 10.Patient choice of qualified provider. The commissioner shall implement 
150.12 	and approve demonstration projects in a manner that allows a patient to choose a primary 
150.13 	care provider and health care home from among all available qualified options.  The 
150.14 	commissioner may require the patient to remain with the chosen provider, health care 
150.15 	home, or demonstration project organization for a period of time determined by the 
150.16 	commissioner.  The commissioner shall implement the demonstration projects in a manner 
150.17 	that ensures that a patient has the option of receiving services, including health care home 
150.18 	services, through a provider designated as an essential community provider under section 
150.19 	62Q.19. Demonstration projects and essential community providers must comply with 
150.20 	section 62Q.19, subdivisions 3 to 7, for purposes of participation of providers in the 
150.21 	demonstration project, except that reimbursement to federally qualified health centers 
150.22 	and federally qualified health center look-alikes as defined in section 145.9269 must be 
150.23 	in compliance with federal law.

150.24 	Sec. 54. Minnesota Statutes 2010, section 256B.0755, is amended by adding a 
150.25 	subdivision to read:
150.26 		Subd. 11.Patient and community engagement. As a condition of approval of 
150.27 	a demonstration project, the commissioner shall require the applicant to demonstrate 
150.28 	that consumers and communities to be served under the project were consulted with and 
150.29 	engaged in the process of developing the project proposal.  The proposal must identify the 
150.30 	needs and preferences of consumers and communities that were identified through this 
150.31 	process of consultation and engagement.  The consumers and communities consulted with 
150.32 	and engaged in the development of the proposal must generally reflect the demographics, 
150.33 	race, and ethnicity of those likely to be served under the demonstration project, with a 
150.34 	special focus on those who experience the greatest health disparities.  The commissioner 
151.1 	shall require that demonstration project providers continue to consult with and engage 
151.2 	consumers and communities during implementation and operation of the demonstration 
151.3 	project.

151.4 	Sec. 55. Minnesota Statutes 2010, section 256B.0755, is amended by adding a 
151.5 	subdivision to read:
151.6 		Subd. 12.Care coordination system. The commissioner of human services, in 
151.7 	consultation with the commissioner of health, shall convene an advisory committee of 
151.8 	small, independent, rural, and safety net primary care clinics, community hospitals, 
151.9 	mental health centers, dental clinics, and other providers to advise the commissioner 
151.10 	on the establishment of a system that will allow providers participating in payment 
151.11 	reform demonstration projects established under this section and section 256B.0756 to 
151.12 	effectively coordinate and deliver care to patients.  In consultation with the advisory 
151.13 	committee, the commissioner shall develop a plan for the care coordination system, issue a 
151.14 	request for proposals, and contract with a vendor or vendors to establish and maintain the 
151.15 	technology for the care coordination system.  Using appropriations made for this purpose, 
151.16 	the commissioner shall fund the planning, development, and establishment of the system. 
151.17 	Ongoing costs must be covered by payments made by the providers who use the system.

151.18 	Sec. 56. Minnesota Statutes 2010, section 256B.0755, is amended by adding a 
151.19 	subdivision to read:
151.20 		Subd. 13.Approval and implementation. Beginning January 1, 2012, the 
151.21 	commissioner of human services shall approve payment reform projects authorized under 
151.22 	this section for medical assistance and MinnesotaCare. The commissioner may approve 
151.23 	projects for persons enrolled in fee-for-service programs and may require managed care 
151.24 	plans and county-based purchasing plans to contract with a demonstration project provider 
151.25 	on the same terms, conditions, and payment arrangements as are established by the 
151.26 	commissioner for fee-for-service programs.

151.27 	Sec. 57. Minnesota Statutes 2010, section 256B.0756, is amended to read:
151.28 	256B.0756 HENNEPIN AND RAMSEY COUNTIES PILOT PROGRAM.
151.29 	(a) The commissioner, upon federal approval of a new waiver request or amendment 
151.30 	of an existing demonstration, may establish a pilot program in Hennepin County or 
151.31 	Ramsey County, or both, to test alternative and innovative integrated health care delivery 
151.32 	networks.
152.1 	(b) Individuals eligible for the pilot program shall be individuals who are eligible for 
152.2 	medical assistance under section 256B.055, subdivision 15, and who reside in Hennepin 
152.3 	County or Ramsey County.
152.4 	(c) Individuals enrolled in the pilot program shall be enrolled in an integrated 
152.5 	health care delivery network in their county of residence. The integrated health care 
152.6 	delivery network in Hennepin County shall be a network, such as an accountable care 
152.7 	organization or a community-based collaborative care network, created by or including 
152.8 	Hennepin County Medical Center. The integrated health care delivery network in Ramsey 
152.9 	County shall be a network, such as an accountable care organization or community-based 
152.10 	collaborative care network, created by or including Regions Hospital.
152.11 	(d) The commissioner shall cap pilot program enrollment at 7,000 enrollees for 
152.12 	Hennepin County and 3,500 enrollees for Ramsey County.
152.13 	(e) In developing a payment system for the pilot programs, the commissioner shall 
152.14 	establish a total cost of care for the recipients enrolled in the pilot programs that equals 
152.15 	the cost of care that would otherwise be spent for these enrollees in the prepaid medical 
152.16 	assistance program.
152.17 	(f) Counties may transfer funds necessary to support the nonfederal share of 
152.18 	payments for integrated health care delivery networks in their county. Such transfers per 
152.19 	county shall not exceed 15 percent of the expected expenses for county enrollees.
152.20 	(g) The commissioner shall apply to the federal government for, or as appropriate, 
152.21 	cooperate with counties, providers, or other entities that are applying for any applicable 
152.22 	grant or demonstration under the Patient Protection and Affordable Health Care Act, Public 
152.23 	Law 111-148, or the Health Care and Education Reconciliation Act of 2010, Public Law 
152.24 	111-152, that would further the purposes of or assist in the creation of an integrated health 
152.25 	care delivery network for the purposes of this subdivision, including, but not limited to, a 
152.26 	global payment demonstration or the community-based collaborative care network grants.
152.27 	(h) A demonstration project established under this section must meet the 
152.28 	requirements of section 256B.0755, subdivisions 8, 9, 10, and 11.

152.29 	Sec. 58. [256B.0758] PREGNANCY CARE HOMES.
152.30 		Subdivision 1.Definitions. (a) For purposes of this section, the following definitions 
152.31 	apply.
152.32 	(b) "Pregnancy care home" means a health care home certified by the commissioner 
152.33 	of health under section 256B.0751 that provides pregnancy care services in a way that 
152.34 	is patient-centered, outcome-driven, comprehensive, and coordinated, and meets the 
152.35 	standards specified and developed under subdivision 3.
153.1 	(c) "Pregnancy care services" means prenatal care, consultative perinatal services, 
153.2 	intrapartum and postpartum care, and well-baby care for the first week.
153.3 	(d) "State health care program" means the medical assistance and MinnesotaCare 
153.4 	programs.
153.5 		Subd. 2.Development and implementation of standards. (a) The commissioners 
153.6 	of human services and health shall develop and implement standards of certification 
153.7 	of pregnancy care homes for state health care programs. In developing standards, the 
153.8 	commissioners shall consult with representatives of the American College of Nurse 
153.9 	Midwives, the American Congress of OB/GYN, the American Academy of Family 
153.10 	Practice, the American Academy of Pediatrics, and relevant local consumer groups.
153.11 		Subd. 3.Criteria for development of standards. (a) A pregnancy care home must 
153.12 	meet the general health care home standards developed by the commissioners under 
153.13 	section 256B.0751, subdivision 2, paragraph (a), clauses (1) to (4), (6), and (8) to (10), and 
153.14 	must also meet specific standards for pregnancy care homes. The specific standards for 
153.15 	pregnancy care homes developed by the commissioners must meet the criteria specified 
153.16 	in this subdivision.
153.17 	(b) A pregnancy care home must provide pregnancy care services. Nonpregnancy 
153.18 	complications, such as preexisting illness, shall be covered by medical assistance outside 
153.19 	of the pregnancy care home. During a pregnancy episode, the pregnancy care home must 
153.20 	coordinate necessary nonpregnancy health care services with the mother's primary care 
153.21 	provider or another appropriate provider.
153.22 	(c) Each pregnancy care home must have adequate malpractice insurance that meets 
153.23 	the standards specified by the commissioners.
153.24 	(d) A pregnancy care home may provide pregnancy services through any health care 
153.25 	professional licensed to provide the service in Minnesota, including but not limited to 
153.26 	licensed traditional midwives, certified nurse midwives, family practitioners, obstetricians, 
153.27 	perinatologists, neonatologists, and other advanced practice registered nurses. 
153.28 	(e) Pregnancy care within a pregnancy care home may be provided at any Minnesota 
153.29 	facility licensed to provide pregnancy care and birth, including but not limited to 
153.30 	freestanding birth centers, integrated birth centers, and hospitals. Each pregnancy care 
153.31 	home must offer the option of midwife-directed pregnancy care services in a licensed 
153.32 	integrated or freestanding birth center.
153.33 	(f) A pregnancy care home must have a governing board comprised of at least 
153.34 	eight members. One-half of the governing board members must be providers licensed to 
153.35 	attend births.
154.1 	(g) Each pregnancy care home must have a formal consultative relationship with at 
154.2 	least one level III perinatal center to provide care for mothers and babies who develop 
154.3 	pregnancy complications.
154.4 	(h) Each pregnancy care home must comply with state and federal requirements for 
154.5 	the use of interoperable electronic medical records.
154.6 	(i) Each pregnancy care home must submit annual reports to the commissioners of 
154.7 	human services and health that document:
154.8 	(1) all relevant pregnancy care outcomes and patient satisfaction measures; and
154.9 	(2) the financial status of the pregnancy care home.
154.10 	All reports are public data under section 13.02.
154.11 	(j) Each pregnancy care home must offer culturally competent  care coordination 
154.12 	services in a manner that is consistent with health care home requirements.
154.13 	(k) For the purposes of developing and implementing the standards in this 
154.14 	subdivision, the commissioners may use the expedited rulemaking process under section 
154.15 	14.389.
154.16 		Subd. 4.Certification process. Providers seeking certification as a pregnancy care 
154.17 	home must apply to the commissioner of health. Providers certified by the commissioner 
154.18 	of health may provide pregnancy care services through pregnancy care homes beginning 
154.19 	July 1, 2012. Certification as a pregnancy care home is voluntary, except that beginning 
154.20 	July 1, 2014, all nonemergency pregnancy care services covered under state health care 
154.21 	programs must be provided through providers certified as pregnancy care homes.
154.22 		Subd. 5.Payments to pregnancy care homes. (a) The commissioner of human 
154.23 	services, in coordination with the commissioner of health, shall develop a payment system 
154.24 	that provides a single per-person payment to pregnancy care homes to cover all pregnancy 
154.25 	care services provided to each mother and infant enrolled in a state health care program. 
154.26 	Pregnancy care homes receiving payments under this subdivision remain eligible for care 
154.27 	coordination payments under section 256B.0753.
154.28 	(b) Payment amounts for pregnancy care homes shall be uniform statewide and 
154.29 	determined annually by the commissioner, based initially upon a specified percentage 
154.30 	of the calculated average cost of care for mothers and infants under state health care 
154.31 	programs for the three most recent fiscal years for which cost information is available. 
154.32 	Beginning July 1, 2014, statewide payment amounts for pregnancy care homes shall be 
154.33 	determined annually by the commissioner by adjusting the current payment amount by 
154.34 	a measure of medical inflation selected by the commissioner that best represents the 
154.35 	change in the cost of pregnancy-related services provided to patients covered by private 
154.36 	sector health coverage.
155.1 	(c) Pregnancy care home payments must initially be made for pregnancy care 
155.2 	services provided to pregnant women who are not high risk, beginning July 1, 2012. 
155.3 	Beginning January 1, 2013, the commissioner shall phase in higher payments for high-risk 
155.4 	pregnancy categories so that beginning July 1, 2014, pregnancy care services for all 
155.5 	low-risk and high-risk pregnancies are reimbursed under this subdivision.

155.6 	Sec. 59. [256B.0759] CARE COORDINATION FOR ENROLLEES.
155.7 		Subdivision 1.Qualified enrollee. For purposes of this section, a "qualified 
155.8 	enrollee" means: (1) a medical assistance enrollee eligible under this chapter; or (2) a 
155.9 	MinnesotaCare enrollee eligible under chapter 256L.
155.10 		Subd. 2.Selection of primary care provider. The commissioner shall require 
155.11 	qualified enrollees who do not have a designated medical condition to select a primary 
155.12 	care provider and agree to receive primary care services from that provider as a condition 
155.13 	of medical assistance or MinnesotaCare enrollment.
155.14 		Subd. 3.Selection of health care home; care coordination. (a) The commissioner 
155.15 	shall require qualified enrollees who have a medical condition designated by the 
155.16 	commissioner to select a health care home certified under section 256B.0751 and agree 
155.17 	to receive primary care and care coordination services through that health care home as 
155.18 	a condition of medical assistance or MinnesotaCare enrollment. For purposes of this 
155.19 	subdivision, the commissioner shall designate medical conditions with a high likelihood 
155.20 	of inappropriate inpatient hospital admissions for which care coordination and prior 
155.21 	authorization of admissions are expected to improve the quality of care and lead to costs 
155.22 	savings for state health care programs.
155.23 	(b) The commissioner shall include on Minnesota health care program enrollment 
155.24 	cards a designation as to whether an enrollee meets the criteria in paragraph (a). In order 
155.25 	to receive medical assistance or MinnesotaCare payment for nonemergency inpatient 
155.26 	hospital admissions for enrollees meeting the criteria in paragraph (a), a hospital must 
155.27 	receive prior authorization from the enrollee's health care home.

155.28 	EFFECTIVE DATE. This section is effective January 1, 2012, for MinnesotaCare 
155.29 	enrollees not eligible for a federal match, and is effective January 1, 2012, or upon federal 
155.30 	approval, whichever is later, for medical assistance enrollees and for MinnesotaCare 
155.31 	enrollees eligible for a federal match.

155.32 	Sec. 60. [256B.0760] ELECTIVE SURGERY.
155.33 		Subdivision 1.Payment prohibition. The commissioner, in consultation with 
155.34 	health care providers, health care homes certified under section 256B.0751, managed 
156.1 	care plans providing services under section 256B.69, and county-based purchasing plans 
156.2 	providing services under section  256B.692, shall identify elective or nonemergency 
156.3 	surgical procedures for which less invasive and less costly alternative treatment methods 
156.4 	are available, and shall prohibit payment for these elective or nonemergency surgical 
156.5 	procedures if the alternative treatment methods have not first been evaluated for use 
156.6 	and, if appropriate, provided to the enrollee.
156.7 		Subd. 2.Implementation. The commissioner shall implement the payment 
156.8 	prohibitions in paragraph (a) for fee-for-service medical assistance providers by January 
156.9 	1, 2012, and shall require managed care and county-based purchasing plans to implement 
156.10 	the payment prohibitions in paragraph (a) for providers employed or under contract for 
156.11 	services provided to medical assistance and MinnesotaCare enrollees beginning January 
156.12 	1, 2012.
156.13 		Subd. 3.Reduction in capitation rates. The commissioner shall reduce medical 
156.14 	assistance and MinnesotaCare capitation rates to managed care and county-based 
156.15 	purchasing plans beginning January 1, 2012, to reflect cost-savings to plans resulting from 
156.16 	implementation of the payment prohibitions required by this subdivision.

156.17 	Sec. 61. Minnesota Statutes 2010, section 256B.37, subdivision 5, is amended to read:
156.18 		Subd. 5.Private benefits to be used first. Private accident and health care 
156.19 	coverage, including Medicare for medical services and coverage provided through the 
156.20 	United States Department of Veterans Affairs, is primary coverage and must be exhausted 
156.21 	before medical assistance or alternative care services are paid for medical services 
156.22 	including home health care, personal care assistance services, hospice, supplies and 
156.23 	equipment, or services covered under a Centers for Medicare and Medicaid Services 
156.24 	waiver. When a person who is otherwise eligible for medical assistance has private 
156.25 	accident or health care coverage, including Medicare or a prepaid health plan or coverage 
156.26 	provided through the United States Department of Veterans Affairs, the private health care 
156.27 	benefits available to the person must be used first and to the fullest extent.

156.28 	Sec. 62. Minnesota Statutes 2010, section 256B.69, subdivision 3a, is amended to read:
156.29 		Subd. 3a.County authority. (a) The commissioner, when implementing or 
156.30 	administering the medical assistance prepayment program within a county, must include 
156.31 	the county board in the process of development, approval, and issuance of the request for 
156.32 	proposals to provide services to eligible individuals within the proposed county, including 
156.33 	proposals for demonstration projects established under section 256B.0755. County boards 
156.34 	must be given reasonable opportunity to make recommendations regarding assist in
157.1 	the development, issuance, review of responses, and changes needed in the request for 
157.2 	proposals. The commissioner must provide county boards the opportunity to review 
157.3 	each proposal based on the identification of community needs under chapters 145A and 
157.4 	256E and county advocacy activities. If a county board finds that a proposal does not 
157.5 	address certain community needs, the county board and commissioner shall continue 
157.6 	efforts for improving the proposal and network prior to the approval of the contract. 
157.7 	The county board shall make recommendations determinations regarding the approval 
157.8 	of local networks and their operations to ensure adequate local availability and access to 
157.9 	covered services. The provider or health plan must respond directly to county advocates 
157.10 	and the state prepaid medical assistance ombudsperson regarding service delivery and 
157.11 	must be accountable to the state regarding contracts with medical assistance funds. The 
157.12 	county board may recommend shall decide a maximum number of participating health 
157.13 	plans including county-based purchasing plans after considering the size of the enrolling 
157.14 	population; ensuring adequate access and capacity; considering the client and county 
157.15 	administrative complexity; and considering the need to promote the viability of locally 
157.16 	developed health plans, managed care plans, or demonstration projects established under 
157.17 	section 256B.0755. The county board or a single entity representing a group of county 
157.18 	boards and the commissioner shall mutually select one or more qualified health plans or 
157.19 	county-based purchasing plans for participation at the time of initial implementation of the 
157.20 	prepaid medical assistance program or a demonstration project established under section 
157.21 	256B.0755 in that county or group of counties and at the time of contract renewal. The 
157.22 	commissioner shall also seek input for contract requirements from the county or single 
157.23 	entity representing a group of county boards at each contract renewal and incorporate 
157.24 	those recommendations into the contract negotiation process.
157.25 	(b) At the option of the county board, the board may develop contract requirements 
157.26 	related to the achievement of local public health goals and health care delivery and access 
157.27 	goals to meet the health needs of medical assistance enrollees. These requirements must 
157.28 	be reasonably related to the performance of health plan managed care or delivery system 
157.29 	demonstration project functions and within the scope of the medical assistance benefit 
157.30 	set. If the county board and the commissioner mutually agree to such requirements, the 
157.31 	department The commissioner shall include such requirements in all health plan contracts 
157.32 	governing the prepaid medical assistance program in that county at initial implementation 
157.33 	of the program or demonstration project in that county and at the time of contract renewal. 
157.34 	The county board may participate in the enforcement of the contract provisions related to 
157.35 	local public health goals.
158.1 	(c) For counties in which a prepaid medical assistance program has not been 
158.2 	established, the commissioner shall not implement that program if a county board submits 
158.3 	an acceptable and timely preliminary and final proposal under section 256B.692, until 
158.4 	county-based purchasing is no longer operational in that county. For counties in which 
158.5 	a prepaid medical assistance program is in existence on or after September 1, 1997, the 
158.6 	commissioner must terminate contracts with health plans according to section 256B.692, 
158.7 	subdivision 5, if the county board submits and the commissioner accepts a preliminary and 
158.8 	final proposal according to that subdivision. The commissioner is not required to terminate 
158.9 	contracts that begin on or after September 1, 1997, according to section 256B.692 until 
158.10 	two years have elapsed from the date of initial enrollment.
158.11 	(d) In the event that a county board or a single entity representing a group of county 
158.12 	boards and the commissioner cannot reach agreement regarding: (i) the selection of 
158.13 	participating health plans or demonstration projects under section 256B.0755 in that 
158.14 	county; (ii) contract requirements; or (iii) implementation and enforcement of county 
158.15 	requirements including provisions regarding local public health goals, the commissioner 
158.16 	shall resolve all disputes after taking into account by approving the recommendations of 
158.17 	a three-person mediation panel. The panel shall be composed of one designee of the 
158.18 	president of the association of Minnesota counties, one designee of the commissioner of 
158.19 	human services, and one person selected jointly by the designee of the commissioner of 
158.20 	human services and the designee of the Association of Minnesota Counties. Within a 
158.21 	reasonable period of time before the hearing, the panelists must be provided all documents 
158.22 	and information relevant to the mediation. The parties to the mediation must be given 
158.23 	30 days' notice of a hearing before the mediation panel.
158.24 	(e) If a county which elects to implement county-based purchasing ceases to 
158.25 	implement county-based purchasing, it is prohibited from assuming the responsibility of 
158.26 	county-based purchasing for a period of five years from the date it discontinues purchasing.
158.27 	(f) The commissioner shall not require that contractual disputes between 
158.28 	county-based purchasing entities and the commissioner be mediated by a panel that 
158.29 	includes a representative of the Minnesota Council of Health Plans.
158.30 	(g) At the request of a county-purchasing entity, the commissioner shall adopt a 
158.31 	contract reprocurement or renewal schedule under which all counties included in the 
158.32 	entity's service area are reprocured or renewed at the same time.
158.33 	(h) The commissioner shall provide a written report under section 3.195 to the chairs 
158.34 	of the legislative committees having jurisdiction over human services in the senate and the 
158.35 	house of representatives describing in detail the activities undertaken by the commissioner 
158.36 	to ensure full compliance with this section. The report must also provide an explanation 
159.1 	for any decisions of the commissioner not to accept the recommendations of a county or 
159.2 	group of counties required to be consulted under this section. The report must be provided 
159.3 	at least 30 days prior to the effective date of a new or renewed prepaid or managed care 
159.4 	contract in a county.
159.5 	(i) This section also applies to other Minnesota health care programs administered 
159.6 	by the commissioner, including but not limited to the MinnesotaCare program.

159.7 	Sec. 63. Minnesota Statutes 2010, section 256B.69, subdivision 4, is amended to read:
159.8 		Subd. 4.Limitation of choice. (a) The commissioner shall develop criteria to 
159.9 	determine when limitation of choice may be implemented in the experimental counties. 
159.10 	The criteria shall ensure that all eligible individuals in the county have continuing access 
159.11 	to the full range of medical assistance services as specified in subdivision 6.
159.12 	(b) The commissioner shall exempt the following persons from participation in the 
159.13 	project, in addition to those who do not meet the criteria for limitation of choice:
159.14 	(1) persons eligible for medical assistance according to section 256B.055, 
159.15 	subdivision 1;
159.16 	(2) persons eligible for medical assistance due to blindness or disability as 
159.17 	determined by the Social Security Administration or the state medical review team, unless:
159.18 	(i) they are 65 years of age or older; or
159.19 	(ii) they reside in Itasca County or they reside in a county in which the commissioner 
159.20 	conducts a pilot project under a waiver granted pursuant to section 1115 of the Social 
159.21 	Security Act;
159.22 	(3) recipients who currently have private coverage through a health maintenance 
159.23 	organization;
159.24 	(4) recipients who are eligible for medical assistance by spending down excess 
159.25 	income for medical expenses other than the nursing facility per diem expense;
159.26 	(5) recipients who receive benefits under the Refugee Assistance Program, 
159.27 	established under United States Code, title 8, section 1522(e);
159.28 	(6) children who are both determined to be severely emotionally disturbed and 
159.29 	receiving case management services according to section 256B.0625, subdivision 20, 
159.30 	except children who are eligible for and who decline enrollment in an approved preferred 
159.31 	integrated network under section 245.4682;
159.32 	(7) adults who are both determined to be seriously and persistently mentally ill and 
159.33 	received case management services according to section 256B.0625, subdivision 20;
159.34 	(8) persons eligible for medical assistance according to section 256B.057, 
159.35 	subdivision 10; and
160.1 	(9) persons with access to cost-effective employer-sponsored private health 
160.2 	insurance or persons enrolled in a non-Medicare individual health plan determined to be 
160.3 	cost-effective according to section 256B.0625, subdivision 15.
160.4 	Children under age 21 who are in foster placement may enroll in the project on an elective 
160.5 	basis. Individuals excluded under clauses (1), (6), and (7) may choose to enroll on an 
160.6 	elective basis. The commissioner may enroll recipients in the prepaid medical assistance 
160.7 	program for seniors who are (1) age 65 and over, and (2) eligible for medical assistance by 
160.8 	spending down excess income.
160.9 	(c) The commissioner may allow persons with a one-month spenddown who are 
160.10 	otherwise eligible to enroll to voluntarily enroll or remain enrolled, if they elect to prepay 
160.11 	their monthly spenddown to the state.
160.12 	(d) The commissioner may require those individuals to enroll in the prepaid medical 
160.13 	assistance program who otherwise would have been excluded under paragraph (b), clauses 
160.14 	(1), (3), and (8), and under Minnesota Rules, part 9500.1452, subpart 2, items H, K, and L.
160.15 	(e) Before limitation of choice is implemented, eligible individuals shall be notified 
160.16 	and after notification, shall be allowed to choose only among demonstration providers. 
160.17 	The commissioner may assign an individual with private coverage through a health 
160.18 	maintenance organization, to the same health maintenance organization for medical 
160.19 	assistance coverage, if the health maintenance organization is under contract for medical 
160.20 	assistance in the individual's county of residence. After initially choosing a provider, 
160.21 	the recipient is allowed to change that choice only at specified times as allowed by the 
160.22 	commissioner. If a demonstration provider ends participation in the project for any reason, 
160.23 	a recipient enrolled with that provider must select a new provider but may change providers 
160.24 	without cause once more within the first 60 days after enrollment with the second provider.
160.25 	(f) An infant born to a woman who is eligible for and receiving medical assistance 
160.26 	and who is enrolled in the prepaid medical assistance program shall be retroactively 
160.27 	enrolled to the month of birth in the same managed care plan as the mother once the 
160.28 	child is enrolled in medical assistance unless the child is determined to be excluded from 
160.29 	enrollment in a prepaid plan under this section.
160.30 	(g) For an eligible individual under the age of 65, in the absence of a specific 
160.31 	managed care plan choice by the individual, the commissioner shall assign the individual to 
160.32 	the county-based purchasing plan, if any, in the county of the individual's residence. For an 
160.33 	eligible individual over the age of 65, the commissioner shall make the default assignment 
160.34 	on the county-based purchasing plan entering into a contract with the commissioner to 
160.35 	serve this population and receiving federal approval as a special needs plan.

161.1 	Sec. 64. Minnesota Statutes 2010, section 256B.69, subdivision 5a, is amended to read:
161.2 		Subd. 5a.Managed care contracts. (a) Managed care contracts under this section 
161.3 	and section 256L.12 shall be entered into or renewed on a calendar year basis beginning 
161.4 	January 1, 1996. Managed care contracts which were in effect on June 30, 1995, and set to 
161.5 	renew on July 1, 1995, shall be renewed for the period July 1, 1995 through December 
161.6 	31, 1995 at the same terms that were in effect on June 30, 1995. The commissioner may 
161.7 	issue separate contracts with requirements specific to services to medical assistance 
161.8 	recipients age 65 and older.
161.9 	(b) A prepaid health plan providing covered health services for eligible persons 
161.10 	pursuant to chapters 256B and 256L is responsible for complying with the terms of its 
161.11 	contract with the commissioner. Requirements applicable to managed care programs 
161.12 	under chapters 256B and 256L established after the effective date of a contract with the 
161.13 	commissioner take effect when the contract is next issued or renewed.
161.14 	(c) Effective for services rendered on or after January 1, 2003, the commissioner 
161.15 	shall withhold five percent of managed care plan payments under this section and 
161.16 	county-based purchasing plan payments under section 256B.692 for the prepaid medical 
161.17 	assistance program pending completion of performance targets. Each performance target 
161.18 	must be quantifiable, objective, measurable, and reasonably attainable, except in the case 
161.19 	of a performance target based on a federal or state law or rule. Criteria for assessment 
161.20 	of each performance target must be outlined in writing prior to the contract effective 
161.21 	date. The managed care plan must demonstrate, to the commissioner's satisfaction, 
161.22 	that the data submitted regarding attainment of the performance target is accurate. The 
161.23 	commissioner shall periodically change the administrative measures used as performance 
161.24 	targets in order to improve plan performance across a broader range of administrative 
161.25 	services. The performance targets must include measurement of plan efforts to contain 
161.26 	spending on health care services and administrative activities. The commissioner may 
161.27 	adopt plan-specific performance targets that take into account factors affecting only one 
161.28 	plan, including characteristics of the plan's enrollee population. The withheld funds 
161.29 	must be returned no sooner than July of the following year if performance targets in the 
161.30 	contract are achieved. The commissioner may exclude special demonstration projects 
161.31 	under subdivision 23.
161.32 	(d) Effective for services rendered on or after January 1, 2009, through December 
161.33 	31, 2009, the commissioner shall withhold three percent of managed care plan payments 
161.34 	under this section and county-based purchasing plan payments under section 256B.692 
161.35 	for the prepaid medical assistance program. The withheld funds must be returned no 
162.1 	sooner than July 1 and no later than July 31 of the following year. The commissioner may 
162.2 	exclude special demonstration projects under subdivision 23.
162.3 	(e) Effective for services provided on or after January 1, 2010, the commissioner 
162.4 	shall require that managed care plans use the assessment and authorization processes, 
162.5 	forms, timelines, standards, documentation, and data reporting requirements, protocols, 
162.6 	billing processes, and policies consistent with medical assistance fee-for-service or the 
162.7 	Department of Human Services contract requirements consistent with medical assistance 
162.8 	fee-for-service or the Department of Human Services contract requirements for all 
162.9 	personal care assistance services under section 256B.0659.
162.10 	(f) Effective for services rendered on or after January 1, 2010, through December 
162.11 	31, 2010, the commissioner shall withhold 4.5 percent of managed care plan payments 
162.12 	under this section and county-based purchasing plan payments under section 256B.692 
162.13 	for the prepaid medical assistance program. The withheld funds must be returned no 
162.14 	sooner than July 1 and no later than July 31 of the following year. The commissioner may 
162.15 	exclude special demonstration projects under subdivision 23.
162.16 	(g) Effective for services rendered on or after January 1, 2011, the commissioner 
162.17 	shall include as part of the performance targets described in paragraph (c) a reduction in 
162.18 	the health plan's emergency room utilization rate for state health care program enrollees 
162.19 	by a measurable rate of five percent from the plan's utilization rate for state health care 
162.20 	program enrollees for the previous calendar year.
162.21 	The withheld funds must be returned no sooner than July 1 and no later than July 31 
162.22 	of the following calendar year if the managed care plan demonstrates to the satisfaction of 
162.23 	the commissioner that a reduction in the utilization rate was achieved.
162.24 	The withhold described in this paragraph shall continue for each consecutive 
162.25 	contract period until the plan's emergency room utilization rate for state health care 
162.26 	program enrollees is reduced by 25 percent of the plan's emergency room utilization 
162.27 	rate for state health care program enrollees for calendar year 2009. Hospitals shall 
162.28 	cooperate with the health plans in meeting this performance target and shall accept 
162.29 	payment withholds that may be returned to the hospitals if the performance target is 
162.30 	achieved. The commissioner shall structure the withhold so that the commissioner returns 
162.31 	a portion of the withheld funds in amounts commensurate with achieved reductions in 
162.32 	utilization less than the targeted amount. The withhold in this paragraph does not apply to 
162.33 	county-based purchasing plans.
162.34 	(h) Effective for services rendered on or after January 1, 2012, the commissioner 
162.35 	shall include as part of the performance targets described in paragraph (c) a reduction in 
162.36 	the plan's hospitalization rates or subsequent hospitalizations within 30 days of a previous 
163.1 	hospitalization of a patient regardless of the reason for the hospitalization for state health 
163.2 	care program enrollees by a measurable rate of five percent from the plan's utilization rate 
163.3 	for state health care program enrollees for the previous calendar year.
163.4 	The withheld funds must be returned no sooner than July 1 and no later than July 31 
163.5 	of the following calendar year if the managed care plan or county-based purchasing plan 
163.6 	demonstrates to the satisfaction of the commissioner that a reduction in the hospitalization 
163.7 	rate was achieved.
163.8 	The withhold described in this paragraph must continue for each consecutive 
163.9 	contract period until the plan's subsequent hospitalization rate for state health care 
163.10 	program enrollees is reduced by 25 percent of the plan's subsequent hospitalization rate 
163.11 	for state health care program enrollees for calendar year 2010. Hospitals shall cooperate 
163.12 	with the plans in meeting this performance target and shall accept payment withholds that 
163.13 	must be returned to the hospitals if the performance target is achieved. The commissioner 
163.14 	shall structure the withhold so that the commissioner returns a portion of the withheld 
163.15 	funds in amounts commensurate with achieved reductions in utilization less than the 
163.16 	targeted amount.
163.17 	(h) (i) Effective for services rendered on or after January 1, 2011, through December 
163.18 	31, 2011, the commissioner shall withhold 4.5 percent of managed care plan payments 
163.19 	under this section and county-based purchasing plan payments under section 256B.692 
163.20 	for the prepaid medical assistance program. The withheld funds must be returned no 
163.21 	sooner than July 1 and no later than July 31 of the following year. The commissioner may 
163.22 	exclude special demonstration projects under subdivision 23.
163.23 	(i) (j) Effective for services rendered on or after January 1, 2012, through December 
163.24 	31, 2012, the commissioner shall withhold 4.5 percent of managed care plan payments 
163.25 	under this section and county-based purchasing plan payments under section 256B.692 
163.26 	for the prepaid medical assistance program. The withheld funds must be returned no 
163.27 	sooner than July 1 and no later than July 31 of the following year. The commissioner may 
163.28 	exclude special demonstration projects under subdivision 23.
163.29 	(j) (k) Effective for services rendered on or after January 1, 2013, through December 
163.30 	31, 2013, the commissioner shall withhold 4.5 percent of managed care plan payments 
163.31 	under this section and county-based purchasing plan payments under section 256B.692 
163.32 	for the prepaid medical assistance program. The withheld funds must be returned no 
163.33 	sooner than July 1 and no later than July 31 of the following year. The commissioner may 
163.34 	exclude special demonstration projects under subdivision 23.
163.35 	(k) (l) Effective for services rendered on or after January 1, 2014, the commissioner 
163.36 	shall withhold three percent of managed care plan payments under this section and 
164.1 	county-based purchasing plan payments under section 256B.692 for the prepaid medical 
164.2 	assistance program. The withheld funds must be returned no sooner than July 1 and 
164.3 	no later than July 31 of the following year. The commissioner may exclude special 
164.4 	demonstration projects under subdivision 23.
164.5 	(l) (m) A managed care plan or a county-based purchasing plan under section 
164.6 	256B.692 may include as admitted assets under section 62D.044 any amount withheld 
164.7 	under this section that is reasonably expected to be returned.
164.8 	(m) (n) Contracts between the commissioner and a prepaid health plan are exempt 
164.9 	from the set-aside and preference provisions of section 16C.16, subdivisions 6, paragraph 
164.10 	(a), and 7.
164.11 	(n) (o) The return of the withhold under paragraphs (d), (f), and (h) to (k) is not 
164.12 	subject to the requirements of paragraph (c).

164.13 	Sec. 65. Minnesota Statutes 2010, section 256B.69, subdivision 5c, is amended to read:
164.14 		Subd. 5c.Medical education and research fund. (a) The commissioner of human 
164.15 	services shall transfer each year to the medical education and research fund established 
164.16 	under section 62J.692, the following:
164.17 	(1) an amount equal to the reduction in the prepaid medical assistance payments as 
164.18 	specified in this clause. Until January 1, 2002, the county medical assistance capitation 
164.19 	base rate prior to plan specific adjustments and after the regional rate adjustments under 
164.20 	subdivision 5b is reduced 6.3 percent for Hennepin County, two percent for the remaining 
164.21 	metropolitan counties, and no reduction for nonmetropolitan Minnesota counties; and after 
164.22 	January 1, 2002, the county medical assistance capitation base rate prior to plan specific 
164.23 	adjustments is reduced 6.3 percent for Hennepin County, two percent for the remaining 
164.24 	metropolitan counties, and 1.6 percent for nonmetropolitan Minnesota counties. Nursing 
164.25 	facility and elderly waiver payments and demonstration project payments operating 
164.26 	under subdivision 23 are excluded from this reduction. The amount calculated under 
164.27 	this clause shall not be adjusted for periods already paid due to subsequent changes to 
164.28 	the capitation payments;
164.29 	(2) beginning July 1, 2003, $4,314,000 from the capitation rates paid under this 
164.30 	section;
164.31 	(3) beginning July 1, 2002, an additional $12,700,000 from the capitation rates 
164.32 	paid under this section; and
164.33 	(4) beginning July 1, 2003, an additional $4,700,000 from the capitation rates paid 
164.34 	under this section.
165.1 	(b) This subdivision shall be effective upon approval of a federal waiver which 
165.2 	allows federal financial participation in the medical education and research fund. Effective 
165.3 	July 1, 2009, and thereafter, the transfers required by paragraph (a), clauses (1) to (4), 
165.4 	shall not exceed the total amount transferred for fiscal year 2009. Any excess shall first 
165.5 	reduce the amounts otherwise required to be transferred under paragraph (a), clauses 
165.6 	(2) to (4). Any excess following this reduction shall proportionally reduce the transfers 
165.7 	under paragraph (a), clause (1).
165.8 	(c) Beginning July 1, 2009, of the amounts in paragraph (a), the commissioner shall 
165.9 	transfer $21,714,000 each fiscal year to the medical education and research fund. The 
165.10 	balance of the transfers under paragraph (a) shall be transferred to the medical education 
165.11 	and research fund no earlier than July 1 of the following fiscal year.
165.12 	(d) Beginning in fiscal year 2012, the commissioner shall reduce the amount 
165.13 	transferred to the medical education research fund under paragraph (a), by $6,404,000 
165.14 	each fiscal year. This reduction must be applied to the amount available for general 
165.15 	distribution under section 62J.692, subdivision 7, clause (5).

165.16 	Sec. 66. Minnesota Statutes 2010, section 256B.69, subdivision 6, is amended to read:
165.17 		Subd. 6.Service delivery. (a) Each demonstration provider shall be responsible for 
165.18 	the health care coordination for eligible individuals. Demonstration providers:
165.19 	(1) shall authorize and arrange for the provision of all needed health services 
165.20 	including but not limited to the full range of services listed in sections 256B.02, 
165.21 	subdivision 8, and 256B.0625 in order to ensure appropriate health care is delivered to 
165.22 	enrollees. Notwithstanding section 256B.0621, demonstration providers that provide 
165.23 	nursing home and community-based services under this section shall provide relocation 
165.24 	service coordination to enrolled persons age 65 and over;
165.25 	(2) shall accept the prospective, per capita payment from the commissioner in return 
165.26 	for the provision of comprehensive and coordinated health care services for eligible 
165.27 	individuals enrolled in the program;
165.28 	(3) may contract with other health care and social service practitioners to provide 
165.29 	services to enrollees; and
165.30 	(4) shall institute recipient grievance procedures according to the method established 
165.31 	by the project, utilizing applicable requirements of chapter 62D. Disputes not resolved 
165.32 	through this process shall be appealable to the commissioner as provided in subdivision 11.
165.33 	(b) Demonstration providers must comply with the standards for claims settlement 
165.34 	under section 72A.201, subdivisions 4, 5, 7, and 8, when contracting with other health 
165.35 	care and social service practitioners to provide services to enrollees. A demonstration 
166.1 	provider must pay a clean claim, as defined in Code of Federal Regulations, title 42, 
166.2 	section 447.45(b), within 30 business days of the date of acceptance of the claim.
166.3 	(c) A demonstration provider must accept into its medical assistance and 
166.4 	MinnesotaCare provider networks any health care or social service provider that agrees 
166.5 	to accept payment, quality assurance, and other contract terms that the demonstration 
166.6 	provider applies to other similarly situated providers in its provider network.

166.7 	EFFECTIVE DATE. This section is effective January 1, 2012, and applies to 
166.8 	provider contracts that take effect on or after that date.

166.9 	Sec. 67. Minnesota Statutes 2010, section 256B.69, is amended by adding a 
166.10 	subdivision to read:
166.11 		Subd. 30.Provider payment rates. (a) Each managed care and county-based plan 
166.12 	shall, by October 1, 2011, array all providers within each provider type, employed by or 
166.13 	under contract with the plan, by their average total annual cost of care for serving medical 
166.14 	assistance and MinnesotaCare enrollees for the most recent reporting year for which data 
166.15 	is available, risk-adjusted for enrollee demographics and health status.
166.16 	(b) Beginning January 1, 2012, and each contract year thereafter, each managed 
166.17 	care and county-based purchasing plan shall implement a progressive payment withhold 
166.18 	methodology for each provider type, under which the withhold for a provider increases 
166.19 	proportionally as the provider's risk-adjusted total annual cost increases, relative to other 
166.20 	providers of the same type. For purposes of this paragraph, the risk-adjusted total annual 
166.21 	cost of care is the dollar amount calculated under paragraph (a).
166.22 	(c) At the end of each contract year, each plan shall array all providers within each 
166.23 	provider type by their average total annual cost of care for serving medical assistance and 
166.24 	MinnesotaCare enrollees for that contract year, risk-adjusted for enrollee demographics 
166.25 	and health status. For each provider whose risk-adjusted total annual cost of care is at or 
166.26 	below a benchmark percentile established by the plan, the plan shall return the full amount 
166.27 	of any withhold. For each provider whose risk-adjusted total annual cost of care is above 
166.28 	the benchmark percentile, the plan shall return only the portion of the withhold sufficient 
166.29 	to bring the provider's payment rate to the average for providers within the provider type 
166.30 	whose risk-adjusted total annual cost of care is at the benchmark percentile. Each plan shall 
166.31 	establish the benchmark percentile at a level that allows the plan to adjust expenditures for 
166.32 	provider payments to reflect the reduction in capitation rates under paragraph (f).
166.33 	(d) Each managed care and county-based purchasing plan must establish an appeals 
166.34 	process to allow providers to appeal determinations of risk-adjusted total annual cost of 
166.35 	care. Each plan's appeals process must be approved by the commissioner.
167.1 	(e) The commissioner shall require each plan to submit to the commissioner, in 
167.2 	the form and manner specified by the commissioner, all provider payment data and 
167.3 	information on the withhold methodology that the commissioner determines is necessary 
167.4 	to verify compliance with this subdivision.
167.5 	(f) The commissioner, for the contract year beginning January 1, 2012, shall reduce 
167.6 	plan capitation rates by 12 percent from the rates that would otherwise apply, absent 
167.7 	application of this subdivision. The reduced rate shall be the historical base rate for 
167.8 	negotiating capitation rates for future contract years. The commissioner may recommend 
167.9 	additional reductions in capitation rates for future contract years to the legislature, if the 
167.10 	commissioner determines this is necessary to ensure that health care providers under 
167.11 	contract with managed care and county-based purchasing plans practice in an efficient 
167.12 	manner.
167.13 	(g) The commissioner of human services, in consultation with the commissioner of 
167.14 	health, shall develop and provide to managed care and county-based purchasing plans, by 
167.15 	September 1, 2011, standard criteria and definitions necessary for consistent calculation 
167.16 	of the total annual risk-adjusted cost of care across plans. The commissioner may use 
167.17 	encounter data collected under section 62U.04 to implement this subdivision, and may 
167.18 	provide encounter data or analyses to plans. Section 62U.04, subdivision 4, paragraph 
167.19 	(b), shall not apply to the commissioners of health and human services for purposes of 
167.20 	this subdivision.
167.21 	(h) For purposes of this subdivision, "provider" means a vendor of medical care 
167.22 	as defined in section 256B.02, subdivision 7, for which sufficient encounter data on 
167.23 	utilization and costs is available to implement this subdivision.

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

167.25 	Sec. 68. Minnesota Statutes 2010, section 256B.69, is amended by adding a 
167.26 	subdivision to read:
167.27 		Subd. 31.Initiatives to reduce incidence of low birth weight. The commissioner 
167.28 	shall require managed care and county-based purchasing plans as a condition of contract 
167.29 	to implement strategies to reduce the incidence of low birth weight in geographic areas 
167.30 	identified by the commissioner as having a higher than average incidence of low birth 
167.31 	weight, with special emphasis on areas within a one-mile radius of hospitals within their 
167.32 	provider networks. These strategies may focus on smoking prevention and cessation, 
167.33 	ensuring that pregnant women get adequate nutrition, and addressing demographic, 
167.34 	social, and environmental risk factors. The strategies must coordinate health care with 
167.35 	social services and the local public health system, and offer patient education through 
168.1 	appropriate means. The commissioner shall require plans to submit proposed initiatives 
168.2 	for approval to the commissioner by January 1, 2012, and the commissioner shall require 
168.3 	plans to implement approved initiatives by July 1, 2012. The commissioner shall evaluate 
168.4 	the strategies adopted to reduce low birth weight and shall require plans to submit outcome 
168.5 	and other data necessary for the evaluation.

168.6 	Sec. 69. Minnesota Statutes 2010, section 256B.69, is amended by adding a 
168.7 	subdivision to read:
168.8 		Subd. 32.Health education. The commissioner shall require managed care and 
168.9 	county-based purchasing plans, as a condition of contract, to provide health education, 
168.10 	wellness training, and information about the availability and benefits of preventive 
168.11 	services to all medical assistance and MinnesotaCare enrollees, beginning January 1, 
168.12 	2012. Plan initiatives developed or implemented to comply with this requirement must be 
168.13 	approved by the commissioner.

168.14 	Sec. 70. Minnesota Statutes 2010, section 256B.692, subdivision 2, is amended to read:
168.15 		Subd. 2.Duties of commissioner of health. (a) Notwithstanding chapters 62D and 
168.16 	62N, a county that elects to purchase medical assistance in return for a fixed sum without 
168.17 	regard to the frequency or extent of services furnished to any particular enrollee is not 
168.18 	required to obtain a certificate of authority under chapter 62D or 62N. The county board 
168.19 	of commissioners is the governing body of a county-based purchasing program. In a 
168.20 	multicounty arrangement, the governing body is a joint powers board established under 
168.21 	section 471.59.
168.22 	(b) A county that elects to purchase medical assistance services under this section 
168.23 	must satisfy the commissioner of health that the requirements for assurance of consumer 
168.24 	protection, provider protection, and, effective January 1, 2010, fiscal solvency of chapter 
168.25 	62D, applicable to health maintenance organizations will be met according to the 
168.26 	following schedule:
168.27 	(1) for a county-based purchasing plan approved on or before June 30, 2008, the 
168.28 	plan must have in reserve:
168.29 	(i) at least 50 percent of the minimum amount required under chapter 62D as 
168.30 	of January 1, 2010;
168.31 	(ii) at least 75 percent of the minimum amount required under chapter 62D as of 
168.32 	January 1, 2011;
168.33 	(iii) at least 87.5 percent of the minimum amount required under chapter 62D as 
168.34 	of January 1, 2012; and
169.1 	(iv) at least 100 percent of the minimum amount required under chapter 62D as 
169.2 	of January 1, 2013; and
169.3 	(2) for a county-based purchasing plan first approved after June 30, 2008, the plan 
169.4 	must have in reserve:
169.5 	(i) at least 50 percent of the minimum amount required under chapter 62D at the 
169.6 	time the plan begins enrolling enrollees;
169.7 	(ii) at least 75 percent of the minimum amount required under chapter 62D after 
169.8 	the first full calendar year;
169.9 	(iii) at least 87.5 percent of the minimum amount required under chapter 62D after 
169.10 	the second full calendar year; and
169.11 	(iv) at least 100 percent of the minimum amount required under chapter 62D after 
169.12 	the third full calendar year.
169.13 	(c) Until a plan is required to have reserves equaling at least 100 percent of the 
169.14 	minimum amount required under chapter 62D, the plan may demonstrate its ability 
169.15 	to cover any losses by satisfying the requirements of chapter 62N. Notwithstanding 
169.16 	this paragraph and paragraph (b), a county-based purchasing plan may satisfy its fiscal 
169.17 	solvency requirements by obtaining written financial guarantees from participating 
169.18 	counties in amounts equivalent to the minimum amounts that would otherwise apply.
169.19 	A county-based purchasing plan must also assure the commissioner of health that the 
169.20 	requirements of sections 62J.041; 62J.48; 62J.71 to 62J.73; 62M.01 to 62M.16; all 
169.21 	applicable provisions of chapter 62Q, including sections 62Q.075; 62Q.1055; 62Q.106; 
169.22 	62Q.12; 62Q.135; 62Q.14; 62Q.145; 62Q.19; 62Q.23, paragraph (c); 62Q.43; 62Q.47; 
169.23 	62Q.50; 62Q.52 to 62Q.56; 62Q.58; 62Q.68 to 62Q.72; and 72A.201 will be met.
169.24 	(d) All enforcement and rulemaking powers available under chapters 62D, 62J, 62M, 
169.25 	62N, and 62Q are hereby granted to the commissioner of health with respect to counties 
169.26 	that purchase medical assistance services under this section.
169.27 	(e) The commissioner, in consultation with county government, shall develop 
169.28 	administrative and financial reporting requirements for county-based purchasing programs 
169.29 	relating to sections 62D.041, 62D.042, 62D.045, 62D.08, 62N.28, 62N.29, and 62N.31, 
169.30 	and other sections as necessary, that are specific to county administrative, accounting, and 
169.31 	reporting systems and consistent with other statutory requirements of counties.
169.32 	(f) The commissioner shall collect from a county-based purchasing plan under 
169.33 	this section the following fees:
169.34 	(1) fees attributable to the costs of audits and other examinations of plan financial 
169.35 	operations. These fees are subject to the provisions of Minnesota Rules, part 4685.2800, 
169.36 	subpart 1, item F;
170.1 	(2) an annual fee of $21,500, to be paid by June 15 of each calendar year, beginning 
170.2 	in calendar year 2009; and
170.3 	(3) for fiscal year 2009 only, a per-enrollee fee of 14.6 cents, based on the number of 
170.4 	enrollees as of December 31, 2008.
170.5 	All fees collected under this paragraph shall be deposited in the state government special 
170.6 	revenue fund.

170.7 	Sec. 71. Minnesota Statutes 2010, section 256B.692, subdivision 5, is amended to read:
170.8 		Subd. 5.County proposals. (a) On or before September 1, 1997, a county board 
170.9 	that wishes to purchase or provide health care under this section must submit a preliminary 
170.10 	proposal that substantially demonstrates the county's ability to meet all the requirements 
170.11 	of this section in response to criteria for proposals issued by the department on or before 
170.12 	July 1, 1997. Counties submitting preliminary proposals must establish a local planning 
170.13 	process that involves input from medical assistance recipients, recipient advocates, 
170.14 	providers and representatives of local school districts, labor, and tribal government to 
170.15 	advise on the development of a final proposal and its implementation.
170.16 	(b) The county board must submit a final proposal on or before July 1, 1998, that 
170.17 	demonstrates the ability to meet all the requirements of this section, including beginning 
170.18 	enrollment on January 1, 1999, unless a delay has been granted under section 256B.69, 
170.19 	subdivision 3a, paragraph (g). 
170.20 	(c) After January 1, 1999, for a county in which the prepaid medical assistance 
170.21 	program is in existence, the county board must submit a preliminary proposal at least 15 
170.22 	months prior to termination of health plan contracts in that county and a final proposal
170.23 	that meets the requirements of this section six months prior to the health plan contract 
170.24 	termination date in order to begin enrollment after the termination. Nothing in this section 
170.25 	shall impede or delay implementation or continuation of the prepaid medical assistance 
170.26 	program in counties for which the board does not submit a proposal, or submits a proposal 
170.27 	that is not in compliance with this section.
170.28 	(d) The commissioner is not required to terminate contracts for the prepaid medical 
170.29 	assistance program that begin on or after September 1, 1997, in a county for which a 
170.30 	county board has submitted a proposal under this paragraph, until two years have elapsed 
170.31 	from the date of initial enrollment in the prepaid medical assistance program.

170.32 	Sec. 72. Minnesota Statutes 2010, section 256B.692, subdivision 7, is amended to read:
170.33 		Subd. 7.Dispute resolution. In the event the commissioner rejects a proposal 
170.34 	under subdivision 6, the county board may request the recommendation decision of a 
171.1 	three-person mediation panel. The commissioner shall resolve all disputes after taking 
171.2 	into account by following the recommendations decision of the mediation panel. The 
171.3 	panel shall be composed of one designee of the president of the Association of Minnesota 
171.4 	Counties, one designee of the commissioner of human services, and one person selected 
171.5 	jointly by the designee of the commissioner of human services and the designee of 
171.6 	the Association of Minnesota Counties. Within a reasonable period of time before the 
171.7 	hearing, the panelists must be provided all documents and information relevant to the 
171.8 	mediation. The parties to the mediation must be given 30 days' notice of a hearing before 
171.9 	the mediation panel.

171.10 	Sec. 73. Minnesota Statutes 2010, section 256B.692, is amended by adding a 
171.11 	subdivision to read:
171.12 		Subd. 11.Patient choice of qualified provider. Effective January 1, 2012, a county 
171.13 	board operating a county-based purchasing plan must ensure that each enrollee has the 
171.14 	option of choosing a primary care provider or a health care home from all qualified 
171.15 	providers who agree to accept the terms, conditions, and payment rates offered by the 
171.16 	plan to similarly situated providers. Notwithstanding this requirement, reimbursement 
171.17 	to federally qualified health centers and federally qualified health center look-alikes as 
171.18 	defined in section 145.9269 must be in compliance with federal law.

171.19 	Sec. 74. Minnesota Statutes 2010, section 256B.694, is amended to read:
171.20 	256B.694 SOLE-SOURCE OR SINGLE-PLAN MANAGED CARE 
171.21 	CONTRACT.
171.22 	(a) Notwithstanding section 256B.692, subdivision 6, clause (1), paragraph (c), 
171.23 	the commissioner of human services shall approve a county-based purchasing health 
171.24 	plan proposal, submitted on behalf of Cass, Crow Wing, Morrison, Todd, and Wadena 
171.25 	Counties, that requires county-based purchasing on a single-plan basis contract if the 
171.26 	implementation of the single-plan purchasing proposal does not limit an enrollee's 
171.27 	provider choice or access to services and all other requirements applicable to health plan 
171.28 	purchasing are satisfied. The commissioner shall continue to use single-health plan, 
171.29 	county-based purchasing arrangements for medical assistance and general assistance 
171.30 	medical care programs and products for the counties that were in single-health plan, 
171.31 	county-based purchasing arrangements on March 1, 2008. This paragraph does not require 
171.32 	the commissioner to terminate an existing contract with a noncounty-based purchasing 
171.33 	plan that had enrollment in a medical assistance program or product in these counties on 
171.34 	March 1, 2008. This paragraph expires on December 31, 2010, or the effective date 
172.1 	of a new contract for medical assistance and general assistance medical care managed 
172.2 	care programs entered into at the conclusion of the commissioner's next scheduled 
172.3 	reprocurement process for the county-based purchasing entities covered by this paragraph, 
172.4 	whichever is later.
172.5 	(b) At the request of a county or group of counties, the commissioner shall consider, 
172.6 	and may approve, contracting on a single-health plan basis with other county-based 
172.7 	purchasing plans, or with other qualified health plans that have coordination arrangements 
172.8 	with counties, to serve persons with a disability who voluntarily enroll, enrolled in 
172.9 	Minnesota health care programs in order to promote better coordination or integration 
172.10 	of health care services, social services and other community-based services, provided 
172.11 	that all requirements applicable to health plan purchasing, including those in section 
172.12 	256B.69, subdivision 23, are satisfied. Nothing in this paragraph supersedes or modifies 
172.13 	the requirements in paragraph (a).

172.14 	Sec. 75. Minnesota Statutes 2010, section 256B.76, subdivision 4, is amended to read:
172.15 		Subd. 4.Critical access dental providers.  (a) Effective for dental services 
172.16 	rendered on or after January 1, 2002, the commissioner shall increase reimbursements 
172.17 	to dentists and dental clinics deemed by the commissioner to be critical access dental 
172.18 	providers. For dental services rendered on or after July 1, 2007, the commissioner shall 
172.19 	increase reimbursement by 30 percent above the reimbursement rate that would otherwise 
172.20 	be paid to the critical access dental provider. The commissioner shall pay the managed 
172.21 	care plans and county-based purchasing plans in amounts sufficient to reflect increased 
172.22 	reimbursements to critical access dental providers as approved by the commissioner.
172.23 	(b) The commissioner shall designate the following dentists and dental clinics as 
172.24 	critical access dental providers:
172.25 	(1) nonprofit community clinics that:
172.26 	(i) have nonprofit status in accordance with chapter 317A;
172.27 	(ii) have tax exempt status in accordance with the Internal Revenue Code, section 
172.28 	501(c)(3);
172.29 	(iii) are established to provide oral health services to patients who are low income, 
172.30 	uninsured, have special needs, and are underserved;
172.31 	(iv) have professional staff familiar with the cultural background of the clinic's 
172.32 	patients;
172.33 	(v) charge for services on a sliding fee scale designed to provide assistance to 
172.34 	low-income patients based on current poverty income guidelines and family size;
173.1 	(vi) do not restrict access or services because of a patient's financial limitations 
173.2 	or public assistance status; and
173.3 	(vii) have free care available as needed;
173.4 	(2) federally qualified health centers, rural health clinics, and public health clinics;
173.5 	(3) county owned and operated hospital-based dental clinics;
173.6 	(4) a dental clinic or dental group owned and operated by a nonprofit corporation in 
173.7 	accordance with chapter 317A with more than 10,000 patient encounters per year with 
173.8 	patients who are uninsured or covered by medical assistance, general assistance medical 
173.9 	care, or MinnesotaCare; and
173.10 	(5) a dental clinic associated with an oral health or dental education program owned 
173.11 	and operated by the University of Minnesota or an institution within the Minnesota State 
173.12 	Colleges and Universities system.
173.13 	 (c) The commissioner may designate a dentist or dental clinic as a critical access 
173.14 	dental provider if the dentist or dental clinic is willing to provide care to patients covered 
173.15 	by medical assistance, general assistance medical care, or MinnesotaCare at a level which 
173.16 	significantly increases access to dental care in the service area.
173.17 	(d) Notwithstanding paragraph (a), critical access payments must not be made for 
173.18 	dental services provided from April 1, 2010, through June 30, 2010.

