1.1 	A bill for an act
1.2 	relating to state government; establishing the health and human services budget; 
1.3 	modifying provisions related to health care and human services; amending 
1.4 	health licensing boards;amending Minnesota Statutes 2010, sections 8.31, 
1.5 	subdivisions 1, 3a; 62E.14, by adding a subdivision; 62J.04, subdivision 3; 
1.6 	62J.17, subdivision 4a; 62J.692, subdivisions 4, 7; 103I.005, subdivisions 
1.7 	2, 8, 12, by adding a subdivision; 103I.101, subdivisions 2, 5; 103I.105; 
1.8 	103I.111, subdivision 8; 103I.205, subdivision 4; 103I.208, subdivision 2; 
1.9 	103I.501; 103I.531, subdivision 5; 103I.535, subdivision 6; 103I.641; 103I.711, 
1.10 	subdivision 1; 103I.715, subdivision 2; 119B.011, subdivision 13; 119B.09, 
1.11 	subdivision 10, by adding subdivisions; 119B.125, by adding a subdivision; 
1.12 	119B.13, subdivisions 1, 1a, 7; 144.125, subdivisions 1, 3; 144.128; 144.396, 
1.13 	subdivisions 5, 6; 145.925, subdivision 1; 145.928, subdivisions 7, 8; 148.108, by 
1.14 	adding a subdivision; 148.191, subdivision 2; 148.212, subdivision 1; 148.231; 
1.15 	151.07; 151.101; 151.102, by adding a subdivision; 151.12; 151.13, subdivision 
1.16 	1; 151.19; 151.25; 151.47, subdivision 1; 151.48; 152.12, subdivision 3; 
1.17 	245A.10, subdivisions 1, 3, 4, by adding subdivisions; 245A.11, subdivision 
1.18 	2b; 245A.143, subdivision 1; 245C.10, by adding a subdivision; 254B.03, 
1.19 	subdivision 4; 254B.04, by adding a subdivision; 254B.06, subdivision 2; 256.01, 
1.20 	subdivisions 14, 24, 29, by adding a subdivision; 256.969, subdivision 2b; 
1.21 	256B.04, subdivision 18; 256B.056, subdivisions 1a, 3; 256B.057, subdivision 9; 
1.22 	256B.06, subdivision 4; 256B.0625, subdivisions 8, 8a, 8b, 8c, 12, 13e, 17, 17a, 
1.23 	18, 19a, 25, 31a, by adding subdivisions; 256B.0651, subdivision 1; 256B.0652, 
1.24 	subdivision 6; 256B.0653, subdivisions 2, 6; 256B.0913, subdivision 4; 
1.25 	256B.0915, subdivisions 3a, 3b, 3e, 3h, 6, 10; 256B.14, by adding a subdivision; 
1.26 	256B.431, subdivisions 2r, 32, 42, by adding a subdivision; 256B.437, 
1.27 	subdivision 6; 256B.441, subdivisions 50a, 59; 256B.48, subdivision 1; 256B.49, 
1.28 	subdivision 16a; 256B.69, subdivisions 4, 5a, by adding a subdivision; 256B.76, 
1.29 	subdivision 4; 256D.02, subdivision 12a; 256D.031, subdivisions 6, 7, 9; 
1.30 	256D.44, subdivision 5; 256D.47; 256D.49, subdivision 3; 256E.30, subdivision 
1.31 	2; 256E.35, subdivisions 5, 6; 256J.12, subdivisions 1a, 2; 256J.37, by adding 
1.32 	a subdivision; 256J.38, subdivision 1; 256L.04, subdivision 7; 256L.05, by 
1.33 	adding a subdivision; 256L.11, subdivision 7; 256L.12, subdivision 9; 297F.10, 
1.34 	subdivision 1; 393.07, subdivision 10; 402A.10, subdivisions 4, 5; 402A.15; 
1.35 	518A.51; Laws 2008, chapter 363, article 18, section 3, subdivision 5; Laws 
1.36 	2010, First Special Session chapter 1, article 15, section 3, subdivision 6; article 
1.37 	16, section 47; article 25, section 3, subdivision 6; proposing coding for new 
1.38 	law in Minnesota Statutes, chapters 1; 145; 148; 151; 214; 256; 256B; 256L; 
1.39 	proposing coding for new law as Minnesota Statutes, chapter 256N; repealing 
2.1 	Minnesota Statutes 2010, sections 62J.17, subdivisions 1, 3, 5a, 6a, 8; 62J.321, 
2.2 	subdivision 5a; 62J.381; 62J.41, subdivisions 1, 2; 103I.005, subdivision 
2.3 	20; 144.1464; 144.147; 144.1487; 144.1488, subdivisions 1, 3, 4; 144.1489; 
2.4 	144.1490; 144.1491; 144.1499; 144.1501; 144.6062; 145.925; 145A.14, 
2.5 	subdivisions 1, 2a; 245A.10, subdivision 5; 256.979, subdivisions 5, 6, 7, 10; 
2.6 	256.9791; 256B.055, subdivision 15; 256B.0625, subdivision 8e; 256B.0653, 
2.7 	subdivision 5; 256B.0756; 256D.01, subdivisions 1, 1a, 1b, 1e, 2; 256D.03, 
2.8 	subdivisions 1, 2, 2a; 256D.031, subdivisions 5, 8; 256D.05, subdivisions 1, 2, 4, 
2.9 	5, 6, 7, 8; 256D.0513; 256D.053, subdivisions 1, 2, 3; 256D.06, subdivisions 
2.10 	1, 1b, 2, 5, 7, 8; 256D.09, subdivisions 1, 2, 2a, 2b, 5, 6; 256D.10; 256D.13; 
2.11 	256D.15; 256D.16; 256D.35, subdivision 8b; 256D.46; Laws 2010, First Special 
2.12 	Session chapter 1, article 16, sections 6; 7; Minnesota Rules, parts 3400.0130, 
2.13 	subpart 8; 4651.0100, subparts 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 14, 15, 16, 
2.14 	16a, 18, 19, 20, 20a, 21, 22, 23; 4651.0110, subparts 2, 2a, 3, 4, 5; 4651.0120; 
2.15 	4651.0130; 4651.0140; 4651.0150; 9500.1243, subpart 3.
2.16 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

2.17 	ARTICLE 1
2.18 	CONTINUING CARE

2.19 	Section 1. Minnesota Statutes 2010, section 256.01, subdivision 24, is amended to read:
2.20 		Subd. 24.Disability linkage line. The commissioner shall establish the disability 
2.21 	linkage line, ato serve as Minnesota's neutral access point for statewide consumer
2.22 	disability information, referral, and assistance system for people with disabilities and 
2.23 	chronic illnesses that. The Disability Linkage Line shall:
2.24 	(1) deliver information and assistance based on national and state standards;
2.25 	(1) provides (2) provide information about state and federal eligibility requirements, 
2.26 	benefits, and service options;
2.27 	(3) provide benefits and options counseling;
2.28 	(2) makes (4) make referrals to appropriate support entities;
2.29 	(3) delivers information and assistance based on national and state standards;
2.30 	(4) assists (5) educate people to on their options so they can make well-informed 
2.31 	decisions choices; and
2.32 	(5) supports (6) help support the timely resolution of service access and benefit 
2.33 	issues;
2.34 	(7) inform people of their long-term community services and supports;
2.35 	(8) provide necessary resources and supports that can lead to employment and 
2.36 	increased economic stability of people with disabilities; and
2.37 	(9) serve as the technical assistance and help center for the Web-based tool, 
2.38 	Minnesota's Disability Benefits 101.org.

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

3.1 	Sec. 2. Minnesota Statutes 2010, section 256.01, subdivision 29, is amended to read:
3.2 		Subd. 29.State medical review team. (a) To ensure the timely processing of 
3.3 	determinations of disability by the commissioner's state medical review team under 
3.4 	sections 256B.055, subdivision 7, paragraph (b), 256B.057, subdivision 9, paragraph 
3.5 	(j), and 256B.055, subdivision 12, the commissioner shall review all medical evidence 
3.6 	submitted by county agencies with a referral and seek additional information from 
3.7 	providers, applicants, and enrollees to support the determination of disability where 
3.8 	necessary. Disability shall be determined according to the rules of title XVI and title 
3.9 	XIX of the Social Security Act and pertinent rules and policies of the Social Security 
3.10 	Administration.
3.11 	(b) Prior to a denial or withdrawal of a requested determination of disability due 
3.12 	to insufficient evidence, the commissioner shall (1) ensure that the missing evidence is 
3.13 	necessary and appropriate to a determination of disability, and (2) assist applicants and 
3.14 	enrollees to obtain the evidence, including, but not limited to, medical examinations 
3.15 	and electronic medical records.
3.16 	(c) The commissioner shall provide the chairs of the legislative committees with 
3.17 	jurisdiction over health and human services finance and budget the following information 
3.18 	on the activities of the state medical review team by February 1 of each year:
3.19 	(1) the number of applications to the state medical review team that were denied, 
3.20 	approved, or withdrawn;
3.21 	(2) the average length of time from receipt of the application to a decision;
3.22 	(3) the number of appeals, appeal results, and the length of time taken from the date 
3.23 	the person involved requested an appeal for a written decision to be made on each appeal;
3.24 	(4) for applicants, their age, health coverage at the time of application, hospitalization 
3.25 	history within three months of application, and whether an application for Social Security 
3.26 	or Supplemental Security Income benefits is pending; and
3.27 	(5) specific information on the medical certification, licensure, or other credentials 
3.28 	of the person or persons performing the medical review determinations and length of 
3.29 	time in that position.
3.30 	(d) Any appeal made under section 256.045, subdivision 3, of a disability 
3.31 	determination made by the state medical review team must be decided according to the 
3.32 	timelines under section 256.0451, subdivision 22, paragraph (a). If a written decision is 
3.33 	not issued within the timelines under section 256.0451, subdivision 22, paragraph (a), the 
3.34 	appeal must be immediately reviewed by the chief appeals referee.

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

4.1 	Sec. 3. Minnesota Statutes 2010, section 256B.056, subdivision 1a, is amended to read:
4.2 		Subd. 1a.Income and assets generally. Unless specifically required by state law or 
4.3 	rule or federal law or regulation, the methodologies used in counting income and assets 
4.4 	to determine eligibility for medical assistance for persons whose eligibility category is 
4.5 	based on blindness, disability, or age of 65 or more years, the methodologies for the 
4.6 	supplemental security income program shall be used, except as provided under subdivision 
4.7 	3, clause (6). Increases in benefits under title II of the Social Security Act shall not be 
4.8 	counted as income for purposes of this subdivision until July 1 of each year. Effective 
4.9 	upon federal approval, for children eligible under section 256B.055, subdivision 12, or 
4.10 	for home and community-based waiver services whose eligibility for medical assistance 
4.11 	is determined without regard to parental income, child support payments, including any 
4.12 	payments made by an obligor in satisfaction of or in addition to a temporary or permanent 
4.13 	order for child support, and Social Security payments are not counted as income. For 
4.14 	families and children, which includes all other eligibility categories, the methodologies 
4.15 	under the state's AFDC plan in effect as of July 16, 1996, as required by the Personal 
4.16 	Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), Public 
4.17 	Law 104-193, shall be used, except that effective October 1, 2003, the earned income 
4.18 	disregards and deductions are limited to those in subdivision 1c. For these purposes, a 
4.19 	"methodology" does not include an asset or income standard, or accounting method, 
4.20 	or method of determining effective dates.

4.21 	Sec. 4. Minnesota Statutes 2010, section 256B.056, subdivision 3, is amended to read:
4.22 		Subd. 3.Asset limitations for individuals and families. (a) To be eligible for 
4.23 	medical assistance, a person must not individually own more than $3,000 in assets, or if a 
4.24 	member of a household with two family members, husband and wife, or parent and child, 
4.25 	the household must not own more than $6,000 in assets, plus $200 for each additional 
4.26 	legal dependent. In addition to these maximum amounts, an eligible individual or family 
4.27 	may accrue interest on these amounts, but they must be reduced to the maximum at the 
4.28 	time of an eligibility redetermination. The accumulation of the clothing and personal 
4.29 	needs allowance according to section 256B.35 must also be reduced to the maximum at 
4.30 	the time of the eligibility redetermination. The value of assets that are not considered in 
4.31 	determining eligibility for medical assistance is the value of those assets excluded under 
4.32 	the supplemental security income program for aged, blind, and disabled persons, with 
4.33 	the following exceptions:
4.34 	(1) household goods and personal effects are not considered;
5.1 	(2) capital and operating assets of a trade or business that the local agency determines 
5.2 	are necessary to the person's ability to earn an income are not considered;
5.3 	(3) motor vehicles are excluded to the same extent excluded by the supplemental 
5.4 	security income program;
5.5 	(4) assets designated as burial expenses are excluded to the same extent excluded by 
5.6 	the supplemental security income program. Burial expenses funded by annuity contracts 
5.7 	or life insurance policies must irrevocably designate the individual's estate as contingent 
5.8 	beneficiary to the extent proceeds are not used for payment of selected burial expenses; and
5.9 	(5) effective upon federal approval, for a person who no longer qualifies as an 
5.10 	employed person with a disability due to loss of earnings, assets allowed while eligible 
5.11 	for medical assistance under section 256B.057, subdivision 9, are not considered for 12 
5.12 	months, beginning with the first month of ineligibility as an employed person with a 
5.13 	disability, to the extent that the person's total assets remain within the allowed limits of 
5.14 	section 256B.057, subdivision 9, paragraph (c) (d); and
5.15 	(6) when a person enrolled in medical assistance under section 256B.057, subdivision 
5.16 	9, reaches age 65 and has been enrolled during each of the 24 consecutive months before 
5.17 	the person's 65th birthday, the assets owned by the person and the person's spouse must 
5.18 	be disregarded, up to the limits of section 256B.057, subdivision 9, paragraph (c), when 
5.19 	determining eligibility for medical assistance under section 256B.055, subdivision 7. The 
5.20 	income of a spouse of a person enrolled in medical assistance under section 256B.057, 
5.21 	subdivision 9, during each of the 24 consecutive months before the person's 65th birthday 
5.22 	must be disregarded when determining eligibility for medical assistance under section 
5.23 	256B.055, subdivision 7, when the person reaches age 65. Persons eligible under this 
5.24 	clause are not subject to the provisions in section 256B.059.
5.25 	(b) No asset limit shall apply to persons eligible under section 256B.055, subdivision 
5.26 	15.

5.27 	Sec. 5. Minnesota Statutes 2010, section 256B.057, subdivision 9, is amended to read:
5.28 		Subd. 9.Employed persons with disabilities. (a) Medical assistance may be paid 
5.29 	for a person who is employed and who:
5.30 	(1) but for excess earnings or assets, meets the definition of disabled under the 
5.31 	Supplemental Security Income program;
5.32 	(2) is at least 16 but less than 65 years of age;
5.33 	(3) meets the asset limits in paragraph (c) (d); and
5.34 	(4) pays a premium and other obligations under paragraph (e).
6.1 	(b) For purposes of eligibility, there is a $65 earned income disregard. To be eligible 
6.2 	for medical assistance under this subdivision, a person must have more than $65 of earned 
6.3 	income. Earned income must have Medicare, Social Security, and applicable state and 
6.4 	federal taxes withheld. The person must document earned income tax withholding. Any 
6.5 	spousal income or assets shall be disregarded for purposes of eligibility and premium 
6.6 	determinations.
6.7 	(b) (c) After the month of enrollment, a person enrolled in medical assistance under 
6.8 	this subdivision who:
6.9 	(1) is temporarily unable to work and without receipt of earned income due to a 
6.10 	medical condition, as verified by a physician, may retain eligibility for up to four calendar 
6.11 	months; or
6.12 	(2) effective January 1, 2004, loses employment for reasons not attributable to the 
6.13 	enrollee, and is without receipt of earned income may retain eligibility for up to four 
6.14 	consecutive months after the month of job loss. To receive a four-month extension, 
6.15 	enrollees must verify the medical condition or provide notification of job loss. All other 
6.16 	eligibility requirements must be met and the enrollee must pay all calculated premium 
6.17 	costs for continued eligibility.
6.18 	(c) (d) For purposes of determining eligibility under this subdivision, a person's 
6.19 	assets must not exceed $20,000, excluding:
6.20 	(1) all assets excluded under section 256B.056;
6.21 	(2) retirement accounts, including individual accounts, 401(k) plans, 403(b) plans, 
6.22 	Keogh plans, and pension plans; and
6.23 	(3) medical expense accounts set up through the person's employer; and
6.24 	(4) spousal assets, including spouse's share of jointly held assets.
6.25 	(d)(1) Effective January 1, 2004, for purposes of eligibility, there will be a $65 
6.26 	earned income disregard. To be eligible, a person applying for medical assistance under 
6.27 	this subdivision must have earned income above the disregard level.
6.28 	(2) Effective January 1, 2004, to be considered earned income, Medicare, Social 
6.29 	Security, and applicable state and federal income taxes must be withheld. To be eligible, 
6.30 	a person must document earned income tax withholding.
6.31 	(e)(1) A person whose earned and unearned income is equal to or greater than 100 
6.32 	percent of federal poverty guidelines for the applicable family size must pay a premium 
6.33 	to be eligible for medical assistance under this subdivision. All enrollees must pay a 
6.34 	premium to be eligible for medical assistance under this subdivision.
6.35 	(1) An enrollee must pay the greater of a $65 premium or the premium shall be
6.36 	calculated based on the person's gross earned and unearned income and the applicable 
7.1 	family size using a sliding fee scale established by the commissioner, which begins at 
7.2 	one percent of income at 100 percent of the federal poverty guidelines and increases 
7.3 	to 7.5 percent of income for those with incomes at or above 300 percent of the federal 
7.4 	poverty guidelines. 
7.5 	(2) Annual adjustments in the premium schedule based upon changes in the federal 
7.6 	poverty guidelines shall be effective for premiums due in July of each year.
7.7 	(2) Effective January 1, 2004, all enrollees must pay a premium to be eligible for 
7.8 	medical assistance under this subdivision. An enrollee shall pay the greater of a $35 
7.9 	premium or the premium calculated in clause (1).
7.10 	(3) Effective November 1, 2003, All enrollees who receive unearned income must 
7.11 	pay one-half of one five percent of unearned income in addition to the premium amount.
7.12 	(4) Effective November 1, 2003, for enrollees whose income does not exceed 200 
7.13 	percent of the federal poverty guidelines and who are also enrolled in Medicare, the 
7.14 	commissioner must reimburse the enrollee for Medicare Part B premiums under section 
7.15 	256B.0625, subdivision 15, paragraph (a).
7.16 	(5) (4) Increases in benefits under title II of the Social Security Act shall not be 
7.17 	counted as income for purposes of this subdivision until July 1 of each year.
7.18 	(f) A person's eligibility and premium shall be determined by the local county 
7.19 	agency. Premiums must be paid to the commissioner. All premiums are dedicated to 
7.20 	the commissioner.
7.21 	(g) Any required premium shall be determined at application and redetermined at 
7.22 	the enrollee's six-month income review or when a change in income or household size is 
7.23 	reported. Enrollees must report any change in income or household size within ten days 
7.24 	of when the change occurs. A decreased premium resulting from a reported change in 
7.25 	income or household size shall be effective the first day of the next available billing month 
7.26 	after the change is reported. Except for changes occurring from annual cost-of-living 
7.27 	increases, a change resulting in an increased premium shall not affect the premium amount 
7.28 	until the next six-month review.
7.29 	(h) Premium payment is due upon notification from the commissioner of the 
7.30 	premium amount required. Premiums may be paid in installments at the discretion of 
7.31 	the commissioner.
7.32 	(i) Nonpayment of the premium shall result in denial or termination of medical 
7.33 	assistance unless the person demonstrates good cause for nonpayment. Good cause exists 
7.34 	if the requirements specified in Minnesota Rules, part 9506.0040, subpart 7, items B to 
7.35 	D, are met. Except when an installment agreement is accepted by the commissioner, 
7.36 	all persons disenrolled for nonpayment of a premium must pay any past due premiums 
8.1 	as well as current premiums due prior to being reenrolled. Nonpayment shall include 
8.2 	payment with a returned, refused, or dishonored instrument. The commissioner may 
8.3 	require a guaranteed form of payment as the only means to replace a returned, refused, 
8.4 	or dishonored instrument.
8.5 	(j) The commissioner shall notify enrollees annually beginning at least 24 months 
8.6 	before the person's 65th birthday of the medical assistance eligibility rules affecting 
8.7 	income, assets, and treatment of a spouse's income and assets that will be applied upon 
8.8 	reaching age 65.
8.9 	(k) For enrollees whose income does not exceed 200 percent of the federal poverty 
8.10 	guidelines and who are also enrolled in Medicare, the commissioner must reimburse 
8.11 	the enrollee for Medicare part B premiums under section 256B.0625, subdivision 15, 
8.12 	paragraph (a).

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

8.15 	Sec. 6. Minnesota Statutes 2010, section 256B.0625, subdivision 19a, is amended to 
8.16 	read:
8.17 		Subd. 19a.Personal care assistance services. Medical assistance covers personal 
8.18 	care assistance services in a recipient's home. Effective January 1, 2010, to qualify for 
8.19 	personal care assistance services, a recipient must require assistance and be determined 
8.20 	dependent in one activity of daily living as defined in section 256B.0659, subdivision 1, 
8.21 	paragraph (b), or in a Level I behavior as defined in section 256B.0659, subdivision 1, 
8.22 	paragraph (c). Beginning July 1, 2011, to qualify for personal care assistance services, a 
8.23 	recipient must require assistance and be determined dependent in at least two activities 
8.24 	of daily living as defined in section 256B.0659. Recipients or responsible parties must 
8.25 	be able to identify the recipient's needs, direct and evaluate task accomplishment, and 
8.26 	provide for health and safety. Approved hours may be used outside the home when normal 
8.27 	life activities take them outside the home. To use personal care assistance services at 
8.28 	school, the recipient or responsible party must provide written authorization in the care 
8.29 	plan identifying the chosen provider and the daily amount of services to be used at school. 
8.30 	Total hours for services, whether actually performed inside or outside the recipient's 
8.31 	home, cannot exceed that which is otherwise allowed for personal care assistance services 
8.32 	in an in-home setting according to sections 256B.0651 to 256B.0656. Medical assistance 
8.33 	does not cover personal care assistance services for residents of a hospital, nursing facility, 
8.34 	intermediate care facility, health care facility licensed by the commissioner of health, or 
8.35 	unless a resident who is otherwise eligible is on leave from the facility and the facility 
9.1 	either pays for the personal care assistance services or forgoes the facility per diem for the 
9.2 	leave days that personal care assistance services are used. All personal care assistance 
9.3 	services must be provided according to sections 256B.0651 to 256B.0656. Personal care 
9.4 	assistance services may not be reimbursed if the personal care assistant is the spouse or 
9.5 	paid guardian of the recipient or the parent of a recipient under age 18, or the responsible 
9.6 	party or the family foster care provider of a recipient who cannot direct the recipient's own 
9.7 	care unless, in the case of a foster care provider, a county or state case manager visits 
9.8 	the recipient as needed, but not less than every six months, to monitor the health and 
9.9 	safety of the recipient and to ensure the goals of the care plan are met. Notwithstanding 
9.10 	the provisions of section 256B.0659, the unpaid guardian or conservator of an adult, 
9.11 	who is not the responsible party and not the personal care provider organization, may be 
9.12 	reimbursed to provide personal care assistance services to the recipient if the guardian or 
9.13 	conservator meets all criteria for a personal care assistant according to section 256B.0659, 
9.14 	and shall not be considered to have a service provider interest for purposes of participation 
9.15 	on the screening team under section 256B.092, subdivision 7.

9.16 	Sec. 7. Minnesota Statutes 2010, section 256B.0652, subdivision 6, is amended to read:
9.17 		Subd. 6. Authorization; personal care assistance and qualified professional.
 9.18 	(a) All personal care assistance services, supervision by a qualified professional, and 
9.19 	additional services beyond the limits established in subdivision 11, must be authorized 
9.20 	by the commissioner or the commissioner's designee before services begin except for the 
9.21 	assessments established in subdivision 11 and section 256B.0911. The authorization for 
9.22 	personal care assistance and qualified professional services under section 256B.0659 must 
9.23 	be completed within 30 days after receiving a complete request.
9.24 	(b) The amount of personal care assistance services authorized must be based 
9.25 	on the recipient's home care rating. The home care rating shall be determined by the 
9.26 	commissioner or the commissioner's designee based on information submitted to the 
9.27 	commissioner identifying the following for recipients with dependencies in two or more 
9.28 	activities of daily living:
9.29 	(1) total number of dependencies of activities of daily living as defined in section 
9.30 	256B.0659;
9.31 	(2) presence of complex health-related needs as defined in section 256B.0659; and
9.32 	(3) presence of Level I behavior as defined in section 256B.0659.
9.33 	(c) For persons meeting the criteria in paragraph (b), the methodology to determine 
9.34 	total time for personal care assistance services for each home care rating is based on 
9.35 	the median paid units per day for each home care rating from fiscal year 2007 data for 
10.1 	the personal care assistance program. Each home care rating has a base level of hours 
10.2 	assigned. Additional time is added through the assessment and identification of the 
10.3 	following:
10.4 	(1) 30 additional minutes per day for a dependency in each critical activity of daily 
10.5 	living as defined in section 256B.0659;
10.6 	(2) 30 additional minutes per day for each complex health-related function as 
10.7 	defined in section 256B.0659; and
10.8 	(3) 30 additional minutes per day for each behavior issue as defined in section 
10.9 	256B.0659, subdivision 4, paragraph (d).
10.10 	(d)  Effective July 1, 2011, the home care rating for recipients who have a dependency 
10.11 	in one activity of daily living or level one behavior shall equal no more than two units 
10.12 	per day.
10.13 	(e) A limit of 96 units of qualified professional supervision may be authorized for 
10.14 	each recipient receiving personal care assistance services. A request to the commissioner 
10.15 	to exceed this total in a calendar year must be requested by the personal care provider 
10.16 	agency on a form approved by the commissioner.

10.17 	Sec. 8. Minnesota Statutes 2010, section 256B.0913, subdivision 4, is amended to read:
10.18 		Subd. 4.Eligibility for funding for services for nonmedical assistance recipients.
 10.19 	(a) Funding for services under the alternative care program is available to persons who 
10.20 	meet the following criteria:
10.21 	(1) the person has been determined by a community assessment under section 
10.22 	256B.0911 to be a person who would require the level of care provided in a nursing 
10.23 	facility, as determined under section 256B.0911, subdivision 4a, paragraph (d), but for 
10.24 	the provision of services under the alternative care program. Effective January 1, 2011, 
10.25 	this determination must be made according to the criteria established in section 144.0724, 
10.26 	subdivision 11;
10.27 	(2) the person is age 65 or older;
10.28 	(3) the person would be eligible for medical assistance within 135 days of admission 
10.29 	to a nursing facility;
10.30 	(4) the person is not ineligible for the payment of long-term care services by the 
10.31 	medical assistance program due to an asset transfer penalty under section 256B.0595 or 
10.32 	equity interest in the home exceeding $500,000 as stated in section 256B.056;
10.33 	(5) the person needs long-term care services that are not funded through other 
10.34 	state or federal funding, or other health insurance or other third-party insurance such as 
10.35 	long-term care insurance;
11.1 	(6) except for individuals described in clause (7), the monthly cost of the alternative 
11.2 	care services funded by the program for this person does not exceed 75 percent of the 
11.3 	monthly limit described under section 256B.0915, subdivision 3a. This monthly limit 
11.4 	does not prohibit the alternative care client from payment for additional services, but in no 
11.5 	case may the cost of additional services purchased under this section exceed the difference 
11.6 	between the client's monthly service limit defined under section 256B.0915, subdivision 
11.7 	3, and the alternative care program monthly service limit defined in this paragraph. If 
11.8 	care-related supplies and equipment or environmental modifications and adaptations are or 
11.9 	will be purchased for an alternative care services recipient, the costs may be prorated on a 
11.10 	monthly basis for up to 12 consecutive months beginning with the month of purchase. 
11.11 	If the monthly cost of a recipient's other alternative care services exceeds the monthly 
11.12 	limit established in this paragraph, the annual cost of the alternative care services shall be 
11.13 	determined. In this event, the annual cost of alternative care services shall not exceed 12 
11.14 	times the monthly limit described in this paragraph;
11.15 	(7) for individuals assigned a case mix classification A as described under section 
11.16 	256B.0915, subdivision 3a, paragraph (a), with (i) no dependencies in activities of daily 
11.17 	living, or (ii) only one dependency up to two dependencies in bathing, dressing, grooming, 
11.18 	or walking, or (iii) a dependency score of less than three if eating is the only dependency
11.19 	and eating when the dependency score in eating is three or greater as determined by 
11.20 	an assessment performed under section 256B.0911, the monthly cost of alternative 
11.21 	care services funded by the program cannot exceed $600 $593 per month for all new 
11.22 	participants enrolled in the program on or after July 1, 2009 2011. This monthly limit 
11.23 	shall be applied to all other participants who meet this criteria at reassessment. This 
11.24 	monthly limit shall be increased annually as described in section 256B.0915, subdivision 
11.25 	3a, paragraph (a). This monthly limit does not prohibit the alternative care client from 
11.26 	payment for additional services, but in no case may the cost of additional services 
11.27 	purchased exceed the difference between the client's monthly service limit defined in this 
11.28 	clause and the limit described in clause (6) for case mix classification A; and
11.29 	(8) the person is making timely payments of the assessed monthly fee.
11.30 	A person is ineligible if payment of the fee is over 60 days past due, unless the person 
11.31 	agrees to:
11.32 	(i) the appointment of a representative payee;
11.33 	(ii) automatic payment from a financial account;
11.34 	(iii) the establishment of greater family involvement in the financial management of 
11.35 	payments; or
11.36 	(iv) another method acceptable to the lead agency to ensure prompt fee payments.
12.1 	The lead agency may extend the client's eligibility as necessary while making 
12.2 	arrangements to facilitate payment of past-due amounts and future premium payments. 
12.3 	Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be 
12.4 	reinstated for a period of 30 days.
12.5 	(b) Alternative care funding under this subdivision is not available for a person 
12.6 	who is a medical assistance recipient or who would be eligible for medical assistance 
12.7 	without a spenddown or waiver obligation. A person whose initial application for medical 
12.8 	assistance and the elderly waiver program is being processed may be served under the 
12.9 	alternative care program for a period up to 60 days. If the individual is found to be eligible 
12.10 	for medical assistance, medical assistance must be billed for services payable under the 
12.11 	federally approved elderly waiver plan and delivered from the date the individual was 
12.12 	found eligible for the federally approved elderly waiver plan. Notwithstanding this 
12.13 	provision, alternative care funds may not be used to pay for any service the cost of which: 
12.14 	(i) is payable by medical assistance; (ii) is used by a recipient to meet a waiver obligation; 
12.15 	or (iii) is used to pay a medical assistance income spenddown for a person who is eligible 
12.16 	to participate in the federally approved elderly waiver program under the special income 
12.17 	standard provision.
12.18 	(c) Alternative care funding is not available for a person who resides in a licensed 
12.19 	nursing home, certified boarding care home, hospital, or intermediate care facility, except 
12.20 	for case management services which are provided in support of the discharge planning 
12.21 	process for a nursing home resident or certified boarding care home resident to assist with 
12.22 	a relocation process to a community-based setting.
12.23 	(d) Alternative care funding is not available for a person whose income is greater 
12.24 	than the maintenance needs allowance under section 256B.0915, subdivision 1d, but equal 
12.25 	to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal 
12.26 	year for which alternative care eligibility is determined, who would be eligible for the 
12.27 	elderly waiver with a waiver obligation.

12.28 	Sec. 9. Minnesota Statutes 2010, section 256B.0915, subdivision 3a, is amended to 
12.29 	read:
12.30 		Subd. 3a.Elderly waiver cost limits. (a) The monthly limit for the cost of 
12.31 	waivered services to an individual elderly waiver client except for individuals described 
12.32 	in paragraph (b) shall be the weighted average monthly nursing facility rate of the case 
12.33 	mix resident class to which the elderly waiver client would be assigned under Minnesota 
12.34 	Rules, parts 9549.0050 to 9549.0059, less the recipient's maintenance needs allowance 
12.35 	as described in subdivision 1d, paragraph (a), until the first day of the state fiscal year in 
13.1 	which the resident assessment system as described in section 256B.438 for nursing home 
13.2 	rate determination is implemented. Effective on the first day of the state fiscal year in 
13.3 	which the resident assessment system as described in section 256B.438 for nursing home 
13.4 	rate determination is implemented and the first day of each subsequent state fiscal year, the 
13.5 	monthly limit for the cost of waivered services to an individual elderly waiver client shall 
13.6 	be the rate of the case mix resident class to which the waiver client would be assigned 
13.7 	under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect on the last day of the 
13.8 	previous state fiscal year, adjusted by the greater of any legislatively adopted home and 
13.9 	community-based services percentage rate increase or the average statewide percentage 
13.10 	increase in nursing facility payment rates adjustment.
13.11 	(b) The monthly limit for the cost of waivered services to an individual elderly 
13.12 	waiver client assigned to a case mix classification A under paragraph (a) with:
13.13 	(1) no dependencies in activities of daily living,; or
13.14 	(2) only one dependency up to two dependencies in bathing, dressing, grooming, or
13.15 	walking, or (3) a dependency score of less than three if eating is the only dependency,
13.16 	and eating when the dependency score in eating is three or greater as determined by 
13.17 	an assessment performed under section 256B.0911 shall be the lower of the case mix 
13.18 	classification amount for case mix A as determined under paragraph (a) or the case mix 
13.19 	classification amount for case mix A  $1,750 per month effective on October July 1, 2008
13.20 	2011, per month for all new participants enrolled in the program on or after July 1, 2009
13.21 	2011. This monthly limit shall be applied to all other participants who meet this criteria at 
13.22 	reassessment. This monthly limit shall be increased annually as described in paragraph (a).
13.23 	
13.24 	(c) If extended medical supplies and equipment or environmental modifications are 
13.25 	or will be purchased for an elderly waiver client, the costs may be prorated for up to 
13.26 	12 consecutive months beginning with the month of purchase. If the monthly cost of a 
13.27 	recipient's waivered services exceeds the monthly limit established in paragraph (a) or 
13.28 	(b), the annual cost of all waivered services shall be determined. In this event, the annual 
13.29 	cost of all waivered services shall not exceed 12 times the monthly limit of waivered 
13.30 	services as described in paragraph (a) or (b).

13.31 	Sec. 10. Minnesota Statutes 2010, section 256B.0915, subdivision 3b, is amended to 
13.32 	read:
13.33 		Subd. 3b.Cost limits for elderly waiver applicants who reside in a nursing 
13.34 	facility. (a) For a person who is a nursing facility resident at the time of requesting a 
13.35 	determination of eligibility for elderly waivered services, a monthly conversion budget 
14.1 	limit for the cost of elderly waivered services may be requested. The monthly conversion 
14.2 	budget limit for the cost of elderly waiver services shall be the resident class assigned 
14.3 	under Minnesota Rules, parts 9549.0050 to 9549.0059, for that resident in the nursing 
14.4 	facility where the resident currently resides until July 1 of the state fiscal year in which 
14.5 	the resident assessment system as described in section 256B.438 for nursing home rate 
14.6 	determination is implemented. Effective on July 1 of the state fiscal year in which the 
14.7 	resident assessment system as described in section 256B.438 for nursing home rate 
14.8 	determination is implemented, the monthly conversion budget limit for the cost of elderly 
14.9 	waiver services shall be based on the per diem nursing facility rate as determined by the 
14.10 	resident assessment system as described in section 256B.438 for that resident residents
14.11 	in the nursing facility where the resident elderly waiver applicant currently resides 
14.12 	multiplied. The monthly conversion budget limit shall be calculated by multiplying the 
14.13 	per diem by 365 and,  divided by 12, less and reduced by  the recipient's maintenance needs 
14.14 	allowance as described in subdivision 1d. The initially approved monthly conversion rate 
14.15 	may budget limit shall be adjusted by the greater of any subsequent legislatively adopted 
14.16 	home and community-based services percentage rate increase or the average statewide 
14.17 	percentage increase in nursing facility payment rates annually as described in subdivision 
14.18 	3a, paragraph (a). The limit under this subdivision only applies to persons discharged from 
14.19 	a nursing facility after a minimum 30-day stay and found eligible for waivered services 
14.20 	on or after July 1, 1997. For conversions from the nursing home to the elderly waiver 
14.21 	with consumer directed community support services, the conversion rate limit is equal to 
14.22 	the nursing facility rate per diem used to calculate the monthly conversion budget limit 
14.23 	must be reduced by a percentage equal to the percentage difference between the consumer 
14.24 	directed services budget limit that would be assigned according to the federally approved 
14.25 	waiver plan and the corresponding community case mix cap, but not to exceed 50 percent.
14.26 	(b) The following costs must be included in determining the total monthly costs 
14.27 	for the waiver client:
14.28 	(1) cost of all waivered services, including extended medical specialized supplies 
14.29 	and equipment and environmental modifications and accessibility adaptations; and
14.30 	(2) cost of skilled nursing, home health aide, and personal care services reimbursable 
14.31 	by medical assistance.

14.32 	Sec. 11. Minnesota Statutes 2010, section 256B.0915, subdivision 3e, is amended to 
14.33 	read:
14.34 		Subd. 3e.Customized living service rate. (a) Payment for customized living 
14.35 	services shall be a monthly rate authorized by the lead agency within the parameters 
15.1 	established by the commissioner. The payment agreement must delineate the amount of 
15.2 	each component service included in the recipient's customized living service plan. The 
15.3 	lead agency shall ensure that there is a documented need within the parameters established 
15.4 	by the commissioner for all component customized living services authorized.
15.5 	(b) The payment rate must be based on the amount of component services to be 
15.6 	provided utilizing component rates established by the commissioner. Counties and tribes 
15.7 	shall use tools issued by the commissioner to develop and document customized living 
15.8 	service plans and rates.
15.9 	(c) Component service rates must not exceed payment rates for comparable elderly 
15.10 	waiver or medical assistance services and must reflect economies of scale. Customized 
15.11 	living services must not include rent or raw food costs.
15.12 	(d) With the exception of individuals described in subdivision 3a, paragraph (b), the 
15.13 	individualized monthly authorized payment for the customized living service plan shall 
15.14 	not exceed 50 percent of the greater of either the statewide or any of the geographic 
15.15 	groups' weighted average monthly nursing facility rate of the case mix resident class 
15.16 	to which the elderly waiver eligible client would be assigned under Minnesota Rules, 
15.17 	parts 9549.0050 to 9549.0059, less the maintenance needs allowance as described 
15.18 	in subdivision 1d, paragraph (a), until the July 1 of the state fiscal year in which the 
15.19 	resident assessment system as described in section 256B.438 for nursing home rate 
15.20 	determination is implemented. Effective on July 1 of the state fiscal year in which 
15.21 	the resident assessment system as described in section 256B.438 for nursing home 
15.22 	rate determination is implemented and July 1 of each subsequent state fiscal year, the 
15.23 	individualized monthly authorized payment for the services described in this clause shall 
15.24 	not exceed the limit which was in effect on June 30 of the previous state fiscal year 
15.25 	updated annually based on legislatively adopted changes to all service rate maximums for 
15.26 	home and community-based service providers.
15.27 	(e) Effective July 1, 2011, the individualized monthly payment for the customized 
15.28 	living service plan for individuals described in subdivision 3a, paragraph (b), must be the 
15.29 	monthly authorized payment limit for customized living for individuals classified as case 
15.30 	mix A, reduced by 25 percent. This rate limit must be applied to all new participants 
15.31 	enrolled in the program on or after July 1, 2011, who meet the criteria described in 
15.32 	subdivision 3a, paragraph (b). This monthly limit also applies to all other participants who 
15.33 	meet the criteria described in subdivision 3a, paragraph (b), at reassessment.
15.34 	 (f) Customized living services are delivered by a provider licensed by the 
15.35 	Department of Health as a class A or class F home care provider and provided in a 
16.1 	building that is registered as a housing with services establishment under chapter 144D.
16.2 	Licensed home care providers are subject to section 256B.0651, subdivision 14.
16.3 	(g) A provider may not bill or otherwise charge an elderly waiver participant or their 
16.4 	family for additional units of any allowable component service beyond those available 
16.5 	under the service rate limits described in paragraph (d), nor for additional units of any 
16.6 	allowable component service beyond those approved in the service plan by the lead agency.

16.7 	Sec. 12. Minnesota Statutes 2010, section 256B.0915, subdivision 3h, is amended to 
16.8 	read:
16.9 		Subd. 3h.Service rate limits; 24-hour customized living services. (a) The 
16.10 	payment rate for 24-hour customized living services is a monthly rate authorized by the 
16.11 	lead agency within the parameters established by the commissioner of human services. 
16.12 	The payment agreement must delineate the amount of each component service included in 
16.13 	each recipient's customized living service plan. The lead agency shall ensure that there is a 
16.14 	documented need within the parameters established by the commissioner for all component 
16.15 	customized living services authorized. The lead agency shall not authorize 24-hour 
16.16 	customized living services unless there is a documented need for 24-hour supervision.
16.17 	(b) For purposes of this section, "24-hour supervision" means that the recipient 
16.18 	requires assistance due to needs related to one or more of the following:
16.19 	(1) intermittent assistance with toileting, positioning, or transferring;
16.20 	(2) cognitive or behavioral issues;
16.21 	(3) a medical condition that requires clinical monitoring; or
16.22 	(4) for all new participants enrolled in the program on or after January July 1, 2011, 
16.23 	and all other participants at their first reassessment after January July 1, 2011, dependency 
16.24 	in at least two three of the following activities of daily living as determined by assessment 
16.25 	under section 256B.0911: bathing; dressing; grooming; walking; or eating when the 
16.26 	dependency score in eating is three or greater; and needs medication management and at 
16.27 	least 50 hours of service per month. The lead agency shall ensure that the frequency and 
16.28 	mode of supervision of the recipient and the qualifications of staff providing supervision 
16.29 	are described and meet the needs of the recipient.
16.30 	(c) The payment rate for 24-hour customized living services must be based on the 
16.31 	amount of component services to be provided utilizing component rates established by the 
16.32 	commissioner. Counties and tribes will use tools issued by the commissioner to develop 
16.33 	and document customized living plans and authorize rates.
16.34 	(d) Component service rates must not exceed payment rates for comparable elderly 
16.35 	waiver or medical assistance services and must reflect economies of scale.
17.1 	(e) The individually authorized 24-hour customized living payments, in combination 
17.2 	with the payment for other elderly waiver services, including case management, must not 
17.3 	exceed the recipient's community budget cap specified in subdivision 3a. Customized 
17.4 	living services must not include rent or raw food costs.
17.5 	(f) The individually authorized 24-hour customized living payment rates shall not 
17.6 	exceed the 95 percentile of statewide monthly authorizations for 24-hour customized 
17.7 	living services in effect and in the Medicaid management information systems on March 
17.8 	31, 2009, for each case mix resident class under Minnesota Rules, parts 9549.0050 
17.9 	to 9549.0059, to which elderly waiver service clients are assigned. When there are 
17.10 	fewer than 50 authorizations in effect in the case mix resident class, the commissioner 
17.11 	shall multiply the calculated service payment rate maximum for the A classification by 
17.12 	the standard weight for that classification under Minnesota Rules, parts 9549.0050 to 
17.13 	9549.0059, to determine the applicable payment rate maximum. Service payment rate 
17.14 	maximums shall be updated annually based on legislatively adopted changes to all service 
17.15 	rates for home and community-based service providers.
17.16 	(g) Notwithstanding the requirements of paragraphs (d) and (f), the commissioner 
17.17 	may establish alternative payment rate systems for 24-hour customized living services in 
17.18 	housing with services establishments which are freestanding buildings with a capacity of 
17.19 	16 or fewer, by applying a single hourly rate for covered component services provided 
17.20 	in either:
17.21 	(1) licensed corporate adult foster homes; or
17.22 	(2) specialized dementia care units which meet the requirements of section 144D.065 
17.23 	and in which:
17.24 	(i) each resident is offered the option of having their own apartment; or
17.25 	(ii) the units are licensed as board and lodge establishments with maximum capacity 
17.26 	of eight residents, and which meet the requirements of Minnesota Rules, part 9555.6205, 
17.27 	subparts 1, 2, 3, and 4, item A.
17.28 	(h) A provider may not bill or otherwise charge an elderly waiver participant or their 
17.29 	family for additional units of any allowable component service beyond those available 
17.30 	under the service rate limits described in paragraph (e), nor for additional units of any 
17.31 	allowable component service beyond those approved in the service plan by the lead agency.

17.32 	Sec. 13. Minnesota Statutes 2010, section 256B.0915, subdivision 6, is amended to 
17.33 	read:
17.34 		Subd. 6.Implementation of care plan. Each elderly waiver client, and the 
17.35 	client's provider of services, shall be provided a copy of a written care plan that meets 
18.1 	the requirements outlined in section 256B.0913, subdivision 8. The care plan must be 
18.2 	implemented by the county of service when it is different than the county of financial 
18.3 	responsibility. The county of service administering waivered services must notify the 
18.4 	county of financial responsibility of the approved care plan.

18.5 	Sec. 14. Minnesota Statutes 2010, section 256B.0915, subdivision 10, is amended to 
18.6 	read:
18.7 		Subd. 10.Waiver payment rates; managed care organizations. The 
18.8 	commissioner shall adjust the elderly waiver capitation payment rates for managed care 
18.9 	organizations paid under section 256B.69, subdivisions 6a and 23, to reflect the maximum 
18.10 	service rate limits for customized living services and 24-hour customized living services 
18.11 	under subdivisions 3e and 3h for the contract period beginning October 1, 2009. Medical 
18.12 	assistance rates paid to customized living providers by managed care organizations under 
18.13 	this section shall not exceed the maximum service rate limits and component rates as 
18.14 	determined by the commissioner under subdivisions 3e and 3h.

18.15 	Sec. 15. Minnesota Statutes 2010, section 256B.14, is amended by adding a 
18.16 	subdivision to read:
18.17 		Subd. 3a.Spousal contribution. (a) For purposes of this subdivision, the following 
18.18 	terms have the meanings given:
18.19 	(1) "commissioner" means the commissioner of human services;
18.20 	(2) "community spouse" means the spouse, who lives in the community, of an 
18.21 	individual receiving long-term care services in a long-term care facility or receiving 
18.22 	home care services pursuant to the Medicaid waiver for elderly services under section 
18.23 	256B.0915 or the alternative care program under section 256B.0913. A community 
18.24 	spouse does not include a spouse living in the community who receives a monthly income 
18.25 	allowance under section 256B.058, subdivision 2, or who receives home care services 
18.26 	under the Medicaid waiver for elderly services under section 256B.0915 or the alternative 
18.27 	care program under section 256B.0913;
18.28 	(3) "cost of care" means the actual fee for service costs or capitated payments for 
18.29 	the long term care spouse;
18.30 	(4) "department" means the Department of Human Services;
18.31 	(5) "disabled child" means a blind or permanently and totally disabled son or 
18.32 	daughter of any age as defined in the Supplemental Security Income program or the State 
18.33 	Medical Review Team;
19.1 	(6) "income" means earned and unearned income, attributable to the community 
19.2 	spouse, used to calculate the adjusted gross income on the prior year's income tax return. 
19.3 	Evidence of income includes, but is not limited to, W-2 and 1099 forms; and
19.4 	(7) "long-term care spouse" means the spouse who is receiving long-term care 
19.5 	services in a long-term care facility or receiving home care services pursuant to the 
19.6 	Medicaid waiver for elderly services under section 256B.0915 or the alternative care 
19.7 	program under section 256B.0913.
19.8 	(b) The community spouse of a long-term care spouse who receives medical 
19.9 	assistance or alternative care services has an obligation to contribute to the cost of care. 
19.10 	The community spouse must pay a monthly fee on a sliding fee scale based on the 
19.11 	community spouse's income, unless a minor or disabled child resides with and receives 
19.12 	care from the community spouse, in  case, no fee shall be assessed.
19.13 	(c) For a community spouse with an income equal to or greater than 250 percent of 
19.14 	the federal poverty guidelines for a family of two and less than 545 percent of the federal 
19.15 	poverty guidelines for a family of two, the spousal contribution shall be determined using 
19.16 	a sliding fee scale established by the commissioner that begins at 7.5 percent of the 
19.17 	community spouse's income and increases to 15 percent for those with an income of up to 
19.18 	545 percent of the federal poverty guidelines for a family of two.
19.19 	(d) For a community spouse with an income equal to or greater than 545 percent of 
19.20 	the federal poverty guidelines for a family of two and less than 750 percent of the federal 
19.21 	poverty guidelines for a family of two, the spousal contribution shall be determined using 
19.22 	a sliding fee scale established by the commissioner that begins at 15 percent of the 
19.23 	community spouse's income and increases to 25 percent for those with an income of up to 
19.24 	750 percent of the federal poverty guidelines for a family of two.
19.25 	(e) For a community spouse with an income equal to or greater than 750 percent of 
19.26 	the federal poverty guidelines for a family of two and less than 975 percent of the federal 
19.27 	poverty guidelines for a family of two, the spousal contribution shall be determined using 
19.28 	a sliding fee scale established by the commissioner that begins at 25 percent of the 
19.29 	community spouse's income and increases to 33 percent for those with an income of up to 
19.30 	975 percent of the federal poverty guidelines for a family of two.
19.31 	(f) For a community spouse with an income equal to or greater than 975 percent of 
19.32 	the federal poverty guidelines for a family of two, the spousal contribution shall be 33 
19.33 	percent of the community spouse's income.
19.34 	(g) The spousal contribution shall be explained in writing at the time eligibility for 
19.35 	medical assistance or alternative care is being determined. In addition to explaining the 
19.36 	formula used to determine the fee, the commissioner shall provide written information 
20.1 	describing how to request a variance for undue hardship, how a contribution may be 
20.2 	reviewed or redetermined, the right to appeal a contribution determination, and that 
20.3 	the consequences for not complying with a request to provide information shall be an 
20.4 	assessment against the community spouse for the full cost of care for the long-term care 
20.5 	spouse.
20.6 	(h) The contribution shall be assessed for each month the long-term care spouse is 
20.7 	eligible for medical assistance or alternative care.
20.8 	(i) The spousal contribution shall be reviewed at least once every 12 months and 
20.9 	when there is a loss or gain in income in excess of ten percent. Thirty days prior to a 
20.10 	review or redetermination, written notice must be provided to the community spouse 
20.11 	and must contain the amount the spouse is required to contribute, notice of the right to 
20.12 	redetermination and appeal, and the telephone number of the division at the department 
20.13 	that is responsible for redetermination and review. If, after review, the contribution amount 
20.14 	is to be adjusted, the commissioner shall mail a written notice to the community spouse 30 
20.15 	days in advance of the effective date of the change in the amount of the contribution:
20.16 	(1) the spouse shall notify the commissioner within 30 days of a gain or loss in 
20.17 	income in excess of ten percent and provide the department supporting documentation to 
20.18 	verify the need for redetermination of the fee;
20.19 	(2) when a spouse requests a review or redetermination of the contribution amount, a 
20.20 	request for information shall be sent to the spouse within ten calendar days after the 
20.21 	commissioner receives the request for review;
20.22 	(3) no action shall be taken on a review or redetermination until the required 
20.23 	information is received by the commissioner;
20.24 	(4) the review of the spousal contribution shall be done within ten days after the 
20.25 	commissioner receives completed information that verifies a loss or gain in income 
20.26 	in excess of ten percent;
20.27 	(5) an increase in the contribution amount is effective in the month in  the increase in 
20.28 	spousal income occurs; and
20.29 	(6) a decrease in the contribution amount is effective in the month the spouse verifies 
20.30 	the reduction in income, retroactive to no longer than six months.
20.31 	(j) In no case shall the spousal contribution exceed the amount of medical assistance 
20.32 	expended or the cost of alternative care services for the care of the long-term care 
20.33 	spouse. At the time of the review, the total amount of medical assistance paid or costs 
20.34 	of alternative care for the care of the long-term care spouse and the total amount of the 
20.35 	spousal contribution shall be compared. If the total amount of the spousal contribution 
20.36 	exceeds the total amount of medical assistance expended or cost of alternative care, the 
21.1 	department shall reimburse the community spouse the excess amount if the long-term 
21.2 	care spouse is no longer receiving services, or apply the excess amount to the spousal 
21.3 	contribution due until the excess amount is exhausted.
21.4 	(k) A spouse who needs to retain the contribution amount for the spouse's personal 
21.5 	medical care may request a variance for undue hardship by submitting a written request 
21.6 	and supporting documentation to the commissioner that states why compliance with 
21.7 	this subdivision would cause undue hardship. The commissioner shall forward to the 
21.8 	spouse a request for financial information within ten days after receiving a written request 
21.9 	for a variance. A spouse must provide the commissioner with the requested financial 
21.10 	information and any other information sufficient to verify the existence of undue hardship 
21.11 	necessitating a waiver:
21.12 	(1) a spouse who requests a variance from a notice of an increase in the amount 
21.13 	of spousal contribution shall continue to make monthly payments at the lower amount 
21.14 	pending determination of the variance request. A spouse who requests a variance from 
21.15 	the initial determination shall not be required to make a payment pending determination 
21.16 	of the variance request. Payments made pending outcome of the variance request that 
21.17 	result in overpayment shall be returned to the spouse if the community spouse is no 
21.18 	longer receiving services or applied to the spousal contribution in the current year. If the 
21.19 	variance is denied, the spouse shall pay the additional amount due from the effective date 
21.20 	of the increase or the total amount due from the effective date of the original notice of 
21.21 	determination of the spousal contribution;
21.22 	(2) a spouse who is granted a variance shall sign a written agreement in which the 
21.23 	spouse agrees to report to the commissioner any changes in circumstances that gave rise 
21.24 	to the undue hardship variance;
21.25 	(3) when the commissioner receives a request for a variance, written notice of a 
21.26 	grant or denial of the variance shall be mailed to the spouse within 30 calendar days 
21.27 	after the commissioner receives the financial information required in this paragraph. The 
21.28 	granting of a variance will necessitate a written agreement between the spouse and the 
21.29 	commissioner with regard to the specific terms of the variance. The variance will not 
21.30 	become effective until the written agreement is signed by the spouse. If the commissioner 
21.31 	denies in whole or in part the request for a variance, the denial notice shall set forth in 
21.32 	writing the reasons for the denial that address the specific hardship and right to appeal;
21.33 	(4) if a variance is granted, the term of the variance shall not exceed 12 months 
21.34 	unless otherwise determined by the commissioner; and
21.35 	(5) undue hardship does not include action taken by a spouse that divested or 
21.36 	diverted income in order to avoid being assessed a spousal contribution.
22.1 	(l) A spouse aggrieved by an action under this subdivision has the right to appeal 
22.2 	under subdivision 4. If the spouse appeals on or before the effective date of an increase in 
22.3 	the spousal fee, the spouse shall continue to make payments to the commissioner in the 
22.4 	lower amount while the appeal is pending. A spouse appealing an initial determination 
22.5 	of a spousal contribution shall not be required to make monthly payments pending an 
22.6 	appeal decision. Payments made that result in an overpayment shall be reimbursed to the 
22.7 	spouse if the long-term care spouse is no longer receiving services, or applied to the 
22.8 	spousal contribution remaining in the current year. If the commissioner's determination is 
22.9 	affirmed, the community spouse shall pay within 90 calendar days of the order the total 
22.10 	amount due from the effective date of the original notice of determination of the spousal 
22.11 	contribution. The commissioner's order is binding on the spouse and the department and 
22.12 	shall be implemented subject to section 256.045, subdivision 7. No additional notice is 
22.13 	required to enforce the commissioner's order.
22.14 	(m) Actions to obtain payment shall be taken under subdivision 2.

