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 continuing care, chemical and mental health, 
1.4 	children and family services, human services licensing, health care programs, 
1.5 	the Department of Health, and health licensing boards; appropriating money to 
1.6 	the departments of health and human services and other health-related boards 
1.7 	and councils; making forecast adjustments; requiring reports; imposing fees; 
1.8 	imposing criminal penalties;amending Minnesota Statutes 2010, sections 8.31, 
1.9 	subdivisions 1, 3a; 62E.14, by adding a subdivision; 62J.04, subdivision 3; 
1.10 	62J.17, subdivision 4a; 62J.692, subdivisions 4, 7; 103I.005, subdivisions 
1.11 	2, 8, 12, by adding a subdivision; 103I.101, subdivisions 2, 5; 103I.105; 
1.12 	103I.111, subdivision 8; 103I.205, subdivision 4; 103I.208, subdivision 2; 
1.13 	103I.501; 103I.531, subdivision 5; 103I.535, subdivision 6; 103I.641; 103I.711, 
1.14 	subdivision 1; 103I.715, subdivision 2; 119B.011, subdivision 13; 119B.09, 
1.15 	subdivision 10, by adding subdivisions; 119B.125, by adding a subdivision; 
1.16 	119B.13, subdivisions 1, 1a, 7; 144.125, subdivisions 1, 3; 144.128; 144.396, 
1.17 	subdivisions 5, 6; 145.925, subdivision 1; 145.928, subdivisions 7, 8; 148.108, by 
1.18 	adding a subdivision; 148.191, subdivision 2; 148.212, subdivision 1; 148.231; 
1.19 	151.07; 151.101; 151.102, by adding a subdivision; 151.12; 151.13, subdivision 
1.20 	1; 151.19; 151.25; 151.47, subdivision 1; 151.48; 152.12, subdivision 3; 
1.21 	245A.10, subdivisions 1, 3, 4, by adding subdivisions; 245A.11, subdivision 
1.22 	2b; 245A.143, subdivision 1; 245C.10, by adding a subdivision; 254B.03, 
1.23 	subdivision 4; 254B.04, by adding a subdivision; 254B.06, subdivision 2; 256.01, 
1.24 	subdivisions 14, 24, 29, by adding a subdivision; 256.969, subdivision 2b; 
1.25 	256B.04, subdivision 18; 256B.056, subdivisions 1a, 3; 256B.057, subdivision 
1.26 	9; 256B.06, subdivision 4; 256B.0625, subdivisions 8, 8a, 8b, 8c, 12, 13e, 
1.27 	17, 17a, 18, 19a, 25, 31a, by adding subdivisions; 256B.0651, subdivision 1; 
1.28 	256B.0652, subdivision 6; 256B.0653, subdivisions 2, 6; 256B.0911, subdivision 
1.29 	3a; 256B.0913, subdivision 4; 256B.0915, subdivisions 3a, 3b, 3e, 3h, 6, 
1.30 	10; 256B.14, by adding a subdivision; 256B.431, subdivisions 2r, 32, 42, by 
1.31 	adding a subdivision; 256B.437, subdivision 6; 256B.441, subdivisions 50a, 
1.32 	59; 256B.48, subdivision 1; 256B.49, subdivision 16a; 256B.69, subdivisions 
1.33 	4, 5a, by adding a subdivision; 256B.76, subdivision 4; 256D.02, subdivision 
1.34 	12a; 256D.031, subdivisions 6, 7, 9; 256D.44, subdivision 5; 256D.47; 256D.49, 
1.35 	subdivision 3; 256E.30, subdivision 2; 256E.35, subdivisions 5, 6; 256J.12, 
1.36 	subdivisions 1a, 2; 256J.37, by adding a subdivision; 256J.38, subdivision 1; 
1.37 	256L.04, subdivision 7; 256L.05, by adding a subdivision; 256L.11, subdivision 
1.38 	7; 256L.12, subdivision 9; 297F.10, subdivision 1; 393.07, subdivision 10; 
1.39 	402A.10, subdivisions 4, 5; 402A.15; 518A.51; Laws 2008, chapter 363, article 
2.1 	18, section 3, subdivision 5; Laws 2010, First Special Session chapter 1, article 
2.2 	15, section 3, subdivision 6; article 25, section 3, subdivision 6; proposing 
2.3 	coding for new law in Minnesota Statutes, chapters 1; 145; 148; 151; 214; 256; 
2.4 	256B; 256L; proposing coding for new law as Minnesota Statutes, chapter 
2.5 	256N; repealing Minnesota Statutes 2010, sections 62J.17, subdivisions 1, 3, 5a, 
2.6 	6a, 8; 62J.321, subdivision 5a; 62J.381; 62J.41, subdivisions 1, 2; 103I.005, 
2.7 	subdivision 20; 144.1464; 144.147; 144.1487; 144.1488, subdivisions 1, 3, 
2.8 	4; 144.1489; 144.1490; 144.1491; 144.1499; 144.1501; 144.6062; 145.925; 
2.9 	145A.14, subdivisions 1, 2a; 245A.10, subdivision 5; 256.979, subdivisions 
2.10 	5, 6, 7, 10; 256.9791; 256B.055, subdivision 15; 256B.0625, subdivision 8e; 
2.11 	256B.0653, subdivision 5; 256B.0756; 256D.01, subdivisions 1, 1a, 1b, 1e, 
2.12 	2; 256D.03, subdivisions 1, 2, 2a; 256D.031, subdivisions 5, 8; 256D.05, 
2.13 	subdivisions 1, 2, 4, 5, 6, 7, 8; 256D.0513; 256D.053, subdivisions 1, 2, 3; 
2.14 	256D.06, subdivisions 1, 1b, 2, 5, 7, 8; 256D.09, subdivisions 1, 2, 2a, 2b, 5, 6; 
2.15 	256D.10; 256D.13; 256D.15; 256D.16; 256D.35, subdivision 8b; 256D.46; Laws 
2.16 	2010, First Special Session chapter 1, article 16, sections 6; 7; Minnesota Rules, 
2.17 	parts 3400.0130, subpart 8; 4651.0100, subparts 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 
2.18 	12, 14, 15, 16, 16a, 18, 19, 20, 20a, 21, 22, 23; 4651.0110, subparts 2, 2a, 3, 4, 5; 
2.19 	4651.0120; 4651.0130; 4651.0140; 4651.0150; 9500.1243, subpart 3.
2.20 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

2.21 	ARTICLE 1
2.22 	CONTINUING CARE

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

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

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

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

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

4.24 	Sec. 4. Minnesota Statutes 2010, section 256B.056, subdivision 3, is amended to read:
4.25 		Subd. 3.Asset limitations for individuals and families. (a) To be eligible for 
4.26 	medical assistance, a person must not individually own more than $3,000 in assets, or if a 
4.27 	member of a household with two family members, husband and wife, or parent and child, 
4.28 	the household must not own more than $6,000 in assets, plus $200 for each additional 
4.29 	legal dependent. In addition to these maximum amounts, an eligible individual or family 
4.30 	may accrue interest on these amounts, but they must be reduced to the maximum at the 
4.31 	time of an eligibility redetermination. The accumulation of the clothing and personal 
4.32 	needs allowance according to section 256B.35 must also be reduced to the maximum at 
4.33 	the time of the eligibility redetermination. The value of assets that are not considered in 
4.34 	determining eligibility for medical assistance is the value of those assets excluded under 
5.1 	the supplemental security income program for aged, blind, and disabled persons, with 
5.2 	the following exceptions:
5.3 	(1) household goods and personal effects are not considered;
5.4 	(2) capital and operating assets of a trade or business that the local agency determines 
5.5 	are necessary to the person's ability to earn an income are not considered;
5.6 	(3) motor vehicles are excluded to the same extent excluded by the supplemental 
5.7 	security income program;
5.8 	(4) assets designated as burial expenses are excluded to the same extent excluded by 
5.9 	the supplemental security income program. Burial expenses funded by annuity contracts 
5.10 	or life insurance policies must irrevocably designate the individual's estate as contingent 
5.11 	beneficiary to the extent proceeds are not used for payment of selected burial expenses; and
5.12 	(5) effective upon federal approval, for a person who no longer qualifies as an 
5.13 	employed person with a disability due to loss of earnings, assets allowed while eligible 
5.14 	for medical assistance under section 256B.057, subdivision 9, are not considered for 12 
5.15 	months, beginning with the first month of ineligibility as an employed person with a 
5.16 	disability, to the extent that the person's total assets remain within the allowed limits of 
5.17 	section 256B.057, subdivision 9, paragraph (c) (d); and
5.18 	(6) when a person enrolled in medical assistance under section 256B.057, subdivision 
5.19 	9, reaches age 65 and has been enrolled during each of the 24 consecutive months before 
5.20 	the person's 65th birthday, the assets owned by the person and the person's spouse must 
5.21 	be disregarded, up to the limits of section 256B.057, subdivision 9, paragraph (c), when 
5.22 	determining eligibility for medical assistance under section 256B.055, subdivision 7. The 
5.23 	income of a spouse of a person enrolled in medical assistance under section 256B.057, 
5.24 	subdivision 9, during each of the 24 consecutive months before the person's 65th birthday 
5.25 	must be disregarded when determining eligibility for medical assistance under section 
5.26 	256B.055, subdivision 7, when the person reaches age 65. Persons eligible under this 
5.27 	clause are not subject to the provisions in section 256B.059.
5.28 	(b) No asset limit shall apply to persons eligible under section 256B.055, subdivision 
5.29 	15.

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

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

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

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

10.20 	Sec. 8. Minnesota Statutes 2010, section 256B.0911, subdivision 3a, is amended to 
10.21 	read:
10.22 		Subd. 3a.Assessment and support planning. (a) Persons requesting assessment, 
10.23 	services planning, or other assistance intended to support community-based living, 
10.24 	including persons who need assessment in order to determine waiver or alternative care 
10.25 	program eligibility, must be visited by a long-term care consultation team within 15 
10.26 	calendar days after the date on which an assessment was requested or recommended. After 
10.27 	January 1, 2011, these requirements also apply to personal care assistance services, private 
10.28 	duty nursing, and home health agency services, on timelines established in subdivision 5. 
10.29 	Face-to-face assessments must be conducted according to paragraphs (b) to (i).
10.30 	(b) The county may utilize a team of either the social worker or public health nurse, 
10.31 	or both. After January 1, 2011, lead agencies shall use certified assessors to conduct the 
10.32 	assessment in a face-to-face interview. The consultation team members must confer 
10.33 	regarding the most appropriate care for each individual screened or assessed.
10.34 	(c) The assessment must be comprehensive and include a person-centered 
10.35 	assessment of the health, psychological, functional, environmental, and social needs of 
11.1 	referred individuals and provide information necessary to develop a support plan that 
11.2 	meets the consumers needs, using an assessment form provided by the commissioner.
11.3 	(d) The assessment must be conducted in a face-to-face interview with the person 
11.4 	being assessed and the person's legal representative, as required by legally executed 
11.5 	documents, and other individuals as requested by the person, who can provide information 
11.6 	on the needs, strengths, and preferences of the person necessary to develop a support 
11.7 	plan that ensures the person's health and safety, but who is not a provider of service or 
11.8 	has any financial interest in the provision of services. With the permission of the person 
11.9 	being assessed or the persons' designated or legal representative, the client's provider 
11.10 	of services may submit a copy of the provider's nursing assessment or written report 
11.11 	outlining their recommendations regarding the client's care needs. The person conducting 
11.12 	the assessment will notify the provider of the date by which this information is to be 
11.13 	submitted. This information shall be provided to the person conducting the assessment 
11.14 	prior to the assessment.
11.15 	(e) The person, or the person's legal representative, must be provided with written 
11.16 	recommendations for community-based services, including consumer-directed options, 
11.17 	or institutional care that include documentation that the most cost-effective alternatives 
11.18 	available were offered to the individual. For purposes of this requirement, "cost-effective 
11.19 	alternatives" means community services and living arrangements that cost the same as or 
11.20 	less than institutional care.
11.21 	(f) If the person chooses to use community-based services, the person or the person's 
11.22 	legal representative must be provided with a written community support plan, regardless 
11.23 	of whether the individual is eligible for Minnesota health care programs. A person may 
11.24 	request assistance in identifying community supports without participating in a complete 
11.25 	assessment. Upon a request for assistance identifying community support, the person must 
11.26 	be transferred or referred to the services available under sections 256.975, subdivision 7, 
11.27 	and 256.01, subdivision 24, for telephone assistance and follow up.
11.28 	(g) The person has the right to make the final decision between institutional 
11.29 	placement and community placement after the recommendations have been provided, 
11.30 	except as provided in subdivision 4a, paragraph (c).
11.31 	(h) The team must give the person receiving assessment or support planning, or 
11.32 	the person's legal representative, materials, and forms supplied by the commissioner 
11.33 	containing the following information:
11.34 	(1) the need for and purpose of preadmission screening if the person selects nursing 
11.35 	facility placement;
12.1 	(2) the role of the long-term care consultation assessment and support planning in 
12.2 	waiver and alternative care program eligibility determination;
12.3 	(3) information about Minnesota health care programs;
12.4 	(4) the person's freedom to accept or reject the recommendations of the team;
12.5 	(5) the person's right to confidentiality under the Minnesota Government Data 
12.6 	Practices Act, chapter 13;
12.7 	(6) the long-term care consultant's decision regarding the person's need for 
12.8 	institutional level of care as determined under criteria established in section 144.0724, 
12.9 	subdivision 11, or 256B.092; and
12.10 	(7) the person's right to appeal the decision regarding the need for nursing facility 
12.11 	level of care or the county's final decisions regarding public programs eligibility according 
12.12 	to section 256.045, subdivision 3.
12.13 	(i) Face-to-face assessment completed as part of eligibility determination for 
12.14 	the alternative care, elderly waiver, community alternatives for disabled individuals, 
12.15 	community alternative care, and traumatic brain injury waiver programs under sections 
12.16 	256B.0915, 256B.0917, and 256B.49 is valid to establish service eligibility for no more 
12.17 	than 60 calendar days after the date of assessment. The effective eligibility start date 
12.18 	for these programs can never be prior to the date of assessment. If an assessment was 
12.19 	completed more than 60 days before the effective waiver or alternative care program 
12.20 	eligibility start date, assessment and support plan information must be updated in a 
12.21 	face-to-face visit and documented in the department's Medicaid Management Information 
12.22 	System (MMIS). The effective date of program eligibility in this case cannot be prior to 
12.23 	the date the updated assessment is completed.

12.24 	Sec. 9. Minnesota Statutes 2010, section 256B.0913, subdivision 4, is amended to read:
12.25 		Subd. 4.Eligibility for funding for services for nonmedical assistance recipients.
 12.26 	(a) Funding for services under the alternative care program is available to persons who 
12.27 	meet the following criteria:
12.28 	(1) the person has been determined by a community assessment under section 
12.29 	256B.0911 to be a person who would require the level of care provided in a nursing 
12.30 	facility, as determined under section 256B.0911, subdivision 4a, paragraph (d), but for 
12.31 	the provision of services under the alternative care program. Effective January 1, 2011, 
12.32 	this determination must be made according to the criteria established in section 144.0724, 
12.33 	subdivision 11;
12.34 	(2) the person is age 65 or older;
13.1 	(3) the person would be eligible for medical assistance within 135 days of admission 
13.2 	to a nursing facility;
13.3 	(4) the person is not ineligible for the payment of long-term care services by the 
13.4 	medical assistance program due to an asset transfer penalty under section 256B.0595 or 
13.5 	equity interest in the home exceeding $500,000 as stated in section 256B.056;
13.6 	(5) the person needs long-term care services that are not funded through other 
13.7 	state or federal funding, or other health insurance or other third-party insurance such as 
13.8 	long-term care insurance;
13.9 	(6) except for individuals described in clause (7), the monthly cost of the alternative 
13.10 	care services funded by the program for this person does not exceed 75 percent of the 
13.11 	monthly limit described under section 256B.0915, subdivision 3a. This monthly limit 
13.12 	does not prohibit the alternative care client from payment for additional services, but in no 
13.13 	case may the cost of additional services purchased under this section exceed the difference 
13.14 	between the client's monthly service limit defined under section 256B.0915, subdivision 
13.15 	3, and the alternative care program monthly service limit defined in this paragraph. If 
13.16 	care-related supplies and equipment or environmental modifications and adaptations are or 
13.17 	will be purchased for an alternative care services recipient, the costs may be prorated on a 
13.18 	monthly basis for up to 12 consecutive months beginning with the month of purchase. 
13.19 	If the monthly cost of a recipient's other alternative care services exceeds the monthly 
13.20 	limit established in this paragraph, the annual cost of the alternative care services shall be 
13.21 	determined. In this event, the annual cost of alternative care services shall not exceed 12 
13.22 	times the monthly limit described in this paragraph;
13.23 	(7) for individuals assigned a case mix classification A as described under section 
13.24 	256B.0915, subdivision 3a, paragraph (a), with (i) no dependencies in activities of daily 
13.25 	living, or (ii) only one dependency up to two dependencies in bathing, dressing, grooming, 
13.26 	or walking, or (iii) a dependency score of less than three if eating is the only dependency
13.27 	and eating when the dependency score in eating is three or greater as determined by 
13.28 	an assessment performed under section 256B.0911, the monthly cost of alternative 
13.29 	care services funded by the program cannot exceed $600 $593 per month for all new 
13.30 	participants enrolled in the program on or after July 1, 2009 2011. This monthly limit 
13.31 	shall be applied to all other participants who meet this criteria at reassessment. This 
13.32 	monthly limit shall be increased annually as described in section 256B.0915, subdivision 
13.33 	3a, paragraph (a). This monthly limit does not prohibit the alternative care client from 
13.34 	payment for additional services, but in no case may the cost of additional services 
13.35 	purchased exceed the difference between the client's monthly service limit defined in this 
13.36 	clause and the limit described in clause (6) for case mix classification A; and
14.1 	(8) the person is making timely payments of the assessed monthly fee.
14.2 	A person is ineligible if payment of the fee is over 60 days past due, unless the person 
14.3 	agrees to:
14.4 	(i) the appointment of a representative payee;
14.5 	(ii) automatic payment from a financial account;
14.6 	(iii) the establishment of greater family involvement in the financial management of 
14.7 	payments; or
14.8 	(iv) another method acceptable to the lead agency to ensure prompt fee payments.
14.9 	The lead agency may extend the client's eligibility as necessary while making 
14.10 	arrangements to facilitate payment of past-due amounts and future premium payments. 
14.11 	Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be 
14.12 	reinstated for a period of 30 days.
14.13 	(b) Alternative care funding under this subdivision is not available for a person 
14.14 	who is a medical assistance recipient or who would be eligible for medical assistance 
14.15 	without a spenddown or waiver obligation. A person whose initial application for medical 
14.16 	assistance and the elderly waiver program is being processed may be served under the 
14.17 	alternative care program for a period up to 60 days. If the individual is found to be eligible 
14.18 	for medical assistance, medical assistance must be billed for services payable under the 
14.19 	federally approved elderly waiver plan and delivered from the date the individual was 
14.20 	found eligible for the federally approved elderly waiver plan. Notwithstanding this 
14.21 	provision, alternative care funds may not be used to pay for any service the cost of which: 
14.22 	(i) is payable by medical assistance; (ii) is used by a recipient to meet a waiver obligation; 
14.23 	or (iii) is used to pay a medical assistance income spenddown for a person who is eligible 
14.24 	to participate in the federally approved elderly waiver program under the special income 
14.25 	standard provision.
14.26 	(c) Alternative care funding is not available for a person who resides in a licensed 
14.27 	nursing home, certified boarding care home, hospital, or intermediate care facility, except 
14.28 	for case management services which are provided in support of the discharge planning 
14.29 	process for a nursing home resident or certified boarding care home resident to assist with 
14.30 	a relocation process to a community-based setting.
14.31 	(d) Alternative care funding is not available for a person whose income is greater 
14.32 	than the maintenance needs allowance under section 256B.0915, subdivision 1d, but equal 
14.33 	to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal 
14.34 	year for which alternative care eligibility is determined, who would be eligible for the 
14.35 	elderly waiver with a waiver obligation.

15.1 	Sec. 10. Minnesota Statutes 2010, section 256B.0915, subdivision 3a, is amended to 
15.2 	read:
15.3 		Subd. 3a.Elderly waiver cost limits. (a) The monthly limit for the cost of 
15.4 	waivered services to an individual elderly waiver client except for individuals described 
15.5 	in paragraph (b) shall be the weighted average monthly nursing facility rate of the case 
15.6 	mix resident class to which the elderly waiver client would be assigned under Minnesota 
15.7 	Rules, parts 9549.0050 to 9549.0059, less the recipient's maintenance needs allowance 
15.8 	as described in subdivision 1d, paragraph (a), until the first day of the state fiscal year in 
15.9 	which the resident assessment system as described in section 256B.438 for nursing home 
15.10 	rate determination is implemented. Effective on the first day of the state fiscal year in 
15.11 	which the resident assessment system as described in section 256B.438 for nursing home 
15.12 	rate determination is implemented and the first day of each subsequent state fiscal year, the 
15.13 	monthly limit for the cost of waivered services to an individual elderly waiver client shall 
15.14 	be the rate of the case mix resident class to which the waiver client would be assigned 
15.15 	under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect on the last day of the 
15.16 	previous state fiscal year, adjusted by the greater of any legislatively adopted home and 
15.17 	community-based services percentage rate increase or the average statewide percentage 
15.18 	increase in nursing facility payment rates adjustment.
15.19 	(b) The monthly limit for the cost of waivered services to an individual elderly 
15.20 	waiver client assigned to a case mix classification A under paragraph (a) with:
15.21 	(1) no dependencies in activities of daily living,; or
15.22 	(2) only one dependency up to two dependencies in bathing, dressing, grooming, or
15.23 	walking, or (3) a dependency score of less than three if eating is the only dependency,
15.24 	and eating when the dependency score in eating is three or greater as determined by 
15.25 	an assessment performed under section 256B.0911 shall be the lower of the case mix 
15.26 	classification amount for case mix A as determined under paragraph (a) or the case mix 
15.27 	classification amount for case mix A  $1,750 per month effective on October July 1, 2008
15.28 	2011, per month for all new participants enrolled in the program on or after July 1, 2009
15.29 	2011. This monthly limit shall be applied to all other participants who meet this criteria at 
15.30 	reassessment. This monthly limit shall be increased annually as described in paragraph (a).
15.31 	(c) If extended medical supplies and equipment or environmental modifications are 
15.32 	or will be purchased for an elderly waiver client, the costs may be prorated for up to 
15.33 	12 consecutive months beginning with the month of purchase. If the monthly cost of a 
15.34 	recipient's waivered services exceeds the monthly limit established in paragraph (a) or 
15.35 	(b), the annual cost of all waivered services shall be determined. In this event, the annual 
16.1 	cost of all waivered services shall not exceed 12 times the monthly limit of waivered 
16.2 	services as described in paragraph (a) or (b).

16.3 	Sec. 11. Minnesota Statutes 2010, section 256B.0915, subdivision 3b, is amended to 
16.4 	read:
16.5 		Subd. 3b.Cost limits for elderly waiver applicants who reside in a nursing 
16.6 	facility. (a) For a person who is a nursing facility resident at the time of requesting a 
16.7 	determination of eligibility for elderly waivered services, a monthly conversion budget 
16.8 	limit for the cost of elderly waivered services may be requested. The monthly conversion 
16.9 	budget limit for the cost of elderly waiver services shall be the resident class assigned 
16.10 	under Minnesota Rules, parts 9549.0050 to 9549.0059, for that resident in the nursing 
16.11 	facility where the resident currently resides until July 1 of the state fiscal year in which 
16.12 	the resident assessment system as described in section 256B.438 for nursing home rate 
16.13 	determination is implemented. Effective on July 1 of the state fiscal year in which the 
16.14 	resident assessment system as described in section 256B.438 for nursing home rate 
16.15 	determination is implemented, the monthly conversion budget limit for the cost of elderly 
16.16 	waiver services shall be based on the per diem nursing facility rate as determined by the 
16.17 	resident assessment system as described in section 256B.438 for that resident residents
16.18 	in the nursing facility where the resident elderly waiver applicant currently resides 
16.19 	multiplied. The monthly conversion budget limit shall be calculated by multiplying the 
16.20 	per diem by 365 and,  divided by 12, less and reduced by  the recipient's maintenance needs 
16.21 	allowance as described in subdivision 1d. The initially approved monthly conversion rate 
16.22 	may budget limit shall be adjusted by the greater of any subsequent legislatively adopted 
16.23 	home and community-based services percentage rate increase or the average statewide 
16.24 	percentage increase in nursing facility payment rates annually as described in subdivision 
16.25 	3a, paragraph (a). The limit under this subdivision only applies to persons discharged from 
16.26 	a nursing facility after a minimum 30-day stay and found eligible for waivered services 
16.27 	on or after July 1, 1997. For conversions from the nursing home to the elderly waiver 
16.28 	with consumer directed community support services, the conversion rate limit is equal to 
16.29 	the nursing facility rate per diem used to calculate the monthly conversion budget limit 
16.30 	must be reduced by a percentage equal to the percentage difference between the consumer 
16.31 	directed services budget limit that would be assigned according to the federally approved 
16.32 	waiver plan and the corresponding community case mix cap, but not to exceed 50 percent.
16.33 	(b) The following costs must be included in determining the total monthly costs 
16.34 	for the waiver client:
17.1 	(1) cost of all waivered services, including extended medical specialized supplies 
17.2 	and equipment and environmental modifications and accessibility adaptations; and
17.3 	(2) cost of skilled nursing, home health aide, and personal care services reimbursable 
17.4 	by medical assistance.

17.5 	Sec. 12. Minnesota Statutes 2010, section 256B.0915, subdivision 3e, is amended to 
17.6 	read:
17.7 		Subd. 3e.Customized living service rate. (a) Payment for customized living 
17.8 	services shall be a monthly rate authorized by the lead agency within the parameters 
17.9 	established by the commissioner. The payment agreement must delineate the amount of 
17.10 	each component service included in the recipient's customized living service plan. The 
17.11 	lead agency, with input from the provider of customized living services, shall ensure that 
17.12 	there is a documented need within the parameters established by the commissioner for all 
17.13 	component customized living services authorized.
17.14 	(b) The payment rate must be based on the amount of component services to be 
17.15 	provided utilizing component rates established by the commissioner. Counties and tribes 
17.16 	shall use tools issued by the commissioner to develop and document customized living 
17.17 	service plans and rates.
17.18 	(c) Component service rates must not exceed payment rates for comparable elderly 
17.19 	waiver or medical assistance services and must reflect economies of scale. Customized 
17.20 	living services must not include rent or raw food costs.
17.21 	(d) With the exception of individuals described in subdivision 3a, paragraph (b), the 
17.22 	individualized monthly authorized payment for the customized living service plan shall 
17.23 	not exceed 50 percent of the greater of either the statewide or any of the geographic 
17.24 	groups' weighted average monthly nursing facility rate of the case mix resident class 
17.25 	to which the elderly waiver eligible client would be assigned under Minnesota Rules, 
17.26 	parts 9549.0050 to 9549.0059, less the maintenance needs allowance as described 
17.27 	in subdivision 1d, paragraph (a), until the July 1 of the state fiscal year in which the 
17.28 	resident assessment system as described in section 256B.438 for nursing home rate 
17.29 	determination is implemented. Effective on July 1 of the state fiscal year in which 
17.30 	the resident assessment system as described in section 256B.438 for nursing home 
17.31 	rate determination is implemented and July 1 of each subsequent state fiscal year, the 
17.32 	individualized monthly authorized payment for the services described in this clause shall 
17.33 	not exceed the limit which was in effect on June 30 of the previous state fiscal year 
17.34 	updated annually based on legislatively adopted changes to all service rate maximums for 
17.35 	home and community-based service providers.
18.1 	(e) Effective July 1, 2011, the individualized monthly payment for the customized 
18.2 	living service plan for individuals described in subdivision 3a, paragraph (b), must be the 
18.3 	monthly authorized payment limit for customized living for individuals classified as case 
18.4 	mix A, reduced by 25 percent. This rate limit must be applied to all new participants 
18.5 	enrolled in the program on or after July 1, 2011, who meet the criteria described in 
18.6 	subdivision 3a, paragraph (b). This monthly limit also applies to all other participants who 
18.7 	meet the criteria described in subdivision 3a, paragraph (b), at reassessment.
18.8 	(f) Customized living services are delivered by a provider licensed by the 
18.9 	Department of Health as a class A or class F home care provider and provided in a 
18.10 	building that is registered as a housing with services establishment under chapter 144D.
18.11 	Licensed home care providers are subject to section 256B.0651, subdivision 14.
18.12 	(g) A provider may not bill or otherwise charge an elderly waiver participant or their 
18.13 	family for additional units of any allowable component service beyond those available 
18.14 	under the service rate limits described in paragraph (d), nor for additional units of any 
18.15 	allowable component service beyond those approved in the service plan by the lead agency.

18.16 	Sec. 13. Minnesota Statutes 2010, section 256B.0915, subdivision 3h, is amended to 
18.17 	read:
18.18 		Subd. 3h.Service rate limits; 24-hour customized living services. (a) The 
18.19 	payment rate for 24-hour customized living services is a monthly rate authorized by the 
18.20 	lead agency within the parameters established by the commissioner of human services. 
18.21 	The payment agreement must delineate the amount of each component service included 
18.22 	in each recipient's customized living service plan. The lead agency, with input from 
18.23 	the provider of customized living services, shall ensure that there is a documented need 
18.24 	within the parameters established by the commissioner for all component customized 
18.25 	living services authorized. The lead agency shall not authorize 24-hour customized living 
18.26 	services unless there is a documented need for 24-hour supervision.
18.27 	(b) For purposes of this section, "24-hour supervision" means that the recipient 
18.28 	requires assistance due to needs related to one or more of the following:
18.29 	(1) intermittent assistance with toileting, positioning, or transferring;
18.30 	(2) cognitive or behavioral issues;
18.31 	(3) a medical condition that requires clinical monitoring; or
18.32 	(4) for all new participants enrolled in the program on or after January July 1, 2011, 
18.33 	and all other participants at their first reassessment after January July 1, 2011, dependency 
18.34 	in at least two three of the following activities of daily living as determined by assessment 
18.35 	under section 256B.0911: bathing; dressing; grooming; walking; or eating when the 
19.1 	dependency score in eating is three or greater; and needs medication management and at 
19.2 	least 50 hours of service per month. The lead agency shall ensure that the frequency and 
19.3 	mode of supervision of the recipient and the qualifications of staff providing supervision 
19.4 	are described and meet the needs of the recipient.
19.5 	(c) The payment rate for 24-hour customized living services must be based on the 
19.6 	amount of component services to be provided utilizing component rates established by the 
19.7 	commissioner. Counties and tribes will use tools issued by the commissioner to develop 
19.8 	and document customized living plans and authorize rates.
19.9 	(d) Component service rates must not exceed payment rates for comparable elderly 
19.10 	waiver or medical assistance services and must reflect economies of scale.
19.11 	(e) The individually authorized 24-hour customized living payments, in combination 
19.12 	with the payment for other elderly waiver services, including case management, must not 
19.13 	exceed the recipient's community budget cap specified in subdivision 3a. Customized 
19.14 	living services must not include rent or raw food costs.
19.15 	(f) The individually authorized 24-hour customized living payment rates shall not 
19.16 	exceed the 95 percentile of statewide monthly authorizations for 24-hour customized 
19.17 	living services in effect and in the Medicaid management information systems on March 
19.18 	31, 2009, for each case mix resident class under Minnesota Rules, parts 9549.0050 
19.19 	to 9549.0059, to which elderly waiver service clients are assigned. When there are 
19.20 	fewer than 50 authorizations in effect in the case mix resident class, the commissioner 
19.21 	shall multiply the calculated service payment rate maximum for the A classification by 
19.22 	the standard weight for that classification under Minnesota Rules, parts 9549.0050 to 
19.23 	9549.0059, to determine the applicable payment rate maximum. Service payment rate 
19.24 	maximums shall be updated annually based on legislatively adopted changes to all service 
19.25 	rates for home and community-based service providers.
19.26 	(g) Notwithstanding the requirements of paragraphs (d) and (f), the commissioner 
19.27 	may establish alternative payment rate systems for 24-hour customized living services in 
19.28 	housing with services establishments which are freestanding buildings with a capacity of 
19.29 	16 or fewer, by applying a single hourly rate for covered component services provided 
19.30 	in either:
19.31 	(1) licensed corporate adult foster homes; or
19.32 	(2) specialized dementia care units which meet the requirements of section 144D.065 
19.33 	and in which:
19.34 	(i) each resident is offered the option of having their own apartment; or
20.1 	(ii) the units are licensed as board and lodge establishments with maximum capacity 
20.2 	of eight residents, and which meet the requirements of Minnesota Rules, part 9555.6205, 
20.3 	subparts 1, 2, 3, and 4, item A.
20.4 	(h) A provider may not bill or otherwise charge an elderly waiver participant or their 
20.5 	family for additional units of any allowable component service beyond those available 
20.6 	under the service rate limits described in paragraph (e), nor for additional units of any 
20.7 	allowable component service beyond those approved in the service plan by the lead agency.

20.8 	Sec. 14. Minnesota Statutes 2010, section 256B.0915, subdivision 6, is amended to 
20.9 	read:
20.10 		Subd. 6.Implementation of care plan. Each elderly waiver client, and the 
20.11 	client's provider of services, shall be provided a copy of a written care plan that meets 
20.12 	the requirements outlined in section 256B.0913, subdivision 8. The care plan must be 
20.13 	implemented by the county of service when it is different than the county of financial 
20.14 	responsibility. The county of service administering waivered services must notify the 
20.15 	county of financial responsibility of the approved care plan.

20.16 	Sec. 15. Minnesota Statutes 2010, section 256B.0915, subdivision 10, is amended to 
20.17 	read:
20.18 		Subd. 10.Waiver payment rates; managed care organizations. The 
20.19 	commissioner shall adjust the elderly waiver capitation payment rates for managed care 
20.20 	organizations paid under section 256B.69, subdivisions 6a and 23, to reflect the maximum 
20.21 	service rate limits for customized living services and 24-hour customized living services 
20.22 	under subdivisions 3e and 3h for the contract period beginning October 1, 2009. Medical 
20.23 	assistance rates paid to customized living providers by managed care organizations under 
20.24 	this section shall not exceed the maximum service rate limits and component rates as 
20.25 	determined by the commissioner under subdivisions 3e and 3h.

20.26 	Sec. 16. Minnesota Statutes 2010, section 256B.14, is amended by adding a 
20.27 	subdivision to read:
20.28 		Subd. 3a.Spousal contribution. (a) For purposes of this subdivision, the following 
20.29 	terms have the meanings given:
20.30 	(1) "commissioner" means the commissioner of human services;
20.31 	(2) "community spouse" means the spouse, who lives in the community, of an 
20.32 	individual receiving long-term care services in a long-term care facility or receiving 
20.33 	home care services pursuant to the Medicaid waiver for elderly services under section 
21.1 	256B.0915 or the alternative care program under section 256B.0913. A community 
21.2 	spouse does not include a spouse living in the community who receives a monthly income 
21.3 	allowance under section 256B.058, subdivision 2, or who receives home care services 
21.4 	under the Medicaid waiver for elderly services under section 256B.0915 or the alternative 
21.5 	care program under section 256B.0913;
21.6 	(3) "cost of care" means the actual fee for service costs or capitated payments for 
21.7 	the long term care spouse;
21.8 	(4) "department" means the Department of Human Services;
21.9 	(5) "disabled child" means a blind or permanently and totally disabled son or 
21.10 	daughter of any age as defined in the Supplemental Security Income program or the State 
21.11 	Medical Review Team;
21.12 	(6) "income" means earned and unearned income, attributable to the community 
21.13 	spouse, used to calculate the adjusted gross income on the prior year's income tax return. 
21.14 	Evidence of income includes, but is not limited to, W-2 and 1099 forms; and
21.15 	(7) "long-term care spouse" means the spouse who is receiving long-term care 
21.16 	services in a long-term care facility or receiving home care services pursuant to the 
21.17 	Medicaid waiver for elderly services under section 256B.0915 or the alternative care 
21.18 	program under section 256B.0913.
21.19 	(b) The community spouse of a long-term care spouse who receives medical 
21.20 	assistance or alternative care services has an obligation to contribute to the cost of care. 
21.21 	The community spouse must pay a monthly fee on a sliding fee scale based on the 
21.22 	community spouse's income, unless a minor or disabled child resides with and receives 
21.23 	care from the community spouse, in  case, no fee shall be assessed.
21.24 	(c) For a community spouse with an income equal to or greater than 250 percent of 
21.25 	the federal poverty guidelines for a family of two and less than 545 percent of the federal 
21.26 	poverty guidelines for a family of two, the spousal contribution shall be determined using 
21.27 	a sliding fee scale established by the commissioner that begins at 7.5 percent of the 
21.28 	community spouse's income and increases to 15 percent for those with an income of up to 
21.29 	545 percent of the federal poverty guidelines for a family of two.
21.30 	(d) For a community spouse with an income equal to or greater than 545 percent of 
21.31 	the federal poverty guidelines for a family of two and less than 750 percent of the federal 
21.32 	poverty guidelines for a family of two, the spousal contribution shall be determined using 
21.33 	a sliding fee scale established by the commissioner that begins at 15 percent of the 
21.34 	community spouse's income and increases to 25 percent for those with an income of up to 
21.35 	750 percent of the federal poverty guidelines for a family of two.
22.1 	(e) For a community spouse with an income equal to or greater than 750 percent of 
22.2 	the federal poverty guidelines for a family of two and less than 975 percent of the federal 
22.3 	poverty guidelines for a family of two, the spousal contribution shall be determined using 
22.4 	a sliding fee scale established by the commissioner that begins at 25 percent of the 
22.5 	community spouse's income and increases to 33 percent for those with an income of up to 
22.6 	975 percent of the federal poverty guidelines for a family of two.
22.7 	(f) For a community spouse with an income equal to or greater than 975 percent of 
22.8 	the federal poverty guidelines for a family of two, the spousal contribution shall be 33 
22.9 	percent of the community spouse's income.
22.10 	(g) The spousal contribution shall be explained in writing at the time eligibility for 
22.11 	medical assistance or alternative care is being determined. In addition to explaining the 
22.12 	formula used to determine the fee, the commissioner shall provide written information 
22.13 	describing how to request a variance for undue hardship, how a contribution may be 
22.14 	reviewed or redetermined, the right to appeal a contribution determination, and that 
22.15 	the consequences for not complying with a request to provide information shall be an 
22.16 	assessment against the community spouse for the full cost of care for the long-term care 
22.17 	spouse.
22.18 	(h) The contribution shall be assessed for each month the long-term care spouse is 
22.19 	eligible for medical assistance or alternative care.
22.20 	(i) The spousal contribution shall be reviewed at least once every 12 months and 
22.21 	when there is a loss or gain in income in excess of ten percent. Thirty days prior to a 
22.22 	review or redetermination, written notice must be provided to the community spouse 
22.23 	and must contain the amount the spouse is required to contribute, notice of the right to 
22.24 	redetermination and appeal, and the telephone number of the division at the department 
22.25 	that is responsible for redetermination and review. If, after review, the contribution amount 
22.26 	is to be adjusted, the commissioner shall mail a written notice to the community spouse 30 
22.27 	days in advance of the effective date of the change in the amount of the contribution:
22.28 	(1) the spouse shall notify the commissioner within 30 days of a gain or loss in 
22.29 	income in excess of ten percent and provide the department supporting documentation to 
22.30 	verify the need for redetermination of the fee;
22.31 	(2) when a spouse requests a review or redetermination of the contribution amount, a 
22.32 	request for information shall be sent to the spouse within ten calendar days after the 
22.33 	commissioner receives the request for review;
22.34 	(3) no action shall be taken on a review or redetermination until the required 
22.35 	information is received by the commissioner;
23.1 	(4) the review of the spousal contribution shall be done within ten days after the 
23.2 	commissioner receives completed information that verifies a loss or gain in income 
23.3 	in excess of ten percent;
23.4 	(5) an increase in the contribution amount is effective in the month in  the increase in 
23.5 	spousal income occurs; and
23.6 	(6) a decrease in the contribution amount is effective in the month the spouse verifies 
23.7 	the reduction in income, retroactive to no longer than six months.
23.8 	(j) In no case shall the spousal contribution exceed the amount of medical assistance 
23.9 	expended or the cost of alternative care services for the care of the long-term care 
23.10 	spouse. At the time of the review, the total amount of medical assistance paid or costs 
23.11 	of alternative care for the care of the long-term care spouse and the total amount of the 
23.12 	spousal contribution shall be compared. If the total amount of the spousal contribution 
23.13 	exceeds the total amount of medical assistance expended or cost of alternative care, the 
23.14 	department shall reimburse the community spouse the excess amount if the long-term 
23.15 	care spouse is no longer receiving services, or apply the excess amount to the spousal 
23.16 	contribution due until the excess amount is exhausted.
23.17 	(k) A spouse who needs to retain the contribution amount for the spouse's personal 
23.18 	medical care may request a variance for undue hardship by submitting a written request 
23.19 	and supporting documentation to the commissioner that states why compliance with 
23.20 	this subdivision would cause undue hardship. The commissioner shall forward to the 
23.21 	spouse a request for financial information within ten days after receiving a written request 
23.22 	for a variance. A spouse must provide the commissioner with the requested financial 
23.23 	information and any other information sufficient to verify the existence of undue hardship 
23.24 	necessitating a waiver:
23.25 	(1) a spouse who requests a variance from a notice of an increase in the amount 
23.26 	of spousal contribution shall continue to make monthly payments at the lower amount 
23.27 	pending determination of the variance request. A spouse who requests a variance from 
23.28 	the initial determination shall not be required to make a payment pending determination 
23.29 	of the variance request. Payments made pending outcome of the variance request that 
23.30 	result in overpayment shall be returned to the spouse if the community spouse is no 
23.31 	longer receiving services or applied to the spousal contribution in the current year. If the 
23.32 	variance is denied, the spouse shall pay the additional amount due from the effective date 
23.33 	of the increase or the total amount due from the effective date of the original notice of 
23.34 	determination of the spousal contribution;
24.1 	(2) a spouse who is granted a variance shall sign a written agreement in which the 
24.2 	spouse agrees to report to the commissioner any changes in circumstances that gave rise 
24.3 	to the undue hardship variance;
24.4 	(3) when the commissioner receives a request for a variance, written notice of a 
24.5 	grant or denial of the variance shall be mailed to the spouse within 30 calendar days 
24.6 	after the commissioner receives the financial information required in this paragraph. The 
24.7 	granting of a variance will necessitate a written agreement between the spouse and the 
24.8 	commissioner with regard to the specific terms of the variance. The variance will not 
24.9 	become effective until the written agreement is signed by the spouse. If the commissioner 
24.10 	denies in whole or in part the request for a variance, the denial notice shall set forth in 
24.11 	writing the reasons for the denial that address the specific hardship and right to appeal;
24.12 	(4) if a variance is granted, the term of the variance shall not exceed 12 months 
24.13 	unless otherwise determined by the commissioner; and
24.14 	(5) undue hardship does not include action taken by a spouse that divested or 
24.15 	diverted income in order to avoid being assessed a spousal contribution.
24.16 	(l) A spouse aggrieved by an action under this subdivision has the right to appeal 
24.17 	under subdivision 4. If the spouse appeals on or before the effective date of an increase in 
24.18 	the spousal fee, the spouse shall continue to make payments to the commissioner in the 
24.19 	lower amount while the appeal is pending. A spouse appealing an initial determination 
24.20 	of a spousal contribution shall not be required to make monthly payments pending an 
24.21 	appeal decision. Payments made that result in an overpayment shall be reimbursed to the 
24.22 	spouse if the long-term care spouse is no longer receiving services, or applied to the 
24.23 	spousal contribution remaining in the current year. If the commissioner's determination is 
24.24 	affirmed, the community spouse shall pay within 90 calendar days of the order the total 
24.25 	amount due from the effective date of the original notice of determination of the spousal 
24.26 	contribution. The commissioner's order is binding on the spouse and the department and 
24.27 	shall be implemented subject to section 256.045, subdivision 7. No additional notice is 
24.28 	required to enforce the commissioner's order.
24.29 	(m) Actions to obtain payment shall be taken under subdivision 2.

24.30 	Sec. 17. Minnesota Statutes 2010, section 256B.431, subdivision 2r, is amended to 
24.31 	read:
24.32 		Subd. 2r.Payment restrictions on leave days. Effective July 1, 1993, the 
24.33 	commissioner shall limit payment for leave days in a nursing facility to 79 percent of that 
24.34 	nursing facility's total payment rate for the involved resident. For services rendered on or 
24.35 	after July 1, 2003, for facilities reimbursed under this section or section 256B.434, the 
25.1 	commissioner shall limit payment for leave days in a nursing facility to 60 percent of 
25.2 	that nursing facility's total payment rate for the involved resident. For services rendered 
25.3 	on or after July 1, 2011, for facilities reimbursed under this section, section 256B.434, 
25.4 	section 256B.441, or any other section, the commissioner shall not pay for leave days, 
25.5 	notwithstanding Minnesota Rules, part 9505.0415.

25.6 	Sec. 18. Minnesota Statutes 2010, section 256B.431, subdivision 32, is amended to 
25.7 	read:
25.8 		Subd. 32.Payment during first 90 30  days. (a) For rate years beginning on or after 
25.9 	July 1, 2001, the total payment rate for a facility reimbursed under this section, section 
25.10 	256B.434, or any other section for the first 90 paid days after admission shall be:
25.11 	(1) for the first 30 paid days, the rate shall be 120 percent of the facility's medical 
25.12 	assistance rate for each case mix class;
25.13 	(2) for the next 60 paid days after the first 30 paid days, the rate shall be 110 percent 
25.14 	of the facility's medical assistance rate for each case mix class;
25.15 	(3) beginning with the 91st paid day after admission, the payment rate shall be the 
25.16 	rate otherwise determined under this section, section 256B.434, or any other section; and
25.17 	(4) payments under this paragraph apply to admissions occurring on or after July 1, 
25.18 	2001, and before July 1, 2003, and to resident days occurring before July 30, 2003.
25.19 	(b) For rate years beginning on or after July 1, 2003 2011, the total payment rate for 
25.20 	a facility reimbursed under this section, section 256B.434, or any other section shall be:
25.21 	(1) for the first 30 calendar days after admission, the rate shall be 120 percent of 
25.22 	the facility's medical assistance rate for each RUG class;
25.23 	(2) beginning with the 31st calendar day after admission, the payment rate shall be 
25.24 	the rate otherwise determined under this section, section 256B.434, or any other section; 
25.25 	and
25.26 	(3) payments under this paragraph apply to admissions occurring on or after July 
25.27 	1, 2003 2011.
25.28 	(c) Effective January 1, 2004, (b)  The enhanced rates under this subdivision shall not 
25.29 	be allowed if a resident has resided during the previous 30 calendar days in:
25.30 	(1) the same nursing facility;
25.31 	(2) a nursing facility owned or operated by a related party; or
25.32 	(3) a nursing facility or part of a facility that closed or was in the process of closing.

25.33 	Sec. 19. Minnesota Statutes 2010, section 256B.431, subdivision 42, is amended to 
25.34 	read:
26.1 		Subd. 42.Incentive to establish single-bed rooms. (a) Beginning July 1, 2005, 
26.2 	the operating payment rate for nursing facilities reimbursed under this section, section 
26.3 	256B.434, or 256B.441 shall be increased by 20 percent multiplied by the ratio of the 
26.4 	number of new single-bed rooms created divided by the number of active beds on July 
26.5 	1, 2005, for each bed closure that results in the creation of a single-bed room after 
26.6 	July 1, 2005. The commissioner may implement rate adjustments for up to 3,000 new 
26.7 	single-bed rooms each year. For eligible bed closures for which the commissioner receives 
26.8 	a notice from a facility during a calendar quarter that a bed has been delicensed and a 
26.9 	new single-bed room has been established, the rate adjustment in this paragraph shall be 
26.10 	effective on the first day of the second month following that calendar quarter.
26.11 	(b) A nursing facility is prohibited from discharging residents for purposes of 
26.12 	establishing single-bed rooms. A nursing facility must submit documentation to the 
26.13 	commissioner in a form prescribed by the commissioner, certifying the occupancy status 
26.14 	of beds closed to create single-bed rooms. In the event that the commissioner determines 
26.15 	that a facility has discharged a resident for purposes of establishing a single-bed room, the 
26.16 	commissioner shall not provide a rate adjustment under paragraph (a).
26.17 	(c) If after August 1, 2005, and before December 31, 2007, more than 4,000 nursing 
26.18 	home beds are removed from service, a portion of the appropriation for nursing homes 
26.19 	shall be transferred to the alternative care program. The amount of this transfer shall equal 
26.20 	the number of beds removed from service less 4,000, multiplied by the average monthly 
26.21 	per-person cost for alternative care, multiplied by 12, and further multiplied by 0.3.
26.22 	(d) Beginning on July 1, 2011, the commissioner shall no longer approve single bed 
26.23 	incentive rate adjustments under this section.

26.24 	Sec. 20. Minnesota Statutes 2010, section 256B.431, is amended by adding a 
26.25 	subdivision to read:
26.26 		Subd. 44.Property rate increase for a facility in Bloomington effective 
26.27 	November 1, 2010. Notwithstanding any other law to the contrary, money available for 
26.28 	moratorium projects under section 144A.073, subdivision 11, shall be used effective 
26.29 	November 1, 2010, to fund an approved moratorium exception project for a nursing 
26.30 	facility in Bloomington licensed for 137 beds as of November 1, 2010, up to a total 
26.31 	property rate adjustment of $19.33.