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

173.20 	Sec. 76. [256B.7671] PATIENT-CENTERED DECISION-MAKING.
173.21 	(a) For purposes of this section, "patient-centered decision-making process" means a 
173.22 	process that involves directed interaction with the patient to assist the patient in arriving at 
173.23 	an informed objective health care decision regarding the surgical procedure that is both 
173.24 	informed and consistent with the patient's preference and values. The interaction may be 
173.25 	conducted by a health care provider or through the electronic use of decision aids. If 
173.26 	decision aids are used in the process, the aids must meet the criteria established by the 
173.27 	International Patients Decision Aids Standards Collaboration or the Cochrane Decision 
173.28 	Aid Registry.
173.29 	(b) Effective January 1, 2012, the commissioner of human services shall require 
173.30 	active participation in a patient-centered decision-making process before authorization is 
173.31 	approved or payment reimbursement is provided for any of the following:
173.32 	(1) a surgical procedure for abnormal uterine bleeding, benign prostate enlargement, 
173.33 	chronic back pain, early stage of breast and prostate cancers, gastroesophageal reflux 
173.34 	disease, hemorrhoids, spinal stenosis, temporomandibular joint dysfunction, ulcerative 
173.35 	colitis, urinary incontinence, uterine fibroids, or varicose veins; and
174.1 	(2) bypass surgery for coronary disease, angioplasty for stable coronary artery 
174.2 	disease, or total hip replacement. 
174.3 	(c) A list of the procedures in paragraph (b) shall be published in the State Register 
174.4 	by October 1, 2011. The list shall be reviewed no less than every two years by the 
174.5 	commissioner, in consultation with the commissioner of health. The commissioner 
174.6 	shall hold a public forum and receive public comment prior to any changes to the list in 
174.7 	paragraph (b). Any changes made shall be published in the State Register.
174.8 	(d) Prior to receiving authorization or reimbursement for the procedures identified 
174.9 	under this section, a health care provider must certify that the patient has participated in a 
174.10 	patient-centered decision-making process. The format for this certification and the process 
174.11 	for coordination between providers shall be developed by the Health Services Policy 
174.12 	Committee under section 256B.0625, subdivision 3c.
174.13 	(e) This section does not apply if any of the procedures identified in this section are 
174.14 	performed under an emergency situation.

174.15 	Sec. 77. [256B.771] COMPLEMENTARY AND ALTERNATIVE MEDICINE 
174.16 	DEMONSTRATION PROJECT.
174.17 		Subdivision 1.Establishment and implementation. The commissioner of 
174.18 	human services, in consultation with the commissioner of health, shall contract 
174.19 	with a Minnesota-based academic and research institution specializing in providing 
174.20 	complementary and alternative medicine education and clinical services to establish and 
174.21 	implement a five-year demonstration project in conjunction with federally qualified health 
174.22 	centers and federally qualified health center look-alikes as defined in section 145.9269, to 
174.23 	improve the quality and cost-effectiveness of care provided under medical assistance to 
174.24 	enrollees with neck and back problems.  The demonstration project must maximize the use 
174.25 	of complementary and alternative medicine-oriented primary care providers, including but 
174.26 	not limited to physicians and chiropractors.  The demonstration project must be designed 
174.27 	to significantly improve physical and mental health for enrollees who present with 
174.28 	neck and back problems while decreasing medical treatment costs. The commissioner, 
174.29 	in consultation with the commissioner of health, shall deliver services through the 
174.30 	demonstration project beginning July 1, 2011, or upon federal approval, whichever is later.
174.31 		Subd. 2.RFP and project criteria. The commissioner, in consultation with the 
174.32 	commissioner of health, shall develop and issue a request for proposal (RFP) for the 
174.33 	demonstration project. The RFP must require the academic and research institution 
174.34 	selected to demonstrate a proven track record over at least five years of conducting 
175.1 	high-quality, federally funded clinical research. The institution and the federally qualified 
175.2 	health centers and federally qualified health center look-alikes shall also:
175.3 	(1) provide patient education, provider education, and enrollment training 
175.4 	components on health and lifestyle issues in order to promote enrollee responsibility for 
175.5 	health care decisions, enhance productivity, prepare enrollees to reenter the workforce, 
175.6 	and reduce future health care expenditures;
175.7 	(2) use high-quality and cost-effective integrated disease management that includes 
175.8 	the best practices of traditional and complementary and alternative medicine;
175.9 	(3) incorporate holistic medical care, appropriate nutrition, exercise, medications, 
175.10 	and conflict resolution techniques;
175.11 	(4) include a provider education component that makes use of professional 
175.12 	organizations representing chiropractors, nurses, and other primary care providers 
175.13 	and provides appropriate educational materials and activities in order to improve the 
175.14 	integration of traditional medical care with licensed chiropractic services and other 
175.15 	alternative health care services and achieve program enrollment objectives; and
175.16 	(5) provide to the commissioner the information and data necessary for the 
175.17 	commissioner to prepare the annual reports required under subdivision 6.
175.18 		Subd. 3.Enrollment. Enrollees from the program shall be selected by the 
175.19 	commissioner from current enrollees in the prepaid medical assistance program who 
175.20 	have, or are determined to be at significant risk of developing, neck and back problems. 
175.21 	Participation in the demonstration project shall be voluntary.  The commissioner shall 
175.22 	seek to enroll, over the term of the demonstration project, ten percent of current and 
175.23 	future medical assistance enrollees who have, or are determined to be at significant risk 
175.24 	of developing, neck and back problems.
175.25 		Subd. 4.Federal approval. The commissioner shall seek any federal waivers and 
175.26 	approvals necessary to implement the demonstration project.
175.27 		Subd. 5.Project costs. The commissioner shall require the academic and research 
175.28 	institution selected, federally qualified health centers, and federally qualified health center 
175.29 	look-alikes to fund all net costs of the demonstration project.
175.30 		Subd. 6.Annual reports. The commissioner, in consultation with the commissioner 
175.31 	of health, beginning December 15, 2011, and each December 15 thereafter through 
175.32 	December 15, 2015, shall report annually to the legislature on the functional and mental 
175.33 	improvements of the populations served by the demonstration project, patient satisfaction, 
175.34 	and the cost-effectiveness of the program. The reports must also include data on hospital 
175.35 	admissions, days in hospital, rates of outpatient surgery and other services, and drug 
176.1 	utilization. The report, due December 15, 2015, must include recommendations on 
176.2 	whether the demonstration project should be continued and expanded.

176.3 	Sec. 78. [256B.841] WAIVER APPLICATION AND PROCESS.
176.4 		Subdivision 1.Intent. It is the intent of the legislature that medical assistance be:
176.5 	(1) a sustainable, cost-effective, person-centered, and opportunity-driven program 
176.6 	utilizing competitive and value-based purchasing to maximize available service options; 
176.7 	and
176.8 	(2) a results-oriented system of coordinated care that focuses on independence 
176.9 	and choice, promotes accountability and transparency, encourages and rewards healthy 
176.10 	outcomes and responsible choices, and promotes efficiency.
176.11 		Subd. 2.Waiver application. (a) By September 1, 2011, the commissioner of 
176.12 	human services shall apply for a waiver and any necessary state plan amendments from 
176.13 	the secretary of the United States Department of Health and Human Services, including, 
176.14 	but not limited to, a waiver of the appropriate sections of title XIX of the federal Social 
176.15 	Security Act, United States Code, title 42, section 1396 et seq., or other provisions of 
176.16 	federal law that provide program flexibility and under which Minnesota will operate all 
176.17 	facets of the state's medical assistance program.
176.18 	(b) The commissioner of human services shall provide the legislative committees 
176.19 	with jurisdiction over health and human services finance and policy with the waiver 
176.20 	application and financial and other related materials, at least ten days prior to submitting 
176.21 	the application and materials to the federal Centers for Medicare and Medicaid Services.
176.22 	(c) If the state's waiver application is approved, the commissioner of human services 
176.23 	shall:
176.24 	(1) notify the chairs of the legislative committees with jurisdiction over health and 
176.25 	human services finance and policy and allow the legislative committees with jurisdiction 
176.26 	over health and human services finance and policy to review the terms of the waiver; and
176.27 	(2) not implement the waiver until ten legislative days have passed following 
176.28 	notification of the chairs.
176.29 		Subd. 3.Rulemaking; legislative proposals. Upon acceptance of the terms of the 
176.30 	waiver, the commissioner of human services shall:
176.31 	(1) adopt rules to implement the waiver; and
176.32 	(2) propose any legislative changes necessary to implement the terms of the waiver.
176.33 		Subd. 4.Joint commission on waiver implementation. (a) After acceptance 
176.34 	of the terms of the waiver, the governor shall establish a joint commission on waiver 
176.35 	implementation. The commission shall consist of eight members; four of whom shall 
177.1 	be members of the senate, not more than three from the same political party, to be 
177.2 	appointed by the Subcommittee on Committees of the senate Committee on Rules and 
177.3 	Administration, and four of whom shall be members of the house of representatives, not 
177.4 	more than three from the same political party, to be appointed by the speaker of the house.
177.5 	(b) The commission shall:
177.6 	(1) oversee implementation of the waiver;
177.7 	(2) confer as necessary with state agency commissioners;
177.8 	(3) make recommendations on services covered under the medical assistance 
177.9 	program;
177.10 	(4) monitor and make recommendations on quality and access to care under the 
177.11 	global waiver; and
177.12 	(5) make recommendations for the efficient and cost-effective administration of the 
177.13 	medical assistance program under the terms of the waiver.

177.14 	Sec. 79. [256B.842] PRINCIPLES AND GOALS FOR MEDICAL ASSISTANCE 
177.15 	REFORM.
177.16 		Subdivision 1.Goals for reform.  In developing the waiver application and 
177.17 	implementing the waiver, the commissioner of human services shall ensure that the 
177.18 	reformed medical assistance program is a person-centered, financially sustainable, and 
177.19 	cost-effective program.
177.20 		Subd. 2.Reformed medical assistance criteria. The reformed medical assistance 
177.21 	program established through the waiver must:
177.22 	(1) empower consumers to make informed and cost-effective choices about their 
177.23 	health and offer consumers rewards for healthy decisions;
177.24 	(2) ensure adequate access to needed services;
177.25 	(3) enable consumers to receive individualized health care that is outcome-oriented 
177.26 	and focused on prevention, disease management, recovery, and maintaining independence;
177.27 	(4) promote competition between health care providers to ensure best value 
177.28 	purchasing, leverage resources, and to create opportunities for improving service quality 
177.29 	and performance;
177.30 	(5) redesign purchasing and payment methods and encourage and reward 
177.31 	high-quality and cost-effective care by incorporating and expanding upon current payment 
177.32 	reform and quality of care initiatives, including but not limited to those initiatives 
177.33 	authorized under chapter 62U; and
178.1 	(6) continually improve technology to take advantage of recent innovations and 
178.2 	advances that help decision makers, consumers, and providers make informed and 
178.3 	cost-effective decisions regarding health care.
178.4 		Subd. 3.Annual report. The commissioner of human services shall annually 
178.5 	submit a report to the governor and the legislature, beginning December 1, 2012, and each 
178.6 	December 1 thereafter, describing the status of the administration and implementation 
178.7 	of the waiver.

178.8 	Sec. 80. [256B.843] WAIVER APPLICATION REQUIREMENTS.
178.9 		Subdivision 1.Requirements for waiver request. The commissioner shall seek 
178.10 	federal approval to:
178.11 	(1) enter into a five-year agreement with the United States Department of Health and 
178.12 	Human Services and Centers for Medicaid and Medicare Services (CMS) under section 
178.13 	1115a to waive provisions of title XIX of the federal Social Security Act, United States 
178.14 	Code, title 42, section 1396 et seq., requiring:
178.15 	(i) statewideness to allow for the provision of different services in different areas or 
178.16 	regions of the state;
178.17 	(ii) comparability of services to allow for the provision of different services to 
178.18 	members of the same or different coverage groups;
178.19 	(iii) no prohibitions restricting the amount, duration, and scope of services included 
178.20 	in the medical assistance state plan;
178.21 	(iv) no prohibitions limiting freedom of choice of providers; and
178.22 	(v) retroactive payment for medical assistance, at the state's discretion;
178.23 	(2) waive the applicable provisions of title XIX of the federal Social Security Act, 
178.24 	United States Code, title 42, section 1396 et seq., in order to:
178.25 	(i) expand cost sharing requirements above the five percent of income threshold for 
178.26 	beneficiaries in certain populations;
178.27 	(ii) establish health savings or power accounts that encourage and reward 
178.28 	beneficiaries who reach certain prevention and wellness targets; and
178.29 	(iii) implement a tiered set of parameters to use as the basis for determining 
178.30 	long-term service care and setting needs;
178.31 	(3) modify income and resource rules in a manner consistent with the goals of the 
178.32 	reformed program;
178.33 	(4) provide enrollees with a choice of appropriate private sector health coverage 
178.34 	options, with full federal financial participation;
179.1 	(5) treat payments made toward the cost of care as a monthly premium for 
179.2 	beneficiaries receiving home and community-based services when applicable;
179.3 	(6) provide health coverage and services to individuals over the age of 65 that are 
179.4 	limited in scope and are available only in the home and community-based setting;
179.5 	(7) consolidate all home and community-based services currently provided under 
179.6 	title XIX of the federal Social Security Act, United States Code, title 42, section 1915(c), 
179.7 	into a single program of home and community-based services that include options for 
179.8 	consumer direction and shared living;
179.9 	(8) expand disease management, care coordination, and wellness programs for all 
179.10 	medical assistance recipients; and
179.11 	(9) empower and encourage able-bodied medical assistance recipients to work, 
179.12 	whenever possible.
179.13 		Subd. 2.Agency coordination. The commissioner shall establish an intraagency 
179.14 	assessment and coordination unit to ensure that decision making and program planning for 
179.15 	recipients who may need long-term care, residential placement, and community support 
179.16 	services are coordinated. The assessment and coordination unit shall determine level of 
179.17 	care, develop service plans and a service budget, make referrals to appropriate settings, 
179.18 	provide education and choice counseling to consumers and providers, track utilization, 
179.19 	and monitor outcomes. 

179.20 	Sec. 81. Minnesota Statutes 2010, section 256L.01, subdivision 4a, is amended to read:
179.21 		Subd. 4a.Gross individual or gross family income. (a) "Gross individual or gross 
179.22 	family income" for nonfarm self-employed means income calculated for the 12-month
179.23 	six-month period of eligibility using as a baseline the adjusted gross income reported 
179.24 	on the applicant's federal income tax form for the previous year and adding back in 
179.25 	depreciation, and carryover net operating loss amounts that apply to the business in which 
179.26 	the family is currently engaged.
179.27 	(b) "Gross individual or gross family income" for farm self-employed means 
179.28 	income calculated for the 12-month six-month period of eligibility using as the baseline 
179.29 	the adjusted gross income reported on the applicant's federal income tax form for the 
179.30 	previous year.
179.31 	(c) "Gross individual or gross family income" means the total income for all family 
179.32 	members, calculated for the 12-month six-month period of eligibility.

179.33 	Sec. 82. Minnesota Statutes 2010, section 256L.02, subdivision 3, is amended to read:
180.1 		Subd. 3.Financial management. (a) The commissioner shall manage spending for 
180.2 	the MinnesotaCare program in a manner that maintains a minimum reserve. As part of 
180.3 	each state revenue and expenditure forecast, the commissioner must make an assessment 
180.4 	of the expected expenditures for the covered services for the remainder of the current 
180.5 	biennium and for the following biennium. The estimated expenditure, including the 
180.6 	reserve, shall be compared to an estimate of the revenues that will be available in the health 
180.7 	care access fund. Based on this comparison, and after consulting with the chairs of the 
180.8 	house of representatives Ways and Means Committee and the senate Finance Committee, 
180.9 	and the Legislative Commission on Health Care Access, the commissioner shall, as 
180.10 	necessary, make the adjustments specified in paragraph (b) to ensure that expenditures 
180.11 	remain within the limits of available revenues for the remainder of the current biennium 
180.12 	and for the following biennium. The commissioner shall not hire additional staff using 
180.13 	appropriations from the health care access fund until the commissioner of management 
180.14 	and budget makes a determination that the adjustments implemented under paragraph (b) 
180.15 	are sufficient to allow MinnesotaCare expenditures to remain within the limits of available 
180.16 	revenues for the remainder of the current biennium and for the following biennium.
180.17 	(b) The adjustments the commissioner shall use must be implemented in this order: 
180.18 	first, stop enrollment of single adults and households without children; second, upon 45 
180.19 	days' notice, stop coverage of single adults and households without children already 
180.20 	enrolled in the MinnesotaCare program; third, upon 90 days' notice, decrease the premium 
180.21 	subsidy amounts by ten percent for children in families with gross annual income above 
180.22 	200 percent of the federal poverty guidelines; fourth, upon 90 days' notice, decrease the 
180.23 	premium subsidy amounts by ten percent for children in families with gross annual income 
180.24 	at or below 200 percent; and fifth, require applicants to be uninsured for at least six months 
180.25 	prior to eligibility in the MinnesotaCare program. If these measures are insufficient to 
180.26 	limit the expenditures to the estimated amount of revenue, the commissioner shall further 
180.27 	limit enrollment or decrease premium subsidies.

180.28 	EFFECTIVE DATE. This section is effective January 1, 2012, or upon federal 
180.29 	approval, whichever is later, and expires June 30, 2013. The commissioner shall notify 
180.30 	the revisor of statutes when federal approval is obtained and publish a notice in the State 
180.31 	Register.

180.32 	Sec. 83. Minnesota Statutes 2010, section 256L.02, subdivision 3, is amended to read:
180.33 		Subd. 3.Financial management. (a) The commissioner shall manage spending for 
180.34 	the MinnesotaCare program in a manner that maintains a minimum reserve. As part of 
180.35 	each state revenue and expenditure forecast, the commissioner must make an assessment 
181.1 	of the expected expenditures for the covered services for the remainder of the current 
181.2 	biennium and for the following biennium. The estimated expenditure, including the 
181.3 	reserve, shall be compared to an estimate of the revenues that will be available in the health 
181.4 	care access fund. Based on this comparison, and after consulting with the chairs of the 
181.5 	house of representatives Ways and Means Committee and the senate Finance Committee, 
181.6 	and the Legislative Commission on Health Care Access, the commissioner shall, as 
181.7 	necessary, make the adjustments specified in paragraph (b) to ensure that expenditures 
181.8 	remain within the limits of available revenues for the remainder of the current biennium 
181.9 	and for the following biennium. The commissioner shall not hire additional staff using 
181.10 	appropriations from the health care access fund until the commissioner of management 
181.11 	and budget makes a determination that the adjustments implemented under paragraph (b) 
181.12 	are sufficient to allow MinnesotaCare expenditures to remain within the limits of available 
181.13 	revenues for the remainder of the current biennium and for the following biennium.
181.14 	(b) The adjustments the commissioner shall use must be implemented in this order: 
181.15 	first, stop enrollment of single adults and households without children; second, upon 45 
181.16 	days' notice, stop coverage of single adults and households without children already 
181.17 	enrolled in the MinnesotaCare program; third, upon 90 days' notice, decrease the premium 
181.18 	subsidy amounts by ten percent for families with gross annual income above 200 percent 
181.19 	of the federal poverty guidelines; fourth, upon 90 days' notice, decrease the premium 
181.20 	subsidy amounts by ten percent for families with gross annual income at or below 200 
181.21 	percent; and fifth, require applicants to be uninsured for at least six months prior to 
181.22 	eligibility in the MinnesotaCare program. If these measures are insufficient to limit the 
181.23 	expenditures to the estimated amount of revenue, the commissioner shall further limit 
181.24 	enrollment or decrease premium subsidies.

181.25 	Sec. 84. Minnesota Statutes 2010, section 256L.03, subdivision 3, is amended to read:
181.26 		Subd. 3.Inpatient hospital services. (a) Covered health services shall include 
181.27 	inpatient hospital services, including inpatient hospital mental health services and inpatient 
181.28 	hospital and residential chemical dependency treatment, subject to those limitations 
181.29 	necessary to coordinate the provision of these services with eligibility under the medical 
181.30 	assistance spenddown. The inpatient hospital benefit for adult enrollees who qualify under 
181.31 	section 256L.04, subdivision 7, or who qualify under section 256L.04, subdivisions 1 and 
181.32 	2, with family gross income that exceeds 200 percent of the federal poverty guidelines or 
181.33 	215 percent of the federal poverty guidelines on or after July 1, 2009, and who are not 
181.34 	pregnant, is subject to an annual limit of $10,000.
182.1 	(b) Admissions for inpatient hospital services paid for under section 256L.11, 
182.2 	subdivision 3, must be certified as medically necessary in accordance with Minnesota 
182.3 	Rules, parts 9505.0500 to 9505.0540, except as provided in clauses (1) and (2):
182.4 	(1) all admissions must be certified, except those authorized under rules established 
182.5 	under section 254A.03, subdivision 3, or approved under Medicare; and
182.6 	(2) payment under section 256L.11, subdivision 3, shall be reduced by five percent 
182.7 	for admissions for which certification is requested more than 30 days after the day of 
182.8 	admission. The hospital may not seek payment from the enrollee for the amount of the 
182.9 	payment reduction under this clause.

182.10 	EFFECTIVE DATE. This section is effective January 1, 2012, or upon federal 
182.11 	approval, whichever is later, and expires June 30, 2013. The commissioner shall notify 
182.12 	the revisor of statutes when federal approval is obtained and publish a notice in the State 
182.13 	Register.

182.14 	Sec. 85. Minnesota Statutes 2010, section 256L.03, subdivision 5, is amended to read:
182.15 		Subd. 5.Co-payments and coinsurance Cost-sharing. (a) Except as provided in 
182.16 	paragraphs (b) and, (c), and (h), the MinnesotaCare benefit plan shall include the following 
182.17 	co-payments and coinsurance cost-sharing requirements for all enrollees:
182.18 	(1) ten percent of the paid charges for inpatient hospital services for adult enrollees, 
182.19 	subject to an annual inpatient out-of-pocket maximum of $1,000 per individual;
182.20 	(2) $3 per prescription for adult enrollees;
182.21 	(3) $25 for eyeglasses for adult enrollees;
182.22 	(4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an 
182.23 	episode of service which is required because of a recipient's symptoms, diagnosis, or 
182.24 	established illness, and which is delivered in an ambulatory setting by a physician or 
182.25 	physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse, 
182.26 	audiologist, optician, or optometrist; and
182.27 	(5) $6 for nonemergency visits to a hospital-based emergency room for services 
182.28 	provided through December 31, 2010, and $3.50 effective January 1, 2011; and
182.29 	(6) a family deductible equal to the maximum amount allowed under Code of 
182.30 	Federal Regulations, title 42, part 447.54.
182.31 	(b) Paragraph (a), clause (1), does and paragraph (e) do not apply to parents and 
182.32 	relative caretakers of children under the age of 21.
182.33 	(c) Paragraph (a) does not apply to pregnant women and children under the age of 21.
182.34 	(d) Paragraph (a), clause (4), does not apply to mental health services.
183.1 	(e) Adult enrollees with family gross income that exceeds 200 percent of the federal 
183.2 	poverty guidelines or 215 percent of the federal poverty guidelines on or after July 1, 2009, 
183.3 	and who are not pregnant shall be financially responsible for the coinsurance amount, if 
183.4 	applicable, and amounts which exceed the $10,000 inpatient hospital benefit limit.
183.5 	(f) When a MinnesotaCare enrollee becomes a member of a prepaid health plan, 
183.6 	or changes from one prepaid health plan to another during a calendar year, any charges 
183.7 	submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket 
183.8 	expenses incurred by the enrollee for inpatient services, that were submitted or incurred 
183.9 	prior to enrollment, or prior to the change in health plans, shall be disregarded.
183.10 	(g) MinnesotaCare reimbursements to fee-for-service providers and payments to 
183.11 	managed care plans or county-based purchasing plans shall not be increased as a result of 
183.12 	the reduction of the co-payments in paragraph (a), clause (5), effective January 1, 2011.
183.13 	(h) Effective January 1, 2012, the following co-payments for nonpreventive visits 
183.14 	shall apply to enrollees who are adults without children eligible under section 256L.04, 
183.15 	subdivision 7:
183.16 	(1) $3 for visits to providers whose average, risk-adjusted, total annual cost of care 
183.17 	per MinnesotaCare enrollee is at the 60th percentile or lower for providers of the same 
183.18 	type;
183.19 	(2) $6 for visits to providers whose average, risk-adjusted, total annual cost of care 
183.20 	per MinnesotaCare enrollee is greater than the 60th percentile but does not exceed the 
183.21 	80th percentile for providers of the same type; and
183.22 	(3) $10 for visits to providers whose average, risk-adjusted, total annual cost of 
183.23 	care per MinnesotaCare enrollee is greater than the 80th percentile for providers of the 
183.24 	same type.
183.25 	Each managed care and county-based purchasing plan shall calculate the average, 
183.26 	risk-adjusted, total annual cost of care for providers under this paragraph using a 
183.27 	methodology that has been approved by the commissioner.

183.28 	EFFECTIVE DATE. The amendments to paragraph (e) are effective January 1, 
183.29 	2012, or upon federal approval, whichever is later, and expires June 30, 2013. The 
183.30 	commissioner shall notify the revisor of statutes when federal approval is obtained and 
183.31 	publish a notice in the State Register.

183.32 	Sec. 86. [256L.031] HEALTHY MINNESOTA CONTRIBUTION PROGRAM.
183.33 		Subdivision 1.Defined contributions to enrollees. (a) Beginning January 1, 2012, 
183.34 	the commissioner shall provide each MinnesotaCare enrollee eligible under section 
183.35 	256L.04, subdivision 7, with gross family income equal to or greater than 133 percent 
184.1 	of the federal poverty guidelines, with a monthly defined contribution to purchase health 
184.2 	coverage under a health plan as defined in section 62A.011, subdivision 3. Beginning 
184.3 	January 1, 2012, or upon federal approval, whichever is later, the commissioner shall 
184.4 	provide each MinnesotaCare enrollee eligible under section 256L.04, subdivision 1, with 
184.5 	gross family income equal to or greater than 133 percent of the federal poverty guidelines, 
184.6 	with a monthly defined contribution to purchase health coverage under a health plan as 
184.7 	defined in section 62A.011, subdivision 3, offered by a health plan company as defined 
184.8 	in section 62Q.01, subdivision 4.
184.9 	(b) Enrollees eligible under paragraph (a) shall not be charged premiums under 
184.10 	section 256L.15 and are exempt from the managed care enrollment requirement of section 
184.11 	256L.12.
184.12 	(c) Sections 256L.03; 256L.05, subdivision 3; and 256L.11 do not apply to 
184.13 	enrollees eligible under paragraph (a). Covered services, cost-sharing, disenrollment 
184.14 	for nonpayment of premium, enrollee appeal rights and complaint procedures, and the 
184.15 	effective date of coverage for enrollees eligible under paragraph (a) shall be as provided 
184.16 	under the terms of the health plan purchased by the enrollee.
184.17 	(d) Unless otherwise provided in this section, all MinnesotaCare requirements 
184.18 	related to eligibility, income and asset methodology, income reporting, and program 
184.19 	administration continue to apply to enrollees obtaining coverage under this section.
184.20 		Subd. 2.Use of defined contribution. An enrollee may use up to the monthly 
184.21 	defined contribution to pay premiums for coverage under a health plan as defined in 
184.22 	section 62A.011, subdivision 3.
184.23 		Subd. 3.Determination of defined contribution amount. (a) The commissioner 
184.24 	shall determine the defined contribution sliding scale using the base contribution specified 
184.25 	in paragraph (b) for the specified age ranges. The commissioner shall use a sliding scale 
184.26 	for defined contributions that provides:
184.27 	(1) persons with household incomes equal to 133 percent of the federal poverty 
184.28 	guidelines with a defined contribution of 150 percent of the base contribution;
184.29 	(2) persons with household incomes equal to 175 percent of the federal poverty 
184.30 	guidelines with a defined contribution of 100 percent of the base contribution;
184.31 	(3) persons with household incomes equal to or greater than 250 percent of 
184.32 	the federal poverty guidelines with a defined contribution of 80 percent of the base 
184.33 	contribution; and
184.34 	(4) persons with household incomes in evenly spaced increments between the 
184.35 	percentages of the federal poverty guideline specified in clauses (1) to (3) with a base 
185.1 	contribution that is a percentage interpolated from the defined contribution percentages 
185.2 	specified in clauses (1) to (3).

185.3	Age
	Monthly Per-Person Base Contribution
	
185.4	Under 21
	$122.79
	
185.5	21-29
	122.79
	
185.6	30-31
	129.19
	
185.7	32-33
	132.38
	
185.8	34-35
	134.31
	
185.9	36-37
	136.06
	
185.10	38-39
	141.02
	
185.11	40-41
	151.25
	
185.12	42-43
	159.89
	
185.13	44-45
	175.08
	
185.14	46-47
	191.71
	
185.15	48-49
	213.13
	
185.16	50-51
	239.51
	
185.17	52-53
	266.69
	
185.18	54-55
	293.88
	
185.19	56-57
	323.77
	
185.20	58-59
	341.20
	
185.21	60+
	357.19
	
185.22 	(b) The commissioner shall multiply the defined contribution amounts developed 
185.23 	under paragraph (a) by 1.20 for enrollees who are denied coverage under an individual 
185.24 	health plan by a health plan company and who purchase coverage through the Minnesota 
185.25 	Comprehensive Health Association.
185.26 	(c) Notwithstanding paragraphs (a) and (b), the monthly defined contribution shall 
185.27 	not exceed 90 percent of the monthly premium for the health plan purchased by the 
185.28 	enrollee. If the enrollee purchases coverage under a health plan that does not include 
185.29 	mental health services and chemical dependency treatment services, the monthly defined 
185.30 	contribution amount determined under this subdivision shall be reduced by five percent.
185.31 		Subd. 4.Administration by commissioner. The commissioner shall administer the 
185.32 	defined contributions. The commissioner shall:
185.33 	(1) calculate and process defined contributions for enrollees; and
185.34 	(2) pay the defined contribution amount to health plan companies or the Minnesota 
185.35 	Comprehensive Health Association, as applicable, for enrollee health plan coverage.
185.36 		Subd. 5.Assistance to enrollees. The commissioner of human services, in 
185.37 	consultation with the commissioner of commerce, shall develop an efficient and 
185.38 	cost-effective method of referring eligible applicants to professional insurance agent 
185.39 	associations.
186.1 		Subd. 6.Minnesota Comprehensive Health Association (MCHA). Beginning 
186.2 	January 1, 2012, MinnesotaCare enrollees who are denied coverage under an individual 
186.3 	health plan by a health plan company are eligible for coverage through a health plan 
186.4 	offered by the MCHA and may enroll in MCHA according to section 62E.14. Any 
186.5 	difference between the revenue and covered losses to the MCHA related to implementation 
186.6 	of this section shall be paid to the MCHA from the health care access fund.
186.7 		Subd. 7.Federal approval. The commissioner shall seek all federal waivers 
186.8 	and approvals necessary to implement coverage under this section for MinnesotaCare 
186.9 	enrollees eligible under section 256L.04, subdivision 1, with gross family incomes equal 
186.10 	to or greater than 133 percent of the federal poverty guidelines, while continuing to 
186.11 	receive federal matching funds.

186.12 	Sec. 87. Minnesota Statutes 2010, section 256L.04, subdivision 1, is amended to read:
186.13 		Subdivision 1.Families with children. (a) Families with Children with family 
186.14 	income equal to or less than 275 percent of the federal poverty guidelines for the 
186.15 	applicable family size and adults in families with children with family income equal to or 
186.16 	less than 200 percent of the federal poverty guidelines for the applicable family size, shall 
186.17 	be eligible for MinnesotaCare according to this section. All other provisions of sections 
186.18 	256L.01 to 256L.18, including the insurance-related barriers to enrollment under section 
186.19 	256L.07, shall apply unless otherwise specified.
186.20 	(b) Parents who enroll in the MinnesotaCare program must also enroll their children, 
186.21 	if the children are eligible. Children may be enrolled separately without enrollment by 
186.22 	parents. However, if one parent in the household enrolls, both parents must enroll, unless 
186.23 	other insurance is available. If one child from a family is enrolled, all children must 
186.24 	be enrolled, unless other insurance is available. If one spouse in a household enrolls, 
186.25 	the other spouse in the household must also enroll, unless other insurance is available. 
186.26 	Families cannot choose to enroll only certain uninsured members.
186.27 	(c) Beginning October 1, 2003, the dependent sibling definition no longer applies 
186.28 	to the MinnesotaCare program. These persons are no longer counted in the parental 
186.29 	household and may apply as a separate household.
186.30 	(d) Beginning July 1, 2010, or upon federal approval, whichever is later, parents are 
186.31 	not eligible for MinnesotaCare if their gross income exceeds $57,500.
186.32 	(e) Children formerly enrolled in medical assistance and automatically deemed 
186.33 	eligible for MinnesotaCare according to section 256B.057, subdivision 2c, are exempt 
186.34 	from the requirements of this section until renewal.
186.35 	(f) [Reserved.]

187.1 	EFFECTIVE DATE. This section is effective January 1, 2012, or upon federal 
187.2 	approval, whichever is later, and expires June 30, 2013, except that the amendment 
187.3 	striking paragraph (e) is effective retroactively from October 1, 2008, does not expire, 
187.4 	and federal approval is no longer necessary. The commissioner shall notify the revisor of 
187.5 	statutes when federal approval is obtained and publish a notice in the State Register.

187.6 	Sec. 88. Minnesota Statutes 2010, section 256L.04, subdivision 7, is amended to read:
187.7 		Subd. 7.Single adults and households with no children. (a) The definition of 
187.8 	eligible persons includes all individuals and households with no children who have gross 
187.9 	family incomes that are equal to or less than 200 percent of the federal poverty guidelines.
187.10 	(b) Effective July 1, 2009, the definition of eligible persons includes all individuals 
187.11 	and households with no children who have gross family incomes that are equal to or less 
187.12 	than 250 percent of the federal poverty guidelines.

187.13 	EFFECTIVE DATE. This section is effective January 1, 2012, and expires June 
187.14 	30, 2013.

187.15 	Sec. 89. Minnesota Statutes 2010, section 256L.05, subdivision 2, is amended to read:
187.16 		Subd. 2.Commissioner's duties. (a) The commissioner or county agency shall 
187.17 	use electronic verification as the primary method of income verification. If there is a 
187.18 	discrepancy between reported income and electronically verified income, an individual 
187.19 	may be required to submit additional verification. In addition, the commissioner shall 
187.20 	perform random audits to verify reported income and eligibility. The commissioner 
187.21 	may execute data sharing arrangements with the Department of Revenue and any other 
187.22 	governmental agency in order to perform income verification related to eligibility and 
187.23 	premium payment under the MinnesotaCare program.
187.24 	(b) In determining eligibility for MinnesotaCare, the commissioner shall require 
187.25 	applicants and enrollees seeking renewal of eligibility to verify both earned and unearned 
187.26 	income. The commissioner shall also require applicants and enrollees to submit the 
187.27 	names of their employers and a contact name with a phone number for each employer 
187.28 	for purposes of verifying whether the applicant or enrollee, and any dependents, are 
187.29 	eligible for employer-subsidized coverage. Data collected is nonpublic data as defined 
187.30 	in section 13.02, subdivision 9.

187.31 	Sec. 90. Minnesota Statutes 2010, section 256L.05, subdivision 3a, is amended to read:
188.1 		Subd. 3a.Renewal of eligibility. (a) Beginning July 1, 2007 2011, an enrollee's 
188.2 	eligibility must be renewed every 12 six months. The 12-month period begins in the 
188.3 	month after the month the application is approved.
188.4 	(b) The first six-month period of eligibility begins the month the application is 
188.5 	received by the commissioner. The effective date of coverage within the first six-month 
188.6 	period of eligibility is as provided in subdivision 3. Each new period of eligibility must 
188.7 	take into account any changes in circumstances that impact eligibility and premium 
188.8 	amount. An enrollee must provide all the information needed to redetermine eligibility 
188.9 	by the first day of the month that ends the eligibility period. If there is no change in 
188.10 	circumstances, the enrollee may renew eligibility at designated locations that include 
188.11 	community clinics and health care providers' offices. The designated sites shall forward 
188.12 	the renewal forms to the commissioner. The commissioner may establish criteria and 
188.13 	timelines for sites to forward applications to the commissioner or county agencies. The 
188.14 	premium for the new period of eligibility must be received as provided in section 256L.06
188.15 	in order for eligibility to continue.
188.16 	(c) An enrollee who fails to submit renewal forms and related documentation 
188.17 	necessary for verification of continued eligibility in a timely manner shall remain eligible 
188.18 	for one additional month beyond the end of the current eligibility period before being 
188.19 	disenrolled. The enrollee remains responsible for MinnesotaCare premiums for the 
188.20 	additional month.

188.21 	Sec. 91. Minnesota Statutes 2010, section 256L.05, subdivision 5, is amended to read:
188.22 		Subd. 5.Availability of private insurance. The commissioner, in consultation with 
188.23 	the commissioners of health and commerce, shall provide information regarding the 
188.24 	availability of private health insurance coverage and the possibility of disenrollment 
188.25 	under section 256L.07, subdivision 1, paragraphs (b) and (c), to all: (1) families enrolled 
188.26 	in the MinnesotaCare program whose gross family income is equal to or more than 225 
188.27 	percent of the federal poverty guidelines; and (2) single adults and households without 
188.28 	children enrolled in the MinnesotaCare program whose gross family income is equal to 
188.29 	or more than 165 percent of the federal poverty guidelines. This information must be 
188.30 	provided upon initial enrollment and annually thereafter. The commissioner shall also 
188.31 	include information regarding the availability of private health insurance coverage in the 
188.32 	notice of ineligibility provided to persons subject to disenrollment under section 256L.07, 
188.33 	subdivision 1, paragraphs (b) and (c).

188.34 	EFFECTIVE DATE. This section is effective January 1, 2012, and expires June 
188.35 	30, 2013.

189.1 	Sec. 92. Minnesota Statutes 2010, section 256L.05, is amended by adding a subdivision 
189.2 	to read:
189.3 		Subd. 6.Referral of veterans. The commissioner shall ensure that all applicants 
189.4 	for MinnesotaCare with incomes less than 133 percent of the federal poverty guidelines 
189.5 	who identify themselves as veterans are referred to a county veterans service officer for 
189.6 	assistance in applying to the United States Department of Veterans Affairs for any veterans 
189.7 	benefits for which they may be eligible.

189.8 	Sec. 93. Minnesota Statutes 2010, section 256L.07, subdivision 1, is amended to read:
189.9 		Subdivision 1.General requirements. (a) Children enrolled in the original 
189.10 	children's health plan as of September 30, 1992, children who enrolled in the 
189.11 	MinnesotaCare program after September 30, 1992, pursuant to Laws 1992, chapter 549, 
189.12 	article 4, section 17, and children who have family gross incomes that are equal to or 
189.13 	less than 150 percent of the federal poverty guidelines are eligible without meeting 
189.14 	the requirements of subdivision 2 and the four-month requirement in subdivision 3, as 
189.15 	long as they maintain continuous coverage in the MinnesotaCare program or medical 
189.16 	assistance. Children who apply for MinnesotaCare on or after the implementation date 
189.17 	of the employer-subsidized health coverage program as described in Laws 1998, chapter 
189.18 	407, article 5, section 45, who have family gross incomes that are equal to or less than 150 
189.19 	percent of the federal poverty guidelines, must meet the requirements of subdivision 2 to 
189.20 	be eligible for MinnesotaCare.
189.21 	(b) Families enrolled in MinnesotaCare under section 256L.04, subdivision 1, whose 
189.22 	income increases above 275 percent of the federal poverty guidelines, are no longer 
189.23 	eligible for the program and shall be disenrolled by the commissioner. Beginning January 
189.24 	1, 2008,
189.25 	(c) Individuals enrolled in MinnesotaCare under section 256L.04, subdivision 7, 
189.26 	whose income increases above 200 percent of the federal poverty guidelines or 250 
189.27 	percent of the federal poverty guidelines on or after July 1, 2009, the limits described 
189.28 	in section 256L.04, subdivision 7, are no longer eligible for the program and shall be 
189.29 	disenrolled by the commissioner.
189.30 	(d) For persons disenrolled under this subdivision, MinnesotaCare coverage 
189.31 	terminates the last day of the calendar month following the month in which the 
189.32 	commissioner determines that the income of a family or individual exceeds program 
189.33 	income limits.
189.34 	(b) (e) Notwithstanding paragraph (a), children may remain enrolled in 
189.35 	MinnesotaCare if ten percent of their gross individual or gross family income as defined 
190.1 	in section 256L.01, subdivision 4, is less than the annual premium for a six-month 
190.2 	policy with a $500 deductible available through the Minnesota Comprehensive Health 
190.3 	Association. Children who are no longer eligible for MinnesotaCare under this clause shall 
190.4 	be given a 12-month notice period from the date that ineligibility is determined before 
190.5 	disenrollment. The premium for children remaining eligible under this clause shall be the 
190.6 	maximum premium determined under section 256L.15, subdivision 2, paragraph (b).
190.7 	(c) (f) Notwithstanding paragraphs (a) and (b) (e), parents are not eligible for 
190.8 	MinnesotaCare if gross household income exceeds $57,500 for the 12-month $25,000 for 
190.9 	the six-month period of eligibility.

190.10 	EFFECTIVE DATE. This section is effective January 1, 2012, and expires June 
190.11 	30, 2013, except the amendments to the new paragraphs (e) and (f) are effective July 1, 
190.12 	2011, and do not expire.

190.13 	Sec. 94. Minnesota Statutes 2010, section 256L.07, subdivision 1, is amended to read:
190.14 		Subdivision 1.General requirements. (a) Children enrolled in the original 
190.15 	children's health plan as of September 30, 1992, children who enrolled in the 
190.16 	MinnesotaCare program after September 30, 1992, pursuant to Laws 1992, chapter 549, 
190.17 	article 4, section 17, and children who have family gross incomes that are equal to or 
190.18 	less than 150 percent of the federal poverty guidelines are eligible without meeting 
190.19 	the requirements of subdivision 2 and the four-month requirement in subdivision 3, as 
190.20 	long as they maintain continuous coverage in the MinnesotaCare program or medical 
190.21 	assistance. Children who apply for MinnesotaCare on or after the implementation date 
190.22 	of the employer-subsidized health coverage program as described in Laws 1998, chapter 
190.23 	407, article 5, section 45, who have family gross incomes that are equal to or less than 150 
190.24 	percent of the federal poverty guidelines, must meet the requirements of subdivision 2 to 
190.25 	be eligible for MinnesotaCare.
190.26 	(b) Families enrolled in MinnesotaCare under section 256L.04, subdivision 1, whose 
190.27 	income increases above 275 percent of the federal poverty guidelines the limits described 
190.28 	in section 256L.04, subdivision 1, are no longer eligible for the program and shall be 
190.29 	disenrolled by the commissioner.
190.30 	(c) Beginning January 1, 2008, individuals enrolled in MinnesotaCare under section 
190.31 	256L.04, subdivision 7, whose income increases above 200 percent of the federal poverty 
190.32 	guidelines or 250 percent of the federal poverty guidelines on or after July 1, 2009, are no 
190.33 	longer eligible for the program and shall be disenrolled by the commissioner.
190.34 	(d) For persons disenrolled under this subdivision, MinnesotaCare coverage 
190.35 	terminates the last day of the calendar month following the month in which the 
191.1 	commissioner determines that the income of a family or individual exceeds program 
191.2 	income limits.
191.3 	(b) (e) Notwithstanding paragraph (a), children may remain enrolled in 
191.4 	MinnesotaCare if ten percent of their gross individual or gross family income as defined in 
191.5 	section 256L.01, subdivision 4, is less than the annual premium for a policy with a $500 
191.6 	deductible available through the Minnesota Comprehensive Health Association. Children 
191.7 	who are no longer eligible for MinnesotaCare under this clause shall be given a 12-month 
191.8 	notice period from the date that ineligibility is determined before disenrollment. The 
191.9 	premium for children remaining eligible under this clause shall be the maximum premium 
191.10 	determined under section 256L.15, subdivision 2, paragraph (b).
191.11 	(c) (f) Notwithstanding paragraphs (a) and (b) (e), parents are not eligible for 
191.12 	MinnesotaCare if gross household income exceeds $57,500 for the 12-month period 
191.13 	of eligibility.

191.14 	EFFECTIVE DATE. The amendment in paragraph (b) is effective January 1, 2012, 
191.15 	or upon federal approval whichever is later, and expires June 30, 2013. The commissioner 
191.16 	shall notify the revisor of statutes when federal approval is obtained and publish a notice 
191.17 	in the State Register.

191.18 	Sec. 95. Minnesota Statutes 2010, section 256L.09, subdivision 4, is amended to read:
191.19 		Subd. 4.Eligibility as Minnesota resident. (a) For purposes of this section, a 
191.20 	permanent Minnesota resident is a person who has demonstrated, through persuasive and 
191.21 	objective evidence, that the person is domiciled in the state and intends to live in the 
191.22 	state permanently.
191.23 	(b) To be eligible as a permanent resident, an applicant must demonstrate the 
191.24 	requisite intent to live in the state permanently by:
191.25 	(1) showing that the applicant maintains a residence at a verified address other than a 
191.26 	place of public accommodation, unless the place of public accommodation is the person's 
191.27 	primary or only residence, through the use of evidence of residence described in section 
191.28 	256D.02, subdivision 12a, paragraph (b), clause (2) (1);
191.29 	(2) demonstrating that the applicant has been continuously domiciled in the state for 
191.30 	no less than 180 days immediately before the application; and
191.31 	(3) signing an affidavit declaring that (A) the applicant currently resides in the state 
191.32 	and intends to reside in the state permanently; and (B) the applicant did not come to the 
191.33 	state for the primary purpose of obtaining medical coverage or treatment.
191.34 	(c) A person who is temporarily absent from the state does not lose eligibility for 
191.35 	MinnesotaCare. "Temporarily absent from the state" means the person is out of the state 
192.1 	for a temporary purpose and intends to return when the purpose of the absence has been 
192.2 	accomplished. A person is not temporarily absent from the state if another state has 
192.3 	determined that the person is a resident for any purpose. If temporarily absent from the 
192.4 	state, the person must follow the requirements of the health plan in which the person is 
192.5 	enrolled to receive services.

192.6 	Sec. 96. Minnesota Statutes 2010, section 256L.11, subdivision 7, is amended to read:
192.7 		Subd. 7.Critical access dental providers. Effective for dental services provided to 
192.8 	MinnesotaCare enrollees on or after January 1, 2007, July 1, 2011, the commissioner shall 
192.9 	increase payment rates to dentists and dental clinics deemed by the commissioner to be 
192.10 	critical access providers under section 256B.76, subdivision 4, by 50 30 percent above 
192.11 	the payment rate that would otherwise be paid to the provider. The commissioner shall 
192.12 	pay the prepaid health plans under contract with the commissioner amounts sufficient to 
192.13 	reflect this rate increase. The prepaid health plan must pass this rate increase to providers 
192.14 	who have been identified by the commissioner as critical access dental providers under 
192.15 	section 256B.76, subdivision 4.

192.16 	Sec. 97. Minnesota Statutes 2010, section 256L.12, subdivision 9, is amended to read:
192.17 		Subd. 9.Rate setting; performance withholds. (a) Rates will be prospective, 
192.18 	per capita, where possible. The commissioner may allow health plans to arrange for 
192.19 	inpatient hospital services on a risk or nonrisk basis. The commissioner shall consult with 
192.20 	an independent actuary to determine appropriate rates.
192.21 	(b) For services rendered on or after January 1, 2004, the commissioner shall 
192.22 	withhold five percent of managed care plan payments and county-based purchasing 
192.23 	plan payments under this section pending completion of performance targets. Each 
192.24 	performance target must be quantifiable, objective, measurable, and reasonably attainable, 
192.25 	except in the case of a performance target based on a federal or state law or rule. Criteria 
192.26 	for assessment of each performance target must be outlined in writing prior to the 
192.27 	contract effective date. The managed care plan must demonstrate, to the commissioner's 
192.28 	satisfaction, that the data submitted regarding attainment of the performance target is 
192.29 	accurate. The commissioner shall periodically change the administrative measures used 
192.30 	as performance targets in order to improve plan performance across a broader range of 
192.31 	administrative services. The performance targets must include measurement of plan 
192.32 	efforts to contain spending on health care services and administrative activities. The 
192.33 	commissioner may adopt plan-specific performance targets that take into account factors 
192.34 	affecting only one plan, such as characteristics of the plan's enrollee population. The 
193.1 	withheld funds must be returned no sooner than July 1 and no later than July 31 of the 
193.2 	following calendar year if performance targets in the contract are achieved.
193.3 	(c) For services rendered on or after January 1, 2011, the commissioner shall 
193.4 	withhold an additional three percent of managed care plan or county-based purchasing 
193.5 	plan payments under this section. The withheld funds must be returned no sooner than 
193.6 	July 1 and no later than July 31 of the following calendar year. The return of the withhold 
193.7 	under this paragraph is not subject to the requirements of paragraph (b).
193.8 	(d) Effective for services rendered on or after January 1, 2011, the commissioner 
193.9 	shall include as part of the performance targets described in paragraph (b) a reduction in 
193.10 	the plan's emergency room utilization rate for state health care program enrollees by a 
193.11 	measurable rate of five percent from the plan's utilization rate for the previous calendar 
193.12 	year.
193.13 	The withheld funds must be returned no sooner than July 1 and no later than July 31 
193.14 	of the following calendar year if the managed care plan demonstrates to the satisfaction of 
193.15 	the commissioner that a reduction in the utilization rate was achieved.
193.16 	The withhold described in this paragraph shall continue for each consecutive 
193.17 	contract period until the plan's emergency room utilization rate for state health care 
193.18 	program enrollees is reduced by 25 percent of the plan's emergency room utilization rate 
193.19 	for state health care program enrollees for calendar year 2009. Hospitals shall cooperate 
193.20 	with the health plans in meeting this performance target and shall accept payment 
193.21 	withholds that may be returned to the hospitals if the performance target is achieved. The 
193.22 	commissioner shall structure the withhold so that the commissioner returns a portion of 
193.23 	the withheld funds in amounts commensurate with achieved reductions in utilization less 
193.24 	than the targeted amount. The withhold described in this paragraph does not apply to 
193.25 	county-based purchasing plans.
193.26 	(e) Effective for services provided on or after January 1, 2012, the commissioner 
193.27 	shall include as part of the performance targets described in paragraph (b) a reduction in 
193.28 	the plan's hospitalization rate for a subsequent hospitalization within 30 days of a previous 
193.29 	hospitalization of a patient regardless of the reason for the hospitalization for state health 
193.30 	care program enrollees by a measurable rate of five percent from the plan's hospitalization 
193.31 	rate for the previous calendar year.
193.32 	The withheld funds must be returned no sooner than July 1 and no later than July 31 
193.33 	of the following calendar year if the managed care plan or county-based purchasing plan 
193.34 	demonstrates to the satisfaction of the commissioner that a reduction in the hospitalization 
193.35 	rate was achieved.
194.1 	The withhold described in this paragraph must continue for each consecutive 
194.2 	contract period until the plan's subsequent hospitalization rate for state health care 
194.3 	program enrollees is reduced by 25 percent of the plan's subsequent hospitalization rate 
194.4 	for state health care program enrollees for calendar year 2010. Hospitals shall cooperate 
194.5 	with the plans in meeting this performance target and shall accept payment withholds that 
194.6 	must be returned to the hospitals if the performance target is achieved. The commissioner 
194.7 	shall structure the withhold so that the commissioner returns a portion of the withheld 
194.8 	funds in amounts commensurate with achieved reductions in utilizations less than the 
194.9 	targeted amount. The withhold described in this paragraph does not apply to county-based 
194.10 	purchasing plans.
194.11 	(e) (f) A managed care plan or a county-based purchasing plan under section 
194.12 	256B.692 may include as admitted assets under section 62D.044 any amount withheld 
194.13 	under this section that is reasonably expected to be returned.

194.14 	Sec. 98. Minnesota Statutes 2010, section 256L.15, subdivision 1a, is amended to read:
194.15 		Subd. 1a.Payment options. The commissioner may offer the following payment 
194.16 	options to an enrollee:
194.17 	(1) payment by check;
194.18 	(2) payment by credit card;
194.19 	(3) payment by recurring automatic checking withdrawal;
194.20 	(4) payment by onetime electronic transfer of funds;
194.21 	(5) payment by wage withholding with the consent of the employer and the 
194.22 	employee; or
194.23 	(6) payment by using state tax refund payments.
194.24 	The commissioner shall include information about the payment options on each 
194.25 	premium notice. At application or reapplication, a MinnesotaCare applicant or enrollee 
194.26 	may authorize the commissioner to use the Revenue Recapture Act in chapter 270A to 
194.27 	collect funds from the applicant's or enrollee's refund for the purposes of meeting all or 
194.28 	part of the applicant's or enrollee's MinnesotaCare premium obligation. The applicant or 
194.29 	enrollee may authorize the commissioner to apply for the state working family tax credit 
194.30 	on behalf of the applicant or enrollee. The setoff due under this subdivision shall not be 
194.31 	subject to the $10 fee under section 270A.07, subdivision 1.

194.32 	Sec. 99. Laws 2008, chapter 363, article 18, section 3, subdivision 5, is amended to 
194.33 	read:

194.34	Subd. 5.Basic Health Care Grants

195.1	(a) MinnesotaCare Grants

195.2	Health Care Access
		-0-
		(770,000)
	
195.3 	Incentive Program and Outreach Grants.
195.4 	Of the appropriation for the Minnesota health 
195.5 	care outreach program in Laws 2007, chapter 
195.6 	147, article 19, section 3, subdivision 7, 
195.7 	paragraph (b):
195.8 	(1) $400,000 in fiscal year 2009 from the 
195.9 	general fund and $200,000 in fiscal year 2009 
195.10 	from the health care access fund are for the 
195.11 	incentive program under Minnesota Statutes, 
195.12 	section 256.962, subdivision 5. For the 
195.13 	biennium beginning July 1, 2009, base level 
195.14 	funding for this activity shall be $360,000 
195.15 	from the general fund and $160,000 from the 
195.16 	health care access fund; and
195.17 	(2) $100,000 in fiscal year 2009 from the 
195.18 	general fund and $50,000 in fiscal year 2009 
195.19 	from the health care access fund are for the 
195.20 	outreach grants under Minnesota Statutes, 
195.21 	section 256.962, subdivision 2. For the 
195.22 	biennium beginning July 1, 2009, base level 
195.23 	funding for this activity shall be $90,000 
195.24 	from the general fund and $40,000 from the 
195.25 	health care access fund.

195.26
195.27	(b) MA Basic Health Care Grants - Families 
and Children
		-0-
		(17,280,000)
	
195.28 	Third-Party Liability. (a) During 
195.29 	fiscal year 2009, the commissioner shall 
195.30 	employ a contractor paid on a percentage 
195.31 	basis to improve third-party collections. 
195.32 	Improvement initiatives may include, but not 
195.33 	be limited to, efforts to improve postpayment 
195.34 	collection from nonresponsive claims and 
196.1 	efforts to uncover third-party payers the 
196.2 	commissioner has been unable to identify.
196.3 	(b) In fiscal year 2009, the first $1,098,000 
196.4 	of recoveries, after contract payments and 
196.5 	federal repayments, is appropriated to 
196.6 	the commissioner for technology-related 
196.7 	expenses.
196.8 	Administrative Costs. (a) For contracts 
196.9 	effective on or after January 1, 2009, 
196.10 	the commissioner shall limit aggregate 
196.11 	administrative costs paid to managed care 
196.12 	plans under Minnesota Statutes, section 
196.13 	256B.69, and to county-based purchasing 
196.14 	plans under Minnesota Statutes, section 
196.15 	256B.692, to an overall average of 6.6 6.1
196.16 	percent of total contract payments under 
196.17 	Minnesota Statutes, sections 256B.69 and 
196.18 	256B.692, for each calendar year. For 
196.19 	purposes of this paragraph, administrative 
196.20 	costs do not include premium taxes paid 
196.21 	under Minnesota Statutes, section 297I.05, 
196.22 	subdivision 5, and provider surcharges paid 
196.23 	under Minnesota Statutes, section 256.9657, 
196.24 	subdivision 3.
196.25 	(b) Notwithstanding any law to the contrary, 
196.26 	the commissioner may reduce or eliminate 
196.27 	administrative requirements to meet the 
196.28 	administrative target under paragraph (a). 
196.29 	(c) Notwithstanding any contrary provision 
196.30 	of this article, this rider shall not expire.
196.31 	Hospital Payment Delay. Notwithstanding 
196.32 	Laws 2005, First Special Session chapter 4, 
196.33 	article 9, section 2, subdivision 6, payments 
196.34 	from the Medicaid Management Information 
196.35 	System that would otherwise have been made 
197.1 	for inpatient hospital services for medical 
197.2 	assistance enrollees are delayed as follows: 
197.3 	(1) for fiscal year 2008, June payments must 
197.4 	be included in the first payments in fiscal 
197.5 	year 2009; and (2) for fiscal year 2009, 
197.6 	June payments must be included in the first 
197.7 	payment of fiscal year 2010. The provisions 
197.8 	of Minnesota Statutes, section 16A.124, 
197.9 	do not apply to these delayed payments. 
197.10 	Notwithstanding any contrary provision in 
197.11 	this article, this paragraph expires on June 
197.12 	30, 2010.