22.15 	Sec. 16. Minnesota Statutes 2010, section 256B.431, subdivision 2r, is amended to 
22.16 	read:
22.17 		Subd. 2r.Payment restrictions on leave days. Effective July 1, 1993, the 
22.18 	commissioner shall limit payment for leave days in a nursing facility to 79 percent of that 
22.19 	nursing facility's total payment rate for the involved resident. For services rendered on or 
22.20 	after July 1, 2003, for facilities reimbursed under this section or section 256B.434, the 
22.21 	commissioner shall limit payment for leave days in a nursing facility to 60 percent of 
22.22 	that nursing facility's total payment rate for the involved resident. For services rendered 
22.23 	on or after July 1, 2011, for facilities reimbursed under this section, section 256B.434, 
22.24 	section 256B.441, or any other section, the commissioner shall not pay for leave days, 
22.25 	notwithstanding Minnesota Rules, part 9505.0415.

22.26 	Sec. 17. Minnesota Statutes 2010, section 256B.431, subdivision 32, is amended to 
22.27 	read:
22.28 		Subd. 32.Payment during first 90 30  days. (a) For rate years beginning on or after 
22.29 	July 1, 2001, the total payment rate for a facility reimbursed under this section, section 
22.30 	256B.434, or any other section for the first 90 paid days after admission shall be:
22.31 	(1) for the first 30 paid days, the rate shall be 120 percent of the facility's medical 
22.32 	assistance rate for each case mix class;
22.33 	(2) for the next 60 paid days after the first 30 paid days, the rate shall be 110 percent 
22.34 	of the facility's medical assistance rate for each case mix class;
23.1 	(3) beginning with the 91st paid day after admission, the payment rate shall be the 
23.2 	rate otherwise determined under this section, section 256B.434, or any other section; and
23.3 	(4) payments under this paragraph apply to admissions occurring on or after July 1, 
23.4 	2001, and before July 1, 2003, and to resident days occurring before July 30, 2003.
23.5 	(b) For rate years beginning on or after July 1, 2003 2011, the total payment rate for 
23.6 	a facility reimbursed under this section, section 256B.434, or any other section shall be:
23.7 	(1) for the first 30 calendar days after admission, the rate shall be 120 percent of 
23.8 	the facility's medical assistance rate for each RUG class;
23.9 	(2) beginning with the 31st calendar day after admission, the payment rate shall be 
23.10 	the rate otherwise determined under this section, section 256B.434, or any other section; 
23.11 	and
23.12 	(3) payments under this paragraph apply to admissions occurring on or after July 
23.13 	1, 2003 2011.
23.14 	(c) Effective January 1, 2004, (b)  The enhanced rates under this subdivision shall not 
23.15 	be allowed if a resident has resided during the previous 30 calendar days in:
23.16 	(1) the same nursing facility;
23.17 	(2) a nursing facility owned or operated by a related party; or
23.18 	(3) a nursing facility or part of a facility that closed or was in the process of closing.

23.19 	Sec. 18. Minnesota Statutes 2010, section 256B.431, subdivision 42, is amended to 
23.20 	read:
23.21 		Subd. 42.Incentive to establish single-bed rooms. (a) Beginning July 1, 2005, 
23.22 	the operating payment rate for nursing facilities reimbursed under this section, section 
23.23 	256B.434, or 256B.441 shall be increased by 20 percent multiplied by the ratio of the 
23.24 	number of new single-bed rooms created divided by the number of active beds on July 
23.25 	1, 2005, for each bed closure that results in the creation of a single-bed room after 
23.26 	July 1, 2005. The commissioner may implement rate adjustments for up to 3,000 new 
23.27 	single-bed rooms each year. For eligible bed closures for which the commissioner receives 
23.28 	a notice from a facility during a calendar quarter that a bed has been delicensed and a 
23.29 	new single-bed room has been established, the rate adjustment in this paragraph shall be 
23.30 	effective on the first day of the second month following that calendar quarter.
23.31 	(b) A nursing facility is prohibited from discharging residents for purposes of 
23.32 	establishing single-bed rooms. A nursing facility must submit documentation to the 
23.33 	commissioner in a form prescribed by the commissioner, certifying the occupancy status 
23.34 	of beds closed to create single-bed rooms. In the event that the commissioner determines 
24.1 	that a facility has discharged a resident for purposes of establishing a single-bed room, the 
24.2 	commissioner shall not provide a rate adjustment under paragraph (a).
24.3 	(c) If after August 1, 2005, and before December 31, 2007, more than 4,000 nursing 
24.4 	home beds are removed from service, a portion of the appropriation for nursing homes 
24.5 	shall be transferred to the alternative care program. The amount of this transfer shall equal 
24.6 	the number of beds removed from service less 4,000, multiplied by the average monthly 
24.7 	per-person cost for alternative care, multiplied by 12, and further multiplied by 0.3.
24.8 	(d) Beginning on July 1, 2011, the commissioner shall no longer approve single bed 
24.9 	incentive rate adjustments under this section.

24.10 	Sec. 19. Minnesota Statutes 2010, section 256B.431, is amended by adding a 
24.11 	subdivision to read:
24.12 		Subd. 44.Property rate increase for a facility in Bloomington effective 
24.13 	November 1, 2010. Notwithstanding any other law to the contrary, money available for 
24.14 	moratorium projects under section 144A.073, subdivision 11, shall be used effective 
24.15 	November 1, 2010, to fund an approved moratorium exception project for a nursing 
24.16 	facility in Bloomington licensed for 137 beds as of November 1, 2010, up to a total 
24.17 	property rate adjustment of $19.33.

24.18 	Sec. 20. Minnesota Statutes 2010, section 256B.437, subdivision 6, is amended to read:
24.19 		Subd. 6.Planned closure rate adjustment. (a) The commissioner of human 
24.20 	services shall calculate the amount of the planned closure rate adjustment available under 
24.21 	subdivision 3, paragraph (b), for up to 5,140 beds according to clauses (1) to (4):
24.22 	(1) the amount available is the net reduction of nursing facility beds multiplied 
24.23 	by $2,080;
24.24 	(2) the total number of beds in the nursing facility or facilities receiving the planned 
24.25 	closure rate adjustment must be identified;
24.26 	(3) capacity days are determined by multiplying the number determined under 
24.27 	clause (2) by 365; and
24.28 	(4) the planned closure rate adjustment is the amount available in clause (1), divided 
24.29 	by capacity days determined under clause (3).
24.30 	(b) A planned closure rate adjustment under this section is effective on the first day 
24.31 	of the month following completion of closure of the facility designated for closure in the 
24.32 	application and becomes part of the nursing facility's total operating payment rate.
24.33 	(c) Applicants may use the planned closure rate adjustment to allow for a property 
24.34 	payment for a new nursing facility or an addition to an existing nursing facility or as an 
25.1 	operating payment rate adjustment. Applications approved under this subdivision are 
25.2 	exempt from other requirements for moratorium exceptions under section 144A.073, 
25.3 	subdivisions 2 and 3.
25.4 	(d) Upon the request of a closing facility, the commissioner must allow the facility a 
25.5 	closure rate adjustment as provided under section 144A.161, subdivision 10.
25.6 	(e) A facility that has received a planned closure rate adjustment may reassign it 
25.7 	to another facility that is under the same ownership at any time within three years of its 
25.8 	effective date. The amount of the adjustment shall be computed according to paragraph (a).
25.9 	(f) If the per bed dollar amount specified in paragraph (a), clause (1), is increased, 
25.10 	the commissioner shall recalculate planned closure rate adjustments for facilities that 
25.11 	delicense beds under this section on or after July 1, 2001, to reflect the increase in the per 
25.12 	bed dollar amount. The recalculated planned closure rate adjustment shall be effective 
25.13 	from the date the per bed dollar amount is increased.
25.14 	(g) For planned closures approved after June 30, 2009, the commissioner of human 
25.15 	services shall calculate the amount of the planned closure rate adjustment available under 
25.16 	subdivision 3, paragraph (b), according to paragraph (a), clauses (1) to (4).
25.17 	(h) Beginning on July 1, 2011, the commissioner shall no longer approve planned 
25.18 	closure rate adjustments under this section.

25.19 	Sec. 21. Minnesota Statutes 2010, section 256B.441, subdivision 50a, is amended to 
25.20 	read:
25.21 		Subd. 50a.Determination of proximity adjustments. (a) For a nursing facility 
25.22 	located in close proximity to another nursing facility of the same facility group type but in 
25.23 	a different peer group and that has higher limits for care-related or other operating costs, 
25.24 	the commissioner shall adjust the limits in accordance with clauses (1) to (4):
25.25 	(1) determine the difference between the limits;
25.26 	(2) determine the distance between the two facilities, by the shortest driving route. If 
25.27 	the distance exceeds 20 miles, no adjustment shall be made;
25.28 	(3) subtract the value in clause (2) from 20 miles, divide by 20, and convert to a 
25.29 	percentage; and
25.30 	(4) increase the limits for the nursing facility with the lower limits by the value 
25.31 	determined in clause (1) multiplied by the value determined in clause (3).
25.32 	(b) Effective October 1, 2011, nursing facilities located no more than one-quarter 
25.33 	mile from a peer group with higher limits under either subdivision 50 or 51, may receive 
25.34 	an operating rate adjustment. The operating payment rates of a lower-limit peer group 
25.35 	facility must be adjusted to be equal to those of the nearest facility in a higher-limit peer 
26.1 	group if that facility's RUG rate with a weight of 1.00 is higher than the lower-limit peer 
26.2 	group facility. Peer groups are those defined in subdivision 30. The nearest facility must 
26.3 	be determined by the most direct driving route.

26.4 	Sec. 22. Minnesota Statutes 2010, section 256B.441, subdivision 59, is amended to 
26.5 	read:
26.6 		Subd. 59.Single-bed payments for medical assistance recipients. Effective 
26.7 	October 1, 2009, the amount paid for a private room under Minnesota Rules, part 
26.8 	9549.0070, subpart 3, is reduced from 115 percent to 111.5 percent. Effective July 1, 2011, 
26.9 	the amount paid for a private room under Minnesota Rules, part 9549.0070, subpart 3, is 
26.10 	reduced from 111.5 percent to 100.0 percent.

26.11 	Sec. 23. Minnesota Statutes 2010, section 256B.48, subdivision 1, is amended to read:
26.12 		Subdivision 1.Prohibited practices. (a) A nursing facility is not eligible to receive 
26.13 	medical assistance payments unless it refrains from all of the following: complies with the 
26.14 	prohibitions and requirements in this subdivision.
26.15 	(a) Charging(b) A nursing facility must not charge private paying residents rates for 
26.16 	similar services which exceed those which are approved by the state agency for medical 
26.17 	assistance recipients as determined by the prospective desk audit rate, except under the 
26.18 	following circumstances: 
26.19 	(1) the nursing facility may (1) (i) charge private paying residents a higher rate for a 
26.20 	private room, and (2) (ii) charge for special services which are not included in the daily 
26.21 	rate if medical assistance residents are charged separately at the same rate for the same 
26.22 	services in addition to the daily rate paid by the commissioner; 
26.23 	(2) effective October 1, 2011, nursing facilities may charge private paying residents 
26.24 	up to two percent higher than the sum of the medical assistance allowable payment rate in 
26.25 	effect on September 30, 2011, plus an adjustment equal to the incremental increase of any 
26.26 	other rate increase provided in law, for the RUGS group currently assigned to the resident; 
26.27 	(3) effective October 1, 2012, nursing facilities may charge private paying residents 
26.28 	rates up to four percent higher than the sum of the medical assistance allowable payment 
26.29 	rate in effect on September 30, 2012, plus an adjustment equal to the incremental increase 
26.30 	of any other rate increase provided in law, for the RUGS group currently assigned to the 
26.31 	resident; 
26.32 	(4) effective October 1, 2013, nursing facilities may charge private paying residents 
26.33 	rates up to six percent higher than the sum of the medical assistance allowable payment 
26.34 	rate in effect on September 30, 2013, plus an adjustment equal to the incremental increase 
27.1 	of any other rate increase provided in law, for the RUGS group currently assigned to 
27.2 	the resident; and 
27.3 	(5) effective October 1, 2014, nursing facilities may charge private paying residents 
27.4 	rates up to eight percent higher than the sum of the medical assistance allowable payment 
27.5 	rate in effect on September 30, 2014, plus an adjustment equal to the incremental increase 
27.6 	of any other rate increase provided in law, for the RUGS group currently assigned to 
27.7 	the resident. Nothing in this section precludes a nursing facility from charging a rate 
27.8 	allowable under the nursing facility's single room election option under Minnesota Rules, 
27.9 	part 9549.0060, subpart 11, or the enhanced rates under section 256B.431, subdivision 32.
27.10 	 Services covered by the payment rate must be the same regardless of payment 
27.11 	source. Special services, if offered, must be available to all residents in all areas of the 
27.12 	nursing facility and charged separately at the same rate. Residents are free to select 
27.13 	or decline special services. Special services must not include services which must be 
27.14 	provided by the nursing facility in order to comply with licensure or certification standards 
27.15 	and that if not provided would result in a deficiency or violation by the nursing facility. 
27.16 	Services beyond those required to comply with licensure or certification standards must 
27.17 	not be charged separately as a special service if they were included in the payment rate for 
27.18 	the previous reporting year. A nursing facility that charges a private paying resident a rate 
27.19 	in violation of this clause paragraph is subject to an action by the state of Minnesota or any 
27.20 	of its subdivisions or agencies for civil damages. A private paying resident or the resident's 
27.21 	legal representative has a cause of action for civil damages against a nursing facility that 
27.22 	charges the resident rates in violation of this clause paragraph. The damages awarded shall 
27.23 	include three times the payments that result from the violation, together with costs and 
27.24 	disbursements, including reasonable attorneys'attorney fees or their equivalent. A private 
27.25 	paying resident or the resident's legal representative, the state, subdivision or agency, or a 
27.26 	nursing facility may request a hearing to determine the allowed rate or rates at issue in 
27.27 	the cause of action. Within 15 calendar days after receiving a request for such a hearing, 
27.28 	the commissioner shall request assignment of an administrative law judge under sections 
27.29 	14.48 to 14.56 to conduct the hearing as soon as possible or according to agreement by 
27.30 	the parties. The administrative law judge shall issue a report within 15 calendar days 
27.31 	following the close of the hearing. The prohibition set forth in this clause paragraph shall 
27.32 	not apply to facilities licensed as boarding care facilities which are not certified as skilled 
27.33 	or intermediate care facilities level I or II for reimbursement through medical assistance.
27.34 	(b) (c) Effective October 1, 2015, paragraph (b) no longer applies, except that special 
27.35 	services, if offered, must be available to all residents of the nursing facility and charged 
27.36 	separately at the same rate. Residents are free to select or decline special services. Special 
28.1 	services must not include services that must be provided by the nursing facility in order to 
28.2 	comply with licensure or certification standards and that, if not provided, would result in a 
28.3 	deficiency or violation by the nursing facility. 
28.4 	(d) A nursing facility shall refrain from all of the following:
28.5 	(1) charging, soliciting, accepting, or receiving from an applicant for admission to 
28.6 	the facility, or from anyone acting in behalf of the applicant, as a condition of admission, 
28.7 	expediting the admission, or as a requirement for the individual's continued stay, any 
28.8 	fee, deposit, gift, money, donation, or other consideration not otherwise required as 
28.9 	payment under the state plan. For residents on medical assistance, payment of the medical 
28.10 	assistance rate according to the state plan must be accepted as payment in full for services 
28.11 	included in the daily rate for continued stay, except where otherwise provided for in statute;
28.12 	(2) requiring an individual, or anyone acting in behalf of the individual, to loan 
28.13 	any money to the nursing facility;
28.14 	(3) requiring an individual, or anyone acting in behalf of the individual, to promise 
28.15 	to leave all or part of the individual's estate to the facility; or
28.16 	(4) requiring a third-party guarantee of payment to the facility as a condition of 
28.17 	admission, expedited admission, or continued stay in the facility.
28.18 	Nothing in this paragraph would prohibit discharge for nonpayment of services in 
28.19 	accordance with state and federal regulations.
28.20 	(c) Requiring (e) A nursing facility must not require any resident of the nursing 
28.21 	facility to utilize a vendor of health care services chosen by the nursing facility. A 
28.22 	nursing facility may require a resident to use pharmacies that utilize unit dose packing 
28.23 	systems approved by the Minnesota Board of Pharmacy, and may require a resident to use 
28.24 	pharmacies that are able to meet the federal regulations for safe and timely administration 
28.25 	of medications such as systems with specific number of doses, prompt delivery of 
28.26 	medications, or access to medications on a 24-hour basis. Notwithstanding the provisions 
28.27 	of this paragraph, nursing facilities shall not restrict a resident's choice of pharmacy 
28.28 	because the pharmacy utilizes a specific system of unit dose drug packing.
28.29 	(d) Providing (f) A nursing facility must not provide differential treatment on the 
28.30 	basis of status with regard to public assistance.
28.31 	(e) Discriminating (g) A nursing facility must not discriminate in admissions, 
28.32 	services offered, or room assignment on the basis of status with regard to public assistance 
28.33 	or refusal to purchase special services. Discrimination in admissions discrimination shall 
28.34 	include, but is not limited to:
28.35 	(1), basing admissions decisions upon assurance by the applicant to the nursing 
28.36 	facility, or the applicant's guardian or conservator, that the applicant is neither eligible for 
29.1 	nor will seek information or assurances regarding current or future eligibility for public 
29.2 	assistance for payment of nursing facility care costs; and.
29.3 	(2) engaging in preferential selection from waiting lists based on an applicant's 
29.4 	ability to pay privately or an applicant's refusal to pay for a special service.
29.5 	The collection and use by a nursing facility of financial information of any applicant 
29.6 	pursuant to a preadmission screening program established by law shall not raise an 
29.7 	inference that the nursing facility is utilizing that information for any purpose prohibited 
29.8 	by this paragraph.
29.9 	(f) Requiring (h) A nursing facility must not require any vendor of medical care as 
29.10 	defined by section 256B.02, subdivision 7, who is reimbursed by medical assistance under 
29.11 	a separate fee schedule, to pay any amount based on utilization or service levels or any 
29.12 	portion of the vendor's fee to the nursing facility except as payment for renting or leasing 
29.13 	space or equipment or purchasing support services from the nursing facility as limited by 
29.14 	section 256B.433. All agreements must be disclosed to the commissioner upon request of 
29.15 	the commissioner. Nursing facilities and vendors of ancillary services that are found to be 
29.16 	in violation of this provision shall each be subject to an action by the state of Minnesota or 
29.17 	any of its subdivisions or agencies for treble civil damages on the portion of the fee in 
29.18 	excess of that allowed by this provision and section 256B.433. Damages awarded must 
29.19 	include three times the excess payments together with costs and disbursements including 
29.20 	reasonable attorney's fees or their equivalent.
29.21 	(g) Refusing (i) A nursing facility must not refuse, for more than 24 hours, to accept 
29.22 	a resident returning to the same bed or a bed certified for the same level of care, in 
29.23 	accordance with a physician's order authorizing transfer, after receiving inpatient hospital 
29.24 	services.
29.25 	(j) For a period not to exceed 180 days, the commissioner may continue to make 
29.26 	medical assistance payments to a nursing facility or boarding care home which is in 
29.27 	violation of this section subdivision if extreme hardship to the residents would result. In 
29.28 	these cases the commissioner shall issue an order requiring the nursing facility to correct 
29.29 	the violation. The nursing facility shall have 20 days from its receipt of the order to correct 
29.30 	the violation. If the violation is not corrected within the 20-day period the commissioner 
29.31 	may reduce the payment rate to the nursing facility by up to 20 percent. The amount of the 
29.32 	payment rate reduction shall be related to the severity of the violation and shall remain 
29.33 	in effect until the violation is corrected. The nursing facility or boarding care home may 
29.34 	appeal the commissioner's action pursuant to the provisions of chapter 14 pertaining to 
29.35 	contested cases. An appeal shall be considered timely if written notice of appeal is received 
29.36 	by the commissioner within 20 days of notice of the commissioner's proposed action.
30.1 	In the event that the commissioner determines that a nursing facility is not eligible 
30.2 	for reimbursement for a resident who is eligible for medical assistance, the commissioner 
30.3 	may authorize the nursing facility to receive reimbursement on a temporary basis until the 
30.4 	resident can be relocated to a participating nursing facility.
30.5 	Certified beds in facilities which do not allow medical assistance intake on July 1, 
30.6 	1984, or after shall be deemed to be decertified for purposes of section 144A.071 only.

30.7 	Sec. 24. MEDICAL NONEMERGENCY TRANSPORTATION SINGLE 
30.8 	ADMINISTRATIVE STRUCTURE PROPOSAL.
 30.9 	(a) The commissioner of human services shall develop a proposal to create a single 
30.10 	administrative structure for providing medical nonemergency transportation services to 
30.11 	fee-for-service medical assistance recipients. This proposal must consolidate access and 
30.12 	special transportation into one administrative structure with the goal of standardizing 
30.13 	eligibility determination processes, scheduling arrangements, billing procedures, data 
30.14 	collection, and oversight mechanisms in order to enhance coordination, improve 
30.15 	accountability, and lessen confusion.
30.16 	(b) In developing the proposal, the commissioner shall:
30.17 	(1) examine the current responsibilities performed by the counties and the 
30.18 	Department of Human Services and consider the shift in costs if these responsibilities are 
30.19 	changed;
30.20 	(2) identify key performance measures to assess the cost effectiveness of medical 
30.21 	nonemergency transportation statewide, including a process to collect, audit, and report 
30.22 	data;
30.23 	(3) develop a statewide complaint system for medical assistance recipients using 
30.24 	special transportation;
30.25 	(4) establish a standardized billing process;
30.26 	(5) establish a process that provides public input from interested parties before 
30.27 	special transportation eligibility policies are implemented or significantly changed;
30.28 	(6) establish specific eligibility criteria that include the frequency of eligibility 
30.29 	assessments and the length of time a recipient remains eligible for special transportation; 
30.30 	and
30.31 	(7) develop a reimbursement method to compensate volunteers for no-load miles 
30.32 	when transporting recipients to or from health-related appointments.
30.33 	(c) In developing the proposal, the commissioner shall consult with the 
30.34 	Nonemergency Medical Transportation Advisory Council established under paragraph (d). 
31.1 	(d) The commissioner shall establish the Nonemergency Medical Transportation 
31.2 	Advisory Council to assist the commissioner in developing a single administrative 
31.3 	structure for providing nonemergency medical transportation services. The council shall 
31.4 	include, but not be limited to, the following:
31.5 	(1) one representative each from the Departments of Human Services and 
31.6 	Transportation;
31.7 	(2) one representative each from the following organizations: the Minnesota State 
31.8 	Council on Disability, the Minnesota Consortium for Citizens with Disabilities, ARC 
31.9 	of Minnesota, the Association of Minnesota Counties, the Metropolitan Inter-County 
31.10 	Association, the R-80 Medical Transportation Coalition, the Minnesota Paratransit 
31.11 	Association, legal aid, the Minnesota Ambulance Association, the National Alliance on 
31.12 	Mental Illness, Medical Transportation Management, and other transportation providers; 
31.13 	and
31.14 	(3) four members from the house of representatives: two from the majority party and 
31.15 	two from the minority party, appointed by the speaker of the house, and four members 
31.16 	from the senate: two from the majority party and two from the minority party, appointed 
31.17 	by the Subcommittee on Committees of the Committee on Rules and Administration. The 
31.18 	council is governed by Minnesota Statutes, section 15.059, except that members shall not 
31.19 	receive per diems. The commissioner of human services shall fund all costs related to the 
31.20 	council from existing resources.
31.21 	(e) The commissioner shall submit the proposal and draft legislation necessary for 
31.22 	implementation to the chairs and ranking minority members of the senate and house of 
31.23 	representatives committees or divisions with jurisdiction over health care policy and 
31.24 	finance by January 15, 2012.

31.25 	Sec. 25. NURSING FACILITY PILOT PROJECT.
 31.26 		Subdivision 1.Report. The commissioner of human services, in consultation with 
31.27 	the commissioner of health, stakeholders, and experts, shall provide to the legislature 
31.28 	recommendations by November 15, 2011, on how to develop a project to demonstrate a 
31.29 	new approach to caring for certain individuals in nursing facilities.
31.30 		Subd. 2.Contents of report. The recommendations shall address the:
31.31 	(1) nature of the demonstration in terms of timing, size, qualifications to participate, 
31.32 	participation selection criteria and postdemonstration options for the demonstration and 
31.33 	for participating facilities;
31.34 	(2) nature of needed new form of licensure;
32.1 	(3) characteristics of the individuals the new model is intended to serve and 
32.2 	comparison of these characteristics with those individuals served by existing models of 
32.3 	care;
32.4 	(4) quality standards for licensure addressing management, types and amounts of 
32.5 	staffing, safety, infection control, care processes, quality improvement, and resident rights;
32.6 	(5) characteristics of inspection process;
32.7 	(6) funding for inspection process;
32.8 	(7) enforcement authorities;
32.9 	(8) role of Medicare;
32.10 	(9) participation in the elderly waiver program, including rate setting;
32.11 	(10) nature of any federal approval or waiver requirements and the method and 
32.12 	timing of obtaining them;
32.13 	(11) consumer rights; and
32.14 	(12) methods and resources needed to evaluate the effectiveness of the model with 
32.15 	regards to cost and quality.

32.16 	ARTICLE 2
32.17 	CHEMICAL AND MENTAL HEALTH

32.18 	Section 1. Minnesota Statutes 2010, section 254B.03, subdivision 4, is amended to read:
32.19 		Subd. 4.Division of costs. Except for services provided by a county under 
32.20 	section 254B.09, subdivision 1, or services provided under section 256B.69 or 256D.03, 
32.21 	subdivision 4, paragraph (b), the county shall, out of local money, pay the state for 
32.22 	16.14 29.76 percent of the cost of chemical dependency services, including those services 
32.23 	provided to persons eligible for medical assistance under chapter 256B and general 
32.24 	assistance medical care under chapter 256D. Counties may use the indigent hospitalization 
32.25 	levy for treatment and hospital payments made under this section. 16.14 29.76 percent 
32.26 	of any state collections from private or third-party pay, less 15 percent for the cost of 
32.27 	payment and collections, must be distributed to the county that paid for a portion of the 
32.28 	treatment under this section.

32.29 	EFFECTIVE DATE. This section is effective for claims processed beginning 
32.30 	July 1, 2011.

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

33.7 	Sec. 3. Minnesota Statutes 2010, section 254B.06, subdivision 2, is amended to read:
33.8 		Subd. 2.Allocation of collections. The commissioner shall allocate all federal 
33.9 	financial participation collections to a special revenue account. The commissioner shall 
33.10 	allocate 83.86 70.24 percent of patient payments and third-party payments to the special 
33.11 	revenue account and 16.14 29.76 percent to the county financially responsible for the 
33.12 	patient.

33.13 	EFFECTIVE DATE. This section is effective for claims processed beginning 
33.14 	July 1, 2011.

33.15 	ARTICLE 3
33.16 	HUMAN SERVICES

33.17 	Section 1. Minnesota Statutes 2010, section 119B.011, subdivision 13, is amended to 
33.18 	read:
33.19 		Subd. 13.Family. "Family" means parents, stepparents, guardians and their spouses, 
33.20 	or other eligible relative caregivers and their spouses, and their blood related dependent 
33.21 	children and adoptive siblings under the age of 18 years living in the same home including 
33.22 	children temporarily absent from the household in settings such as schools, foster care, and 
33.23 	residential treatment facilities or parents, stepparents, guardians and their spouses, or other 
33.24 	relative caregivers and their spouses temporarily absent from the household in settings 
33.25 	such as schools, military service, or rehabilitation programs. An adult family member who 
33.26 	is not in an authorized activity under this chapter may be temporarily absent for up to 60 
33.27 	days. When a minor parent or parents and his, her, or their child or children are living with 
33.28 	other relatives, and the minor parent or parents apply for a child care subsidy, "family" 
33.29 	means only the minor parent or parents and their child or children. An adult age 18 or 
33.30 	older who meets this definition of family and is a full-time high school or postsecondary 
33.31 	student may be considered a dependent member of the family unit if 50 percent or more of 
33.32 	the adult's support is provided by the parents, stepparents, guardians, and their spouses or 
33.33 	eligible relative caregivers and their spouses residing in the same household.

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

34.2 	Sec. 2. Minnesota Statutes 2010, section 119B.09, is amended by adding a subdivision 
34.3 	to read:
34.4 		Subd. 9a.Child care centers; assistance. (a) For the purposes of this subdivision, 
34.5 	"qualifying child" means a child who satisfies both of the following:
34.6 	(1) is not a child or dependent of an employee of the child care provider; and
34.7 	(2) does not reside with an employee of the child care provider.
34.8 	(b) Funds distributed under this chapter must not be paid for child care services 
34.9 	that are provided for a child by a child care provider who employs either the parent of 
34.10 	the child or a person who resides with the child, unless at all times at least 50 percent of 
34.11 	the children for whom the child care provider is providing care are qualifying children 
34.12 	under paragraph (a).
34.13 	(c) If a child care provider satisfies the requirements for payment under paragraph 
34.14 	(b), but the percentage of qualifying children under paragraph (a) for whom the provider 
34.15 	is providing care falls below 50 percent, the provider shall have four weeks to raise the 
34.16 	percentage of qualifying children for whom the provider is providing care to at least 50 
34.17 	percent before payments to the provider are discontinued for child care services provided 
34.18 	for a child who is not a qualifying child.

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

34.20 	Sec. 3. Minnesota Statutes 2010, section 119B.09, subdivision 10, is amended to read:
34.21 		Subd. 10.Payment of funds. All federal, state, and local child care funds must 
34.22 	be paid directly to the parent when a provider cares for children in the children's own 
34.23 	home. In all other cases, all federal, state, and local child care funds must be paid directly 
34.24 	to the child care provider, either licensed or legal nonlicensed, on behalf of the eligible 
34.25 	family. Funds distributed under this chapter must not be used for child care services that 
34.26 	are provided for a child by a child care provider who resides in the same household or 
34.27 	occupies the same residence as the child.

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

34.29 	Sec. 4. Minnesota Statutes 2010, section 119B.09, is amended by adding a subdivision 
34.30 	to read:
35.1 		Subd. 13.Child care in the child's home. Child care assistance must only be 
35.2 	authorized in the child's home if the child's parents have authorized activities outside of 
35.3 	the home and if one or more of the following circumstances are met:
35.4 	(1) the parents' qualifying activity occurs during times when out-of-home care is 
35.5 	not available. If child care is needed during any period when out-of-home care is not 
35.6 	available, in-home care can be approved for the entire time care is needed;
35.7 	(2) the family lives in an area where out-of-home care is not available; or
35.8 	(3) a child has a verified illness or disability that would place the child or other 
35.9 	children in an out-of-home facility at risk or creates a hardship for the child and the family 
35.10 	to take the child out of the home to a child care home or center.

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

35.12 	Sec. 5. Minnesota Statutes 2010, section 119B.125, is amended by adding a subdivision 
35.13 	to read:
35.14 		Subd. 1b.Training required. (a) Effective November 1, 2011, prior to initial 
35.15 	authorization as required in subdivision 1, a legal nonlicensed family child care provider 
35.16 	must complete first aid and CPR training and provide the verification of first aid and CPR 
35.17 	training to the county. The training documentation must have valid effective dates as of 
35.18 	the date the registration request is submitted to the county and the training must have been 
35.19 	provided by an individual approved to provide first aid and CPR instruction.
35.20 	(b) Legal nonlicensed family child care providers with an authorization effective 
35.21 	before November 1, 2011, must be notified of the requirements before October 1, 2011, or 
35.22 	at authorization, and must meet the requirements upon renewal of an authorization that 
35.23 	occurs on or after January 1, 2012.
35.24 	(c) Upon each reauthorization after the authorization period when the initial first aid 
35.25 	and CPR training requirements are met, a legal nonlicensed family child care provider 
35.26 	must provide verification of at least eight hours of additional training listed in the 
35.27 	Minnesota Center for Professional Development Registry.
35.28 	(d) This subdivision only applies to legal nonlicensed family child care providers.

35.29 	Sec. 6. Minnesota Statutes 2010, section 119B.13, subdivision 1, is amended to read:
35.30 		Subdivision 1.Subsidy restrictions. (a) Beginning July 1, 2006 2011, the maximum 
35.31 	rate paid for child care assistance in any county or multicounty region under the child care 
35.32 	fund shall be the rate for like-care arrangements in the county effective JanuaryJuly 1, 
35.33 	2006, increaseddecreased by sixfive percent.
36.1 	(b) Rate changes shall be implemented for services provided in September 2006 
36.2 	unless a participant eligibility redetermination or a new provider agreement is completed 
36.3 	between July 1, 2006, and August 31, 2006.
36.4 	As necessary, appropriate notice of adverse action must be made according to 
36.5 	Minnesota Rules, part 3400.0185, subparts 3 and 4.
36.6 	New cases approved on or after July 1, 2006, shall have the maximum rates under 
36.7 	paragraph (a), implemented immediately.
36.8 	(c)(b) Every year, the commissioner shall survey rates charged by child care 
36.9 	providers in Minnesota to determine the 75th percentile for like-care arrangements in 
36.10 	counties. When the commissioner determines that, using the commissioner's established 
36.11 	protocol, the number of providers responding to the survey is too small to determine 
36.12 	the 75th percentile rate for like-care arrangements in a county or multicounty region, 
36.13 	the commissioner may establish the 75th percentile maximum rate based on like-care 
36.14 	arrangements in a county, region, or category that the commissioner deems to be similar.
36.15 	(d)(c) A rate which includes a special needs rate paid under subdivision 3 or under a 
36.16 	school readiness service agreement paid under section 119B.231, may be in excess of the 
36.17 	maximum rate allowed under this subdivision.
36.18 	(e)(d) The department shall monitor the effect of this paragraph on provider rates. 
36.19 	The county shall pay the provider's full charges for every child in care up to the maximum 
36.20 	established. The commissioner shall determine the maximum rate for each type of care 
36.21 	on an hourly, full-day, and weekly basis, including special needs and disability care. The 
36.22 	maximum payment to a provider for one day of care must not exceed the daily rate. The 
36.23 	maximum payment to a provider for one week of care must not exceed the weekly rate.
36.24 	(e) Child care providers receiving reimbursement under this chapter must not be 
36.25 	paid activity fees or an additional amount above the maximum rates for care provided 
36.26 	during nonstandard hours for families receiving assistance.
36.27 	(f) When the provider charge is greater than the maximum provider rate allowed, 
36.28 	the parent is responsible for payment of the difference in the rates in addition to any 
36.29 	family co-payment fee.
36.30 	(g) All maximum provider rates changes shall be implemented on the Monday 
36.31 	following the effective date of the maximum provider rate.

36.32 	EFFECTIVE DATE. Paragraph (d) is effective April 16, 2012. Paragraph (e) 
36.33 	is effective September 3, 2012.

36.34 	Sec. 7. Minnesota Statutes 2010, section 119B.13, subdivision 1a, is amended to read:
37.1 		Subd. 1a.Legal nonlicensed family child care provider rates. (a) Legal 
37.2 	nonlicensed family child care providers receiving reimbursement under this chapter must 
37.3 	be paid on an hourly basis for care provided to families receiving assistance.
37.4 	(b) The maximum rate paid to legal nonlicensed family child care providers must be 
37.5 	80 percent of the county maximum hourly rate for licensed family child care providers. In 
37.6 	counties where the maximum hourly rate for licensed family child care providers is higher 
37.7 	than the maximum weekly rate for those providers divided by 50, the maximum hourly 
37.8 	rate that may be paid to legal nonlicensed family child care providers is the rate equal to 
37.9 	the maximum weekly rate for licensed family child care providers divided by 50 and then 
37.10 	multiplied by 0.80. The maximum payment to a provider for one day of care must not 
37.11 	exceed the maximum hourly rate times ten. The maximum payment to a provider for one 
37.12 	week of care must not exceed the maximum hourly rate times 50.
37.13 	(c) A rate which includes a special needs rate paid under subdivision 3 may be in 
37.14 	excess of the maximum rate allowed under this subdivision.
37.15 	(d) Legal nonlicensed family child care providers receiving reimbursement under 
37.16 	this chapter may not be paid registration fees for families receiving assistance.

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

37.18 	Sec. 8. Minnesota Statutes 2010, section 119B.13, subdivision 7, is amended to read:
37.19 		Subd. 7.Absent days. (a) Licensed child care providers may and license-exempt 
37.20 	centers must not be reimbursed for more than 25 ten full-day absent days per child, 
37.21 	excluding holidays, in a fiscal year, or for more than ten consecutive full-day absent days, 
37.22 	unless the child has a documented medical condition that causes more frequent absences. 
37.23 	Absences due to a documented medical condition of a parent or sibling who lives in the 
37.24 	same residence as the child receiving child care assistance do not count against the 25-day 
37.25 	absent day limit in a fiscal year. Documentation of medical conditions must be on the 
37.26 	forms and submitted according to the timelines established by the commissioner. A public 
37.27 	health nurse or school nurse may verify the illness in lieu of a medical practitioner. If a 
37.28 	provider sends a child home early due to a medical reason, including, but not limited to, 
37.29 	fever or contagious illness, the child care center director or lead teacher may verify the 
37.30 	illness in lieu of a medical practitioner. Legal nonlicensed family child care providers 
37.31 	must not be reimbursed for absent days. If a child attends for part of the time authorized to 
37.32 	be in care in a day, but is absent for part of the time authorized to be in care in that same 
37.33 	day, the absent time will must be reimbursed but the time will must not count toward the 
37.34 	ten consecutive or 25 cumulative absent day limits limit. Children in families where at 
37.35 	least one parent is under the age of 21, does not have a high school or general equivalency 
38.1 	diploma, and is a student in a school district or another similar program that provides or 
38.2 	arranges for child care, as well as parenting, social services, career and employment 
38.3 	supports, and academic support to achieve high school graduation, may be exempt from 
38.4 	the absent day limits upon request of the program and approval of the county. If a child 
38.5 	attends part of an authorized day, payment to the provider must be for the full amount 
38.6 	of care authorized for that day. Child care providers may must only be reimbursed for 
38.7 	absent days if the provider has a written policy for child absences and charges all other 
38.8 	families in care for similar absences.
38.9 	(b) Child care providers must be reimbursed for up to ten federal or state holidays 
38.10 	or designated holidays per year when the provider charges all families for these days 
38.11 	and the holiday or designated holiday falls on a day when the child is authorized to be 
38.12 	in attendance. Parents may substitute other cultural or religious holidays for the ten 
38.13 	recognized state and federal holidays. Holidays do not count toward the ten consecutive 
38.14 	or 25 cumulative absent day limits limit.
38.15 	(c) A family or child care provider may must not be assessed an overpayment for an 
38.16 	absent day payment unless (1) there was an error in the amount of care authorized for the 
38.17 	family, (2) all of the allowed full-day absent payments for the child have been paid, or (3) 
38.18 	the family or provider did not timely report a change as required under law.
38.19 	(d) The provider and family must receive notification of the number of absent days 
38.20 	used upon initial provider authorization for a family and when the family has used 15 
38.21 	cumulative absent days. Upon statewide implementation of the Minnesota Electronic 
38.22 	Child Care System, the provider and family shall receive notification of the number of 
38.23 	absent days used upon initial provider authorization for a family and ongoing notification 
38.24 	of the number of absent days used as of the date of the notification.
38.25 	(e) A county may pay for more absent days than the statewide absent day policy 
38.26 	established under this subdivision if current market practice in the county justifies payment 
38.27 	for those additional days. County policies for payment of absent days in excess of the 
38.28 	statewide absent day policy and justification for these county policies must be included in 
38.29 	the county's child care fund plan under section 119B.08, subdivision 3.

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

38.31 	Sec. 9. Minnesota Statutes 2010, section 256.01, subdivision 14, is amended to read:
38.32 		Subd. 14.Child welfare reform pilots. The commissioner of human services 
38.33 	shall encourage local reforms in the delivery of child welfare services, within available 
38.34 	appropriations, and is authorized to approve local pilot programs which focus on reforming 
38.35 	the child protection and child welfare systems in Minnesota. Authority to approve pilots 
39.1 	includes authority to waive existing state rules as needed to accomplish reform efforts. 
39.2 	Notwithstanding section 626.556, subdivision 10, 10b, or 10d, the commissioner may 
39.3 	authorize programs to use alternative methods of investigating and assessing reports of 
39.4 	child maltreatment, provided that the programs comply with the provisions of section 
39.5 	626.556 dealing with the rights of individuals who are subjects of reports or investigations, 
39.6 	including notice and appeal rights and data practices requirements. Pilot programs must 
39.7 	be required to address responsibility for safety and protection of children, be time limited, 
39.8 	and include evaluation of the pilot program.

39.9 	Sec. 10. [256.0145] COMPUTER SYSTEM SIMPLIFICATION.
39.10 		Subdivision 1.Reprogram MAXIS. The commissioner of human services shall 
39.11 	reprogram the MAXIS computer system to automatically apply child support payments 
39.12 	entered into the PRISM computer system to a MAXIS case file.
39.13 		Subd. 2.Program the social service information system. The commissioner of 
39.14 	human services shall require health plans to accept billing formats in compliance with 
39.15 	national standards and with section 62J.536 and corresponding compliance guides as they 
39.16 	apply to mental health targeted case management claims, elderly waiver claims, and other 
39.17 	claim categories as added to the benefits set. The commissioner shall make any necessary 
39.18 	change to the SSIS system to align with these requirements.

39.19 	Sec. 11. Minnesota Statutes 2010, section 256B.69, is amended by adding a subdivision 
39.20 	to read:
39.21 		Subd. 30.Provision of required materials in alternative formats. (a) For the 
39.22 	purposes of this subdivision, "alternative format" means a medium other than paper and 
39.23 	"prepaid health plan" means managed care plans and county-based purchasing plans.
39.24 	(b) A prepaid health plan may provide in an alternative format a provider directory 
39.25 	and certificate of coverage, or materials otherwise required to be available in writing 
39.26 	under Code of Federal Regulations, title 42, section 438.10, or under the commissioner's 
39.27 	contract with the prepaid health plan, if the following conditions are met:
39.28 	(1) the prepaid health plan, local agency, or commissioner, as applicable, informs the 
39.29 	enrollee that:
39.30 	(i) an alternative format is available and the enrollee affirmatively requests of 
39.31 	the prepaid health plan that the provider directory, certificate of coverage, or materials 
39.32 	otherwise required under Code of Federal Regulations, title 42, section 438.10, or under 
39.33 	the commissioner's contract with the prepaid health plan be provided in an alternative 
39.34 	format; and
40.1 	(ii) a record of the enrollee request is retained by the prepaid health plan in the 
40.2 	form of written direction from the enrollee or a documented telephone call followed by a 
40.3 	confirmation letter to the enrollee from the prepaid health plan that explains that the 
40.4 	enrollee may change the request at any time;
40.5 	(2) the materials are sent to a secure electronic mailbox and are made available at a 
40.6 	password-protected secure electronic Web site or on a data storage device if the materials 
40.7 	contain enrollee data that is individually identifiable;
40.8 	(3) the enrollee is provided a customer service number on the enrollee's membership 
40.9 	card that may be called to request a paper version of the materials provided in an 
40.10 	alternative format; and
40.11 	(4) the materials provided in an alternative format meets all other requirements of 
40.12 	the commissioner regarding content, size of the typeface, and any required time frames 
40.13 	for distribution. "Required time frames for distribution" must permit sufficient time for 
40.14 	prepaid health plans to distribute materials in alternative formats upon receipt of enrollees' 
40.15 	requests for the materials.
40.16 	(c) A prepaid health plan may provide in an alternative format its primary care 
40.17 	network list to the commissioner and to local agencies within its service area. The 
40.18 	commissioner or local agency, as applicable, shall inform a potential enrollee of the 
40.19 	availability of a prepaid health plan's primary care network list in an alternative format. If 
40.20 	the potential enrollee requests an alternative format of the prepaid health plan's primary 
40.21 	care network list, a record of that request shall be retained by the commissioner or local 
40.22 	agency. The potential enrollee is permitted to withdraw the request at any time.
40.23 	The prepaid health plan shall submit sufficient paper versions of the primary 
40.24 	care network list to the commissioner and to local agencies within its service area to 
40.25 	accommodate potential enrollee requests for paper versions of the primary care network 
40.26 	list.
40.27 	(d) A prepaid health plan may provide in an alternative format materials otherwise 
40.28 	required to be available in writing under Code of Federal Regulations, title 42, section 
40.29 	438.10, or under the commissioner's contract with the prepaid health plan, if the conditions 
40.30 	of paragraphs (b), (c), and (e), are met for persons who are eligible for enrollment in 
40.31 	managed care.
40.32 	(e) The commissioner shall seek any federal Medicaid waivers within 90 days after 
40.33 	the effective date of this subdivision that are necessary to provide alternative formats of 
40.34 	required material to enrollees of prepaid health plans as authorized under this subdivision.
40.35 	(f) The commissioner shall consult with managed care plans, county-based 
40.36 	purchasing plans, counties, and other interested parties to determine how materials 
41.1 	required to be made available to enrollees under Code of Federal Regulations, title 42, 
41.2 	section 438.10, or under the commissioner's contract with a prepaid health plan may 
41.3 	be provided in an alternative format on the basis that the enrollee has not opted in to 
41.4 	receive the alternative format. The commissioner shall consult with managed care 
41.5 	plans, county-based purchasing plans, counties, and other interested parties to develop 
41.6 	recommendations relating to the conditions that must be met for an opt-out process 
41.7 	to be granted.

41.8 	Sec. 12. Minnesota Statutes 2010, section 256D.02, subdivision 12a, is amended to 
41.9 	read:
41.10 		Subd. 12a.Resident; general assistance medical care. (a) For purposes of 
41.11 	eligibility for general assistance and general assistance medical care, a person must be a 
41.12 	resident of this state.
41.13 	(b) A "resident" is a person living in the state for at least 30 days with the intention of 
41.14 	making the person's home here and not for any temporary purpose. Time spent in a shelter 
41.15 	for battered women shall count toward satisfying the 30-day residency requirement. All 
41.16 	applicants for these programs are required to demonstrate the requisite intent and can do 
41.17 	so in any of the following ways:
41.18 	(1) by showing that the applicant maintains a residence at a verified address, other 
41.19 	than a place of public accommodation. An applicant may verify a residence address by 
41.20 	presenting a valid state driver's license,; a state identification card,; a voter registration 
41.21 	card,; a rent receipt,; a statement by the landlord, apartment manager, or homeowner 
41.22 	verifying that the individual is residing at the address,; or other form of verification 
41.23 	approved by the commissioner; or
41.24 	(2) by verifying residence according to Minnesota Rules, part 9500.1219, subpart 
41.25 	3, item C.
41.26 	(c) For general assistance medical care, a county agency shall waive the 30-day 
41.27 	residency requirement in cases of medical emergencies. For general assistance, a county 
41.28 	shall waive the 30-day residency requirement where unusual hardship would result from 
41.29 	denial of general assistance. For purposes of this subdivision, "unusual hardship" means 
41.30 	the applicant is without shelter or is without available resources for food.
41.31 	The county agency must report to the commissioner within 30 days on any waiver 
41.32 	granted under this section. The county shall not deny an application solely because the 
41.33 	applicant does not meet at least one of the criteria in this subdivision, but shall continue to 
41.34 	process the application and leave the application pending until the residency requirement 
41.35 	is met or until eligibility or ineligibility is established.
42.1 	(d) For purposes of paragraph (c), the following definitions apply (1) "metropolitan 
42.2 	statistical area" is as defined by the United States Census Bureau; (2) "shelter" includes 
42.3 	any shelter that is located within the metropolitan statistical area containing the county 
42.4 	and for which the applicant is eligible, provided the applicant does not have to travel more 
42.5 	than 20 miles to reach the shelter and has access to transportation to the shelter. Clause (2) 
42.6 	does not apply to counties in the Minneapolis-St. Paul metropolitan statistical area.
42.7 	(e) Migrant workers as defined in section 256J.08 and, until March 31, 1998, their 
42.8 	immediate families are exempt from the residency requirements of this section, provided 
42.9 	the migrant worker provides verification that the migrant family worked in this state 
42.10 	within the last 12 months and earned at least $1,000 in gross wages during the time the 
42.11 	migrant worker worked in this state. 
42.12 	(f) For purposes of eligibility for emergency general assistance, the 30-day residency 
42.13 	requirement under this section shall not be waived.
42.14 	(g) (e) If any provision of this subdivision is enjoined from implementation or found 
42.15 	unconstitutional by any court of competent jurisdiction, the remaining provisions shall 
42.16 	remain valid and shall be given full effect.

42.17 	Sec. 13. Minnesota Statutes 2010, section 256D.44, subdivision 5, is amended to read:
42.18 		Subd. 5.Special needs. In addition to the state standards of assistance established in 
42.19 	subdivisions 1 to 4, payments are allowed for the following special needs of recipients of 
42.20 	Minnesota supplemental aid who are not residents of a nursing home, a regional treatment 
42.21 	center, or a group residential housing facility.
42.22 	(a) The county agency shall pay a monthly allowance for medically prescribed 
42.23 	diets if the cost of those additional dietary needs cannot be met through some other 
42.24 	maintenance benefit. The need for special diets or dietary items must be prescribed by 
42.25 	a licensed physician. Costs for special diets shall be determined as percentages of the 
42.26 	allotment for a one-person household under the thrifty food plan as defined by the United 
42.27 	States Department of Agriculture. The types of diets and the percentages of the thrifty 
42.28 	food plan that are covered are as follows:
42.29 	(1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;
42.30 	(2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent 
42.31 	of thrifty food plan;
42.32 	(3) controlled protein diet, less than 40 grams and requires special products, 125 
42.33 	percent of thrifty food plan;
42.34 	(4) low cholesterol diet, 25 percent of thrifty food plan;
42.35 	(5) high residue diet, 20 percent of thrifty food plan;
43.1 	(6) pregnancy and lactation diet, 35 percent of thrifty food plan;
43.2 	(7) gluten-free diet, 25 percent of thrifty food plan;
43.3 	(8) lactose-free diet, 25 percent of thrifty food plan;
43.4 	(9) antidumping diet, 15 percent of thrifty food plan;
43.5 	(10) hypoglycemic diet, 15 percent of thrifty food plan; or
43.6 	(11) ketogenic diet, 25 percent of thrifty food plan.
43.7 	(b) Payment for nonrecurring special needs must be allowed for necessary home 
43.8 	repairs or necessary repairs or replacement of household furniture and appliances using 
43.9 	the payment standard of the AFDC program in effect on July 16, 1996, for these expenses, 
43.10 	as long as other funding sources are not available.
43.11 	(c) A fee for guardian or conservator service is allowed at a reasonable rate 
43.12 	negotiated by the county or approved by the court. This rate shall not exceed five percent 
43.13 	of the assistance unit's gross monthly income up to a maximum of $100 per month. If the 
43.14 	guardian or conservator is a member of the county agency staff, no fee is allowed.
43.15 	(d) The county agency shall continue to pay a monthly allowance of $68 for 
43.16 	restaurant meals for a person who was receiving a restaurant meal allowance on June 1, 
43.17 	1990, and who eats two or more meals in a restaurant daily. The allowance must continue 
43.18 	until the person has not received Minnesota supplemental aid for one full calendar month 
43.19 	or until the person's living arrangement changes and the person no longer meets the criteria 
43.20 	for the restaurant meal allowance, whichever occurs first.
43.21 	(e) A fee of ten percent of the recipient's gross income or $25, whichever is less, 
43.22 	is allowed for representative payee services provided by an agency that meets the 
43.23 	requirements under SSI regulations to charge a fee for representative payee services. This 
43.24 	special need is available to all recipients of Minnesota supplemental aid regardless of 
43.25 	their living arrangement.
43.26 	(f) (a)(1) Notwithstanding the language in this subdivision, An amount equal to the 
43.27 	maximum allotment authorized by the federal Food Stamp Program for a single individual 
43.28 	which is in effect on the first day of July of each year will be added to the standards of 
43.29 	assistance established in subdivisions 1 to 4 for adults under the age of 65 who qualify 
43.30 	as shelter needy and are: (i) relocating from an institution, or an adult mental health 
43.31 	residential treatment program under section 256B.0622; (ii) eligible for the self-directed 
43.32 	supports option as defined under section 256B.0657, subdivision 2; or (iii) home and 
43.33 	community-based waiver recipients living in their own home or rented or leased apartment 
43.34 	which is not owned, operated, or controlled by a provider of service not related by blood 
43.35 	or marriage, unless allowed under paragraph (g) (b).
44.1 	(2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the 
44.2 	shelter needy benefit under this paragraph is considered a household of one. An eligible 
44.3 	individual who receives this benefit prior to age 65 may continue to receive the benefit 
44.4 	after the age of 65.
44.5 	(3) "Shelter needy" means that the assistance unit incurs monthly shelter costs that 
44.6 	exceed 40 percent of the assistance unit's gross income before the application of this 
44.7 	special needs standard. "Gross income" for the purposes of this section is the applicant's or 
44.8 	recipient's income as defined in section 256D.35, subdivision 10, or the standard specified 
44.9 	in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient of a federal or 
44.10 	state housing subsidy, that limits shelter costs to a percentage of gross income, shall not be 
44.11 	considered shelter needy for purposes of this paragraph.
44.12 	(g) Notwithstanding this subdivision,(b) To access housing and services as provided 
44.13 	in paragraph (f) (a), the recipient may choose housing that may be owned, operated, or 
44.14 	controlled by the recipient's service provider. In a multifamily building of four or more 
44.15 	units, the maximum number of apartments that may be used by recipients of this program 
44.16 	shall be 50 percent of the units in a building. This paragraph expires on June 30, 2012.