26.32 	Sec. 21. Minnesota Statutes 2010, section 256B.437, subdivision 6, is amended to read:
27.1 		Subd. 6.Planned closure rate adjustment. (a) The commissioner of human 
27.2 	services shall calculate the amount of the planned closure rate adjustment available under 
27.3 	subdivision 3, paragraph (b), for up to 5,140 beds according to clauses (1) to (4):
27.4 	(1) the amount available is the net reduction of nursing facility beds multiplied 
27.5 	by $2,080;
27.6 	(2) the total number of beds in the nursing facility or facilities receiving the planned 
27.7 	closure rate adjustment must be identified;
27.8 	(3) capacity days are determined by multiplying the number determined under 
27.9 	clause (2) by 365; and
27.10 	(4) the planned closure rate adjustment is the amount available in clause (1), divided 
27.11 	by capacity days determined under clause (3).
27.12 	(b) A planned closure rate adjustment under this section is effective on the first day 
27.13 	of the month following completion of closure of the facility designated for closure in the 
27.14 	application and becomes part of the nursing facility's total operating payment rate.
27.15 	(c) Applicants may use the planned closure rate adjustment to allow for a property 
27.16 	payment for a new nursing facility or an addition to an existing nursing facility or as an 
27.17 	operating payment rate adjustment. Applications approved under this subdivision are 
27.18 	exempt from other requirements for moratorium exceptions under section 144A.073, 
27.19 	subdivisions 2 and 3.
27.20 	(d) Upon the request of a closing facility, the commissioner must allow the facility a 
27.21 	closure rate adjustment as provided under section 144A.161, subdivision 10.
27.22 	(e) A facility that has received a planned closure rate adjustment may reassign it 
27.23 	to another facility that is under the same ownership at any time within three years of its 
27.24 	effective date. The amount of the adjustment shall be computed according to paragraph (a).
27.25 	(f) If the per bed dollar amount specified in paragraph (a), clause (1), is increased, 
27.26 	the commissioner shall recalculate planned closure rate adjustments for facilities that 
27.27 	delicense beds under this section on or after July 1, 2001, to reflect the increase in the per 
27.28 	bed dollar amount. The recalculated planned closure rate adjustment shall be effective 
27.29 	from the date the per bed dollar amount is increased.
27.30 	(g) For planned closures approved after June 30, 2009, the commissioner of human 
27.31 	services shall calculate the amount of the planned closure rate adjustment available under 
27.32 	subdivision 3, paragraph (b), according to paragraph (a), clauses (1) to (4).
27.33 	(h) Beginning on July 1, 2011, the commissioner shall no longer approve planned 
27.34 	closure rate adjustments under this section.

28.1 	Sec. 22. Minnesota Statutes 2010, section 256B.441, subdivision 50a, is amended to 
28.2 	read:
28.3 		Subd. 50a.Determination of proximity adjustments. (a) For a nursing facility 
28.4 	located in close proximity to another nursing facility of the same facility group type but in 
28.5 	a different peer group and that has higher limits for care-related or other operating costs, 
28.6 	the commissioner shall adjust the limits in accordance with clauses (1) to (4):
28.7 	(1) determine the difference between the limits;
28.8 	(2) determine the distance between the two facilities, by the shortest driving route. If 
28.9 	the distance exceeds 20 miles, no adjustment shall be made;
28.10 	(3) subtract the value in clause (2) from 20 miles, divide by 20, and convert to a 
28.11 	percentage; and
28.12 	(4) increase the limits for the nursing facility with the lower limits by the value 
28.13 	determined in clause (1) multiplied by the value determined in clause (3).
28.14 	(b) Effective October 1, 2011, nursing facilities located no more than one-quarter 
28.15 	mile from a peer group with higher limits under either subdivision 50 or 51, may receive 
28.16 	an operating rate adjustment. The operating payment rates of a lower-limit peer group 
28.17 	facility must be adjusted to be equal to those of the nearest facility in a higher-limit peer 
28.18 	group if that facility's RUG rate with a weight of 1.00 is higher than the lower-limit peer 
28.19 	group facility. Peer groups are those defined in subdivision 30. The nearest facility must 
28.20 	be determined by the most direct driving route.

28.21 	Sec. 23. Minnesota Statutes 2010, section 256B.441, subdivision 59, is amended to 
28.22 	read:
28.23 		Subd. 59.Single-bed payments for medical assistance recipients. Effective 
28.24 	October 1, 2009, the amount paid for a private room under Minnesota Rules, part 
28.25 	9549.0070, subpart 3, is reduced from 115 percent to 111.5 percent. Effective July 1, 2011, 
28.26 	the amount paid for a private room under Minnesota Rules, part 9549.0070, subpart 3, is 
28.27 	reduced from 111.5 percent to 100.0 percent.

28.28 	Sec. 24. Minnesota Statutes 2010, section 256B.48, subdivision 1, is amended to read:
28.29 		Subdivision 1.Prohibited practices. (a) A nursing facility is not eligible to receive 
28.30 	medical assistance payments unless it refrains from all of the following: complies with the 
28.31 	prohibitions and requirements in this subdivision.
28.32 	(a) Charging(b) A nursing facility must not charge private paying residents rates for 
28.33 	similar services which exceed those which are approved by the state agency for medical 
29.1 	assistance recipients as determined by the prospective desk audit rate, except under the 
29.2 	following circumstances: 
29.3 	(1) the nursing facility may (1) (i) charge private paying residents a higher rate for a 
29.4 	private room, and (2) (ii) charge for special services which are not included in the daily 
29.5 	rate if medical assistance residents are charged separately at the same rate for the same 
29.6 	services in addition to the daily rate paid by the commissioner; 
29.7 	(2) effective October 1, 2011, nursing facilities may charge private paying residents 
29.8 	up to two percent higher than the sum of the medical assistance allowable payment rate in 
29.9 	effect on September 30, 2011, plus an adjustment equal to the incremental increase of any 
29.10 	other rate increase provided in law, for the RUGS group currently assigned to the resident; 
29.11 	(3) effective October 1, 2012, nursing facilities may charge private paying residents 
29.12 	rates up to four percent higher than the sum of the medical assistance allowable payment 
29.13 	rate in effect on September 30, 2012, plus an adjustment equal to the incremental increase 
29.14 	of any other rate increase provided in law, for the RUGS group currently assigned to the 
29.15 	resident; 
29.16 	(4) effective October 1, 2013, nursing facilities may charge private paying residents 
29.17 	rates up to six percent higher than the sum of the medical assistance allowable payment 
29.18 	rate in effect on September 30, 2013, plus an adjustment equal to the incremental increase 
29.19 	of any other rate increase provided in law, for the RUGS group currently assigned to 
29.20 	the resident; and 
29.21 	(5) effective October 1, 2014, nursing facilities may charge private paying residents 
29.22 	rates up to eight percent higher than the sum of the medical assistance allowable payment 
29.23 	rate in effect on September 30, 2014, plus an adjustment equal to the incremental increase 
29.24 	of any other rate increase provided in law, for the RUGS group currently assigned to 
29.25 	the resident. Nothing in this section precludes a nursing facility from charging a rate 
29.26 	allowable under the nursing facility's single room election option under Minnesota Rules, 
29.27 	part 9549.0060, subpart 11, or the enhanced rates under section 256B.431, subdivision 32.
29.28 	 Services covered by the payment rate must be the same regardless of payment 
29.29 	source. Special services, if offered, must be available to all residents in all areas of the 
29.30 	nursing facility and charged separately at the same rate. Residents are free to select 
29.31 	or decline special services. Special services must not include services which must be 
29.32 	provided by the nursing facility in order to comply with licensure or certification standards 
29.33 	and that if not provided would result in a deficiency or violation by the nursing facility. 
29.34 	Services beyond those required to comply with licensure or certification standards must 
29.35 	not be charged separately as a special service if they were included in the payment rate for 
29.36 	the previous reporting year. A nursing facility that charges a private paying resident a rate 
30.1 	in violation of this clause paragraph is subject to an action by the state of Minnesota or any 
30.2 	of its subdivisions or agencies for civil damages. A private paying resident or the resident's 
30.3 	legal representative has a cause of action for civil damages against a nursing facility that 
30.4 	charges the resident rates in violation of this clause paragraph. The damages awarded shall 
30.5 	include three times the payments that result from the violation, together with costs and 
30.6 	disbursements, including reasonable attorneys'attorney fees or their equivalent. A private 
30.7 	paying resident or the resident's legal representative, the state, subdivision or agency, or a 
30.8 	nursing facility may request a hearing to determine the allowed rate or rates at issue in 
30.9 	the cause of action. Within 15 calendar days after receiving a request for such a hearing, 
30.10 	the commissioner shall request assignment of an administrative law judge under sections 
30.11 	14.48 to 14.56 to conduct the hearing as soon as possible or according to agreement by 
30.12 	the parties. The administrative law judge shall issue a report within 15 calendar days 
30.13 	following the close of the hearing. The prohibition set forth in this clause paragraph shall 
30.14 	not apply to facilities licensed as boarding care facilities which are not certified as skilled 
30.15 	or intermediate care facilities level I or II for reimbursement through medical assistance.
30.16 	(b) (c) Effective October 1, 2015, paragraph (b) no longer applies, except that special 
30.17 	services, if offered, must be available to all residents of the nursing facility and charged 
30.18 	separately at the same rate. Residents are free to select or decline special services. Special 
30.19 	services must not include services that must be provided by the nursing facility in order to 
30.20 	comply with licensure or certification standards and that, if not provided, would result in a 
30.21 	deficiency or violation by the nursing facility. 
30.22 	(d) A nursing facility shall refrain from all of the following:
30.23 	(1) charging, soliciting, accepting, or receiving from an applicant for admission to 
30.24 	the facility, or from anyone acting in behalf of the applicant, as a condition of admission, 
30.25 	expediting the admission, or as a requirement for the individual's continued stay, any 
30.26 	fee, deposit, gift, money, donation, or other consideration not otherwise required as 
30.27 	payment under the state plan. For residents on medical assistance, payment of the medical 
30.28 	assistance rate according to the state plan must be accepted as payment in full for services 
30.29 	included in the daily rate for continued stay, except where otherwise provided for in statute;
30.30 	(2) requiring an individual, or anyone acting in behalf of the individual, to loan 
30.31 	any money to the nursing facility;
30.32 	(3) requiring an individual, or anyone acting in behalf of the individual, to promise 
30.33 	to leave all or part of the individual's estate to the facility; or
30.34 	(4) requiring a third-party guarantee of payment to the facility as a condition of 
30.35 	admission, expedited admission, or continued stay in the facility.
31.1 	Nothing in this paragraph would prohibit discharge for nonpayment of services in 
31.2 	accordance with state and federal regulations.
31.3 	(c) Requiring (e) A nursing facility must not require any resident of the nursing 
31.4 	facility to utilize a vendor of health care services chosen by the nursing facility. A 
31.5 	nursing facility may require a resident to use pharmacies that utilize unit dose packing 
31.6 	systems approved by the Minnesota Board of Pharmacy, and may require a resident to use 
31.7 	pharmacies that are able to meet the federal regulations for safe and timely administration 
31.8 	of medications such as systems with specific number of doses, prompt delivery of 
31.9 	medications, or access to medications on a 24-hour basis. Notwithstanding the provisions 
31.10 	of this paragraph, nursing facilities shall not restrict a resident's choice of pharmacy 
31.11 	because the pharmacy utilizes a specific system of unit dose drug packing.
31.12 	(d) Providing (f) A nursing facility must not provide differential treatment on the 
31.13 	basis of status with regard to public assistance.
31.14 	(e) Discriminating (g) A nursing facility must not discriminate in admissions, 
31.15 	services offered, or room assignment on the basis of status with regard to public assistance 
31.16 	or refusal to purchase special services. Discrimination in admissions discrimination shall 
31.17 	include, but is not limited to:
31.18 	(1), basing admissions decisions upon assurance by the applicant to the nursing 
31.19 	facility, or the applicant's guardian or conservator, that the applicant is neither eligible for 
31.20 	nor will seek information or assurances regarding current or future eligibility for public 
31.21 	assistance for payment of nursing facility care costs; and.
31.22 	(2) engaging in preferential selection from waiting lists based on an applicant's 
31.23 	ability to pay privately or an applicant's refusal to pay for a special service.
31.24 	The collection and use by a nursing facility of financial information of any applicant 
31.25 	pursuant to a preadmission screening program established by law shall not raise an 
31.26 	inference that the nursing facility is utilizing that information for any purpose prohibited 
31.27 	by this paragraph.
31.28 	(f) Requiring (h) A nursing facility must not require any vendor of medical care as 
31.29 	defined by section 256B.02, subdivision 7, who is reimbursed by medical assistance under 
31.30 	a separate fee schedule, to pay any amount based on utilization or service levels or any 
31.31 	portion of the vendor's fee to the nursing facility except as payment for renting or leasing 
31.32 	space or equipment or purchasing support services from the nursing facility as limited by 
31.33 	section 256B.433. All agreements must be disclosed to the commissioner upon request of 
31.34 	the commissioner. Nursing facilities and vendors of ancillary services that are found to be 
31.35 	in violation of this provision shall each be subject to an action by the state of Minnesota or 
31.36 	any of its subdivisions or agencies for treble civil damages on the portion of the fee in 
32.1 	excess of that allowed by this provision and section 256B.433. Damages awarded must 
32.2 	include three times the excess payments together with costs and disbursements including 
32.3 	reasonable attorney's fees or their equivalent.
32.4 	(g) Refusing (i) A nursing facility must not refuse, for more than 24 hours, to accept 
32.5 	a resident returning to the same bed or a bed certified for the same level of care, in 
32.6 	accordance with a physician's order authorizing transfer, after receiving inpatient hospital 
32.7 	services.
32.8 	(j) For a period not to exceed 180 days, the commissioner may continue to make 
32.9 	medical assistance payments to a nursing facility or boarding care home which is in 
32.10 	violation of this section subdivision if extreme hardship to the residents would result. In 
32.11 	these cases the commissioner shall issue an order requiring the nursing facility to correct 
32.12 	the violation. The nursing facility shall have 20 days from its receipt of the order to correct 
32.13 	the violation. If the violation is not corrected within the 20-day period the commissioner 
32.14 	may reduce the payment rate to the nursing facility by up to 20 percent. The amount of the 
32.15 	payment rate reduction shall be related to the severity of the violation and shall remain 
32.16 	in effect until the violation is corrected. The nursing facility or boarding care home may 
32.17 	appeal the commissioner's action pursuant to the provisions of chapter 14 pertaining to 
32.18 	contested cases. An appeal shall be considered timely if written notice of appeal is received 
32.19 	by the commissioner within 20 days of notice of the commissioner's proposed action.
32.20 	In the event that the commissioner determines that a nursing facility is not eligible 
32.21 	for reimbursement for a resident who is eligible for medical assistance, the commissioner 
32.22 	may authorize the nursing facility to receive reimbursement on a temporary basis until the 
32.23 	resident can be relocated to a participating nursing facility.
32.24 	Certified beds in facilities which do not allow medical assistance intake on July 1, 
32.25 	1984, or after shall be deemed to be decertified for purposes of section 144A.071 only.

32.26 	Sec. 25. MEDICAL NONEMERGENCY TRANSPORTATION SINGLE 
32.27 	ADMINISTRATIVE STRUCTURE PROPOSAL.
 32.28 	(a) The commissioner of human services shall develop a proposal to create a single 
32.29 	administrative structure for providing medical nonemergency transportation services to 
32.30 	fee-for-service medical assistance recipients. This proposal must consolidate access and 
32.31 	special transportation into one administrative structure with the goal of standardizing 
32.32 	eligibility determination processes, scheduling arrangements, billing procedures, data 
32.33 	collection, and oversight mechanisms in order to enhance coordination, improve 
32.34 	accountability, and lessen confusion.
32.35 	(b) In developing the proposal, the commissioner shall:
33.1 	(1) examine the current responsibilities performed by the counties and the 
33.2 	Department of Human Services and consider the shift in costs if these responsibilities are 
33.3 	changed;
33.4 	(2) identify key performance measures to assess the cost effectiveness of medical 
33.5 	nonemergency transportation statewide, including a process to collect, audit, and report 
33.6 	data;
33.7 	(3) develop a statewide complaint system for medical assistance recipients using 
33.8 	special transportation;
33.9 	(4) establish a standardized billing process;
33.10 	(5) establish a process that provides public input from interested parties before 
33.11 	special transportation eligibility policies are implemented or significantly changed;
33.12 	(6) establish specific eligibility criteria that include the frequency of eligibility 
33.13 	assessments and the length of time a recipient remains eligible for special transportation; 
33.14 	and
33.15 	(7) develop a reimbursement method to compensate volunteers for no-load miles 
33.16 	when transporting recipients to or from health-related appointments.
33.17 	(c) In developing the proposal, the commissioner shall consult with the 
33.18 	Nonemergency Medical Transportation Advisory Council established under paragraph (d). 
33.19 	(d) The commissioner shall establish the Nonemergency Medical Transportation 
33.20 	Advisory Council to assist the commissioner in developing a single administrative 
33.21 	structure for providing nonemergency medical transportation services. The council shall 
33.22 	include, but not be limited to, the following:
33.23 	(1) one representative each from the Departments of Human Services and 
33.24 	Transportation;
33.25 	(2) one representative each from the following organizations: the Minnesota State 
33.26 	Council on Disability, the Minnesota Consortium for Citizens with Disabilities, ARC 
33.27 	of Minnesota, the Association of Minnesota Counties, the Metropolitan Inter-County 
33.28 	Association, the R-80 Medical Transportation Coalition, the Minnesota Paratransit 
33.29 	Association, legal aid, the Minnesota Ambulance Association, the National Alliance on 
33.30 	Mental Illness, Medical Transportation Management, and other transportation providers; 
33.31 	and
33.32 	(3) four members from the house of representatives: two from the majority party and 
33.33 	two from the minority party, appointed by the speaker of the house, and four members 
33.34 	from the senate: two from the majority party and two from the minority party, appointed 
33.35 	by the Subcommittee on Committees of the Committee on Rules and Administration. The 
33.36 	council is governed by Minnesota Statutes, section 15.059, except that members shall not 
34.1 	receive per diems. The commissioner of human services shall fund all costs related to the 
34.2 	council from existing resources.
34.3 	(e) The commissioner shall submit the proposal and draft legislation necessary for 
34.4 	implementation to the chairs and ranking minority members of the senate and house of 
34.5 	representatives committees or divisions with jurisdiction over health care policy and 
34.6 	finance by January 15, 2012.

34.7 	Sec. 26. NURSING FACILITY PILOT PROJECT.
 34.8 		Subdivision 1.Report. The commissioner of human services, in consultation with 
34.9 	the commissioner of health, stakeholders, and experts, shall provide to the legislature 
34.10 	recommendations by November 15, 2011, on how to develop a project to demonstrate a 
34.11 	new approach to caring for certain individuals in nursing facilities.
34.12 		Subd. 2.Contents of report. The recommendations shall address the:
34.13 	(1) nature of the demonstration in terms of timing, size, qualifications to participate, 
34.14 	participation selection criteria and postdemonstration options for the demonstration and 
34.15 	for participating facilities;
34.16 	(2) nature of needed new form of licensure;
34.17 	(3) characteristics of the individuals the new model is intended to serve and 
34.18 	comparison of these characteristics with those individuals served by existing models of 
34.19 	care;
34.20 	(4) quality standards for licensure addressing management, types and amounts of 
34.21 	staffing, safety, infection control, care processes, quality improvement, and resident rights;
34.22 	(5) characteristics of inspection process;
34.23 	(6) funding for inspection process;
34.24 	(7) enforcement authorities;
34.25 	(8) role of Medicare;
34.26 	(9) participation in the elderly waiver program, including rate setting;
34.27 	(10) nature of any federal approval or waiver requirements and the method and 
34.28 	timing of obtaining them;
34.29 	(11) consumer rights; and
34.30 	(12) methods and resources needed to evaluate the effectiveness of the model with 
34.31 	regards to cost and quality.

34.32 	ARTICLE 2
34.33 	CHEMICAL AND MENTAL HEALTH

34.34 	Section 1. Minnesota Statutes 2010, section 254B.03, subdivision 4, is amended to read:
35.1 		Subd. 4.Division of costs. Except for services provided by a county under 
35.2 	section 254B.09, subdivision 1, or services provided under section 256B.69 or 256D.03, 
35.3 	subdivision 4, paragraph (b), the county shall, out of local money, pay the state for 
35.4 	16.14 29.76 percent of the cost of chemical dependency services, including those services 
35.5 	provided to persons eligible for medical assistance under chapter 256B and general 
35.6 	assistance medical care under chapter 256D. Counties may use the indigent hospitalization 
35.7 	levy for treatment and hospital payments made under this section. 16.14 29.76 percent 
35.8 	of any state collections from private or third-party pay, less 15 percent for the cost of 
35.9 	payment and collections, must be distributed to the county that paid for a portion of the 
35.10 	treatment under this section.

35.11 	EFFECTIVE DATE. This section is effective for claims processed beginning 
35.12 	July 1, 2011.

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

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

35.27 	EFFECTIVE DATE. This section is effective for claims processed beginning 
35.28 	July 1, 2011.

35.29 	ARTICLE 3
35.30 	HUMAN SERVICES

35.31 	Section 1. Minnesota Statutes 2010, section 119B.011, subdivision 13, is amended to 
35.32 	read:
36.1 		Subd. 13.Family. "Family" means parents, stepparents, guardians and their spouses, 
36.2 	or other eligible relative caregivers and their spouses, and their blood related dependent 
36.3 	children and adoptive siblings under the age of 18 years living in the same home including 
36.4 	children temporarily absent from the household in settings such as schools, foster care, and 
36.5 	residential treatment facilities or parents, stepparents, guardians and their spouses, or other 
36.6 	relative caregivers and their spouses temporarily absent from the household in settings 
36.7 	such as schools, military service, or rehabilitation programs. An adult family member who 
36.8 	is not in an authorized activity under this chapter may be temporarily absent for up to 60 
36.9 	days. When a minor parent or parents and his, her, or their child or children are living with 
36.10 	other relatives, and the minor parent or parents apply for a child care subsidy, "family" 
36.11 	means only the minor parent or parents and their child or children. An adult age 18 or 
36.12 	older who meets this definition of family and is a full-time high school or postsecondary 
36.13 	student may be considered a dependent member of the family unit if 50 percent or more of 
36.14 	the adult's support is provided by the parents, stepparents, guardians, and their spouses or 
36.15 	eligible relative caregivers and their spouses residing in the same household.

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

36.17 	Sec. 2. Minnesota Statutes 2010, section 119B.09, is amended by adding a subdivision 
36.18 	to read:
36.19 		Subd. 9a.Child care centers; assistance. (a) For the purposes of this subdivision, 
36.20 	"qualifying child" means a child who satisfies both of the following:
36.21 	(1) is not a child or dependent of an employee of the child care provider; and
36.22 	(2) does not reside with an employee of the child care provider.
36.23 	(b) Funds distributed under this chapter must not be paid for child care services 
36.24 	that are provided for a child by a child care provider who employs either the parent of 
36.25 	the child or a person who resides with the child, unless at all times at least 50 percent of 
36.26 	the children for whom the child care provider is providing care are qualifying children 
36.27 	under paragraph (a).
36.28 	(c) If a child care provider satisfies the requirements for payment under paragraph 
36.29 	(b), but the percentage of qualifying children under paragraph (a) for whom the provider 
36.30 	is providing care falls below 50 percent, the provider shall have four weeks to raise the 
36.31 	percentage of qualifying children for whom the provider is providing care to at least 50 
36.32 	percent before payments to the provider are discontinued for child care services provided 
36.33 	for a child who is not a qualifying child.

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

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

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

37.10 	Sec. 4. Minnesota Statutes 2010, section 119B.09, is amended by adding a subdivision 
37.11 	to read:
37.12 		Subd. 13.Child care in the child's home. Child care assistance must only be 
37.13 	authorized in the child's home if the child's parents have authorized activities outside of 
37.14 	the home and if one or more of the following circumstances are met:
37.15 	(1) the parents' qualifying activity occurs during times when out-of-home care is 
37.16 	not available. If child care is needed during any period when out-of-home care is not 
37.17 	available, in-home care can be approved for the entire time care is needed;
37.18 	(2) the family lives in an area where out-of-home care is not available; or
37.19 	(3) a child has a verified illness or disability that would place the child or other 
37.20 	children in an out-of-home facility at risk or creates a hardship for the child and the family 
37.21 	to take the child out of the home to a child care home or center.

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

37.23 	Sec. 5. Minnesota Statutes 2010, section 119B.125, is amended by adding a subdivision 
37.24 	to read:
37.25 		Subd. 1b.Training required. (a) Effective November 1, 2011, prior to initial 
37.26 	authorization as required in subdivision 1, a legal nonlicensed family child care provider 
37.27 	must complete first aid and CPR training and provide the verification of first aid and CPR 
37.28 	training to the county. The training documentation must have valid effective dates as of 
37.29 	the date the registration request is submitted to the county and the training must have been 
37.30 	provided by an individual approved to provide first aid and CPR instruction.
37.31 	(b) Legal nonlicensed family child care providers with an authorization effective 
37.32 	before November 1, 2011, must be notified of the requirements before October 1, 2011, or 
38.1 	at authorization, and must meet the requirements upon renewal of an authorization that 
38.2 	occurs on or after January 1, 2012.
38.3 	(c) Upon each reauthorization after the authorization period when the initial first aid 
38.4 	and CPR training requirements are met, a legal nonlicensed family child care provider 
38.5 	must provide verification of at least eight hours of additional training listed in the 
38.6 	Minnesota Center for Professional Development Registry.
38.7 	(d) This subdivision only applies to legal nonlicensed family child care providers.

38.8 	Sec. 6. Minnesota Statutes 2010, section 119B.13, subdivision 1, is amended to read:
38.9 		Subdivision 1.Subsidy restrictions. (a) Beginning July 1, 2006 2011, the maximum 
38.10 	rate paid for child care assistance in any county or multicounty region under the child care 
38.11 	fund shall be the rate for like-care arrangements in the county effective JanuaryJuly 1, 
38.12 	2006, increaseddecreased by sixfive percent.
38.13 	(b) Rate changes shall be implemented for services provided in September 2006 
38.14 	unless a participant eligibility redetermination or a new provider agreement is completed 
38.15 	between July 1, 2006, and August 31, 2006.
38.16 	As necessary, appropriate notice of adverse action must be made according to 
38.17 	Minnesota Rules, part 3400.0185, subparts 3 and 4.
38.18 	New cases approved on or after July 1, 2006, shall have the maximum rates under 
38.19 	paragraph (a), implemented immediately.
38.20 	(c)(b) Every year, the commissioner shall survey rates charged by child care 
38.21 	providers in Minnesota to determine the 75th percentile for like-care arrangements in 
38.22 	counties. When the commissioner determines that, using the commissioner's established 
38.23 	protocol, the number of providers responding to the survey is too small to determine 
38.24 	the 75th percentile rate for like-care arrangements in a county or multicounty region, 
38.25 	the commissioner may establish the 75th percentile maximum rate based on like-care 
38.26 	arrangements in a county, region, or category that the commissioner deems to be similar.
38.27 	(d)(c) A rate which includes a special needs rate paid under subdivision 3 or under a 
38.28 	school readiness service agreement paid under section 119B.231, may be in excess of the 
38.29 	maximum rate allowed under this subdivision.
38.30 	(e)(d) The department shall monitor the effect of this paragraph on provider rates. 
38.31 	The county shall pay the provider's full charges for every child in care up to the maximum 
38.32 	established. The commissioner shall determine the maximum rate for each type of care 
38.33 	on an hourly, full-day, and weekly basis, including special needs and disability care. The 
38.34 	maximum payment to a provider for one day of care must not exceed the daily rate. The 
38.35 	maximum payment to a provider for one week of care must not exceed the weekly rate.
39.1 	(e) Child care providers receiving reimbursement under this chapter must not be 
39.2 	paid activity fees or an additional amount above the maximum rates for care provided 
39.3 	during nonstandard hours for families receiving assistance.
39.4 	(f) When the provider charge is greater than the maximum provider rate allowed, 
39.5 	the parent is responsible for payment of the difference in the rates in addition to any 
39.6 	family co-payment fee.
39.7 	(g) All maximum provider rates changes shall be implemented on the Monday 
39.8 	following the effective date of the maximum provider rate.

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

39.11 	Sec. 7. Minnesota Statutes 2010, section 119B.13, subdivision 1a, is amended to read:
39.12 		Subd. 1a.Legal nonlicensed family child care provider rates. (a) Legal 
39.13 	nonlicensed family child care providers receiving reimbursement under this chapter must 
39.14 	be paid on an hourly basis for care provided to families receiving assistance.
39.15 	(b) The maximum rate paid to legal nonlicensed family child care providers must be 
39.16 	80 percent of the county maximum hourly rate for licensed family child care providers. In 
39.17 	counties where the maximum hourly rate for licensed family child care providers is higher 
39.18 	than the maximum weekly rate for those providers divided by 50, the maximum hourly 
39.19 	rate that may be paid to legal nonlicensed family child care providers is the rate equal to 
39.20 	the maximum weekly rate for licensed family child care providers divided by 50 and then 
39.21 	multiplied by 0.80. The maximum payment to a provider for one day of care must not 
39.22 	exceed the maximum hourly rate times ten. The maximum payment to a provider for one 
39.23 	week of care must not exceed the maximum hourly rate times 50.
39.24 	(c) A rate which includes a special needs rate paid under subdivision 3 may be in 
39.25 	excess of the maximum rate allowed under this subdivision.
39.26 	(d) Legal nonlicensed family child care providers receiving reimbursement under 
39.27 	this chapter may not be paid registration fees for families receiving assistance.

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

39.29 	Sec. 8. Minnesota Statutes 2010, section 119B.13, subdivision 7, is amended to read:
39.30 		Subd. 7.Absent days. (a) Licensed child care providers may and license-exempt 
39.31 	centers must not be reimbursed for more than 25 ten full-day absent days per child, 
39.32 	excluding holidays, in a fiscal year, or for more than ten consecutive full-day absent days, 
39.33 	unless the child has a documented medical condition that causes more frequent absences. 
40.1 	Absences due to a documented medical condition of a parent or sibling who lives in the 
40.2 	same residence as the child receiving child care assistance do not count against the 25-day 
40.3 	absent day limit in a fiscal year. Documentation of medical conditions must be on the 
40.4 	forms and submitted according to the timelines established by the commissioner. A public 
40.5 	health nurse or school nurse may verify the illness in lieu of a medical practitioner. If a 
40.6 	provider sends a child home early due to a medical reason, including, but not limited to, 
40.7 	fever or contagious illness, the child care center director or lead teacher may verify the 
40.8 	illness in lieu of a medical practitioner. Legal nonlicensed family child care providers 
40.9 	must not be reimbursed for absent days. If a child attends for part of the time authorized to 
40.10 	be in care in a day, but is absent for part of the time authorized to be in care in that same 
40.11 	day, the absent time will must be reimbursed but the time will must not count toward the 
40.12 	ten consecutive or 25 cumulative absent day limits limit. Children in families where at 
40.13 	least one parent is under the age of 21, does not have a high school or general equivalency 
40.14 	diploma, and is a student in a school district or another similar program that provides or 
40.15 	arranges for child care, as well as parenting, social services, career and employment 
40.16 	supports, and academic support to achieve high school graduation, may be exempt from 
40.17 	the absent day limits upon request of the program and approval of the county. If a child 
40.18 	attends part of an authorized day, payment to the provider must be for the full amount 
40.19 	of care authorized for that day. Child care providers may must only be reimbursed for 
40.20 	absent days if the provider has a written policy for child absences and charges all other 
40.21 	families in care for similar absences.
40.22 	(b) Child care providers must be reimbursed for up to ten federal or state holidays 
40.23 	or designated holidays per year when the provider charges all families for these days 
40.24 	and the holiday or designated holiday falls on a day when the child is authorized to be 
40.25 	in attendance. Parents may substitute other cultural or religious holidays for the ten 
40.26 	recognized state and federal holidays. Holidays do not count toward the ten consecutive 
40.27 	or 25 cumulative absent day limits limit.
40.28 	(c) A family or child care provider may must not be assessed an overpayment for an 
40.29 	absent day payment unless (1) there was an error in the amount of care authorized for the 
40.30 	family, (2) all of the allowed full-day absent payments for the child have been paid, or (3) 
40.31 	the family or provider did not timely report a change as required under law.
40.32 	(d) The provider and family must receive notification of the number of absent days 
40.33 	used upon initial provider authorization for a family and when the family has used 15 
40.34 	cumulative absent days. Upon statewide implementation of the Minnesota Electronic 
40.35 	Child Care System, the provider and family shall receive notification of the number of 
41.1 	absent days used upon initial provider authorization for a family and ongoing notification 
41.2 	of the number of absent days used as of the date of the notification.
41.3 	(e) A county may pay for more absent days than the statewide absent day policy 
41.4 	established under this subdivision if current market practice in the county justifies payment 
41.5 	for those additional days. County policies for payment of absent days in excess of the 
41.6 	statewide absent day policy and justification for these county policies must be included in 
41.7 	the county's child care fund plan under section 119B.08, subdivision 3.

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

41.9 	Sec. 9. Minnesota Statutes 2010, section 256.01, subdivision 14, is amended to read:
41.10 		Subd. 14.Child welfare reform pilots. The commissioner of human services 
41.11 	shall encourage local reforms in the delivery of child welfare services, within available 
41.12 	appropriations, and is authorized to approve local pilot programs which focus on reforming 
41.13 	the child protection and child welfare systems in Minnesota. Authority to approve pilots 
41.14 	includes authority to waive existing state rules as needed to accomplish reform efforts. 
41.15 	Notwithstanding section 626.556, subdivision 10, 10b, or 10d, the commissioner may 
41.16 	authorize programs to use alternative methods of investigating and assessing reports of 
41.17 	child maltreatment, provided that the programs comply with the provisions of section 
41.18 	626.556 dealing with the rights of individuals who are subjects of reports or investigations, 
41.19 	including notice and appeal rights and data practices requirements. Pilot programs must 
41.20 	be required to address responsibility for safety and protection of children, be time limited, 
41.21 	and include evaluation of the pilot program.

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

41.32 	Sec. 11. Minnesota Statutes 2010, section 256B.69, is amended by adding a subdivision 
41.33 	to read:
42.1 		Subd. 30.Provision of required materials in alternative formats. (a) For the 
42.2 	purposes of this subdivision, "alternative format" means a medium other than paper and 
42.3 	"prepaid health plan" means managed care plans and county-based purchasing plans.
42.4 	(b) A prepaid health plan may provide in an alternative format a provider directory 
42.5 	and certificate of coverage, or materials otherwise required to be available in writing 
42.6 	under Code of Federal Regulations, title 42, section 438.10, or under the commissioner's 
42.7 	contract with the prepaid health plan, if the following conditions are met:
42.8 	(1) the prepaid health plan, local agency, or commissioner, as applicable, informs the 
42.9 	enrollee that:
42.10 	(i) an alternative format is available and the enrollee affirmatively requests of 
42.11 	the prepaid health plan that the provider directory, certificate of coverage, or materials 
42.12 	otherwise required under Code of Federal Regulations, title 42, section 438.10, or under 
42.13 	the commissioner's contract with the prepaid health plan be provided in an alternative 
42.14 	format; and
42.15 	(ii) a record of the enrollee request is retained by the prepaid health plan in the 
42.16 	form of written direction from the enrollee or a documented telephone call followed by a 
42.17 	confirmation letter to the enrollee from the prepaid health plan that explains that the 
42.18 	enrollee may change the request at any time;
42.19 	(2) the materials are sent to a secure electronic mailbox and are made available at a 
42.20 	password-protected secure electronic Web site or on a data storage device if the materials 
42.21 	contain enrollee data that is individually identifiable;
42.22 	(3) the enrollee is provided a customer service number on the enrollee's membership 
42.23 	card that may be called to request a paper version of the materials provided in an 
42.24 	alternative format; and
42.25 	(4) the materials provided in an alternative format meets all other requirements of 
42.26 	the commissioner regarding content, size of the typeface, and any required time frames 
42.27 	for distribution. "Required time frames for distribution" must permit sufficient time for 
42.28 	prepaid health plans to distribute materials in alternative formats upon receipt of enrollees' 
42.29 	requests for the materials.
42.30 	(c) A prepaid health plan may provide in an alternative format its primary care 
42.31 	network list to the commissioner and to local agencies within its service area. The 
42.32 	commissioner or local agency, as applicable, shall inform a potential enrollee of the 
42.33 	availability of a prepaid health plan's primary care network list in an alternative format. If 
42.34 	the potential enrollee requests an alternative format of the prepaid health plan's primary 
42.35 	care network list, a record of that request shall be retained by the commissioner or local 
42.36 	agency. The potential enrollee is permitted to withdraw the request at any time.
43.1 	The prepaid health plan shall submit sufficient paper versions of the primary 
43.2 	care network list to the commissioner and to local agencies within its service area to 
43.3 	accommodate potential enrollee requests for paper versions of the primary care network 
43.4 	list.
43.5 	(d) A prepaid health plan may provide in an alternative format materials otherwise 
43.6 	required to be available in writing under Code of Federal Regulations, title 42, section 
43.7 	438.10, or under the commissioner's contract with the prepaid health plan, if the conditions 
43.8 	of paragraphs (b), (c), and (e), are met for persons who are eligible for enrollment in 
43.9 	managed care.
43.10 	(e) The commissioner shall seek any federal Medicaid waivers within 90 days after 
43.11 	the effective date of this subdivision that are necessary to provide alternative formats of 
43.12 	required material to enrollees of prepaid health plans as authorized under this subdivision.
43.13 	(f) The commissioner shall consult with managed care plans, county-based 
43.14 	purchasing plans, counties, and other interested parties to determine how materials 
43.15 	required to be made available to enrollees under Code of Federal Regulations, title 42, 
43.16 	section 438.10, or under the commissioner's contract with a prepaid health plan may 
43.17 	be provided in an alternative format on the basis that the enrollee has not opted in to 
43.18 	receive the alternative format. The commissioner shall consult with managed care 
43.19 	plans, county-based purchasing plans, counties, and other interested parties to develop 
43.20 	recommendations relating to the conditions that must be met for an opt-out process 
43.21 	to be granted.

43.22 	Sec. 12. Minnesota Statutes 2010, section 256D.02, subdivision 12a, is amended to 
43.23 	read:
43.24 		Subd. 12a.Resident; general assistance medical care. (a) For purposes of 
43.25 	eligibility for general assistance and general assistance medical care, a person must be a 
43.26 	resident of this state.
43.27 	(b) A "resident" is a person living in the state for at least 30 days with the intention of 
43.28 	making the person's home here and not for any temporary purpose. Time spent in a shelter 
43.29 	for battered women shall count toward satisfying the 30-day residency requirement. All 
43.30 	applicants for these programs are required to demonstrate the requisite intent and can do 
43.31 	so in any of the following ways:
43.32 	(1) by showing that the applicant maintains a residence at a verified address, other 
43.33 	than a place of public accommodation. An applicant may verify a residence address by 
43.34 	presenting a valid state driver's license,; a state identification card,; a voter registration 
43.35 	card,; a rent receipt,; a statement by the landlord, apartment manager, or homeowner 
44.1 	verifying that the individual is residing at the address,; or other form of verification 
44.2 	approved by the commissioner; or
44.3 	(2) by verifying residence according to Minnesota Rules, part 9500.1219, subpart 
44.4 	3, item C.
44.5 	(c) For general assistance medical care, a county agency shall waive the 30-day 
44.6 	residency requirement in cases of medical emergencies. For general assistance, a county 
44.7 	shall waive the 30-day residency requirement where unusual hardship would result from 
44.8 	denial of general assistance. For purposes of this subdivision, "unusual hardship" means 
44.9 	the applicant is without shelter or is without available resources for food.
44.10 	The county agency must report to the commissioner within 30 days on any waiver 
44.11 	granted under this section. The county shall not deny an application solely because the 
44.12 	applicant does not meet at least one of the criteria in this subdivision, but shall continue to 
44.13 	process the application and leave the application pending until the residency requirement 
44.14 	is met or until eligibility or ineligibility is established.
44.15 	(d) For purposes of paragraph (c), the following definitions apply (1) "metropolitan 
44.16 	statistical area" is as defined by the United States Census Bureau; (2) "shelter" includes 
44.17 	any shelter that is located within the metropolitan statistical area containing the county 
44.18 	and for which the applicant is eligible, provided the applicant does not have to travel more 
44.19 	than 20 miles to reach the shelter and has access to transportation to the shelter. Clause (2) 
44.20 	does not apply to counties in the Minneapolis-St. Paul metropolitan statistical area.
44.21 	(e) Migrant workers as defined in section 256J.08 and, until March 31, 1998, their 
44.22 	immediate families are exempt from the residency requirements of this section, provided 
44.23 	the migrant worker provides verification that the migrant family worked in this state 
44.24 	within the last 12 months and earned at least $1,000 in gross wages during the time the 
44.25 	migrant worker worked in this state. 
44.26 	(f) For purposes of eligibility for emergency general assistance, the 30-day residency 
44.27 	requirement under this section shall not be waived.
44.28 	(g) (e) If any provision of this subdivision is enjoined from implementation or found 
44.29 	unconstitutional by any court of competent jurisdiction, the remaining provisions shall 
44.30 	remain valid and shall be given full effect.

44.31 	Sec. 13. Minnesota Statutes 2010, section 256D.44, subdivision 5, is amended to read:
44.32 		Subd. 5.Special needs. In addition to the state standards of assistance established in 
44.33 	subdivisions 1 to 4, payments are allowed for the following special needs of recipients of 
44.34 	Minnesota supplemental aid who are not residents of a nursing home, a regional treatment 
44.35 	center, or a group residential housing facility.
45.1 	(a) The county agency shall pay a monthly allowance for medically prescribed 
45.2 	diets if the cost of those additional dietary needs cannot be met through some other 
45.3 	maintenance benefit. The need for special diets or dietary items must be prescribed by 
45.4 	a licensed physician. Costs for special diets shall be determined as percentages of the 
45.5 	allotment for a one-person household under the thrifty food plan as defined by the United 
45.6 	States Department of Agriculture. The types of diets and the percentages of the thrifty 
45.7 	food plan that are covered are as follows:
45.8 	(1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;
45.9 	(2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent 
45.10 	of thrifty food plan;
45.11 	(3) controlled protein diet, less than 40 grams and requires special products, 125 
45.12 	percent of thrifty food plan;
45.13 	(4) low cholesterol diet, 25 percent of thrifty food plan;
45.14 	(5) high residue diet, 20 percent of thrifty food plan;
45.15 	(6) pregnancy and lactation diet, 35 percent of thrifty food plan;
45.16 	(7) gluten-free diet, 25 percent of thrifty food plan;
45.17 	(8) lactose-free diet, 25 percent of thrifty food plan;
45.18 	(9) antidumping diet, 15 percent of thrifty food plan;
45.19 	(10) hypoglycemic diet, 15 percent of thrifty food plan; or
45.20 	(11) ketogenic diet, 25 percent of thrifty food plan.
45.21 	(b) Payment for nonrecurring special needs must be allowed for necessary home 
45.22 	repairs or necessary repairs or replacement of household furniture and appliances using 
45.23 	the payment standard of the AFDC program in effect on July 16, 1996, for these expenses, 
45.24 	as long as other funding sources are not available.
45.25 	(c) A fee for guardian or conservator service is allowed at a reasonable rate 
45.26 	negotiated by the county or approved by the court. This rate shall not exceed five percent 
45.27 	of the assistance unit's gross monthly income up to a maximum of $100 per month. If the 
45.28 	guardian or conservator is a member of the county agency staff, no fee is allowed.
45.29 	(d) The county agency shall continue to pay a monthly allowance of $68 for 
45.30 	restaurant meals for a person who was receiving a restaurant meal allowance on June 1, 
45.31 	1990, and who eats two or more meals in a restaurant daily. The allowance must continue 
45.32 	until the person has not received Minnesota supplemental aid for one full calendar month 
45.33 	or until the person's living arrangement changes and the person no longer meets the criteria 
45.34 	for the restaurant meal allowance, whichever occurs first.
45.35 	(e) A fee of ten percent of the recipient's gross income or $25, whichever is less, 
45.36 	is allowed for representative payee services provided by an agency that meets the 
46.1 	requirements under SSI regulations to charge a fee for representative payee services. This 
46.2 	special need is available to all recipients of Minnesota supplemental aid regardless of 
46.3 	their living arrangement.
46.4 	(f) (a)(1) Notwithstanding the language in this subdivision, An amount equal to the 
46.5 	maximum allotment authorized by the federal Food Stamp Program for a single individual 
46.6 	which is in effect on the first day of July of each year will be added to the standards of 
46.7 	assistance established in subdivisions 1 to 4 for adults under the age of 65 who qualify 
46.8 	as shelter needy and are: (i) relocating from an institution, or an adult mental health 
46.9 	residential treatment program under section 256B.0622; (ii) eligible for the self-directed 
46.10 	supports option as defined under section 256B.0657, subdivision 2; or (iii) home and 
46.11 	community-based waiver recipients living in their own home or rented or leased apartment 
46.12 	which is not owned, operated, or controlled by a provider of service not related by blood 
46.13 	or marriage, unless allowed under paragraph (g) (b).
46.14 	(2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the 
46.15 	shelter needy benefit under this paragraph is considered a household of one. An eligible 
46.16 	individual who receives this benefit prior to age 65 may continue to receive the benefit 
46.17 	after the age of 65.
46.18 	(3) "Shelter needy" means that the assistance unit incurs monthly shelter costs that 
46.19 	exceed 40 percent of the assistance unit's gross income before the application of this 
46.20 	special needs standard. "Gross income" for the purposes of this section is the applicant's or 
46.21 	recipient's income as defined in section 256D.35, subdivision 10, or the standard specified 
46.22 	in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient of a federal or 
46.23 	state housing subsidy, that limits shelter costs to a percentage of gross income, shall not be 
46.24 	considered shelter needy for purposes of this paragraph.
46.25 	(g) Notwithstanding this subdivision,(b) To access housing and services as provided 
46.26 	in paragraph (f) (a), the recipient may choose housing that may be owned, operated, or 
46.27 	controlled by the recipient's service provider. In a multifamily building of four or more 
46.28 	units, the maximum number of apartments that may be used by recipients of this program 
46.29 	shall be 50 percent of the units in a building. This paragraph expires on June 30, 2012.

46.30 	Sec. 14. Minnesota Statutes 2010, section 256D.47, is amended to read:
46.31 	256D.47 PAYMENT METHODS.
46.32 	Minnesota supplemental aid payments must be issued to the recipient, a protective 
46.33 	payee, or a conservator or guardian of the recipient's estate in the form of county warrants 
46.34 	immediately redeemable in cash, electronic benefits transfer, or by direct deposit into the 
46.35 	recipient's account in a financial institution. Minnesota supplemental aid payments must 
47.1 	be issued regularly on the first day of the month. The supplemental aid warrants must be 
47.2 	mailed only to the address at which the recipient resides, unless another address has been 
47.3 	approved in advance by the county agency. Vendor payments must not be issued by the 
47.4 	county agency except for nonrecurring emergency need payments; at the request of the 
47.5 	recipient; for special needs, other than special diets; or when the agency determines the 
47.6 	need for protective payments exist.

47.7 	Sec. 15. Minnesota Statutes 2010, section 256D.49, subdivision 3, is amended to read:
47.8 		Subd. 3.Overpayment of monthly grants and recovery of ATM errors. (a) When 
47.9 	the county agency determines that an overpayment of the recipient's monthly payment 
47.10 	of Minnesota supplemental aid has occurred, it shall issue a notice of overpayment 
47.11 	to the recipient. If the person is no longer receiving Minnesota supplemental aid, the 
47.12 	county agency may request voluntary repayment or pursue civil recovery. If the person is 
47.13 	receiving Minnesota supplemental aid, the county agency shall recover the overpayment 
47.14 	by withholding an amount equal to three percent of the standard of assistance for the 
47.15 	recipient or the total amount of the monthly grant, whichever is less. 
47.16 	(b) Establishment of an overpayment is limited to 12 months from the date of 
47.17 	discovery due to agency error. Establishment of an overpayment is limited to six years 
47.18 	prior to the month of discovery due to client error or an intentional program violation 
47.19 	determined under section 256.046.
47.20 	(c) For recipients receiving benefits via electronic benefit transfer, if the overpayment 
47.21 	is a result of an automated teller machine (ATM) dispensing funds in error to the recipient, 
47.22 	the agency may recover the ATM error by immediately withdrawing funds from the 
47.23 	recipient's electronic benefit transfer account, up to the amount of the error. 
47.24 	(d) Residents of nursing homes, regional treatment centers, andlicensed residential 
47.25 	facilities with negotiated rates shall not have overpayments recovered from their personal 
47.26 	needs allowance.