197.13
197.14	(c) MA Basic Health Care Grants - Elderly and 
Disabled
		(14,028,000)
		(9,368,000)
	
197.15 	Minnesota Disability Health Options Rate 
197.16 	Setting Methodology. The commissioner 
197.17 	shall develop and implement a methodology 
197.18 	for risk adjusting payments for community 
197.19 	alternatives for disabled individuals (CADI) 
197.20 	and traumatic brain injury (TBI) home 
197.21 	and community-based waiver services 
197.22 	delivered under the Minnesota disability 
197.23 	health options program (MnDHO) effective 
197.24 	January 1, 2009. The commissioner shall 
197.25 	take into account the weighting system used 
197.26 	to determine county waiver allocations in 
197.27 	developing the new payment methodology. 
197.28 	Growth in the number of enrollees receiving 
197.29 	CADI or TBI waiver payments through 
197.30 	MnDHO is limited to an increase of 200 
197.31 	enrollees in each calendar year from January 
197.32 	2009 through December 2011. If those limits 
197.33 	are reached, additional members may be 
197.34 	enrolled in MnDHO for basic care services 
197.35 	only as defined under Minnesota Statutes, 
197.36 	section 256B.69, subdivision 28, and the 
198.1 	commissioner may establish a waiting list for 
198.2 	future access of MnDHO members to those 
198.3 	waiver services.
198.4 	MA Basic Elderly and Disabled 
198.5 	Adjustments. For the fiscal year ending June 
198.6 	30, 2009, the commissioner may adjust the 
198.7 	rates for each service affected by rate changes 
198.8 	under this section in such a manner across 
198.9 	the fiscal year to achieve the necessary cost 
198.10 	savings and minimize disruption to service 
198.11 	providers, notwithstanding the requirements 
198.12 	of Laws 2007, chapter 147, article 7, section 
198.13 	71.

198.14	(d) General Assistance Medical Care Grants
		-0-
		(6,971,000)

198.15	(e) Other Health Care Grants
		-0-
		(17,000)
	
198.16 	MinnesotaCare Outreach Grants Special 
198.17 	Revenue Account. The balance in the 
198.18 	MinnesotaCare outreach grants special 
198.19 	revenue account on July 1, 2009, estimated 
198.20 	to be $900,000, must be transferred to the 
198.21 	general fund.
198.22 	Grants Reduction. Effective July 1, 2008, 
198.23 	base level funding for nonforecast, general 
198.24 	fund health care grants issued under this 
198.25 	paragraph shall be reduced by 1.8 percent at 
198.26 	the allotment level.

198.27 	Sec. 100. PLAN TO COORDINATE CARE FOR CHILDREN WITH 
198.28 	HIGH-COST MENTAL HEALTH CONDITIONS.
 198.29 	The commissioner of human services shall develop and submit to the legislature 
198.30 	by December 15, 2011, a plan to provide care coordination to medical assistance and 
198.31 	MinnesotaCare enrollees who are children with high-cost mental health conditions. For 
198.32 	purposes of this section, a child has a "high-cost mental health condition" if mental health 
198.33 	and medical expenses over the past year totalled $100,000 or more. For purposes of this 
198.34 	section, "care coordination" means collaboration between an advanced practice nurse and 
199.1 	primary care physicians and specialists to manage care; development of mental health 
199.2 	management plans for recurrent mental health issues; oversight and coordination of all 
199.3 	aspects of care in partnership with families; organization of medical, treatment, and 
199.4 	therapy information into a summary of critical information; coordination and appropriate 
199.5 	sequencing of evaluations and multiple appointments; information and assistance with 
199.6 	accessing resources; and telephone triage for behavior or other problems.

199.7 	Sec. 101. DATA ON CLAIMS AND UTILIZATION.
 199.8 	The commissioner of human services, in consultation with the Health and Human 
199.9 	Services Reform Committee, shall develop and provide to the legislature by December 15, 
199.10 	2011, a methodology and any draft legislation necessary to allow for the release, upon 
199.11 	request, of summary data as defined in Minnesota Statutes, section 13.02, subdivision 19, 
199.12 	on claims and utilization for medical assistance, general assistance medical care, and 
199.13 	MinnesotaCare enrollees at no charge to the University of Minnesota Medical School, the 
199.14 	Mayo Medical School, Northwestern Health Sciences University, the Institute for Clinical 
199.15 	Systems Improvement, and other research institutions to conduct analyses of health care 
199.16 	outcomes and treatment effectiveness, provided the research institutions do not release 
199.17 	private or nonpublic data or data for which dissemination is prohibited by law.

199.18 	Sec. 102. REDUCTION OF STATE-MANDATED ADMINISTRATIVE 
199.19 	REPORTS.
 199.20 	(a) The commissioner of management and budget shall convene a report reduction 
199.21 	working group of persons designated by the commissioners of health, human services, and 
199.22 	commerce to eliminate redundant, unnecessary, obsolete, and low-priority state-mandated 
199.23 	administrative reports required of health plans and county-based purchasing plans 
199.24 	that serve persons enrolled in Minnesota health care programs. The commissioner of 
199.25 	management and budget and the report reduction working group shall develop a plan to 
199.26 	oversee the report reduction activities of the individual state agencies and coordinate the 
199.27 	activities of multiple state agencies to consolidate reports or eliminate redundant reports 
199.28 	required by more than one state agency on the same or a similar topic.
199.29 	(b) The commissioners of health, human services, and commerce shall reduce, 
199.30 	eliminate, or consolidate state-mandated reports according to the plan developed by the 
199.31 	commissioner of management and budget through the report reduction working group. 
199.32 	In addition to other report reduction actions the commissioners or the working group 
199.33 	may undertake, the commissioners shall:
200.1 	(1) collect encounter data, including provider payment data if collected, in a 
200.2 	consolidated report provided to a single state agency, with the data collected by that state 
200.3 	agency to be shared with other state agencies who need the data;
200.4 	(2) collect only one provider network report annually through a single state agency, 
200.5 	with the data collected by that state agency to be shared with other state agencies who 
200.6 	need the data;
200.7 	(3) collect only one standard financial report through a single state agency, with 
200.8 	the data collected by that state agency to be shared with other state agencies who need 
200.9 	the data.  Data collected must be of a nature and in a format to allow comparison of the 
200.10 	cost-effectiveness of fee-for-service payment systems and prepaid programs administered 
200.11 	by health plans and county-based purchasing plans;
200.12 	(4) consolidate and simplify reports and documentation requirements relating to 
200.13 	member communications and marketing materials, and establish a single review process 
200.14 	for all programs, products, and agencies in order to ensure uniform and consistent 
200.15 	regulation of  health plan contracts;
200.16 	(5) consolidate state regulation and oversight of health plans and county-based 
200.17 	purchasing plans so that activities of multiple agencies are administered through an 
200.18 	efficient and uniform multiagency process of oversight and audits, with consistent 
200.19 	standards, measures, and definitions for state oversight of quality, utilization management, 
200.20 	care management, delegation accountability, access to care, appeals and grievances, and 
200.21 	financial management;
200.22 	(6) establish uniform requirements and procedures for denial, termination, or 
200.23 	reduction of services and member appeals and grievances, and align state requirements 
200.24 	and procedures with federal requirements and procedures; and
200.25 	(7) reform the state's performance improvement projects, requirements, and 
200.26 	procedures to be more flexible and efficient, and to place greater focus on measuring 
200.27 	improvement of outcomes and less on mandating detailed or prescriptive requirements for 
200.28 	specific performance improvement projects or activities.
200.29 	(d) New reporting requirements or ad hoc report requests shall be established by a 
200.30 	state agency only:
200.31 	(1) if required by a federal agency;
200.32 	(2) if needed for a state regulatory audit or corrective action plan; or
200.33 	(3) after the completion of a review and analysis, and the development of 
200.34 	recommendations by the commissioner of management and budget, in consultation 
200.35 	with the report reduction working group, regarding the necessity, importance, and 
200.36 	administrative cost of the new report, and after completing a review to determine 
201.1 	whether the information sought can be obtained through another available state or federal 
201.2 	report. The results of the review, analysis, and recommendations of the commissioner of 
201.3 	management and budget must be provided to health plans and county-based purchasing 
201.4 	plans for review and comment at least 60 days before a new report or requirement is 
201.5 	established.
201.6 	(e) To the extent possible, all state agencies shall use the procedures, reports, 
201.7 	and audits of the Centers for Medicare and Medicaid Services instead of requiring an 
201.8 	additional state-mandated report on the same or a similar topic.
201.9 	(f) By January 15, 2012, the commissioner of management and budget shall provide 
201.10 	a report on the activities and results of the report reduction project to the legislature. 
201.11 	The report must include:
201.12 	(1) a timetable for report reduction actions already taken or planned by the 
201.13 	commissioners or the report reduction working group;
201.14 	(2) the specific reports that have been or will be eliminated or consolidated;
201.15 	(3) the amount of money that will be saved through reductions in administrative 
201.16 	costs of health plans and county-based purchasing plans as a result of the report reduction 
201.17 	project; and
201.18 	(4) proposed legislation for changes to laws or rules that are needed to allow state 
201.19 	agencies to further reduce, consolidate, or eliminate reports when the changes cannot 
201.20 	be made administratively.

201.21 	Sec. 103. COMPETITIVE BIDDING PILOT.
 201.22 	For managed care contracts effective January 1, 2012, the commissioner of 
201.23 	human services is required to establish a competitive price bidding pilot for nonelderly, 
201.24 	nondisabled adults and children in medical assistance and MinnesotaCare in the 
201.25 	seven-county metropolitan area. The pilot must allow a minimum of two managed care 
201.26 	organizations to serve the metropolitan area. The pilot shall expire after two full calendar 
201.27 	years on December 31, 2013. The commissioner of human service shall conduct an 
201.28 	evaluation of the pilot to determine the cost-effectiveness and impacts to provider access at 
201.29 	the end of the two-year period. The commissioner must consult with other states that have 
201.30 	experience implementing competitive bidding in their medical assistance population and 
201.31 	incorporate best practices from those states in designing this pilot. The commissioner, prior 
201.32 	to implementation, must also consult with stakeholders on the design and implementation 
201.33 	of the pilot, including providers, plans, advocacy groups, and other interested parties.

201.34 	Sec. 104. REQUEST FOR PROPOSAL; PROVIDER BILLING PATTERNS.
 202.1 	(a) The commissioner of human services shall issue a request for proposal, using 
202.2 	existing resources, to identify abnormal provider billing patterns in order to prevent and 
202.3 	identify improper medical assistance payments.
202.4 	(b) The request for proposal must include the following requirements for the 
202.5 	contractor:
202.6 	(1) identification and reporting of improper claims, outlier claims, and improper 
202.7 	payments, both prior to and subsequent to reimbursement; 
202.8 	(2) utilization of fraud detection methods that maximize contemporary predictive 
202.9 	analytic tools, including but not limited to identity analytics, link analysis, and matching 
202.10 	capabilities; 
202.11 	(3) utilization of data analytics that improve fraud detection through the identification 
202.12 	of outlier reimbursement; 
202.13 	(4) reduction in state expenditures by reducing or eliminating payouts of improper 
202.14 	medical assistance claims; and 
202.15 	(5) demonstrated success with other states and state agencies using the specified 
202.16 	proposed solution, deployment, and implementation.  
202.17 	(c) The commissioner shall enter into a contract for the services in this section by 
202.18 	October 1, 2011. The contract must incorporate a performance-based vendor financing 
202.19 	mechanism under which the vendor shares in the risk of the project's success.

202.20 	Sec. 105. HEALTH SERVICES POLICY COMMITTEE STUDIES.
 202.21 	(a) The commissioner of human services, through the health services policy 
202.22 	committee established under Minnesota Statutes, section 256B.0625, subdivision 3c, shall 
202.23 	identify and review medical assistance services provided by health care professionals who 
202.24 	are not trained to provide the services in a high-quality manner. The commissioner shall 
202.25 	develop a process to limit payment for medical assistance services to providers who are 
202.26 	not appropriately trained to provide the service, and shall present recommendations and 
202.27 	draft legislation by January 15, 2012, to the legislature.
202.28 	(b) The commissioner of human services, through the health services policy 
202.29 	committee established under Minnesota Statutes, section 256B.0625, subdivision 3c, shall 
202.30 	study the effectiveness of new strategies for wound care treatment for medical assistance 
202.31 	and MinnesotaCare enrollees with diabetes, including but not limited to the use of new 
202.32 	wound care technologies, assessment tools, and reporting programs. The commissioner 
202.33 	shall present recommendations by December 15, 2011, to the legislature on whether these 
202.34 	new strategies for wound care treatment should be covered under medical assistance 
202.35 	and MinnesotaCare.

203.1 	Sec. 106. SPECIALIZED MAINTENANCE THERAPY.
 203.2 	The commissioner of human services shall evaluate whether providing medical 
203.3 	assistance coverage for specialized maintenance therapy for enrollees with serious and 
203.4 	persistent mental illness who are at risk of hospitalization will improve the quality of 
203.5 	care and lower medical assistance spending by reducing rates of hospitalization. The 
203.6 	commissioner shall present findings and recommendations to the chairs and ranking 
203.7 	minority members of the legislative committees with jurisdiction over health and human 
203.8 	services finance and policy by December 15, 2011.

203.9 	Sec. 107. COVERAGE FOR LOWER-INCOME MINNESOTACARE 
203.10 	ENROLLEES.
 203.11 	The commissioner of human services shall develop and present to the legislature, 
203.12 	by December 15, 2011, a plan to redesign service delivery for MinnesotaCare enrollees 
203.13 	eligible under Minnesota Statutes, section 256L.04, subdivisions 1 and 7, with incomes 
203.14 	less than 133 percent of the federal poverty guidelines. The plan must be designed to 
203.15 	improve continuity and quality of care, reduce unnecessary emergency room visits, and 
203.16 	reduce average per-enrollee costs. In developing the plan, the commissioner shall consider 
203.17 	innovative methods of service delivery, including but not limited to increasing the use 
203.18 	and choice of private sector health plan coverage and encouraging the use of community 
203.19 	health clinics, as defined in the federal Community Health Care Act of 1964, as health 
203.20 	care homes.

203.21 	Sec. 108. DIRECTION TO COMMISSIONER; FEDERAL WAIVERS.
 203.22 	(a) The commissioner of human services shall apply to the Centers for Medicare 
203.23 	and Medicaid Services (CMS) for federal waivers to cover:
203.24 	(1) families with children eligible under Minnesota Statutes, section 256L.04, 
203.25 	subdivision 1; and
203.26 	(2) adults eligible under Minnesota Statutes, section 256L.04, subdivision 1, 
203.27 	under the MinnesotaCare healthy Minnesota contribution program established under 
203.28 	Minnesota Statutes, section 256L.031, by July 1, 2011. The commissioner shall report to 
203.29 	the legislative committees with jurisdiction over health and human services policy and 
203.30 	finance whether or not the federal waiver application was accepted within ten working 
203.31 	days of receipt of the decision.
203.32 	(b) The commissioner of human services shall apply to the CMS for a section 
203.33 	1115(a) demonstration waiver, and any other necessary federal waivers and amendments, 
203.34 	including, but not limited to, a waiver of the appropriate sections of title XIX, United 
204.1 	States Code, title 42, section 1396a, and a waiver of any applicable federal maintenance of 
204.2 	effort provisions that would provide Minnesota with medical assistance program flexibility 
204.3 	in exchange for federal budget certainty. The commissioner shall seek federal approval to 
204.4 	enter into an agreement with CMS under which Minnesota would:
204.5 	(1) accept an aggregate annual allotment for the medical assistance program, trended 
204.6 	forward at an agreed upon rate, with protections to cover medical inflation and projected 
204.7 	caseload growth; and
204.8 	(2) receive federal waivers of Medicaid requirements related to: statewideness and 
204.9 	comparability of services; the amount, duration, and scope of services; freedom of choice; 
204.10 	cost-sharing; and other areas of program administration specified by the commissioner.

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

204.12 	Sec. 109. TRANSPARENCY AND QUALITY REPORTING FOR PUBLIC 
204.13 	HEALTH CARE PROGRAMS.
 204.14 	When negotiating with external vendors to provide managed care services, the 
204.15 	commissioner of human services shall require use of an advanced request for information 
204.16 	tool. This tool must provide the department with an evidence-based assessment that 
204.17 	focuses on the cost control, quality, and information transparency of the health care 
204.18 	vendor. The assessment may include evidence-based performance measures that have 
204.19 	been shown to influence better health, better health care, and more cost-effective use of 
204.20 	resources including, but not limited to, areas that determine each plan's capabilities and 
204.21 	performance with respect to:
204.22 	(1) consumer engagement, support, and incentives;
204.23 	(2) processes and outcomes for closing gaps in care according to clinical guideline 
204.24 	expectations;
204.25 	(3) provider management, including outcome and population-based reimbursement, 
204.26 	transparent measurement of provider performance, and support of physician practice 
204.27 	structures that lead to better care; and
204.28 	(4) measures of clinical outcomes and waste approved by the National Quality 
204.29 	Forum.

204.30 	Sec. 110. RISK CORRIDORS.
 204.31 	(a) Effective for services rendered on or after January 1, 2012, the commissioner 
204.32 	shall establish risk corridors for state public programs that are actuarially sound for each 
204.33 	managed care plan and each county-based purchasing plan. The risk corridors will be 
204.34 	calculated annually based on the calendar year's net underwriting gain or loss. If the 
205.1 	managed care plan or county-based purchasing plan has achieved a net underwriting gain 
205.2 	of greater than three percent of revenue, 80 percent of any excess must be repaid to the 
205.3 	commissioner by July 31 of the year following calculation of the risk corridor year, and 
205.4 	20 percent must be invested by the plan directly into programs for improving quality of 
205.5 	care or access to care for state public health care program enrollees. If the managed 
205.6 	care plan or county-based purchasing plan has incurred a net underwriting loss greater 
205.7 	than three percent of total revenue, 50 percent of any excess must be repaid to the plan 
205.8 	by the commissioner by July 31 of the year following calculation of the risk corridor 
205.9 	year. Determination of total revenues and net underwriting gain or loss must be based 
205.10 	on the Minnesota Supplement Report #1 which is filed on April 1 of the year following 
205.11 	calculation of the risk corridor and adjusted for the actual withhold calculation under 
205.12 	sections 256B.69, subdivision 5a, and 256L.12, subdivision 9. The report must be filed 
205.13 	with and publicly disclosed by the Department of Health.
205.14 	(b) For purposes of this section, "state public programs" means those prepaid 
205.15 	medical assistance and MinnesotaCare programs for which a managed care plan or 
205.16 	county-based purchasing plan contracts with the commissioner to provide coverage under 
205.17 	sections 256B.69, 256B.692, and 256L.12. The risk corridors shall not apply to plans for 
205.18 	persons who are enrolled in integrated Medicare and medical assistance programs under 
205.19 	section 256B.69, subdivisions 23 and 28.
205.20 	(c) This section expires January 1, 2014.

205.21 	Sec. 111. CONTINGENT REINSTATEMENT OF GAMC.
 205.22 	Notwithstanding their contingent repeal in Laws 2010, First Special Session chapter 
205.23 	1, article 16, section 47, the following statutes are revived and have the force of law:
205.24 	(1) Minnesota Statutes 2010, section 256D.03, subdivisions 3, 3a, 5, 6, 7, and 8; and
205.25 	(2) Laws 2010, chapter 200, article 1, section 12, subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 
205.26 	9, 10, 18, and 19.

205.27 	EFFECTIVE DATE. This section is effective January 1, 2013, if by that date the 
205.28 	federal government has not approved the global medical assistance waiver submitted 
205.29 	under Minnesota Statutes, section 256B.841.

205.30 	Sec. 112.  REPEALER.
 205.31 	(a) Minnesota Statutes 2010, section 256.01, subdivision 2b, (performance 
205.32 	payments) is repealed effective July 1, 2011.
205.33 	(b) Minnesota Statutes 2010, section 62J.07, subdivisions 1, 2, and 3, (Legislative 
205.34 	Commission on Health Care Access) are repealed.
206.1 	(c) Laws 2009, chapter 79, article 5, section 64, (256L.07, subdivision 2) is repealed 
206.2 	retroactively from July 1, 2009, and federal approval is no longer necessary.
206.3 	(d) Laws 2009, chapter 79, article 5, section 65,  (256L.07, subdivision 3) is repealed 
206.4 	retroactively from July 1, 2009, and federal approval is no longer necessary.
206.5 	(e) Laws 2009, chapter 79, article 5, section 68,  (256L.15, subdivision 2, exemption 
206.6 	of low-income children from MinnesotaCare premiums and insurance barriers) is 
206.7 	repealed retroactively from July 1, 2009, and federal approval is no longer necessary.
206.8 	(f) Minnesota Statutes 2010, section 256L.07, subdivision 7, exempting eligibility 
206.9 	for children formally under medical assistance, is repealed retroactively from October 
206.10 	1, 2008, and federal approval is no longer necessary.
206.11 	(g) The amendment in Laws 2009, chapter 79, article 5, section 55, as amended by 
206.12 	Laws 2009, chapter 173, article 1, section 36, (256L.04, subdivision 1, children deemed 
206.13 	eligible are exempt from eligibility requirements) is repealed retroactively from January 
206.14 	1, 2009, and federal approval is no longer necessary.
206.15 	(h) Laws 2009, chapter 79, article 5, section 56,  (256L.04, subdivision 1b, 
206.16 	exemption from income limit for children) is repealed retroactively from July 1, 2009, 
206.17 	and federal approval is no longer necessary.
206.18 	(i) Laws 2009, chapter 79, article 5, section 60, (256L.05, subdivision 1c, open 
206.19 	enrollment and streamlined application) is repealed retroactively from July 1, 2009, 
206.20 	and federal approval is no longer necessary.
206.21 	(j) Laws 2009, chapter 79, article 5, section 66, (256L.07, subdivision 8, automatic 
206.22 	eligibility certain children) is repealed retroactively from July 1, 2009, and federal 
206.23 	approval is no longer necessary.
206.24 	(k) The amendment in Laws 2009, chapter 79, article 5, section 57, (256L.04, 
206.25 	subdivision 7a, ineligibility for adults with certain income) is repealed retroactively 
206.26 	from July 1, 2009, and federal approval is no longer necessary.
206.27 	(l) The amendment in Laws 2009, chapter 79, article 5, section 61,  (256L.05, 
206.28 	subdivision 3, children eligibility following termination from foster care) is repealed 
206.29 	retroactively from July 1, 2009, and federal approval is no longer necessary.
206.30 	(m) The amendment in Laws 2009, chapter 79, article 5, section 62,  (256L.05, 
206.31 	subdivision 3a, exemption from cancellation for nonrenewal for children) is repealed 
206.32 	retroactively from July 1, 2009, and federal approval is no longer necessary.
206.33 	(n) The amendment in Laws 2009, chapter 79, article 5, section 63,  (256L.07, 
206.34 	subdivision 1, children whose gross family income is greater than 275 percent FPG 
206.35 	may remain enrolled) is repealed retroactively from July 1, 2009, and federal approval is 
206.36 	no longer necessary.
207.1 	(o) The amendment in Laws 2009, chapter 79, article 5, section 64,  (256L.07, 
207.2 	subdivision 2, exempts children from requirement not to have employer-subsidized 
207.3 	coverage) is repealed retroactively from July 1, 2009, and federal approval is no longer 
207.4 	necessary.
207.5 	(p) The amendment in Laws 2009, chapter 79, article 5, section 65,  (256L.07, 
207.6 	subdivision 3, requires children with family gross income over 200 percent of FPG 
207.7 	to have had no health coverage for four months prior to application) is repealed 
207.8 	retroactively from July 1, 2009, and federal approval is no longer necessary.
207.9 	(q) The amendment in Laws 2009, chapter 79, article 5, section 68,  (256L.15, 
207.10 	subdivision 2, children in families with income less than 200 percent FPG pay no 
207.11 	premium) is repealed retroactively from July 1, 2009, and federal approval is no longer 
207.12 	necessary.
207.13 	(r) The amendment in Laws 2009, chapter 79, article 5, section 69,  (256L.15, 
207.14 	subdivision 3, exempts children with family income below 200 percent FPG from 
207.15 	sliding fee scale) is repealed retroactively from July 1, 2009, and federal approval is 
207.16 	no longer necessary.
207.17 	(s) Laws 2009, chapter 79, article 5, section 79,  (uncoded federal approval) is 
207.18 	repealed the day following final enactment.
207.19 	(t) Minnesota Statutes 2010, section 256B.057, subdivision 2c, (extended medical 
207.20 	assistance for certain children) is repealed.
207.21 	(u) The amendments in Laws 2008, chapter 358, article 3, sections 8; and 9, 
207.22 	(renewal rolling month and premium grace month) are repealed.

207.23 	Sec. 113.  CONTINGENT REPEALER; MEDICAL ASSISTANCE EARLY 
207.24 	EXPANSION.
 207.25 	Minnesota Statutes 2010, sections 256B.055, subdivision 15; and 256B.0756, and 
207.26 	Laws 2010, First Special Session chapter 1, article 16, sections 6; and 7,  are repealed.

207.27 	EFFECTIVE DATE. This section is effective January 1, 2013, if by that date the 
207.28 	federal government has not approved the global medical assistance waiver submitted 
207.29 	under Minnesota Statutes, section 256B.841.

207.30 	ARTICLE 7
207.31 	CONTINUING CARE

207.32 	Section 1. Minnesota Statutes 2010, section 245A.03, subdivision 2, is amended to 
207.33 	read:
208.1 		Subd. 2.Exclusion from licensure. (a) This chapter does not apply to:
208.2 	(1) residential or nonresidential programs that are provided to a person by an 
208.3 	individual who is related unless the residential program is a child foster care placement 
208.4 	made by a local social services agency or a licensed child-placing agency, except as 
208.5 	provided in subdivision 2a;
208.6 	(2) nonresidential programs that are provided by an unrelated individual to persons 
208.7 	from a single related family;
208.8 	(3) residential or nonresidential programs that are provided to adults who do 
208.9 	not abuse chemicals or who do not have a chemical dependency, a mental illness, a 
208.10 	developmental disability, a functional impairment, or a physical disability;
208.11 	(4) sheltered workshops or work activity programs that are certified by the 
208.12 	commissioner of employment and economic development;
208.13 	(5) programs operated by a public school for children 33 months or older;
208.14 	(6) nonresidential programs primarily for children that provide care or supervision 
208.15 	for periods of less than three hours a day while the child's parent or legal guardian is in 
208.16 	the same building as the nonresidential program or present within another building that is 
208.17 	directly contiguous to the building in which the nonresidential program is located;
208.18 	(7) nursing homes or hospitals licensed by the commissioner of health except as 
208.19 	specified under section 245A.02;
208.20 	(8) board and lodge facilities licensed by the commissioner of health that do not 
208.21 	provide children's residential services under Minnesota Rules, chapter 2960, mental health 
208.22 	or chemical dependency treatment;
208.23 	(9) homes providing programs for persons placed by a county or a licensed agency 
208.24 	for legal adoption, unless the adoption is not completed within two years;
208.25 	(10) programs licensed by the commissioner of corrections;
208.26 	(11) recreation programs for children or adults that are operated or approved by a 
208.27 	park and recreation board whose primary purpose is to provide social and recreational 
208.28 	activities;
208.29 	(12) programs operated by a school as defined in section 120A.22, subdivision 4; 
208.30 	YMCA as defined in section 315.44; YWCA as defined in section 315.44; or JCC as 
208.31 	defined in section 315.51, whose primary purpose is to provide child care or services to 
208.32 	school-age children;
208.33 	(13) Head Start nonresidential programs which operate for less than 45 days in 
208.34 	each calendar year;
208.35 	(14) noncertified boarding care homes unless they provide services for five or more 
208.36 	persons whose primary diagnosis is mental illness or a developmental disability;
209.1 	(15) programs for children such as scouting, boys clubs, girls clubs, and sports and 
209.2 	art programs, and nonresidential programs for children provided for a cumulative total of 
209.3 	less than 30 days in any 12-month period;
209.4 	(16) residential programs for persons with mental illness, that are located in hospitals;
209.5 	(17) the religious instruction of school-age children; Sabbath or Sunday schools; or 
209.6 	the congregate care of children by a church, congregation, or religious society during the 
209.7 	period used by the church, congregation, or religious society for its regular worship;
209.8 	(18) camps licensed by the commissioner of health under Minnesota Rules, chapter 
209.9 	4630;
209.10 	(19) mental health outpatient services for adults with mental illness or children 
209.11 	with emotional disturbance;
209.12 	(20) residential programs serving school-age children whose sole purpose is cultural 
209.13 	or educational exchange, until the commissioner adopts appropriate rules;
209.14 	(21) unrelated individuals who provide out-of-home respite care services to persons 
209.15 	with developmental disabilities from a single related family for no more than 90 days in a 
209.16 	12-month period and the respite care services are for the temporary relief of the person's 
209.17 	family or legal representative;
209.18 	(22) respite care services provided as a home and community-based service to a 
209.19 	person with a developmental disability, in the person's primary residence;
209.20 	(23) community support services programs as defined in section 245.462, subdivision 
209.21 	6, and family community support services as defined in section 245.4871, subdivision 17;
209.22 	(24) the placement of a child by a birth parent or legal guardian in a preadoptive 
209.23 	home for purposes of adoption as authorized by section 259.47;
209.24 	(25) settings registered under chapter 144D which provide home care services 
209.25 	licensed by the commissioner of health to fewer than seven adults;
209.26 	(26) chemical dependency or substance abuse treatment activities of licensed 
209.27 	professionals in private practice as defined in Minnesota Rules, part 9530.6405, subpart 
209.28 	15, when the treatment activities are not paid for by the consolidated chemical dependency 
209.29 	treatment fund;
209.30 	(27) consumer-directed community support service funded under the Medicaid 
209.31 	waiver for persons with developmental disabilities when the individual who provided 
209.32 	the service is:
209.33 	(i) the same individual who is the direct payee of these specific waiver funds or paid 
209.34 	by a fiscal agent, fiscal intermediary, or employer of record; and
209.35 	(ii) not otherwise under the control of a residential or nonresidential program that is 
209.36 	required to be licensed under this chapter when providing the service; or
210.1 	(28) a program serving only children who are age 33 months or older, that is 
210.2 	operated by a nonpublic school, for no more than four hours per day per child, with no 
210.3 	more than 20 children at any one time, and that is accredited by:
210.4 	(i) an accrediting agency that is formally recognized by the commissioner of 
210.5 	education as a nonpublic school accrediting organization; or
210.6 	(ii) an accrediting agency that requires background studies and that receives and 
210.7 	investigates complaints about the services provided; or
210.8 	(29) residential facilities that are federally certified as intermediate care facilities 
210.9 	that serve people with developmental disabilities.
210.10 	A program that asserts its exemption from licensure under clause (28), item (ii), shall, 
210.11 	upon request from the commissioner, provide the commissioner with documentation from 
210.12 	the accrediting agency that verifies: that the accreditation is current; that the accrediting 
210.13 	agency investigates complaints about services; and that the accrediting agency's standards 
210.14 	require background studies on all people providing direct contact services.
210.15 	(b) For purposes of paragraph (a), clause (6), a building is directly contiguous to a 
210.16 	building in which a nonresidential program is located if it shares a common wall with the 
210.17 	building in which the nonresidential program is located or is attached to that building by 
210.18 	skyway, tunnel, atrium, or common roof.
210.19 	(c) Nothing in this chapter shall be construed to require licensure for any services 
210.20 	provided and funded according to an approved federal waiver plan where licensure is 
210.21 	specifically identified as not being a condition for the services and funding.

210.22 	Sec. 2. Minnesota Statutes 2010, section 252.27, subdivision 2a, is amended to read:
210.23 		Subd. 2a.Contribution amount. (a) The natural or adoptive parents of a minor 
210.24 	child, including a child determined eligible for medical assistance without consideration of 
210.25 	parental income, must contribute to the cost of services used by making monthly payments 
210.26 	on a sliding scale based on income, unless the child is married or has been married, 
210.27 	parental rights have been terminated, or the child's adoption is subsidized according to 
210.28 	section 259.67 or through title IV-E of the Social Security Act. The parental contribution 
210.29 	is a partial or full payment for medical services provided for diagnostic, therapeutic, 
210.30 	curing, treating, mitigating, rehabilitation, maintenance, and personal care services as 
210.31 	defined in United States Code, title 26, section 213, needed by the child with a chronic 
210.32 	illness or disability.
210.33 	(b) For households with adjusted gross income equal to or greater than 100 percent 
210.34 	of federal poverty guidelines, the parental contribution shall be computed by applying the 
210.35 	following schedule of rates to the adjusted gross income of the natural or adoptive parents:
211.1 	(1) if the adjusted gross income is equal to or greater than 100 percent of federal 
211.2 	poverty guidelines and less than 175 percent of federal poverty guidelines, the parental 
211.3 	contribution is $4 per month;
211.4 	(2) if the adjusted gross income is equal to or greater than 175 percent of federal 
211.5 	poverty guidelines and less than or equal to 545 525 percent of federal poverty guidelines, 
211.6 	the parental contribution shall be determined using a sliding fee scale established by the 
211.7 	commissioner of human services which begins at one percent of adjusted gross income at 
211.8 	175 percent of federal poverty guidelines and increases to 7.5 eight percent of adjusted 
211.9 	gross income for those with adjusted gross income up to 545 525 percent of federal 
211.10 	poverty guidelines;
211.11 	(3) if the adjusted gross income is greater than 545 525 percent of federal 
211.12 	poverty guidelines and less than 675 percent of federal poverty guidelines, the parental 
211.13 	contribution shall be 7.5 9.5 percent of adjusted gross income;
211.14 	(4) if the adjusted gross income is equal to or greater than 675 percent of federal 
211.15 	poverty guidelines and less than 975 900 percent of federal poverty guidelines, the parental 
211.16 	contribution shall be determined using a sliding fee scale established by the commissioner 
211.17 	of human services which begins at 7.5 9.5 percent of adjusted gross income at 675 percent 
211.18 	of federal poverty guidelines and increases to ten 12 percent of adjusted gross income for 
211.19 	those with adjusted gross income up to 975 900 percent of federal poverty guidelines; and
211.20 	(5) if the adjusted gross income is equal to or greater than 975 900 percent of 
211.21 	federal poverty guidelines, the parental contribution shall be 12.5 13.5 percent of adjusted 
211.22 	gross income.
211.23 	If the child lives with the parent, the annual adjusted gross income is reduced by 
211.24 	$2,400 prior to calculating the parental contribution. If the child resides in an institution 
211.25 	specified in section 256B.35, the parent is responsible for the personal needs allowance 
211.26 	specified under that section in addition to the parental contribution determined under this 
211.27 	section. The parental contribution is reduced by any amount required to be paid directly to 
211.28 	the child pursuant to a court order, but only if actually paid.
211.29 	(c) The household size to be used in determining the amount of contribution under 
211.30 	paragraph (b) includes natural and adoptive parents and their dependents, including the 
211.31 	child receiving services. Adjustments in the contribution amount due to annual changes 
211.32 	in the federal poverty guidelines shall be implemented on the first day of July following 
211.33 	publication of the changes.
211.34 	(d) For purposes of paragraph (b), "income" means the adjusted gross income of the 
211.35 	natural or adoptive parents determined according to the previous year's federal tax form, 
212.1 	except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds 
212.2 	have been used to purchase a home shall not be counted as income.
212.3 	(e) The contribution shall be explained in writing to the parents at the time eligibility 
212.4 	for services is being determined. The contribution shall be made on a monthly basis 
212.5 	effective with the first month in which the child receives services. Annually upon 
212.6 	redetermination or at termination of eligibility, if the contribution exceeded the cost of 
212.7 	services provided, the local agency or the state shall reimburse that excess amount to 
212.8 	the parents, either by direct reimbursement if the parent is no longer required to pay a 
212.9 	contribution, or by a reduction in or waiver of parental fees until the excess amount is 
212.10 	exhausted. All reimbursements must include a notice that the amount reimbursed may be 
212.11 	taxable income if the parent paid for the parent's fees through an employer's health care 
212.12 	flexible spending account under the Internal Revenue Code, section 125, and that the 
212.13 	parent is responsible for paying the taxes owed on the amount reimbursed.
212.14 	(f) The monthly contribution amount must be reviewed at least every 12 months; 
212.15 	when there is a change in household size; and when there is a loss of or gain in income 
212.16 	from one month to another in excess of ten percent. The local agency shall mail a written 
212.17 	notice 30 days in advance of the effective date of a change in the contribution amount. 
212.18 	A decrease in the contribution amount is effective in the month that the parent verifies a 
212.19 	reduction in income or change in household size.
212.20 	(g) Parents of a minor child who do not live with each other shall each pay the 
212.21 	contribution required under paragraph (a). An amount equal to the annual court-ordered 
212.22 	child support payment actually paid on behalf of the child receiving services shall be 
212.23 	deducted from the adjusted gross income of the parent making the payment prior to 
212.24 	calculating the parental contribution under paragraph (b).
212.25 	(h) The contribution under paragraph (b) shall be increased by an additional five 
212.26 	percent if the local agency determines that insurance coverage is available but not 
212.27 	obtained for the child. For purposes of this section, "available" means the insurance is a 
212.28 	benefit of employment for a family member at an annual cost of no more than five percent 
212.29 	of the family's annual income. For purposes of this section, "insurance" means health 
212.30 	and accident insurance coverage, enrollment in a nonprofit health service plan, health 
212.31 	maintenance organization, self-insured plan, or preferred provider organization.
212.32 	Parents who have more than one child receiving services shall not be required 
212.33 	to pay more than the amount for the child with the highest expenditures. There shall 
212.34 	be no resource contribution from the parents. The parent shall not be required to pay 
212.35 	a contribution in excess of the cost of the services provided to the child, not counting 
213.1 	payments made to school districts for education-related services. Notice of an increase in 
213.2 	fee payment must be given at least 30 days before the increased fee is due.
213.3 	(i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if, 
213.4 	in the 12 months prior to July 1:
213.5 	(1) the parent applied for insurance for the child;
213.6 	(2) the insurer denied insurance;
213.7 	(3) the parents submitted a complaint or appeal, in writing to the insurer, submitted 
213.8 	a complaint or appeal, in writing, to the commissioner of health or the commissioner of 
213.9 	commerce, or litigated the complaint or appeal; and
213.10 	(4) as a result of the dispute, the insurer reversed its decision and granted insurance.
213.11 	For purposes of this section, "insurance" has the meaning given in paragraph (h).
213.12 	A parent who has requested a reduction in the contribution amount under this 
213.13 	paragraph shall submit proof in the form and manner prescribed by the commissioner or 
213.14 	county agency, including, but not limited to, the insurer's denial of insurance, the written 
213.15 	letter or complaint of the parents, court documents, and the written response of the insurer 
213.16 	approving insurance. The determinations of the commissioner or county agency under this 
213.17 	paragraph are not rules subject to chapter 14.
213.18 	(j) Notwithstanding paragraph (b), for the period from July 1, 2010, to June 30, 
213.19 	2013, the parental contribution shall be computed by applying the following contribution 
213.20 	schedule to the adjusted gross income of the natural or adoptive parents:
213.21 	(1) if the adjusted gross income is equal to or greater than 100 percent of federal 
213.22 	poverty guidelines and less than 175 percent of federal poverty guidelines, the parental 
213.23 	contribution is $4 per month;
213.24 	(2) if the adjusted gross income is equal to or greater than 175 percent of federal 
213.25 	poverty guidelines and less than or equal to 525 percent of federal poverty guidelines, 
213.26 	the parental contribution shall be determined using a sliding fee scale established by the 
213.27 	commissioner of human services which begins at one percent of adjusted gross income 
213.28 	at 175 percent of federal poverty guidelines and increases to eight percent of adjusted 
213.29 	gross income for those with adjusted gross income up to 525 percent of federal poverty 
213.30 	guidelines;
213.31 	(3) if the adjusted gross income is greater than 525 percent of federal poverty 
213.32 	guidelines and less than 675 percent of federal poverty guidelines, the parental contribution 
213.33 	shall be 9.5 percent of adjusted gross income;
213.34 	(4) if the adjusted gross income is equal to or greater than 675 percent of federal 
213.35 	poverty guidelines and less than 900 percent of federal poverty guidelines, the parental 
213.36 	contribution shall be determined using a sliding fee scale established by the commissioner 
214.1 	of human services which begins at 9.5 percent of adjusted gross income at 675 percent of 
214.2 	federal poverty guidelines and increases to 12 percent of adjusted gross income for those 
214.3 	with adjusted gross income up to 900 percent of federal poverty guidelines; and
214.4 	(5) if the adjusted gross income is equal to or greater than 900 percent of federal 
214.5 	poverty guidelines, the parental contribution shall be 13.5 percent of adjusted gross 
214.6 	income. If the child lives with the parent, the annual adjusted gross income is reduced by 
214.7 	$2,400 prior to calculating the parental contribution. If the child resides in an institution 
214.8 	specified in section 256B.35, the parent is responsible for the personal needs allowance 
214.9 	specified under that section in addition to the parental contribution determined under this 
214.10 	section. The parental contribution is reduced by any amount required to be paid directly to 
214.11 	the child pursuant to a court order, but only if actually paid.

214.12 	Sec. 3. Minnesota Statutes 2010, section 252.291, subdivision 2, is amended to read:
214.13 		Subd. 2.Exceptions. (a) The commissioner of human services in coordination 
214.14 	with the commissioner of health may approve a newly constructed or newly established 
214.15 	publicly or privately operated community intermediate care facility for six 16 or fewer 
214.16 	persons with developmental disabilities only when:
214.17 	(1) the facility is developed in accordance with a request for proposal approved 
214.18 	by the commissioner of human services;
214.19 	(2) the facility is necessary to serve the needs of identified persons with 
214.20 	developmental disabilities who are seriously behaviorally disordered or who are seriously 
214.21 	physically or sensorily impaired. No more than 40 percent of the capacity specified in the 
214.22 	proposal submitted to the commissioner must be used for persons being discharged from 
214.23 	regional treatment centers; and
214.24 	(3) the commissioner determines that the need for increased service capacity cannot 
214.25 	be met by the use of alternative resources or the modification of existing facilities.
214.26 	(b) The percentage limitation in paragraph (a), clause (2), does not apply to 
214.27 	state-operated, community-based facilities.

214.28 	Sec. 4. Minnesota Statutes 2010, section 256.01, subdivision 24, is amended to read:
214.29 		Subd. 24.Disability Linkage Line. The commissioner shall establish the Disability 
214.30 	Linkage Line, ato serve as Minnesota's neutral access point for statewide consumer
214.31 	disability information, referral, and assistance system for people with disabilities and 
214.32 	chronic illnesses that. The Disability Linkage Line shall:
214.33 	(1) deliver information and assistance based on national and state standards;
215.1 	(1) provides (2) provide information about state and federal eligibility requirements, 
215.2 	benefits, and service options;
215.3 	(3) provide benefits and options counseling;
215.4 	(2) makes (4) make referrals to appropriate support entities;
215.5 	(3) delivers information and assistance based on national and state standards;
215.6 	(4) assists (5) educate people to on their options so they can make well-informed 
215.7 	decisions choices; and
215.8 	(5) supports (6) help support the timely resolution of service access and benefit 
215.9 	issues.;
215.10 	(7) inform people of their long-term community services and supports;
215.11 	(8) provide necessary resources and supports that can lead to employment and 
215.12 	increased economic stability of people with disabilities; and
215.13 	(9) serve as the technical assistance and help center for the Web-based tool, 
215.14 	Minnesota's Disability Benefits 101.org.

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

215.16 	Sec. 5. Minnesota Statutes 2010, section 256.01, subdivision 29, is amended to read:
215.17 		Subd. 29.State medical review team. (a) To ensure the timely processing of 
215.18 	determinations of disability by the commissioner's state medical review team under 
215.19 	sections 256B.055, subdivision 7, paragraph (b), 256B.057, subdivision 9, paragraph 
215.20 	(j), and 256B.055, subdivision 12, the commissioner shall review all medical evidence 
215.21 	submitted by county agencies with a referral and seek additional information from 
215.22 	providers, applicants, and enrollees to support the determination of disability where 
215.23 	necessary. Disability shall be determined according to the rules of title XVI and title 
215.24 	XIX of the Social Security Act and pertinent rules and policies of the Social Security 
215.25 	Administration.
215.26 	(b) Prior to a denial or withdrawal of a requested determination of disability due 
215.27 	to insufficient evidence, the commissioner shall (1) ensure that the missing evidence is 
215.28 	necessary and appropriate to a determination of disability, and (2) assist applicants and 
215.29 	enrollees to obtain the evidence, including, but not limited to, medical examinations 
215.30 	and electronic medical records.
215.31 	(c) The commissioner shall provide the chairs of the legislative committees with 
215.32 	jurisdiction over health and human services finance and budget the following information 
215.33 	on the activities of the state medical review team by February 1 of each year:
215.34 	(1) the number of applications to the state medical review team that were denied, 
215.35 	approved, or withdrawn;
216.1 	(2) the average length of time from receipt of the application to a decision;
216.2 	(3) the number of appeals, appeal results, and the length of time taken from the date 
216.3 	the person involved requested an appeal for a written decision to be made on each appeal;
216.4 	(4) for applicants, their age, health coverage at the time of application, hospitalization 
216.5 	history within three months of application, and whether an application for Social Security 
216.6 	or Supplemental Security Income benefits is pending; and
216.7 	(5) specific information on the medical certification, licensure, or other credentials 
216.8 	of the person or persons performing the medical review determinations and length of 
216.9 	time in that position.
216.10 	(d) Any appeal made under section 256.045, subdivision 3, of a disability 
216.11 	determination made by the state medical review team must be decided according to the 
216.12 	timelines under section 256.0451, subdivision 22, paragraph (a). If a written decision is 
216.13 	not issued within the timelines under section 256.0451, subdivision 22, paragraph (a), the 
216.14 	appeal must be immediately reviewed by the chief appeals referee.

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

216.16 	Sec. 6. Minnesota Statutes 2010, section 256.045, subdivision 4a, is amended to read:
216.17 		Subd. 4a.Case management appeals temporary stay of demission. Any recipient 
216.18 	of case management services pursuant to section 256B.092, who contests the county 
216.19 	agency's action or failure to act in the provision of those services, other than a failure 
216.20 	to act with reasonable promptness or a suspension, reduction, denial, or termination of 
216.21 	services, must submit a written request for a conciliation conference to the county agency. 
216.22 	The county agency shall inform the commissioner of the receipt of a request when it is 
216.23 	submitted and shall schedule a conciliation conference. The county agency shall notify the 
216.24 	recipient, the commissioner, and all interested persons of the time, date, and location of the 
216.25 	conciliation conference. The commissioner may assist the county by providing mediation 
216.26 	services or by identifying other resources that may assist in the mediation between the 
216.27 	parties. Within 30 days, the county agency shall conduct the conciliation conference 
216.28 	and inform the recipient in writing of the action the county agency is going to take and 
216.29 	when that action will be taken and notify the recipient of the right to a hearing under this 
216.30 	subdivision. The conciliation conference shall be conducted in a manner consistent with 
216.31 	the commissioner's instructions. If the county fails to conduct the conciliation conference 
216.32 	and issue its report within 30 days, or, at any time up to 90 days after the conciliation 
216.33 	conference is held, a recipient may submit to the commissioner a written request for a 
216.34 	hearing before a state human services referee to determine whether case management 
216.35 	services have been provided in accordance with applicable laws and rules or whether the 
217.1 	county agency has assured that the services identified in the recipient's individual service 
217.2 	plan have been delivered in accordance with the laws and rules governing the provision 
217.3 	of those services. The state human services referee shall recommend an order to the 
217.4 	commissioner, who shall, in accordance with the procedure in subdivision 5, issue a final 
217.5 	order within 60 days of the receipt of the request for a hearing, unless the commissioner 
217.6 	refuses to accept the recommended order, in which event a final order shall issue within 90 
217.7 	days of the receipt of that request. The order may direct the county agency to take those 
217.8 	actions necessary to comply with applicable laws or rules. The commissioner may issue a 
217.9 	temporary order prohibiting the demission of a recipient of case management services 
217.10 	under section 256B.092 from a residential or day habilitation program licensed under 
217.11 	chapter 245A, while a county agency review process or an appeal brought by a recipient 
217.12 	under this subdivision is pending, or for the period of time necessary for the county agency 
217.13 	to implement the commissioner's order. The commissioner shall not issue a final order 
217.14 	staying the demission of a recipient of case management services from a residential or day 
217.15 	habilitation program licensed under chapter 245A.

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

217.17 	Sec. 7. Minnesota Statutes 2010, section 256B.056, subdivision 3, is amended to read:
217.18 		Subd. 3.Asset limitations for individuals and families. (a) To be eligible for 
217.19 	medical assistance, a person must not individually own more than $3,000 in assets, or if a 
217.20 	member of a household with two family members, husband and wife, or parent and child, 
217.21 	the household must not own more than $6,000 in assets, plus $200 for each additional 
217.22 	legal dependent. In addition to these maximum amounts, an eligible individual or family 
217.23 	may accrue interest on these amounts, but they must be reduced to the maximum at the 
217.24 	time of an eligibility redetermination. The accumulation of the clothing and personal 
217.25 	needs allowance according to section 256B.35 must also be reduced to the maximum at 
217.26 	the time of the eligibility redetermination. The value of assets that are not considered in 
217.27 	determining eligibility for medical assistance is the value of those assets excluded under 
217.28 	the supplemental security income program for aged, blind, and disabled persons, with 
217.29 	the following exceptions:
217.30 	(1) household goods and personal effects are not considered;
217.31 	(2) capital and operating assets of a trade or business that the local agency determines 
217.32 	are necessary to the person's ability to earn an income are not considered;
217.33 	(3) motor vehicles are excluded to the same extent excluded by the supplemental 
217.34 	security income program;
218.1 	(4) assets designated as burial expenses are excluded to the same extent excluded by 
218.2 	the supplemental security income program. Burial expenses funded by annuity contracts 
218.3 	or life insurance policies must irrevocably designate the individual's estate as contingent 
218.4 	beneficiary to the extent proceeds are not used for payment of selected burial expenses; and
218.5 	(5) effective upon federal approval, for a person who no longer qualifies as an 
218.6 	employed person with a disability due to loss of earnings, assets allowed while eligible 
218.7 	for medical assistance under section 256B.057, subdivision 9, are not considered for 12 
218.8 	months, beginning with the first month of ineligibility as an employed person with a 
218.9 	disability, to the extent that the person's total assets remain within the allowed limits of 
218.10 	section 256B.057, subdivision 9, paragraph (c) (d).
218.11 	(b) No asset limit shall apply to persons eligible under section 256B.055, subdivision 
218.12 	15.

218.13 	EFFECTIVE DATE. This section is effective January 1, 2014.

218.14 	Sec. 8. Minnesota Statutes 2010, section 256B.056, is amended by adding a 
218.15 	subdivision to read:
218.16 		Subd. 5d.Spenddown adjustments. When income is projected for a six-month 
218.17 	budget period, retroactive adjustments to income determined to be available to a person 
218.18 	under section 256B.0575 must be made at the end of each six-month budget period 
218.19 	based on changes occurring during the budget period. For changes occurring outside the 
218.20 	six-month budget period, such retroactive adjustments are limited to the six full calendar 
218.21 	months before the month the change is reported or discovered.

218.22 	Sec. 9. Minnesota Statutes 2010, section 256B.057, subdivision 9, is amended to read:
218.23 		Subd. 9.Employed persons with disabilities. (a) Medical assistance may be paid 
218.24 	for a person who is employed and who:
218.25 	(1) but for excess earnings or assets, meets the definition of disabled under the 
218.26 	Supplemental Security Income program;
218.27 	(2) is at least 16 but less than 65 years of age;
218.28 	(3) meets the asset limits in paragraph (c) (d); and
218.29 	(4) pays a premium and other obligations under paragraph (e).
218.30 	(b) For purposes of eligibility, there is a $65 earned income disregard. To be eligible 
218.31 	for medical assistance under this subdivision, a person must have more than $65 of earned 
218.32 	income. Earned income must have Medicare, Social Security, and applicable state and 
218.33 	federal taxes withheld. The person must document earned income tax withholding. Any 
219.1 	spousal income or assets shall be disregarded for purposes of eligibility and premium 
219.2 	determinations.
219.3 	(b) (c) After the month of enrollment, a person enrolled in medical assistance under 
219.4 	this subdivision who:
219.5 	(1) is temporarily unable to work and without receipt of earned income due to a 
219.6 	medical condition, as verified by a physician, may retain eligibility for up to four calendar 
219.7 	months; or
219.8 	(2) effective January 1, 2004, loses employment for reasons not attributable to the 
219.9 	enrollee, and is without receipt of earned income may retain eligibility for up to four 
219.10 	consecutive months after the month of job loss. To receive a four-month extension, 
219.11 	enrollees must verify the medical condition or provide notification of job loss. All other 
219.12 	eligibility requirements must be met and the enrollee must pay all calculated premium 
219.13 	costs for continued eligibility.
219.14 	(c) (d) For purposes of determining eligibility under this subdivision, a person's 
219.15 	assets must not exceed $20,000, excluding:
219.16 	(1) all assets excluded under section 256B.056;
219.17 	(2) retirement accounts, including individual accounts, 401(k) plans, 403(b) plans, 
219.18 	Keogh plans, and pension plans; and
219.19 	(3) medical expense accounts set up through the person's employer.; and
219.20 	(4) spousal assets, including spouse's share of jointly held assets.
219.21 	(d)(1) Effective January 1, 2004, for purposes of eligibility, there will be a $65 
219.22 	earned income disregard. To be eligible, a person applying for medical assistance under 
219.23 	this subdivision must have earned income above the disregard level.
219.24 	(2) Effective January 1, 2004, to be considered earned income, Medicare, Social 
219.25 	Security, and applicable state and federal income taxes must be withheld. To be eligible, 
219.26 	a person must document earned income tax withholding.
219.27 	(e)(1) A person whose earned and unearned income is equal to or greater than 100 
219.28 	percent of federal poverty guidelines for the applicable family size must pay a premium 
219.29 	to be eligible for medical assistance under this subdivision. (e) All enrollees must pay a 
219.30 	premium to be eligible for medical assistance under this subdivision.
219.31 	(1) An enrollee must pay the greater of a $65 premium or the premium shall be
219.32 	calculated based on the person's gross earned and unearned income and the applicable 
219.33 	family size using a sliding fee scale established by the commissioner, which begins at 
219.34 	one percent of income at 100 percent of the federal poverty guidelines and increases 
219.35 	to 7.5 percent of income for those with incomes at or above 300 percent of the federal 
219.36 	poverty guidelines. 
220.1 	(2) Annual adjustments in the premium schedule based upon changes in the federal 
220.2 	poverty guidelines shall be effective for premiums due in July of each year.
220.3 	(2) Effective January 1, 2004, all enrollees must pay a premium to be eligible for 
220.4 	medical assistance under this subdivision. An enrollee shall pay the greater of a $35 
220.5 	premium or the premium calculated in clause (1).
220.6 	(3) Effective November 1, 2003, All enrollees who receive unearned income must 
220.7 	pay one-half of one five percent of unearned income in addition to the premium amount.
220.8 	(4) Effective November 1, 2003, for enrollees whose income does not exceed 200 
220.9 	percent of the federal poverty guidelines and who are also enrolled in Medicare, the 
220.10 	commissioner must reimburse the enrollee for Medicare Part B premiums under section 
220.11 	256B.0625, subdivision 15, paragraph (a).
220.12 	(5) (4) Increases in benefits under title II of the Social Security Act shall not be 
220.13 	counted as income for purposes of this subdivision until July 1 of each year.
220.14 	(f) A person's eligibility and premium shall be determined by the local county 
220.15 	agency. Premiums must be paid to the commissioner. All premiums are dedicated to 
220.16 	the commissioner.
220.17 	(g) Any required premium shall be determined at application and redetermined at 
220.18 	the enrollee's six-month income review or when a change in income or household size is 
220.19 	reported. Enrollees must report any change in income or household size within ten days 
220.20 	of when the change occurs. A decreased premium resulting from a reported change in 
220.21 	income or household size shall be effective the first day of the next available billing month 
220.22 	after the change is reported. Except for changes occurring from annual cost-of-living 
220.23 	increases, a change resulting in an increased premium shall not affect the premium amount 
220.24 	until the next six-month review.
220.25 	(h) Premium payment is due upon notification from the commissioner of the 
220.26 	premium amount required. Premiums may be paid in installments at the discretion of 
220.27 	the commissioner.
220.28 	(i) Nonpayment of the premium shall result in denial or termination of medical 
220.29 	assistance unless the person demonstrates good cause for nonpayment. Good cause exists 
220.30 	if the requirements specified in Minnesota Rules, part 9506.0040, subpart 7, items B to 
220.31 	D, are met. Except when an installment agreement is accepted by the commissioner, 
220.32 	all persons disenrolled for nonpayment of a premium must pay any past due premiums 
220.33 	as well as current premiums due prior to being reenrolled. Nonpayment shall include 
220.34 	payment with a returned, refused, or dishonored instrument. The commissioner may 
220.35 	require a guaranteed form of payment as the only means to replace a returned, refused, 
220.36 	or dishonored instrument.
221.1 	(j) The commissioner shall notify enrollees annually beginning at least 24 months 
221.2 	before the person's 65th birthday of the medical assistance eligibility rules affecting 
221.3 	income, assets, and treatment of a spouse's income and assets that will be applied upon 
221.4 	reaching age 65.
221.5 	(k) For enrollees whose income does not exceed 200 percent of the federal poverty 
221.6 	guidelines and who are also enrolled in Medicare, the commissioner shall reimburse 
221.7 	the enrollee for Medicare part B premiums under section 256B.0625, subdivision 15, 
221.8 	paragraph (a).

221.9 	EFFECTIVE DATE. This section is effective January 1, 2014, for adults age 21 or 
221.10 	older, and October 1, 2019, for children age 16 to before the child's 21st birthday.