44.17 	Sec. 14. Minnesota Statutes 2010, section 256D.47, is amended to read:
44.18 	256D.47 PAYMENT METHODS.
44.19 	Minnesota supplemental aid payments must be issued to the recipient, a protective 
44.20 	payee, or a conservator or guardian of the recipient's estate in the form of county warrants 
44.21 	immediately redeemable in cash, electronic benefits transfer, or by direct deposit into the 
44.22 	recipient's account in a financial institution. Minnesota supplemental aid payments must 
44.23 	be issued regularly on the first day of the month. The supplemental aid warrants must be 
44.24 	mailed only to the address at which the recipient resides, unless another address has been 
44.25 	approved in advance by the county agency. Vendor payments must not be issued by the 
44.26 	county agency except for nonrecurring emergency need payments; at the request of the 
44.27 	recipient; for special needs, other than special diets; or when the agency determines the 
44.28 	need for protective payments exist.

44.29 	Sec. 15. Minnesota Statutes 2010, section 256D.49, subdivision 3, is amended to read:
44.30 		Subd. 3.Overpayment of monthly grants and recovery of ATM errors. (a) When 
44.31 	the county agency determines that an overpayment of the recipient's monthly payment 
44.32 	of Minnesota supplemental aid has occurred, it shall issue a notice of overpayment 
44.33 	to the recipient. If the person is no longer receiving Minnesota supplemental aid, the 
44.34 	county agency may request voluntary repayment or pursue civil recovery. If the person is 
45.1 	receiving Minnesota supplemental aid, the county agency shall recover the overpayment 
45.2 	by withholding an amount equal to three percent of the standard of assistance for the 
45.3 	recipient or the total amount of the monthly grant, whichever is less. 
45.4 	(b) Establishment of an overpayment is limited to 12 months from the date of 
45.5 	discovery due to agency error. Establishment of an overpayment is limited to six years 
45.6 	prior to the month of discovery due to client error or an intentional program violation 
45.7 	determined under section 256.046.
45.8 	(c) For recipients receiving benefits via electronic benefit transfer, if the overpayment 
45.9 	is a result of an automated teller machine (ATM) dispensing funds in error to the recipient, 
45.10 	the agency may recover the ATM error by immediately withdrawing funds from the 
45.11 	recipient's electronic benefit transfer account, up to the amount of the error. 
45.12 	(d) Residents of nursing homes, regional treatment centers, andlicensed residential 
45.13 	facilities with negotiated rates shall not have overpayments recovered from their personal 
45.14 	needs allowance.

45.15 	Sec. 16. Minnesota Statutes 2010, section 256E.30, subdivision 2, is amended to read:
45.16 		Subd. 2.Allocation of money. (a) State money appropriated and Community 
45.17 	service block grant money allotted to the state and all money transferred to the community 
45.18 	service block grant from other block grants shall be allocated annually to community 
45.19 	action agencies and Indian reservation governments under clauses (b) and (c), and to 
45.20 	migrant and seasonal farmworker organizations under clause (d).
45.21 	(b) The available annual money will provide base funding to all community action 
45.22 	agencies and the Indian reservations. Base funding amounts per agency are as follows: for 
45.23 	agencies with low income populations up to 3,999, $25,000; 4,000 to 23,999, $50,000; 
45.24 	and 24,000 or more, $100,000.
45.25 	(c) All remaining money of the annual money available after the base funding has 
45.26 	been determined must be allocated to each agency and reservation in proportion to the 
45.27 	size of the poverty level population in the agency's service area compared to the size of 
45.28 	the poverty level population in the state.
45.29 	(d) Allocation of money to migrant and seasonal farmworker organizations must not 
45.30 	exceed three percent of the total annual money available. Base funding allocations must 
45.31 	be made for all community action agencies and Indian reservations that received money 
45.32 	under this subdivision, in fiscal year 1984, and for community action agencies designated 
45.33 	under this section with a service area population of 35,000 or greater.

45.34 	Sec. 17. Minnesota Statutes 2010, section 256E.35, subdivision 5, is amended to read:
46.1 		Subd. 5.Household eligibility; participation. (a) To be eligible for state or TANF
46.2 	matching funds in the family assets for independence initiative, a household must meet the 
46.3 	eligibility requirements of the federal Assets for Independence Act, Public Law 105-285, 
46.4 	in Title IV, section 408 of that act.
46.5 	(b) Each participating household must sign a family asset agreement that includes 
46.6 	the amount of scheduled deposits into its savings account, the proposed use, and the 
46.7 	proposed savings goal. A participating household must agree to complete an economic 
46.8 	literacy training program.
46.9 	Participating households may only deposit money that is derived from household 
46.10 	earned income or from state and federal income tax credits.

46.11 	Sec. 18. Minnesota Statutes 2010, section 256E.35, subdivision 6, is amended to read:
46.12 		Subd. 6.Withdrawal; matching; permissible uses. (a) To receive a match, a 
46.13 	participating household must transfer funds withdrawn from a family asset account to its 
46.14 	matching fund custodial account held by the fiscal agent, according to the family asset 
46.15 	agreement. The fiscal agent must determine if the match request is for a permissible use 
46.16 	consistent with the household's family asset agreement.
46.17 	The fiscal agent must ensure the household's custodial account contains the 
46.18 	applicable matching funds to match the balance in the household's account, including 
46.19 	interest, on at least a quarterly basis and at the time of an approved withdrawal. Matches 
46.20 	must be provided as follows:
46.21 	(1) from state grant and TANF funds a matching contribution of $1.50 for every $1 
46.22 	of funds withdrawn from the family asset account equal to the lesser of $720 per year or a 
46.23 	$3,000 lifetime limit; and
46.24 	(2) from nonstate funds, a matching contribution of no less than $1.50 for every $1 
46.25 	of funds withdrawn from the family asset account equal to the lesser of $720 per year or 
46.26 	a $3,000 lifetime limit.
46.27 	(b) Upon receipt of transferred custodial account funds, the fiscal agent must make a 
46.28 	direct payment to the vendor of the goods or services for the permissible use.

46.29 	Sec. 19. Minnesota Statutes 2010, section 256J.12, subdivision 1a, is amended to read:
46.30 		Subd. 1a.30-day 60-day residency requirement. An assistance unit is considered 
46.31 	to have established residency in this state only when a child or caregiver has resided in this 
46.32 	state for at least 30 60 consecutive days with the intention of making the person's home 
46.33 	here and not for any temporary purpose. The birth of a child in Minnesota to a member 
46.34 	of the assistance unit does not automatically establish the residency in this state under 
47.1 	this subdivision of the other members of the assistance unit. Time spent in a shelter for 
47.2 	battered women shall count toward satisfying the 30-day 60-day residency requirement.

47.3 	Sec. 20. Minnesota Statutes 2010, section 256J.12, subdivision 2, is amended to read:
47.4 		Subd. 2.Exceptions. (a) A county shall waive the 30-day residency requirement 
47.5 	where unusual hardship would result from denial of assistance.
47.6 	(b) For purposes of this section, unusual hardship means an assistance unit:
47.7 	(1) is without alternative shelter; or
47.8 	(2) is without available resources for food.
47.9 	(c) For purposes of this subdivision, the following definitions apply (1) "metropolitan 
47.10 	statistical area" is as defined by the U.S. Census Bureau; (2) "alternative shelter" includes 
47.11 	any shelter that is located within the metropolitan statistical area containing the county and 
47.12 	for which the family is eligible, provided the assistance unit does not have to travel more 
47.13 	than 20 miles to reach the shelter and has access to transportation to the shelter. Clause (2) 
47.14 	does not apply to counties in the Minneapolis-St. Paul metropolitan statistical area.
47.15 	(d) Applicants are considered to meet the residency requirement under subdivision 
47.16 	1a if they once resided in Minnesota and:
47.17 	(1) joined the United States armed services, returned to Minnesota within 30 days of 
47.18 	leaving the armed services, and intend to remain in Minnesota; or
47.19 	(2) left to attend school in another state, paid nonresident tuition or Minnesota 
47.20 	tuition rates under a reciprocity agreement, and returned to Minnesota within 30 days of 
47.21 	graduation with the intent to remain in Minnesota.
47.22 	(e) (b) The 30-day 60-day residence requirement is met when:
47.23 	(1) a minor child or a minor caregiver moves from another state to the residence of 
47.24 	a relative caregiver; and
47.25 	(2) the relative caregiver has resided in Minnesota for at least 30 60 consecutive 
47.26 	days and:
47.27 	(i) the minor caregiver applies for and receives MFIP; or
47.28 	(ii) the relative caregiver applies for assistance for the minor child but does not 
47.29 	choose to be a member of the MFIP assistance unit.

47.30 	Sec. 21. Minnesota Statutes 2010, section 256J.37, is amended by adding a subdivision 
47.31 	to read:
47.32 		Subd. 3c.Treatment of Supplemental Security Income. Effective July 1, 2011, the 
47.33 	county shall reduce the cash portion of the MFIP grant by $150.00 per SSI recipient who 
47.34 	resides in the household, and who would otherwise be included in the MFIP assistance 
48.1 	unit under section 256J.24, subdivision 2, but is excluded solely due to the SSI recipient 
48.2 	status under section 256J.24, subdivision 3, paragraph (a), clause (1). If the SSI recipient 
48.3 	receives less than $150 of SSI, only the amount received shall be used in calculating the 
48.4 	MFIP cash assistance payment. This provision does not apply to relative caregivers who 
48.5 	could elect to be included in the MFIP assistance unit under section 256J.24, subdivision 
48.6 	4, unless the caregiver's children or stepchildren are included in the MFIP assistance unit.

48.7 	Sec. 22. Minnesota Statutes 2010, section 256J.38, subdivision 1, is amended to read:
48.8 		Subdivision 1.Scope of overpayment. (a) When a participant or former participant 
48.9 	receives an overpayment due to agency, client, or ATM error, or due to assistance received 
48.10 	while an appeal is pending and the participant or former participant is determined 
48.11 	ineligible for assistance or for less assistance than was received, the county agency must 
48.12 	recoup or recover the overpayment using the following methods:
48.13 	(1) reconstruct each affected budget month and corresponding payment month;
48.14 	(2) use the policies and procedures that were in effect for the payment month; and
48.15 	(3) do not allow employment disregards in section 256J.21, subdivision 3 or 4, in the 
48.16 	calculation of the overpayment when the unit has not reported within two calendar months 
48.17 	following the end of the month in which the income was received. 
48.18 	(b) Establishment of an overpayment is limited to 12 months prior to the month of 
48.19 	discovery due to agency error. Establishment of an overpayment is limited to six years 
48.20 	prior to the month of discovery due to client error or an intentional program violation 
48.21 	determined under section 256.046.

48.22 	Sec. 23. [256N.10] ADULT ASSISTANCE GRANT PROGRAM.
48.23 	The adult assistance grant program is a capped allocation to counties that can be 
48.24 	spent in a flexible manner, to the extent funds are available, for adult assistance.

48.25 	Sec. 24. [256N.20] DEFINITIONS.
48.26 		Subdivision 1.Scope. For the purposes of sections 256N.01 to 256N.80, the terms 
48.27 	defined in this section have the meanings given them.
48.28 		Subd. 2.Adult assistance. "Adult assistance" means a capped allocation provided 
48.29 	or arranged for by county boards for ongoing emergency needs, special diets, or special 
48.30 	needs as determined by the county.
48.31 		Subd. 3.Commissioner. "Commissioner" means the commissioner of human 
48.32 	services.
49.1 		Subd. 4.County board. "County board" means the board of county commissioners 
49.2 	in each county.
49.3 		Subd. 5.Eligible participant. "Eligible participant" means low-income adults who 
49.4 	meet the residency requirements under section 256N.22, and who were previously eligible 
49.5 	for programs under subdivision 6 are eligible for adult assistance. The commissioner may 
49.6 	develop more specific eligibility criteria.
49.7 		Subd. 6.Former programs. "Former programs" means funding for:
49.8 	(1) general assistance;
49.9 	(2) emergency general assistance;
49.10 	(3) emergency supplemental aid; and
49.11 	(4) Minnesota supplemental aid special needs and special diets.

49.12 	Sec. 25. [256N.22] RESIDENCY.
49.13 	(a) For purposes of eligibility for adult assistance, a person must be a resident of 
49.14 	this state.
49.15 	(b) A "resident" is a person living in the state for at least 60 days with the intention of 
49.16 	making the person's home here and not for any temporary purpose. Time spent in a shelter 
49.17 	for battered women shall count toward satisfying the 60-day residency requirement. All 
49.18 	applicants for these programs are required to demonstrate the requisite intent and may do 
49.19 	so in any of the following ways:
49.20 	(1) by showing that the applicant maintains a residence at a verified address, other 
49.21 	than a place of public accommodation. An applicant may verify a residence address by 
49.22 	presenting a valid state driver's license, a state identification card, a voter registration 
49.23 	card, or a rent receipt; or
49.24 	(2) by verifying residence according to Minnesota Rules, part 9500.1219, subpart 
49.25 	3, item C. 
49.26 	(c) The county shall not deny an application solely because the applicant does not 
49.27 	meet at least one of the criteria in this subdivision, but shall continue to process the 
49.28 	application and leave the application pending until the residency requirement is met or 
49.29 	until eligibility or ineligibility is established. 
49.30 	(d) If any provision of this subdivision is enjoined from implementation or found 
49.31 	unconstitutional by any court of competent jurisdiction, the remaining provisions shall 
49.32 	remain valid and shall be given full effect. 

49.33 	Sec. 26. [256N.25] PROGRAM EVALUATION.
50.1 		Subdivision 1.County evaluation. Each county shall submit to the commissioner 
50.2 	data from the past calendar year on the outcomes and performance indicators, and 
50.3 	information as to how grant funds are being spent on the target population. The 
50.4 	commissioner shall prescribe standard methods to be used by the counties in providing 
50.5 	the data. The data shall be submitted no later than March 1 of each year, beginning with 
50.6 	March 1, 2013. The commissioner shall define outcomes and performance indicators.
50.7 		Subd. 2.Statewide evaluation. Six months after the end of the first full calendar 
50.8 	year and biennially thereafter, the commissioner shall prepare a report on the counties' 
50.9 	progress in improving the outcomes of adults related to safety and well-being. This report 
50.10 	shall be disseminated electronically throughout the state.

50.11 	Sec. 27. [256N.30] FUNDING.
50.12 		Subdivision 1.Purpose. Counties may use the capped allocation for adult assistance 
50.13 	for individuals under section 256N.20, subdivision 2.
50.14 		Subd. 2.Allocation. Funding for the adult assistance grant program is limited to the 
50.15 	appropriation. The commissioner shall allocate to counties the money appropriated for the 
50.16 	program based on each county agency's average share of the state's former programs under 
50.17 	section 256N.20, subdivision 6. The commissioner may reallocate any unspent amounts 
50.18 	to other counties. No county shall be allocated less than $1,000 for the fiscal year. Any 
50.19 	adult assistance aid expenditures by a county above the amount of the commissioner's 
50.20 	allocation to the county must be made from county funds.

50.21 	Sec. 28. Minnesota Statutes 2010, section 393.07, subdivision 10, is amended to read:
50.22 		Subd. 10.Food stamp program; Maternal and Child Nutrition Act. (a) The local 
50.23 	social services agency shall establish and administer the food stamp program according 
50.24 	to rules of the commissioner of human services, the supervision of the commissioner as 
50.25 	specified in section 256.01, and all federal laws and regulations. The commissioner of 
50.26 	human services shall monitor food stamp program delivery on an ongoing basis to ensure 
50.27 	that each county complies with federal laws and regulations. Program requirements to be 
50.28 	monitored include, but are not limited to, number of applications, number of approvals, 
50.29 	number of cases pending, length of time required to process each application and deliver 
50.30 	benefits, number of applicants eligible for expedited issuance, length of time required 
50.31 	to process and deliver expedited issuance, number of terminations and reasons for 
50.32 	terminations, client profiles by age, household composition and income level and sources, 
50.33 	and the use of phone certification and home visits. The commissioner shall determine the 
50.34 	county-by-county and statewide participation rate.
51.1 	(b) On July 1 of each year, the commissioner of human services shall determine a 
51.2 	statewide and county-by-county food stamp program participation rate. The commissioner 
51.3 	may designate a different agency to administer the food stamp program in a county if the 
51.4 	agency administering the program fails to increase the food stamp program participation 
51.5 	rate among families or eligible individuals, or comply with all federal laws and regulations 
51.6 	governing the food stamp program. The commissioner shall review agency performance 
51.7 	annually to determine compliance with this paragraph.
51.8 	(c) A person who commits any of the following acts has violated section 256.98 or 
51.9 	609.821, or both, and is subject to both the criminal and civil penalties provided under 
51.10 	those sections:
51.11 	(1) obtains or attempts to obtain, or aids or abets any person to obtain by means of a 
51.12 	willful statement or misrepresentation, or intentional concealment of a material fact, food 
51.13 	stamps or vouchers issued according to sections 145.891 to 145.897 to which the person 
51.14 	is not entitled or in an amount greater than that to which that person is entitled or which 
51.15 	specify nutritional supplements to which that person is not entitled; or
51.16 	(2) presents or causes to be presented, coupons or vouchers issued according to 
51.17 	sections 145.891 to 145.897 for payment or redemption knowing them to have been 
51.18 	received, transferred or used in a manner contrary to existing state or federal law; or
51.19 	(3) willfully uses, possesses, or transfers food stamp coupons, authorization to 
51.20 	purchase cards or vouchers issued according to sections 145.891 to 145.897 in any manner 
51.21 	contrary to existing state or federal law, rules, or regulations; or
51.22 	(4) buys or sells food stamp coupons, authorization to purchase cards, other 
51.23 	assistance transaction devices, vouchers issued according to sections 145.891 to 145.897, 
51.24 	or any food obtained through the redemption of vouchers issued according to sections 
51.25 	145.891 to 145.897 for cash or consideration other than eligible food.
51.26 	(d) A peace officer or welfare fraud investigator may confiscate food stamps, 
51.27 	authorization to purchase cards, or other assistance transaction devices found in the 
51.28 	possession of any person who is neither a recipient of the food stamp program nor 
51.29 	otherwise authorized to possess and use such materials. Confiscated property shall be 
51.30 	disposed of as the commissioner may direct and consistent with state and federal food 
51.31 	stamp law. The confiscated property must be retained for a period of not less than 30 days 
51.32 	to allow any affected person to appeal the confiscation under section 256.045.
51.33 	(e) Food stamp overpayment claims which are due in whole or in part to client error 
51.34 	shall be established by the county agency for a period of six years from the date of any 
51.35 	resultant overpayment Establishment of an overpayment is limited to 12 months prior to 
51.36 	the month of discovery due to agency error. Establishment of an overpayment is limited 
52.1 	to six years prior to the month of discovery due to client error or an intentional program 
52.2 	violation determined under section 256.046.
52.3 	(f) With regard to the federal tax revenue offset program only, recovery incentives 
52.4 	authorized by the federal food and consumer service shall be retained at the rate of 50 
52.5 	percent by the state agency and 50 percent by the certifying county agency.
52.6 	(g) A peace officer, welfare fraud investigator, federal law enforcement official, 
52.7 	or the commissioner of health may confiscate vouchers found in the possession of any 
52.8 	person who is neither issued vouchers under sections 145.891 to 145.897, nor otherwise 
52.9 	authorized to possess and use such vouchers. Confiscated property shall be disposed of 
52.10 	as the commissioner of health may direct and consistent with state and federal law. The 
52.11 	confiscated property must be retained for a period of not less than 30 days.
52.12 	(h) The commissioner of human services may seek a waiver from the United States 
52.13 	Department of Agriculture to allow the state to specify foods that may and may not be 
52.14 	purchased in Minnesota with benefits funded by the federal Food Stamp Program. The 
52.15 	commissioner shall consult with the members of the house of representatives and senate 
52.16 	policy committees having jurisdiction over food support issues in developing the waiver. 
52.17 	The commissioner, in consultation with the commissioners of health and education, shall 
52.18 	develop a broad public health policy related to improved nutrition and health status. The 
52.19 	commissioner must seek legislative approval prior to implementing the waiver.

52.20 	Sec. 29. Minnesota Statutes 2010, section 402A.10, subdivision 4, is amended to read:
52.21 		Subd. 4.Essential human services or essential services. "Essential human 
52.22 	services" or "essential services" means assistance and services to recipients or potential 
52.23 	recipients of public welfare and other services delivered by counties or tribes that are 
52.24 	mandated in federal and state law that are to be available in all counties of the state.

52.25 	Sec. 30. Minnesota Statutes 2010, section 402A.10, subdivision 5, is amended to read:
52.26 		Subd. 5.Service delivery authority. "Service delivery authority" means a single 
52.27 	county, or group consortium of counties operating by execution of a joint powers 
52.28 	agreement under section 471.59 or other contractual agreement, that has voluntarily 
52.29 	chosen by resolution of the county board of commissioners to participate in the redesign 
52.30 	under this chapter or has been assigned by the commissioner pursuant to section 402A.18. 
52.31 	A service delivery authority includes an Indian tribe or group of tribes that have voluntarily 
52.32 	chosen by resolution of tribal government to participate in redesign under this chapter.

53.1 	Sec. 31. Minnesota Statutes 2010, section 402A.15, is amended to read:
53.2 	402A.15 STEERING COMMITTEE ON PERFORMANCE AND OUTCOME 
53.3 	REFORMS.
53.4 		Subdivision 1.Duties. (a) The Steering Committee on Performance and Outcome 
53.5 	Reforms shall develop a uniform process to establish and review performance and outcome 
53.6 	standards for all essential human services based on the current level of resources available, 
53.7 	and to shall develop appropriate reporting measures and a uniform accountability process 
53.8 	for responding to a county's or human service delivery authority's failure to make adequate 
53.9 	progress on achieving performance measures. The accountability process shall focus on 
53.10 	the performance measures rather than inflexible implementation requirements.
53.11 	(b) The steering committee shall:
53.12 	(1) by November 1, 2009, establish an agreed-upon list of essential services;
53.13 	(2) by February 15, 2010, develop and recommend to the legislature a uniform, 
53.14 	graduated process, in addition to the remedies identified in section 402A.18, for responding 
53.15 	to a county's failure to make adequate progress on achieving performance measures; and
53.16 	(3) by December 15, 2012, for each essential service, make recommendations 
53.17 	to the legislature regarding (1) (i) performance measures and goals based on those 
53.18 	measures for each essential service, (2) and (ii) a system for reporting on the performance 
53.19 	measures and goals, and (3) appropriate resources, including funding, needed to achieve 
53.20 	those performance measures and goals. The resource recommendations shall take into 
53.21 	consideration program demand and the unique differences of local areas in geography and 
53.22 	the populations served. Priority shall be given to services with the greatest variation in 
53.23 	availability and greatest administrative demands. By January 15 of each year starting 
53.24 	January 15, 2011, the steering committee shall report its recommendations to the governor 
53.25 	and legislative committees with jurisdiction over health and human services. As part of its 
53.26 	report, the steering committee shall, as appropriate, recommend statutory provisions, rules 
53.27 	and requirements, and reports that should be repealed or eliminated.
53.28 	(c) As far as possible, the performance measures, reporting system, and funding 
53.29 	shall be consistent across program areas. The development of performance measures shall 
53.30 	consider the manner in which data will be collected and performance will be reported. 
53.31 	The steering committee shall consider state and local administrative costs related to 
53.32 	collecting data and reporting outcomes when developing performance measures. The 
53.33 	steering committee shall correlate the performance measures and goals to available levels 
53.34 	of resources, including state and local funding. The steering committee shall also identify 
53.35 	and incorporate federal performance measures in its recommendations for those program 
53.36 	areas where federal funding is contingent on meeting federal performance standards. The 
54.1 	steering committee shall take into consideration that the goal of implementing changes 
54.2 	to program monitoring and reporting the progress toward achieving outcomes is to 
54.3 	significantly minimize the cost of administrative requirements and to allow funds freed 
54.4 	by reduced administrative expenditures to be used to provide additional services, allow 
54.5 	flexibility in service design and management, and focus energies on achieving program 
54.6 	and client outcomes.
54.7 	(d) In making its recommendations, the steering committee shall consider input from 
54.8 	the council established in section 402A.20. The steering committee shall review the 
54.9 	measurable goals established in a memorandum of understanding entered into under 
54.10 	section 402A.30, subdivision 2, paragraph (b), and consider whether they may be applied 
54.11 	as statewide performance outcomes.
54.12 	(e) The steering committee shall form work groups that include persons who provide 
54.13 	or receive essential services and representatives of organizations who advocate on behalf 
54.14 	of those persons.
54.15 	(f) By December 15, 2009, the steering committee shall establish a three-year 
54.16 	schedule for completion of its work. The schedule shall be published on the Department of 
54.17 	Human Services Web site and reported to the legislative committees with jurisdiction over 
54.18 	health and human services. In addition, the commissioner shall post quarterly updates on 
54.19 	the progress of the steering committee on the Department of Human Services Web site.
54.20 		Subd. 2.Composition. (a) The steering committee shall include:
54.21 	(1) the commissioner of human services, or designee, and two additional 
54.22 	representatives of the department;
54.23 	(2) two county commissioners, representative of rural and urban counties, selected 
54.24 	by the Association of Minnesota Counties;
54.25 	(3) two county directors of human services, representative of rural and urban 
54.26 	counties, selected by the Minnesota Association of County Social Service Administrators; 
54.27 	and
54.28 	(4) three clients or client advocates representing different populations receiving 
54.29 	services from the Department of Human Services, who are appointed by the commissioner.
54.30 	(b) The commissioner, or designee, and a county commissioner shall serve as 
54.31 	cochairs of the committee. The committee shall be convened within 60 days of May 
54.32 	15, 2009.
54.33 	(c) State agency staff shall serve as informational resources and staff to the steering 
54.34 	committee. Statewide county associations may assemble county program data as required.
54.35 	(d) To promote information sharing and coordination between the steering committee 
54.36 	and council, one of the county representatives from paragraph (a), clause (2), and one of the 
55.1 	county representatives from paragraph (a), clause (3), must also serve as a representative 
55.2 	on the council under section 402A.20, subdivision 1, paragraph (b), clause (5) or (6).

55.3 	Sec. 32. Minnesota Statutes 2010, section 518A.51, is amended to read:
55.4 	518A.51 FEES FOR IV-D SERVICES.
55.5 	(a) When a recipient of IV-D services is no longer receiving assistance under the 
55.6 	state's title IV-A, IV-E foster care, medical assistance, or MinnesotaCare programs, the 
55.7 	public authority responsible for child support enforcement must notify the recipient, 
55.8 	within five working days of the notification of ineligibility, that IV-D services will be 
55.9 	continued unless the public authority is notified to the contrary by the recipient. The 
55.10 	notice must include the implications of continuing to receive IV-D services, including the 
55.11 	available services and fees, cost recovery fees, and distribution policies relating to fees.
55.12 	(b) An application fee of $25 shall be paid by the person who applies for child 
55.13 	support and maintenance collection services, except persons who are receiving public 
55.14 	assistance as defined in section 256.741 and the diversionary work program under section 
55.15 	256J.95, persons who transfer from public assistance to nonpublic assistance status, and 
55.16 	minor parents and parents enrolled in a public secondary school, area learning center, or 
55.17 	alternative learning program approved by the commissioner of education.
55.18 	(c) In the case of an individual who has never received assistance under a state 
55.19 	program funded under title IV-A of the Social Security Act and for whom the public 
55.20 	authority has collected at least $500 of support, the public authority must impose an 
55.21 	annual federal collections fee of $25 for each case in which services are furnished. This 
55.22 	fee must be retained by the public authority from support collected on behalf of the 
55.23 	individual, but not from the first $500 collected.
55.24 	(d) When the public authority provides full IV-D services to an obligee who has 
55.25 	applied for those services, upon written notice to the obligee, the public authority must 
55.26 	charge a cost recovery fee of one two percent of the amount collected. This fee must 
55.27 	be deducted from the amount of the child support and maintenance collected and not 
55.28 	assigned under section 256.741 before disbursement to the obligee. This fee does not 
55.29 	apply to an obligee who:
55.30 	(1) is currently receiving assistance under the state's title IV-A, IV-E foster care, 
55.31 	medical assistance, or MinnesotaCare programs; or
55.32 	(2) has received assistance under the state's title IV-A or IV-E foster care programs, 
55.33 	until the person has not received this assistance for 24 consecutive months.
55.34 	 (e) When the public authority provides full IV-D services to an obligor who has 
55.35 	applied for such services, upon written notice to the obligor, the public authority must 
56.1 	charge a cost recovery fee of one two percent of the monthly court-ordered child support 
56.2 	and maintenance obligation. The fee may be collected through income withholding, as 
56.3 	well as by any other enforcement remedy available to the public authority responsible for 
56.4 	child support enforcement.
56.5 	 (f) Fees assessed by state and federal tax agencies for collection of overdue support 
56.6 	owed to or on behalf of a person not receiving public assistance must be imposed on the 
56.7 	person for whom these services are provided. The public authority upon written notice to 
56.8 	the obligee shall assess a fee of $25 to the person not receiving public assistance for each 
56.9 	successful federal tax interception. The fee must be withheld prior to the release of the 
56.10 	funds received from each interception and deposited in the general fund.
56.11 	 (g) Federal collections fees collected under paragraph (c) and cost recovery 
56.12 	fees collected under paragraphs (d) and (e) retained by the commissioner of human 
56.13 	services shall be considered child support program income according to Code of Federal 
56.14 	Regulations, title 45, section 304.50, and shall be deposited in the special revenue fund 
56.15 	account established under paragraph (i). The commissioner of human services must elect 
56.16 	to recover costs based on either actual or standardized costs.
56.17 	 (h) The limitations of this section on the assessment of fees shall not apply to 
56.18 	the extent inconsistent with the requirements of federal law for receiving funds for the 
56.19 	programs under title IV-A and title IV-D of the Social Security Act, United States Code, 
56.20 	title 42, sections 601 to 613 and United States Code, title 42, sections 651 to 662.
56.21 	 (i) The commissioner of human services is authorized to establish a special revenue 
56.22 	fund account to receive the federal collections fees collected under paragraph (c) and cost 
56.23 	recovery fees collected under paragraphs (d) and (e). A portion of the nonfederal share of 
56.24 	these fees may be retained for expenditures necessary to administer the fees and must be 
56.25 	transferred to the child support system special revenue account. The remaining nonfederal 
56.26 	share of the federal collections fees and cost recovery fees must be retained by the 
56.27 	commissioner and dedicated to the child support general fund county performance-based 
56.28 	grant account authorized under sections 256.979 and 256.9791.
56.29 	(j) The nonfederal share of the cost recovery fee revenue must be retained by the 
56.30 	commissioner and distributed as follows:
56.31 	(1) one-half of the revenue must be transferred to the child support system special 
56.32 	revenue account to support the state's administration of the child support enforcement 
56.33 	program and its federally mandated automated system;
56.34 	(2) an additional portion of the revenue must be transferred to the child support 
56.35 	system special revenue account for expenditures necessary to administer the fees; and
57.1 	(3) the remaining portion of the revenue must be distributed to the counties to aid the 
57.2 	counties in funding their child support enforcement programs.
57.3 	(k) The nonfederal share of the federal collections fees must be distributed to the 
57.4 	counties to aid them in funding their child support enforcement programs.
57.5 	(l) The commissioner of human services shall distribute quarterly any of the funds 
57.6 	dedicated to the counties under paragraphs (j) and (k) using the methodology specified in 
57.7 	section 256.979, subdivision 11. The funds received by the counties must be reinvested in 
57.8 	the child support enforcement program and the counties must not reduce the funding of 
57.9 	their child support programs by the amount of the funding distributed.

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

57.11 	Sec. 33. COUNTY ELECTRONIC VERIFICATION PROCEDURES.
 57.12 	The commissioner of human services shall define which public assistance program 
57.13 	requirements may be electronically verified for the purposes of determining eligibility, 
57.14 	and shall also define procedures for electronic verification. The commissioner of human 
57.15 	services shall report back to the chairs and ranking minority members of the legislative 
57.16 	committees with jurisdiction over these issues by January 15, 2012, with draft legislation 
57.17 	to implement the procedures if legislation is necessary for purposes of implementation.

57.18 	Sec. 34. ALIGNMENT OF PROGRAM POLICY AND PROCEDURES.
 57.19 	The commissioner of human services, in consultation with counties and other key 
57.20 	stakeholders, shall analyze and develop recommendations to align program policy and 
57.21 	procedures across all public assistance programs to simplify and streamline program 
57.22 	eligibility and access. The commissioner shall report back to the chairs and ranking 
57.23 	minority members of the legislative committees with jurisdiction over these issues by 
57.24 	January 15, 2013, with draft legislation to implement the recommendations.

57.25 	Sec. 35. ALTERNATIVE STRATEGIES FOR CERTAIN 
57.26 	REDETERMINATIONS.
 57.27 	The commissioner of human services shall develop and implement by January 15, 
57.28 	2012, a simplified process to redetermine eligibility for recipient populations in the medical 
57.29 	assistance, Minnesota supplemental aid, food support, and group residential housing 
57.30 	programs who are eligible based upon disability, age, or chronic medical conditions, and 
57.31 	who are expected to experience minimal change in income or assets from month to month. 
57.32 	The commissioner shall apply for any federal waivers needed to implement this section.

58.1 	Sec. 36. REQUEST FOR PROPOSALS; COMBINED ONLINE APPLICATION.
 58.2 	(a) The commissioner of human services shall issue a request for proposals for a 
58.3 	contract to implement an integrated online eligibility and application portal for food 
58.4 	support, cash assistance, child care, and health care programs. The request for proposals 
58.5 	must require that the system recommended and implemented by the contractor:
58.6 	(1) streamline eligibility determination and case processing in the state to support 
58.7 	statewide eligibility processing;
58.8 	(2) enable interested persons to determine their eligibility for each program, and to 
58.9 	apply for programs online in a manner that asks the applicant only those questions that 
58.10 	relate to the programs the person is applying for;
58.11 	(3) leverage technology that has been operational in production in other similar 
58.12 	state environments; and
58.13 	(4) include Web-based application and worker application processing support and 
58.14 	opportunity for expansion.
58.15 	(b) If responses to the request for proposals meet the requirements under paragraph 
58.16 	(a), the commissioner shall enter into a contract for the services specified in paragraph 
58.17 	(a) by January 31, 2012. The contract must incorporate a performance-based vendor 
58.18 	financing option whereby the vendor contributes the nonfederal share of the cost. If the 
58.19 	commissioner determines that an adequate vendor cannot be chosen based on responses to 
58.20 	the request for proposals, the commissioner shall report back to the chairs and ranking 
58.21 	minority members of the legislative committees having jurisdiction over health and human 
58.22 	services prior to the January 31, 2012, contract date.

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

58.24 	Sec. 37. UNIFORM ASSET LIMIT REQUIREMENTS.
 58.25 	The commissioner of human services, in consultation with county human services 
58.26 	representatives, shall analyze the differences in asset limit requirements across human 
58.27 	services assistance programs, including group residential housing, Minnesota supplemental 
58.28 	aid, general assistance, Minnesota family investment program, diversionary work program, 
58.29 	the federal Supplemental Nutrition Assistance Program, state food assistance programs, 
58.30 	and child care programs. The goal of the analysis is to establish a consistent asset limit 
58.31 	across human services programs and minimize the administrative burdens on counties in 
58.32 	implementing asset tests. The commissioner shall report its findings and conclusions to 
58.33 	the health and human services legislative committees by January 15, 2012, and include 
58.34 	draft legislation establishing a uniform asset limit for human services assistance programs.

59.1 	Sec. 38. ANALYSIS OF PROGRAMS AND THEIR AFFECT ON HEALTHY 
59.2 	MARRIAGES.
 59.3 		Subdivision 1.Analysis. The commissioner of human services shall conduct an 
59.4 	analysis of whether current human services programs affect the motivation and capacity of 
59.5 	individuals to form and sustain healthy marriages in which to raise children. Programs 
59.6 	to be examined in this marriage impact analysis include, but are not limited to, medical 
59.7 	assistance, MinnesotaCare, Minnesota Family Investment program, general assistance, 
59.8 	child protection, child support enforcement, child welfare services, and services for people 
59.9 	who are mentally ill, chemically dependent, or have physical or developmental disabilities.
59.10 		Subd. 2.Report. Before January 1, 2012, the commissioner shall submit a report to 
59.11 	the legislature describing the results of this analysis and outlining proposals to improve 
59.12 	the ability of human services programs to help people who are interested in marriage to 
59.13 	form and sustain healthy marriages in which to raise children. The commissioner shall 
59.14 	ensure that experts on healthy marriage are consulted on the process of conducting the 
59.15 	analysis and writing the report.

59.16 	Sec. 39. REVISOR'S INSTRUCTION.
 59.17 	The revisor of statutes shall make conforming amendments and correct statutory 
59.18 	cross-references as necessitated by the creation of Minnesota Statutes, chapter 256N, and 
59.19 	related repealers in this article.

59.20 	Sec. 40.  REPEALER.
 59.21 	(a) Minnesota Statutes 2010, sections 256.979, subdivisions 5, 6, 7, and 10; 
59.22 	256.9791; 256D.01, subdivisions 1, 1a, 1b, 1e, and 2; 256D.03, subdivisions 1, 2, and 2a; 
59.23 	256D.05, subdivisions 1, 2, 4, 5, 6, 7, and 8; 256D.0513; 256D.053, subdivisions 1, 2, 
59.24 	and 3; 256D.06, subdivisions 1, 1b, 2, 5, 7, and 8; 256D.09, subdivisions 1, 2, 2a, 2b, 5, 
59.25 	and 6; 256D.10; 256D.13; 256D.15; 256D.16; 256D.35, subdivision 8b; and 256D.46, are 
59.26 	repealed.
59.27 	(b) Minnesota Rules, part 9500.1243, subpart 3, is repealed.
59.28 	(c) Minnesota Rules, part 3400.0130, subpart 8, is repealed effective September 
59.29 	3, 2012.

59.30 	ARTICLE 4
59.31 	DEPARTMENT OF HUMAN SERVICES LICENSING

59.32 	Section 1. Minnesota Statutes 2010, section 245A.10, subdivision 1, is amended to 
59.33 	read:
60.1 		Subdivision 1.Application or license fee required, programs exempt from fee.
 60.2 	(a) Unless exempt under paragraph (b), the commissioner shall charge a fee for evaluation 
60.3 	of applications and inspection of programs which are licensed under this chapter.
60.4 	(b) Except as provided under subdivision 2, no application or license fee shall be 
60.5 	charged for child foster care, adult foster care, or family and group family child care or 
60.6 	state-operated programs, unless the state-operated program is an intermediate care facility 
60.7 	for persons with developmental disabilities (ICF/MR).

60.8 	Sec. 2. Minnesota Statutes 2010, section 245A.10, subdivision 3, is amended to read:
60.9 		Subd. 3.Application fee for initial license or certification. (a) For fees required 
60.10 	under subdivision 1, an applicant for an initial license or certification issued by the 
60.11 	commissioner shall submit a $500 application fee with each new application required 
60.12 	under this subdivision. The application fee shall not be prorated, is nonrefundable, and 
60.13 	is in lieu of the annual license or certification fee that expires on December 31. The 
60.14 	commissioner shall not process an application until the application fee is paid.
60.15 	(b) Except as provided in clauses (1) to (3) (4), an applicant shall apply for a license 
60.16 	to provide services at a specific location.
60.17 	(1) For a license to provide residential-based habilitation services to persons with 
60.18 	developmental disabilities under chapter 245B, an applicant shall submit an application 
60.19 	for each county in which the services will be provided. Upon licensure, the license 
60.20 	holder may provide services to persons in that county plus no more than three persons 
60.21 	at any one time in each of up to ten additional counties. A license holder in one county 
60.22 	may not provide services under the home and community-based waiver for persons with 
60.23 	developmental disabilities to more than three people in a second county without holding 
60.24 	a separate license for that second county. Applicants or licensees providing services 
60.25 	under this clause to not more than three persons remain subject to the inspection fees 
60.26 	established in section 245A.10, subdivision 2, for each location. The license issued by 
60.27 	the commissioner must state the name of each additional county where services are being 
60.28 	provided to persons with developmental disabilities. A license holder must notify the 
60.29 	commissioner before making any changes that would alter the license information listed 
60.30 	under section 245A.04, subdivision 7, paragraph (a), including any additional counties 
60.31 	where persons with developmental disabilities are being served.
60.32 	(2) For a license to provide supported employment, crisis respite, or 
60.33 	semi-independent living services to persons with developmental disabilities under chapter 
60.34 	245B, an applicant shall submit a single application to provide services statewide.
61.1 	(3) For a license to provide independent living assistance for youth under section 
61.2 	245A.22, an applicant shall submit a single application to provide services statewide.
61.3 	(4) For a license for a private agency to provide foster care or adoption services 
61.4 	under Minnesota Rules, parts 9545.0755 to 9545.0845, an applicant shall submit a single 
61.5 	application to provide services statewide.

61.6 	Sec. 3. Minnesota Statutes 2010, section 245A.10, subdivision 4, is amended to read:
61.7 		Subd. 4.License or certification fee for certain programs. (a) Child care centers 
61.8 	and programs with a licensed capacity shall pay an annual nonrefundable license or 
61.9 	certification fee based on the following schedule:

61.10
61.11		Licensed Capacity
	Child Care Center
License Fee
	Other Program 
License Fee
	
61.12		1 to 24 persons
	$225$200
		$400
	
61.13		25 to 49 persons
	$340$300
		$600
	
61.14		50 to 74 persons
	$450$400
		$800
	
61.15		75 to 99 persons
	$565$500
		$1,000
	
61.16		100 to 124 persons
	$675$600
		$1,200
	
61.17		125 to 149 persons
	$900$700
		$1,400
	
61.18		150 to 174 persons
	$1,050$800
		$1,600
	
61.19		175 to 199 persons
	$1,200$900
		$1,800
	
61.20
61.21		200 to 224 persons
	$1,350
$1,000
		$2,000
	
61.22
61.23		225 or more persons
	$1,500
$1,100
		$2,500
	
61.24 	(b) A day training and habilitation program serving persons with developmental 
61.25 	disabilities or related conditions shall be assessed apay an annual nonrefundable license 
61.26 	fee based on the following schedule in paragraph (a) unless the license holder serves more 
61.27 	than 50 percent of the same persons at two or more locations in the community.:

61.28		Licensed Capacity
	License Fee
	
61.29		1 to 24 persons
	$800
	
61.30		25 to 49 persons
	$1,000
	
61.31		50 to 74 persons
	$1,200
	
61.32		75 to 99 persons
	$1,400
	
61.33		100 to 124 persons
	$1,600
	
61.34		125 to 149 persons
	$1,800
	
61.35		150 or more persons
	$2,000
	
61.36 	Except as provided in paragraph (c), when a day training and habilitation program 
61.37 	serves more than 50 percent of the same persons in two or more locations in a community, 
61.38 	the day training and habilitation program shall pay a license fee based on the licensed 
62.1 	capacity of the largest facility and the other facility or facilities shall be charged a license 
62.2 	fee based on a licensed capacity of a residential program serving one to 24 persons.
62.3 	(c) When a day training and habilitation program serving persons with developmental 
62.4 	disabilities or related conditions seeks a single license allowed under section 245B.07, 
62.5 	subdivision 12, clause (2) or (3), the licensing fee must be based on the combined licensed 
62.6 	capacity for each location.
62.7 	(d) A program licensed to provide supported employment services to persons 
62.8 	with developmental disabilities under chapter 245B shall pay an annual nonrefundable 
62.9 	license fee of $650.
62.10 	(e) A program licensed to provide crisis respite services to persons with 
62.11 	developmental disabilities under chapter 245B shall pay an annual nonrefundable license 
62.12 	fee of $700.
62.13 	(f) A program licensed to provide semi-independent living services to persons 
62.14 	with developmental disabilities under chapter 245B shall pay an annual nonrefundable 
62.15 	license fee of $700.
62.16 	(g) A program licensed to provide residential-based habilitation services under the 
62.17 	home and community-based waiver for persons with developmental disabilities shall pay 
62.18 	an annual license fee that includes a base rate of $690 plus $60 times the number of clients 
62.19 	served on the first day of July of the current license year.
62.20 	(h) A residential program certified by the Department of Health as an intermediate 
62.21 	care facility for persons with developmental disabilities (ICF/MR) and a noncertified 
62.22 	residential program licensed to provide health or rehabilitative services for persons 
62.23 	with developmental disabilities shall pay an annual nonrefundable license fee based on 
62.24 	the following schedule:

62.25		Licensed Capacity
	License Fee
	
62.26		1 to 24 persons
	$535
	
62.27		25 to 49 persons
	$735
	
62.28		50 or more persons
	$935
	
62.29 	(i) A chemical dependency treatment program licensed under Minnesota Rules, parts 
62.30 	9530.6405 to 9530.6505, to provide chemical dependency treatment shall pay an annual 
62.31 	nonrefundable license fee based on the following schedule:

62.32		Licensed Capacity
	License Fee
	
62.33		1 to 24 persons
	$600
	
62.34		25 to 49 persons
	$800
	
62.35		50 to 74 persons
	$1,000
	
62.36		75 to 99 persons
	$1,200
	
62.37		100 or more persons
	$1,400
	
63.1 	(j) A chemical dependency program licensed under Minnesota Rules, parts 
63.2 	9530.6510 to 9530.6590, to provide detoxification services shall pay an annual 
63.3 	nonrefundable license fee based on the following schedule:

63.4		Licensed Capacity
	License Fee
	
63.5		1 to 24 persons
	$760
	
63.6		25 to 49 persons
	$960
	
63.7		50 or more persons
	$1,160
	
63.8 	(k) Except for child foster care, a residential facility licensed under Minnesota 
63.9 	Rules, chapter 2960, to serve children shall pay an annual nonrefundable license fee 
63.10 	based on the following schedule:

63.11		Licensed Capacity
	License Fee
	
63.12		1 to 24 persons
	$1,000
	
63.13		25 to 49 persons
	$1,100
	
63.14		50 to 74 persons
	$1,200
	
63.15		75 to 99 persons
	$1,300
	
63.16		100 or more persons
	$1,400
	
63.17 	(l) A residential facility licensed under Minnesota Rules, parts 9520.0500 to 
63.18 	9520.0670, to serve persons with mental illness shall pay an annual nonrefundable license 
63.19 	fee based on the following schedule:

63.20		Licensed Capacity
	License Fee
	
63.21		1 to 24 persons
	$2,525
	
63.22		25 or more persons
	$2,725
	
63.23 	(m) A residential facility licensed under Minnesota Rules, parts 9570.2000 to 
63.24 	9570.3400, to serve persons with physical disabilities shall pay an annual nonrefundable 
63.25 	license fee based on the following schedule:

63.26		Licensed Capacity
	License Fee
	
63.27		1 to 24 persons
	$450
	
63.28		25 to 49 persons
	$650
	
63.29		50 to 74 persons
	$850
	
63.30		75 to 99 persons
	$1,050
	
63.31		100 or more persons
	$1,250
	
63.32 	(n) A program licensed to provide independent living assistance for youth under 
63.33 	section 245A.22 shall pay an annual nonrefundable license fee of $1,500.
63.34 	(o) A private agency licensed to provide foster care and adoption services under 
63.35 	Minnesota Rules, parts 9545.0755 to 9545.0845, shall pay an annual nonrefundable 
63.36 	license fee of $875.
64.1 	(p) A program licensed as an adult day care center licensed under Minnesota Rules, 
64.2 	parts 9555.9600 to 9555.9730, shall pay an annual nonrefundable license fee based on 
64.3 	the following schedule:

64.4		Licensed Capacity
	License Fee
	
64.5		1 to 24 persons
	$500
	
64.6		25 to 49 persons
	$700
	
64.7		50 to 74 persons
	$900
	
64.8		75 to 99 persons
	$1,100
	
64.9		100 or more persons
	$1,300
	
64.10 	(q) A program licensed to provide treatment services to persons with sexual 
64.11 	psychopathic personalities or sexually dangerous persons under Minnesota Rules, parts 
64.12 	9515.3000 to 9515.3110, shall pay an annual nonrefundable license fee of $20,000.
64.13 	(r) A mental health center or mental health clinic requesting certification for 
64.14 	purposes of insurance and subscriber contract reimbursement under Minnesota Rules, 
64.15 	parts 9520.0750 to 9520.0870, shall pay a certification fee of $1,550 per year. If the 
64.16 	mental health center or mental health clinic provides services at a primary location with 
64.17 	satellite facilities, the satellite facilities shall be certified with the primary location without 
64.18 	an additional charge.

64.19 	Sec. 4. Minnesota Statutes 2010, section 245A.10, is amended by adding a subdivision 
64.20 	to read:
64.21 		Subd. 7.Human services licensing fees to recover expenditures. Notwithstanding 
64.22 	section 16A.1285, subdivision 2, related to activities for which the commissioner charges 
64.23 	a fee, the commissioner must plan to fully recover direct expenditures for licensing 
64.24 	activities under this chapter over a five-year period. The commissioner may have 
64.25 	anticipated expenditures in excess of anticipated revenues in a biennium by using surplus 
64.26 	revenues accumulated in previous bienniums.

64.27 	Sec. 5. Minnesota Statutes 2010, section 245A.10, is amended by adding a subdivision 
64.28 	to read:
64.29 		Subd. 8.Deposit of license fees. A human services licensing account is created in 
64.30 	the state government special revenue fund. Fees collected under subdivisions 3 and 4 must 
64.31 	be deposited in the human services licensing account and are annually appropriated to the 
64.32 	commissioner for licensing activities authorized under this chapter.

64.33 	Sec. 6. Minnesota Statutes 2010, section 245A.11, subdivision 2b, is amended to read:
65.1 		Subd. 2b.Adult foster care; family adult day services. An adult foster care 
65.2 	license holder licensed under the conditions in subdivision 2a may also provide family 
65.3 	adult day care for adults age 55 age 18 or over if no persons in the adult foster or family 
65.4 	adult day services program have a serious and persistent mental illness or a developmental 
65.5 	disability. Family adult day services provided in a licensed adult foster care setting must 
65.6 	be provided as specified under section 245A.143. Authorization to provide family adult 
65.7 	day services in the adult foster care setting shall be printed on the license certificate by 
65.8 	the commissioner. Adult foster care homes licensed under this section and family adult 
65.9 	day services licensed under section 245A.143 shall not be subject to licensure by the 
65.10 	commissioner of health under the provisions of chapter 144, 144A, 157, or any other 
65.11 	law requiring facility licensure by the commissioner of health. A separate license is not 
65.12 	required to provide family adult day services in a licensed adult foster care home.

65.13 	Sec. 7. Minnesota Statutes 2010, section 245A.143, subdivision 1, is amended to read:
65.14 		Subdivision 1.Scope. (a) The licensing standards in this section must be met to 
65.15 	obtain and maintain a license to provide family adult day services. For the purposes of this 
65.16 	section, family adult day services means a program operating fewer than 24 hours per day 
65.17 	that provides functionally impaired adults, none of which are under age 55, have serious 
65.18 	or persistent mental illness, or have developmental disabilities, age 18 or older with an 
65.19 	individualized and coordinated set of services including health services, social services, 
65.20 	and nutritional services that are directed at maintaining or improving the participants' 
65.21 	capabilities for self-care.
65.22 	(b) A family adult day services license shall only be issued when the services are 
65.23 	provided in the license holder's primary residence, and the license holder is the primary 
65.24 	provider of care. The license holder may not serve more than eight adults at one time, 
65.25 	including residents, if any, served under a license issued under Minnesota Rules, parts 
65.26 	9555.5105 to 9555.6265.
65.27 	(c) An adult foster care license holder may provide family adult day services under 
65.28 	the license holder's adult foster care license if the license holder meets the requirements 
65.29 	of this section.
65.30 	(d) When an applicant or license holder submits an application for initial licensure 
65.31 	or relicensure for both adult foster care and family adult day services, the county agency 
65.32 	shall process the request as a single application and shall conduct concurrent routine 
65.33 	licensing inspections.
65.34 	(e) Adult foster care license holders providing family adult day services under their 
65.35 	foster care license on March 30, 2004, shall be permitted to continue providing these 
66.1 	services with no additional requirements until their adult foster care license is due for 
66.2 	renewal. At the time of relicensure, an adult foster care license holder may continue to 
66.3 	provide family adult day services upon demonstration of compliance with this section. 
66.4 	Adult foster care license holders who provide only family adult day services on August 1, 
66.5 	2004, may apply for a license under this section instead of an adult foster care license.

