4E Relating to the organization, operation and financing of state government; establishing the health and human services budget; redesigning delivery; modifying certain provisions relating to health care, human services and health licensing boards

ARTICLE 1 - CHILDREN AND FAMILY SERVICES

Allowing a defined adult family member absence; reducing the at-home infant child care program assistance amount rate; defining qualifying child for child care assistance; prohibiting payment of child care funds for children and child care providers sharing the same residence; specifying conditions for child care assistance in the child's home; requiring legal nonlicensed family child care provider first aid and CPR training and verification; decreasing child care assistance county subsidies and placing maximum payment restrictions; reducing absent days for reimbursement; regulating electronic benefit transfer (EBT) card use; modifying residency and eligibility requirements for Minnesota family investment program (MFIP) and general assistance (GA); specifying a minimum county general assistance GA amount; eliminating certain general assistance GA county monthly allowance payments; modifying community social services; defining supplementary services to group residential housing residents; modifying group residential individual eligibility requirements and regulating county agreements; increasing the Minnesota family investment program (MFIP) residency requirement and modifying property limitations, treatment of supplemental security income, the work activity definition, and postsecondary education or training approval; creating and providing for the adult assistance grant program as a capped allocation to counties for adult assistance, requiring residency; modifying juvenile treatment screening provisions; requiring screenings to be conducted within a certain number of days and requiring the team to have a parent or guardian member, clarifying conduct of and case plan preparation oversight; requiring county quarterly distribution of remaining nonfederal share of fees for the child support enforcement program; requiring liquor and tobacco stores, gambling establishments, and tattoo parlors to negotiate to block electronic benefit transaction (EBT) card cash transactions; establishing the Minnesota EBT business task force; requiring a streamlining alternative to current reporting for the children and community services act; repealing various human services relating to child and medical support and general assistance GA

ARTICLE 2 - DEPARTMENT OF HEALTH

Requiring health maintenance organizations (HMO) annual report administrative expenses definition to be consistent with the national association of insurance commissioners (NAIC); modifying health care cost containment duties, expenditure reporting, clinical medical training application process and funding amounts and funds distribution; requiring Alzheimer's disease prevalence and screening measures; modifying the dental designated rural area; qualifying statewide tobacco prevention and local tobacco prevention grants awards availability; modifying certification of environmental laboratories requirements by creating exemptions for national standards for quality control and personnel and for proficiency testing frequency; requiring the commissioner to apply for waivers from federal rules and regulations for nursing homes and home care; requiring certain electronic data transmissions; requiring the emergency medical services regulatory board to convene a working group to redesign certain policies; prohibiting the practice of cloning of human beings; qualifying family planning grants and eliminating health disparities grants availability; prohibiting state grants from the commissioner to organizations performing or making patient referrals for abortions; requiring the White Earth band of Ojibwe Indians to establish and operate an urban clinic to serve the White Earth tribe; providing for community mental health center grants and grants to expand community health centers; defining family service providers and requiring permission for certain sharing certain information for family services; defining a limited food establishment; regulating variance applications from state agency rules for food inspection frequency and risk categories; requiring the commissioner of health in consultation with the commissioner of human services to evaluate and recommend options for reorganizing health and human services regulatory responsibilities; requiring the commissioner of health to contract for a study of for-profit health maintenance organizations (HMO); establishing the Minnesota task force on prematurity; requiring commissioner nursing home regulatory efficiency with regard to unnecessary reporting; repealing certain provisions relating to health care cost containment expenditure, data collection and processing procedures, prescription drug price disclosure, data from providers, summer health care interns, the rural hospital planning and transition grant program, and promotion of health care and long-term care careers

ARTICLE 3 - MISCELLANEOUS

Expanding licensing classification requirements for special family day care homes; requiring the commissioner of human services to conduct background studies when initiated by a children's therapeutic services and supports provider and requiring costs recovery; controlling the cost for performing a level of need determination for nonemergency medical transportation, exemption; specifying medical transportation mileage determination; allowing backgrounds studies requirements to be met by children's therapeutic services and supports services; specifying spousal contribution for medical assistance (MA) for long-term care services; modifying the timeline for compliance with elevator code changes affecting existing elevators and related devices; requiring the commissioner to develop a proposal to create a single administrative structure for providing nonemergency medical transportation services

ARTICLE 4 - HEALTH RELATED LICENSING

Requiring Minnesota management and budget (MMB) to set chiropractic board and board of behavioral health and therapy license renewal fees; imposing an animal chiropractic registration fee; authorizing the board of nursing to accept and expend grants or gifts and accept registration fees for meetings; modifying permit procedure; establishing nurse professional fees; enacting "The Nurse Licensure Compact" defining terms, specifying application of compact to existing law and compact withdrawal, and establishing a nurse licensure compact advisory committee; specifying fees for the board of marriage and family therapy; specifying certain dentistry professional fees and pharmacy professional fees; establishing administrative services for health-related licensing boards to perform certain administrative, financial, and management functions