221.11 	Sec. 10. Minnesota Statutes 2010, section 256B.0657, is amended to read:
221.12 	256B.0657 SELF-DIRECTED SUPPORTS OPTION.
221.13 		Subdivision 1.Definition. (a) "Lead agency" has the meaning given in section 
221.14 	256B.0911, subdivision 1a, paragraph (d).
221.15 	(b) "Legal representative" means a legal guardian of a child or an adult, or parent of 
221.16 	a minor child.
221.17 	(c) "Managing partner" means an individual who has been authorized, in a written 
221.18 	statement by the person or the person's legal representative, to speak on the person's 
221.19 	behalf and help the person understand and make informed choices in matters related 
221.20 	to identification of needs and choice of services and supports and assist the person to 
221.21 	implement an approved support plan and has no financial interest in the provision of 
221.22 	any other services included in the individual's plan unless related by blood, adoption, or 
221.23 	marriage.
221.24 	(d) "Self-directed supports option" means personal assistance, supports, items, and 
221.25 	related services purchased under an approved budget plan and budget by a recipient.
221.26 		Subd. 2.Eligibility. (a) The self-directed supports option is available to a person 
221.27 	who:
221.28 	(1) is a recipient of medical assistance as determined under sections 256B.055, 
221.29 	256B.056, and 256B.057, subdivision 9;
221.30 	(2) is eligible for personal care assistance services under section 256B.0659, or 
221.31 	for a home and community-based services waiver program under section 256B.0915, 
221.32 	256B.092, or 256B.49, or alternative care under section 256B.0913;
222.1 	(3) lives in the person's own apartment or home, which is not owned, operated, or 
222.2 	controlled by a provider of services not related by blood or, adoption, marriage, or foster 
222.3 	care;
222.4 	(4) has the ability to hire, fire, supervise, establish staff compensation for, and 
222.5 	manage the individuals providing services, and to choose and obtain items, related 
222.6 	services, and supports as described in the participant's plan. If the recipient is not able to 
222.7 	carry out these functions but has a legal guardian, managing partner,  or parent to carry 
222.8 	them out, the guardian, managing partner,  or parent may fulfill these functions on behalf 
222.9 	of the recipient; and
222.10 	(5) has not been excluded or disenrolled by the commissioner.
222.11 	(b) The commissioner may disenroll or, exclude, or require other measures such as 
222.12 	training, increased assistance, reporting, or oversight for recipients, including guardians 
222.13 	and,  parents, and managing partners under the following circumstances:
222.14 	(1) recipients who have been restricted by the Primary Care Utilization Review 
222.15 	Committee may be excluded for a specified time period;
222.16 	(2) recipients who exit the self-directed supports option during the recipient's 
222.17 	service plan year shall not access the self-directed supports option for the remainder of 
222.18 	that service plan year; and
222.19 	(3) when the department determines that the recipient cannot manage recipient 
222.20 	responsibilities under the program.
222.21 	(c) For vendors or other self-directed service providers, the commissioner may 
222.22 	take any action authorized under surveillance and integrity review in Minnesota Rules, 
222.23 	parts 9505.2160 to 9505.2245.
222.24 		Subd. 3.Eligibility for other services. Selection of the self-directed supports 
222.25 	option by a recipient shall not restrict access to other medically necessary care and 
222.26 	services furnished under the state plan medical assistance benefit, including home care 
222.27 	targeted case management, except that a person receiving choosing lead agency managed
222.28 	home and community-based waiver services, agency-provided personal care assistance 
222.29 	services, a family support grant, or a consumer support grant is not eligible for funding 
222.30 	under the self-directed supports option.
222.31 		Subd. 4.Assessment requirements. (a) The self-directed supports option 
222.32 	assessment must meet the following requirements:
222.33 	(1) it shall be conducted by the county public health nurse or a certified public health 
222.34 	nurse under contract with the county consistent with the requirements of personal care 
222.35 	assistance services under section 256B.0659, subdivision 3a; home and community-based 
222.36 	waiver services programs under section 256B.0915, 256B.092, or 256B.49; and the 
223.1 	alternative care program under section 256B.0913, until section 256B.0911, subdivision 
223.2 	3a, has been implemented;
223.3 	(2) it shall be conducted face-to-face in the recipient's home initially, and at least 
223.4 	annually thereafter; when there is a significant change in the recipient's condition; and 
223.5 	when there is a change in the person's need for personal care assistance services under the 
223.6 	programs listed in subdivision 2, paragraph (a), clause (2). A recipient who is residing in a 
223.7 	facility may be assessed for the self-directed support option for the purpose of returning 
223.8 	to the community using this option; and
223.9 	(3) it shall be completed using the format established by the commissioner.
223.10 	(b) The results of the personal care assistance assessment and recommendations 
223.11 	shall be communicated to the commissioner and the recipient by the county public health 
223.12 	nurse or certified public health nurse under contract with the county as required under 
223.13 	section 256B.0659, subdivision 3a. The person's annual and self-directed budget amount 
223.14 	shall be provided within 40 days after the personal care assessment or reassessment, or 
223.15 	within ten days after a request not related to an assessment.
223.16 	(c) The lead agency responsible for administration of home and community-based 
223.17 	waiver services under section 256B.0915, 256B.092, or 256B.49, and alternative care 
223.18 	under section 256B.0913, shall provide annual and monthly self-directed services budget 
223.19 	amounts for all eligible persons within 40 days after an initial assessment or annual review 
223.20 	and within ten days if requested at a time unrelated to the assessment or annual review.
223.21 		Subd. 5.Self-directed supports option plan requirements. (a) The plan for the 
223.22 	self-directed supports option must meet the following requirements:
223.23 	(1) the plan must be completed using a person-centered process that:
223.24 	(i) builds upon the recipient's capacity to engage in activities that promote 
223.25 	community life;
223.26 	(ii) respects the recipient's preferences, choices, and abilities;
223.27 	(iii) involves families, friends, and professionals in the planning or delivery of 
223.28 	services or supports as desired or required by the recipient; and
223.29 	(iv) addresses the need for personal care assistance and other services and supports
223.30 	identified in the recipient's self-directed supports option assessment;
223.31 	(2) the plan shall be developed by the recipient, legal representative, or by the 
223.32 	guardian of an adult recipient or by a parent or guardian of a minor child,managing 
223.33 	partner, and may be assisted by a provider who meets the requirements established for 
223.34 	using a person-centered planning process and shall be reviewed at least annually upon 
223.35 	reassessment or when there is a significant change in the recipient's condition; and
224.1 	(3) the plan must include the total budget amount available divided into monthly 
224.2 	amounts that cover the number of months of personal care assistance services or home 
224.3 	and community-based waiver or alternative care authorization included in the budget. 
224.4 	A recipient may reserve funds monthly for the purchase of items that meet the standards 
224.5 	in subdivision 6, paragraph (a), clause (2), and are reflected in the support plan. The 
224.6 	amount used each month may vary, but additional funds shall not be provided above the 
224.7 	annual personal care assistance services authorized amount unless a change in condition 
224.8 	is documented.
224.9 	(b) The commissioner or the commissioner's designee shall:
224.10 	(1) establish the format and criteria for the plan as well as the provider enrollment 
224.11 	requirements for providers who will engage in outreach and training on self-directed 
224.12 	options, assist with plan development, and offer person-centered plan support services 
224.13 	including benefits counseling to support employment;
224.14 	(2) review the assessment and plan and, within 30 days after receiving the 
224.15 	assessment and plan, make a decision on approval of the plan;
224.16 	(3) notify the recipient, parent, or guardian legal representative, or managing partner
224.17 	of approval or denial of the plan and provide notice of the right to appeal under section 
224.18 	256.045; and
224.19 	(4) provide a copy of the plan to the fiscal support entity selected by the recipient
224.20 	from among at least three certified entities.
224.21 		Subd. 6.Services covered. (a) Services covered under the self-directed supports 
224.22 	option include:
224.23 	(1) personal care assistance services under section 256B.0659, and services under 
224.24 	the home and community-based waivers, except those provided in licensed or registered 
224.25 	residential settings; and
224.26 	(2) items, related services, and supports, including assistive technology, that increase 
224.27 	independence or substitute for human assistance to the extent expenditures would 
224.28 	otherwise be used for human assistance.
224.29 	(b) Items, supports, and related services purchased under this option shall not be 
224.30 	considered home care services for the purposes of section 144A.43.
224.31 		Subd. 7.Noncovered services. Services or supports that are not eligible for 
224.32 	payment under the self-directed supports option include:
224.33 	(1) services, goods, or supports that do not benefit the recipient;
224.34 	(2) any fees incurred by the recipient, such as Minnesota health care program fees 
224.35 	and co-pays, legal fees, or costs related to advocate agencies;
225.1 	(3) insurance, except for insurance costs related to employee coverage or fiscal 
225.2 	support entity payments;
225.3 	(4) room and board and personal items that are not related to the disability, except 
225.4 	that medically prescribed specialized diet items may be covered if they reduce the need for 
225.5 	human assistance;
225.6 	(5) home modifications that add square footage, except those modifications that 
225.7 	configure a bathroom to accommodate a wheelchair;
225.8 	(6) home modifications for a residence other than the primary residence of the 
225.9 	recipient, or in the event of a minor with parents not living together, the primary residences 
225.10 	of the parents;
225.11 	(7) expenses for travel, lodging, or meals related to training the recipient, the 
225.12 	parent or guardian of an adult recipient, or the parent or guardian of a minor child legal 
225.13 	representative, or paid or unpaid caregivers that exceed $500 in a 12-month period;
225.14 	(8) experimental treatment;
225.15 	(9) any service or item to the extent the service or item is covered by other medical 
225.16 	assistance state plan services, including prescription and over-the-counter medications, 
225.17 	compounds, and solutions and related fees, including premiums and co-payments;
225.18 	(10) membership dues or costs, except when the service is necessary and appropriate 
225.19 	to treat a physical condition or to improve or maintain the recipient's physical condition. 
225.20 	The condition must be identified in the recipient's plan of care and monitored by a 
225.21 	Minnesota health care program enrolled physician;
225.22 	(11) vacation expenses other than the cost of direct services;
225.23 	(12) vehicle maintenance or modifications not related to the disability;
225.24 	(13) tickets and related costs to attend sporting or other recreational events; and
225.25 	(14) costs related to Internet access, except when necessary for operation of assistive 
225.26 	technology, to increase independence, or to substitute for human assistance.
225.27 		Subd. 8.Self-directed budget requirements. (a) The budget for the provision of 
225.28 	the self-directed service option shall be established for persons eligible for personal care 
225.29 	assistance services under section 256B.0659 based on:
225.30 	(1) assessed personal care assistance units, not to exceed the maximum number of 
225.31 	personal care assistance units available, as determined by section 256B.0659; and
225.32 	(2) the personal care assistance unit rate:
225.33 	(i) with a reduction to the unit rate to pay for a program administrator as defined in 
225.34 	subdivision 10; and
225.35 	(ii) an additional adjustment to the unit rate as needed to ensure cost neutrality for 
225.36 	the state.
226.1 	(b) The budget for persons eligible for programs listed in subdivision 2, paragraph 
226.2 	(a), clause (2), is based on the approved budget methodologies for each program.
226.3 		Subd. 9.Quality assurance and risk management. (a) The commissioner 
226.4 	shall establish quality assurance and risk management measures for use in developing 
226.5 	and implementing self-directed plans and budgets that (1) recognize the roles and 
226.6 	responsibilities involved in obtaining services in a self-directed manner, and (2) assure 
226.7 	the appropriateness of such plans and budgets based upon a recipient's resources and 
226.8 	capabilities. These measures must include (i) background studies, and (ii) backup and 
226.9 	emergency plans, including disaster planning, and (iii) monitoring by the lead agency on 
226.10 	quality assurance measures and recipient health, safety, and welfare.
226.11 	(b) The commissioner shall provide ongoing technical assistance and resource 
226.12 	and educational materials for families and recipients selecting the self-directed option, 
226.13 	including information on the quality assurance efforts and activities of region 10 under 
226.14 	sections 256B.095 to 256B.096.
226.15 	(c) Performance assessments measures, such as of a recipient's  functioning, 
226.16 	satisfaction with the services and supports, and ongoing monitoring of health and 
226.17 	well-being shall be identified in consultation with the stakeholder group and monitored 
226.18 	by the lead agency.
226.19 		Subd. 10.Fiscal support entity. (a) Each recipient or legal representative shall 
226.20 	choose a fiscal support entity provider certified by the commissioner to make payments 
226.21 	for services, items, supports, and administrative costs related to managing a self-directed 
226.22 	service plan authorized for payment in the approved plan and budget. Recipients The 
226.23 	recipient or legal representative  shall also choose the payroll, agency with choice, or the 
226.24 	fiscal conduit model of financial and service management.
226.25 	(b) The fiscal support entity:
226.26 	(1) may not limit or restrict the recipient's choice of service or support providers, 
226.27 	including use of the payroll, agency with choice, or fiscal conduit model of financial 
226.28 	and service management;
226.29 	(2) must have a written agreement with the recipient, managing partner,  or the 
226.30 	recipient's legal representative that identifies the duties and responsibilities to be 
226.31 	performed and the specific related charges;
226.32 	(3) must provide the recipient and the home care targeted case manager, legal 
226.33 	representative, and managing partner with a monthly written summary of the self-directed 
226.34 	supports option services that were billed, including charges from the fiscal support entity;
226.35 	(4) must be knowledgeable of and comply with Internal Revenue Service 
226.36 	requirements necessary to process employer and employee deductions, provide appropriate 
227.1 	and timely submission of employer tax liabilities, and maintain documentation to support 
227.2 	medical assistance claims;
227.3 	(5) must have current and adequate liability insurance and bonding and sufficient 
227.4 	cash flow and have on staff or under contract a certified public accountant or an individual 
227.5 	with a baccalaureate degree in accounting; and
227.6 	(6) must maintain records to track all self-directed supports option services 
227.7 	expenditures, including time records of persons paid to provide supports and receipts for 
227.8 	any goods purchased. The records must be maintained for a minimum of five years from 
227.9 	the claim date and be available for audit or review upon request. Claims submitted by 
227.10 	the fiscal support entity must correspond with services, amounts, and time periods as 
227.11 	authorized in the recipient's self-directed supports option plan.
227.12 	(c) The commissioner shall have authority to:
227.13 	(1) set or negotiate rates with fiscal support entities;
227.14 	(2) limit the number of fiscal support entities;
227.15 	(3) identify a process to certify and recertify fiscal support entities and assure fiscal 
227.16 	support entities are available to recipients throughout the state; and
227.17 	(4) establish a uniform format and protocol to be used by eligible fiscal support 
227.18 	entities.
227.19 		Subd. 11.Stakeholder consultation. The commissioner shall consult with 
227.20 	a statewide consumer-directed self-directed  services stakeholder group, including 
227.21 	representatives of all types of consumer-directed self-directed  service users, advocacy 
227.22 	organizations, counties, and consumer-directed self-directed  service providers. The 
227.23 	commissioner shall seek recommendations from this stakeholder group in developing, 
227.24 	monitoring, evaluating, and modifying:
227.25 	(1) the self-directed plan format;
227.26 	(2) requirements and guidelines for the person-centered plan assessment and 
227.27 	planning process;
227.28 	(3) implementation of the option and the quality assurance and risk management 
227.29 	techniques; and
227.30 	(4) standards and requirements, including rates for the personal support plan 
227.31 	development provider and the fiscal support entity; policies; training; and implementation; 
227.32 	and
227.33 	(5) the self-directed supports options available through the home and 
227.34 	community-based waivers under section 256B.0916 and the personal care assistance 
227.35 	program under section 256B.0659, including ways to increase participation, improve 
227.36 	flexibility, and include incentives for recipients to participate in a life transition and crisis 
228.1 	funding pool with others to save and contribute part of their authorized budgets, which 
228.2 	can be carried over year to year and used according to priority standards under section 
228.3 	256B.092, subdivision 12, paragraph (a), clauses (1), (3), (4), (5), and (6).
228.4 	The stakeholder group shall provide recommendations on the repeal of the personal 
228.5 	care assistance choice option, transition issues, and whether the consumer support grant 
228.6 	program under section 256.476 should be modified. The stakeholder group shall meet 
228.7 	at least three times each year to provide advice on policy, implementation, and other 
228.8 	aspects of consumer and self-directed services.
228.9 		Subd. 12.Enrollment and evaluation. Enrollment in the self-directed supports 
228.10 	option is available to current personal care assistance recipients upon annual personal 
228.11 	care assistance reassessment, with a maximum enrollment of 1,000 2,000 people in the 
228.12 	first fiscal year of implementation and an additional 1,000 3,000 people in the second 
228.13 	fiscal year. The commissioner shall evaluate the self-directed supports option during the 
228.14 	first two years of implementation and make any necessary changes prior to the option 
228.15 	becoming available statewide.

228.16 	EFFECTIVE DATE. This section is effective July 1, 2012.

228.17 	Sec. 11. Minnesota Statutes 2010, section 256B.0659, subdivision 2, is amended to 
228.18 	read:
228.19 		Subd. 2.Personal care assistance services; covered services. (a) The personal 
228.20 	care assistance services eligible for payment include services and supports furnished 
228.21 	to an individual, as needed, to assist in:
228.22 	(1) activities of daily living;
228.23 	(2) health-related procedures and tasks;
228.24 	(3) observation and redirection of behaviors; and
228.25 	(4) instrumental activities of daily living.
228.26 	(b) Activities of daily living include the following covered services:
228.27 	(1) dressing, including assistance with choosing, application, and changing of 
228.28 	clothing and application of special appliances, wraps, or clothing;
228.29 	(2) grooming, including assistance with basic hair care, oral care, shaving, applying 
228.30 	cosmetics and deodorant, and care of eyeglasses and hearing aids. Nail care is included, 
228.31 	except for recipients who are diabetic or have poor circulation;
228.32 	(3) bathing, including assistance with basic personal hygiene and skin care;
228.33 	(4) eating, including assistance with hand washing and application of orthotics 
228.34 	required for eating, transfers, and feeding;
229.1 	(5) transfers, including assistance with transferring the recipient from one seating or 
229.2 	reclining area to another;
229.3 	(6) mobility, including assistance with ambulation, including use of a wheelchair. 
229.4 	Mobility does not include providing transportation for a recipient;
229.5 	(7) positioning, including assistance with positioning or turning a recipient for 
229.6 	necessary care and comfort; and
229.7 	(8) toileting, including assistance with helping recipient with bowel or bladder 
229.8 	elimination and care including transfers, mobility, positioning, feminine hygiene, use of 
229.9 	toileting equipment or supplies, cleansing the perineal area, inspection of the skin, and 
229.10 	adjusting clothing.
229.11 	(c) Health-related procedures and tasks include the following covered services:
229.12 	(1) range of motion and passive exercise to maintain a recipient's strength and 
229.13 	muscle functioning;
229.14 	(2) assistance with self-administered medication as defined by this section, including 
229.15 	reminders to take medication, bringing medication to the recipient, and assistance with 
229.16 	opening medication under the direction of the recipient or responsible party;
229.17 	(3) interventions for seizure disorders, including monitoring and observation; and
229.18 	(4) other activities considered within the scope of the personal care service and 
229.19 	meeting the definition of health-related procedures and tasks under this section, including 
229.20 	assisting recipients with rehabilitation exercises that are part of a recipient's care plan if 
229.21 	trained in the procedures and tasks and no additional personal care assistance service time 
229.22 	is necessary to complete this task.
229.23 	(d) A personal care assistant may provide health-related procedures and tasks 
229.24 	associated with the complex health-related needs of a recipient if the procedures and 
229.25 	tasks meet the definition of health-related procedures and tasks under this section and the 
229.26 	personal care assistant is trained by a qualified professional and demonstrates competency 
229.27 	to safely complete the procedures and tasks. Delegation of health-related procedures and 
229.28 	tasks and all training must be documented in the personal care assistance care plan and the 
229.29 	recipient's and personal care assistant's files.
229.30 	(e) Effective January 1, 2010, for a personal care assistant to provide the 
229.31 	health-related procedures and tasks of tracheostomy suctioning and services to recipients 
229.32 	on ventilator support there must be:
229.33 	(1) delegation and training by a registered nurse, certified or licensed respiratory 
229.34 	therapist, or a physician;
229.35 	(2) utilization of clean rather than sterile procedure;
230.1 	(3) specialized training about the health-related procedures and tasks and equipment, 
230.2 	including ventilator operation and maintenance;
230.3 	(4) individualized training regarding the needs of the recipient; and
230.4 	(5) supervision by a qualified professional who is a registered nurse.
230.5 	(f) Effective January 1, 2010, a personal care assistant may observe and redirect the 
230.6 	recipient for episodes where there is a need for redirection due to behaviors. Training of 
230.7 	the personal care assistant must occur based on the needs of the recipient, the personal 
230.8 	care assistance care plan, and any other support services provided.
230.9 	(g) Instrumental activities of daily living under subdivision 1, paragraph (i).

230.10 	Sec. 12. Minnesota Statutes 2010, section 256B.0659, subdivision 11, is amended to 
230.11 	read:
230.12 		Subd. 11.Personal care assistant; requirements. (a) A personal care assistant 
230.13 	must meet the following requirements:
230.14 	(1) be at least 18 years of age with the exception of persons who are 16 or 17 years 
230.15 	of age with these additional requirements:
230.16 	(i) supervision by a qualified professional every 60 days; and
230.17 	(ii) employment by only one personal care assistance provider agency responsible 
230.18 	for compliance with current labor laws;
230.19 	(2) be employed by a personal care assistance provider agency;
230.20 	(3) enroll with the department as a personal care assistant after clearing a background 
230.21 	study. Except as provided in subdivision 11a, before a personal care assistant provides 
230.22 	services, the personal care assistance provider agency must initiate a background study on 
230.23 	the personal care assistant under chapter 245C, and the personal care assistance provider 
230.24 	agency must have received a notice from the commissioner that the personal care assistant 
230.25 	is:
230.26 	(i) not disqualified under section 245C.14; or
230.27 	(ii) is disqualified, but the personal care assistant has received a set aside of the 
230.28 	disqualification under section 245C.22;
230.29 	(4) be able to effectively communicate with the recipient and personal care 
230.30 	assistance provider agency;
230.31 	(5) be able to provide covered personal care assistance services according to the 
230.32 	recipient's personal care assistance care plan, respond appropriately to recipient needs, 
230.33 	and report changes in the recipient's condition to the supervising qualified professional 
230.34 	or physician;
230.35 	(6) not be a consumer of personal care assistance services;
231.1 	(7) maintain daily written records including, but not limited to, time sheets under 
231.2 	subdivision 12;
231.3 	(8) effective January 1, 2010, complete standardized training as determined 
231.4 	by the commissioner before completing enrollment. The training must be available 
231.5 	in languages other than English and to those who need accommodations due to 
231.6 	disabilities. Personal care assistant training must include successful completion of the 
231.7 	following training components: basic first aid, vulnerable adult, child maltreatment, 
231.8 	OSHA universal precautions, basic roles and responsibilities of personal care assistants 
231.9 	including information about assistance with lifting and transfers for recipients, emergency 
231.10 	preparedness, orientation to positive behavioral practices, fraud issues, and completion of 
231.11 	time sheets. Upon completion of the training components, the personal care assistant must 
231.12 	demonstrate the competency to provide assistance to recipients;
231.13 	(9) complete training and orientation on the needs of the recipient within the first 
231.14 	seven days after the services begin; and
231.15 	(10) be limited to providing and being paid for up to 275 hours per month, except 
231.16 	that this limit shall be 275 hours per month for the period July 1, 2009, through June 30, 
231.17 	2011, of personal care assistance services regardless of the number of recipients being 
231.18 	served or the number of personal care assistance provider agencies enrolled with. The 
231.19 	number of hours worked per day shall not be disallowed by the department unless in 
231.20 	violation of the law.
231.21 	(b) A legal guardian may be a personal care assistant if the guardian is not being paid 
231.22 	for the guardian services and meets the criteria for personal care assistants in paragraph (a).
231.23 	(c) Effective January 1, 2010, persons who do not qualify as a personal care assistant 
231.24 	include parents and stepparents of minors, spouses, paid legal guardians, family foster 
231.25 	care providers, except as otherwise allowed in section 256B.0625, subdivision 19a, or 
231.26 	staff of a residential setting. When the personal care assistant is a relative of the recipient, 
231.27 	the commissioner shall pay 80 percent of the provider rate. For purposes of this section, 
231.28 	relative means the parent or adoptive parent of an adult child, a sibling aged 16 years or 
231.29 	older, an adult child, a grandparent, or a grandchild. 

231.30 	Sec. 13. Minnesota Statutes 2010, section 256B.0659, subdivision 28, is amended to 
231.31 	read:
231.32 		Subd. 28.Personal care assistance provider agency; required documentation.
 231.33 	(a) Required documentation must be completed and kept in the personal care assistance 
231.34 	provider agency file or the recipient's home residence. The required documentation 
231.35 	consists of:
232.1 	(1) employee files, including:
232.2 	(i) applications for employment;
232.3 	(ii) background study requests and results;
232.4 	(iii) orientation records about the agency policies;
232.5 	(iv) trainings completed with demonstration of competence;
232.6 	(v) supervisory visits;
232.7 	(vi) evaluations of employment; and
232.8 	(vii) signature on fraud statement;
232.9 	(2) recipient files, including:
232.10 	(i) demographics;
232.11 	(ii) emergency contact information and emergency backup plan;
232.12 	(iii) personal care assistance service plan;
232.13 	(iv) personal care assistance care plan;
232.14 	(v) month-to-month service use plan;
232.15 	(vi) all communication records;
232.16 	(vii) start of service information, including the written agreement with recipient; and
232.17 	(viii) date the home care bill of rights was given to the recipient;
232.18 	(3) agency policy manual, including:
232.19 	(i) policies for employment and termination;
232.20 	(ii) grievance policies with resolution of consumer grievances;
232.21 	(iii) staff and consumer safety;
232.22 	(iv) staff misconduct; and
232.23 	(v) staff hiring, service delivery, staff and consumer safety, staff misconduct, and 
232.24 	resolution of consumer grievances;
232.25 	(4) time sheets for each personal care assistant along with completed activity sheets 
232.26 	for each recipient served; and
232.27 	(5) agency marketing and advertising materials and documentation of marketing 
232.28 	activities and costs; and
232.29 	(6) for each personal care assistant, whether or not the personal care assistant is 
232.30 	providing care to a relative as defined in subdivision 11.
232.31 	(b) The commissioner may assess a fine of up to $500 on provider agencies that do 
232.32 	not consistently comply with the requirements of this subdivision.

232.33 	Sec. 14. [256B.0661] HOME AND COMMUNITY-BASED ATTENDANT 
232.34 	SERVICES AND SUPPORTS.
233.1 		Subdivision 1.Definitions. (a) For purposes of this section, the following terms 
233.2 	have the meanings given.
233.3 	(b) "Activities of daily living" means basic personal everyday activities, including 
233.4 	eating, toileting, grooming, dressing, bathing, transferring, positioning, and mobility.
233.5 	(c) "Extended home and community-based attendant services and supports" means 
233.6 	home and community-based attendant services included in a service plan under one of 
233.7 	the home and community-based services waivers under sections 256B.0915; 256B.092, 
233.8 	subdivision 5; and 256B.49, which exceed the amount, duration, and frequency of the state 
233.9 	plan home and community-based attendant services for participants who:
233.10 	(1) need assistance provided periodically during a week but less than daily and will 
233.11 	not be able to remain in their homes without assistance, and other replacement services 
233.12 	are more expensive or are not available when home and community-based attendant 
233.13 	services are to be reduced; or
233.14 	(2) need additional personal care assistant services beyond the amount authorized 
233.15 	by the state plan personal care assistance assessment in order to ensure that their safety, 
233.16 	health, and welfare are provided for in their homes.
233.17 	(d) "Health-related tasks" means those tasks and procedures listed in section 
233.18 	256B.0659, subdivision 2, paragraph (c).
233.19 	(e) "Home and community-based attendant services and supports" means personal 
233.20 	assistance, supports, items, and related services that provide assistance with accomplishing 
233.21 	activities of daily living (ADLs), instrumental activities of daily living (IADLs), and 
233.22 	health-related tasks including necessary supervision by a qualified professional.
233.23 	(f) "Individual's representative" means a parent, family member, advocate, or other 
233.24 	representative of the individual, authorized in a written statement by the person or 
233.25 	the person's legal representative, to speak on the person's behalf and help the person 
233.26 	understand and make informed choices in matters related to identification of needs and 
233.27 	choice of services and supports and assist the person in the implementation of an approved 
233.28 	support plan. For minor children and adults who cannot direct their own care, the 
233.29 	individual representative must meet the requirements of section 256B.0659, subdivisions 
233.30 	9 and 10, and shall not act as the home and community-based attendant for the individual.
233.31 	(g) "Instrumental activities of daily living" means activities related to living 
233.32 	independently in the community, including meal planning and preparation, managing 
233.33 	finances, shopping for food, clothing, and other essential items, performing essential 
233.34 	household chores, communicating by phone or other media, traveling, and participating 
233.35 	in the community.
233.36 	(h) "Legal representative" means the legal guardian or parent of a minor.
234.1 	(i) "Qualified professional" means a professional providing supervision of home 
234.2 	and community-based attendant services and staff as defined in section 256B.0625, 
234.3 	subdivision 19c.
234.4 		Subd. 2.Eligibility. (a) The home and community-based attendant services and 
234.5 	supports option is available to a person who:
234.6 	(1) is a recipient of medical assistance as determined under sections 256B.055, 
234.7 	256B.056, and 256B.057, subdivision 9;
234.8 	(2) has an income that meets one of the following thresholds as determined annually:
234.9 	(i) is equal to or less than 150 percent of the federal poverty guidelines; or
234.10 	(ii) is eligible for nursing facility services under the state plan and for whom it has 
234.11 	been determined that in the absence of home and community-based attendant services 
234.12 	and supports, the individual would otherwise require a level of care covered by medical 
234.13 	assistance and furnished in a hospital, a nursing facility, an intermediate care facility for 
234.14 	persons with developmental disabilities, or an institution for mental diseases;
234.15 	(3) meets the qualification criteria for personal care assistance services under 
234.16 	section 256B.0625, subdivision 19a, in effect on July 1, 2010, which requires at least one 
234.17 	dependency in an activity of daily living or Level I behavior; and
234.18 	(4) lives in the person's own apartment or home, which is not owned, operated, or 
234.19 	controlled by a provider of services under this section, not related by blood, adoption, 
234.20 	family foster care, or marriage. The person does not live in a nursing facility, institution 
234.21 	for mental diseases, intermediate care facility for persons with developmental disabilities, 
234.22 	or any setting located in a building that is also an inpatient institution or custodial care 
234.23 	facility or a building on the grounds or immediately adjacent to a public institution or 
234.24 	disability-specific housing complex, as defined by the commissioner.
234.25 		Subd. 3.Eligibility for other services. Selection of the home and community-based 
234.26 	attendant services and supports option by a recipient does not restrict access to other 
234.27 	medically necessary care and services furnished under the state plan medical assistance 
234.28 	benefit or through other funding, except that a person receiving personal care assistance 
234.29 	services, a family support grant, semi-independent living services, or a consumer support 
234.30 	grant is not eligible for funding under the home and community-based attendant services 
234.31 	and supports option.
234.32 		Subd. 4.Assessment requirements. (a) The home and community-based attendant 
234.33 	services and supports option assessment must meet the following requirements:
234.34 	(1) for persons whose income is below 150 percent of the federal poverty guidelines, 
234.35 	be consistent with the requirements of the personal care assistance services assessment 
234.36 	under section 256B.0659, subdivision 3a;
235.1 	(2) for persons whose income is above 150 percent of the federal poverty guidelines, 
235.2 	the person must meet the level of care for a nursing facility, intermediate care facility 
235.3 	for persons with developmental disabilities, neurobehavioral hospital, or an institution 
235.4 	for mental diseases;
235.5 	(3) be conducted face-to-face in the recipient's home initially and at least annually 
235.6 	thereafter; when there is a significant change in the recipient's condition; and when there is 
235.7 	a change in the person's need for services under this option. A recipient who is residing in 
235.8 	a facility may be assessed for home and community-based attendant services and supports 
235.9 	for purposes of returning to the community using this option;
235.10 	(4) be completed using the format established by the commissioner; and
235.11 	(5) for persons whose need for services and supports meets the definition of extended 
235.12 	home and community-based attendant services, the lead agency is required to assess for 
235.13 	home and community-based services waiver eligibility.
235.14 	(b) The results of the home and community-based attendant services and supports 
235.15 	option assessment and recommendations shall be communicated to the commissioner and 
235.16 	the recipient as required under section 256B.0659, subdivision 3a.
235.17 	(c) The lead agency responsible for administration and implementation of the 
235.18 	home and community-based attendant services and supports shall provide the annual and 
235.19 	monthly self-directed service budget amounts for all eligible persons within 40 days after 
235.20 	an initial assessment or annual review and within ten days if requested at a time unrelated 
235.21 	to the assessment or annual review.
235.22 		Subd. 5.Service plan requirements. (a) The plan for home and community-based 
235.23 	attendant services and supports option must meet the following requirements:
235.24 	(1) the plan must be completed using a person-centered process consistent with the 
235.25 	requirements in section 256B.0657, subdivision 5;
235.26 	(2) reflects the clinical and support needs identified through the assessment;
235.27 	(3) includes the person's chosen individual goals and providers;
235.28 	(4) includes the services and supports, both paid and unpaid, that will assist the 
235.29 	individual to achieve identified goals;
235.30 	(5) includes an assessment of risk factors and measures to minimize risks and 
235.31 	a backup plan; and
235.32 	(6) must be signed by the individual or legal representative and other persons 
235.33 	responsible for aspects of the plan.
235.34 		Subd. 6.Covered services. (a) Services covered under the home and 
235.35 	community-based attendant services and supports option include:
236.1 	(1) assistance with activities of daily living, as described under section 256B.0659, 
236.2 	subdivision 2;
236.3 	(2) assistance with instrumental activities of daily living as defined in section 
236.4 	256B.0659, subdivision 1, paragraph (i), for both children and adults;
236.5 	(3) assistance with health-related procedures and tasks, as defined in section 
236.6 	256B.0659, subdivision 2;
236.7 	(4) backup systems or mechanisms to ensure continuity of services and supports;
236.8 	(5) voluntary training for recipients on how to select, manage, and dismiss staff;
236.9 	(6) expenditures for transition costs such as rent, utility deposits, first and last 
236.10 	month's rent, basic kitchen supplies, and other necessities required for an individual to 
236.11 	transition from a nursing facility, institution for mental diseases, or intermediate care 
236.12 	facility for persons with developmental disabilities to a community-based home setting 
236.13 	where the individual resides; and
236.14 	(7) expenditures related to a need identified in the individual's person-centered plan 
236.15 	of services that increase a participant's independence or substitute for human assistance, to 
236.16 	the extent that expenditures would otherwise be made for human assistance.
236.17 	(b) The services and supports that are purchased must be linked to an assessed need 
236.18 	or goal established in the individual's person-centered service plan.
236.19 	(c) All services must be provided to assist the recipient to acquire or enhance skills 
236.20 	or to maintain functioning so that the individual can accomplish the activities of daily 
236.21 	living, instrumental activities of daily living, and health-related tasks in order to remain or 
236.22 	become as independent as possible at home and in the community.
236.23 	(d) Shared services under this section must meet the requirements of section 
236.24 	256B.0659, subdivisions 16 and 17.
236.25 		Subd. 7.Noncovered services. Services and supports that are not eligible for 
236.26 	payment under the home and community-based attendant services and supports option 
236.27 	include:
236.28 	(1) services, goods, or supports that do not benefit the recipient;
236.29 	(2) special education and related services provided under the Individuals with 
236.30 	Disabilities Education Act that are related to education only and vocational rehabilitation 
236.31 	services provided under the Rehabilitation Act of 1973;
236.32 	(3) room and board costs for the individual, except for allowable transition services 
236.33 	listed in subdivision 6;
236.34 	(4) assistive devices and assistive technology services other than those identified in 
236.35 	subdivision 6, or those that are based on a specific need identified in the service plan when 
236.36 	used in conjunction with other home and community-based attendant services;
237.1 	(5) medical supplies and equipment;
237.2 	(6) home modifications; and
237.3 	(7) items or services listed in section 256B.0659, subdivision 3, except that essential 
237.4 	household chores and instrumental activities of daily living for children are allowed to the 
237.5 	extent the need and service is documented in the support plan.
237.6 		Subd. 8.Service budget requirements. The budget allocation for a person's 
237.7 	home and community-based attendant services and supports option must be based on 
237.8 	the budget amount allowed under the assessment for personal care assistant services in 
237.9 	section 256B.0659.
237.10 		Subd. 9.Staff and qualified professional requirements. (a) A home and 
237.11 	community-based attendant must meet the requirements in section 256B.0659, 
237.12 	subdivisions 11, 11a, and 12.
237.13 	(b) Qualified professionals must meet the requirements in section 256B.0659, 
237.14 	subdivisions 13 and 14.
237.15 		Subd. 10.Requirements for initial enrollment; annual reenrollment; enrollment 
237.16 	after termination. (a) All home and community-based attendant services and supports 
237.17 	option provider agencies must meet the enrollment requirements under section 256B.0659, 
237.18 	subdivision 21.
237.19 	(b) All home and community-based attendant services and supports option provider 
237.20 	agencies shall resubmit, on an annual basis, the information required in a format 
237.21 	determined by the commissioner as required under section 256B.0659, subdivision 22.
237.22 	(c) A home and community-based attendant services and supports provider agency 
237.23 	that has been disenrolled must meet the requirements of section 256B.0659, subdivision 
237.24 	23, to reenroll.
237.25 		Subd. 11.General duties of provider agencies. Home and community-based 
237.26 	attendant services and supports option provider agencies are required to follow section 
237.27 	256B.0659, subdivisions 24, 25, 26, 27, and 28.
237.28 		Subd. 12.Stakeholder development and implementation council. (a) 
237.29 	The commissioner shall establish and consult with a stakeholder development and 
237.30 	implementation council comprised primarily of individuals with disabilities, elderly 
237.31 	individuals and their representatives, and other interested stakeholders, including 
237.32 	representatives of assessment agencies and provider agencies.
237.33 	(b) The commissioner shall consult and collaborate with the council in the 
237.34 	development and implementation of a state plan amendment to provide home and 
237.35 	community-based attendant services and supports, on matters of data collection, analysis, 
237.36 	and outcomes, including the cost of services provided and the cost of alternatives if home 
238.1 	and community-based attendant services and supports were not provided, and other health 
238.2 	care and community support and social service costs, as well as other costs involving 
238.3 	local, state, and federal funds, and quality assurance issues and measures.
238.4 		Subd. 13.Quality assurance and risk management. (a) The commissioner 
238.5 	shall establish quality assurance and risk management measures for the home and 
238.6 	community-based attendant services and supports option that:
238.7 	(1) recognizes the person-centered services role of the recipient and chosen advocate 
238.8 	or other legal representative, and assure the appropriateness of support plans and budgets 
238.9 	based upon the person's resources, capabilities, and needs; and
238.10 	(2) includes background studies, backup emergency plans, and disaster planning.
238.11 	(b) The commissioner shall provide ongoing technical assistance and resource 
238.12 	education and materials for recipients and their legal representatives and other involved 
238.13 	parties, including appropriate information, counseling, training, and assistance.
238.14 	(c) Performance assessment measures and other outcome data such as the recipient's 
238.15 	functioning in their home and community, satisfaction with services and supports, and 
238.16 	ongoing monitoring of health and safety shall be identified in consultation with the 
238.17 	stakeholder council.
238.18 		Subd. 14.Self-directed home and community-based services and supports.
 238.19 	The home and community-based services and supports option includes the option to 
238.20 	self-directed services under section 256B.0657.

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

238.22 	Sec. 15. Minnesota Statutes 2010, section 256B.0911, subdivision 1a, is amended to 
238.23 	read:
238.24 		Subd. 1a.Definitions. For purposes of this section, the following definitions apply:
238.25 	(a) "Long-term care consultation services" means:
238.26 	(1) assistance in identifying services needed to maintain an individual in the most 
238.27 	inclusive environment;
238.28 	(2) providing recommendations on cost-effective community services that are 
238.29 	available to the individual;
238.30 	(3) development of an individual's person-centered community support plan;
238.31 	(4) providing information regarding eligibility for Minnesota health care programs;
238.32 	(5) face-to-face long-term care consultation assessments, which may be completed 
238.33 	in a hospital, nursing facility, intermediate care facility for persons with developmental 
238.34 	disabilities (ICF/DDs), regional treatment centers, or the person's current or planned 
238.35 	residence;
239.1 	(6) federally mandated screening to determine the need for an institutional level of 
239.2 	care under subdivision 4a;
239.3 	(7) determination of home and community-based waiver service eligibility 
239.4 	including level of care determination for individuals who need an institutional level of 
239.5 	care as defined under section 144.0724, subdivision 11, or 256B.092, service eligibility 
239.6 	including state plan home care services identified in sections 256B.0625, subdivisions 
239.7 	6, 7, and 19, paragraphs (a) and (c), and 256B.0657, based on assessment and support 
239.8 	plan development with appropriate referrals, including the option for consumer-directed 
239.9 	communityself-directed supports;
239.10 	(8) providing recommendations for nursing facility placement when there are no 
239.11 	cost-effective community services available; and
239.12 	(9) assistance to transition people back to community settings after facility 
239.13 	admission; and
239.14 	(10) providing notice to the individual and legal representative of the annual and 
239.15 	monthly amount authorized for traditional agency services and self-directed services under 
239.16 	section 256B.0657 for which the recipient is found eligible.
239.17 	(b) "Long-term care options counseling" means the services provided by the linkage 
239.18 	lines as mandated by sections 256.01 and 256.975, subdivision 7, and also includes 
239.19 	telephone assistance and follow up once a long-term care consultation assessment has 
239.20 	been completed.
239.21 	(c) "Minnesota health care programs" means the medical assistance program under 
239.22 	chapter 256B and the alternative care program under section 256B.0913.
239.23 	(d) "Lead agencies" means counties or a collaboration of counties, tribes, and health 
239.24 	plans administering long-term care consultation assessment and support planning services.

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

239.26 	Sec. 16. Minnesota Statutes 2010, section 256B.0911, subdivision 3a, is amended to 
239.27 	read:
239.28 		Subd. 3a.Assessment and support planning. (a) Persons requesting assessment, 
239.29 	services planning, or other assistance intended to support community-based living, 
239.30 	including persons who need assessment in order to determine waiver or alternative 
239.31 	care program eligibility, must be visited by a long-term care consultation team within 
239.32 	15 calendar 20 working days after the date on which an assessment was requested or 
239.33 	recommended. After January 1, 2011, these requirements also apply to personal care 
239.34 	assistance services, private duty nursing, and home health agency services, on timelines 
240.1 	established in subdivision 5. Face-to-face assessments must be conducted according 
240.2 	to paragraphs (b) to (i).
240.3 	(b) The county may utilize a team of either the social worker or public health nurse, 
240.4 	or both. After January 1, 2011, lead agencies shall use certified assessors to conduct the 
240.5 	assessment in a face-to-face interview. The consultation team members must confer 
240.6 	regarding the most appropriate care for each individual screened or assessed.
240.7 	(c) The assessment must be comprehensive and include a person-centered 
240.8 	assessment of the health, psychological, functional, environmental, and social needs of 
240.9 	referred individuals and provide information necessary to develop a support plan that 
240.10 	meets the consumers needs, using an assessment form provided by the commissioner.
240.11 	(d) The assessment must be conducted in a face-to-face interview with the person 
240.12 	being assessed and the person's legal representative, as required by legally executed 
240.13 	documents, and other individuals as requested by the person, who can provide information 
240.14 	on the needs, strengths, and preferences of the person necessary to develop a support plan 
240.15 	that ensures the person's health and safety, but who is not a provider of service or has any 
240.16 	financial interest in the provision of services.
240.17 	(e) The person, or the person's legal representative, must be provided with 
240.18 	written recommendations for community-based services, including consumer-directed
240.19 	self-directed  options, or institutional care that include documentation that the most 
240.20 	cost-effective alternatives available were offered to the individual. For purposes of 
240.21 	this requirement, "cost-effective alternatives" means community services and living 
240.22 	arrangements that cost the same as or less than institutional care. For persons determined 
240.23 	eligible for services defined under subdivision 1a, paragraph (a), clauses (7) to (9), the 
240.24 	community support plan must also include the estimated annual and monthly budget 
240.25 	amount for those services.
240.26 	(f) If the person chooses to use community-based services, the person or the person's 
240.27 	legal representative must be provided with a written community support plan, regardless 
240.28 	of whether the individual is eligible for Minnesota health care programs. A person may 
240.29 	request assistance in identifying community supports without participating in a complete 
240.30 	assessment. Upon a request for assistance identifying community support, the person must 
240.31 	be transferred or referred to the services available under sections 256.975, subdivision 7, 
240.32 	and 256.01, subdivision 24, for telephone assistance and follow up.
240.33 	(g) The person has the right to make the final decision between institutional 
240.34 	placement and community placement after the recommendations have been provided, 
240.35 	except as provided in subdivision 4a, paragraph (c).
241.1 	(h) The team must give the person receiving assessment or support planning, or 
241.2 	the person's legal representative, materials, and forms supplied by the commissioner 
241.3 	containing the following information:
241.4 	(1) the need for and purpose of preadmission screening if the person selects nursing 
241.5 	facility placement;
241.6 	(2) the role of the long-term care consultation assessment and support planning in 
241.7 	waiver and alternative care program eligibility determination;
241.8 	(3) information about Minnesota health care programs;
241.9 	(4) the person's freedom to accept or reject the recommendations of the team;
241.10 	(5) the person's right to confidentiality under the Minnesota Government Data 
241.11 	Practices Act, chapter 13;
241.12 	(6) the long-term care consultant's decision regarding the person's need for 
241.13 	institutional level of care as determined under criteria established in section 144.0724, 
241.14 	subdivision 11, or 256B.092; and
241.15 	(7) the person's right to appeal the decision regarding the need for nursing facility 
241.16 	level of care or the county's final decisions regarding public programs eligibility according 
241.17 	to section 256.045, subdivision 3.
241.18 	(i) Face-to-face assessment completed as part of eligibility determination for 
241.19 	the alternative care, elderly waiver, community alternatives for disabled individuals, 
241.20 	community alternative care, and traumatic brain injury waiver programs under sections 
241.21 	256B.0915, 256B.0917, and 256B.49 is valid to establish service eligibility for no more 
241.22 	than 60 calendar days after the date of assessment. The effective eligibility start date 
241.23 	for these programs can never be prior to the date of assessment. If an assessment was 
241.24 	completed more than 60 days before the effective waiver or alternative care program 
241.25 	eligibility start date, assessment and support plan information must be updated in a 
241.26 	face-to-face visit and documented in the department's Medicaid Management Information 
241.27 	System (MMIS). The updated assessment may be completed by face-to-face visit, written 
241.28 	communication, or telephone. The effective date of program eligibility in this case cannot 
241.29 	be prior to the date the updated assessment is completed.

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

241.31 	Sec. 17. Minnesota Statutes 2010, section 256B.0911, subdivision 4a, is amended to 
241.32 	read:
241.33 		Subd. 4a.Preadmission screening activities related to nursing facility 
241.34 	admissions. (a) All applicants to Medicaid certified nursing facilities, including certified 
241.35 	boarding care facilities, must be screened prior to admission regardless of income, assets, 
242.1 	or funding sources for nursing facility care, except as described in subdivision 4b. The 
242.2 	purpose of the screening is to determine the need for nursing facility level of care as 
242.3 	described in paragraph (d) and to complete activities required under federal law related to 
242.4 	mental illness and developmental disability as outlined in paragraph (b).
242.5 	(b) A person who has a diagnosis or possible diagnosis of mental illness or 
242.6 	developmental disability must receive a preadmission screening before admission 
242.7 	regardless of the exemptions outlined in subdivision 4b, paragraph (b), to identify the need 
242.8 	for further evaluation and specialized services, unless the admission prior to screening is 
242.9 	authorized by the local mental health authority or the local developmental disabilities case 
242.10 	manager, or unless authorized by the county agency according to Public Law 101-508.
242.11 	The following criteria apply to the preadmission screening:
242.12 	(1) the county must use forms and criteria developed by the commissioner to identify 
242.13 	persons who require referral for further evaluation and determination of the need for 
242.14 	specialized services; and
242.15 	(2) the evaluation and determination of the need for specialized services must be 
242.16 	done by:
242.17 	(i) a qualified independent mental health professional, for persons with a primary or 
242.18 	secondary diagnosis of a serious mental illness; or
242.19 	(ii) a qualified developmental disability professional, for persons with a primary or 
242.20 	secondary diagnosis of developmental disability. For purposes of this requirement, a 
242.21 	qualified developmental disability professional must meet the standards for a qualified 
242.22 	developmental disability professional under Code of Federal Regulations, title 42, section 
242.23 	483.430.
242.24 	(c) The local county mental health authority or the state developmental disability 
242.25 	authority under Public Law Numbers 100-203 and 101-508 may prohibit admission to a 
242.26 	nursing facility if the individual does not meet the nursing facility level of care criteria or 
242.27 	needs specialized services as defined in Public Law Numbers 100-203 and 101-508. For 
242.28 	purposes of this section, "specialized services" for a person with developmental disability 
242.29 	means active treatment as that term is defined under Code of Federal Regulations, title 
242.30 	42, section 483.440 (a)(1).
242.31 	(d) The determination of the need for nursing facility level of care must be made 
242.32 	according to criteria established developed by the commissioner, and in section 144.0724, 
242.33 	subdivision 11, and256B.092, using forms developed by the commissioner. Effective no 
242.34 	sooner than on or after January 1, 2014, for individuals age 21 and older, and on or after 
242.35 	October 1, 2019, for individuals under age 21, the determination of need for nursing 
242.36 	facility level of care shall be based on criteria in section 144.0724, subdivision 11. In 
243.1 	assessing a person's needs, consultation team members shall have a physician available for 
243.2 	consultation and shall consider the assessment of the individual's attending physician, if 
243.3 	any. The individual's physician must be included if the physician chooses to participate. 
243.4 	Other personnel may be included on the team as deemed appropriate by the county.

243.5 	Sec. 18. Minnesota Statutes 2010, section 256B.0911, subdivision 6, is amended to 
243.6 	read:
243.7 		Subd. 6.Payment for long-term care consultation services. (a) Seventy-five 
243.8 	percent of the total payment for each county must be paid monthly by certified nursing 
243.9 	facilities in the county. The monthly amount to be paid by each nursing facility for each 
243.10 	fiscal year must be determined by dividing the county's annual allocation for long-term 
243.11 	care consultation services by 12 to determine the monthly payment and allocating the 
243.12 	monthly payment to each nursing facility based on the number of licensed beds in the 
243.13 	nursing facility. Payments to counties in which there is no certified nursing facility must be 
243.14 	made by increasing the payment rate of the two facilities located nearest to the county seat.
243.15 	(b) The commissioner shall include the total annual payment determined under 
243.16 	paragraph (a) for each nursing facility reimbursed under section 256B.431 or 256B.434 
243.17 	according to section 256B.431, subdivision 2b, paragraph (g).
243.18 	(c) In the event of the layaway, delicensure and decertification, or removal from 
243.19 	layaway of 25 percent or more of the beds in a facility, the commissioner may adjust 
243.20 	the per diem payment amount in paragraph (b) and may adjust the monthly payment 
243.21 	amount in paragraph (a). The effective date of an adjustment made under this paragraph 
243.22 	shall be on or after the first day of the month following the effective date of the layaway, 
243.23 	delicensure and decertification, or removal from layaway.
243.24 	(d) Payments for long-term care consultation services are available to the county 
243.25 	or counties to cover staff salaries and expenses to provide the services described in 
243.26 	subdivision 1a. The county shall employ, or contract with other agencies to employ, within 
243.27 	the limits of available funding, sufficient personnel to provide long-term care consultation 
243.28 	services while meeting the state's long-term care outcomes and objectives as defined in 
243.29 	section 256B.0917, subdivision 1. The county shall be accountable for meeting local 
243.30 	objectives as approved by the commissioner in the biennial home and community-based 
243.31 	services quality assurance plan on a form provided by the commissioner.
243.32 	(e) Notwithstanding section 256B.0641, overpayments attributable to payment of the 
243.33 	screening costs under the medical assistance program may not be recovered from a facility.
243.34 	(f) The commissioner of human services shall amend the Minnesota medical 
243.35 	assistance plan to include reimbursement for the local consultation teams.
244.1 	(g) The county may bill, as case management services, assessments, support 
244.2 	planning, and follow-along provided to persons determined to be eligible for case 
244.3 	management under Minnesota health care programs. No individual or family member 
244.4 	shall be charged for an initial assessment or initial support plan development provided 
244.5 	under subdivision 3a or 3b. Counties may set a fee schedule for initial assessments and 
244.6 	support plan development for individuals who are not financially eligible for medical 
244.7 	assistance or MinnesotaCare. The maximum fee must not be greater than the actual cost 
244.8 	of the initial assessment and support plan development.
244.9 	(h) The commissioner shall develop an alternative payment methodology for 
244.10 	long-term care consultation services that includes the funding available under this 
244.11 	subdivision, and sections 256B.092 and 256B.0659. In developing the new payment 
244.12 	methodology, the commissioner shall consider the maximization of federal funding for 
244.13 	this activity.

244.14 	Sec. 19. Minnesota Statutes 2010, section 256B.0913, subdivision 4, is amended to 
244.15 	read:
244.16 		Subd. 4.Eligibility for funding for services for nonmedical assistance recipients.
 244.17 	(a) Funding for services under the alternative care program is available to persons who 
244.18 	meet the following criteria:
244.19 	(1) the person has been determined by a community assessment under section 
244.20 	256B.0911 to be a person who would require the level of care provided in a nursing 
244.21 	facility, as determined under section 256B.0911, subdivision 4a, paragraph (d), but for 
244.22 	the provision of services under the alternative care program. Effective January 1, 2011, 
244.23 	this determination must be made according to the criteria established in section 144.0724, 
244.24 	subdivision 11;
244.25 	(2) the person is age 65 or older;
244.26 	(3) the person would be eligible for medical assistance within 135 days of admission 
244.27 	to a nursing facility;
244.28 	(4) the person is not ineligible for the payment of long-term care services by the 
244.29 	medical assistance program due to an asset transfer penalty under section 256B.0595 or 
244.30 	equity interest in the home exceeding $500,000 as stated in section 256B.056;
244.31 	(5) the person needs long-term care services that are not funded through other 
244.32 	state or federal funding, or other health insurance or other third-party insurance such as 
244.33 	long-term care insurance;
244.34 	(6) except for individuals described in clause (7), the monthly cost of the alternative 
244.35 	care services funded by the program for this person does not exceed 75 percent of the 
245.1 	monthly limit described under section 256B.0915, subdivision 3a. This monthly limit 
245.2 	does not prohibit the alternative care client from payment for additional services, but in no 
245.3 	case may the cost of additional services purchased under this section exceed the difference 
245.4 	between the client's monthly service limit defined under section 256B.0915, subdivision 
245.5 	3, and the alternative care program monthly service limit defined in this paragraph. If 
245.6 	care-related supplies and equipment or environmental modifications and adaptations are or 
245.7 	will be purchased for an alternative care services recipient, the costs may be prorated on a 
245.8 	monthly basis for up to 12 consecutive months beginning with the month of purchase. 
245.9 	If the monthly cost of a recipient's other alternative care services exceeds the monthly 
245.10 	limit established in this paragraph, the annual cost of the alternative care services shall be 
245.11 	determined. In this event, the annual cost of alternative care services shall not exceed 12 
245.12 	times the monthly limit described in this paragraph;
245.13 	(7) for individuals assigned a case mix classification A as described under section 
245.14 	256B.0915, subdivision 3a, paragraph (a), with (i) no dependencies in activities of daily 
245.15 	living, or (ii) only one dependency up to two dependencies in bathing, dressing, grooming, 
245.16 	or walking, or (iii) a dependency score of less than three if eating is the only dependency
245.17 	and eating when the dependency score in eating is three or greater as determined by 
245.18 	an assessment performed under section 256B.0911, the monthly cost of alternative 
245.19 	care services funded by the program cannot exceed $600 $593 per month for all new 
245.20 	participants enrolled in the program on or after July 1, 2009 2011. This monthly limit 
245.21 	shall be applied to all other participants who meet this criteria at reassessment. This 
245.22 	monthly limit shall be increased annually as described in section 256B.0915, subdivision 
245.23 	3a, paragraph (a). This monthly limit does not prohibit the alternative care client from 
245.24 	payment for additional services, but in no case may the cost of additional services 
245.25 	purchased exceed the difference between the client's monthly service limit defined in this 
245.26 	clause and the limit described in clause (6) for case mix classification A; and
245.27 	(8) the person is making timely payments of the assessed monthly fee.
245.28 	A person is ineligible if payment of the fee is over 60 days past due, unless the person 
245.29 	agrees to:
245.30 	(i) the appointment of a representative payee;
245.31 	(ii) automatic payment from a financial account;
245.32 	(iii) the establishment of greater family involvement in the financial management of 
245.33 	payments; or
245.34 	(iv) another method acceptable to the lead agency to ensure prompt fee payments.
245.35 	The lead agency may extend the client's eligibility as necessary while making 
245.36 	arrangements to facilitate payment of past-due amounts and future premium payments. 
246.1 	Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be 
246.2 	reinstated for a period of 30 days.
246.3 	(b) Alternative care funding under this subdivision is not available for a person 
246.4 	who is a medical assistance recipient or who would be eligible for medical assistance 
246.5 	without a spenddown or waiver obligation. A person whose initial application for medical 
246.6 	assistance and the elderly waiver program is being processed may be served under the 
246.7 	alternative care program for a period up to 60 days. If the individual is found to be eligible 
246.8 	for medical assistance, medical assistance must be billed for services payable under the 
246.9 	federally approved elderly waiver plan and delivered from the date the individual was 
246.10 	found eligible for the federally approved elderly waiver plan. Notwithstanding this 
246.11 	provision, alternative care funds may not be used to pay for any service the cost of which: 
246.12 	(i) is payable by medical assistance; (ii) is used by a recipient to meet a waiver obligation; 
246.13 	or (iii) is used to pay a medical assistance income spenddown for a person who is eligible 
246.14 	to participate in the federally approved elderly waiver program under the special income 
246.15 	standard provision.
246.16 	(c) Alternative care funding is not available for a person who resides in a licensed 
246.17 	nursing home, certified boarding care home, hospital, or intermediate care facility, except 
246.18 	for case management services which are provided in support of the discharge planning 
246.19 	process for a nursing home resident or certified boarding care home resident to assist with 
246.20 	a relocation process to a community-based setting.
246.21 	(d) Alternative care funding is not available for a person whose income is greater 
246.22 	than the maintenance needs allowance under section 256B.0915, subdivision 1d, but equal 
246.23 	to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal 
246.24 	year for which alternative care eligibility is determined, who would be eligible for the 
246.25 	elderly waiver with a waiver obligation.