47.27 	Sec. 16. Minnesota Statutes 2010, section 256E.30, subdivision 2, is amended to read:
47.28 		Subd. 2.Allocation of money. (a) State money appropriated and Community 
47.29 	service block grant money allotted to the state and all money transferred to the community 
47.30 	service block grant from other block grants shall be allocated annually to community 
47.31 	action agencies and Indian reservation governments under clauses (b) and (c), and to 
47.32 	migrant and seasonal farmworker organizations under clause (d).
47.33 	(b) The available annual money will provide base funding to all community action 
47.34 	agencies and the Indian reservations. Base funding amounts per agency are as follows: for 
48.1 	agencies with low income populations up to 3,999, $25,000; 4,000 to 23,999, $50,000; 
48.2 	and 24,000 or more, $100,000.
48.3 	(c) All remaining money of the annual money available after the base funding has 
48.4 	been determined must be allocated to each agency and reservation in proportion to the 
48.5 	size of the poverty level population in the agency's service area compared to the size of 
48.6 	the poverty level population in the state.
48.7 	(d) Allocation of money to migrant and seasonal farmworker organizations must not 
48.8 	exceed three percent of the total annual money available. Base funding allocations must 
48.9 	be made for all community action agencies and Indian reservations that received money 
48.10 	under this subdivision, in fiscal year 1984, and for community action agencies designated 
48.11 	under this section with a service area population of 35,000 or greater.

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

48.23 	Sec. 18. Minnesota Statutes 2010, section 256E.35, subdivision 6, is amended to read:
48.24 		Subd. 6.Withdrawal; matching; permissible uses. (a) To receive a match, a 
48.25 	participating household must transfer funds withdrawn from a family asset account to its 
48.26 	matching fund custodial account held by the fiscal agent, according to the family asset 
48.27 	agreement. The fiscal agent must determine if the match request is for a permissible use 
48.28 	consistent with the household's family asset agreement.
48.29 	The fiscal agent must ensure the household's custodial account contains the 
48.30 	applicable matching funds to match the balance in the household's account, including 
48.31 	interest, on at least a quarterly basis and at the time of an approved withdrawal. Matches 
48.32 	must be provided as follows:
49.1 	(1) from state grant and TANF funds a matching contribution of $1.50 for every $1 
49.2 	of funds withdrawn from the family asset account equal to the lesser of $720 per year or a 
49.3 	$3,000 lifetime limit; and
49.4 	(2) from nonstate funds, a matching contribution of no less than $1.50 for every $1 
49.5 	of funds withdrawn from the family asset account equal to the lesser of $720 per year or 
49.6 	a $3,000 lifetime limit.
49.7 	(b) Upon receipt of transferred custodial account funds, the fiscal agent must make a 
49.8 	direct payment to the vendor of the goods or services for the permissible use.

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

49.17 	Sec. 20. Minnesota Statutes 2010, section 256J.12, subdivision 2, is amended to read:
49.18 		Subd. 2.Exceptions. (a) A county shall waive the 30-day residency requirement 
49.19 	where unusual hardship would result from denial of assistance.
49.20 	(b) For purposes of this section, unusual hardship means an assistance unit:
49.21 	(1) is without alternative shelter; or
49.22 	(2) is without available resources for food.
49.23 	(c) For purposes of this subdivision, the following definitions apply (1) "metropolitan 
49.24 	statistical area" is as defined by the U.S. Census Bureau; (2) "alternative shelter" includes 
49.25 	any shelter that is located within the metropolitan statistical area containing the county and 
49.26 	for which the family is eligible, provided the assistance unit does not have to travel more 
49.27 	than 20 miles to reach the shelter and has access to transportation to the shelter. Clause (2) 
49.28 	does not apply to counties in the Minneapolis-St. Paul metropolitan statistical area.
49.29 	(d) Applicants are considered to meet the residency requirement under subdivision 
49.30 	1a if they once resided in Minnesota and:
49.31 	(1) joined the United States armed services, returned to Minnesota within 30 days of 
49.32 	leaving the armed services, and intend to remain in Minnesota; or
50.1 	(2) left to attend school in another state, paid nonresident tuition or Minnesota 
50.2 	tuition rates under a reciprocity agreement, and returned to Minnesota within 30 days of 
50.3 	graduation with the intent to remain in Minnesota.
50.4 	(e) (b) The 30-day 60-day residence requirement is met when:
50.5 	(1) a minor child or a minor caregiver moves from another state to the residence of 
50.6 	a relative caregiver; and
50.7 	(2) the relative caregiver has resided in Minnesota for at least 30 60 consecutive 
50.8 	days and:
50.9 	(i) the minor caregiver applies for and receives MFIP; or
50.10 	(ii) the relative caregiver applies for assistance for the minor child but does not 
50.11 	choose to be a member of the MFIP assistance unit.

50.12 	Sec. 21. Minnesota Statutes 2010, section 256J.37, is amended by adding a subdivision 
50.13 	to read:
50.14 		Subd. 3c.Treatment of Supplemental Security Income. Effective July 1, 2011, the 
50.15 	county shall reduce the cash portion of the MFIP grant by $150.00 per SSI recipient who 
50.16 	resides in the household, and who would otherwise be included in the MFIP assistance 
50.17 	unit under section 256J.24, subdivision 2, but is excluded solely due to the SSI recipient 
50.18 	status under section 256J.24, subdivision 3, paragraph (a), clause (1). If the SSI recipient 
50.19 	receives less than $150 of SSI, only the amount received shall be used in calculating the 
50.20 	MFIP cash assistance payment. This provision does not apply to relative caregivers who 
50.21 	could elect to be included in the MFIP assistance unit under section 256J.24, subdivision 
50.22 	4, unless the caregiver's children or stepchildren are included in the MFIP assistance unit.

50.23 	Sec. 22. Minnesota Statutes 2010, section 256J.38, subdivision 1, is amended to read:
50.24 		Subdivision 1.Scope of overpayment. (a) When a participant or former participant 
50.25 	receives an overpayment due to agency, client, or ATM error, or due to assistance received 
50.26 	while an appeal is pending and the participant or former participant is determined 
50.27 	ineligible for assistance or for less assistance than was received, the county agency must 
50.28 	recoup or recover the overpayment using the following methods:
50.29 	(1) reconstruct each affected budget month and corresponding payment month;
50.30 	(2) use the policies and procedures that were in effect for the payment month; and
50.31 	(3) do not allow employment disregards in section 256J.21, subdivision 3 or 4, in the 
50.32 	calculation of the overpayment when the unit has not reported within two calendar months 
50.33 	following the end of the month in which the income was received. 
51.1 	(b) Establishment of an overpayment is limited to 12 months prior to the month of 
51.2 	discovery due to agency error. Establishment of an overpayment is limited to six years 
51.3 	prior to the month of discovery due to client error or an intentional program violation 
51.4 	determined under section 256.046.

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

51.8 	Sec. 24. [256N.20] DEFINITIONS.
51.9 		Subdivision 1.Scope. For the purposes of sections 256N.01 to 256N.80, the terms 
51.10 	defined in this section have the meanings given them.
51.11 		Subd. 2.Adult assistance. "Adult assistance" means a capped allocation provided 
51.12 	or arranged for by county boards for ongoing emergency needs, special diets, or special 
51.13 	needs as determined by the county.
51.14 		Subd. 3.Commissioner. "Commissioner" means the commissioner of human 
51.15 	services.
51.16 		Subd. 4.County board. "County board" means the board of county commissioners 
51.17 	in each county.
51.18 		Subd. 5.Eligible participant. "Eligible participant" means low-income adults who 
51.19 	meet the residency requirements under section 256N.22, and who were previously eligible 
51.20 	for programs under subdivision 6 are eligible for adult assistance. The commissioner may 
51.21 	develop more specific eligibility criteria.
51.22 		Subd. 6.Former programs. "Former programs" means funding for:
51.23 	(1) general assistance;
51.24 	(2) emergency general assistance;
51.25 	(3) emergency supplemental aid; and
51.26 	(4) Minnesota supplemental aid special needs and special diets.

51.27 	Sec. 25. [256N.22] RESIDENCY.
51.28 	(a) For purposes of eligibility for adult assistance, a person must be a resident of 
51.29 	this state.
51.30 	(b) A "resident" is a person living in the state for at least 60 days with the intention of 
51.31 	making the person's home here and not for any temporary purpose. Time spent in a shelter 
51.32 	for battered women shall count toward satisfying the 60-day residency requirement. All 
52.1 	applicants for these programs are required to demonstrate the requisite intent and may do 
52.2 	so in any of the following ways:
52.3 	(1) by showing that the applicant maintains a residence at a verified address, other 
52.4 	than a place of public accommodation. An applicant may verify a residence address by 
52.5 	presenting a valid state driver's license, a state identification card, a voter registration 
52.6 	card, or a rent receipt; or
52.7 	(2) by verifying residence according to Minnesota Rules, part 9500.1219, subpart 
52.8 	3, item C. 
52.9 	(c) The county shall not deny an application solely because the applicant does not 
52.10 	meet at least one of the criteria in this subdivision, but shall continue to process the 
52.11 	application and leave the application pending until the residency requirement is met or 
52.12 	until eligibility or ineligibility is established. 
52.13 	(d) If any provision of this subdivision is enjoined from implementation or found 
52.14 	unconstitutional by any court of competent jurisdiction, the remaining provisions shall 
52.15 	remain valid and shall be given full effect. 

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

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

53.3 	Sec. 28. Minnesota Statutes 2010, section 393.07, subdivision 10, is amended to read:
53.4 		Subd. 10.Food stamp program; Maternal and Child Nutrition Act. (a) The local 
53.5 	social services agency shall establish and administer the food stamp program according 
53.6 	to rules of the commissioner of human services, the supervision of the commissioner as 
53.7 	specified in section 256.01, and all federal laws and regulations. The commissioner of 
53.8 	human services shall monitor food stamp program delivery on an ongoing basis to ensure 
53.9 	that each county complies with federal laws and regulations. Program requirements to be 
53.10 	monitored include, but are not limited to, number of applications, number of approvals, 
53.11 	number of cases pending, length of time required to process each application and deliver 
53.12 	benefits, number of applicants eligible for expedited issuance, length of time required 
53.13 	to process and deliver expedited issuance, number of terminations and reasons for 
53.14 	terminations, client profiles by age, household composition and income level and sources, 
53.15 	and the use of phone certification and home visits. The commissioner shall determine the 
53.16 	county-by-county and statewide participation rate.
53.17 	(b) On July 1 of each year, the commissioner of human services shall determine a 
53.18 	statewide and county-by-county food stamp program participation rate. The commissioner 
53.19 	may designate a different agency to administer the food stamp program in a county if the 
53.20 	agency administering the program fails to increase the food stamp program participation 
53.21 	rate among families or eligible individuals, or comply with all federal laws and regulations 
53.22 	governing the food stamp program. The commissioner shall review agency performance 
53.23 	annually to determine compliance with this paragraph.
53.24 	(c) A person who commits any of the following acts has violated section 256.98 or 
53.25 	609.821, or both, and is subject to both the criminal and civil penalties provided under 
53.26 	those sections:
53.27 	(1) obtains or attempts to obtain, or aids or abets any person to obtain by means of a 
53.28 	willful statement or misrepresentation, or intentional concealment of a material fact, food 
53.29 	stamps or vouchers issued according to sections 145.891 to 145.897 to which the person 
53.30 	is not entitled or in an amount greater than that to which that person is entitled or which 
53.31 	specify nutritional supplements to which that person is not entitled; or
53.32 	(2) presents or causes to be presented, coupons or vouchers issued according to 
53.33 	sections 145.891 to 145.897 for payment or redemption knowing them to have been 
53.34 	received, transferred or used in a manner contrary to existing state or federal law; or
54.1 	(3) willfully uses, possesses, or transfers food stamp coupons, authorization to 
54.2 	purchase cards or vouchers issued according to sections 145.891 to 145.897 in any manner 
54.3 	contrary to existing state or federal law, rules, or regulations; or
54.4 	(4) buys or sells food stamp coupons, authorization to purchase cards, other 
54.5 	assistance transaction devices, vouchers issued according to sections 145.891 to 145.897, 
54.6 	or any food obtained through the redemption of vouchers issued according to sections 
54.7 	145.891 to 145.897 for cash or consideration other than eligible food.
54.8 	(d) A peace officer or welfare fraud investigator may confiscate food stamps, 
54.9 	authorization to purchase cards, or other assistance transaction devices found in the 
54.10 	possession of any person who is neither a recipient of the food stamp program nor 
54.11 	otherwise authorized to possess and use such materials. Confiscated property shall be 
54.12 	disposed of as the commissioner may direct and consistent with state and federal food 
54.13 	stamp law. The confiscated property must be retained for a period of not less than 30 days 
54.14 	to allow any affected person to appeal the confiscation under section 256.045.
54.15 	(e) Food stamp overpayment claims which are due in whole or in part to client error 
54.16 	shall be established by the county agency for a period of six years from the date of any 
54.17 	resultant overpayment Establishment of an overpayment is limited to 12 months prior to 
54.18 	the month of discovery due to agency error. Establishment of an overpayment is limited 
54.19 	to six years prior to the month of discovery due to client error or an intentional program 
54.20 	violation determined under section 256.046.
54.21 	(f) With regard to the federal tax revenue offset program only, recovery incentives 
54.22 	authorized by the federal food and consumer service shall be retained at the rate of 50 
54.23 	percent by the state agency and 50 percent by the certifying county agency.
54.24 	(g) A peace officer, welfare fraud investigator, federal law enforcement official, 
54.25 	or the commissioner of health may confiscate vouchers found in the possession of any 
54.26 	person who is neither issued vouchers under sections 145.891 to 145.897, nor otherwise 
54.27 	authorized to possess and use such vouchers. Confiscated property shall be disposed of 
54.28 	as the commissioner of health may direct and consistent with state and federal law. The 
54.29 	confiscated property must be retained for a period of not less than 30 days.
54.30 	(h) The commissioner of human services may seek a waiver from the United States 
54.31 	Department of Agriculture to allow the state to specify foods that may and may not be 
54.32 	purchased in Minnesota with benefits funded by the federal Food Stamp Program. The 
54.33 	commissioner shall consult with the members of the house of representatives and senate 
54.34 	policy committees having jurisdiction over food support issues in developing the waiver. 
54.35 	The commissioner, in consultation with the commissioners of health and education, shall 
55.1 	develop a broad public health policy related to improved nutrition and health status. The 
55.2 	commissioner must seek legislative approval prior to implementing the waiver.

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

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

55.16 	Sec. 31. Minnesota Statutes 2010, section 402A.15, is amended to read:
55.17 	402A.15 STEERING COMMITTEE ON PERFORMANCE AND OUTCOME 
55.18 	REFORMS.
55.19 		Subdivision 1.Duties. (a) The Steering Committee on Performance and Outcome 
55.20 	Reforms shall develop a uniform process to establish and review performance and outcome 
55.21 	standards for all essential human services based on the current level of resources available, 
55.22 	and to shall develop appropriate reporting measures and a uniform accountability process 
55.23 	for responding to a county's or human service delivery authority's failure to make adequate 
55.24 	progress on achieving performance measures. The accountability process shall focus on 
55.25 	the performance measures rather than inflexible implementation requirements.
55.26 	(b) The steering committee shall:
55.27 	(1) by November 1, 2009, establish an agreed-upon list of essential services;
55.28 	(2) by February 15, 2010, develop and recommend to the legislature a uniform, 
55.29 	graduated process, in addition to the remedies identified in section 402A.18, for responding 
55.30 	to a county's failure to make adequate progress on achieving performance measures; and
55.31 	(3) by December 15, 2012, for each essential service, make recommendations 
55.32 	to the legislature regarding (1) (i) performance measures and goals based on those 
55.33 	measures for each essential service, (2) and (ii) a system for reporting on the performance 
56.1 	measures and goals, and (3) appropriate resources, including funding, needed to achieve 
56.2 	those performance measures and goals. The resource recommendations shall take into 
56.3 	consideration program demand and the unique differences of local areas in geography and 
56.4 	the populations served. Priority shall be given to services with the greatest variation in 
56.5 	availability and greatest administrative demands. By January 15 of each year starting 
56.6 	January 15, 2011, the steering committee shall report its recommendations to the governor 
56.7 	and legislative committees with jurisdiction over health and human services. As part of its 
56.8 	report, the steering committee shall, as appropriate, recommend statutory provisions, rules 
56.9 	and requirements, and reports that should be repealed or eliminated.
56.10 	(c) As far as possible, the performance measures, reporting system, and funding 
56.11 	shall be consistent across program areas. The development of performance measures shall 
56.12 	consider the manner in which data will be collected and performance will be reported. 
56.13 	The steering committee shall consider state and local administrative costs related to 
56.14 	collecting data and reporting outcomes when developing performance measures. The 
56.15 	steering committee shall correlate the performance measures and goals to available levels 
56.16 	of resources, including state and local funding. The steering committee shall also identify 
56.17 	and incorporate federal performance measures in its recommendations for those program 
56.18 	areas where federal funding is contingent on meeting federal performance standards. The 
56.19 	steering committee shall take into consideration that the goal of implementing changes 
56.20 	to program monitoring and reporting the progress toward achieving outcomes is to 
56.21 	significantly minimize the cost of administrative requirements and to allow funds freed 
56.22 	by reduced administrative expenditures to be used to provide additional services, allow 
56.23 	flexibility in service design and management, and focus energies on achieving program 
56.24 	and client outcomes.
56.25 	(d) In making its recommendations, the steering committee shall consider input from 
56.26 	the council established in section 402A.20. The steering committee shall review the 
56.27 	measurable goals established in a memorandum of understanding entered into under 
56.28 	section 402A.30, subdivision 2, paragraph (b), and consider whether they may be applied 
56.29 	as statewide performance outcomes.
56.30 	(e) The steering committee shall form work groups that include persons who provide 
56.31 	or receive essential services and representatives of organizations who advocate on behalf 
56.32 	of those persons.
56.33 	(f) By December 15, 2009, the steering committee shall establish a three-year 
56.34 	schedule for completion of its work. The schedule shall be published on the Department of 
56.35 	Human Services Web site and reported to the legislative committees with jurisdiction over 
57.1 	health and human services. In addition, the commissioner shall post quarterly updates on 
57.2 	the progress of the steering committee on the Department of Human Services Web site.
57.3 		Subd. 2.Composition. (a) The steering committee shall include:
57.4 	(1) the commissioner of human services, or designee, and two additional 
57.5 	representatives of the department;
57.6 	(2) two county commissioners, representative of rural and urban counties, selected 
57.7 	by the Association of Minnesota Counties;
57.8 	(3) two county directors of human services, representative of rural and urban 
57.9 	counties, selected by the Minnesota Association of County Social Service Administrators; 
57.10 	and
57.11 	(4) three clients or client advocates representing different populations receiving 
57.12 	services from the Department of Human Services, who are appointed by the commissioner.
57.13 	(b) The commissioner, or designee, and a county commissioner shall serve as 
57.14 	cochairs of the committee. The committee shall be convened within 60 days of May 
57.15 	15, 2009.
57.16 	(c) State agency staff shall serve as informational resources and staff to the steering 
57.17 	committee. Statewide county associations may assemble county program data as required.
57.18 	(d) To promote information sharing and coordination between the steering committee 
57.19 	and council, one of the county representatives from paragraph (a), clause (2), and one of the 
57.20 	county representatives from paragraph (a), clause (3), must also serve as a representative 
57.21 	on the council under section 402A.20, subdivision 1, paragraph (b), clause (5) or (6).

57.22 	Sec. 32. Minnesota Statutes 2010, section 518A.51, is amended to read:
57.23 	518A.51 FEES FOR IV-D SERVICES.
57.24 	(a) When a recipient of IV-D services is no longer receiving assistance under the 
57.25 	state's title IV-A, IV-E foster care, medical assistance, or MinnesotaCare programs, the 
57.26 	public authority responsible for child support enforcement must notify the recipient, 
57.27 	within five working days of the notification of ineligibility, that IV-D services will be 
57.28 	continued unless the public authority is notified to the contrary by the recipient. The 
57.29 	notice must include the implications of continuing to receive IV-D services, including the 
57.30 	available services and fees, cost recovery fees, and distribution policies relating to fees.
57.31 	(b) An application fee of $25 shall be paid by the person who applies for child 
57.32 	support and maintenance collection services, except persons who are receiving public 
57.33 	assistance as defined in section 256.741 and the diversionary work program under section 
57.34 	256J.95, persons who transfer from public assistance to nonpublic assistance status, and 
58.1 	minor parents and parents enrolled in a public secondary school, area learning center, or 
58.2 	alternative learning program approved by the commissioner of education.
58.3 	(c) In the case of an individual who has never received assistance under a state 
58.4 	program funded under title IV-A of the Social Security Act and for whom the public 
58.5 	authority has collected at least $500 of support, the public authority must impose an 
58.6 	annual federal collections fee of $25 for each case in which services are furnished. This 
58.7 	fee must be retained by the public authority from support collected on behalf of the 
58.8 	individual, but not from the first $500 collected.
58.9 	(d) When the public authority provides full IV-D services to an obligee who has 
58.10 	applied for those services, upon written notice to the obligee, the public authority must 
58.11 	charge a cost recovery fee of one two percent of the amount collected. This fee must 
58.12 	be deducted from the amount of the child support and maintenance collected and not 
58.13 	assigned under section 256.741 before disbursement to the obligee. This fee does not 
58.14 	apply to an obligee who:
58.15 	(1) is currently receiving assistance under the state's title IV-A, IV-E foster care, 
58.16 	medical assistance, or MinnesotaCare programs; or
58.17 	(2) has received assistance under the state's title IV-A or IV-E foster care programs, 
58.18 	until the person has not received this assistance for 24 consecutive months.
58.19 	 (e) When the public authority provides full IV-D services to an obligor who has 
58.20 	applied for such services, upon written notice to the obligor, the public authority must 
58.21 	charge a cost recovery fee of one two percent of the monthly court-ordered child support 
58.22 	and maintenance obligation. The fee may be collected through income withholding, as 
58.23 	well as by any other enforcement remedy available to the public authority responsible for 
58.24 	child support enforcement.
58.25 	 (f) Fees assessed by state and federal tax agencies for collection of overdue support 
58.26 	owed to or on behalf of a person not receiving public assistance must be imposed on the 
58.27 	person for whom these services are provided. The public authority upon written notice to 
58.28 	the obligee shall assess a fee of $25 to the person not receiving public assistance for each 
58.29 	successful federal tax interception. The fee must be withheld prior to the release of the 
58.30 	funds received from each interception and deposited in the general fund.
58.31 	 (g) Federal collections fees collected under paragraph (c) and cost recovery 
58.32 	fees collected under paragraphs (d) and (e) retained by the commissioner of human 
58.33 	services shall be considered child support program income according to Code of Federal 
58.34 	Regulations, title 45, section 304.50, and shall be deposited in the special revenue fund 
58.35 	account established under paragraph (i). The commissioner of human services must elect 
58.36 	to recover costs based on either actual or standardized costs.
59.1 	 (h) The limitations of this section on the assessment of fees shall not apply to 
59.2 	the extent inconsistent with the requirements of federal law for receiving funds for the 
59.3 	programs under title IV-A and title IV-D of the Social Security Act, United States Code, 
59.4 	title 42, sections 601 to 613 and United States Code, title 42, sections 651 to 662.
59.5 	 (i) The commissioner of human services is authorized to establish a special revenue 
59.6 	fund account to receive the federal collections fees collected under paragraph (c) and cost 
59.7 	recovery fees collected under paragraphs (d) and (e). A portion of the nonfederal share of 
59.8 	these fees may be retained for expenditures necessary to administer the fees and must be 
59.9 	transferred to the child support system special revenue account. The remaining nonfederal 
59.10 	share of the federal collections fees and cost recovery fees must be retained by the 
59.11 	commissioner and dedicated to the child support general fund county performance-based 
59.12 	grant account authorized under sections 256.979 and 256.9791.
59.13 	(j) The nonfederal share of the cost recovery fee revenue must be retained by the 
59.14 	commissioner and distributed as follows:
59.15 	(1) one-half of the revenue must be transferred to the child support system special 
59.16 	revenue account to support the state's administration of the child support enforcement 
59.17 	program and its federally mandated automated system;
59.18 	(2) an additional portion of the revenue must be transferred to the child support 
59.19 	system special revenue account for expenditures necessary to administer the fees; and
59.20 	(3) the remaining portion of the revenue must be distributed to the counties to aid the 
59.21 	counties in funding their child support enforcement programs.
59.22 	(k) The nonfederal share of the federal collections fees must be distributed to the 
59.23 	counties to aid them in funding their child support enforcement programs.
59.24 	(l) The commissioner of human services shall distribute quarterly any of the funds 
59.25 	dedicated to the counties under paragraphs (j) and (k) using the methodology specified in 
59.26 	section 256.979, subdivision 11. The funds received by the counties must be reinvested in 
59.27 	the child support enforcement program and the counties must not reduce the funding of 
59.28 	their child support programs by the amount of the funding distributed.

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

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

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

60.10 	Sec. 35. ALTERNATIVE STRATEGIES FOR CERTAIN 
60.11 	REDETERMINATIONS.
 60.12 	The commissioner of human services shall develop and implement by January 15, 
60.13 	2012, a simplified process to redetermine eligibility for recipient populations in the medical 
60.14 	assistance, Minnesota supplemental aid, food support, and group residential housing 
60.15 	programs who are eligible based upon disability, age, or chronic medical conditions, and 
60.16 	who are expected to experience minimal change in income or assets from month to month. 
60.17 	The commissioner shall apply for any federal waivers needed to implement this section.

60.18 	Sec. 36. REQUEST FOR PROPOSALS; COMBINED ONLINE APPLICATION.
 60.19 	(a) The commissioner of human services shall issue a request for proposals for a 
60.20 	contract to implement an integrated online eligibility and application portal for food 
60.21 	support, cash assistance, child care, and health care programs. The request for proposals 
60.22 	must require that the system recommended and implemented by the contractor:
60.23 	(1) streamline eligibility determination and case processing in the state to support 
60.24 	statewide eligibility processing;
60.25 	(2) enable interested persons to determine their eligibility for each program, and to 
60.26 	apply for programs online in a manner that asks the applicant only those questions that 
60.27 	relate to the programs the person is applying for;
60.28 	(3) leverage technology that has been operational in production in other similar 
60.29 	state environments; and
60.30 	(4) include Web-based application and worker application processing support and 
60.31 	opportunity for expansion.
60.32 	(b) If responses to the request for proposals meet the requirements under paragraph 
60.33 	(a), the commissioner shall enter into a contract for the services specified in paragraph 
61.1 	(a) by January 31, 2012. The contract must incorporate a performance-based vendor 
61.2 	financing option whereby the vendor contributes the nonfederal share of the cost. If the 
61.3 	commissioner determines that an adequate vendor cannot be chosen based on responses to 
61.4 	the request for proposals, the commissioner shall report back to the chairs and ranking 
61.5 	minority members of the legislative committees having jurisdiction over health and human 
61.6 	services prior to the January 31, 2012, contract date.

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

61.8 	Sec. 37. UNIFORM ASSET LIMIT REQUIREMENTS.
 61.9 	The commissioner of human services, in consultation with county human services 
61.10 	representatives, shall analyze the differences in asset limit requirements across human 
61.11 	services assistance programs, including group residential housing, Minnesota supplemental 
61.12 	aid, general assistance, Minnesota family investment program, diversionary work program, 
61.13 	the federal Supplemental Nutrition Assistance Program, state food assistance programs, 
61.14 	and child care programs. The goal of the analysis is to establish a consistent asset limit 
61.15 	across human services programs and minimize the administrative burdens on counties in 
61.16 	implementing asset tests. The commissioner shall report its findings and conclusions to 
61.17 	the health and human services legislative committees by January 15, 2012, and include 
61.18 	draft legislation establishing a uniform asset limit for human services assistance programs.

61.19 	Sec. 38. ANALYSIS OF PROGRAMS AND THEIR AFFECT ON HEALTHY 
61.20 	MARRIAGES.
 61.21 		Subdivision 1.Analysis. The commissioner of human services shall conduct an 
61.22 	analysis of whether current human services programs affect the motivation and capacity of 
61.23 	individuals to form and sustain healthy marriages in which to raise children. Programs 
61.24 	to be examined in this marriage impact analysis include, but are not limited to, medical 
61.25 	assistance, MinnesotaCare, Minnesota Family Investment program, general assistance, 
61.26 	child protection, child support enforcement, child welfare services, and services for people 
61.27 	who are mentally ill, chemically dependent, or have physical or developmental disabilities.
61.28 		Subd. 2.Report. Before January 1, 2012, the commissioner shall submit a report to 
61.29 	the legislature describing the results of this analysis and outlining proposals to improve 
61.30 	the ability of human services programs to help people who are interested in marriage to 
61.31 	form and sustain healthy marriages in which to raise children. The commissioner shall 
61.32 	ensure that experts on healthy marriage are consulted on the process of conducting the 
61.33 	analysis and writing the report.

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

62.5 	Sec. 40.  REPEALER.
 62.6 	(a) Minnesota Statutes 2010, sections 256.979, subdivisions 5, 6, 7, and 10; 
62.7 	256.9791; 256D.01, subdivisions 1, 1a, 1b, 1e, and 2; 256D.03, subdivisions 1, 2, and 2a; 
62.8 	256D.05, subdivisions 1, 2, 4, 5, 6, 7, and 8; 256D.0513; 256D.053, subdivisions 1, 2, 
62.9 	and 3; 256D.06, subdivisions 1, 1b, 2, 5, 7, and 8; 256D.09, subdivisions 1, 2, 2a, 2b, 5, 
62.10 	and 6; 256D.10; 256D.13; 256D.15; 256D.16; 256D.35, subdivision 8b; and 256D.46, are 
62.11 	repealed.
62.12 	(b) Minnesota Rules, part 9500.1243, subpart 3, is repealed.
62.13 	(c) Minnesota Rules, part 3400.0130, subpart 8, is repealed effective September 
62.14 	3, 2012.

62.15 	ARTICLE 4
62.16 	DEPARTMENT OF HUMAN SERVICES LICENSING

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

62.26 	Sec. 2. Minnesota Statutes 2010, section 245A.10, subdivision 3, is amended to read:
62.27 		Subd. 3.Application fee for initial license or certification. (a) For fees required 
62.28 	under subdivision 1, an applicant for an initial license or certification issued by the 
62.29 	commissioner shall submit a $500 application fee with each new application required 
62.30 	under this subdivision. The application fee shall not be prorated, is nonrefundable, and 
62.31 	is in lieu of the annual license or certification fee that expires on December 31. The 
62.32 	commissioner shall not process an application until the application fee is paid.
63.1 	(b) Except as provided in clauses (1) to (3) (4), an applicant shall apply for a license 
63.2 	to provide services at a specific location.
63.3 	(1) For a license to provide residential-based habilitation services to persons with 
63.4 	developmental disabilities under chapter 245B, an applicant shall submit an application 
63.5 	for each county in which the services will be provided. Upon licensure, the license 
63.6 	holder may provide services to persons in that county plus no more than three persons 
63.7 	at any one time in each of up to ten additional counties. A license holder in one county 
63.8 	may not provide services under the home and community-based waiver for persons with 
63.9 	developmental disabilities to more than three people in a second county without holding 
63.10 	a separate license for that second county. Applicants or licensees providing services 
63.11 	under this clause to not more than three persons remain subject to the inspection fees 
63.12 	established in section 245A.10, subdivision 2, for each location. The license issued by 
63.13 	the commissioner must state the name of each additional county where services are being 
63.14 	provided to persons with developmental disabilities. A license holder must notify the 
63.15 	commissioner before making any changes that would alter the license information listed 
63.16 	under section 245A.04, subdivision 7, paragraph (a), including any additional counties 
63.17 	where persons with developmental disabilities are being served.
63.18 	(2) For a license to provide supported employment, crisis respite, or 
63.19 	semi-independent living services to persons with developmental disabilities under chapter 
63.20 	245B, an applicant shall submit a single application to provide services statewide.
63.21 	(3) For a license to provide independent living assistance for youth under section 
63.22 	245A.22, an applicant shall submit a single application to provide services statewide.
63.23 	(4) For a license for a private agency to provide foster care or adoption services 
63.24 	under Minnesota Rules, parts 9545.0755 to 9545.0845, an applicant shall submit a single 
63.25 	application to provide services statewide.

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

63.30
63.31		Licensed Capacity
	Child Care Center
License Fee
	Other Program 
License Fee
	
63.32		1 to 24 persons
	$225$200
		$400
	
63.33		25 to 49 persons
	$340$300
		$600
	
63.34		50 to 74 persons
	$450$400
		$800
	
63.35		75 to 99 persons
	$565$500
		$1,000
	
63.36		100 to 124 persons
	$675$600
		$1,200
	
64.1		125 to 149 persons
	$900$700
		$1,400
	
64.2		150 to 174 persons
	$1,050$800
		$1,600
	
64.3		175 to 199 persons
	$1,200$900
		$1,800
	
64.4
64.5		200 to 224 persons
	$1,350
$1,000
		$2,000
	
64.6
64.7		225 or more persons
	$1,500
$1,100
		$2,500
	
64.8 	(b) A day training and habilitation program serving persons with developmental 
64.9 	disabilities or related conditions shall be assessed apay an annual nonrefundable license 
64.10 	fee based on the following schedule in paragraph (a) unless the license holder serves more 
64.11 	than 50 percent of the same persons at two or more locations in the community.:

64.12		Licensed Capacity
	License Fee
	
64.13		1 to 24 persons
	$800
	
64.14		25 to 49 persons
	$1,000
	
64.15		50 to 74 persons
	$1,200
	
64.16		75 to 99 persons
	$1,400
	
64.17		100 to 124 persons
	$1,600
	
64.18		125 to 149 persons
	$1,800
	
64.19		150 or more persons
	$2,000
	
64.20 	Except as provided in paragraph (c), when a day training and habilitation program 
64.21 	serves more than 50 percent of the same persons in two or more locations in a community, 
64.22 	the day training and habilitation program shall pay a license fee based on the licensed 
64.23 	capacity of the largest facility and the other facility or facilities shall be charged a license 
64.24 	fee based on a licensed capacity of a residential program serving one to 24 persons.
64.25 	(c) When a day training and habilitation program serving persons with developmental 
64.26 	disabilities or related conditions seeks a single license allowed under section 245B.07, 
64.27 	subdivision 12, clause (2) or (3), the licensing fee must be based on the combined licensed 
64.28 	capacity for each location.
64.29 	(d) A program licensed to provide supported employment services to persons 
64.30 	with developmental disabilities under chapter 245B shall pay an annual nonrefundable 
64.31 	license fee of $650.
64.32 	(e) A program licensed to provide crisis respite services to persons with 
64.33 	developmental disabilities under chapter 245B shall pay an annual nonrefundable license 
64.34 	fee of $700.
64.35 	(f) A program licensed to provide semi-independent living services to persons 
64.36 	with developmental disabilities under chapter 245B shall pay an annual nonrefundable 
64.37 	license fee of $700.
65.1 	(g) A program licensed to provide residential-based habilitation services under the 
65.2 	home and community-based waiver for persons with developmental disabilities shall pay 
65.3 	an annual license fee that includes a base rate of $690 plus $60 times the number of clients 
65.4 	served on the first day of July of the current license year.
65.5 	(h) A residential program certified by the Department of Health as an intermediate 
65.6 	care facility for persons with developmental disabilities (ICF/MR) and a noncertified 
65.7 	residential program licensed to provide health or rehabilitative services for persons 
65.8 	with developmental disabilities shall pay an annual nonrefundable license fee based on 
65.9 	the following schedule:

65.10		Licensed Capacity
	License Fee
	
65.11		1 to 24 persons
	$535
	
65.12		25 to 49 persons
	$735
	
65.13		50 or more persons
	$935
	
65.14 	(i) A chemical dependency treatment program licensed under Minnesota Rules, parts 
65.15 	9530.6405 to 9530.6505, to provide chemical dependency treatment shall pay an annual 
65.16 	nonrefundable license fee based on the following schedule:

65.17		Licensed Capacity
	License Fee
	
65.18		1 to 24 persons
	$600
	
65.19		25 to 49 persons
	$800
	
65.20		50 to 74 persons
	$1,000
	
65.21		75 to 99 persons
	$1,200
	
65.22		100 or more persons
	$1,400
	
65.23 	(j) A chemical dependency program licensed under Minnesota Rules, parts 
65.24 	9530.6510 to 9530.6590, to provide detoxification services shall pay an annual 
65.25 	nonrefundable license fee based on the following schedule:

65.26		Licensed Capacity
	License Fee
	
65.27		1 to 24 persons
	$760
	
65.28		25 to 49 persons
	$960
	
65.29		50 or more persons
	$1,160
	
65.30 	(k) Except for child foster care, a residential facility licensed under Minnesota 
65.31 	Rules, chapter 2960, to serve children shall pay an annual nonrefundable license fee 
65.32 	based on the following schedule:

65.33		Licensed Capacity
	License Fee
	
65.34		1 to 24 persons
	$1,000
	
65.35		25 to 49 persons
	$1,100
	
65.36		50 to 74 persons
	$1,200
	
65.37		75 to 99 persons
	$1,300
	
65.38		100 or more persons
	$1,400
	
66.1 	(l) A residential facility licensed under Minnesota Rules, parts 9520.0500 to 
66.2 	9520.0670, to serve persons with mental illness shall pay an annual nonrefundable license 
66.3 	fee based on the following schedule:

66.4		Licensed Capacity
	License Fee
	
66.5		1 to 24 persons
	$2,525
	
66.6		25 or more persons
	$2,725
	
66.7 	(m) A residential facility licensed under Minnesota Rules, parts 9570.2000 to 
66.8 	9570.3400, to serve persons with physical disabilities shall pay an annual nonrefundable 
66.9 	license fee based on the following schedule:

66.10		Licensed Capacity
	License Fee
	
66.11		1 to 24 persons
	$450
	
66.12		25 to 49 persons
	$650
	
66.13		50 to 74 persons
	$850
	
66.14		75 to 99 persons
	$1,050
	
66.15		100 or more persons
	$1,250
	
66.16 	(n) A program licensed to provide independent living assistance for youth under 
66.17 	section 245A.22 shall pay an annual nonrefundable license fee of $1,500.
66.18 	(o) A private agency licensed to provide foster care and adoption services under 
66.19 	Minnesota Rules, parts 9545.0755 to 9545.0845, shall pay an annual nonrefundable 
66.20 	license fee of $875.
66.21 	(p) A program licensed as an adult day care center licensed under Minnesota Rules, 
66.22 	parts 9555.9600 to 9555.9730, shall pay an annual nonrefundable license fee based on 
66.23 	the following schedule:

66.24		Licensed Capacity
	License Fee
	
66.25		1 to 24 persons
	$500
	
66.26		25 to 49 persons
	$700
	
66.27		50 to 74 persons
	$900
	
66.28		75 to 99 persons
	$1,100
	
66.29		100 or more persons
	$1,300
	
66.30 	(q) A program licensed to provide treatment services to persons with sexual 
66.31 	psychopathic personalities or sexually dangerous persons under Minnesota Rules, parts 
66.32 	9515.3000 to 9515.3110, shall pay an annual nonrefundable license fee of $20,000.
66.33 	(r) A mental health center or mental health clinic requesting certification for 
66.34 	purposes of insurance and subscriber contract reimbursement under Minnesota Rules, 
66.35 	parts 9520.0750 to 9520.0870, shall pay a certification fee of $1,550 per year. If the 
66.36 	mental health center or mental health clinic provides services at a primary location with 
67.1 	satellite facilities, the satellite facilities shall be certified with the primary location without 
67.2 	an additional charge.

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

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

67.17 	Sec. 6. Minnesota Statutes 2010, section 245A.11, subdivision 2b, is amended to read:
67.18 		Subd. 2b.Adult foster care; family adult day services. An adult foster care 
67.19 	license holder licensed under the conditions in subdivision 2a may also provide family 
67.20 	adult day care for adults age 55 age 18 or over if no persons in the adult foster or family 
67.21 	adult day services program have a serious and persistent mental illness or a developmental 
67.22 	disability. Family adult day services provided in a licensed adult foster care setting must 
67.23 	be provided as specified under section 245A.143. Authorization to provide family adult 
67.24 	day services in the adult foster care setting shall be printed on the license certificate by 
67.25 	the commissioner. Adult foster care homes licensed under this section and family adult 
67.26 	day services licensed under section 245A.143 shall not be subject to licensure by the 
67.27 	commissioner of health under the provisions of chapter 144, 144A, 157, or any other 
67.28 	law requiring facility licensure by the commissioner of health. A separate license is not 
67.29 	required to provide family adult day services in a licensed adult foster care home.

67.30 	Sec. 7. Minnesota Statutes 2010, section 245A.143, subdivision 1, is amended to read:
67.31 		Subdivision 1.Scope. (a) The licensing standards in this section must be met to 
67.32 	obtain and maintain a license to provide family adult day services. For the purposes of this 
68.1 	section, family adult day services means a program operating fewer than 24 hours per day 
68.2 	that provides functionally impaired adults, none of which are under age 55, have serious 
68.3 	or persistent mental illness, or have developmental disabilities, age 18 or older with an 
68.4 	individualized and coordinated set of services including health services, social services, 
68.5 	and nutritional services that are directed at maintaining or improving the participants' 
68.6 	capabilities for self-care.
68.7 	(b) A family adult day services license shall only be issued when the services are 
68.8 	provided in the license holder's primary residence, and the license holder is the primary 
68.9 	provider of care. The license holder may not serve more than eight adults at one time, 
68.10 	including residents, if any, served under a license issued under Minnesota Rules, parts 
68.11 	9555.5105 to 9555.6265.
68.12 	(c) An adult foster care license holder may provide family adult day services under 
68.13 	the license holder's adult foster care license if the license holder meets the requirements 
68.14 	of this section.
68.15 	(d) When an applicant or license holder submits an application for initial licensure 
68.16 	or relicensure for both adult foster care and family adult day services, the county agency 
68.17 	shall process the request as a single application and shall conduct concurrent routine 
68.18 	licensing inspections.
68.19 	(e) Adult foster care license holders providing family adult day services under their 
68.20 	foster care license on March 30, 2004, shall be permitted to continue providing these 
68.21 	services with no additional requirements until their adult foster care license is due for 
68.22 	renewal. At the time of relicensure, an adult foster care license holder may continue to 
68.23 	provide family adult day services upon demonstration of compliance with this section. 
68.24 	Adult foster care license holders who provide only family adult day services on August 1, 
68.25 	2004, may apply for a license under this section instead of an adult foster care license.

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

68.34 	Sec. 9. Minnesota Statutes 2010, section 256B.49, subdivision 16a, is amended to read:
69.1 		Subd. 16a.Medical assistance reimbursement. (a) The commissioner shall 
69.2 	seek federal approval for medical assistance reimbursement of independent living skills 
69.3 	services, foster care waiver service, supported employment, prevocational service, and 
69.4 	structured day service under the home and community-based waiver for persons with a 
69.5 	traumatic brain injury, the community alternatives for disabled individuals waivers, and 
69.6 	the community alternative care waivers.
69.7 	(b) Medical reimbursement shall be made only when the provider demonstrates 
69.8 	evidence of its capacity to meet basic health, safety, and protection standards through 
69.9 	the following methods:
69.10 	(1) for independent living skills services, supported employment, prevocational 
69.11 	service, and structured day service through one of the methods in paragraphs (c) and 
69.12 	(d); and
69.13 	(2) for foster care waiver services through the method in paragraph (e).
69.14 	(c) The provider is licensed to provide services under chapter 245B and agrees 
69.15 	to apply these standards to services funded through the traumatic brain injury, 
69.16 	community alternatives for disabled persons, or community alternative care home and 
69.17 	community-based waivers.
69.18 	(d) The commissioner shall certify that the provider has policies and procedures 
69.19 	governing the following:
69.20 	(1) protection of the consumer's rights and privacy;
69.21 	(2) risk assessment and planning;
69.22 	(3) record keeping and reporting of incidents and emergencies with documentation 
69.23 	of corrective action if needed;
69.24 	(4) service outcomes, regular reviews of progress, and periodic reports;
69.25 	(5) complaint and grievance procedures;
69.26 	(6) service termination or suspension;
69.27 	(7) necessary training and supervision of direct care staff that includes:
69.28 	(i) documentation in personnel files of 20 hours of orientation training in providing 
69.29 	training related to service provision;
69.30 	(ii) training in recognizing the symptoms and effects of certain disabilities, health 
69.31 	conditions, and positive behavioral supports and interventions;
69.32 	(iii) a minimum of five hours of related training annually; and
69.33 	(iv) when applicable:
69.34 	(A) safe medication administration;
69.35 	(B) proper handling of consumer funds; and
70.1 	(C) compliance with prohibitions and standards developed by the commissioner to 
70.2 	satisfy federal requirements regarding the use of restraints and restrictive interventions. 
70.3 	The commissioner shall review at least biennially that each service provider's policies 
70.4 	and procedures governing basic health, safety, and protection of rights continue to meet 
70.5 	minimum standards.
70.6 	(e) The commissioner shall seek federal approval for Medicaid reimbursement 
70.7 	of foster care services under the home and community-based waiver for persons with 
70.8 	a traumatic brain injury, the community alternatives for disabled individuals waiver, 
70.9 	and community alternative care waiver when the provider demonstrates evidence of 
70.10 	its capacity to meet basic health, safety, and protection standards. The commissioner 
70.11 	shall verify that the adult foster care provider is licensed under Minnesota Rules, parts 
70.12 	9555.5105 to 9555.6265; that the child foster care provider is licensed as a family foster 
70.13 	care or a foster care residence under Minnesota Rules, parts 2960.3000 to 2960.3340, and 
70.14 	certify that the provider has policies and procedures that govern:
70.15 	(1) compliance with prohibitions and standards developed by the commissioner to 
70.16 	meet federal requirements regarding the use of restraints and restrictive interventions;
70.17 	(2) documentation of service needs and outcomes, regular reviews of progress, 
70.18 	and periodic reports; and
70.19 	(3) safe medication management and administration.
70.20 	The commissioner shall review at least biennially that each service provider's policies and 
70.21 	procedures governing basic health, safety, and protection of rights standards continue to 
70.22 	meet minimum standards.
70.23 	(f) The commissioner shall seek federal waiver approval for Medicaid reimbursement 
70.24 	of family adult day services under all disability waivers. After the waiver is granted, the 
70.25 	commissioner shall include family adult day services in the common services menu that 
70.26 	is currently under development.

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

70.28 	Sec. 10.  REPEALER.
 70.29 	Minnesota Statutes 2010, section 245A.10, subdivision 5, is repealed.

70.30 	ARTICLE 5
70.31 	HEALTH CARE

70.32 	Section 1. [1.06] FREEDOM OF CHOICE IN HEALTH CARE ACT.
71.1 		Subdivision 1.Citation. This section shall be known as and may be cited as the 
71.2 	"Freedom of Choice in Health Care Act."
71.3 		Subd. 2.Definitions. (a) For purposes of this section, the following terms have 
71.4 	the meaning given them.
71.5 	(b) "Health care service" means any service, treatment, or provision of a product for 
71.6 	the care of a physical or mental disease, illness, injury, defect, or condition, or to otherwise 
71.7 	maintain or improve physical or mental health, subject to all laws and rules regulating 
71.8 	health service providers and products within the state of Minnesota.
71.9 	(c) "Mode of securing" means to purchase directly or on credit or by trade, or to 
71.10 	contract for third-party payment by insurance or other legal means as authorized by the 
71.11 	state of Minnesota, or to apply for or accept employer-sponsored or government-sponsored 
71.12 	health care benefits under such conditions as may legally be required as a condition of 
71.13 	such benefits, or any combination of the same.
71.14 	(d) "Penalty" means any civil or criminal fine, tax, salary or wage withholding, 
71.15 	surcharge, fee, or any other imposed consequence established by law or rule of a 
71.16 	government or its subdivision or agency that is used to punish or discourage the exercise 
71.17 	of rights protected under this section.
71.18 		Subd. 3.Statement of public policy. (a) The power to require or regulate a person's 
71.19 	choice in the mode of securing health care services, or to impose a penalty related to that 
71.20 	choice, is not found in the Constitution of the United States of America, and is therefore a 
71.21 	power reserved to the people pursuant to the Ninth Amendment, and to the several states 
71.22 	pursuant to the Tenth Amendment. The state of Minnesota hereby exercises its sovereign 
71.23 	power to declare the public policy of the state of Minnesota regarding the right of all 
71.24 	persons residing in the state in choosing the mode of securing health care services.
71.25 	(b) It is hereby declared that the public policy of the state of Minnesota, consistent 
71.26 	with our constitutionally recognized and inalienable rights of liberty, is that every person 
71.27 	within the state of Minnesota is and shall be free to choose or decline to choose any mode 
71.28 	of securing health care services without penalty or threat of penalty.
71.29 	(c) The policy stated under this section shall not be applied to impair any right of 
71.30 	contract related to the provision of health care services to any person or group.
71.31 		Subd. 4.Enforcement. (a) No public official, employee, or agent of the state of 
71.32 	Minnesota or any of its political subdivisions shall act to impose, collect, enforce, or 
71.33 	effectuate any penalty in the state of Minnesota that violates the public policy set forth 
71.34 	in this section.
71.35 	(b) The attorney general shall take any action as is provided in this section or section 
71.36 	8.31 in the defense or prosecution of rights protected under this section.