66.6 	Sec. 8. Minnesota Statutes 2010, section 245C.10, is amended by adding a subdivision 
66.7 	to read:
66.8 		Subd. 8.Human services licensed programs. The commissioner shall recover 
66.9 	the cost of background studies required under section 245C.03, subdivision 1, for all 
66.10 	programs that are licensed by the commissioner, except child foster care and family child 
66.11 	care, through a fee of no more than $20 per study charged to the license holder. The fees 
66.12 	collected under this subdivision are appropriated to the commissioner for the purpose of 
66.13 	conducting background studies.

66.14 	Sec. 9. Minnesota Statutes 2010, section 256B.49, subdivision 16a, is amended to read:
66.15 		Subd. 16a.Medical assistance reimbursement. (a) The commissioner shall 
66.16 	seek federal approval for medical assistance reimbursement of independent living skills 
66.17 	services, foster care waiver service, supported employment, prevocational service, and 
66.18 	structured day service under the home and community-based waiver for persons with a 
66.19 	traumatic brain injury, the community alternatives for disabled individuals waivers, and 
66.20 	the community alternative care waivers.
66.21 	(b) Medical reimbursement shall be made only when the provider demonstrates 
66.22 	evidence of its capacity to meet basic health, safety, and protection standards through 
66.23 	the following methods:
66.24 	(1) for independent living skills services, supported employment, prevocational 
66.25 	service, and structured day service through one of the methods in paragraphs (c) and 
66.26 	(d); and
66.27 	(2) for foster care waiver services through the method in paragraph (e).
66.28 	(c) The provider is licensed to provide services under chapter 245B and agrees 
66.29 	to apply these standards to services funded through the traumatic brain injury, 
66.30 	community alternatives for disabled persons, or community alternative care home and 
66.31 	community-based waivers.
66.32 	(d) The commissioner shall certify that the provider has policies and procedures 
66.33 	governing the following:
66.34 	(1) protection of the consumer's rights and privacy;
67.1 	(2) risk assessment and planning;
67.2 	(3) record keeping and reporting of incidents and emergencies with documentation 
67.3 	of corrective action if needed;
67.4 	(4) service outcomes, regular reviews of progress, and periodic reports;
67.5 	(5) complaint and grievance procedures;
67.6 	(6) service termination or suspension;
67.7 	(7) necessary training and supervision of direct care staff that includes:
67.8 	(i) documentation in personnel files of 20 hours of orientation training in providing 
67.9 	training related to service provision;
67.10 	(ii) training in recognizing the symptoms and effects of certain disabilities, health 
67.11 	conditions, and positive behavioral supports and interventions;
67.12 	(iii) a minimum of five hours of related training annually; and
67.13 	(iv) when applicable:
67.14 	(A) safe medication administration;
67.15 	(B) proper handling of consumer funds; and
67.16 	(C) compliance with prohibitions and standards developed by the commissioner to 
67.17 	satisfy federal requirements regarding the use of restraints and restrictive interventions. 
67.18 	The commissioner shall review at least biennially that each service provider's policies 
67.19 	and procedures governing basic health, safety, and protection of rights continue to meet 
67.20 	minimum standards.
67.21 	(e) The commissioner shall seek federal approval for Medicaid reimbursement 
67.22 	of foster care services under the home and community-based waiver for persons with 
67.23 	a traumatic brain injury, the community alternatives for disabled individuals waiver, 
67.24 	and community alternative care waiver when the provider demonstrates evidence of 
67.25 	its capacity to meet basic health, safety, and protection standards. The commissioner 
67.26 	shall verify that the adult foster care provider is licensed under Minnesota Rules, parts 
67.27 	9555.5105 to 9555.6265; that the child foster care provider is licensed as a family foster 
67.28 	care or a foster care residence under Minnesota Rules, parts 2960.3000 to 2960.3340, and 
67.29 	certify that the provider has policies and procedures that govern:
67.30 	(1) compliance with prohibitions and standards developed by the commissioner to 
67.31 	meet federal requirements regarding the use of restraints and restrictive interventions;
67.32 	(2) documentation of service needs and outcomes, regular reviews of progress, 
67.33 	and periodic reports; and
67.34 	(3) safe medication management and administration.
68.1 	The commissioner shall review at least biennially that each service provider's policies and 
68.2 	procedures governing basic health, safety, and protection of rights standards continue to 
68.3 	meet minimum standards.
68.4 	(f) The commissioner shall seek federal waiver approval for Medicaid reimbursement 
68.5 	of family adult day services under all disability waivers. After the waiver is granted, the 
68.6 	commissioner shall include family adult day services in the common services menu that 
68.7 	is currently under development.

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

68.9 	Sec. 10.  REPEALER.
 68.10 	Minnesota Statutes 2010, section 245A.10, subdivision 5, is repealed.

68.11 	ARTICLE 5
68.12 	HEALTH CARE

68.13 	Section 1. [1.06] FREEDOM OF CHOICE IN HEALTH CARE ACT.
68.14 		Subdivision 1.Citation. This section shall be known as and may be cited as the 
68.15 	"Freedom of Choice in Health Care Act."
68.16 		Subd. 2.Definitions. (a) For purposes of this section, the following terms have 
68.17 	the meaning given them.
68.18 	(b) "Health care service" means any service, treatment, or provision of a product for 
68.19 	the care of a physical or mental disease, illness, injury, defect, or condition, or to otherwise 
68.20 	maintain or improve physical or mental health, subject to all laws and rules regulating 
68.21 	health service providers and products within the state of Minnesota.
68.22 	(c) "Mode of securing" means to purchase directly or on credit or by trade, or to 
68.23 	contract for third-party payment by insurance or other legal means as authorized by the 
68.24 	state of Minnesota, or to apply for or accept employer-sponsored or government-sponsored 
68.25 	health care benefits under such conditions as may legally be required as a condition of 
68.26 	such benefits, or any combination of the same.
68.27 	(d) "Penalty" means any civil or criminal fine, tax, salary or wage withholding, 
68.28 	surcharge, fee, or any other imposed consequence established by law or rule of a 
68.29 	government or its subdivision or agency that is used to punish or discourage the exercise 
68.30 	of rights protected under this section.
68.31 		Subd. 3.Statement of public policy. (a) The power to require or regulate a person's 
68.32 	choice in the mode of securing health care services, or to impose a penalty related to that 
68.33 	choice, is not found in the Constitution of the United States of America, and is therefore a 
69.1 	power reserved to the people pursuant to the Ninth Amendment, and to the several states 
69.2 	pursuant to the Tenth Amendment. The state of Minnesota hereby exercises its sovereign 
69.3 	power to declare the public policy of the state of Minnesota regarding the right of all 
69.4 	persons residing in the state in choosing the mode of securing health care services.
69.5 	(b) It is hereby declared that the public policy of the state of Minnesota, consistent 
69.6 	with our constitutionally recognized and inalienable rights of liberty, is that every person 
69.7 	within the state of Minnesota is and shall be free to choose or decline to choose any mode 
69.8 	of securing health care services without penalty or threat of penalty.
69.9 	(c) The policy stated under this section shall not be applied to impair any right of 
69.10 	contract related to the provision of health care services to any person or group.
69.11 		Subd. 4.Enforcement. (a) No public official, employee, or agent of the state of 
69.12 	Minnesota or any of its political subdivisions shall act to impose, collect, enforce, or 
69.13 	effectuate any penalty in the state of Minnesota that violates the public policy set forth 
69.14 	in this section.
69.15 	(b) The attorney general shall take any action as is provided in this section or section 
69.16 	8.31 in the defense or prosecution of rights protected under this section.

69.17 	Sec. 2. Minnesota Statutes 2010, section 8.31, subdivision 1, is amended to read:
69.18 		Subdivision 1.Investigate offenses against provisions of certain designated 
69.19 	sections; assist in enforcement. (a) The attorney general shall investigate violations of the 
69.20 	law of this state respecting unfair, discriminatory, and other unlawful practices in business, 
69.21 	commerce, or trade, and specifically, but not exclusively, the Nonprofit Corporation Act 
69.22 	(sections 317A.001 to 317A.909), the Act Against Unfair Discrimination and Competition 
69.23 	(sections 325D.01 to 325D.07), the Unlawful Trade Practices Act (sections 325D.09 to 
69.24 	325D.16), the Antitrust Act (sections 325D.49 to 325D.66), section 325F.67 and other 
69.25 	laws against false or fraudulent advertising, the antidiscrimination acts contained in 
69.26 	section 325D.67, the act against monopolization of food products (section 325D.68), 
69.27 	the act regulating telephone advertising services (section 325E.39), the Prevention of 
69.28 	Consumer Fraud Act (sections 325F.68 to 325F.70), and chapter 53A regulating currency 
69.29 	exchanges and assist in the enforcement of those laws as in this section provided. 
69.30 	(b) The attorney general shall seek injunctive and any other appropriate relief as 
69.31 	expeditiously as possible to preserve the rights and property of the residents of Minnesota, 
69.32 	and to defend as necessary the state of Minnesota, its officials, employees, and agents in 
69.33 	the event that any law or regulation violating the public policy set forth in the Freedom 
69.34 	of Choice in Health Care Act in this section is enacted by any government, subdivision, 
69.35 	or agency thereof.
70.1 	(c) The attorney general shall seek injunctive and any other appropriate relief 
70.2 	as expeditiously as possible in the event that any law or regulation violating the public 
70.3 	policy set forth in the Freedom of Choice in Health Care Act in this section is enacted 
70.4 	without adequate federal funding to the state to ensure affordable health care coverage 
70.5 	is available to the residents of Minnesota.

70.6 	Sec. 3. Minnesota Statutes 2010, section 8.31, subdivision 3a, is amended to read:
70.7 		Subd. 3a.Private remedies. In addition to the remedies otherwise provided by law, 
70.8 	any person injured by a violation of any of the laws referred to in subdivision 1 or a 
70.9 	violation of the public policy in section 1.06 may bring a civil action and recover damages, 
70.10 	together with costs and disbursements, including costs of investigation and reasonable 
70.11 	attorney's fees, and receive other equitable relief as determined by the court. The court 
70.12 	may, as appropriate, enter a consent judgment or decree without the finding of illegality. 
70.13 	In any action brought by the attorney general pursuant to this section, the court may award 
70.14 	any of the remedies allowable under this subdivision. An action under this subdivision 
70.15 	for any violation of section 1.06 is in the public interest.

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

70.23 	Sec. 5. Minnesota Statutes 2010, section 62J.692, subdivision 7, is amended to read:
70.24 		Subd. 7.Transfers from the commissioner of human services. Of the amount 
70.25 	transferred according to section 256B.69, subdivision 5c, paragraph (a), clauses (1) to (4), 
70.26 	$21,714,000 shall be distributed as follows:
70.27 	(1) $2,157,000 shall be distributed by the commissioner to the University of 
70.28 	Minnesota Board of Regents for the purposes described in sections 137.38 to 137.40;
70.29 	(2) $1,035,360 shall be distributed by the commissioner to the Hennepin County 
70.30 	Medical Center for clinical medical education;
70.31 	(3) $17,400,000 shall be distributed by the commissioner to the University of 
70.32 	Minnesota Board of Regents for purposes of medical education; and
71.1 	(4) $1,121,640 shall be distributed by the commissioner to clinical medical education 
71.2 	dental innovation grants in accordance with subdivision 7a; and
71.3 	(5) the remainder of the amount transferred according to section 256B.69, 
71.4 	subdivision 5c, clauses (1) to (4), shall be distributed by the commissioner annually to 
71.5 	clinical medical education programs that meet the qualifications of subdivision 3 based on 
71.6 	the formula in subdivision 4, paragraph (a).

71.7 	Sec. 6. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision 
71.8 	to read:
71.9 		Subd. 33.Contingency contract fees. When the commissioner enters into 
71.10 	a contigency-based contract for the purpose of recovering medical assistance or 
71.11 	MinnesotaCare funds, the commissioner may retain that portion of the recovered funds 
71.12 	equal to the amount of the contingency fee.

71.13 	Sec. 7. Minnesota Statutes 2010, section 256.969, subdivision 2b, is amended to read:
71.14 		Subd. 2b.Operating payment rates. In determining operating payment rates for 
71.15 	admissions occurring on or after the rate year beginning January 1, 1991, and every two 
71.16 	years after, or more frequently as determined by the commissioner, the commissioner 
71.17 	shall obtain operating data from an updated base year and establish operating payment 
71.18 	rates per admission for each hospital based on the cost-finding methods and allowable 
71.19 	costs of the Medicare program in effect during the base year. Rates under the general 
71.20 	assistance medical care, medical assistance, and MinnesotaCare programs shall not be 
71.21 	rebased to more current data on January 1, 1997, January 1, 2005, for the first 24 months 
71.22 	of the rebased period beginning January 1, 2009. For the first 24 months of the rebased 
71.23 	period beginning January 1, 2011, rates shall not be rebased, except that a Minnesota 
71.24 	long-term hospital shall be rebased effective January 1, 2011, based on its most recent 
71.25 	Medicare cost report ending on or before September 1, 2008, with the provisions under 
71.26 	subdivisions 9 and 23, based on the rates in effect on December 31, 2010. For subsequent 
71.27 	rate setting periods in which the base years are updated, a Minnesota long-term hospital's 
71.28 	base year shall remain within the same period as other hospitals. Effective January 1, 
71.29 	2013, rates shall be rebased at full value Rates must not be rebased to more current data 
71.30 	for the first six months of the rebased period beginning January 1, 2013. The base year 
71.31 	operating payment rate per admission is standardized by the case mix index and adjusted 
71.32 	by the hospital cost index, relative values, and disproportionate population adjustment. 
71.33 	The cost and charge data used to establish operating rates shall only reflect inpatient 
72.1 	services covered by medical assistance and shall not include property cost information 
72.2 	and costs recognized in outlier payments.

72.3 	Sec. 8. Minnesota Statutes 2010, section 256B.04, subdivision 18, is amended to read:
72.4 		Subd. 18.Applications for medical assistance. (a) The state agency may 
72.5 	take applications for medical assistance and conduct eligibility determinations for 
72.6 	MinnesotaCare enrollees.
72.7 	(b) The commissioner of human services shall modify the Minnesota health care 
72.8 	programs application form to add a question asking applicants: "Are you a U.S. military 
72.9 	veteran?" 

72.10 	Sec. 9. Minnesota Statutes 2010, section 256B.06, subdivision 4, is amended to read:
72.11 		Subd. 4.Citizenship requirements. (a) Eligibility for medical assistance is limited 
72.12 	to citizens of the United States, qualified noncitizens as defined in this subdivision, and 
72.13 	other persons residing lawfully in the United States. Citizens or nationals of the United 
72.14 	States must cooperate in obtaining satisfactory documentary evidence of citizenship or 
72.15 	nationality according to the requirements of the federal Deficit Reduction Act of 2005, 
72.16 	Public Law 109-171.
72.17 	(b) "Qualified noncitizen" means a person who meets one of the following 
72.18 	immigration criteria:
72.19 	(1) admitted for lawful permanent residence according to United States Code, title 8;
72.20 	(2) admitted to the United States as a refugee according to United States Code, 
72.21 	title 8, section 1157;
72.22 	(3) granted asylum according to United States Code, title 8, section 1158;
72.23 	(4) granted withholding of deportation according to United States Code, title 8, 
72.24 	section 1253(h);
72.25 	(5) paroled for a period of at least one year according to United States Code, title 8, 
72.26 	section 1182(d)(5);
72.27 	(6) granted conditional entrant status according to United States Code, title 8, 
72.28 	section 1153(a)(7);
72.29 	(7) determined to be a battered noncitizen by the United States Attorney General 
72.30 	according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, 
72.31 	title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;
72.32 	(8) is a child of a noncitizen determined to be a battered noncitizen by the United 
72.33 	States Attorney General according to the Illegal Immigration Reform and Immigrant 
73.1 	Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill, 
73.2 	Public Law 104-200; or
73.3 	(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public 
73.4 	Law 96-422, the Refugee Education Assistance Act of 1980.
73.5 	(c) All qualified noncitizens who were residing in the United States before August 
73.6 	22, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for 
73.7 	medical assistance with federal financial participation.
73.8 	(d) All qualified noncitizens who entered the United States on or after August 22, 
73.9 	1996, and who otherwise meet the eligibility requirements of this chapter, are eligible for 
73.10 	medical assistance with federal financial participation through November 30, 1996.
73.11 	Beginning December 1, 1996, qualified noncitizens who entered the United States 
73.12 	on or after August 22, 1996, and who otherwise meet the eligibility requirements of this 
73.13 	chapter are eligible for medical assistance with federal participation for five years if they 
73.14 	meet one of the following criteria:
73.15 	(i) refugees admitted to the United States according to United States Code, title 8, 
73.16 	section 1157;
73.17 	(ii) persons granted asylum according to United States Code, title 8, section 1158;
73.18 	(iii) persons granted withholding of deportation according to United States Code, 
73.19 	title 8, section 1253(h);
73.20 	(iv) veterans of the United States armed forces with an honorable discharge for 
73.21 	a reason other than noncitizen status, their spouses and unmarried minor dependent 
73.22 	children; or
73.23 	(v) persons on active duty in the United States armed forces, other than for training, 
73.24 	their spouses and unmarried minor dependent children.
73.25 	Beginning December 1, 1996, qualified noncitizens who do not meet one of the 
73.26 	criteria in items (i) to (v) are eligible for medical assistance without federal financial 
73.27 	participation as described in paragraph (j).
73.28 	Notwithstanding paragraph (j), Beginning July 1, 2010, children and pregnant 
73.29 	women who are noncitizens described in paragraph (b) or (e) who are lawfully in the 
73.30 	United States as defined in Code of Federal Regulations, title 8, section 103.12, and who 
73.31 	otherwise meet eligibility requirements of this chapter, are eligible for medical assistance 
73.32 	with federal financial participation as provided by the federal Children's Health Insurance 
73.33 	Program Reauthorization Act of 2009, Public Law 111-3.
73.34 	(e) Noncitizens who are not qualified noncitizens as defined in paragraph (b), who 
73.35 	are lawfully present in the United States, as defined in Code of Federal Regulations, title 
73.36 	8, section 103.12, and who otherwise meet the eligibility requirements of this chapter, are 
74.1 	eligible for medical assistance under clauses (1) to (3). These individuals must cooperate 
74.2 	with the United States Citizenship and Immigration Services to pursue any applicable 
74.3 	immigration status, including citizenship, that would qualify them for medical assistance 
74.4 	with federal financial participation.
74.5 	(1) Persons who were medical assistance recipients on August 22, 1996, are eligible 
74.6 	for medical assistance with federal financial participation through December 31, 1996.
74.7 	(2) Beginning January 1, 1997, persons described in clause (1) are eligible for 
74.8 	medical assistance without federal financial participation as described in paragraph (j).
74.9 	(3) Beginning December 1, 1996, persons residing in the United States prior to 
74.10 	August 22, 1996, who were not receiving medical assistance and persons who arrived on 
74.11 	or after August 22, 1996, are eligible for medical assistance without federal financial 
74.12 	participation as described in paragraph (j).
74.13 	(f) (e) Nonimmigrants who otherwise meet the eligibility requirements of this 
74.14 	chapter are eligible for the benefits as provided in paragraphs (g)(f) to (i) (h). For purposes 
74.15 	of this subdivision, a "nonimmigrant" is a person in one of the classes listed in United 
74.16 	States Code, title 8, section 1101(a)(15).
74.17 	(g) (f) Payment shall also be made for care and services that are furnished to 
74.18 	noncitizens, regardless of immigration status, who otherwise meet the eligibility 
74.19 	requirements of this chapter, if such care and services are necessary for the treatment of an 
74.20 	emergency medical condition, except for organ transplants and related care and services 
74.21 	and, routine prenatal care, and treatment related to chronic conditions.
74.22 	(h) (g) For purposes of this subdivision, the term "emergency medical condition" 
74.23 	means a medical condition that meets the requirements of United States Code, title 42, 
74.24 	section 1396b(v).
74.25 	(i) (h) Beginning July 1, 2009, pregnant noncitizens who are undocumented, 
74.26 	nonimmigrants, or lawfully present as designated in paragraph (e) and whoin the United 
74.27 	States as defined in Code of Federal Regulations, title 8, section 103.12, are not covered by 
74.28 	a group health plan or health insurance coverage according to Code of Federal Regulations, 
74.29 	title 42, section 457.310, and who otherwise meet the eligibility requirements of this 
74.30 	chapter, are eligible for medical assistance through the period of pregnancy, including 
74.31 	labor and delivery, and 60 days postpartum, to the extent federal funds are available under 
74.32 	title XXI of the Social Security Act, and the state children's health insurance program.
74.33 	(j) Qualified noncitizens as described in paragraph (d), and all other noncitizens 
74.34 	lawfully residing in the United States as described in paragraph (e), who are ineligible 
74.35 	for medical assistance with federal financial participation and who otherwise meet the 
74.36 	eligibility requirements of chapter 256B and of this paragraph, are eligible for medical 
75.1 	assistance without federal financial participation. Qualified noncitizens as described 
75.2 	in paragraph (d) are only eligible for medical assistance without federal financial 
75.3 	participation for five years from their date of entry into the United States.
75.4 	(k) (j) Beginning October 1, 2003, persons who are receiving care and rehabilitation 
75.5 	services from a nonprofit center established to serve victims of torture and are otherwise 
75.6 	ineligible for medical assistance under this chapter are eligible for medical assistance 
75.7 	without federal financial participation. These individuals are eligible only for the period 
75.8 	during which they are receiving services from the center. Individuals eligible under this 
75.9 	paragraph shall not be required to participate in prepaid medical assistance.

75.10 	Sec. 10. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 
75.11 	subdivision to read:
75.12 		Subd. 3g.Chiropractic services. Chiropractic services are not covered.

75.13 	Sec. 11. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 
75.14 	subdivision to read:
75.15 		Subd. 3h.Podiatric services. Podiatric services are not covered.

75.16 	Sec. 12. Minnesota Statutes 2010, section 256B.0625, subdivision 8, is amended to 
75.17 	read:
75.18 		Subd. 8.Physical therapy. (a) Medical assistance covers physical therapy and 
75.19 	related services, including specialized maintenance therapy for eligible recipients under 
75.20 	21 years of age.
75.21 	(b) Authorization by the commissioner is required to provide medically necessary 
75.22 	services to a recipient beyond any of the following onetime service thresholds, or a lower 
75.23 	threshold where one has been established by the commissioner for a specified service: (1) 
75.24 	80 units of any approved CPT code other than modalities; (2) 20 modality sessions; and 
75.25 	(3) three evaluations or reevaluations. Services provided by a physical therapy assistant 
75.26 	shall be reimbursed at the same rate as services performed by a physical therapist when 
75.27 	the services of the physical therapy assistant are provided under the direction of a physical 
75.28 	therapist who is on the premises. Services provided by a physical therapy assistant that 
75.29 	are provided under the direction of a physical therapist who is not on the premises shall 
75.30 	be reimbursed at 65 percent of the physical therapist rate.

75.31 	EFFECTIVE DATE. The amendment to paragraph (a) is effective July 1, 2011, for 
75.32 	services provided on a fee-for-service basis, and January 1, 2012, for services provided 
76.1 	by a managed care plan or county-based purchasing plan. The amendment to paragraph 
76.2 	(b) is effective March 1, 2012.

76.3 	Sec. 13. Minnesota Statutes 2010, section 256B.0625, subdivision 8a, is amended to 
76.4 	read:
76.5 		Subd. 8a.Occupational therapy. (a) Medical assistance covers occupational 
76.6 	therapy and related services, including specialized maintenance therapy for eligible 
76.7 	recipients under 21 years of age.
76.8 	(b) Authorization by the commissioner is required to provide medically necessary 
76.9 	services to a recipient beyond any of the following onetime service thresholds, or a lower 
76.10 	threshold where one has been established by the commissioner for a specified service: 
76.11 	(1) 120 units of any combination of approved CPT codes; and (2) two evaluations or 
76.12 	reevaluations. Services provided by an occupational therapy assistant shall be reimbursed 
76.13 	at the same rate as services performed by an occupational therapist when the services of 
76.14 	the occupational therapy assistant are provided under the direction of the occupational 
76.15 	therapist who is on the premises. Services provided by an occupational therapy assistant 
76.16 	that are provided under the direction of an occupational therapist who is not on the 
76.17 	premises shall be reimbursed at 65 percent of the occupational therapist rate.

76.18 	EFFECTIVE DATE. The amendment to paragraph (a) is effective July 1, 2011, for 
76.19 	services provided on a fee-for-service basis, and January 1, 2012, for services provided 
76.20 	by a managed care plan or county-based purchasing plan. The amendment to paragraph 
76.21 	(b) is effective March 1, 2012.

76.22 	Sec. 14. Minnesota Statutes 2010, section 256B.0625, subdivision 8b, is amended to 
76.23 	read:
76.24 		Subd. 8b.Speech-language pathology and audiology services. (a) Medical 
76.25 	assistance covers speech-language pathology and related services, including specialized 
76.26 	maintenance therapy for eligible recipients under 21 years of age.
76.27 	(b) Authorization by the commissioner is required to provide medically necessary
76.28 	speech-language pathology services to a recipient beyond any of the following 
76.29 	onetime service thresholds, or a lower threshold where one has been established by the 
76.30 	commissioner for a specified service: (1) 50 treatment sessions with any combination 
76.31 	of approved CPT codes; and (2) one evaluation. Medical assistance covers audiology 
76.32 	services and related services. Services provided by a person who has been issued a 
76.33 	temporary registration under section 148.5161 shall be reimbursed at the same rate 
77.1 	as services performed by a speech-language pathologist or audiologist as long as the 
77.2 	requirements of section 148.5161, subdivision 3, are met.

77.3 	EFFECTIVE DATE. The amendment to paragraph (a) is effective July 1, 2011, for 
77.4 	services provided on a fee-for-service basis, and January 1, 2012, for services provided 
77.5 	by a managed care plan or county-based purchasing plan. The amendment to paragraph 
77.6 	(b) is effective March 1, 2012.

77.7 	Sec. 15. Minnesota Statutes 2010, section 256B.0625, subdivision 8c, is amended to 
77.8 	read:
77.9 		Subd. 8c.Care management; rehabilitation services. (a) Effective July 1, 1999, 
77.10 	onetime thresholds shall replace annual thresholds for provision of rehabilitation services 
77.11 	described in subdivisions 8, 8a, and 8b. The onetime thresholds will be the same in amount 
77.12 	and description as the thresholds prescribed by the Department of Human Services health 
77.13 	care programs provider manual for calendar year 1997, except they will not be renewed 
77.14 	annually, and they will include sensory skills and cognitive training skills.
77.15 	(b) (a) A care management approach for authorization of rehabilitation services 
77.16 	beyond the threshold described in subdivisions 8, 8a, and 8b  shall be instituted in 
77.17 	conjunction with the onetime thresholds. The care management approach shall require 
77.18 	the provider and the department rehabilitation reviewer to work together directly through 
77.19 	written communication, or telephone communication when appropriate, to establish a 
77.20 	medically necessary care management plan. Authorization for rehabilitation services 
77.21 	shall include approval for up to 12 six months of services at a time without additional 
77.22 	documentation from the provider during the extended period, when the rehabilitation 
77.23 	services are medically necessary due to an ongoing health condition.
77.24 	(c) (b) The commissioner shall implement an expedited five-day turnaround time to 
77.25 	review authorization requests for recipients who need emergency rehabilitation services 
77.26 	and who have exhausted their onetime threshold limit for those services.

77.27 	EFFECTIVE DATE. This section is effective March 1, 2012.

77.28 	Sec. 16. Minnesota Statutes 2010, section 256B.0625, subdivision 12, is amended to 
77.29 	read:
77.30 		Subd. 12.Eyeglasses, dentures, and prosthetic devices. Medical assistance covers 
77.31 	eyeglasses, dentures, and prosthetic devices for eligible recipients under 21 years of age if 
77.32 	prescribed by a licensed practitioner.

78.1 	Sec. 17. Minnesota Statutes 2010, section 256B.0625, subdivision 13e, is amended to 
78.2 	read:
78.3 		Subd. 13e.Payment rates. (a) The basis for determining the amount of payment 
78.4 	shall be the lower of the actual acquisition costs of the drugs plus a fixed dispensing fee; 
78.5 	the maximum allowable cost set by the federal government or by the commissioner plus 
78.6 	the fixed dispensing fee; or the usual and customary price charged to the public. The 
78.7 	amount of payment basis must be reduced to reflect all discount amounts applied to the 
78.8 	charge by any provider/insurer agreement or contract for submitted charges to medical 
78.9 	assistance programs. The net submitted charge may not be greater than the patient liability 
78.10 	for the service. The pharmacy dispensing fee shall be $3.65, except that the dispensing fee 
78.11 	for intravenous solutions which must be compounded by the pharmacist shall be $8 per 
78.12 	bag, $14 per bag for cancer chemotherapy products, and $30 per bag for total parenteral 
78.13 	nutritional products dispensed in one liter quantities, or $44 per bag for total parenteral 
78.14 	nutritional products dispensed in quantities greater than one liter. Actual acquisition cost 
78.15 	includes quantity and other special discounts except time and cash discounts. Effective 
78.16 	July 1, 2009 July 1, 2011, the actual acquisition cost of a drug shall be estimated by the 
78.17 	commissioner, at average wholesale price minus 15 percent wholesale acquisition cost 
78.18 	plus two percent. The actual acquisition cost of antihemophilic factor drugs shall be 
78.19 	estimated at the average wholesale price minus 30 percent Wholesale acquisition cost is 
78.20 	defined as the manufacturer's list price for a drug or biological to wholesalers or direct 
78.21 	purchasers in the United States, not including prompt pay or other discounts, rebates, 
78.22 	or reductions in price, for the most recent month for which information is available, as 
78.23 	reported in wholesale price guides or other publications of drug or biological pricing data. 
78.24 	The maximum allowable cost of a multisource drug may be set by the commissioner and it 
78.25 	shall be comparable to, but no higher than, the maximum amount paid by other third-party 
78.26 	payors in this state who have maximum allowable cost programs. Establishment of the 
78.27 	amount of payment for drugs shall not be subject to the requirements of the Administrative 
78.28 	Procedure Act.
78.29 	(b) An additional dispensing fee of $.30 may be added to the dispensing fee paid 
78.30 	to pharmacists for legend drug prescriptions dispensed to residents of long-term care 
78.31 	facilities when a unit dose blister card system, approved by the department, is used. Under 
78.32 	this type of dispensing system, the pharmacist must dispense a 30-day supply of drug. 
78.33 	The National Drug Code (NDC) from the drug container used to fill the blister card must 
78.34 	be identified on the claim to the department. The unit dose blister card containing the 
78.35 	drug must meet the packaging standards set forth in Minnesota Rules, part 6800.2700, 
78.36 	that govern the return of unused drugs to the pharmacy for reuse. The pharmacy provider 
79.1 	will be required to credit the department for the actual acquisition cost of all unused 
79.2 	drugs that are eligible for reuse. Over-the-counter medications must be dispensed in the 
79.3 	manufacturer's unopened package. The commissioner may permit the drug clozapine to be 
79.4 	dispensed in a quantity that is less than a 30-day supply.
79.5 	(c) Whenever a maximum allowable cost has been set for a multisource drug, 
79.6 	payment shall be on the basis of the maximum allowable cost established by the 
79.7 	commissioner unless prior authorization for the brand name product has been granted 
79.8 	according to the criteria established by the Drug Formulary Committee as required by 
79.9 	subdivision 13f, paragraph (a), and the prescriber has indicated "dispense as written" on 
79.10 	the prescription in a manner consistent with section 151.21, subdivision 2.
79.11 	(d) The basis for determining the amount of payment for drugs administered in an 
79.12 	outpatient setting shall be the lower of the usual and customary cost submitted by the 
79.13 	provider or the amount established for Medicare by the 106 percent of the average sales 
79.14 	price as determined by the United States Department of Health and Human Services 
79.15 	pursuant to title XVIII, section 1847a of the federal Social Security Act. If the average 
79.16 	sales price is unavailable, the amount of payment shall be the lower of the usual and 
79.17 	customary cost submitted by the provider or the wholesale acquisition cost.
79.18 	(e) The commissioner may negotiate lower reimbursement rates for specialty 
79.19 	pharmacy products than the rates specified in paragraph (a). The commissioner may 
79.20 	require individuals enrolled in the health care programs administered by the department 
79.21 	to obtain specialty pharmacy products from providers with whom the commissioner has 
79.22 	negotiated lower reimbursement rates. Specialty pharmacy products are defined as those 
79.23 	used by a small number of recipients or recipients with complex and chronic diseases 
79.24 	that require expensive and challenging drug regimens. Examples of these conditions 
79.25 	include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis 
79.26 	C, growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms 
79.27 	of cancer. Specialty pharmaceutical products include injectable and infusion therapies, 
79.28 	biotechnology drugs, antihemophilic factor products, high-cost therapies, and therapies 
79.29 	that require complex care. The commissioner shall consult with the formulary committee 
79.30 	to develop a list of specialty pharmacy products subject to this paragraph. In consulting 
79.31 	with the formulary committee in developing this list, the commissioner shall take into 
79.32 	consideration the population served by specialty pharmacy products, the current delivery 
79.33 	system and standard of care in the state, and access to care issues. The commissioner shall 
79.34 	have the discretion to adjust the reimbursement rate to prevent access to care issues.
79.35 	(f) Home infusion therapy services provided by home infusion therapy pharmacies 
79.36 	must be paid at rates according to subdivision 8d.

80.1 	Sec. 18. Minnesota Statutes 2010, section 256B.0625, subdivision 17, is amended to 
80.2 	read:
80.3 		Subd. 17.Transportation costs. (a) Medical assistance covers medical 
80.4 	transportation costs incurred solely for obtaining emergency medical care or transportation 
80.5 	costs incurred by eligible persons in obtaining emergency or nonemergency medical 
80.6 	care when paid directly to an ambulance company, common carrier, or other recognized 
80.7 	providers of transportation services. Medical transportation must be provided by:
80.8 	(1) an ambulance, as defined in section 144E.001, subdivision 2;
80.9 	(2) special transportation; or
80.10 	(3) common carrier including, but not limited to, bus, taxicab, other commercial 
80.11 	carrier, or private automobile.
80.12 	(b) Medical assistance covers special transportation, as defined in Minnesota Rules, 
80.13 	part 9505.0315, subpart 1, item F, if the recipient has a physical or mental impairment that 
80.14 	would prohibit the recipient from safely accessing and using a bus, taxi, other commercial 
80.15 	transportation, or private automobile.
80.16 	The commissioner may use an order by the recipient's attending physician to certify that 
80.17 	the recipient requires special transportation services. Special transportation providers shall 
80.18 	perform driver-assisted services for eligible individuals. Driver-assisted service includes 
80.19 	passenger pickup at and return to the individual's residence or place of business, assistance 
80.20 	with admittance of the individual to the medical facility, and assistance in passenger 
80.21 	securement or in securing of wheelchairs or stretchers in the vehicle. Special transportation 
80.22 	providers must obtain written documentation from the health care service provider who 
80.23 	is serving the recipient being transported, identifying the time that the recipient arrived. 
80.24 	Special transportation providers may not bill for separate base rates for the continuation of 
80.25 	a trip beyond the original destination. Special transportation providers must take recipients 
80.26 	to the nearest appropriate health care provider, using the most direct route. The minimum 
80.27 	medical assistance reimbursement rates for special transportation services are:
80.28 	(1) (i) $17 for the base rate and $1.35 per mile for special transportation services to 
80.29 	eligible persons who need a wheelchair-accessible van;
80.30 	(ii) $11.50 for the base rate and $1.30 per mile for special transportation services to 
80.31 	eligible persons who do not need a wheelchair-accessible van; and
80.32 	(iii) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, for 
80.33 	special transportation services to eligible persons who need a stretcher-accessible vehicle;
80.34 	(2) the base rates for special transportation services in areas defined under RUCA 
80.35 	to be super rural shall be equal to the reimbursement rate established in clause (1) plus 
80.36 	11.3 percent; and
81.1 	(3) for special transportation services in areas defined under RUCA to be rural 
81.2 	or super rural areas:
81.3 	(i) for a trip equal to 17 miles or less, mileage reimbursement shall be equal to 125 
81.4 	percent of the respective mileage rate in clause (1); and
81.5 	(ii) for a trip between 18 and 50 miles, mileage reimbursement shall be equal to 
81.6 	112.5 percent of the respective mileage rate in clause (1).
81.7 	(c) For purposes of reimbursement rates for special transportation services under 
81.8 	paragraph (b), the zip code of the recipient's place of residence shall determine whether 
81.9 	the urban, rural, or super rural reimbursement rate applies.
81.10 	(d) For purposes of this subdivision, "rural urban commuting area" or "RUCA" 
81.11 	means a census-tract based classification system under which a geographical area is 
81.12 	determined to be urban, rural, or super rural.
81.13 	(e) Effective for services provided on or after July 1, 2011, nonemergency 
81.14 	transportation rates, including special transportation, taxi, and other commercial carriers, 
81.15 	are reduced 4.5 percent. Payments made to managed care plans and county-based 
81.16 	purchasing plans must be reduced for services provided on or after January 1, 2012, 
81.17 	to reflect this reduction.

81.18 	Sec. 19. Minnesota Statutes 2010, section 256B.0625, subdivision 17a, is amended to 
81.19 	read:
81.20 		Subd. 17a.Payment for ambulance services. (a) Medical assistance covers 
81.21 	ambulance services. Providers shall bill ambulance services according to Medicare 
81.22 	criteria. Nonemergency ambulance services shall not be paid as emergencies. Effective 
81.23 	for services rendered on or after July 1, 2001, medical assistance payments for ambulance 
81.24 	services shall be paid at the Medicare reimbursement rate or at the medical assistance 
81.25 	payment rate in effect on July 1, 2000, whichever is greater.
81.26 	(b) Effective for services provided on or after July 1, 2011, ambulance services 
81.27 	payment rates are reduced 4.5 percent. Payments made to managed care plans and 
81.28 	county-based purchasing plans must be reduced for services provided on or after January 
81.29 	1, 2012, to reflect this reduction.

81.30 	Sec. 20. Minnesota Statutes 2010, section 256B.0625, subdivision 18, is amended to 
81.31 	read:
81.32 		Subd. 18.Bus or taxicab transportation. To the extent authorized by rule of the 
81.33 	state agency, medical assistance covers costs of the most appropriate and cost-effective 
82.1 	form of transportation incurred by any ambulatory eligible person for obtaining 
82.2 	nonemergency medical care.

82.3 	Sec. 21. Minnesota Statutes 2010, section 256B.0625, subdivision 25, is amended to 
82.4 	read:
82.5 		Subd. 25.Prior authorization required. (a) The commissioner shall publish 
82.6 	in the Minnesota health care programs provider manual and on the department's Web 
82.7 	site a list of health services that require prior authorization, as well as the criteria and 
82.8 	standards used to select health services on the list. The list and the criteria and standards 
82.9 	used to formulate it are not subject to the requirements of sections 14.001 to 14.69. The 
82.10 	commissioner's decision whether prior authorization is required for a health service is not 
82.11 	subject to administrative appeal.
82.12 	(b) The commissioner shall implement a modernized electronic system for providers 
82.13 	to request prior authorization. The modernization electronic system must include at least 
82.14 	the following functionalities:
82.15 	(1) authorizations are recipient-centric, not provider-centric;
82.16 	(2) adequate flexibility to support authorizations for an episode of care, continuous 
82.17 	drug therapy, or for individual onetime services and allows an ordering and a rendering 
82.18 	provider to both submit information into one request;
82.19 	(3) allows providers to review previous authorization requests and determine where 
82.20 	a submitted request is within the authorization process;
82.21 	(4) supports automated workflows that allow providers to securely submit medical 
82.22 	information that can be accessed by medical and pharmacy review vendors as well as 
82.23 	department staff; and
82.24 	(5) supports development of automated clinical algorithms that can verify 
82.25 	information and provide responses in real time.
82.26 	(c) The system described in paragraph (b) shall be completed by March 1, 2012. 
82.27 	All authorization requests submitted on and after March 1, 2012, must be submitted 
82.28 	electronically by providers, except requests for drugs dispensed by an outpatient 
82.29 	pharmacy, services that are provided outside of the state and surrounding local trade area, 
82.30 	and services included on a service agreement.

82.31 	Sec. 22. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 
82.32 	subdivision to read:
82.33 		Subd. 25b.Authorization with third-party liability. (a) Except as otherwise 
82.34 	allowed under this subdivision or required under federal or state regulations, the 
83.1 	commissioner must not consider a request for authorization of a service when the recipient 
83.2 	has coverage from a third-party payer unless the provider requesting authorization has 
83.3 	made a good faith effort to receive payment or authorization from the third-party payer. 
83.4 	A good faith effort is established by supplying with the authorization request to the 
83.5 	commissioner the following:
83.6 	(1) a determination of payment for the service from the third-party payer, a 
83.7 	determination of authorization for the service from the third-party payer, or a verification 
83.8 	of noncoverage of the service by the third-party payer; and
83.9 	(2) the information or records required by the department to document the reason for 
83.10 	the determination or to validate noncoverage from the third-party payer.
83.11 	(b) A provider requesting authorization for services covered by Medicare is not 
83.12 	required to bill Medicare before requesting authorization from the commissioner if the 
83.13 	provider has reason to believe that a service covered by Medicare is not eligible for 
83.14 	payment. The provider must document that, because of recent claim experiences with 
83.15 	Medicare or because of written communication from Medicare, coverage is not available 
83.16 	for the service.
83.17 	(c) Authorization is not required if a third-party payer has made payment that is 
83.18 	equal to or greater than 60 percent of the maximum payment amount for the service 
83.19 	allowed under medical assistance.

83.20 	Sec. 23. Minnesota Statutes 2010, section 256B.0625, subdivision 31a, is amended to 
83.21 	read:
83.22 		Subd. 31a.Augmentative and alternative communication systems. (a) Medical 
83.23 	assistance covers augmentative and alternative communication systems consisting of 
83.24 	electronic or nonelectronic devices and the related components necessary to enable a 
83.25 	person with severe expressive communication limitations to produce or transmit messages 
83.26 	or symbols in a manner that compensates for that disability.
83.27 	(b) Until the volume of systems purchased increases to allow a discount price, the 
83.28 	commissioner shall reimburse augmentative and alternative communication manufacturers 
83.29 	and vendors at the manufacturer's suggested retail price for augmentative and alternative 
83.30 	communication systems and related components. The commissioner shall separately 
83.31 	reimburse providers for purchasing and integrating individual communication systems 
83.32 	which are unavailable as a package from an augmentative and alternative communication 
83.33 	vendor. Augmentative and alternative communication systems must be paid the lower 
83.34 	of the: 
83.35 	(1) submitted charge; or
84.1 	(2)(i) manufacturer's suggested retail price minus 20 percent for providers that are 
84.2 	manufacturers of augmentative and alternative communication systems; or
84.3 	(ii) manufacturer's invoice charge plus 20 percent for providers that are not 
84.4 	manufacturers of augmentative and alternative communication systems.
84.5 	(c) Reimbursement rates established by this purchasing program are not subject to 
84.6 	Minnesota Rules, part 9505.0445, item S or T.

84.7 	Sec. 24. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 
84.8 	subdivision to read:
84.9 		Subd. 55.Payment for noncovered services. (a) Except when specifically 
84.10 	prohibited by the commissioner or federal law, a provider may seek payment from the 
84.11 	recipient for services not eligible for payment under the medical assistance program when 
84.12 	the provider, prior to delivering the service, reviews and considers all other available 
84.13 	covered alternatives with the recipient and obtains a signed acknowledgment from the 
84.14 	recipient of the potential of the recipient's liability. The signed acknowledgment must be 
84.15 	in a form approved by the commissioner.
84.16 	(b) Conditions under which a provider must not request payment from the recipient 
84.17 	include, but are not limited to:
84.18 	(1) a service that requires prior authorization, unless authorization has been denied 
84.19 	as not medically necessary and all other therapeutic alternatives have been reviewed;
84.20 	(2) a service for which payment has been denied for reasons relating to billing 
84.21 	requirements;
84.22 	(3) standard shipping or delivery and setup of medical equipment or medical 
84.23 	supplies;
84.24 	(4) services that are included in the recipient's long term care per diem;
84.25 	(5) the recipient is enrolled in the Restricted Recipient Program and the provider is 
84.26 	one of a provider type designated for the recipient's health care services; and
84.27 	(6) the noncovered service is a prescriptive drug identified by the commissioner as 
84.28 	having the potential for abuse and overuse, except where payment by the recipient is 
84.29 	specifically approved by the commissioner on the date of service based upon compelling 
84.30 	evidence supplied by the prescribing provider that establishes medical necessity for that 
84.31 	particular drug.
84.32 	(c) The payment requested from recipients for noncovered services under this 
84.33 	subdivision must not exceed the provider's usual and customary charge for the actual 
84.34 	service received by the recipient. A recipient must not be billed for the difference between 
85.1 	what medical assistance paid for the service or would pay for a less costly alternative 
85.2 	service.

85.3 	Sec. 25. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 
85.4 	subdivision to read:
85.5 		Subd. 56.Evidence-based childbirth program. (a) The commissioner shall 
85.6 	implement a program to reduce the number of elective inductions of labor prior to 39 
85.7 	weeks' gestation. In this subdivision, the term "elective induction of labor" means the 
85.8 	use of artificial means to stimulate labor in a woman without the presence of a medical 
85.9 	condition affecting the woman or the child that makes the onset of labor a medical 
85.10 	necessity. The program must promote the implementation of policies within hospitals 
85.11 	providing services to recipients of medical assistance or MinnesotaCare that prohibit the 
85.12 	use of elective inductions prior to 39 weeks' gestation, and adherence to such policies by 
85.13 	the attending providers.
85.14 	(b) For all births covered by medical assistance or MinnesotaCare on or after 
85.15 	January 1, 2012, a payment for professional services associated with the delivery of a 
85.16 	child in a hospital must not be made unless the provider has submitted information about 
85.17 	the nature of the labor and delivery including any induction of labor that was performed 
85.18 	in conjunction with that specific birth. The information must be on a form prescribed by 
85.19 	the commissioner.
85.20 	(c) The requirements in paragraph (b) must not apply to deliveries performed 
85.21 	at a hospital that has policies and processes in place that have been approved by the 
85.22 	commissioner which prohibit elective inductions prior to 39 weeks gestation. A process 
85.23 	for review of hospital induction policies must be established by the commissioner and 
85.24 	review of policies must occur at the discretion of the commissioner. The commissioner's 
85.25 	decision to approve or rescind approval must include verification and review of items 
85.26 	including, but not limited to:
85.27 	(1) policies that prohibit use of elective inductions for gestation less than 39 weeks;
85.28 	(2) policies that encourage providers to document and communicate with patients a 
85.29 	final expected date of delivery by 20 weeks' gestation that includes data from ultrasound 
85.30 	measurements as applicable;
85.31 	(3) policies that encourage patient education regarding elective inductions, and 
85.32 	requires documentation of the processes used to educate patients;
85.33 	(4) ongoing quality improvement review as determined by the commissioner; and
85.34 	(5) any data that has been collected by the commissioner.
86.1 	(d) All hospitals must report annually to the commissioner induction information 
86.2 	for all births that were covered by medical assistance or MinnesotaCare in a format and 
86.3 	manner to be established by the commissioner.
86.4 	(e) The commissioner at any time may choose not to implement or may discontinue 
86.5 	any or all aspects of the program if the commissioner is able to determine that hospitals 
86.6 	representing at least 90 percent of births covered by medical assistance or MinnesotaCare 
86.7 	have approved policies in place.

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

86.9 	Sec. 26. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 
86.10 	subdivision to read:
86.11 		Subd. 57.Payment for Part B Medicare crossover claims. Effective for services 
86.12 	provided on or after January 1, 2012, medical assistance payment for an enrollee's cost 
86.13 	sharing associated with Medicare Part B is limited to an amount up to the medical 
86.14 	assistance total allowed, when the medical assistance rate exceeds the amount paid by 
86.15 	Medicare.

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

86.17 	Sec. 27. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 
86.18 	subdivision to read:
86.19 		Subd. 58.Early and periodic screening, diagnosis, and treatment services.
 86.20 	Medical assistance covers early and periodic screening, diagnosis, and treatment services 
86.21 	(EPSDT). The payment amount for a complete EPSDT screening shall not exceed the rate 
86.22 	established per Minnesota Rules, part 9505.0445, item M, effective October 1, 2010.

86.23 	Sec. 28. Minnesota Statutes 2010, section 256B.0651, subdivision 1, is amended to 
86.24 	read:
86.25 		Subdivision 1.Definitions. (a) For the purposes of sections 256B.0651 to 
86.26 	256B.0656 and 256B.0659, the terms in paragraphs (b) to (g) have the meanings given.
86.27 	(b) "Activities of daily living" has the meaning given in section 256B.0659, 
86.28 	subdivision 1, paragraph (b).
86.29 	(c) "Assessment" means a review and evaluation of a recipient's need for home 
86.30 	care services conducted in person.
86.31 	(d) "Home care services" means medical assistance covered services that are home 
86.32 	health agency services, including skilled nurse visits; home health aide visits; physical 
87.1 	therapy, occupational therapy, respiratory therapy, and language-speech pathology 
87.2 	therapy; private duty nursing; and personal care assistance.
87.3 	(e) "Home residence," effective January 1, 2010, means a residence owned or 
87.4 	rented by the recipient either alone, with roommates of the recipient's choosing, or with 
87.5 	an unpaid responsible party or legal representative; or a family foster home where the 
87.6 	license holder lives with the recipient and is not paid to provide home care services for the 
87.7 	recipient except as allowed under sections 256B.0652, subdivision 10, and 256B.0654, 
87.8 	subdivision 4.
87.9 	(f) "Medically necessary" has the meaning given in Minnesota Rules, parts 
87.10 	9505.0170 to 9505.0475.
87.11 	(g) "Ventilator-dependent" means an individual who receives mechanical ventilation 
87.12 	for life support at least six hours per day and is expected to be or has been dependent on a 
87.13 	ventilator for at least 30 consecutive days.

87.14 	Sec. 29. Minnesota Statutes 2010, section 256B.0653, subdivision 2, is amended to 
87.15 	read:
87.16 		Subd. 2.Definitions. For the purposes of this section, the following terms have 
87.17 	the meanings given.
87.18 	(a) "Assessment" means an evaluation of the recipient's medical need for home 
87.19 	health agency services by a registered nurse or appropriate therapist that is conducted 
87.20 	within 30 days of a request.
87.21 	(b) "Home care therapies" means occupational, physical, and respiratory therapy 
87.22 	and speech-language pathology services provided in the home by a Medicare certified 
87.23 	home health agency.
87.24 	(c) "Home health agency services" means services delivered in the recipient's home 
87.25 	residence, except as specified in section 256B.0625, by a home health agency to a recipient 
87.26 	with medical needs due to illness, disability, or physical conditions.
87.27 	(d)(c) "Home health aide" means an employee of a home health agency who 
87.28 	completes medically oriented tasks written in the plan of care for a recipient.
87.29 	(e)(d) "Home health agency" means a home care provider agency that is 
87.30 	Medicare-certified.
87.31 	(f) "Occupational therapy services" mean the services defined in Minnesota Rules, 
87.32 	part 9505.0390.
87.33 	(g) "Physical therapy services" mean the services defined in Minnesota Rules, part 
87.34 	9505.0390.
88.1 	(h) "Respiratory therapy services" mean the services defined in chapter 147C and 
88.2 	Minnesota Rules, part 4668.0003, subpart 37.
88.3 	(i) "Speech-language pathology services" mean the services defined in Minnesota 
88.4 	Rules, part 9505.0390.
88.5 	(j)(e) "Skilled nurse visit" means a professional nursing visit to complete nursing 
88.6 	tasks required due to a recipient's medical condition that can only be safely provided by a 
88.7 	professional nurse to restore and maintain optimal health.
88.8 	(k)(f) "Store-and-forward technology" means telehomecare services that do not 
88.9 	occur in real time via synchronous transmissions such as diabetic and vital sign monitoring.
88.10 	(l)(g) "Telehomecare" means the use of telecommunications technology 
88.11 	via live, two-way interactive audiovisual technology which may be augmented by 
88.12 	store-and-forward technology.
88.13 	(m)(h) "Telehomecare skilled nurse visit" means a visit by a professional nurse 
88.14 	to deliver a skilled nurse visit to a recipient located at a site other than the site where 
88.15 	the nurse is located and is used in combination with face-to-face skilled nurse visits to 
88.16 	adequately meet the recipient's needs.