246.26 	Sec. 20. Minnesota Statutes 2010, section 256B.0915, subdivision 3a, is amended to 
246.27 	read:
246.28 		Subd. 3a.Elderly waiver cost limits. (a) The monthly limit for the cost of 
246.29 	waivered services to an individual elderly waiver client except for individuals described 
246.30 	in paragraph (b) shall be the weighted average monthly nursing facility rate of the case 
246.31 	mix resident class to which the elderly waiver client would be assigned under Minnesota 
246.32 	Rules, parts 9549.0050 to 9549.0059, less the recipient's maintenance needs allowance 
246.33 	as described in subdivision 1d, paragraph (a), until the first day of the state fiscal year in 
246.34 	which the resident assessment system as described in section 256B.438 for nursing home 
246.35 	rate determination is implemented. Effective on the first day of the state fiscal year in 
247.1 	which the resident assessment system as described in section 256B.438 for nursing home 
247.2 	rate determination is implemented and the first day of each subsequent state fiscal year, the 
247.3 	monthly limit for the cost of waivered services to an individual elderly waiver client shall 
247.4 	be the rate of the case mix resident class to which the waiver client would be assigned 
247.5 	under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect on the last day of the 
247.6 	previous state fiscal year, adjusted by the greater of any legislatively adopted home and 
247.7 	community-based services percentage rate increase or the average statewide percentage 
247.8 	increase in nursing facility payment rates adjustment.
247.9 	(b) The monthly limit for the cost of waivered services to an individual elderly 
247.10 	waiver client assigned to a case mix classification A under paragraph (a) with:
247.11 	(1) no dependencies in activities of daily living,; or
247.12 	(2) only one dependency up to two dependencies in bathing, dressing, grooming, or
247.13 	walking, or (3) a dependency score of less than three if eating is the only dependency,
247.14 	and eating when the dependency score in eating is three or greater as determined by an 
247.15 	assessment performed under section 256B.0911
247.16 	 shall be the lower of the case mix classification amount for case mix A as determined 
247.17 	under paragraph (a) or the case mix classification amount for case mix A$1,750 per 
247.18 	month effective on October July 1, 2008 2011, per month for all new participants enrolled 
247.19 	in the program on or after July 1, 2009 2011. This monthly limit shall be applied to all 
247.20 	other participants who meet this criteria at reassessment. This monthly limit shall be 
247.21 	increased annually as described in paragraph (a).
247.22 	(c) If extended medical supplies and equipment or environmental modifications are 
247.23 	or will be purchased for an elderly waiver client, the costs may be prorated for up to 
247.24 	12 consecutive months beginning with the month of purchase. If the monthly cost of a 
247.25 	recipient's waivered services exceeds the monthly limit established in paragraph (a) or 
247.26 	(b), the annual cost of all waivered services shall be determined. In this event, the annual 
247.27 	cost of all waivered services shall not exceed 12 times the monthly limit of waivered 
247.28 	services as described in paragraph (a) or (b).

247.29 	Sec. 21. Minnesota Statutes 2010, section 256B.0915, subdivision 3b, is amended to 
247.30 	read:
247.31 		Subd. 3b.Cost limits for elderly waiver applicants who reside in a nursing 
247.32 	facility. (a) For a person who is a nursing facility resident at the time of requesting a 
247.33 	determination of eligibility for elderly waivered services, a monthly conversion budget 
247.34 	limit for the cost of elderly waivered services may be requested. The monthly conversion 
247.35 	budget limit for the cost of elderly waiver services shall be the resident class assigned 
248.1 	under Minnesota Rules, parts 9549.0050 to 9549.0059, for that resident in the nursing 
248.2 	facility where the resident currently resides until July 1 of the state fiscal year in which 
248.3 	the resident assessment system as described in section 256B.438 for nursing home rate 
248.4 	determination is implemented. Effective on July 1 of the state fiscal year in which the 
248.5 	resident assessment system as described in section 256B.438 for nursing home rate 
248.6 	determination is implemented, the monthly conversion budget limit for the cost of elderly 
248.7 	waiver services shall be based on the per diem nursing facility rate as determined by the 
248.8 	resident assessment system as described in section 256B.438 for that resident residents
248.9 	in the nursing facility where the resident elderly waiver applicant currently resides 
248.10 	multiplied. The monthly conversion budget limit shall be calculated by multiplying the 
248.11 	per diem by 365 and,  divided by 12, less and reduced by  the recipient's maintenance needs 
248.12 	allowance as described in subdivision 1d. The initially approved monthly conversion rate 
248.13 	may budget limit shall be adjusted by the greater of any subsequent legislatively adopted 
248.14 	home and community-based services percentage rate increase or the average statewide 
248.15 	percentage increase in nursing facility payment rates annually as described in subdivision 
248.16 	3a, paragraph (a). The limit under this subdivision only applies to persons discharged from 
248.17 	a nursing facility after a minimum 30-day stay and found eligible for waivered services 
248.18 	on or after July 1, 1997. For conversions from the nursing home to the elderly waiver 
248.19 	with consumer directed community support services, the conversion rate limit is equal to 
248.20 	the nursing facility rate per diem used to calculate the monthly conversion budget limit 
248.21 	must be reduced by a percentage equal to the percentage difference between the consumer 
248.22 	directed services budget limit that would be assigned according to the federally approved 
248.23 	waiver plan and the corresponding community case mix cap, but not to exceed 50 percent.
248.24 	(b) The following costs must be included in determining the total monthly costs 
248.25 	for the waiver client:
248.26 	(1) cost of all waivered services, including extended medical specialized supplies 
248.27 	and equipment and environmental modifications and accessibility adaptations; and
248.28 	(2) cost of skilled nursing, home health aide, and personal care services reimbursable 
248.29 	by medical assistance.

248.30 	Sec. 22. Minnesota Statutes 2010, section 256B.0915, subdivision 3e, is amended to 
248.31 	read:
248.32 		Subd. 3e.Customized living service rate. (a) Payment for customized living 
248.33 	services shall be a monthly rate authorized by the lead agency within the parameters 
248.34 	established by the commissioner. The payment agreement must delineate the amount of 
248.35 	each component service included in the recipient's customized living service plan. The 
249.1 	lead agency shall ensure that there is a documented need within the parameters established 
249.2 	by the commissioner for all component customized living services authorized.
249.3 	(b) The payment rate must be based on the amount of component services to be 
249.4 	provided utilizing component rates established by the commissioner. Counties and tribes 
249.5 	shall use tools issued by the commissioner to develop and document customized living 
249.6 	service plans and rates.
249.7 	(c) Component service rates must not exceed payment rates for comparable elderly 
249.8 	waiver or medical assistance services and must reflect economies of scale. Customized 
249.9 	living services must not include rent or raw food costs.
249.10 	(d) With the exception of individuals described in subdivision 3a, paragraph (b), the 
249.11 	individualized monthly authorized payment for the customized living service plan shall 
249.12 	not exceed 50 percent of the greater of either the statewide or any of the geographic 
249.13 	groups' weighted average monthly nursing facility rate of the case mix resident class 
249.14 	to which the elderly waiver eligible client would be assigned under Minnesota Rules, 
249.15 	parts 9549.0050 to 9549.0059, less the maintenance needs allowance as described 
249.16 	in subdivision 1d, paragraph (a), until the July 1 of the state fiscal year in which the 
249.17 	resident assessment system as described in section 256B.438 for nursing home rate 
249.18 	determination is implemented. Effective on July 1 of the state fiscal year in which 
249.19 	the resident assessment system as described in section 256B.438 for nursing home 
249.20 	rate determination is implemented and July 1 of each subsequent state fiscal year, the 
249.21 	individualized monthly authorized payment for the services described in this clause shall 
249.22 	not exceed the limit which was in effect on June 30 of the previous state fiscal year 
249.23 	updated annually based on legislatively adopted changes to all service rate maximums for 
249.24 	home and community-based service providers.
249.25 	(e) Effective July 1, 2011, the individualized monthly payment for the customized 
249.26 	living service plan for individuals described in subdivision 3a, paragraph (b), must be the 
249.27 	monthly authorized payment limit for customized living for individuals classified as case 
249.28 	mix A, reduced by 25 percent. This rate limit must be applied to all new participants 
249.29 	enrolled in the program on or after July 1, 2011, who meet the criteria described in 
249.30 	subdivision 3a, paragraph (b). This monthly limit also applies to all other participants who 
249.31 	meet the criteria described in subdivision 3a, paragraph (b), at reassessment.
249.32 	(e) (f) Customized living services are delivered by a provider licensed by the 
249.33 	Department of Health as a class A or class F home care provider and provided in a 
249.34 	building that is registered as a housing with services establishment under chapter 144D.
249.35 	Licensed home care providers are subject to section 256B.0651, subdivision 14.
250.1 	(g) A provider may not bill or otherwise charge an elderly waiver participant or their 
250.2 	family for additional units of any allowable component service beyond those available 
250.3 	under the service rate limits described in paragraph (d), nor for additional units of any 
250.4 	allowable component service beyond those approved in the service plan by the lead agency.

250.5 	Sec. 23. Minnesota Statutes 2010, section 256B.0915, subdivision 3h, is amended to 
250.6 	read:
250.7 		Subd. 3h.Service rate limits; 24-hour customized living services. (a) The 
250.8 	payment rate for 24-hour customized living services is a monthly rate authorized by the 
250.9 	lead agency within the parameters established by the commissioner of human services. 
250.10 	The payment agreement must delineate the amount of each component service included in 
250.11 	each recipient's customized living service plan. The lead agency shall ensure that there is a 
250.12 	documented need within the parameters established by the commissioner for all component 
250.13 	customized living services authorized. The lead agency shall not authorize 24-hour 
250.14 	customized living services unless there is a documented need for 24-hour supervision.
250.15 	(b) For purposes of this section, "24-hour supervision" means that the recipient 
250.16 	requires assistance due to needs related to one or more of the following:
250.17 	(1) intermittent assistance with toileting, positioning, or transferring;
250.18 	(2) cognitive or behavioral issues;
250.19 	(3) a medical condition that requires clinical monitoring; or
250.20 	(4) for all new participants enrolled in the program on or after January July 1, 2011, 
250.21 	and all other participants at their first reassessment after January July 1, 2011, dependency 
250.22 	in at least two three of the following activities of daily living as determined by assessment 
250.23 	under section 256B.0911: bathing; dressing; grooming; walking; or eating when the 
250.24 	dependency score in eating is three or greater; and needs medication management and at 
250.25 	least 50 hours of service per month. The lead agency shall ensure that the frequency and 
250.26 	mode of supervision of the recipient and the qualifications of staff providing supervision 
250.27 	are described and meet the needs of the recipient.
250.28 	(c) The payment rate for 24-hour customized living services must be based on the 
250.29 	amount of component services to be provided utilizing component rates established by the 
250.30 	commissioner. Counties and tribes will use tools issued by the commissioner to develop 
250.31 	and document customized living plans and authorize rates.
250.32 	(d) Component service rates must not exceed payment rates for comparable elderly 
250.33 	waiver or medical assistance services and must reflect economies of scale.
250.34 	(e) The individually authorized 24-hour customized living payments, in combination 
250.35 	with the payment for other elderly waiver services, including case management, must not 
251.1 	exceed the recipient's community budget cap specified in subdivision 3a. Customized 
251.2 	living services must not include rent or raw food costs.
251.3 	(f) The individually authorized 24-hour customized living payment rates shall not 
251.4 	exceed the 95 percentile of statewide monthly authorizations for 24-hour customized 
251.5 	living services in effect and in the Medicaid management information systems on March 
251.6 	31, 2009, for each case mix resident class under Minnesota Rules, parts 9549.0050 
251.7 	to 9549.0059, to which elderly waiver service clients are assigned. When there are 
251.8 	fewer than 50 authorizations in effect in the case mix resident class, the commissioner 
251.9 	shall multiply the calculated service payment rate maximum for the A classification by 
251.10 	the standard weight for that classification under Minnesota Rules, parts 9549.0050 to 
251.11 	9549.0059, to determine the applicable payment rate maximum. Service payment rate 
251.12 	maximums shall be updated annually based on legislatively adopted changes to all service 
251.13 	rates for home and community-based service providers.
251.14 	(g) Notwithstanding the requirements of paragraphs (d) and (f), the commissioner 
251.15 	may establish alternative payment rate systems for 24-hour customized living services in 
251.16 	housing with services establishments which are freestanding buildings with a capacity of 
251.17 	16 or fewer, by applying a single hourly rate for covered component services provided 
251.18 	in either:
251.19 	(1) licensed corporate adult foster homes; or
251.20 	(2) specialized dementia care units which meet the requirements of section 144D.065 
251.21 	and in which:
251.22 	(i) each resident is offered the option of having their own apartment; or
251.23 	(ii) the units are licensed as board and lodge establishments with maximum capacity 
251.24 	of eight residents, and which meet the requirements of Minnesota Rules, part 9555.6205, 
251.25 	subparts 1, 2, 3, and 4, item A.
251.26 	(h) A provider may not bill or otherwise charge an elderly waiver participant or their 
251.27 	family for additional units of any allowable component service beyond those available 
251.28 	under the service rate limits described in paragraph (e), nor for additional units of any 
251.29 	allowable component service beyond those approved in the service plan by the lead agency.

251.30 	Sec. 24. Minnesota Statutes 2010, section 256B.0915, subdivision 5, is amended to 
251.31 	read:
251.32 		Subd. 5.Assessments and reassessments for waiver clients. (a) Each client 
251.33 	shall receive an initial assessment of strengths, informal supports, and need for services 
251.34 	in accordance with section 256B.0911, subdivisions 3, 3a, and 3b. A reassessment of a 
251.35 	client served under the elderly waiver must be conducted at least every 12 months and 
252.1 	at other times when the case manager determines that there has been significant change 
252.2 	in the client's functioning. This may include instances where the client is discharged 
252.3 	from the hospital. There must be a determination that the client requires nursing facility 
252.4 	level of care as defined in section 144.0724, subdivision 11 256B.0911, subdivision 4a, 
252.5 	paragraph (d), at initial and subsequent assessments to initiate and maintain participation 
252.6 	in the waiver program.
252.7 	(b) Regardless of other assessments identified in section 144.0724, subdivision 
252.8 	4, as appropriate to determine nursing facility level of care for purposes of medical 
252.9 	assistance payment for nursing facility services, only face-to-face assessments conducted 
252.10 	according to section 256B.0911, subdivisions 3a and 3b, that result in a nursing facility 
252.11 	level of care determination will be accepted for purposes of initial and ongoing access to 
252.12 	waiver service payment.

252.13 	Sec. 25. Minnesota Statutes 2010, section 256B.0915, subdivision 10, is amended to 
252.14 	read:
252.15 		Subd. 10.Waiver payment rates; managed care organizations. The 
252.16 	commissioner shall adjust the elderly waiver capitation payment rates for managed care 
252.17 	organizations paid under section 256B.69, subdivisions 6a and 23, to reflect the maximum 
252.18 	service rate limits for customized living services and 24-hour customized living services 
252.19 	under subdivisions 3e and 3h for the contract period beginning October 1, 2009. Medical 
252.20 	assistance rates paid to customized living providers by managed care organizations under 
252.21 	this section shall not exceed the maximum service rate limits and component rates as 
252.22 	determined by the commissioner under subdivisions 3e and 3h.

252.23 	Sec. 26. Minnesota Statutes 2010, section 256B.0916, subdivision 6a, is amended to 
252.24 	read:
252.25 		Subd. 6a.Statewide availability of consumer-directed community self-directed 
252.26 	 support services. (a) The commissioner shall submit to the federal Health Care Financing 
252.27 	Administration by August 1, 2001, an amendment to the home and community-based 
252.28 	waiver for persons with developmental disabilities under section 256B.092 and by April 1, 
252.29 	2005, for waivers under sections 256B.0915 and 256B.49,  to make consumer-directed 
252.30 	community self-directed support services available in every county of the state by January 
252.31 	1, 2002.
252.32 	(b) Until the waiver amendment for self-directed community supports under 
252.33 	section 54 is effective, if a county declines to meet the requirements for provision of 
252.34 	consumer-directed communityself-directed supports, the commissioner shall contract 
253.1 	with another county, a group of counties, or a private agency to plan for and administer 
253.2 	consumer-directed community self-directed  supports in that county.
253.3 	(c) The state of Minnesota, county agencies, tribal governments, or administrative 
253.4 	entities under contract to participate in the implementation and administration of the home 
253.5 	and community-based waiver for persons with developmental disabilities, shall not be 
253.6 	liable for damages, injuries, or liabilities sustained through the purchase of support by the 
253.7 	individual, the individual's family, legal representative, or the authorized representative 
253.8 	with funds received through the consumer-directed community self-directed support 
253.9 	service under this section. Liabilities include but are not limited to: workers' compensation 
253.10 	liability, the Federal Insurance Contributions Act (FICA), or the Federal Unemployment 
253.11 	Tax Act (FUTA).

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

253.13 	Sec. 27. Minnesota Statutes 2010, section 256B.092, subdivision 1a, is amended to 
253.14 	read:
253.15 		Subd. 1a.Case management administration and services. (a) The administrative 
253.16 	functions of case management provided to or arranged for a person include:
253.17 	(1) review of eligibility for services;
253.18 	(2) screening;
253.19 	(3) intake;
253.20 	(4) diagnosis;
253.21 	(5) the review and authorization of services based upon an individualized service 
253.22 	plan; and
253.23 	(6) responding to requests for conciliation conferences and appeals according 
253.24 	to section 256.045 made by the person, the person's legal guardian or conservator, or 
253.25 	the parent if the person is a minor. Case management services must be provided by a 
253.26 	public or private agency that is enrolled as a medical assistance provider determined by 
253.27 	the commissioner to meet all of the requirements in the approved federal waiver plans. 
253.28 	Case management services cannot be provided to a recipient by a private agency that has 
253.29 	any financial interest in the provisions of any other services included in the recipient's 
253.30 	coordinated service and support plan.
253.31 	(b) Case management service activities provided to or arranged for a person include
253.32 	services must be provided to each recipient of home and community-based waiver 
253.33 	services and available to those eligible for case management under sections 256B.0621 
253.34 	and 256B.0924, subdivision 4, who choose this service. Case management services for an 
253.35 	eligible person include:
254.1 	(1) development of the individualcoordinated service and support plan;
254.2 	(2) informing the individual or the individual's legal guardian or conservator, or 
254.3 	parent if the person is a minor, of service options;
254.4 	(3) consulting with relevant medical experts or service providers;
254.5 	(4) assisting the person in the identification of potential providers;
254.6 	(5) assisting the person to access services;
254.7 	(6) coordination of services, including coordinating with the person's health care 
254.8 	home or health coordinator, if coordination of long-term care or community supports and 
254.9 	health care is not provided by another service provider;
254.10 	(7) evaluation and monitoring of the services identified in the plan including at least 
254.11 	one face-to-face visit with each person annually by the case manager; and
254.12 	(8) annual reviews of service plans and services provided providing the lead agency 
254.13 	with recommendations for service authorization based upon the individual's needs 
254.14 	identified in the support plan within ten working days after receiving the community 
254.15 	support plan from the certified assessor under section 256B.0911.
254.16 	(c) Case management administration and service activities that are provided to the 
254.17 	person with a developmental disability shall be provided directly by county agencies or 
254.18 	under contract a public or private agency that is enrolled as a medical assistance provider 
254.19 	determined by the commissioner to meet all of the requirements in section 256B.0621, 
254.20 	subdivision 5, paragraphs (a) and (b), clauses (1) to (5), and has no financial interest in the 
254.21 	provision of any other services to the person choosing case management service.
254.22 	(d) Case managers are responsible for the administrative duties and service 
254.23 	provisions listed in paragraphs (a) and (b). Case managers shall collaborate with 
254.24 	consumers, families, legal representatives, and relevant medical experts and service 
254.25 	providers in the development and annual review of the individualized service and 
254.26 	habilitation plans.
254.27 	(e) The Department of Human Services shall offer ongoing education in case 
254.28 	management to case managers. Case managers shall receive no less than ten hours of case 
254.29 	management education and disability-related training each year.
254.30 	(f) Persons eligible for home and community-based waiver services may choose a 
254.31 	case management service provider from among the public or private vendors enrolled 
254.32 	according to paragraph (d).
254.33 	(g) For persons eligible for case management under section 256B.0924, and 
254.34 	Minnesota Rules, parts 9525.0004 to 9525.0036, the county or lead agency shall designate 
254.35 	the case management service provider.

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

255.1 	Sec. 28. Minnesota Statutes 2010, section 256B.092, subdivision 1b, is amended to 
255.2 	read:
255.3 		Subd. 1b.Individual Coordinated service and support plan. The individualEach 
255.4 	recipient of case management services and any legal representative shall be provided a 
255.5 	written copy of the coordinated service  and support plan must, which:
255.6 	(1) includeis developed within ten working days after the case management service 
255.7 	receives the community support plan from the certified assessor under section 256B.0911;
255.8 	(2) includes the results of the assessment information on the person's need for 
255.9 	service, including identification of service needs that will be or that are met by the person's 
255.10 	relatives, friends, and others, as well as community services used by the general public;
255.11 	(3) reasonably assures the health, safety, and welfare of the recipient;
255.12 	(2) identify(4) identifies the person's preferences for services as stated by the person, 
255.13 	the person's legal guardian or conservator, or the parent if the person is a minor;
255.14 	(5) provides for an informed choice, as defined in section 256B.77, subdivision 2, 
255.15 	paragraph (o), of service and support providers;
255.16 	(3) identify(6) identifies long- and short-range goals for the person;
255.17 	(4) identify (7) identifies specific services and the amount and frequency of the 
255.18 	services to be provided to the person based on assessed needs, preferences, and available 
255.19 	resources. The individualcoordinated service and support plan shall also specify other 
255.20 	services the person needs that are not available;
255.21 	(5) identify (8) identifies the need for an individual programindividual's provider 
255.22 	plan to be developed by the provider according to the respective state and federal licensing 
255.23 	and certification standards, and additional assessments to be completed or arranged by the 
255.24 	provider after service initiation;
255.25 	(6) identify (9) identifies provider responsibilities to implement and make 
255.26 	recommendations for modification to the individualcoordinated service and support plan;
255.27 	(7) include(10) includes notice of the right to have assessments completed and 
255.28 	service plans developed within specified time periods, the right to appeal action or 
255.29 	inaction, and the right to request a conciliation conference or a hearing an appeal under 
255.30 	section 256.045;
255.31 	(8) be (11) is agreed upon and signed by the person, the person's legal guardian 
255.32 	or conservator, or the parent if the person is a minor, and the authorized county 
255.33 	representative; and
255.34 	(9) be (12) is reviewed by a health professional if the person has overriding medical 
255.35 	needs that impact the delivery of services.
256.1 	Service planning formats developed for interagency planning such as transition, 
256.2 	vocational, and individual family service plans may be substituted for service planning 
256.3 	formats developed by county agencies.

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

256.5 	Sec. 29. Minnesota Statutes 2010, section 256B.092, subdivision 1e, is amended to 
256.6 	read:
256.7 		Subd. 1e.Case management service monitoring, coordination, and evaluation, 
256.8 	and monitoring of services duties. (a) If the individualcoordinated service and support 
256.9 	plan identifies the need for individual programprovider plans for authorized services, 
256.10 	the case managermanagement service provider shall assure that individual programthe 
256.11 	individual provider plans are developed by the providers according to clauses (2) to (5). 
256.12 	The providers shall assure that the individual programprovider plans:
256.13 	(1) are developed according to the respective state and federal licensing and 
256.14 	certification requirements;
256.15 	(2) are designed to achieve the goals of the individual service plan;
256.16 	(3) are consistent with other aspects of the individualcoordinated service and 
256.17 	support plan;
256.18 	(4) assure the health and safety of the person; and
256.19 	(5) are developed with consistent and coordinated approaches to services among the 
256.20 	various service providers.
256.21 	(b) The case managermanagement service provider shall monitor the provision of 
256.22 	services:
256.23 	(1) to assure that the individual service plan is being followed according to 
256.24 	paragraph (a);
256.25 	(2) to identify any changes or modifications that might be needed in the individual 
256.26 	service plan, including changes resulting from recommendations of current service 
256.27 	providers;
256.28 	(3) to determine if the person's legal rights are protected, and if not, notify the 
256.29 	person's legal guardian or conservator, or the parent if the person is a minor, protection 
256.30 	services, or licensing agencies as appropriate; and
256.31 	(4) to determine if the person, the person's legal guardian or conservator, or the 
256.32 	parent if the person is a minor, is satisfied with the services provided.
256.33 	(c) If the provider fails to develop or carry out the individual program plan according 
256.34 	to paragraph (a), the case manager shall notify the person's legal guardian or conservator, 
256.35 	or the parent if the person is a minor, the provider, the respective licensing and certification 
257.1 	agencies, and the county board where the services are being provided. In addition, the 
257.2 	case manager shall identify other steps needed to assure the person receives the services 
257.3 	identified in the individualcoordinated service and support plan.

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

257.5 	Sec. 30. Minnesota Statutes 2010, section 256B.092, subdivision 1g, is amended to 
257.6 	read:
257.7 		Subd. 1g.Conditions not requiring development of individuala coordinated 
257.8 	service and support plan. Unless otherwise required by federal law, the county agency is 
257.9 	not required to complete an individual a coordinated service and support plan as defined in 
257.10 	subdivision 1b for:
257.11 	(1) persons whose families are requesting respite care for their family member who 
257.12 	resides with them, or whose families are requesting a family support grant and are not 
257.13 	requesting purchase or arrangement of habilitative services; and
257.14 	(2) persons with developmental disabilities, living independently without authorized 
257.15 	services or receiving funding for services at a rehabilitation facility as defined in section 
257.16 	268A.01, subdivision 6, and not in need of or requesting additional services.

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

257.18 	Sec. 31. Minnesota Statutes 2010, section 256B.092, subdivision 3, is amended to read:
257.19 		Subd. 3.Authorization and termination of services. County agency case 
257.20 	managers Lead agencies, under rules of the commissioner, shall authorize and terminate 
257.21 	services of community and regional treatment center providers according to individual
257.22 	coordinated  service and support plans. Services provided to persons with developmental 
257.23 	disabilities may only be authorized and terminated by case managers according to (1) 
257.24 	rules of the commissioner and (2) the individualcoordinated service and support plan as 
257.25 	defined in subdivision 1b. Medical assistance services not needed shall not be authorized 
257.26 	by county agencies or funded by the commissioner. When purchasing or arranging for 
257.27 	unlicensed respite care services for persons with overriding health needs, the county 
257.28 	agency shall seek the advice of a health care professional in assessing provider staff 
257.29 	training needs and skills necessary to meet the medical needs of the person.

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

257.31 	Sec. 32. Minnesota Statutes 2010, section 256B.092, subdivision 8, is amended to read:
258.1 		Subd. 8.Screening teamAdditional certified assessor duties. The screening team
258.2 	certified assessor shall:
258.3 	(1) review diagnostic data;
258.4 	(2) review health, social, and developmental assessment data using a uniform 
258.5 	screeningcomprehensive assessment tool specified by the commissioner;
258.6 	(3) identify the level of services appropriate to maintain the person in the most 
258.7 	normal and least restrictive setting that is consistent with the person's treatment needs;
258.8 	(4) identify other noninstitutional public assistance or social service that may prevent 
258.9 	or delay long-term residential placement;
258.10 	(5) assess whether a person is in need of long-term residential care;
258.11 	(6) make recommendations regarding placementservices and payment for: (i) social 
258.12 	service or public assistance support, or both, to maintain a person in the person's own home 
258.13 	or other place of residence; (ii) training and habilitation service, vocational rehabilitation, 
258.14 	and employment training activities; (iii) community residential placement services; (iv) 
258.15 	regional treatment center placement; or (v) (iv)  a home and community-based service 
258.16 	alternative to community residential placement or regional treatment center placement;
258.17 	(7) evaluate the availability, location, and quality of the services listed in clause 
258.18 	(6), including the impact of placement alternativesservices and supports options on the 
258.19 	person's ability to maintain or improve existing patterns of contact and involvement with 
258.20 	parents and other family members;
258.21 	(8) identify the cost implications of recommendations in clause (6) and provide 
258.22 	written notice of the annual and monthly amount authorized to be spent for services for 
258.23 	the recipient;
258.24 	(9) make recommendations to a court as may be needed to assist the court in making 
258.25 	decisions regarding commitment of persons with developmental disabilities; and
258.26 	(10) inform the person and the person's legal guardian or conservator, or the parent if 
258.27 	the person is a minor, that appeal may be made to the commissioner pursuant to section 
258.28 	256.045.

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

258.30 	Sec. 33. [256B.0961] STATE QUALITY ASSURANCE, QUALITY 
258.31 	IMPROVEMENT, AND LICENSING SYSTEM.
258.32 		Subdivision 1.Scope. (a) In order to improve the quality of services provided to 
258.33 	Minnesotans with disabilities and to meet the requirements of the federally approved 
258.34 	home and community-based waivers under section 1915c of the Social Security Act, a 
258.35 	State Quality Assurance, Quality Improvement, and Licensing System for Minnesotans 
259.1 	receiving disability services is enacted. This system is a partnership between the 
259.2 	Department of Human Services and the State Quality Council established under 
259.3 	subdivision 3.
259.4 	(b) This system is a result of the recommendations from the Department of Human 
259.5 	Services' licensing and alternative quality assurance study mandated under Laws 2005, 
259.6 	First Special Session chapter 4, article 7, section 57, and presented to the legislature 
259.7 	in February 2007.
259.8 	(c) The disability services eligible under this section include:
259.9 	(1) the home and community-based services waiver programs for persons with 
259.10 	developmental disabilities under section 256B.092, subdivision 4, or section 256B.49, 
259.11 	including traumatic brain injuries and services for those who qualify for nursing facility 
259.12 	level of care or hospital facility level of care;
259.13 	(2) home care services under section 256B.0651;
259.14 	(3) family support grants under section 252.32;
259.15 	(4) consumer support grants under section 256.476;
259.16 	(5) semi-independent living services under section 252.275; and
259.17 	(6) services provided through an intermediate care facility for the developmentally 
259.18 	1.27 disabled.
259.19 	(d) For purposes of this section, the following definitions apply:
259.20 	(1) "commissioner" means the commissioner of human services;
259.21 	(2) "council" means the State Quality Council under subdivision 3;
259.22 	(3) "Quality Assurance Commission" means the commission under section 
259.23 	256B.0951; and
259.24 	(4) "system" means the State Quality Assurance, Quality Improvement and 2.7 
259.25 	Licensing System under this section.
259.26 		Subd. 2.Duties of the commissioner of human services. (a) The commissioner of 
259.27 	human services shall establish the State Quality Council under subdivision 3.
259.28 	(b) The commissioner shall initially delegate authority to perform licensing 
259.29 	functions and activities according to section 245A.16 to a host county in Region 10. The 
259.30 	commissioner must not license or reimburse a participating facility, program, or service 
259.31 	located in Region 10 if the commissioner has received notification from the host county 
259.32 	that the facility, program, or service has failed to qualify for licensure.
259.33 	(c) The commissioner may conduct random licensing inspections based on outcomes 
259.34 	adopted under section 256B.0951, subdivision 3, at facilities or programs, and of services 
259.35 	eligible under this section. The role of the random inspections is to verify that the system 
260.1 	protects the safety and well-being of persons served and maintains the availability of 
260.2 	high-quality services for persons with disabilities.
260.3 	(d) The commissioner shall ensure that the federal home and community-based 
260.4 	waiver requirements are met and that incidents that may have jeopardized safety and health 
260.5 	or violated services-related assurances, civil and human rights, and other protections 
260.6 	designed to prevent abuse, neglect, and exploitation, are reviewed, investigated, and 
260.7 	acted upon in a timely manner.
260.8 	(e) The commissioner shall seek a federal waiver by July 1, 2012 to allow 
260.9 	intermediate care facilities for persons with developmental disabilities to participate in 
260.10 	this system.
260.11 		Subd. 3.State Quality Council. (a) There is hereby created a State Quality 
260.12 	Council which must define regional quality councils, and carry out a community-based, 
260.13 	person-directed quality review component, and a comprehensive system for effective 
260.14 	incident reporting, investigation, analysis, and follow-up.
260.15 	(b) By August 1, 2011, the commissioner of human services shall appoint the 
260.16 	members of the initial State Quality Council. Members shall include representatives 
260.17 	from the following groups:
260.18 	(1) disability service recipients and their family members; 
260.19 	(2) during the first two years of the State Quality Council, there must be at least three 
260.20 	members from the Region 10 stakeholders. As regional quality councils are formed under 
260.21 	subdivision 4, each regional quality council shall appoint one member;
260.22 	(3) disability service providers;
260.23 	(4) disability advocacy groups; and
260.24 	(5) county human services agencies and staff from the Departments of Human 
260.25 	Services and Health, and Ombudsman for Mental Health and Developmental Disabilities;
260.26 	(c) Members of the council who do not receive a salary or wages from an employer 
260.27 	for time spent on council duties may receive a per diem payment when performing council 
260.28 	duties and functions.
260.29 	(d) The State Quality Council shall:
260.30 	(1) assist the Departments of Human Services and Health in fulfilling federally 
260.31 	mandated obligations by monitoring disability service quality and quality assurance and 
260.32 	improvement practices in Minnesota; and
260.33 	(2) establish state quality improvement priorities with methods for achieving results 
260.34 	and provide an annual report to the legislative committees with jurisdiction over policy 
260.35 	and funding of disability services on the outcomes, improvement priorities, and activities 
260.36 	undertaken by the commission during the previous state fiscal year.
261.1 	(e) The State Quality Council, in partnership with the commissioner, shall:
261.2 	(1) approve and direct implementation of the community-based, person-directed 
261.3 	system established in this section;
261.4 	(2) recommend an appropriate method of funding this system, and determine the 
261.5 	feasibility of the use of Medicaid, licensing fees, as well as other possible funding options;
261.6 	(3) approve measurable outcomes in the areas of health and safety, consumer 
261.7 	evaluation, education and training, providers, and systems;
261.8 	(4) establish variable licensure periods not to exceed three years based on outcomes 
261.9 	achieved; and
261.10 	(5) in cooperation with the Quality Assurance Commission, design a transition plan 
261.11 	for licensed providers from Region 10 into the alternative licensing system by July 1, 2013.
261.12 	(f) The State Quality Council shall notify the commissioner of human services that a 
261.13 	facility, program, or service has been reviewed by quality assurance team members under 
261.14 	subdivision 4, paragraph (b), clause (13), and qualifies for a license.
261.15 	(g) The State Quality Council, in partnership with the commissioner, shall establish 
261.16 	an ongoing review process for the system. The review shall take into account the 
261.17 	comprehensive nature of the system which is designed to evaluate the broad spectrum of 
261.18 	licensed and unlicensed entities that provide services to persons with disabilities. The 
261.19 	review shall address efficiencies and effectiveness of the system.
261.20 	(h) The State Quality Council may recommend to the commissioner certain 
261.21 	variances from the standards governing licensure of programs for persons with disabilities 
261.22 	in order to improve the quality of services so long as the recommended variances do 
261.23 	not adversely affect the health or safety of persons being served or compromise the 
261.24 	qualifications of staff to provide services.
261.25 	(i) The safety standards, rights, or procedural protections referenced under 
261.26 	subdivision 2, paragraph (c), shall not be varied. The State Quality Council may make 
261.27 	recommendations to the commissioner or to the legislature in the report required under 
261.28 	paragraph (c) regarding alternatives or modifications to the safety standards, rights, or 
261.29 	procedural protections referenced under subdivision 2, paragraph (c).
261.30 	(j) The State Quality Council may hire staff to perform the duties assigned in this 
261.31 	4.14 subdivision.
261.32 		Subd. 4.Regional quality councils. (a) The commissioner shall establish, as 
261.33 	selected by the State Quality Council, regional quality councils of key stakeholders, 
261.34 	including regional representatives of:
261.35 	(1) disability service recipients and their family members;
261.36 	(2) disability service providers;
262.1 	(3) disability advocacy groups; and
262.2 	(4) county human services agencies and staff from the Departments of Human 
262.3 	Services, and Health, and Ombudsman for Mental Health and Developmental Disabilities.
262.4 	(b) Each regional quality council shall:
262.5 	(1) direct and monitor the community-based, person-directed quality assurance 
262.6 	system in this section;
262.7 	(2) approve a training program for quality assurance team members under clause 
262.8 	(13);
262.9 	(3) review summary reports from quality assurance team reviews and make 
262.10 	recommendations to the State Quality Council regarding program licensure;
262.11 	(4) make recommendations to the State Quality Council regarding the system;
262.12 	(5) resolve complaints between the quality assurance teams, counties, providers, 
262.13 	persons receiving services, their families, and legal representatives;
262.14 	(6) analyze and review quality outcomes and critical incident data reporting 
262.15 	incidents of life safety concerns immediately to the Department of Human Services 
262.16 	licensing division;
262.17 	(7) provide information and training programs for persons with disabilities and their 
262.18 	families and legal representatives on service options and quality expectations;
262.19 	(8) disseminate information and resources developed to other regional quality 
262.20 	councils;
262.21 	(9) respond to state-level priorities;
262.22 	(10) establish regional priorities for quality improvement;
262.23 	(11) submit an annual report to the State Quality Council on the status, outcomes, 
262.24 	improvement priorities, and activities in the region;
262.25 	(12) choose a representative to participate on the State Quality Council and assume 
262.26 	other responsibilities consistent with the priorities of the State Quality Council; and
262.27 	(13) recruit, train, and assign duties to members of quality assurance teams, taking 
262.28 	into account the size of the service provider, the number of services to be reviewed, 
262.29 	the skills necessary for the team members to complete the process, and ensure that no 
262.30 	team member has a financial, personal, or family relationship with the facility, program, 
262.31 	or service being reviewed or with anyone served at the facility, program, or service. 
262.32 	Quality assurance teams must be comprised of county staff, persons receiving services 
262.33 	or the person's families, legal representatives, members of advocacy organizations, 
262.34 	providers, and other involved community members. Team members must complete 
262.35 	the training program approved by the regional quality council and must demonstrate 
263.1 	performance-based competency. Team members may be paid a per diem and reimbursed 
263.2 	for expenses related to their participation in the quality assurance process.
263.3 	(c) The commissioner shall monitor the safety standards, rights, and procedural 
263.4 	protections for the monitoring of psychotropic medications and those identified under 
263.5 	sections 245.825; 245.91 to 245.97; 245A.09, subdivision 2, paragraph (c), clauses (2) 
263.6 	and (5); 245A.12; 245A.13; 252.41, subdivision 9; 256B.092, subdivision 1b, clause 
263.7 	(7); 626.556; and 626.557.
263.8 	(d) The regional quality councils may hire staff to perform the duties assigned in 
263.9 	this subdivision.
263.10 	(e) The regional quality councils may charge fees for their services.
263.11 	(f) The quality assurance process undertaken by a regional quality council consists of 
263.12 	an evaluation by a quality assurance team of the facility, program, or service. The process 
263.13 	must include an evaluation of a random sample of persons served. The sample must be 
263.14 	representative of each service provided. The sample size must be at least five percent but 
263.15 	not less than two persons served. All persons must be given the opportunity to be included 
263.16 	in the quality assurance process in addition to those chosen for the random sample.
263.17 	(g) A facility, program, or service may contest a licensing decision of the regional 
263.18 	quality council as permitted under chapter 245A.
263.19 		Subd. 5.Annual survey of service recipients. The commissioner, in consultation 
263.20 	with the State Quality Council, shall conduct an annual independent statewide survey 
263.21 	of service recipients, randomly selected, to determine the effectiveness and quality 
263.22 	of disability services. The survey must be consistent with the system performance 
263.23 	expectations of the Centers for Medicare and Medicaid Services (CMS) Quality 
263.24 	Framework. The survey must analyze whether desired outcomes for persons with different 
263.25 	demographic, diagnostic, health, and functional needs, who are receiving different types 
263.26 	of services in different settings and with different costs, have been achieved. Annual 
263.27 	statewide and regional reports of the results must be published and used to assist regions, 
263.28 	counties, and providers to plan and measure the impact of quality improvement activities.
263.29 		Subd. 6.Mandated reporters. Members of the State Quality Council under 
263.30 	subdivision 3, the regional quality counsels under subdivision 4, and quality assurance 
263.31 	team members under subdivision 4, paragraph (b), clause (13), are mandated reporters as 
263.32 	defined in sections 626.556, subdivision 3, and 626.5572, subdivision 16.

263.33 	EFFECTIVE DATE. (a) Subdivisions 1 to 6 are effective July 1, 2011.
263.34 	(b) The jurisdictions of the regional quality councils in subdivision 4 must be 
263.35 	defined, with implementation dates, by July 1, 2012. During the biennium beginning 
263.36 	July 6.20 1, 2011, the Quality Assurance Commission shall continue to implement the 
264.1 	alternative licensing system under this section. An additional two regional quality 
264.2 	counsels must begin implementation on July 1, 2012, and the final three regional quality 
264.3 	counsels must begin implementation on July 1, 2013.

264.4 	Sec. 34. Minnesota Statutes 2010, section 256B.19, is amended by adding a 
264.5 	subdivision to read:
264.6 		Subd. 2d.Obligation of local agency to process medical assistance applications 
264.7 	within established timelines. (a) Except as provided in paragraph (b), when an individual 
264.8 	submits an application for medical assistance and the applicant's eligibility is based on 
264.9 	disability or on being age 65 or older, the county must determine the applicant's eligibility 
264.10 	and mail a notice of its decision to the applicant within:
264.11 	(1) 60 days from the date of the application for an individual whose eligibility 
264.12 	is based on disability; or
264.13 	(2) 45 days from the date of the application for an individual whose eligibility is 
264.14 	based on being age 65 or older.
264.15 	(b) The county must determine eligibility and mail a notice of its decision within the 
264.16 	time frames stated in paragraph (a), except in the following circumstances: 
264.17 	(1) the county cannot make a determination because, despite reasonable efforts by 
264.18 	the county to communicate what is required, the applicant or an examining physician 
264.19 	delays or fails to take a required action; or 
264.20 	(2) there is an administrative or other emergency beyond the county's control.  For 
264.21 	purposes of this clause, a staffing shortage does not constitute an emergency beyond 
264.22 	the county's control.
264.23 	For the events in either clause (1) or (2), the county must document in the applicant's 
264.24 	case record the reason for delaying beyond the established time frames. 
264.25 	(c) The county must not use the time frames established in paragraph (a) as a waiting 
264.26 	period before determining eligibility or as a reason for denying eligibility because it has 
264.27 	not determined eligibility within the established time frames.
264.28 	(d) Effective July 1, 2011, unless one of the exceptions listed under paragraph (b) 
264.29 	applies, if a county fails to comply with paragraph (a) and the applicant ultimately is 
264.30 	determined to be eligible for medical assistance, the county is responsible for the entire 
264.31 	cost of medical assistance services provided to the applicant by a nursing facility and not 
264.32 	paid for by federal funds, from and including the first date of eligibility through the date 
264.33 	on which the county mails written notice of its decision on the application. The applicable 
264.34 	facility will bill and receive payment directly from the commissioner in customary 
265.1 	fashion, and the commissioner shall deduct any obligation incurred under this paragraph 
265.2 	from the amount due to the local agency under subdivision 1. 
265.3 	(e) This subdivision supersedes subdivision 1, clause (2), if both apply to an 
265.4 	applicant.

265.5 	Sec. 35. Minnesota Statutes 2010, section 256B.431, subdivision 2r, is amended to 
265.6 	read:
265.7 		Subd. 2r.Payment restrictions on leave days. (a) Effective July 1, 1993, the 
265.8 	commissioner shall limit payment for leave days in a nursing facility to 79 percent of that 
265.9 	nursing facility's total payment rate for the involved resident. 
265.10 	(b) For services rendered on or after July 1, 2003, for facilities reimbursed under this 
265.11 	section or section 256B.434, the commissioner shall limit payment for leave days in a 
265.12 	nursing facility to 60 percent of that nursing facility's total payment rate for the involved 
265.13 	resident.
265.14 	(c) For services rendered on or after July 1, 2011, for facilities reimbursed under 
265.15 	this chapter, the commissioner shall limit payment for leave days in a nursing facility 
265.16 	to 30 percent of that nursing facility's total payment rate for the involved resident, and 
265.17 	shall allow this payment only when the occupancy of the nursing facility, inclusive of 
265.18 	bed hold days, is equal to or greater than 96 percent, notwithstanding Minnesota Rules, 
265.19 	part 9505.0415.

265.20 	Sec. 36. Minnesota Statutes 2010, section 256B.431, is amended by adding a 
265.21 	subdivision to read:
265.22 		Subd. 44.Property rate increase for a facility in Bloomington effective 
265.23 	November 1, 2010. Notwithstanding any other law to the contrary, money available for 
265.24 	moratorium projects under section 144A.073, subdivision 11, shall be used, effective 
265.25 	November 1, 2010, to fund an approved moratorium exception project for a nursing 
265.26 	facility in Bloomington licensed for 137 beds as of November 1, 2010, up to a total 
265.27 	property rate adjustment of $19.33.

265.28 	Sec. 37. Minnesota Statutes 2010, section 256B.434, subdivision 4, is amended to read:
265.29 		Subd. 4.Alternate rates for nursing facilities. (a) For nursing facilities which 
265.30 	have their payment rates determined under this section rather than section 256B.431, the 
265.31 	commissioner shall establish a rate under this subdivision. The nursing facility must enter 
265.32 	into a written contract with the commissioner.
266.1 	(b) A nursing facility's case mix payment rate for the first rate year of a facility's 
266.2 	contract under this section is the payment rate the facility would have received under 
266.3 	section 256B.431.
266.4 	(c) A nursing facility's case mix payment rates for the second and subsequent years 
266.5 	of a facility's contract under this section are the previous rate year's contract payment 
266.6 	rates plus an inflation adjustment and, for facilities reimbursed under this section or 
266.7 	section 256B.431, an adjustment to include the cost of any increase in Health Department 
266.8 	licensing fees for the facility taking effect on or after July 1, 2001. The index for the 
266.9 	inflation adjustment must be based on the change in the Consumer Price Index-All Items 
266.10 	(United States City average) (CPI-U) forecasted by the commissioner of management and 
266.11 	budget's national economic consultant, as forecasted in the fourth quarter of the calendar 
266.12 	year preceding the rate year. The inflation adjustment must be based on the 12-month 
266.13 	period from the midpoint of the previous rate year to the midpoint of the rate year for 
266.14 	which the rate is being determined. For the rate years beginning on July 1, 1999, July 1, 
266.15 	2000, July 1, 2001, July 1, 2002, July 1, 2003, July 1, 2004, July 1, 2005, July 1, 2006, 
266.16 	July 1, 2007, July 1, 2008, October 1, 2009, and October 1, 2010, October 1, 2011, and 
266.17 	October 1, 2012. this paragraph shall apply only to the property-related payment rate, 
266.18 	except that adjustments to include the cost of any increase in Health Department licensing 
266.19 	fees taking effect on or after July 1, 2001, shall be provided. For the rate years beginning 
266.20 	on October 1, 2011, and October 1, 2012, the rate adjustment under this paragraph shall 
266.21 	be suspended. Beginning in 2005, adjustment to the property payment rate under this 
266.22 	section and section 256B.431 shall be effective on October 1. In determining the amount 
266.23 	of the property-related payment rate adjustment under this paragraph, the commissioner 
266.24 	shall determine the proportion of the facility's rates that are property-related based on the 
266.25 	facility's most recent cost report.
266.26 	(d) The commissioner shall develop additional incentive-based payments of up to 
266.27 	five percent above a facility's operating payment rate for achieving outcomes specified 
266.28 	in a contract. The commissioner may solicit contract amendments and implement those 
266.29 	which, on a competitive basis, best meet the state's policy objectives. The commissioner 
266.30 	shall limit the amount of any incentive payment and the number of contract amendments 
266.31 	under this paragraph to operate the incentive payments within funds appropriated for this 
266.32 	purpose. The contract amendments may specify various levels of payment for various 
266.33 	levels of performance. Incentive payments to facilities under this paragraph may be in the 
266.34 	form of time-limited rate adjustments or onetime supplemental payments. In establishing 
266.35 	the specified outcomes and related criteria, the commissioner shall consider the following 
266.36 	state policy objectives:
267.1 	(1) successful diversion or discharge of residents to the residents' prior home or other 
267.2 	community-based alternatives;
267.3 	(2) adoption of new technology to improve quality or efficiency;
267.4 	(3) improved quality as measured in the Nursing Home Report Card;
267.5 	(4) reduced acute care costs; and
267.6 	(5) any additional outcomes proposed by a nursing facility that the commissioner 
267.7 	finds desirable.
267.8 	(e) Notwithstanding the threshold in section 256B.431, subdivision 16, facilities that 
267.9 	take action to come into compliance with existing or pending requirements of the life 
267.10 	safety code provisions or federal regulations governing sprinkler systems must receive 
267.11 	reimbursement for the costs associated with compliance if all of the following conditions 
267.12 	are met:
267.13 	(1) the expenses associated with compliance occurred on or after January 1, 2005, 
267.14 	and before December 31, 2008;
267.15 	(2) the costs were not otherwise reimbursed under subdivision 4f or section 
267.16 	144A.071 or 144A.073; and
267.17 	(3) the total allowable costs reported under this paragraph are less than the minimum 
267.18 	threshold established under section 256B.431, subdivision 15, paragraph (e), and 
267.19 	subdivision 16.
267.20 	The commissioner shall use money appropriated for this purpose to provide to qualifying 
267.21 	nursing facilities a rate adjustment beginning October 1, 2007, and ending September 30, 
267.22 	2008. Nursing facilities that have spent money or anticipate the need to spend money 
267.23 	to satisfy the most recent life safety code requirements by (1) installing a sprinkler 
267.24 	system or (2) replacing all or portions of an existing sprinkler system may submit to the 
267.25 	commissioner by June 30, 2007, on a form provided by the commissioner the actual 
267.26 	costs of a completed project or the estimated costs, based on a project bid, of a planned 
267.27 	project. The commissioner shall calculate a rate adjustment equal to the allowable 
267.28 	costs of the project divided by the resident days reported for the report year ending 
267.29 	September 30, 2006. If the costs from all projects exceed the appropriation for this 
267.30 	purpose, the commissioner shall allocate the money appropriated on a pro rata basis 
267.31 	to the qualifying facilities by reducing the rate adjustment determined for each facility 
267.32 	by an equal percentage. Facilities that used estimated costs when requesting the rate 
267.33 	adjustment shall report to the commissioner by January 31, 2009, on the use of this 
267.34 	money on a form provided by the commissioner. If the nursing facility fails to provide 
267.35 	the report, the commissioner shall recoup the money paid to the facility for this purpose. 
267.36 	If the facility reports expenditures allowable under this subdivision that are less than 
268.1 	the amount received in the facility's annualized rate adjustment, the commissioner shall 
268.2 	recoup the difference.

268.3 	Sec. 38. Minnesota Statutes 2010, section 256B.437, subdivision 6, is amended to read:
268.4 		Subd. 6.Planned closure rate adjustment. (a) The commissioner of human 
268.5 	services shall calculate the amount of the planned closure rate adjustment available under 
268.6 	subdivision 3, paragraph (b), for up to 5,140 beds according to clauses (1) to (4):
268.7 	(1) the amount available is the net reduction of nursing facility beds multiplied 
268.8 	by $2,080;
268.9 	(2) the total number of beds in the nursing facility or facilities receiving the planned 
268.10 	closure rate adjustment must be identified;
268.11 	(3) capacity days are determined by multiplying the number determined under 
268.12 	clause (2) by 365; and
268.13 	(4) the planned closure rate adjustment is the amount available in clause (1), divided 
268.14 	by capacity days determined under clause (3).
268.15 	(b) A planned closure rate adjustment under this section is effective on the first day 
268.16 	of the month following completion of closure of the facility designated for closure in the 
268.17 	application and becomes part of the nursing facility's total operating payment rate.
268.18 	(c) Applicants may use the planned closure rate adjustment to allow for a property 
268.19 	payment for a new nursing facility or an addition to an existing nursing facility or as an 
268.20 	operating payment rate adjustment. Applications approved under this subdivision are 
268.21 	exempt from other requirements for moratorium exceptions under section 144A.073, 
268.22 	subdivisions 2 and 3.
268.23 	(d) Upon the request of a closing facility, the commissioner must allow the facility a 
268.24 	closure rate adjustment as provided under section 144A.161, subdivision 10.
268.25 	(e) A facility that has received a planned closure rate adjustment may reassign it 
268.26 	to another facility that is under the same ownership at any time within three years of its 
268.27 	effective date. The amount of the adjustment shall be computed according to paragraph (a).
268.28 	(f) If the per bed dollar amount specified in paragraph (a), clause (1), is increased, 
268.29 	the commissioner shall recalculate planned closure rate adjustments for facilities that 
268.30 	delicense beds under this section on or after July 1, 2001, to reflect the increase in the per 
268.31 	bed dollar amount. The recalculated planned closure rate adjustment shall be effective 
268.32 	from the date the per bed dollar amount is increased.
268.33 	(g) For planned closures approved after June 30, 2009, the commissioner of human 
268.34 	services shall calculate the amount of the planned closure rate adjustment available under 
268.35 	subdivision 3, paragraph (b), according to paragraph (a), clauses (1) to (4).
269.1 	(h) Beginning July 16, 2011, the commissioner shall no longer approve planned 
269.2 	closure rate adjustments under this subdivision.

269.3 	Sec. 39. Minnesota Statutes 2010, section 256B.441, is amended by adding a 
269.4 	subdivision to read:
269.5 		Subd. 60.Rate increase for low-rate facilities. (a) Effective October 1, 2011, 
269.6 	the commissioner shall adjust the operating payment rates of a nursing facility whose 
269.7 	operating payment rate on September 30, 2011, is greater than the 95th percentile of all 
269.8 	nursing facilities operating payment rates. The commissioner shall:
269.9 	(1) array all operating payment rates in effect on September 30, 2011, at a case-mix 
269.10 	weight equal to 1.00 (DDF) from lowest to highest;
269.11 	(2) remove from the array any nursing facility determined by the commissioner to 
269.12 	be providing specialized care, determined in accordance with criteria in subdivision 51a, 
269.13 	paragraph (b), and any facilities receiving a rate increase under paragraph (c), clause (1);
269.14 	(3) determine the 95th percentile of the array in clause (1);
269.15 	(4) compute a reduction amount not to exceed three percent, if a facility's amount 
269.16 	in clause (1) is greater than the amount computed in clause (3) by subtracting a facility's 
269.17 	DDF rate in clause (1) from the amount computed in clause (3);
269.18 	(5) compute the portion of each facility's DDF operating payment rate that is the 
269.19 	direct care per diem based on the rates in effect on September 30, 2011; and
269.20 	(6) determine the change for all other case-mix levels, by multiplying the amount in 
269.21 	clause (4) by the percentage in clause (5) and by the corresponding case-mix weight for 
269.22 	each care level. Add to this product the non-direct care per diem portion of the amount 
269.23 	in clause (4).
269.24 	(b) The total amount to be saved by the rate reductions will be computed. The 
269.25 	commissioner shall:
269.26 	(1) for each facility receiving a rate change in paragraph (a), multiply each case-mix 
269.27 	level's rate change in paragraph (a), clause (6), by the corresponding case-mix resident 
269.28 	days from the most recent cost report that has been desk audited; and
269.29 	(2) sum all the products computed in clause (1).
269.30 	(c) The amount of total payment reductions computed in paragraph (b) shall be 
269.31 	distributed to the facilities with the lowest DDF operating payment rates determined in 
269.32 	paragraph (a), clause (1). The commissioner shall:
269.33 	(1) for nursing facilities located no more than one-quarter mile from a peer group 
269.34 	with higher limits under either subdivision 50 or 51, give an operating rate adjustment. 
269.35 	The operating payment rates of a lower-limit peer group facility must be adjusted to be 
270.1 	equal to those of the nearest facility in a higher-limit peer group if that facility's RUG rate 
270.2 	with a weight of 1.00 is higher than the lower-limit peer group facility. Peer groups are 
270.3 	those defined in subdivision 30. The nearest facility must be determined by the most 
270.4 	direct driving route;
270.5 	(2) start with the facility or facilities with the lowest DDF operating payment rate 
270.6 	and compute the amount of a rate adjustment needed to make the DDF rate equal to the 
270.7 	DDF of the facility directly below it in the array;
270.8 	(3) compute the rate increases for the other case-mix levels using the amount 
270.9 	computed in clause (2), and the process stated in paragraph (a), clauses (5) and (6);
270.10 	(4) compute the total amount the lowest facilities will receive using the process 
270.11 	described in paragraph (b);
270.12 	(5) compute the running total to be spent at all facilities receiving an increase under 
270.13 	this paragraph by summing each facility's amount computed in clause (4); and 
270.14 	(6) repeat the process in clauses (2) to (5) as long as the amount in clause (5) does 
270.15 	not exceed the amount in paragraph (b), clause (2). In no case shall the DDF operating 
270.16 	payment rate increase determined in clauses (2) to (6) exceed two percent.

270.17 	Sec. 40. Minnesota Statutes 2010, section 256B.441, is amended by adding a 
270.18 	subdivision to read:
270.19 		Subd. 61.Rate reduction for low-need residents. Beginning July 1, 2011, the 
270.20 	operating payment paid to nursing facilities by Medicaid or private pay and reimbursed 
270.21 	under this chapter for all residents classified as PA1 shall be reduced by the lesser of: (1) 
270.22 	25 percent of the PA1 rate in effect on June 30, 2011, for the specific facility; or (2) the 
270.23 	PA1 rate in effect on June 30, 2011, for the specific facility less the PA1 rate in effect 
270.24 	on June 30, 2011, for the facility at the tenth percentile of all facilities ranked from the 
270.25 	highest to the lowest PA1 rate in effect on June 30, 2011. No operating payment rate 
270.26 	increases may result from this provision.