72.1 	Sec. 2. Minnesota Statutes 2010, section 8.31, subdivision 1, is amended to read:
72.2 		Subdivision 1.Investigate offenses against provisions of certain designated 
72.3 	sections; assist in enforcement. (a) The attorney general shall investigate violations of the 
72.4 	law of this state respecting unfair, discriminatory, and other unlawful practices in business, 
72.5 	commerce, or trade, and specifically, but not exclusively, the Nonprofit Corporation Act 
72.6 	(sections 317A.001 to 317A.909), the Act Against Unfair Discrimination and Competition 
72.7 	(sections 325D.01 to 325D.07), the Unlawful Trade Practices Act (sections 325D.09 to 
72.8 	325D.16), the Antitrust Act (sections 325D.49 to 325D.66), section 325F.67 and other 
72.9 	laws against false or fraudulent advertising, the antidiscrimination acts contained in 
72.10 	section 325D.67, the act against monopolization of food products (section 325D.68), 
72.11 	the act regulating telephone advertising services (section 325E.39), the Prevention of 
72.12 	Consumer Fraud Act (sections 325F.68 to 325F.70), and chapter 53A regulating currency 
72.13 	exchanges and assist in the enforcement of those laws as in this section provided. 
72.14 	(b) The attorney general shall seek injunctive and any other appropriate relief as 
72.15 	expeditiously as possible to preserve the rights and property of the residents of Minnesota, 
72.16 	and to defend as necessary the state of Minnesota, its officials, employees, and agents in 
72.17 	the event that any law or regulation violating the public policy set forth in the Freedom 
72.18 	of Choice in Health Care Act in this section is enacted by any government, subdivision, 
72.19 	or agency thereof.
72.20 	(c) The attorney general shall seek injunctive and any other appropriate relief 
72.21 	as expeditiously as possible in the event that any law or regulation violating the public 
72.22 	policy set forth in the Freedom of Choice in Health Care Act in this section is enacted 
72.23 	without adequate federal funding to the state to ensure affordable health care coverage 
72.24 	is available to the residents of Minnesota.

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

73.1 	Sec. 4. Minnesota Statutes 2010, section 62E.14, is amended by adding a subdivision 
73.2 	to read:
73.3 		Subd. 4f.Waiver of preexisting conditions for persons covered by healthy 
73.4 	Minnesota contribution program. A person may enroll in the comprehensive plan with 
73.5 	a waiver of the preexisting condition limitation in subdivision 3 if the person is eligible for 
73.6 	the healthy Minnesota contribution program, and has been denied coverage as described 
73.7 	under section 256B.695, subdivision 6, or section 256L.031, subdivision 6.

73.8 	Sec. 5. Minnesota Statutes 2010, section 62J.692, subdivision 7, is amended to read:
73.9 		Subd. 7.Transfers from the commissioner of human services. Of the amount 
73.10 	transferred according to section 256B.69, subdivision 5c, paragraph (a), clauses (1) to (4), 
73.11 	$21,714,000 shall be distributed as follows:
73.12 	(1) $2,157,000 shall be distributed by the commissioner to the University of 
73.13 	Minnesota Board of Regents for the purposes described in sections 137.38 to 137.40;
73.14 	(2) $1,035,360 shall be distributed by the commissioner to the Hennepin County 
73.15 	Medical Center for clinical medical education;
73.16 	(3) $17,400,000 shall be distributed by the commissioner to the University of 
73.17 	Minnesota Board of Regents for purposes of medical education; and
73.18 	(4) $1,121,640 shall be distributed by the commissioner to clinical medical education 
73.19 	dental innovation grants in accordance with subdivision 7a; and
73.20 	(5) the remainder of the amount transferred according to section 256B.69, 
73.21 	subdivision 5c, clauses (1) to (4), shall be distributed by the commissioner annually to 
73.22 	clinical medical education programs that meet the qualifications of subdivision 3 based on 
73.23 	the formula in subdivision 4, paragraph (a).

73.24 	Sec. 6. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision 
73.25 	to read:
73.26 		Subd. 33.Contingency contract fees. When the commissioner enters into 
73.27 	a contingency-based contract for the purpose of recovering medical assistance or 
73.28 	MinnesotaCare funds, the commissioner may retain that portion of the recovered funds 
73.29 	equal to the amount of the contingency fee.

73.30 	Sec. 7. Minnesota Statutes 2010, section 256.969, subdivision 2b, is amended to read:
73.31 		Subd. 2b.Operating payment rates. In determining operating payment rates for 
73.32 	admissions occurring on or after the rate year beginning January 1, 1991, and every two 
73.33 	years after, or more frequently as determined by the commissioner, the commissioner 
74.1 	shall obtain operating data from an updated base year and establish operating payment 
74.2 	rates per admission for each hospital based on the cost-finding methods and allowable 
74.3 	costs of the Medicare program in effect during the base year. Rates under the general 
74.4 	assistance medical care, medical assistance, and MinnesotaCare programs shall not be 
74.5 	rebased to more current data on January 1, 1997, January 1, 2005, for the first 24 months 
74.6 	of the rebased period beginning January 1, 2009. For the first 24 months of the rebased 
74.7 	period beginning January 1, 2011, rates shall not be rebased, except that a Minnesota 
74.8 	long-term hospital shall be rebased effective January 1, 2011, based on its most recent 
74.9 	Medicare cost report ending on or before September 1, 2008, with the provisions under 
74.10 	subdivisions 9 and 23, based on the rates in effect on December 31, 2010. For subsequent 
74.11 	rate setting periods in which the base years are updated, a Minnesota long-term hospital's 
74.12 	base year shall remain within the same period as other hospitals. Effective January 1, 
74.13 	2013, rates shall be rebased at full value Rates must not be rebased to more current data 
74.14 	for the first six months of the rebased period beginning January 1, 2013. The base year 
74.15 	operating payment rate per admission is standardized by the case mix index and adjusted 
74.16 	by the hospital cost index, relative values, and disproportionate population adjustment. 
74.17 	The cost and charge data used to establish operating rates shall only reflect inpatient 
74.18 	services covered by medical assistance and shall not include property cost information 
74.19 	and costs recognized in outlier payments.

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

74.27 	Sec. 9. Minnesota Statutes 2010, section 256B.06, subdivision 4, is amended to read:
74.28 		Subd. 4.Citizenship requirements. (a) Eligibility for medical assistance is limited 
74.29 	to citizens of the United States, qualified noncitizens as defined in this subdivision, and 
74.30 	other persons residing lawfully in the United States. Citizens or nationals of the United 
74.31 	States must cooperate in obtaining satisfactory documentary evidence of citizenship or 
74.32 	nationality according to the requirements of the federal Deficit Reduction Act of 2005, 
74.33 	Public Law 109-171.
75.1 	(b) "Qualified noncitizen" means a person who meets one of the following 
75.2 	immigration criteria:
75.3 	(1) admitted for lawful permanent residence according to United States Code, title 8;
75.4 	(2) admitted to the United States as a refugee according to United States Code, 
75.5 	title 8, section 1157;
75.6 	(3) granted asylum according to United States Code, title 8, section 1158;
75.7 	(4) granted withholding of deportation according to United States Code, title 8, 
75.8 	section 1253(h);
75.9 	(5) paroled for a period of at least one year according to United States Code, title 8, 
75.10 	section 1182(d)(5);
75.11 	(6) granted conditional entrant status according to United States Code, title 8, 
75.12 	section 1153(a)(7);
75.13 	(7) determined to be a battered noncitizen by the United States Attorney General 
75.14 	according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, 
75.15 	title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;
75.16 	(8) is a child of a noncitizen determined to be a battered noncitizen by the United 
75.17 	States Attorney General according to the Illegal Immigration Reform and Immigrant 
75.18 	Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill, 
75.19 	Public Law 104-200; or
75.20 	(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public 
75.21 	Law 96-422, the Refugee Education Assistance Act of 1980.
75.22 	(c) All qualified noncitizens who were residing in the United States before August 
75.23 	22, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for 
75.24 	medical assistance with federal financial participation.
75.25 	(d) All qualified noncitizens who entered the United States on or after August 22, 
75.26 	1996, and who otherwise meet the eligibility requirements of this chapter, are eligible for 
75.27 	medical assistance with federal financial participation through November 30, 1996.
75.28 	Beginning December 1, 1996, qualified noncitizens who entered the United States 
75.29 	on or after August 22, 1996, and who otherwise meet the eligibility requirements of this 
75.30 	chapter are eligible for medical assistance with federal participation for five years if they 
75.31 	meet one of the following criteria:
75.32 	(i) refugees admitted to the United States according to United States Code, title 8, 
75.33 	section 1157;
75.34 	(ii) persons granted asylum according to United States Code, title 8, section 1158;
75.35 	(iii) persons granted withholding of deportation according to United States Code, 
75.36 	title 8, section 1253(h);
76.1 	(iv) veterans of the United States armed forces with an honorable discharge for 
76.2 	a reason other than noncitizen status, their spouses and unmarried minor dependent 
76.3 	children; or
76.4 	(v) persons on active duty in the United States armed forces, other than for training, 
76.5 	their spouses and unmarried minor dependent children.
76.6 	Beginning December 1, 1996, qualified noncitizens who do not meet one of the 
76.7 	criteria in items (i) to (v) are eligible for medical assistance without federal financial 
76.8 	participation as described in paragraph (j).
76.9 	Notwithstanding paragraph (j), Beginning July 1, 2010, children and pregnant 
76.10 	women who are noncitizens described in paragraph (b) or (e) who are lawfully in the 
76.11 	United States as defined in Code of Federal Regulations, title 8, section 103.12, and who 
76.12 	otherwise meet eligibility requirements of this chapter, are eligible for medical assistance 
76.13 	with federal financial participation as provided by the federal Children's Health Insurance 
76.14 	Program Reauthorization Act of 2009, Public Law 111-3.
76.15 	(e) Noncitizens who are not qualified noncitizens as defined in paragraph (b), who 
76.16 	are lawfully present in the United States, as defined in Code of Federal Regulations, title 
76.17 	8, section 103.12, and who otherwise meet the eligibility requirements of this chapter, are 
76.18 	eligible for medical assistance under clauses (1) to (3). These individuals must cooperate 
76.19 	with the United States Citizenship and Immigration Services to pursue any applicable 
76.20 	immigration status, including citizenship, that would qualify them for medical assistance 
76.21 	with federal financial participation.
76.22 	(1) Persons who were medical assistance recipients on August 22, 1996, are eligible 
76.23 	for medical assistance with federal financial participation through December 31, 1996.
76.24 	(2) Beginning January 1, 1997, persons described in clause (1) are eligible for 
76.25 	medical assistance without federal financial participation as described in paragraph (j).
76.26 	(3) Beginning December 1, 1996, persons residing in the United States prior to 
76.27 	August 22, 1996, who were not receiving medical assistance and persons who arrived on 
76.28 	or after August 22, 1996, are eligible for medical assistance without federal financial 
76.29 	participation as described in paragraph (j).
76.30 	(f) (e) Nonimmigrants who otherwise meet the eligibility requirements of this 
76.31 	chapter are eligible for the benefits as provided in paragraphs (g)(f) to (i) (h). For purposes 
76.32 	of this subdivision, a "nonimmigrant" is a person in one of the classes listed in United 
76.33 	States Code, title 8, section 1101(a)(15).
76.34 	(g) (f) Payment shall also be made for care and services that are furnished to 
76.35 	noncitizens, regardless of immigration status, who otherwise meet the eligibility 
76.36 	requirements of this chapter, if such care and services are necessary for the treatment of an 
77.1 	emergency medical condition, except for organ transplants and related care and services 
77.2 	and routine prenatal care.
77.3 	(h) (g) For purposes of this subdivision, the term "emergency medical condition" 
77.4 	means a medical condition that meets the requirements of United States Code, title 42, 
77.5 	section 1396b(v).
77.6 	(h) Notwithstanding paragraph (g), services that are necessary for the treatment of 
77.7 	an emergency medical condition are limited to the following:
77.8 	(1) services delivered in an emergency room that are directly related to the treatment 
77.9 	of an emergency medical condition;
77.10 	(2) services delivered in an inpatient hospital setting following admission from an 
77.11 	emergency room or clinic for an acute emergency condition; and
77.12 	(3) follow-up services that are directly related to the original service provided to 
77.13 	treat the emergency medical condition and are covered by the global payment made to the 
77.14 	provider.
77.15 	Services for the treatment of emergency medical conditions do not include:
77.16 	(1) services delivered in an emergency room or inpatient setting to treat a 
77.17 	nonemergency condition;
77.18 	(2) organ transplants and related care;
77.19 	(3) services for routine prenatal care;
77.20 	(4) continuing care, including long-term care, nursing facility services, home health 
77.21 	care, adult day care, day training, or supportive living services;
77.22 	(5) elective surgery;
77.23 	(6) outpatient prescription drugs, unless the drugs are administered or dispensed as 
77.24 	part of an emergency room visit;
77.25 	(7) preventative health care and family planning services;
77.26 	(8) dialysis;
77.27 	(9) chemotherapy or therapeutic radiation services;
77.28 	(10) rehabilitation services;
77.29 	(11) physical, occupational, or speech therapy;
77.30 	(12) transportation services;
77.31 	(13) case management;
77.32 	(14) prosthetics, orthotics, durable medical equipment, or medical supplies;
77.33 	(15) dental services;
77.34 	(16) hospice care;
77.35 	(17) audiology services and hearing aids;
77.36 	(18) podiatry services;
78.1 	(19) chiropractic services;
78.2 	(20) immunizations;
78.3 	(21) vision services and eyeglasses;
78.4 	(22) waiver services;
78.5 	(23) individualized education programs; or
78.6 	(24) chemical dependency treatment.
78.7 	(i) Beginning July 1, 2009, pregnant noncitizens who are undocumented, 
78.8 	nonimmigrants, or lawfully present as designated in paragraph (e) and whoin the United 
78.9 	States as defined in Code of Federal Regulations, title 8, section 103.12, are not covered by 
78.10 	a group health plan or health insurance coverage according to Code of Federal Regulations, 
78.11 	title 42, section 457.310, and who otherwise meet the eligibility requirements of this 
78.12 	chapter, are eligible for medical assistance through the period of pregnancy, including 
78.13 	labor and delivery, and 60 days postpartum, to the extent federal funds are available under 
78.14 	title XXI of the Social Security Act, and the state children's health insurance program.
78.15 	(j) Qualified noncitizens as described in paragraph (d), and all other noncitizens 
78.16 	lawfully residing in the United States as described in paragraph (e), who are ineligible 
78.17 	for medical assistance with federal financial participation and who otherwise meet the 
78.18 	eligibility requirements of chapter 256B and of this paragraph, are eligible for medical 
78.19 	assistance without federal financial participation. Qualified noncitizens as described 
78.20 	in paragraph (d) are only eligible for medical assistance without federal financial 
78.21 	participation for five years from their date of entry into the United States.
78.22 	(k) (j) Beginning October 1, 2003, persons who are receiving care and rehabilitation 
78.23 	services from a nonprofit center established to serve victims of torture and are otherwise 
78.24 	ineligible for medical assistance under this chapter are eligible for medical assistance 
78.25 	without federal financial participation. These individuals are eligible only for the period 
78.26 	during which they are receiving services from the center. Individuals eligible under this 
78.27 	paragraph shall not be required to participate in prepaid medical assistance.

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

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

79.1 	Sec. 12. Minnesota Statutes 2010, section 256B.0625, subdivision 8, is amended to 
79.2 	read:
79.3 		Subd. 8.Physical therapy. (a) Medical assistance covers physical therapy and 
79.4 	related services, including specialized maintenance therapy for eligible recipients under 
79.5 	21 years of age.
79.6 	(b) Authorization by the commissioner is required to provide medically necessary 
79.7 	services to a recipient beyond any of the following onetime service thresholds, or a lower 
79.8 	threshold where one has been established by the commissioner for a specified service: (1) 
79.9 	80 units of any approved CPT code other than modalities; (2) 20 modality sessions; and 
79.10 	(3) three evaluations or reevaluations. Services provided by a physical therapy assistant 
79.11 	shall be reimbursed at the same rate as services performed by a physical therapist when 
79.12 	the services of the physical therapy assistant are provided under the direction of a physical 
79.13 	therapist who is on the premises. Services provided by a physical therapy assistant that 
79.14 	are provided under the direction of a physical therapist who is not on the premises shall 
79.15 	be reimbursed at 65 percent of the physical therapist rate.

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

79.20 	Sec. 13. Minnesota Statutes 2010, section 256B.0625, subdivision 8a, is amended to 
79.21 	read:
79.22 		Subd. 8a.Occupational therapy. (a) Medical assistance covers occupational 
79.23 	therapy and related services, including specialized maintenance therapy for eligible 
79.24 	recipients under 21 years of age.
79.25 	(b) Authorization by the commissioner is required to provide medically necessary 
79.26 	services to a recipient beyond any of the following onetime service thresholds, or a lower 
79.27 	threshold where one has been established by the commissioner for a specified service: 
79.28 	(1) 120 units of any combination of approved CPT codes; and (2) two evaluations or 
79.29 	reevaluations. Services provided by an occupational therapy assistant shall be reimbursed 
79.30 	at the same rate as services performed by an occupational therapist when the services of 
79.31 	the occupational therapy assistant are provided under the direction of the occupational 
79.32 	therapist who is on the premises. Services provided by an occupational therapy assistant 
79.33 	that are provided under the direction of an occupational therapist who is not on the 
79.34 	premises shall be reimbursed at 65 percent of the occupational therapist rate.

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

80.5 	Sec. 14. Minnesota Statutes 2010, section 256B.0625, subdivision 8b, is amended to 
80.6 	read:
80.7 		Subd. 8b.Speech-language pathology and audiology services. (a) Medical 
80.8 	assistance covers speech-language pathology and related services, including specialized 
80.9 	maintenance therapy for eligible recipients under 21 years of age.
80.10 	(b) Authorization by the commissioner is required to provide medically necessary
80.11 	speech-language pathology services to a recipient beyond any of the following 
80.12 	onetime service thresholds, or a lower threshold where one has been established by the 
80.13 	commissioner for a specified service: (1) 50 treatment sessions with any combination 
80.14 	of approved CPT codes; and (2) one evaluation. Medical assistance covers audiology 
80.15 	services and related services. Services provided by a person who has been issued a 
80.16 	temporary registration under section 148.5161 shall be reimbursed at the same rate 
80.17 	as services performed by a speech-language pathologist or audiologist as long as the 
80.18 	requirements of section 148.5161, subdivision 3, are met.

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

80.23 	Sec. 15. Minnesota Statutes 2010, section 256B.0625, subdivision 8c, is amended to 
80.24 	read:
80.25 		Subd. 8c.Care management; rehabilitation services. (a) Effective July 1, 1999, 
80.26 	onetime thresholds shall replace annual thresholds for provision of rehabilitation services 
80.27 	described in subdivisions 8, 8a, and 8b. The onetime thresholds will be the same in amount 
80.28 	and description as the thresholds prescribed by the Department of Human Services health 
80.29 	care programs provider manual for calendar year 1997, except they will not be renewed 
80.30 	annually, and they will include sensory skills and cognitive training skills.
80.31 	(b) (a) A care management approach for authorization of rehabilitation services 
80.32 	beyond the threshold described in subdivisions 8, 8a, and 8b  shall be instituted in 
80.33 	conjunction with the onetime thresholds. The care management approach shall require 
80.34 	the provider and the department rehabilitation reviewer to work together directly through 
81.1 	written communication, or telephone communication when appropriate, to establish a 
81.2 	medically necessary care management plan. Authorization for rehabilitation services 
81.3 	shall include approval for up to 12 six months of services at a time without additional 
81.4 	documentation from the provider during the extended period, when the rehabilitation 
81.5 	services are medically necessary due to an ongoing health condition.
81.6 	(c) (b) The commissioner shall implement an expedited five-day turnaround time to 
81.7 	review authorization requests for recipients who need emergency rehabilitation services 
81.8 	and who have exhausted their onetime threshold limit for those services.

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

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

81.15 	Sec. 17. Minnesota Statutes 2010, section 256B.0625, subdivision 13e, is amended to 
81.16 	read:
81.17 		Subd. 13e.Payment rates. (a) The basis for determining the amount of payment 
81.18 	shall be the lower of the actual acquisition costs of the drugs plus a fixed dispensing fee; 
81.19 	the maximum allowable cost set by the federal government or by the commissioner plus 
81.20 	the fixed dispensing fee; or the usual and customary price charged to the public. The 
81.21 	amount of payment basis must be reduced to reflect all discount amounts applied to the 
81.22 	charge by any provider/insurer agreement or contract for submitted charges to medical 
81.23 	assistance programs. The net submitted charge may not be greater than the patient liability 
81.24 	for the service. The pharmacy dispensing fee shall be $3.65, except that the dispensing fee 
81.25 	for intravenous solutions which must be compounded by the pharmacist shall be $8 per 
81.26 	bag, $14 per bag for cancer chemotherapy products, and $30 per bag for total parenteral 
81.27 	nutritional products dispensed in one liter quantities, or $44 per bag for total parenteral 
81.28 	nutritional products dispensed in quantities greater than one liter. Actual acquisition cost 
81.29 	includes quantity and other special discounts except time and cash discounts. Effective 
81.30 	July 1, 2009 July 1, 2011, the actual acquisition cost of a drug shall be estimated by the 
81.31 	commissioner, at average wholesale price minus 15 percent wholesale acquisition cost 
81.32 	plus two percent. The actual acquisition cost of antihemophilic factor drugs shall be 
81.33 	estimated at the average wholesale price minus 30 percent Wholesale acquisition cost is 
81.34 	defined as the manufacturer's list price for a drug or biological to wholesalers or direct 
82.1 	purchasers in the United States, not including prompt pay or other discounts, rebates, 
82.2 	or reductions in price, for the most recent month for which information is available, as 
82.3 	reported in wholesale price guides or other publications of drug or biological pricing data. 
82.4 	The maximum allowable cost of a multisource drug may be set by the commissioner and it 
82.5 	shall be comparable to, but no higher than, the maximum amount paid by other third-party 
82.6 	payors in this state who have maximum allowable cost programs. Establishment of the 
82.7 	amount of payment for drugs shall not be subject to the requirements of the Administrative 
82.8 	Procedure Act.
82.9 	(b) An additional dispensing fee of $.30 may be added to the dispensing fee paid 
82.10 	to pharmacists for legend drug prescriptions dispensed to residents of long-term care 
82.11 	facilities when a unit dose blister card system, approved by the department, is used. Under 
82.12 	this type of dispensing system, the pharmacist must dispense a 30-day supply of drug. 
82.13 	The National Drug Code (NDC) from the drug container used to fill the blister card must 
82.14 	be identified on the claim to the department. The unit dose blister card containing the 
82.15 	drug must meet the packaging standards set forth in Minnesota Rules, part 6800.2700, 
82.16 	that govern the return of unused drugs to the pharmacy for reuse. The pharmacy provider 
82.17 	will be required to credit the department for the actual acquisition cost of all unused 
82.18 	drugs that are eligible for reuse. Over-the-counter medications must be dispensed in the 
82.19 	manufacturer's unopened package. The commissioner may permit the drug clozapine to be 
82.20 	dispensed in a quantity that is less than a 30-day supply.
82.21 	(c) Whenever a maximum allowable cost has been set for a multisource drug, 
82.22 	payment shall be on the basis of the maximum allowable cost established by the 
82.23 	commissioner unless prior authorization for the brand name product has been granted 
82.24 	according to the criteria established by the Drug Formulary Committee as required by 
82.25 	subdivision 13f, paragraph (a), and the prescriber has indicated "dispense as written" on 
82.26 	the prescription in a manner consistent with section 151.21, subdivision 2.
82.27 	(d) The basis for determining the amount of payment for drugs administered in an 
82.28 	outpatient setting shall be the lower of the usual and customary cost submitted by the 
82.29 	provider or the amount established for Medicare by the 106 percent of the average sales 
82.30 	price as determined by the United States Department of Health and Human Services 
82.31 	pursuant to title XVIII, section 1847a of the federal Social Security Act. If the average 
82.32 	sales price is unavailable, the amount of payment shall be the lower of the usual and 
82.33 	customary cost submitted by the provider or the wholesale acquisition cost.
82.34 	(e) The commissioner may negotiate lower reimbursement rates for specialty 
82.35 	pharmacy products than the rates specified in paragraph (a). The commissioner may 
82.36 	require individuals enrolled in the health care programs administered by the department 
83.1 	to obtain specialty pharmacy products from providers with whom the commissioner has 
83.2 	negotiated lower reimbursement rates. Specialty pharmacy products are defined as those 
83.3 	used by a small number of recipients or recipients with complex and chronic diseases 
83.4 	that require expensive and challenging drug regimens. Examples of these conditions 
83.5 	include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis 
83.6 	C, growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms 
83.7 	of cancer. Specialty pharmaceutical products include injectable and infusion therapies, 
83.8 	biotechnology drugs, antihemophilic factor products, high-cost therapies, and therapies 
83.9 	that require complex care. The commissioner shall consult with the formulary committee 
83.10 	to develop a list of specialty pharmacy products subject to this paragraph. In consulting 
83.11 	with the formulary committee in developing this list, the commissioner shall take into 
83.12 	consideration the population served by specialty pharmacy products, the current delivery 
83.13 	system and standard of care in the state, and access to care issues. The commissioner shall 
83.14 	have the discretion to adjust the reimbursement rate to prevent access to care issues.
83.15 	(f) Home infusion therapy services provided by home infusion therapy pharmacies 
83.16 	must be paid at rates according to subdivision 8d.

83.17 	Sec. 18. Minnesota Statutes 2010, section 256B.0625, subdivision 17, is amended to 
83.18 	read:
83.19 		Subd. 17.Transportation costs. (a) Medical assistance covers medical 
83.20 	transportation costs incurred solely for obtaining emergency medical care or transportation 
83.21 	costs incurred by eligible persons in obtaining emergency or nonemergency medical 
83.22 	care when paid directly to an ambulance company, common carrier, or other recognized 
83.23 	providers of transportation services. Medical transportation must be provided by:
83.24 	(1) an ambulance, as defined in section 144E.001, subdivision 2;
83.25 	(2) special transportation; or
83.26 	(3) common carrier including, but not limited to, bus, taxicab, other commercial 
83.27 	carrier, or private automobile.
83.28 	(b) Medical assistance covers special transportation, as defined in Minnesota Rules, 
83.29 	part 9505.0315, subpart 1, item F, if the recipient has a physical or mental impairment that 
83.30 	would prohibit the recipient from safely accessing and using a bus, taxi, other commercial 
83.31 	transportation, or private automobile.
83.32 	The commissioner may use an order by the recipient's attending physician to certify that 
83.33 	the recipient requires special transportation services. Special transportation providers shall 
83.34 	perform driver-assisted services for eligible individuals. Driver-assisted service includes 
83.35 	passenger pickup at and return to the individual's residence or place of business, assistance 
84.1 	with admittance of the individual to the medical facility, and assistance in passenger 
84.2 	securement or in securing of wheelchairs or stretchers in the vehicle. Special transportation 
84.3 	providers must obtain written documentation from the health care service provider who 
84.4 	is serving the recipient being transported, identifying the time that the recipient arrived. 
84.5 	Special transportation providers may not bill for separate base rates for the continuation of 
84.6 	a trip beyond the original destination. Special transportation providers must take recipients 
84.7 	to the nearest appropriate health care provider, using the most direct route. The minimum 
84.8 	medical assistance reimbursement rates for special transportation services are:
84.9 	(1) (i) $17 for the base rate and $1.35 per mile for special transportation services to 
84.10 	eligible persons who need a wheelchair-accessible van;
84.11 	(ii) $11.50 for the base rate and $1.30 per mile for special transportation services to 
84.12 	eligible persons who do not need a wheelchair-accessible van; and
84.13 	(iii) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, for 
84.14 	special transportation services to eligible persons who need a stretcher-accessible vehicle;
84.15 	(2) the base rates for special transportation services in areas defined under RUCA 
84.16 	to be super rural shall be equal to the reimbursement rate established in clause (1) plus 
84.17 	11.3 percent; and
84.18 	(3) for special transportation services in areas defined under RUCA to be rural 
84.19 	or super rural areas:
84.20 	(i) for a trip equal to 17 miles or less, mileage reimbursement shall be equal to 125 
84.21 	percent of the respective mileage rate in clause (1); and
84.22 	(ii) for a trip between 18 and 50 miles, mileage reimbursement shall be equal to 
84.23 	112.5 percent of the respective mileage rate in clause (1).
84.24 	(c) For purposes of reimbursement rates for special transportation services under 
84.25 	paragraph (b), the zip code of the recipient's place of residence shall determine whether 
84.26 	the urban, rural, or super rural reimbursement rate applies.
84.27 	(d) For purposes of this subdivision, "rural urban commuting area" or "RUCA" 
84.28 	means a census-tract based classification system under which a geographical area is 
84.29 	determined to be urban, rural, or super rural.
84.30 	(e) Effective for services provided on or after July 1, 2011, nonemergency 
84.31 	transportation rates, including special transportation, taxi, and other commercial carriers, 
84.32 	are reduced 4.5 percent. Payments made to managed care plans and county-based 
84.33 	purchasing plans must be reduced for services provided on or after January 1, 2012, 
84.34 	to reflect this reduction.

85.1 	Sec. 19. Minnesota Statutes 2010, section 256B.0625, subdivision 17a, is amended to 
85.2 	read:
85.3 		Subd. 17a.Payment for ambulance services. (a) Medical assistance covers 
85.4 	ambulance services. Providers shall bill ambulance services according to Medicare 
85.5 	criteria. Nonemergency ambulance services shall not be paid as emergencies. Effective 
85.6 	for services rendered on or after July 1, 2001, medical assistance payments for ambulance 
85.7 	services shall be paid at the Medicare reimbursement rate or at the medical assistance 
85.8 	payment rate in effect on July 1, 2000, whichever is greater.
85.9 	(b) Effective for services provided on or after July 1, 2011, ambulance services 
85.10 	payment rates are reduced 4.5 percent. Payments made to managed care plans and 
85.11 	county-based purchasing plans must be reduced for services provided on or after January 
85.12 	1, 2012, to reflect this reduction.

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

85.19 	Sec. 21. Minnesota Statutes 2010, section 256B.0625, subdivision 25, is amended to 
85.20 	read:
85.21 		Subd. 25.Prior authorization required. (a) The commissioner shall publish 
85.22 	in the Minnesota health care programs provider manual and on the department's Web 
85.23 	site a list of health services that require prior authorization, as well as the criteria and 
85.24 	standards used to select health services on the list. The list and the criteria and standards 
85.25 	used to formulate it are not subject to the requirements of sections 14.001 to 14.69. The 
85.26 	commissioner's decision whether prior authorization is required for a health service is not 
85.27 	subject to administrative appeal.
85.28 	(b) The commissioner shall implement a modernized electronic system for providers 
85.29 	to request prior authorization. The modernization electronic system must include at least 
85.30 	the following functionalities:
85.31 	(1) authorizations are recipient-centric, not provider-centric;
85.32 	(2) adequate flexibility to support authorizations for an episode of care, continuous 
85.33 	drug therapy, or for individual onetime services and allows an ordering and a rendering 
85.34 	provider to both submit information into one request;
86.1 	(3) allows providers to review previous authorization requests and determine where 
86.2 	a submitted request is within the authorization process;
86.3 	(4) supports automated workflows that allow providers to securely submit medical 
86.4 	information that can be accessed by medical and pharmacy review vendors as well as 
86.5 	department staff; and
86.6 	(5) supports development of automated clinical algorithms that can verify 
86.7 	information and provide responses in real time.
86.8 	(c) The system described in paragraph (b) shall be completed by March 1, 2012. 
86.9 	All authorization requests submitted on and after March 1, 2012, must be submitted 
86.10 	electronically by providers, except requests for drugs dispensed by an outpatient 
86.11 	pharmacy, services that are provided outside of the state and surrounding local trade area, 
86.12 	and services included on a service agreement.

86.13 	Sec. 22. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 
86.14 	subdivision to read:
86.15 		Subd. 25b.Authorization with third-party liability. (a) Except as otherwise 
86.16 	allowed under this subdivision or required under federal or state regulations, the 
86.17 	commissioner must not consider a request for authorization of a service when the recipient 
86.18 	has coverage from a third-party payer unless the provider requesting authorization has 
86.19 	made a good faith effort to receive payment or authorization from the third-party payer. 
86.20 	A good faith effort is established by supplying with the authorization request to the 
86.21 	commissioner the following:
86.22 	(1) a determination of payment for the service from the third-party payer, a 
86.23 	determination of authorization for the service from the third-party payer, or a verification 
86.24 	of noncoverage of the service by the third-party payer; and
86.25 	(2) the information or records required by the department to document the reason for 
86.26 	the determination or to validate noncoverage from the third-party payer.
86.27 	(b) A provider requesting authorization for services covered by Medicare is not 
86.28 	required to bill Medicare before requesting authorization from the commissioner if the 
86.29 	provider has reason to believe that a service covered by Medicare is not eligible for 
86.30 	payment. The provider must document that, because of recent claim experiences with 
86.31 	Medicare or because of written communication from Medicare, coverage is not available 
86.32 	for the service.
86.33 	(c) Authorization is not required if a third-party payer has made payment that is 
86.34 	equal to or greater than 60 percent of the maximum payment amount for the service 
86.35 	allowed under medical assistance.

87.1 	Sec. 23. Minnesota Statutes 2010, section 256B.0625, subdivision 31a, is amended to 
87.2 	read:
87.3 		Subd. 31a.Augmentative and alternative communication systems. (a) Medical 
87.4 	assistance covers augmentative and alternative communication systems consisting of 
87.5 	electronic or nonelectronic devices and the related components necessary to enable a 
87.6 	person with severe expressive communication limitations to produce or transmit messages 
87.7 	or symbols in a manner that compensates for that disability.
87.8 	(b) Until the volume of systems purchased increases to allow a discount price, the 
87.9 	commissioner shall reimburse augmentative and alternative communication manufacturers 
87.10 	and vendors at the manufacturer's suggested retail price for augmentative and alternative 
87.11 	communication systems and related components. The commissioner shall separately 
87.12 	reimburse providers for purchasing and integrating individual communication systems 
87.13 	which are unavailable as a package from an augmentative and alternative communication 
87.14 	vendor. Augmentative and alternative communication systems must be paid the lower 
87.15 	of the: 
87.16 	(1) submitted charge; or
87.17 	(2)(i) manufacturer's suggested retail price minus 20 percent for providers that are 
87.18 	manufacturers of augmentative and alternative communication systems; or
87.19 	(ii) manufacturer's invoice charge plus 20 percent for providers that are not 
87.20 	manufacturers of augmentative and alternative communication systems.
87.21 	(c) Reimbursement rates established by this purchasing program are not subject to 
87.22 	Minnesota Rules, part 9505.0445, item S or T.

87.23 	Sec. 24. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 
87.24 	subdivision to read:
87.25 		Subd. 55.Payment for noncovered services. (a) Except when specifically 
87.26 	prohibited by the commissioner or federal law, a provider may seek payment from the 
87.27 	recipient for services not eligible for payment under the medical assistance program when 
87.28 	the provider, prior to delivering the service, reviews and considers all other available 
87.29 	covered alternatives with the recipient and obtains a signed acknowledgment from the 
87.30 	recipient of the potential of the recipient's liability. The signed acknowledgment must be 
87.31 	in a form approved by the commissioner.
87.32 	(b) Conditions under which a provider must not request payment from the recipient 
87.33 	include, but are not limited to:
87.34 	(1) a service that requires prior authorization, unless authorization has been denied 
87.35 	as not medically necessary and all other therapeutic alternatives have been reviewed;
88.1 	(2) a service for which payment has been denied for reasons relating to billing 
88.2 	requirements;
88.3 	(3) standard shipping or delivery and setup of medical equipment or medical 
88.4 	supplies;
88.5 	(4) services that are included in the recipient's long term care per diem;
88.6 	(5) the recipient is enrolled in the Restricted Recipient Program and the provider is 
88.7 	one of a provider type designated for the recipient's health care services; and
88.8 	(6) the noncovered service is a prescriptive drug identified by the commissioner as 
88.9 	having the potential for abuse and overuse, except where payment by the recipient is 
88.10 	specifically approved by the commissioner on the date of service based upon compelling 
88.11 	evidence supplied by the prescribing provider that establishes medical necessity for that 
88.12 	particular drug.
88.13 	(c) The payment requested from recipients for noncovered services under this 
88.14 	subdivision must not exceed the provider's usual and customary charge for the actual 
88.15 	service received by the recipient. A recipient must not be billed for the difference between 
88.16 	what medical assistance paid for the service or would pay for a less costly alternative 
88.17 	service.

88.18 	Sec. 25. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 
88.19 	subdivision to read:
88.20 		Subd. 56.Evidence-based childbirth program. (a) The commissioner shall 
88.21 	implement a program to reduce the number of elective inductions of labor prior to 39 
88.22 	weeks' gestation. In this subdivision, the term "elective induction of labor" means the 
88.23 	use of artificial means to stimulate labor in a woman without the presence of a medical 
88.24 	condition affecting the woman or the child that makes the onset of labor a medical 
88.25 	necessity. The program must promote the implementation of policies within hospitals 
88.26 	providing services to recipients of medical assistance or MinnesotaCare that prohibit the 
88.27 	use of elective inductions prior to 39 weeks' gestation, and adherence to such policies by 
88.28 	the attending providers.
88.29 	(b) For all births covered by medical assistance or MinnesotaCare on or after 
88.30 	January 1, 2012, a payment for professional services associated with the delivery of a 
88.31 	child in a hospital must not be made unless the provider has submitted information about 
88.32 	the nature of the labor and delivery including any induction of labor that was performed 
88.33 	in conjunction with that specific birth. The information must be on a form prescribed by 
88.34 	the commissioner.
89.1 	(c) The requirements in paragraph (b) must not apply to deliveries performed 
89.2 	at a hospital that has policies and processes in place that have been approved by the 
89.3 	commissioner which prohibit elective inductions prior to 39 weeks gestation. A process 
89.4 	for review of hospital induction policies must be established by the commissioner and 
89.5 	review of policies must occur at the discretion of the commissioner. The commissioner's 
89.6 	decision to approve or rescind approval must include verification and review of items 
89.7 	including, but not limited to:
89.8 	(1) policies that prohibit use of elective inductions for gestation less than 39 weeks;
89.9 	(2) policies that encourage providers to document and communicate with patients a 
89.10 	final expected date of delivery by 20 weeks' gestation that includes data from ultrasound 
89.11 	measurements as applicable;
89.12 	(3) policies that encourage patient education regarding elective inductions, and 
89.13 	requires documentation of the processes used to educate patients;
89.14 	(4) ongoing quality improvement review as determined by the commissioner; and
89.15 	(5) any data that has been collected by the commissioner.
89.16 	(d) All hospitals must report annually to the commissioner induction information 
89.17 	for all births that were covered by medical assistance or MinnesotaCare in a format and 
89.18 	manner to be established by the commissioner.
89.19 	(e) The commissioner at any time may choose not to implement or may discontinue 
89.20 	any or all aspects of the program if the commissioner is able to determine that hospitals 
89.21 	representing at least 90 percent of births covered by medical assistance or MinnesotaCare 
89.22 	have approved policies in place.

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

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

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

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

90.5 	Sec. 28. Minnesota Statutes 2010, section 256B.0651, subdivision 1, is amended to 
90.6 	read:
90.7 		Subdivision 1.Definitions. (a) For the purposes of sections 256B.0651 to 
90.8 	256B.0656 and 256B.0659, the terms in paragraphs (b) to (g) have the meanings given.
90.9 	(b) "Activities of daily living" has the meaning given in section 256B.0659, 
90.10 	subdivision 1, paragraph (b).
90.11 	(c) "Assessment" means a review and evaluation of a recipient's need for home 
90.12 	care services conducted in person.
90.13 	(d) "Home care services" means medical assistance covered services that are home 
90.14 	health agency services, including skilled nurse visits; home health aide visits; physical 
90.15 	therapy, occupational therapy, respiratory therapy, and language-speech pathology 
90.16 	therapy; private duty nursing; and personal care assistance.
90.17 	(e) "Home residence," effective January 1, 2010, means a residence owned or 
90.18 	rented by the recipient either alone, with roommates of the recipient's choosing, or with 
90.19 	an unpaid responsible party or legal representative; or a family foster home where the 
90.20 	license holder lives with the recipient and is not paid to provide home care services for the 
90.21 	recipient except as allowed under sections 256B.0652, subdivision 10, and 256B.0654, 
90.22 	subdivision 4.
90.23 	(f) "Medically necessary" has the meaning given in Minnesota Rules, parts 
90.24 	9505.0170 to 9505.0475.
90.25 	(g) "Ventilator-dependent" means an individual who receives mechanical ventilation 
90.26 	for life support at least six hours per day and is expected to be or has been dependent on a 
90.27 	ventilator for at least 30 consecutive days.

90.28 	Sec. 29. Minnesota Statutes 2010, section 256B.0653, subdivision 2, is amended to 
90.29 	read:
90.30 		Subd. 2.Definitions. For the purposes of this section, the following terms have 
90.31 	the meanings given.
90.32 	(a) "Assessment" means an evaluation of the recipient's medical need for home 
90.33 	health agency services by a registered nurse or appropriate therapist that is conducted 
90.34 	within 30 days of a request.
91.1 	(b) "Home care therapies" means occupational, physical, and respiratory therapy 
91.2 	and speech-language pathology services provided in the home by a Medicare certified 
91.3 	home health agency.
91.4 	(c) "Home health agency services" means services delivered in the recipient's home 
91.5 	residence, except as specified in section 256B.0625, by a home health agency to a recipient 
91.6 	with medical needs due to illness, disability, or physical conditions.
91.7 	(d)(c) "Home health aide" means an employee of a home health agency who 
91.8 	completes medically oriented tasks written in the plan of care for a recipient.
91.9 	(e)(d) "Home health agency" means a home care provider agency that is 
91.10 	Medicare-certified.
91.11 	(f) "Occupational therapy services" mean the services defined in Minnesota Rules, 
91.12 	part 9505.0390.
91.13 	(g) "Physical therapy services" mean the services defined in Minnesota Rules, part 
91.14 	9505.0390.
91.15 	(h) "Respiratory therapy services" mean the services defined in chapter 147C and 
91.16 	Minnesota Rules, part 4668.0003, subpart 37.
91.17 	(i) "Speech-language pathology services" mean the services defined in Minnesota 
91.18 	Rules, part 9505.0390.
91.19 	(j)(e) "Skilled nurse visit" means a professional nursing visit to complete nursing 
91.20 	tasks required due to a recipient's medical condition that can only be safely provided by a 
91.21 	professional nurse to restore and maintain optimal health.
91.22 	(k)(f) "Store-and-forward technology" means telehomecare services that do not 
91.23 	occur in real time via synchronous transmissions such as diabetic and vital sign monitoring.
91.24 	(l)(g) "Telehomecare" means the use of telecommunications technology 
91.25 	via live, two-way interactive audiovisual technology which may be augmented by 
91.26 	store-and-forward technology.
91.27 	(m)(h) "Telehomecare skilled nurse visit" means a visit by a professional nurse 
91.28 	to deliver a skilled nurse visit to a recipient located at a site other than the site where 
91.29 	the nurse is located and is used in combination with face-to-face skilled nurse visits to 
91.30 	adequately meet the recipient's needs.

91.31 	Sec. 30. Minnesota Statutes 2010, section 256B.0653, subdivision 6, is amended to 
91.32 	read:
91.33 		Subd. 6.Noncovered home health agency services. The following are not eligible 
91.34 	for payment under medical assistance as a home health agency service:
92.1 	(1) telehomecare skilled nurses services that is communication between the home 
92.2 	care nurse and recipient that consists solely of a telephone conversation, facsimile, 
92.3 	electronic mail, or a consultation between two health care practitioners;
92.4 	(2) the following skilled nurse visits:
92.5 	(i) for the purpose of monitoring medication compliance with an established 
92.6 	medication program for a recipient;
92.7 	(ii) administering or assisting with medication administration, including injections, 
92.8 	prefilling syringes for injections, or oral medication setup of an adult recipient, when, 
92.9 	as determined and documented by the registered nurse, the need can be met by an 
92.10 	available pharmacy or the recipient or a family member is physically and mentally able 
92.11 	to self-administer or prefill a medication;
92.12 	(iii) services done for the sole purpose of supervision of the home health aide or 
92.13 	personal care assistant;
92.14 	(iv) services done for the sole purpose to train other home health agency workers;
92.15 	(v) services done for the sole purpose of blood samples or lab draw when the 
92.16 	recipient is able to access these services outside the home; and
92.17 	(vi) Medicare evaluation or administrative nursing visits required by Medicare;
92.18 	(3) home health aide visits when the following activities are the sole purpose for the 
92.19 	visit: companionship, socialization, household tasks, transportation, and education; and
92.20 	(4) home care therapies provided in other settings such as a clinic, day program, or as 
92.21 	an inpatient or when the recipient can access therapy outside of the recipient's residence.

92.22 	Sec. 31. Minnesota Statutes 2010, section 256B.69, subdivision 4, is amended to read:
92.23 		Subd. 4.Limitation of choice. (a) The commissioner shall develop criteria to 
92.24 	determine when limitation of choice may be implemented in the experimental counties. 
92.25 	The criteria shall ensure that all eligible individuals in the county have continuing access 
92.26 	to the full range of medical assistance services as specified in subdivision 6.
92.27 	(b) The commissioner shall exempt the following persons from participation in the 
92.28 	project, in addition to those who do not meet the criteria for limitation of choice:
92.29 	(1) persons eligible for medical assistance according to section 256B.055, 
92.30 	subdivision 1;
92.31 	(2) persons eligible for medical assistance due to blindness or disability as 
92.32 	determined by the Social Security Administration or the state medical review team, unless:
92.33 	(i) they are 65 years of age or older; or
93.1 	(ii) they reside in Itasca County or they reside in a county in which the commissioner 
93.2 	conducts a pilot project under a waiver granted pursuant to section 1115 of the Social 
93.3 	Security Act;
93.4 	(3) recipients who currently have private coverage through a health maintenance 
93.5 	organization;
93.6 	(4)(3) recipients who are eligible for medical assistance by spending down excess 
93.7 	income for medical expenses other than the nursing facility per diem expense;
93.8 	(5)(4) recipients who receive benefits under the Refugee Assistance Program, 
93.9 	established under United States Code, title 8, section 1522(e);
93.10 	(6)(5) children who are both determined to be severely emotionally disturbed and 
93.11 	receiving case management services according to section 256B.0625, subdivision 20, 
93.12 	except children who are eligible for and who decline enrollment in an approved preferred 
93.13 	integrated network under section 245.4682;
93.14 	(7)(6) adults who are both determined to be seriously and persistently mentally ill 
93.15 	and received case management services according to section 256B.0625, subdivision 20;
93.16 	(8)(7) persons eligible for medical assistance according to section 256B.057, 
93.17 	subdivision 10; and
93.18 	(9)(8) persons with access to cost-effective employer-sponsored private health 
93.19 	insurance or persons enrolled in a non-Medicare individual health plan determined to be 
93.20 	cost-effective according to section 256B.0625, subdivision 15.
93.21 	Children under age 21 who are in foster placement may enroll in the project on an elective 
93.22 	basis. Individuals excluded under clauses (1), (6) (5), and (7)(6) may choose to enroll 
93.23 	on an elective basis. The commissioner may enroll recipients in the prepaid medical 
93.24 	assistance program for seniors who are (1) age 65 and over, and (2) eligible for medical 
93.25 	assistance by spending down excess income.
93.26 	(c) The commissioner may allow persons with a one-month spenddown who are 
93.27 	otherwise eligible to enroll to voluntarily enroll or remain enrolled, if they elect to prepay 
93.28 	their monthly spenddown to the state.
93.29 	(d) The commissioner may require those individuals to enroll in the prepaid medical 
93.30 	assistance program who otherwise would have been excluded under paragraph (b), clauses 
93.31 	(1), (3) (2), and (8) (7), and under Minnesota Rules, part 9500.1452, subpart 2, items H, 
93.32 	K, and L.
93.33 	(e) Before limitation of choice is implemented, eligible individuals shall be notified 
93.34 	and after notification, shall be allowed to choose only among demonstration providers. 
93.35 	The commissioner may assign an individual with private coverage through a health 
93.36 	maintenance organization, to the same health maintenance organization for medical 
94.1 	assistance coverage, if the health maintenance organization is under contract for medical 
94.2 	assistance in the individual's county of residence. After initially choosing a provider, 
94.3 	the recipient is allowed to change that choice only at specified times as allowed by the 
94.4 	commissioner. If a demonstration provider ends participation in the project for any reason, 
94.5 	a recipient enrolled with that provider must select a new provider but may change providers 
94.6 	without cause once more within the first 60 days after enrollment with the second provider.
94.7 	(f) An infant born to a woman who is eligible for and receiving medical assistance 
94.8 	and who is enrolled in the prepaid medical assistance program shall be retroactively 
94.9 	enrolled to the month of birth in the same managed care plan as the mother once the 
94.10 	child is enrolled in medical assistance unless the child is determined to be excluded from 
94.11 	enrollment in a prepaid plan under this section.
94.12 	(g) The commissioner shall enroll persons eligible for medical assistance due to 
94.13 	blindness or disability as determined by the Social Security Administration or the state 
94.14 	medical review team in the prepaid medical assistance program, unless the person elects 
94.15 	to opt out. This opt-out option does not apply to persons who would otherwise be eligible 
94.16 	but who are (1) 65 years of age or older; or (2) reside in Itasca County or reside in a 
94.17 	county in which the commissioner conducts a pilot under a waiver granted pursuant to 
94.18 	section 1115 of the Social Security Act.