88.17 	Sec. 30. Minnesota Statutes 2010, section 256B.0653, subdivision 6, is amended to 
88.18 	read:
88.19 		Subd. 6.Noncovered home health agency services. The following are not eligible 
88.20 	for payment under medical assistance as a home health agency service:
88.21 	(1) telehomecare skilled nurses services that is communication between the home 
88.22 	care nurse and recipient that consists solely of a telephone conversation, facsimile, 
88.23 	electronic mail, or a consultation between two health care practitioners;
88.24 	(2) the following skilled nurse visits:
88.25 	(i) for the purpose of monitoring medication compliance with an established 
88.26 	medication program for a recipient;
88.27 	(ii) administering or assisting with medication administration, including injections, 
88.28 	prefilling syringes for injections, or oral medication setup of an adult recipient, when, 
88.29 	as determined and documented by the registered nurse, the need can be met by an 
88.30 	available pharmacy or the recipient or a family member is physically and mentally able 
88.31 	to self-administer or prefill a medication;
88.32 	(iii) services done for the sole purpose of supervision of the home health aide or 
88.33 	personal care assistant;
88.34 	(iv) services done for the sole purpose to train other home health agency workers;
89.1 	(v) services done for the sole purpose of blood samples or lab draw when the 
89.2 	recipient is able to access these services outside the home; and
89.3 	(vi) Medicare evaluation or administrative nursing visits required by Medicare;
89.4 	(3) home health aide visits when the following activities are the sole purpose for the 
89.5 	visit: companionship, socialization, household tasks, transportation, and education; and
89.6 	(4) home care therapies provided in other settings such as a clinic, day program, or as 
89.7 	an inpatient or when the recipient can access therapy outside of the recipient's residence.

89.8 	Sec. 31. Minnesota Statutes 2010, section 256B.69, subdivision 4, is amended to read:
89.9 		Subd. 4.Limitation of choice. (a) The commissioner shall develop criteria to 
89.10 	determine when limitation of choice may be implemented in the experimental counties. 
89.11 	The criteria shall ensure that all eligible individuals in the county have continuing access 
89.12 	to the full range of medical assistance services as specified in subdivision 6.
89.13 	(b) The commissioner shall exempt the following persons from participation in the 
89.14 	project, in addition to those who do not meet the criteria for limitation of choice:
89.15 	(1) persons eligible for medical assistance according to section 256B.055, 
89.16 	subdivision 1;
89.17 	(2) persons eligible for medical assistance due to blindness or disability as 
89.18 	determined by the Social Security Administration or the state medical review team, unless:
89.19 	(i) they are 65 years of age or older; or
89.20 	(ii) they reside in Itasca County or they reside in a county in which the commissioner 
89.21 	conducts a pilot project under a waiver granted pursuant to section 1115 of the Social 
89.22 	Security Act;
89.23 	(3) recipients who currently have private coverage through a health maintenance 
89.24 	organization;
89.25 	(4)(3) recipients who are eligible for medical assistance by spending down excess 
89.26 	income for medical expenses other than the nursing facility per diem expense;
89.27 	(5)(4) recipients who receive benefits under the Refugee Assistance Program, 
89.28 	established under United States Code, title 8, section 1522(e);
89.29 	(6)(5) children who are both determined to be severely emotionally disturbed and 
89.30 	receiving case management services according to section 256B.0625, subdivision 20, 
89.31 	except children who are eligible for and who decline enrollment in an approved preferred 
89.32 	integrated network under section 245.4682;
89.33 	(7)(6) adults who are both determined to be seriously and persistently mentally ill 
89.34 	and received case management services according to section 256B.0625, subdivision 20;
90.1 	(8)(7) persons eligible for medical assistance according to section 256B.057, 
90.2 	subdivision 10; and
90.3 	(9)(8) persons with access to cost-effective employer-sponsored private health 
90.4 	insurance or persons enrolled in a non-Medicare individual health plan determined to be 
90.5 	cost-effective according to section 256B.0625, subdivision 15.
90.6 	Children under age 21 who are in foster placement may enroll in the project on an elective 
90.7 	basis. Individuals excluded under clauses (1), (6) (5), and (7)(6) may choose to enroll 
90.8 	on an elective basis. The commissioner may enroll recipients in the prepaid medical 
90.9 	assistance program for seniors who are (1) age 65 and over, and (2) eligible for medical 
90.10 	assistance by spending down excess income.
90.11 	(c) The commissioner may allow persons with a one-month spenddown who are 
90.12 	otherwise eligible to enroll to voluntarily enroll or remain enrolled, if they elect to prepay 
90.13 	their monthly spenddown to the state.
90.14 	(d) The commissioner may require those individuals to enroll in the prepaid medical 
90.15 	assistance program who otherwise would have been excluded under paragraph (b), clauses 
90.16 	(1), (3) (2), and (8) (7), and under Minnesota Rules, part 9500.1452, subpart 2, items H, 
90.17 	K, and L.
90.18 	(e) Before limitation of choice is implemented, eligible individuals shall be notified 
90.19 	and after notification, shall be allowed to choose only among demonstration providers. 
90.20 	The commissioner may assign an individual with private coverage through a health 
90.21 	maintenance organization, to the same health maintenance organization for medical 
90.22 	assistance coverage, if the health maintenance organization is under contract for medical 
90.23 	assistance in the individual's county of residence. After initially choosing a provider, 
90.24 	the recipient is allowed to change that choice only at specified times as allowed by the 
90.25 	commissioner. If a demonstration provider ends participation in the project for any reason, 
90.26 	a recipient enrolled with that provider must select a new provider but may change providers 
90.27 	without cause once more within the first 60 days after enrollment with the second provider.
90.28 	(f) An infant born to a woman who is eligible for and receiving medical assistance 
90.29 	and who is enrolled in the prepaid medical assistance program shall be retroactively 
90.30 	enrolled to the month of birth in the same managed care plan as the mother once the 
90.31 	child is enrolled in medical assistance unless the child is determined to be excluded from 
90.32 	enrollment in a prepaid plan under this section.
90.33 	(g) The commissioner shall enroll persons eligible for medical assistance due to 
90.34 	blindness or disability as determined by the Social Security Administration or the state 
90.35 	medical review team in the prepaid medical assistance program, unless the person elects 
90.36 	to opt out. This opt-out option does not apply to persons who would otherwise be eligible 
91.1 	but who are (1) 65 years of age or older; or (2) reside in Itasca County or reside in a 
91.2 	county in which the commissioner conducts a pilot under a waiver granted pursuant to 
91.3 	section 1115 of the Social Security Act.

91.4 	Sec. 32. Minnesota Statutes 2010, section 256B.69, subdivision 5a, is amended to read:
91.5 		Subd. 5a.Managed care contracts. (a) Managed care contracts under this section 
91.6 	and section 256L.12 shall be entered into or renewed on a calendar year basis beginning 
91.7 	January 1, 1996. Managed care contracts which were in effect on June 30, 1995, and set to 
91.8 	renew on July 1, 1995, shall be renewed for the period July 1, 1995 through December 
91.9 	31, 1995 at the same terms that were in effect on June 30, 1995. The commissioner may 
91.10 	issue separate contracts with requirements specific to services to medical assistance 
91.11 	recipients age 65 and older.
91.12 	(b) A prepaid health plan providing covered health services for eligible persons 
91.13 	pursuant to chapters 256B and 256L is responsible for complying with the terms of its 
91.14 	contract with the commissioner. Requirements applicable to managed care programs 
91.15 	under chapters 256B and 256L established after the effective date of a contract with the 
91.16 	commissioner take effect when the contract is next issued or renewed.
91.17 	(c) Effective for services rendered on or after January 1, 2003, the commissioner 
91.18 	shall withhold five percent of managed care plan payments under this section and 
91.19 	county-based purchasing plan payments under section 256B.692 for the prepaid medical 
91.20 	assistance program pending completion of performance targets. Each performance target 
91.21 	must be quantifiable, objective, measurable, and reasonably attainable, except in the case 
91.22 	of a performance target based on a federal or state law or rule. Criteria for assessment 
91.23 	of each performance target must be outlined in writing prior to the contract effective 
91.24 	date. The managed care plan must demonstrate, to the commissioner's satisfaction, 
91.25 	that the data submitted regarding attainment of the performance target is accurate. The 
91.26 	commissioner shall periodically change the administrative measures used as performance 
91.27 	targets in order to improve plan performance across a broader range of administrative 
91.28 	services. The performance targets must include measurement of plan efforts to contain 
91.29 	spending on health care services and administrative activities. The commissioner may 
91.30 	adopt plan-specific performance targets that take into account factors affecting only one 
91.31 	plan, including characteristics of the plan's enrollee population. The withheld funds 
91.32 	must be returned no sooner than July of the following year if performance targets in the 
91.33 	contract are achieved. The commissioner may exclude special demonstration projects 
91.34 	under subdivision 23.
92.1 	(d) Effective for services rendered on or after January 1, 2009, through December 
92.2 	31, 2009, the commissioner shall withhold three percent of managed care plan payments 
92.3 	under this section and county-based purchasing plan payments under section 256B.692 
92.4 	for the prepaid medical assistance program. The withheld funds must be returned no 
92.5 	sooner than July 1 and no later than July 31 of the following year. The commissioner may 
92.6 	exclude special demonstration projects under subdivision 23.
92.7 	(e) Effective for services provided on or after January 1, 2010, the commissioner 
92.8 	shall require that managed care plans use the assessment and authorization processes, 
92.9 	forms, timelines, standards, documentation, and data reporting requirements, protocols, 
92.10 	billing processes, and policies consistent with medical assistance fee-for-service or the 
92.11 	Department of Human Services contract requirements consistent with medical assistance 
92.12 	fee-for-service or the Department of Human Services contract requirements for all 
92.13 	personal care assistance services under section 256B.0659.
92.14 	(f) Effective for services rendered on or after January 1, 2010, through December 
92.15 	31, 2010, the commissioner shall withhold 4.5 percent of managed care plan payments 
92.16 	under this section and county-based purchasing plan payments under section 256B.692 
92.17 	for the prepaid medical assistance program. The withheld funds must be returned no 
92.18 	sooner than July 1 and no later than July 31 of the following year. The commissioner may 
92.19 	exclude special demonstration projects under subdivision 23.
92.20 	(g) Effective for services rendered on or after January 1, 2011, the commissioner 
92.21 	shall include as part of the performance targets described in paragraph (c) a reduction in 
92.22 	the health plan's emergency room utilization rate for state health care program enrollees 
92.23 	by a measurable rate of five percent from the plan's utilization rate for state health care 
92.24 	program enrollees for the previous calendar year.
92.25 	The withheld funds must be returned no sooner than July 1 and no later than July 31 
92.26 	of the following calendar year if the managed care plan demonstrates to the satisfaction of 
92.27 	the commissioner that a reduction in the utilization rate was achieved.
92.28 	The withhold described in this paragraph shall continue for each consecutive 
92.29 	contract period until the plan's emergency room utilization rate for state health care 
92.30 	program enrollees is reduced by 25 percent of the plan's emergency room utilization 
92.31 	rate for state health care program enrollees for calendar year 2009. Hospitals shall 
92.32 	cooperate with the health plans in meeting this performance target and shall accept 
92.33 	payment withholds that may be returned to the hospitals if the performance target is 
92.34 	achieved. The commissioner shall structure the withhold so that the commissioner returns 
92.35 	a portion of the withheld funds in amounts commensurate with achieved reductions in 
93.1 	utilization less than the targeted amount. The withhold in this paragraph does not apply to 
93.2 	county-based purchasing plans.
93.3 	(h) Effective for services rendered on or after January 1, 2012, the commissioner 
93.4 	shall include as part of the performance targets described in paragraph (c) a reduction in 
93.5 	the plan's hospitalization rates or subsequent hospitalizations within 30 days of a previous 
93.6 	hospitalization of a patient regardless of the reason for the hospitalization for state health 
93.7 	care program enrollees by a measurable rate of five percent from the plan's utilization rate 
93.8 	for state health care program enrollees for the previous calendar year.
93.9 	The withheld funds must be returned no sooner than July 1 and no later than July 31 
93.10 	of the following calendar year if the managed care plan or county-based purchasing plan 
93.11 	demonstrates to the satisfaction of the commissioner that a reduction in the hospitalization 
93.12 	rate was achieved.
93.13 	The withhold described in this paragraph must continue for each consecutive 
93.14 	contract period until the plan's subsequent hospitalization rate for state health care 
93.15 	program enrollees is reduced by 25 percent of the plan's subsequent hospitalization rate 
93.16 	for state health care program enrollees for calendar year 2010. Hospitals shall cooperate 
93.17 	with the plans in meeting this performance target and shall accept payment withholds that 
93.18 	must be returned to the hospitals if the performance target is achieved. The commissioner 
93.19 	shall structure the withhold so that the commissioner returns a portion of the withheld 
93.20 	funds in amounts commensurate with achieved reductions in utilization less than the 
93.21 	targeted amount.
93.22 	 (i) Effective for services rendered on or after January 1, 2011, through December 31, 
93.23 	2011, the commissioner shall withhold 4.5 percent of managed care plan payments under 
93.24 	this section and county-based purchasing plan payments under section 256B.692 for the 
93.25 	prepaid medical assistance program. The withheld funds must be returned no sooner than 
93.26 	July 1 and no later than July 31 of the following year. The commissioner may exclude 
93.27 	special demonstration projects under subdivision 23.
93.28 	(i) (j) Effective for services rendered on or after January 1, 2012, through December 
93.29 	31, 2012, the commissioner shall withhold 4.5 percent of managed care plan payments 
93.30 	under this section and county-based purchasing plan payments under section 256B.692 
93.31 	for the prepaid medical assistance program. The withheld funds must be returned no 
93.32 	sooner than July 1 and no later than July 31 of the following year. The commissioner may 
93.33 	exclude special demonstration projects under subdivision 23.
93.34 	(j) (k) Effective for services rendered on or after January 1, 2013, through December 
93.35 	31, 2013, the commissioner shall withhold 4.5 percent of managed care plan payments 
93.36 	under this section and county-based purchasing plan payments under section 256B.692 
94.1 	for the prepaid medical assistance program. The withheld funds must be returned no 
94.2 	sooner than July 1 and no later than July 31 of the following year. The commissioner may 
94.3 	exclude special demonstration projects under subdivision 23.
94.4 	(k) (l) Effective for services rendered on or after January 1, 2014, the commissioner 
94.5 	shall withhold three percent of managed care plan payments under this section and 
94.6 	county-based purchasing plan payments under section 256B.692 for the prepaid medical 
94.7 	assistance program. The withheld funds must be returned no sooner than July 1 and 
94.8 	no later than July 31 of the following year. The commissioner may exclude special 
94.9 	demonstration projects under subdivision 23.
94.10 	(l) (m) A managed care plan or a county-based purchasing plan under section 
94.11 	256B.692 may include as admitted assets under section 62D.044 any amount withheld 
94.12 	under this section that is reasonably expected to be returned.
94.13 	(m) (n) Contracts between the commissioner and a prepaid health plan are exempt 
94.14 	from the set-aside and preference provisions of section 16C.16, subdivisions 6, paragraph 
94.15 	(a), and 7.
94.16 	(n) (o) The return of the withhold under paragraphs (d), (f), and (h) (k) to (k) (j) is 
94.17 	not subject to the requirements of paragraph (c).

94.18 	Sec. 33. [256B.695] HEALTHY MINNESOTA CONTRIBUTION PROGRAM.
94.19 		Subdivision 1.Defined contributions to enrollees. (a) Beginning January 1, 2012, 
94.20 	the commissioner shall provide each medical assistance enrollee eligible under section 
94.21 	256B.055, subdivisions 3, 3a, 4, 9, and 10b, with family income greater than 75 percent 
94.22 	of the federal poverty guidelines as determined under section 256B.056, with a monthly 
94.23 	defined contribution to purchase health coverage under a health plan as defined in section 
94.24 	62A.011, subdivision 3, offered by a health plan company as defined in section 62Q.01, 
94.25 	subdivision 4.
94.26 	(b) Enrollees eligible under paragraph (a) are exempt from the managed care 
94.27 	enrollment requirement of sections 256B.69 and 256B.692.
94.28 	(c) Section 256B.0625 does not apply to enrollees eligible under paragraph (a). 
94.29 	Covered services, cost sharing, and disenrollment for nonpayment of premium for 
94.30 	enrollees eligible under paragraph (a) shall be as provided under the terms of the health 
94.31 	plan purchased by the enrollee. A health plan purchased by an eligible enrollee under this 
94.32 	section shall be considered a prepaid health plan for purposes of section 256.045.
94.33 	(d) Unless otherwise provided in this section, all medical assistance requirements 
94.34 	related to eligibility, income and asset methodology, income reporting, and program 
95.1 	administration, continue to apply to enrollees obtaining coverage under this section. 
95.2 	Section 256B.056, subdivision 7, shall apply to enrollees eligible under this section.
95.3 		Subd. 2.Use of defined contribution. An enrollee may use up to the monthly 
95.4 	defined contribution to pay premiums for coverage under a health plan as defined in 
95.5 	section 62A.011, subdivision 3.
95.6 		Subd. 3.Determination of defined contribution amount. (a) The commissioner 
95.7 	shall determine the defined contribution sliding scale using the base contribution specified 
95.8 	in paragraph (b) for the specified age ranges. The commissioner shall use a sliding scale 
95.9 	for defined contributions that provides:
95.10 	(1) persons with household incomes greater than 75 percent of the federal poverty 
95.11 	guidelines to 133 percent of the federal poverty guidelines with a defined contribution 
95.12 	of 110 percent of the base contribution;
95.13 	(2) persons with household incomes equal to 175 percent of the federal poverty 
95.14 	guidelines with a defined contribution of 100 percent of the base contribution;
95.15 	(3) persons with household incomes equal to or greater than 250 percent of 
95.16 	the federal poverty guidelines with a defined contribution of 80 percent of the base 
95.17 	contribution; and
95.18 	(4) persons with household incomes in evenly spaced increments between the 
95.19 	percentages of the federal poverty guidelines specified in clauses (1) to (3) with a base 
95.20 	contribution that is a percentage interpolated from the defined contribution percentages 
95.21 	specified in clauses (1) to (3).

95.22	Age
	Monthly Per-Person Base Contribution
	
95.23	Under 21
	$122.79
	
95.24	21-29
	122.79
	
95.25	30-31
	129.19
	
95.26	32-33
	132.38
	
95.27	34-35
	134.31
	
95.28	36-37
	136.06
	
95.29	38-39
	141.02
	
95.30	40-41
	151.25
	
95.31	42-43
	159.89
	
95.32	44-45
	175.08
	
95.33	46-47
	191.71
	
95.34	48-49
	213.13
	
95.35	50-51
	239.51
	
95.36	52-53
	266.69
	
95.37	54-55
	293.88
	
95.38	56-57
	323.77
	
96.1	58-59
	341.20
	
96.2	60+
	357.19
	
96.3 	(b) The commissioner shall multiply the defined contribution amounts developed 
96.4 	under paragraph (a) by 1.20 for enrollees who are denied coverage under an individual 
96.5 	health plan by a health plan company and who purchase coverage through the Minnesota 
96.6 	Comprehensive Health Association.
96.7 	(c) Notwithstanding paragraphs (a) and (b), the monthly defined contribution shall 
96.8 	not exceed 90 percent of the monthly premium for the health plan purchased by the 
96.9 	enrollee. If the enrollee purchases coverage under a health plan that does not include 
96.10 	mental health services and chemical dependency treatment services, the monthly defined 
96.11 	contribution amount determined under this subdivision shall be reduced by five percent.
96.12 		Subd. 4.Administration by commissioner. The commissioner shall administer the 
96.13 	defined contributions. The commissioner shall:
96.14 	(1) calculate and process defined contributions for enrollees; and
96.15 	(2) pay the defined contribution amount to health plan companies or the Minnesota 
96.16 	Comprehensive Health Association, as applicable, for enrollee health plan coverage.
96.17 		Subd. 5.Assistance to enrollees. The commissioner of human services, in 
96.18 	consultation with the commissioner of commerce, shall develop an efficient and 
96.19 	cost-effective method of referring eligible applicants to professional insurance agent 
96.20 	associations.
96.21 		Subd. 6.Minnesota Comprehensive Health Association (MCHA). Beginning 
96.22 	January 1, 2012, medical assistance enrollees who are denied coverage under an individual 
96.23 	health plan by a health plan company are eligible for coverage through a health plan 
96.24 	offered by the Minnesota Comprehensive Health Association and may enroll in MCHA 
96.25 	in accordance with section 62E.14. Any difference between the revenue and covered 
96.26 	losses to the MCHA related to implementation of this section shall be paid to the MCHA 
96.27 	from the health care access fund.
96.28 		Subd. 7.Federal approval. The commissioner shall seek all federal waivers and 
96.29 	approvals necessary to implement coverage under this section for medical assistance 
96.30 	enrollees eligible under subdivision 1 and to continue to receive federal matching funds.

96.31 	Sec. 34. Minnesota Statutes 2010, section 256B.76, subdivision 4, is amended to read:
96.32 		Subd. 4.Critical access dental providers.  (a) Effective for dental services 
96.33 	rendered on or after January 1, 2002, the commissioner shall increase reimbursements 
96.34 	to dentists and dental clinics deemed by the commissioner to be critical access dental 
96.35 	providers. For dental services rendered on or after July 1, 2007, the commissioner shall 
97.1 	increase reimbursement by 30 percent above the reimbursement rate that would otherwise 
97.2 	be paid to the critical access dental provider. The commissioner shall pay the managed 
97.3 	care plans and county-based purchasing plans in amounts sufficient to reflect increased 
97.4 	reimbursements to critical access dental providers as approved by the commissioner.
97.5 	(b) The commissioner shall designate the following dentists and dental clinics as 
97.6 	critical access dental providers:
97.7 	(1) nonprofit community clinics that:
97.8 	(i) have nonprofit status in accordance with chapter 317A;
97.9 	(ii) have tax exempt status in accordance with the Internal Revenue Code, section 
97.10 	501(c)(3);
97.11 	(iii) are established to provide oral health services to patients who are low income, 
97.12 	uninsured, have special needs, and are underserved;
97.13 	(iv) have professional staff familiar with the cultural background of the clinic's 
97.14 	patients;
97.15 	(v) charge for services on a sliding fee scale designed to provide assistance to 
97.16 	low-income patients based on current poverty income guidelines and family size;
97.17 	(vi) do not restrict access or services because of a patient's financial limitations 
97.18 	or public assistance status; and
97.19 	(vii) have free care available as needed;
97.20 	(2) federally qualified health centers, rural health clinics, and public health clinics;
97.21 	(3) county owned and operated hospital-based dental clinics;
97.22 	(4) a dental clinic or dental group owned and operated by a nonprofit corporation in 
97.23 	accordance with chapter 317A with more than 10,000 patient encounters per year with 
97.24 	patients who are uninsured or covered by medical assistance, general assistance medical 
97.25 	care, or MinnesotaCare; and
97.26 	(5) a dental clinic associated with an oral health or dental education program owned 
97.27 	and operated by the University of Minnesota or an institution within the Minnesota State 
97.28 	Colleges and Universities system.
97.29 	 (c) The commissioner may designate a dentist or dental clinic as a critical access 
97.30 	dental provider if the dentist or dental clinic is willing to provide care to patients covered 
97.31 	by medical assistance, general assistance medical care, or MinnesotaCare at a level which 
97.32 	significantly increases access to dental care in the service area.
97.33 	(d) Notwithstanding paragraph (a), critical access payments must not be made for 
97.34 	dental services provided from April 1, 2010, through June 30, 2010.

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

98.1 	Sec. 35. [256B.841] WAIVER APPLICATION AND PROCESS.
98.2 		Subdivision 1.Intent. It is the intent of the legislature that medical assistance be:
98.3 	(1) a sustainable, cost-effective, person-centered, and opportunity-driven program 
98.4 	utilizing competitive and value-based purchasing to maximize available service options; 
98.5 	and
98.6 	(2) a results-oriented system of coordinated care that focuses on independence 
98.7 	and choice, promotes accountability and transparency, encourages and rewards healthy 
98.8 	outcomes and responsible choices, and promotes efficiency.
98.9 		Subd. 2.Waiver application. (a) The commissioner of human services shall apply 
98.10 	for a waiver and any necessary state plan amendments from the secretary of the United 
98.11 	States Department of Health and Human Services, including, but not limited to, a waiver 
98.12 	of the appropriate sections of title XIX of the federal Social Security Act, United States 
98.13 	Code, title 42, section 1396 et seq. and a waiver of maintenance of effort provisions in 
98.14 	section 2001 of the Patient Protection and Affordable Care Act, Public Law 111-148, as 
98.15 	amended by the Health Care and Education Reconciliation Act of 2010, Public Law 
98.16 	111-152, that provide program flexibility and under which Minnesota will operate all 
98.17 	facets of the state's medical assistance program.
98.18 	(b) The commissioner of human services shall provide the legislative committees 
98.19 	with jurisdiction over health and human services finance and policy with the waiver 
98.20 	application and financial and other related materials, at least ten days prior to submitting 
98.21 	the application and materials to the federal Centers for Medicare and Medicaid Services.
98.22 	(c) If the state's waiver application is approved, the commissioner of human services 
98.23 	shall:
98.24 	(1) notify the chairs of the legislative committees with jurisdiction over health and 
98.25 	human services finance and policy and allow the legislative committees with jurisdiction 
98.26 	over health and human services finance and policy to review the terms of the waiver; and
98.27 	(2) not implement the waiver until ten legislative days have passed following 
98.28 	notification of the chairs.
98.29 		Subd. 3.Rulemaking; legislative proposals. Upon acceptance of the terms of the 
98.30 	waiver, the commissioner of human services shall:
98.31 	(1) adopt rules to implement the waiver; and
98.32 	(2) propose any legislative changes necessary to implement the terms of the waiver.
98.33 		Subd. 4.Joint commission on waiver implementation. (a) After acceptance 
98.34 	of the terms of the waiver, the governor shall establish a joint commission on waiver 
98.35 	implementation. The commission shall consist of eight members; four of whom shall 
98.36 	be members of the senate, not more than three from the same political party, to be 
99.1 	appointed by the Subcommittee on Committees of the senate Committee on Rules and 
99.2 	Administration, and four of whom shall be members of the house of representatives, not 
99.3 	more than three from the same political party, to be appointed by the speaker of the house.
99.4 	(b) The commission shall:
99.5 	(1) oversee implementation of the waiver;
99.6 	(2) confer as necessary with state agency commissioners;
99.7 	(3) make recommendations on services covered under the medical assistance 
99.8 	program;
99.9 	(4) monitor and make recommendations on quality and access to care under the 
99.10 	global waiver; and
99.11 	(5) make recommendations for the efficient and cost-effective administration of the 
99.12 	medical assistance program under the terms of the waiver.

99.13 	Sec. 36. [256B.842] PRINCIPLES AND GOALS FOR MEDICAL ASSISTANCE 
99.14 	REFORM.
99.15 		Subdivision 1.Goals for reform.  In developing the waiver application and 
99.16 	implementing the waiver, the commissioner of human services shall ensure that the 
99.17 	reformed medical assistance program is a person-centered, financially sustainable, and 
99.18 	cost-effective program.
99.19 		Subd. 2.Reformed medical assistance criteria. The reformed medical assistance 
99.20 	program established through the waiver must:
99.21 	(1) empower consumers to make informed and cost-effective choices about their 
99.22 	health and offer consumers rewards for healthy decisions;
99.23 	(2) ensure adequate access to needed services;
99.24 	(3) enable consumers to receive individualized health care that is outcome-oriented 
99.25 	and focused on prevention, disease management, recovery, and maintaining independence;
99.26 	(4) promote competition between health care providers to ensure best value 
99.27 	purchasing, leverage resources, and to create opportunities for improving service quality 
99.28 	and performance;
99.29 	(5) redesign purchasing and payment methods and encourage and reward 
99.30 	high-quality and cost-effective care by incorporating and expanding upon current payment 
99.31 	reform and quality of care initiatives, including, but not limited to, those initiatives 
99.32 	authorized under chapter 62U; and
99.33 	(6) continually improve technology to take advantage of recent innovations and 
99.34 	advances that help decision makers, consumers, and providers make informed and 
99.35 	cost-effective decisions regarding health care.
100.1 		Subd. 3.Annual report. The commissioner of human services shall annually 
100.2 	submit a report to the governor and the legislature, beginning December 1, 2012, and each 
100.3 	December 1 thereafter, describing the status of the administration and implementation 
100.4 	of the waiver.

100.5 	Sec. 37. [256B.843] WAIVER APPLICATION REQUIREMENTS.
100.6 		Subdivision 1.Requirements for waiver request. The commissioner shall seek 
100.7 	federal approval to:
100.8 	(1) enter into a five-year agreement with the United States Department of Health and 
100.9 	Human Services and Centers for Medicaid and Medicare Services (CMS) under section 
100.10 	1115a to waive provisions of title XIX of the federal Social Security Act, United States 
100.11 	Code, title 42, section 1396 et seq., requiring:
100.12 	(i) state-wideness to allow for the provision of different services in different areas or 
100.13 	regions of the state;
100.14 	(ii) comparability of services to allow for the provision of different services to 
100.15 	members of the same or different coverage groups;
100.16 	(iii) no prohibitions restricting the amount, duration, and scope of services included 
100.17 	in the medical assistance state plan;
100.18 	(iv) no prohibitions limiting freedom of choice of providers; and
100.19 	(v) retroactive payment for medical assistance, at the state's discretion;
100.20 	(2) waive the applicable provisions of title XIX of the federal Social Security Act, 
100.21 	United States Code, title 42, section 1396 et seq., in order to:
100.22 	(i) expand cost sharing requirements above the five percent of income threshold for 
100.23 	beneficiaries in certain populations;
100.24 	(ii) establish health savings or power accounts that encourage and reward 
100.25 	beneficiaries who reach certain prevention and wellness targets; and
100.26 	(iii) implement a tiered set of parameters to use as the basis for determining 
100.27 	long-term service care and setting needs;
100.28 	(3) modify income and resource rules in a manner consistent with the goals of the 
100.29 	reformed program;
100.30 	(4) provide enrollees with a choice of appropriate private sector health coverage 
100.31 	options, with full federal financial participation;
100.32 	(5) treat payments made toward the cost of care as a monthly premium for 
100.33 	beneficiaries receiving home and community-based services when applicable;
100.34 	(6) provide health coverage and services to individuals over the age of 65 that are 
100.35 	limited in scope and are available only in the home and community-based setting;
101.1 	(7) consolidate all home and community-based services currently provided under 
101.2 	title XIX of the federal Social Security Act, United States Code, title 42, section 1915(c), 
101.3 	into a single program of home and community-based services that include options for 
101.4 	consumer direction and shared living;
101.5 	(8) expand disease management, care coordination, and wellness programs for all 
101.6 	medical assistance recipients; and
101.7 	(9) empower and encourage able-bodied medical assistance recipients to work, 
101.8 	whenever possible.
101.9 		Subd. 2.Agency coordination. The commissioner shall establish an intra-agency 
101.10 	assessment and coordination unit to ensure that decision making and program planning for 
101.11 	recipients who may need long-term care, residential placement, and community support 
101.12 	services are coordinated. The assessment and coordination unit shall determine level of 
101.13 	care, develop service plans and a service budget, make referrals to appropriate settings, 
101.14 	provide education and choice counseling to consumers and providers, track utilization, 
101.15 	and monitor outcomes. 

101.16 	Sec. 38. Minnesota Statutes 2010, section 256D.031, subdivision 6, is amended to read:
101.17 		Subd. 6.Coordinated care delivery systems. (a) Effective June 1, 2010 July 
101.18 	1, 2011, the commissioner shall contract with hospitals or groups of hospitals that 
101.19 	qualify under paragraph (b) and agree to deliver services according to this subdivision. 
101.20 	Contracting hospitals shall develop and implement a coordinated care delivery system to 
101.21 	provide health care services to individuals who are eligible for general assistance medical 
101.22 	care under this section and who either choose to receive services through the coordinated 
101.23 	care delivery system or who are enrolled by the commissioner under paragraph (c). The 
101.24 	health care services provided by the system must include: (1) the services described in 
101.25 	subdivision 4 with the exception of outpatient prescription drug coverage but shall include 
101.26 	drugs administered in a clinic or other outpatient setting; or (2) a set of comprehensive 
101.27 	and medically necessary health services that the recipients might reasonably require to be 
101.28 	maintained in good health and that has been approved by the commissioner, including at a 
101.29 	minimum, but not limited to, emergency care, medical transportation services, inpatient 
101.30 	hospital and physician care, outpatient health services, preventive health services, mental 
101.31 	health services, and prescription drugs administered in a clinic or other outpatient setting. 
101.32 	Outpatient prescription drug coverage is covered on a fee-for-service basis in accordance 
101.33 	with section 256D.03, subdivision 3, and funded under subdivision 9. A hospital 
101.34 	establishing a coordinated care delivery system under this subdivision must ensure that the 
101.35 	requirements of this subdivision are met.
102.1 	(b) A hospital or group of hospitals may contract with the commissioner to develop 
102.2 	and implement a coordinated care delivery system as follows: if the hospital or group of 
102.3 	hospitals agrees to satisfy the requirements of this subdivision.
102.4 	(1) effective June 1, 2010, a hospital qualifies under this subdivision if: (i) during 
102.5 	calendar year 2008, it received fee-for-service payments for services to general assistance 
102.6 	medical care recipients (A) equal to or greater than $1,500,000, or (B) equal to or greater 
102.7 	than 1.3 percent of net patient revenue; or (ii) a contract with the hospital is necessary to 
102.8 	provide geographic access or to ensure that at least 80 percent of enrollees have access to 
102.9 	a coordinated care delivery system; and
102.10 	(2) effective December 1, 2010, a Minnesota hospital not qualified under clause 
102.11 	(1) may contract with the commissioner under this subdivision if it agrees to satisfy the 
102.12 	requirements of this subdivision.
102.13 	Participation by hospitals shall become effective quarterly on June 1, September 1, 
102.14 	December 1, or March 1, or June 1. Hospital participation is effective for a period of 12 
102.15 	months and may be renewed for successive 12-month periods.
102.16 	(c) Applicants and recipients may enroll in any available coordinated care delivery 
102.17 	system statewide. If more than one coordinated care delivery system is available, the 
102.18 	applicant or recipient shall be allowed to choose among the systems. The commissioner 
102.19 	may assign an applicant or recipient to a coordinated care delivery system if no choice 
102.20 	is made by the applicant or recipient or under paragraph (k). The commissioner shall 
102.21 	consider a recipient's zip code, city of residence, county of residence, or distance from 
102.22 	a participating coordinated care delivery system when determining default assignment. 
102.23 	An applicant or recipient may decline enrollment in a coordinated care delivery system
102.24 	but services are only available through a coordinated care delivery system. Upon 
102.25 	enrollment into a coordinated care delivery system, the recipient must agree to receive 
102.26 	all nonemergency services through the coordinated care delivery system. Enrollment in 
102.27 	a coordinated care delivery system is for six months and may be renewed for additional 
102.28 	six-month periods, except that initial enrollment is for six months or until the end of a 
102.29 	recipient's period of general assistance medical care eligibility, whichever occurs first. 
102.30 	A recipient who continues to meet the eligibility requirements of this section is not 
102.31 	eligible to enroll in MinnesotaCare during a period of enrollment in a coordinated care 
102.32 	delivery system. From June 1, 2010, to February 28, 2011, applicants and recipients not 
102.33 	enrolled in a coordinated care delivery system may seek services from a hospital eligible 
102.34 	for reimbursement under the temporary uncompensated care pool established under 
102.35 	subdivision 8. After February 28, 2011, services are available only through a coordinated 
102.36 	care delivery system.
103.1 	(d) The hospital may contract and coordinate with providers and clinics for the 
103.2 	delivery of services and shall contract with essential community providers as defined 
103.3 	under section 62Q.19, subdivision 1, paragraph (a), clauses (1) and (2), to the extent 
103.4 	practicable. If a provider or clinic contracts with a hospital to provide services through the 
103.5 	coordinated care delivery system, the provider may not refuse to provide services to any 
103.6 	recipient enrolled in the system, and payment for services shall be negotiated with the 
103.7 	hospital and paid by the hospital from the system's allocation under subdivision 7.
103.8 	(e) A coordinated care delivery system must:
103.9 	(1) provide the covered services required under paragraph (a) to recipients enrolled 
103.10 	in the coordinated care delivery system, and comply with the requirements of subdivision 
103.11 	4, paragraphs (b) to (g);
103.12 	(2) establish a process to monitor enrollment and ensure the quality of care provided;
103.13 	(3) in cooperation with counties, coordinate the delivery of health care services with 
103.14 	existing homeless prevention, supportive housing, and rent subsidy programs and funding 
103.15 	administered by the Minnesota Housing Finance Agency under chapter 462A; and
103.16 	(4) adopt innovative and cost-effective methods of care delivery and coordination, 
103.17 	which may include the use of allied health professionals, telemedicine, patient educators, 
103.18 	care coordinators, and community health workers.
103.19 	(f) The hospital may require a recipient to designate a primary care provider or 
103.20 	a primary care clinic. The hospital may limit the delivery of services to a network of 
103.21 	providers who have contracted with the hospital to deliver services in accordance with 
103.22 	this subdivision, and require a recipient to seek services only within this network. The 
103.23 	hospital may also require a referral to a provider before the service is eligible for payment. 
103.24 	A coordinated care delivery system is not required to provide payment to a provider who 
103.25 	is not employed by or under contract with the system for services provided to a recipient 
103.26 	enrolled in the system, except in cases of an emergency. For purposes of this section, 
103.27 	emergency services are defined in accordance with Code of Federal Regulations, title 
103.28 	42, section 438.114 (a).
103.29 	(g) A recipient enrolled in a coordinated care delivery system has the right to appeal 
103.30 	to the commissioner according to section 256.045.
103.31 	(h) The state shall not be liable for the payment of any cost or obligation incurred 
103.32 	by the coordinated care delivery system.
103.33 	(i) The hospital must provide the commissioner with data necessary for assessing 
103.34 	enrollment, quality of care, cost, and utilization of services. Each hospital must provide, 
103.35 	on a quarterly basis on a form prescribed by the commissioner for each recipient served by 
103.36 	the coordinated care delivery system, the services provided, the cost of services provided, 
104.1 	and the actual payment amount for the services provided and any other information the 
104.2 	commissioner deems necessary to claim federal Medicaid match. The commissioner must 
104.3 	provide this data to the legislature on a quarterly basis.
104.4 	(j) Effective June 1, 2010, The provisions of section 256.9695, subdivision 2, 
104.5 	paragraph (b), do not apply to general assistance medical care provided under this section.
104.6 	(k) Notwithstanding any other provision in this section to the contrary, for 
104.7 	participation beginning September 1, 2010, the commissioner shall offer the same contract 
104.8 	terms related tomay implement an enrollment threshold formula and financial liability 
104.9 	protections to a hospital or group of hospitals qualified under this subdivision to develop 
104.10 	and implement a coordinated care delivery system as those contained in the coordinated 
104.11 	care delivery system contracts effective June 1, 2010.
104.12 	(l) If sections 256B.055, subdivision 15, and 256B.056, subdivisions 3 and 4, are 
104.13 	implemented effective July 1, 2010, this subdivision must not be implemented.

104.14 	Sec. 39. Minnesota Statutes 2010, section 256D.031, subdivision 7, is amended to read:
104.15 		Subd. 7.Payments; rate setting for the hospital coordinated care delivery 
104.16 	system. (a) Effective for general assistance medical care services, with the exception 
104.17 	of outpatient prescription drug coverage, provided on or after June 1, 2010, through a 
104.18 	coordinated care delivery system, the commissioner shall allocate the annual appropriation 
104.19 	for the coordinated care delivery system to hospitals participating under subdivision 
104.20 	6 in quarterly payments, beginning on the first scheduled warrant on or after June 1, 
104.21 	2010 September 1, 2011. The payment shall be allocated among all hospitals qualified to 
104.22 	participate on the allocation date as follows:
104.23 	(1) each hospital or group of hospitals shall be allocated an initial amount based on 
104.24 	the hospital's or group of hospitals' pro rata share of calendar year 20082009 payments for 
104.25 	general assistance medical care services to all participating hospitals;
104.26 	(2) the initial allocations to Hennepin County Medical Center; Regions Hospital; 
104.27 	Saint Mary's Medical Center; and the University of Minnesota Medical Center, Fairview, 
104.28 	shall be increased to 110 percent of the value determined in clause (1);
104.29 	(3) the initial allocation to hospitals not listed in clause (2) shall be reduced a pro rata 
104.30 	amount in order to keep the allocations within the limit of available appropriations; and
104.31 	(4) the amounts determined under clauses (1) to (3) shall be allocated to participating 
104.32 	hospitals.
104.33 	The commissioner may prospectively reallocate payments to participating hospitals on 
104.34 	a biannual basis to ensure that final allocations reflect actual coordinated care delivery 
105.1 	system enrollment. The 20082009 base year shall be updated by one calendar year each 
105.2 	June 1, beginning June 1, 2011 2012.
105.3 	(b) Beginning June 1, 2010 2012, and every quarter beginning in June thereafter, the 
105.4 	commissioner shall make one-third of the quarterly payment in June and the remaining 
105.5 	two-thirds of the quarterly payment in July to each participating hospital or group of 
105.6 	hospitals.
105.7 	(c) In order to be reimbursed under this section, nonhospital providers of health 
105.8 	care services shall contract with one or more hospitals described in paragraph (a) to 
105.9 	provide services to general assistance medical care recipients through the coordinated care 
105.10 	delivery system established by the hospital. The hospital shall reimburse bills submitted 
105.11 	by nonhospital providers participating under this paragraph at a rate negotiated between 
105.12 	the hospital and the nonhospital provider.
105.13 	(d) The commissioner shall apply for federal matching funds under section 
105.14 	256B.199, paragraphs (a) to (d), for expenditures under this subdivision.
105.15 	(e) Outpatient prescription drug coverage is provided in accordance with section 
105.16 	256D.03, subdivision 3, and paid on a fee-for-service basis under subdivision 9.

105.17 	Sec. 40. Minnesota Statutes 2010, section 256D.031, subdivision 9, is amended to read:
105.18 		Subd. 9.Prescription drug pool. (a) The commissioner shall establish an outpatient 
105.19 	prescription drug pool, effective June 1, 2010 July 1, 2011. Money in the pool must 
105.20 	be used to reimburse pharmacies and other pharmacy service providers as defined in 
105.21 	Minnesota Rules, part 9505.0340, for the covered outpatient prescription drugs dispensed 
105.22 	to recipients. Payment for drugs shall be on a fee-for-service basis according to the rates 
105.23 	established in section 256B.0625, subdivision 13e. Outpatient prescription drug coverage 
105.24 	is subject to the availability of funds in the pool. If the commissioner forecasts that 
105.25 	expenditures under this subdivision will exceed the appropriation for this purpose, the 
105.26 	commissioner may bring recommendations to the Legislative Advisory Commission on 
105.27 	methods to resolve the shortfall.
105.28 	(b) Effective June 1, 2010 September 1, 2011, coordinated care delivery systems 
105.29 	established under subdivision 6 shall pay to the commissioner, on a quarterly basis, an 
105.30 	assessment equal to 20 percent of payments for the prescribed drugs for recipients of 
105.31 	services through that coordinated care delivery system, as calculated by the commissioner 
105.32 	based on the most recent available data.

105.33 	Sec. 41. [256L.031] HEALTHY MINNESOTA CONTRIBUTION PROGRAM.
106.1 		Subdivision 1.Defined contributions to enrollees. (a) Beginning January 1, 2012, 
106.2 	the commissioner shall provide each MinnesotaCare enrollee eligible under section 
106.3 	256L.04, subdivision 7, with a monthly defined contribution to purchase health coverage 
106.4 	under a health plan as defined in section 62A.011, subdivision 3.
106.5 	(b) Beginning January 1, 2012, or upon federal approval, whichever is later, the 
106.6 	commissioner shall provide each MinnesotaCare enrollee eligible under section 256L.04, 
106.7 	subdivision 1, with a monthly defined contribution to purchase health coverage under a 
106.8 	health plan as defined in section 62A.011, subdivision 3, offered by a health plan company 
106.9 	as defined in section 62Q.01, subdivision 4.
106.10 	(c) Enrollees eligible under paragraph (a) or (b) shall not be charged premiums 
106.11 	under section 256L.15 and are exempt from the managed care enrollment requirement 
106.12 	of section 256L.12.
106.13 	(d) Sections 256L.03; 256L.05, subdivision 3; and 256L.11 do not apply to enrollees 
106.14 	eligible under paragraph (a) or (b). Covered services, cost sharing, disenrollment for 
106.15 	nonpayment of premium, enrollee appeal rights and complaint procedures, and the 
106.16 	effective date of coverage for enrollees eligible under paragraph (a) shall be as provided 
106.17 	under the terms of the health plan purchased by the enrollee.
106.18 	(e) Unless otherwise provided in this section, all MinnesotaCare requirements 
106.19 	related to eligibility, income and asset methodology, income reporting, and program 
106.20 	administration, continue to apply to enrollees obtaining coverage under this section.
106.21 		Subd. 2.Use of defined contribution. An enrollee may use up to the monthly 
106.22 	defined contribution to pay premiums for coverage under a health plan as defined in 
106.23 	section 62A.011, subdivision 3.
106.24 		Subd. 3.Determination of defined contribution amount. (a) The commissioner 
106.25 	shall determine the defined contribution sliding scale using the base contribution specified 
106.26 	in paragraph (b) for the specified age ranges. The commissioner shall use a sliding scale 
106.27 	for defined contributions that provides:
106.28 	(1) persons with household incomes greater than 75 percent of the federal poverty 
106.29 	guidelines to 133 percent of the federal poverty guidelines with a defined contribution 
106.30 	of 150 percent of the base contribution;
106.31 	(2) persons with household incomes equal to 175 percent of the federal poverty 
106.32 	guidelines with a defined contribution of 100 percent of the base contribution;
106.33 	(3) persons with household incomes equal to or greater than 250 percent of 
106.34 	the federal poverty guidelines with a defined contribution of 80 percent of the base 
106.35 	contribution; and
107.1 	(4) persons with household incomes in evenly spaced increments between the 
107.2 	percentages of the federal poverty guidelines specified in clauses (1) to (3) with a base 
107.3 	contribution that is a percentage interpolated from the defined contribution percentages 
107.4 	specified in clauses (1) to (3).

107.5	Age
	Monthly Per-Person Base Contribution
	
107.6	Under 21
	$122.79
	
107.7	21-29
	122.79
	
107.8	30-31
	129.19
	
107.9	32-33
	132.38
	
107.10	34-35
	134.31
	
107.11	36-37
	136.06
	
107.12	38-39
	141.02
	
107.13	40-41
	151.25
	
107.14	42-43
	159.89
	
107.15	44-45
	175.08
	
107.16	46-47
	191.71
	
107.17	48-49
	213.13
	
107.18	50-51
	239.51
	
107.19	52-53
	266.69
	
107.20	54-55
	293.88
	
107.21	56-57
	323.77
	
107.22	58-59
	341.20
	
107.23	60+
	357.19
	
107.24 	(b) The commissioner shall multiply the defined contribution amounts developed 
107.25 	under paragraph (a) by 1.20 for enrollees who are denied coverage under an individual 
107.26 	health plan by a health plan company and who purchase coverage through the Minnesota 
107.27 	Comprehensive Health Association.
107.28 	(c) Notwithstanding paragraphs (a) and (b), the monthly defined contribution shall 
107.29 	not exceed 90 percent of the monthly premium for the health plan purchased by the 
107.30 	enrollee. If the enrollee purchases coverage under a health plan that does not include 
107.31 	mental health services and chemical dependency treatment services, the monthly defined 
107.32 	contribution amount determined under this subdivision shall be reduced by five percent.
107.33 		Subd. 4.Administration by commissioner. The commissioner shall administer the 
107.34 	defined contributions. The commissioner shall:
107.35 	(1) calculate and process defined contributions for enrollees; and
107.36 	(2) pay the defined contribution amount to health plan companies or the Minnesota 
107.37 	Comprehensive Health Association, as applicable, for enrollee health plan coverage.
107.38 		Subd. 5.Assistance to enrollees. The commissioner of human services, in 
107.39 	consultation with the commissioner of commerce, shall develop an efficient and 
108.1 	cost-effective method of referring eligible applicants to professional insurance agent 
108.2 	associations.
108.3 		Subd. 6.Minnesota Comprehensive Health Association (MCHA). Beginning 
108.4 	January 1, 2012, MinnesotaCare enrollees who are denied coverage under an individual 
108.5 	health plan by a health plan company are eligible for coverage through a health plan 
108.6 	offered by the Minnesota Comprehensive Health Association and may enroll in MCHA 
108.7 	in accordance with section 62E.14. Any difference between the revenue and covered 
108.8 	losses to the MCHA related to implementation of this section shall be paid to the MCHA 
108.9 	from the health care access fund.
108.10 		Subd. 7.Federal approval. The commissioner shall seek all federal waivers 
108.11 	and approvals necessary to implement coverage under this section for MinnesotaCare 
108.12 	enrollees eligible under subdivision 1 while continuing to receive federal matching funds.

108.13 	Sec. 42. Minnesota Statutes 2010, section 256L.04, subdivision 7, is amended to read:
108.14 		Subd. 7.Single adults and households with no children. (a) The definition of 
108.15 	eligible persons includes all individuals and households with no children who have gross 
108.16 	family incomes that are equal to or less than 200 percent of the federal poverty guidelines.
108.17 	(b) Effective July 1, 2009 2011, the definition of eligible persons includes all 
108.18 	individuals and households with no children who have gross family incomes that are equal 
108.19 	to orgreater than 75 percent of the federal poverty guidelines and less than 250 percent 
108.20 	of the federal poverty guidelines.

108.21 	Sec. 43. Minnesota Statutes 2010, section 256L.05, is amended by adding a subdivision 
108.22 	to read:
108.23 		Subd. 6.Referral of veterans. The commissioner shall ensure that all applicants 
108.24 	for MinnesotaCare with incomes less than 133 percent of the federal poverty guidelines 
108.25 	who identify themselves as veterans are referred to a county veterans service officer for 
108.26 	assistance in applying to the U.S. Department of Veterans Affairs for any veterans benefits 
108.27 	for which they may be eligible.

108.28 	Sec. 44. Minnesota Statutes 2010, section 256L.11, subdivision 7, is amended to read:
108.29 		Subd. 7.Critical access dental providers. Effective for dental services provided to 
108.30 	MinnesotaCare enrollees on or after January 1, 2007, July 1, 2011, the commissioner shall 
108.31 	increase payment rates to dentists and dental clinics deemed by the commissioner to be 
108.32 	critical access providers under section 256B.76, subdivision 4, by 50 30 percent above 
108.33 	the payment rate that would otherwise be paid to the provider. The commissioner shall 
109.1 	pay the prepaid health plans under contract with the commissioner amounts sufficient to 
109.2 	reflect this rate increase. The prepaid health plan must pass this rate increase to providers 
109.3 	who have been identified by the commissioner as critical access dental providers under 
109.4 	section 256B.76, subdivision 4.

109.5 	Sec. 45. Minnesota Statutes 2010, section 256L.12, subdivision 9, is amended to read:
109.6 		Subd. 9.Rate setting; performance withholds. (a) Rates will be prospective, 
109.7 	per capita, where possible. The commissioner may allow health plans to arrange for 
109.8 	inpatient hospital services on a risk or nonrisk basis. The commissioner shall consult with 
109.9 	an independent actuary to determine appropriate rates.
109.10 	(b) For services rendered on or after January 1, 2004, the commissioner shall 
109.11 	withhold five percent of managed care plan payments and county-based purchasing 
109.12 	plan payments under this section pending completion of performance targets. Each 
109.13 	performance target must be quantifiable, objective, measurable, and reasonably attainable, 
109.14 	except in the case of a performance target based on a federal or state law or rule. Criteria 
109.15 	for assessment of each performance target must be outlined in writing prior to the 
109.16 	contract effective date. The managed care plan must demonstrate, to the commissioner's 
109.17 	satisfaction, that the data submitted regarding attainment of the performance target is 
109.18 	accurate. The commissioner shall periodically change the administrative measures used 
109.19 	as performance targets in order to improve plan performance across a broader range of 
109.20 	administrative services. The performance targets must include measurement of plan 
109.21 	efforts to contain spending on health care services and administrative activities. The 
109.22 	commissioner may adopt plan-specific performance targets that take into account factors 
109.23 	affecting only one plan, such as characteristics of the plan's enrollee population. The 
109.24 	withheld funds must be returned no sooner than July 1 and no later than July 31 of the 
109.25 	following calendar year if performance targets in the contract are achieved.
109.26 	(c) For services rendered on or after January 1, 2011, the commissioner shall 
109.27 	withhold an additional three percent of managed care plan or county-based purchasing 
109.28 	plan payments under this section. The withheld funds must be returned no sooner than 
109.29 	July 1 and no later than July 31 of the following calendar year. The return of the withhold 
109.30 	under this paragraph is not subject to the requirements of paragraph (b).
109.31 	(d) Effective for services rendered on or after January 1, 2011, the commissioner 
109.32 	shall include as part of the performance targets described in paragraph (b) a reduction in 
109.33 	the plan's emergency room utilization rate for state health care program enrollees by a 
109.34 	measurable rate of five percent from the plan's utilization rate for the previous calendar 
109.35 	year.
110.1 	The withheld funds must be returned no sooner than July 1 and no later than July 31 
110.2 	of the following calendar year if the managed care plan demonstrates to the satisfaction of 
110.3 	the commissioner that a reduction in the utilization rate was achieved.
110.4 	The withhold described in this paragraph shall continue for each consecutive 
110.5 	contract period until the plan's emergency room utilization rate for state health care 
110.6 	program enrollees is reduced by 25 percent of the plan's emergency room utilization rate 
110.7 	for state health care program enrollees for calendar year 2009. Hospitals shall cooperate 
110.8 	with the health plans in meeting this performance target and shall accept payment 
110.9 	withholds that may be returned to the hospitals if the performance target is achieved. The 
110.10 	commissioner shall structure the withhold so that the commissioner returns a portion of 
110.11 	the withheld funds in amounts commensurate with achieved reductions in utilization less 
110.12 	than the targeted amount. The withhold described in this paragraph does not apply to 
110.13 	county-based purchasing plans.
110.14 	(e) Effective for services provided on or after January 1, 2012, the commissioner 
110.15 	shall include as part of the performance targets described in paragraph (b) a reduction in 
110.16 	the plan's hospitalization rate for a subsequent hospitalization within 30 days of a previous 
110.17 	hospitalization of a patient regardless of the reason for the hospitalization for state health 
110.18 	care program enrollees by a measurable rate of five percent from the plan's hospitalization 
110.19 	rate for the previous calendar year.
110.20 	The withheld funds must be returned no sooner than July 1 and no later than July 31 
110.21 	of the following calendar year if the managed care plan or county-based purchasing plan 
110.22 	demonstrates to the satisfaction of the commissioner that a reduction in the hospitalization 
110.23 	rate was achieved.
110.24 	The withhold described in this paragraph must continue for each consecutive 
110.25 	contract period until the plan's subsequent hospitalization rate for state health care 
110.26 	program enrollees is reduced by 25 percent of the plan's subsequent hospitalization rate 
110.27 	for state health care program enrollees for calendar year 2010. Hospitals shall cooperate 
110.28 	with the plans in meeting this performance target and shall accept payment withholds that 
110.29 	must be returned to the hospitals if the performance target is achieved. The commissioner 
110.30 	shall structure the withhold so that the commissioner returns a portion of the withheld 
110.31 	funds in amounts commensurate with achieved reductions in utilizations less than the 
110.32 	targeted amount. The withhold described in this paragraph does not apply to county-based 
110.33 	purchasing plans.
110.34 	 (f) A managed care plan or a county-based purchasing plan under section 256B.692 
110.35 	may include as admitted assets under section 62D.044 any amount withheld under this 
110.36 	section that is reasonably expected to be returned.