ARTICLE 5 - HEALTH CARE

"Freedom of Choice in Health Care Act"; providing a statement of public policy declaring every resident of Minnesota has freedom of choice in health care, prohibiting penalties and requiring attorney general injunctive relief; requiring the Minnesota comprehensive health association (MCHA) to offer a high-deductible, basic plan meeting certain requirements, specifying deductible, out-of-pocket maximums, and coverage, permitting enrollment with a waiver of the preexisting condition limitation under certain conditions; modifying state growth limits methodology review, prohibiting billing for procedures to correct medical errors, providing legislative oversight, directing contingency contract fees allowable use, regulating rates rebasing; requiring medical assistance (MA) application modification to reflect military service; removing an MA asset limitation exemption; modifying nonresident MA eligibility; requiring the commissioner to implement a program to reduce the number of elective childbirth inductions of labor; limiting specialized maintenance therapy; increasing chiropractic services under MA; allowing MA coverage for acupuncture; modifying MA payment rate determination for pharmaceuticals, medication therapy management services, transportation costs, ambulance services payment, augmentative and alternative communication systems, and co-payments (cost-sharing); specifying MA conditions for third-party liability authorization, payment for noncovered services, medical service coordination, payment for part B Medicare crossover claims, early and periodic screening, services provided by advanced dental therapists and cost-sharing, deductibles; permitting providers to limit new MA, general assistance medical care (GAMC), and MinnesotaCare patient eligibility for rehabilitative services; requiring waiver of health care home certification requirements and county local services coordination; requiring hospitalization rates reduction as part of the performance targets; modifying the medical education and research fund; requiring the commissioner to enroll persons with disabilities in managed care under prepaid health plans and providing for opt out; establishing a method for determining provider payment rates for providers serving MA and MinnesotaCare patients; requiring the commissioner to require managed care and county-based purchasing plans to provide health education, wellness training, and preventive services benefits; establishing the complementary and alternative medicine demonstration project; requiring the commissioner to apply for a waiver and state plan amendments from federal law to be known as the Minnesota Consumer Health Opportunities and Innovative Care Excellence (CHOICE) waiver and requiring the governor to establish a joint commission on CHOICE waiver implementation; establishing principles and goals for MA reform; specifying CHOICE waiver application requirements; modifying GA program dates, eligibility requirements, coordinated care delivery systems, and coordinated care delivery rate setting and payments; modifying the MinnesotaCare gross individual or gross family income period of eligibility and adding a family deductible and certain co-payments; establishing the healthy Minnesota contribution program for MinnesotaCare enrollees; changing income qualifications for MinnesotaCare and requiring citizenship status; requiring earned and unearned income verification, more frequent eligibility renewal, veteran referral to county veterans service officers, commissioner coordinated care for children with high-cost mental health conditions, MMB regulatory simplification and report reduction work group convention, specialized maintenance therapy, benefit set options, reduced hospitalization rates, Medicaid fraud prevention and detection, and new strategies for wound care treatment; prohibiting state funds set use to implement the Patient Protection and Affordable Care Act; requiring the commissioner to suspend implementation and administration of the early MA expansion; reviving the general assistance medical care (GAMC) program; repealing the legislative oversight commission and the MinnesotaCare eligibility exception for children; repealing certain health care provisions related to children, income, and grace month in MinnesotaCare; repealing MA adults without children coverage and the Hennepin and Ramsey counties pilot program

ARTICLE 6 - CONTINUING CARE

Authorizing designation of state agency programs as performance-based organizations to provide the best services in the cost effective manner to people with disabilities; requiring implementation of a performance-based agreement; modifying the parental contribution amount for children with disabilities services and the disability linkage line purpose; requiring certain amounts from the money follow the person rebalancing demonstration project to be transferred from medical assistance (MA) in the general fund to the special revenue fund; requiring local agencies to act on MA applications within a certain time period; modifying MA requirements for employed persons with disabilities; allowing personal care assistant payments for relative caregivers and specifying payment and fine amounts; modifying the long-term care consultation services definition, long-term care consultation team assessment and support planning requirements, and the Medicaid waiver for elderly services; changing consumer-directed community support services to self-directed support services for elderly and disabled waivered programs; modifying services for persons with developmental disabilities; enacting a state quality assurance, quality improvement, and licensing system for Minnesotans receiving disability services, requiring a state quality council and regional quality councils; modifying residential facility payment restrictions, alternate rates, nursing facility planned closure rate adjustment, and proximity adjustments; establishing a rate increase for low-rate nursing facilities; expanding nursing facility prohibited practices; modifying home and community-based service waivers for the disabled; increasing the daily rate for an intermediate care facility for the developmentally disabled (ICF/MR) in Clearwater county; allowing an ICF/MR rate adjustment; removing certain previous appropriations for alternative to personal care assistance services; requiring the establishment of rates for shared home and community-based waiver services, the establishment of rate for case management services, and recommendations for further case management redesign; establishing the my life, my choices task force for people with disabilities; requiring the ombudsman for long-term care to develop a work group to address certain issues; requiring counties to inform individuals receiving service reductions of right to request informal review conferences; requiring a report on nursing facility pilot project development