94.19 	Sec. 32. Minnesota Statutes 2010, section 256B.69, subdivision 5a, is amended to read:
94.20 		Subd. 5a.Managed care contracts. (a) Managed care contracts under this section 
94.21 	and section 256L.12 shall be entered into or renewed on a calendar year basis beginning 
94.22 	January 1, 1996. Managed care contracts which were in effect on June 30, 1995, and set to 
94.23 	renew on July 1, 1995, shall be renewed for the period July 1, 1995 through December 
94.24 	31, 1995 at the same terms that were in effect on June 30, 1995. The commissioner may 
94.25 	issue separate contracts with requirements specific to services to medical assistance 
94.26 	recipients age 65 and older.
94.27 	(b) A prepaid health plan providing covered health services for eligible persons 
94.28 	pursuant to chapters 256B and 256L is responsible for complying with the terms of its 
94.29 	contract with the commissioner. Requirements applicable to managed care programs 
94.30 	under chapters 256B and 256L established after the effective date of a contract with the 
94.31 	commissioner take effect when the contract is next issued or renewed.
94.32 	(c) Effective for services rendered on or after January 1, 2003, the commissioner 
94.33 	shall withhold five percent of managed care plan payments under this section and 
94.34 	county-based purchasing plan payments under section 256B.692 for the prepaid medical 
94.35 	assistance program pending completion of performance targets. Each performance target 
95.1 	must be quantifiable, objective, measurable, and reasonably attainable, except in the case 
95.2 	of a performance target based on a federal or state law or rule. Criteria for assessment 
95.3 	of each performance target must be outlined in writing prior to the contract effective 
95.4 	date. The managed care plan must demonstrate, to the commissioner's satisfaction, 
95.5 	that the data submitted regarding attainment of the performance target is accurate. The 
95.6 	commissioner shall periodically change the administrative measures used as performance 
95.7 	targets in order to improve plan performance across a broader range of administrative 
95.8 	services. The performance targets must include measurement of plan efforts to contain 
95.9 	spending on health care services and administrative activities. The commissioner may 
95.10 	adopt plan-specific performance targets that take into account factors affecting only one 
95.11 	plan, including characteristics of the plan's enrollee population. The withheld funds 
95.12 	must be returned no sooner than July of the following year if performance targets in the 
95.13 	contract are achieved. The commissioner may exclude special demonstration projects 
95.14 	under subdivision 23.
95.15 	(d) Effective for services rendered on or after January 1, 2009, through December 
95.16 	31, 2009, the commissioner shall withhold three percent of managed care plan payments 
95.17 	under this section and county-based purchasing plan payments under section 256B.692 
95.18 	for the prepaid medical assistance program. The withheld funds must be returned no 
95.19 	sooner than July 1 and no later than July 31 of the following year. The commissioner may 
95.20 	exclude special demonstration projects under subdivision 23.
95.21 	(e) Effective for services provided on or after January 1, 2010, the commissioner 
95.22 	shall require that managed care plans use the assessment and authorization processes, 
95.23 	forms, timelines, standards, documentation, and data reporting requirements, protocols, 
95.24 	billing processes, and policies consistent with medical assistance fee-for-service or the 
95.25 	Department of Human Services contract requirements consistent with medical assistance 
95.26 	fee-for-service or the Department of Human Services contract requirements for all 
95.27 	personal care assistance services under section 256B.0659.
95.28 	(f) Effective for services rendered on or after January 1, 2010, through December 
95.29 	31, 2010, the commissioner shall withhold 4.5 percent of managed care plan payments 
95.30 	under this section and county-based purchasing plan payments under section 256B.692 
95.31 	for the prepaid medical assistance program. The withheld funds must be returned no 
95.32 	sooner than July 1 and no later than July 31 of the following year. The commissioner may 
95.33 	exclude special demonstration projects under subdivision 23.
95.34 	(g) Effective for services rendered on or after January 1, 2011, the commissioner 
95.35 	shall include as part of the performance targets described in paragraph (c) a reduction in 
95.36 	the health plan's emergency room utilization rate for state health care program enrollees 
96.1 	by a measurable rate of five percent from the plan's utilization rate for state health care 
96.2 	program enrollees for the previous calendar year.
96.3 	The withheld funds must be returned no sooner than July 1 and no later than July 31 
96.4 	of the following calendar year if the managed care plan demonstrates to the satisfaction of 
96.5 	the commissioner that a reduction in the utilization rate was achieved.
96.6 	The withhold described in this paragraph shall continue for each consecutive 
96.7 	contract period until the plan's emergency room utilization rate for state health care 
96.8 	program enrollees is reduced by 25 percent of the plan's emergency room utilization 
96.9 	rate for state health care program enrollees for calendar year 2009. Hospitals shall 
96.10 	cooperate with the health plans in meeting this performance target and shall accept 
96.11 	payment withholds that may be returned to the hospitals if the performance target is 
96.12 	achieved. The commissioner shall structure the withhold so that the commissioner returns 
96.13 	a portion of the withheld funds in amounts commensurate with achieved reductions in 
96.14 	utilization less than the targeted amount. The withhold in this paragraph does not apply to 
96.15 	county-based purchasing plans.
96.16 	(h) Effective for services rendered on or after January 1, 2012, the commissioner 
96.17 	shall include as part of the performance targets described in paragraph (c) a reduction in 
96.18 	the plan's hospitalization rates or subsequent hospitalizations within 30 days of a previous 
96.19 	hospitalization of a patient regardless of the reason for the hospitalization for state health 
96.20 	care program enrollees by a measurable rate of five percent from the plan's utilization rate 
96.21 	for state health care program enrollees for the previous calendar year.
96.22 	The withheld funds must be returned no sooner than July 1 and no later than July 31 
96.23 	of the following calendar year if the managed care plan or county-based purchasing plan 
96.24 	demonstrates to the satisfaction of the commissioner that a reduction in the hospitalization 
96.25 	rate was achieved.
96.26 	The withhold described in this paragraph must continue for each consecutive 
96.27 	contract period until the plan's subsequent hospitalization rate for state health care 
96.28 	program enrollees is reduced by 25 percent of the plan's subsequent hospitalization rate 
96.29 	for state health care program enrollees for calendar year 2010. Hospitals shall cooperate 
96.30 	with the plans in meeting this performance target and shall accept payment withholds that 
96.31 	must be returned to the hospitals if the performance target is achieved. The commissioner 
96.32 	shall structure the withhold so that the commissioner returns a portion of the withheld 
96.33 	funds in amounts commensurate with achieved reductions in utilization less than the 
96.34 	targeted amount.
96.35 	 (i) Effective for services rendered on or after January 1, 2011, through December 31, 
96.36 	2011, the commissioner shall withhold 4.5 percent of managed care plan payments under 
97.1 	this section and county-based purchasing plan payments under section 256B.692 for the 
97.2 	prepaid medical assistance program. The withheld funds must be returned no sooner than 
97.3 	July 1 and no later than July 31 of the following year. The commissioner may exclude 
97.4 	special demonstration projects under subdivision 23.
97.5 	(i) (j) Effective for services rendered on or after January 1, 2012, through December 
97.6 	31, 2012, the commissioner shall withhold 4.5 percent of managed care plan payments 
97.7 	under this section and county-based purchasing plan payments under section 256B.692 
97.8 	for the prepaid medical assistance program. The withheld funds must be returned no 
97.9 	sooner than July 1 and no later than July 31 of the following year. The commissioner may 
97.10 	exclude special demonstration projects under subdivision 23.
97.11 	(j) (k) Effective for services rendered on or after January 1, 2013, through December 
97.12 	31, 2013, the commissioner shall withhold 4.5 percent of managed care plan payments 
97.13 	under this section and county-based purchasing plan payments under section 256B.692 
97.14 	for the prepaid medical assistance program. The withheld funds must be returned no 
97.15 	sooner than July 1 and no later than July 31 of the following year. The commissioner may 
97.16 	exclude special demonstration projects under subdivision 23.
97.17 	(k) (l) Effective for services rendered on or after January 1, 2014, the commissioner 
97.18 	shall withhold three percent of managed care plan payments under this section and 
97.19 	county-based purchasing plan payments under section 256B.692 for the prepaid medical 
97.20 	assistance program. The withheld funds must be returned no sooner than July 1 and 
97.21 	no later than July 31 of the following year. The commissioner may exclude special 
97.22 	demonstration projects under subdivision 23.
97.23 	(l) (m) A managed care plan or a county-based purchasing plan under section 
97.24 	256B.692 may include as admitted assets under section 62D.044 any amount withheld 
97.25 	under this section that is reasonably expected to be returned.
97.26 	(m) (n) Contracts between the commissioner and a prepaid health plan are exempt 
97.27 	from the set-aside and preference provisions of section 16C.16, subdivisions 6, paragraph 
97.28 	(a), and 7.
97.29 	(n) (o) The return of the withhold under paragraphs (d), (f), and (h) (k) to (k) (j) is 
97.30 	not subject to the requirements of paragraph (c).

97.31 	Sec. 33. [256B.695] HEALTHY MINNESOTA CONTRIBUTION PROGRAM.
97.32 		Subdivision 1.Defined contributions to enrollees. (a) Beginning January 1, 2012, 
97.33 	the commissioner shall provide each medical assistance enrollee eligible under section 
97.34 	256B.055, subdivisions 3, 3a, 4, 9, and 10b, with family income greater than 75 percent 
97.35 	of the federal poverty guidelines as determined under section 256B.056, with a monthly 
98.1 	defined contribution to purchase health coverage under a health plan as defined in section 
98.2 	62A.011, subdivision 3, offered by a health plan company as defined in section 62Q.01, 
98.3 	subdivision 4.
98.4 	(b) Enrollees eligible under paragraph (a) are exempt from the managed care 
98.5 	enrollment requirement of sections 256B.69 and 256B.692.
98.6 	(c) Section 256B.0625 does not apply to enrollees eligible under paragraph (a). 
98.7 	Covered services, cost sharing, and disenrollment for nonpayment of premium for 
98.8 	enrollees eligible under paragraph (a) shall be as provided under the terms of the health 
98.9 	plan purchased by the enrollee. A health plan purchased by an eligible enrollee under this 
98.10 	section shall be considered a prepaid health plan for purposes of section 256.045.
98.11 	(d) Unless otherwise provided in this section, all medical assistance requirements 
98.12 	related to eligibility, income and asset methodology, income reporting, and program 
98.13 	administration, continue to apply to enrollees obtaining coverage under this section. 
98.14 	Section 256B.056, subdivision 7, shall apply to enrollees eligible under this section.
98.15 		Subd. 2.Use of defined contribution. An enrollee may use up to the monthly 
98.16 	defined contribution to pay premiums for coverage under a health plan as defined in 
98.17 	section 62A.011, subdivision 3.
98.18 		Subd. 3.Determination of defined contribution amount. (a) The commissioner 
98.19 	shall determine the defined contribution sliding scale using the base contribution specified 
98.20 	in paragraph (b) for the specified age ranges. The commissioner shall use a sliding scale 
98.21 	for defined contributions that provides:
98.22 	(1) persons with household incomes greater than 75 percent of the federal poverty 
98.23 	guidelines to 133 percent of the federal poverty guidelines with a defined contribution 
98.24 	of 110 percent of the base contribution;
98.25 	(2) persons with household incomes equal to 175 percent of the federal poverty 
98.26 	guidelines with a defined contribution of 100 percent of the base contribution;
98.27 	(3) persons with household incomes equal to or greater than 250 percent of 
98.28 	the federal poverty guidelines with a defined contribution of 80 percent of the base 
98.29 	contribution; and
98.30 	(4) persons with household incomes in evenly spaced increments between the 
98.31 	percentages of the federal poverty guidelines specified in clauses (1) to (3) with a base 
98.32 	contribution that is a percentage interpolated from the defined contribution percentages 
98.33 	specified in clauses (1) to (3).

98.34	Age
	Monthly Per-Person Base Contribution
	
98.35	Under 21
	$122.79
	
98.36	21-29
	122.79
	
99.1	30-31
	129.19
	
99.2	32-33
	132.38
	
99.3	34-35
	134.31
	
99.4	36-37
	136.06
	
99.5	38-39
	141.02
	
99.6	40-41
	151.25
	
99.7	42-43
	159.89
	
99.8	44-45
	175.08
	
99.9	46-47
	191.71
	
99.10	48-49
	213.13
	
99.11	50-51
	239.51
	
99.12	52-53
	266.69
	
99.13	54-55
	293.88
	
99.14	56-57
	323.77
	
99.15	58-59
	341.20
	
99.16	60+
	357.19
	
99.17 	(b) The commissioner shall multiply the defined contribution amounts developed 
99.18 	under paragraph (a) by 1.20 for enrollees who are denied coverage under an individual 
99.19 	health plan by a health plan company and who purchase coverage through the Minnesota 
99.20 	Comprehensive Health Association.
99.21 	(c) Notwithstanding paragraphs (a) and (b), the monthly defined contribution shall 
99.22 	not exceed 90 percent of the monthly premium for the health plan purchased by the 
99.23 	enrollee. If the enrollee purchases coverage under a health plan that does not include 
99.24 	mental health services and chemical dependency treatment services, the monthly defined 
99.25 	contribution amount determined under this subdivision shall be reduced by five percent.
99.26 		Subd. 4.Administration by commissioner. The commissioner shall administer the 
99.27 	defined contributions. The commissioner shall:
99.28 	(1) calculate and process defined contributions for enrollees; and
99.29 	(2) pay the defined contribution amount to health plan companies or the Minnesota 
99.30 	Comprehensive Health Association, as applicable, for enrollee health plan coverage.
99.31 		Subd. 5.Assistance to enrollees. The commissioner of human services, in 
99.32 	consultation with the commissioner of commerce, shall develop an efficient and 
99.33 	cost-effective method of referring eligible applicants to professional insurance agent 
99.34 	associations.
99.35 		Subd. 6.Minnesota Comprehensive Health Association (MCHA). Beginning 
99.36 	January 1, 2012, medical assistance enrollees who are denied coverage under an individual 
99.37 	health plan by a health plan company are eligible for coverage through a health plan 
99.38 	offered by the Minnesota Comprehensive Health Association and may enroll in MCHA 
100.1 	in accordance with section 62E.14. Any difference between the revenue and covered 
100.2 	losses to the MCHA related to implementation of this section shall be paid to the MCHA 
100.3 	from the health care access fund.
100.4 		Subd. 7.Federal approval. The commissioner shall seek all federal waivers and 
100.5 	approvals necessary to implement coverage under this section for medical assistance 
100.6 	enrollees eligible under subdivision 1 and to continue to receive federal matching funds.

100.7 	Sec. 34. Minnesota Statutes 2010, section 256B.76, subdivision 4, is amended to read:
100.8 		Subd. 4.Critical access dental providers.  (a) Effective for dental services 
100.9 	rendered on or after January 1, 2002, the commissioner shall increase reimbursements 
100.10 	to dentists and dental clinics deemed by the commissioner to be critical access dental 
100.11 	providers. For dental services rendered on or after July 1, 2007, the commissioner shall 
100.12 	increase reimbursement by 30 percent above the reimbursement rate that would otherwise 
100.13 	be paid to the critical access dental provider. The commissioner shall pay the managed 
100.14 	care plans and county-based purchasing plans in amounts sufficient to reflect increased 
100.15 	reimbursements to critical access dental providers as approved by the commissioner.
100.16 	(b) The commissioner shall designate the following dentists and dental clinics as 
100.17 	critical access dental providers:
100.18 	(1) nonprofit community clinics that:
100.19 	(i) have nonprofit status in accordance with chapter 317A;
100.20 	(ii) have tax exempt status in accordance with the Internal Revenue Code, section 
100.21 	501(c)(3);
100.22 	(iii) are established to provide oral health services to patients who are low income, 
100.23 	uninsured, have special needs, and are underserved;
100.24 	(iv) have professional staff familiar with the cultural background of the clinic's 
100.25 	patients;
100.26 	(v) charge for services on a sliding fee scale designed to provide assistance to 
100.27 	low-income patients based on current poverty income guidelines and family size;
100.28 	(vi) do not restrict access or services because of a patient's financial limitations 
100.29 	or public assistance status; and
100.30 	(vii) have free care available as needed;
100.31 	(2) federally qualified health centers, rural health clinics, and public health clinics;
100.32 	(3) county owned and operated hospital-based dental clinics;
100.33 	(4) a dental clinic or dental group owned and operated by a nonprofit corporation in 
100.34 	accordance with chapter 317A with more than 10,000 patient encounters per year with 
101.1 	patients who are uninsured or covered by medical assistance, general assistance medical 
101.2 	care, or MinnesotaCare; and
101.3 	(5) a dental clinic associated with an oral health or dental education program owned 
101.4 	and operated by the University of Minnesota or an institution within the Minnesota State 
101.5 	Colleges and Universities system.
101.6 	 (c) The commissioner may designate a dentist or dental clinic as a critical access 
101.7 	dental provider if the dentist or dental clinic is willing to provide care to patients covered 
101.8 	by medical assistance, general assistance medical care, or MinnesotaCare at a level which 
101.9 	significantly increases access to dental care in the service area.
101.10 	(d) Notwithstanding paragraph (a), critical access payments must not be made for 
101.11 	dental services provided from April 1, 2010, through June 30, 2010.

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

101.13 	Sec. 35. [256B.841] WAIVER APPLICATION AND PROCESS.
101.14 		Subdivision 1.Intent. It is the intent of the legislature that medical assistance be:
101.15 	(1) a sustainable, cost-effective, person-centered, and opportunity-driven program 
101.16 	utilizing competitive and value-based purchasing to maximize available service options; 
101.17 	and
101.18 	(2) a results-oriented system of coordinated care that focuses on independence 
101.19 	and choice, promotes accountability and transparency, encourages and rewards healthy 
101.20 	outcomes and responsible choices, and promotes efficiency.
101.21 		Subd. 2.Waiver application. (a) The commissioner of human services shall apply 
101.22 	for a waiver and any necessary state plan amendments from the secretary of the United 
101.23 	States Department of Health and Human Services, including, but not limited to, a waiver 
101.24 	of the appropriate sections of title XIX of the federal Social Security Act, United States 
101.25 	Code, title 42, section 1396 et seq. and a waiver of maintenance of effort provisions in 
101.26 	section 2001 of the Patient Protection and Affordable Care Act, Public Law 111-148, as 
101.27 	amended by the Health Care and Education Reconciliation Act of 2010, Public Law 
101.28 	111-152, that provide program flexibility and under which Minnesota will operate all 
101.29 	facets of the state's medical assistance program.
101.30 	(b) The commissioner of human services shall provide the legislative committees 
101.31 	with jurisdiction over health and human services finance and policy with the waiver 
101.32 	application and financial and other related materials, at least ten days prior to submitting 
101.33 	the application and materials to the federal Centers for Medicare and Medicaid Services.
101.34 	(c) If the state's waiver application is approved, the commissioner of human services 
101.35 	shall:
102.1 	(1) notify the chairs of the legislative committees with jurisdiction over health and 
102.2 	human services finance and policy and allow the legislative committees with jurisdiction 
102.3 	over health and human services finance and policy to review the terms of the waiver; and
102.4 	(2) not implement the waiver until ten legislative days have passed following 
102.5 	notification of the chairs.
102.6 		Subd. 3.Rulemaking; legislative proposals. Upon acceptance of the terms of the 
102.7 	waiver, the commissioner of human services shall:
102.8 	(1) adopt rules to implement the waiver; and
102.9 	(2) propose any legislative changes necessary to implement the terms of the waiver.
102.10 		Subd. 4.Joint commission on waiver implementation. (a) After acceptance 
102.11 	of the terms of the waiver, the governor shall establish a joint commission on waiver 
102.12 	implementation. The commission shall consist of eight members; four of whom shall 
102.13 	be members of the senate, not more than three from the same political party, to be 
102.14 	appointed by the Subcommittee on Committees of the senate Committee on Rules and 
102.15 	Administration, and four of whom shall be members of the house of representatives, not 
102.16 	more than three from the same political party, to be appointed by the speaker of the house.
102.17 	(b) The commission shall:
102.18 	(1) oversee implementation of the waiver;
102.19 	(2) confer as necessary with state agency commissioners;
102.20 	(3) make recommendations on services covered under the medical assistance 
102.21 	program;
102.22 	(4) monitor and make recommendations on quality and access to care under the 
102.23 	global waiver; and
102.24 	(5) make recommendations for the efficient and cost-effective administration of the 
102.25 	medical assistance program under the terms of the waiver.

102.26 	Sec. 36. [256B.842] PRINCIPLES AND GOALS FOR MEDICAL ASSISTANCE 
102.27 	REFORM.
102.28 		Subdivision 1.Goals for reform.  In developing the waiver application and 
102.29 	implementing the waiver, the commissioner of human services shall ensure that the 
102.30 	reformed medical assistance program is a person-centered, financially sustainable, and 
102.31 	cost-effective program.
102.32 		Subd. 2.Reformed medical assistance criteria. The reformed medical assistance 
102.33 	program established through the waiver must:
102.34 	(1) empower consumers to make informed and cost-effective choices about their 
102.35 	health and offer consumers rewards for healthy decisions;
103.1 	(2) ensure adequate access to needed services;
103.2 	(3) enable consumers to receive individualized health care that is outcome-oriented 
103.3 	and focused on prevention, disease management, recovery, and maintaining independence;
103.4 	(4) promote competition between health care providers to ensure best value 
103.5 	purchasing, leverage resources, and to create opportunities for improving service quality 
103.6 	and performance;
103.7 	(5) redesign purchasing and payment methods and encourage and reward 
103.8 	high-quality and cost-effective care by incorporating and expanding upon current payment 
103.9 	reform and quality of care initiatives, including, but not limited to, those initiatives 
103.10 	authorized under chapter 62U; and
103.11 	(6) continually improve technology to take advantage of recent innovations and 
103.12 	advances that help decision makers, consumers, and providers make informed and 
103.13 	cost-effective decisions regarding health care.
103.14 		Subd. 3.Annual report. The commissioner of human services shall annually 
103.15 	submit a report to the governor and the legislature, beginning December 1, 2012, and each 
103.16 	December 1 thereafter, describing the status of the administration and implementation 
103.17 	of the waiver.

103.18 	Sec. 37. [256B.843] WAIVER APPLICATION REQUIREMENTS.
103.19 		Subdivision 1.Requirements for waiver request. The commissioner shall seek 
103.20 	federal approval to:
103.21 	(1) enter into a five-year agreement with the United States Department of Health and 
103.22 	Human Services and Centers for Medicaid and Medicare Services (CMS) under section 
103.23 	1115a to waive provisions of title XIX of the federal Social Security Act, United States 
103.24 	Code, title 42, section 1396 et seq., requiring:
103.25 	(i) state-wideness to allow for the provision of different services in different areas or 
103.26 	regions of the state;
103.27 	(ii) comparability of services to allow for the provision of different services to 
103.28 	members of the same or different coverage groups;
103.29 	(iii) no prohibitions restricting the amount, duration, and scope of services included 
103.30 	in the medical assistance state plan;
103.31 	(iv) no prohibitions limiting freedom of choice of providers; and
103.32 	(v) retroactive payment for medical assistance, at the state's discretion;
103.33 	(2) waive the applicable provisions of title XIX of the federal Social Security Act, 
103.34 	United States Code, title 42, section 1396 et seq., in order to:
104.1 	(i) expand cost sharing requirements above the five percent of income threshold for 
104.2 	beneficiaries in certain populations;
104.3 	(ii) establish health savings or power accounts that encourage and reward 
104.4 	beneficiaries who reach certain prevention and wellness targets; and
104.5 	(iii) implement a tiered set of parameters to use as the basis for determining 
104.6 	long-term service care and setting needs;
104.7 	(3) modify income and resource rules in a manner consistent with the goals of the 
104.8 	reformed program;
104.9 	(4) provide enrollees with a choice of appropriate private sector health coverage 
104.10 	options, with full federal financial participation;
104.11 	(5) treat payments made toward the cost of care as a monthly premium for 
104.12 	beneficiaries receiving home and community-based services when applicable;
104.13 	(6) provide health coverage and services to individuals over the age of 65 that are 
104.14 	limited in scope and are available only in the home and community-based setting;
104.15 	(7) consolidate all home and community-based services currently provided under 
104.16 	title XIX of the federal Social Security Act, United States Code, title 42, section 1915(c), 
104.17 	into a single program of home and community-based services that include options for 
104.18 	consumer direction and shared living;
104.19 	(8) expand disease management, care coordination, and wellness programs for all 
104.20 	medical assistance recipients; and
104.21 	(9) empower and encourage able-bodied medical assistance recipients to work, 
104.22 	whenever possible.
104.23 		Subd. 2.Agency coordination. The commissioner shall establish an intra-agency 
104.24 	assessment and coordination unit to ensure that decision making and program planning for 
104.25 	recipients who may need long-term care, residential placement, and community support 
104.26 	services are coordinated. The assessment and coordination unit shall determine level of 
104.27 	care, develop service plans and a service budget, make referrals to appropriate settings, 
104.28 	provide education and choice counseling to consumers and providers, track utilization, 
104.29 	and monitor outcomes. 

104.30 	Sec. 38. Minnesota Statutes 2010, section 256D.031, subdivision 6, is amended to read:
104.31 		Subd. 6.Coordinated care delivery systems. (a) Effective June 1, 2010 July 
104.32 	1, 2011, the commissioner shall contract with hospitals or groups of hospitals that 
104.33 	qualify under paragraph (b) and agree to deliver services according to this subdivision. 
104.34 	Contracting hospitals shall develop and implement a coordinated care delivery system to 
104.35 	provide health care services to individuals who are eligible for general assistance medical 
105.1 	care under this section and who either choose to receive services through the coordinated 
105.2 	care delivery system or who are enrolled by the commissioner under paragraph (c). The 
105.3 	health care services provided by the system must include: (1) the services described in 
105.4 	subdivision 4 with the exception of outpatient prescription drug coverage but shall include 
105.5 	drugs administered in a clinic or other outpatient setting; or (2) a set of comprehensive 
105.6 	and medically necessary health services that the recipients might reasonably require to be 
105.7 	maintained in good health and that has been approved by the commissioner, including at a 
105.8 	minimum, but not limited to, emergency care, medical transportation services, inpatient 
105.9 	hospital and physician care, outpatient health services, preventive health services, mental 
105.10 	health services, and prescription drugs administered in a clinic or other outpatient setting. 
105.11 	Outpatient prescription drug coverage is covered on a fee-for-service basis in accordance 
105.12 	with section 256D.03, subdivision 3, and funded under subdivision 9. A hospital 
105.13 	establishing a coordinated care delivery system under this subdivision must ensure that the 
105.14 	requirements of this subdivision are met.
105.15 	(b) A hospital or group of hospitals may contract with the commissioner to develop 
105.16 	and implement a coordinated care delivery system as follows: if the hospital or group of 
105.17 	hospitals agrees to satisfy the requirements of this subdivision.
105.18 	(1) effective June 1, 2010, a hospital qualifies under this subdivision if: (i) during 
105.19 	calendar year 2008, it received fee-for-service payments for services to general assistance 
105.20 	medical care recipients (A) equal to or greater than $1,500,000, or (B) equal to or greater 
105.21 	than 1.3 percent of net patient revenue; or (ii) a contract with the hospital is necessary to 
105.22 	provide geographic access or to ensure that at least 80 percent of enrollees have access to 
105.23 	a coordinated care delivery system; and
105.24 	(2) effective December 1, 2010, a Minnesota hospital not qualified under clause 
105.25 	(1) may contract with the commissioner under this subdivision if it agrees to satisfy the 
105.26 	requirements of this subdivision.
105.27 	Participation by hospitals shall become effective quarterly on June 1, September 1, 
105.28 	December 1, or March 1, or June 1. Hospital participation is effective for a period of 12 
105.29 	months and may be renewed for successive 12-month periods.
105.30 	(c) Applicants and recipients may enroll in any available coordinated care delivery 
105.31 	system statewide. If more than one coordinated care delivery system is available, the 
105.32 	applicant or recipient shall be allowed to choose among the systems. The commissioner 
105.33 	may assign an applicant or recipient to a coordinated care delivery system if no choice 
105.34 	is made by the applicant or recipient or under paragraph (k). The commissioner shall 
105.35 	consider a recipient's zip code, city of residence, county of residence, or distance from 
105.36 	a participating coordinated care delivery system when determining default assignment. 
106.1 	An applicant or recipient may decline enrollment in a coordinated care delivery system
106.2 	but services are only available through a coordinated care delivery system. Upon 
106.3 	enrollment into a coordinated care delivery system, the recipient must agree to receive 
106.4 	all nonemergency services through the coordinated care delivery system. Enrollment in 
106.5 	a coordinated care delivery system is for six months and may be renewed for additional 
106.6 	six-month periods, except that initial enrollment is for six months or until the end of a 
106.7 	recipient's period of general assistance medical care eligibility, whichever occurs first. 
106.8 	A recipient who continues to meet the eligibility requirements of this section is not 
106.9 	eligible to enroll in MinnesotaCare during a period of enrollment in a coordinated care 
106.10 	delivery system. From June 1, 2010, to February 28, 2011, applicants and recipients not 
106.11 	enrolled in a coordinated care delivery system may seek services from a hospital eligible 
106.12 	for reimbursement under the temporary uncompensated care pool established under 
106.13 	subdivision 8. After February 28, 2011, services are available only through a coordinated 
106.14 	care delivery system.
106.15 	(d) The hospital may contract and coordinate with providers and clinics for the 
106.16 	delivery of services and shall contract with essential community providers as defined 
106.17 	under section 62Q.19, subdivision 1, paragraph (a), clauses (1) and (2), to the extent 
106.18 	practicable. If a provider or clinic contracts with a hospital to provide services through the 
106.19 	coordinated care delivery system, the provider may not refuse to provide services to any 
106.20 	recipient enrolled in the system, and payment for services shall be negotiated with the 
106.21 	hospital and paid by the hospital from the system's allocation under subdivision 7.
106.22 	(e) A coordinated care delivery system must:
106.23 	(1) provide the covered services required under paragraph (a) to recipients enrolled 
106.24 	in the coordinated care delivery system, and comply with the requirements of subdivision 
106.25 	4, paragraphs (b) to (g);
106.26 	(2) establish a process to monitor enrollment and ensure the quality of care provided;
106.27 	(3) in cooperation with counties, coordinate the delivery of health care services with 
106.28 	existing homeless prevention, supportive housing, and rent subsidy programs and funding 
106.29 	administered by the Minnesota Housing Finance Agency under chapter 462A; and
106.30 	(4) adopt innovative and cost-effective methods of care delivery and coordination, 
106.31 	which may include the use of allied health professionals, telemedicine, patient educators, 
106.32 	care coordinators, and community health workers.
106.33 	(f) The hospital may require a recipient to designate a primary care provider or 
106.34 	a primary care clinic. The hospital may limit the delivery of services to a network of 
106.35 	providers who have contracted with the hospital to deliver services in accordance with 
106.36 	this subdivision, and require a recipient to seek services only within this network. The 
107.1 	hospital may also require a referral to a provider before the service is eligible for payment. 
107.2 	A coordinated care delivery system is not required to provide payment to a provider who 
107.3 	is not employed by or under contract with the system for services provided to a recipient 
107.4 	enrolled in the system, except in cases of an emergency. For purposes of this section, 
107.5 	emergency services are defined in accordance with Code of Federal Regulations, title 
107.6 	42, section 438.114 (a).
107.7 	(g) A recipient enrolled in a coordinated care delivery system has the right to appeal 
107.8 	to the commissioner according to section 256.045.
107.9 	(h) The state shall not be liable for the payment of any cost or obligation incurred 
107.10 	by the coordinated care delivery system.
107.11 	(i) The hospital must provide the commissioner with data necessary for assessing 
107.12 	enrollment, quality of care, cost, and utilization of services. Each hospital must provide, 
107.13 	on a quarterly basis on a form prescribed by the commissioner for each recipient served by 
107.14 	the coordinated care delivery system, the services provided, the cost of services provided, 
107.15 	and the actual payment amount for the services provided and any other information the 
107.16 	commissioner deems necessary to claim federal Medicaid match. The commissioner must 
107.17 	provide this data to the legislature on a quarterly basis.
107.18 	(j) Effective June 1, 2010, The provisions of section 256.9695, subdivision 2, 
107.19 	paragraph (b), do not apply to general assistance medical care provided under this section.
107.20 	(k) Notwithstanding any other provision in this section to the contrary, for 
107.21 	participation beginning September 1, 2010, the commissioner shall offer the same contract 
107.22 	terms related tomay implement an enrollment threshold formula and financial liability 
107.23 	protections to a hospital or group of hospitals qualified under this subdivision to develop 
107.24 	and implement a coordinated care delivery system as those contained in the coordinated 
107.25 	care delivery system contracts effective June 1, 2010.
107.26 	(l) If sections 256B.055, subdivision 15, and 256B.056, subdivisions 3 and 4, are 
107.27 	implemented effective July 1, 2010, this subdivision must not be implemented.

107.28 	Sec. 39. Minnesota Statutes 2010, section 256D.031, subdivision 7, is amended to read:
107.29 		Subd. 7.Payments; rate setting for the hospital coordinated care delivery 
107.30 	system. (a) Effective for general assistance medical care services, with the exception 
107.31 	of outpatient prescription drug coverage, provided on or after June 1, 2010, through a 
107.32 	coordinated care delivery system, the commissioner shall allocate the annual appropriation 
107.33 	for the coordinated care delivery system to hospitals participating under subdivision 
107.34 	6 in quarterly payments, beginning on the first scheduled warrant on or after June 1, 
108.1 	2010 September 1, 2011. The payment shall be allocated among all hospitals qualified to 
108.2 	participate on the allocation date as follows:
108.3 	(1) each hospital or group of hospitals shall be allocated an initial amount based on 
108.4 	the hospital's or group of hospitals' pro rata share of calendar year 20082009 payments for 
108.5 	general assistance medical care services to all participating hospitals;
108.6 	(2) the initial allocations to Hennepin County Medical Center; Regions Hospital; 
108.7 	Saint Mary's Medical Center; and the University of Minnesota Medical Center, Fairview, 
108.8 	shall be increased to 110 percent of the value determined in clause (1);
108.9 	(3) the initial allocation to hospitals not listed in clause (2) shall be reduced a pro rata 
108.10 	amount in order to keep the allocations within the limit of available appropriations; and
108.11 	(4) the amounts determined under clauses (1) to (3) shall be allocated to participating 
108.12 	hospitals.
108.13 	The commissioner may prospectively reallocate payments to participating hospitals on 
108.14 	a biannual basis to ensure that final allocations reflect actual coordinated care delivery 
108.15 	system enrollment. The 20082009 base year shall be updated by one calendar year each 
108.16 	June 1, beginning June 1, 2011 2012.
108.17 	(b) Beginning June 1, 2010 2012, and every quarter beginning in June thereafter, the 
108.18 	commissioner shall make one-third of the quarterly payment in June and the remaining 
108.19 	two-thirds of the quarterly payment in July to each participating hospital or group of 
108.20 	hospitals.
108.21 	(c) In order to be reimbursed under this section, nonhospital providers of health 
108.22 	care services shall contract with one or more hospitals described in paragraph (a) to 
108.23 	provide services to general assistance medical care recipients through the coordinated care 
108.24 	delivery system established by the hospital. The hospital shall reimburse bills submitted 
108.25 	by nonhospital providers participating under this paragraph at a rate negotiated between 
108.26 	the hospital and the nonhospital provider.
108.27 	(d) The commissioner shall apply for federal matching funds under section 
108.28 	256B.199, paragraphs (a) to (d), for expenditures under this subdivision.
108.29 	(e) Outpatient prescription drug coverage is provided in accordance with section 
108.30 	256D.03, subdivision 3, and paid on a fee-for-service basis under subdivision 9.

108.31 	Sec. 40. Minnesota Statutes 2010, section 256D.031, subdivision 9, is amended to read:
108.32 		Subd. 9.Prescription drug pool. (a) The commissioner shall establish an outpatient 
108.33 	prescription drug pool, effective June 1, 2010 July 1, 2011. Money in the pool must 
108.34 	be used to reimburse pharmacies and other pharmacy service providers as defined in 
108.35 	Minnesota Rules, part 9505.0340, for the covered outpatient prescription drugs dispensed 
109.1 	to recipients. Payment for drugs shall be on a fee-for-service basis according to the rates 
109.2 	established in section 256B.0625, subdivision 13e. Outpatient prescription drug coverage 
109.3 	is subject to the availability of funds in the pool. If the commissioner forecasts that 
109.4 	expenditures under this subdivision will exceed the appropriation for this purpose, the 
109.5 	commissioner may bring recommendations to the Legislative Advisory Commission on 
109.6 	methods to resolve the shortfall.
109.7 	(b) Effective June 1, 2010 September 1, 2011, coordinated care delivery systems 
109.8 	established under subdivision 6 shall pay to the commissioner, on a quarterly basis, an 
109.9 	assessment equal to 20 percent of payments for the prescribed drugs for recipients of 
109.10 	services through that coordinated care delivery system, as calculated by the commissioner 
109.11 	based on the most recent available data.

109.12 	Sec. 41. [256L.031] HEALTHY MINNESOTA CONTRIBUTION PROGRAM.
109.13 		Subdivision 1.Defined contributions to enrollees. (a) Beginning January 1, 2012, 
109.14 	the commissioner shall provide each MinnesotaCare enrollee eligible under section 
109.15 	256L.04, subdivision 7, with family income greater than 75 percent of the federal poverty 
109.16 	guidelines with a monthly defined contribution to purchase health coverage under a health 
109.17 	plan as defined in section 62A.011, subdivision 3.
109.18 	(b) Beginning January 1, 2012, the commissioner shall provide each MinnesotaCare 
109.19 	enrollee eligible under section 256L.04, subdivision 1, with a monthly defined contribution 
109.20 	to purchase health coverage under a health plan as defined in section 62A.011, subdivision 
109.21 	3, offered by a health plan company as defined in section 62Q.01, subdivision 4.
109.22 	(c) Enrollees eligible under paragraph (a) or (b) shall not be charged premiums 
109.23 	under section 256L.15 and are exempt from the managed care enrollment requirement 
109.24 	of section 256L.12.
109.25 	(d) Sections 256L.03; 256L.05, subdivision 3; and 256L.11 do not apply to enrollees 
109.26 	eligible under paragraph (a) or (b). Covered services, cost sharing, disenrollment for 
109.27 	nonpayment of premium, enrollee appeal rights and complaint procedures, and the 
109.28 	effective date of coverage for enrollees eligible under paragraph (a) shall be as provided 
109.29 	under the terms of the health plan purchased by the enrollee.
109.30 	(e) Unless otherwise provided in this section, all MinnesotaCare requirements 
109.31 	related to eligibility, income and asset methodology, income reporting, and program 
109.32 	administration, continue to apply to enrollees obtaining coverage under this section.
109.33 		Subd. 2.Use of defined contribution. An enrollee may use up to the monthly 
109.34 	defined contribution to pay premiums for coverage under a health plan as defined in 
109.35 	section 62A.011, subdivision 3.
110.1 		Subd. 3.Determination of defined contribution amount. (a) The commissioner 
110.2 	shall determine the defined contribution sliding scale using the base contribution specified 
110.3 	in paragraph (b) for the specified age ranges. The commissioner shall use a sliding scale 
110.4 	for defined contributions that provides:
110.5 	(1) persons with household incomes greater than 75 percent of the federal poverty 
110.6 	guidelines to 133 percent of the federal poverty guidelines with a defined contribution 
110.7 	of 110 percent of the base contribution;
110.8 	(2) persons with household incomes equal to 175 percent of the federal poverty 
110.9 	guidelines with a defined contribution of 100 percent of the base contribution;
110.10 	(3) persons with household incomes equal to or greater than 250 percent of 
110.11 	the federal poverty guidelines with a defined contribution of 80 percent of the base 
110.12 	contribution; and
110.13 	(4) persons with household incomes in evenly spaced increments between the 
110.14 	percentages of the federal poverty guidelines specified in clauses (1) to (3) with a base 
110.15 	contribution that is a percentage interpolated from the defined contribution percentages 
110.16 	specified in clauses (1) to (3).

110.17	Age
	Monthly Per-Person Base Contribution
	
110.18	Under 21
	$122.79
	
110.19	21-29
	122.79
	
110.20	30-31
	129.19
	
110.21	32-33
	132.38
	
110.22	34-35
	134.31
	
110.23	36-37
	136.06
	
110.24	38-39
	141.02
	
110.25	40-41
	151.25
	
110.26	42-43
	159.89
	
110.27	44-45
	175.08
	
110.28	46-47
	191.71
	
110.29	48-49
	213.13
	
110.30	50-51
	239.51
	
110.31	52-53
	266.69
	
110.32	54-55
	293.88
	
110.33	56-57
	323.77
	
110.34	58-59
	341.20
	
110.35	60+
	357.19
	
110.36 	(b) The commissioner shall multiply the defined contribution amounts developed 
110.37 	under paragraph (a) by 1.20 for enrollees who are denied coverage under an individual 
110.38 	health plan by a health plan company and who purchase coverage through the Minnesota 
110.39 	Comprehensive Health Association.
111.1 	(c) Notwithstanding paragraphs (a) and (b), the monthly defined contribution shall 
111.2 	not exceed 90 percent of the monthly premium for the health plan purchased by the 
111.3 	enrollee. If the enrollee purchases coverage under a health plan that does not include 
111.4 	mental health services and chemical dependency treatment services, the monthly defined 
111.5 	contribution amount determined under this subdivision shall be reduced by five percent.
111.6 		Subd. 4.Administration by commissioner. The commissioner shall administer the 
111.7 	defined contributions. The commissioner shall:
111.8 	(1) calculate and process defined contributions for enrollees; and
111.9 	(2) pay the defined contribution amount to health plan companies or the Minnesota 
111.10 	Comprehensive Health Association, as applicable, for enrollee health plan coverage.
111.11 		Subd. 5.Assistance to enrollees. The commissioner of human services, in 
111.12 	consultation with the commissioner of commerce, shall develop an efficient and 
111.13 	cost-effective method of referring eligible applicants to professional insurance agent 
111.14 	associations.
111.15 		Subd. 6.Minnesota Comprehensive Health Association (MCHA). Beginning 
111.16 	January 1, 2012, MinnesotaCare enrollees who are denied coverage under an individual 
111.17 	health plan by a health plan company are eligible for coverage through a health plan 
111.18 	offered by the Minnesota Comprehensive Health Association and may enroll in MCHA 
111.19 	in accordance with section 62E.14. Any difference between the revenue and covered 
111.20 	losses to the MCHA related to implementation of this section shall be paid to the MCHA 
111.21 	from the health care access fund.
111.22 		Subd. 7.Federal approval. The commissioner shall seek all federal waivers 
111.23 	and approvals necessary to implement coverage under this section for MinnesotaCare 
111.24 	enrollees eligible under subdivision 1 while continuing to receive federal matching funds.

111.25 	Sec. 42. Minnesota Statutes 2010, section 256L.04, subdivision 7, is amended to read:
111.26 		Subd. 7.Single adults and households with no children. (a) The definition of 
111.27 	eligible persons includes all individuals and households with no children who have gross 
111.28 	family incomes that are equal to or less than 200 percent of the federal poverty guidelines.
111.29 	(b) Effective July 1, 2009 2011, the definition of eligible persons includes all 
111.30 	individuals and households with no children who have gross family incomes that are equal 
111.31 	to orgreater than 75 percent of the federal poverty guidelines and less than 250 percent 
111.32 	of the federal poverty guidelines.

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

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

112.16 	Sec. 45. Minnesota Statutes 2010, section 256L.12, subdivision 9, is amended to read:
112.17 		Subd. 9.Rate setting; performance withholds. (a) Rates will be prospective, 
112.18 	per capita, where possible. The commissioner may allow health plans to arrange for 
112.19 	inpatient hospital services on a risk or nonrisk basis. The commissioner shall consult with 
112.20 	an independent actuary to determine appropriate rates.
112.21 	(b) For services rendered on or after January 1, 2004, the commissioner shall 
112.22 	withhold five percent of managed care plan payments and county-based purchasing 
112.23 	plan payments under this section pending completion of performance targets. Each 
112.24 	performance target must be quantifiable, objective, measurable, and reasonably attainable, 
112.25 	except in the case of a performance target based on a federal or state law or rule. Criteria 
112.26 	for assessment of each performance target must be outlined in writing prior to the 
112.27 	contract effective date. The managed care plan must demonstrate, to the commissioner's 
112.28 	satisfaction, that the data submitted regarding attainment of the performance target is 
112.29 	accurate. The commissioner shall periodically change the administrative measures used 
112.30 	as performance targets in order to improve plan performance across a broader range of 
112.31 	administrative services. The performance targets must include measurement of plan 
112.32 	efforts to contain spending on health care services and administrative activities. The 
112.33 	commissioner may adopt plan-specific performance targets that take into account factors 
112.34 	affecting only one plan, such as characteristics of the plan's enrollee population. The 
113.1 	withheld funds must be returned no sooner than July 1 and no later than July 31 of the 
113.2 	following calendar year if performance targets in the contract are achieved.
113.3 	(c) For services rendered on or after January 1, 2011, the commissioner shall 
113.4 	withhold an additional three percent of managed care plan or county-based purchasing 
113.5 	plan payments under this section. The withheld funds must be returned no sooner than 
113.6 	July 1 and no later than July 31 of the following calendar year. The return of the withhold 
113.7 	under this paragraph is not subject to the requirements of paragraph (b).
113.8 	(d) Effective for services rendered on or after January 1, 2011, the commissioner 
113.9 	shall include as part of the performance targets described in paragraph (b) a reduction in 
113.10 	the plan's emergency room utilization rate for state health care program enrollees by a 
113.11 	measurable rate of five percent from the plan's utilization rate for the previous calendar 
113.12 	year.
113.13 	The withheld funds must be returned no sooner than July 1 and no later than July 31 
113.14 	of the following calendar year if the managed care plan demonstrates to the satisfaction of 
113.15 	the commissioner that a reduction in the utilization rate was achieved.
113.16 	The withhold described in this paragraph shall continue for each consecutive 
113.17 	contract period until the plan's emergency room utilization rate for state health care 
113.18 	program enrollees is reduced by 25 percent of the plan's emergency room utilization rate 
113.19 	for state health care program enrollees for calendar year 2009. Hospitals shall cooperate 
113.20 	with the health plans in meeting this performance target and shall accept payment 
113.21 	withholds that may be returned to the hospitals if the performance target is achieved. The 
113.22 	commissioner shall structure the withhold so that the commissioner returns a portion of 
113.23 	the withheld funds in amounts commensurate with achieved reductions in utilization less 
113.24 	than the targeted amount. The withhold described in this paragraph does not apply to 
113.25 	county-based purchasing plans.
113.26 	(e) Effective for services provided on or after January 1, 2012, the commissioner 
113.27 	shall include as part of the performance targets described in paragraph (b) a reduction in 
113.28 	the plan's hospitalization rate for a subsequent hospitalization within 30 days of a previous 
113.29 	hospitalization of a patient regardless of the reason for the hospitalization for state health 
113.30 	care program enrollees by a measurable rate of five percent from the plan's hospitalization 
113.31 	rate for the previous calendar year.
113.32 	The withheld funds must be returned no sooner than July 1 and no later than July 31 
113.33 	of the following calendar year if the managed care plan or county-based purchasing plan 
113.34 	demonstrates to the satisfaction of the commissioner that a reduction in the hospitalization 
113.35 	rate was achieved.
114.1 	The withhold described in this paragraph must continue for each consecutive 
114.2 	contract period until the plan's subsequent hospitalization rate for state health care 
114.3 	program enrollees is reduced by 25 percent of the plan's subsequent hospitalization rate 
114.4 	for state health care program enrollees for calendar year 2010. Hospitals shall cooperate 
114.5 	with the plans in meeting this performance target and shall accept payment withholds that 
114.6 	must be returned to the hospitals if the performance target is achieved. The commissioner 
114.7 	shall structure the withhold so that the commissioner returns a portion of the withheld 
114.8 	funds in amounts commensurate with achieved reductions in utilizations less than the 
114.9 	targeted amount. The withhold described in this paragraph does not apply to county-based 
114.10 	purchasing plans.
114.11 	 (f) A managed care plan or a county-based purchasing plan under section 256B.692 
114.12 	may include as admitted assets under section 62D.044 any amount withheld under this 
114.13 	section that is reasonably expected to be returned.

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

114.16	Subd. 5.Basic Health Care Grants

114.17	(a) MinnesotaCare Grants

114.18	Health Care Access
		-0-
		(770,000)
	
114.19 	Incentive Program and Outreach Grants.
114.20 	Of the appropriation for the Minnesota health 
114.21 	care outreach program in Laws 2007, chapter 
114.22 	147, article 19, section 3, subdivision 7, 
114.23 	paragraph (b):
114.24 	(1) $400,000 in fiscal year 2009 from the 
114.25 	general fund and $200,000 in fiscal year 2009 
114.26 	from the health care access fund are for the 
114.27 	incentive program under Minnesota Statutes, 
114.28 	section 256.962, subdivision 5. For the 
114.29 	biennium beginning July 1, 2009, base level 
114.30 	funding for this activity shall be $360,000 
114.31 	from the general fund and $160,000 from the 
114.32 	health care access fund; and
115.1 	(2) $100,000 in fiscal year 2009 from the 
115.2 	general fund and $50,000 in fiscal year 2009 
115.3 	from the health care access fund are for the 
115.4 	outreach grants under Minnesota Statutes, 
115.5 	section 256.962, subdivision 2. For the 
115.6 	biennium beginning July 1, 2009, base level 
115.7 	funding for this activity shall be $90,000 
115.8 	from the general fund and $40,000 from the 
115.9 	health care access fund.