111.1 	Sec. 46. Laws 2008, chapter 363, article 18, section 3, subdivision 5, is amended to 
111.2 	read:

111.3	Subd. 5.Basic Health Care Grants

111.4	(a) MinnesotaCare Grants

111.5	Health Care Access
		-0-
		(770,000)
	
111.6 	Incentive Program and Outreach Grants.
111.7 	Of the appropriation for the Minnesota health 
111.8 	care outreach program in Laws 2007, chapter 
111.9 	147, article 19, section 3, subdivision 7, 
111.10 	paragraph (b):
111.11 	(1) $400,000 in fiscal year 2009 from the 
111.12 	general fund and $200,000 in fiscal year 2009 
111.13 	from the health care access fund are for the 
111.14 	incentive program under Minnesota Statutes, 
111.15 	section 256.962, subdivision 5. For the 
111.16 	biennium beginning July 1, 2009, base level 
111.17 	funding for this activity shall be $360,000 
111.18 	from the general fund and $160,000 from the 
111.19 	health care access fund; and
111.20 	(2) $100,000 in fiscal year 2009 from the 
111.21 	general fund and $50,000 in fiscal year 2009 
111.22 	from the health care access fund are for the 
111.23 	outreach grants under Minnesota Statutes, 
111.24 	section 256.962, subdivision 2. For the 
111.25 	biennium beginning July 1, 2009, base level 
111.26 	funding for this activity shall be $90,000 
111.27 	from the general fund and $40,000 from the 
111.28 	health care access fund.

111.29
111.30	(b) MA Basic Health Care Grants - Families 
and Children
		-0-
		(17,280,000)
	
111.31 	Third-Party Liability. (a) During 
111.32 	fiscal year 2009, the commissioner shall 
111.33 	employ a contractor paid on a percentage 
111.34 	basis to improve third-party collections. 
112.1 	Improvement initiatives may include, but not 
112.2 	be limited to, efforts to improve postpayment 
112.3 	collection from nonresponsive claims and 
112.4 	efforts to uncover third-party payers the 
112.5 	commissioner has been unable to identify.
112.6 	(b) In fiscal year 2009, the first $1,098,000 
112.7 	of recoveries, after contract payments and 
112.8 	federal repayments, is appropriated to 
112.9 	the commissioner for technology-related 
112.10 	expenses.
112.11 	Administrative Costs. (a) For contracts 
112.12 	effective on or after January 1, 2009, 
112.13 	the commissioner shall limit aggregate 
112.14 	administrative costs paid to managed care 
112.15 	plans under Minnesota Statutes, section 
112.16 	256B.69, and to county-based purchasing 
112.17 	plans under Minnesota Statutes, section 
112.18 	256B.692, to an overall average of 6.6 5.3
112.19 	percent of total contract payments under 
112.20 	Minnesota Statutes, sections 256B.69 and 
112.21 	256B.692, for each calendar year. For 
112.22 	purposes of this paragraph, administrative 
112.23 	costs do not include premium taxes paid 
112.24 	under Minnesota Statutes, section 297I.05, 
112.25 	subdivision 5, and provider surcharges paid 
112.26 	under Minnesota Statutes, section 256.9657, 
112.27 	subdivision 3.
112.28 	(b) Notwithstanding any law to the contrary, 
112.29 	the commissioner may reduce or eliminate 
112.30 	administrative requirements to meet the 
112.31 	administrative target under paragraph (a). 
112.32 	(c) Notwithstanding any contrary provision 
112.33 	of this article, this rider shall not expire.
112.34 	Hospital Payment Delay. Notwithstanding 
112.35 	Laws 2005, First Special Session chapter 4, 
113.1 	article 9, section 2, subdivision 6, payments 
113.2 	from the Medicaid Management Information 
113.3 	System that would otherwise have been made 
113.4 	for inpatient hospital services for medical 
113.5 	assistance enrollees are delayed as follows: 
113.6 	(1) for fiscal year 2008, June payments must 
113.7 	be included in the first payments in fiscal 
113.8 	year 2009; and (2) for fiscal year 2009, 
113.9 	June payments must be included in the first 
113.10 	payment of fiscal year 2010. The provisions 
113.11 	of Minnesota Statutes, section 16A.124, 
113.12 	do not apply to these delayed payments. 
113.13 	Notwithstanding any contrary provision in 
113.14 	this article, this paragraph expires on June 
113.15 	30, 2010.

113.16
113.17	(c) MA Basic Health Care Grants - Elderly and 
Disabled
		(14,028,000)
		(9,368,000)
	
113.18 	Minnesota Disability Health Options Rate 
113.19 	Setting Methodology. The commissioner 
113.20 	shall develop and implement a methodology 
113.21 	for risk adjusting payments for community 
113.22 	alternatives for disabled individuals (CADI) 
113.23 	and traumatic brain injury (TBI) home 
113.24 	and community-based waiver services 
113.25 	delivered under the Minnesota disability 
113.26 	health options program (MnDHO) effective 
113.27 	January 1, 2009. The commissioner shall 
113.28 	take into account the weighting system used 
113.29 	to determine county waiver allocations in 
113.30 	developing the new payment methodology. 
113.31 	Growth in the number of enrollees receiving 
113.32 	CADI or TBI waiver payments through 
113.33 	MnDHO is limited to an increase of 200 
113.34 	enrollees in each calendar year from January 
113.35 	2009 through December 2011. If those limits 
113.36 	are reached, additional members may be 
114.1 	enrolled in MnDHO for basic care services 
114.2 	only as defined under Minnesota Statutes, 
114.3 	section 256B.69, subdivision 28, and the 
114.4 	commissioner may establish a waiting list for 
114.5 	future access of MnDHO members to those 
114.6 	waiver services.
114.7 	MA Basic Elderly and Disabled 
114.8 	Adjustments. For the fiscal year ending June 
114.9 	30, 2009, the commissioner may adjust the 
114.10 	rates for each service affected by rate changes 
114.11 	under this section in such a manner across 
114.12 	the fiscal year to achieve the necessary cost 
114.13 	savings and minimize disruption to service 
114.14 	providers, notwithstanding the requirements 
114.15 	of Laws 2007, chapter 147, article 7, section 
114.16 	71.

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

114.18	(e) Other Health Care Grants
		-0-
		(17,000)
	
114.19 	MinnesotaCare Outreach Grants Special 
114.20 	Revenue Account. The balance in the 
114.21 	MinnesotaCare outreach grants special 
114.22 	revenue account on July 1, 2009, estimated 
114.23 	to be $900,000, must be transferred to the 
114.24 	general fund.
114.25 	Grants Reduction. Effective July 1, 2008, 
114.26 	base level funding for nonforecast, general 
114.27 	fund health care grants issued under this 
114.28 	paragraph shall be reduced by 1.8 percent at 
114.29 	the allotment level.

114.30 	Sec. 47. Laws 2010, First Special Session chapter 1, article 16, section 47, is amended 
114.31 	to read:
114.32 	Sec. 47. REPEALER.
 115.1 	(a)Minnesota Statutes 2008, section 256D.03, subdivisions 3, 3a,subdivision 5, 6, 
115.2 	7, and 8,areis repealed contingently upon implementation of Minnesota Statutes, sections 
115.3 	256B.055, subdivision 15, and 256B.056, subdivisions 3 and 4.
115.4 	(b) Laws 2010, chapter 200, article 1, sections 12, subdivisions 1, 2, 3, and 5; 18; 
115.5 	and 19, are repealed contingently upon implementation of Minnesota Statutes, sections 
115.6 	256B.055, subdivision 15, and 256B.056, subdivisions 3 and 4.
115.7 	(c) Laws 2010, chapter 200, article 1, section 12, subdivisions 4, 6, 7, 8, 9, and 10, 
115.8 	are repealed contingently upon implementation of Minnesota Statutes, sections 256B.055, 
115.9 	subdivision 15, and 256B.056, subdivisions 3 and 4.

115.10 	EFFECTIVE DATE. This section is effective the day following final enactment
115.11 	May 17, 2010.

115.12 	Sec. 48. Laws 2010, First Special Session chapter 1, article 25, section 3, subdivision 
115.13 	6, is amended to read:

115.14	Subd. 6.Health Care Grants

115.15	(a) MinnesotaCare Grants
		998,000
		(13,376,000)
	
115.16 	This appropriation is from the health care 
115.17 	access fund.
115.18 	Health Care Access Fund Transfer to 
115.19 	General Fund. The commissioner of 
115.20 	management and budget shall transfer 
115.21 	the following amounts in the following 
115.22 	years from the health care access fund to 
115.23 	the general fund: $998,000 in fiscal year 
115.24 	2010; and $176,704,000 in fiscal year 
115.25 	2011; $141,041,000 in fiscal year 2012; and 
115.26 	$286,150,000 in fiscal year 2013. If at any 
115.27 	time the governor issues an executive order 
115.28 	not to participate in early medical assistance 
115.29 	expansion, no funds shall be transferred from 
115.30 	the health care access fund to the general 
115.31 	fund until early medical assistance expansion 
115.32 	takes effect. This paragraph is effective the 
115.33 	day following final enactment.
116.1 	MinnesotaCare Ratable Reduction.
116.2 	Effective for services rendered on or after 
116.3 	July 1, 2010, to December 31, 2013, 
116.4 	MinnesotaCare payments to managed care 
116.5 	plans under Minnesota Statutes, section 
116.6 	256L.12, for single adults and households 
116.7 	without children whose income is greater 
116.8 	than 75 percent of federal poverty guidelines 
116.9 	shall be reduced by 15 percent. Effective 
116.10 	for services provided from July 1, 2010, to 
116.11 	June 30, 2011, this reduction shall apply to 
116.12 	all services. Effective for services provided 
116.13 	from July 1, 2011, to December 31, 2013, this 
116.14 	reduction shall apply to all services except 
116.15 	inpatient hospital services. Notwithstanding 
116.16 	any contrary provision of this article, this 
116.17 	paragraph shall expire on December 31, 
116.18 	2013.

116.19
116.20	(b) Medical Assistance Basic Health Care 
Grants - Families and Children
		-0-
		295,512,000
	
116.21 	Critical Access Dental. Of the general 
116.22 	fund appropriation, $731,000 in fiscal year 
116.23 	2011 is to the commissioner for critical 
116.24 	access dental provider reimbursement 
116.25 	payments under Minnesota Statutes, section 
116.26 	256B.76 subdivision 4. This is a onetime 
116.27 	appropriation.
116.28 	Nonadministrative Rate Reduction. For 
116.29 	services rendered on or after July 1, 2010, 
116.30 	to December 31, 2013, the commissioner 
116.31 	shall reduce contract rates paid to managed 
116.32 	care plans under Minnesota Statutes, 
116.33 	sections 256B.69 and 256L.12, and to 
116.34 	county-based purchasing plans under 
116.35 	Minnesota Statutes, section 256B.692, by 
116.36 	three percent of the contract rate attributable 
117.1 	to nonadministrative services in effect on 
117.2 	June 30, 2010. Notwithstanding any contrary 
117.3 	provision in this article, this rider expires on 
117.4 	December 31, 2013.

117.5
117.6	(c) Medical Assistance Basic Health Care 
Grants - Elderly and Disabled
		-0-
		(30,265,000)

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

117.8	(e)  Other Health Care Grants
		-0-
		(7,000,000)
	
117.9 	Cobra Carryforward. Unexpended funds 
117.10 	appropriated in fiscal year 2010 for COBRA 
117.11 	grants under Laws 2009, chapter 79, article 
117.12 	5, section 78, do not cancel and are available 
117.13 	to the commissioner for fiscal year 2011 
117.14 	COBRA grant expenditures. Up to $111,000 
117.15 	of the fiscal year 2011 appropriation for 
117.16 	COBRA grants provided in Laws 2009, 
117.17 	chapter 79, article 13, section 3, subdivision 
117.18 	6, may be used by the commissioner for costs 
117.19 	related to administration of the COBRA 
117.20 	grants.

117.21 	Sec. 49. COMPETITIVE BIDDING PILOT.
 117.22 	For managed care contracts effective January 1, 2012, the commissioner of 
117.23 	human services is required to establish a competitive price bidding pilot for nonelderly, 
117.24 	nondisabled adults and children in medical assistance and MinnesotaCare in the 
117.25 	seven-county metropolitan area. The pilot must allow a minimum of two managed care 
117.26 	organizations to serve the metropolitan area. The pilot shall expire after two full calendar 
117.27 	years on December 31, 2013. The commissioner of human service shall conduct an 
117.28 	evaluation of the pilot to determine the cost-effectiveness and impacts to provider access 
117.29 	at the end of the two-year period.

117.30 	Sec. 50. DIRECTION TO COMMISSIONER; FEDERAL WAIVER.
 117.31 	The commissioner of human services shall apply to the Centers for Medicare and 
117.32 	Medicaid Services for federal waivers to cover:
118.1 	(1) children eligible under Minnesota Statutes, section 256B.055, subdivisions 9 
118.2 	and 10b;
118.3 	(2) families with children eligible under Minnesota Statutes, sections 256B.055, 
118.4 	subdivisions 3 and 3a, and 256L.04, subdivision 1; and 
118.5 	(3) adults eligible under Minnesota Statutes, section 256L.04, subdivision 1, under 
118.6 	the MinnesotaCare healthy Minnesota contribution program established under Minnesota 
118.7 	Statutes, section 256B.695. The commissioner shall report to the legislative committees 
118.8 	with jurisdiction over health and human services policy and finance whether or not the 
118.9 	federal waiver application was accepted within ten working days of receipt of the decision.

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

118.11 	Sec. 51. MEDICAID FRAUD PREVENTION AND DETECTION.
 118.12 		Subdivision 1.Request for proposals. By July 1, 2011, the commissioner of human 
118.13 	services shall issue a request for proposals to prevent and detect Medicaid fraud and 
118.14 	mispayment. The request for proposals shall require the vendor to provide data analytics 
118.15 	capabilities, including, but not limited to, predictive modeling techniques and other forms 
118.16 	of advanced analytics that will integrate into the current claim processing system to detect 
118.17 	improper payments both before and after payments are made.
118.18 		Subd. 2.Proof of concept phase. The selected vendor, at no cost to the state, 
118.19 	shall be required to implement its recommendations on a subset of data provided by the 
118.20 	commissioner to demonstrate the cost-savings potential of the solution.
118.21 		Subd. 3.Data. Data provided by the commissioner to the vendor under this section 
118.22 	must not include not public data, as defined in section 13.02, subdivision 8a.
118.23 		Subd. 4.Full implementation phase. The request for proposals must require the 
118.24 	commissioner to implement the recommendations provided by the vendor if the work done 
118.25 	under the requirements of subdivision 2 provides material savings to the state. After the 
118.26 	full implementation of the system provided by the vendor, the vendor shall be paid by 
118.27 	the state from the savings attributable to the work done by the vendor, according to the 
118.28 	terms and performance measures negotiated in the contract.
118.29 		Subd. 5.Selection of vendor. The commissioner of human services shall select a 
118.30 	vendor from the responses to the request for proposals by September 1, 2011.
118.31 		Subd. 6.Progress report. The commissioner shall provide a report describing the 
118.32 	progress made under this section to the governor and the chairs and ranking minority 
118.33 	members of the legislative committees with jurisdiction over the Department of Human 
118.34 	Services by January 15, 2012. The report shall provide a dynamic scoring analysis of 
118.35 	the work described in the report.

119.1 	Sec. 52. PROHIBITION OF STATE FUNDS TO IMPLEMENT CERTAIN 
119.2 	FEDERAL HEALTH CARE REFORMS.
 119.3 	State funds must not be expended in the planning or implementation of the Patient 
119.4 	Protection and Affordable Care Act, Public Law 111-148, as amended by the Health Care 
119.5 	and Education Affordability and Reconciliation Act of 2010, Public Law 111-152, and no 
119.6 	provisions of the act may be implemented, until the constitutionality of the act has been 
119.7 	affirmed by the United States Supreme Court.

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

119.9 	Sec. 53.  REPEALER.
 119.10 	(a) Minnesota Statutes 2010, sections 256B.0625, subdivision 8e; 256B.0653, 
119.11 	subdivision 5; 256B.0756; and 256D.031, subdivisions 5 and 8, are repealed.
119.12 	(b) Minnesota Statutes 2010, section 256B.055, subdivision 15, is repealed effective 
119.13 	October 1, 2011.
119.14 	(c) Laws 2010, First Special Session chapter 1, article 16, sections 6; and 7, are 
119.15 	repealed effective October 1, 2011.

119.16 	ARTICLE 6
119.17 	DEPARTMENT OF HEALTH

119.18 	Section 1. Minnesota Statutes 2010, section 62J.04, subdivision 3, is amended to read:
119.19 		Subd. 3.Cost containment duties. The commissioner shall:
119.20 	(1) establish statewide and regional cost containment goals for total health care 
119.21 	spending under this section and collect data as described in sections 62J.38to 62J.41 and 
119.22 	62J.40 to monitor statewide achievement of the cost containment goals; 
119.23 	(2) divide the state into no fewer than four regions, with one of those regions being 
119.24 	the Minneapolis/St. Paul metropolitan statistical area but excluding Chisago, Isanti, 
119.25 	Wright, and Sherburne Counties, for purposes of fostering the development of regional 
119.26 	health planning and coordination of health care delivery among regional health care 
119.27 	systems and working to achieve the cost containment goals;
119.28 	(3) monitor the quality of health care throughout the state and take action as 
119.29 	necessary to ensure an appropriate level of quality;
119.30 	(4) issue recommendations regarding uniform billing forms, uniform electronic 
119.31 	billing procedures and data interchanges, patient identification cards, and other uniform 
119.32 	claims and administrative procedures for health care providers and private and public 
119.33 	sector payers. In developing the recommendations, the commissioner shall review the 
120.1 	work of the work group on electronic data interchange (WEDI) and the American National 
120.2 	Standards Institute (ANSI) at the national level, and the work being done at the state and 
120.3 	local level. The commissioner may adopt rules requiring the use of the Uniform Bill 
120.4 	82/92 form, the National Council of Prescription Drug Providers (NCPDP) 3.2 electronic 
120.5 	version, the Centers for Medicare and Medicaid Services 1500 form, or other standardized 
120.6 	forms or procedures;
120.7 	(5) undertake health planning responsibilities;
120.8 	(6) authorize, fund, or promote research and experimentation on new technologies 
120.9 	and health care procedures;
120.10 	(7) within the limits of appropriations for these purposes, administer or contract for 
120.11 	statewide consumer education and wellness programs that will improve the health of 
120.12 	Minnesotans and increase individual responsibility relating to personal health and the 
120.13 	delivery of health care services, undertake prevention programs including initiatives to 
120.14 	improve birth outcomes, expand childhood immunization efforts, and provide start-up 
120.15 	grants for worksite wellness programs;
120.16 	(8) undertake other activities to monitor and oversee the delivery of health care 
120.17 	services in Minnesota with the goal of improving affordability, quality, and accessibility of 
120.18 	health care for all Minnesotans; and
120.19 	(9) make the cost containment goal data available to the public in a 
120.20 	consumer-oriented manner.

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

120.22 	Sec. 2. Minnesota Statutes 2010, section 62J.17, subdivision 4a, is amended to read:
120.23 		Subd. 4a.Expenditure reporting. Each hospital, outpatient surgical center, 
120.24 	and diagnostic imaging center, and physician clinic shall report annually to the 
120.25 	commissioner on all major spending commitments, in the form and manner specified by 
120.26 	the commissioner. The report shall include the following information:
120.27 	(a) a description of major spending commitments made during the previous year, 
120.28 	including the total dollar amount of major spending commitments and purpose of the 
120.29 	expenditures;
120.30 	(b) the cost of land acquisition, construction of new facilities, and renovation of 
120.31 	existing facilities;
120.32 	(c) the cost of purchased or leased medical equipment, by type of equipment;
120.33 	(d) expenditures by type for specialty care and new specialized services;
120.34 	(e) information on the amount and types of added capacity for diagnostic imaging 
120.35 	services, outpatient surgical services, and new specialized services; and
121.1 	(f) information on investments in electronic medical records systems.
121.2 	For hospitals and outpatient surgical centers, this information shall be included in reports 
121.3 	to the commissioner that are required under section 144.698. For diagnostic imaging 
121.4 	centers, this information shall be included in reports to the commissioner that are required 
121.5 	under section 144.565. For physician clinics, this information shall be included in reports 
121.6 	to the commissioner that are required under section 62J.41. For all other health care 
121.7 	providers that are subject to this reporting requirement, reports must be submitted to the 
121.8 	commissioner by March 1 each year for the preceding calendar year.

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

121.10 	Sec. 3. Minnesota Statutes 2010, section 62J.692, subdivision 4, is amended to read:
121.11 		Subd. 4.Distribution of funds. (a) Following the distribution described under 
121.12 	paragraph (b), the commissioner shall annually distribute the available medical education 
121.13 	funds to all qualifying applicants based on a distribution formula that reflects a summation 
121.14 	of two factors:
121.15 	(1) a public program volume factor, which is determined by the total volume of 
121.16 	public program revenue received by each training site as a percentage of all public 
121.17 	program revenue received by all training sites in the fund pool; and
121.18 	(2) a supplemental public program volume factor, which is determined by providing 
121.19 	a supplemental payment of 20 percent of each training site's grant to training sites whose 
121.20 	public program revenue accounted for at least 0.98 percent of the total public program 
121.21 	revenue received by all eligible training sites. Grants to training sites whose public 
121.22 	program revenue accounted for less than 0.98 percent of the total public program revenue 
121.23 	received by all eligible training sites shall be reduced by an amount equal to the total 
121.24 	value of the supplemental payment.
121.25 	Public program revenue for the distribution formula includes revenue from medical 
121.26 	assistance, prepaid medical assistance, general assistance medical care, and prepaid 
121.27 	general assistance medical care. Training sites that receive no public program revenue 
121.28 	are ineligible for funds available under this subdivision. For purposes of determining 
121.29 	training-site level grants to be distributed under paragraph (a), total statewide average 
121.30 	costs per trainee for medical residents is based on audited clinical training costs per trainee 
121.31 	in primary care clinical medical education programs for medical residents. Total statewide 
121.32 	average costs per trainee for dental residents is based on audited clinical training costs 
121.33 	per trainee in clinical medical education programs for dental students. Total statewide 
122.1 	average costs per trainee for pharmacy residents is based on audited clinical training costs 
122.2 	per trainee in clinical medical education programs for pharmacy students.
122.3 	(b) $5,350,000 of the available medical education funds shall be distributed as 
122.4 	follows:
122.5 	(1) $1,475,000 to the University of Minnesota Medical Center-Fairview;
122.6 	(2) $2,075,000 to the University of Minnesota School of Dentistry; and
122.7 	(3) $1,800,000 to the Academic Health Center. $150,000 of the funds distributed to 
122.8 	the Academic Health Center under this paragraph shall be used for a program to assist 
122.9 	internationally trained physicians who are legal residents and who commit to serving 
122.10 	underserved Minnesota communities in a health professional shortage area to successfully 
122.11 	compete for family medicine residency programs at the University of Minnesota.
122.12 	(c)(b) Funds distributed shall not be used to displace current funding appropriations 
122.13 	from federal or state sources.
122.14 	(d)(c) Funds shall be distributed to the sponsoring institutions indicating the amount 
122.15 	to be distributed to each of the sponsor's clinical medical education programs based on 
122.16 	the criteria in this subdivision and in accordance with the commissioner's approval letter. 
122.17 	Each clinical medical education program must distribute funds allocated under paragraph 
122.18 	(a) to the training sites as specified in the commissioner's approval letter. Sponsoring 
122.19 	institutions, which are accredited through an organization recognized by the Department 
122.20 	of Education or the Centers for Medicare and Medicaid Services, may contract directly 
122.21 	with training sites to provide clinical training. To ensure the quality of clinical training, 
122.22 	those accredited sponsoring institutions must:
122.23 	(1) develop contracts specifying the terms, expectations, and outcomes of the clinical 
122.24 	training conducted at sites; and
122.25 	(2) take necessary action if the contract requirements are not met. Action may 
122.26 	include the withholding of payments under this section or the removal of students from 
122.27 	the site.
122.28 	(e)(d) Any funds not distributed in accordance with the commissioner's approval 
122.29 	letter must be returned to the medical education and research fund within 30 days of 
122.30 	receiving notice from the commissioner. The commissioner shall distribute returned funds 
122.31 	to the appropriate training sites in accordance with the commissioner's approval letter.
122.32 	(f)(e) A maximum of $150,000 of the funds dedicated to the commissioner 
122.33 	under section 297F.10, subdivision 1, clause (2), may be used by the commissioner for 
122.34 	administrative expenses associated with implementing this section.

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

123.1 	Sec. 4. Minnesota Statutes 2010, section 103I.005, is amended by adding a subdivision 
123.2 	to read:
123.3 		Subd. 1a.Bored geothermal heat exchanger. "Bored geothermal heat exchanger" 
123.4 	means an earth-coupled heating or cooling device consisting of a sealed closed-loop 
123.5 	piping system installed in a boring in the ground to transfer heat to or from the surrounding 
123.6 	earth with no discharge.

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

123.8 	Sec. 5. Minnesota Statutes 2010, section 103I.005, subdivision 2, is amended to read:
123.9 		Subd. 2.Boring. "Boring" means a hole or excavation that is not used to extract 
123.10 	water and includes exploratory borings, environmental bore holes, verticalbored 
123.11 	geothermal heat exchangers, and elevator shafts borings.

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

123.13 	Sec. 6. Minnesota Statutes 2010, section 103I.005, subdivision 8, is amended to read:
123.14 		Subd. 8.Environmental bore hole. "Environmental bore hole" means a hole or 
123.15 	excavation in the ground that penetrates a confining layer or is greater than 25 feet in 
123.16 	depth and enters or goes through a water bearing layer and is used to monitor or measure 
123.17 	physical, chemical, radiological, or biological parameters without extracting water. An 
123.18 	environmental bore hole also includes bore holes constructed for vapor recovery or 
123.19 	venting systems. An environmental bore hole does not include a well, elevator shaft
123.20 	boring, exploratory boring, or monitoring well.

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

123.22 	Sec. 7. Minnesota Statutes 2010, section 103I.005, subdivision 12, is amended to read:
123.23 		Subd. 12.Limited well/boring contractor. "Limited well/boring contractor" means 
123.24 	a person with a limited well/boring contractor's license issued by the commissioner. 
123.25 	Limited well/boring contractor's licenses are issued for constructing, repairing, and sealing 
123.26 	vertical bored geothermal heat exchangers; installing, repairing, and modifying pitless 
123.27 	units and pitless adaptors, well casings above the pitless unit or pitless adaptor, well 
123.28 	screens, or well diameters; constructing, repairing, and sealing drive point wells or dug 
123.29 	wells; constructing, repairing, and sealing dewatering wells; sealing wells; and installing 
123.30 	well pumps or pumping equipment.

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

124.1 	Sec. 8. Minnesota Statutes 2010, section 103I.101, subdivision 2, is amended to read:
124.2 		Subd. 2.Duties. The commissioner shall:
124.3 	(1) regulate the drilling, construction, modification, repair, and sealing of wells 
124.4 	and borings;
124.5 	(2) examine and license well contractors; persons constructing, repairing, and 
124.6 	sealing vertical bored geothermal heat exchangers; persons modifying or repairing well 
124.7 	casings, well screens, or well diameters; persons constructing, repairing, and sealing drive 
124.8 	point wells or dug wells; persons constructing, repairing, and sealing dewatering wells; 
124.9 	persons sealing wells; persons installing well pumps or pumping equipment; and persons 
124.10 	excavating or drilling holes for the installation ofconstructing, repairing, and sealing 
124.11 	elevator borings or hydraulic cylinders;
124.12 	(3) register and examine monitoring well contractors;
124.13 	(4) license explorers engaged in exploratory boring and examine individuals who 
124.14 	supervise or oversee exploratory boring;
124.15 	(5) after consultation with the commissioner of natural resources and the Pollution 
124.16 	Control Agency, establish standards for the design, location, construction, repair, and 
124.17 	sealing of wells and borings within the state; and
124.18 	(6) issue permits for wells, groundwater thermal devices, vertical bored geothermal
124.19 	heat exchangers, and elevator borings.

124.20 	Sec. 9. Minnesota Statutes 2010, section 103I.101, subdivision 5, is amended to read:
124.21 		Subd. 5.Commissioner to adopt rules. The commissioner shall adopt rules 
124.22 	including:
124.23 	(1) issuance of licenses for:
124.24 	(i) qualified well contractors, persons modifying or repairing well casings, well 
124.25 	screens, or well diameters;
124.26 	(ii) persons constructing, repairing, and sealing drive point wells or dug wells;
124.27 	(iii) persons constructing, repairing, and sealing dewatering wells;
124.28 	(iv) persons sealing wells;
124.29 	(v) persons installing well pumps or pumping equipment;
124.30 	(vi) persons constructing, repairing, and sealing vertical bored geothermal heat 
124.31 	exchangers; and
124.32 	(vii) persons constructing, repairing, and sealing elevator borings;
124.33 	(2) issuance of registration for monitoring well contractors;
124.34 	(3) establishment of conditions for examination and review of applications for 
124.35 	license and registration;
125.1 	(4) establishment of conditions for revocation and suspension of license and 
125.2 	registration;
125.3 	(5) establishment of minimum standards for design, location, construction, repair, 
125.4 	and sealing of wells and borings to implement the purpose and intent of this chapter;
125.5 	(6) establishment of a system for reporting on wells and borings drilled and sealed;
125.6 	(7) establishment of standards for the construction, maintenance, sealing, and water 
125.7 	quality monitoring of wells in areas of known or suspected contamination;
125.8 	(8) establishment of wellhead protection measures for wells serving public water 
125.9 	supplies;
125.10 	(9) establishment of procedures to coordinate collection of well and boring data with 
125.11 	other state and local governmental agencies;
125.12 	(10) establishment of criteria and procedures for submission of well and boring logs, 
125.13 	formation samples or well or boring cuttings, water samples, or other special information 
125.14 	required for and water resource mapping; and
125.15 	(11) establishment of minimum standards for design, location, construction, 
125.16 	maintenance, repair, sealing, safety, and resource conservation related to borings, 
125.17 	including exploratory borings as defined in section 103I.005, subdivision 9.

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

125.19 	Sec. 10. Minnesota Statutes 2010, section 103I.105, is amended to read:
125.20 	103I.105 ADVISORY COUNCIL ON WELLS AND BORINGS.
125.21 	(a) The Advisory Council on Wells and Borings is established as an advisory council 
125.22 	to the commissioner. The advisory council shall consist of 18 voting members. Of the 
125.23 	18 voting members:
125.24 	(1) one member must be from the Department of Health, appointed by the 
125.25 	commissioner of health;
125.26 	(2) one member must be from the Department of Natural Resources, appointed 
125.27 	by the commissioner of natural resources;
125.28 	(3) one member must be a member of the Minnesota Geological Survey of the 
125.29 	University of Minnesota, appointed by the director;
125.30 	(4) one member must be a responsible individual for a licensed explorer;
125.31 	(5) one member must be a certified representative of a licensed elevator boring 
125.32 	contractor;
125.33 	(6) two members must be members of the public who are not connected with the 
125.34 	boring or well drilling industry;
126.1 	(7) one member must be from the Pollution Control Agency, appointed by the 
126.2 	commissioner of the Pollution Control Agency;
126.3 	(8) one member must be from the Department of Transportation, appointed by the 
126.4 	commissioner of transportation;
126.5 	(9) one member must be from the Board of Water and Soil Resources appointed by 
126.6 	its chair;
126.7 	(10) one member must be a certified representative of a monitoring well contractor;
126.8 	(11) six members must be residents of this state appointed by the commissioner, who 
126.9 	are certified representatives of licensed well contractors, with not more than two from 
126.10 	the seven-county metropolitan area and at least four from other areas of the state who 
126.11 	represent different geographical regions; and
126.12 	(12) one member must be a certified representative of a licensed vertical bored 
126.13 	geothermal heat exchanger contractor.
126.14 	(b) An appointee of the well drilling industry may not serve more than two 
126.15 	consecutive terms.
126.16 	(c) The appointees to the advisory council from the well drilling industry must:
126.17 	(1) have been residents of this state for at least three years before appointment; and
126.18 	(2) have at least five years' experience in the well drilling business.
126.19 	(d) The terms of the appointed members and the compensation and removal of all 
126.20 	members are governed by section 15.059, except section 15.059, subdivision 5, relating to 
126.21 	expiration of the advisory council does not apply.

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

126.23 	Sec. 11. Minnesota Statutes 2010, section 103I.111, subdivision 8, is amended to read:
126.24 		Subd. 8.Municipal regulation of drilling. A municipality may regulate all drilling, 
126.25 	except well, elevator shaft boring, and exploratory drilling that is subject to the provisions 
126.26 	of this chapter, above, in, through, and adjacent to subsurface areas designated for mined 
126.27 	underground space development and existing mined underground space. The regulations 
126.28 	may prohibit, restrict, control, and require permits for the drilling.

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

126.30 	Sec. 12. Minnesota Statutes 2010, section 103I.205, subdivision 4, is amended to read:
126.31 		Subd. 4.License required. (a) Except as provided in paragraph (b), (c), (d), or (e), 
126.32 	section 103I.401, subdivision 2, or section 103I.601, subdivision 2, a person may not 
127.1 	drill, construct, repair, or seal a well or boring unless the person has a well contractor's 
127.2 	license in possession.
127.3 	(b) A person may construct, repair, and seal a monitoring well if the person:
127.4 	(1) is a professional engineer licensed under sections 326.02 to 326.15 in the 
127.5 	branches of civil or geological engineering;
127.6 	(2) is a hydrologist or hydrogeologist certified by the American Institute of 
127.7 	Hydrology;
127.8 	(3) is a professional geoscientist licensed under sections 326.02 to 326.15;
127.9 	(4) is a geologist certified by the American Institute of Professional Geologists; or
127.10 	(5) meets the qualifications established by the commissioner in rule.
127.11 	A person must register with the commissioner as a monitoring well contractor on 
127.12 	forms provided by the commissioner.
127.13 	(c) A person may do the following work with a limited well/boring contractor's 
127.14 	license in possession. A separate license is required for each of the six activities:
127.15 	(1) installing or repairing well screens or pitless units or pitless adaptors and well 
127.16 	casings from the pitless adaptor or pitless unit to the upper termination of the well casing;
127.17 	(2) constructing, repairing, and sealing drive point wells or dug wells;
127.18 	(3) installing well pumps or pumping equipment;
127.19 	(4) sealing wells;
127.20 	(5) constructing, repairing, or sealing dewatering wells; or
127.21 	(6) constructing, repairing, or sealing vertical bored geothermal heat exchangers.
127.22 	(d) A person may construct, repair, and seal an elevator boring with an elevator 
127.23 	boring contractor's license.
127.24 	(e) Notwithstanding other provisions of this chapter requiring a license or 
127.25 	registration, a license or registration is not required for a person who complies with the 
127.26 	other provisions of this chapter if the person is:
127.27 	(1) an individual who constructs a well on land that is owned or leased by the 
127.28 	individual and is used by the individual for farming or agricultural purposes or as the 
127.29 	individual's place of abode; or
127.30 	(2) an individual who performs labor or services for a contractor licensed or 
127.31 	registered under the provisions of this chapter in connection with the construction, sealing, 
127.32 	or repair of a well or boring at the direction and under the personal supervision of a 
127.33 	contractor licensed or registered under the provisions of this chapter.

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

127.35 	Sec. 13. Minnesota Statutes 2010, section 103I.208, subdivision 2, is amended to read:
128.1 		Subd. 2.Permit fee. The permit fee to be paid by a property owner is:
128.2 	(1) for a water supply well that is not in use under a maintenance permit, $175 
128.3 	annually;
128.4 	(2) for construction of a monitoring well, $215, which includes the state core 
128.5 	function fee;
128.6 	(3) for a monitoring well that is unsealed under a maintenance permit, $175 annually;
128.7 	(4) for a monitoring well owned by a federal agency, state agency, or local unit of 
128.8 	government that is unsealed under a maintenance permit, $50 annually. "Local unit of 
128.9 	government" means a statutory or home rule charter city, town, county, or soil and water 
128.10 	conservation district, watershed district, an organization formed for the joint exercise of 
128.11 	powers under section 471.59, a board of health or community health board, or other 
128.12 	special purpose district or authority with local jurisdiction in water and related land 
128.13 	resources management;
128.14 	(5) for monitoring wells used as a leak detection device at a single motor fuel retail 
128.15 	outlet, a single petroleum bulk storage site excluding tank farms, or a single agricultural 
128.16 	chemical facility site, the construction permit fee is $215, which includes the state core 
128.17 	function fee, per site regardless of the number of wells constructed on the site, and 
128.18 	the annual fee for a maintenance permit for unsealed monitoring wells is $175 per site 
128.19 	regardless of the number of monitoring wells located on site;
128.20 	(6) for a groundwater thermal exchange device, in addition to the notification fee for 
128.21 	water supply wells, $215, which includes the state core function fee;
128.22 	(7) for a vertical bored geothermal heat exchanger with less than ten tons of 
128.23 	heating/cooling capacity, $215;
128.24 	(8) for a vertical bored geothermal heat exchanger with ten to 50 tons of 
128.25 	heating/cooling capacity, $425;
128.26 	(9) for a vertical bored geothermal heat exchanger with greater than 50 tons of 
128.27 	heating/cooling capacity, $650;
128.28 	(10) for a dewatering well that is unsealed under a maintenance permit, $175 
128.29 	annually for each dewatering well, except a dewatering project comprising more than five 
128.30 	dewatering wells shall be issued a single permit for $875 annually for dewatering wells 
128.31 	recorded on the permit; and
128.32 	(11) for an elevator boring, $215 for each boring.

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

129.1 	Sec. 14. Minnesota Statutes 2010, section 103I.501, is amended to read:
129.2 	103I.501 LICENSING AND REGULATION OF WELLS AND BORINGS.
129.3 	(a) The commissioner shall regulate and license:
129.4 	(1) drilling, constructing, and repair of wells;
129.5 	(2) sealing of wells;
129.6 	(3) installing of well pumps and pumping equipment;
129.7 	(4) excavating, drilling, repairing, and sealing of elevator borings;
129.8 	(5) construction, repair, and sealing of environmental bore holes; and
129.9 	(6) construction, repair, and sealing of vertical bored geothermal heat exchangers.
129.10 	(b) The commissioner shall examine and license well contractors, limited 
129.11 	well/boring contractors, and elevator boring contractors, and examine and register 
129.12 	monitoring well contractors.
129.13 	(c) The commissioner shall license explorers engaged in exploratory boring and 
129.14 	shall examine persons who supervise or oversee exploratory boring.

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

129.16 	Sec. 15. Minnesota Statutes 2010, section 103I.531, subdivision 5, is amended to read:
129.17 		Subd. 5.Bond. (a) As a condition of being issued a limited well/boring contractor's 
129.18 	license for constructing, repairing, and sealing drive point wells or dug wells, sealing 
129.19 	wells or borings, constructing, repairing, and sealing dewatering wells, or constructing, 
129.20 	repairing, and sealing vertical bored geothermal heat exchangers, the applicant must 
129.21 	submit a corporate surety bond for $10,000 approved by the commissioner. As a condition 
129.22 	of being issued a limited well/boring contractor's license for installing or repairing well 
129.23 	screens or pitless units or pitless adaptors and well casings from the pitless adaptor 
129.24 	or pitless unit to the upper termination of the well casing, or installing well pumps or 
129.25 	pumping equipment, the applicant must submit a corporate surety bond for $2,000 
129.26 	approved by the commissioner. The bonds required in this paragraph must be conditioned 
129.27 	to pay the state on performance of work in this state that is not in compliance with this 
129.28 	chapter or rules adopted under this chapter. The bonds are in lieu of other license bonds 
129.29 	required by a political subdivision of the state.
129.30 	(b) From proceeds of a bond required in paragraph (a), the commissioner may 
129.31 	compensate persons injured or suffering financial loss because of a failure of the applicant 
129.32 	to perform work or duties in compliance with this chapter or rules adopted under this 
129.33 	chapter.

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

130.1 	Sec. 16. Minnesota Statutes 2010, section 103I.535, subdivision 6, is amended to read:
130.2 		Subd. 6.License fee. The fee for an elevator shaft boring contractor's license is $75.

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

130.4 	Sec. 17. Minnesota Statutes 2010, section 103I.641, is amended to read:
130.5 	103I.641 VERTICAL BORED GEOTHERMAL HEAT EXCHANGERS.
130.6 		Subdivision 1.Requirements. A person may not drill or construct an excavation 
130.7 	used to install a vertical bored geothermal heat exchanger unless the person is a limited 
130.8 	well/boring contractor licensed for constructing, repairing, and sealing vertical bored 
130.9 	geothermal heat exchangers or a well contractor.
130.10 		Subd. 2.Regulations for vertical bored geothermal heat exchangers. Vertical
130.11 	Bored geothermal heat exchangers must be constructed, maintained, and sealed under the 
130.12 	provisions of this chapter.
130.13 		Subd. 3.Permit required. (a) A vertical bored geothermal heat exchanger 
130.14 	may not be installed without first obtaining a permit for the vertical bored geothermal
130.15 	heat exchanger from the commissioner. A limited well/boring contractor licensed for 
130.16 	constructing, repairing, and sealing vertical bored geothermal heat exchangers or a well 
130.17 	contractor must apply for the permit on forms provided by the commissioner and must 
130.18 	pay the permit fee.
130.19 	(b) As a condition of the permit, the owner of the property where the vertical
130.20 	bored geothermal heat exchanger is to be installed must agree to allow inspection by the 
130.21 	commissioner during regular working hours of Department of Health inspectors.

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

130.23 	Sec. 18. Minnesota Statutes 2010, section 103I.711, subdivision 1, is amended to read:
130.24 		Subdivision 1.Impoundment. The commissioner may apply to district court for a 
130.25 	warrant authorizing seizure and impoundment of all drilling machines or hoists owned or 
130.26 	used by a person. The court shall issue an impoundment order upon the commissioner's 
130.27 	showing that a person is constructing, repairing, or sealing wells or borings or installing 
130.28 	pumps or pumping equipment or excavating holes for installing elevator shafts without a 
130.29 	license or registration as required under this chapter. A sheriff on receipt of the warrant 
130.30 	must seize and impound all drilling machines and hoists owned or used by the person. A 
130.31 	person from whom equipment is seized under this subdivision may file an action in district 
130.32 	court for the purpose of establishing that the equipment was wrongfully seized.

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

131.2 	Sec. 19. Minnesota Statutes 2010, section 103I.715, subdivision 2, is amended to read:
131.3 		Subd. 2.Gross misdemeanors. A person is guilty of a gross misdemeanor who:
131.4 	(1) willfully violates a provision of this chapter or order of the commissioner;
131.5 	(2) engages in the business of drilling or making wells or borings, sealing wells
131.6 	or borings, or installing pumps or pumping equipment, or constructing elevator shafts
131.7 	without a license required by this chapter; or
131.8 	(3) engages in the business of exploratory boring without an exploratory borer's 
131.9 	license under this chapter.

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

131.11 	Sec. 20. Minnesota Statutes 2010, section 144.125, subdivision 1, is amended to read:
131.12 		Subdivision 1.Duty to perform testing. It is the duty of (1) the administrative 
131.13 	officer or other person in charge of each institution caring for infants 28 days or less 
131.14 	of age, (2) the person required in pursuance of the provisions of section 144.215, to 
131.15 	register the birth of a child, or (3) the nurse midwife or midwife in attendance at the 
131.16 	birth, to arrange to have administered to every infant or child in its care tests for heritable 
131.17 	and congenital disorders according to subdivision 2 and rules prescribed by the state 
131.18 	commissioner of health. Testing and the recording and reporting of test results shall be 
131.19 	performed at the times and in the manner prescribed by the commissioner of health. The 
131.20 	commissioner shall charge a fee so that the total of fees collected will approximate the 
131.21 	costs of conducting the tests and implementing and maintaining a system to follow-up 
131.22 	infants with heritable or congenital disorders, including hearing loss detected through the 
131.23 	early hearing detection and intervention program under section 144.966. The fee is $101 
131.24 	per specimen. Effective July 1, 2010, the fee shall be increased to $106 per specimen. The 
131.25 	increased fee amount shall be deposited in the general fund. Costs associated with capital 
131.26 	expenditures and the development of new procedures may be prorated over a three-year 
131.27 	period when calculating the amount of the fees.

131.28 	Sec. 21. Minnesota Statutes 2010, section 144.125, subdivision 3, is amended to read:
131.29 		Subd. 3.Objection of parents to test. Persons with a duty to perform testing under 
131.30 	subdivision 1 shall advise parents of infants (1) that the blood or tissue samples will be 
131.31 	used to perform testing thereunder as well as the results of such testing may be retained by 
131.32 	the Department of Health, (2) the benefit of retaining the blood or tissue sample, and (3)
131.33 	(2) that a form is available in which the following options are available to themmay be 
132.1 	chosen with respect to the testing: (i) to decline to have the tests, or (ii) to elect to have 
132.2 	the tests butand to require thatallow all blood samples and records of test results to be 
132.3 	destroyed within retained by the Department of Health for 24 months ofafter the testing. 
132.4 	If the parents of an infant object in writing to testing for heritable and congenital disorders 
132.5 	or elect to require thatallow blood samples and test results to be destroyed retained, 
132.6 	the objection or election shall be recorded on a form that is signed by a parent or legal 
132.7 	guardian and made part of the infant's medical record. A written objection exempts an 
132.8 	infant from the requirements of this section and section 144.128.

132.9 	Sec. 22. Minnesota Statutes 2010, section 144.128, is amended to read:
132.10 	144.128 COMMISSIONER'S DUTIES; STORED BLOOD AND TISSUE 
132.11 	SAMPLES.
132.12 	The commissioner shall:
132.13 	(1) notify the physicians of newborns tested of the results of the tests performed;
132.14 	(2) make referrals for the necessary treatment of diagnosed cases of heritable and 
132.15 	congenital disorders when treatment is indicated;
132.16 	(3) maintain a registry of the cases of heritable and congenital disorders detected by 
132.17 	the screening program for the purpose of follow-up services;
132.18 	(4) prepare a separate form for use by parents or by adults who were tested as minors 
132.19 	to direct that blood samples and test results be destroyed;
132.20 	(5) comply with a destruction request within 45 days after receiving it;
132.21 	(6) notify individuals who request destruction of samples and test results that the 
132.22 	samples and test results have been destroyed; and
132.23 	(7) adopt rules to carry out sections 144.125 to 144.128.
132.24 	(3) destroy blood or tissue samples obtained from test results immediately after 
132.25 	completion of the test results, unless the parent of the newborn tested elects under section 
132.26 	144.125, subdivision 3, to retain the results, in which case the test results may be retained 
132.27 	for up to 24 months; and
132.28 	(4) destroy all blood or tissue samples and material and records related to stored 
132.29 	samples that were collected and stored by the commissioner before August 1, 2011.

132.30 	Sec. 23. Minnesota Statutes 2010, section 144.396, subdivision 5, is amended to read:
132.31 		Subd. 5.Statewide tobacco prevention grants. (a) To the extent funds are 
132.32 	appropriated for the purposes of this subdivision, the commissioner of health shall
132.33 	may, within available appropriations, award competitive grants to eligible applicants 
133.1 	for projects and initiatives directed at the prevention of tobacco use. The project areas 
133.2 	for grants include:
133.3 	(1) statewide public education and information campaigns which include 
133.4 	implementation at the local level; and
133.5 	(2) coordinated special projects, including training and technical assistance, a 
133.6 	resource clearinghouse, and contracts with ethnic and minority communities.
133.7 	(b) Eligible applicants may include, but are not limited to, nonprofit organizations, 
133.8 	colleges and universities, professional health associations, community health boards, and 
133.9 	other health care organizations. Applicants must submit proposals to the commissioner. 
133.10 	The proposals must specify the strategies to be implemented to target tobacco use among 
133.11 	youth, and must take into account the need for a coordinated statewide tobacco prevention 
133.12 	effort.
133.13 	(c) The commissioner must give priority to applicants who demonstrate that the 
133.14 	proposed project:
133.15 	(1) is research based or based on proven effective strategies;
133.16 	(2) is designed to coordinate with other activities and education messages related 
133.17 	to other health initiatives;
133.18 	(3) utilizes and enhances existing prevention activities and resources; or
133.19 	(4) involves innovative approaches preventing tobacco use among youth.

133.20 	Sec. 24. Minnesota Statutes 2010, section 144.396, subdivision 6, is amended to read:
133.21 		Subd. 6.Local tobacco prevention grants. (a) The commissioner shall award 
133.22 	grants, within available appropriations, to eligible applicants for local and regional 
133.23 	projects and initiatives directed at tobacco prevention in coordination with other health 
133.24 	areas aimed at reducing high-risk behaviors in youth that lead to adverse health-related 
133.25 	problems. The project areas for grants include:
133.26 	(1) school-based tobacco prevention programs aimed at youth and parents;
133.27 	(2) local public awareness and education projects aimed at tobacco prevention in 
133.28 	coordination with locally assessed community public health needs pursuant to chapter 
133.29 	145A; or
133.30 	(3) local initiatives aimed at reducing high-risk behavior in youth associated with 
133.31 	tobacco use and the health consequences of these behaviors.
133.32 	(b) Eligible applicants may include, but are not limited to, community health boards, 
133.33 	school districts, community clinics, Indian tribes, nonprofit organizations, and other health 
133.34 	care organizations. Applicants must submit proposals to the commissioner. The proposals 
134.1 	must specify the strategies to be implemented to target tobacco use among youth, and must 
134.2 	be targeted to achieve the outcomes established in subdivision 2.
134.3 	(c) The commissioner must give priority to applicants who demonstrate that the 
134.4 	proposed project or initiative is:
134.5 	(1) supported by the community in which the applicant serves;
134.6 	(2) is based on research or on proven effective strategies;
134.7 	(3) is designed to coordinate with other community activities related to other health 
134.8 	initiatives;
134.9 	(4) incorporates an understanding of the role of community in influencing behavioral 
134.10 	changes among youth regarding tobacco use and other high-risk health-related behaviors; 
134.11 	or
134.12 	(5) addresses disparities among populations of color related to tobacco use and 
134.13 	other high-risk health-related behaviors.
134.14 	(d) The commissioner shall divide the state into specific geographic regions and 
134.15 	allocate a percentage of the money available for distribution to projects or initiatives 
134.16 	aimed at that geographic region. If the commissioner does not receive a sufficient number 
134.17 	of grant proposals from applicants that serve a particular region or the proposals submitted 
134.18 	do not meet the criteria developed by the commissioner, the commissioner shall provide 
134.19 	technical assistance and expertise to ensure the development of adequate proposals 
134.20 	aimed at addressing the public health needs of that region. In awarding the grants, the 
134.21 	commissioner shall consider locally assessed community public health needs pursuant to 
134.22 	chapter 145A.

134.23 	Sec. 25. [145.4221] HUMAN CLONING PROHIBITED.
134.24 		Subdivision 1.Definitions. (a) For purposes of this section, the following terms 
134.25 	have the meanings given.
134.26 	(b) "Human cloning" means human asexual reproduction accomplished by 
134.27 	introducing nuclear material from one or more human somatic cells into a fertilized 
134.28 	or unfertilized oocyte whose nuclear material has been removed or inactivated so as 
134.29 	to produce a living organism at any stage of development that is genetically virtually 
134.30 	identical to an existing or previously existing human organism.
134.31 	(c) "Somatic cell" means a diploid cell, having a complete set of chromosomes, 
134.32 	obtained or derived from a living or deceased human body at any stage of development.
134.33 		Subd. 2.Prohibition on cloning. No person or entity, whether public or private, 
134.34 	may:
134.35 	(1) perform or attempt to perform human cloning;
135.1 	(2) participate in an attempt to perform human cloning;
135.2 	(3) ship, import, or receive for any purpose an embryo produced by human cloning 
135.3 	or any product derived from such an embryo; or 
135.4 	(4) ship or receive, in whole or in part, any oocyte, embryo, fetus, or human somatic 
135.5 	cell, for the purpose of human cloning.
135.6 		Subd. 3.Scientific research. Nothing in this section shall restrict areas of scientific 
135.7 	research not specifically prohibited by this section, including research in the use of nuclear 
135.8 	transfer or other cloning techniques to produce molecules, DNA, cells other than human 
135.9 	embryos, tissues, organs, plants, or animals other than humans. In addition, nothing in this 
135.10 	section shall restrict, inhibit, or make unlawful the scientific field of stem cell research, 
135.11 	unless explicitly prohibited.
135.12 		Subd. 4.Penalties. Any person or entity that knowingly or recklessly violates 
135.13 	subdivision 2 is guilty of a misdemeanor.
135.14 		Subd. 5.Severability. If any provision, section, subdivision, sentence, clause, 
135.15 	phrase, or word in this section or the application thereof to any person or circumstance is 
135.16 	found to be unconstitutional, the same is hereby declared to be severable and the remainder 
135.17 	of this section shall remain effective notwithstanding such unconstitutional provision. The 
135.18 	legislature declares that it would have passed this section and each provision, subdivision, 
135.19 	sentence, clause, phrase, or word thereof, regardless of the fact that any provision, section, 
135.20 	subdivision, sentence, clause, phrase, or word is declared unconstitutional.