270.27 	Sec. 41. Minnesota Statutes 2010, section 256B.48, subdivision 1, is amended to read:
270.28 		Subdivision 1.Prohibited practices. A nursing facility is not eligible to receive 
270.29 	medical assistance payments unless it refrains from all of the following:
270.30 	(a) Charging private paying residents rates for similar services which exceed those 
270.31 	which are approved by the state agency for medical assistance recipients as determined by 
270.32 	the prospective desk audit rate, except under the following circumstances:
270.33 	(1) the nursing facility may:
270.34 	(1)(i) charge private paying residents a higher rate for a private room,; and 
271.1 	(2)(ii) charge for special services which are not included in the daily rate if medical 
271.2 	assistance residents are charged separately at the same rate for the same services in 
271.3 	addition to the daily rate paid by the commissioner.;
271.4 	(2) effective July 1, 2011, through September 30, 2012, nursing facilities may charge 
271.5 	private paying residents rates up to two percent higher than the allowable payment rate 
271.6 	determined by the commissioner for the RUGS group currently assigned to the resident;
271.7 	(3) effective October 1, 2012, through September 30, 2013, nursing facilities 
271.8 	may charge private paying residents rates up to four percent higher than the allowable 
271.9 	payment rate determined by the commissioner for the RUGS group currently assigned 
271.10 	to the resident;
271.11 	(4) effective October 1, 2013, through September 30, 2014, nursing facilities may 
271.12 	charge private paying residents rates up to six percent higher than the allowable payment 
271.13 	rate determined by the commissioner for the RUGS group currently assigned to the 
271.14 	resident;
271.15 	(5) effective October 1, 2014, nursing facilities may charge private paying 
271.16 	residents up to eight percent higher than the allowable payment rate determined by the 
271.17 	commissioner for the RUGS group currently assigned to the resident; and
271.18 	(6) the higher private pay charges allowed in this paragraph shall be limited to actual 
271.19 	costs per resident day, as determined by the commissioner, based on data provided in the 
271.20 	statistical and cost report in section 256B.441.
271.21 	Nothing in this section precludes a nursing facility from charging a rate allowable 
271.22 	under the facility's single room election option under Minnesota Rules, part 9549.0060, 
271.23 	subpart 11. Services covered by the payment rate must be the same regardless of payment 
271.24 	source. Special services, if offered, must be available to all residents in all areas of the 
271.25 	nursing facility and charged separately at the same rate. Residents are free to select 
271.26 	or decline special services. Special services must not include services which must be 
271.27 	provided by the nursing facility in order to comply with licensure or certification standards 
271.28 	and that if not provided would result in a deficiency or violation by the nursing facility. 
271.29 	Services beyond those required to comply with licensure or certification standards must 
271.30 	not be charged separately as a special service if they were included in the payment rate for 
271.31 	the previous reporting year. A nursing facility that charges a private paying resident a rate 
271.32 	in violation of this clause is subject to an action by the state of Minnesota or any of its 
271.33 	subdivisions or agencies for civil damages. A private paying resident or the resident's legal 
271.34 	representative has a cause of action for civil damages against a nursing facility that charges 
271.35 	the resident rates in violation of this clause. The damages awarded shall include three 
271.36 	times the payments that result from the violation, together with costs and disbursements, 
272.1 	including reasonable attorneys' fees or their equivalent. A private paying resident or the 
272.2 	resident's legal representative, the state, subdivision or agency, or a nursing facility may 
272.3 	request a hearing to determine the allowed rate or rates at issue in the cause of action. 
272.4 	Within 15 calendar days after receiving a request for such a hearing, the commissioner 
272.5 	shall request assignment of an administrative law judge under sections 14.48 to 14.56 to 
272.6 	conduct the hearing as soon as possible or according to agreement by the parties. The 
272.7 	administrative law judge shall issue a report within 15 calendar days following the close 
272.8 	of the hearing. The prohibition set forth in this clause shall not apply to facilities licensed 
272.9 	as boarding care facilities which are not certified as skilled or intermediate care facilities 
272.10 	level I or II for reimbursement through medical assistance. 
272.11 	(b)(1) Charging, soliciting, accepting, or receiving from an applicant for admission 
272.12 	to the facility, or from anyone acting in behalf of the applicant, as a condition of 
272.13 	admission, expediting the admission, or as a requirement for the individual's continued 
272.14 	stay, any fee, deposit, gift, money, donation, or other consideration not otherwise required 
272.15 	as payment under the state plan. For residents on medical assistance, medical assistance 
272.16 	payment according to the state plan must be accepted as payment in full for continued 
272.17 	stay, except where otherwise provided for under statute;
272.18 	(2) requiring an individual, or anyone acting in behalf of the individual, to loan 
272.19 	any money to the nursing facility;
272.20 	(3) requiring an individual, or anyone acting in behalf of the individual, to promise 
272.21 	to leave all or part of the individual's estate to the facility; or
272.22 	(4) requiring a third-party guarantee of payment to the facility as a condition of 
272.23 	admission, expedited admission, or continued stay in the facility.
272.24 	Nothing in this paragraph would prohibit discharge for nonpayment of services in 
272.25 	accordance with state and federal regulations.
272.26 	(c) Requiring any resident of the nursing facility to utilize a vendor of health care 
272.27 	services chosen by the nursing facility. A nursing facility may require a resident to use 
272.28 	pharmacies that utilize unit dose packing systems approved by the Minnesota Board of 
272.29 	Pharmacy, and may require a resident to use pharmacies that are able to meet the federal 
272.30 	regulations for safe and timely administration of medications such as systems with specific 
272.31 	number of doses, prompt delivery of medications, or access to medications on a 24-hour 
272.32 	basis. Notwithstanding the provisions of this paragraph, nursing facilities shall not restrict 
272.33 	a resident's choice of pharmacy because the pharmacy utilizes a specific system of unit 
272.34 	dose drug packing.
272.35 	(d) Providing differential treatment on the basis of status with regard to public 
272.36 	assistance.
273.1 	(e) Discriminating in admissions, services offered, or room assignment on the 
273.2 	basis of status with regard to public assistance or refusal to purchase special services. 
273.3 	Discrimination in admissions discrimination, services offered, or room assignment shall 
273.4 	include, but is not limited to:
273.5 	(1) basing admissions decisions upon assurance by the applicant to the nursing 
273.6 	facility, or the applicant's guardian or conservator, that the applicant is neither eligible for 
273.7 	nor will seekinformation or assurances regarding current or future eligibility for public 
273.8 	assistance for payment of nursing facility care costs; and
273.9 	(2) engaging in preferential selection from waiting lists based on an applicant's 
273.10 	ability to pay privately or an applicant's refusal to pay for a special service.
273.11 	The collection and use by a nursing facility of financial information of any applicant 
273.12 	pursuant to a preadmission screening program established by law shall not raise an 
273.13 	inference that the nursing facility is utilizing that information for any purpose prohibited 
273.14 	by this paragraph.
273.15 	(f) Requiring any vendor of medical care as defined by section 256B.02, subdivision 
273.16 	7, who is reimbursed by medical assistance under a separate fee schedule, to pay any 
273.17 	amount based on utilization or service levels or any portion of the vendor's fee to the 
273.18 	nursing facility except as payment for renting or leasing space or equipment or purchasing 
273.19 	support services from the nursing facility as limited by section 256B.433. All agreements 
273.20 	must be disclosed to the commissioner upon request of the commissioner. Nursing 
273.21 	facilities and vendors of ancillary services that are found to be in violation of this provision 
273.22 	shall each be subject to an action by the state of Minnesota or any of its subdivisions or 
273.23 	agencies for treble civil damages on the portion of the fee in excess of that allowed by 
273.24 	this provision and section 256B.433. Damages awarded must include three times the 
273.25 	excess payments together with costs and disbursements including reasonable attorney's 
273.26 	fees or their equivalent. 
273.27 	(g) Refusing, for more than 24 hours, to accept a resident returning to the same 
273.28 	bed or a bed certified for the same level of care, in accordance with a physician's order 
273.29 	authorizing transfer, after receiving inpatient hospital services.
273.30 	(h) For a period not to exceed 180 days, the commissioner may continue to make 
273.31 	medical assistance payments to a nursing facility or boarding care home which is in 
273.32 	violation of this section if extreme hardship to the residents would result. In these cases 
273.33 	the commissioner shall issue an order requiring the nursing facility to correct the violation. 
273.34 	The nursing facility shall have 20 days from its receipt of the order to correct the violation. 
273.35 	If the violation is not corrected within the 20-day period the commissioner may reduce 
273.36 	the payment rate to the nursing facility by up to 20 percent. The amount of the payment 
274.1 	rate reduction shall be related to the severity of the violation and shall remain in effect 
274.2 	until the violation is corrected. The nursing facility or boarding care home may appeal the 
274.3 	commissioner's action pursuant to the provisions of chapter 14 pertaining to contested 
274.4 	cases. An appeal shall be considered timely if written notice of appeal is received by the 
274.5 	commissioner within 20 days of notice of the commissioner's proposed action.
274.6 	In the event that the commissioner determines that a nursing facility is not eligible 
274.7 	for reimbursement for a resident who is eligible for medical assistance, the commissioner 
274.8 	may authorize the nursing facility to receive reimbursement on a temporary basis until the 
274.9 	resident can be relocated to a participating nursing facility.
274.10 	Certified beds in facilities which do not allow medical assistance intake on July 1, 
274.11 	1984, or after shall be deemed to be decertified for purposes of section 144A.071 only. 

274.12 	Sec. 42. Minnesota Statutes 2010, section 256B.49, is amended by adding a 
274.13 	subdivision to read:
274.14 		Subd. 10a.Definitions. (a) For purposes of this section, the following terms have 
274.15 	the meanings given.
274.16 	(b) "Comprehensive transitional service plan" means a plan detailing specific 
274.17 	measurable functional skills and timelines and additional systems of support for achieving 
274.18 	the fundamental service outcome.
274.19 	(c) "Functional milestone" means a functional skill attained through service 
274.20 	outcomes that take the place of a provider funded service.
274.21 	(d) "Fundamental service outcome" means the specific end objective for the service 
274.22 	being provided.
274.23 	(e) "Natural community supports" means relationships developed with friends, 
274.24 	family, work places, neighborhoods, and organizations that are not reimbursed to provide 
274.25 	supportive relationships that enhance the quality and security of individuals in their 
274.26 	communities.
274.27 	(f) "Short-term service outcome" means the measurable functional skill outcomes 
274.28 	necessary to achieve the fundamental service outcome.
274.29 	(g) "Transitional service planning team" means the individual receiving services; 
274.30 	the case manager; service providers; the guardian, if applicable; and other identified 
274.31 	individuals such as advocates, family members, and other natural supports who are able 
274.32 	to commit to a plan of support, housing, and treatment that maximizes the individual's 
274.33 	opportunity for success in transitioning to community living or the next level of care.

274.34 	Sec. 43. Minnesota Statutes 2010, section 256B.49, subdivision 12, is amended to read:
275.1 		Subd. 12.Informed choice. Persons who are determined likely to require the 
275.2 	level of care provided in a nursing facility as determined under sections 144.0724, 
275.3 	subdivision 11, and section256B.0911, or a hospital shall be informed of the home and 
275.4 	community-based support alternatives to the provision of inpatient hospital services or 
275.5 	nursing facility services. Each person must be given the choice of either institutional or 
275.6 	home and community-based services using the provisions described in section 256B.77, 
275.7 	subdivision 2, paragraph (p).

275.8 	Sec. 44. Minnesota Statutes 2010, section 256B.49, subdivision 13, is amended to read:
275.9 		Subd. 13.Case management. (a) Each recipient of a home and community-based 
275.10 	waiver under this section shall be provided case management services according to 
275.11 	section 256B.092, subdivisions 1a, 1b, and 1e, by qualified vendors as described in the 
275.12 	federally approved waiver application. The case management service activities provided 
275.13 	will include:
275.14 	(1) assessing the needs of the individual within 20 working days of a recipient's 
275.15 	request;
275.16 	(2) developing the written individual service plan within ten working days after the 
275.17 	assessment is completed;
275.18 	(3) informing the recipient or the recipient's legal guardian or conservator of service 
275.19 	options;
275.20 	(4) assisting the recipient in the identification of potential service providers;
275.21 	(5) assisting the recipient to access services;
275.22 	(6) coordinating, evaluating, and monitoring of the services identified in the service 
275.23 	plan;
275.24 	(7) completing the annual reviews of the service plan; and
275.25 	(8) informing the recipient or legal representative of the right to have assessments 
275.26 	completed and service plans developed within specified time periods, and to appeal county 
275.27 	action or inaction under section 256.045, subdivision 3, including the determination of 
275.28 	nursing facility level of care.
275.29 	(b) The case manager may delegate certain aspects of the case management service 
275.30 	activities to another individual provided there is oversight by the case manager. The case 
275.31 	manager may not delegate those aspects which require professional judgment including 
275.32 	assessments, reassessments, and care plan development.

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

275.34 	Sec. 45. Minnesota Statutes 2010, section 256B.49, subdivision 14, is amended to read:
276.1 		Subd. 14.Assessment and reassessment. (a) Assessments of each recipient's 
276.2 	strengths, informal support systems, and need for services shall be completed within 20 
276.3 	working days of the recipient's request as provided in section 256B.0911. Reassessment 
276.4 	of each recipient's strengths, support systems, and need for services shall be conducted 
276.5 	at least every 12 months and at other times when there has been a significant change in 
276.6 	the recipient's functioning.
276.7 	(b) There must be a determination that the client requires a hospital level of care or a 
276.8 	nursing facility level of care as defined in section 144.0724, subdivision 11 256B.0911, 
276.9 	subdivision 4a, paragraph (d), at initial and subsequent assessments to initiate and 
276.10 	maintain participation in the waiver program.
276.11 	(c) Regardless of other assessments identified in section 144.0724, subdivision 4, as 
276.12 	appropriate to determine nursing facility level of care for purposes of medical assistance 
276.13 	payment for nursing facility services, only face-to-face assessments conducted according 
276.14 	to section 256B.0911, subdivisions 3a, 3b, and 4d, that result in a hospital level of care 
276.15 	determination or a nursing facility level of care determination must be accepted for 
276.16 	purposes of initial and ongoing access to waiver services payment.
276.17 	(d) Persons with developmental disabilities who apply for services under the nursing 
276.18 	facility level waiver programs shall be screened for the appropriate level of care according 
276.19 	to section 256B.092.
276.20 	(e) Recipients who are found eligible for home and community-based services under 
276.21 	this section before their 65th birthday may remain eligible for these services after their 
276.22 	65th birthday if they continue to meet all other eligibility factors.
276.23 	(f) The commissioner shall develop criteria to identify individuals whose level of 
276.24 	functioning is reasonably expected to improve and reassess these individuals every six 
276.25 	months. Individuals who meet these criteria must have a comprehensive transitional 
276.26 	service plan developed under subdivision 15, paragraphs (b) and (c). Counties, case 
276.27 	managers, and service providers are responsible for conducting these reassessments and 
276.28 	shall complete the reassessments out of existing funds.

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

276.30 	Sec. 46. Minnesota Statutes 2010, section 256B.49, subdivision 15, is amended to read:
276.31 		Subd. 15.Individualized Coordinated service and support plan; comprehensive 
276.32 	transitional service plan; maintenance service plan. (a) Each recipient of home and 
276.33 	community-based waivered services shall be provided a copy of the written coordinated
276.34 	service and support plan which: that complies with the requirements of section 256B.092, 
276.35 	subdivision 1b.
277.1 	(1) is developed and signed by the recipient within ten working days of the 
277.2 	completion of the assessment;
277.3 	(2) meets the assessed needs of the recipient;
277.4 	(3) reasonably ensures the health and safety of the recipient;
277.5 	(4) promotes independence;
277.6 	(5) allows for services to be provided in the most integrated settings; and
277.7 	(6) provides for an informed choice, as defined in section 256B.77, subdivision 2, 
277.8 	paragraph (p), of service and support providers.
277.9 	(b) In developing the comprehensive transitional service plan, the individual 
277.10 	receiving services, the case manager, and the guardian, if applicable, will identify 
277.11 	the transitional service plan fundamental service outcome and anticipated timeline to 
277.12 	achieve this outcome. Within the first 20 days following a recipient's request for an 
277.13 	assessment or reassessment, the transitional service planning team must be identified. A 
277.14 	team leader must be identified who will be responsible for assigning responsibility and 
277.15 	communicating with team members to ensure implementation of the transition plan and 
277.16 	ongoing assessment and communication process. The team leader should be an individual, 
277.17 	such as the case manager or guardian, who has the opportunity to follow the individual to 
277.18 	the next level of service.
277.19 	Within ten days following an assessment, a comprehensive transitional service plan 
277.20 	must be developed incorporating elements of a comprehensive functional assessment and 
277.21 	including short-term measurable outcomes and timelines for achievement of and reporting 
277.22 	on these outcomes. Functional milestones must also be identified and reported according 
277.23 	to the timelines agreed upon by the transitional service planning team. In addition, the 
277.24 	comprehensive transitional service plan must identify additional supports that may assist 
277.25 	in the achievement of the fundamental service outcome such as the development of greater 
277.26 	natural community support, increased collaboration among agencies, and technological 
277.27 	supports.
277.28 	The timelines for reporting on functional milestones will prompt a reassessment of 
277.29 	services provided, the units of services, rates, and appropriate service providers. It is 
277.30 	the responsibility of the transitional service planning team leader to review functional 
277.31 	milestone reporting to determine if the milestones are consistent with observable skills 
277.32 	and that milestone achievement prompts any needed changes to the comprehensive 
277.33 	transitional service plan.
277.34 	For those whose fundamental transitional service outcome involves the need to 
277.35 	procure housing, a plan for the individual to seek the resources necessary to secure 
278.1 	the least restrictive housing possible should be incorporated into the plan, including 
278.2 	employment and public supports such as housing access and shelter needy funding.
278.3 	(c) Counties and other agencies responsible for funding community placement and 
278.4 	ongoing community supportive services are responsible for the implementation of the 
278.5 	comprehensive transitional service plans. Oversight responsibilities include both ensuring 
278.6 	effective transitional service delivery and efficient utilization of funding resources.
278.7 	(d) Following one year of transitional services, the transitional services planning 
278.8 	team will make a determination as to whether or not the individual receiving services 
278.9 	requires the current level of continuous and consistent support in order to maintain the 
278.10 	individual's current level of functioning. Individuals who move from a transitional to a 
278.11 	maintenance service plan must be reassessed to determine if the individual would benefit 
278.12 	from a transitional service plan on at least an annual basis. This assessment should 
278.13 	consider any changes to technological or natural community supports.
278.14 	(b) (e) When a county is evaluating denials, reductions, or terminations of home 
278.15 	and community-based services under section 256B.49 for an individual, the case manager 
278.16 	shall offer to meet with the individual or the individual's guardian in order to discuss the 
278.17 	prioritization of service needs within the individualized service plan, comprehensive 
278.18 	transitional service plan, or maintenance service plan. The reduction in the authorized 
278.19 	services for an individual due to changes in funding for waivered services may not exceed 
278.20 	the amount needed to ensure medically necessary services to meet the individual's health, 
278.21 	safety, and welfare.

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

278.23 	Sec. 47. Minnesota Statutes 2010, section 256B.5012, is amended by adding a 
278.24 	subdivision to read:
278.25 		Subd. 9.ICF/MR rate increase. Effective July 1, 2011, the commissioner shall 
278.26 	increase the daily rate to $138.23 at an intermediate care facility for the developmentally 
278.27 	disabled located in Clearwater County and classified as a class A facility with 15 beds.

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

278.29 	Sec. 48. Minnesota Statutes 2010, section 256B.5012, is amended by adding a 
278.30 	subdivision to read:
278.31 		Subd. 10.ICF/MR rate adjustment. For each facility reimbursed under this 
278.32 	section, except for a facility located in Clearwater County and classified as a class A 
278.33 	facility with 15 beds, the commissioner shall decrease operating payment rates equal to ... 
279.1 	percent of the operating payment rates in effect on June 30, 2011. For each facility, the 
279.2 	commissioner shall apply the rate reduction, based on occupied beds, using the percentage 
279.3 	specified in this subdivision multiplied by the total payment rate, including the variable rate 
279.4 	but excluding the property-related payment rate, in effect on the preceding date. The total 
279.5 	rate reduction shall include the adjustment provided in section 256B.501, subdivision 12.

279.6 	Sec. 49. Minnesota Statutes 2010, section 256G.02, subdivision 6, is amended to read:
279.7 		Subd. 6.Excluded time. "Excluded time" means:
279.8 	(a) any period an applicant spends in a hospital, sanitarium, nursing home, shelter 
279.9 	other than an emergency shelter, halfway house, foster home, semi-independent living 
279.10 	domicile or services program, residential facility offering care, board and lodging facility 
279.11 	or other institution for the hospitalization or care of human beings, as defined in section 
279.12 	144.50, 144A.01, or 245A.02, subdivision 14; maternity home, battered women's shelter, 
279.13 	or correctional facility; or any facility based on an emergency hold under sections 
279.14 	253B.05, subdivisions 1 and 2, and 253B.07, subdivision 6;
279.15 	(b) any period an applicant spends on a placement basis in a training and habilitation 
279.16 	program, including a rehabilitation facility or work or employment program as defined 
279.17 	in section 268A.01; or receiving personal care assistance services pursuant to section 
279.18 	256B.0659; semi-independent living services provided under section 252.275, and 
279.19 	Minnesota Rules, parts 9525.0500 to 9525.0660; day training and habilitation programs 
279.20 	and assisted living services; and
279.21 	(c) any placement for a person with an indeterminate commitment, including 
279.22 	independent living.

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

279.24 	Sec. 50. Laws 2009, chapter 79, article 8, section 4, the effective date, as amended by 
279.25 	Laws 2010, First Special Session chapter 1, article 24, section 12, is amended to read:

279.26 	EFFECTIVE DATE. The This section is effective July 1, 2011 on or after January 
279.27 	1, 2014, for individuals age 21 and older, and on or after October 1, 2019, for individuals 
279.28 	under age 21.

279.29 	Sec. 51. Laws 2009, chapter 79, article 8, section 51, the effective date, as amended by 
279.30 	Laws 2010, First Special Session chapter 1, article 17, section 14, is amended to read:

279.31 	EFFECTIVE DATE. This section is effective July 1, 2011 January 1, 2014.

280.1 	Sec. 52. Laws 2009, chapter 79, article 13, section 3, subdivision 8, as amended by 
280.2 	Laws 2009, chapter 173, article 2, section 1, subdivision 8, and Laws 2010, First Special 
280.3 	Session chapter 1, article 15, section 5, and article 25, section 16, is amended to read:

280.4	Subd. 8.Continuing Care Grants
 					
280.5 	The amounts that may be spent from the 
280.6 	appropriation for each purpose are as follows:

280.7	(a) Aging and Adult Services Grants
		13,499,000
		15,805,000
	
280.8 	Base Adjustment. The general fund base is 
280.9 	increased by $5,751,000 in fiscal year 2012 
280.10 	and $6,705,000 in fiscal year 2013.
280.11 	Information and Assistance 
280.12 	Reimbursement. Federal administrative 
280.13 	reimbursement obtained from information 
280.14 	and assistance services provided by the 
280.15 	Senior LinkAge or Disability Linkage lines 
280.16 	to people who are identified as eligible for 
280.17 	medical assistance shall be appropriated to 
280.18 	the commissioner for this activity.
280.19 	Community Service Development Grant 
280.20 	Reduction. Funding for community service 
280.21 	development grants must be reduced by 
280.22 	$260,000 for fiscal year 2010; $284,000 in 
280.23 	fiscal year 2011; $43,000 in fiscal year 2012; 
280.24 	and $43,000 in fiscal year 2013. Base level 
280.25 	funding shall be restored in fiscal year 2014.
280.26 	Community Service Development Grant 
280.27 	Community Initiative. Funding for 
280.28 	community service development grants shall 
280.29 	be used to offset the cost of aging support 
280.30 	grants. Base level funding shall be restored 
280.31 	in fiscal year 2014.
280.32 	Senior Nutrition Use of Federal Funds.
280.33 	For fiscal year 2010, general fund grants 
280.34 	for home-delivered meals and congregate 
281.1 	dining shall be reduced by $500,000. The 
281.2 	commissioner must replace these general 
281.3 	fund reductions with equal amounts from 
281.4 	federal funding for senior nutrition from the 
281.5 	American Recovery and Reinvestment Act 
281.6 	of 2009.

281.7	(b) Alternative Care Grants
		50,234,000
		48,576,000
	
281.8 	Base Adjustment. The general fund base is 
281.9 	decreased by $3,598,000 in fiscal year 2012 
281.10 	and $3,470,000 in fiscal year 2013.
281.11 	Alternative Care Transfer. Any money 
281.12 	allocated to the alternative care program that 
281.13 	is not spent for the purposes indicated does 
281.14 	not cancel but must be transferred to the 
281.15 	medical assistance account.

281.16
281.17	(c) Medical Assistance Grants; Long-Term 
Care Facilities.
		367,444,000
		419,749,000

281.18
281.19	(d) Medical Assistance Long-Term Care 
Waivers and Home Care Grants
		853,567,000
		1,039,517,000
	
281.20 	Manage Growth in TBI and CADI 
281.21 	Waivers. During the fiscal years beginning 
281.22 	on July 1, 2009, and July 1, 2010, the 
281.23 	commissioner shall allocate money for home 
281.24 	and community-based waiver programs 
281.25 	under Minnesota Statutes, section 256B.49, 
281.26 	to ensure a reduction in state spending that is 
281.27 	equivalent to limiting the caseload growth of 
281.28 	the TBI waiver to 12.5 allocations per month 
281.29 	each year of the biennium and the CADI 
281.30 	waiver to 95 allocations per month each year 
281.31 	of the biennium. Limits do not apply: (1) 
281.32 	when there is an approved plan for nursing 
281.33 	facility bed closures for individuals under 
281.34 	age 65 who require relocation due to the 
281.35 	bed closure; (2) to fiscal year 2009 waiver 
282.1 	allocations delayed due to unallotment; or (3) 
282.2 	to transfers authorized by the commissioner 
282.3 	from the personal care assistance program 
282.4 	of individuals having a home care rating 
282.5 	of "CS," "MT," or "HL." Priorities for the 
282.6 	allocation of funds must be for individuals 
282.7 	anticipated to be discharged from institutional 
282.8 	settings or who are at imminent risk of a 
282.9 	placement in an institutional setting.
282.10 	Manage Growth in DD Waiver. The 
282.11 	commissioner shall manage the growth in 
282.12 	the DD waiver by limiting the allocations 
282.13 	included in the February 2009 forecast to 15 
282.14 	additional diversion allocations each month 
282.15 	for the calendar years that begin on January 
282.16 	1, 2010, and January 1, 2011. Additional 
282.17 	allocations must be made available for 
282.18 	transfers authorized by the commissioner 
282.19 	from the personal care program of individuals 
282.20 	having a home care rating of "CS," "MT," 
282.21 	or "HL."
282.22 	Adjustment to Lead Agency Waiver 
282.23 	Allocations. Prior to the availability of the 
282.24 	alternative license defined in Minnesota 
282.25 	Statutes, section 245A.11, subdivision 8, 
282.26 	the commissioner shall reduce lead agency 
282.27 	waiver allocations for the purposes of 
282.28 	implementing a moratorium on corporate 
282.29 	foster care.
282.30 	Alternatives to Personal Care Assistance 
282.31 	Services. Base level funding of $3,237,000 
282.32 	in fiscal year 2012 and $4,856,000 in 
282.33 	fiscal year 2013 is to implement alternative 
282.34 	services to personal care assistance services 
282.35 	for persons with mental health and other 
283.1 	behavioral challenges who can benefit 
283.2 	from other services that more appropriately 
283.3 	meet their needs and assist them in living 
283.4 	independently in the community. These 
283.5 	services may include, but not be limited to, a 
283.6 	1915(i) state plan option.

283.7	(e) Mental Health Grants

283.8	Appropriations by Fund
	
283.9	General
	77,739,000
	77,739,000
	
283.10	Health Care Access
	750,000
	750,000
	
283.11	Lottery Prize
	1,508,000
	1,508,000
	
283.12 	Funding Usage. Up to 75 percent of a fiscal 
283.13 	year's appropriation for adult mental health 
283.14 	grants may be used to fund allocations in that 
283.15 	portion of the fiscal year ending December 
283.16 	31.

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

283.18	(g) Chemical Dependency Entitlement Grants
		111,303,000
		122,822,000
	
283.19 	Payments for Substance Abuse Treatment.
283.20 	For placements beginning during fiscal years 
283.21 	2010 and 2011, county-negotiated rates and 
283.22 	provider claims to the consolidated chemical 
283.23 	dependency fund must not exceed the lesser 
283.24 	of:
283.25 	(1) rates charged for these services on 
283.26 	January 1, 2009; or
283.27 	(2) 160 percent of the average rate on January 
283.28 	1, 2009, for each group of vendors with 
283.29 	similar attributes.
283.30 	Rates for fiscal years 2010 and 2011 must 
283.31 	not exceed 160 percent of the average rate on 
283.32 	January 1, 2009, for each group of vendors 
283.33 	with similar attributes.
284.1 	Effective July 1, 2010, rates that were above 
284.2 	the average rate on January 1, 2009, are 
284.3 	reduced by five percent from the rates in 
284.4 	effect on June 1, 2010. Rates below the 
284.5 	average rate on January 1, 2009, are reduced 
284.6 	by 1.8 percent from the rates in effect on 
284.7 	June 1, 2010. Services provided under 
284.8 	this section by state-operated services are 
284.9 	exempt from the rate reduction. For services 
284.10 	provided in fiscal years 2012 and 2013, the 
284.11 	statewide aggregate payment under the new 
284.12 	rate methodology to be developed under 
284.13 	Minnesota Statutes, section 254B.12, must 
284.14 	not exceed the projected aggregate payment 
284.15 	under the rates in effect for fiscal year 2011 
284.16 	excluding the rate reduction for rates that 
284.17 	were below the average on January 1, 2009, 
284.18 	plus a state share increase of $3,787,000 for 
284.19 	fiscal year 2012 and $5,023,000 for fiscal 
284.20 	year 2013. Notwithstanding any provision 
284.21 	to the contrary in this article, this provision 
284.22 	expires on June 30, 2013.
284.23 	Chemical Dependency Special Revenue 
284.24 	Account. For fiscal year 2010, $750,000 
284.25 	must be transferred from the consolidated 
284.26 	chemical dependency treatment fund 
284.27 	administrative account and deposited into the 
284.28 	general fund.
284.29 	County CD Share of MA Costs for 
284.30 	ARRA Compliance. Notwithstanding the 
284.31 	provisions of Minnesota Statutes, chapter 
284.32 	254B, for chemical dependency services 
284.33 	provided during the period October 1, 2008, 
284.34 	to December 31, 2010, and reimbursed by 
284.35 	medical assistance at the enhanced federal 
284.36 	matching rate provided under the American 
285.1 	Recovery and Reinvestment Act of 2009, the 
285.2 	county share is 30 percent of the nonfederal 
285.3 	share. This provision is effective the day 
285.4 	following final enactment.

285.5
285.6	(h) Chemical Dependency Nonentitlement 
Grants
		1,729,000
		1,729,000

285.7	(i) Other Continuing Care Grants
		19,201,000
		17,528,000
	
285.8 	Base Adjustment. The general fund base is 
285.9 	increased by $2,639,000 in fiscal year 2012 
285.10 	and increased by $3,854,000 in fiscal year 
285.11 	2013.
285.12 	Technology Grants. $650,000 in fiscal 
285.13 	year 2010 and $1,000,000 in fiscal year 
285.14 	2011 are for technology grants, case 
285.15 	consultation, evaluation, and consumer 
285.16 	information grants related to developing and 
285.17 	supporting alternatives to shift-staff foster 
285.18 	care residential service models.
285.19 	Other Continuing Care Grants; HIV 
285.20 	Grants. Money appropriated for the HIV 
285.21 	drug and insurance grant program in fiscal 
285.22 	year 2010 may be used in either year of the 
285.23 	biennium.
285.24 	Quality Assurance Commission. Effective 
285.25 	July 1, 2009, state funding for the quality 
285.26 	assurance commission under Minnesota 
285.27 	Statutes, section 256B.0951, is canceled.

285.28 	Sec. 53. DIRECTIONS TO COMMISSIONER.
 285.29 		Subdivision 1.Community first choice option. (a) The commissioner shall 
285.30 	provide information on all state-funded grants and medical assistance-funded services and 
285.31 	programs which could be included in the community first choice option, including those in 
285.32 	the continuing care and mental health and children's mental health divisions that provide 
285.33 	assistance in a home or in the community for individuals in the eligibility categories 
285.34 	described in paragraph (b). Recommendations on the grants and programs and the number 
286.1 	of persons who use those grants and programs and would be eligible for home and 
286.2 	community-based attendant services and supports and any changes to Minnesota Statutes 
286.3 	or Minnesota Rules shall be provided to the legislative committees with jurisdiction over 
286.4 	health and human services finance and policy by January 15, 2012.
286.5 	(b) For individuals whose income is less than 150 percent of the federal poverty 
286.6 	guidelines and who qualify for semi-independent living services under Minnesota 
286.7 	Statutes, section 252.275, and epilepsy demonstration project funding, the commissioner 
286.8 	shall assure an assessment under Minnesota Statutes, section 256B.0659, subdivision 3a, 
286.9 	is completed by November 30, 2011, for home and community-based attendant services 
286.10 	and supports.
286.11 		Subd. 2.Co-payments for home and community-based services. Upon federal 
286.12 	approval, the commissioner of human services shall develop and implement a co-payment 
286.13 	schedule for individuals receiving home and community-based services under Minnesota 
286.14 	Statutes, chapter 256B.
286.15 		Subd. 3.Federal waiver amendment. The commissioner shall seek an amendment 
286.16 	to the 1915c home and community-based waivers under Minnesota Statutes, sections 
286.17 	256B.092 and 256B.49, to allow properly licensed residential programs under Minnesota 
286.18 	Statutes, section 245A.02, subdivision 14, to provide residential services to up to eight 
286.19 	individuals with physical or developmental disabilities, chronic illnesses, or traumatic 
286.20 	brain injuries.
286.21 		Subd. 4.Recommendations for personal care assistance service changes. The 
286.22 	commissioner shall consult with stakeholder groups, including counties, advocates, 
286.23 	persons receiving personal care assistance services, and personal care assistance providers, 
286.24 	and make recommendations to the legislature by February 1, 2012, on changes that could 
286.25 	be made to the program to improve oversight, program efficiency, and cost-effectiveness.
286.26 		Subd. 5.Nursing facility pay-for-performance reimbursement system.
 286.27 	The commissioner of human services shall report to the legislative committees with 
286.28 	jurisdiction over nursing facility policy and finance with recommendations for developing 
286.29 	and implementing a pay-for-performance reimbursement system with a quality add-on by 
286.30 	January 15, 2012.
286.31 		Subd. 6.ICF/MR transition plan. The commissioner of human services shall 
286.32 	work with stakeholders to develop and implement a plan by June 30, 2013, to transition 
286.33 	individuals currently residing in intermediate care facilities for persons with developmental 
286.34 	disabilities into the least restrictive community settings possible. The plan must include a 
286.35 	requirement for a cooperative planning process between the counties and providers for 
286.36 	the downsizing or closure of intermediate care facilities for persons with developmental 
287.1 	disabilities, with funding from the bed closures converting to home and community-based 
287.2 	waiver funding to fund services for those leaving the intermediate care facilities for 
287.3 	persons with developmental disabilities based on a plan approved by the commissioner. In 
287.4 	order to facilitate this process, the commissioner shall provide information to facilities and 
287.5 	counties about the number of people in facilities who have requested to move to home and 
287.6 	community-based services. Individuals residing in intermediate care facilities for persons 
287.7 	with developmental disabilities who choose to remain there or whose health or safety 
287.8 	would be put at risk in a less restrictive setting may continue to reside in intermediate care 
287.9 	facilities for persons with developmental disabilities.

287.10 	Sec. 54. STATE PLAN AMENDMENT TO IMPLEMENT SELF-DIRECTED 
287.11 	PERSONAL SUPPORTS.
 287.12 	By July 15, 2011, the commissioner shall submit a state plan amendment to 
287.13 	implement Minnesota Statutes, section 256B.0657, as soon as possible upon federal 
287.14 	approval.

287.15 	Sec. 55. AMENDMENT FOR SELF-DIRECTED COMMUNITY SUPPORTS.
 287.16 	By September 1, 2011, the commissioner shall submit an amendment to the home 
287.17 	and community-based waiver programs consistent with implementing the self-directed 
287.18 	option under Minnesota Statutes, section 256B.0657, through statewide enrolled providers 
287.19 	contracted to provide outreach information, training, and fiscal support entity services to 
287.20 	all eligible recipients choosing this option and with shared care in some types of services. 
287.21 	The waiver amendment shall be consistent with changes in case management services 
287.22 	under Minnesota Statutes, section 256B.092.

287.23 	Sec. 56. ESTABLISHMENT OF RATES FOR SHARED HOME AND 
287.24 	COMMUNITY-BASED WAIVER SERVICES.
 287.25 	By January 1, 2012, the commissioner shall establish rates to be paid for in-home 
287.26 	services and personal supports under all of the home and community-based waiver 
287.27 	services programs consistent with the standards in Minnesota Statutes, section 256B.4912, 
287.28 	subdivision 2.

287.29 	Sec. 57. ESTABLISHMENT OF RATE FOR CASE MANAGEMENT 
287.30 	SERVICES.
 288.1 	By January 1, 2012, the commissioner shall establish the rate to be paid for 
288.2 	case management services under Minnesota Statutes, sections 256B.092 and 256B.49, 
288.3 	consistent with the standards in Minnesota Statutes, section 256B.4912, subdivision 2.

288.4 	Sec. 58. RECOMMENDATIONS FOR FURTHER CASE MANAGEMENT 
288.5 	REDESIGN.
 288.6 	By February 1, 2012, the commissioner of human services shall develop a legislative 
288.7 	report with specific recommendations and language for proposed legislation to be effective 
288.8 	July 1, 2012, for the following:
288.9 	(1) definitions of service and consolidation of standards and rates to the extent 
288.10 	appropriate for all types of medical assistance case management services, including 
288.11 	targeted case management under Minnesota Statutes, sections 256B.0621; 256B.0625, 
288.12 	subdivision 20; and 256B.0924; mental health case management services for children 
288.13 	and adults, all types of home and community-based waiver case management, and case 
288.14 	management under Minnesota Rules, parts 9525.0004 to 9525.0036. This work shall be 
288.15 	completed in collaboration with efforts under Minnesota Statutes, section 256B.4912;
288.16 	(2) recommendations on county of financial responsibility requirements and quality 
288.17 	assurance measures for case management; 
288.18 	(3) identification of county administrative functions that may remain entwined in 
288.19 	case management service delivery models; and
288.20 	(4) implementation of a methodology to fully fund county case management 
288.21 	administrative functions. 

288.22 	Sec. 59. MY LIFE, MY CHOICES TASK FORCE.
 288.23 		Subdivision 1.Establishment. The My Life, My Choices Task Force is established 
288.24 	to create a system of supports and services for people with disabilities governed by the 
288.25 	following principles:
288.26 	(1) freedom to act as a consumer of services in the marketplace;
288.27 	(2) freedom to choose to take as much risk as any other citizen;
288.28 	(3) more choices in levels of service that may vary throughout life;
288.29 	(4) opportunity to work with a trusted partner and fiscal support entity to manage a 
288.30 	personal budget and to be accountable for reporting spending and personal outcomes;
288.31 	(5) opportunity to live with minimal constraints instead of minimal freedoms; and
288.32 	(6) ability to consolidate funding streams into an individualized budget.
288.33 		Subd. 2.Membership. The My Life, My Choices Task Force shall consist of the 
288.34 	lieutenant governor; the commissioner of human services, or designee; a representative of 
289.1 	the Minnesota Chamber of Commerce; and the following to be appointed by the governor: 
289.2 	one administrative law judge, one labor representative, two family members of people 
289.3 	with disabilities, and one individual with disabilities. In addition, the following shall be 
289.4 	appointed jointly by the speaker of the house and the senate Subcommittee on Committees 
289.5 	of the Committee on Rules and Administration, a representative of a disability advocacy 
289.6 	organization; a representative of a disability legal services advocacy organization; 
289.7 	representatives of two nonprofit organizations, one of which serves all 87 counties; and 
289.8 	a representative of a philanthropic organization. Appointed nongovernmental members 
289.9 	of the task force shall serve as staff for the task force and take on the responsibilities of 
289.10 	coordinating meetings, reporting on committee recommendations, and providing other 
289.11 	staff support as needed to meet the responsibilities of the task force as described in 
289.12 	subdivision 3. Legislative appointment of nongovernmental members of the task force 
289.13 	shall be conditioned upon agreement from the appointees to provide staff assistance to 
289.14 	execute the work of the task force. The chairs and ranking minority members of the 
289.15 	legislative committees with jurisdiction over health and human services policy and finance 
289.16 	shall serve as ex officio members.
289.17 		Subd. 3.Duties. The task force shall make recommendations, including proposed 
289.18 	legislation, and report to the legislative committees with jurisdiction over health and 
289.19 	human services policy and finance by November 15, 2011, on creating a system of 
289.20 	supports and services for people with disabilities by July 1, 2012, as governed by the 
289.21 	principles under subdivision 1. In making recommendations and proposed legislation, the 
289.22 	council shall work in conjunction with the Consumer-Directed Community Supports Task 
289.23 	Force and shall include self-directed planning, individual budgeting, choice of trusted 
289.24 	partner, self-directed purchasing of services and supports, reporting of outcomes, ability 
289.25 	to share in any savings, and any additional rules or laws that may need to be waived. 
289.26 	Recommendations from the task force shall be fully implemented by July 1, 2013.
289.27 		Subd. 4.Expense reimbursement. The members of the task force shall not be 
289.28 	reimbursed for expenses related to the duties of the task force. The task force shall be 
289.29 	independently staffed and coordinated by nongovernmental appointees who serve on the 
289.30 	task force, and no state funding shall be appropriated for expenses related to the task 
289.31 	force under this section.
289.32 		Subd. 5.Expiration. The task force expires on July 1, 2013.

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

290.1 	ARTICLE 8
290.2 	REDESIGNING SERVICE DELIVERY

290.3 	Section 1. Minnesota Statutes 2010, section 119B.09, is amended by adding a 
290.4 	subdivision to read:
290.5 		Subd. 4b.Electronic verification. County agencies are authorized to use all 
290.6 	automated databases containing information regarding recipients' or applicants' income 
290.7 	in order to determine eligibility for the child care assistance under this chapter. The 
290.8 	information is sufficient to determine eligibility.

290.9 	Sec. 2. Minnesota Statutes 2010, section 256.01, subdivision 14b, is amended to read:
290.10 		Subd. 14b.American Indian child welfare projects. (a) The commissioner of 
290.11 	human services may authorize projects to test tribal delivery of child welfare services to 
290.12 	American Indian children and their parents and custodians living on the reservation. 
290.13 	The commissioner has authority to solicit and determine which tribes may participate 
290.14 	in a project. Grants may be issued to Minnesota Indian tribes to support the projects. 
290.15 	The commissioner may waive existing state rules as needed to accomplish the projects. 
290.16 	Notwithstanding section 626.556, the commissioner may authorize projects to use 
290.17 	alternative methods of investigating and assessing reports of child maltreatment, provided 
290.18 	that the projects comply with the provisions of section 626.556 dealing with the rights 
290.19 	of individuals who are subjects of reports or investigations, including notice and appeal 
290.20 	rights and data practices requirements. The commissioner may seek any federal approvals 
290.21 	necessary to carry out the projects as well as seek and use any funds available to the 
290.22 	commissioner, including use of federal funds, foundation funds, existing grant funds, 
290.23 	and other funds. The commissioner is authorized to advance state funds as necessary to 
290.24 	operate the projects. Federal reimbursement applicable to the projects is appropriated 
290.25 	to the commissioner for the purposes of the projects. The projects must be required to 
290.26 	address responsibility for safety, permanency, and well-being of children.
290.27 	(b) For the purposes of this section, "American Indian child" means a person under 
290.28 	18 years of age who is a tribal member or eligible for membership in one of the tribes 
290.29 	chosen for a project under this subdivision and who is residing on the reservation of 
290.30 	that tribe.
290.31 	(c) In order to qualify for an American Indian child welfare project, a tribe must:
290.32 	(1) be one of the existing tribes with reservation land in Minnesota;
290.33 	(2) have a tribal court with jurisdiction over child custody proceedings;
291.1 	(3) have a substantial number of children for whom determinations of maltreatment 
291.2 	have occurred;
291.3 	(4) have capacity to respond to reports of abuse and neglect under section 626.556;
291.4 	(5) provide a wide range of services to families in need of child welfare services; and
291.5 	(6) have a tribal-state title IV-E agreement in effect.
291.6 	(d) Grants awarded under this section may be used for the nonfederal costs of 
291.7 	providing child welfare services to American Indian children on the tribe's reservation, 
291.8 	including costs associated with:
291.9 	(1) assessment and prevention of child abuse and neglect;
291.10 	(2) family preservation;
291.11 	(3) facilitative, supportive, and reunification services;
291.12 	(4) out-of-home placement for children removed from the home for child protective 
291.13 	purposes; and
291.14 	(5) other activities and services approved by the commissioner that further the goals 
291.15 	of providing safety, permanency, and well-being of American Indian children.
291.16 	(e) When a tribe has initiated a project and has been approved by the commissioner 
291.17 	to assume child welfare responsibilities for American Indian children of that tribe under 
291.18 	this section, the affected county social service agency is relieved of responsibility for 
291.19 	responding to reports of abuse and neglect under section 626.556 for those children 
291.20 	during the time within which the tribal project is in effect and funded. The commissioner 
291.21 	shall work with tribes and affected counties to develop procedures for data collection, 
291.22 	evaluation, and clarification of ongoing role and financial responsibilities of the county 
291.23 	and tribe for child welfare services prior to initiation of the project. Children who have not 
291.24 	been identified by the tribe as participating in the project shall remain the responsibility 
291.25 	of the county. Nothing in this section shall alter responsibilities of the county for law 
291.26 	enforcement or court services.
291.27 	(f) Participating tribes may conduct children's mental health screenings under section 
291.28 	245.4874, subdivision 1, paragraph (a), clause (14), for children who are eligible for the 
291.29 	initiative and living on the reservation and who meet one of the following criteria:
291.30 	(1) the child must be receiving child protective services;
291.31 	(2) the child must be in foster care; or
291.32 	(3) the child's parents must have had parental rights suspended or terminated.
291.33 	Tribes may access reimbursement from available state funds for conducting the screenings. 
291.34 	Nothing in this section shall alter responsibilities of the county for providing services 
291.35 	under section 245.487.
292.1 	(g) Participating tribes may establish a local child mortality review panel. In 
292.2 	establishing a local child mortality review panel, the tribe agrees to conduct local child 
292.3 	mortality reviews for child deaths or near-fatalities occurring on the reservation under 
292.4 	subdivision 12. Tribes with established child mortality review panels shall have access 
292.5 	to nonpublic data and shall protect nonpublic data under subdivision 12, paragraphs (c) 
292.6 	to (e). The tribe shall provide written notice to the commissioner and affected counties 
292.7 	when a local child mortality review panel has been established and shall provide data upon 
292.8 	request of the commissioner for purposes of sharing nonpublic data with members of the 
292.9 	state child mortality review panel in connection to an individual case.
292.10 	(h) The commissioner shall collect information on outcomes relating to child safety, 
292.11 	permanency, and well-being of American Indian children who are served in the projects. 
292.12 	Participating tribes must provide information to the state in a format and completeness 
292.13 	deemed acceptable by the state to meet state and federal reporting requirements.
292.14 	(i) The commissioner may authorize a project to test the provision of child welfare 
292.15 	services by the White Earth Band of Ojibwe Indians to White Earth member children 
292.16 	who reside in Hennepin County. This project will be subject to all provisions of this 
292.17 	subdivision. Hennepin County shall transfer to the tribe the proportion of property taxes 
292.18 	collected and used to fund child welfare services received by White Earth member 
292.19 	children when the tribe assumes responsibility for providing child welfare services.

292.20 	Sec. 3. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision 
292.21 	to read:
292.22 		Subd. 14c.American Indian child welfare, social, and human services project; 
292.23 	White Earth Band of Ojibwe. (a) The commissioner of human services shall enter into a 
292.24 	contractual agreement as authorized under subdivision 2, paragraph (a), clause (7), with 
292.25 	the White Earth Band of Ojibwe Indians for the tribe to provide all human services and 
292.26 	public assistance programs that are under the supervision of the commissioner to tribal 
292.27 	members who reside on the reservation. Grants may be issued to the White Earth Band 
292.28 	of Ojibwe Indians to support the project. The commissioner may waive existing rules to 
292.29 	support this project. The commissioner shall seek any federal approvals necessary to carry 
292.30 	out the project as well as seek and use any funds available to the commissioner, including 
292.31 	use of federal funds, foundation funds, existing grant funds, and other funds. The 
292.32 	commissioner is authorized to advance state funds as necessary to operate the projects. 
292.33 	Federal reimbursement applicable to the projects is appropriated to the commissioner for 
292.34 	purposes of the project.
293.1 	(b) The commissioner shall redirect all funds provided to Mahnomen County for 
293.2 	these services, including administrative expenses, to the White Earth Band of Ojibwe 
293.3 	Indians.
293.4 	(c) The commissioner, in consultation with the tribe, is authorized to determine: (1) 
293.5 	which programs not currently provided by the White Earth Band of Ojibwe Indians will be 
293.6 	transferred to the tribe; and (2) the process by which the new programs will be transferred. 
293.7 	In the case of a dispute, a two-thirds vote of the tribal council to transfer a program to 
293.8 	the tribe must overrule the decision of the commissioner.
293.9 	(d) When the commissioner approves transfer of programs and the tribe assumes 
293.10 	responsibility under this section, Mahnomen County is relieved of responsibility for 
293.11 	providing program services to tribal members who live on the reservation while the tribal 
293.12 	project is in effect and funded. Mahnomen County shall transfer to the tribe the proportion 
293.13 	of property taxes allocated for funding of the county social services that are assumed by 
293.14 	the tribe.
293.15 	(e) The tribe shall comply with all reporting and record keeping requirements under 
293.16 	state and federal laws and rules.

293.17 	Sec. 4. [256.0145] COMPUTER SYSTEM SIMPLIFICATION.
293.18 		Subdivision 1.Reprogram MAXIS. The commissioner of human services, as part 
293.19 	of the enterprise architecture project, shall reprogram the MAXIS computer system to 
293.20 	automatically apply child support payments entered into the PRISM computer system to 
293.21 	a MAXIS case file.
293.22 		Subd. 2.Program the social service information system. The commissioner of 
293.23 	human services shall require all prepaid health plans to accept a billing format identical to 
293.24 	the MMIS billing format for payment to county agencies for mental health targeted case 
293.25 	management claims, elderly waiver claims, and other claim categories as added to the 
293.26 	benefit set. The commissioner shall make any necessary changes to the SSIS system to 
293.27 	bill prepaid health plans for those claims.

293.28 	Sec. 5. [256.0147] COUNTY ELECTRONIC VERIFICATION TO DETERMINE 
293.29 	ELIGIBILITY.
293.30 	County agencies are authorized to use all automated databases containing 
293.31 	information regarding recipients' or applicants' income in order to determine eligibility 
293.32 	for child support enforcement, general assistance, Minnesota supplemental aid, and 
293.33 	programs, services, and supports under chapter 256J. The information is sufficient to 
293.34 	determine eligibility. State and county caseworkers shall not be cited in error, as part of 
294.1 	any audit and quality review, for an incorrect eligibility determination based on current but 
294.2 	inaccurate information received through a state-approved electronic data source. If there 
294.3 	is a potential error, the reviewer must forward a corrective action notice to the caseworker 
294.4 	for proper and immediate correction. If the state or county caseworker has data available 
294.5 	through client reporting, or other means, that are more accurate than state-approved 
294.6 	electronic data, the caseworker should use the more accurate information in making the 
294.7 	eligibility determination.

294.8 	Sec. 6. Minnesota Statutes 2010, section 256.045, subdivision 4a, is amended to read:
294.9 		Subd. 4a.Case management appeals. (a) Any recipient of case management 
294.10 	services pursuant to section 256B.0625 or 256B.092, or personal care assistance services 
294.11 	under section 256B.0625, who contests the county agency's action, reduction, suspension, 
294.12 	denial, or termination of services,  or failure to act in the provision of those services, 
294.13 	other than a failure to act with reasonable promptness or a suspension, reduction, denial, 
294.14 	or termination of services, must submit a written request for a conciliationan informal 
294.15 	conference with the recipient's case worker and the county social service director or 
294.16 	designee to the county agency. The county agency shall inform the commissioner of the 
294.17 	receipt of a request when it is submitted and shall schedule a conciliation conference
294.18 	within ten days of receipt of the recipient's written request. The county agency shall notify 
294.19 	the recipient, the commissioner, and all interested persons of the time, date, and location 
294.20 	of the conciliation conference. The commissioner may assist the county by providing 
294.21 	mediation services or by identifying other resources that may assist in the mediation 
294.22 	between the parties. Within 30 15 days of the conference, the county agency shall conduct 
294.23 	the conciliation conference and inform the recipient in writing of the action the county 
294.24 	agency is going to take and when that action will be taken and notify the recipient of the 
294.25 	right to a hearing under this subdivision. The conciliation conference shall be conducted 
294.26 	in a manner consistent with the commissioner's instructions.
294.27 	(b) If the county fails to conduct the conciliation conference and issue its report 
294.28 	within 3015 days, or, at any time up to 90 days after the conciliation conference is held, 
294.29 	a recipient may submit to the commissioner a written request for a hearing before a 
294.30 	state human services referee to determine whether case management services have been 
294.31 	provided in accordance with applicable laws and rules or whether the county agency has 
294.32 	assured that the services identified in the recipient's individual service plan have been 
294.33 	delivered in accordance with the laws and rules governing the provision of those services. 
294.34 	The state human services referee shall recommend an order to the commissioner, who 
294.35 	shall, in accordance with the procedure in subdivision 5, issue a final order within 60 days 
295.1 	of the receipt of the request for a hearing, unless the commissioner refuses to accept the 
295.2 	recommended order, in which event a final order shall issue within 90 days of the receipt 
295.3 	of that request. The order may direct the county agency to take those actions necessary to 
295.4 	comply with applicable laws or rules. The commissioner may issue a temporary order 
295.5 	prohibiting the demission of a recipient of case management services from a residential 
295.6 	or day habilitation program licensed under chapter 245A, while a county agency review 
295.7 	process or an appeal brought by a recipient under this subdivision is pending, or for the 
295.8 	period of time necessary for the county agency to implement the commissioner's order. 
295.9 	The commissioner shall not issue a final order staying the demission of a recipient of 
295.10 	case management services from a residential or day habilitation program licensed under 
295.11 	chapter 245A.
295.12 	(c) Any recipient of case management services under section 256B.0625 or 
295.13 	256B.092, or personal care assistance services under section 256B.0625, must be 
295.14 	informed in writing at the time of application and at the time of any change in services 
295.15 	of the recipient's right to submit a written request to the county agency for an informal 
295.16 	conference with the case manager and the county social services director.

295.17 	Sec. 7. Minnesota Statutes 2010, section 256B.69, is amended by adding a subdivision 
295.18 	to read:
295.19 		Subd. 30.Provision of required materials in alternative formats. (a) For the 
295.20 	purposes of this subdivision, "alternative format" means a medium other than paper and 
295.21 	"prepaid health plan" means managed care plans and county-based purchasing plans.
295.22 	(b) A prepaid health plan may provide in an alternative format a provider directory 
295.23 	and certificate of coverage, or materials otherwise required to be available in writing 
295.24 	under Code of Federal Regulations, title 42, section 438.10, or under the commissioner's 
295.25 	contract with the prepaid health plan, if the following conditions are met:
295.26 	(1) the prepaid health plan, local agency, or commissioner, as applicable, informs the 
295.27 	enrollee that:
295.28 	(i) provision in an alternative format is available and the enrollee affirmatively 
295.29 	requests of the prepaid health plan that the provider directory, certificate of coverage, 
295.30 	or materials otherwise required under Code of Federal Regulations, title 42, section 
295.31 	438.10, or under the commissioner's contract with the prepaid health plan be provided in 
295.32 	an alternative format; and
295.33 	(ii) a record of the enrollee request is retained by the prepaid health plan in the 
295.34 	form of written direction from the enrollee or a documented telephone call followed by a 
296.1 	confirmation letter to the enrollee from the prepaid health plan that explains that the 
296.2 	enrollee may change the request at any time;
296.3 	(2) the materials are sent to a secured mailbox and are made available at a 
296.4 	password-protected secured Web site or on a data storage device if the materials contain 
296.5 	enrollee data that is individually identifiable;
296.6 	(3) the enrollee is provided a customer service number on the enrollee's membership 
296.7 	card that may be called to request a paper version of the materials provided in an 
296.8 	alternative format; and
296.9 	(4) the materials provided in an alternative format meet all other requirements of 
296.10 	the commissioner regarding content, size of typeface, and any required time frames for 
296.11 	distribution. "Required time frames for distribution" must permit sufficient time for 
296.12 	prepaid health plans to distribute materials in alternative formats upon receipt of enrollees' 
296.13 	requests for the materials.
296.14 	(c) A prepaid health plan may provide in an alternative format its primary care 
296.15 	network list to the commissioner and to local agencies within its service area. The 
296.16 	commissioner or local agency, as applicable, shall inform a potential enrollee of the 
296.17 	availability of a prepaid health plan's primary care network list in an alternative format. If 
296.18 	the potential enrollee requests an alternative format of the prepaid health plan's primary 
296.19 	care network list, a record of that request shall be retained by the commissioner or local 
296.20 	agency. The potential enrollee is permitted to withdraw the request at any time.
296.21 	The prepaid health plan shall submit sufficient paper versions of the primary 
296.22 	care network list to the commissioner and to local agencies within its service area to 
296.23 	accommodate potential enrollee requests for paper versions of the primary care network 
296.24 	list.
296.25 	(d) A prepaid health plan may provide in an alternative format materials otherwise 
296.26 	required to be available in writing under Code of Federal Regulations, title 42, section 
296.27 	438.10, or under the commissioner's contract with the prepaid health plan, if the conditions 
296.28 	of paragraphs (b), (c), and (e), are met for persons who are:
296.29 	(1) enrolled in integrated Medicare and Medicaid programs under subdivisions 
296.30 	23 and 28;
296.31 	(2) enrolled in managed care long-term care programs under subdivision 6b;
296.32 	(3) dually eligible for Medicare and medical assistance; or
296.33 	(4) in the waiting period for Medicare.
296.34 	(e) The commissioner shall seek any federal Medicaid waivers within 90 days after 
296.35 	the effective date of this subdivision that are necessary to provide alternative formats of 
296.36 	required material to enrollees of prepaid health plans as authorized under this subdivision.
297.1 	(f) The commissioner shall consult with managed care plans, county-based 
297.2 	purchasing plans, counties, and other interested parties to determine how materials 
297.3 	required to be made available to enrollees under Code of Federal Regulations, title 42, 
297.4 	section 438.10, or under the commissioner's contract with a prepaid health plan may 
297.5 	be provided in an alternative format on the basis that the enrollee has not opted in to 
297.6 	receive the alternative format. The commissioner shall consult with managed care 
297.7 	plans, county-based purchasing plans, counties, and other interested parties to develop 
297.8 	recommendations relating to the conditions that must be met for an opt-out process 
297.9 	to be granted.