115.10
115.11	(b) MA Basic Health Care Grants - Families 
and Children
		-0-
		(17,280,000)
	
115.12 	Third-Party Liability. (a) During 
115.13 	fiscal year 2009, the commissioner shall 
115.14 	employ a contractor paid on a percentage 
115.15 	basis to improve third-party collections. 
115.16 	Improvement initiatives may include, but not 
115.17 	be limited to, efforts to improve postpayment 
115.18 	collection from nonresponsive claims and 
115.19 	efforts to uncover third-party payers the 
115.20 	commissioner has been unable to identify.
115.21 	(b) In fiscal year 2009, the first $1,098,000 
115.22 	of recoveries, after contract payments and 
115.23 	federal repayments, is appropriated to 
115.24 	the commissioner for technology-related 
115.25 	expenses.
115.26 	Administrative Costs. (a) For contracts 
115.27 	effective on or after January 1, 2009, 
115.28 	the commissioner shall limit aggregate 
115.29 	administrative costs paid to managed care 
115.30 	plans under Minnesota Statutes, section 
115.31 	256B.69, and to county-based purchasing 
115.32 	plans under Minnesota Statutes, section 
115.33 	256B.692, to an overall average of 6.6 5.3
115.34 	percent of total contract payments under 
115.35 	Minnesota Statutes, sections 256B.69 and 
115.36 	256B.692, for each calendar year. For 
116.1 	purposes of this paragraph, administrative 
116.2 	costs do not include premium taxes paid 
116.3 	under Minnesota Statutes, section 297I.05, 
116.4 	subdivision 5, and provider surcharges paid 
116.5 	under Minnesota Statutes, section 256.9657, 
116.6 	subdivision 3.
116.7 	(b) Notwithstanding any law to the contrary, 
116.8 	the commissioner may reduce or eliminate 
116.9 	administrative requirements to meet the 
116.10 	administrative target under paragraph (a). 
116.11 	(c) Notwithstanding any contrary provision 
116.12 	of this article, this rider shall not expire.
116.13 	Hospital Payment Delay. Notwithstanding 
116.14 	Laws 2005, First Special Session chapter 4, 
116.15 	article 9, section 2, subdivision 6, payments 
116.16 	from the Medicaid Management Information 
116.17 	System that would otherwise have been made 
116.18 	for inpatient hospital services for medical 
116.19 	assistance enrollees are delayed as follows: 
116.20 	(1) for fiscal year 2008, June payments must 
116.21 	be included in the first payments in fiscal 
116.22 	year 2009; and (2) for fiscal year 2009, 
116.23 	June payments must be included in the first 
116.24 	payment of fiscal year 2010. The provisions 
116.25 	of Minnesota Statutes, section 16A.124, 
116.26 	do not apply to these delayed payments. 
116.27 	Notwithstanding any contrary provision in 
116.28 	this article, this paragraph expires on June 
116.29 	30, 2010.

116.30
116.31	(c) MA Basic Health Care Grants - Elderly and 
Disabled
		(14,028,000)
		(9,368,000)
	
116.32 	Minnesota Disability Health Options Rate 
116.33 	Setting Methodology. The commissioner 
116.34 	shall develop and implement a methodology 
116.35 	for risk adjusting payments for community 
117.1 	alternatives for disabled individuals (CADI) 
117.2 	and traumatic brain injury (TBI) home 
117.3 	and community-based waiver services 
117.4 	delivered under the Minnesota disability 
117.5 	health options program (MnDHO) effective 
117.6 	January 1, 2009. The commissioner shall 
117.7 	take into account the weighting system used 
117.8 	to determine county waiver allocations in 
117.9 	developing the new payment methodology. 
117.10 	Growth in the number of enrollees receiving 
117.11 	CADI or TBI waiver payments through 
117.12 	MnDHO is limited to an increase of 200 
117.13 	enrollees in each calendar year from January 
117.14 	2009 through December 2011. If those limits 
117.15 	are reached, additional members may be 
117.16 	enrolled in MnDHO for basic care services 
117.17 	only as defined under Minnesota Statutes, 
117.18 	section 256B.69, subdivision 28, and the 
117.19 	commissioner may establish a waiting list for 
117.20 	future access of MnDHO members to those 
117.21 	waiver services.
117.22 	MA Basic Elderly and Disabled 
117.23 	Adjustments. For the fiscal year ending June 
117.24 	30, 2009, the commissioner may adjust the 
117.25 	rates for each service affected by rate changes 
117.26 	under this section in such a manner across 
117.27 	the fiscal year to achieve the necessary cost 
117.28 	savings and minimize disruption to service 
117.29 	providers, notwithstanding the requirements 
117.30 	of Laws 2007, chapter 147, article 7, section 
117.31 	71.

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

117.33	(e) Other Health Care Grants
		-0-
		(17,000)
	
117.34 	MinnesotaCare Outreach Grants Special 
117.35 	Revenue Account. The balance in the 
118.1 	MinnesotaCare outreach grants special 
118.2 	revenue account on July 1, 2009, estimated 
118.3 	to be $900,000, must be transferred to the 
118.4 	general fund.
118.5 	Grants Reduction. Effective July 1, 2008, 
118.6 	base level funding for nonforecast, general 
118.7 	fund health care grants issued under this 
118.8 	paragraph shall be reduced by 1.8 percent at 
118.9 	the allotment level.

118.10 	Sec. 47. Laws 2010, First Special Session chapter 1, article 25, section 3, subdivision 
118.11 	6, is amended to read:

118.12	Subd. 6.Health Care Grants

118.13	(a) MinnesotaCare Grants
		998,000
		(13,376,000)
	
118.14 	This appropriation is from the health care 
118.15 	access fund.
118.16 	Health Care Access Fund Transfer to 
118.17 	General Fund. The commissioner of 
118.18 	management and budget shall transfer 
118.19 	the following amounts in the following 
118.20 	years from the health care access fund to 
118.21 	the general fund: $998,000 in fiscal year 
118.22 	2010; and $176,704,000 in fiscal year 
118.23 	2011; $141,041,000 in fiscal year 2012; and 
118.24 	$286,150,000 in fiscal year 2013. If at any 
118.25 	time the governor issues an executive order 
118.26 	not to participate in early medical assistance 
118.27 	expansion, no funds shall be transferred from 
118.28 	the health care access fund to the general 
118.29 	fund until early medical assistance expansion 
118.30 	takes effect. This paragraph is effective the 
118.31 	day following final enactment.
118.32 	MinnesotaCare Ratable Reduction.
118.33 	Effective for services rendered on or after 
118.34 	July 1, 2010, to December 31, 2013, 
119.1 	MinnesotaCare payments to managed care 
119.2 	plans under Minnesota Statutes, section 
119.3 	256L.12, for single adults and households 
119.4 	without children whose income is greater 
119.5 	than 75 percent of federal poverty guidelines 
119.6 	shall be reduced by 15 percent. Effective 
119.7 	for services provided from July 1, 2010, to 
119.8 	June 30, 2011, this reduction shall apply to 
119.9 	all services. Effective for services provided 
119.10 	from July 1, 2011, to December 31, 2013, this 
119.11 	reduction shall apply to all services except 
119.12 	inpatient hospital services. Notwithstanding 
119.13 	any contrary provision of this article, this 
119.14 	paragraph shall expire on December 31, 
119.15 	2013.

119.16
119.17	(b) Medical Assistance Basic Health Care 
Grants - Families and Children
		-0-
		295,512,000
	
119.18 	Critical Access Dental. Of the general 
119.19 	fund appropriation, $731,000 in fiscal year 
119.20 	2011 is to the commissioner for critical 
119.21 	access dental provider reimbursement 
119.22 	payments under Minnesota Statutes, section 
119.23 	256B.76 subdivision 4. This is a onetime 
119.24 	appropriation.
119.25 	Nonadministrative Rate Reduction. For 
119.26 	services rendered on or after July 1, 2010, 
119.27 	to December 31, 2013, the commissioner 
119.28 	shall reduce contract rates paid to managed 
119.29 	care plans under Minnesota Statutes, 
119.30 	sections 256B.69 and 256L.12, and to 
119.31 	county-based purchasing plans under 
119.32 	Minnesota Statutes, section 256B.692, by 
119.33 	three percent of the contract rate attributable 
119.34 	to nonadministrative services in effect on 
119.35 	June 30, 2010. Notwithstanding any contrary 
120.1 	provision in this article, this rider expires on 
120.2 	December 31, 2013.

120.3
120.4	(c) Medical Assistance Basic Health Care 
Grants - Elderly and Disabled
		-0-
		(30,265,000)

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

120.6	(e)  Other Health Care Grants
		-0-
		(7,000,000)
	
120.7 	Cobra Carryforward. Unexpended funds 
120.8 	appropriated in fiscal year 2010 for COBRA 
120.9 	grants under Laws 2009, chapter 79, article 
120.10 	5, section 78, do not cancel and are available 
120.11 	to the commissioner for fiscal year 2011 
120.12 	COBRA grant expenditures. Up to $111,000 
120.13 	of the fiscal year 2011 appropriation for 
120.14 	COBRA grants provided in Laws 2009, 
120.15 	chapter 79, article 13, section 3, subdivision 
120.16 	6, may be used by the commissioner for costs 
120.17 	related to administration of the COBRA 
120.18 	grants.

120.19 	Sec. 48. COMPETITIVE BIDDING PILOT.
 120.20 	For managed care contracts effective January 1, 2012, the commissioner of 
120.21 	human services is required to establish a competitive price bidding pilot for nonelderly, 
120.22 	nondisabled adults and children in medical assistance and MinnesotaCare in the 
120.23 	seven-county metropolitan area. The pilot must allow a minimum of two managed care 
120.24 	organizations to serve the metropolitan area. The pilot shall expire after two full calendar 
120.25 	years on December 31, 2013. The commissioner of human service shall conduct an 
120.26 	evaluation of the pilot to determine the cost-effectiveness and impacts to provider access 
120.27 	at the end of the two-year period.

120.28 	Sec. 49. DIRECTION TO COMMISSIONER; FEDERAL WAIVER.
 120.29 	The commissioner of human services shall apply to the Centers for Medicare and 
120.30 	Medicaid Services for federal waivers to cover:
120.31 	(1) children eligible under Minnesota Statutes, section 256B.055, subdivisions 9 
120.32 	and 10b;
121.1 	(2) families with children eligible under Minnesota Statutes, sections 256B.055, 
121.2 	subdivisions 3 and 3a, and 256L.04, subdivision 1; and 
121.3 	(3) adults eligible under Minnesota Statutes, section 256L.04, subdivision 1, under 
121.4 	the MinnesotaCare healthy Minnesota contribution program established under Minnesota 
121.5 	Statutes, section 256B.695, and section 256L.031. The commissioner shall report to 
121.6 	the legislative committees with jurisdiction over health and human services policy and 
121.7 	finance whether or not the federal waiver application was accepted within ten working 
121.8 	days of receipt of the decision.

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

121.10 	Sec. 50. MEDICAID FRAUD PREVENTION AND DETECTION.
 121.11 		Subdivision 1.Request for proposals. By July 1, 2011, the commissioner of human 
121.12 	services shall issue a request for proposals to prevent and detect Medicaid fraud and 
121.13 	mispayment. The request for proposals shall require the vendor to provide data analytics 
121.14 	capabilities, including, but not limited to, predictive modeling techniques and other forms 
121.15 	of advanced analytics that will integrate into the current claim processing system to detect 
121.16 	improper payments both before and after payments are made.
121.17 		Subd. 2.Proof of concept phase. The selected vendor, at no cost to the state, 
121.18 	shall be required to implement its recommendations on a subset of data provided by the 
121.19 	commissioner to demonstrate the cost-savings potential of the solution.
121.20 		Subd. 3.Data. Data provided by the commissioner to the vendor under this section 
121.21 	must not include not public data, as defined in section 13.02, subdivision 8a.
121.22 		Subd. 4.Full implementation phase. The request for proposals must require the 
121.23 	commissioner to implement the recommendations provided by the vendor if the work done 
121.24 	under the requirements of subdivision 2 provides material savings to the state. After the 
121.25 	full implementation of the system provided by the vendor, the vendor shall be paid by 
121.26 	the state from the savings attributable to the work done by the vendor, according to the 
121.27 	terms and performance measures negotiated in the contract.
121.28 		Subd. 5.Selection of vendor. The commissioner of human services shall select a 
121.29 	vendor from the responses to the request for proposals by September 1, 2011.
121.30 		Subd. 6.Progress report. The commissioner shall provide a report describing the 
121.31 	progress made under this section to the governor and the chairs and ranking minority 
121.32 	members of the legislative committees with jurisdiction over the Department of Human 
121.33 	Services and data practices by January 15, 2012. The report shall provide a dynamic 
121.34 	scoring analysis of the work described in the report and address data access and privacy 
121.35 	issues involved in implementation of the system.

122.1 	Sec. 51. PROHIBITION OF STATE FUNDS TO IMPLEMENT CERTAIN 
122.2 	FEDERAL HEALTH CARE REFORMS.
 122.3 	State funds must not be expended in the planning or implementation of the Patient 
122.4 	Protection and Affordable Care Act, Public Law 111-148, as amended by the Health Care 
122.5 	and Education Affordability and Reconciliation Act of 2010, Public Law 111-152, and no 
122.6 	provisions of the act may be implemented, until the constitutionality of the act has been 
122.7 	affirmed by the United States Supreme Court.

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

122.9 	Sec. 52. CONTINGENT REINSTATEMENT OF GAMC.
 122.10 	Notwithstanding their contingent repeal in Laws 2010, First Special Session chapter 
122.11 	1, article 16, section 47, the following statutes are revived and have the force of law:
122.12 	(1) Minnesota Statutes 2010, section 256D.03, subdivisions 3, 3a, 5, 6, 7, and 8; and
122.13 	(2) Laws 2010, chapter 200, article 1, section 12, subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 
122.14 	9, 10, 18, and 19.

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

122.18 	Sec. 53.  REPEALER.
 122.19 	(a) Minnesota Statutes 2010, sections 256B.0625, subdivision 8e; 256B.0653, 
122.20 	subdivision 5; 256B.0756; and 256D.031, subdivisions 5 and 8, are repealed.
122.21 	(b) Minnesota Statutes 2010, section 256B.055, subdivision 15, is repealed effective 
122.22 	October 1, 2011.
122.23 	(c) Laws 2010, First Special Session chapter 1, article 16, sections 6; and 7, are 
122.24 	repealed effective October 1, 2011.

122.25 	ARTICLE 6
122.26 	DEPARTMENT OF HEALTH

122.27 	Section 1. Minnesota Statutes 2010, section 62J.04, subdivision 3, is amended to read:
122.28 		Subd. 3.Cost containment duties. The commissioner shall:
122.29 	(1) establish statewide and regional cost containment goals for total health care 
122.30 	spending under this section and collect data as described in sections 62J.38to 62J.41 and 
122.31 	62J.40 to monitor statewide achievement of the cost containment goals; 
123.1 	(2) divide the state into no fewer than four regions, with one of those regions being 
123.2 	the Minneapolis/St. Paul metropolitan statistical area but excluding Chisago, Isanti, 
123.3 	Wright, and Sherburne Counties, for purposes of fostering the development of regional 
123.4 	health planning and coordination of health care delivery among regional health care 
123.5 	systems and working to achieve the cost containment goals;
123.6 	(3) monitor the quality of health care throughout the state and take action as 
123.7 	necessary to ensure an appropriate level of quality;
123.8 	(4) issue recommendations regarding uniform billing forms, uniform electronic 
123.9 	billing procedures and data interchanges, patient identification cards, and other uniform 
123.10 	claims and administrative procedures for health care providers and private and public 
123.11 	sector payers. In developing the recommendations, the commissioner shall review the 
123.12 	work of the work group on electronic data interchange (WEDI) and the American National 
123.13 	Standards Institute (ANSI) at the national level, and the work being done at the state and 
123.14 	local level. The commissioner may adopt rules requiring the use of the Uniform Bill 
123.15 	82/92 form, the National Council of Prescription Drug Providers (NCPDP) 3.2 electronic 
123.16 	version, the Centers for Medicare and Medicaid Services 1500 form, or other standardized 
123.17 	forms or procedures;
123.18 	(5) undertake health planning responsibilities;
123.19 	(6) authorize, fund, or promote research and experimentation on new technologies 
123.20 	and health care procedures;
123.21 	(7) within the limits of appropriations for these purposes, administer or contract for 
123.22 	statewide consumer education and wellness programs that will improve the health of 
123.23 	Minnesotans and increase individual responsibility relating to personal health and the 
123.24 	delivery of health care services, undertake prevention programs including initiatives to 
123.25 	improve birth outcomes, expand childhood immunization efforts, and provide start-up 
123.26 	grants for worksite wellness programs;
123.27 	(8) undertake other activities to monitor and oversee the delivery of health care 
123.28 	services in Minnesota with the goal of improving affordability, quality, and accessibility of 
123.29 	health care for all Minnesotans; and
123.30 	(9) make the cost containment goal data available to the public in a 
123.31 	consumer-oriented manner.

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

123.33 	Sec. 2. Minnesota Statutes 2010, section 62J.17, subdivision 4a, is amended to read:
123.34 		Subd. 4a.Expenditure reporting. Each hospital, outpatient surgical center, 
123.35 	and diagnostic imaging center, and physician clinic shall report annually to the 
124.1 	commissioner on all major spending commitments, in the form and manner specified by 
124.2 	the commissioner. The report shall include the following information:
124.3 	(a) a description of major spending commitments made during the previous year, 
124.4 	including the total dollar amount of major spending commitments and purpose of the 
124.5 	expenditures;
124.6 	(b) the cost of land acquisition, construction of new facilities, and renovation of 
124.7 	existing facilities;
124.8 	(c) the cost of purchased or leased medical equipment, by type of equipment;
124.9 	(d) expenditures by type for specialty care and new specialized services;
124.10 	(e) information on the amount and types of added capacity for diagnostic imaging 
124.11 	services, outpatient surgical services, and new specialized services; and
124.12 	(f) information on investments in electronic medical records systems.
124.13 	For hospitals and outpatient surgical centers, this information shall be included in reports 
124.14 	to the commissioner that are required under section 144.698. For diagnostic imaging 
124.15 	centers, this information shall be included in reports to the commissioner that are required 
124.16 	under section 144.565. For physician clinics, this information shall be included in reports 
124.17 	to the commissioner that are required under section 62J.41. For all other health care 
124.18 	providers that are subject to this reporting requirement, reports must be submitted to the 
124.19 	commissioner by March 1 each year for the preceding calendar year.

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

124.21 	Sec. 3. Minnesota Statutes 2010, section 62J.692, subdivision 4, is amended to read:
124.22 		Subd. 4.Distribution of funds. (a) Following the distribution described under 
124.23 	paragraph (b), the commissioner shall annually distribute the available medical education 
124.24 	funds to all qualifying applicants based on a distribution formula that reflects a summation 
124.25 	of two factors:
124.26 	(1) a public program volume factor, which is determined by the total volume of 
124.27 	public program revenue received by each training site as a percentage of all public 
124.28 	program revenue received by all training sites in the fund pool; and
124.29 	(2) a supplemental public program volume factor, which is determined by providing 
124.30 	a supplemental payment of 20 percent of each training site's grant to training sites whose 
124.31 	public program revenue accounted for at least 0.98 percent of the total public program 
124.32 	revenue received by all eligible training sites. Grants to training sites whose public 
124.33 	program revenue accounted for less than 0.98 percent of the total public program revenue 
125.1 	received by all eligible training sites shall be reduced by an amount equal to the total 
125.2 	value of the supplemental payment.
125.3 	Public program revenue for the distribution formula includes revenue from medical 
125.4 	assistance, prepaid medical assistance, general assistance medical care, and prepaid 
125.5 	general assistance medical care. Training sites that receive no public program revenue 
125.6 	are ineligible for funds available under this subdivision. For purposes of determining 
125.7 	training-site level grants to be distributed under paragraph (a), total statewide average 
125.8 	costs per trainee for medical residents is based on audited clinical training costs per trainee 
125.9 	in primary care clinical medical education programs for medical residents. Total statewide 
125.10 	average costs per trainee for dental residents is based on audited clinical training costs 
125.11 	per trainee in clinical medical education programs for dental students. Total statewide 
125.12 	average costs per trainee for pharmacy residents is based on audited clinical training costs 
125.13 	per trainee in clinical medical education programs for pharmacy students.
125.14 	(b) $5,350,000 of the available medical education funds shall be distributed as 
125.15 	follows:
125.16 	(1) $1,475,000 to the University of Minnesota Medical Center-Fairview;
125.17 	(2) $2,075,000 to the University of Minnesota School of Dentistry; and
125.18 	(3) $1,800,000 to the Academic Health Center. $150,000 of the funds distributed to 
125.19 	the Academic Health Center under this paragraph shall be used for a program to assist 
125.20 	internationally trained physicians who are legal residents and who commit to serving 
125.21 	underserved Minnesota communities in a health professional shortage area to successfully 
125.22 	compete for family medicine residency programs at the University of Minnesota.
125.23 	(c)(b) Funds distributed shall not be used to displace current funding appropriations 
125.24 	from federal or state sources.
125.25 	(d)(c) Funds shall be distributed to the sponsoring institutions indicating the amount 
125.26 	to be distributed to each of the sponsor's clinical medical education programs based on 
125.27 	the criteria in this subdivision and in accordance with the commissioner's approval letter. 
125.28 	Each clinical medical education program must distribute funds allocated under paragraph 
125.29 	(a) to the training sites as specified in the commissioner's approval letter. Sponsoring 
125.30 	institutions, which are accredited through an organization recognized by the Department 
125.31 	of Education or the Centers for Medicare and Medicaid Services, may contract directly 
125.32 	with training sites to provide clinical training. To ensure the quality of clinical training, 
125.33 	those accredited sponsoring institutions must:
125.34 	(1) develop contracts specifying the terms, expectations, and outcomes of the clinical 
125.35 	training conducted at sites; and
126.1 	(2) take necessary action if the contract requirements are not met. Action may 
126.2 	include the withholding of payments under this section or the removal of students from 
126.3 	the site.
126.4 	(e)(d) Any funds not distributed in accordance with the commissioner's approval 
126.5 	letter must be returned to the medical education and research fund within 30 days of 
126.6 	receiving notice from the commissioner. The commissioner shall distribute returned funds 
126.7 	to the appropriate training sites in accordance with the commissioner's approval letter.
126.8 	(f)(e) A maximum of $150,000 of the funds dedicated to the commissioner 
126.9 	under section 297F.10, subdivision 1, clause (2), may be used by the commissioner for 
126.10 	administrative expenses associated with implementing this section.

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

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

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

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

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

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

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

127.2 	Sec. 7. Minnesota Statutes 2010, section 103I.005, subdivision 12, is amended to read:
127.3 		Subd. 12.Limited well/boring contractor. "Limited well/boring contractor" means 
127.4 	a person with a limited well/boring contractor's license issued by the commissioner. 
127.5 	Limited well/boring contractor's licenses are issued for constructing, repairing, and sealing 
127.6 	vertical bored geothermal heat exchangers; installing, repairing, and modifying pitless 
127.7 	units and pitless adaptors, well casings above the pitless unit or pitless adaptor, well 
127.8 	screens, or well diameters; constructing, repairing, and sealing drive point wells or dug 
127.9 	wells; constructing, repairing, and sealing dewatering wells; sealing wells; and installing 
127.10 	well pumps or pumping equipment.

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

127.12 	Sec. 8. Minnesota Statutes 2010, section 103I.101, subdivision 2, is amended to read:
127.13 		Subd. 2.Duties. The commissioner shall:
127.14 	(1) regulate the drilling, construction, modification, repair, and sealing of wells 
127.15 	and borings;
127.16 	(2) examine and license well contractors; persons constructing, repairing, and 
127.17 	sealing vertical bored geothermal heat exchangers; persons modifying or repairing well 
127.18 	casings, well screens, or well diameters; persons constructing, repairing, and sealing drive 
127.19 	point wells or dug wells; persons constructing, repairing, and sealing dewatering wells; 
127.20 	persons sealing wells; persons installing well pumps or pumping equipment; and persons 
127.21 	excavating or drilling holes for the installation ofconstructing, repairing, and sealing 
127.22 	elevator borings or hydraulic cylinders;
127.23 	(3) register and examine monitoring well contractors;
127.24 	(4) license explorers engaged in exploratory boring and examine individuals who 
127.25 	supervise or oversee exploratory boring;
127.26 	(5) after consultation with the commissioner of natural resources and the Pollution 
127.27 	Control Agency, establish standards for the design, location, construction, repair, and 
127.28 	sealing of wells and borings within the state; and
127.29 	(6) issue permits for wells, groundwater thermal devices, vertical bored geothermal
127.30 	heat exchangers, and elevator borings.

127.31 	Sec. 9. Minnesota Statutes 2010, section 103I.101, subdivision 5, is amended to read:
127.32 		Subd. 5.Commissioner to adopt rules. The commissioner shall adopt rules 
127.33 	including:
128.1 	(1) issuance of licenses for:
128.2 	(i) qualified well contractors, persons modifying or repairing well casings, well 
128.3 	screens, or well diameters;
128.4 	(ii) persons constructing, repairing, and sealing drive point wells or dug wells;
128.5 	(iii) persons constructing, repairing, and sealing dewatering wells;
128.6 	(iv) persons sealing wells;
128.7 	(v) persons installing well pumps or pumping equipment;
128.8 	(vi) persons constructing, repairing, and sealing vertical bored geothermal heat 
128.9 	exchangers; and
128.10 	(vii) persons constructing, repairing, and sealing elevator borings;
128.11 	(2) issuance of registration for monitoring well contractors;
128.12 	(3) establishment of conditions for examination and review of applications for 
128.13 	license and registration;
128.14 	(4) establishment of conditions for revocation and suspension of license and 
128.15 	registration;
128.16 	(5) establishment of minimum standards for design, location, construction, repair, 
128.17 	and sealing of wells and borings to implement the purpose and intent of this chapter;
128.18 	(6) establishment of a system for reporting on wells and borings drilled and sealed;
128.19 	(7) establishment of standards for the construction, maintenance, sealing, and water 
128.20 	quality monitoring of wells in areas of known or suspected contamination;
128.21 	(8) establishment of wellhead protection measures for wells serving public water 
128.22 	supplies;
128.23 	(9) establishment of procedures to coordinate collection of well and boring data with 
128.24 	other state and local governmental agencies;
128.25 	(10) establishment of criteria and procedures for submission of well and boring logs, 
128.26 	formation samples or well or boring cuttings, water samples, or other special information 
128.27 	required for and water resource mapping; and
128.28 	(11) establishment of minimum standards for design, location, construction, 
128.29 	maintenance, repair, sealing, safety, and resource conservation related to borings, 
128.30 	including exploratory borings as defined in section 103I.005, subdivision 9.

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

128.32 	Sec. 10. Minnesota Statutes 2010, section 103I.105, is amended to read:
128.33 	103I.105 ADVISORY COUNCIL ON WELLS AND BORINGS.
129.1 	(a) The Advisory Council on Wells and Borings is established as an advisory council 
129.2 	to the commissioner. The advisory council shall consist of 18 voting members. Of the 
129.3 	18 voting members:
129.4 	(1) one member must be from the Department of Health, appointed by the 
129.5 	commissioner of health;
129.6 	(2) one member must be from the Department of Natural Resources, appointed 
129.7 	by the commissioner of natural resources;
129.8 	(3) one member must be a member of the Minnesota Geological Survey of the 
129.9 	University of Minnesota, appointed by the director;
129.10 	(4) one member must be a responsible individual for a licensed explorer;
129.11 	(5) one member must be a certified representative of a licensed elevator boring 
129.12 	contractor;
129.13 	(6) two members must be members of the public who are not connected with the 
129.14 	boring or well drilling industry;
129.15 	(7) one member must be from the Pollution Control Agency, appointed by the 
129.16 	commissioner of the Pollution Control Agency;
129.17 	(8) one member must be from the Department of Transportation, appointed by the 
129.18 	commissioner of transportation;
129.19 	(9) one member must be from the Board of Water and Soil Resources appointed by 
129.20 	its chair;
129.21 	(10) one member must be a certified representative of a monitoring well contractor;
129.22 	(11) six members must be residents of this state appointed by the commissioner, who 
129.23 	are certified representatives of licensed well contractors, with not more than two from 
129.24 	the seven-county metropolitan area and at least four from other areas of the state who 
129.25 	represent different geographical regions; and
129.26 	(12) one member must be a certified representative of a licensed vertical bored 
129.27 	geothermal heat exchanger contractor.
129.28 	(b) An appointee of the well drilling industry may not serve more than two 
129.29 	consecutive terms.
129.30 	(c) The appointees to the advisory council from the well drilling industry must:
129.31 	(1) have been residents of this state for at least three years before appointment; and
129.32 	(2) have at least five years' experience in the well drilling business.
129.33 	(d) The terms of the appointed members and the compensation and removal of all 
129.34 	members are governed by section 15.059, except section 15.059, subdivision 5, relating to 
129.35 	expiration of the advisory council does not apply.

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

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

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

130.8 	Sec. 12. Minnesota Statutes 2010, section 103I.205, subdivision 4, is amended to read:
130.9 		Subd. 4.License required. (a) Except as provided in paragraph (b), (c), (d), or (e), 
130.10 	section 103I.401, subdivision 2, or section 103I.601, subdivision 2, a person may not 
130.11 	drill, construct, repair, or seal a well or boring unless the person has a well contractor's 
130.12 	license in possession.
130.13 	(b) A person may construct, repair, and seal a monitoring well if the person:
130.14 	(1) is a professional engineer licensed under sections 326.02 to 326.15 in the 
130.15 	branches of civil or geological engineering;
130.16 	(2) is a hydrologist or hydrogeologist certified by the American Institute of 
130.17 	Hydrology;
130.18 	(3) is a professional geoscientist licensed under sections 326.02 to 326.15;
130.19 	(4) is a geologist certified by the American Institute of Professional Geologists; or
130.20 	(5) meets the qualifications established by the commissioner in rule.
130.21 	A person must register with the commissioner as a monitoring well contractor on 
130.22 	forms provided by the commissioner.
130.23 	(c) A person may do the following work with a limited well/boring contractor's 
130.24 	license in possession. A separate license is required for each of the six activities:
130.25 	(1) installing or repairing well screens or pitless units or pitless adaptors and well 
130.26 	casings from the pitless adaptor or pitless unit to the upper termination of the well casing;
130.27 	(2) constructing, repairing, and sealing drive point wells or dug wells;
130.28 	(3) installing well pumps or pumping equipment;
130.29 	(4) sealing wells;
130.30 	(5) constructing, repairing, or sealing dewatering wells; or
130.31 	(6) constructing, repairing, or sealing vertical bored geothermal heat exchangers.
130.32 	(d) A person may construct, repair, and seal an elevator boring with an elevator 
130.33 	boring contractor's license.
131.1 	(e) Notwithstanding other provisions of this chapter requiring a license or 
131.2 	registration, a license or registration is not required for a person who complies with the 
131.3 	other provisions of this chapter if the person is:
131.4 	(1) an individual who constructs a well on land that is owned or leased by the 
131.5 	individual and is used by the individual for farming or agricultural purposes or as the 
131.6 	individual's place of abode; or
131.7 	(2) an individual who performs labor or services for a contractor licensed or 
131.8 	registered under the provisions of this chapter in connection with the construction, sealing, 
131.9 	or repair of a well or boring at the direction and under the personal supervision of a 
131.10 	contractor licensed or registered under the provisions of this chapter.

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

131.12 	Sec. 13. Minnesota Statutes 2010, section 103I.208, subdivision 2, is amended to read:
131.13 		Subd. 2.Permit fee. The permit fee to be paid by a property owner is:
131.14 	(1) for a water supply well that is not in use under a maintenance permit, $175 
131.15 	annually;
131.16 	(2) for construction of a monitoring well, $215, which includes the state core 
131.17 	function fee;
131.18 	(3) for a monitoring well that is unsealed under a maintenance permit, $175 annually;
131.19 	(4) for a monitoring well owned by a federal agency, state agency, or local unit of 
131.20 	government that is unsealed under a maintenance permit, $50 annually. "Local unit of 
131.21 	government" means a statutory or home rule charter city, town, county, or soil and water 
131.22 	conservation district, watershed district, an organization formed for the joint exercise of 
131.23 	powers under section 471.59, a board of health or community health board, or other 
131.24 	special purpose district or authority with local jurisdiction in water and related land 
131.25 	resources management;
131.26 	(5) for monitoring wells used as a leak detection device at a single motor fuel retail 
131.27 	outlet, a single petroleum bulk storage site excluding tank farms, or a single agricultural 
131.28 	chemical facility site, the construction permit fee is $215, which includes the state core 
131.29 	function fee, per site regardless of the number of wells constructed on the site, and 
131.30 	the annual fee for a maintenance permit for unsealed monitoring wells is $175 per site 
131.31 	regardless of the number of monitoring wells located on site;
131.32 	(6) for a groundwater thermal exchange device, in addition to the notification fee for 
131.33 	water supply wells, $215, which includes the state core function fee;
131.34 	(7) for a vertical bored geothermal heat exchanger with less than ten tons of 
131.35 	heating/cooling capacity, $215;
132.1 	(8) for a vertical bored geothermal heat exchanger with ten to 50 tons of 
132.2 	heating/cooling capacity, $425;
132.3 	(9) for a vertical bored geothermal heat exchanger with greater than 50 tons of 
132.4 	heating/cooling capacity, $650;
132.5 	(10) for a dewatering well that is unsealed under a maintenance permit, $175 
132.6 	annually for each dewatering well, except a dewatering project comprising more than five 
132.7 	dewatering wells shall be issued a single permit for $875 annually for dewatering wells 
132.8 	recorded on the permit; and
132.9 	(11) for an elevator boring, $215 for each boring.

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

132.11 	Sec. 14. Minnesota Statutes 2010, section 103I.501, is amended to read:
132.12 	103I.501 LICENSING AND REGULATION OF WELLS AND BORINGS.
132.13 	(a) The commissioner shall regulate and license:
132.14 	(1) drilling, constructing, and repair of wells;
132.15 	(2) sealing of wells;
132.16 	(3) installing of well pumps and pumping equipment;
132.17 	(4) excavating, drilling, repairing, and sealing of elevator borings;
132.18 	(5) construction, repair, and sealing of environmental bore holes; and
132.19 	(6) construction, repair, and sealing of vertical bored geothermal heat exchangers.
132.20 	(b) The commissioner shall examine and license well contractors, limited 
132.21 	well/boring contractors, and elevator boring contractors, and examine and register 
132.22 	monitoring well contractors.
132.23 	(c) The commissioner shall license explorers engaged in exploratory boring and 
132.24 	shall examine persons who supervise or oversee exploratory boring.

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

132.26 	Sec. 15. Minnesota Statutes 2010, section 103I.531, subdivision 5, is amended to read:
132.27 		Subd. 5.Bond. (a) As a condition of being issued a limited well/boring contractor's 
132.28 	license for constructing, repairing, and sealing drive point wells or dug wells, sealing 
132.29 	wells or borings, constructing, repairing, and sealing dewatering wells, or constructing, 
132.30 	repairing, and sealing vertical bored geothermal heat exchangers, the applicant must 
132.31 	submit a corporate surety bond for $10,000 approved by the commissioner. As a condition 
132.32 	of being issued a limited well/boring contractor's license for installing or repairing well 
132.33 	screens or pitless units or pitless adaptors and well casings from the pitless adaptor 
133.1 	or pitless unit to the upper termination of the well casing, or installing well pumps or 
133.2 	pumping equipment, the applicant must submit a corporate surety bond for $2,000 
133.3 	approved by the commissioner. The bonds required in this paragraph must be conditioned 
133.4 	to pay the state on performance of work in this state that is not in compliance with this 
133.5 	chapter or rules adopted under this chapter. The bonds are in lieu of other license bonds 
133.6 	required by a political subdivision of the state.
133.7 	(b) From proceeds of a bond required in paragraph (a), the commissioner may 
133.8 	compensate persons injured or suffering financial loss because of a failure of the applicant 
133.9 	to perform work or duties in compliance with this chapter or rules adopted under this 
133.10 	chapter.

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

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

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

133.15 	Sec. 17. Minnesota Statutes 2010, section 103I.641, is amended to read:
133.16 	103I.641 VERTICAL BORED GEOTHERMAL HEAT EXCHANGERS.
133.17 		Subdivision 1.Requirements. A person may not drill or construct an excavation 
133.18 	used to install a vertical bored geothermal heat exchanger unless the person is a limited 
133.19 	well/boring contractor licensed for constructing, repairing, and sealing vertical bored 
133.20 	geothermal heat exchangers or a well contractor.
133.21 		Subd. 2.Regulations for vertical bored geothermal heat exchangers. Vertical
133.22 	Bored geothermal heat exchangers must be constructed, maintained, and sealed under the 
133.23 	provisions of this chapter.
133.24 		Subd. 3.Permit required. (a) A vertical bored geothermal heat exchanger 
133.25 	may not be installed without first obtaining a permit for the vertical bored geothermal
133.26 	heat exchanger from the commissioner. A limited well/boring contractor licensed for 
133.27 	constructing, repairing, and sealing vertical bored geothermal heat exchangers or a well 
133.28 	contractor must apply for the permit on forms provided by the commissioner and must 
133.29 	pay the permit fee.
133.30 	(b) As a condition of the permit, the owner of the property where the vertical
133.31 	bored geothermal heat exchanger is to be installed must agree to allow inspection by the 
133.32 	commissioner during regular working hours of Department of Health inspectors.

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

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

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

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

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

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

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

135.21 	Sec. 22. Minnesota Statutes 2010, section 144.128, is amended to read:
135.22 	144.128 COMMISSIONER'S DUTIES; STORED BLOOD AND TISSUE 
135.23 	SAMPLES.
135.24 	The commissioner shall:
135.25 	(1) notify the physicians of newborns tested of the results of the tests performed;
135.26 	(2) make referrals for the necessary treatment of diagnosed cases of heritable and 
135.27 	congenital disorders when treatment is indicated;
135.28 	(3) maintain a registry of the cases of heritable and congenital disorders detected by 
135.29 	the screening program for the purpose of follow-up services;
135.30 	(4) prepare a separate form for use by parents or by adults who were tested as minors 
135.31 	to direct that blood samples and test results be destroyed;
135.32 	(5) comply with a destruction request within 45 days after receiving it;
135.33 	(6) notify individuals who request destruction of samples and test results that the 
135.34 	samples and test results have been destroyed; and
136.1 	(7) adopt rules to carry out sections 144.125 to 144.128.
136.2 	(3) destroy blood or tissue samples obtained from test results immediately after 
136.3 	completion of the test results, unless the parent of the newborn tested elects under section 
136.4 	144.125, subdivision 3, to retain the results, in which case the test results may be retained 
136.5 	for up to 24 months; and
136.6 	(4) destroy all blood or tissue samples and material and records related to stored 
136.7 	samples that were collected and stored by the commissioner before August 1, 2011.

136.8 	Sec. 23. Minnesota Statutes 2010, section 144.396, subdivision 5, is amended to read:
136.9 		Subd. 5.Statewide tobacco prevention grants. (a) To the extent funds are 
136.10 	appropriated for the purposes of this subdivision, the commissioner of health shall
136.11 	may, within available appropriations, award competitive grants to eligible applicants 
136.12 	for projects and initiatives directed at the prevention of tobacco use. The project areas 
136.13 	for grants include:
136.14 	(1) statewide public education and information campaigns which include 
136.15 	implementation at the local level; and
136.16 	(2) coordinated special projects, including training and technical assistance, a 
136.17 	resource clearinghouse, and contracts with ethnic and minority communities.
136.18 	(b) Eligible applicants may include, but are not limited to, nonprofit organizations, 
136.19 	colleges and universities, professional health associations, community health boards, and 
136.20 	other health care organizations. Applicants must submit proposals to the commissioner. 
136.21 	The proposals must specify the strategies to be implemented to target tobacco use among 
136.22 	youth, and must take into account the need for a coordinated statewide tobacco prevention 
136.23 	effort.
136.24 	(c) The commissioner must give priority to applicants who demonstrate that the 
136.25 	proposed project:
136.26 	(1) is research based or based on proven effective strategies;
136.27 	(2) is designed to coordinate with other activities and education messages related 
136.28 	to other health initiatives;
136.29 	(3) utilizes and enhances existing prevention activities and resources; or
136.30 	(4) involves innovative approaches preventing tobacco use among youth.

136.31 	Sec. 24. Minnesota Statutes 2010, section 144.396, subdivision 6, is amended to read:
136.32 		Subd. 6.Local tobacco prevention grants. (a) The commissioner shall award 
136.33 	grants, within available appropriations, to eligible applicants for local and regional 
136.34 	projects and initiatives directed at tobacco prevention in coordination with other health 
137.1 	areas aimed at reducing high-risk behaviors in youth that lead to adverse health-related 
137.2 	problems. The project areas for grants include:
137.3 	(1) school-based tobacco prevention programs aimed at youth and parents;
137.4 	(2) local public awareness and education projects aimed at tobacco prevention in 
137.5 	coordination with locally assessed community public health needs pursuant to chapter 
137.6 	145A; or
137.7 	(3) local initiatives aimed at reducing high-risk behavior in youth associated with 
137.8 	tobacco use and the health consequences of these behaviors.
137.9 	(b) Eligible applicants may include, but are not limited to, community health boards, 
137.10 	school districts, community clinics, Indian tribes, nonprofit organizations, and other health 
137.11 	care organizations. Applicants must submit proposals to the commissioner. The proposals 
137.12 	must specify the strategies to be implemented to target tobacco use among youth, and must 
137.13 	be targeted to achieve the outcomes established in subdivision 2.
137.14 	(c) The commissioner must give priority to applicants who demonstrate that the 
137.15 	proposed project or initiative is:
137.16 	(1) supported by the community in which the applicant serves;
137.17 	(2) is based on research or on proven effective strategies;
137.18 	(3) is designed to coordinate with other community activities related to other health 
137.19 	initiatives;
137.20 	(4) incorporates an understanding of the role of community in influencing behavioral 
137.21 	changes among youth regarding tobacco use and other high-risk health-related behaviors; 
137.22 	or
137.23 	(5) addresses disparities among populations of color related to tobacco use and 
137.24 	other high-risk health-related behaviors.
137.25 	(d) The commissioner shall divide the state into specific geographic regions and 
137.26 	allocate a percentage of the money available for distribution to projects or initiatives 
137.27 	aimed at that geographic region. If the commissioner does not receive a sufficient number 
137.28 	of grant proposals from applicants that serve a particular region or the proposals submitted 
137.29 	do not meet the criteria developed by the commissioner, the commissioner shall provide 
137.30 	technical assistance and expertise to ensure the development of adequate proposals 
137.31 	aimed at addressing the public health needs of that region. In awarding the grants, the 
137.32 	commissioner shall consider locally assessed community public health needs pursuant to 
137.33 	chapter 145A.

137.34 	Sec. 25. [145.4221] HUMAN CLONING PROHIBITED.
138.1 		Subdivision 1.Definitions. (a) For purposes of this section, the following terms 
138.2 	have the meanings given.
138.3 	(b) "Human cloning" means human asexual reproduction accomplished by 
138.4 	introducing nuclear material from one or more human somatic cells into a fertilized 
138.5 	or unfertilized oocyte whose nuclear material has been removed or inactivated so as 
138.6 	to produce a living organism at any stage of development that is genetically virtually 
138.7 	identical to an existing or previously existing human organism.
138.8 	(c) "Somatic cell" means a diploid cell, having a complete set of chromosomes, 
138.9 	obtained or derived from a living or deceased human body at any stage of development.
138.10 		Subd. 2.Prohibition on cloning. No person or entity, whether public or private, 
138.11 	may:
138.12 	(1) perform or attempt to perform human cloning;
138.13 	(2) participate in an attempt to perform human cloning;
138.14 	(3) ship, import, or receive for any purpose an embryo produced by human cloning 
138.15 	or any product derived from such an embryo; or 
138.16 	(4) ship or receive, in whole or in part, any oocyte, embryo, fetus, or human somatic 
138.17 	cell, for the purpose of human cloning.
138.18 		Subd. 3.Scientific research. Nothing in this section shall restrict areas of scientific 
138.19 	research not specifically prohibited by this section, including research in the use of nuclear 
138.20 	transfer or other cloning techniques to produce molecules, DNA, cells other than human 
138.21 	embryos, tissues, organs, plants, or animals other than humans. In addition, nothing in this 
138.22 	section shall restrict, inhibit, or make unlawful the scientific field of stem cell research, 
138.23 	unless explicitly prohibited.
138.24 		Subd. 4.Penalties. Any person or entity that knowingly or recklessly violates 
138.25 	subdivision 2 is guilty of a misdemeanor.
138.26 		Subd. 5.Severability. If any provision, section, subdivision, sentence, clause, 
138.27 	phrase, or word in this section or the application thereof to any person or circumstance is 
138.28 	found to be unconstitutional, the same is hereby declared to be severable and the remainder 
138.29 	of this section shall remain effective notwithstanding such unconstitutional provision. The 
138.30 	legislature declares that it would have passed this section and each provision, subdivision, 
138.31 	sentence, clause, phrase, or word thereof, regardless of the fact that any provision, section, 
138.32 	subdivision, sentence, clause, phrase, or word is declared unconstitutional.

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

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

139.4 	Sec. 27. Minnesota Statutes 2010, section 145.928, subdivision 7, is amended to read:
139.5 		Subd. 7.Community grant program; immunization rates and infant mortality 
139.6 	rates. (a) The commissioner shallmay, within available appropriations, award grants to 
139.7 	eligible applicants for local or regional projects and initiatives directed at reducing health 
139.8 	disparities in one or both of the following priority areas:
139.9 	(1) decreasing racial and ethnic disparities in infant mortality rates; or
139.10 	(2) increasing adult and child immunization rates in nonwhite racial and ethnic 
139.11 	populations.
139.12 	(b) The commissioner may award up to 20 percent of the funds available as planning 
139.13 	grants. Planning grants must be used to address such areas as community assessment, 
139.14 	coordination activities, and development of community supported strategies.
139.15 	(c) Eligible applicants may include, but are not limited to, faith-based organizations, 
139.16 	social service organizations, community nonprofit organizations, community health 
139.17 	boards, tribal governments, and community clinics. Applicants must submit proposals to 
139.18 	the commissioner. A proposal must specify the strategies to be implemented to address 
139.19 	one or both of the priority areas listed in paragraph (a) and must be targeted to achieve the 
139.20 	outcomes established according to subdivision 3.
139.21 	(d) The commissioner shall give priority to applicants who demonstrate that their 
139.22 	proposed project or initiative:
139.23 	(1) is supported by the community the applicant will serve;
139.24 	(2) is research-based or based on promising strategies;
139.25 	(3) is designed to complement other related community activities;
139.26 	(4) utilizes strategies that positively impact both priority areas;
139.27 	(5) reflects racially and ethnically appropriate approaches; and
139.28 	(6) will be implemented through or with community-based organizations that reflect 
139.29 	the race or ethnicity of the population to be reached.

139.30 	Sec. 28. Minnesota Statutes 2010, section 145.928, subdivision 8, is amended to read:
139.31 		Subd. 8.Community grant program; other health disparities. (a) The 
139.32 	commissioner shallmay, within available appropriations, award grants to eligible 
139.33 	applicants for local or regional projects and initiatives directed at reducing health 
139.34 	disparities in one or more of the following priority areas:
140.1 	(1) decreasing racial and ethnic disparities in morbidity and mortality rates from 
140.2 	breast and cervical cancer;
140.3 	(2) decreasing racial and ethnic disparities in morbidity and mortality rates from 
140.4 	HIV/AIDS and sexually transmitted infections;
140.5 	(3) decreasing racial and ethnic disparities in morbidity and mortality rates from 
140.6 	cardiovascular disease;
140.7 	(4) decreasing racial and ethnic disparities in morbidity and mortality rates from 
140.8 	diabetes; or
140.9 	(5) decreasing racial and ethnic disparities in morbidity and mortality rates from 
140.10 	accidental injuries or violence.
140.11 	(b) The commissioner may award up to 20 percent of the funds available as planning 
140.12 	grants. Planning grants must be used to address such areas as community assessment, 
140.13 	determining community priority areas, coordination activities, and development of 
140.14 	community supported strategies.
140.15 	(c) Eligible applicants may include, but are not limited to, faith-based organizations, 
140.16 	social service organizations, community nonprofit organizations, community health 
140.17 	boards, and community clinics. Applicants shall submit proposals to the commissioner. 
140.18 	A proposal must specify the strategies to be implemented to address one or more of 
140.19 	the priority areas listed in paragraph (a) and must be targeted to achieve the outcomes 
140.20 	established according to subdivision 3.
140.21 	(d) The commissioner shall give priority to applicants who demonstrate that their 
140.22 	proposed project or initiative:
140.23 	(1) is supported by the community the applicant will serve;
140.24 	(2) is research-based or based on promising strategies;
140.25 	(3) is designed to complement other related community activities;
140.26 	(4) utilizes strategies that positively impact more than one priority area;
140.27 	(5) reflects racially and ethnically appropriate approaches; and
140.28 	(6) will be implemented through or with community-based organizations that reflect 
140.29 	the race or ethnicity of the population to be reached.

140.30 	Sec. 29. Minnesota Statutes 2010, section 297F.10, subdivision 1, is amended to read:
140.31 		Subdivision 1.Tax and use tax on cigarettes. Revenue received from cigarette 
140.32 	taxes, as well as related penalties, interest, license fees, and miscellaneous sources of 
140.33 	revenue shall be deposited by the commissioner in the state treasury and credited as 
140.34 	follows:
141.1 	(1) $22,220,000 for fiscal year 2006 and $22,250,000 for fiscal year 2007 and each 
141.2 	year thereafter must be credited to the Academic Health Center special revenue fund 
141.3 	hereby created and is annually appropriated to the Board of Regents at the University of 
141.4 	Minnesota for Academic Health Center funding at the University of Minnesota; and
141.5 	(2) $8,553,000 for fiscal year 2006 and $8,550,000 for fiscal yearyears 2007 and 
141.6 	each year thereafterthrough fiscal year 2012 and $3,937,000 each year thereafter must be 
141.7 	credited to the medical education and research costs account hereby created in the special 
141.8 	revenue fund and is annually appropriated to the commissioner of health for distribution 
141.9 	under section 62J.692, subdivision 4; and
141.10 	(3) the balance of the revenues derived from taxes, penalties, and interest (under 
141.11 	this chapter) and from license fees and miscellaneous sources of revenue shall be credited 
141.12 	to the general fund.