135.21 	EFFECTIVE DATE. This section is effective August 1, 2011, and applies to crimes 
135.22 	committed on or after that date.

135.23 	Sec. 26. Minnesota Statutes 2010, section 145.925, subdivision 1, is amended to read:
135.24 		Subdivision 1.Eligible organizations; purpose. The commissioner of health may, 
135.25 	within available appropriations, make special grants to cities, counties, groups of cities or 
135.26 	counties, or nonprofit corporations to provide prepregnancy family planning services.

135.27 	Sec. 27. Minnesota Statutes 2010, section 145.928, subdivision 7, is amended to read:
135.28 		Subd. 7.Community grant program; immunization rates and infant mortality 
135.29 	rates. (a) The commissioner shallmay, within available appropriations, award grants to 
135.30 	eligible applicants for local or regional projects and initiatives directed at reducing health 
135.31 	disparities in one or both of the following priority areas:
135.32 	(1) decreasing racial and ethnic disparities in infant mortality rates; or
135.33 	(2) increasing adult and child immunization rates in nonwhite racial and ethnic 
135.34 	populations.
136.1 	(b) The commissioner may award up to 20 percent of the funds available as planning 
136.2 	grants. Planning grants must be used to address such areas as community assessment, 
136.3 	coordination activities, and development of community supported strategies.
136.4 	(c) Eligible applicants may include, but are not limited to, faith-based organizations, 
136.5 	social service organizations, community nonprofit organizations, community health 
136.6 	boards, tribal governments, and community clinics. Applicants must submit proposals to 
136.7 	the commissioner. A proposal must specify the strategies to be implemented to address 
136.8 	one or both of the priority areas listed in paragraph (a) and must be targeted to achieve the 
136.9 	outcomes established according to subdivision 3.
136.10 	(d) The commissioner shall give priority to applicants who demonstrate that their 
136.11 	proposed project or initiative:
136.12 	(1) is supported by the community the applicant will serve;
136.13 	(2) is research-based or based on promising strategies;
136.14 	(3) is designed to complement other related community activities;
136.15 	(4) utilizes strategies that positively impact both priority areas;
136.16 	(5) reflects racially and ethnically appropriate approaches; and
136.17 	(6) will be implemented through or with community-based organizations that reflect 
136.18 	the race or ethnicity of the population to be reached.

136.19 	Sec. 28. Minnesota Statutes 2010, section 145.928, subdivision 8, is amended to read:
136.20 		Subd. 8.Community grant program; other health disparities. (a) The 
136.21 	commissioner shallmay, within available appropriations, award grants to eligible 
136.22 	applicants for local or regional projects and initiatives directed at reducing health 
136.23 	disparities in one or more of the following priority areas:
136.24 	(1) decreasing racial and ethnic disparities in morbidity and mortality rates from 
136.25 	breast and cervical cancer;
136.26 	(2) decreasing racial and ethnic disparities in morbidity and mortality rates from 
136.27 	HIV/AIDS and sexually transmitted infections;
136.28 	(3) decreasing racial and ethnic disparities in morbidity and mortality rates from 
136.29 	cardiovascular disease;
136.30 	(4) decreasing racial and ethnic disparities in morbidity and mortality rates from 
136.31 	diabetes; or
136.32 	(5) decreasing racial and ethnic disparities in morbidity and mortality rates from 
136.33 	accidental injuries or violence.
136.34 	(b) The commissioner may award up to 20 percent of the funds available as planning 
136.35 	grants. Planning grants must be used to address such areas as community assessment, 
137.1 	determining community priority areas, coordination activities, and development of 
137.2 	community supported strategies.
137.3 	(c) Eligible applicants may include, but are not limited to, faith-based organizations, 
137.4 	social service organizations, community nonprofit organizations, community health 
137.5 	boards, and community clinics. Applicants shall submit proposals to the commissioner. 
137.6 	A proposal must specify the strategies to be implemented to address one or more of 
137.7 	the priority areas listed in paragraph (a) and must be targeted to achieve the outcomes 
137.8 	established according to subdivision 3.
137.9 	(d) The commissioner shall give priority to applicants who demonstrate that their 
137.10 	proposed project or initiative:
137.11 	(1) is supported by the community the applicant will serve;
137.12 	(2) is research-based or based on promising strategies;
137.13 	(3) is designed to complement other related community activities;
137.14 	(4) utilizes strategies that positively impact more than one priority area;
137.15 	(5) reflects racially and ethnically appropriate approaches; and
137.16 	(6) will be implemented through or with community-based organizations that reflect 
137.17 	the race or ethnicity of the population to be reached.

137.18 	Sec. 29. Minnesota Statutes 2010, section 297F.10, subdivision 1, is amended to read:
137.19 		Subdivision 1.Tax and use tax on cigarettes. Revenue received from cigarette 
137.20 	taxes, as well as related penalties, interest, license fees, and miscellaneous sources of 
137.21 	revenue shall be deposited by the commissioner in the state treasury and credited as 
137.22 	follows:
137.23 	(1) $22,220,000 for fiscal year 2006 and $22,250,000 for fiscal year 2007 and each 
137.24 	year thereafter must be credited to the Academic Health Center special revenue fund 
137.25 	hereby created and is annually appropriated to the Board of Regents at the University of 
137.26 	Minnesota for Academic Health Center funding at the University of Minnesota; and
137.27 	(2) $8,553,000 for fiscal year 2006 and $8,550,000 for fiscal yearyears 2007 and 
137.28 	each year thereafterthrough fiscal year 2012 and $3,937,000 each year thereafter must be 
137.29 	credited to the medical education and research costs account hereby created in the special 
137.30 	revenue fund and is annually appropriated to the commissioner of health for distribution 
137.31 	under section 62J.692, subdivision 4; and
137.32 	(3) the balance of the revenues derived from taxes, penalties, and interest (under 
137.33 	this chapter) and from license fees and miscellaneous sources of revenue shall be credited 
137.34 	to the general fund.

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

138.1 	Sec. 30. FAMILY PLANNING GRANTS.
 138.2 	The Department of Health shall not appropriate state funds or accept federal funds 
138.3 	for family planning special projects or family planning services.

138.4 	Sec. 31.  REPEALER.
 138.5 	(a) Minnesota Statutes 2010, sections 144.1464; 144.147; 144.1487; 144.1488, 
138.6 	subdivisions 1, 3, and 4; 144.1489; 144.1490; 144.1491; 144.1499; 144.1501; 144.6062; 
138.7 	145.925; 145A.14, subdivisions 1 and 2a, are repealed.
138.8 	(b) Minnesota Statutes 2010, sections 62J.17, subdivisions 1, 3, 5a, 6a, and 8; 
138.9 	62J.321, subdivision 5a; 62J.381; 62J.41, subdivisions 1 and 2; and 103I.005, subdivision 
138.10 	20, are repealed effective July 1, 2011.
138.11 	(c) Minnesota Rules, parts 4651.0100, subparts 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 
138.12 	14, 15, 16, 16a, 18, 19, 20, 20a, 21, 22, and 23; 4651.0110, subparts 2, 2a, 3, 4, and 5; 
138.13 	4651.0120; 4651.0130; 4651.0140; and 4651.0150, are repealed effective July 1, 2011.

138.14 	ARTICLE 7
138.15 	HEALTH LICENSING BOARDS

138.16 	Section 1. Minnesota Statutes 2010, section 148.108, is amended by adding a 
138.17 	subdivision to read:
138.18 		Subd. 4.Animal chiropractic. The animal chiropractic registration fee is $125, 
138.19 	animal registration renewal fee is $75, and animal chiropractic inactive renewal fee is $25.

138.20 	Sec. 2. Minnesota Statutes 2010, section 148.191, subdivision 2, is amended to read:
138.21 		Subd. 2.Powers. (a) The board is authorized to adopt and, from time to time, revise 
138.22 	rules not inconsistent with the law, as may be necessary to enable it to carry into effect the 
138.23 	provisions of sections 148.171 to 148.285. The board shall prescribe by rule curricula 
138.24 	and standards for schools and courses preparing persons for licensure under sections 
138.25 	148.171 to 148.285. It shall conduct or provide for surveys of such schools and courses 
138.26 	at such times as it may deem necessary. It shall approve such schools and courses as 
138.27 	meet the requirements of sections 148.171 to 148.285 and board rules. It shall examine, 
138.28 	license, and renew the license of duly qualified applicants. It shall hold examinations 
138.29 	at least once in each year at such time and place as it may determine. It shall by rule 
138.30 	adopt, evaluate, and periodically revise, as necessary, requirements for licensure and for 
138.31 	registration and renewal of registration as defined in section 148.231. It shall maintain a 
138.32 	record of all persons licensed by the board to practice professional or practical nursing and 
138.33 	all registered nurses who hold Minnesota licensure and registration and are certified as 
139.1 	advanced practice registered nurses. It shall cause the prosecution of all persons violating 
139.2 	sections 148.171 to 148.285 and have power to incur such necessary expense therefor. 
139.3 	It shall register public health nurses who meet educational and other requirements 
139.4 	established by the board by rule, including payment of a fee. Prior to the adoption of rules, 
139.5 	the board shall use the same procedures used by the Department of Health to certify public 
139.6 	health nurses. It shall have power to issue subpoenas, and to compel the attendance of 
139.7 	witnesses and the production of all necessary documents and other evidentiary material. 
139.8 	Any board member may administer oaths to witnesses, or take their affirmation. It shall 
139.9 	keep a record of all its proceedings. 
139.10 	(b) The board shall have access to hospital, nursing home, and other medical records 
139.11 	of a patient cared for by a nurse under review. If the board does not have a written consent 
139.12 	from a patient permitting access to the patient's records, the nurse or facility shall delete 
139.13 	any data in the record that identifies the patient before providing it to the board. The board 
139.14 	shall have access to such other records as reasonably requested by the board to assist the 
139.15 	board in its investigation. Nothing herein may be construed to allow access to any records 
139.16 	protected by section 145.64. The board shall maintain any records obtained pursuant to 
139.17 	this paragraph as investigative data under chapter 13. 
139.18 	(c) The board may accept and expend grants or gifts of money or in-kind services 
139.19 	from a person, a public or private entity, or any other source for purposes consistent with 
139.20 	the board's role and within the scope of its statutory authority.
139.21 	(d) The board may accept registration fees for meetings and conferences conducted 
139.22 	for the purposes of board activities that are within the scope of its authority.

139.23 	Sec. 3. Minnesota Statutes 2010, section 148.212, subdivision 1, is amended to read:
139.24 		Subdivision 1.Issuance. Upon receipt of the applicable licensure or reregistration 
139.25 	fee and permit fee, and in accordance with rules of the board, the board may issue 
139.26 	a nonrenewable temporary permit to practice professional or practical nursing to an 
139.27 	applicant for licensure or reregistration who is not the subject of a pending investigation 
139.28 	or disciplinary action, nor disqualified for any other reason, under the following 
139.29 	circumstances:
139.30 	(a) The applicant for licensure by examination under section 148.211, subdivision 
139.31 	1, has graduated from an approved nursing program within the 60 days preceding board 
139.32 	receipt of an affidavit of graduation or transcript and has been authorized by the board to 
139.33 	write the licensure examination for the first time in the United States. The permit holder 
139.34 	must practice professional or practical nursing under the direct supervision of a registered 
140.1 	nurse. The permit is valid from the date of issue until the date the board takes action on 
140.2 	the application or for 60 days whichever occurs first. 
140.3 	(b) The applicant for licensure by endorsement under section 148.211, subdivision 2, 
140.4 	is currently licensed to practice professional or practical nursing in another state, territory, 
140.5 	or Canadian province. The permit is valid from submission of a proper request until the 
140.6 	date of board action on the application or for 60 days, whichever comes first. 
140.7 	(c) (b) The applicant for licensure by endorsement under section 148.211, 
140.8 	subdivision 2, or for reregistration under section 148.231, subdivision 5, is currently 
140.9 	registered in a formal, structured refresher course or its equivalent for nurses that includes 
140.10 	clinical practice. 
140.11 	(d) The applicant for licensure by examination under section 148.211, subdivision 
140.12 	1, who graduated from a nursing program in a country other than the United States or 
140.13 	Canada has completed all requirements for licensure except registering for and taking the 
140.14 	nurse licensure examination for the first time in the United States. The permit holder must 
140.15 	practice professional nursing under the direct supervision of a registered nurse. The permit 
140.16 	is valid from the date of issue until the date the board takes action on the application or for 
140.17 	60 days, whichever occurs first. 

140.18 	Sec. 4. Minnesota Statutes 2010, section 148.231, is amended to read:
140.19 	148.231 REGISTRATION; FAILURE TO REGISTER; REREGISTRATION; 
140.20 	VERIFICATION.
140.21 		Subdivision 1.Registration. Every person licensed to practice professional or 
140.22 	practical nursing must maintain with the board a current registration for practice as a 
140.23 	registered nurse or licensed practical nurse which must be renewed at regular intervals 
140.24 	established by the board by rule. No certificate of registration shall be issued by the board 
140.25 	to a nurse until the nurse has submitted satisfactory evidence of compliance with the 
140.26 	procedures and minimum requirements established by the board.
140.27 	The fee for periodic registration for practice as a nurse shall be determined by the 
140.28 	board by rule law. A penalty fee shall be added for any application received after the 
140.29 	required date as specified by the board by rule. Upon receipt of the application and the 
140.30 	required fees, the board shall verify the application and the evidence of completion of 
140.31 	continuing education requirements in effect, and thereupon issue to the nurse a certificate 
140.32 	of registration for the next renewal period.
140.33 		Subd. 4.Failure to register. Any person licensed under the provisions of sections 
140.34 	148.171 to 148.285 who fails to register within the required period shall not be entitled to 
140.35 	practice nursing in this state as a registered nurse or licensed practical nurse. 
141.1 		Subd. 5.Reregistration. A person whose registration has lapsed desiring to 
141.2 	resume practice shall make application for reregistration, submit satisfactory evidence of 
141.3 	compliance with the procedures and requirements established by the board, and pay the 
141.4 	registration reregistration fee for the current period to the board. A penalty fee shall be 
141.5 	required from a person who practiced nursing without current registration. Thereupon, the
141.6 	registration certificate shall be issued to the person who shall immediately be placed on 
141.7 	the practicing list as a registered nurse or licensed practical nurse.
141.8 		Subd. 6.Verification. A person licensed under the provisions of sections 148.171 to 
141.9 	148.285 who requests the board to verify a Minnesota license to another state, territory, 
141.10 	or country or to an agency, facility, school, or institution shall pay a fee to the board
141.11 	for each verification. 

141.12 	Sec. 5. [148.243] FEE AMOUNTS.
141.13 		Subdivision 1.Licensure by examination. The fee for licensure by examination is 
141.14 	$105.
141.15 		Subd. 2.Reexamination fee. The reexamination fee is $60.
141.16 		Subd. 3.Licensure by endorsement. The fee for licensure by endorsement is $105.
141.17 		Subd. 4.Registration renewal. The fee for registration renewal is $85.
141.18 		Subd. 5.Reregistration. The fee for reregistration is $105.
141.19 		Subd. 6.Replacement license. The fee for a replacement license is $20.
141.20 		Subd. 7.Public health nurse certification. The fee for public health nurse 
141.21 	certification is $30.
141.22 		Subd. 8.Drug Enforcement Administration verification for Advanced Practice 
141.23 	Registered Nurse (APRN). The Drug Enforcement Administration verification for 
141.24 	APRN is $50.
141.25 		Subd. 9.Licensure verification other than through Nursys. The fee for 
141.26 	verification of licensure status other than through Nursys verification is $20.
141.27 		Subd. 10.Verification of examination scores. The fee for verification of 
141.28 	examination scores is $20.
141.29 		Subd. 11.Microfilmed licensure application materials. The fee for a copy of 
141.30 	microfilmed licensure application materials is $20.
141.31 		Subd. 12.Nursing business registration; initial application. The fee for the initial 
141.32 	application for nursing business registration is $100.
141.33 		Subd. 13.Nursing business registration; annual application. The fee for the 
141.34 	annual application for nursing business registration is $25.
142.1 		Subd. 14.Practicing without current registration. The fee for practicing without 
142.2 	current registration is two times the amount of the current registration renewal fee for any 
142.3 	part of the first calendar month, plus the current registration renewal fee for any part of 
142.4 	any subsequent month up to 24 months.
142.5 		Subd. 15.Practicing without current APRN certification. The fee for practicing 
142.6 	without current APRN certification is $200 for the first month or any part thereof, plus 
142.7 	$100 for each subsequent month or part thereof.
142.8 		Subd. 16.Dishonored check fee. The service fee for a dishonored check is as 
142.9 	provided in section 604.113.
142.10 		Subd. 17.Border state registry fee. The initial application fee for border state 
142.11 	registration is $50. Any subsequent notice of employment change to remain or be 
142.12 	reinstated on the registry is $50.

142.13 	Sec. 6. [148.2855] NURSE LICENSURE COMPACT.
142.14 	The Nurse Licensure Compact is enacted into law and entered into with all other 
142.15 	jurisdictions legally joining in it, in the form substantially as follows:
142.16 	ARTICLE 1
142.17 	DEFINITIONS
142.18 	As used in this compact:
142.19 	(a) "Adverse action" means a home or remote state action.
142.20 	(b) "Alternative program" means a voluntary, nondisciplinary monitoring program 
142.21 	approved by a nurse licensing board.
142.22 	(c) "Coordinated licensure information system" means an integrated process for 
142.23 	collecting, storing, and sharing information on nurse licensure and enforcement activities 
142.24 	related to nurse licensure laws, which is administered by a nonprofit organization 
142.25 	composed of and controlled by state nurse licensing boards.
142.26 	(d) "Current significant investigative information" means:
142.27 	(1) investigative information that a licensing board, after a preliminary inquiry that 
142.28 	includes notification and an opportunity for the nurse to respond if required by state law, 
142.29 	has reason to believe is not groundless and, if proved true, would indicate more than a 
142.30 	minor infraction; or
142.31 	(2) investigative information that indicates that the nurse represents an immediate 
142.32 	threat to public health and safety regardless of whether the nurse has been notified and 
142.33 	had an opportunity to respond.
142.34 	(e) "Home state" means the party state which is the nurse's primary state of residence.
143.1 	(f) "Home state action" means any administrative, civil, equitable, or criminal 
143.2 	action permitted by the home state's laws which are imposed on a nurse by the home 
143.3 	state's licensing board or other authority including actions against an individual's license 
143.4 	such as revocation, suspension, probation, or any other action which affects a nurse's 
143.5 	authorization to practice.
143.6 	(g) "Licensing board" means a party state's regulatory body responsible for issuing 
143.7 	nurse licenses.
143.8 	(h) "Multistate licensure privilege" means current, official authority from a 
143.9 	remote state permitting the practice of nursing as either a registered nurse or a licensed 
143.10 	practical/vocational nurse in the party state. All party states have the authority, according 
143.11 	to existing state due process law, to take actions against the nurse's privilege such as 
143.12 	revocation, suspension, probation, or any other action which affects a nurse's authorization 
143.13 	to practice.
143.14 	(i) "Nurse" means a registered nurse or licensed practical/vocational nurse as those 
143.15 	terms are defined by each party state's practice laws.
143.16 	(j) "Party state" means any state that has adopted this compact.
143.17 	(k) "Remote state" means a party state other than the home state:
143.18 	(1) where the patient is located at the time nursing care is provided; or
143.19 	(2) in the case of the practice of nursing not involving a patient, in the party state 
143.20 	where the recipient of nursing practice is located.
143.21 	(l) "Remote state action" means:
143.22 	(1) any administrative, civil, equitable, or criminal action permitted by a remote 
143.23 	state's laws which are imposed on a nurse by the remote state's licensing board or other 
143.24 	authority including actions against an individual's multistate licensure privilege to practice 
143.25 	in the remote state; and
143.26 	(2) cease and desist and other injunctive or equitable orders issued by remote states 
143.27 	or the licensing boards of those states.
143.28 	(m) "State" means a state, territory, or possession of the United States, the District of 
143.29 	Columbia, or the Commonwealth of Puerto Rico.
143.30 	(n) "State practice laws" means individual party state laws and regulations that 
143.31 	govern the practice of nursing, define the scope of nursing practice, and create the 
143.32 	methods and grounds for imposing discipline. State practice laws does not include the 
143.33 	initial qualifications for licensure or requirements necessary to obtain and retain a license, 
143.34 	except for qualifications or requirements of the home state.
143.35 	ARTICLE 2
143.36 	GENERAL PROVISIONS AND JURISDICTION
144.1 	(a) A license to practice registered nursing issued by a home state to a resident in 
144.2 	that state will be recognized by each party state as authorizing a multistate licensure 
144.3 	privilege to practice as a registered nurse in the party state. A license to practice licensed 
144.4 	practical/vocational nursing issued by a home state to a resident in that state will be 
144.5 	recognized by each party state as authorizing a multistate licensure privilege to practice 
144.6 	as a licensed practical/vocational nurse in the party state. In order to obtain or retain a 
144.7 	license, an applicant must meet the home state's qualifications for licensure and license 
144.8 	renewal as well as all other applicable state laws.
144.9 	(b) Party states may, according to state due process laws, limit or revoke the 
144.10 	multistate licensure privilege of any nurse to practice in their state and may take any other 
144.11 	actions under their applicable state laws necessary to protect the health and safety of 
144.12 	their citizens. If a party state takes such action, it shall promptly notify the administrator 
144.13 	of the coordinated licensure information system. The administrator of the coordinated 
144.14 	licensure information system shall promptly notify the home state of any such actions by 
144.15 	remote states.
144.16 	(c) Every nurse practicing in a party state must comply with the state practice laws of 
144.17 	the state in which the patient is located at the time care is rendered. In addition, the practice 
144.18 	of nursing is not limited to patient care, but shall include all nursing practice as defined by 
144.19 	the state practice laws of the party state. The practice of nursing will subject a nurse to the 
144.20 	jurisdiction of the nurse licensing board, the courts, and the laws in the party state.
144.21 	(d) This compact does not affect additional requirements imposed by states for 
144.22 	advanced practice registered nursing. However, a multistate licensure privilege to practice 
144.23 	registered nursing granted by a party state shall be recognized by other party states as a 
144.24 	license to practice registered nursing if one is required by state law as a precondition for 
144.25 	qualifying for advanced practice registered nurse authorization.
144.26 	(e) Individuals not residing in a party state shall continue to be able to apply for 
144.27 	nurse licensure as provided for under the laws of each party state. However, the license 
144.28 	granted to these individuals will not be recognized as granting the privilege to practice 
144.29 	nursing in any other party state unless explicitly agreed to by that party state.
144.30 	ARTICLE 3
144.31 	APPLICATIONS FOR LICENSURE IN A PARTY STATE
144.32 	(a) Upon application for a license, the licensing board in a party state shall ascertain, 
144.33 	through the coordinated licensure information system, whether the applicant has ever held 
144.34 	or is the holder of a license issued by any other state, whether there are any restrictions 
144.35 	on the multistate licensure privilege, and whether any other adverse action by a state 
144.36 	has been taken against the license.
145.1 	(b) A nurse in a party state shall hold licensure in only one party state at a time, 
145.2 	issued by the home state.
145.3 	(c) A nurse who intends to change primary state of residence may apply for licensure 
145.4 	in the new home state in advance of the change. However, new licenses will not be 
145.5 	issued by a party state until after a nurse provides evidence of change in primary state of 
145.6 	residence satisfactory to the new home state's licensing board.
145.7 	(d) When a nurse changes primary state of residence by:
145.8 	(1) moving between two party states, and obtains a license from the new home state, 
145.9 	the license from the former home state is no longer valid;
145.10 	(2) moving from a nonparty state to a party state, and obtains a license from the new 
145.11 	home state, the individual state license issued by the nonparty state is not affected and will 
145.12 	remain in full force if so provided by the laws of the nonparty state; or
145.13 	(3) moving from a party state to a nonparty state, the license issued by the prior 
145.14 	home state converts to an individual state license, valid only in the former home state, 
145.15 	without the multistate licensure privilege to practice in other party states.
145.16 	ARTICLE 4
145.17 	ADVERSE ACTIONS
145.18 	In addition to the general provisions described in article 2, the provisions in this 
145.19 	article apply.
145.20 	(a) The licensing board of a remote state shall promptly report to the administrator 
145.21 	of the coordinated licensure information system any remote state actions including the 
145.22 	factual and legal basis for the action, if known. The licensing board of a remote state shall 
145.23 	also promptly report any significant current investigative information yet to result in a 
145.24 	remote state action. The administrator of the coordinated licensure information system 
145.25 	shall promptly notify the home state of any reports.
145.26 	(b) The licensing board of a party state shall have the authority to complete any 
145.27 	pending investigation for a nurse who changes primary state of residence during the 
145.28 	course of the investigation. The board shall also have the authority to take appropriate 
145.29 	action, and shall promptly report the conclusion of the investigation to the administrator 
145.30 	of the coordinated licensure information system. The administrator of the coordinated 
145.31 	licensure information system shall promptly notify the new home state of any action.
145.32 	(c) A remote state may take adverse action affecting the multistate licensure 
145.33 	privilege to practice within that party state. However, only the home state shall have the 
145.34 	power to impose adverse action against the license issued by the home state.
145.35 	(d) For purposes of imposing adverse actions, the licensing board of the home state 
145.36 	shall give the same priority and effect to reported conduct received from a remote state as 
146.1 	it would if the conduct had occurred within the home state. In so doing, it shall apply its 
146.2 	own state laws to determine appropriate action.
146.3 	(e) The home state may take adverse action based on the factual findings of the 
146.4 	remote state, provided each state follows its own procedures for imposing the adverse 
146.5 	action.
146.6 	(f) Nothing in this compact shall override a party state's decision that participation 
146.7 	in an alternative program may be used in lieu of licensure action and that participation 
146.8 	shall remain nonpublic if required by the party state's laws.
146.9 	Party states must require nurses who enter any alternative programs to agree not to 
146.10 	practice in any other party state during the term of the alternative program without prior 
146.11 	authorization from the other party state.
146.12 	ARTICLE 5
146.13 	ADDITIONAL AUTHORITIES INVESTED IN 
146.14 	PARTY STATE NURSE LICENSING BOARDS
146.15 	Notwithstanding any other laws, party state nurse licensing boards shall have the 
146.16 	authority to:
146.17 	(1) if otherwise permitted by state law, recover from the affected nurse the costs of 
146.18 	investigation and disposition of cases resulting from any adverse action taken against 
146.19 	that nurse;
146.20 	(2) issue subpoenas for both hearings and investigations which require the attendance 
146.21 	and testimony of witnesses, and the production of evidence. Subpoenas issued by a nurse 
146.22 	licensing board in a party state for the attendance and testimony of witnesses, and the 
146.23 	production of evidence from another party state, shall be enforced in the latter state by 
146.24 	any court of competent jurisdiction according to the practice and procedure of that court 
146.25 	applicable to subpoenas issued in proceedings pending before it. The issuing authority 
146.26 	shall pay any witness fees, travel expenses, mileage, and other fees required by the service 
146.27 	statutes of the state where the witnesses and evidence are located;
146.28 	(3) issue cease and desist orders to limit or revoke a nurse's authority to practice 
146.29 	in the nurse's state; and
146.30 	(4) adopt uniform rules and regulations as provided for in article 7, paragraph (c).
146.31 	ARTICLE 6
146.32 	COORDINATED LICENSURE INFORMATION SYSTEM
146.33 	(a) All party states shall participate in a cooperative effort to create a coordinated 
146.34 	database of all licensed registered nurses and licensed practical/vocational nurses. This 
146.35 	system shall include information on the licensure and disciplinary history of each 
147.1 	nurse, as contributed by party states, to assist in the coordination of nurse licensure and 
147.2 	enforcement efforts.
147.3 	(b) Notwithstanding any other provision of law, all party states' licensing boards shall 
147.4 	promptly report adverse actions, actions against multistate licensure privileges, any current 
147.5 	significant investigative information yet to result in adverse action, denials of applications, 
147.6 	and the reasons for the denials to the coordinated licensure information system.
147.7 	(c) Current significant investigative information shall be transmitted through the 
147.8 	coordinated licensure information system only to party state licensing boards.
147.9 	(d) Notwithstanding any other provision of law, all party states' licensing boards 
147.10 	contributing information to the coordinated licensure information system may designate 
147.11 	information that may not be shared with nonparty states or disclosed to other entities or 
147.12 	individuals without the express permission of the contributing state.
147.13 	(e) Any personally identifiable information obtained by a party state's licensing 
147.14 	board from the coordinated licensure information system may not be shared with nonparty 
147.15 	states or disclosed to other entities or individuals except to the extent permitted by the 
147.16 	laws of the party state contributing the information.
147.17 	(f) Any information contributed to the coordinated licensure information system that 
147.18 	is subsequently required to be expunged by the laws of the party state contributing that 
147.19 	information shall also be expunged from the coordinated licensure information system.
147.20 	(g) The compact administrators, acting jointly with each other and in consultation 
147.21 	with the administrator of the coordinated licensure information system, shall formulate 
147.22 	necessary and proper procedures for the identification, collection, and exchange of 
147.23 	information under this compact.
147.24 	ARTICLE 7
147.25 	COMPACT ADMINISTRATION AND
147.26 	INTERCHANGE OF INFORMATION
147.27 	(a) The head or designee of the nurse licensing board of each party state shall be the 
147.28 	administrator of this compact for that state.
147.29 	(b) The compact administrator of each party state shall furnish to the compact 
147.30 	administrator of each other party state any information and documents including, but not 
147.31 	limited to, a uniform data set of investigations, identifying information, licensure data, and 
147.32 	disclosable alternative program participation information to facilitate the administration of 
147.33 	this compact.
147.34 	(c) Compact administrators shall have the authority to develop uniform rules to 
147.35 	facilitate and coordinate implementation of this compact. These uniform rules shall be 
147.36 	adopted by party states under the authority in article 5, clause (4).
148.1 	ARTICLE 8
148.2 	IMMUNITY
148.3 	A party state or the officers, employees, or agents of a party state's nurse licensing 
148.4 	board who acts in good faith according to the provisions of this compact shall not be 
148.5 	liable for any act or omission while engaged in the performance of their duties under 
148.6 	this compact. Good faith shall not include willful misconduct, gross negligence, or 
148.7 	recklessness.
148.8 	ARTICLE 9
148.9 	ENACTMENT, WITHDRAWAL, AND AMENDMENT
148.10 	(a) This compact shall become effective for each state when it has been enacted by 
148.11 	that state. Any party state may withdraw from this compact by repealing the nurse licensure 
148.12 	compact, but no withdrawal shall take effect until six months after the withdrawing state 
148.13 	has given notice of the withdrawal to the executive heads of all other party states.
148.14 	(b) No withdrawal shall affect the validity or applicability by the licensing boards 
148.15 	of states remaining party to the compact of any report of adverse action occurring prior 
148.16 	to the withdrawal.
148.17 	(c) Nothing contained in this compact shall be construed to invalidate or prevent any 
148.18 	nurse licensure agreement or other cooperative arrangement between a party state and a 
148.19 	nonparty state that is made according to the other provisions of this compact.
148.20 	(d) This compact may be amended by the party states. No amendment to this 
148.21 	compact shall become effective and binding upon the party states until it is enacted into 
148.22 	the laws of all party states.
148.23 	ARTICLE 10
148.24 	CONSTRUCTION AND SEVERABILITY
148.25 	(a) This compact shall be liberally construed to effectuate the purposes of the 
148.26 	compact. The provisions of this compact shall be severable and if any phrase, clause, 
148.27 	sentence, or provision of this compact is declared to be contrary to the constitution of any 
148.28 	party state or of the United States or the applicability thereof to any government, agency, 
148.29 	person, or circumstance is held invalid, the validity of the remainder of this compact and 
148.30 	the applicability of it to any government, agency, person, or circumstance shall not be 
148.31 	affected by it. If this compact is held contrary to the constitution of any party state, the 
148.32 	compact shall remain in full force and effect for the remaining party states and in full force 
148.33 	and effect for the party state affected as to all severable matters.
148.34 	(b) In the event party states find a need for settling disputes arising under this 
148.35 	compact:
149.1 	(1) the party states may submit the issues in dispute to an arbitration panel which 
149.2 	shall be comprised of an individual appointed by the compact administrator in the home 
149.3 	state, an individual appointed by the compact administrator in the remote states involved, 
149.4 	and an individual mutually agreed upon by the compact administrators of the party states 
149.5 	involved in the dispute; and
149.6 	(2) the decision of a majority of the arbitrators shall be final and binding.

149.7 	Sec. 7. [148.2856] APPLICATION OF NURSE LICENSURE COMPACT TO 
149.8 	EXISTING LAWS.
149.9 	(a) A nurse practicing professional or practical nursing in Minnesota under the 
149.10 	authority of section 148.2855 shall have the same obligations, privileges, and rights as if 
149.11 	the nurse was licensed in Minnesota. Notwithstanding any contrary provisions in section 
149.12 	148.2855, the Board of Nursing shall comply with and follow all laws and rules with 
149.13 	respect to registered and licensed practical nurses practicing professional or practical 
149.14 	nursing in Minnesota under the authority of section 148.2855, and all such individuals 
149.15 	shall be governed and regulated as if they were licensed by the board.
149.16 	(b) Section 148.2855 does not relieve employers of nurses from complying with 
149.17 	statutorily imposed obligations.
149.18 	(c) Section 148.2855 does not supersede existing state labor laws.
149.19 	(d) For purposes of the Minnesota Government Data Practices Act, chapter 13, 
149.20 	an individual not licensed as a nurse under sections 148.171 to 148.285 who practices 
149.21 	professional or practical nursing in Minnesota under the authority of section 148.2855 is 
149.22 	considered to be a licensee of the board.
149.23 	(e) Uniform rules developed by the compact administrators shall not be subject 
149.24 	to the provisions of sections 14.05 to 14.389, except for sections 14.07, 14.08, 14.101, 
149.25 	14.131, 14.18, 14.22, 14.23, 14.27, 14.28, 14.365, 14.366, 14.37, and 14.38.
149.26 	(f) Proceedings brought against an individual's multistate privilege shall be 
149.27 	adjudicated following the procedures listed in sections 14.50 to 14.62 and shall be subject 
149.28 	to judicial review as provided for in sections 14.63 to 14.69.
149.29 	(g) For purposes of sections 62M.09, subdivision 2; 121A.22, subdivision 4; 
149.30 	144.051; 144.052; 145A.02, subdivision 18; 148.975; 151.37; 152.12; 154.04; 256B.0917, 
149.31 	subdivision 8; 595.02, subdivision 1, paragraph (g); 604.20, subdivision 5; and 631.40, 
149.32 	subdivision 2; and chapters 319B and 364, holders of a multistate privilege who are 
149.33 	licensed as registered or licensed practical nurses in the home state shall be considered 
149.34 	to be licensees in Minnesota. If any of the statutes listed in this paragraph are limited to 
149.35 	registered nurses or the practice of professional nursing, then only holders of a multistate 
150.1 	privilege who are licensed as registered nurses in the home state shall be considered 
150.2 	licensees.
150.3 	(h) The reporting requirements of sections 144.4175, 148.263, 626.52, and 626.557 
150.4 	apply to individuals not licensed as registered or licensed practical nurses under sections 
150.5 	148.171 to 148.285 who practice professional or practical nursing in Minnesota under 
150.6 	the authority of section 148.2855.
150.7 	(i) The board may take action against an individual's multistate privilege based on 
150.8 	the grounds listed in section 148.261, subdivision 1, and any other statute authorizing or 
150.9 	requiring the board to take corrective or disciplinary action.
150.10 	(j) The board may take all forms of disciplinary action provided for in section 
150.11 	148.262, subdivision 1, and corrective action provided for in section 214.103, subdivision 
150.12 	6, against an individual's multistate privilege.
150.13 	(k) The immunity provisions of section 148.264, subdivision 1, apply to individuals 
150.14 	who practice professional or practical nursing in Minnesota under the authority of section 
150.15 	148.2855.
150.16 	(l) The cooperation requirements of section 148.265 apply to individuals who 
150.17 	practice professional or practical nursing in Minnesota under the authority of section 
150.18 	148.2855.
150.19 	(m) The provisions of section 148.283 shall not apply to individuals who practice 
150.20 	professional or practical nursing in Minnesota under the authority of section 148.2855.
150.21 	(n) Complaints against individuals who practice professional or practical nursing 
150.22 	in Minnesota under the authority of section 148.2855 shall be handled as provided in 
150.23 	sections 214.10 and 214.103.
150.24 	(o) All provisions of section 148.2855 authorizing or requiring the board to provide 
150.25 	data to party states are authorized by section 214.10, subdivision 8, paragraph (d).
150.26 	(p) Except as provided in section 13.41, subdivision 6, the board shall not report to a 
150.27 	remote state any active investigative data regarding a complaint investigation against a 
150.28 	nurse licensed under sections 148.171 to 148.285, unless the board obtains reasonable 
150.29 	assurances from the remote state that the data will be maintained with the same protections 
150.30 	as provided in Minnesota law.
150.31 	(q) The provisions of sections 214.17 to 214.25 apply to individuals who practice 
150.32 	professional or practical nursing in Minnesota under the authority of section 148.2855 
150.33 	when the practice involves direct physical contact between the nurse and a patient.
150.34 	(r) A nurse practicing professional or practical nursing in Minnesota under the 
150.35 	authority of section 148.2855 must comply with any criminal background check required 
150.36 	under Minnesota law.

151.1 	Sec. 8. [148.2857] WITHDRAWAL FROM COMPACT.
151.2 	The governor may withdraw the state from the compact in section 148.2855 if 
151.3 	the Board of Nursing notifies the governor that a party state to the compact changed 
151.4 	the party state's requirements for nurse licensure after July 1, 2009, and that the party 
151.5 	state's requirements, as changed, are substantially lower than the requirements for nurse 
151.6 	licensure in this state.

151.7 	Sec. 9. [148.2858] MISCELLANEOUS PROVISIONS.
151.8 	(a) For the purposes of section 148.2855, "head of the Nurse Licensing Board" 
151.9 	means the executive director of the board.
151.10 	(b) The Board of Nursing shall have the authority to recover from a nurse practicing 
151.11 	professional or practical nursing in Minnesota under the authority of section 148.2855 
151.12 	the costs of investigation and disposition of cases resulting from any adverse action 
151.13 	taken against the nurse.
151.14 	(c) The board may implement a system of identifying individuals who practice 
151.15 	professional or practical nursing in Minnesota under the authority of section 148.2855.

151.16 	Sec. 10. [148.2859] NURSE LICENSURE COMPACT ADVISORY 
151.17 	COMMITTEE.
151.18 		Subdivision 1.Establishment; membership. A Nurse Licensure Compact Advisory 
151.19 	Committee is established to advise the compact administrator in the implementation of 
151.20 	section 148.2855. Members of the advisory committee shall be appointed by the board 
151.21 	and shall be composed of representatives of Minnesota nursing organizations, Minnesota 
151.22 	licensed nurses who practice in nursing facilities or hospitals, Minnesota licensed nurses 
151.23 	who provide home care, Minnesota licensed advanced practice registered nurses, and 
151.24 	public members as defined in section 214.02.
151.25 		Subd. 2.Duties. The advisory committee shall advise the compact administrator in 
151.26 	the implementation of section 148.2855.
151.27 		Subd. 3.Organization. The advisory committee shall be organized and 
151.28 	administered under section 15.059.

151.29 	Sec. 11. [151.065] FEE AMOUNTS.
151.30 		Subdivision 1.Application fees. Application fees for licensure and registration 
151.31 	are as follows:
151.32 	(1) pharmacist licensed by examination, $130;
151.33 	(2) pharmacist licensed by reciprocity, $225;
152.1 	(3) pharmacy intern, $30;
152.2 	(4) pharmacy technician, $30;
152.3 	(5) pharmacy, $190;
152.4 	(6) drug wholesaler, legend drugs only, $200;
152.5 	(7) drug wholesaler, legend and nonlegend drugs, $200;
152.6 	(8) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, $175;
152.7 	(9) drug wholesaler, medical gases, $150;
152.8 	(10) drug wholesaler, also licensed as a pharmacy in Minnesota, $125;
152.9 	(11) drug manufacturer, legend drugs only, $200;
152.10 	(12) drug manufacturer, legend and nonlegend drugs, $200;
152.11 	(13) drug manufacturer, nonlegend or veterinary legend drugs, $175;
152.12 	(14) drug manufacturer, medical gases, $150;
152.13 	(15) drug manufacturer, also licensed as a pharmacy in Minnesota, $125;
152.14 	(16) medical gas distributor, $75;
152.15 	(17) controlled substance researcher, $50; and
152.16 	(18) pharmacy professional corporation, $100.
152.17 		Subd. 2.Original license fees. A pharmacist original licensure fee is $130.
152.18 		Subd. 3.Annual renewal fees. Annual licensure and registration renewal fees 
152.19 	are as follows:
152.20 	(1) pharmacist, $130;
152.21 	(2) pharmacy technician, $30;
152.22 	(3) pharmacy, $190;
152.23 	(4) wholesaler, legend drugs only, $200;
152.24 	(5) wholesaler, legend and nonlegend drugs, $200;
152.25 	(6) wholesaler, nonlegend drugs, veterinary legend drugs, or both, $175;
152.26 	(7) wholesaler, medical gases, $150;
152.27 	(8) wholesaler, also licensed as a pharmacy in Minnesota, $125;
152.28 	(9) manufacturer, legend drugs only, $200;
152.29 	(10) manufacturer, legend and nonlegend drugs, $200;
152.30 	(11) manufacturer, nonlegend drugs, veterinary legend drugs, or both, $175;
152.31 	(12) manufacturer, medical gases, $150;
152.32 	(13) manufacturer, also licensed as a pharmacy in Minnesota, $125;
152.33 	(14) medical gas distributor, $75;
152.34 	(15) controlled substance researcher, $50; and
152.35 	(16) pharmacy professional corporation, $45.
153.1 		Subd. 4.Miscellaneous fees. Fees for issuance of affidavits and duplicate licenses 
153.2 	and certificates are as follows:
153.3 	(1) intern affidavit, $15;
153.4 	(2) duplicate small license, $15; and
153.5 	(3) duplicate large certificate, $25.
153.6 		Subd. 5.Late fees. All annual renewal fees are subject to a 50 percent late fee if 
153.7 	the renewal fee and application are not received by the board prior to the date specified 
153.8 	by the board.
153.9 		Subd. 6.Reinstatement fees. Reinstatement fees are as follows:
153.10 	(1) pharmacists who have allowed their license to lapse may reinstate the license 
153.11 	with board approval and upon payment of any fees and late fees in arrears, up to a 
153.12 	maximum of $1,000;
153.13 	(2) pharmacy technicians who have allowed their registration to lapse may reinstate 
153.14 	the registration with board approval and upon payment of any fees and late fees in arrears, 
153.15 	up to a maximum of $90;
153.16 	(3) an owner of a pharmacy, drug wholesaler, drug manufacturer, or medical gas 
153.17 	distributor who has allowed the license of the establishment to lapse may reinstate the 
153.18 	license with board approval and upon payment of any fees and late fees in arrears;
153.19 	(4) controlled substance researchers who have allowed their registration to lapse 
153.20 	may reinstate the registration with board approval and upon payment of any fees and 
153.21 	late fees in arrears; and
153.22 	(5) pharmacist owners of a pharmacy professional corporation who have allowed 
153.23 	the corporation's registration to lapse may reinstate the registration with board approval 
153.24 	and upon payment of the fees and the late fees in arrears.

153.25 	Sec. 12. Minnesota Statutes 2010, section 151.07, is amended to read:
153.26 	151.07 MEETINGS; EXAMINATION FEE.
153.27 	The board shall meet at times as may be necessary and as it may determine to 
153.28 	examine applicants for licensure and to transact its other business, giving reasonable 
153.29 	notice of all examinations by mail to known applicants therefor. The secretary shall record 
153.30 	the names of all persons licensed by the board, together with the grounds upon which 
153.31 	the right of each to licensure was claimed. The fee for examination shall be in such the
153.32 	amount as the board may determine specified in section 151.065, which fee may in the 
153.33 	discretion of the board be returned to applicants not taking the examination.

154.1 	Sec. 13. Minnesota Statutes 2010, section 151.101, is amended to read:
154.2 	151.101 INTERNSHIP.
154.3 	Upon payment of the fee specified in section 151.065, the board may license register
154.4 	as an intern any natural persons who have satisfied the board that they are of good moral 
154.5 	character, not physically or mentally unfit, and who have successfully completed the 
154.6 	educational requirements for intern licensure registration prescribed by the board. The 
154.7 	board shall prescribe standards and requirements for interns, pharmacist-preceptors, and 
154.8 	internship training but may not require more than one year of such training.
154.9 	The board in its discretion may accept internship experience obtained in another 
154.10 	state provided the internship requirements in such other state are in the opinion of the 
154.11 	board equivalent to those herein provided.

154.12 	Sec. 14. Minnesota Statutes 2010, section 151.102, is amended by adding a subdivision 
154.13 	to read:
154.14 		Subd. 3.Registration fee. The board shall not register an individual as a pharmacy 
154.15 	technician unless all applicable fees in section 151.065 have been paid.

154.16 	Sec. 15. Minnesota Statutes 2010, section 151.12, is amended to read:
154.17 	151.12 RECIPROCITY; LICENSURE.
154.18 	The board may in its discretion grant licensure without examination to any 
154.19 	pharmacist licensed by the Board of Pharmacy or a similar board of another state which 
154.20 	accords similar recognition to licensees of this state; provided, the requirements for 
154.21 	licensure in such other state are in the opinion of the board equivalent to those herein 
154.22 	provided. The fee for licensure shall be in such the amount as the board may determine by 
154.23 	rule specified in section 151.065.

154.24 	Sec. 16. Minnesota Statutes 2010, section 151.13, subdivision 1, is amended to read:
154.25 		Subdivision 1.Renewal fee. Every person licensed by the board as a pharmacist 
154.26 	shall pay to the board a the annual renewal fee to be fixed by it specified in section 
154.27 	151.065. The board may promulgate by rule a charge to be assessed for the delinquent 
154.28 	payment of a fee the late fee specified in section 151.065 if the renewal fee and application 
154.29 	are not received by the board prior to the date specified by the board. It shall be unlawful 
154.30 	for any person licensed as a pharmacist who refuses or fails to pay such any applicable
154.31 	renewal or late fee to practice pharmacy in this state. Every certificate and license shall 
154.32 	expire at the time therein prescribed.

155.1 	Sec. 17. Minnesota Statutes 2010, section 151.19, is amended to read:
155.2 	151.19 REGISTRATION; FEES.
155.3 		Subdivision 1.Pharmacy registration. The board shall require and provide for the 
155.4 	annual registration of every pharmacy now or hereafter doing business within this state. 
155.5 	Upon the payment of a any applicable fee to be set by the board in section 151.065, the 
155.6 	board shall issue a registration certificate in such form as it may prescribe to such persons 
155.7 	as may be qualified by law to conduct a pharmacy. Such certificate shall be displayed in a 
155.8 	conspicuous place in the pharmacy for which it is issued and expire on the 30th day of 
155.9 	June following the date of issue. It shall be unlawful for any person to conduct a pharmacy 
155.10 	unless such certificate has been issued to the person by the board.
155.11 		Subd. 2.Nonresident pharmacies. The board shall require and provide for an 
155.12 	annual nonresident special pharmacy registration for all pharmacies located outside of this 
155.13 	state that regularly dispense medications for Minnesota residents and mail, ship, or deliver 
155.14 	prescription medications into this state. Nonresident special pharmacy registration shall 
155.15 	be granted by the board upon payment of any applicable fee in section 151.065 and the 
155.16 	disclosure and certification by a pharmacy:
155.17 	(1) that it is licensed in the state in which the dispensing facility is located and from 
155.18 	which the drugs are dispensed;
155.19 	(2) the location, names, and titles of all principal corporate officers and all 
155.20 	pharmacists who are dispensing drugs to residents of this state;
155.21 	(3) that it complies with all lawful directions and requests for information from 
155.22 	the Board of Pharmacy of all states in which it is licensed or registered, except that it 
155.23 	shall respond directly to all communications from the board concerning emergency 
155.24 	circumstances arising from the dispensing of drugs to residents of this state;
155.25 	(4) that it maintains its records of drugs dispensed to residents of this state so that the 
155.26 	records are readily retrievable from the records of other drugs dispensed;
155.27 	(5) that it cooperates with the board in providing information to the Board of 
155.28 	Pharmacy of the state in which it is licensed concerning matters related to the dispensing 
155.29 	of drugs to residents of this state;
155.30 	(6) that during its regular hours of operation, but not less than six days per week, for 
155.31 	a minimum of 40 hours per week, a toll-free telephone service is provided to facilitate 
155.32 	communication between patients in this state and a pharmacist at the pharmacy who has 
155.33 	access to the patients' records; the toll-free number must be disclosed on the label affixed 
155.34 	to each container of drugs dispensed to residents of this state; and
155.35 	(7) that, upon request of a resident of a long-term care facility located within the 
155.36 	state of Minnesota, the resident's authorized representative, or a contract pharmacy or 
156.1 	licensed health care facility acting on behalf of the resident, the pharmacy will dispense 
156.2 	medications prescribed for the resident in unit-dose packaging or, alternatively, comply 
156.3 	with the provisions of section 151.415, subdivision 5.
156.4 		Subd. 3.Sale of federally restricted medical gases. The board shall require and 
156.5 	provide for the annual registration of every person or establishment not licensed as a 
156.6 	pharmacy or a practitioner engaged in the retail sale or distribution of federally restricted 
156.7 	medical gases. Upon the payment of a any applicable fee to be set by the board specified 
156.8 	in section 151.065, the board shall issue a registration certificate in such form as it may 
156.9 	prescribe to those persons or places that may be qualified to sell or distribute federally 
156.10 	restricted medical gases. The certificate shall be displayed in a conspicuous place in the 
156.11 	business for which it is issued and expire on the date set by the board. It is unlawful for 
156.12 	a person to sell or distribute federally restricted medical gases unless a certificate has 
156.13 	been issued to that person by the board.

156.14 	Sec. 18. Minnesota Statutes 2010, section 151.25, is amended to read:
156.15 	151.25 REGISTRATION OF MANUFACTURERS; FEE; PROHIBITIONS.
156.16 	The board shall require and provide for the annual registration of every person 
156.17 	engaged in manufacturing drugs, medicines, chemicals, or poisons for medicinal purposes, 
156.18 	now or hereafter doing business with accounts in this state. Upon a payment of a any 
156.19 	applicable fee as set by the board in section 151.065, the board shall issue a registration 
156.20 	certificate in such form as it may prescribe to such manufacturer. Such registration 
156.21 	certificate shall be displayed in a conspicuous place in such manufacturer's or wholesaler's 
156.22 	place of business for which it is issued and expire on the date set by the board. It shall 
156.23 	be unlawful for any person to manufacture drugs, medicines, chemicals, or poisons for 
156.24 	medicinal purposes unless such a certificate has been issued to the person by the board. 
156.25 	It shall be unlawful for any person engaged in the manufacture of drugs, medicines, 
156.26 	chemicals, or poisons for medicinal purposes, or the person's agent, to sell legend drugs to 
156.27 	other than a pharmacy, except as provided in this chapter.

156.28 	Sec. 19. Minnesota Statutes 2010, section 151.47, subdivision 1, is amended to read:
156.29 		Subdivision 1.Requirements. All wholesale drug distributors are subject to the 
156.30 	requirements in paragraphs (a) to (f).
156.31 	(a) No person or distribution outlet shall act as a wholesale drug distributor without 
156.32 	first obtaining a license from the board and paying the required any applicable fee
156.33 	specified in section 151.065.
157.1 	(b) No license shall be issued or renewed for a wholesale drug distributor to operate 
157.2 	unless the applicant agrees to operate in a manner prescribed by federal and state law and 
157.3 	according to the rules adopted by the board.
157.4 	(c) The board may require a separate license for each facility directly or indirectly 
157.5 	owned or operated by the same business entity within the state, or for a parent entity 
157.6 	with divisions, subsidiaries, or affiliate companies within the state, when operations 
157.7 	are conducted at more than one location and joint ownership and control exists among 
157.8 	all the entities.
157.9 	(d) As a condition for receiving and retaining a wholesale drug distributor license 
157.10 	issued under sections 151.42 to 151.51, an applicant shall satisfy the board that it has 
157.11 	and will continuously maintain: 
157.12 	(1) adequate storage conditions and facilities;
157.13 	(2) minimum liability and other insurance as may be required under any applicable 
157.14 	federal or state law;
157.15 	(3) a viable security system that includes an after hours central alarm, or comparable 
157.16 	entry detection capability; restricted access to the premises; comprehensive employment 
157.17 	applicant screening; and safeguards against all forms of employee theft;
157.18 	(4) a system of records describing all wholesale drug distributor activities set forth 
157.19 	in section 151.44 for at least the most recent two-year period, which shall be reasonably 
157.20 	accessible as defined by board regulations in any inspection authorized by the board; 
157.21 	(5) principals and persons, including officers, directors, primary shareholders, 
157.22 	and key management executives, who must at all times demonstrate and maintain their 
157.23 	capability of conducting business in conformity with sound financial practices as well 
157.24 	as state and federal law;
157.25 	(6) complete, updated information, to be provided to the board as a condition for 
157.26 	obtaining and retaining a license, about each wholesale drug distributor to be licensed, 
157.27 	including all pertinent corporate licensee information, if applicable, or other ownership, 
157.28 	principal, key personnel, and facilities information found to be necessary by the board;
157.29 	(7) written policies and procedures that assure reasonable wholesale drug distributor 
157.30 	preparation for, protection against, and handling of any facility security or operation 
157.31 	problems, including, but not limited to, those caused by natural disaster or government 
157.32 	emergency, inventory inaccuracies or product shipping and receiving, outdated product 
157.33 	or other unauthorized product control, appropriate disposition of returned goods, and 
157.34 	product recalls;
157.35 	(8) sufficient inspection procedures for all incoming and outgoing product 
157.36 	shipments; and
158.1 	(9) operations in compliance with all federal requirements applicable to wholesale 
158.2 	drug distribution.
158.3 	(e) An agent or employee of any licensed wholesale drug distributor need not seek 
158.4 	licensure under this section.
158.5 	(f) A wholesale drug distributor shall file with the board an annual report, in a 
158.6 	form and on the date prescribed by the board, identifying all payments, honoraria, 
158.7 	reimbursement or other compensation authorized under section 151.461, clauses (3) to 
158.8 	(5), paid to practitioners in Minnesota during the preceding calendar year. The report 
158.9 	shall identify the nature and value of any payments totaling $100 or more, to a particular 
158.10 	practitioner during the year, and shall identify the practitioner. Reports filed under this 
158.11 	provision are public data. 