297.10 	Sec. 8. Minnesota Statutes 2010, section 256D.09, subdivision 6, is amended to read:
297.11 		Subd. 6.Recovery of overpayments. (a) If an amount of general assistance or 
297.12 	family general assistance is paid to a recipient in excess of the payment due, it shall be 
297.13 	recoverable by the county agency. The agency shall give written notice to the recipient of 
297.14 	its intention to recover the overpayment.
297.15 	(b) Except as provided for interim assistance in section 256D.06, subdivision 
297.16 	5, when an overpayment occurs, the county agency shall recover the overpayment 
297.17 	from a current recipient by reducing the amount of aid payable to the assistance unit of 
297.18 	which the recipient is a member, for one or more monthly assistance payments, until 
297.19 	the overpayment is repaid. All county agencies in the state shall reduce the assistance 
297.20 	payment by three percent of the assistance unit's standard of need in nonfraud cases and 
297.21 	ten percent where fraud has occurred, or the amount of the monthly payment, whichever is 
297.22 	less, for all overpayments.
297.23 	(c) In cases when there is both an overpayment and underpayment, the county 
297.24 	agency shall offset one against the other in correcting the payment.
297.25 	(d) Overpayments may also be voluntarily repaid, in part or in full, by the individual, 
297.26 	in addition to the aid reductions provided in this subdivision, to include further voluntary 
297.27 	reductions in the grant level agreed to in writing by the individual, until the total amount 
297.28 	of the overpayment is repaid.
297.29 	(e) The county agency shall make reasonable efforts to recover overpayments to 
297.30 	persons no longer on assistance under standards adopted in rule by the commissioner 
297.31 	of human services. The county agency need not attempt to recover overpayments of 
297.32 	less than $35 paid to an individual no longer on assistance if the individual does not 
297.33 	receive assistance again within three years, unless the individual has been convicted of 
297.34 	violating section 256.98.
298.1 	(f) Establishment of an overpayment is limited to 12 months prior to the month of 
298.2 	discovery due to agency error and six years prior to the month of discovery due to client 
298.3 	error or an intentional program violation determined under section 256.046.

298.4 	Sec. 9. Minnesota Statutes 2010, section 256D.49, subdivision 3, is amended to read:
298.5 		Subd. 3.Overpayment of monthly grants and recovery of ATM errors. (a) When 
298.6 	the county agency determines that an overpayment of the recipient's monthly payment 
298.7 	of Minnesota supplemental aid has occurred, it shall issue a notice of overpayment 
298.8 	to the recipient. If the person is no longer receiving Minnesota supplemental aid, the 
298.9 	county agency may request voluntary repayment or pursue civil recovery. If the person is 
298.10 	receiving Minnesota supplemental aid, the county agency shall recover the overpayment 
298.11 	by withholding an amount equal to three percent of the standard of assistance for the 
298.12 	recipient or the total amount of the monthly grant, whichever is less. 
298.13 	(b) Establishment of an overpayment is limited to 12 months from the date of 
298.14 	discovery due to agency error and six years prior to the month of discovery due to client 
298.15 	error or an intentional program violation determined under section 256.046.
298.16 	(c) For recipients receiving benefits via electronic benefit transfer, if the overpayment 
298.17 	is a result of an automated teller machine (ATM) dispensing funds in error to the recipient, 
298.18 	the agency may recover the ATM error by immediately withdrawing funds from the 
298.19 	recipient's electronic benefit transfer account, up to the amount of the error. 
298.20 	(d) Residents of nursing homes, regional treatment centers, andlicensed residential 
298.21 	facilities with negotiated rates shall not have overpayments recovered from their personal 
298.22 	needs allowance.

298.23 	Sec. 10. Minnesota Statutes 2010, section 256J.38, subdivision 1, is amended to read:
298.24 		Subdivision 1.Scope of overpayment. (a) When a participant or former participant 
298.25 	receives an overpayment due to agency, client, or ATM error, or due to assistance received 
298.26 	while an appeal is pending and the participant or former participant is determined 
298.27 	ineligible for assistance or for less assistance than was received, the county agency must 
298.28 	recoup or recover the overpayment using the following methods:
298.29 	(1) reconstruct each affected budget month and corresponding payment month;
298.30 	(2) use the policies and procedures that were in effect for the payment month; and
298.31 	(3) do not allow employment disregards in section 256J.21, subdivision 3 or 4, in the 
298.32 	calculation of the overpayment when the unit has not reported within two calendar months 
298.33 	following the end of the month in which the income was received. 
299.1 	(b) Establishment of an overpayment is limited to 12 months prior to the month of 
299.2 	discovery due to agency error and six years prior to the month of discovery due to client 
299.3 	error or an intentional program violation determined under section 256.046.

299.4 	Sec. 11. Minnesota Statutes 2010, section 393.07, subdivision 10, is amended to read:
299.5 		Subd. 10.Food stamp program; Maternal and Child Nutrition Act. (a) The local 
299.6 	social services agency shall establish and administer the food stamp program according 
299.7 	to rules of the commissioner of human services, the supervision of the commissioner as 
299.8 	specified in section 256.01, and all federal laws and regulations. The commissioner of 
299.9 	human services shall monitor food stamp program delivery on an ongoing basis to ensure 
299.10 	that each county complies with federal laws and regulations. Program requirements to be 
299.11 	monitored include, but are not limited to, number of applications, number of approvals, 
299.12 	number of cases pending, length of time required to process each application and deliver 
299.13 	benefits, number of applicants eligible for expedited issuance, length of time required 
299.14 	to process and deliver expedited issuance, number of terminations and reasons for 
299.15 	terminations, client profiles by age, household composition and income level and sources, 
299.16 	and the use of phone certification and home visits. The commissioner shall determine the 
299.17 	county-by-county and statewide participation rate.
299.18 	(b) On July 1 of each year, the commissioner of human services shall determine a 
299.19 	statewide and county-by-county food stamp program participation rate. The commissioner 
299.20 	may designate a different agency to administer the food stamp program in a county if the 
299.21 	agency administering the program fails to increase the food stamp program participation 
299.22 	rate among families or eligible individuals, or comply with all federal laws and regulations 
299.23 	governing the food stamp program. The commissioner shall review agency performance 
299.24 	annually to determine compliance with this paragraph.
299.25 	(c) A person who commits any of the following acts has violated section 256.98 or 
299.26 	609.821, or both, and is subject to both the criminal and civil penalties provided under 
299.27 	those sections:
299.28 	(1) obtains or attempts to obtain, or aids or abets any person to obtain by means of a 
299.29 	willful statement or misrepresentation, or intentional concealment of a material fact, food 
299.30 	stamps or vouchers issued according to sections 145.891 to 145.897 to which the person 
299.31 	is not entitled or in an amount greater than that to which that person is entitled or which 
299.32 	specify nutritional supplements to which that person is not entitled; or
299.33 	(2) presents or causes to be presented, coupons or vouchers issued according to 
299.34 	sections 145.891 to 145.897 for payment or redemption knowing them to have been 
299.35 	received, transferred or used in a manner contrary to existing state or federal law; or
300.1 	(3) willfully uses, possesses, or transfers food stamp coupons, authorization to 
300.2 	purchase cards or vouchers issued according to sections 145.891 to 145.897 in any manner 
300.3 	contrary to existing state or federal law, rules, or regulations; or
300.4 	(4) buys or sells food stamp coupons, authorization to purchase cards, other 
300.5 	assistance transaction devices, vouchers issued according to sections 145.891 to 145.897, 
300.6 	or any food obtained through the redemption of vouchers issued according to sections 
300.7 	145.891 to 145.897 for cash or consideration other than eligible food.
300.8 	(d) A peace officer or welfare fraud investigator may confiscate food stamps, 
300.9 	authorization to purchase cards, or other assistance transaction devices found in the 
300.10 	possession of any person who is neither a recipient of the food stamp program nor 
300.11 	otherwise authorized to possess and use such materials. Confiscated property shall be 
300.12 	disposed of as the commissioner may direct and consistent with state and federal food 
300.13 	stamp law. The confiscated property must be retained for a period of not less than 30 days 
300.14 	to allow any affected person to appeal the confiscation under section 256.045.
300.15 	(e) Food stamp overpayment claims which are due in whole or in part to client error 
300.16 	shall be established by the county agency for a period of six years from the date of any 
300.17 	resultant overpayment Establishment of an overpayment is limited to 12 months prior to 
300.18 	the month of discovery due to agency error and six years prior to the month of discovery 
300.19 	due to client error or an intentional program violation determined under section 256.046.
300.20 	(f) With regard to the federal tax revenue offset program only, recovery incentives 
300.21 	authorized by the federal food and consumer service shall be retained at the rate of 50 
300.22 	percent by the state agency and 50 percent by the certifying county agency.
300.23 	(g) A peace officer, welfare fraud investigator, federal law enforcement official, 
300.24 	or the commissioner of health may confiscate vouchers found in the possession of any 
300.25 	person who is neither issued vouchers under sections 145.891 to 145.897, nor otherwise 
300.26 	authorized to possess and use such vouchers. Confiscated property shall be disposed of 
300.27 	as the commissioner of health may direct and consistent with state and federal law. The 
300.28 	confiscated property must be retained for a period of not less than 30 days.
300.29 	(h) The commissioner of human services may seek a waiver from the United States 
300.30 	Department of Agriculture to allow the state to specify foods that may and may not be 
300.31 	purchased in Minnesota with benefits funded by the federal Food Stamp Program. The 
300.32 	commissioner shall consult with the members of the house of representatives and senate 
300.33 	policy committees having jurisdiction over food support issues in developing the waiver. 
300.34 	The commissioner, in consultation with the commissioners of health and education, shall 
300.35 	develop a broad public health policy related to improved nutrition and health status. The 
300.36 	commissioner must seek legislative approval prior to implementing the waiver.

301.1 	Sec. 12. Minnesota Statutes 2010, section 402A.10, subdivision 4, is amended to read:
301.2 		Subd. 4.Essential human services or essential services. "Essential human 
301.3 	services" or "essential services" means assistance and services to recipients or potential 
301.4 	recipients of public welfare and other services delivered by counties or tribes that are 
301.5 	mandated in federal and state law that are to be available in all counties of the state.

301.6 	Sec. 13. Minnesota Statutes 2010, section 402A.10, subdivision 5, is amended to read:
301.7 		Subd. 5.Service delivery authority. "Service delivery authority" means a single 
301.8 	county, or group consortium of counties operating by execution of a joint powers 
301.9 	agreement under section 471.59 or other contractual agreement, that has voluntarily 
301.10 	chosen by resolution of the county board of commissioners to participate in the redesign 
301.11 	under this chapter or has been assigned by the commissioner pursuant to section 402A.18. 
301.12 	A service delivery authority includes an Indian tribe or group of tribes that have voluntarily 
301.13 	chosen by resolution of tribal government to participate in redesign under this chapter.

301.14 	Sec. 14. Minnesota Statutes 2010, section 402A.15, is amended to read:
301.15 	402A.15 STEERING COMMITTEE ON PERFORMANCE AND OUTCOME 
301.16 	REFORMS.
301.17 		Subdivision 1.Duties. (a) The Steering Committee on Performance and Outcome 
301.18 	Reforms shall develop a uniform process to establish and review performance and outcome 
301.19 	standards for all essential human services based on the current level of resources available, 
301.20 	and to shall develop appropriate reporting measures and a uniform accountability process 
301.21 	for responding to a county's or human service delivery authority's failure to make adequate 
301.22 	progress on achieving performance measures. The accountability process shall focus on 
301.23 	the performance measures rather than inflexible implementation requirements.
301.24 	(b) The steering committee shall:
301.25 	(1) by November 1, 2009, establish an agreed-upon list of essential services;
301.26 	(2) by February 15, 2010, develop and recommend to the legislature a uniform, 
301.27 	graduated process, in addition to the remedies identified in section 402A.18, for responding 
301.28 	to a county's failure to make adequate progress on achieving performance measures; and
301.29 	(3) by December 15, 2012, for each essential service, make recommendations 
301.30 	to the legislature regarding (1) (i) performance measures and goals based on those 
301.31 	measures for each essential service, (2) and (ii) a system for reporting on the performance 
301.32 	measures and goals, and (3) appropriate resources, including funding, needed to achieve 
301.33 	those performance measures and goals. The resource recommendations shall take into 
301.34 	consideration program demand and the unique differences of local areas in geography and 
302.1 	the populations served. Priority shall be given to services with the greatest variation in 
302.2 	availability and greatest administrative demands. By January 15 of each year starting 
302.3 	January 15, 2011, the steering committee shall report its recommendations to the governor 
302.4 	and legislative committees with jurisdiction over health and human services. As part of its 
302.5 	report, the steering committee shall, as appropriate, recommend statutory provisions, rules 
302.6 	and requirements, and reports that should be repealed or eliminated.
302.7 	(c) As far as possible, the performance measures, reporting system, and funding 
302.8 	shall be consistent across program areas. The development of performance measures shall 
302.9 	consider the manner in which data will be collected and performance will be reported. 
302.10 	The steering committee shall consider state and local administrative costs related to 
302.11 	collecting data and reporting outcomes when developing performance measures. The 
302.12 	steering committee shall correlate the performance measures and goals to available levels 
302.13 	of resources, including state and local funding. The steering committee shall also identify 
302.14 	and incorporate federal performance measures in its recommendations for those program 
302.15 	areas where federal funding is contingent on meeting federal performance standards. The 
302.16 	steering committee shall take into consideration that the goal of implementing changes 
302.17 	to program monitoring and reporting the progress toward achieving outcomes is to 
302.18 	significantly minimize the cost of administrative requirements and to allow funds freed 
302.19 	by reduced administrative expenditures to be used to provide additional services, allow 
302.20 	flexibility in service design and management, and focus energies on achieving program 
302.21 	and client outcomes.
302.22 	(d) In making its recommendations, the steering committee shall consider input from 
302.23 	the council established in section 402A.20. The steering committee shall review the 
302.24 	measurable goals established in a memorandum of understanding entered into under 
302.25 	section 402A.30, subdivision 2, paragraph (b), and consider whether they may be applied 
302.26 	as statewide performance outcomes.
302.27 	(e) The steering committee shall form work groups that include persons who provide 
302.28 	or receive essential services and representatives of organizations who advocate on behalf 
302.29 	of those persons.
302.30 	(f) By December 15, 2009, the steering committee shall establish a three-year 
302.31 	schedule for completion of its work. The schedule shall be published on the Department of 
302.32 	Human Services Web site and reported to the legislative committees with jurisdiction over 
302.33 	health and human services. In addition, the commissioner shall post quarterly updates on 
302.34 	the progress of the steering committee on the Department of Human Services Web site.
302.35 		Subd. 2.Composition. (a) The steering committee shall include:
303.1 	(1) the commissioner of human services, or designee, and two additional 
303.2 	representatives of the department;
303.3 	(2) two county commissioners, representative of rural and urban counties, selected 
303.4 	by the Association of Minnesota Counties;
303.5 	(3) two county directors of human services, representative of rural and urban 
303.6 	counties, selected by the Minnesota Association of County Social Service Administrators; 
303.7 	and
303.8 	(4) three clients or client advocates representing different populations receiving 
303.9 	services from the Department of Human Services, who are appointed by the commissioner.
303.10 	(b) The commissioner, or designee, and a county commissioner shall serve as 
303.11 	cochairs of the committee. The committee shall be convened within 60 days of May 
303.12 	15, 2009.
303.13 	(c) State agency staff shall serve as informational resources and staff to the steering 
303.14 	committee. Statewide county associations may assemble county program data as required.
303.15 	(d) To promote information sharing and coordination between the steering committee 
303.16 	and council, one of the county representatives from paragraph (a), clause (2), and one of the 
303.17 	county representatives from paragraph (a), clause (3), must also serve as a representative 
303.18 	on the council under section 402A.20, subdivision 1, paragraph (b), clause (5) or (6).

303.19 	Sec. 15. Minnesota Statutes 2010, section 402A.18, is amended to read:
303.20 	402A.18 COMMISSIONER POWER TO REMEDY FAILURE TO MEET 
303.21 	PERFORMANCE OUTCOMES.
303.22 		Subdivision 1.Underperforming county; specific service. If the commissioner 
303.23 	determines that a county or service delivery authority is deficient in achieving minimum 
303.24 	performance outcomes for a specific essential service, the commissioner may impose the 
303.25 	following remedies and adjust state and federal program allocations accordingly:
303.26 	(1) voluntary incorporation of the administration and operation of the specific 
303.27 	essential service with an existing service delivery authority or another county. A 
303.28 	service delivery authority or county incorporating an underperforming county shall 
303.29 	not be financially liable for the costs associated with remedying performance outcome 
303.30 	deficiencies;
303.31 	(2) mandatory incorporation of the administration and operation of the specific 
303.32 	essential service with an existing service delivery authority or another county. A 
303.33 	service delivery authority or county incorporating an underperforming county shall 
303.34 	not be financially liable for the costs associated with remedying performance outcome 
303.35 	deficiencies; or 
304.1 	(3) transfer of authority for program administration and operation of the specific 
304.2 	essential service to the commissioner.
304.3 		Subd. 2.Underperforming county; more than one-half of service services. If 
304.4 	the commissioner determines that a county or service delivery authority is deficient in 
304.5 	achieving minimum performance outcomes for more than one-half of the defined essential 
304.6 	service services, the commissioner may impose the following remedies:
304.7 	(1) voluntary incorporation of the administration and operation of the specific
304.8 	essential service services with an existing service delivery authority or another county. 
304.9 	A service delivery authority or county incorporating an underperforming county shall 
304.10 	not be financially liable for the costs associated with remedying performance outcome 
304.11 	deficiencies;
304.12 	(2) mandatory incorporation of the administration and operation of the specific
304.13 	essential service services with an existing service delivery authority or another county. 
304.14 	A service delivery authority or county incorporating an underperforming county shall 
304.15 	not be financially liable for the costs associated with remedying performance outcome 
304.16 	deficiencies; or 
304.17 	(3) transfer of authority for program administration and operation of the specific
304.18 	essential service services to the commissioner.
304.19 		Subd. 2a.Financial responsibility of underperforming county. A county subject 
304.20 	to remedies under subdivision 1 or 2 shall provide to the entity assuming administration of 
304.21 	the essential service or essential services the amount of nonfederal and nonstate funding 
304.22 	needed to remedy performance outcome deficiencies.
304.23 		Subd. 3.Conditions prior to imposing remedies. Before the commissioner may 
304.24 	impose the remedies authorized under this section, the following conditions must be met:
304.25 	(1) the county or service delivery authority determined by the commissioner 
304.26 	to be deficient in achieving minimum performance outcomes has the opportunity, in 
304.27 	coordination with the council, to develop a program outcome improvement plan. The 
304.28 	program outcome improvement plan must be developed no later than six months from the 
304.29 	date of the deficiency determination; and
304.30 	(2) the council has conducted an assessment of the program outcome improvement 
304.31 	plan to determine if the county or service delivery authority has made satisfactory 
304.32 	progress toward performance outcomes and has made a recommendation about remedies 
304.33 	to the commissioner. The review assessment and recommendation must be made to the 
304.34 	commissioner within 12 months from the date of the deficiency determination.

305.1 	Sec. 16. Minnesota Statutes 2010, section 402A.20, is amended to read:
305.2 	402A.20 COUNCIL.
305.3 		Subdivision 1.Council. (a) The State-County Results, Accountability, and Service 
305.4 	Delivery Redesign Council is established. Appointed council members must be appointed 
305.5 	by their respective agencies, associations, or governmental units by November 1, 2009. 
305.6 	The council shall be cochaired by the commissioner of human services, or designee, and a 
305.7 	county representative from paragraph (b), clause (4) or (5), appointed by the Association 
305.8 	of Minnesota Counties. Recommendations of the council must be approved by a majority 
305.9 	of the voting council members. The provisions of section 15.059 do not apply to this 
305.10 	council, and this council does not expire.
305.11 	(b) The council must consist of the following members:
305.12 	(1) two legislators appointed by the speaker of the house, one from the minority 
305.13 	and one from the majority;
305.14 	(2) two legislators appointed by the Senate Rules Committee, one from the majority 
305.15 	and one from the minority;
305.16 	(3) the commissioner of human services, or designee, and three employees from 
305.17 	the department;
305.18 	(4) two county commissioners appointed by the Association of Minnesota Counties;
305.19 	(5) two county representatives appointed by the Minnesota Association of County 
305.20 	Social Service Administrators; 
305.21 	(6) one representative appointed by AFSCME as a nonvoting member; and
305.22 	(7) one representative appointed by the Teamsters as a nonvoting member.
305.23 	(c) Administrative support to the council may be provided by the Association of 
305.24 	Minnesota Counties and affiliates.
305.25 	(d) Member agencies and associations are responsible for initial and subsequent 
305.26 	appointments to the council.
305.27 		Subd. 2.Council duties. The council shall:
305.28 	(1) provide review of the service delivery redesign process, including proposed 
305.29 	memoranda of understanding to establish a service delivery authority to conduct and 
305.30 	administer experimental projects to test new methods and procedures of delivering 
305.31 	services;
305.32 	(2) certify, in accordance with section 402A.30, subdivision 4, the formation of 
305.33 	a service delivery authority, including the memorandum of understanding in section 
305.34 	402A.30, subdivision 2, paragraph (b);
306.1 	(3) ensure the consistency of the memorandum of understanding entered into 
306.2 	under section 402A.30, subdivision 2, paragraph (b), with the performance standards 
306.3 	recommended by the steering committee and enacted by the legislature;
306.4 	(4) (2) ensure the consistency of the memorandum of understanding, to the extent 
306.5 	appropriate, or with other memorandum of understanding entered into by other service 
306.6 	delivery authorities; 
306.7 	(3) review and make recommendations on applications from a service delivery 
306.8 	authority for waivers of statutory or rule program requirements that are needed for 
306.9 	flexibility to determine the most cost-effective means of achieving specified measurable 
306.10 	goals in a redesign of human services delivery;
306.11 	(5) (4) establish a process to take public input on the service delivery framework 
306.12 	specified in the memorandum of understanding in section 402A.30, subdivision 2, 
306.13 	paragraph (b) scope of essential services over which a service delivery authority has 
306.14 	jurisdiction;
306.15 	(6) (5) form work groups as necessary to carry out the duties of the council under the 
306.16 	redesign;
306.17 	(7) (6) serve as a forum for resolving conflicts among participating counties and 
306.18 	tribes or between participating counties or tribes and the commissioner of human services, 
306.19 	provided nothing in this section is intended to create a formal binding legal process;
306.20 	(8) (7) engage in the program improvement process established in section 402A.18, 
306.21 	subdivision 3; and
306.22 	(9) (8) identify and recommend incentives for counties and tribes to participate in 
306.23 	human services service delivery authorities.
306.24 		Subd. 3.Program evaluation. By December 15, 2014, the council shall request 
306.25 	consideration by the legislative auditor for a reevaluation under section 3.971, subdivision 
306.26 	7, of those aspects of the program evaluation of human services administration reported 
306.27 	in January 2007 affected by this chapter.

306.28 	Sec. 17. [402A.35] DESIGNATION OF SERVICE DELIVERY AUTHORITY.
306.29 		Subdivision 1.Requirements for establishing a service delivery authority.
 306.30 	(a) A county, tribe, or consortium of counties is eligible to establish a service delivery 
306.31 	authority if:
306.32 	(1) the county, tribe, or consortium of counties is:
306.33 	(i) a single county with a population of 55,000 or more;
306.34 	(ii) a consortium of counties with a total combined population of 55,000 or more;
307.1 	(iii) a consortium of four or more counties in reasonable geographic proximity 
307.2 	without regard to population; or
307.3 	(iv) one or more tribes with a total combined population of 25,000 or more.
307.4 	The council may recommend that the commissioner of human services exempt a 
307.5 	single county, tribe, or consortium of counties from the minimum population standard if 
307.6 	the county, tribe, or consortium of counties can demonstrate that it can otherwise meet 
307.7 	the requirements of this chapter.
307.8 	(b) A service delivery authority shall:
307.9 	(1) comply with current state and federal law, including any existing federal or state 
307.10 	performance measures and performance measures under section 402A.15 when they are 
307.11 	enacted into law, except where waivers are approved by the commissioner. Nothing 
307.12 	in this subdivision requires the establishment of performance measures under section 
307.13 	402A.15 prior to a service delivery authority participating in the service delivery redesign 
307.14 	under this chapter;
307.15 	(2) define the scope of essential services over which the service delivery authority 
307.16 	has jurisdiction;
307.17 	(3) designate a single administrative structure to oversee the delivery of those 
307.18 	services included in a proposal for a redesigned service or services and identify a single 
307.19 	administrative agent for purposes of contact and communication with the department;
307.20 	(4) identify the waivers from statutory or rule program requirements that are needed 
307.21 	to ensure greater local control and flexibility to determine the most cost-effective means of 
307.22 	achieving specified measurable goals that the participating service delivery authority is 
307.23 	expected to achieve;
307.24 	(5) set forth a reasonable level of targeted reductions in overhead and administrative 
307.25 	costs for each service delivery authority participating in the service delivery redesign; and
307.26 	(6) set forth the terms under which a county, tribe, or consortium of counties may 
307.27 	withdraw from participation.
307.28 	(c) Once a county, tribe, or consortium of counties establishes a service delivery 
307.29 	authority, no county, tribe, or consortium of counties that is a member of the service 
307.30 	delivery authority may participate as a member of any other service delivery authority. 
307.31 	The service delivery authority may allow an additional county, a tribe, or a consortium of 
307.32 	counties to join the service delivery authority subject to the approval of the council and 
307.33 	the commissioner.
307.34 	(d) Nothing in this chapter precludes local governments from using sections 465.81 
307.35 	and 465.82 to establish procedures for local governments to merge, with the consent 
307.36 	of the voters. Nothing in this chapter limits the authority of a county board or tribal 
308.1 	council to enter into contractual agreements for services not covered by the provisions 
308.2 	of a memorandum of understanding establishing a service delivery authority with other 
308.3 	agencies or with other units of government.
308.4 		Subd. 2.Relief from statutory requirements. (a) Unless otherwise identified in 
308.5 	the memorandum of understanding, any county, tribe, or consortium of counties forming a 
308.6 	service delivery authority is exempt from the provisions of sections 245.465; 245.4835; 
308.7 	245.4874; 245.492, subdivision 2; 245.4932; 256F.13; 256J.626, subdivision 2, paragraph 
308.8 	(b); and 256M.30.
308.9 	(b) This subdivision does not preclude any county, tribe, or consortium of counties 
308.10 	forming a service delivery authority from requesting additional waivers from statutory and 
308.11 	rule requirements to ensure greater local control and flexibility.
308.12 		Subd. 3.Duties. The service delivery authority shall:
308.13 	(1) within the scope of essential services set forth in the memorandum of 
308.14 	understanding establishing the authority, carry out the responsibilities required of local 
308.15 	agencies under chapter 393 and human services boards under chapter 402;
308.16 	(2) manage the public resources devoted to human services and other public services 
308.17 	delivered or purchased by the counties or tribes that are subsidized or regulated by the 
308.18 	Department of Human Services under chapters 245 to 261;
308.19 	(3) employ staff to assist in carrying out its duties;
308.20 	(4) develop and maintain a continuity of operations plan to ensure the continued 
308.21 	operation or resumption of essential human services functions in the event of any business 
308.22 	interruption according to local, state, and federal emergency planning requirements;
308.23 	(5) receive and expend funds received for the redesign process under the 
308.24 	memorandum of understanding;
308.25 	(6) plan and deliver services directly or through contract with other governmental, 
308.26 	tribal, or nongovernmental providers;
308.27 	(7) rent, purchase, sell, and otherwise dispose of real and personal property as 
308.28 	necessary to carry out the redesign; and
308.29 	(8) carry out any other service designated as a responsibility of a county.
308.30 		Subd. 4.Process for establishing a service delivery authority. (a) The county, 
308.31 	tribe, or consortium of counties meeting the requirements of section 402A.30 and 
308.32 	proposing to establish a service delivery authority shall present to the council:
308.33 	(1) in conjunction with the commissioner, a proposed memorandum of understanding 
308.34 	meeting the requirements of subdivision 1, paragraph (b), and outlining:
308.35 	(i) the details of the proposal;
309.1 	(ii) the state, tribal, and local resources, which may include, but are not limited to, 
309.2 	funding, administrative and technology support, and other requirements necessary for 
309.3 	the service delivery authority; and
309.4 	(iii) the relief available to the service delivery authority if the resource commitments 
309.5 	identified in item (ii) are not met; and
309.6 	(2) a board resolution from the board of commissioners of each participating county 
309.7 	stating the county's intent to participate, or in the case of a tribe, a resolution from tribal 
309.8 	government, stating the tribe's intent to participate.
309.9 	(b) After the council has considered and recommended approval of a proposed 
309.10 	memorandum of understanding, the commissioner may finalize and execute the 
309.11 	memorandum of understanding.
309.12 		Subd. 5.Commissioner authority to seek waivers. The commissioner may use the 
309.13 	authority under section 256.01, subdivision 2, paragraph (l), to grant waivers identified as 
309.14 	part of a proposed service delivery authority under subdivision 1, paragraph (b), clause 
309.15 	(4), except that waivers granted under this section must be approved by the council under 
309.16 	section 402A.20 rather than the Legislative Advisory Committee.

309.17 	Sec. 18. ALIGNMENT OF VERIFICATION AND REDETERMINATION 
309.18 	POLICIES.
 309.19 	The commissioner of human services shall develop recommendations to align 
309.20 	eligibility verification procedures for all health care, economic assistance, food support, 
309.21 	child support enforcement, and child care programs. The commissioner shall report back 
309.22 	to the chairs of the legislative committees with jurisdiction over these issues by January 
309.23 	15, 2012, with recommendations and draft legislation to implement the alignment of 
309.24 	eligibility verifications.

309.25 	Sec. 19. ALTERNATIVE STRATEGIES FOR CERTAIN 
309.26 	REDETERMINATIONS.
 309.27 	The commissioner of human services shall develop and implement by January 15, 
309.28 	2012, a simplified process to redetermine eligibility for recipient populations in the medical 
309.29 	assistance, Minnesota supplemental aid, food support, and group residential housing 
309.30 	programs who are eligible based upon disability, age, or chronic medical conditions, and 
309.31 	who are expected to experience minimal change in income or assets from month to month. 
309.32 	The commissioner shall apply for any federal waivers needed to implement this section.

309.33 	Sec. 20. REQUEST FOR PROPOSALS; COMBINED ONLINE APPLICATION.
 310.1 	(a) The commissioner of human services shall issue a request for proposals for a 
310.2 	contract to implement a phased-in integrated online eligibility and application portal for 
310.3 	health care programs, if federal matching funds are available. The health care portal must 
310.4 	be developed in phases with the capacity to integrate food support, cash assistance, and 
310.5 	child care programs as funds are available. The request for proposals must require that the 
310.6 	system recommended and implemented by the contractor:
310.7 	(1) streamline eligibility determination and case processing in the state to support 
310.8 	statewide eligibility processing;
310.9 	(2) enable interested persons to determine eligibility for each program, and to apply 
310.10 	for programs online in a manner that the applicant will be asked only those questions that 
310.11 	relate to the programs the person is applying for;
310.12 	(3) leverage technology that has been operational in production in other similar 
310.13 	state environments; and
310.14 	(4) include Web-based application and worker application processing support and 
310.15 	opportunity for expansion.
310.16 	(b) If responses to the request for proposals meet the requirements set forth, the 
310.17 	commissioner shall enter into a contract for the services specified in paragraph (a) by 
310.18 	January 31, 2012. The contract may incorporate a performance-based vendor financing 
310.19 	option whereby the vendor shares the risk of the project's success. If the commissioner 
310.20 	determines there is no adequate response to the request for proposals, the commissioner 
310.21 	shall report this to the chairs and ranking minority members of the legislative committees 
310.22 	with jurisdiction over health and human services prior to January 31, 2012.

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

310.24 	Sec. 21.  REPEALER.
 310.25 	(a) Minnesota Statutes 2010, sections 402A.30; and 402A.45, are repealed.
310.26 	(b) Minnesota Rules, part 9500.1243, subpart 3, is repealed.

310.27 	ARTICLE 9
310.28 	CHEMICAL AND MENTAL HEALTH

310.29 	Section 1. Minnesota Statutes 2010, section 246B.10, is amended to read:
310.30 	246B.10 LIABILITY OF COUNTY; REIMBURSEMENT.
310.31 	The civilly committed sex offender's county shall pay to the state a portion of the 
310.32 	cost of care provided in the Minnesota sex offender program to a civilly committed sex 
310.33 	offender who has legally settled in that county. A county's payment must be made from 
311.1 	the county's own sources of revenue and payments must equal ten 30 percent of the cost of 
311.2 	care, as determined by the commissioner, for each day or portion of a day, that the civilly 
311.3 	committed sex offender spends at the facility. If payments received by the state under this 
311.4 	chapter exceed 90 70 percent of the cost of care, the county is responsible for paying the 
311.5 	state the remaining amount. The county is not entitled to reimbursement from the civilly 
311.6 	committed sex offender, the civilly committed sex offender's estate, or from the civilly 
311.7 	committed sex offender's relatives, except as provided in section 246B.07.

311.8 	EFFECTIVE DATE. This section is effective for all individuals who are civilly 
311.9 	committed to the Minnesota sex offender program on or after August 1, 2011.

311.10 	Sec. 2. Minnesota Statutes 2010, section 252.025, subdivision 7, is amended to read:
311.11 		Subd. 7.Minnesota extended treatment options. The commissioner shall develop 
311.12 	by July 1, 1997, the Minnesota extended treatment options to serve Minnesotans who 
311.13 	have developmental disabilities and exhibit severe behaviors which present a risk to 
311.14 	public safety. This program is statewide and must provide specialized residential services 
311.15 	in Cambridge and an array of community-based services with sufficient levels of care 
311.16 	and a sufficient number of specialists to ensure that individuals referred to the program 
311.17 	receive the appropriate care. The individuals working in the community-based services 
311.18 	under this section are state employees supervised by the commissioner of human services. 
311.19 	No midcontract layoffs shall occur as a result of restructuring under this section, but 
311.20 	layoffs may occur as a normal consequence of a low census or closure of the facility 
311.21 	due to decreased census.

311.22 	Sec. 3. Minnesota Statutes 2010, section 253B.212, is amended to read:
311.23 	253B.212 COMMITMENT; RED LAKE BAND OF CHIPPEWA INDIANS; 
311.24 	WHITE EARTH BAND OF OJIBWE.
311.25 		Subdivision 1.Cost of care; commitment by tribal court order; Red Lake 
311.26 	Band of Chippewa Indians. The commissioner of human services may contract with 
311.27 	and receive payment from the Indian Health Service of the United States Department of 
311.28 	Health and Human Services for the care and treatment of those members of the Red 
311.29 	Lake Band of Chippewa Indians who have been committed by tribal court order to the 
311.30 	Indian Health Service for care and treatment of mental illness, developmental disability, or 
311.31 	chemical dependency. The contract shall provide that the Indian Health Service may not 
311.32 	transfer any person for admission to a regional center unless the commitment procedure 
312.1 	utilized by the tribal court provided due process protections similar to those afforded 
312.2 	by sections 253B.05 to 253B.10.
312.3 		Subd. 1a.Cost of care; commitment by tribal court order; White Earth Band of 
312.4 	Ojibwe Indians. The commissioner of human services may contract with and receive 
312.5 	payment from the Indian Health Service of the United States Department of Health and 
312.6 	Human Services for the care and treatment of those members of the White Earth Band 
312.7 	of Ojibwe Indians who have been committed by tribal court order to the Indian Health 
312.8 	Service for care and treatment of mental illness, developmental disability, or chemical 
312.9 	dependency. The tribe may also contract directly with the commissioner for treatment 
312.10 	of those members of the White Earth Band who have been committed by tribal court 
312.11 	order to the White Earth Department of Health for care and treatment of mental illness, 
312.12 	developmental disability, or chemical dependency. The contract shall provide that the 
312.13 	Indian Health Service and the White Earth Band shall not transfer any person for admission 
312.14 	to a regional center unless the commitment procedure utilized by the tribal court provided 
312.15 	due process protections similar to those afforded by sections 253B.05 to 253B.10.
312.16 		Subd. 2.Effect given to tribal commitment order. When, under an agreement 
312.17 	entered into pursuant to subdivision 1 subdivisions 1 or 1a, the Indian Health Service 
312.18 	applies to a regional center for admission of a person committed to the jurisdiction of the 
312.19 	health service by the tribal court as a person who is mentally ill, developmentally disabled, 
312.20 	or chemically dependent, the commissioner may treat the patient with the consent of 
312.21 	the Indian Health Service.
312.22 	A person admitted to a regional center pursuant to this section has all the rights 
312.23 	accorded by section 253B.03. In addition, treatment reports, prepared in accordance with 
312.24 	the requirements of section 253B.12, subdivision 1, shall be filed with the Indian Health 
312.25 	Service within 60 days of commencement of the patient's stay at the facility. A subsequent 
312.26 	treatment report shall be filed with the Indian Health Service within six months of the 
312.27 	patient's admission to the facility or prior to discharge, whichever comes first. Provisional 
312.28 	discharge or transfer of the patient may be authorized by the head of the treatment facility 
312.29 	only with the consent of the Indian Health Service. Discharge from the facility to the 
312.30 	Indian Health Service may be authorized by the head of the treatment facility after notice 
312.31 	to and consultation with the Indian Health Service.

312.32 	Sec. 4. Minnesota Statutes 2010, section 254B.03, subdivision 1, is amended to read:
312.33 		Subdivision 1.Local agency duties. (a) Every local agency shall provide chemical 
312.34 	dependency services to persons residing within its jurisdiction who meet criteria 
312.35 	established by the commissioner for placement in a chemical dependency residential 
313.1 	or nonresidential treatment service subject to the limitations on residential chemical 
313.2 	dependency treatment in section 254B.04, subdivision 1. Chemical dependency money 
313.3 	must be administered by the local agencies according to law and rules adopted by the 
313.4 	commissioner under sections 14.001 to 14.69.
313.5 	(b) In order to contain costs, the commissioner of human services shall select eligible 
313.6 	vendors of chemical dependency services who can provide economical and appropriate 
313.7 	treatment. Unless the local agency is a social services department directly administered by 
313.8 	a county or human services board, the local agency shall not be an eligible vendor under 
313.9 	section 254B.05. The commissioner may approve proposals from county boards to provide 
313.10 	services in an economical manner or to control utilization, with safeguards to ensure that 
313.11 	necessary services are provided. If a county implements a demonstration or experimental 
313.12 	medical services funding plan, the commissioner shall transfer the money as appropriate.
313.13 	(c) A culturally specific vendor that provides assessments under a variance under 
313.14 	Minnesota Rules, part 9530.6610, shall be allowed to provide assessment services to 
313.15 	persons not covered by the variance.

313.16 	Sec. 5. Minnesota Statutes 2010, section 254B.03, subdivision 4, is amended to read:
313.17 		Subd. 4.Division of costs. Except for services provided by a county under 
313.18 	section 254B.09, subdivision 1, or services provided under section 256B.69 or 256D.03, 
313.19 	subdivision 4, paragraph (b), the county shall, out of local money, pay the state for 
313.20 	16.14 22.95 percent of the cost of chemical dependency services, including those services 
313.21 	provided to persons eligible for medical assistance under chapter 256B and general 
313.22 	assistance medical care under chapter 256D. Counties may use the indigent hospitalization 
313.23 	levy for treatment and hospital payments made under this section. 16.14 22.95 percent 
313.24 	of any state collections from private or third-party pay, less 15 percent for the cost of 
313.25 	payment and collections, must be distributed to the county that paid for a portion of the 
313.26 	treatment under this section.

313.27 	EFFECTIVE DATE. This section is effective for claims processed beginning 
313.28 	July 1, 2011.

313.29 	Sec. 6. Minnesota Statutes 2010, section 254B.04, subdivision 1, is amended to read:
313.30 		Subdivision 1.Eligibility. (a) Persons eligible for benefits under Code of Federal 
313.31 	Regulations, title 25, part 20, persons eligible for medical assistance benefits under 
313.32 	sections 256B.055, 256B.056, and 256B.057, subdivisions 1, 2, 5, and 6, or who meet 
313.33 	the income standards of section 256B.056, subdivision 4, and persons eligible for general 
313.34 	assistance medical care under section 256D.03, subdivision 3, are entitled to chemical 
314.1 	dependency fund services subject to the following limitations: (1) no more than three 
314.2 	residential chemical dependency treatment episodes for the same person in a four-year 
314.3 	period of time unless the person meets the criteria established by the commissioner of 
314.4 	human services; and (2) no more than four residential chemical dependency treatment 
314.5 	episodes in a lifetime unless the person meets the criteria established by the commissioner 
314.6 	of human services. State money appropriated for this paragraph must be placed in a 
314.7 	separate account established for this purpose. 
314.8 	Persons with dependent children who are determined to be in need of chemical 
314.9 	dependency treatment pursuant to an assessment under section 626.556, subdivision 10, or 
314.10 	a case plan under section 260C.201, subdivision 6, or 260C.212, shall be assisted by the 
314.11 	local agency to access needed treatment services. Treatment services must be appropriate 
314.12 	for the individual or family, which may include long-term care treatment or treatment in a 
314.13 	facility that allows the dependent children to stay in the treatment facility. The county 
314.14 	shall pay for out-of-home placement costs, if applicable. 
314.15 	(b) A person not entitled to services under paragraph (a), but with family income 
314.16 	that is less than 215 percent of the federal poverty guidelines for the applicable family 
314.17 	size, shall be eligible to receive chemical dependency fund services within the limit 
314.18 	of funds appropriated for this group for the fiscal year. If notified by the state agency 
314.19 	of limited funds, a county must give preferential treatment to persons with dependent 
314.20 	children who are in need of chemical dependency treatment pursuant to an assessment 
314.21 	under section 626.556, subdivision 10, or a case plan under section 260C.201, subdivision 
314.22 	6, or 260C.212. A county may spend money from its own sources to serve persons under 
314.23 	this paragraph. State money appropriated for this paragraph must be placed in a separate 
314.24 	account established for this purpose. 
314.25 	(c) Persons whose income is between 215 percent and 412 percent of the federal 
314.26 	poverty guidelines for the applicable family size shall be eligible for chemical dependency 
314.27 	services on a sliding fee basis, within the limit of funds appropriated for this group for the 
314.28 	fiscal year. Persons eligible under this paragraph must contribute to the cost of services 
314.29 	according to the sliding fee scale established under subdivision 3. A county may spend 
314.30 	money from its own sources to provide services to persons under this paragraph. State 
314.31 	money appropriated for this paragraph must be placed in a separate account established 
314.32 	for this purpose.

314.33 	EFFECTIVE DATE. This section is effective for all chemical dependency 
314.34 	residential treatment beginning on or after July 1, 2011.

315.1 	Sec. 7. Minnesota Statutes 2010, section 254B.04, is amended by adding a subdivision 
315.2 	to read:
315.3 		Subd. 2a.Eligibility for treatment in residential settings. Notwithstanding 
315.4 	provisions of Minnesota Rules, part 9530.6622, subparts 5 and 6, related to an assessor's 
315.5 	discretion in making placements to residential treatment settings, a person eligible for 
315.6 	services under this section must score at level 4 on assessment dimensions related to 
315.7 	relapse, continued use, and recovery environment in order to be assigned to services with 
315.8 	a room and board component reimbursed under this section.

315.9 	Sec. 8. Minnesota Statutes 2010, section 254B.06, subdivision 2, is amended to read:
315.10 		Subd. 2.Allocation of collections. The commissioner shall allocate all federal 
315.11 	financial participation collections to a special revenue account. The commissioner shall 
315.12 	allocate 83.86 77.05 percent of patient payments and third-party payments to the special 
315.13 	revenue account and 16.14 22.95 percent to the county financially responsible for the 
315.14 	patient.

315.15 	EFFECTIVE DATE. This section is effective for claims processed beginning 
315.16 	July 1, 2011.

315.17 	Sec. 9. Minnesota Statutes 2010, section 256B.0625, subdivision 41, is amended to 
315.18 	read:
315.19 		Subd. 41.Residential services for children with severe emotional disturbance.
 315.20 	Medical assistance covers rehabilitative services in accordance with section 256B.0945
315.21 	that are provided by a county or an American Indian tribe through a residential facility, 
315.22 	for children who have been diagnosed with severe emotional disturbance and have been 
315.23 	determined to require the level of care provided in a residential facility.

315.24 	EFFECTIVE DATE. This section is effective October 1, 2011.

315.25 	Sec. 10. Minnesota Statutes 2010, section 256B.0945, subdivision 4, is amended to 
315.26 	read:
315.27 		Subd. 4.Payment rates. (a) Notwithstanding sections 256B.19 and 256B.041, 
315.28 	payments to counties for residential services provided by a residential facility shall only 
315.29 	be made of federal earnings for services provided under this section, and the nonfederal 
315.30 	share of costs for services provided under this section shall be paid by the county from 
315.31 	sources other than federal funds or funds used to match other federal funds. Payment to 
315.32 	counties for services provided according to this section shall be a proportion of the per 
316.1 	day contract rate that relates to rehabilitative mental health services and shall not include 
316.2 	payment for costs or services that are billed to the IV-E program as room and board.
316.3 	(b) Per diem rates paid to providers under this section by prepaid plans shall be 
316.4 	the proportion of the per-day contract rate that relates to rehabilitative mental health 
316.5 	services and shall not include payment for group foster care costs or services that are 
316.6 	billed to the county of financial responsibility. Services provided in facilities located in 
316.7 	bordering states are eligible for reimbursement on a fee-for-service basis only as described 
316.8 	in paragraph (a) and are not covered under prepaid health plans.
316.9 	(c) Payment for mental health rehabilitative services provided under this section by 
316.10 	or under contract with an American Indian tribe or tribal organization or by agencies 
316.11 	operated by or under contract with an American Indian tribe or tribal organization must 
316.12 	be made according to section 256B.0625, subdivision 34, or other relevant federally 
316.13 	approved rate-setting methodology.
316.14 	(d) The commissioner shall set aside a portion not to exceed five percent of the 
316.15 	federal funds earned for county expenditures under this section to cover the state costs of 
316.16 	administering this section. Any unexpended funds from the set-aside shall be distributed 
316.17 	to the counties in proportion to their earnings under this section.

316.18 	EFFECTIVE DATE. This section is effective October 1, 2011.

316.19 	Sec. 11. COMMUNITY MENTAL HEALTH SERVICES; USE OF 
316.20 	BEHAVIORAL HEALTH HOSPITALS.
 316.21 	The commissioner shall issue a written report to the chairs and ranking minority 
316.22 	members of the house and senate committees with jurisdiction of health and human 
316.23 	services by December 31, 2011, on how the community behavioral health hospital 
316.24 	facilities will be fully utilized to meet the mental health needs of regions in which the 
316.25 	hospitals are located. The commissioner must consult with the regional planning work 
316.26 	groups for adult mental health and must include the recommendations of the work groups 
316.27 	in the legislative report. The report must address future use of community behavioral 
316.28 	health hospitals that are not certified as Medicaid eligible by CMS or have a less than 65 
316.29 	percent licensed bed occupancy rate, and using the facilities for another purpose that will 
316.30 	meet the mental health needs of residents of the region. The regional planning work 
316.31 	groups shall work with the commissioner to prioritize the needs of their regions. These 
316.32 	priorities, by region, must be included in the commissioner's report to the legislature.

316.33 	Sec. 12. INTEGRATED DUAL DIAGNOSIS TREATMENT.
 317.1 	(a) The commissioner shall require individuals who perform chemical dependency 
317.2 	assessments or mental health assessments to use approved screening tools in order to 
317.3 	identify whether an individual who is the subject of the assessment has a co-occurring 
317.4 	mental health or chemical dependency disorder. Screening for co-occurring disorders must 
317.5 	begin no later than December 31, 2011.
317.6 	(b) No later than October 1, 2011, the commissioner shall develop and implement a 
317.7 	certification process for integrated dual diagnosis treatment providers.
317.8 	(c) No later than December 31, 2011, the commissioner shall develop and implement 
317.9 	a referral system so that individuals who, at screening, are identified with co-occurring 
317.10 	disorders are referred to certified integrated dual diagnosis treatment providers.
317.11 	(d) The commissioner shall apply for any federal waivers necessary to secure, to the 
317.12 	extent allowed by law, federal financial participation for the provision of integrated dual 
317.13 	diagnosis treatment to persons with co-occurring disorders.

317.14 	Sec. 13. CLOSURE OF STATE-OPERATED SERVICES FACILITIES.
 317.15 	(a) The commissioner shall close the Willmar Community Behavioral Health 
317.16 	Hospital no later than October 1, 2011.
317.17 	(b) The commissioner shall close the inpatient child and adolescent behavioral 
317.18 	health services program in Willmar, the subacute mental health facility in Wadena, and 
317.19 	the Community Behavioral Health Hospitals in Alexandria, Annandale, Baxter, Bemidji, 
317.20 	Fergus Falls, and Rochester no later than October 1, 2012.
317.21 	(c) The commissioner shall present a plan to the legislative committees with 
317.22 	jurisdiction over health and human services finance no later than January 15, 2012, on 
317.23 	how the department will:
317.24 	(1) accommodate the mental health needs of clients impacted by the closure of 
317.25 	these state-operated services facilities; and
317.26 	(2) accommodate the state employees adversely affected by the closure of these 
317.27 	facilities.

317.28 	Sec. 14. REGIONAL TREATMENT CENTERS; EMPLOYEES; REPORT.
 317.29 	(a) No layoffs shall occur as a result of restructuring services at the Anoka-Metro 
317.30 	Regional Treatment Center.
317.31 	(b) The commissioner shall issue a report to the legislative committees with 
317.32 	jurisdiction over health and human services finance no later than December 31, 2011, 
317.33 	which provides the number of employees in management positions at the Anoka-Metro 
318.1 	Regional Treatment Center and the Minnesota Security Hospital at St. Peter and the ratio 
318.2 	of management to direct-care staff for each facility.

318.3 	Sec. 15. COMMISSIONER'S CRITERIA FOR RESIDENTIAL TREATMENT.
 318.4 	The commissioner shall develop specific criteria to approve treatment for individuals 
318.5 	who require residential chemical dependency treatment in excess of the maximum allowed 
318.6 	in section 254B.04, subdivision 1, due to co-occurring disorders, including disorders 
318.7 	related to cognition, traumatic brain injury, or documented disability. Criteria shall be 
318.8 	developed for use no later than October 1, 2011.

318.9 	Sec. 16.  REPEALER.
 318.10 	Laws 2009, chapter 79, article 3, section 18, as amended by Laws 2010, First Special 
318.11 	Session chapter 1, article 19, section 19, is repealed.

318.12 	ARTICLE 10
318.13 	HEALTH AND HUMAN SERVICES APPROPRIATIONS

318.14	Section 1.  SUMMARY OF APPROPRIATIONS.
 	
318.15 	The amounts shown in this section summarize direct appropriations, by fund, made 
318.16 	in this article.

318.17			2012
		2013
		Total
	
318.18	General
	$
	5,551,038,000
	$
	5,192,190,000
	$
	10,743,228,000
	
318.19
318.20	State Government Special 
Revenue
		63,198,000
		63,154,000
		126,352,000
	
318.21	Health Care Access
		398,372,000
		400,962,000
		799,334,000
	
318.22	Federal TANF
		274,091,000
		282,814,000
		556,905,000
	
318.23	Lottery Prize Fund
		1,584,000
		1,587,000
		3,171,000
	
318.24	Total
	$
	6,288,283,000
	$
	5,940,707,000
	$
	12,228,990,000

318.25	Sec. 2. HUMAN SERVICES APPROPRIATIONS.
 	
318.26 	The sums shown in the columns marked "Appropriations" are appropriated to the 
318.27 	agencies and for the purposes specified in this article. The appropriations are from the 
318.28 	general fund, or another named fund, and are available for the fiscal years indicated 
318.29 	for each purpose. The figures "2012" and "2013" used in this article mean that the 
318.30 	appropriations listed under them are available for the fiscal year ending June 30, 2012, or 
318.31 	June 30, 2013, respectively. "The first year" is fiscal year 2012. "The second year" is fiscal 
318.32 	year 2013. "The biennium" is fiscal years 2012 and 2013.

319.1				APPROPRIATIONS
	
319.2				Available for the Year
	
319.3				Ending June 30
	
319.4					2012
		2013

319.5
319.6	Sec. 3. COMMISSIONER OF HUMAN 
SERVICES

319.7	Subdivision 1.Total Appropriation
 	$
	6,117,437,000
	$
	5,779,413,000

319.8	Appropriations by Fund
	
319.9		2012
	2013
	
319.10	General
	5,468,249,000
	5,114,297,000
	
319.11
319.12	State Government 
Special Revenue
	565,000
	565,000
	
319.13	Health Care Access
	384,661,000
	391,863,000
	
319.14	Federal TANF
	262,378,000
	271,101,000
	
319.15	Lottery Prize Fund
	1,584,000
	1,587,000
	
319.16 	Receipts for Systems Projects. 
319.17 	Appropriations and federal receipts for 
319.18 	information systems projects for MAXIS, 
319.19 	PRISM, MMIS, and SSIS must be deposited 
319.20 	in the state systems account authorized in 
319.21 	Minnesota Statutes, section 256.014. Money 
319.22 	appropriated for computer projects approved 
319.23 	by the Minnesota Office of Enterprise 
319.24 	Technology, funded by the legislature, 
319.25 	and approved by the commissioner of 
319.26 	Minnesota Management and Budget, may 
319.27 	be transferred from one project to another 
319.28 	and from development to operations as the 
319.29 	commissioner of human services considers 
319.30 	necessary. Any unexpended balance in 
319.31 	the appropriation for these projects does 
319.32 	not cancel but is available for ongoing 
319.33 	development and operations.
319.34 	Nonfederal Share Transfers. The 
319.35 	nonfederal share of activities for which 
319.36 	federal administrative reimbursement is 
320.1 	appropriated to the commissioner may be 
320.2 	transferred to the special revenue fund.
320.3 	TANF Maintenance of Effort.
320.4 	(a) In order to meet the basic maintenance 
320.5 	of effort (MOE) requirements of the TANF 
320.6 	block grant specified under Code of Federal 
320.7 	Regulations, title 45, section 263.1, the 
320.8 	commissioner may only report nonfederal 
320.9 	money expended for allowable activities 
320.10 	listed in the following clauses as TANF/MOE 
320.11 	expenditures:
320.12 	(1) MFIP cash, diversionary work program, 
320.13 	and food assistance benefits under Minnesota 
320.14 	Statutes, chapter 256J;
320.15 	(2) the child care assistance programs 
320.16 	under Minnesota Statutes, sections 119B.03 
320.17 	and 119B.05, and county child care 
320.18 	administrative costs under Minnesota 
320.19 	Statutes, section 119B.15;
320.20 	(3) state and county MFIP administrative 
320.21 	costs under Minnesota Statutes, chapters 
320.22 	256J and 256K;
320.23 	(4) state, county, and tribal MFIP 
320.24 	employment services under Minnesota 
320.25 	Statutes, chapters 256J and 256K;
320.26 	(5) expenditures made on behalf of 
320.27 	noncitizen MFIP recipients who qualify 
320.28 	for the medical assistance without federal 
320.29 	financial participation program under 
320.30 	Minnesota Statutes, section 256B.06, 
320.31 	subdivision 4, paragraphs (d), (e), and (j);
320.32 	(6) qualifying working family credit 
320.33 	expenditures under Minnesota Statutes, 
320.34 	section 290.0671; and
321.1 	(7) qualifying Minnesota education credit 
321.2 	expenditures under Minnesota Statutes, 
321.3 	section 290.0674.
321.4 	(b) The commissioner shall ensure that 
321.5 	sufficient qualified nonfederal expenditures 
321.6 	are made each year to meet the state's 
321.7 	TANF/MOE requirements. For the activities 
321.8 	listed in paragraph (a), clauses (2) to 
321.9 	(7), the commissioner may only report 
321.10 	expenditures that are excluded from the 
321.11 	definition of assistance under Code of 
321.12 	Federal Regulations, title 45, section 260.31.
321.13 	(c) For fiscal years beginning with state fiscal 
321.14 	year 2003, the commissioner shall assure 
321.15 	that the maintenance of effort used by the 
321.16 	commissioner of management and budget 
321.17 	for the February and November forecasts 
321.18 	required under Minnesota Statutes, section 
321.19 	16A.103, contains expenditures under 
321.20 	paragraph (a), clause (1), equal to at least 16 
321.21 	percent of the total required under Code of 
321.22 	Federal Regulations, title 45, section 263.1.
321.23 	(d) Minnesota Statutes, section 256.011, 
321.24 	subdivision 3, which requires that federal 
321.25 	grants or aids secured or obtained under that 
321.26 	subdivision be used to reduce any direct 
321.27 	appropriations provided by law, do not apply 
321.28 	if the grants or aids are federal TANF funds.
321.29 	(e) Notwithstanding any contrary provision 
321.30 	in this article, paragraph (a), clauses (1) to 
321.31 	(7), and paragraphs (b) to (d), expire June 
321.32 	30, 2015.
321.33 	Working Family Credit Expenditures 
321.34 	as TANF/MOE. The commissioner may 
321.35 	claim as TANF maintenance of effort up to 
322.1 	$6,707,000 per year of working family credit 
322.2 	expenditures for fiscal years 2012 and 2013.
322.3 	Working Family Credit Expenditures 
322.4 	to be Claimed for TANF/MOE. The 
322.5 	commissioner may count the following 
322.6 	amounts of working family credit 
322.7 	expenditures as TANF/MOE:
322.8 	(1) fiscal year 2012, $12,037,000;
322.9 	(2) fiscal year 2013, $29,942,000;
322.10 	(3) fiscal year 2014, $23,235,000; and
322.11 	(4) fiscal year 2015, $23,198,000.
322.12 	Notwithstanding any contrary provision in 
322.13 	this article, this rider expires June 30, 2015.
322.14 	TANF Transfer to Federal Child Care 
322.15 	and Development Fund. (a) The following 
322.16 	TANF fund amounts are appropriated 
322.17 	to the commissioner for purposes of 
322.18 	MFIP/Transition Year Child Care Assistance 
322.19 	under Minnesota Statutes, section 119B.05:
322.20 	(1) fiscal year 2012, $11,020,000;
322.21 	(2) fiscal year 2013, $35,020,000;
322.22 	(3) fiscal year 2014, $14,020,000; and
322.23 	(4) fiscal year 2015, $14,020,000.
322.24 	(b) The commissioner shall authorize the 
322.25 	transfer of sufficient TANF funds to the 
322.26 	federal child care and development fund to 
322.27 	meet this appropriation and shall ensure that 
322.28 	all transferred funds are expended according 
322.29 	to federal child care and development fund 
322.30 	regulations.
322.31 	Food Stamps Employment and Training 
322.32 	Funds. (a) Notwithstanding Minnesota 
322.33 	Statutes, sections 256D.051, subdivisions 1a, 
323.1 	6b, and 6c, and 256J.626, federal food stamps 
323.2 	employment and training funds received 
323.3 	as reimbursement for child care assistance 
323.4 	program expenditures must be deposited in 
323.5 	the general fund. The amount of funds must 
323.6 	be limited to $500,000 per year in fiscal 
323.7 	years 2012 through 2015, contingent upon 
323.8 	approval by the federal Food and Nutrition 
323.9 	Service.
323.10 	(b) Consistent with the receipt of these 
323.11 	federal funds, the commissioner may 
323.12 	adjust the level of working family credit 
323.13 	expenditures claimed as TANF maintenance 
323.14 	of effort. Notwithstanding any contrary 
323.15 	provision in this article, this rider expires 
323.16 	June 30, 2015.
323.17 	ARRA Food Support Benefit Increases. 
323.18 	The funds provided for food support benefit 
323.19 	increases under the Supplemental Nutrition 
323.20 	Assistance Program provisions of the 
323.21 	American Recovery and Reinvestment Act 
323.22 	(ARRA) of 2009 must be used for benefit 
323.23 	increases beginning July 1, 2009.
323.24 	Supplemental Security Interim Assistance 
323.25 	Reimbursement Funds. $2,800,000 of 
323.26 	uncommitted revenue available to the 
323.27 	commissioner of human services for SSI 
323.28 	advocacy and outreach services must be 
323.29 	transferred to and deposited into the general 
323.30 	fund by June 30, 2012.