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

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

141.17 	Sec. 31.  REPEALER.
 141.18 	(a) Minnesota Statutes 2010, sections 144.1464; 144.147; 144.1487; 144.1488, 
141.19 	subdivisions 1, 3, and 4; 144.1489; 144.1490; 144.1491; 144.1499; 144.1501; 144.6062; 
141.20 	145.925; 145A.14, subdivisions 1 and 2a, are repealed.
141.21 	(b) Minnesota Statutes 2010, sections 62J.17, subdivisions 1, 3, 5a, 6a, and 8; 
141.22 	62J.321, subdivision 5a; 62J.381; 62J.41, subdivisions 1 and 2; and 103I.005, subdivision 
141.23 	20, are repealed effective July 1, 2011.
141.24 	(c) Minnesota Rules, parts 4651.0100, subparts 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 
141.25 	14, 15, 16, 16a, 18, 19, 20, 20a, 21, 22, and 23; 4651.0110, subparts 2, 2a, 3, 4, and 5; 
141.26 	4651.0120; 4651.0130; 4651.0140; and 4651.0150, are repealed effective July 1, 2011.

141.27 	ARTICLE 7
141.28 	HEALTH LICENSING BOARDS

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

142.1 	Sec. 2. Minnesota Statutes 2010, section 148.191, subdivision 2, is amended to read:
142.2 		Subd. 2.Powers. (a) The board is authorized to adopt and, from time to time, revise 
142.3 	rules not inconsistent with the law, as may be necessary to enable it to carry into effect the 
142.4 	provisions of sections 148.171 to 148.285. The board shall prescribe by rule curricula 
142.5 	and standards for schools and courses preparing persons for licensure under sections 
142.6 	148.171 to 148.285. It shall conduct or provide for surveys of such schools and courses 
142.7 	at such times as it may deem necessary. It shall approve such schools and courses as 
142.8 	meet the requirements of sections 148.171 to 148.285 and board rules. It shall examine, 
142.9 	license, and renew the license of duly qualified applicants. It shall hold examinations 
142.10 	at least once in each year at such time and place as it may determine. It shall by rule 
142.11 	adopt, evaluate, and periodically revise, as necessary, requirements for licensure and for 
142.12 	registration and renewal of registration as defined in section 148.231. It shall maintain a 
142.13 	record of all persons licensed by the board to practice professional or practical nursing and 
142.14 	all registered nurses who hold Minnesota licensure and registration and are certified as 
142.15 	advanced practice registered nurses. It shall cause the prosecution of all persons violating 
142.16 	sections 148.171 to 148.285 and have power to incur such necessary expense therefor. 
142.17 	It shall register public health nurses who meet educational and other requirements 
142.18 	established by the board by rule, including payment of a fee. Prior to the adoption of rules, 
142.19 	the board shall use the same procedures used by the Department of Health to certify public 
142.20 	health nurses. It shall have power to issue subpoenas, and to compel the attendance of 
142.21 	witnesses and the production of all necessary documents and other evidentiary material. 
142.22 	Any board member may administer oaths to witnesses, or take their affirmation. It shall 
142.23 	keep a record of all its proceedings. 
142.24 	(b) The board shall have access to hospital, nursing home, and other medical records 
142.25 	of a patient cared for by a nurse under review. If the board does not have a written consent 
142.26 	from a patient permitting access to the patient's records, the nurse or facility shall delete 
142.27 	any data in the record that identifies the patient before providing it to the board. The board 
142.28 	shall have access to such other records as reasonably requested by the board to assist the 
142.29 	board in its investigation. Nothing herein may be construed to allow access to any records 
142.30 	protected by section 145.64. The board shall maintain any records obtained pursuant to 
142.31 	this paragraph as investigative data under chapter 13. 
142.32 	(c) The board may accept and expend grants or gifts of money or in-kind services 
142.33 	from a person, a public or private entity, or any other source for purposes consistent with 
142.34 	the board's role and within the scope of its statutory authority.
142.35 	(d) The board may accept registration fees for meetings and conferences conducted 
142.36 	for the purposes of board activities that are within the scope of its authority.

143.1 	Sec. 3. Minnesota Statutes 2010, section 148.212, subdivision 1, is amended to read:
143.2 		Subdivision 1.Issuance. Upon receipt of the applicable licensure or reregistration 
143.3 	fee and permit fee, and in accordance with rules of the board, the board may issue 
143.4 	a nonrenewable temporary permit to practice professional or practical nursing to an 
143.5 	applicant for licensure or reregistration who is not the subject of a pending investigation 
143.6 	or disciplinary action, nor disqualified for any other reason, under the following 
143.7 	circumstances:
143.8 	(a) The applicant for licensure by examination under section 148.211, subdivision 
143.9 	1, has graduated from an approved nursing program within the 60 days preceding board 
143.10 	receipt of an affidavit of graduation or transcript and has been authorized by the board to 
143.11 	write the licensure examination for the first time in the United States. The permit holder 
143.12 	must practice professional or practical nursing under the direct supervision of a registered 
143.13 	nurse. The permit is valid from the date of issue until the date the board takes action on 
143.14 	the application or for 60 days whichever occurs first. 
143.15 	(b) The applicant for licensure by endorsement under section 148.211, subdivision 2, 
143.16 	is currently licensed to practice professional or practical nursing in another state, territory, 
143.17 	or Canadian province. The permit is valid from submission of a proper request until the 
143.18 	date of board action on the application or for 60 days, whichever comes first. 
143.19 	(c) (b) The applicant for licensure by endorsement under section 148.211, 
143.20 	subdivision 2, or for reregistration under section 148.231, subdivision 5, is currently 
143.21 	registered in a formal, structured refresher course or its equivalent for nurses that includes 
143.22 	clinical practice. 
143.23 	(d) The applicant for licensure by examination under section 148.211, subdivision 
143.24 	1, who graduated from a nursing program in a country other than the United States or 
143.25 	Canada has completed all requirements for licensure except registering for and taking the 
143.26 	nurse licensure examination for the first time in the United States. The permit holder must 
143.27 	practice professional nursing under the direct supervision of a registered nurse. The permit 
143.28 	is valid from the date of issue until the date the board takes action on the application or for 
143.29 	60 days, whichever occurs first. 

143.30 	Sec. 4. Minnesota Statutes 2010, section 148.231, is amended to read:
143.31 	148.231 REGISTRATION; FAILURE TO REGISTER; REREGISTRATION; 
143.32 	VERIFICATION.
143.33 		Subdivision 1.Registration. Every person licensed to practice professional or 
143.34 	practical nursing must maintain with the board a current registration for practice as a 
143.35 	registered nurse or licensed practical nurse which must be renewed at regular intervals 
144.1 	established by the board by rule. No certificate of registration shall be issued by the board 
144.2 	to a nurse until the nurse has submitted satisfactory evidence of compliance with the 
144.3 	procedures and minimum requirements established by the board.
144.4 	The fee for periodic registration for practice as a nurse shall be determined by the 
144.5 	board by rule law. A penalty fee shall be added for any application received after the 
144.6 	required date as specified by the board by rule. Upon receipt of the application and the 
144.7 	required fees, the board shall verify the application and the evidence of completion of 
144.8 	continuing education requirements in effect, and thereupon issue to the nurse a certificate 
144.9 	of registration for the next renewal period.
144.10 		Subd. 4.Failure to register. Any person licensed under the provisions of sections 
144.11 	148.171 to 148.285 who fails to register within the required period shall not be entitled to 
144.12 	practice nursing in this state as a registered nurse or licensed practical nurse. 
144.13 		Subd. 5.Reregistration. A person whose registration has lapsed desiring to 
144.14 	resume practice shall make application for reregistration, submit satisfactory evidence of 
144.15 	compliance with the procedures and requirements established by the board, and pay the 
144.16 	registration reregistration fee for the current period to the board. A penalty fee shall be 
144.17 	required from a person who practiced nursing without current registration. Thereupon, the
144.18 	registration certificate shall be issued to the person who shall immediately be placed on 
144.19 	the practicing list as a registered nurse or licensed practical nurse.
144.20 		Subd. 6.Verification. A person licensed under the provisions of sections 148.171 to 
144.21 	148.285 who requests the board to verify a Minnesota license to another state, territory, 
144.22 	or country or to an agency, facility, school, or institution shall pay a fee to the board
144.23 	for each verification. 

144.24 	Sec. 5. [148.243] FEE AMOUNTS.
144.25 		Subdivision 1.Licensure by examination. The fee for licensure by examination is 
144.26 	$105.
144.27 		Subd. 2.Reexamination fee. The reexamination fee is $60.
144.28 		Subd. 3.Licensure by endorsement. The fee for licensure by endorsement is $105.
144.29 		Subd. 4.Registration renewal. The fee for registration renewal is $85.
144.30 		Subd. 5.Reregistration. The fee for reregistration is $105.
144.31 		Subd. 6.Replacement license. The fee for a replacement license is $20.
144.32 		Subd. 7.Public health nurse certification. The fee for public health nurse 
144.33 	certification is $30.
145.1 		Subd. 8.Drug Enforcement Administration verification for Advanced Practice 
145.2 	Registered Nurse (APRN). The Drug Enforcement Administration verification for 
145.3 	APRN is $50.
145.4 		Subd. 9.Licensure verification other than through Nursys. The fee for 
145.5 	verification of licensure status other than through Nursys verification is $20.
145.6 		Subd. 10.Verification of examination scores. The fee for verification of 
145.7 	examination scores is $20.
145.8 		Subd. 11.Microfilmed licensure application materials. The fee for a copy of 
145.9 	microfilmed licensure application materials is $20.
145.10 		Subd. 12.Nursing business registration; initial application. The fee for the initial 
145.11 	application for nursing business registration is $100.
145.12 		Subd. 13.Nursing business registration; annual application. The fee for the 
145.13 	annual application for nursing business registration is $25.
145.14 		Subd. 14.Practicing without current registration. The fee for practicing without 
145.15 	current registration is two times the amount of the current registration renewal fee for any 
145.16 	part of the first calendar month, plus the current registration renewal fee for any part of 
145.17 	any subsequent month up to 24 months.
145.18 		Subd. 15.Practicing without current APRN certification. The fee for practicing 
145.19 	without current APRN certification is $200 for the first month or any part thereof, plus 
145.20 	$100 for each subsequent month or part thereof.
145.21 		Subd. 16.Dishonored check fee. The service fee for a dishonored check is as 
145.22 	provided in section 604.113.
145.23 		Subd. 17.Border state registry fee. The initial application fee for border state 
145.24 	registration is $50. Any subsequent notice of employment change to remain or be 
145.25 	reinstated on the registry is $50.

145.26 	Sec. 6. [148.2855] NURSE LICENSURE COMPACT.
145.27 	The Nurse Licensure Compact is enacted into law and entered into with all other 
145.28 	jurisdictions legally joining in it, in the form substantially as follows:
145.29 	ARTICLE 1
145.30 	DEFINITIONS
145.31 	As used in this compact:
145.32 	(a) "Adverse action" means a home or remote state action.
145.33 	(b) "Alternative program" means a voluntary, nondisciplinary monitoring program 
145.34 	approved by a nurse licensing board.
146.1 	(c) "Coordinated licensure information system" means an integrated process for 
146.2 	collecting, storing, and sharing information on nurse licensure and enforcement activities 
146.3 	related to nurse licensure laws, which is administered by a nonprofit organization 
146.4 	composed of and controlled by state nurse licensing boards.
146.5 	(d) "Current significant investigative information" means:
146.6 	(1) investigative information that a licensing board, after a preliminary inquiry that 
146.7 	includes notification and an opportunity for the nurse to respond if required by state law, 
146.8 	has reason to believe is not groundless and, if proved true, would indicate more than a 
146.9 	minor infraction; or
146.10 	(2) investigative information that indicates that the nurse represents an immediate 
146.11 	threat to public health and safety regardless of whether the nurse has been notified and 
146.12 	had an opportunity to respond.
146.13 	(e) "Home state" means the party state which is the nurse's primary state of residence.
146.14 	(f) "Home state action" means any administrative, civil, equitable, or criminal 
146.15 	action permitted by the home state's laws which are imposed on a nurse by the home 
146.16 	state's licensing board or other authority including actions against an individual's license 
146.17 	such as revocation, suspension, probation, or any other action which affects a nurse's 
146.18 	authorization to practice.
146.19 	(g) "Licensing board" means a party state's regulatory body responsible for issuing 
146.20 	nurse licenses.
146.21 	(h) "Multistate licensure privilege" means current, official authority from a 
146.22 	remote state permitting the practice of nursing as either a registered nurse or a licensed 
146.23 	practical/vocational nurse in the party state. All party states have the authority, according 
146.24 	to existing state due process law, to take actions against the nurse's privilege such as 
146.25 	revocation, suspension, probation, or any other action which affects a nurse's authorization 
146.26 	to practice.
146.27 	(i) "Nurse" means a registered nurse or licensed practical/vocational nurse as those 
146.28 	terms are defined by each party state's practice laws.
146.29 	(j) "Party state" means any state that has adopted this compact.
146.30 	(k) "Remote state" means a party state other than the home state:
146.31 	(1) where the patient is located at the time nursing care is provided; or
146.32 	(2) in the case of the practice of nursing not involving a patient, in the party state 
146.33 	where the recipient of nursing practice is located.
146.34 	(l) "Remote state action" means:
146.35 	(1) any administrative, civil, equitable, or criminal action permitted by a remote 
146.36 	state's laws which are imposed on a nurse by the remote state's licensing board or other 
147.1 	authority including actions against an individual's multistate licensure privilege to practice 
147.2 	in the remote state; and
147.3 	(2) cease and desist and other injunctive or equitable orders issued by remote states 
147.4 	or the licensing boards of those states.
147.5 	(m) "State" means a state, territory, or possession of the United States, the District of 
147.6 	Columbia, or the Commonwealth of Puerto Rico.
147.7 	(n) "State practice laws" means individual party state laws and regulations that 
147.8 	govern the practice of nursing, define the scope of nursing practice, and create the 
147.9 	methods and grounds for imposing discipline. State practice laws does not include the 
147.10 	initial qualifications for licensure or requirements necessary to obtain and retain a license, 
147.11 	except for qualifications or requirements of the home state.
147.12 	ARTICLE 2
147.13 	GENERAL PROVISIONS AND JURISDICTION
147.14 	(a) A license to practice registered nursing issued by a home state to a resident in 
147.15 	that state will be recognized by each party state as authorizing a multistate licensure 
147.16 	privilege to practice as a registered nurse in the party state. A license to practice licensed 
147.17 	practical/vocational nursing issued by a home state to a resident in that state will be 
147.18 	recognized by each party state as authorizing a multistate licensure privilege to practice 
147.19 	as a licensed practical/vocational nurse in the party state. In order to obtain or retain a 
147.20 	license, an applicant must meet the home state's qualifications for licensure and license 
147.21 	renewal as well as all other applicable state laws.
147.22 	(b) Party states may, according to state due process laws, limit or revoke the 
147.23 	multistate licensure privilege of any nurse to practice in their state and may take any other 
147.24 	actions under their applicable state laws necessary to protect the health and safety of 
147.25 	their citizens. If a party state takes such action, it shall promptly notify the administrator 
147.26 	of the coordinated licensure information system. The administrator of the coordinated 
147.27 	licensure information system shall promptly notify the home state of any such actions by 
147.28 	remote states.
147.29 	(c) Every nurse practicing in a party state must comply with the state practice laws of 
147.30 	the state in which the patient is located at the time care is rendered. In addition, the practice 
147.31 	of nursing is not limited to patient care, but shall include all nursing practice as defined by 
147.32 	the state practice laws of the party state. The practice of nursing will subject a nurse to the 
147.33 	jurisdiction of the nurse licensing board, the courts, and the laws in the party state.
147.34 	(d) This compact does not affect additional requirements imposed by states for 
147.35 	advanced practice registered nursing. However, a multistate licensure privilege to practice 
147.36 	registered nursing granted by a party state shall be recognized by other party states as a 
148.1 	license to practice registered nursing if one is required by state law as a precondition for 
148.2 	qualifying for advanced practice registered nurse authorization.
148.3 	(e) Individuals not residing in a party state shall continue to be able to apply for 
148.4 	nurse licensure as provided for under the laws of each party state. However, the license 
148.5 	granted to these individuals will not be recognized as granting the privilege to practice 
148.6 	nursing in any other party state unless explicitly agreed to by that party state.
148.7 	ARTICLE 3
148.8 	APPLICATIONS FOR LICENSURE IN A PARTY STATE
148.9 	(a) Upon application for a license, the licensing board in a party state shall ascertain, 
148.10 	through the coordinated licensure information system, whether the applicant has ever held 
148.11 	or is the holder of a license issued by any other state, whether there are any restrictions 
148.12 	on the multistate licensure privilege, and whether any other adverse action by a state 
148.13 	has been taken against the license.
148.14 	(b) A nurse in a party state shall hold licensure in only one party state at a time, 
148.15 	issued by the home state.
148.16 	(c) A nurse who intends to change primary state of residence may apply for licensure 
148.17 	in the new home state in advance of the change. However, new licenses will not be 
148.18 	issued by a party state until after a nurse provides evidence of change in primary state of 
148.19 	residence satisfactory to the new home state's licensing board.
148.20 	(d) When a nurse changes primary state of residence by:
148.21 	(1) moving between two party states, and obtains a license from the new home state, 
148.22 	the license from the former home state is no longer valid;
148.23 	(2) moving from a nonparty state to a party state, and obtains a license from the new 
148.24 	home state, the individual state license issued by the nonparty state is not affected and will 
148.25 	remain in full force if so provided by the laws of the nonparty state; or
148.26 	(3) moving from a party state to a nonparty state, the license issued by the prior 
148.27 	home state converts to an individual state license, valid only in the former home state, 
148.28 	without the multistate licensure privilege to practice in other party states.
148.29 	ARTICLE 4
148.30 	ADVERSE ACTIONS
148.31 	In addition to the general provisions described in article 2, the provisions in this 
148.32 	article apply.
148.33 	(a) The licensing board of a remote state shall promptly report to the administrator 
148.34 	of the coordinated licensure information system any remote state actions including the 
148.35 	factual and legal basis for the action, if known. The licensing board of a remote state shall 
148.36 	also promptly report any significant current investigative information yet to result in a 
149.1 	remote state action. The administrator of the coordinated licensure information system 
149.2 	shall promptly notify the home state of any reports.
149.3 	(b) The licensing board of a party state shall have the authority to complete any 
149.4 	pending investigation for a nurse who changes primary state of residence during the 
149.5 	course of the investigation. The board shall also have the authority to take appropriate 
149.6 	action, and shall promptly report the conclusion of the investigation to the administrator 
149.7 	of the coordinated licensure information system. The administrator of the coordinated 
149.8 	licensure information system shall promptly notify the new home state of any action.
149.9 	(c) A remote state may take adverse action affecting the multistate licensure 
149.10 	privilege to practice within that party state. However, only the home state shall have the 
149.11 	power to impose adverse action against the license issued by the home state.
149.12 	(d) For purposes of imposing adverse actions, the licensing board of the home state 
149.13 	shall give the same priority and effect to reported conduct received from a remote state as 
149.14 	it would if the conduct had occurred within the home state. In so doing, it shall apply its 
149.15 	own state laws to determine appropriate action.
149.16 	(e) The home state may take adverse action based on the factual findings of the 
149.17 	remote state, provided each state follows its own procedures for imposing the adverse 
149.18 	action.
149.19 	(f) Nothing in this compact shall override a party state's decision that participation 
149.20 	in an alternative program may be used in lieu of licensure action and that participation 
149.21 	shall remain nonpublic if required by the party state's laws.
149.22 	Party states must require nurses who enter any alternative programs to agree not to 
149.23 	practice in any other party state during the term of the alternative program without prior 
149.24 	authorization from the other party state.
149.25 	ARTICLE 5
149.26 	ADDITIONAL AUTHORITIES INVESTED IN 
149.27 	PARTY STATE NURSE LICENSING BOARDS
149.28 	Notwithstanding any other laws, party state nurse licensing boards shall have the 
149.29 	authority to:
149.30 	(1) if otherwise permitted by state law, recover from the affected nurse the costs of 
149.31 	investigation and disposition of cases resulting from any adverse action taken against 
149.32 	that nurse;
149.33 	(2) issue subpoenas for both hearings and investigations which require the attendance 
149.34 	and testimony of witnesses, and the production of evidence. Subpoenas issued by a nurse 
149.35 	licensing board in a party state for the attendance and testimony of witnesses, and the 
149.36 	production of evidence from another party state, shall be enforced in the latter state by 
150.1 	any court of competent jurisdiction according to the practice and procedure of that court 
150.2 	applicable to subpoenas issued in proceedings pending before it. The issuing authority 
150.3 	shall pay any witness fees, travel expenses, mileage, and other fees required by the service 
150.4 	statutes of the state where the witnesses and evidence are located;
150.5 	(3) issue cease and desist orders to limit or revoke a nurse's authority to practice 
150.6 	in the nurse's state; and
150.7 	(4) adopt uniform rules and regulations as provided for in article 7, paragraph (c).
150.8 	ARTICLE 6
150.9 	COORDINATED LICENSURE INFORMATION SYSTEM
150.10 	(a) All party states shall participate in a cooperative effort to create a coordinated 
150.11 	database of all licensed registered nurses and licensed practical/vocational nurses. This 
150.12 	system shall include information on the licensure and disciplinary history of each 
150.13 	nurse, as contributed by party states, to assist in the coordination of nurse licensure and 
150.14 	enforcement efforts.
150.15 	(b) Notwithstanding any other provision of law, all party states' licensing boards shall 
150.16 	promptly report adverse actions, actions against multistate licensure privileges, any current 
150.17 	significant investigative information yet to result in adverse action, denials of applications, 
150.18 	and the reasons for the denials to the coordinated licensure information system.
150.19 	(c) Current significant investigative information shall be transmitted through the 
150.20 	coordinated licensure information system only to party state licensing boards.
150.21 	(d) Notwithstanding any other provision of law, all party states' licensing boards 
150.22 	contributing information to the coordinated licensure information system may designate 
150.23 	information that may not be shared with nonparty states or disclosed to other entities or 
150.24 	individuals without the express permission of the contributing state.
150.25 	(e) Any personally identifiable information obtained by a party state's licensing 
150.26 	board from the coordinated licensure information system may not be shared with nonparty 
150.27 	states or disclosed to other entities or individuals except to the extent permitted by the 
150.28 	laws of the party state contributing the information.
150.29 	(f) Any information contributed to the coordinated licensure information system that 
150.30 	is subsequently required to be expunged by the laws of the party state contributing that 
150.31 	information shall also be expunged from the coordinated licensure information system.
150.32 	(g) The compact administrators, acting jointly with each other and in consultation 
150.33 	with the administrator of the coordinated licensure information system, shall formulate 
150.34 	necessary and proper procedures for the identification, collection, and exchange of 
150.35 	information under this compact.
150.36 	ARTICLE 7
151.1 	COMPACT ADMINISTRATION AND
151.2 	INTERCHANGE OF INFORMATION
151.3 	(a) The head or designee of the nurse licensing board of each party state shall be the 
151.4 	administrator of this compact for that state.
151.5 	(b) The compact administrator of each party state shall furnish to the compact 
151.6 	administrator of each other party state any information and documents including, but not 
151.7 	limited to, a uniform data set of investigations, identifying information, licensure data, and 
151.8 	disclosable alternative program participation information to facilitate the administration of 
151.9 	this compact.
151.10 	(c) Compact administrators shall have the authority to develop uniform rules to 
151.11 	facilitate and coordinate implementation of this compact. These uniform rules shall be 
151.12 	adopted by party states under the authority in article 5, clause (4).
151.13 	ARTICLE 8
151.14 	IMMUNITY
151.15 	A party state or the officers, employees, or agents of a party state's nurse licensing 
151.16 	board who acts in good faith according to the provisions of this compact shall not be 
151.17 	liable for any act or omission while engaged in the performance of their duties under 
151.18 	this compact. Good faith shall not include willful misconduct, gross negligence, or 
151.19 	recklessness.
151.20 	ARTICLE 9
151.21 	ENACTMENT, WITHDRAWAL, AND AMENDMENT
151.22 	(a) This compact shall become effective for each state when it has been enacted by 
151.23 	that state. Any party state may withdraw from this compact by repealing the nurse licensure 
151.24 	compact, but no withdrawal shall take effect until six months after the withdrawing state 
151.25 	has given notice of the withdrawal to the executive heads of all other party states.
151.26 	(b) No withdrawal shall affect the validity or applicability by the licensing boards 
151.27 	of states remaining party to the compact of any report of adverse action occurring prior 
151.28 	to the withdrawal.
151.29 	(c) Nothing contained in this compact shall be construed to invalidate or prevent any 
151.30 	nurse licensure agreement or other cooperative arrangement between a party state and a 
151.31 	nonparty state that is made according to the other provisions of this compact.
151.32 	(d) This compact may be amended by the party states. No amendment to this 
151.33 	compact shall become effective and binding upon the party states until it is enacted into 
151.34 	the laws of all party states.
151.35 	ARTICLE 10
151.36 	CONSTRUCTION AND SEVERABILITY
152.1 	(a) This compact shall be liberally construed to effectuate the purposes of the 
152.2 	compact. The provisions of this compact shall be severable and if any phrase, clause, 
152.3 	sentence, or provision of this compact is declared to be contrary to the constitution of any 
152.4 	party state or of the United States or the applicability thereof to any government, agency, 
152.5 	person, or circumstance is held invalid, the validity of the remainder of this compact and 
152.6 	the applicability of it to any government, agency, person, or circumstance shall not be 
152.7 	affected by it. If this compact is held contrary to the constitution of any party state, the 
152.8 	compact shall remain in full force and effect for the remaining party states and in full force 
152.9 	and effect for the party state affected as to all severable matters.
152.10 	(b) In the event party states find a need for settling disputes arising under this 
152.11 	compact:
152.12 	(1) the party states may submit the issues in dispute to an arbitration panel which 
152.13 	shall be comprised of an individual appointed by the compact administrator in the home 
152.14 	state, an individual appointed by the compact administrator in the remote states involved, 
152.15 	and an individual mutually agreed upon by the compact administrators of the party states 
152.16 	involved in the dispute; and
152.17 	(2) the decision of a majority of the arbitrators shall be final and binding.

152.18 	Sec. 7. [148.2856] APPLICATION OF NURSE LICENSURE COMPACT TO 
152.19 	EXISTING LAWS.
152.20 	(a) A nurse practicing professional or practical nursing in Minnesota under the 
152.21 	authority of section 148.2855 shall have the same obligations, privileges, and rights as if 
152.22 	the nurse was licensed in Minnesota. Notwithstanding any contrary provisions in section 
152.23 	148.2855, the Board of Nursing shall comply with and follow all laws and rules with 
152.24 	respect to registered and licensed practical nurses practicing professional or practical 
152.25 	nursing in Minnesota under the authority of section 148.2855, and all such individuals 
152.26 	shall be governed and regulated as if they were licensed by the board.
152.27 	(b) Section 148.2855 does not relieve employers of nurses from complying with 
152.28 	statutorily imposed obligations.
152.29 	(c) Section 148.2855 does not supersede existing state labor laws.
152.30 	(d) For purposes of the Minnesota Government Data Practices Act, chapter 13, 
152.31 	an individual not licensed as a nurse under sections 148.171 to 148.285 who practices 
152.32 	professional or practical nursing in Minnesota under the authority of section 148.2855 is 
152.33 	considered to be a licensee of the board.
153.1 	(e) Uniform rules developed by the compact administrators shall not be subject 
153.2 	to the provisions of sections 14.05 to 14.389, except for sections 14.07, 14.08, 14.101, 
153.3 	14.131, 14.18, 14.22, 14.23, 14.27, 14.28, 14.365, 14.366, 14.37, and 14.38.
153.4 	(f) Proceedings brought against an individual's multistate privilege shall be 
153.5 	adjudicated following the procedures listed in sections 14.50 to 14.62 and shall be subject 
153.6 	to judicial review as provided for in sections 14.63 to 14.69.
153.7 	(g) For purposes of sections 62M.09, subdivision 2; 121A.22, subdivision 4; 
153.8 	144.051; 144.052; 145A.02, subdivision 18; 148.975; 151.37; 152.12; 154.04; 256B.0917, 
153.9 	subdivision 8; 595.02, subdivision 1, paragraph (g); 604.20, subdivision 5; and 631.40, 
153.10 	subdivision 2; and chapters 319B and 364, holders of a multistate privilege who are 
153.11 	licensed as registered or licensed practical nurses in the home state shall be considered 
153.12 	to be licensees in Minnesota. If any of the statutes listed in this paragraph are limited to 
153.13 	registered nurses or the practice of professional nursing, then only holders of a multistate 
153.14 	privilege who are licensed as registered nurses in the home state shall be considered 
153.15 	licensees.
153.16 	(h) The reporting requirements of sections 144.4175, 148.263, 626.52, and 626.557 
153.17 	apply to individuals not licensed as registered or licensed practical nurses under sections 
153.18 	148.171 to 148.285 who practice professional or practical nursing in Minnesota under 
153.19 	the authority of section 148.2855.
153.20 	(i) The board may take action against an individual's multistate privilege based on 
153.21 	the grounds listed in section 148.261, subdivision 1, and any other statute authorizing or 
153.22 	requiring the board to take corrective or disciplinary action.
153.23 	(j) The board may take all forms of disciplinary action provided for in section 
153.24 	148.262, subdivision 1, and corrective action provided for in section 214.103, subdivision 
153.25 	6, against an individual's multistate privilege.
153.26 	(k) The immunity provisions of section 148.264, subdivision 1, apply to individuals 
153.27 	who practice professional or practical nursing in Minnesota under the authority of section 
153.28 	148.2855.
153.29 	(l) The cooperation requirements of section 148.265 apply to individuals who 
153.30 	practice professional or practical nursing in Minnesota under the authority of section 
153.31 	148.2855.
153.32 	(m) The provisions of section 148.283 shall not apply to individuals who practice 
153.33 	professional or practical nursing in Minnesota under the authority of section 148.2855.
153.34 	(n) Complaints against individuals who practice professional or practical nursing 
153.35 	in Minnesota under the authority of section 148.2855 shall be handled as provided in 
153.36 	sections 214.10 and 214.103.
154.1 	(o) All provisions of section 148.2855 authorizing or requiring the board to provide 
154.2 	data to party states are authorized by section 214.10, subdivision 8, paragraph (d).
154.3 	(p) Except as provided in section 13.41, subdivision 6, the board shall not report to a 
154.4 	remote state any active investigative data regarding a complaint investigation against a 
154.5 	nurse licensed under sections 148.171 to 148.285, unless the board obtains reasonable 
154.6 	assurances from the remote state that the data will be maintained with the same protections 
154.7 	as provided in Minnesota law.
154.8 	(q) The provisions of sections 214.17 to 214.25 apply to individuals who practice 
154.9 	professional or practical nursing in Minnesota under the authority of section 148.2855 
154.10 	when the practice involves direct physical contact between the nurse and a patient.
154.11 	(r) A nurse practicing professional or practical nursing in Minnesota under the 
154.12 	authority of section 148.2855 must comply with any criminal background check required 
154.13 	under Minnesota law.

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

154.20 	Sec. 9. [148.2858] MISCELLANEOUS PROVISIONS.
154.21 	(a) For the purposes of section 148.2855, "head of the Nurse Licensing Board" 
154.22 	means the executive director of the board.
154.23 	(b) The Board of Nursing shall have the authority to recover from a nurse practicing 
154.24 	professional or practical nursing in Minnesota under the authority of section 148.2855 
154.25 	the costs of investigation and disposition of cases resulting from any adverse action 
154.26 	taken against the nurse.
154.27 	(c) The board may implement a system of identifying individuals who practice 
154.28 	professional or practical nursing in Minnesota under the authority of section 148.2855.

154.29 	Sec. 10. [148.2859] NURSE LICENSURE COMPACT ADVISORY 
154.30 	COMMITTEE.
154.31 		Subdivision 1.Establishment; membership. A Nurse Licensure Compact Advisory 
154.32 	Committee is established to advise the compact administrator in the implementation of 
154.33 	section 148.2855. Members of the advisory committee shall be appointed by the board 
155.1 	and shall be composed of representatives of Minnesota nursing organizations, Minnesota 
155.2 	licensed nurses who practice in nursing facilities or hospitals, Minnesota licensed nurses 
155.3 	who provide home care, Minnesota licensed advanced practice registered nurses, and 
155.4 	public members as defined in section 214.02.
155.5 		Subd. 2.Duties. The advisory committee shall advise the compact administrator in 
155.6 	the implementation of section 148.2855.
155.7 		Subd. 3.Organization. The advisory committee shall be organized and 
155.8 	administered under section 15.059.

155.9 	Sec. 11. [151.065] FEE AMOUNTS.
155.10 		Subdivision 1.Application fees. Application fees for licensure and registration 
155.11 	are as follows:
155.12 	(1) pharmacist licensed by examination, $130;
155.13 	(2) pharmacist licensed by reciprocity, $225;
155.14 	(3) pharmacy intern, $30;
155.15 	(4) pharmacy technician, $30;
155.16 	(5) pharmacy, $190;
155.17 	(6) drug wholesaler, legend drugs only, $200;
155.18 	(7) drug wholesaler, legend and nonlegend drugs, $200;
155.19 	(8) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, $175;
155.20 	(9) drug wholesaler, medical gases, $150;
155.21 	(10) drug wholesaler, also licensed as a pharmacy in Minnesota, $125;
155.22 	(11) drug manufacturer, legend drugs only, $200;
155.23 	(12) drug manufacturer, legend and nonlegend drugs, $200;
155.24 	(13) drug manufacturer, nonlegend or veterinary legend drugs, $175;
155.25 	(14) drug manufacturer, medical gases, $150;
155.26 	(15) drug manufacturer, also licensed as a pharmacy in Minnesota, $125;
155.27 	(16) medical gas distributor, $75;
155.28 	(17) controlled substance researcher, $50; and
155.29 	(18) pharmacy professional corporation, $100.
155.30 		Subd. 2.Original license fees. A pharmacist original licensure fee is $130.
155.31 		Subd. 3.Annual renewal fees. Annual licensure and registration renewal fees 
155.32 	are as follows:
155.33 	(1) pharmacist, $130;
155.34 	(2) pharmacy technician, $30;
155.35 	(3) pharmacy, $190;
156.1 	(4) wholesaler, legend drugs only, $200;
156.2 	(5) wholesaler, legend and nonlegend drugs, $200;
156.3 	(6) wholesaler, nonlegend drugs, veterinary legend drugs, or both, $175;
156.4 	(7) wholesaler, medical gases, $150;
156.5 	(8) wholesaler, also licensed as a pharmacy in Minnesota, $125;
156.6 	(9) manufacturer, legend drugs only, $200;
156.7 	(10) manufacturer, legend and nonlegend drugs, $200;
156.8 	(11) manufacturer, nonlegend drugs, veterinary legend drugs, or both, $175;
156.9 	(12) manufacturer, medical gases, $150;
156.10 	(13) manufacturer, also licensed as a pharmacy in Minnesota, $125;
156.11 	(14) medical gas distributor, $75;
156.12 	(15) controlled substance researcher, $50; and
156.13 	(16) pharmacy professional corporation, $45.
156.14 		Subd. 4.Miscellaneous fees. Fees for issuance of affidavits and duplicate licenses 
156.15 	and certificates are as follows:
156.16 	(1) intern affidavit, $15;
156.17 	(2) duplicate small license, $15; and
156.18 	(3) duplicate large certificate, $25.
156.19 		Subd. 5.Late fees. All annual renewal fees are subject to a 50 percent late fee if 
156.20 	the renewal fee and application are not received by the board prior to the date specified 
156.21 	by the board.
156.22 		Subd. 6.Reinstatement fees. Reinstatement fees are as follows:
156.23 	(1) pharmacists who have allowed their license to lapse may reinstate the license 
156.24 	with board approval and upon payment of any fees and late fees in arrears, up to a 
156.25 	maximum of $1,000;
156.26 	(2) pharmacy technicians who have allowed their registration to lapse may reinstate 
156.27 	the registration with board approval and upon payment of any fees and late fees in arrears, 
156.28 	up to a maximum of $90;
156.29 	(3) an owner of a pharmacy, drug wholesaler, drug manufacturer, or medical gas 
156.30 	distributor who has allowed the license of the establishment to lapse may reinstate the 
156.31 	license with board approval and upon payment of any fees and late fees in arrears;
156.32 	(4) controlled substance researchers who have allowed their registration to lapse 
156.33 	may reinstate the registration with board approval and upon payment of any fees and 
156.34 	late fees in arrears; and
157.1 	(5) pharmacist owners of a pharmacy professional corporation who have allowed 
157.2 	the corporation's registration to lapse may reinstate the registration with board approval 
157.3 	and upon payment of the fees and the late fees in arrears.

157.4 	Sec. 12. Minnesota Statutes 2010, section 151.07, is amended to read:
157.5 	151.07 MEETINGS; EXAMINATION FEE.
157.6 	The board shall meet at times as may be necessary and as it may determine to 
157.7 	examine applicants for licensure and to transact its other business, giving reasonable 
157.8 	notice of all examinations by mail to known applicants therefor. The secretary shall record 
157.9 	the names of all persons licensed by the board, together with the grounds upon which 
157.10 	the right of each to licensure was claimed. The fee for examination shall be in such the
157.11 	amount as the board may determine specified in section 151.065, which fee may in the 
157.12 	discretion of the board be returned to applicants not taking the examination.

157.13 	Sec. 13. Minnesota Statutes 2010, section 151.101, is amended to read:
157.14 	151.101 INTERNSHIP.
157.15 	Upon payment of the fee specified in section 151.065, the board may license register
157.16 	as an intern any natural persons who have satisfied the board that they are of good moral 
157.17 	character, not physically or mentally unfit, and who have successfully completed the 
157.18 	educational requirements for intern licensure registration prescribed by the board. The 
157.19 	board shall prescribe standards and requirements for interns, pharmacist-preceptors, and 
157.20 	internship training but may not require more than one year of such training.
157.21 	The board in its discretion may accept internship experience obtained in another 
157.22 	state provided the internship requirements in such other state are in the opinion of the 
157.23 	board equivalent to those herein provided.

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

157.28 	Sec. 15. Minnesota Statutes 2010, section 151.12, is amended to read:
157.29 	151.12 RECIPROCITY; LICENSURE.
157.30 	The board may in its discretion grant licensure without examination to any 
157.31 	pharmacist licensed by the Board of Pharmacy or a similar board of another state which 
158.1 	accords similar recognition to licensees of this state; provided, the requirements for 
158.2 	licensure in such other state are in the opinion of the board equivalent to those herein 
158.3 	provided. The fee for licensure shall be in such the amount as the board may determine by 
158.4 	rule specified in section 151.065.

158.5 	Sec. 16. Minnesota Statutes 2010, section 151.13, subdivision 1, is amended to read:
158.6 		Subdivision 1.Renewal fee. Every person licensed by the board as a pharmacist 
158.7 	shall pay to the board a the annual renewal fee to be fixed by it specified in section 
158.8 	151.065. The board may promulgate by rule a charge to be assessed for the delinquent 
158.9 	payment of a fee the late fee specified in section 151.065 if the renewal fee and application 
158.10 	are not received by the board prior to the date specified by the board. It shall be unlawful 
158.11 	for any person licensed as a pharmacist who refuses or fails to pay such any applicable
158.12 	renewal or late fee to practice pharmacy in this state. Every certificate and license shall 
158.13 	expire at the time therein prescribed.

158.14 	Sec. 17. Minnesota Statutes 2010, section 151.19, is amended to read:
158.15 	151.19 REGISTRATION; FEES.
158.16 		Subdivision 1.Pharmacy registration. The board shall require and provide for the 
158.17 	annual registration of every pharmacy now or hereafter doing business within this state. 
158.18 	Upon the payment of a any applicable fee to be set by the board in section 151.065, the 
158.19 	board shall issue a registration certificate in such form as it may prescribe to such persons 
158.20 	as may be qualified by law to conduct a pharmacy. Such certificate shall be displayed in a 
158.21 	conspicuous place in the pharmacy for which it is issued and expire on the 30th day of 
158.22 	June following the date of issue. It shall be unlawful for any person to conduct a pharmacy 
158.23 	unless such certificate has been issued to the person by the board.
158.24 		Subd. 2.Nonresident pharmacies. The board shall require and provide for an 
158.25 	annual nonresident special pharmacy registration for all pharmacies located outside of this 
158.26 	state that regularly dispense medications for Minnesota residents and mail, ship, or deliver 
158.27 	prescription medications into this state. Nonresident special pharmacy registration shall 
158.28 	be granted by the board upon payment of any applicable fee in section 151.065 and the 
158.29 	disclosure and certification by a pharmacy:
158.30 	(1) that it is licensed in the state in which the dispensing facility is located and from 
158.31 	which the drugs are dispensed;
158.32 	(2) the location, names, and titles of all principal corporate officers and all 
158.33 	pharmacists who are dispensing drugs to residents of this state;
159.1 	(3) that it complies with all lawful directions and requests for information from 
159.2 	the Board of Pharmacy of all states in which it is licensed or registered, except that it 
159.3 	shall respond directly to all communications from the board concerning emergency 
159.4 	circumstances arising from the dispensing of drugs to residents of this state;
159.5 	(4) that it maintains its records of drugs dispensed to residents of this state so that the 
159.6 	records are readily retrievable from the records of other drugs dispensed;
159.7 	(5) that it cooperates with the board in providing information to the Board of 
159.8 	Pharmacy of the state in which it is licensed concerning matters related to the dispensing 
159.9 	of drugs to residents of this state;
159.10 	(6) that during its regular hours of operation, but not less than six days per week, for 
159.11 	a minimum of 40 hours per week, a toll-free telephone service is provided to facilitate 
159.12 	communication between patients in this state and a pharmacist at the pharmacy who has 
159.13 	access to the patients' records; the toll-free number must be disclosed on the label affixed 
159.14 	to each container of drugs dispensed to residents of this state; and
159.15 	(7) that, upon request of a resident of a long-term care facility located within the 
159.16 	state of Minnesota, the resident's authorized representative, or a contract pharmacy or 
159.17 	licensed health care facility acting on behalf of the resident, the pharmacy will dispense 
159.18 	medications prescribed for the resident in unit-dose packaging or, alternatively, comply 
159.19 	with the provisions of section 151.415, subdivision 5.
159.20 		Subd. 3.Sale of federally restricted medical gases. The board shall require and 
159.21 	provide for the annual registration of every person or establishment not licensed as a 
159.22 	pharmacy or a practitioner engaged in the retail sale or distribution of federally restricted 
159.23 	medical gases. Upon the payment of a any applicable fee to be set by the board specified 
159.24 	in section 151.065, the board shall issue a registration certificate in such form as it may 
159.25 	prescribe to those persons or places that may be qualified to sell or distribute federally 
159.26 	restricted medical gases. The certificate shall be displayed in a conspicuous place in the 
159.27 	business for which it is issued and expire on the date set by the board. It is unlawful for 
159.28 	a person to sell or distribute federally restricted medical gases unless a certificate has 
159.29 	been issued to that person by the board.

159.30 	Sec. 18. Minnesota Statutes 2010, section 151.25, is amended to read:
159.31 	151.25 REGISTRATION OF MANUFACTURERS; FEE; PROHIBITIONS.
159.32 	The board shall require and provide for the annual registration of every person 
159.33 	engaged in manufacturing drugs, medicines, chemicals, or poisons for medicinal purposes, 
159.34 	now or hereafter doing business with accounts in this state. Upon a payment of a any 
159.35 	applicable fee as set by the board in section 151.065, the board shall issue a registration 
160.1 	certificate in such form as it may prescribe to such manufacturer. Such registration 
160.2 	certificate shall be displayed in a conspicuous place in such manufacturer's or wholesaler's 
160.3 	place of business for which it is issued and expire on the date set by the board. It shall 
160.4 	be unlawful for any person to manufacture drugs, medicines, chemicals, or poisons for 
160.5 	medicinal purposes unless such a certificate has been issued to the person by the board. 
160.6 	It shall be unlawful for any person engaged in the manufacture of drugs, medicines, 
160.7 	chemicals, or poisons for medicinal purposes, or the person's agent, to sell legend drugs to 
160.8 	other than a pharmacy, except as provided in this chapter.

160.9 	Sec. 19. Minnesota Statutes 2010, section 151.47, subdivision 1, is amended to read:
160.10 		Subdivision 1.Requirements. All wholesale drug distributors are subject to the 
160.11 	requirements in paragraphs (a) to (f).
160.12 	(a) No person or distribution outlet shall act as a wholesale drug distributor without 
160.13 	first obtaining a license from the board and paying the required any applicable fee
160.14 	specified in section 151.065.
160.15 	(b) No license shall be issued or renewed for a wholesale drug distributor to operate 
160.16 	unless the applicant agrees to operate in a manner prescribed by federal and state law and 
160.17 	according to the rules adopted by the board.
160.18 	(c) The board may require a separate license for each facility directly or indirectly 
160.19 	owned or operated by the same business entity within the state, or for a parent entity 
160.20 	with divisions, subsidiaries, or affiliate companies within the state, when operations 
160.21 	are conducted at more than one location and joint ownership and control exists among 
160.22 	all the entities.
160.23 	(d) As a condition for receiving and retaining a wholesale drug distributor license 
160.24 	issued under sections 151.42 to 151.51, an applicant shall satisfy the board that it has 
160.25 	and will continuously maintain: 
160.26 	(1) adequate storage conditions and facilities;
160.27 	(2) minimum liability and other insurance as may be required under any applicable 
160.28 	federal or state law;
160.29 	(3) a viable security system that includes an after hours central alarm, or comparable 
160.30 	entry detection capability; restricted access to the premises; comprehensive employment 
160.31 	applicant screening; and safeguards against all forms of employee theft;
160.32 	(4) a system of records describing all wholesale drug distributor activities set forth 
160.33 	in section 151.44 for at least the most recent two-year period, which shall be reasonably 
160.34 	accessible as defined by board regulations in any inspection authorized by the board; 
161.1 	(5) principals and persons, including officers, directors, primary shareholders, 
161.2 	and key management executives, who must at all times demonstrate and maintain their 
161.3 	capability of conducting business in conformity with sound financial practices as well 
161.4 	as state and federal law;
161.5 	(6) complete, updated information, to be provided to the board as a condition for 
161.6 	obtaining and retaining a license, about each wholesale drug distributor to be licensed, 
161.7 	including all pertinent corporate licensee information, if applicable, or other ownership, 
161.8 	principal, key personnel, and facilities information found to be necessary by the board;
161.9 	(7) written policies and procedures that assure reasonable wholesale drug distributor 
161.10 	preparation for, protection against, and handling of any facility security or operation 
161.11 	problems, including, but not limited to, those caused by natural disaster or government 
161.12 	emergency, inventory inaccuracies or product shipping and receiving, outdated product 
161.13 	or other unauthorized product control, appropriate disposition of returned goods, and 
161.14 	product recalls;
161.15 	(8) sufficient inspection procedures for all incoming and outgoing product 
161.16 	shipments; and
161.17 	(9) operations in compliance with all federal requirements applicable to wholesale 
161.18 	drug distribution.
161.19 	(e) An agent or employee of any licensed wholesale drug distributor need not seek 
161.20 	licensure under this section.
161.21 	(f) A wholesale drug distributor shall file with the board an annual report, in a 
161.22 	form and on the date prescribed by the board, identifying all payments, honoraria, 
161.23 	reimbursement or other compensation authorized under section 151.461, clauses (3) to 
161.24 	(5), paid to practitioners in Minnesota during the preceding calendar year. The report 
161.25 	shall identify the nature and value of any payments totaling $100 or more, to a particular 
161.26 	practitioner during the year, and shall identify the practitioner. Reports filed under this 
161.27 	provision are public data. 

161.28 	Sec. 20. Minnesota Statutes 2010, section 151.48, is amended to read:
161.29 	151.48 OUT-OF-STATE WHOLESALE DRUG DISTRIBUTOR LICENSING.
161.30 	(a) It is unlawful for an out-of-state wholesale drug distributor to conduct business 
161.31 	in the state without first obtaining a license from the board and paying the required any 
161.32 	applicable fee in section 151.065.
161.33 	(b) Application for an out-of-state wholesale drug distributor license under this 
161.34 	section shall be made on a form furnished by the board.
162.1 	(c) No person acting as principal or agent for any out-of-state wholesale drug 
162.2 	distributor may sell or distribute drugs in the state unless the distributor has obtained 
162.3 	a license.
162.4 	(d) The board may adopt regulations that permit out-of-state wholesale drug 
162.5 	distributors to obtain a license on the basis of reciprocity to the extent that an out-of-state 
162.6 	wholesale drug distributor:
162.7 	(1) possesses a valid license granted by another state under legal standards 
162.8 	comparable to those that must be met by a wholesale drug distributor of this state as 
162.9 	prerequisites for obtaining a license under the laws of this state; and
162.10 	(2) can show that the other state would extend reciprocal treatment under its own 
162.11 	laws to a wholesale drug distributor of this state.