ARTICLE 7 - CHEMICAL AND MENTAL HEALTH

Modifying the sex offender program reimbursement; regulating lay-offs for staff working with persons with developmental disabilities; authorizing the commissioner to contract with the federal Indian health service for care and treatment of committed White Earth band Ojibwe Indians; increasing the local share of the division of costs for chemical dependency treatment; limiting the number of residential chemical dependency treatments; specifying scoring for residential setting treatment eligibility; modifying commissioner federal financial participation collections allocation; extending medical assistance (MA) coverage for residential services for children with severe emotional disturbance to rehabilitative services provided by American Indian tribes; requiring the commissioner to issue a legislative report on how community behavioral health hospital facilities will be utilized to meet regional mental health needs; requiring the commissioner to require individuals performing chemical dependency assessments or mental health diagnostic assessment to screen for integrated dual diagnosis treatment; requiring the commissioner to make a legislative report on Anoka-Metro regional treatment center and the Minnesota security hospital at St. Peter management adequacy; requiring the commissioner to develop criteria for residential chemical dependency treatment; repealing the requirement for Anoka-Metro regional treatment center mental health services development

ARTICLE 8 - REDESIGNING SERVICE DELIVERY

Requiring the commissioner to develop a plan to transfer legal responsibility for providing child protection to White Earth band children residing in Hennepin county to the White Earth band; allowing alternative formats for prepaid health plan documents; specifying general assistance (GA), Minnesota family investment program (MFIP) and food stamp overpayment time limits; including Indian tribes in service delivery authorities; requiring the steering committee on performance and outcome reforms to identify and incorporate federal performance measures in recommendations for programs with contingent federal funding; allowing the commissioner to adjust state and federal program allocations for underperformance and assigning county financial responsibility; modifying state-county results, accountability and service delivery redesign council duties; authorizing and providing for counties, tribes, or consortia service delivery authority establishment and classifying employers and employees as public and providing a transition to a new bargaining unit structure; providing county electronic verification procedures, alignment of program policy and procedures, alternative strategies for certain redeterminations, and simplification of eligibility and enrollment process; requiring the commissioner to transfer legal responsibility for providing human services to the White Earth band of the Ojibwe tribe; repealing designation of service delivery authority and essential services outside jurisdiction of service delivery authority

ARTICLE 9 - HUMAN SERVICES FORECAST ADJUSTMENTS

Providing a summary of department of human services forecast adjustment appropriations

ARTICLE 10 - HEALTH AND HUMAN SERVICES APPROPRIATIONS

Providing a summary of appropriations; providing terms and conditions for systems project receipts, nonfederal share transfers, temporary assistance for needy families (TANF) maintenance of effort (MOE), working family credit expenditures, federal child care and development fund, food stamps employment and training funds, American recovery and reinvestment act (ARRA) food support benefit increases, supplemental security interim assistance reimbursement funds, and fund transfer requirements; appropriating money to the commissioner of human services for central office operations, cost settlements, children and families, health care, continuing care, chemical and mental health, Minnesota family investment program/diversionary work program (MFIP/DWP), child care assistance, general assistance (GA) and adult assistance, Minnesota supplemental aid funds, group residential housing, MinnesotaCare grants, GAMC, medical assistance (MA), alternative care, chemical dependency entitlement, support services, basic sliding fee child care assistance, child care and development, child support enforcement, children's services, children and community services, children and economic support, aging and adult services, deaf and hard-of-hearing, disabilities, adult mental health, children's mental health, and chemical dependency nonentitlement grants, and for state-operated services and the sex offender program, providing terms and conditions for managed care incentive payments, capitation payment delay, certain reductions, programs growth management and limits, reductions, and personal care assistance relative care; appropriating money to the commissioner of health for community and family health promotion, policy quality and compliance, health protection, and administrative support services; appropriating money to the council on disability, the ombudsman for mental health and developmental disabilities, the ombudsperson for families, the health-related boards, and to the emergency medical services regulatory board; dedicating the federal administrative reimbursement to decrease unnecessary pharmaceutical costs in MA; reducing previous community service/service development grants; eliminating the developmental disability waiver acuity factor; reducing other continuing care grants; appropriating money for deaf and hard-of-hearing grants and requiring a onetime adjustment; authorizing the commissioner of human services to transfer unencumbered appropriation balances among public assistance programs; allowing the departments of health and human services to transfer positions, salary money, and nonsalary administrative money within the departments; prohibiting indirect cost allocations use to pay for program operational costs
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