323.31	Subd. 2.Central Office Operations
 					
323.32 	The amounts that may be spent from this 
323.33 	appropriation for each purpose are as follows:

323.34	(a) Operations

324.1	Appropriations by Fund
	
324.2	General
	81,119,000
	80,932,000
	
324.3	Health Care Access
	11,742,000
	11,508,000
	
324.4
324.5	State Government 
Special Revenue
	440,000
	440,000
	
324.6	Federal TANF
	222,000
	222,000
	
324.7 	DHS Receipt Center Accounting. The 
324.8 	commissioner is authorized to transfer 
324.9 	appropriations to, and account for DHS 
324.10 	receipt center operations in, the special 
324.11 	revenue fund.
324.12 	Base Adjustment. The general fund base 
324.13 	for fiscal year 2014 shall be increased by 
324.14 	$79,000. This adjustment is onetime.

324.15	(b) Children and Families

324.16	Appropriations by Fund
	
324.17	General
	9,302,000
	9,227,000
	
324.18	Federal TANF
	2,160,000
	2,160,000
	
324.19 	Financial Institution Data Match and 
324.20 	Payment of Fees. The commissioner is 
324.21 	authorized to allocate up to $310,000 each 
324.22 	year in fiscal years 2012 and 2013 from the 
324.23 	PRISM special revenue account to make 
324.24 	payments to financial institutions in exchange 
324.25 	for performing data matches between account 
324.26 	information held by financial institutions 
324.27 	and the public authority's database of child 
324.28 	support obligors as authorized by Minnesota 
324.29 	Statutes, section 13B.06, subdivision 7.

324.30	(c) Health Care

324.31	Appropriations by Fund
	
324.32	General
	15,989,000
	15,801,000
	
324.33	Health Care Access
	22,574,000
	22,439,000
	
324.34 	Minnesota Senior Health Options 
324.35 	Reimbursement. Federal administrative 
325.1 	reimbursement resulting from the Minnesota 
325.2 	senior health options project is appropriated 
325.3 	to the commissioner for this activity.
325.4 	Utilization Review. Federal administrative 
325.5 	reimbursement resulting from prior 
325.6 	authorization and inpatient admission 
325.7 	certification by a professional review 
325.8 	organization shall be dedicated to the 
325.9 	commissioner for these purposes. A portion 
325.10 	of these funds must be used for activities to 
325.11 	decrease unnecessary pharmaceutical costs 
325.12 	in medical assistance.
325.13 	Base Adjustment. The general fund base 
325.14 	shall be decreased by $2,000 in fiscal year 
325.15 	2014 and $114,000 in 2015.
325.16 	The health care access fund base is decreased 
325.17 	by $16,000 in fiscal year 2014 and $142,000 
325.18 	in 2015.

325.19	(d) Continuing Care

325.20	Appropriations by Fund
	
325.21	General
	16,706,000
	16,661,000
	
325.22
325.23	State Government 
Special Revenue
	125,000
	125,000
	
325.24 	Base Adjustment. The general fund base is 
325.25 	decreased by $259,000 in each of fiscal years 
325.26 	2014 and 2015.

325.27	(e) Chemical and Mental Health

325.28	Appropriations by Fund
	
325.29	General
	4,194,000
	4,194,000
	
325.30	Lottery Prize
	157,000
	157,000

325.31	Subd. 3.Forecasted Programs
 					
325.32 	The amounts that may be spent from this 
325.33 	appropriation for each purpose are as follows:

325.34	(a) MFIP/DWP Grants

326.1	Appropriations by Fund
	
326.2	General
	84,276,000
	91,331,000
	
326.3	Federal TANF
	84,425,000
	75,417,000

326.4	(b) MFIP Child Care Assistance Grants
		55,258,000
		24,789,000

326.5	(c) General Assistance Grants
		49,664,000
		49,775,000
	
326.6 	General Assistance Standard. The 
326.7 	commissioner shall set the monthly standard 
326.8 	of assistance for general assistance units 
326.9 	consisting of an adult recipient who is 
326.10 	childless and unmarried or living apart 
326.11 	from parents or a legal guardian at $203. 
326.12 	The commissioner may reduce this amount 
326.13 	according to Laws 1997, chapter 85, article 
326.14 	3, section 54.
326.15 	Emergency General Assistance. The 
326.16 	amount appropriated for emergency general 
326.17 	assistance funds is limited to no more 
326.18 	than $7,889,812 in fiscal year 2012 and 
326.19 	$7,889,812 in fiscal year 2013. Funds 
326.20 	to counties shall be allocated by the 
326.21 	commissioner using the allocation method 
326.22 	specified in Minnesota Statutes, section 
326.23 	256D.06.

326.24	(d) Minnesota Supplemental Aid Grants
		38,095,000
		39,120,000
	
326.25 	Emergency Minnesota Supplemental 
326.26 	Aid Funds. The amount appropriated for 
326.27 	emergency Minnesota supplemental aid 
326.28 	funds is limited to no more than $1,100,000 
326.29 	in fiscal year 2012 and $1,100,000 in fiscal 
326.30 	year 2013. Funds to counties shall be 
326.31 	allocated by the commissioner using the 
326.32 	allocation method specified in Minnesota 
326.33 	Statutes, section 256D.46.

326.34	(e) Group Residential Housing Grants
		121,092,000
		129,250,000

327.1	(f) MinnesotaCare Grants
		349,445,000
		357,016,000
	
327.2 	This appropriation is from the health care 
327.3 	access fund.

327.4	(g) GAMC Grants
					
327.5 	Payments for Cost Settlements. The 
327.6 	commissioner is authorized to use amounts 
327.7 	repaid to the general assistance medical care 
327.8 	program under Minnesota Statutes 2009 
327.9 	Supplement, section 256D.03, subdivision 
327.10 	3, to pay cost settlements for claims for 
327.11 	services provided prior to June 1, 2010. 
327.12 	Notwithstanding any contrary provision in 
327.13 	this article, this provision does not expire.

327.14	(h) Medical Assistance Grants
		4,287,303,000
		3,983,684,000
	
327.15 	Managed Care Incentive Payments. The 
327.16 	commissioner shall not make managed care 
327.17 	incentive payments for expanding preventive 
327.18 	services during fiscal years beginning July 1, 
327.19 	2011 and July 1, 2012.
327.20 	Region 10. $450,000 for the biennium 
327.21 	beginning July 1, 2011, is to administer 
327.22 	the State Quality Assurance, Quality 
327.23 	Improvement, and Licensing System under 
327.24 	Minnesota Statutes, section 256B.0961. 
327.25 	Of this appropriation, $200,000 is for the 
327.26 	State Quality Council and $250,000 is 
327.27 	for the continuation of Region 10 Quality 
327.28 	Assurance.
327.29 	Limit Growth in the Developmental 
327.30 	Disability Waiver. The commissioner shall 
327.31 	limit growth in the developmental disability 
327.32 	waiver to 15 diversion allocations per month 
327.33 	beginning July 1, 2011, through June 30, 
327.34 	2013. Waiver allocations shall be available 
328.1 	to individuals who meet the priorities for 
328.2 	accessing waiver services identified in 
328.3 	Minnesota Statutes, 256B.092, subdivision 
328.4 	12. The limits do not include conversions 
328.5 	from intermediate care facilities for persons 
328.6 	with developmental disabilities.
328.7 	Limit Growth in the Community 
328.8 	Alternatives for Disabled Individuals 
328.9 	Waiver. The commissioner shall limit 
328.10 	growth in the community alternatives for 
328.11 	disabled individuals waiver to 85 allocations 
328.12 	per month beginning July 1, 2011, through 
328.13 	June 30, 2013. Waiver allocations must 
328.14 	be available to individuals who meet the 
328.15 	priorities for accessing waiver services 
328.16 	identified in Minnesota Statutes, section 
328.17 	256B.49, subdivision 11a. The limits include 
328.18 	conversions and diversions, unless the 
328.19 	commissioner has approved a plan to convert 
328.20 	funding due to the closure or downsizing 
328.21 	of a residential facility or nursing facility 
328.22 	to serve directly affected individuals on 
328.23 	the community alternatives for disabled 
328.24 	individuals waiver.
328.25 	Reduction of Rates for Congregate 
328.26 	Living for Individuals with Lower Needs. 
328.27 	Beginning October 1, 2011, lead agencies 
328.28 	must reduce rates in effect on January 1, 
328.29 	2011, by ten percent for individuals with 
328.30 	lower needs living in foster care settings 
328.31 	where the license holder does not share the 
328.32 	residence with recipients on the CADI, DD, 
328.33 	and TBI waivers and customized living 
328.34 	settings for CADI and TBI. Lead agencies 
328.35 	must adjust contracts within 60 days of the 
328.36 	effective date.
329.1 	Reduction of Lead Agency Waiver 
329.2 	Allocations to Implement Rate Reductions 
329.3 	for Congregate Living for Individuals 
329.4 	with Lower Needs. Beginning October 1, 
329.5 	2011, the commissioner shall reduce lead 
329.6 	agency waiver allocations to implement the 
329.7 	reduction of rates for individuals with lower 
329.8 	needs living in foster care settings where the 
329.9 	license holder does not share the residence 
329.10 	with recipients on the CADI, DD, and TBI 
329.11 	waivers and customized living settings for 
329.12 	CADI and TBI.
329.13 	Home and Community-Based Waiver 
329.14 	Appropriations Limits. (a) Total state and 
329.15 	federal funding for the biennium beginning 
329.16 	on July 1, 2011, for the medicaid home and 
329.17 	community-based waivers for the elderly and 
329.18 	persons with disabilities including elderly 
329.19 	waiver under Minnesota Statutes, section 
329.20 	256B.0915; DD waiver under Minnesota 
329.21 	Statutes, section 256B.092; and the CAC, 
329.22 	CADI, and TBI waivers under Minnesota 
329.23 	Statutes, section 256B.49, are limited to 
329.24 	the following amounts: the DD waiver is 
329.25 	limited to $1,964,344,000; elderly waiver 
329.26 	fee-for-service is limited to $69,114,000; 
329.27 	elderly waiver managed care is limited 
329.28 	to $530,566,000; the CADI waiver is 
329.29 	limited to $820,176,000; the CAC waiver 
329.30 	is limited to $41,444,000; and the TBI 
329.31 	waiver is limited to $194,092,000. Of 
329.32 	these amounts, the commissioner shall set 
329.33 	aside five percent of each waiver amount 
329.34 	to manage emergency situations around the 
329.35 	state. The commissioner must ensure that at 
329.36 	least the same number of people are served 
330.1 	on the home and community-based waiver 
330.2 	programs as were served on March 22, 
330.3 	2010. Notwithstanding any law or rule to the 
330.4 	contrary, in order to meet the funding limits 
330.5 	in this provision, the commissioner may 
330.6 	reduce or adjust benefits and services, reduce 
330.7 	or adjust case-mix capitation rates, limit or 
330.8 	freeze waiver enrollment, establish needed 
330.9 	thresholds for service eligibility, adjust 
330.10 	eligibility criteria to the extent allowable 
330.11 	under federal regulations, establish prior 
330.12 	authorization criteria, and adjust county home 
330.13 	and community-based waiver allocations 
330.14 	as needed. Priorities for the use of waiver 
330.15 	slots must be for individuals anticipated to 
330.16 	be discharged from an institutional setting or 
330.17 	who are at imminent risk of an institutional 
330.18 	placement. The limits include conversions 
330.19 	and diversions, unless the commissioner has 
330.20 	approved a plan to convert funding due to 
330.21 	the restructuring, closure, or downsizing of 
330.22 	a residential facility or nursing facility to 
330.23 	serve directly affected individuals on the 
330.24 	home and community-based waivers. The 
330.25 	commissioner and counties are prohibited 
330.26 	from reducing provider rates under this 
330.27 	provision. The commissioner shall maintain 
330.28 	the waiting list and access to the waiver.
330.29 	(b) If the commissioner determines that 
330.30 	application of the methods specified in 
330.31 	paragraph (a) will not allow spending to 
330.32 	remain within the limits specified in that 
330.33 	paragraph, the commissioner, effective July 
330.34 	1, 2011, must reduce by ten percent the 
330.35 	salaries of all central office staff who, as of 
331.1 	June 1, 2011, received a salary of greater 
331.2 	than $90,000.
331.3 	(c) If the commissioner determines that 
331.4 	the application of the methods specified 
331.5 	in paragraphs (a) and (b) will not allow 
331.6 	spending to remain within the limits specified 
331.7 	in paragraph (a), the commissioner may 
331.8 	reduce provider payment rates by the 
331.9 	amount necessary to remain within the limits 
331.10 	specified in paragraph (a).
331.11 	Management of Fee-for-Service Spending. 
331.12 	Total state and federal funding for the 
331.13 	biennium beginning on July 1, 2011, for 
331.14 	fee-for-service medical assistance basic care 
331.15 	for the elderly and persons with disabilities 
331.16 	is limited to $2,536,949,000. Total state and 
331.17 	federal funding for the biennium beginning 
331.18 	July 1, 2011, for fee-for-service medical 
331.19 	assistance basic care for adults without 
331.20 	children is limited to $526,251,000.
331.21 	Freeze in Fee-for-Service Spending. The 
331.22 	commissioner shall manage spending within 
331.23 	these limits by:
331.24 	(1) managing and coordinating the care 
331.25 	provided by high-cost providers;
331.26 	(2) expanding the use of health care homes to 
331.27 	manage the care provided to enrollees with 
331.28 	chronic conditions;
331.29 	(3) implementing payment reform to 
331.30 	encourage efficient and cost-effective service 
331.31 	provision; and
331.32 	(4) modifying or restricting medical 
331.33 	assistance program eligibility, and seeking 
332.1 	any necessary approvals or waivers related to 
332.2 	federal maintenance of effort requirements.
332.3 	Contingent Rate Reductions. If 
332.4 	the commissioner determines that 
332.5 	implementation of the global waiver under 
332.6 	Minnesota Statutes, sections 256B.841, 
332.7 	256B.842, and 256B.843, will not achieve a 
332.8 	state general fund savings of $300,000,000 
332.9 	for the biennium beginning July 1, 2011, the 
332.10 	commissioner shall calculate an estimate of 
332.11 	the shortfall in savings, and, for the fiscal 
332.12 	year beginning July 1, 2012, shall reduce 
332.13 	medical assistance provider payment rates, 
332.14 	including but not limited to rates to individual 
332.15 	health care providers and provider agencies, 
332.16 	hospitals, nursing facilities, other residential 
332.17 	settings, and capitation rates provided to 
332.18 	managed care and county-based purchasing 
332.19 	plans, by the amount necessary to recoup the 
332.20 	shortfall in savings over that fiscal year.

332.21	(i) Alternative Care Grants
		44,978,000
		45,106,000
	
332.22 	Alternative Care Transfer. Any money 
332.23 	allocated to the alternative care program that 
332.24 	is not spent for the purposes indicated does 
332.25 	not cancel but shall be transferred to the 
332.26 	medical assistance account.

332.27	(j) Chemical Dependency Entitlement Grants
		94,675,000
		93,298,000

332.28	Subd. 4.Grant Programs
 					
332.29 	The amounts that may be spent from this 
332.30 	appropriation for each purpose are as follows:

332.31	(a) Support Services Grants

332.32	Appropriations by Fund
	
332.33	General
	9,165,000
	9,165,000
	
332.34	Federal TANF
	96,525,000
	90,611,000
	
333.1 	MFIP Consolidated Fund Grants. The 
333.2 	TANF fund base is reduced by $14,000,000 
333.3 	each year beginning in fiscal year 2012.
333.4 	Subsidized Employment Funding Through 
333.5 	ARRA. The commissioner is authorized to 
333.6 	apply for TANF emergency fund grants for 
333.7 	subsidized employment activities. Growth 
333.8 	in expenditures for subsidized employment 
333.9 	within the supported work program and the 
333.10 	MFIP consolidated fund over the amount 
333.11 	expended in the calendar year quarters in 
333.12 	the TANF emergency fund base year shall 
333.13 	be used to leverage the TANF emergency 
333.14 	fund grants for subsidized employment and 
333.15 	to fund supported work. The commissioner 
333.16 	shall develop procedures to maximize 
333.17 	reimbursement of these expenditures over the 
333.18 	TANF emergency fund base year quarters, 
333.19 	and may contract directly with employers 
333.20 	and providers to maximize these TANF 
333.21 	emergency fund grants.
333.22 	Healthy Communities. $150,000 in fiscal 
333.23 	year 2012 and $150,000 in fiscal year 2013 
333.24 	are appropriated from the general fund to 
333.25 	the commissioner of human services for 
333.26 	contracting with the Search Institute to 
333.27 	promote healthy community initiatives. 
333.28 	The commissioner may expend up to five 
333.29 	percent of the appropriation to provide for 
333.30 	the program evaluation.
333.31 	Circles of Support. $200,000 in fiscal year 
333.32 	2012 and $200,000 in fiscal year 2013 are 
333.33 	appropriated from the general fund to the 
333.34 	commissioner of human services for the 
333.35 	purpose of providing grants to community 
334.1 	action agencies for circles of support 
334.2 	initiatives.
334.3 	Northern Connections. $100,000 is 
334.4 	appropriated in fiscal year 2012 and 
334.5 	$100,000 is appropriated in fiscal year 2013 
334.6 	from the general fund to the commissioner 
334.7 	of human services for a grant to expand 
334.8 	Northern Connections workforce program 
334.9 	that provides one-stop supportive services 
334.10 	to individuals as they transition into the 
334.11 	workforce to up to two interested counties in 
334.12 	rural Minnesota.

334.13
334.14	(b) Basic Sliding Fee Child Care Assistance 
Grants
		37,771,000
		39,686,000
	
334.15 	Base Adjustment. The general fund base is 
334.16 	decreased by $1,131,000 in fiscal year 2014 
334.17 	and $1,126,000 in fiscal year 2015.
334.18 	Child Care and Development Fund 
334.19 	Unexpended Balance. In addition to 
334.20 	the amount provided in this section, the 
334.21 	commissioner shall expend $5,000,000 
334.22 	in fiscal year 2012 from the federal child 
334.23 	care and development fund unexpended 
334.24 	balance for basic sliding fee child care under 
334.25 	Minnesota Statutes, section 119B.03. The 
334.26 	commissioner shall ensure that all child 
334.27 	care and development funds are expended 
334.28 	according to the federal child care and 
334.29 	development fund regulations.

334.30	(c) Child Care Development Grants
		1,487,000
		1,487,000
	
334.31 	Child Care Development Funds. The 
334.32 	commissioner of human services shall direct 
334.33 	$1,000,000 in federal child care development 
334.34 	funds for the purpose of continuing the 
334.35 	quality rating and improvement system as 
335.1 	described in Minnesota Statutes, section 
335.2 	119B.135, in the original pilot area and 
335.3 	expanding the system to two new rural 
335.4 	geographic locations.

335.5	(d) Child Support Enforcement Grants
		50,000
		50,000
	
335.6 	Federal Child Support Demonstration 
335.7 	Grants. Federal administrative 
335.8 	reimbursement resulting from the federal 
335.9 	child support grant expenditures authorized 
335.10 	under section 1115a of the Social Security 
335.11 	Act is appropriated to the commissioner for 
335.12 	this activity.

335.13	(e) Children's Services Grants

335.14	Appropriations by Fund
	
335.15	General
	45,427,000
	45,127,000
	
335.16	Federal TANF
	140,000
	140,000
	
335.17 	Adoption Assistance and Relative Custody 
335.18 	Assistance.  The commissioner may transfer 
335.19 	unencumbered appropriation balances for 
335.20 	adoption assistance and relative custody 
335.21 	assistance between fiscal years and between 
335.22 	programs.
335.23 	Privatized Adoption Grants. Federal 
335.24 	reimbursement for privatized adoption grant 
335.25 	and foster care recruitment grant expenditures 
335.26 	is appropriated to the commissioner for 
335.27 	adoption grants and foster care and adoption 
335.28 	administrative purposes.
335.29 	Adoption Assistance Incentive Grants.
335.30 	Federal funds available during fiscal year 
335.31 	2012 and fiscal year 2013 for adoption 
335.32 	incentive grants are appropriated to the 
335.33 	commissioner for these purposes.

335.34	(f) Children and Community Services Grants
		64,301,000
		64,301,000

336.1	(g) Children and Economic Support Grants
		16,505,000
		15,315,000
	
336.2 	Long-term homeless services. $700,000 
336.3 	is appropriated from the federal TANF 
336.4 	fund for the biennium beginning July 
336.5 	1, 2011, to the commissioner of human 
336.6 	services for long-term homeless services 
336.7 	for low-income homeless families under 
336.8 	Minnesota Statutes, section 256K.26. This 
336.9 	is a onetime appropriation and is not added 
336.10 	to the base.
336.11 	Base Adjustment. The general fund base 
336.12 	is increased by $491,000 in fiscal year 2014 
336.13 	only.

336.14	(h) Health Care Grants

336.15	Appropriations by Fund
	
336.16	General
	750,000
	750,000
	
336.17	Health Care Access
	900,000
	900,000
	
336.18 	Surplus Appropriation Canceled. Of the 
336.19 	appropriation in Laws 2009, chapter 79, 
336.20 	article 13, section 3, subdivision 6, paragraph 
336.21 	(e), for the COBRA premium state subsidy 
336.22 	program, $11,750,000 must be canceled in 
336.23 	fiscal year 2011. This provision is effective 
336.24 	the day following final enactment.
336.25 	Grant Cancellation. Effective for the 
336.26 	biennium beginning July 1, 2011, the 
336.27 	following appropriations are canceled: (1) a 
336.28 	general fund appropriation of $205,000 for 
336.29 	the U Special Kids program; (2) a general 
336.30 	fund appropriation of $90,000 for medical 
336.31 	assistance outreach grants; and (3) a health 
336.32 	care access fund appropriation of $40,000 for 
336.33 	MinnesotaCare outreach grants.
337.1 	State Subsidy Program for Community 
337.2 	Mental Health Centers. $100,000 is 
337.3 	appropriated from the general fund to 
337.4 	the commissioner of human services for 
337.5 	the biennium beginning July 1, 2011, to 
337.6 	provide onetime grants to establish new 
337.7 	community mental health centers that are 
337.8 	eligible for payment under Minnesota 
337.9 	Statutes, section 256B.0625, subdivision 5. 
337.10 	In awarding grants, the commissioner shall 
337.11 	give preference to areas of the state that 
337.12 	lack access to mental health services or are 
337.13 	underserved.

337.14	(i) Aging and Adult Services Grants
		18,834,000
		19,010,000
	
337.15 	Aging Grants Reduction. Effective July 
337.16 	1, 2011, funding for grants made under 
337.17 	Minnesota Statutes, sections 256.9754 and 
337.18 	256B.0917, subdivision 13, is reduced by 
337.19 	$3,600,000 for each year of the biennium. 
337.20 	These reductions are onetime and do 
337.21 	not affect base funding for the 2014-2015 
337.22 	biennium. Grants made during the 2012-2013 
337.23 	biennium under Minnesota Statutes, section 
337.24 	256B.9754, must not be used for new 
337.25 	construction or building renovation.
337.26 	Essential Community Support Grant 
337.27 	Delay. Essential community supports 
337.28 	grants under Minnesota Statutes, section 
337.29 	256B.0917, subdivision 14, is reduced 
337.30 	by $6,410,000 in fiscal year 2012 and 
337.31 	$7,279,000 in fiscal year 2013. Base level 
337.32 	funding for fiscal year 2014 is reduced by 
337.33 	$5,919,000. These reductions are onetime 
337.34 	and do not affect base level funding for fiscal 
337.35 	year 2015.

338.1	(j) Deaf and Hard-of-Hearing Grants
		1,936,000
		1,767,000

338.2	(k) Disabilities Grants
		21,700,000
		23,538,000
	
338.3 	Local Planning Grants for Creating 
338.4 	Alternatives to Congregate Living for 
338.5 	Individuals with Lower Needs. The 
338.6 	commissioner shall make available a total 
338.7 	of $250,000 per year in local planning 
338.8 	grants, beginning July 1, 2011, to assist 
338.9 	lead agencies and provider organizations in 
338.10 	developing alternatives to congregate living 
338.11 	within the available level of resources for the 
338.12 	home and community-based services waivers 
338.13 	for persons with disabilities.

338.14	(l) Adult Mental Health Grants

338.15	Appropriations by Fund
	
338.16	General
	76,789,000
	76,789,000
	
338.17	Lottery Prize Fund
	1,427,000
	1,430,000
	
338.18 	Funding Usage. Up to 75 percent of a fiscal 
338.19 	year's appropriation for adult mental health 
338.20 	grants may be used to fund allocations in that 
338.21 	portion of the fiscal year ending December 
338.22 	31.
338.23 	Base Adjustment. The lottery prize fund 
338.24 	base for this program shall be increased by 
338.25 	$78,000 in each of fiscal years 2014 and 
338.26 	2015.

338.27	(m) Children's Mental Health Grants
		16,682,000
		16,682,000
	
338.28 	Funding Usage. Up to 75 percent of a fiscal 
338.29 	year's appropriation for children's mental 
338.30 	health grants may be used to fund allocations 
338.31 	in that portion of the fiscal year ending 
338.32 	December 31.

338.33
338.34	(n) Chemical Dependency Nonentitlement 
Grants
		1,336,000
		1,336,000

339.1	Subd. 5.State-Operated Services
 					
339.2 	Transfer Authority Related to 
339.3 	State-Operated Services. Money 
339.4 	appropriated for state-operated services 
339.5 	may be transferred between fiscal years 
339.6 	of the biennium with the approval of the 
339.7 	commissioner of management and budget.

339.8	(a) State-Operated Services Mental Health
		115,196,000
		80,603,000
	
339.9 	State-Operated Services.  To achieve these 
339.10 	savings, the commissioner shall close the 
339.11 	Willmar Community Behavioral Health 
339.12 	Hospital no later than October 1, 2011, and 
339.13 	shall close the inpatient child and adolescent 
339.14 	behavioral health service program in 
339.15 	Willmar, the subacute mental health facility 
339.16 	in Wadena, and the community behavioral 
339.17 	health hospitals in Alexandria, Annandale, 
339.18 	Baxter, Bemidji, Fergus Falls, and Rochester 
339.19 	no later than October 1, 2012.
339.20 	Base Adjustment. The general fund base is 
339.21 	reduced by $8,443,000 in fiscal year 2014 
339.22 	and $11,543,000 in fiscal year 2015.

339.23	(b) Minnesota Security Hospital
		69,582,000
		69,582,000

339.24	Subd. 6.Sex Offender Program
 		68,787,000
		65,941,000
	
339.25 	Transfer Authority Related to Minnesota 
339.26 	Sex Offender Program. Money 
339.27 	appropriated for the Minnesota sex offender 
339.28 	program may be transferred between fiscal 
339.29 	years of the biennium with the approval 
339.30 	of the commissioner of management and 
339.31 	budget.
339.32 	Minnesota Sex Offender Program 
339.33 	Reduction.  The fiscal year 2011 general 
339.34 	fund appropriation for Minnesota sex 
340.1 	offender services under Laws 2009, chapter 
340.2 	79, article 13, section 3, subdivision 10, 
340.3 	paragraph (b), is reduced by $3,000,000.

340.4	Subd. 7.Technical Activities
 		78,206,000
		102,551,000
	
340.5 	This appropriation is from the federal TANF 
340.6 	fund.

340.7	Sec. 4. COMMISSIONER OF HEALTH

340.8	Subdivision 1.Total Appropriation
 	$
	147,845,000
	$
	136,538,000

340.9	Appropriations by Fund
	
340.10		2012
	2013
	
340.11	General
	77,603,000
	72,707,000
	
340.12
340.13	State Government 
Special Revenue
	45,268,000
	45,325,000
	
340.14	Health Care Access
	13,711,000
	9,099,000
	
340.15	Federal TANF
	11,713,000
	11,713,000
	
340.16 	The amounts that may be spent for each 
340.17 	purpose are specified in the following 
340.18 	subdivisions.

340.19
340.20	Subd. 2.Community and Family Health 
Promotion

340.21	Appropriations by Fund
	
340.22	General
	50,430,000
	45,690,000
	
340.23
340.24	State Government 
Special Revenue
	1,033,000
	1,033,000
	
340.25	Health Care Access
	2,918,000
	2,459,000
	
340.26	Federal TANF
	11,713,000
	11,713,000
	
340.27 	TANF Appropriations. (1) $1,156,000 of 
340.28 	the TANF funds is appropriated each year to 
340.29 	the commissioner for family planning grants 
340.30 	under Minnesota Statutes, section 145.925.
340.31 	(2) $3,579,000 of the TANF funds is 
340.32 	appropriated each year to the commissioner 
340.33 	for home visiting and nutritional services 
340.34 	listed under Minnesota Statutes, section 
340.35 	145.882, subdivision 7, clauses (6) and (7). 
340.36 	Funds must be distributed to community 
341.1 	health boards according to Minnesota 
341.2 	Statutes, section 145A.131, subdivision 1.
341.3 	(3) $2,000,000 of the TANF funds is 
341.4 	appropriated each year to the commissioner 
341.5 	for decreasing racial and ethnic disparities 
341.6 	in infant mortality rates under Minnesota 
341.7 	Statutes, section 145.928, subdivision 7.
341.8 	(4) $4,978,000 of the TANF funds is 
341.9 	appropriated each year to the commissioner 
341.10 	for the family home visiting grant program 
341.11 	according to Minnesota Statutes, section 
341.12 	145A.17. $4,000,000 of the funding must 
341.13 	be distributed to community health boards 
341.14 	according to Minnesota Statutes, section 
341.15 	145A.131, subdivision 1. $978,000 of 
341.16 	the funding must be distributed to tribal 
341.17 	governments based on Minnesota Statutes, 
341.18 	section 145A.14, subdivision 2a.
341.19 	(5) The commissioner may use up to 6.23 
341.20 	percent of the funds appropriated each fiscal 
341.21 	year to conduct the ongoing evaluations 
341.22 	required under Minnesota Statutes, section 
341.23 	145A.17, subdivision 7, and training and 
341.24 	technical assistance as required under 
341.25 	Minnesota Statutes, section 145A.17, 
341.26 	subdivisions 4 and 5.
341.27 	TANF Carryforward. Any unexpended 
341.28 	balance of the TANF appropriation in the 
341.29 	first year of the biennium does not cancel but 
341.30 	is available for the second year.

341.31	Subd. 3.Policy Quality and Compliance

341.32	Appropriations by Fund
	
341.33	General
	10,403,000
	10,199,000
	
342.1
342.2	State Government 
Special Revenue
	14,026,000
	14,083,000
	
342.3	Health Care Access
	10,793,000
	6,640,000
	
342.4 	MERC Fund Transfers. The commissioner 
342.5 	of management and budget shall transfer 
342.6 	$9,800,000 from the MERC fund to the 
342.7 	general fund by October 1, 2011.
342.8 	Unused Federal Match Funds. Of the 
342.9 	funds appropriated in Laws 2009, chapter 
342.10 	79, article 13, section 4, subdivision 3, for 
342.11 	state matching funds for the federal Health 
342.12 	Information Technology for Economic and 
342.13 	Clinical Health Act, $2,800,000 is transferred 
342.14 	to the health care access fund by October 1, 
342.15 	2011.
342.16 	Advisory Committee on Patient and 
342.17 	Community Engagement. $50,000 is 
342.18 	appropriated  to the commissioner of health 
342.19 	to provide a grant to a private sector 
342.20 	organization designated as the advisory 
342.21 	committee on patient and community 
342.22 	engagement to be used by the organization 
342.23 	for:
342.24 	(1) per diems and expenses for persons who 
342.25 	serve on the designated organization's board; 
342.26 	and 
342.27 	(2) expenses for conducting focus groups, 
342.28 	community engagement events, surveys, and 
342.29 	other activities undertaken by the designated 
342.30 	organization to obtain information, input, 
342.31 	and preferences from diverse communities 
342.32 	for purposes of community engagement in 
342.33 	health system issues.
342.34 	Health Careers Opportunities Grants. 
342.35 	$447,000 each year is appropriated to the 
343.1 	commissioner of health from the health 
343.2 	care access fund for the health careers 
343.3 	opportunities grant program under Minnesota 
343.4 	Statutes, section 144.1499.
343.5 	Health Professions Opportunities 
343.6 	Scholarship Program. $63,000 each year is 
343.7 	appropriated to the commissioner of health 
343.8 	from the health care access fund for the 
343.9 	health professions opportunities scholarship 
343.10 	program under Minnesota Statutes, section 
343.11 	144.1503. $138,000 in fiscal year 2012 and 
343.12 	$276,000 each year thereafter is appropriated 
343.13 	to the commissioner of health from the 
343.14 	general fund for the health professions 
343.15 	opportunities scholarship program under 
343.16 	Minnesota Statutes, section 144.1503.
343.17 	Base Level Adjustment. The state 
343.18 	government special revenue fund base shall 
343.19 	be reduced by $141,000 in fiscal years 2014 
343.20 	and 2015. The health care access base shall 
343.21 	be increased by $600,000 in fiscal year 2014.

343.22	Subd. 4.Health Protection

343.23	Appropriations by Fund
	
343.24	General
	9,370,000
	9,370,000
	
343.25
343.26	State Government 
Special Revenue
	30,209,000
	30,209,000

343.27	Subd. 5.Administrative Support Services
 		7,440,000
		7,488,000

343.28	Sec. 5. COUNCIL ON DISABILITY
 	$
	524,000
	$
	524,000

343.29
343.30
343.31	Sec. 6. OMBUDSMAN FOR MENTAL 
HEALTH AND DEVELOPMENTAL 
DISABILITIES
 	$
	1,655,000
	$
	1,655,000
	
343.32 	Funds appropriated for fiscal year 2011 are 
343.33 	available until expended.

343.34	Sec. 7. OMBUDSPERSON FOR FAMILIES
 	$
	265,000
	$
	265,000

344.1	Sec. 8. HEALTH-RELATED BOARDS

344.2	Subdivision 1.Total Appropriation
 	$
	17,365,000
	$
	17,264,000
	
344.3 	This appropriation is from the state 
344.4 	government special revenue fund. The 
344.5 	amounts that may be spent for each  purpose 
344.6 	are specified in the following  subdivisions.

344.7	Subd. 2.Board of Chiropractic Examiners
 		469,000
		469,000

344.8	Subd. 3.Board of Dentistry
 		1,959,000
		1,914,000
	
344.9 	Health Professional Services Program.
344.10 	$834,000 in fiscal year 2012 and $804,000 in 
344.11 	fiscal year 2013 from the state government 
344.12 	special revenue fund are for the health 
344.13 	professional services program.

344.14
344.15	Subd. 4.Board of Dietetic and Nutrition 
Practice
 		110,000
		110,000

344.16
344.17	Subd. 5.Board of Marriage and Family 
Therapy
 		192,000
		167,000
	
344.18 	Rulemaking. Of this appropriation, $25,000 
344.19 	in fiscal year 2012 is for rulemaking. This is 
344.20 	a onetime appropriation.

344.21	Subd. 6.Board of Medical Practice
 		3,866,000
		3,866,000

344.22	Subd. 7.Board of Nursing
 		3,545,000
		3,545,000

344.23
344.24	Subd. 8.Board of Nursing Home 
Administrators
 		2,153,000
		2,145,000
	
344.25 	Rulemaking. Of this appropriation, $44,000 
344.26 	in fiscal year 2012 is for rulemaking. This is 
344.27 	a onetime appropriation.
344.28 	Electronic Licensing System Adaptors.
344.29 	Of this appropriation, $761,000 in fiscal 
344.30 	year 2013 from the state government special 
344.31 	revenue fund is to the administrative services 
344.32 	unit to cover the costs to connect to the 
344.33 	e-licensing system. Minnesota Statutes, 
345.1 	section 16E.22. Base level funding  for this 
345.2 	activity in fiscal year 2014 shall be  $100,000. 
345.3 	Base level funding for this activity in fiscal 
345.4 	year 2015 shall be $50,000.
345.5 	Development and Implementation of a 
345.6 	Disciplinary, Regulatory, Licensing and 
345.7 	Information Management System. Of this 
345.8 	appropriation, $800,000 in fiscal  year 2012 
345.9 	and $300,000 in fiscal year 2013 are  for the 
345.10 	development of a shared system.   Base level 
345.11 	funding for this activity in fiscal year  2014 
345.12 	shall be $50,000.
345.13 	Administrative Services Unit - Operating 
345.14 	Costs. Of this appropriation, $526,000 
345.15 	in fiscal year 2012 and $526,000 in 
345.16 	fiscal year 2013 are for operating costs 
345.17 	of the administrative services unit. The 
345.18 	administrative services unit may receive 
345.19 	and expend reimbursements for services 
345.20 	performed by other agencies.
345.21 	Administrative Services Unit - Retirement 
345.22 	Costs. Of this appropriation in fiscal year 
345.23 	2012, $225,000 is for onetime retirement 
345.24 	costs in the health-related boards. This 
345.25 	funding may be transferred to the health 
345.26 	boards incurring those costs for their 
345.27 	payment. These funds are available either 
345.28 	year of the biennium.
345.29 	Administrative Services Unit - Volunteer 
345.30 	Health Care Provider Program. Of this 
345.31 	appropriation, $150,000 in fiscal year 2012 
345.32 	and $150,000 in fiscal year 2013 are to pay 
345.33 	for medical professional liability coverage 
345.34 	required under Minnesota Statutes, section 
345.35 	214.40.
346.1 	Administrative Services Unit - Contested 
346.2 	Cases and Other Legal Proceedings.
346.3 	Of  this appropriation, $200,000 in fiscal 
346.4 	year  2012 and $200,000 in fiscal year 
346.5 	2013  are for costs of contested case 
346.6 	hearings  and other unanticipated costs of 
346.7 	legal  proceedings involving health-related 
346.8 	boards funded under this section. Upon 
346.9 	certification of a health-related board to the 
346.10 	administrative services unit that the costs 
346.11 	will be incurred and that there is insufficient 
346.12 	money available to pay for the costs out of 
346.13 	money currently available to that board, the 
346.14 	administrative services unit is authorized 
346.15 	to transfer money from this appropriation 
346.16 	to the board for payment of those costs 
346.17 	with the approval of the commissioner of 
346.18 	finance. This appropriation does not cancel. 
346.19 	Any unencumbered and unspent balances 
346.20 	remain available for these expenditures in 
346.21 	subsequent fiscal years.

346.22	Subd. 9.Board of Optometry
 		106,000
		106,000

346.23	Subd. 10.Board of Pharmacy
 		1,977,000
		1,980,000
	
346.24 	Prescription Electronic Reporting. Of 
346.25 	this appropriation, $356,000 in fiscal year 
346.26 	2012 and $356,000 in fiscal year 2013 from 
346.27 	the state government special revenue fund 
346.28 	are to the board to operate the prescription 
346.29 	electronic reporting system in Minnesota 
346.30 	Statutes, section 152.126. Base level funding 
346.31 	for this activity in fiscal year 2014 shall be 
346.32 	$356,000.

346.33	Subd. 11.Board of Physical Therapy
 		389,000
		345,000
	
347.1 	Rulemaking. Of this appropriation, $44,000 
347.2 	in fiscal year 2012 is for rulemaking. This is 
347.3 	a onetime appropriation.

347.4	Subd. 12.Board of Podiatry
 		75,000
		75,000

347.5	Subd. 13.Board of Psychology
 		846,000
		846,000

347.6	Subd. 14.Board of Social Work
 		1,036,000
		1,053,000

347.7	Subd. 15.Board of Veterinary Medicine
 		228,000
		229,000

347.8
347.9	Subd. 16.Board of Behavioral Health and 
Therapy
 		414,000
		414,000

347.10
347.11	Sec. 9. EMERGENCY MEDICAL SERVICES 
BOARD
 	$
	2,742,000
	$
	2,742,000
	
347.12 	Of the appropriation, $700,000 in fiscal year 
347.13 	2012 and $700,000 in fiscal year 2013 are 
347.14 	for the Cooper/Sams volunteer ambulance 
347.15 	program under Minnesota Statutes, section 
347.16 	144E.40.

347.17 	Sec. 10. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision 
347.18 	to read:
347.19 		Subd. 33.Federal administrative reimbursement dedicated. Federal 
347.20 	administrative reimbursement resulting from the following activities is appropriated to the 
347.21 	commissioner for the designated purposes:
347.22 	(1) reimbursement for the Minnesota senior health options project; and
347.23 	(2) reimbursement related to prior authorization and inpatient admission certification 
347.24 	by a professional review organization. A portion of these funds must be used for activities 
347.25 	to decrease unnecessary pharmaceutical costs in medical assistance.

347.26 	Sec. 11. Laws 2010, First Special Session chapter 1, article 15, section 3, subdivision 
347.27 	6, is amended to read:

347.28	Subd. 6.Continuing Care Grants

347.29	(a) Aging and Adult Services Grants
		(3,600,000)
		(3,600,000)
	
347.30 	Community Service/Service Development 
347.31 	Grants Reduction. Effective retroactively 
348.1 	from July 1, 2009, funding for grants made 
348.2 	under Minnesota Statutes, sections 256.9754
348.3 	and 256B.0917, subdivision 13, is reduced 
348.4 	by $5,807,000 for each year of the biennium. 
348.5 	Grants made during the biennium under 
348.6 	Minnesota Statutes, section 256.9754, shall 
348.7 	not be used for new construction or building 
348.8 	renovation.
348.9 	Aging Grants Delay. Aging grants must be 
348.10 	reduced by $917,000 in fiscal year 2011 and 
348.11 	increased by $917,000 in fiscal year 2012. 
348.12 	These adjustments are onetime and must not 
348.13 	be applied to the base. This provision expires 
348.14 	June 30, 2012.

348.15
348.16	(b) Medical Assistance Long-Term Care 
Facilities Grants
		(3,827,000)
		(2,745,000)
	
348.17 	ICF/MR Variable Rates Suspension.
348.18 	Effective retroactively from July 1, 2009, 
348.19 	to June 30, 2010, no new variable rates 
348.20 	shall be authorized for intermediate care 
348.21 	facilities for persons with developmental 
348.22 	disabilities under Minnesota Statutes, section 
348.23 	256B.5013, subdivision 1.
348.24 	ICF/MR Occupancy Rate Adjustment 
348.25 	Suspension. Effective retroactively from 
348.26 	July 1, 2009, to June 30, 2011, approval 
348.27 	of new applications for occupancy rate 
348.28 	adjustments for unoccupied short-term 
348.29 	beds under Minnesota Statutes, section 
348.30 	256B.5013, subdivision 7, is suspended.

348.31
348.32	(c) Medical Assistance Long-Term Care 
Waivers and Home Care Grants
		(2,318,000)
		(5,807,000)
	
348.33 	Developmental Disability Waiver Acuity 
348.34 	Factor. Effective retroactively from January 
348.35 	1, 2010, the January 1, 2010, one percent 
349.1 	growth factor in the developmental disability 
349.2 	waiver allocations under Minnesota Statutes, 
349.3 	section 256B.092, subdivisions 4 and 5, 
349.4 	that is attributable to changes in acuity, is 
349.5 	suspended to June 30, 2011 eliminated. 
349.6 	Notwithstanding any law to the contrary, this 
349.7 	provision does not expire.

349.8	(d) Adult Mental Health Grants
		(5,000,000)
		-0-

349.9	(e) Chemical Dependency Entitlement Grants
		(3,622,000)
		(3,622,000)

349.10
349.11	(f) Chemical Dependency Nonentitlement 
Grants
		(393,000)
		(393,000)

349.12
349.13	(g) Other Continuing Care Grants
		-0-
		(2,500,000)
(1,414,000)
	
349.14 	Other Continuing Care Grants Delay.
349.15 	Other continuing care grants must be reduced 
349.16 	by $1,414,000 in fiscal year 2011 and 
349.17 	increased by $1,414,000 in fiscal year 2012. 
349.18 	These adjustments are onetime and must not 
349.19 	be applied to the base. This provision expires 
349.20 	June 30, 2012.

349.21	(h) Deaf and Hard-of-Hearing Grants
		-0-
		(169,000)
	
349.22 	Deaf and Hard-of-Hearing Grants Delay.
349.23 	Effective retroactively from July 1, 2010, 
349.24 	deaf and hard-of-hearing grants must be 
349.25 	reduced by $169,000 in fiscal year 2011 and 
349.26 	increased by $169,000 in fiscal year 2012. 
349.27 	These adjustments are onetime and must not 
349.28 	be applied to the base. This provision expires 
349.29 	June 30, 2012.

349.30 	Sec. 12. TRANSFERS.
 349.31 		Subdivision 1.Grants. The commissioner of human services, with the approval 
349.32 	of the commissioner of management and budget, and after notification of the chairs of 
349.33 	the senate health and human services budget and policy committee and the house of 
349.34 	representatives health and human services finance committee, may transfer unencumbered 
350.1 	appropriation balances for the biennium ending June 30, 2013, within fiscal years among 
350.2 	the MFIP; general assistance; general assistance medical care under Minnesota Statutes 
350.3 	2009 Supplement, section 256D.03, subdivision 3; medical assistance; MFIP child care 
350.4 	assistance under Minnesota Statutes, section 119B.05; Minnesota supplemental aid; 
350.5 	and group residential housing programs, and the entitlement portion of the chemical 
350.6 	dependency consolidated treatment fund, and between fiscal years of the biennium.
350.7 		Subd. 2.Administration. Positions, salary money, and nonsalary administrative 
350.8 	money may be transferred within the Departments of Health and Human Services as the 
350.9 	commissioners consider necessary, with the advance approval of the commissioner of 
350.10 	management and budget. The commissioner shall inform the chairs of the senate health 
350.11 	and human services budget and policy committee and the house of representatives health 
350.12 	and human services finance committee quarterly about transfers made under this provision.

350.13 	Sec. 13. INDIRECT COSTS NOT TO FUND PROGRAMS.
 350.14 	The commissioners of health and human services shall not use indirect cost 
350.15 	allocations to pay for the operational costs of any program for which they are responsible.

350.16 	Sec. 14. EXPIRATION OF UNCODIFIED LANGUAGE.
 350.17 	All uncodified language contained in this article expires on June 30, 2013, unless a 
350.18 	different expiration date is explicit.

350.19 	Sec. 15. EFFECTIVE DATE.
 350.20 	The provisions in this article are effective July 1, 2011, unless a different effective 
350.21 	date is specified.

350.22 	ARTICLE 11
350.23 	HUMAN SERVICES FORECAST ADJUSTMENTS

350.24
350.25	Section 1. DEPARTMENT OF HUMAN SERVICES FORECAST ADJUSTMENT 
APPROPRIATIONS.
 	
350.26 	The sums shown are added to, or if shown in parentheses, are subtracted from the 
350.27 	appropriations in Laws 2009, chapter 79, article 13, as amended by Laws 2009, chapter 
350.28 	173, article 2; Laws 2010, First Special Session chapter 1, articles 15, 23, and 25; and 
350.29 	Laws 2010, Second Special Session chapter 1, article 3, to the commissioner of human 
350.30 	services and for the purposes specified in this article. The appropriations are from the 
350.31 	general fund or another named fund and are available for the fiscal year indicated for 
351.1 	each purpose. The figure "2011" used in this article means that the appropriation or 
351.2 	appropriations listed are available for the fiscal year ending June 30, 2011.

351.3
351.4	Sec. 2. COMMISSIONER OF HUMAN 
SERVICES

351.5	Subdivision 1.Total Appropriation
 			$
	(235,463,000)

351.6	Appropriations by Fund
	
351.7			2011
	
351.8	General
		(381,869,000)
	
351.9	Health Care Access
		169,514,000
	
351.10	Federal TANF
		(23,108,000)
	
351.11 	The amounts that may be spent for each 
351.12 	purpose are specified in the following 
351.13 	subdivisions.

351.14	Subd. 2.Revenue and Pass-through
 				732,000
	
351.15 	This appropriation is from the federal TANF 
351.16 	fund.

351.17
351.18	Subd. 3.Children and Economic Assistance 
Grants

351.19	Appropriations by Fund
	
351.20	General
		(7,098,000)
	
351.21	Federal TANF
		(23,840,000)

351.22	(a) MFIP/DWP Grants

351.23	Appropriations by Fund
	
351.24	General
		18,715,000
	
351.25	Federal TANF
		(23,840,000)

351.26	(b) MFIP Child Care Assistance Grants
				(24,394,000)

351.27	(c) General Assistance Grants
				(664,000)

351.28	(d) Minnesota Supplemental Aid Grants
				793,000

351.29	(e) Group Residential Housing Grants
				(1,548,000)

351.30	Subd. 4.Basic Health Care Grants

351.31	Appropriations by Fund
	
351.32	General
		(335,050,000)
	
351.33	Health Care Access
		169,514,000

351.34	(a) MinnesotaCare Grants
				169,514,000
	
352.1 	This appropriation is from the health care 
352.2 	access fund.

352.3
352.4	(b) Medical Assistance Basic Health Care - 
Families and Children
				(49,368,000)

352.5
352.6	(c) Medical Assistance Basic Health Care - 
Elderly and Disabled
				(43,258,000)

352.7
352.8	(d) Medical Assistance Basic Health Care - 
Adults without Children
				(242,424,000)

352.9	Subd. 5.Continuing Care Grants
 				(39,721,000)

352.10
352.11	(a) Medical Assistance Long-Term Care 
Facilities
				(14,627,000)

352.12
352.13	(b) Medical Assistance Long-Term Care 
Waivers
				(44,718,000)

352.14	(c) Chemical Dependency Entitlement Grants
				19,624,000

352.15 	Sec. 3. Laws 2010, First Special Session chapter 1, article 25, section 3, subdivision 6, 
352.16 	is amended to read:

352.17	Subd. 6.Health Care Grants

352.18	(a) MinnesotaCare Grants
		998,000
		(13,376,000)
	
352.19 	This appropriation is from the health care 
352.20 	access fund.
352.21 	Health Care Access Fund Transfer to 
352.22 	General Fund. The commissioner of 
352.23 	management and budget shall transfer the 
352.24 	following amounts in the following years 
352.25 	from the health care access fund to the 
352.26 	general fund: $998,000 $0 in fiscal year 
352.27 	2010; $176,704,000 $59,901,000 in fiscal 
352.28 	year 2011; $141,041,000 in fiscal year 2012; 
352.29 	and $286,150,000 in fiscal year 2013. If at 
352.30 	any time the governor issues an executive 
352.31 	order not to participate in early medical 
352.32 	assistance expansion, no funds shall be 
352.33 	transferred from the health care access 
352.34 	fund to the general fund until early medical 
353.1 	assistance expansion takes effect. This 
353.2 	paragraph is effective the day following final 
353.3 	enactment.
353.4 	MinnesotaCare Ratable Reduction.
353.5 	Effective for services rendered on or after 
353.6 	July 1, 2010, to December 31, 2013, 
353.7 	MinnesotaCare payments to managed care 
353.8 	plans under Minnesota Statutes, section 
353.9 	256L.12, for single adults and households 
353.10 	without children whose income is greater 
353.11 	than 75 percent of federal poverty guidelines 
353.12 	shall be reduced by 15 percent. Effective 
353.13 	for services provided from July 1, 2010, to 
353.14 	June 30, 2011, this reduction shall apply to 
353.15 	all services. Effective for services provided 
353.16 	from July 1, 2011, to December 31, 2013, this 
353.17 	reduction shall apply to all services except 
353.18 	inpatient hospital services. Notwithstanding 
353.19 	any contrary provision of this article, this 
353.20 	paragraph shall expire on December 31, 
353.21 	2013.

353.22
353.23	(b) Medical Assistance Basic Health Care 
Grants - Families and Children
		-0-
		295,512,000
	
353.24 	Critical Access Dental. Of the general 
353.25 	fund appropriation, $731,000 in fiscal year 
353.26 	2011 is to the commissioner for critical 
353.27 	access dental provider reimbursement 
353.28 	payments under Minnesota Statutes, section 
353.29 	256B.76 subdivision 4. This is a onetime 
353.30 	appropriation.
353.31 	Nonadministrative Rate Reduction. For 
353.32 	services rendered on or after July 1, 2010, 
353.33 	to December 31, 2013, the commissioner 
353.34 	shall reduce contract rates paid to managed 
353.35 	care plans under Minnesota Statutes, 
353.36 	sections 256B.69 and 256L.12, and to 
354.1 	county-based purchasing plans under 
354.2 	Minnesota Statutes, section 256B.692, by 
354.3 	three percent of the contract rate attributable 
354.4 	to nonadministrative services in effect on 
354.5 	June 30, 2010. Notwithstanding any contrary 
354.6 	provision in this article, this rider expires on 
354.7 	December 31, 2013.

354.8
354.9	(c) Medical Assistance Basic Health Care 
Grants - Elderly and Disabled
		-0-
		(30,265,000)

354.10
354.11	(d) General Assistance Medical Care Grants
		-0-
		(75,389,000)
(59,583,000)
	
354.12 	The reduction to general assistance medical 
354.13 	care grants is contingent upon the effective 
354.14 	date in Laws 2010, First Special Session 
354.15 	chapter 1, article 16, section 48. The 
354.16 	reduction shall be reestimated based upon 
354.17 	the actual effective date of the law. The 
354.18 	commissioner of management and budget 
354.19 	shall make adjustments in fiscal year 
354.20 	2011 to general assistance medical care 
354.21 	appropriations to conform to the total 
354.22 	expected expenditure reductions specified in 
354.23 	this section.

354.24	(e)  Other Health Care Grants
		-0-
		(7,000,000)
	
354.25 	Cobra Carryforward. Unexpended funds 
354.26 	appropriated in fiscal year 2010 for COBRA 
354.27 	grants under Laws 2009, chapter 79, article 
354.28 	5, section 78, do not cancel and are available 
354.29 	to the commissioner for fiscal year 2011 
354.30 	COBRA grant expenditures. Up to $111,000 
354.31 	of the fiscal year 2011 appropriation for 
354.32 	COBRA grants provided in Laws 2009, 
354.33 	chapter 79, article 13, section 3, subdivision 
354.34 	6, may be used by the commissioner for costs 
354.35 	related to administration of the COBRA 
354.36 	grants.

355.1 	Sec. 4. EFFECTIVE DATE.
 355.2 	This article is effective the day following final enactment.