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

162.21 	Sec. 22. [214.107] HEALTH-RELATED LICENSING BOARDS 
162.22 	ADMINISTRATIVE SERVICES UNIT.
162.23 		Subdivision 1.Establishment. An administrative services unit is established 
162.24 	for the health-related licensing boards in section 214.01, subdivision 2, to perform 
162.25 	administrative, financial, and management functions common to all the boards in a manner 
162.26 	that streamlines services, reduces expenditures, targets the use of state resources, and 
162.27 	meets the mission of public protection.
162.28 		Subd. 2.Authority. The administrative services unit shall act as an agent of the 
162.29 	boards.
162.30 		Subd. 3.Funding. (a) The administrative service unit shall apportion among the 
162.31 	health-related licensing boards an amount to be paid through an interagency agreement 
162.32 	between each respective board and the administrative services unit. The amount 
162.33 	apportioned to each board shall equal each board's share of the annual operating costs for 
162.34 	the unit and shall be paid from each board's appropriation.
163.1 	(b) The administrative services unit may receive and expend reimbursements for 
163.2 	services performed for other agencies.

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

163.7 	ARTICLE 8
163.8 	HEALTH AND HUMAN SERVICES APPROPRIATIONS

163.9	Section 1.  SUMMARY OF APPROPRIATIONS.
 	
163.10 	The amounts shown in this section summarize direct appropriations, by fund, made 
163.11 	in this article.

163.12			2012
		2013
		Total
	
163.13	General
	$
	5,566,399,000
	$
	5,396,137,000
	$
	10,962,536,000
	
163.14
163.15	State Government Special 
Revenue
		 67,012,000
		 66,910,000
		 133,922,000
	
163.16	Health Care Access
		304,207,000
		293,893,000
		598,100,000
	
163.17	Federal TANF
		264,658,000
		250,081,000
		514,739,000
	
163.18	Lottery Prize 
		1,665,000
		1,665,000
		3,330,000
	
163.19	Total
	$
	 6,203,941,000
	$
	 6,008,686,000
	$
	 12,212,627,000

163.20	Sec. 2. HUMAN SERVICES APPROPRIATIONS.
 	
163.21 	The sums shown in the columns marked "Appropriations" are appropriated to the 
163.22 	agencies and for the purposes specified in this article. The appropriations are from the 
163.23 	general fund, or another named fund, and are available for the fiscal years indicated 
163.24 	for each purpose. The figures "2012" and "2013" used in this article mean that the 
163.25 	appropriations listed under them are available for the fiscal year ending June 30, 2012, or 
163.26 	June 30, 2013, respectively. "The first year" is fiscal year 2012. "The second year" is fiscal 
163.27 	year 2013. "The biennium" is fiscal years 2012 and 2013.

163.28				APPROPRIATIONS
	
163.29				Available for the Year
	
163.30				Ending June 30
	
163.31					2012
		2013

163.32
163.33	Sec. 3. COMMISSIONER OF HUMAN 
SERVICES

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

164.1	Appropriations by Fund
	
164.2		2012
	2013
	
164.3	General
	5,498,253,000
	5,332,690,000
	
164.4
164.5	State Government 
Special Revenue
	3,565,000
	3,565,000
	
164.6	Health Care Access
	293,324,000
	284,658,000
	
164.7	Federal TANF
	264,658,000
	250,081,000
	
164.8	Lottery Prize Fund
	1,665,000
	1,665,000
	
164.9 	Receipts for Systems Projects. 
164.10 	Appropriations and federal receipts for 
164.11 	information systems projects for MAXIS, 
164.12 	PRISM, MMIS, and SSIS must be deposited 
164.13 	in the state systems account authorized in 
164.14 	Minnesota Statutes, section 256.014. Money 
164.15 	appropriated for computer projects approved 
164.16 	by the Minnesota Office of Enterprise 
164.17 	Technology, funded by the legislature, 
164.18 	and approved by the commissioner 
164.19 	of management and budget, may be 
164.20 	transferred from one project to another 
164.21 	and from development to operations as the 
164.22 	commissioner of human services considers 
164.23 	necessary. Any unexpended balance in 
164.24 	the appropriation for these projects does 
164.25 	not cancel but is available for ongoing 
164.26 	development and operations.
164.27 	Nonfederal Share Transfers. The 
164.28 	nonfederal share of activities for which 
164.29 	federal administrative reimbursement is 
164.30 	appropriated to the commissioner may be 
164.31 	transferred to the special revenue fund.
164.32 	TANF Maintenance of Effort.
164.33 	(a) In order to meet the basic maintenance 
164.34 	of effort (MOE) requirements of the TANF 
164.35 	block grant specified under Code of Federal 
164.36 	Regulations, title 45, section 263.1, the 
165.1 	commissioner may only report nonfederal 
165.2 	money expended for allowable activities 
165.3 	listed in the following clauses as TANF/MOE 
165.4 	expenditures:
165.5 	(1) MFIP cash, diversionary work program, 
165.6 	and food assistance benefits under Minnesota 
165.7 	Statutes, chapter 256J;
165.8 	(2) the child care assistance programs 
165.9 	under Minnesota Statutes, sections 119B.03 
165.10 	and 119B.05, and county child care 
165.11 	administrative costs under Minnesota 
165.12 	Statutes, section 119B.15;
165.13 	(3) state and county MFIP administrative 
165.14 	costs under Minnesota Statutes, chapters 
165.15 	256J and 256K;
165.16 	(4) state, county, and tribal MFIP 
165.17 	employment services under Minnesota 
165.18 	Statutes, chapters 256J and 256K;
165.19 	(5) qualifying working family credit 
165.20 	expenditures under Minnesota Statutes, 
165.21 	section 290.0671; and
165.22 	(6) qualifying Minnesota education credit 
165.23 	expenditures under Minnesota Statutes, 
165.24 	section 290.0674.
165.25 	(b) The commissioner shall ensure that 
165.26 	sufficient qualified nonfederal expenditures 
165.27 	are made each year to meet the state's 
165.28 	TANF/MOE requirements. For the activities 
165.29 	listed in paragraph (a), clauses (2) to 
165.30 	(6), the commissioner may only report 
165.31 	expenditures that are excluded from the 
165.32 	definition of assistance under Code of 
165.33 	Federal Regulations, title 45, section 260.31.
166.1 	(c) For fiscal years beginning with state fiscal 
166.2 	year 2003, the commissioner shall assure 
166.3 	that the maintenance of effort used by the 
166.4 	commissioner of management and budget 
166.5 	for the February and November forecasts 
166.6 	required under Minnesota Statutes, section 
166.7 	16A.103, contains expenditures under 
166.8 	paragraph (a), clause (1), equal to at least 16 
166.9 	percent of the total required under Code of 
166.10 	Federal Regulations, title 45, section 263.1.
166.11 	(d) Minnesota Statutes, section 256.011, 
166.12 	subdivision 3, which requires that federal 
166.13 	grants or aids secured or obtained under that 
166.14 	subdivision be used to reduce any direct 
166.15 	appropriations provided by law, do not apply 
166.16 	if the grants or aids are federal TANF funds.
166.17 	(e) Notwithstanding any contrary provision 
166.18 	in this article, paragraph (a), clauses (1) to 
166.19 	(6), and paragraphs (b) to (d), expire June 
166.20 	30, 2015.
166.21 	Working Family Credit Expenditures 
166.22 	as TANF/MOE. The commissioner may 
166.23 	claim as TANF maintenance of effort up to 
166.24 	$6,707,000 per year of working family credit 
166.25 	expenditures for fiscal years 2012 and 2013.
166.26 	Working Family Credit Expenditures 
166.27 	to be Claimed for TANF/MOE. The 
166.28 	commissioner may count the following 
166.29 	amounts of working family credit 
166.30 	expenditures as TANF/MOE:
166.31 	(1) fiscal year 2012, $12,037,000;
166.32 	(2) fiscal year 2013, $29,942,000;
166.33 	(3) fiscal year 2014, $23,235,000; and
166.34 	(4) fiscal year 2015, $23,198,000.
167.1 	Notwithstanding any contrary provision in 
167.2 	this article, this rider expires June 30, 2015.
167.3 	Food Stamps Employment and Training 
167.4 	Funds. (a) Notwithstanding Minnesota 
167.5 	Statutes, sections 256D.051, subdivisions 1a, 
167.6 	6b, and 6c, and 256J.626, federal food stamps 
167.7 	employment and training funds received 
167.8 	as reimbursement for child care assistance 
167.9 	program expenditures must be deposited in 
167.10 	the general fund. The amount of funds must 
167.11 	be limited to $500,000 per year in fiscal 
167.12 	years 2012 through 2015, contingent upon 
167.13 	approval by the federal Food and Nutrition 
167.14 	Service.
167.15 	(b) Consistent with the receipt of these 
167.16 	federal funds, the commissioner may 
167.17 	adjust the level of working family credit 
167.18 	expenditures claimed as TANF maintenance 
167.19 	of effort. Notwithstanding any contrary 
167.20 	provision in this article, this rider expires 
167.21 	June 30, 2015.
167.22 	ARRA Food Support Benefit Increases. 
167.23 	The funds provided for food support benefit 
167.24 	increases under the Supplemental Nutrition 
167.25 	Assistance Program provisions of the 
167.26 	American Recovery and Reinvestment Act 
167.27 	(ARRA) of 2009 must be used for benefit 
167.28 	increases beginning July 1, 2009.
167.29 	Supplemental Security Interim Assistance 
167.30 	Reimbursement Funds. $2,800,000 of 
167.31 	uncommitted revenue available to the 
167.32 	commissioner of human services for SSI 
167.33 	advocacy and outreach services must be 
167.34 	transferred to and deposited into the general 
167.35 	fund by October 1, 2011.
168.1 	Transfer.  By June 30, 2013, the 
168.2 	commissioner of management and budget 
168.3 	must transfer $109,303,000 from the health 
168.4 	care access fund to the general fund.

168.5	Subd. 2.Central Office Operations
 					
168.6 	The amounts that may be spent from this 
168.7 	appropriation for each purpose are as follows:

168.8	(a) Operations

168.9	Appropriations by Fund
	
168.10	General
	68,187,000
	66,563,000
	
168.11
168.12	State Government 
Special Revenue
	3,440,000
	3,440,000
	
168.13	Health Care Access
	11,508,000
	11,508,000
	
168.14	Federal TANF
	222,000
	222,000
	
168.15 	DHS Receipt Center Accounting. The 
168.16 	commissioner is authorized to transfer 
168.17 	appropriations to, and account for DHS 
168.18 	receipt center operations in, the special 
168.19 	revenue fund.
168.20 	Human Services Licensing Activities. 
168.21 	$3,000,000 each year of the biennium is 
168.22 	appropriated from the state government 
168.23 	special revenue fund to the commissioner 
168.24 	for human services licensing activities under 
168.25 	Minnesota Statutes, chapter 245A.
168.26 	Child Support Cost Recovery Fees. The 
168.27 	commissioner shall transfer $31,000 of child 
168.28 	support cost recovery fees collected in fiscal 
168.29 	year 2012 to the PRISM special revenue 
168.30 	account to offset PRISM system costs of 
168.31 	implementing the fee.
168.32 	Base Level Adjustment.  The general fund 
168.33 	base is increased by $79,000 in fiscal year 
168.34 	2014 only.

168.35	(b) Children and Families

169.1	Appropriations by Fund
	
169.2	General
	9,474,000
	9,227,000
	
169.3	Federal TANF
	2,160,000
	2,160,000
	
169.4 	Financial Institution Data Match and 
169.5 	Payment of Fees. The commissioner is 
169.6 	authorized to allocate up to $310,000 each 
169.7 	year in fiscal years 2012 and 2013 from the 
169.8 	PRISM special revenue account to make 
169.9 	payments to financial institutions in exchange 
169.10 	for performing data matches between account 
169.11 	information held by financial institutions 
169.12 	and the public authority's database of child 
169.13 	support obligors as authorized by Minnesota 
169.14 	Statutes, section 13B.06, subdivision 7.

169.15	(c) Health Care

169.16	Appropriations by Fund
	
169.17	General
	16,203,000
	16,195,000
	
169.18	Health Care Access
	23,115,000
	23,758,000
	
169.19 	Minnesota Senior Health Options 
169.20 	Reimbursement. Federal administrative 
169.21 	reimbursement resulting from the Minnesota 
169.22 	senior health options project is appropriated 
169.23 	to the commissioner for this activity.
169.24 	Utilization Review. Federal administrative 
169.25 	reimbursement resulting from prior 
169.26 	authorization and inpatient admission 
169.27 	certification by a professional review 
169.28 	organization shall be dedicated to the 
169.29 	commissioner for these purposes. A portion 
169.30 	of these funds must be used for activities to 
169.31 	decrease unnecessary pharmaceutical costs 
169.32 	in medical assistance.
169.33 	Base Level Adjustment.  The general fund 
169.34 	base is decreased by $13,000 in fiscal year 
170.1 	2014 and decreased by $125,000 in fiscal 
170.2 	year 2015.

170.3	(d) Continuing Care

170.4	Appropriations by Fund
	
170.5	General
	17,433,000
	17,339,000
	
170.6
170.7	State Government 
Special Revenue
	125,000
	125,000
	
170.8 	Base Level Adjustment.  The general fund 
170.9 	base is decreased by $587,000 in fiscal year 
170.10 	2014 and decreased by $687,000 in fiscal 
170.11 	year 2015.

170.12	(e) Chemical and Mental Health

170.13	Appropriations by Fund
	
170.14	General
	4,194,000
	4,194,000
	
170.15	Lottery Prize
	157,000
	157,000

170.16	Subd. 3.Forecasted Programs
 					
170.17 	The amounts that may be spent from this 
170.18 	appropriation for each purpose are as follows:

170.19	(a) MFIP/DWP Grants

170.20	Appropriations by Fund
	
170.21	General
	75,140,000
	78,040,000
	
170.22	Federal TANF
	84,425,000
	75,417,000

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

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

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

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

170.27	(f) MinnesotaCare Grants
		255,629,000
		242,742,000
	
170.28 	This appropriation is from the health care 
170.29 	access fund.

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

170.31	(h) Medical Assistance Grants

171.1	Appropriations by Fund
	
171.2	General
	4,160,632,000
	3,968,969,000
	
171.3	Health Care Access
	2,882,000
	6,460,000
	
171.4 	Manage Elderly Waiver Growth. 
171.5 	Beginning July 1, 2011, and ending on June 
171.6 	30, 2013, the commissioner shall manage 
171.7 	the elderly waiver so that the number of 
171.8 	people does not exceed the number on June 
171.9 	30, 2011.
171.10 	Manage Growth in TBI and CADI 
171.11 	Waivers. During the fiscal years beginning 
171.12 	on July 1, 2011, and July 1, 2012, the 
171.13 	commissioner shall allocate money for home 
171.14 	and community-based waiver programs 
171.15 	under Minnesota Statutes, section 256B.49, 
171.16 	to ensure a reduction in state spending that is 
171.17 	equivalent to limiting the caseload growth of 
171.18 	the TBI waiver to no additional allocations 
171.19 	per month each year of the biennium and the 
171.20 	CADI waiver to no additional allocations 
171.21 	per month each year of the biennium. For 
171.22 	the TBI waiver and the CADI waiver, 
171.23 	the commissioner may reuse existing 
171.24 	allocations. Limits do not apply when there 
171.25 	is an approved plan for nursing facility bed 
171.26 	closures for individuals under age 65 who 
171.27 	require relocation due to the bed closure.
171.28 	Priorities for the allocation of funds must be 
171.29 	for individuals anticipated to be discharged 
171.30 	from institutional settings or who are 
171.31 	at imminent risk of a placement in an 
171.32 	institutional setting.
171.33 	Manage Growth in DD Waiver. The 
171.34 	commissioner shall manage the growth in the 
171.35 	DD waiver by limiting the allocations to no 
172.1 	additional diversion allocations each month 
172.2 	for the calendar years that begin on January 
172.3 	1, 2012, and January 1, 2013. 
172.4 	Reduction of Rates for Congregate 
172.5 	Living for Individuals with Lower Needs.
172.6 	Beginning October 1, 2011, lead agencies 
172.7 	must reduce rates in effect on January 1, 
172.8 	2011, by ten percent for individuals with 
172.9 	lower needs living in foster care settings 
172.10 	where the licenseholder does not share the 
172.11 	residence with recipients on the community 
172.12 	alternatives for disabled individuals (CADI), 
172.13 	developmental disabilities (DD), and 
172.14 	traumatic brain injury (TBI) waivers and 
172.15 	customized living settings for CADI and 
172.16 	TBI. Beginning July 1, 2013, the rate in 
172.17 	effect on January 1, 2011, must be reduced 
172.18 	by 15 percent. This reduction may include a 
172.19 	reduction or other modification in services. 
172.20 	Lead agencies must adjust contracts within 
172.21 	60 days of the effective date.
172.22 	Reduction of Lead Agency Waiver 
172.23 	Allocations to Implement Rate Reductions 
172.24 	for Congregate Living for Individuals 
172.25 	with Lower Needs. Beginning October 1, 
172.26 	2011, the commissioner shall reduce lead 
172.27 	agency waiver allocations to implement 
172.28 	the reduction of rates for individuals with 
172.29 	lower needs living in foster care settings 
172.30 	where the licenseholder does not share the 
172.31 	residence with recipients on the community 
172.32 	alternatives for disabled individuals (CADI), 
172.33 	developmental disabilities (DD), and 
172.34 	traumatic brain injury (TBI) waivers and 
172.35 	customized living settings for CADI and 
172.36 	TBI.
173.1 	Managed Care Incentive Payments. The 
173.2 	commissioner shall not make managed care 
173.3 	incentive payments for expanding preventive 
173.4 	services. This provision does not expire.
173.5 	Nonadministrative Rate Reduction. For 
173.6 	services rendered on or after January 1, 2012, 
173.7 	the commissioner shall reduce contract rates 
173.8 	paid to managed care plans under Minnesota 
173.9 	Statutes, sections 256B.69 and 256L.12, 
173.10 	and to county-based purchasing plans under 
173.11 	Minnesota Statutes, section 256B.692, for 
173.12 	nonadministrative services, excluding elderly 
173.13 	waiver services, by 2.75 percent.

173.14	(i) Alternative Care Grants
		45,727,000
		47,877,000
	
173.15 	Alternative Care Transfer. Any money 
173.16 	allocated to the alternative care program that 
173.17 	is not spent for the purposes indicated does 
173.18 	not cancel but shall be transferred to the 
173.19 	medical assistance account.

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

173.21	Subd. 4.Grant Programs
 					
173.22 	The amounts that may be spent from this 
173.23 	appropriation for each purpose are as follows:

173.24	(a) Support Services Grants

173.25	Appropriations by Fund
	
173.26	General
	8,715,000
	8,715,000
	
173.27	Federal TANF
	110,525,000
	104,611,000
	
173.28 	Subsidized Employment Funding Through 
173.29 	ARRA. The commissioner is authorized to 
173.30 	apply for TANF emergency fund grants for 
173.31 	subsidized employment activities. Growth 
173.32 	in expenditures for subsidized employment 
173.33 	within the supported work program and the 
173.34 	MFIP consolidated fund over the amount 
174.1 	expended in the calendar year quarters in 
174.2 	the TANF emergency fund base year shall 
174.3 	be used to leverage the TANF emergency 
174.4 	fund grants for subsidized employment and 
174.5 	to fund supported work. The commissioner 
174.6 	shall develop procedures to maximize 
174.7 	reimbursement of these expenditures over the 
174.8 	TANF emergency fund base year quarters, 
174.9 	and may contract directly with employers 
174.10 	and providers to maximize these TANF 
174.11 	emergency fund grants.

174.12
174.13	(b) Basic Sliding Fee Child Care Assistance 
Grants
		37,192,000
		38,428,000
	
174.14 	Child Care and Development Fund 
174.15 	Unexpended Balance. In addition to 
174.16 	the amount provided in this section, the 
174.17 	commissioner shall expend $5,000,000 
174.18 	in fiscal year 2012 from the federal child 
174.19 	care and development fund unexpended 
174.20 	balance for basic sliding fee child care under 
174.21 	Minnesota Statutes, section 119B.03. The 
174.22 	commissioner shall ensure that all child 
174.23 	care and development funds are expended 
174.24 	according to the federal child care and 
174.25 	development fund regulations.
174.26 	Base Level Adjustment.  The general fund 
174.27 	base is decreased by $1,041,000 in fiscal 
174.28 	year 2014 and decreased by $1,036,000 in 
174.29 	fiscal year 2015.

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

174.31	(d) Child Support Enforcement Grants
		50,000
		50,000
	
174.32 	Federal Child Support Demonstration 
174.33 	Grants. Federal administrative 
174.34 	reimbursement resulting from the federal 
174.35 	child support grant expenditures authorized 
175.1 	under section 1115a of the Social Security 
175.2 	Act is appropriated to the commissioner for 
175.3 	this activity.

175.4	(e) Children's Services Grants

175.5	Appropriations by Fund
	
175.6	General
	34,701,000
	34,701,000
	
175.7	Federal TANF
	140,000
	140,000
	
175.8 	Adoption Assistance and Relative Custody 
175.9 	Assistance.  The commissioner may transfer 
175.10 	unencumbered appropriation balances for 
175.11 	adoption assistance and relative custody 
175.12 	assistance between fiscal years and between 
175.13 	programs.
175.14 	Privatized Adoption Grants. Federal 
175.15 	reimbursement for privatized adoption grant 
175.16 	and foster care recruitment grant expenditures 
175.17 	is appropriated to the commissioner for 
175.18 	adoption grants and foster care and adoption 
175.19 	administrative purposes.
175.20 	Adoption Assistance Incentive Grants.
175.21 	Federal funds available during fiscal year 
175.22 	2012 and fiscal year 2013 for adoption 
175.23 	incentive grants are appropriated to the 
175.24 	commissioner for these purposes.

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

175.26	(g) Children and Economic Support Grants
		 9,496,000
		 9,610,000
	
175.27 	Base Level Adjustment. The general fund 
175.28 	base is decreased by $1,000 in fiscal year 
175.29 	2014 only.

175.30	(h) Health Care Grants
		190,000
		190,000
	
175.31 	This appropriation is from the health care 
175.32 	access fund.
176.1 	Surplus Appropriation Canceled. Of the 
176.2 	health care access fund appropriation in 
176.3 	Laws 2009, chapter 79, article 13, section 3, 
176.4 	subdivision 6, paragraph (e), for the COBRA 
176.5 	premium state subsidy program, $11,750,000 
176.6 	must be canceled in fiscal year 2011. This 
176.7 	provision is effective the day following final 
176.8 	enactment.

176.9	(i) Aging and Adult Services Grants
		 17,278,000
		 17,572,000
	
176.10 	Aging Grants Reduction. Effective July 
176.11 	1, 2011, funding for grants made under 
176.12 	Minnesota Statutes, sections 256.9754 and 
176.13 	256B.0917, subdivision 13, is reduced by 
176.14 	$3,600,000 for each year of the biennium. 
176.15 	These reductions are onetime and do 
176.16 	not affect base funding for the 2014-2015 
176.17 	biennium. Grants made during the 2012-2013 
176.18 	biennium under Minnesota Statutes, section 
176.19 	256B.9754, must not be used for new 
176.20 	construction or building renovation.
176.21 	Base Level Adjustment.  The general fund 
176.22 	base is increased by $3,600,000 in fiscal year 
176.23 	2014 and increased by $3,600,000 in fiscal 
176.24 	year 2015.

176.25	(j) Deaf and Hard-of-Hearing Grants
		1,679,000
		1,510,000
	
176.26 	Deaf and Hard-of-Hearing Grants 
176.27 	Reduction. Deaf and hard-of-hearing grants 
176.28 	are reduced by $257,000 in fiscal year 2012 
176.29 	and $257,000 in fiscal year 2013.

176.30	(k) Disabilities Grants
		13,181,000
		16,358,000
	
176.31 	HIV Grants. The general fund appropriation 
176.32 	for the HIV drug and insurance grant 
176.33 	program shall be reduced by $2,425,000 in 
176.34 	fiscal year 2012 and increased by $2,425,000 
177.1 	in fiscal year 2014. These adjustments are 
177.2 	onetime and shall not be applied to the base. 
177.3 	Notwithstanding any contrary provision, this 
177.4 	provision expires June 30, 2014.
177.5 	Personal Care Assistance Funding. Of 
177.6 	the appropriation for grants to provide 
177.7 	alternatives for those recipients losing access 
177.8 	to personal care assistance services on July 1, 
177.9 	2011, due to the 2009 personal care assistance 
177.10 	legislative changes, and $3,237,000 in fiscal 
177.11 	year 2012 and $4,856,000 in fiscal year 
177.12 	2013 is transferred from the disabilities 
177.13 	grants budget activity to the appropriation 
177.14 	for medical assistance grants.
177.15 	Base Level Adjustment.  The general fund 
177.16 	base is increased by $2,425,000 in fiscal year 
177.17 	2014 only.
177.18 	Local Planning Grants for Creating 
177.19 	Alternatives to Congregate Living for 
177.20 	Individuals with Lower Needs. The 
177.21 	commissioner shall make available a total 
177.22 	of $250,000 per year in local planning 
177.23 	grants, beginning July 1, 2011, to assist 
177.24 	lead agencies and provider organizations in 
177.25 	developing alternatives to congregate living 
177.26 	within the available level of resources for the 
177.27 	home and community-based services waivers 
177.28 	for persons with disabilities.

177.29	(l) Adult Mental Health Grants

177.30	Appropriations by Fund
	
177.31	General
	69,143,000
	69,143,000
	
177.32	Lottery Prize
	1,508,000
	1,508,000
	
177.33 	Funding Usage. Up to 75 percent of a fiscal 
177.34 	year's appropriation for adult mental health 
177.35 	grants may be used to fund allocations in that 
178.1 	portion of the fiscal year ending December 
178.2 	31.

178.3	(m) Children's Mental Health Grants
		7,044,000
		7,044,000
	
178.4 	Funding Usage. Up to 75 percent of a fiscal 
178.5 	year's appropriation for children's mental 
178.6 	health grants may be used to fund allocations 
178.7 	in that portion of the fiscal year ending 
178.8 	December 31.

178.9178.10
	(n) Chemical Dependency Nonentitlement 
Grants
		1,336,000
		1,336,000

178.11	Subd. 5.State-Operated Services
 					
178.12 	Transfer Authority Related to 
178.13 	State-Operated Services. Money 
178.14 	appropriated for state-operated services 
178.15 	may be transferred between fiscal years 
178.16 	of the biennium with the approval of the 
178.17 	commissioner of management and budget.

178.18	(a) State-Operated Services Mental Health
		115,286,000
		115,135,000
	
178.19 	The commissioner shall close the Community 
178.20 	Behavioral Health Hospital-Willmar on or 
178.21 	before June 30, 2011. The commissioner 
178.22 	shall relocate the Child and Adolescent 
178.23 	Behavioral Health Hospital located in 
178.24 	the former Willmar Regional Treatment 
178.25 	Center to the facility previously housing 
178.26 	the Community Behavioral Health 
178.27 	Hospital-Willmar.

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

178.29	Subd. 6.Sex Offender Program
 		67,570,000
		67,570,000
	
178.30 	Transfer Authority Related to Minnesota 
178.31 	Sex Offender Program. Money 
178.32 	appropriated for the Minnesota sex offender 
178.33 	program may be transferred between fiscal 
178.34 	years of the biennium with the approval 
179.1 	of the commissioner of management and 
179.2 	budget.

179.3	Subd. 7.Technical Activities
 		67,186,000
		67,531,000
	
179.4 	This appropriation is from the federal TANF 
179.5 	fund.
179.6 	Base Level Adjustment.  The TANF fund 
179.7 	base is increased by $357,000 in fiscal year 
179.8 	2014 and increased by $784,000 in fiscal 
179.9 	year 2015.

179.10	Sec. 4. COMMISSIONER OF HEALTH

179.11	Subdivision 1.Total Appropriation
 	$
	 119,824,000
	$
	 113,589,000

179.12	Appropriations by Fund
	
179.13		2012
	2013
	
179.14	General
	62,960,000
	58,261,000
	
179.15
179.16	State Government 
Special Revenue
	 45,981,000
	 46,093,000
	
179.17	Health Care Access
	10,883,000
	9,235,000
	
179.18 	The amounts that may be spent for each 
179.19 	purpose are specified in the following 
179.20 	subdivisions.

179.21
179.22	Subd. 2.Community and Family Health 
Promotion

179.23	Appropriations by Fund
	
179.24	General
	38,728,000
	34,031,000
	
179.25
179.26	State Government 
Special Revenue
	1,033,000
	1,033,000
	
179.27	Health Care Access
	1,719,000
	1,719,000

179.28	Subd. 3.Policy Quality and Compliance

179.29	Appropriations by Fund
	
179.30	General
	9,190,000
	9,190,000
	
179.31
179.32	State Government 
Special Revenue
	14,026,000
	14,083,000
	
179.33	Health Care Access
	9,164,000
	7,516,000
	
179.34 	Medical Education and Research 
179.35 	Costs (MERC) Fund Transfers. The 
179.36 	commissioner of management and budget 
180.1 	shall transfer $9,800,000 from the MERC 
180.2 	fund to the general fund by October 1, 2011.
180.3 	Unused Federal Match Funds. Of the 
180.4 	funds appropriated in Laws 2009, chapter 
180.5 	79, article 13, section 4, subdivision 3, for 
180.6 	state matching funds for the federal Health 
180.7 	Information Technology for Economic and 
180.8 	Clinical Health Act, $2,800,000 is transferred 
180.9 	to the health care access fund by October 1, 
180.10 	2011.
180.11 	Loan Forgiveness. $1,014,000 is 
180.12 	appropriated from the health care access 
180.13 	fund in fiscal year 2012 for the department to 
180.14 	fulfill existing obligations of loan forgiveness 
180.15 	agreements. This funding is available 
180.16 	through fiscal year 2014. In addition, prior 
180.17 	year funds appropriated for loan forgiveness 
180.18 	and required to fulfill existing obligations do 
180.19 	not expire and are available until expended.
180.20 	Base Level Adjustment. The state 
180.21 	government special revenue fund base shall 
180.22 	be reduced by $141,000 in fiscal years 2014 
180.23 	and 2015. The health care access base shall 
180.24 	be increased by $600,000 in fiscal year 2014 
180.25 	only.

180.26	Subd. 4.Health Protection

180.27	Appropriations by Fund
	
180.28	General
	8,891,000
	8,891,000
	
180.29
180.30	State Government 
Special Revenue
	 30,922,000
	 30,977,000

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

180.32	Sec. 5. HEALTH-RELATED BOARDS

180.33	Subdivision 1.Total Appropriation
 	$
	17,466,000
	$
	17,252,000
	
181.1 	This appropriation is from the state 
181.2 	government special revenue fund.
181.3 	The amounts that may be spent for each 
181.4 	purpose are specified in the following 
181.5 	subdivisions.

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

181.7	Subd. 3.Board of Dentistry
 		1,829,000
		1,814,000
	
181.8 	Health Professional Services Program. Of 
181.9 	this appropriation, $704,000 in fiscal year 
181.10 	2012 and $704,000 in fiscal year 2013 from 
181.11 	the state government special revenue fund are 
181.12 	for the health professional services program.

181.13
181.14	Subd. 4.Board of Dietetic and Nutrition 
Practice
 		105,000
		105,000

181.15
181.16	Subd. 5.Board of Marriage and Family 
Therapy
 		184,000
		159,000

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

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

181.19
181.20	Subd. 8.Board of Nursing Home 
Administrators
 		2,153,000
		2,145,000
	
181.21 	Administrative Services Unit - Operating 
181.22 	Costs. Of this appropriation, $526,000 
181.23 	in fiscal year 2012 and $526,000 in fiscal 
181.24 	year 2013 are for the operating costs 
181.25 	of the administrative services unit. The 
181.26 	administrative services unit may receive 
181.27 	and expend reimbursements for services 
181.28 	performed by other agencies.
181.29 	Administrative Services Unit - Retirement 
181.30 	Costs. Of this appropriation in fiscal year 
181.31 	2012, $225,000 is for onetime retirement 
181.32 	costs in the health-related boards. This 
181.33 	funding may be transferred to the health 
181.34 	boards incurring those costs for their 
182.1 	payment. These funds are available either 
182.2 	year of the biennium.
182.3 	Administrative Services Unit - Volunteer 
182.4 	Health Care Provider Program. Of this 
182.5 	appropriation, $150,000 in fiscal year 2012 
182.6 	and $150,000 in fiscal year 2013 are to pay 
182.7 	for medical professional liability coverage 
182.8 	required under Minnesota Statutes, section 
182.9 	214.40.
182.10 	Administrative Services Unit - Contested 
182.11 	Cases and Other Legal Proceedings. Of 
182.12 	this appropriation, $200,000 in fiscal year 
182.13 	2012 and $200,000 in fiscal year 2013 are 
182.14 	for costs of contested case hearings and other 
182.15 	unanticipated costs of legal proceedings 
182.16 	involving health-related boards funded 
182.17 	under this section. Upon certification of a 
182.18 	health-related board to the administrative 
182.19 	services unit that the costs will be incurred 
182.20 	and that there is insufficient money available 
182.21 	to pay for the costs out of money currently 
182.22 	available to that board, the administrative 
182.23 	services unit is authorized to transfer money 
182.24 	from this appropriation to the board for 
182.25 	payment of those costs with the approval 
182.26 	of the commissioner of management and 
182.27 	budget. This appropriation does not cancel. 
182.28 	Any unencumbered and unspent balances 
182.29 	remain available for these expenditures in 
182.30 	subsequent fiscal years.
182.31 	The state government special revenue fund 
182.32 	base is reduced by $911,000 in fiscal year 
182.33 	2014 and $1,011,000 in fiscal year 2015.

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

182.35	Subd. 10.Board of Pharmacy
 		2,341,000
		2,344,000
	
183.1 	Prescription Electronic Reporting. Of 
183.2 	this appropriation, $356,000 in fiscal year 
183.3 	2012 and $356,000 in fiscal year 2013 from 
183.4 	the state government special revenue fund 
183.5 	are to the board to operate the prescription 
183.6 	electronic reporting system in Minnesota 
183.7 	Statutes, section 152.126. Base level funding 
183.8 	for this activity in fiscal year 2014 shall be 
183.9 	$356,000.

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

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

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

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

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

183.15
183.16	Subd. 16.Board of Behavioral Health and 
Therapy
 		394,000
		394,000

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

183.18
183.19
183.20	Sec. 7. OMBUDSMAN FOR MENTAL 
HEALTH AND DEVELOPMENTAL 
DISABILITIES
 	$
	1,655,000
	$
	1,655,000

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

183.22
183.23	Sec. 9. EMERGENCY MEDICAL SERVICES 
BOARD
 	$
	2,742,000
	$
	2,742,000
	
183.24 	Regional Grants. $585,000 in fiscal year 
183.25 	2012 and $585,000 in fiscal year 2013 are 
183.26 	for regional emergency medical services 
183.27 	programs, to be distributed equally to the 
183.28 	eight emergency medical service regions. 
183.29 	Notwithstanding Minnesota Statutes, section 
183.30 	144E.50, 100 percent of the appropriation 
183.31 	shall be granted to the emergency medical 
183.32 	service regions.
184.1 	Cooper/Sams Volunteer Ambulance 
184.2 	Program. $700,000 in fiscal year 2012 and 
184.3 	$700,000 in fiscal year 2013 are for the 
184.4 	Cooper/Sams volunteer ambulance program 
184.5 	under Minnesota Statutes, section 144E.40.
184.6 	(a) Of this amount, $611,000 in fiscal year 
184.7 	2012 and $611,000 in fiscal year 2013 
184.8 	are for the ambulance service personnel 
184.9 	longevity award and incentive program, 
184.10 	under Minnesota Statutes, section 144E.40. 
184.11 	(b) Of this amount, $89,000 in fiscal year 
184.12 	2012 and $89,000 in fiscal year 2013 are 
184.13 	for the operations of the ambulance service 
184.14 	personnel longevity award and incentive 
184.15 	program, under Minnesota Statutes, section 
184.16 	144E.40. 
184.17 	Ambulance Training Grant. $361,000 in 
184.18 	fiscal year 2012 and $361,000 in fiscal year 
184.19 	2013 are for training grants.
184.20 	EMSRB Board Operations. $1,096,000 in 
184.21 	fiscal year 2012 and $1,096,000 in fiscal year 
184.22 	2013 are for operations.

184.23 	Sec. 10. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision 
184.24 	to read:
184.25 		Subd. 33.Federal administrative reimbursement dedicated. Federal 
184.26 	administrative reimbursement resulting from the following activities is appropriated to the 
184.27 	commissioner for the designated purposes:
184.28 	(1) reimbursement for the Minnesota senior health options project; and
184.29 	(2) reimbursement related to prior authorization and inpatient admission certification 
184.30 	by a professional review organization. A portion of these funds must be used for activities 
184.31 	to decrease unnecessary pharmaceutical costs in medical assistance.

184.32 	Sec. 11. Laws 2010, First Special Session chapter 1, article 15, section 3, subdivision 
184.33 	6, is amended to read:

185.1	Subd. 6.Continuing Care Grants

185.2	(a) Aging and Adult Services Grants
		(3,600,000)
		(3,600,000)
	
185.3 	Community Service/Service Development 
185.4 	Grants Reduction. Effective retroactively 
185.5 	from July 1, 2009, funding for grants made 
185.6 	under Minnesota Statutes, sections 256.9754
185.7 	and 256B.0917, subdivision 13, is reduced 
185.8 	by $5,807,000 for each year of the biennium. 
185.9 	Grants made during the biennium under 
185.10 	Minnesota Statutes, section 256.9754, shall 
185.11 	not be used for new construction or building 
185.12 	renovation.
185.13 	Aging Grants Delay. Aging grants must be 
185.14 	reduced by $917,000 in fiscal year 2011 and 
185.15 	increased by $917,000 in fiscal year 2012. 
185.16 	These adjustments are onetime and must not 
185.17 	be applied to the base. This provision expires 
185.18 	June 30, 2012.

185.19
185.20	(b) Medical Assistance Long-Term Care 
Facilities Grants
		(3,827,000)
		(2,745,000)
	
185.21 	ICF/MR Variable Rates Suspension.
185.22 	Effective retroactively from July 1, 2009, 
185.23 	to June 30, 2010, no new variable rates 
185.24 	shall be authorized for intermediate care 
185.25 	facilities for persons with developmental 
185.26 	disabilities under Minnesota Statutes, section 
185.27 	256B.5013, subdivision 1.
185.28 	ICF/MR Occupancy Rate Adjustment 
185.29 	Suspension. Effective retroactively from 
185.30 	July 1, 2009, to June 30, 2011, approval 
185.31 	of new applications for occupancy rate 
185.32 	adjustments for unoccupied short-term 
185.33 	beds under Minnesota Statutes, section 
185.34 	256B.5013, subdivision 7, is suspended.

186.1
186.2	(c) Medical Assistance Long-Term Care 
Waivers and Home Care Grants
		(2,318,000)
		(5,807,000)
	
186.3 	Developmental Disability Waiver Acuity 
186.4 	Factor. Effective retroactively from January 
186.5 	1, 2010, the January 1, 2010, one percent 
186.6 	growth factor in the developmental disability 
186.7 	waiver allocations under Minnesota Statutes, 
186.8 	section 256B.092, subdivisions 4 and 5, 
186.9 	that is attributable to changes in acuity, is 
186.10 	suspended to June 30, 2011 eliminated. 
186.11 	Notwithstanding any law to the contrary, this 
186.12 	provision does not expire.

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

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

186.15
186.16	(f) Chemical Dependency Nonentitlement 
Grants
		(393,000)
		(393,000)

186.17
186.18	(g) Other Continuing Care Grants
		-0-
		(2,500,000)
(1,414,000)
	
186.19 	Other Continuing Care Grants Delay.
186.20 	Other continuing care grants must be reduced 
186.21 	by $1,414,000 in fiscal year 2011 and 
186.22 	increased by $1,414,000 in fiscal year 2012. 
186.23 	These adjustments are onetime and must not 
186.24 	be applied to the base. This provision expires 
186.25 	June 30, 2012.

186.26	(h) Deaf and Hard-of-Hearing Grants
		-0-
		(169,000)
	
186.27 	Deaf and Hard-of-Hearing Grants Delay.
186.28 	Effective retroactively from July 1, 2010, 
186.29 	deaf and hard-of-hearing grants must be 
186.30 	reduced by $169,000 in fiscal year 2011 and 
186.31 	increased by $169,000 in fiscal year 2012. 
186.32 	These adjustments are onetime and must not 
186.33 	be applied to the base. This provision expires 
186.34 	June 30, 2012.

187.1 	Sec. 12. TRANSFERS.
 187.2 		Subdivision 1.Grants. The commissioner of human services, with the approval 
187.3 	of the commissioner of management and budget, and after notification of the chairs of 
187.4 	the senate health and human services budget and policy committee and the house of 
187.5 	representatives health and human services finance committee, may transfer unencumbered 
187.6 	appropriation balances for the biennium ending June 30, 2013, within fiscal years among 
187.7 	the MFIP; general assistance; general assistance medical care under Minnesota Statutes, 
187.8 	section 256D.03, subdivision 3; medical assistance; MFIP child care assistance under 
187.9 	Minnesota Statutes, section 119B.05; Minnesota supplemental aid; and group residential 
187.10 	housing programs, and the entitlement portion of the chemical dependency consolidated 
187.11 	treatment fund, and between fiscal years of the biennium.
187.12 		Subd. 2.Administration. Positions, salary money, and nonsalary administrative 
187.13 	money may be transferred within the Departments of Health and Human Services as the 
187.14 	commissioners consider necessary, with the advance approval of the commissioner of 
187.15 	management and budget. The commissioner shall inform the chairs of the senate health 
187.16 	and human services budget and policy committee and the house of representatives health 
187.17 	and human services finance committee quarterly about transfers made under this provision.

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

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

187.24 	Sec. 15. EFFECTIVE DATE.
 187.25 	The provisions in this article are effective July 1, 2011, unless a different effective 
187.26 	date is specified.

187.27 	ARTICLE 9
187.28 	HUMAN SERVICES FORECAST ADJUSTMENTS

187.29
187.30	Section 1. DEPARTMENT OF HUMAN SERVICES FORECAST ADJUSTMENT 
APPROPRIATIONS.
 	
188.1 	The sums shown are added to, or if shown in parentheses, are subtracted from the 
188.2 	appropriations in Laws 2009, chapter 79, article 13, as amended by Laws 2009, chapter 
188.3 	173, article 2; Laws 2010, First Special Session chapter 1, articles 15, 23, and 25; and 
188.4 	Laws 2010, Second Special Session chapter 1, article 3, to the commissioner of human 
188.5 	services and for the purposes specified in this article. The appropriations are from the 
188.6 	general fund or another named fund and are available for the fiscal year indicated for 
188.7 	each purpose. The figure "2011" used in this article means that the appropriation or 
188.8 	appropriations listed are available for the fiscal year ending June 30, 2011.

188.9188.10
	Sec. 2. COMMISSIONER OF HUMAN 
SERVICES

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

188.12	Appropriations by Fund
	
188.13			2011
	
188.14	General
		(381,869,000)
	
188.15	Health Care Access
		169,514,000
	
188.16	Federal TANF
		(23,108,000)
	
188.17 	The amounts that may be spent for each 
188.18 	purpose are specified in the following 
188.19 	subdivisions.

188.20	Subd. 2.Revenue and Pass-through
 				732,000
	
188.21 	This appropriation is from the federal TANF 
188.22 	fund.

188.23
188.24	Subd. 3.Children and Economic Assistance 
Grants

188.25	Appropriations by Fund
	
188.26	General
		(7,098,000)
	
188.27	Federal TANF
		(23,840,000)

188.28	(a) MFIP/DWP Grants

188.29	Appropriations by Fund
	
188.30	General
		18,715,000
	
188.31	Federal TANF
		(23,840,000)

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

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

188.34	(d) Minnesota Supplemental Aid Grants
				793,000

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

189.2	Subd. 4.Basic Health Care Grants

189.3	Appropriations by Fund
	
189.4	General
		(335,050,000)
	
189.5	Health Care Access
		169,514,000

189.6	(a) MinnesotaCare Grants
				169,514,000
	
189.7 	This appropriation is from the health care 
189.8 	access fund.

189.9189.10
	(b) Medical Assistance Basic Health Care - 
Families and Children
				(49,368,000)

189.11
189.12	(c) Medical Assistance Basic Health Care - 
Elderly and Disabled
				(43,258,000)

189.13
189.14	(d) Medical Assistance Basic Health Care - 
Adults without Children
				(242,424,000)

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

189.16
189.17	(a) Medical Assistance Long-Term Care 
Facilities
				(14,627,000)

189.18
189.19	(b) Medical Assistance Long-Term Care 
Waivers
				(44,718,000)

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

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

189.23	Subd. 6.Health Care Grants

189.24	(a) MinnesotaCare Grants
		998,000
		(13,376,000)
	
189.25 	This appropriation is from the health care 
189.26 	access fund.
189.27 	Health Care Access Fund Transfer to 
189.28 	General Fund. The commissioner of 
189.29 	management and budget shall transfer the 
189.30 	following amounts in the following years 
189.31 	from the health care access fund to the 
189.32 	general fund: $998,000 $0 in fiscal year 
190.1 	2010; $176,704,000 $59,901,000 in fiscal 
190.2 	year 2011; $141,041,000 in fiscal year 2012; 
190.3 	and $286,150,000 in fiscal year 2013. If at 
190.4 	any time the governor issues an executive 
190.5 	order not to participate in early medical 
190.6 	assistance expansion, no funds shall be 
190.7 	transferred from the health care access 
190.8 	fund to the general fund until early medical 
190.9 	assistance expansion takes effect. This 
190.10 	paragraph is effective the day following final 
190.11 	enactment.
190.12 	MinnesotaCare Ratable Reduction.
190.13 	Effective for services rendered on or after 
190.14 	July 1, 2010, to December 31, 2013, 
190.15 	MinnesotaCare payments to managed care 
190.16 	plans under Minnesota Statutes, section 
190.17 	256L.12, for single adults and households 
190.18 	without children whose income is greater 
190.19 	than 75 percent of federal poverty guidelines 
190.20 	shall be reduced by 15 percent. Effective 
190.21 	for services provided from July 1, 2010, to 
190.22 	June 30, 2011, this reduction shall apply to 
190.23 	all services. Effective for services provided 
190.24 	from July 1, 2011, to December 31, 2013, this 
190.25 	reduction shall apply to all services except 
190.26 	inpatient hospital services. Notwithstanding 
190.27 	any contrary provision of this article, this 
190.28 	paragraph shall expire on December 31, 
190.29 	2013.

190.30
190.31	(b) Medical Assistance Basic Health Care 
Grants - Families and Children
		-0-
		295,512,000
	
190.32 	Critical Access Dental. Of the general 
190.33 	fund appropriation, $731,000 in fiscal year 
190.34 	2011 is to the commissioner for critical 
190.35 	access dental provider reimbursement 
190.36 	payments under Minnesota Statutes, section 
191.1 	256B.76 subdivision 4. This is a onetime 
191.2 	appropriation.
191.3 	Nonadministrative Rate Reduction. For 
191.4 	services rendered on or after July 1, 2010, 
191.5 	to December 31, 2013, the commissioner 
191.6 	shall reduce contract rates paid to managed 
191.7 	care plans under Minnesota Statutes, 
191.8 	sections 256B.69 and 256L.12, and to 
191.9 	county-based purchasing plans under 
191.10 	Minnesota Statutes, section 256B.692, by 
191.11 	three percent of the contract rate attributable 
191.12 	to nonadministrative services in effect on 
191.13 	June 30, 2010. Notwithstanding any contrary 
191.14 	provision in this article, this rider expires on 
191.15 	December 31, 2013.

191.16
191.17	(c) Medical Assistance Basic Health Care 
Grants - Elderly and Disabled
		-0-
		(30,265,000)

191.18
191.19	(d) General Assistance Medical Care Grants
		-0-
		(75,389,000)
(59,583,000)
	
191.20 	The reduction to general assistance medical 
191.21 	care grants is contingent upon the effective 
191.22 	date in Laws 2010, First Special Session 
191.23 	chapter 1, article 16, section 48. The 
191.24 	reduction shall be reestimated based upon 
191.25 	the actual effective date of the law. The 
191.26 	commissioner of management and budget 
191.27 	shall make adjustments in fiscal year 
191.28 	2011 to general assistance medical care 
191.29 	appropriations to conform to the total 
191.30 	expected expenditure reductions specified in 
191.31 	this section.

191.32	(e)  Other Health Care Grants
		-0-
		(7,000,000)
	
191.33 	Cobra Carryforward. Unexpended funds 
191.34 	appropriated in fiscal year 2010 for COBRA 
191.35 	grants under Laws 2009, chapter 79, article 
192.1 	5, section 78, do not cancel and are available 
192.2 	to the commissioner for fiscal year 2011 
192.3 	COBRA grant expenditures. Up to $111,000 
192.4 	of the fiscal year 2011 appropriation for 
192.5 	COBRA grants provided in Laws 2009, 
192.6 	chapter 79, article 13, section 3, subdivision 
192.7 	6, may be used by the commissioner for costs 
192.8 	related to administration of the COBRA 
192.9 	grants.

192.10 	Sec. 4. EFFECTIVE DATE.
 192.11 	This article is effective the day following final enactment.