158.12 	Sec. 20. Minnesota Statutes 2010, section 151.48, is amended to read:
158.13 	151.48 OUT-OF-STATE WHOLESALE DRUG DISTRIBUTOR LICENSING.
158.14 	(a) It is unlawful for an out-of-state wholesale drug distributor to conduct business 
158.15 	in the state without first obtaining a license from the board and paying the required any 
158.16 	applicable fee in section 151.065.
158.17 	(b) Application for an out-of-state wholesale drug distributor license under this 
158.18 	section shall be made on a form furnished by the board.
158.19 	(c) No person acting as principal or agent for any out-of-state wholesale drug 
158.20 	distributor may sell or distribute drugs in the state unless the distributor has obtained 
158.21 	a license.
158.22 	(d) The board may adopt regulations that permit out-of-state wholesale drug 
158.23 	distributors to obtain a license on the basis of reciprocity to the extent that an out-of-state 
158.24 	wholesale drug distributor:
158.25 	(1) possesses a valid license granted by another state under legal standards 
158.26 	comparable to those that must be met by a wholesale drug distributor of this state as 
158.27 	prerequisites for obtaining a license under the laws of this state; and
158.28 	(2) can show that the other state would extend reciprocal treatment under its own 
158.29 	laws to a wholesale drug distributor of this state.

158.30 	Sec. 21. Minnesota Statutes 2010, section 152.12, subdivision 3, is amended to read:
158.31 		Subd. 3.Research project use of controlled substances. Any qualified person 
158.32 	may use controlled substances in the course of a bona fide research project but cannot 
158.33 	administer or dispense such drugs to human beings unless such drugs are prescribed, 
158.34 	dispensed and administered by a person lawfully authorized to do so. Every person 
159.1 	who engages in research involving the use of such substances shall apply annually for 
159.2 	registration by the state Board of Pharmacy and shall pay any applicable fee specified in 
159.3 	section 151.065, provided that such registration shall not be required if the person is 
159.4 	covered by and has complied with federal laws covering such research projects.

159.5 	Sec. 22. [214.107] HEALTH-RELATED LICENSING BOARDS 
159.6 	ADMINISTRATIVE SERVICES UNIT.
159.7 		Subdivision 1.Establishment. An administrative services unit is established 
159.8 	for the health-related licensing boards in section 214.01, subdivision 2, to perform 
159.9 	administrative, financial, and management functions common to all the boards in a manner 
159.10 	that streamlines services, reduces expenditures, targets the use of state resources, and 
159.11 	meets the mission of public protection.
159.12 		Subd. 2.Authority. The administrative services unit shall act as an agent of the 
159.13 	boards.
159.14 		Subd. 3.Funding. (a) The administrative service unit shall apportion among the 
159.15 	health-related licensing boards an amount to be paid through an interagency agreement 
159.16 	between each respective board and the administrative services unit. The amount 
159.17 	apportioned to each board shall equal each board's share of the annual operating costs for 
159.18 	the unit and shall be paid from each board's appropriation.
159.19 	(b) The administrative services unit may receive and expend reimbursements for 
159.20 	services performed for other agencies.

159.21 	Sec. 23. EFFECTIVE DATE.
 159.22 	Sections 6 to 10 are effective upon implementation of the coordinated licensure 
159.23 	information system defined in Minnesota Statutes, section 148.2855, but no sooner than 
159.24 	July 1, 2012.

159.25 	ARTICLE 8
159.26 	HEALTH AND HUMAN SERVICES APPROPRIATIONS

159.27	Section 1.  SUMMARY OF APPROPRIATIONS.
 	
159.28 	The amounts shown in this section summarize direct appropriations, by fund, made 
159.29 	in this article.

159.30			2012
		2013
		Total
	
159.31	General
	$
	5,566,399,000
	$
	5,396,137,000
	$
	10,962,536,000
	
159.32
159.33	State Government Special 
Revenue
		66,299,000
		66,142,000
		132,441,000
	
160.1	Health Care Access
		304,207,000
		293,893,000
		598,100,000
	
160.2	Federal TANF
		264,658,000
		250,081,000
		514,739,000
	
160.3	Lottery Prize 
		1,665,000
		1,665,000
		3,330,000
	
160.4	Total
	$
	6,203,228,000
	$
	6,007,918,000
	$
	12,211,146,000

160.5	Sec. 2. HUMAN SERVICES APPROPRIATIONS.
 	
160.6 	The sums shown in the columns marked "Appropriations" are appropriated to the 
160.7 	agencies and for the purposes specified in this article. The appropriations are from the 
160.8 	general fund, or another named fund, and are available for the fiscal years indicated 
160.9 	for each purpose. The figures "2012" and "2013" used in this article mean that the 
160.10 	appropriations listed under them are available for the fiscal year ending June 30, 2012, or 
160.11 	June 30, 2013, respectively. "The first year" is fiscal year 2012. "The second year" is fiscal 
160.12 	year 2013. "The biennium" is fiscal years 2012 and 2013.

160.13				APPROPRIATIONS
	
160.14				Available for the Year
	
160.15				Ending June 30
	
160.16					2012
		2013

160.17
160.18	Sec. 3. COMMISSIONER OF HUMAN 
SERVICES

160.19	Subdivision 1.Total Appropriation
 	$
	6,061,465,000
	$
	5,872,659,000

160.20	Appropriations by Fund
	
160.21		2012
	2013
	
160.22	General
	5,498,253,000
	5,332,690,000
	
160.23
160.24	State Government 
Special Revenue
	3,565,000
	3,565,000
	
160.25	Health Care Access
	293,324,000
	284,658,000
	
160.26	Federal TANF
	264,658,000
	250,081,000
	
160.27	Lottery Prize Fund
	1,665,000
	1,665,000
	
160.28 	Receipts for Systems Projects. 
160.29 	Appropriations and federal receipts for 
160.30 	information systems projects for MAXIS, 
160.31 	PRISM, MMIS, and SSIS must be deposited 
160.32 	in the state systems account authorized in 
160.33 	Minnesota Statutes, section 256.014. Money 
160.34 	appropriated for computer projects approved 
160.35 	by the Minnesota Office of Enterprise 
160.36 	Technology, funded by the legislature, 
161.1 	and approved by the commissioner 
161.2 	of management and budget, may be 
161.3 	transferred from one project to another 
161.4 	and from development to operations as the 
161.5 	commissioner of human services considers 
161.6 	necessary. Any unexpended balance in 
161.7 	the appropriation for these projects does 
161.8 	not cancel but is available for ongoing 
161.9 	development and operations.
161.10 	Nonfederal Share Transfers. The 
161.11 	nonfederal share of activities for which 
161.12 	federal administrative reimbursement is 
161.13 	appropriated to the commissioner may be 
161.14 	transferred to the special revenue fund.
161.15 	TANF Maintenance of Effort.
161.16 	(a) In order to meet the basic maintenance 
161.17 	of effort (MOE) requirements of the TANF 
161.18 	block grant specified under Code of Federal 
161.19 	Regulations, title 45, section 263.1, the 
161.20 	commissioner may only report nonfederal 
161.21 	money expended for allowable activities 
161.22 	listed in the following clauses as TANF/MOE 
161.23 	expenditures:
161.24 	(1) MFIP cash, diversionary work program, 
161.25 	and food assistance benefits under Minnesota 
161.26 	Statutes, chapter 256J;
161.27 	(2) the child care assistance programs 
161.28 	under Minnesota Statutes, sections 119B.03 
161.29 	and 119B.05, and county child care 
161.30 	administrative costs under Minnesota 
161.31 	Statutes, section 119B.15;
161.32 	(3) state and county MFIP administrative 
161.33 	costs under Minnesota Statutes, chapters 
161.34 	256J and 256K;
162.1 	(4) state, county, and tribal MFIP 
162.2 	employment services under Minnesota 
162.3 	Statutes, chapters 256J and 256K;
162.4 	(5) qualifying working family credit 
162.5 	expenditures under Minnesota Statutes, 
162.6 	section 290.0671; and
162.7 	(6) qualifying Minnesota education credit 
162.8 	expenditures under Minnesota Statutes, 
162.9 	section 290.0674.
162.10 	(b) The commissioner shall ensure that 
162.11 	sufficient qualified nonfederal expenditures 
162.12 	are made each year to meet the state's 
162.13 	TANF/MOE requirements. For the activities 
162.14 	listed in paragraph (a), clauses (2) to 
162.15 	(6), the commissioner may only report 
162.16 	expenditures that are excluded from the 
162.17 	definition of assistance under Code of 
162.18 	Federal Regulations, title 45, section 260.31.
162.19 	(c) For fiscal years beginning with state fiscal 
162.20 	year 2003, the commissioner shall assure 
162.21 	that the maintenance of effort used by the 
162.22 	commissioner of management and budget 
162.23 	for the February and November forecasts 
162.24 	required under Minnesota Statutes, section 
162.25 	16A.103, contains expenditures under 
162.26 	paragraph (a), clause (1), equal to at least 16 
162.27 	percent of the total required under Code of 
162.28 	Federal Regulations, title 45, section 263.1.
162.29 	(d) Minnesota Statutes, section 256.011, 
162.30 	subdivision 3, which requires that federal 
162.31 	grants or aids secured or obtained under that 
162.32 	subdivision be used to reduce any direct 
162.33 	appropriations provided by law, do not apply 
162.34 	if the grants or aids are federal TANF funds.
163.1 	(e) Notwithstanding any contrary provision 
163.2 	in this article, paragraph (a), clauses (1) to 
163.3 	(6), and paragraphs (b) to (d), expire June 
163.4 	30, 2015.
163.5 	Working Family Credit Expenditures 
163.6 	as TANF/MOE. The commissioner may 
163.7 	claim as TANF maintenance of effort up to 
163.8 	$6,707,000 per year of working family credit 
163.9 	expenditures for fiscal years 2012 and 2013.
163.10 	Working Family Credit Expenditures 
163.11 	to be Claimed for TANF/MOE. The 
163.12 	commissioner may count the following 
163.13 	amounts of working family credit 
163.14 	expenditures as TANF/MOE:
163.15 	(1) fiscal year 2012, $12,037,000;
163.16 	(2) fiscal year 2013, $29,942,000;
163.17 	(3) fiscal year 2014, $23,235,000; and
163.18 	(4) fiscal year 2015, $23,198,000.
163.19 	Notwithstanding any contrary provision in 
163.20 	this article, this rider expires June 30, 2015.
163.21 	Food Stamps Employment and Training 
163.22 	Funds. (a) Notwithstanding Minnesota 
163.23 	Statutes, sections 256D.051, subdivisions 1a, 
163.24 	6b, and 6c, and 256J.626, federal food stamps 
163.25 	employment and training funds received 
163.26 	as reimbursement for child care assistance 
163.27 	program expenditures must be deposited in 
163.28 	the general fund. The amount of funds must 
163.29 	be limited to $500,000 per year in fiscal 
163.30 	years 2012 through 2015, contingent upon 
163.31 	approval by the federal Food and Nutrition 
163.32 	Service.
163.33 	(b) Consistent with the receipt of these 
163.34 	federal funds, the commissioner may 
164.1 	adjust the level of working family credit 
164.2 	expenditures claimed as TANF maintenance 
164.3 	of effort. Notwithstanding any contrary 
164.4 	provision in this article, this rider expires 
164.5 	June 30, 2015.
164.6 	ARRA Food Support Benefit Increases. 
164.7 	The funds provided for food support benefit 
164.8 	increases under the Supplemental Nutrition 
164.9 	Assistance Program provisions of the 
164.10 	American Recovery and Reinvestment Act 
164.11 	(ARRA) of 2009 must be used for benefit 
164.12 	increases beginning July 1, 2009.
164.13 	Supplemental Security Interim Assistance 
164.14 	Reimbursement Funds. $2,800,000 of 
164.15 	uncommitted revenue available to the 
164.16 	commissioner of human services for SSI 
164.17 	advocacy and outreach services must be 
164.18 	transferred to and deposited into the general 
164.19 	fund by October 1, 2011.
164.20 	Transfer.  By June 30, 2013, the 
164.21 	commissioner must transfer $109,303,000 
164.22 	from the health care access fund to the 
164.23 	general fund.

164.24	Subd. 2.Central Office Operations
 					
164.25 	The amounts that may be spent from this 
164.26 	appropriation for each purpose are as follows:

164.27	(a) Operations

164.28	Appropriations by Fund
	
164.29	General
	68,187,000
	66,563,000
	
164.30
164.31	State Government 
Special Revenue
	3,440,000
	3,440,000
	
164.32	Health Care Access
	11,508,000
	11,508,000
	
164.33	Federal TANF
	222,000
	222,000
	
164.34 	DHS Receipt Center Accounting. The 
164.35 	commissioner is authorized to transfer 
165.1 	appropriations to, and account for DHS 
165.2 	receipt center operations in, the special 
165.3 	revenue fund.
165.4 	Human Services Licensing Activities. 
165.5 	$3,000,000 each year of the biennium is 
165.6 	appropriated from the state government 
165.7 	special revenue fund to the commissioner 
165.8 	for human services licensing activities under 
165.9 	Minnesota Statutes, chapter 245A.
165.10 	Child Support Cost Recovery Fees. The 
165.11 	commissioner shall transfer $31,000 of child 
165.12 	support cost recovery fees collected in fiscal 
165.13 	year 2012 to the PRISM special revenue 
165.14 	account to offset PRISM system costs of 
165.15 	implementing the fee.
165.16 	Base Level Adjustment.  The general fund 
165.17 	base is increased by $79,000 in fiscal year 
165.18 	2014 only.

165.19	(b) Children and Families

165.20	Appropriations by Fund
	
165.21	General
	9,474,000
	9,227,000
	
165.22	Federal TANF
	2,160,000
	2,160,000
	
165.23 	Financial Institution Data Match and 
165.24 	Payment of Fees. The commissioner is 
165.25 	authorized to allocate up to $310,000 each 
165.26 	year in fiscal years 2012 and 2013 from the 
165.27 	PRISM special revenue account to make 
165.28 	payments to financial institutions in exchange 
165.29 	for performing data matches between account 
165.30 	information held by financial institutions 
165.31 	and the public authority's database of child 
165.32 	support obligors as authorized by Minnesota 
165.33 	Statutes, section 13B.06, subdivision 7.

165.34	(c) Health Care

166.1	Appropriations by Fund
	
166.2	General
	16,203,000
	16,195,000
	
166.3	Health Care Access
	23,115,000
	23,758,000
	
166.4 	Minnesota Senior Health Options 
166.5 	Reimbursement. Federal administrative 
166.6 	reimbursement resulting from the Minnesota 
166.7 	senior health options project is appropriated 
166.8 	to the commissioner for this activity.
166.9 	Utilization Review. Federal administrative 
166.10 	reimbursement resulting from prior 
166.11 	authorization and inpatient admission 
166.12 	certification by a professional review 
166.13 	organization shall be dedicated to the 
166.14 	commissioner for these purposes. A portion 
166.15 	of these funds must be used for activities to 
166.16 	decrease unnecessary pharmaceutical costs 
166.17 	in medical assistance.
166.18 	Base Level Adjustment.  The general fund 
166.19 	base is decreased by $13,000 in fiscal year 
166.20 	2014 and decreased by $125,000 in fiscal 
166.21 	year 2015.

166.22	(d) Continuing Care

166.23	Appropriations by Fund
	
166.24	General
	17,433,000
	17,339,000
	
166.25
166.26	State Government 
Special Revenue
	125,000
	125,000
	
166.27 	Base Level Adjustment.  The general fund 
166.28 	base is decreased by $587,000 in fiscal year 
166.29 	2014 and decreased by $687,000 in fiscal 
166.30 	year 2015.

166.31	(e) Chemical and Mental Health

166.32	Appropriations by Fund
	
166.33	General
	4,194,000
	4,194,000
	
166.34	Lottery Prize
	157,000
	157,000

166.35	Subd. 3.Forecasted Programs
 					
167.1 	The amounts that may be spent from this 
167.2 	appropriation for each purpose are as follows:

167.3	(a) MFIP/DWP Grants

167.4	Appropriations by Fund
	
167.5	General
	75,140,000
	78,040,000
	
167.6	Federal TANF
	84,425,000
	75,417,000

167.7	(b) MFIP Child Care Assistance Grants
		65,544,000
		58,908,000

167.8	(c) Adult Assistance 
		44,610,000
		44,610,000

167.9	(d) Minnesota Supplemental Aid Grants
		33,270,000
		33,554,000

167.10	(e) Group Residential Housing Grants
		121,080,000
		129,238,000

167.11	(f) MinnesotaCare Grants
		255,629,000
		242,742,000
	
167.12 	This appropriation is from the health care 
167.13 	access fund.

167.14	(g) GAMC Grants
		225,000,000
		225,000,000

167.15	(h) Medical Assistance Grants

167.16	Appropriations by Fund
	
167.17	General
	4,160,632,000
	3,968,969,000
	
167.18	Health Care Access
	2,882,000
	6,460,000
	
167.19 	Manage Elderly Waiver Growth. 
167.20 	Beginning July 1, 2011, and ending on June 
167.21 	30, 2013, the commissioner shall manage 
167.22 	the elderly waiver so that the number of 
167.23 	people does not exceed the number on June 
167.24 	30, 2011.
167.25 	Manage Growth in TBI and CADI 
167.26 	Waivers. During the fiscal years beginning 
167.27 	on July 1, 2011, and July 1, 2012, the 
167.28 	commissioner shall allocate money for home 
167.29 	and community-based waiver programs 
167.30 	under Minnesota Statutes, section 256B.49, 
167.31 	to ensure a reduction in state spending that is 
167.32 	equivalent to limiting the caseload growth of 
167.33 	the TBI waiver to no additional allocations 
168.1 	per month each year of the biennium and the 
168.2 	CADI waiver to no additional allocations 
168.3 	per month each year of the biennium. For 
168.4 	the TBI waiver and the CADI waiver, the 
168.5 	commissioner may reuse existing allocations. 
168.6 	Limits do not apply: 
168.7 	(1) when there is an approved plan for 
168.8 	nursing facility bed closures for individuals 
168.9 	under age 65 who require relocation due to 
168.10 	the bed closure;
168.11 	(2) to fiscal year 2009 waiver allocations 
168.12 	delayed due to unallotment; or
168.13 	(3) to transfers authorized by the 
168.14 	commissioner from the personal care 
168.15 	assistance program of individuals having a 
168.16 	home care rating of "CS," "MT," or "HL." 
168.17 	Priorities for the allocation of funds must be 
168.18 	for individuals anticipated to be discharged 
168.19 	from institutional settings or who are 
168.20 	at imminent risk of a placement in an 
168.21 	institutional setting.
168.22 	Manage Growth in DD Waiver. The 
168.23 	commissioner shall manage the growth in 
168.24 	the DD waiver by limiting the allocations 
168.25 	to no additional diversion allocations each 
168.26 	month for the calendar years that begin 
168.27 	on January 1, 2012, and January 1, 2013. 
168.28 	Existing allocations may be reused and must 
168.29 	be made available for transfers authorized 
168.30 	by the commissioner from the personal care 
168.31 	program of individuals having a home care 
168.32 	rating of "CS," "MT," or "HL."
168.33 	Reduction of Rates for Congregate 
168.34 	Living for Individuals with Lower Needs.
168.35 	Beginning October 1, 2011, lead agencies 
169.1 	must reduce rates in effect on January 1, 
169.2 	2011, by ten percent for individuals with 
169.3 	lower needs living in foster care settings 
169.4 	where the licenseholder does not share the 
169.5 	residence with recipients on the community 
169.6 	alternatives for disabled individuals (CADI), 
169.7 	developmental disabilities (DD), and 
169.8 	traumatic brain injury (TBI) waivers and 
169.9 	customized living settings for CADI and 
169.10 	TBI. Beginning July 1, 2013, the rate in 
169.11 	effect on January 1, 2011, must be reduced 
169.12 	by 15 percent. This reduction may include a 
169.13 	reduction or other modification in services. 
169.14 	Lead agencies must adjust contracts within 
169.15 	60 days of the effective date.
169.16 	Reduction of Lead Agency Waiver 
169.17 	Allocations to Implement Rate Reductions 
169.18 	for Congregate Living for Individuals 
169.19 	with Lower Needs. Beginning October 1, 
169.20 	2011, the commissioner shall reduce lead 
169.21 	agency waiver allocations to implement 
169.22 	the reduction of rates for individuals with 
169.23 	lower needs living in foster care settings 
169.24 	where the licenseholder does not share the 
169.25 	residence with recipients on the community 
169.26 	alternatives for disabled individuals (CADI), 
169.27 	developmental disabilities (DD), and 
169.28 	traumatic brain injury (TBI) waivers and 
169.29 	customized living settings for CADI and 
169.30 	TBI.
169.31 	Local Planning Grants for Creating 
169.32 	Alternatives to Congregate Living for 
169.33 	Individuals with Lower Needs. The 
169.34 	commissioner shall make available a total 
169.35 	of $250,000 per year in local planning 
169.36 	grants, beginning July 1, 2011, to assist 
170.1 	lead agencies and provider organizations in 
170.2 	developing alternatives to congregate living 
170.3 	within the available level of resources for the 
170.4 	home and community-based services waivers 
170.5 	for persons with disabilities.
170.6 	Managed Care Incentive Payments. The 
170.7 	commissioner shall not make managed care 
170.8 	incentive payments for expanding preventive 
170.9 	services. This provision does not expire.
170.10 	Nonadministrative Rate Reduction. For 
170.11 	services rendered on or after January 1, 2012, 
170.12 	the commissioner shall reduce contract rates 
170.13 	paid to managed care plans under Minnesota 
170.14 	Statutes, sections 256B.69 and 256L.12, 
170.15 	and to county-based purchasing plans under 
170.16 	Minnesota Statutes, section 256B.692, for 
170.17 	nonadministrative services, excluding elderly 
170.18 	waiver services, by 2.75 percent.

170.19	(i) Alternative Care Grants
		45,727,000
		47,877,000
	
170.20 	Alternative Care Transfer. Any money 
170.21 	allocated to the alternative care program that 
170.22 	is not spent for the purposes indicated does 
170.23 	not cancel but shall be transferred to the 
170.24 	medical assistance account.

170.25	(j) Chemical Dependency Entitlement Grants
		105,058,000
		123,774,000

170.26	Subd. 4.Grant Programs
 					
170.27 	The amounts that may be spent from this 
170.28 	appropriation for each purpose are as follows:

170.29	(a) Support Services Grants

170.30	Appropriations by Fund
	
170.31	General
	8,715,000
	8,715,000
	
170.32	Federal TANF
	110,525,000
	104,611,000
	
170.33 	Subsidized Employment Funding Through 
170.34 	ARRA. The commissioner is authorized to 
171.1 	apply for TANF emergency fund grants for 
171.2 	subsidized employment activities. Growth 
171.3 	in expenditures for subsidized employment 
171.4 	within the supported work program and the 
171.5 	MFIP consolidated fund over the amount 
171.6 	expended in the calendar year quarters in 
171.7 	the TANF emergency fund base year shall 
171.8 	be used to leverage the TANF emergency 
171.9 	fund grants for subsidized employment and 
171.10 	to fund supported work. The commissioner 
171.11 	shall develop procedures to maximize 
171.12 	reimbursement of these expenditures over the 
171.13 	TANF emergency fund base year quarters, 
171.14 	and may contract directly with employers 
171.15 	and providers to maximize these TANF 
171.16 	emergency fund grants.

171.17
171.18	(b) Basic Sliding Fee Child Care Assistance 
Grants
		37,192,000
		38,428,000
	
171.19 	Child Care and Development Fund 
171.20 	Unexpended Balance. In addition to 
171.21 	the amount provided in this section, the 
171.22 	commissioner shall expend $5,000,000 
171.23 	in fiscal year 2012 from the federal child 
171.24 	care and development fund unexpended 
171.25 	balance for basic sliding fee child care under 
171.26 	Minnesota Statutes, section 119B.03. The 
171.27 	commissioner shall ensure that all child 
171.28 	care and development funds are expended 
171.29 	according to the federal child care and 
171.30 	development fund regulations.
171.31 	Base Level Adjustment.  The general fund 
171.32 	base is decreased by $1,041,000 in fiscal 
171.33 	year 2014 and decreased by $1,036,000 in 
171.34 	fiscal year 2015.

171.35	(c) Child Care Development Grants
		147,000
		147,000

172.1	(d) Child Support Enforcement Grants
		50,000
		50,000
	
172.2 	Federal Child Support Demonstration 
172.3 	Grants. Federal administrative 
172.4 	reimbursement resulting from the federal 
172.5 	child support grant expenditures authorized 
172.6 	under section 1115a of the Social Security 
172.7 	Act is appropriated to the commissioner for 
172.8 	this activity.

172.9	(e) Children's Services Grants

172.10	Appropriations by Fund
	
172.11	General
	34,701,000
	34,701,000
	
172.12	Federal TANF
	140,000
	140,000
	
172.13 	Adoption Assistance and Relative Custody 
172.14 	Assistance.  The commissioner may transfer 
172.15 	unencumbered appropriation balances for 
172.16 	adoption assistance and relative custody 
172.17 	assistance between fiscal years and between 
172.18 	programs.
172.19 	Privatized Adoption Grants. Federal 
172.20 	reimbursement for privatized adoption grant 
172.21 	and foster care recruitment grant expenditures 
172.22 	is appropriated to the commissioner for 
172.23 	adoption grants and foster care and adoption 
172.24 	administrative purposes.
172.25 	Adoption Assistance Incentive Grants.
172.26 	Federal funds available during fiscal year 
172.27 	2012 and fiscal year 2013 for adoption 
172.28 	incentive grants are appropriated to the 
172.29 	commissioner for these purposes.

172.30	(f) Children and Community Services Grants
		54,301,000
		52,301,000

172.31	(g) Children and Economic Support Grants
		10,892,000
		10,894,000
	
172.32 	Base Level Adjustment. The general fund 
172.33 	base is decreased by $1,000 in fiscal year 
172.34 	2014 only.

173.1	(h) Health Care Grants
		190,000
		190,000
	
173.2 	This appropriation is from the health care 
173.3 	access fund.
173.4 	Surplus Appropriation Canceled. Of the 
173.5 	health care access fund appropriation in 
173.6 	Laws 2009, chapter 79, article 13, section 3, 
173.7 	subdivision 6, paragraph (e), for the COBRA 
173.8 	premium state subsidy program, $11,750,000 
173.9 	must be canceled in fiscal year 2011. This 
173.10 	provision is effective the day following final 
173.11 	enactment.

173.12	(i) Aging and Adult Services Grants
		15,882,000
		16,288,000
	
173.13 	Aging Grants Reduction. Effective July 
173.14 	1, 2011, funding for grants made under 
173.15 	Minnesota Statutes, sections 256.9754 and 
173.16 	256B.0917, subdivision 13, is reduced by 
173.17 	$3,600,000 for each year of the biennium. 
173.18 	These reductions are onetime and do 
173.19 	not affect base funding for the 2014-2015 
173.20 	biennium. Grants made during the 2012-2013 
173.21 	biennium under Minnesota Statutes, section 
173.22 	256B.9754, must not be used for new 
173.23 	construction or building renovation.
173.24 	Base Level Adjustment.  The general fund 
173.25 	base is increased by $3,600,000 in fiscal year 
173.26 	2014 and increased by $3,600,000 in fiscal 
173.27 	year 2015.

173.28	(j) Deaf and Hard-of-Hearing Grants
		1,679,000
		1,510,000
	
173.29 	Deaf and Hard-of-Hearing Grants 
173.30 	Reduction. Deaf and hard-of-hearing grants 
173.31 	are reduced by $257,000 in fiscal year 2012 
173.32 	and $257,000 in fiscal year 2013.

173.33	(k) Disabilities Grants
		13,181,000
		16,358,000
	
174.1 	HIV Grants. The general fund appropriation 
174.2 	for the HIV drug and insurance grant 
174.3 	program shall be reduced by $2,425,000 in 
174.4 	fiscal year 2012 and increased by $2,425,000 
174.5 	in fiscal year 2014. These adjustments are 
174.6 	onetime and shall not be applied to the base. 
174.7 	Notwithstanding any contrary provision, this 
174.8 	provision expires June 30, 2014.
174.9 	Personal Care Assistance Funding. Of 
174.10 	the appropriation for grants to provide 
174.11 	alternatives for those recipients losing access 
174.12 	to personal care assistance services on July 1, 
174.13 	2011, due to the 2009 personal care assistance 
174.14 	legislative changes, and $3,237,000 in fiscal 
174.15 	year 2012 and $4,856,000 in fiscal year 
174.16 	2013 is transferred from the disabilities 
174.17 	grants budget activity to the appropriation 
174.18 	for medical assistance grants.
174.19 	Base Level Adjustment.  The general fund 
174.20 	base is increased by $2,425,000 in fiscal year 
174.21 	2014 only.

174.22	(l) Adult Mental Health Grants

174.23	Appropriations by Fund
	
174.24	General
	69,143,000
	69,143,000
	
174.25	Lottery Prize
	1,508,000
	1,508,000
	
174.26 	Funding Usage. Up to 75 percent of a fiscal 
174.27 	year's appropriation for adult mental health 
174.28 	grants may be used to fund allocations in that 
174.29 	portion of the fiscal year ending December 
174.30 	31.

174.31	(m) Children's Mental Health Grants
		7,044,000
		7,044,000
	
174.32 	Funding Usage. Up to 75 percent of a fiscal 
174.33 	year's appropriation for children's mental 
174.34 	health grants may be used to fund allocations 
175.1 	in that portion of the fiscal year ending 
175.2 	December 31.

175.3
175.4	(n) Chemical Dependency Nonentitlement 
Grants
		1,336,000
		1,336,000

175.5	Subd. 5.State-Operated Services
 					
175.6 	Transfer Authority Related to 
175.7 	State-Operated Services. Money 
175.8 	appropriated for state-operated services 
175.9 	may be transferred between fiscal years 
175.10 	of the biennium with the approval of the 
175.11 	commissioner of management and budget.

175.12	(a) State-Operated Services Mental Health
		115,286,000
		115,135,000
	
175.13 	The commissioner shall close the Community 
175.14 	Behavioral Health Hospital-Willmar on or 
175.15 	before June 30, 2011. The commissioner 
175.16 	shall relocate the Child and Adolescent 
175.17 	Behavioral Health Hospital located in 
175.18 	the former Willmar Regional Treatment 
175.19 	Center to the facility previously housing 
175.20 	the Community Behavioral Health 
175.21 	Hospital-Willmar.

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

175.23	Subd. 6.Sex Offender Program
 		67,570,000
		67,570,000
	
175.24 	Transfer Authority Related to Minnesota 
175.25 	Sex Offender Program. Money 
175.26 	appropriated for the Minnesota sex offender 
175.27 	program may be transferred between fiscal 
175.28 	years of the biennium with the approval 
175.29 	of the commissioner of management and 
175.30 	budget.

175.31	Subd. 7.Technical Activities
 		67,186,000
		67,531,000
	
175.32 	This appropriation is from the federal TANF 
175.33 	fund.
176.1 	Base Level Adjustment.  The TANF fund 
176.2 	base is increased by $357,000 in fiscal year 
176.3 	2014 and increased by $784,000 in fiscal 
176.4 	year 2015.

176.5	Sec. 4. COMMISSIONER OF HEALTH

176.6	Subdivision 1.Total Appropriation
 	$
	119,111,000
	$
	112,821,000

176.7	Appropriations by Fund
	
176.8		2012
	2013
	
176.9	General
	62,960,000
	58,261,000
	
176.10
176.11	State Government 
Special Revenue
	45,268,000
	45,325,000
	
176.12	Health Care Access
	10,883,000
	9,235,000
	
176.13 	The amounts that may be spent for each 
176.14 	purpose are specified in the following 
176.15 	subdivisions.

176.16
176.17	Subd. 2.Community and Family Health 
Promotion

176.18	Appropriations by Fund
	
176.19	General
	38,728,000
	34,031,000
	
176.20
176.21	State Government 
Special Revenue
	1,033,000
	1,033,000
	
176.22	Health Care Access
	1,719,000
	1,719,000

176.23	Subd. 3.Policy Quality and Compliance

176.24	Appropriations by Fund
	
176.25	General
	9,190,000
	9,190,000
	
176.26
176.27	State Government 
Special Revenue
	14,026,000
	14,083,000
	
176.28	Health Care Access
	9,164,000
	7,516,000
	
176.29 	Medical Education and Research 
176.30 	Costs (MERC) Fund Transfers. The 
176.31 	commissioner of management and budget 
176.32 	shall transfer $9,800,000 from the MERC 
176.33 	fund to the general fund by October 1, 2011.
176.34 	Unused Federal Match Funds. Of the 
176.35 	funds appropriated in Laws 2009, chapter 
176.36 	79, article 13, section 4, subdivision 3, for 
177.1 	state matching funds for the federal Health 
177.2 	Information Technology for Economic and 
177.3 	Clinical Health Act, $2,800,000 is transferred 
177.4 	to the health care access fund by October 1, 
177.5 	2011.
177.6 	Loan Forgiveness. $1,014,000 is 
177.7 	appropriated from the health care access 
177.8 	fund in fiscal year 2012 for the department to 
177.9 	fulfill existing obligations of loan forgiveness 
177.10 	agreements. This funding is available 
177.11 	through fiscal year 2014. In addition, prior 
177.12 	year funds appropriated for loan forgiveness 
177.13 	and required to fulfill existing obligations do 
177.14 	not expire and are available until expended.
177.15 	Base Level Adjustment. The state 
177.16 	government special revenue fund base shall 
177.17 	be reduced by $141,000 in fiscal years 2014 
177.18 	and 2015. The health care access base shall 
177.19 	be increased by $600,000 in fiscal year 2014 
177.20 	only.

177.21	Subd. 4.Health Protection

177.22	Appropriations by Fund
	
177.23	General
	8,891,000
	8,891,000
	
177.24
177.25	State Government 
Special Revenue
	30,209,000
	30,209,000

177.26	Subd. 5.Administrative Support Services
 		6,151,000
		6,149,000

177.27	Sec. 5. HEALTH-RELATED BOARDS

177.28	Subdivision 1.Total Appropriation
 	$
	17,466,000
	$
	17,252,000
	
177.29 	This appropriation is from the state 
177.30 	government special revenue fund.
177.31 	The amounts that may be spent for each 
177.32 	purpose are specified in the following 
177.33 	subdivisions.

177.34	Subd. 2.Board of Chiropractic Examiners
 		453,0000
		453,000

178.1	Subd. 3.Board of Dentistry
 		1,829,000
		1,814,000
	
178.2 	Health Professional Services Program. Of 
178.3 	this appropriation, $704,000 in fiscal year 
178.4 	2012 and $704,000 in fiscal year 2013 from 
178.5 	the state government special revenue fund are 
178.6 	for the health professional services program.

178.7
178.8	Subd. 4.Board of Dietetic and Nutrition 
Practice
 		105,000
		105,000

178.9178.10
	Subd. 5.Board of Marriage and Family 
Therapy
 		184,000
		159,000

178.11	Subd. 6.Board of Medical Practice
 		3,682,000
		3,682,000

178.12	Subd. 7.Board of Nursing
 		3,694,000
		3,551,000

178.13
178.14	Subd. 8.Board of Nursing Home 
Administrators
 		2,153,000
		2,145,000
	
178.15 	Administrative Services Unit - Operating 
178.16 	Costs. Of this appropriation, $526,000 
178.17 	in fiscal year 2012 and $526,000 in fiscal 
178.18 	year 2013 are for the operating costs 
178.19 	of the administrative services unit. The 
178.20 	administrative services unit may receive 
178.21 	and expend reimbursements for services 
178.22 	performed by other agencies.
178.23 	Administrative Services Unit - Retirement 
178.24 	Costs. Of this appropriation in fiscal year 
178.25 	2012, $225,000 is for onetime retirement 
178.26 	costs in the health-related boards. This 
178.27 	funding may be transferred to the health 
178.28 	boards incurring those costs for their 
178.29 	payment. These funds are available either 
178.30 	year of the biennium.
178.31 	Administrative Services Unit - Volunteer 
178.32 	Health Care Provider Program. Of this 
178.33 	appropriation, $150,000 in fiscal year 2012 
178.34 	and $150,000 in fiscal year 2013 are to pay 
179.1 	for medical professional liability coverage 
179.2 	required under Minnesota Statutes, section 
179.3 	214.40.
179.4 	Administrative Services Unit - Contested 
179.5 	Cases and Other Legal Proceedings. Of 
179.6 	this appropriation, $200,000 in fiscal year 
179.7 	2012 and $200,000 in fiscal year 2013 are 
179.8 	for costs of contested case hearings and other 
179.9 	unanticipated costs of legal proceedings 
179.10 	involving health-related boards funded 
179.11 	under this section. Upon certification of a 
179.12 	health-related board to the administrative 
179.13 	services unit that the costs will be incurred 
179.14 	and that there is insufficient money available 
179.15 	to pay for the costs out of money currently 
179.16 	available to that board, the administrative 
179.17 	services unit is authorized to transfer money 
179.18 	from this appropriation to the board for 
179.19 	payment of those costs with the approval 
179.20 	of the commissioner of management and 
179.21 	budget. This appropriation does not cancel. 
179.22 	Any unencumbered and unspent balances 
179.23 	remain available for these expenditures in 
179.24 	subsequent fiscal years.
179.25 	The state government special revenue fund 
179.26 	base is reduced by $1,011,000 in fiscal years 
179.27 	2014 and 2015.

179.28	Subd. 9.Board of Optometry
 		101,000
		101,000

179.29	Subd. 10.Board of Pharmacy
 		2,341,000
		2,344,000
	
179.30 	Prescription Electronic Reporting. Of 
179.31 	this appropriation, $356,000 in fiscal year 
179.32 	2012 and $356,000 in fiscal year 2013 from 
179.33 	the state government special revenue fund 
179.34 	are to the board to operate the prescription 
179.35 	electronic reporting system in Minnesota 
180.1 	Statutes, section 152.126. Base level funding 
180.2 	for this activity in fiscal year 2014 shall be 
180.3 	$356,000.

180.4	Subd. 11.Board of Physical Therapy
 		389,000
		345,000

180.5	Subd. 12.Board of Podiatry
 		71,000
		71,000

180.6	Subd. 13.Board of Psychology
 		806,000
		806,000

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

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

180.9180.10
	Subd. 16.Board of Behavioral Health and 
Therapy
 		394,000
		394,000

180.11	Sec. 6. COUNCIL ON DISABILITY
 	$
	524,000
	$
	524,000

180.12
180.13
180.14	Sec. 7. OMBUDSMAN FOR MENTAL 
HEALTH AND DEVELOPMENTAL 
DISABILITIES
 	$
	1,655,000
	$
	1,655,000

180.15	Sec. 8. OMBUDSPERSON FOR FAMILIES
 	$
	265,000
	$
	265,000

180.16
180.17	Sec. 9. EMERGENCY MEDICAL SERVICES 
BOARD
 	$
	2,742,000
	$
	2,742,000
	
180.18 	Of the appropriation, $700,000 in fiscal year 
180.19 	2012 and $700,000 in fiscal year 2013 are 
180.20 	for the Cooper/Sams volunteer ambulance 
180.21 	program under Minnesota Statutes, section 
180.22 	144E.40.

180.23 	Sec. 10. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision 
180.24 	to read:
180.25 		Subd. 33.Federal administrative reimbursement dedicated. Federal 
180.26 	administrative reimbursement resulting from the following activities is appropriated to the 
180.27 	commissioner for the designated purposes:
180.28 	(1) reimbursement for the Minnesota senior health options project; and
180.29 	(2) reimbursement related to prior authorization and inpatient admission certification 
180.30 	by a professional review organization. A portion of these funds must be used for activities 
180.31 	to decrease unnecessary pharmaceutical costs in medical assistance.

181.1 	Sec. 11. Laws 2010, First Special Session chapter 1, article 15, section 3, subdivision 
181.2 	6, is amended to read:

181.3	Subd. 6.Continuing Care Grants

181.4	(a) Aging and Adult Services Grants
		(3,600,000)
		(3,600,000)
	
181.5 	Community Service/Service Development 
181.6 	Grants Reduction. Effective retroactively 
181.7 	from July 1, 2009, funding for grants made 
181.8 	under Minnesota Statutes, sections 256.9754
181.9 	and 256B.0917, subdivision 13, is reduced 
181.10 	by $5,807,000 for each year of the biennium. 
181.11 	Grants made during the biennium under 
181.12 	Minnesota Statutes, section 256.9754, shall 
181.13 	not be used for new construction or building 
181.14 	renovation.
181.15 	Aging Grants Delay. Aging grants must be 
181.16 	reduced by $917,000 in fiscal year 2011 and 
181.17 	increased by $917,000 in fiscal year 2012. 
181.18 	These adjustments are onetime and must not 
181.19 	be applied to the base. This provision expires 
181.20 	June 30, 2012.

181.21
181.22	(b) Medical Assistance Long-Term Care 
Facilities Grants
		(3,827,000)
		(2,745,000)
	
181.23 	ICF/MR Variable Rates Suspension.
181.24 	Effective retroactively from July 1, 2009, 
181.25 	to June 30, 2010, no new variable rates 
181.26 	shall be authorized for intermediate care 
181.27 	facilities for persons with developmental 
181.28 	disabilities under Minnesota Statutes, section 
181.29 	256B.5013, subdivision 1.
181.30 	ICF/MR Occupancy Rate Adjustment 
181.31 	Suspension. Effective retroactively from 
181.32 	July 1, 2009, to June 30, 2011, approval 
181.33 	of new applications for occupancy rate 
181.34 	adjustments for unoccupied short-term 
182.1 	beds under Minnesota Statutes, section 
182.2 	256B.5013, subdivision 7, is suspended.

182.3
182.4	(c) Medical Assistance Long-Term Care 
Waivers and Home Care Grants
		(2,318,000)
		(5,807,000)
	
182.5 	Developmental Disability Waiver Acuity 
182.6 	Factor. Effective retroactively from January 
182.7 	1, 2010, the January 1, 2010, one percent 
182.8 	growth factor in the developmental disability 
182.9 	waiver allocations under Minnesota Statutes, 
182.10 	section 256B.092, subdivisions 4 and 5, 
182.11 	that is attributable to changes in acuity, is 
182.12 	suspended to June 30, 2011 eliminated. 
182.13 	Notwithstanding any law to the contrary, this 
182.14 	provision does not expire.

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

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

182.17
182.18	(f) Chemical Dependency Nonentitlement 
Grants
		(393,000)
		(393,000)

182.19
182.20	(g) Other Continuing Care Grants
		-0-
		(2,500,000)
(1,414,000)
	
182.21 	Other Continuing Care Grants Delay.
182.22 	Other continuing care grants must be reduced 
182.23 	by $1,414,000 in fiscal year 2011 and 
182.24 	increased by $1,414,000 in fiscal year 2012. 
182.25 	These adjustments are onetime and must not 
182.26 	be applied to the base. This provision expires 
182.27 	June 30, 2012.

182.28	(h) Deaf and Hard-of-Hearing Grants
		-0-
		(169,000)
	
182.29 	Deaf and Hard-of-Hearing Grants Delay.
182.30 	Effective retroactively from July 1, 2010, 
182.31 	deaf and hard-of-hearing grants must be 
182.32 	reduced by $169,000 in fiscal year 2011 and 
182.33 	increased by $169,000 in fiscal year 2012. 
182.34 	These adjustments are onetime and must not 
183.1 	be applied to the base. This provision expires 
183.2 	June 30, 2012.

183.3 	Sec. 12. TRANSFERS.
 183.4 		Subdivision 1.Grants. The commissioner of human services, with the approval 
183.5 	of the commissioner of management and budget, and after notification of the chairs of 
183.6 	the senate health and human services budget and policy committee and the house of 
183.7 	representatives health and human services finance committee, may transfer unencumbered 
183.8 	appropriation balances for the biennium ending June 30, 2013, within fiscal years among 
183.9 	the MFIP; general assistance; general assistance medical care under Minnesota Statutes, 
183.10 	section 256D.03, subdivision 3; medical assistance; MFIP child care assistance under 
183.11 	Minnesota Statutes, section 119B.05; Minnesota supplemental aid; and group residential 
183.12 	housing programs, and the entitlement portion of the chemical dependency consolidated 
183.13 	treatment fund, and between fiscal years of the biennium.
183.14 		Subd. 2.Administration. Positions, salary money, and nonsalary administrative 
183.15 	money may be transferred within the Departments of Health and Human Services as the 
183.16 	commissioners consider necessary, with the advance approval of the commissioner of 
183.17 	management and budget. The commissioner shall inform the chairs of the senate health 
183.18 	and human services budget and policy committee and the house of representatives health 
183.19 	and human services finance committee quarterly about transfers made under this provision.

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

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

183.26 	Sec. 15. EFFECTIVE DATE.
 183.27 	The provisions in this article are effective July 1, 2011, unless a different effective 
183.28 	date is specified.

184.1 	ARTICLE 9
184.2 	HUMAN SERVICES FORECAST ADJUSTMENTS

184.3
184.4	Section 1. DEPARTMENT OF HUMAN SERVICES FORECAST ADJUSTMENT 
APPROPRIATIONS.
 	
184.5 	The sums shown are added to, or if shown in parentheses, are subtracted from the 
184.6 	appropriations in Laws 2009, chapter 79, article 13, as amended by Laws 2009, chapter 
184.7 	173, article 2; Laws 2010, First Special Session chapter 1, articles 15, 23, and 25; and 
184.8 	Laws 2010, Second Special Session chapter 1, article 3, to the commissioner of human 
184.9 	services and for the purposes specified in this article. The appropriations are from the 
184.10 	general fund or another named fund and are available for the fiscal year indicated for 
184.11 	each purpose. The figure "2011" used in this article means that the appropriation or 
184.12 	appropriations listed are available for the fiscal year ending June 30, 2011.

184.13
184.14	Sec. 2. COMMISSIONER OF HUMAN 
SERVICES

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

184.16	Appropriations by Fund
	
184.17			2011
	
184.18	General
		(381,869,000)
	
184.19	Health Care Access
		169,514,000
	
184.20	Federal TANF
		(23,108,000)
	
184.21 	The amounts that may be spent for each 
184.22 	purpose are specified in the following 
184.23 	subdivisions.

184.24	Subd. 2.Revenue and Pass-through
 				732,000
	
184.25 	This appropriation is from the federal TANF 
184.26 	fund.

184.27
184.28	Subd. 3.Children and Economic Assistance 
Grants

184.29	Appropriations by Fund
	
184.30	General
		(7,098,000)
	
184.31	Federal TANF
		(23,840,000)

184.32	(a) MFIP/DWP Grants

184.33	Appropriations by Fund
	
184.34	General
		18,715,000
	
184.35	Federal TANF
		(23,840,000)

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

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

185.3	(d) Minnesota Supplemental Aid Grants
				793,000

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

185.5	Subd. 4.Basic Health Care Grants

185.6	Appropriations by Fund
	
185.7	General
		(335,050,000)
	
185.8	Health Care Access
		169,514,000

185.9	(a) MinnesotaCare Grants
				169,514,000
	
185.10 	This appropriation is from the health care 
185.11 	access fund.

185.12
185.13	(b) Medical Assistance Basic Health Care - 
Families and Children
				(49,368,000)

185.14
185.15	(c) Medical Assistance Basic Health Care - 
Elderly and Disabled
				(43,258,000)

185.16
185.17	(d) Medical Assistance Basic Health Care - 
Adults without Children
				(242,424,000)

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

185.19
185.20	(a) Medical Assistance Long-Term Care 
Facilities
				(14,627,000)

185.21
185.22	(b) Medical Assistance Long-Term Care 
Waivers
				(44,718,000)

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

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

185.26	Subd. 6.Health Care Grants

185.27	(a) MinnesotaCare Grants
		998,000
		(13,376,000)
	
185.28 	This appropriation is from the health care 
185.29 	access fund.
185.30 	Health Care Access Fund Transfer to 
185.31 	General Fund. The commissioner of 
186.1 	management and budget shall transfer the 
186.2 	following amounts in the following years 
186.3 	from the health care access fund to the 
186.4 	general fund: $998,000 $0 in fiscal year 
186.5 	2010; $176,704,000 $59,901,000 in fiscal 
186.6 	year 2011; $141,041,000 in fiscal year 2012; 
186.7 	and $286,150,000 in fiscal year 2013. If at 
186.8 	any time the governor issues an executive 
186.9 	order not to participate in early medical 
186.10 	assistance expansion, no funds shall be 
186.11 	transferred from the health care access 
186.12 	fund to the general fund until early medical 
186.13 	assistance expansion takes effect. This 
186.14 	paragraph is effective the day following final 
186.15 	enactment.
186.16 	MinnesotaCare Ratable Reduction.
186.17 	Effective for services rendered on or after 
186.18 	July 1, 2010, to December 31, 2013, 
186.19 	MinnesotaCare payments to managed care 
186.20 	plans under Minnesota Statutes, section 
186.21 	256L.12, for single adults and households 
186.22 	without children whose income is greater 
186.23 	than 75 percent of federal poverty guidelines 
186.24 	shall be reduced by 15 percent. Effective 
186.25 	for services provided from July 1, 2010, to 
186.26 	June 30, 2011, this reduction shall apply to 
186.27 	all services. Effective for services provided 
186.28 	from July 1, 2011, to December 31, 2013, this 
186.29 	reduction shall apply to all services except 
186.30 	inpatient hospital services. Notwithstanding 
186.31 	any contrary provision of this article, this 
186.32 	paragraph shall expire on December 31, 
186.33 	2013.

186.34
186.35	(b) Medical Assistance Basic Health Care 
Grants - Families and Children
		-0-
		295,512,000
	
187.1 	Critical Access Dental. Of the general 
187.2 	fund appropriation, $731,000 in fiscal year 
187.3 	2011 is to the commissioner for critical 
187.4 	access dental provider reimbursement 
187.5 	payments under Minnesota Statutes, section 
187.6 	256B.76 subdivision 4. This is a onetime 
187.7 	appropriation.
187.8 	Nonadministrative Rate Reduction. For 
187.9 	services rendered on or after July 1, 2010, 
187.10 	to December 31, 2013, the commissioner 
187.11 	shall reduce contract rates paid to managed 
187.12 	care plans under Minnesota Statutes, 
187.13 	sections 256B.69 and 256L.12, and to 
187.14 	county-based purchasing plans under 
187.15 	Minnesota Statutes, section 256B.692, by 
187.16 	three percent of the contract rate attributable 
187.17 	to nonadministrative services in effect on 
187.18 	June 30, 2010. Notwithstanding any contrary 
187.19 	provision in this article, this rider expires on 
187.20 	December 31, 2013.

187.21
187.22	(c) Medical Assistance Basic Health Care 
Grants - Elderly and Disabled
		-0-
		(30,265,000)

187.23
187.24	(d) General Assistance Medical Care Grants
		-0-
		(75,389,000)
(59,583,000)
	
187.25 	The reduction to general assistance medical 
187.26 	care grants is contingent upon the effective 
187.27 	date in Laws 2010, First Special Session 
187.28 	chapter 1, article 16, section 48. The 
187.29 	reduction shall be reestimated based upon 
187.30 	the actual effective date of the law. The 
187.31 	commissioner of management and budget 
187.32 	shall make adjustments in fiscal year 
187.33 	2011 to general assistance medical care 
187.34 	appropriations to conform to the total 
187.35 	expected expenditure reductions specified in 
187.36 	this section.

188.1	(e)  Other Health Care Grants
		-0-
		(7,000,000)
	
188.2 	Cobra Carryforward. Unexpended funds 
188.3 	appropriated in fiscal year 2010 for COBRA 
188.4 	grants under Laws 2009, chapter 79, article 
188.5 	5, section 78, do not cancel and are available 
188.6 	to the commissioner for fiscal year 2011 
188.7 	COBRA grant expenditures. Up to $111,000 
188.8 	of the fiscal year 2011 appropriation for 
188.9 	COBRA grants provided in Laws 2009, 
188.10 	chapter 79, article 13, section 3, subdivision 
188.11 	6, may be used by the commissioner for costs 
188.12 	related to administration of the COBRA 
188.13 	grants.

188.14 	Sec. 4. EFFECTIVE DATE.
 188.15 	This article is effective the day following final enactment.